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Digital Outbound Payments Heat Up

Since February, driven by the pandemic, the pace of progress on digital payments has accelerated beyond what we thought fathomable.

The heat of summer is kicking in around the U.S., and the temperature is rising, too, in the digital transformation in one area of the market: digital outbound payments in claims.

Since February, the pace has accelerated beyond what we even thought fathomable. COVID-19 has been horrific, but it has brought clarity about the areas that are urgently in need of digital transformation.

SMA recently published findings from our latest market pulse survey, titled P&C Tech Plans in the COVID-19 Era. The report reveals that fully 81% of personal lines insurers and 57% of commercial lines insurers are investing in digital payments. 

In January 2019, I wrote that this area was positioned to explode. The focus on enhancing the customer experience was pushing P&C insurers forward. The digital payment process possessed the potential to provide operational improvements, especially in efficiency. The flexibility around payments became the target of many critical initiatives.

See also: Cloud Computing Wins in COVID-19 World  

Fast forward to May 2020. When we went into lockdown, we quickly realized which activities required intervention – those that required people coming into the office to print paper checks to be sent to customers and third parties. It becomes obvious that this is low-hanging fruit, and a plethora of vendors have solutions in the market today.

Join SMA and TDI on July 15 for a first-of-its-kind industry event that showcases the capabilities of digital payments and how vendors are bringing these capabilities to life.


Karen Furtado

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Karen Furtado

Karen Furtado, a partner at SMA, is a recognized industry expert in the core systems space. Given her exceptional knowledge of policy administration, rating, billing and claims, insurers seek her unparalleled knowledge in mapping solutions to business requirements and IT needs.

Want to See Social Media Genius?

K-pop can serve as an exemplar for insurers and agents as we all try to figure out how to engage with clients more often and increase their affinity for our brands.

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Over the weekend, Korean pop made news because fans supposedly helped bait the Trump campaign into overestimating by an order of magnitude the number of people who would show up for a rally in Tulsa, Okla. No matter how big the actual effect, K-pop can serve as an exemplar for insurers and agents as we all try to figure out how to engage with clients more often and increase their affinity for our brands.

Yes, there will have to be considerable translation -- and not just from Korean to English -- to bring ideas from K-pop's outreach into our industry. Insurance customers would never even want to hear from companies and agents as often as K-pop fans engage with the idols -- "idol" being an official term for a K-pop group member.

But K-pop is very much an industry, with "factories" that create idol groups from among the thousands of youngsters who sign up for several years of training on how to sing and dance and on how an idol should act. And the interactions with the fan base are carefully and skillfully designed.

Now, no insurance company will ever get 750,000 fans to simultaneously do anything, as the most popular K-pop group, BTS, did with a live, pay-per-view concert last week -- my daughters stayed up to watch from 2am to 4am California time. But let's take off our insurance hats for a moment, look at the sorts of outreach BTS does and see if we can't be a bit more creative about what insurance clients might appreciate.

The group of seven young men, ranging in age from 22 to 27, have released four albums in two years, an aggressive schedule. But it's the steady stream of creative ways they interact with fans in between albums that stands out for me. Since my younger daughter found time to indulge her BTS fan-dom -- when her law school classes went online and her side gig as a waitress in the D.C. area was put on hold -- I'm sure a week hasn't gone by without some lengthy bit of new material. Sometimes, it seems that barely a day goes by.

In their seven years as a group, BTS has produced more than 100 episodes of Run BTS, a sort of variety show where they do things like bungee jumping or competing at a water park. The videos are engaging on their own, despite the need for subtitles for those many of us who don't speak Korean, while letting fans see the individual personalities in ways that can't always come across in the group's highly choreographed, elaborate shows.

Members of the group appear regularly on a live streaming app where they may, for instance, talk to the camera about what's going on in their lives or may answer fans' questions. There's nothing slick about the production values. A recent one showed two members sitting in a kitchen trying to figure out how to make gimbap, a traditional dish akin to sushi rolls that their moms made for them growing up. That's it. But fans love the videos. (An American singer learned one day that a song he had released a while ago had popped to the top of the iTunes charts in South Korea. What was going on? A BTS member had sung the song on one of the live streams. That's all it took.)

BTS recycles old material creatively, too. For instance, the group "held" a festival in April that replayed eight of their concerts from 2014 to 2018.

The group leans into social causes, as well. For instance, BTS donated $1 million to Black Lives Matter causes -- fans almost instantly raised a matching amount, then an individual fan, pro wrestler and actor John Cena, added a further $1 million. This week, the group announced that it was donating an additional $1 million to a cause helping those whose work at concert venues has been canceled by the pandemic. BTS, and K-pop in general, have become so identified with social causes that fans in the U.S. identified hashtags associated with white supremacy and flooded them with K-pop videos to drown out expressions of hate in the wake of George Floyd's death. (The New York Times detailed the K-pop activism this week.)

If BTS itself ever posts a photo on Twitter, well, look out: There could easily be two million likes.

The steady interactions with fans have produced unprecedented popularity for a K-pop group. They were not only invited to appear on the YouTube "graduation ceremony" in early June, alongside the Obamas and others, but were given two large blocks of time, first so each of the seven could offer thoughts to the graduates and then to perform three songs.

Of course, that sort of exposure just feeds more popularity. When BTS released a single a few days ago, called "Stay Gold," it instantly went to the top of the iTunes charts in more than 80 countries. BTS's last four albums have hit No. 1 on the Billboard charts, a Herculean feat given that songs in Korean get so little radio play in the U.S., and radio play is such a big factor for Billboard.

How can insurers match BTS?

They can't, not even if Greg Case, Brian Duperreault or some other executive sings and dances a whole lot better than I know. But it seems to me that there are still lessons that can be learned from the group's outreach, about the benefits of continual (welcomed) communication, about the different possibilities presented by various media and about the lack of need for great production values, even from the industry heavyweights.

In personal lines, I imagine that health and auto insurance present the greatest opportunities.

During this pandemic, especially, there are loads of reasons for my health insurer to be keeping me updated about what's being learned about how the coronavirus is spread, what preventive measures I can take, what therapies are showing promise, how many cases are being found in or near my ZIP code, etc. I already gather that sort of information on my own, but I'd certainly welcome an occasional email from my health insurer that promised me updates. I might well click through to a video that illustrated some key point or to a brief Ask Me Anything-style post, whether in word form or just as a Zoom-style recording of some expert sitting in her living room answering questions I might have. Nothing fancy needed: just some good information delivered periodically.

Al Lewis delivers through Quizzify the sorts of updates I'm imagining; his employer clients send monthly trivia quizzes that educate employees about COVID and other current topics, as well as broader healthcare issues, both to help employees and to keep them from undergoing unnecessary care that can cost employers dearly. But, as far as I can tell, health insurers could be doing a lot more.

