Is Insurtech a Game Changer? It Sure Is
Some insurers may think they’ve dodged a bullet. But insurtech’s threat is more stealthy, and no less powerful.
Some insurers may think they’ve dodged a bullet. But insurtech’s threat is more stealthy, and no less powerful.
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Marie Carr is the global growth strategy lead and a partner with PwC's U.S. financial services practice, where she serves numerous Fortune 500 insurance and financial services clients.
Over more than 30 years, her work has helped executive teams leverage market disruption and innovation to create competitive advantage. In addition, she regularly consults to corporate boards on the impacts of social, technological, economic, environmental and political change.
Carr is the insurance sector champion and has overseen the development of numerous PwC insurance thought leadership pieces, including PwC's annual Next in Insurance and Top Insurance Industry Issues reports.
Companies and boards are increasingly expected to focus on environmental, social and governance (ESG) issues, such as climate change.
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Laura F. Coppola is regional head of financial lines for Allianz Global Corporate & Specialty in North America.
The future of insurance is not going to be about making buying insurance fun; it will be about making insurance disappear.
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Matthew Grant is the CEO of Instech, which publishes reports, newsletters, podcasts and articles and hosts weekly events to support leading providers of innovative technology in and around insurance.
As John F. Kennedy said, "There are risks and costs to action. But they are far less than the long-range risks of comfortable inaction.”
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Mike Manes was branded by Jack Burke as a “Cajun Philosopher.” He self-defines as a storyteller – “a guy with some brain tissue and much more scar tissue.” His organizational and life mantra is Carpe Mañana.
This article by Lemonade co-founder and CEO Daniel Schreiber tackles a profound issue for insurance and offers an innovative solution. The article suggests a smart way to watch for bias hidden in algorithms and to correct for it. In the process, Daniel provides an opening toward a holy grail: being able to price risk accurately for each individual.
The article is well worth your time. We're delighted to be able to share it with you and hope you'll share it, too. The change will require support not just from incumbents and insurtechs but also from regulators, whose structures, as Daniel notes, are reasonably friendly in Europe but would require more adaptation in the U.S.
I won't describe in any detail what Daniel calls his "uniform loss ratio" test, which makes sure that AI-based pricing for individuals produces defensible results for every group when losses are measured against pricing at the group level. But I want to build on his proposed test and explore the implications for how we'll all need to adapt to a world of much more individualized pricing of risk.
First, consider the technical requirements that must be met. Specifically, the data requirements will necessitate a continuous re-examination of privacy issues. The industry is already facing legislation designed to prevent an insurer's access to specific, individual data. A few in the public policy sector have taken this to an extreme by introducing legislation that would deny consumers even the option to voluntarily share data with their insurer for their own benefit.
Second, the more data that is aggregated by any organization, the more it becomes a target for bad actors. While all insurers ferociously protect their customers' data, the convergence of the required new computational capabilities and vast array of data raises the bar on cyber security significantly.
Third, basing premiums on an individual's risk profile will intensify the spotlight on operational expenses. As insurers zero in on an individual's risk, that individual will have more transparency about the process and will tend to sign on with whatever insurer can cover his or her risk at lowest cost.
Fourth, how will customers react? The move to individualized pricing creates huge opportunities for innovation, but consumers need to participate in the development. Would we not want consumers to have a choice between traditional, segmented, pricing and the new, individual pricing?
The benefits of individualized pricing are clear. If we can be sure to avoid bias, we can take advantage of the full array of capabilities of artificial intelligence. And the "uniform loss ratio" test can get rid of the "ghosts in the machine": biases that are unintentional but that are currently unrecognized and unavoidable given the limitations of our data and computational capabilities. We can then democratize access to services and products and accelerate the move away from ratings and recovery and toward preventing risks.
The journey from here to there:
Might as well get moving, right?
Regards,
Guy Fraker
Chief Innovation Officer
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Insurance Thought Leadership (ITL) delivers engaging, informative articles from our global network of thought leaders and decision makers. Their insights are transforming the insurance and risk management marketplace through knowledge sharing, big ideas on a wide variety of topics, and lessons learned through real-life applications of innovative technology.
