THE HARTFORD’S CLAIMS
OPERATION: A COMPETITIVE
ADVANTAGE
NOVEMBER 8, 2016
THE HARTFORD’S CLAIMS OPERATION:
A COMPETITIVE ADVANTAGE
NOVEMBER 8, 2016
Sabra Purtill
SVP, Investor Relations
Safe Harbor
Certain statements made in this presentation should be considered forward-looking statements as defined in the
Private Securities Litigation Reform Act of 1995. These include statements about The Hartford’s future results of
operations. We caution investors that these forward-looking statements are not guarantees of future performance, and
actual results may differ materially. Investors should consider the important risks and uncertainties that may cause
actual results to differ, including those discussed in The Hartford’s news release issued on October 27, 2016, The
Hartford’s Quarterly Reports on Form 10-Q, The Hartford’s 2015 Annual Report on Form 10-K, and other filings we
make with the U.S. Securities and Exchange Commission. We assume no obligation to update this presentation,
which speaks as of today’s date.
From time to time, The Hartford may use its website to disseminate material company information. Financial and other
important information regarding The Hartford is routinely accessible through and posted on our website at
https://ir.thehartford.com. In addition, you may automatically receive email alerts and other information about
The Hartford when you enroll your email address by visiting the “Email Alerts” section at https://ir.thehartford.com.
3
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THE HARTFORD’S CLAIMS OPERATION:
A COMPETITIVE ADVANTAGE
Doug Elliot
President
Agenda
Hartford Claims Overview
John Kinney
Claims Data Lifecycle
Michael Kearney, Paul Drennan, Paula
Beland
Workers’ Compensation
Mary Nasenbenny, Dr. Marcos Iglesias
Customer Loyalty
First Notice of Loss
Tour Stops
Q&A
John Kinney
Vicky Pace, Irene Herrera
In groups, rotate through office
All
5
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THE HARTFORD’S CLAIMS OPERATION:
A COMPETITIVE ADVANTAGE
TALENT | DATA | EXECUTION
John Kinney
EVP, Chief Claim Officer
The Hartford Claims Advantage
1
Our talent, data and
execution strategy enables
us to restore customers’
lives while driving profitable
growth for the company
3
Our unique organization
design drives results
4
Our people are our
competitive advantage
Our innovative structure, including combined
Workers’ Compensation and Group Benefits
units, enables us to leverage synergies and
learnings to improve outcomes and accelerate
continuous improvements.
The Hartford’s Claims organization is a true
differentiator for the company.
2
We are harnessing the
power of big data
Our technology and analytics solutions provide
actionable insights to support accurate decisions and
better outcomes. Our data scientists have built the
machines that make it possible.
The talent we have is key to restoring
customer lives and driving profitable company
growth. We have a unique approach to
recruiting, training and retention that builds
capabilities and fuels employee engagement.
7
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Expense Flexibility, But Also Focused On Accurate Outcomes
Property
14%
Liability
3%
Annual
Claims Volume
(1.1M)
P&C Other Ops
3%
Workers
Comp
12%
Liability
12%
Property
9%
Group
Benefits
26%
Auto
45%
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Auto
27%
Other
1% Workers
Comp
19%
2015
Claims
Payments
($8.3B)
Group
Benefits
29% 8
Our Unique Business Mix Demands Unique Acumen
Workers’ Comp
36%
P&C Other Ops
12%
Using expertise to
thoughtfully inform reserves
and effectively manage
short- and long-tail claims
Liability
15%
Property
2%
Auto 9%
2015 Year-End
Reserves
($24B)
Group Benefits
26%
9
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Our National Reach With Deep Local Connections Enables
Market-Specific Knowledge And Drives Best Strategy And Decisions
THE HARTFORD CLAIMS STAFF IN STATE
NO CLAIMS STAFF IN STATE
WA
CLAIMS CENTER
VT
ND
MT
MA
NH
NH
MN
OR
ID
WI
SD
NY
MI
WY
IA
NE
NV
UT
CA
CO
IN OH
MD
WV
IL
KS
MO
OK
NM
KY
TX
AL
RI
CT
NJ
DE
GENERAL LIABILITY
Phoenix, AZ
Windsor, CT
GROUP BENEFITS
Bloomington, MN
Hartford/Windsor, CT
Lake Mary, FL
Rancho Cordova, CA
VA
NC
SC
AR
MS
NJ
PAPA
TN
AZ
ME
AUTO/PROPERTY
Aurora, IL
Phoenix, AZ
San Antonio, TX
Windsor, CT
LITIGATION