My auto insurer has kept me updated about premium credits as long as mileage plunged for months, but why not also tell me about how quickly driving is picking up, what the new version of rush hour looks like and is likely to look like, etc.? Auto insurers might run out of topics much faster than health insurers, but there are still event-based communications that I'd welcome. For instance, I relied on personal experience when teaching my daughters to drive, but surely there is a host of collected wisdom that an insurer knows about and that could have been flagged to me as soon as a teen showed up on my insurance. Again, the advice could have taken a variety of forms, many of them low-cost, along the lines of an Ask Me Anything -- perhaps augmented by a slick video designed to scare the bejeezus out of kids about all the bad things that their phones can suck them into doing.

The same sort of email/social/video outreach could work in small commercial lines, too, especially at a time of so much uncertainty. Think a pizza parlor or small retailer wouldn't welcome a stream of advice, with the promise of additional resources, on how to reopen while protecting customers and employers? Think they wouldn't welcome help thinking through all the workers' compensation issues that are floating around?

The really good agents and brokers are, of course, pulling together all sorts of advice and providing it to clients in our current health and economic crisis. But it seems to me that the advice outreach could be much more systematic, could be organized more by the insurers so that more agents can provide top-notch service and should be set to extend long after the crisis passes.

So, think BTS. You'll never be as popular as they are. But think about the language barriers they overcame while establishing links straight into the hearts and minds of so many, and take heart.

As the latest single says in its opening:

In a world where you feel cold
You gotta stay gold

Stay safe. And stay gold.

Paul

P.S. Here are the six articles I'd like to highlight from the past week:

We Are Open for Business; Now What?

Expectations for success continue to rise as more businesses reopen with safety as a top priority.

Keys to ‘Intelligent Automation’

Combining robotic process automation and machine learning, IA accomplishes the end-to-end automation of business processes.

Insurance Innovation — Alive and Kicking

An abundance of startups shows the industry adopting a two-speed strategy, around speed of operation and speed of innovation.

3-Step Framework to Manage COVID Risk

Insurers need a comprehensive yet customizable approach to assess operational risk quickly and dynamically and chart responses to COVID-19.

Epic Policy Failure on Contractors

California is making a mess as courts, the legislature and possibly voters sort out who qualifies as an employee and who as a contractor.

Loss Prevention or a Trojan Horse?

"Ecospheres of prevention" sound great, but they may just be a way for insurers to use, say, leak detection devices to gain leverage on clients.


Paul Carroll

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Paul Carroll

Paul Carroll is the editor-in-chief of Insurance Thought Leadership.

He is also co-author of A Brief History of a Perfect Future: Inventing the Future We Can Proudly Leave Our Kids by 2050 and Billion Dollar Lessons: What You Can Learn From the Most Inexcusable Business Failures of the Last 25 Years and the author of a best-seller on IBM, published in 1993.

Carroll spent 17 years at the Wall Street Journal as an editor and reporter; he was nominated twice for the Pulitzer Prize. He later was a finalist for a National Magazine Award.

Insurance Innovation — Alive and Kicking

An abundance of startups shows the industry adopting a two-speed strategy, around speed of operation and speed of innovation.

Insurance innovation is alive and kicking, and gaining traction, as represented by the wide array of submissions for the 2020 Innovation in Insurance Awards, sponsored by Efma and Accenture. Last year, I was honored to be selected as a judge, and the winners were just announced in a virtual award ceremony.  Congrats to all for carrying the commitment to innovation for our industry!

With customer demographics and expectations changing, with new channels and competitors appearing and with so many technological possibilities opening up, we see a two-speed strategy around innovation: speed of operation and speed of innovation. 

Speed of operation focuses on optimizing the existing business model while speed of innovation looks at new business models that will disrupt the business. This two-speed strategy aligns well to AM Best’s innovation ratings.

Innovation That Stands Out

So, how are insurers innovating? In the submissions this year, there are leaders who understand the intersection of customer, technology and market boundary shifts and are blazing trails.

See also: COVID-19: Innovation, Your Time Has Come  

Here are six interesting trends and focus areas that stood out to me:

1. Personalized digital platforms

While a number of portal or mobile app submissions focused on niches such as bill payment, they did not provide the engagement offered by personalized digital solutions that delivered the kind of great experience customers increasingly expect. One submission offered services and rewards to clients with life insurance and monitored customer behaviors to provide personalized recommendations and rewards that would encourage healthy behavior. The result was a fully executed digital platform for behavior change.

2. Home and wearable IOT ideas

IoT and wearables have matured rapidly over the past five years. As I discussed last year, Insurance at the Intersections of Protection and Prevention, the real opportunity for these technologies was to create a bridge from P&C and home security into home health and wellness. P&C insurers (using IoT devices to protect the home) can use health awareness devices to serve those who choose to age-in-place – connected home and health all in one. With more than 10,000 Baby Boomers retiring each day, this is a huge market opportunity. One submission used smart technology to safeguard clients and their home while providing access to a range of services, including home repairs and maintenance, food delivery and medication reminders. The concept, a creative use of traditional P&C and life & health, epitomizes a customer-first approach, rather than a product approach. In today’s COVID-19 environment, and with the cost of nursing home care increasing, this option could appeal to a lot of customers.

3. Data ecosystem

Innovative uses of data are driving growth, and ecosystems can accelerate it. One submission built a data ecosystem with partners across a wide array of industries that allowed the entrant to visualize and use data for underwriting and helping clients minimize risks, thus increasing the company's business. The opportunities to build on this concept are enormous.

4. Travel insurance's customer experience

While buying travel insurance via an app seems commoditized, one submitting team changed the policy transaction into a broader customer experience, driving engagement, value and loyalty. Travelers receive recommendations on where to go, safety and security alerts (using geo-location from the mobile phone) and other services that improve the experience while reducing risk. This submission is a great example of thinking beyond the traditional risk policy to a broader customer relationship.

5. Family insurance

A number of years ago, the concept of a single insurance policy that would adapt as you went through life was discussed within a company where I worked. But the idea could not be done on the old mainframes prevalent back then. Fast forward, and the idea has morphed and emerged in one of the submissions. The entry looked at a single policy that would meet the needs of the family, including facets of home, accident, health and pet protection – all wrapped into a digital service that helps manage common, high-level family needs over the lifetime of the policy. This concept is radically different – approaching the need from the customer point of view, not from our long-held insurance point of view.

6. Agriculture

The last area that stood out is near and dear to my heart – agriculture. As an “Iowa farm girl,” I see the rapidly changing agriculture landscape and the use of technology to aid farmers from planting through harvest – well beyond just for potential risk and claims. There were three submissions that stood out to me. The first was a digital experience for farmers in India that focused on providing crop insurance but also included services such as cultivation recommendations that would help increase crop yields. The second was insurance that also provided intelligent traceability of agriculture products to minimize potential risks – all about secure sourcing and food safety. The third was parametric insurance for coffee growers. All of these highlighted how a centuries-old agriculture industry is ripe for new products and services to help optimize it while also protecting it.

See also: Step 1 to Your After-COVID Future  

Innovation is Defining the Future of Insurance

Each of these companies – and others I did not mention – are reimagining the future of insurance with the customer at the forefront. They are taking control of their future before someone else does. And they are doing it with a focus on both operational and strategic innovation, fitting within A.M. Best’s innovation criteria.

