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See your advertisement here

Company's product helps fight insurance fraud

by MSNBC.com - Jun 19,2006

JACKSONVILLE -- SkyeTec, an indoor environmental-consulting company, will launch a hosted computer application on July 1 designed to help insurers review claims for drying structures damaged by water.

SkyeTec executives say the company's property claims calculator can reduce or mitigate the rise in property-insurance premiums based on the company's experience performing manually the kind of review the new program is designed to accomplish.

Co-founder and President Ted Nelson said SkyeTec saved one insurance company $550,000 in a year in which it charged the insurer about $25,000 based on an average fee of $500 per review.

The claims calculator, which began beta testing June 7, could save more money because users would pay a set fee of $75 per review. It would also save the time required to exchange data SkyeTec personnel need to evaluate claims because adjusters could input the data online themselves.

"It's the same impact using the software as if we did it," Nelson said.

Nelson said the calculator goes beyond other cost estimators on the market. He said it not only estimates what it costs to run equipment and perform the labor involved, it determines what equipment is needed, how it should be deployed and how long it should be run -- all based on standards and scientific formulas developed by the Institute of Inspection, Cleaning and Restoration Certification or the IICRC.

SkyeTec's claims calculator is the next step in its evolution in the sciences of mold and water damage and its growing comfort with software technology and the Internet. About two and a half years ago, an insurance provider hired SkyeTec to review all mold remediation claims in Florida. When SkyeTec began reviewing the company's claims, the average bill was $18,000. A year later, the average was $5,000 using the same vendors, Nelson said.

"What you got was behavior modification on the part of the vendors," he said.

About the time those results were being realized, SkyeTec began applying its review techniques to water damage claims with similar results. It found bills that should have ranged from $2,000 to $5,000 inflated by about $3,000 on average, Nelson said.

During an insurance conference in September, Dale Miller, an environmental claims services analyst for SkyeTec, got positive feedback when he asked adjusters whether they'd be more likely to use

SkyeTec's service if it could be converted to an online program. Miller began developing a Microsoft Excel-based program that was turned over to programmers to create the Web site.

He said once the water extraction program is launched, the next step will be to add mold remediation.

At least one recognized expert in the field, however, is skeptical that a program such as SkyeTec's will catch on.

Jeff Bishop, a technical adviser to the IICRC who helped write that organization's standards for drying structures, said he doubts adjusters have time to check vendors' calculations, even if a computer program speeds the process.

"Insurance companies, like everybody else, think computers can do everything," Bishop said. "They'd prefer to have no contact with people at all."

He also cautions that such a tool, if used to determine limits on what an insurer will pay, could lead to litigation based on allegations of price fixing.

But one vendor accustomed to having bills scrutinized by SkyeTec on behalf of an insurance company believes the calculator can be a useful tool for adjusters to determine whether bills are reasonable.

Harold Fletcher, owner of Ankle Deep in Broward County, was given a preview of the program and allowed to compare some of his invoices to what the calculator would have determined to be a reasonable charge.

"I was surprised at how dead on the equipment calculator was," Fletcher said.

He found that, in general, it would favor reputable contractors who know how to price jobs fairly. And he said it likely will expose those who knowingly or unknowingly gouge homeowners, Fletcher said.

"A majority of contractors doing this type of work don't know what they're doing," he said. "A lot of companies are charging a whole lot more than they need to, throwing equipment at jobs with no rhyme or reason."

____________________________________

By Tony Quesada
The Business Journal of Jacksonville

© 2006 MSNBC.com
© 2006 Microsoft

 

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