Phoenix, AZ
Windsor, CT
WORKERS’ COMP
Aurora, IL
Lake Mary, FL
Rancho Cordova, CA
Syracuse, NY
GA
LA
AK
HI
FL
10
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Our Team’s Alignment Creates Unique Synergies
For Knowledge Sharing, Optimal Outcomes
STAFFING BY BUSINESS SEGMENT* (in full time employees)
1,800 1,600 700
Workers’ Comp
&
Group Benefits
Auto & Property
400
1,000
200
First
Auto Litigation Supporting Functions Subrogation
Notice of Strategic Claims
Legal & Medical
& Salvage
Loss
Management &
(FNOL)
Liability
&
Operations
Total ~5,700 Employees
*As of August 2016
11
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Bringing It All Together…
INSIGHTS
DATA
TALENT
EXECUTION
ENGAGEMENT
12
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Our Unique Approach To Recruiting, Training And Recognizing Our
Staff Yields Best In Class Employee Engagement, High Retention
INSIGHTS
DATA
TALENT
EXECUTION
ENGAGEMENT
13
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We’ve Developed A Patented Approach To Upskilling Staff
In Key Capabilities
14
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Employees Are Recognized Publicly And Digitally
In Our Company Directory For Ongoing Reinforcement
15
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Key Takeaways - Talent
• We’re a national carrier with local presence
coast to coast
• Our flexible staffing model adjusts to the
businesses’ evolving needs
• By harnessing
our unique organizational
TALENT
structure, we can craft innovative solutions
to the biggest challenges facing our clients
• We’re only as good as our talent. We’ve built a
patented world-class platform to attract, train
and retain employees best suited for today’s
challenges
16
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Our Investments In Systems And Technologies Enable Us To
Turn Data Into Actionable Insights That Change Behavior And
Drive Better Outcomes
INSIGHTS
DATA
TALENT
EXECUTION
ENGAGEMENT
17
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DATA AND ANALYTICS
Michael Kearney
VP, Claims CIO
Paul Drennan
VP, Data Science
Paula Beland
VP, Claims Business Solutions
Our Claims Data Lifecycle Drives Better Decision Making,
Action And Outcomes
Claims Data
Mart (CDM)
ECOS*
CAPTURE
Predict
“what might happen?”
Prescribe
CLAIMS
DATA
LIFECYCLE
Confirm
Quality
ENRICH
Diagnose
“why did it happen?”
ANALYZE, ACT
Describe
“what happened?”
Claims Fraud
Systems
Text Mine
DELIVER
“what should I do?”
Workflow
Integration
Predictive
Models
Structure
Reports
and Output
*Enterprise Claims Operating System
19
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Our Front Line Leaders Use Data Visualization
To Help Drive Outcomes
20
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Data + Rules = Consistent Decision Making, Improved Efficiency
First Notice of Loss
Disability Calculator
Guardrails Created
• Decisions made/action
taken in seconds vs.
days
• State level calculations
automated
• Duration decisions
informed by 3rd party
data
• Customer needs met
• Variation reduced
• Process simplified
• Right claim to right
resource immediately
• Preemptive escalations
embedded in workflow
• Dashboards alert team
leaders
21
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Our Group Benefits Analytics Tool Guides Adjuster Thought Process
To Ensure We Capture Every Possible Dollar Of Savings
• Our adjusters identify ~99%
of Social Security offsets
• Our rules engine identifies the
other ~1%
Social
Security
Metadata
• Outcome is many millions
of recaptured dollars annually
• Tool is highly dynamic and
immediately configurable –
without technology spend
Neighboring
Claims
Policy
Provisions
Claim
Demographics
Social
Security
Disability
Offset
Example
22
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Predictive Models Unlock Additional Opportunity
Identifying
subrogation
opportunities to
support our
handlers’ work
23
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Our Analytics Help Us Connect The Dots To Fight Fraud
Doctor
Doctor
Doctor
Doctor
Doctor
Chiropractor
Chiropractor
Doctor
Doctor
Leader
Pharmacy
Chiropractor
Staff
Doctor
Staff
Doctor
Pharmacy
Chiropractor
Illustration shows the alleged network of those indicted by the Orange County Grand Jury.
(Photo courtesy of the Orange County D.A.)