These companies and the winners are well along the path to becoming the innovation experts that will reshape the future of insurance. Congratulations to all!  I can’t wait to see next year’s innovative ideas come to life!


Denise Garth

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Denise Garth

Denise Garth is senior vice president, strategic marketing, responsible for leading marketing, industry relations and innovation in support of Majesco's client-centric strategy.

We Are Open for Business; Now What?

Expectations for success continue to rise as more businesses reopen with safety as a top priority.

Established continuity plans are an essential part of a business’ reopening in a post-COVID-19 world. Expectations for success continue to rise as more businesses reopen with safety as a top priority. With a growing list of resources and recommendations, many employers are wondering where to start.  

We partnered with the Public Agency Risk Management Association (PARMA) for our latest Out Front Ideas with Kimberly and Mark webinar, where three special guests joined us, to discuss employer considerations for returning to a physical workspace:

  • Tim Karcz, senior risk manager | California Joint Powers Insurance Authority
  • Traci Parke, partner | Burke, Williams & Sorenson
  • Chuck Pode, risk manager | county of Ventura

Physical Workspace

There is an abundance of public health recommendations for reopening safely, but businesses are left to develop their own policies and practices to implement these standards. The Centers for Disease Control and Prevention (CDC) has outlined how to create a plan for implementation, including measures for separation, social distancing and sanitizing. Many public entities are requiring a site-specific plan addressing these issues before reopening. One of the best ways to get started is to conduct a walkthrough of the facility, acting as one of the employees. Before completing the walkthrough, you should know what day-to-day activity looks like, where to make necessary adjustments and what the expectations are for both employees and custodial staff. Be open to changing and revising the plan constantly and communicating the changes with employees.

Your continuity plan should include:

  • Engineering controls, like barriers and social distancing measures.
  • Administrative controls, like staffing level changes.
  • Personal protective equipment to control transmission, like masks.
  • Cleaning and disinfecting procedures.
  • Employee training to address check-ins, health screens, social distancing and usage of personal protective equipment (PPE).
  • Employee-specific guidelines to address when an employee feels ill, or if someone in the person's household is feeling sick. 
  • Updated data security measures.

See also: Access to Care, Return to Work in a Pandemic  

Safety Considerations

An excellent resource for preparing a safe return to work is OSHA document 3990-03: Guidance on Preparing Workplaces for COVID-19, which follows standard regulatory requirements. There are six key elements listed for implementing a successful reopening model:

  1. Develop an infectious disease and response plan. Ask your business partners if they have any resources readily available. There are resource templates available for what applies to your industry, but OSHA is encouraging more personalized plans to meet your organization’s needs.
  2. Prepare and implement basic infection prevention methods. These include refraining from physical contact, using a key or pen to open doors, throwing away used tissues and not touching your face, mouth or nose with unwashed hands. Make these guidelines inclusive to all employees within your industry. 
  3. Develop policies and procedures for prompt identification and isolation of sick people. Encourage employees to self-isolate if they are experiencing symptoms and have a plan in place if someone exhibits symptoms within the workplace.
  4. Develop, implement and communicate about workplace flexibilities and procedures. Talk to your employees about their concerns regarding leave, safety, childcare and any other issues that may arise. Flexibility with current policies is critical to continued success. 
  5. Implement workplace controls. Engineering, administrative and protective equipment measures all need to be addressed. 
  6. Follow existing OSHA standards. Many existing rules apply to current prevention methods and should be included as part of any continuity plan. 

OSHA also suggests classifying worker exposure to COVID-19 into four risk categories: very high, high, medium and low. The guidance document has specific definitions for each:

  • Very high risk includes those exposed to known or suspected COVID-19 patients.
  • High risk includes those exposed through medical services, like first responders. 
  • Medium risk includes those possibly exposed to someone who may be infected, but may not know they are infected.
  • Low risk includes the majority of employees, who are not required to be around those who may be infected but could be exposed at some point.

ADA Considerations

As COVID-19 makes a more significant impact on the day-to-day lives of employees, compliance with the Americans with Disabilities Act (ADA) may pose a greater challenge for employers. The Equal Employment Opportunity Commission (EEOC) has published guidance on complying with the ADA with COVID-19 in mind. A few of the commonly addressed questions include:

  1. How much information can an employer request from someone who is sick to protect the workforce? Typically, the employer cannot request details of the illness, but, because of COVID-19, the employer can request that the employee disclose any symptoms related to COVID-19. The employer must keep this information confidential. 
  2. Can employers take employee temperatures or require health screens before entrance into the workforce? Yes, although the screening can present confidentiality issues because there is no real playbook for how to conduct the health screens. If implementing this process, it is a good practice to disclose plans to employees before they return to the workplace. Specific states will require a notice of collection before screening employees. This information will also need to remain confidential. 
  3. What can we do to protect our high-risk employees or any employee who seeks health-related accommodations? ADA duties and obligations still apply to provide accommodations for anyone with a preexisting condition or disability that makes the person particularly susceptible to COVID-19. Think about the individual risk factors that these employees may face in the workplace. Accommodations may vary depending on the essential functions of their day-to-day job. Get input from the employee and the person's manager to protect them. Telecommuting is highly encouraged by the EEOC and should be seriously considered if it does not cause undue hardship for the employer.

See also: Strategies to Reopen Your Business Safely  

To listen to the full Out Front Ideas with Kimberly and Mark webinar on this topic, click here.


Kimberly George

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Kimberly George

Kimberly George is a senior vice president, senior healthcare adviser at Sedgwick. She will explore and work to improve Sedgwick’s understanding of how healthcare reform affects its business models and product and service offerings.

Keys to 'Intelligent Automation'

Combining robotic process automation and machine learning, IA accomplishes the end-to-end automation of business processes.

With new technologies and evolving customer expectations driving rapid change in the insurance sector, research suggests that more than 65% of insurance carriers will adopt at least limited automation by 2024. But, today, the insurance sector largely relies on multiple layers of manual processes that make customers wait while employees try to make sense of complex documents.

Intelligent automation (IA) offers insurance businesses an opportunity to revolutionize the way they operate to meet increasing demands from customers and pressures from the market and to plan for future, unanticipated interruptions. Through the combination of robotic process automation (RPA) and machine learning (ML), IA solves complex enterprise issues through the end-to-end automation of a business process.

The Insurance Ecosystem Involves Many Parties and a Deluge of Data

Many third parties are involved in the end-to-end insurance lifecycle. That’s the case whether you are in commercial, employee benefits, retail or any other type of insurance. A lot of information gets passed around. 

Brokers and insurers share data and documents. Advisers working with clients provide information, as do others, such as loss adjusters and lawyers. And the data arrives in the format preferred by the person who shares it.

That Data Comes in a Variety of Formats 

Data used for insurance purposes comes in many formats — structured, unstructured and semi-structured — and must be ingested, understood and digitized with accuracy before any automated processing takes place. This involves making sense of data such as cursive handwriting, which is commonly found in life insurance change-of-address and name-change forms, as well as in beneficiary documents. Insurance entities must extract data from highly unstructured employee benefits documents, such as dental, income protection, long- and short-term disability and medical documents. 

