If insurers want to mitigate risk, rather than risk their time and money with litigation, if they want to guard against fraudulent claims, if they want to protect good doctors against wrongful claims, then they should invest in sound legal counsel. Insurers should highlight the value of retaining healthcare lawyers with the intelligence to know—and the strength to do—what is necessary to defeat false allegations of fraud or abuse. A doctor’s career can hang in the balance when defending against a professional liability claim. Without sound counsel, our best doctors may not be able to practice medicine. Unless we work to stop fraudulent claims, or make it more difficult for fraudsters to enlist the government to pursue these claims, our healthcare system will continue to suffer. Stopping this injustice starts with healthcare lawyers in search of justice—namely, healthcare lawyers whose expertise doctors need. See also: Proof of Value for Medical Management   According to Fenton Law Group, which specializes in defending healthcare providers against allegations of fraud and abuse, the charges themselves have their own nuances and degrees of sensitivity. Take the firm’s representation of Dr. Alwin Lewis (Lewis v. Medical Board) before the Supreme Court of California, regarding a purported violation of a patient’s privacy rights. Because HIPAA prevents people from delving into personal medical records, an insurer cannot muster much of a defense without access to and knowledge of the very things that would exonerate a doctor from a wrongful claim. Bear in mind, too, that insurance companies often hire panel counsel to defend against claims of fraud. Which is not to say that all insurance companies put savings ahead of saving doctors from fraudulent claims. Given these circumstances, doctors need effective counsel. Insurers should, in turn, at least listen to what healthcare lawyers have to say about what constitutes a smart legal strategy. Perhaps elevating the role of defense counsel will benefit insurers, reducing the number of fraudulent claims by increasing the difficulty of bringing claims against doctors who have done nothing wrong. Perhaps hiring the right healthcare lawyers is the right thing do. Perhaps, indeed; but until then—until the honest unite against the dishonest—we need defense lawyers who can expose fraudulent claims and dismantle claims of fraud against innocent doctors. We cannot afford to do otherwise. Not if we want to preserve our healthcare system and protect our preferred providers of healthcare. We cannot afford to have insurers settle all fraudulent claims, either, because we will pay the price for these payouts in higher premiums and deductibles. See also: 4 Reasons to Join Agency Networks   The price will come at the expense of choice, leaving us with one of two choices: less affordable care or no care at all. We must avoid that false choice. We must have lawyers who champion our rights. We must have lawyers who defend the rights of doctors and healthcare providers. We must have lawyers who expand our rights. To have lawyers at the forefront of this cause is a good thing, an altogether just and necessary thing.

Globalization is affecting just about every business these days. Even if a company operates only in the U.S., its customers, suppliers and traveling employees may very well be in another country. That means the laws, regulations and cultural differences in those areas are likely affecting the organization. This increased globalization of businesses means risk managers must have more of a global focus. Managing risk on a multinational basis was one of our "Issues to Watch" for 2019, as many risk managers are looking for ideas and resources. To help us better understand the issue, we had four distinguished experts join us for our most recent Out Front Ideas with Kimberly and Mark webinar:

• Maggie Biggs, VP of insurance and risk management for VF Corporation
• Kevin Hoskinson, client executive of global risk management for Marsh
• Mary Roth, CEO of the Risk & Insurance Management Society
• David Stills, VP of global risk management for Walmart

Why It Matters Companies with no physical presence outside the U.S. are nevertheless affected by international regulations around issues such as data privacy. For example, the General Data Protection Regulation (GDPR), a law that regulates how companies protect the personal data of citizens in the European Union, caries stiff penalties for noncompliance. Businesses must be aware of the tenets of the law and adhere to them. Issues such as the expansion of the GDPR prompted RIMS to address the idea of globalization several years ago. With members in more than 60 countries, the organization was hearing that the risk management culture present in the U.S. was just not the same in other areas of the world. RIMS identified the Asia Pacific region as the area where it could truly make an impact by bringing in its resources. After surveying its members, the organization set up advisory groups that include people in risk management in the affected