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“Example Equipment” Orange County DA
24
Key Takeaways - Data
• Our significant investments in systems
and technologies enable us to turn data
into actionable insights that change
behavior and drive better outcomes
TALENT
DATA
• Insights are TALENT
deeply embedded into our
process discipline
• We bring considerable data and
analytics muscle to counter fraud and
are planning future investments to stay
one step ahead
25
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Bringing It All Together…
INSIGHTS
DATA
TALENT
EXECUTION
ENGAGEMENT
26
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WORKERS’ COMPENSATION CLAIMS:
INDUSTRY-LEADING CAPABILITIES DRIVE
SUPERIOR OUTCOMES
Mary Nasenbenny
SVP, Workers’ Compensation & Group Benefits Claims
Marcos Iglesias
MD, VP, Medical Director
Our Innovative Programs Proactively Combat
Emerging Sociocultural Challenges And Trends
U.S. Workforce, Age 55+
Obesity Impact on Severity
30%
20%
10%
0%
2000
2010
2020
(Projected)
28
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Medical Management and Return To Work Programs
Deliver Outstanding Results
6%
Medical Only
27%
Lost Time
33%
47%
73%
Medical Only
94%
Lost Time
Wages
Medical
Costs
20%
PPD**
2015
Claim Counts*
2015
Claim Costs*
*Ultimates for Accident Year 2015
**Permanent Partial Disability
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2015
Lost Time*
29
Data Drives Decisions And Strategic Interventions
MEDICAL NETWORKS
CLAIM MANAGEMENT
Pharmacy
programs
save 34%
30,000
case
mgmt
reviews
220 clinical medical
staff support our
adjusters
One million
network
medical providers
network
pharmacies
1. Bill received
2. System reviews
• Applies discounts and
fee schedules
• Corrects duplicates
• Flags and routes
MSA*
reviews
at 60%
savings
3. Specialist reviews
90%
medical
network
penetration
65,000
MED BILL REVIEW
• Reviews for accuracy
and “right-coding”
opportunities
• Nurse review advanced
medical components
Lien
team
98%
success
rate
Medical
programs
save 62%
PPD review
saves 9%
4.
Results coordinated
with handler and paid
30
*Medicare set asides
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Our Specialized Clinical Units Are Second to None
62%
38%
Wages
9%
PPD
PPD Savings
PPD Review Process
1
Doctor assigns
PPD rating
2
3
The Hartford
reviews &
recommends
Doctor may revise rating
4
Handler resolves
claim using
accurate PPD info
31
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Our Programs Combat Opioid Abuse
The country is
experiencing an
opioid epidemic
300%
increase in
opioid
prescriptions
1999
Source: Health, National Prescription Audit, years 1997-2013, Data Extracted 2014.
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2013
32
Excessive Opioid Usage Contributes To Overdose And
Does Not Markedly Alleviate Pain
Dramatic rise
in overdose
deaths
MMWR (Morbidity and Mortality Weekly – CDC) report: Increases
in Drug and Opioid Overdose Deaths — United States, 2000–
2014. January 1, 2016.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm
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33
Our Medical Management Strategy Mitigates Potential Opioid Abuse
Number of Opioid Fills on
HIG Workers' Compensation Claims
• Opioid utilization on The
Hartford’s claims dropped
by 25%
11,000
10,000
• Average morphine
equivalent dose per claim
decreased by 9% on The
Hartford’s claims
9,000
• From 2014–2015, we’ve
reduced opioid usage on
our claims at a rate 50%
better than industry average
7,000
8,000
6,000
Jan-15 Apr-15 Jul-15 Oct-15 Jan-16 Apr-16 Jul-16 Oct-16
Number of Opioids Filled
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34
Our Biopsychosocial Model Addresses The Whole Patient
And Seeks To Improve Functional Recovery
Bio
Psych
Social
35
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Nonmedical Psychosocial Factors Can Delay Recovery:
Our Analytics Model Identifies Claimants With Those Factors
Cost
Disability
Actual Outcome
Gap Between Expected and Actual Outcome
Expected Outcome
Time
37
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Our iRECOVERSM Program Includes A Continuum Of Interventions
Depending Upon Patients’ Particular Circumstances
Higher risk
Longer disability
Abbreviated
functional
restoration
program
CBT +
physical
therapy (PT)
Functional
restoration
program
(FRP)
Chronic
pain
program
Cognitive
behavioral
therapy
(CBT)
Full coaching
interventions
App plus
wearable
device
No
Intervention
App
(content)
only
Hartford
Coach
Psychologist
Counselor +
PT
MD + psych +
PT + others
Claim Handling: Biopsychosocial Approach
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MD + psych +
PT + others
Nurse Case
Mgr + MD
mgmt + FRP
iRECOVERSM Produces Optimal Results
For Our Customers And Injured Workers
“I feel confident going back to work.