Brokers and insurers also need to compare and extract data from binders/slips, which can be up to 400 pages long and may use different words to describe the same thing. Insurers looking to ingest unstructured data (like email attachments, handwritten documents, PDFs and unlabeled data) — which is estimated to compose 80% of any enterprise’s data — can find their answer with cognitive machine reading (CMR).

While the industry's standard data ingestion tool — optical character recognition (OCR) — can digitize structured data, it falls down when it comes to reading and extracting unstructured data such as tables, checkboxes and many other forms. In addition, OCR can't read and digitize handwriting and signatures. 

A CMR-enabled intelligent automation platform (IAP) can analyze and process large amounts of unstructured data and complex business contracts in a fraction of the time it takes with traditional, manual processes. An IAP enables insurance companies to address the error-, labor- and time-intensive challenges involved with human-driven processes. 

For example, a global broking client wanted to extract 17 data points from commercial policies and endorsements. The documents came in from many different insurance carriers and in varying formats. All the data points required rules or reference tables to make the output usable, and most of the data didn’t have labels. In just a three-week period, with the samples of only 220 documents, with 40 different formats, multiple insurers and 10 coverage types, an IAP learned to extract 98.7% of the data, with 96.8% accuracy. Following this proof of concept, the client decided to implement this solution in multiple geographies.

See also: Automation Lets Compassion Scale   

CMR Allows Insurance Entities to Do More

John Hancock illustrates the many benefits businesses can derive from a CMR-enabled IAP. The company originally used manual processes to handle the large volume of policy management documents it received. Many of those documents held vast amounts of unstructured data — especially handwritten text in bold and cursive. 

Since adopting AntWorks’ CMR-enabled IAP solution, John Hancock has enjoyed higher business productivity, lower turnaround times and a more than 65% increase in accuracy for handwritten cursive recognition. Because the AntWorks IAP uses assistive and adaptive machine learning to learn from exceptions, the system’s accuracy gets better over time.

Insurance entities also can greatly increase their case volumes with the help of CMR. Using manual processes would require armies of people to do validation checks and take a lot more time, while producing higher error rates.

One of the world’s largest human resources consulting firms implemented AntWorks technology to manage large volumes of data and provide optimized quotations to customers for new policies and renewals. This company eliminated manual keying and automated healthcare claims-related processes by extracting data from paper documents and validating for accuracy. That enabled 70% faster processing and a 40% increase in accuracy.

A Fortune 500 insurance company that provides title insurance protection and professional settlement services found that the manual process of validating title documents was leading to error-prone and inconsistent output. CMR technology enabled this company to increase field accuracy across orders by more than 75% and increase productivity by 200%. (Field accuracy is one of the key performance indicators that insurance companies, their technology suppliers and analyst firms like NelsonHall use to evaluate automation solutions. For example, NelsonHall in its SmartLabTest evaluation of document cognition platforms looks at the proportion of fields correctly recognized, accuracy of extraction of recognized fields and proportion of fields overall that are 100% accurate and require no manual intervention.)

IAP Equates to Faster Time to Revenue and Richer User and Employee Experiences

When insurers adopt automation, they dramatically improve the experience for all parties — the broker, the customer and the insurer. They relieve employees from doing what is considered value-added but repetitive work like manual data entry. Automation also eliminates the need for error-prone, stare-and-compare work that’s common in the insurance industry.

That elevates the customer experience because IA allows insurance companies to process requests and respond much more quickly. Digitizing processes also delivers a better experience because customers don’t have to contend with the cumbersome process of filling out and handling paper forms. Meanwhile, IA enables insurance businesses to enrich their data with both structured and unstructured data from other sources and use data analytics and predictive analytics to make their propositions better and more personalized. 

IA also can enable businesses in the insurance ecosystem to move faster. That can help them to be more profitable.

Imagine a person is underwriting a life insurance case. If the data that person submits for the case is referred, an insurer would then have to go out to a doctor to get a medical report value. The underwriter would need to assess that report to understand whether it’s an acceptable case and communicate with the customer.

Getting and processing all the data can take weeks, delaying the policy kick-off. But if you can use intelligent automation to understand the data within medical reports, use rules to decide whether to accept or decline and automate the outcome, things happen much faster. 

The title insurance protection and professional settlement services insurance company mentioned earlier reduced its processing time by 70% after adopting a CMR-based IAP solution. Meanwhile, the human resources consulting firm noted above increased its operational efficiency by speeding turn-around time, leading to higher customer renewals, an uptick in new customers and increased revenues. 

Process Discovery Helps Companies Better Understand the Work They Do

Often, a lack of knowledge and understanding of process flows leads to automation failure. If you’re not quite sure which processes are the most optimal to automate or you’re not clear on all the steps involved in your process (and you don’t have time to do workshops with lots of analysts and business subject matter experts to figure things out), then process discovery is an excellent way of understanding exactly how the process is conducted. 

Process discovery enables organizations to identify high-value processes for automation by recording actions that users undertake. If an organization can look at, say, 10 different people doing the same process, it can better understand not only how the process really works but also all the variations in the process, including things like the different process times and different applications accessed. The discovery enables the organization to see the steps involved and create automated processes that use the optimal approaches to those processes. The organizations can then apply what they learned to claims data extraction, fraud detection, mortgage verification and processing, account set-up, policy administration, quotation validation, title verification and a wide variety of other insurance use cases.

In addition to helping companies better understand their processes, process discovery can help in identifying opportunities for automation, expedite digital transformation and unveil previously unknown processes for in-depth process mapping.

See also: Evolving Trends in a Post-Covid-19 World  

Intelligent Automation Makes Companies More Resilient

Our new normal puts increased focus on the importance of business resiliency. Manual processes work against that because they often mean that workers need to go to physical business locations to handle paperwork. That creates risk in today’s environment. Intelligent automation frees people and organizations from on-site, paper-based manual processes and instead relies on processes that are better suited to today’s digital, distributed, remote work world. IA also scales, as needed, to adjust to changing circumstances.

The time has come for insurance companies to look at ways to improve their operational processes through technology innovation. IA has the capabilities to help insurance practitioners to do business much faster, more efficiently and with greater security.


Asheesh Mehra

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Asheesh Mehra

Asheesh Mehra is co-founder and group CEO for AntWorks, which has successfully deployed integrated automation solutions in insurance across claims, commercial, employee benefits, life and more — across all regions in multiple languages.

Epic Policy Failure on Contractors

California is making a mess as courts, the legislature and possibly voters sort out who qualifies as an employee and who as a contractor.

“The rest, in swarms, will overrun the boat deck

They'll lose all sense of right and wrong

It will be every man for himself, all right!

The weak thrown in with the strong!”

Titanic, A New Musical (1997)

On April 30, 2018, the California Supreme Court issued its opinion in Dynamex Operations West, Inc. v. Superior Court (2018), 4 Cal. 5th 903. The court filled a void, in its view, of how to determine whether someone was an employee subject to wage orders of the Industrial Accident Commission.