We also connect our network of authors and readers in ways that help them uncover opportunities and that lead to innovation and strategic advantage.
This article by Lemonade co-founder and CEO Daniel Schreiber tackles a profound issue for insurance and offers an innovative solution. The article suggests a smart way to watch for bias hidden in algorithms and to correct for it. In the process, Daniel provides an opening toward a holy grail: being able to price risk accurately for each individual.
The article is well worth your time. We're delighted to be able to share it with you and hope you'll share it, too. The change will require support not just from incumbents and insurtechs but also from regulators, whose structures, as Daniel notes, are reasonably friendly in Europe but would require more adaptation in the U.S.
I won't describe in any detail what Daniel calls his "uniform loss ratio" test, which makes sure that AI-based pricing for individuals produces defensible results for every group when losses are measured against pricing at the group level. But I want to build on his proposed test and explore the implications for how we'll all need to adapt to a world of much more individualized pricing of risk.
First, consider the technical requirements that must be met. Specifically, the data requirements will necessitate a continuous re-examination of privacy issues. The industry is already facing legislation designed to prevent an insurer's access to specific, individual data. A few in the public policy sector have taken this to an extreme by introducing legislation that would deny consumers even the option to voluntarily share data with their insurer for their own benefit.
Second, the more data that is aggregated by any organization, the more it becomes a target for bad actors. While all insurers ferociously protect their customers' data, the convergence of the required new computational capabilities and vast array of data raises the bar on cyber security significantly.
Third, basing premiums on an individual's risk profile will intensify the spotlight on operational expenses. As insurers zero in on an individual's risk, that individual will have more transparency about the process and will tend to sign on with whatever insurer can cover his or her risk at lowest cost.
Fourth, how will customers react? The move to individualized pricing creates huge opportunities for innovation, but consumers need to participate in the development. Would we not want consumers to have a choice between traditional, segmented, pricing and the new, individual pricing?
The benefits of individualized pricing are clear. If we can be sure to avoid bias, we can take advantage of the full array of capabilities of artificial intelligence. And the "uniform loss ratio" test can get rid of the "ghosts in the machine": biases that are unintentional but that are currently unrecognized and unavoidable given the limitations of our data and computational capabilities. We can then democratize access to services and products and accelerate the move away from ratings and recovery and toward preventing risks.
The journey from here to there:
Might as well get moving, right?
Regards,
Guy Fraker
Chief Innovation Officer
Get Involved
Our authors are what set Insurance Thought Leadership apart.
|
Partner with us
We’d love to talk to you about how we can improve your marketing ROI.
|
Insurance Thought Leadership (ITL) delivers engaging, informative articles from our global network of thought leaders and decision makers. Their insights are transforming the insurance and risk management marketplace through knowledge sharing, big ideas on a wide variety of topics, and lessons learned through real-life applications of innovative technology.
We also connect our network of authors and readers in ways that help them uncover opportunities and that lead to innovation and strategic advantage.
A "uniform loss ratio" test can eliminate bias in underwriting and open the way for truly individualized, AI-driven assessments of risk.

| Phase 1: | ![]() |
| Phase 2: | ![]() |
So while crude groupings may be statistically sound, Phase 2 might penalize low-risk men by tarring all men with the same brush.
The second problem is that—even if the groups don’t represent protected classes—responsible members of the group are still made to pay more (per unit of risk) than their less responsible compatriots. That’s what happens when you impose a uniform rate on a nonuniform group. As we saw, this is the textbook definition of unfair discrimination, which we tolerate as a necessary evil, born of practical limitations' But the practical limitations of yesteryear are crumbling, and there's a four-letter word for a "necessary evil" that is no longer necessary...