markets and is building programs there. Program Structure Setting up a risk management program in another part of the world depends on several factors, such as the country and its laws and regulations and the organization. While centralized and decentralized are the two basic models, many companies instead have a hybrid. A totally centralized model means all decisions are made at the corporate office. These decisions could include factors like the risks to retain in addition to which brokers and other partners to use. The other extreme is all decisions made within each country. Going completely one way or the other may be a mistake. Instead, our panelists said the process should be fluid and allow for changes in leadership. See also: Why Risk Management Is a Leadership Issue   A centralized decision-making model may be more balanced and less expensive. On the other hand, local regulations can complicate things. Communication barriers can also present problems, as one panelist explained. A simple question from a team member in Asia would not reach her desk for 12 hours; then it would go to the broker team and others. It could take a week before there was an answer. Program enhancements to address such hurdles that our panelists have tried include consolidating broker relationships into a single hub and ensuring the broker has local input to help place insurance with capable companies that meet the business’ needs. An important consideration in a program’s structure is premium allocations. Regulators and taxing authorities are finding that premium taxes can be a new revenue source. Regulatory officials are looking at what a company has in terms of exposures and requiring the business to justify that the premium is commensurate with the risk. For example, one panelist noted a situation with a client who sustained a large property loss in France but had not allocated any premiums specifically to that country. While the insurer was happy to pay the claim, it was difficult to determine whether shifting the money paid in the U.S. to a local French subsidiary constituted income or a gift, both of which were taxable. The issue can be complicated and expensive. Businesses should at least have an idea of how they might handle such a situation. Culture Addressing cultural differences is one of the most important things a risk manager can do, our panelists said. It’s critical to understand these differences and learn how to work within various cultures. For example, employees in some Asian countries may feel embarrassed or even ashamed to admit, let alone report, their injuries. Implementing safety strategies and incident reporting processes would need to be done in a way that respects that cultural difference. The typical challenges encountered by any business are that much more complicated because of language barriers, time differences, regulatory disparities and cultural variances. The key to overcoming these hurdles is solid communication and strong relationships with the company’s international partners. It is important to dispel the idea that the world revolves around the U.S. and how we do things here. That perception creates obstacles for businesses trying to work effectively in other countries. The theme of “Think globally, act locally” was endorsed by several of our panelists. It means adapting to local nuances and practices. Risk tolerance levels, for example, may be different in another country. Instead of dictating how things should work, it is better to get local input. There are also different applications of law in other countries. Negligence or leases, for example, may not have the same elements as in the U.S. It behooves a company to discover the local laws and how they are applied. Something as simple as communicating with international partners can be complex. Instead of email, for example, WhatsApp or WeChat may be the more popular mode of messaging. Risk Management Differences Companies need to be aware of risk management differences in countries outside of the U.S. Our speakers outlined several examples:

• Court system differences. There may or may not be a jury system. The class action mechanism may not be available in certain countries, creating a difficult environment for mass claims. The speed of the legal system may be incredibly slow, compared with the U.S.
• Adequacy of damages. Other countries have different perspectives on what is considered adequate. Some jurisdictions lean toward inflated awards that make no sense to us. Or, a company might not need the level of general liability coverage, for example, that it would need in the U.S.
• Deductible levels. In some countries, there is a strong preference to have first-dollar insurance. While that may not seem cost-effective, teams in some countries are responsible for their own profits and losses and can be severely affected by a large hit. In some cases, international policies for general liability will have zero-dollar deductibles, while other lines – such as property/casualty and directors and officers liability – have large deductibles globally.