Even before the ink fully dried on this monumental opinion, the California legislature sprang into action. Assembly Bill 5 (Gonzalez) was introduced on Dec. 3, 2018, to codify this new rule of law and to expand its “ABC test” to unemployment and workers’ compensation. From that effort then sprang a comical – or tragic, depending on your point of view – effort by a multitude of businesses to gain a reprieve from the ABC test, which was adopted by the court without legislative blessing, or even at the urging of the parties in the litigation, in an effort to curb the abuses of misclassification of workers as independent contractors.

AB 5 granted various forms of absolution to a multitude of businesses. Some achieved an appropriate complete exemption from the now-codified ABC test. Others are now compelled to go through various requirements to achieve dispensation, some requirements either being hopelessly ambiguous or impossible (or meaningless) to comply with. Still others were left outside the cathedral doors (also known as the Capitol in Sacramento) in hopes that their petitions for relief would be heard.

The ABC test as codified and amplified by AB 5, now Labor Code § 2750.3, is a complicated set of outright exemptions, quasi-exemptions and – as was seen with the case of various freelance artists and writers – exemptions that were illusory in the face of the reality of such work. The freelancers began an aggressive campaign last fall to get the law changed in 2020. In some respects, their efforts are succeeding.  

When the legislature returned in 2020, there were dozens of bills introduced to delay, modify or outright repeal AB 5. Most were by Republican authors, and most were never heard in policy committees: the Assembly Labor and Employment Committee or the Senate Labor, Public Employment and Retirement Committee. Today, changes to AB 5 will have to come from two bills by the same author, Assemblymember Lorena Gonzalez (D- Dan Diego), who is also the author of AB 5. The first bill is Assembly Bill 1850 (Gonzalez), the second Assembly Bill 2257 (Gonzalez). Both bills are moving in the legislative process. AB 2257 specifically deals with the issues raised by freelancers. According to the analysis in the Assembly Labor and Employment Committee, California Freelance Writers United supports the measure, as do many others in the art, music and content-creation industries who use freelance workers. And, per the analysis by the Assembly Labor and Employment Committee, Assemblymember Gonzalez intends to add an urgency clause to AB 2257, meaning that it would become effective on signature by the governor and not upon Jan. 1, 2021. And so, freelancers achieved their objective.

AB 1850 includes the same language as AB 2257, at least for the moment. It also contains much more. This includes rewriting and reorganizing Labor Code § 2750.3 and adding still more exemptions from the ABC test. 

As proposed in AB 1850, there are nearly 50 occupations or business relationships that are not subject to the ABC test in Labor Code § 2750.3. Some of these exemptions are based on occupations, some on occupations provided that certain criteria are met and some on business-to-business or referral agency relationships. Many of these exemptions will require a careful analysis by a business if they are to be sure of passing muster with the labor commissioner, the Employment Development Department (EDD) and workers’ compensation insurance company premium auditors. The exemptions, in one form or another, maintain the venerable multi-factor test in S. G. Borello & Sons, Inc. v. Department of Industrial Relations (1989) 48 Cal.3d 341 or, in the case of occupations where the legislature augmented this standard, what is now called “Borello +.”  

See also: How to Lead and Collaborate in Claims  

The business-to-business exemption remains inscrutable and should particularly cause persons involved in a franchise relationship great concern even as the applicability of Dynamex to franchises remains the subject of significant litigation. The problem remains that, while the relationship between a worker and a business service provider is governed by the ABC test, the statutory language in Labor Code § 2750.3 refers to the degree of control of the contracting business over the business service provider and not the employees of the business service provider. This seemingly obvious distinction was not clarified by the Sept. 13, 2019, letter from Assemblymember Gonzalez to the Assembly clerk trying to explain on the one hand whether a business service provider was an employee of the contracting business while also stating that nothing in AB 5 was intended to change the laws relating to joint employment.

The claimed abuses of application-based drivers and service providers have frequently been cited as the raison d’être for AB 5. There is a battle in the California courts over the classification status of workers in the digital marketplace. Most recently, on May 5, 2020, in People of the State of California v. Uber Technologies, San Francisco County Superior Court No. CGC20584402, California Attorney General Javier Becerra and several city attorneys stated:

“But rather than own up to their legal responsibilities, Uber and Lyft have worked relentlessly to find a work-around. They lobbied for an exemption to A.B. 5, but the legislature declined. They utilize driver contracts with mandatory arbitration and class action waiver provisions to stymie private enforcement of drivers’ rights. And now, even amid a once-in-a-century pandemic, they have gone to extraordinary lengths to convince the public that their unlawful misclassification scheme is in the public interest. Both companies have launched an aggressive public relations campaign in the hopes of enshrining their ability to mistreat their workers, all while peddling the lie that driver flexibility and worker protections are somehow legally incompatible.”

This lengthy polemic is another way of saying Uber and Lyft (among others) have gone and filed an initiative to deal with the classification issue. Well, shame on them.

On May 22, 2020, the initiative, “Protect App-Based Drivers and Services Act," became eligible for placement on the November 2020 ballot. If it is not withdrawn by June 25, the voters of California will decide whether app-based workers, such as those for Uber or Lyft, are employees or independent contractors. The issue, as you might assume, is clearly more complicated than that, given the various requirements in the initiative necessary to qualify for an exemption to the ABC test.

See also: 4 Key Changes to WC From COVID-19  

It is safe to assume that the initiative polls very well with the public. It also is likely to pass.

So, by next year, the ABC test, “… whose objective is to create a simpler, clearer test for determining whether the worker is an employee or an independent contractor,” (Dynamex, 4 Cal. 5th 951, fn. 20) will have dozens of exemptions acquiesced to by the legislature and, likely, an exception that nearly overwhelms the rule should the initiative pass on app-based drivers and service providers. 

Why are we doing this? It is an epic public policy failure to suggest the only distinction between an entrepreneurial worker and an exploited one is whether 21 senators, 41 Assembly members and one governor in Sacramento decide to issue a pass. It may be too late to reset the dialogue in California on this issue, between court challenges and, potentially, a successful ballot measure. It is not too late elsewhere, including in Congress.


Mark Webb

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Mark Webb

Mark Webb is owner of Proposition 23 Advisors, a consulting firm specializing in workers’ compensation best practices and governance, risk and compliance (GRC) programs for businesses.

3-Step Framework to Manage COVID Risk

Insurers need a comprehensive yet customizable approach to assess operational risk quickly and dynamically and chart responses to COVID-19.

For insurance leaders, the full impacts of the COVID-19 pandemic will unfold over the coming months, but the rapid evolution of the crisis is forcing organizations to constantly evaluate how they are responding today.

Realistically, most business continuity procedures will prove inadequate. Very few would have planned and provided for a global crisis that kept virtually all of their workforce sequestered at home for weeks or months. Because there is no proven methodology for what we’re navigating today, organizations are having to collaborate virtually, sometimes on a global scale, to rapidly adapt business operations, frequently and simultaneously across several businesses on very short time cycles. Some solutions will succeed, and some will not. Others might not work until conditions change. Also, business decisions driven by the current situation will create unexpected demands on operation risk management. For example, several insurance carriers announced premium credits to their auto policyholders due to a significant drop in usage. Such decisions will require an ability to process large volume of one-time transactions, in a controlled yet customer-friendly manner.