Which brings us to Phase 3.
| Phase 3: | ![]() |
Insurance Can Tame AI
It's encouraging to know that Phase 3 has the potential to make insurance fairer, but how can we audit the algorithm to ensure it actually lives up to this promise? There's been some progress toward "explainability" in machine learning, but, without true transparency into that black box, how are we to assess the impartiality of its outputs?
By their outcomes.
But we must tread gingerly and check our intuitions at the door. It's tempting to say that an algorithm that charges women more than men, or black people more than white people, or Jews more than gentiles is discriminating unfairly. That's the obvious conclusion, the traditional one, and—in Phase 3—it's likely to be the wrong one.
Let's say that I am Jewish (I am) and that part of my tradition involves lighting a bunch of candles throughout the year (it does). In our home, we light candles every Friday night and every holiday eve, and we'll burn through about 200 candles over the eight nights of Hanukkah. It would not be surprising if I, and others like me, represented a higher risk of fire than the national average. So, if the AI charges Jews, on average, more than non-Jews for fire insurance, is that unfairly discriminatory?
It depends.
It would definitely be a problem if being Jewish, per se, resulted in higher premiums whether or not you’re the candle-lighting kind of Jew. Not all Jews are avid candle lighters, and an algorithm that treats all Jews like the "average Jew," would be despicable. That, though, is a Phase 2 problem.
A Phase 3 algorithm that identifies people’s proclivity for candle lighting, and charges them more for the risk that this penchant actually represents, is entirely fair. The fact that such a fondness for candles is unevenly distributed in the population, and more highly concentrated among Jews, means that, on average, Jews will pay more. It does not mean that people are charged more for being Jewish.
It's hard to overstate the importance of this distinction. All cows have four legs, but not all things with four legs are cows.
The upshot is that the mere fact that an algorithm charges Jews—or women, or black people—more on average does not render it unfairly discriminatory. Phase 3 doesn't do averages. In common with Dr. Martin Luther King, we dream of living in a world where we are judged by the content of our character. We want to be assessed as individuals, not by reference to our racial, gender or religious markers. If the AI is treating us all this way, as humans, then it is being fair. If I'm charged more for my candle-lighting habit, that's as it should be, even if the behavior I’m being charged for is disproportionately common among Jews. The AI is responding to my fondness for candles (which is a real risk factor), not to my tribal affiliation (which is not).
So if differential pricing isn't proof of unfair pricing, what is? What outcome is the telltale sign of unfair discrimination in Phase 3?
Differential loss ratios.
The "pure loss ratio" is the ratio of the dollars paid out in claims by the insurance company, to the dollars it collects in premiums. If an insurance company charges all customers a rate proportionate to the risk they pose, this ratio should be constant across their customer base. We'd expect to see fluctuations among individuals, sure, but once we aggregate people into sizable groupings—say by gender, ethnicity or religion—the law of large numbers should kick in, and we should see a consistent loss ratio across such cohorts. If that's the case, that would suggest that even if certain groups—on average—are paying more, these higher rates are fair, because they represent commensurately higher claim payouts. A system is fair—by law—if each of us is paying in direct proportion to the risk we represent.
This is what the proposed Uniform Loss Ratio (ULR) test, tests. It puts insurance in the enviable position of being able to keep AI honest with a simple, objective and easily administered test.
It is possible, of course, for an insurance company to charge a fair premium but then have a bias when it comes to paying claims. The beauty of the ULR test is that such a bias would be readily exposed. Simply put, if certain groups have a lower loss ratio than the population at large, that would signal that they are being treated unfairly. Their rates are too high, relative to the payout they are receiving.
ULR helps us overcome another major concern with AI. Even though machines do not have inherent biases, they can inherit biases. Imagine that the machine finds that people who are arrested are also more likely to be robbed. I have no idea whether this is the case, but it wouldn't be a shocking discovery. Prior run-ins with the police would, in this hypothetical, become a legitimate factor in assessing property-insurance premiums. So far, so objective.