Risk managers are used to reviewing contracts to ensure their company is protected from risks associated with a business arrangement. However, internationally there is a tendency to deal with those risks on a business basis rather than through insurance. Because of this, there may not be adequate insurance in place to cover risks. As an example, consider a manufacturer and supplier in China that does not buy the product liability coverage limits typically seen in U.S. contracts, but the part it makes is entering the U.S. market. There are situations where there was a large loss on a product in the U.S., and it basically shut down the Chinese company because the insurance coverage was inadequate. Additional Considerations Political risk and supply chain are two issues that can have a significant impact on global risk management programs. U.S./China relations of late have generated the risk of tariffs on Chinese-made products imported into the U.S. Likewise, there can be a backlash on U.S. brands sold elsewhere. A regulatory change could spark political unrest that causes damage or looting to a business. There is also the risk of local governments confiscating properly. See also: How to Improve ‘Model Risk Management’   A political uprising or natural disaster could devastate a company. The panel advised businesses to consider, for example, whether remote operations are warranted, or whether backup stock of products is necessary. Supply chain challenges related to theft can be a major concern for multinational companies, especially products traveling through Mexico and South America. There’s also potential risk to the security of the people moving the products. Monitoring the political climate of other countries, and lobbying where possible, is invaluable. Some companies do an annual deep dive evaluation of the risks in specific countries. While it may not be possible to manage all the risks, understanding what is happening can go a long way to protecting property and people. Available Resources Organizations looking for help to better understand and address global risk management issues can turn to RIMS for help. Since the organization embarked on its globalization efforts several years ago, it has developed a plethora of resources for risk managers. Under the Community section of the RIMS web page, you will find all their global resources. The link is HERE. To listen to the full Out Front Ideas webinar on Globalization of Risk Management, please click HERE.

Enterprise risk management (ERM) is often viewed as a bureaucratic and unnecessary process, subtly or overtly motivated by regulation, accompanied by internal risk leadership kingdom building and suggesting an unclear value proposition. Occasionally, these perceptions are correct, and ERM fails. Yet, there is hope for a successful ERM approach with the right motivations and when designed and implemented with the real business goals and culture of the organization in mind. This is when ERM becomes an invaluable approach to learning about and managing truly destructive risks. A successful ERM approach also creates a clearer lens for seeing and responding to emerging risks, including potential impacts, and helping to prioritize the more valuable solutions. The resulting ERM processes are, however, often fraught with hurdles, preventing many organizations from achieving a level of risk astuteness and maturity beyond ad-hoc decision making. Few risks affect organizations with the diversity, impact and pervasiveness of cyber. As we are now a truly internet-connected and -dependent world, few organizations escape material exposure to this ever-evolving risk and its wide range of impacts; fewer still seem to have effective plans for cyber risk mitigation or an ability to calculate the value “in play” gained, or not, from their cybersecurity strategies. This is not to say many organizations haven’t addressed or aren’t trying to address cyber risk. Beyond regulatory requirements, no effective governance structure today would allow management to ignore or not actively investigate this growingly complex enterprise-wide risk. Even so, why would cybersecurity become a clarion call for ERM? What role does ERM play in helping to solve the cyber dilemma, and to assess this critical cross enterprise risk? We are glad you asked. Every organization should approach risk management in a way that is effective for itself and its key stakeholders, both internal and external. This sounds good but, as mentioned, is hard to accomplish. ERM often means something much less than a comprehensive, multi-step framework and numerous processes addressing a full gamut of ERM components. ERM should at least mean, however, that those elements that most meaningfully contribute to solving the problem (i.e. understanding and controlling the risk) are employed. Certainly, at a minimum, this means identifying and valuing the significance of the exposure, treating it appropriately and then monitoring its status until it is no longer a significant threat. However, is it necessary to first build a risk culture, create a risk appetite, implement a risk tolerance strategy, appoint risk liaisons across the business, establish ERM committees and invest in sophisticated risk modeling? Likely not, unless your key stakeholders suggest or regulation requires otherwise. ERM processes can easily become overly complicated and burdensome, often working to slow or complicate risk identification and mitigating responses and unnecessarily constraining the business. Further, many ERM processes focus repetitively on risks with a potential for the most obvious and severe impacts (larger inherent risks), sacrificing an ability to otherwise tease out emerging risks and those subtle, often related, frequency risk impacts (lower-level risks), which may be slowly (or rapidly) correlating across the business. ERM frameworks primarily focused on a severity approach, unfortunately, result in a blurry ERM lens and may inadvertently expose the organization to emerging and systemic risk blind-spots. A good example of an emerging risk blind-spot is the various