In these conditions, insurers need a more comprehensive yet customizable approach to assess operational risk quickly and dynamicly and chart responses to COVID-19. 

Organizations should undertake a three-step approach to better understand the impact of the coronavirus on their operations, identify high-impact and high-priority areas, assess new and increased risks and develop actions to address business critical priorities.

Assess

Companies should use an integrated process-health check that brings together business continuity process and crisis management teams to define and implement targeted response decisions. A thorough assessment will identify gaps specific to the current pandemic, as well as heightened or new risks.

Some of the factors that have increased risks under COVID-19 and affect processes include:

  • Dependency on technology that is less effective when working from home 
  • Activities that require physical interaction, such as check printing and mail rooms 
  • Activities that rely on in-person interactions and meetings
  • Numerous process handoffs, particularly across functions 
  • Regulatory constraints such as time-sensitive and mandatory requirements

Insurers must quickly document processes severely affected by the current crisis and identify areas with a high number of manual touch points and mandatory in-person interactions. Companies need a framework agile enough to provide leaders with increased visibility into their processes, including changes to daily tasks, implications for working remotely and identifying tasks that cannot be handled without manual intervention. The right framework should also highlight regulatory risks for non-compliance and potential impact on quality assurance procedures.

Using strategies such as a lightweight, questionnaire-based approach, leaders can gather insights into their processes that account for the impact of COVID-19 in two to three business days and require minimal time from process owners. Responses to a well-designed questionnaire will not only identify process gaps specific to the current crisis but will also find candidates for future improvements and innovations. 

See also: Rethinking Risk Management in a COVID-19 World

Align

A centralized and purpose-based response structure works best to solve company-wide issues for many carriers. Key decisions related to organizational priorities, customers, employees and costs must be made in the face of uncertainty and incomplete information. Central ownership and accountability in the form of a dedicated response team will ensure a consistent, iterative approach and effective risk management.

The right framework captures this information and ranks it from both business criticality and risk perspectives. Once risks have been identified and prioritized, operation leaders should align on potential scenarios and recommended solutions. While recommendations will vary across organizations and functions, they will typically include:

  • Identify processes that have changed during COVID-19 and implement new process steps on an interim basis. Rapidly create or update existing process map documentation and communicate this information to relevant stakeholders
  • Identify new risks, controls and testing procedures. Develop plans to reinforce controls that have been relaxed in any transitions to work-at-home
  • Identify and recommend changes to employee responsibilities including deprioritizing non-business critical activities, and the strategic navigation of key business continuity process resources
  • Supplement processes with additional collaboration tools to enhance remote work output, such as digital check printing solutions, document sharing tools and other interventions.

Business leaders know they need to act now instead of waiting to design the perfect solution. Senior executives should communicate to business units and function leaders a broad outline within which solutions should be developed. Such guardrails are usually based on the organization’s vision, culture, business critical requirements and other non-negotiables. Then, the focus of operations leaders must turn to segmenting the overall organization response strategy into actionable plans for their responsibility areas. Clearly, action plans should be detailed enough to include ownership, timelines and measurable, expected outcomes.

Adapt

Response managers must also establish feedback loops to monitor the efficacy of their response strategy and tweak it as required. New challenges will emerge. Unanticipated situations will develop, and a significant percentage of responses will at least partially fail to meet their objective. In these scenarios, an agile, test-and-learn approach allows leaders to adapt to changing requirements as quickly as possible. Following are a few agile principles that would allow leaders to strike a balance between business support and risk management, and move forward with speed:

  • Build and deliver working solutions, with a preference to short time cycles 
  • Learn and change. Be creative and promote non-standard solutions 
  • Set up cross-functional and diverse response teams 
  • Clearly define ownership and outcome expectations 
  • Hyper-track progress, using frequent touch points

Every crisis presents opportunities, and some companies will come out of this crisis stronger. Post-crisis, speed and agility to adapt will differentiate the leaders from laggards in this new normal. According to a McKinsey study, companies that managed the 2008 financial crisis with speed, discipline and resiliency saw 30% increases in revenue and big reductions in operating costs during the recovery. 

See also: 7 Biases Customers Have About Risks  

There is an opportunity to accelerate an agenda advancing the future of work as companies consider an environment that promotes virtual teams, provides online collaboration tools to employees and uses digital operational capabilities to supplement human workers. As operations stabilize and the new normal takes hold, the response team should pivot and identify opportunities to continue to transform. This will allow companies to leverage learnings from the current crisis and build stronger crisis response capabilities.

An adaptive risk assessment framework approach requires a strong alignment among functional and operations leaders. It also requires a status cadence that allows a quick rollout of actionable recommendations, rapid reviews of their impact with process owners and the ability to course correct frequently. 

Notes From Germany on COVID's Lessons

We must completely say farewell to the antiquated ways and rigid mechanisms of everyday office life as we knew it.

Many people over here in Europe are tired of hearing the phrase "opportunities from the corona crisis." Especially because nobody knows how the pandemic will continue to play out. Nevertheless, an aspect is emerging that strongly affects the economy and our industry. The new world of work is no longer fiction but reality. 

What will the world of work look like in a few months?  

It is clear to everyone involved (employers and employees) that there will be enormous changes. We will completely say farewell to the antiquated ways and rigid mechanisms of everyday office life as we knew it.
There is a preliminary study in Germany by the Fraunhofer Institute for Applied Information Technology FIT, which launched a home office survey on the internet in April 2020.

The results are astonishing: 80% of those surveyed (79% of women and 85% of men) are satisfied with working from home. However, social and professional exchanges between colleagues and the support and solidarity within the team were rated rather poorly.

What does this mean for a company in the insurance industry?

In the future, my company wants to permanently offer the home office model for 30% of all employees and expand online sales formats such as trade fairs, webinars and roadshows rapidly. Employees will be happier, and the company will save on office space and travel expenses. In travel costs alone (trade fairs, events and seminars), we expect to see a decrease of around 60% to 70%.   

The additional financial resources thus gained would offer flexibility for investment in digital infrastructure and in training. That will be money well spent.

A further advantage: With this modern working model, OCC can attract talent and specialists throughout Germany and the rest of Europe. Nobody has to move to our headquarters (located in the beautiful, but a little remote, city of Lübeck) to work for us any more. Nobody has to give up his group of friends or uproot children from familiar surroundings just to move for a job. There is more time for the family; satisfaction and productivity also increase.

Many bosses certainly wonder how to measure productivity when they no longer see the employee at work. We need to get away from antiquated thinking: Superiors still often measure performance by attendance and working hours rather than by the actual result. In some areas, even time clocks are still in use. But there are better ways to monitor employees.

The well-known German entrepreneur and startup investor Carsten Maschmeyer recently said that people who are not productive in the office are not productive at home, either. He nailed it. I think that working from home unleashes creativity. We need creativity and innovation to survive in a market that is constantly changing.   

See also: COVID-19’s Once-in-a-Lifetime Opportunity  

Besides, commuters spend an average of 46 hours a year in traffic jams, according to a recent analysis by Inrix. That's almost six complete working days -- or holidays. The economic damage is running into billions. The damage to the environment caused by harmful emissions is serious. 