The problem arises if some of the arresting officers are themselves biased, leading—for example—to an elevated rate of black people being arrested for no good reason. If that were the case, the rating algorithm would inherit the humans' racial bias: A person wouldn't pay more insurance premiums for being black, per se, but the person would pay more for being arrested—and the likelihood of that happening would be heightened for black people.
While my example is hypothetical, the problem is very real. Worried about AI-inherited biases, many people are understandably sounding the retreat. The better response, though, is to sound the advance.
You see, machines can overcome the biases that contaminate their training data if they can continuously calibrate their algorithms against unbiased data. In insurance, ULR provides such a true north. Applying the ULR test, the AI would quickly determine that having been arrested isn’t equally predictive of claims across the population. As data accumulate, the "been arrested" group would subdivide, because the AI would detect that for certain people being arrested is less predictive of future claims than it is for others. The algorithm would self-correct, adjusting the weighting of this datum to compensate for human bias.
(When a system is accused of bias, the go-to defense runs something like: "But we don't even collect information on gender, race, religion or sexual preference." Such indignation is doubly misplaced. For one, as we've seen, systems can be prejudiced without direct knowledge of these factors. For another, the best way for ULR-calibrated-systems to neutralize bias is to actually know these factors.)
Bottom line: Problems that arise while using five factors aren't multiplied by millions of bits of data—the problems are divided by them.
The Machines Are Coming. Look Busy.
Phase 3 doesn't exist yet, but it's a future we should embrace and prepare for. That requires insurance companies to redesign their customer journey to be entirely digital and reconstitute their systems and processes on an AI substrate. In many jurisdictions, how insurance pricing is regulated also must be rethought. Adopting the ULR test would be a big step forward. In Europe, the regulatory framework could become Phase-3-ready with minor tweaks. In the U.S., filing rates in a simple and static multiplication chart for human review doesn't scale as we move from Phase 2 to 3. At a minimum, regulators should allow these lookup-tables to include a column for a black box "risk factor." The ULR test would ensure these never cause more harm than good, while this additional pricing factor would enable emerging technologies to benefit insurers and insureds alike.
Nice to Meet You
When we meet someone for the first time, we tend to lump them with others with whom they share surface similarities. It's human nature, and it can be unfair. Once we learn more about that individual, superficial judgments should give way to a merits-based assessment. It's a welcome progression, and it's powered by intelligence and data.
What intelligence and data have done for humanity throughout our history, artificial intelligence and big data can start to do for the insurance industry. This is not only increasingly possible as a matter of technology, it is also desirable as a matter of policy. Furthermore, as the change will represent a huge competitive advantage, it is also largely inevitable. Those who fail to embrace the precision underwriting and pricing of Phase 3 will ultimately be adversely selected out of business.
Insurance is the business of assessing risks, and pricing policies to match. As no two people are entirely alike, that means treating different people differently. For the first time in history, we’re on the cusp of being able to do precisely that.
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Daniel Schreiber is CEO and co-founder at Lemonade, a licensed insurance carrier offering homeowners and renters insurance powered by artificial intelligence and behavioral economics. By replacing brokers and bureaucracy with bots and machine learning, Lemonade promises zero paperwork and instant everything.
To fulfill insurtech's promise, insurers must get their heads around cognitive computing, big data and data exchange standards.
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Mike de Waal is senior vice president of sales at Majesco.
Climate change, the rise of new ecosystems and operating models and more inclusive insurance are looming.
As insurance executives look out for the industry’s next wave, they will see a paradox of great risk and opportunity. The most serious threats — societal megatrends, disruptive technology advancements and intensifying competition from both new and traditional players — also hold the greatest potential for growth and transformation.
As the strategic evolution of the industry accelerates, the most effective response for insurers is to harness the power of change and thoughtfully design their futures. They must develop their vision for the future and adjust their strategic and tactical plans to realize that vision.
Certainly, these recommendations apply to three of the top issues the industry faces — climate change, the rise of new ecosystems and operating models and more inclusive insurance. These are just a few of the trends and scenarios we explore in our recently released report titled, NextWave Insurance: personal lines and small commercial.
