Insurer Mergers

An overview of the insurer merger tool

The insurer merger tool allows insurers who have undergone mergers to combine their organizations in HCAI in a parent-child set up. This tool has the ability to provide relief to companies that have undergone mergers by reducing the number of user logins required and permitting the transfer of documents between merged companies.

Below is a visual representation of how the merger tool can merge two companies together to one structure.

An overview of the parent-child structure in HCAI

In HCAI, an insurer is defined as an entity that insures the policyholder and owns any claim information generated by the policy. A ‘parent insurer’ is one that is comprised of several subsidiary organizations (child insurers), each of which functions as a distinct insuring entity with its own reporting structure.

In the parent-child structure, each company—whether it is a parent or a child—maintains its own claim and claimant records. Administrative staff can be assigned access to manage information and documents for both the parent and child or the child company alone. When a form is received in ‘unmatched status,’ a form manager with access to both the parent and child companies can match the document to a claimant from any company within the parent-child structure.

Facilities will still be able to see and send forms to all companies in the parent-child structure. They might not even be aware that parent-child companies are affiliated. However, if a facility incorrectly sends a form to the wrong insurer, the insurer can easily and seamlessly transfer the form to any company within the parent-child structure.

Work effort involved in implementing the insurer merger tool

There is no additional cost from HCAI to use the merger tool, but Insurers should be aware that some manual work effort is required. Insurers are strongly encouraged to review their own organizational structure to understand the benefits associated with the tool before deciding to implement the tool. Once the merge takes place, organizations cannot revert back to their prior structure.

Below are a few work items that may be necessary in order to benefit from the tool:

Deactivating duplicate user IDs

Once the merge takes effect, users who had more than one user ID to access companies will now have two user IDs within the same parent-child structure. Insurers will want to update access to only a single user ID once the companies have merged.

Updating user access

The degree to which companies and users are integrated with parent and child companies is a business decision. For example, some insurers may decide to operate the parent and child companies mostly independently with separate adjusting teams for each. Other companies may want their adjusters and claims staff to be able to access documents for both organizations.

In most cases, insurers will need to plan to update user access for at least some staff. Some examples of access updates that may need to take place after the merge are:

• Claim/Claimant Administrators who match documents may need to be given access to match documents with claimants in both the parent and child organizations

• If adjusters will be handling claims in both the parent and child company, adjuster users will need to be given access to their worklists in both companies

• User administrators of the new child company will need to update their access if they wish to maintain this level of access

Matching forms with claimants

Once the merge takes effect, staff who perform matching will see unmatched documents intended for the parent as well as the child organization. These staff members will need to be trained to identify whether the claim belongs to the parent company or one of the child companies.

For statistical reporting purposes, it is important that insurers continue to maintain separate claim-claimant records for the parent and child companies in HCAI. Despite any legal merger that takes place, claims must continue to be reported under the insurer that originally issued the policy.

Requesting the merger tool for your organization

If you would like to request the merger tool for your organization, please request a copy of the merger consent form from Insurer Support (insurersupport@hcaiinfo.ca). This form must be completed for each company that you wish to merge and signed by an individual with authorization to bind the company.

Mergers will run during HCAI’s weekly maintenance window on Sundays. Only one organization may be merged in each window.