In Germany, we have the problem that rents have skyrocketed in urban areas. This means that more and more people are moving to the countryside or to small towns where rents are still affordable. But it also means that they often have to accept traveling long distances to work. Working from home will solve such problems for many.

We are currently preparing the first online trade fair for classic cars in Germany, which will start on June 19. There has never been an online trade fair for classic cars like this before. In April, we launched the first webinars for our brokerage partners, which were very well received. We will continue to expand these types of customer loyalty events,. A minimum amount of technical and financial investment is required, and the return is very high in terms of corporate image, knowledge transfer and competence. 

See also: COVID-19 and Need for Decision Intelligence  

Let me think a bit further, maybe even dream a little. Wouldn't a company be more powerful as an underwriting agency if it had not just one large head office but many small branches? These would then be the new home offices of our employees. Many small OCCs instead of one large, central office. All offices connected to each other with the latest IT as if in a neural network where everything comes together and is distributed. 

Hopp-de-Bäse! That is Swiss German, and it means: Let's go!


Désirée Mettraux

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Désirée Mettraux

Désirée Mettraux is CEO of classic car insurance specialist OCC Assekuradeur in Germany. OCC is the market leader in the DACH region for the insurance of classic vehicles.

4 Ways AI Helps Insurers Thrive

AI can change the traditional siloed mindset to one that engages employees, encourages innovation and promotes collaboration.

Artificial intelligence (AI) is one of the most transformative technologies of our time. According to Statista, the global AI software market is expected to grow approximately 154% year-on-year, reaching a forecast size of  $22.6 billion by 2025. As AI grows to permeate seemingly every industry, there’s an opportunity for the insurance industry to leverage AI in day-to-day business operations and to improve the overall customer experience. 

For starters, insurance is a data-driven industry. Advanced technology like AI allows insurance companies to maximize the value they derive from that data. With the right technology, insurance companies can change the traditional siloed mindset to one that engages employees, encourages innovation and promotes collaboration both internally and externally. Insurance companies can thrive in four key areas of their business operations. 

Improve recruitment and retention

Organizations can use AI in recruiting efforts to maximize retention and speed up the process. In fact, according to a recent study, 96% of senior HR professionals believe AI has the potential to greatly enhance talent acquisition and retention. Additionally, it takes an average of 13 hours per week for recruiters to sift through applications to find the right match. Using AI, hiring teams at insurance companies can use data to better match skills with job descriptions to recruit the most qualified candidates. 

Enhance the customer experience

As more insurance companies begin implementing AI, they see the underlying effect it has on their customers’ experience. With the integration of AI comes opportunities for teams to use data to improve the customer experience. 

For example, insurance companies may receive hundreds, if not thousands, of calls per day from customers with questions on filing claims or finding the best quote. Companies can eliminate the need to wait on hold for the next available agent by using AI-powered chatbots and virtual assistants to answer common customer service questions. Additionally, the benefits trickle down to employees, because it’s nearly impossible to be “on” all the time answering customer inquiries around the clock. Companies can lean on AI for common issues, leaving human resources to address more pressing requests or those that require a “softer” touch. This allows customers to feel heard anywhere in the world, all day, every day. 

See also: A Quarantine Dispatch on the Insurtech Trio  

Save time on claims processing and underwriting services

AI can also help insurance companies speed up and streamline their claims processing and underwriting services. On average, an insurance company needs about one to two days to receive and process a claim. Nowadays, most insurance companies have created an app for their customers to use in case they get into an accident. A driver can upload an image of the damage and talk to a representative with the click of a button. AI can expedite the claims process and spot inconsistencies –– which provides teams and customers with peace of mind.

Use data to discover underlying commonalities

AI also enables insurance companies to quickly pull up a customer’s information when the person calls. AI collects and stores data about the customer and allows insurers to better understand why the customer is calling based on previously gathered data or reoccurring requests.

Additionally, insurers can use AI to uncover any underlying customer patterns. A sales team can then better predict customer spending and adjust pricing and product recommendations in a timely manner.

AI is poised to disrupt the industry like never before for both insurers and their customers. AI helps the insurance industry put massive amounts of data to optimal use, which in turn can improve the bottom line and transform business processes. It’s only a matter of time before insurance companies rely solely on AI to give them a competitive advantage in today’s marketplace while setting them up for long-term success.

Loss Prevention or a Trojan Horse?

"Ecospheres of prevention" sound great, but they may just be a way for insurers to use, say, leak detection devices to gain leverage on clients.

A buzz phrase gaining momentum in the insurance market at the moment is "ecospheres of prevention." It’s about using smart devices to monitor for signs of impending loss events, and to then signal that to policyholders. For policyholders, this means events relating to your health, your house, your car and other such life contexts. It’s exciting stuff, a harbinger of a new insurance that focuses on preventing losses rather than simply paying out for them. Yet it is replete with issues of ethics and power, which I’ll explore in this post.

I should start by making clear that I’m a big fan of loss prevention. I spent several years immersed in the commercial side of it early on in my insurance career, with qualifications to match. Later on, I often got involved in related negotiations for personal lines policyholders with particular needs. So the idea of an ecosphere of prevention rings a bell with me.

The more I looked into this phrase, though, and weighed up the sector drivers being messaged around it, the more that bell began to sound like one of warning. Might I perhaps be over interpreting a trend still in its early stages? I think not, for it is already influencing the shape of insurance products and services. And, as academics often remind me, if what you see now seems still to be taking shape, address it now, for you’re almost certainly seeing only the tip of the iceberg.

Not Something New

These ecospheres of prevention are being used to position the sector as taking the lead in reducing losses. Yet is that really the case? It’s a mixed record.

On the one hand, personal policyholders have been calling for a long time for some form of recognition for taking the initiative on loss prevention. The sector’s response has instead been to position loss prevention measures as policy endorsements for above average risk properties, such as with locks for theft cover. Anything that didn’t fit into such endorsements was ignored, the argument being that there just weren’t the premium levels in, say, household insurance to warrant meaningful reductions.

On the other hand, the sector would argue that it was accepting that above average risk property at market rates because of that locks endorsement. In effect, this gave an inbuilt reduction in premium from what would otherwise be an exorbitant (go away) price. There’s some mileage in that, but I think in overall terms the personal lines market has seen loss prevention measures in a pot half empty way, despite policyholders urging a pot half full approach.

What I believe this adds up to is that it is not the financial dimension that has moved the retail insurance sector down this ecosphere of prevention road. The underlying, substantive reasons can be summed up as power and data.

The EOW Problem

I’m going to focus now on one particular use to which this ecosphere of prevention is being put, and that is around the "escape of water" peril, henceforth referred to as EOW. The last few years have seen a noticeable increase in debate about what is often referred to as the escalating problem of EOW claims.

It’s been explained to me that this is down to the age of what is being insured. Our housing stock is getting older, and the pipe work in it is just as bad. To this can be added the financial pressures that many families have faced since the financial crisis of 2008. The result is houses having pipe work that could be past its "best by" date. It’s an interesting narrative, with some mileage in it, but I’m not totally convinced that this seeming eruption of dire pipe work is so new a problem as it’s made out to be.