Climate change: Climate change is arguably the biggest challenge facing humanity today. For insurers, it also presents an array of new uncertainties that make pricing risk harder than ever. The potential impact of climate change on the insurance sector is staggeringly large. Just consider these numbers:
As storms grow more severe, insurers have a clear opportunity to offer increased protection to families, businesses and communities. Only 30% of catastrophic losses were covered by insurance between 2009 and 2018, according to Aon Benfield. It also estimates that there is a $180 billion global protection gap for weather-related risks.
Of course, insurers must be able to accurately model and price the risk of climate change if they are to collect more premium dollars. They must also understand the potentially detrimental impact of pricing customers out of the market and increasing the underserved community.
As societies around the world come to terms with the implications of global climate change, it’s clear that the insurance industry has a leading role to play in managing risk and offering protection. The earlier that firms grapple with and understand these complex climate-related risks, the more likely they are to derive value from them. Instead of waiting for perfect information, firms should take a flexible approach to this fast-moving topic and embed climate-related considerations into their decision-making.
The rise of ecosystems: Today’s insurance marketplace is hypercompetitive, with extremely tight margins, slow (if any) growth and high operating costs. The industry’s current economics are unsustainable, which means insurers need to rethink their business models.
See also: The Insurance Lead Ecosystem
Ecosystems, which entail multiple companies partnering to offer specialized, but complementary, services in mutually beneficial ways, are one way for them to enhance the value of their offerings. Ecosystems can take many forms — strategic partnerships, alliances, mergers and acquisitions and joint ventures. The cloud, artificial intelligence and new data sources are key to enabling the development of ecosystems and other new business models.
Early adopters and forward-looking insurers can capture market share by defining their role in the ecosystem relative to other types of entities (e.g., sharing platforms, social media, insurtechs, data providers, customer associations and business services). By connecting with insurtechs, leaders can rapidly add innovative technologies and enhance business processes and customer experiences. Ecosystems and other new operating models will spark innovation and change multiple parts of the business.
Direct, digital and embedded sales will become dominant channels for growth, and ecosystems can help position insurers to capture their fair share of revenue. Subscription models will make insurance more deeply woven into consumers’ everyday lives, clarifying the value insurers deliver.
Ecosystems are one example of how insurers will change both what they deliver and how they deliver it. And the industry appears ready to adopt these models; a full 76% of insurance executives view partnerships and ecosystems as determinants of a future competitive advantage, according to Swiss Re. Small and mid-tier carriers that lack focus and differentiation may find it hard to make the required investments in people and technology, while achieving their financial targets.
More inclusive insurance: Insurers are well-positioned to help protect the many underinsured consumers and businesses around the world. They must find ways to engage younger consumers — so-called “generation rent” — sooner. As these consumers wait longer to purchase vehicles (which they may never do), buy homes, get married and have children, their first interactions with insurers happen later in life.
See also: Opportunities and Risks in the IoT
Insurers must innovate with technology to engage and support the underinsured and other underserved markets. It’s worth noting how insurers in emerging markets exhibited great creativity in using mobile phones to provide microinsurance, asset-based coverages and embedded insurance purchases in their efforts to connect to the underinsured. These approaches are likely to succeed with the underserved and underinsured segments in mature markets, too. As carriers use greater amounts of information and advanced analytics, they need to be sensitive to pricing customers out of the market.
Seizing opportunity while navigating risk The fundamental question to ask is: Will growth opportunities outweigh the threats in the next wave of insurance? Insurers’ actions and investments in the next five to 10 years will determine if they maximize the upside of these opportunities or struggle with the downside.
The views expressed by the presenters are their own and not necessarily those of Ernst & Young LLP or other members of the global EY organization.
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Ed Majkowski is EY’s insurance sector leader for the Americas and is responsible for EY’s consulting businesses, markets and clients in this region.
Life and critical illness products protect policyholders from financial loss but until now have helped little on safeguarding customers’ health.
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Ross Campbell is chief underwriter, research and development, based in Gen Re’s London office.