A good part of this is due to my participation
in iRECOVER.”
“Insurance companies get a bad rap
these days and the fact you’ve put
this program into play is wonderful.”
“I think what you do, is probably as important
as medical treatment.”
38
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Key Takeaways - Execution
• Our workers’ compensation
adjusters and clinical staff are
experts
• Data is deeply integrated into our
decision-making processes
• Unique capabilities drive best-inclass results
39
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CUSTOMER FEEDBACK DRIVES CONTINUOUS
IMPROVEMENT; TALENT DRIVES EXECUTION
John Kinney
EVP, Chief Claim Officer
Our Patent-Pending Customer Loyalty Approach Enables Real-Time
Continuous Improvement And Exceptional Customer Care
When a service alert is issued, our
end-of-claim score rises by about 50%
Claim begins
Pulse check
call to insured
Low rating
or question
Investigation
completed
End-of-claim
survey
Service alert
Claim supervisor
responsible to
resolve issue
41
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We Display Our Customer Feedback On Thehartford.com
4.8 OUT OF 5
STAR RATING
FROM OUR
CUSTOMERS
FOR THEIR CLAIM
EXPERIENCE
42
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J.D. Power Awards Our Customer Care And Auto Claims Teams
Their Number One Ranking For 2016
43
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The Hartford Claims Advantage
1
Our talent, data and
execution strategy enables
us to restore customers’
lives while driving profitable
growth for the company
3
Our unique organization
design drives results
4
Our people are our
competitive advantage
Our innovative structure, including combined
Workers’ Compensation and Group Benefits
units, enables us to leverage synergies and
learnings to improve outcomes and accelerate
continuous improvements.
The Hartford’s Claims organization is a true
differentiator for the company.
2
We are harnessing the
power of big data
Our technology and analytics solutions provide
actionable insights to support accurate decisions and
better outcomes. Our data scientists have built the
machines that make it possible.
The talent we have is key to restoring
customer lives and driving profitable company
growth. We have a unique approach to
recruiting, training and retention that builds
capabilities and fuels employee engagement.
44
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CUSTOMER CARE TEAM:
FIRST NOTICE OF LOSS
Vicky Pace
VP, Claims Solutions & Analytics
Our Customer Care Team Excels By Blending Empathy And Data
To Deliver Exceptional Customer Experiences
•
•
•
•
•
450 customer service reps, 50 leaders
24/7/365 availability
6 locations
Omni-channel interactions
Our human face combines with significant system capabilities
o Reflexive questioning
o Data capture, fueling predictive analytics
o Real time servicing
o Customer preferences
o Clinical nurse intake capabilities
46
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Tour Stop Logistics
Group
Number
1
Tour Leader
First Stop
Brendon Kelly, VP Reinsurance Asset
Mgmt and Central Recovery Operations
Indoors – General Liability
2
Steve Deane, VP Group Benefits
Indoors – Auto and
Property
3
Keren Shemesh, AVP Claims Strategy and
Innovation
Outside – CAT van
4
Lisa Roche, AVP Claims Solutions and
Analytics
Outside – Repair vehicle
47
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A
QUESTIONS
John Kinney
Executive Vice President and Chief Claim Officer
As head of The Hartford’s Personal and Commercial Lines Claims organizations, John Kinney leads approximately
5,500 workers’ compensation, automobile, property, general liability, Group Benefits and support claim professionals.
The Claims organization’s mission is to deliver exceptional customer service and highest quality claim outcomes.
Collaboratively with Claims leaders and across the company, he participates in the design, build and implementation
of operational and strategic initiatives that support The Harford’s growth and profitability objectives. In addition, he
oversees The Hartford’s property and casualty run-off operations.
Prior to joining The Hartford in 2003, Kinney held various legal positions at The Travelers Companies’ Special
Liability Group, where he focused on the management of asbestos litigation. At both Travelers and The Hartford,
John has worked closely with state and federal legislators regarding various tort reform initiatives.
Kinney holds a B.A. from Fairfield University in Political Science and a J.D. from Seton Hall University School of Law.
He is admitted to practice law in Connecticut.
49
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Paula Beland
Vice President Claims Business Solutions
Paula Beland has leadership accountability for several Claims enabling capabilities including Claims’ Data Office,
Strategy and Innovation, and large scale project design and implementation. She also leads Claims’ Customer
Experience/Digital strategy. She recently led the transition to ECOS – The Hartford’s new front end claims
management system. Her accountabilities extend across Personal, Commercial Lines and Group Benefit Claims
functions.