See also: COVID-19’s Once-in-a-Lifetime Opportunity  

It doesn’t help that, so often, the chatter in the trade press about the EOW problem takes the form of sponsored articles co-written by an insurer and its leak detection partner. Not hard to see a rather massive conflict of interest there. So I’m prepared to give little more than a nod to this narrative, until some serious, independent data and analysis is available.

Enforcing an Old Policy Warranty

The narrative we actually hear little to nothing of is that of policy warranties. Every property policy has a maintenance warranty, requiring the policyholder to keep the property in good repair. If the policy holder doesn't, then the claim is likely to be turned down. After all, why should insurance pay for that lack of proper maintenance?

The problem, however, with the maintenance warranty is that it has not always been easy to enforce, and only then in an "after the event" situation. The sector felt it was invariably going to be on the defensive, only able to apply the warranty in the most extreme cases.

And this is where leak detection devices came in. Installed in the home, these devices signal to the policyholder and the insurer that a leak has happened, and, if the device is sophisticated enough, turn the water off automatically before much damage is done. Great, you may think, but remember that that device now puts the insurer in a much stronger position in terms of how it uses that maintenance warranty.

Able to detect even a dripping tap, the data streaming to the insurer now equips it with an evidence base for assessing the extent to which a loss was down to lack of maintenance or an insured event. It allows the insurer to apply the maintenance warranty earlier and more confidently. And it is the policyholder who then has to argument for the warranty not to be applied and the claim covered. Power has swung most definitely in the insurer’s favor.

A More Telling Narrative

Yet what’s wrong with that? many insurance people will ask. If the loss was down to maintenance, then great, the sector no longer has to pay out for the policyholder’s inadequate upkeep of the pipe work. And I recognize that argument, but then interpret it against the context of a wider and more telling narrative.

Consider what one leading European device manufacturer said recently about a partnership with an insurer: “We have created a blueprint for the introduction of water safety systems on a large scale to limit the risks for insurers.” And this from the same source: “a complete solution to eliminate the biggest cost driver in home contents insurance: water damage.”  

That is the language of business performance. It is not the language of loss prevention. This is about deploying devices with the aim of “eliminating” EOW claims. And in the process, pushing the cost of those leaks onto the policyholder.

Again, I hear insurance people say, what’s wrong with that? We don’t pay for maintenance; it’s the policyholder who should. That’s right, but that’s a position predicated on a number of attributes about that device, about the data streaming from it, about the analytics analyzing it and about the human or system assessing it. Accuracy is one of them, the best interests of the customer another, and several others lie in between. The opaqueness with which these ecospheres of prevention are assembled makes it hard to just go along with the apparent efficacy of the decision chain set up by these devices. This brings us to the data that such devices produce.

Data Harvesting

Leakage device manufacturers often talk about how well their product can detect even a dripping tap, and about how well it can interpret the incoming signals. Some talk about tracking patterns of behavior within the house, simply through water use. This is more than a lot of flushing in the morning and evenings. It's about harvesting lots of data and using it to anticipate behaviors. This is hydraulic modeling and inferential analytics, using machine learning for anomaly detection. What’s more, it may not even be personal data. Inferential analytics bypasses the need for it.

What all this points to then are property utilities supporting lifestyle monitoring, through devices trained to detect down to the level of a drip of water. This is not an ecosphere of prevention. It is an "infosphere of assessment." In other words, the house as an informational environment, used by insurers to identify business opportunities.

This could put insurers onto a tightrope of compliance. The senior managers and certification regime requires U.K. insurers (and European insurers by similar directives) to always act in the best interests of each customer. The accountability risk that’s present here is in the form of a gross/net gap, between what insurers say and what they do. In other words, the actual outcomes that result.

That risk is going to become much more tangible for senior management functions as supervisory technologies are put to judging the outcomes emerging as a result of gross/net gaps like this. The reason for turning those supervisory technologies onto something as apparently mundane as escape of water detection is that it is just one of a series of devices being promulgated by insurers across health, life, motor, commercial equipment and household portfolios.

This device-led "infosphere of assessment" should be a central part of a regulatory review of data ethics in the insurance sector. While the current pandemic has delayed the FCA’s data ethics review, it has also allowed the regulator to weigh up the implications of device-driven insurance even more carefully. Insurers should do the same.

A Divided Market

Let’s move on and look at another aspect of this situation, again using EOW losses as an example. Leak detection devices fall into two categories. At the cheaper end, they detect but don’t turn off. At the more costly end, they do both.

At the more costly end, Grohe’s Sense Guard retails at around £400 and is being marketed by insurers to more affluent customers, for example those with second homes. Fine, but that could still be a tough sell in terms of value, even before you add in the cost of all the sensors. Yet that value needs to be seen relative to devices at the lower end of that cost spectrum (the ones that detect but don’t turn off).

What emerges is a near future that could look something like this: Affluent customers will be required to install a "detect and turn off" device in their second homes. They will also be encouraged financially to install a "detect and turn off" device in their main home, and in return get continuing EOW cover, probably a lower excess and several frills as part of the package.

Less affluent customers could face this choice: either a) install a detect only device and get some cover, but with a high excess, or b) with no device, face higher excesses, less cover and a firmer handling of that maintenance warranty.

See also: Step 1 to Your After-COVID Future  

This is in effect moving the risk (and cost) of most EOW claims over to the policyholder. Of course, that’s not how this whole EOW movement wants to portray it, preferring instead to use words like water safety and water guard. In particular, the emphasis is on the reduction in losses as an all-'round good thing (which it is), rather than the reduction in cover, which is not a good thing.

The point, however, is this: If reasonable levels of EOW cover are only available in a device-oriented medium- to high-net-worth market, then the broad insuring public will feel let down. Times two. Stratification of the household market will step up, with actual cover (as opposed to loss prevention offers) being, for most people, harder and harder to acquire.

Summing up

The EOW water debate is moving in directions that risk undermining trust in the sector. In considering how to position themselves in relation to that debate, insurers might want to start with a small survey. At the next board meeting, ask each of the directors to confirm (anonymously, of course) whether, in the last five years, he or she has had their home’s pipe work tested and repaired by a competent trades person, for no other reason than it seemed about time to do so? Then ask the same question of technical underwriters, and this time ask them to evidence it.

I suspect few in either group will have done so. And that should tell you something. Is it asking too much of the sector, as the saying goes, to align the talk with the walk?

EOW has been a standard peril for so many, for so long, that something more imaginative, more innovative than so-called ecospheres of prevention is needed. Yes, engage in any necessary reform of EOW cover and the maintenance warranty. No, don’t use leak detection devices as a Trojan horse for household data.

Bring your customers with you: It will be worth it in the end.

You can find the article originally published here.


Duncan Minty

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Duncan Minty

Duncan Minty is an independent ethics consultant with a particular interest in the insurance sector. Minty is a chartered insurance practitioner and the author of ethics courses and guidance papers for the Chartered Insurance Institute.