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Insurance coverage matrix (Read 10250 times)
John Doernberg
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Insurance coverage matrix
Jan 07th, 2010, 10:05am
 
I apologize for the newbieness of this question.

I am working with an insurance product and want to keep track of which insurance carriers do/do not offer each of the particular coverages that may be available for this product (each insurer has its own policy form, and the scope of coverage can vary among insurers). My goal is to be able to use agents to ask in effect, "Which insurers offer this particular coverage?" and "Which coverages does this particular insurer offer?"

I have created a prototype note called "Coverage Issue." I have been thinking that I need to create in the prototype an attribute that will let me identify which specific insurers offer the particular coverage addressed by each new note.  Do I create in the prototype a generic string attribute called "Insurers" and then, when I create a note for a new coverage issue, have to type in the name of each insurer that offers that coverage? Do I instead create in the prototype a separate boolean attribute for each insurer in the marketplace, and then check off the insurers offering each coverage when I create a new note describing that coverage?

To make it more complicated, various insurers may offer a particular coverage, but have in their respective policies different wordings that are more/less favorable to the insured. It would be great if I could keep track of that as well.

I have a strong suspicion that there is a much better and easier way of accomplishing my goal, and that I am just too new to Tinderbox to understand how to do it. Thanks for your patience and for any help you can provide.

John Doernberg
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Mark Bernstein
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Re: Insurance coverage matrix
Reply #1 - Jan 7th, 2010, 11:20am
 
This sounds like a terrific application!  (In The Tinderbox Way, I discuss a related task -- deciding which digital camera to supply to each member of the corporate sales team -- but this domain raises some new and interesting challenges.

Of course, most of us know little about insurance!  So a bit of education might be in order.

What I'd suggest here is that we begin by exploring the data.  What do we know about the products?  About the vendors?  And how shall we capture that knowledge in notes?  

We might start with some forum notes, or a simply Tinderbox document that shows a few "typical" notes.  What attributes will be need? What sort of values can we expect in those attributes?

Then, when we have a little feel for the data, we might look at ways to organize it.  I can envision uses for agents, for maps, and maybe for smart adornments -- but I don't know enough about the task yet.  Let's start by exploring the data.
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John Doernberg
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Re: Insurance coverage matrix
Reply #2 - Jan 7th, 2010, 3:35pm
 
Thanks, Mark. I just bought a copy of The Tinderbox Way, and after posting I read your camera example. My situation is not dissimilar.

The insurance aspect of my situation shouldn't render the matter more esoteric than your camera example. The insurance policies offered by various carriers are analogous to the cameras offered by different camera companies. If in your example, your company could not design its own camera but had to buy one "as is" from a vendor or negotiate for some enhancements, then our situations would be even more similar.

As it happens, I'm now focusing on insurance relating to data security and privacy. The insurance policies offered by different carriers have various "features" as do cameras. Some features are common to all carriers, although they can vary in their quality. For example, just as all cameras have lenses (but a Zeiss lens is superior to many other brands), all insurance policies have notice provisions (but some may allow notice to be given up to 90 days after a breach while others may require that notice be given within 60 days). An added twist in my case is that Insurer X may provide for 60 days' notice in its base policy form, but be willing to change it to 90 days by endorsement (amendment) if you ask. It would be great to capture that as well.

Then there are coverage features offered by some insurers but not others. In your camera example, some vendors made ruggedized bodies, others didn't. By analogy, some insurers, may provide coverage for data in written form, while others will provide coverage only for electronic data; some may pay defense costs associated with regulatory enforcement, others won't. As described in the preceding paragraph, many insurers will have more restrictive provisions in their base policy forms but will be willing to broaden them by endorsement if you ask.

So say there are 15 insurers in this marketplace. I want to know which insurers provide for 60 days' notice, which provide for 90 days' notice, and which start out with 60 days but will change it to 90 if asked. I also want to know which insurers will offer coverage for written (in addition to electronic) data, which will pay for defense costs incurred in regulatory proceedings, which use standard and narrower "for" language in specific exclusions (narrower exclusions are more favorable to my client the insured) and which use standard broader "arising out of, directly or indirectly," language (less favorable to the insured), etc. And of course, I want to record which insurers will amend these provisions if asked.

As you might imagine, traditionally this kind of data has been represented in a spreadsheet, with "Coverage Provision" on the vertical axis and "Insurer" across the top on the horizontal access. This isn't bad, as it gives the reader some sense of the comparative positions of the different insurers and can be sorted to show what each particular insurer is willing to offer.

But this strikes me as too "static." If you negotiated coverage with several carriers, generally at the end of the process you have some carriers' policies that are superior in certain respects, while other carriers' policies are better in different respects. That doesn't do much to give you a sense of which product is preferable given the varying priorities of, say,  an insured that is an online retailer, a local bank, or a healthcare provider.

I'm a newbie, but I already have a strong sense that Tinderbox provides a better way to capture and represent this type of information that will be far superior to the standard spreadsheet. Now I just have to figure out how.

Sorry to be so long-winded, but I wanted to give you enough information to suggest an approach. I know attributes will play a major part. Will links and aliases help too?

Your advice much appreciated.

Thanks,

John
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Mark Bernstein
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Re: Insurance coverage matrix
Reply #3 - Jan 8th, 2010, 1:37pm
 
What I'd suggest is this:

a) Identify a few attributes that you're really pretty sure will be important.

b) Make those attributes.

c) Make a prototype "policy" or "product", with suitable Key Attributes.

d) Make a few instances of that policy, and fill in some preliminary information.

Since you're comfortable with spreadsheets, using Columns in OutlineView might be a good starting point.

When you've got that far, perhaps you could post the document here, along with a screen shot!
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