Previous roles include VP of Claims Shared Services, accountable for subrogation, real estate, counter fraud, and
call centers that support the P&C lines of business. Before assuming that role, Beland spent over 15 years in Field
Claims and has leadership experience in all lines of business.
Over her 30+ year tenure with the Hartford, she has received several Chairman’s Awards and holds several patent
applications. She has served as an advisor in a number of industry panels and is a frequent speaker on the topics of
technology, and strategy.
Prior to joining The Hartford, Beland worked as an educator. She holds a Bachelor of Science degree from the
University of Delaware.
50
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Paul Drennan
Vice President Data Science
Paul Drennan is vice president and predictive analytics lead in the data science unit at The Hartford. In this role,
Drennan focuses on marrying world class analytics with deep process knowledge in large scale operations to create
sustained profitable changes in business practices.
Drennan joined The Hartford in 2008 as the chief technology officer for Trumbull Services. In that role, Drennan led
the design and deployment of a subrogation data warehouse and reporting application using SQL Server. He joined
The Hartford’s data science unit in 2010.
With more than 20 years of experience establishing and leading applied analytics teams across multiple industries,
Drennan has led operations data science practices at J.P. Morgan Chase, Network Solutions/Verisign and United
Healthcare.
Drennan earned a Bachelor of Science in Engineering and History from the U.S. Naval Academy and a Master of
Science in Operations Research from the Naval Postgraduate School. Drennan was an officer in the U.S. Navy and
served several tours in Operation Desert Storm.
51
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Marcos Iglesias, M.D.
Vice President and Claims Medical Director
Dr. Marco Iglesias oversees the Claims Medical Strategy group, which focuses on creating innovative medical
strategies to drive best outcomes for our customers’ ill and injured workers. His professional interests include the
prevention and mitigation of delayed recovery and disability. His passion for helping workers live active, productive
and fulfilling lives has led him to develop innovative proprietary comprehensive disability management solutions that
focus on early identification of risk factors and appropriate early interventions to return workers to preinjury function.
He has over 25 years of experience as a physician taking care of injured workers and as an insurance professional,
having served as medical director for workers compensation primary and excess carriers.
52
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Michael Kearney
Vice President and Claims CIO
Michael Kearney joined The Hartford in 2012. Prior to his present role, he was responsible for strategy and execution of
transition of the Collaborative Technologies organization to a business focused, cost competitive service-based
infrastructure. Kearney has 30 years of experience as a senior executive responsible for building and optimizing
information technology capabilities to improve organizational growth and efficiency.
Prior to joining The Hartford, Kearney worked at Alvarez and Marsal, where he led IT consulting engagements in
financial services institutions. He was also senior vice president and chief information officer at World Learning, a
nonprofit organization advancing leadership through education, exchange, and development programs in more than 60
countries. Under his leadership, World Learning upgraded its technological infrastructure and obtained multi-million
dollar grants from Cisco and Microsoft. He also served as chief technology officer and senior vice president at The
Knights of Columbus, where he built a sophisticated technology team and global infrastructure for the Fortune 1000
insurance firm, and as the chief operations officer for the Phoenix Companies’ investment subsidiary in Hartford,
Connecticut.
Kearney is a graduate of Bryant University with a bachelor's degree in business administration and a concentration in
management information systems.
53
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Mary Nasenbenny
Senior Vice President Group Benefits & Workers’ Compensation Claims
In her current role, Mary Nasenbenny has oversight responsibility for all aspects of the Group Benefits and Workers’
Compensation Claims organizations, including Field and Major Case claim handling, strategy, practices, and medical
and disability management.
Prior to her current role, Nasenbenny was SVP of Claims Solutions & Analytics, with oversight accountability for
numerous Claims shared services areas including Legal Operations, Data Analytics, Special Investigations,
Subrogation, FNOL Call Centers, Customer Loyalty, ECOS, the Project Management Organization, and Claims
Training and Auditing. Previous roles included VP of Workers’ Compensation Claims and VP of Claims Legal
Operations and National Director of Counsel, where she oversaw Claims’ in-house counsel program, which provides
policy-related legal representation to The Hartford’s customers nationwide.
Prior to joining The Hartford in 1999, Nasenbenny practiced law for several years with a large Chicago-based
insurance defense firm. There, her work focused largely on the litigation of ERISA and professional liability matters.
Nasenbenny holds a Bachelor of Arts degree from the University of Notre Dame and earned her J.D., with highest
honors, from Chicago-Kent College of Law.
Nasenbenny serves on Board of Directors of Hartford Insurance Company of Illinois.
54
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