risks found today within a category of risks associated with information security (i.e. cyber risks). See also: Why Risk Management Is a Leadership Issue Cyber risks are a notably different type, when compared with the types of risks historically addressed within an enterprise-wide risk management framework. Why? Cyber risk management is analogous to identifying and responding to risk impacts from multiple, simultaneous “smart tornadoes" (e.g., advanced persistent threats). For example, consider these two facts: 1) cyber risk can be high-frequency and low-severity, or high-frequency and high-severity, at the same time; and 2) cyber risk “impacts” vary widely depending on complexity of known and unknown harm administered, success rate of harm administered and internal acceleration of any such harm (dwell time, lateral movement, then organizational detection and response). These variables create an infinite number of impacts and costs, matrixed across a business. This is an unusual risk behavior, to say the least, and today’s dynamic cyber risk ecosystem creates a delicate challenge for many in the information security profession. When a person proclaims (or attests, or suggests) “don’t worry, we have cyber risk covered” (e.g., managed or otherwise solved for), then she is suggesting an ability to see the future. In other words, she is implying that she generally knows how those smart cyber tornadoes are going to behave outside, inside and throughout the business, every day. Admittedly, for most, it is difficult to acknowledge what we do not know and, especially, the vulnerability we may have in facing a first-of-its kind risk management challenge – with various risks we are unlikely to completely mitigate. However, as more and more businesses engage cloud service providers and increase use cases for Internet of Things (IoT) endpoints, organizational key stakeholders, such as boards of directors, regulators and rating agencies, are becoming increasingly concerned about how organizations are identifying gaps in cybersecurity efforts. There is movement by these stakeholders to test and confirm that risk management processes are in effect and that the enterprise is identifying and responding to risks associated with those smart cyber tornadoes. It is important to understand that even if an organization believes it “has cyber risk covered” by virtue of its current information security (‘InfoSec’) approach, there is still, for many, a critical regulatory requirement to assess the cybersecurity risk itself. Failure to adequately identify, test, monitor, trend and report on enterprise-wide cyber risks creates significant financial, regulatory, reputational and operational exposure for the organization. Static reports that capture log data but are not otherwise normalized or matched to enterprise risk profiles and controls are arguably not offering complete or robust information to the enterprise, for either historical or prospective time periods. And, when we say a risk is managed, it is important to note we are applying a risk management term of art – regulators often have definitions and tests to demonstrate assurance. Managing a risk means identifying, tracking, scoring and valuing, normalizing and trending risk performance, including the net impacts. These steps are performed in accordance with compliance standards and aligned with risk tolerance. Management also includes evaluating how the risk profile (e.g., an enterprise grouping of all defined cyber risks) is changing over time (and we know it is changing) and what key risk impacts the organization is facing from the portfolio of (cyber) risks. This is where the ERM framework and ERM processes can help. The existence of an ERM framework does not provide a carte blanche solution for cyber risk management or mitigation of undesirable cyber risk outcomes. Instead, consider ERM a distinct, enterprise-wide enabler for addressing cyber risk management. In many cases, in-force ERM processes and protocols provide the “plumbing” that InfoSec leaders can immediately access and rely on to deploy quick(er) cyber risk identification, monitor the effects of specific risk mitigation strategies and capture and analyze overall enterprise-wide cybersecurity results. The interplay between ERM and InfoSec serves a critical function for the business. It helps to optimize risk management resources to ensure the InfoSec team is able to focus on the cybersecurity battle at hand. Hacker-driven intrusions and internal actors, along with many other threat vectors and attack surfaces, keep the InfoSec community scrambling for the best depth of defense and tactical offenses required to maintain uptime productivity, lower dwell times, accelerate responses and ensure overall data governance. Meanwhile, together with ERM, InfoSec faces global regulation of personal data actively shifting underfoot, resulting in increasing complexities and wider adoption of cybersecurity regulatory standards. These newly enacted regulatory standards are providing regulators with an ability to dig deep and assess enterprise-wide cybersecurity risk management. For instance, the National Association of Insurance Commissioners recently said: "State insurance regulators have undertaken a number of steps to enhance data security expectations to ensure these entities are adequately protecting this information. As part of these efforts, the NAIC developed Principles for Effective Cybersecurity that set forth the framework through which insurance regulators will evaluate efforts by insurers, producers, and other regulated entities to protect consumer information entrusted…(sic)" Additionally, the New York Department of Financial Services recently said: "Given the seriousness of the issue and the risk to all regulated entities, certain regulatory minimum standards are warranted, while not being overly prescriptive so that cybersecurity programs can match the relevant risks and keep pace with technological advances. Accordingly, this regulation is designed to promote the protection of customer information as well as the information technology systems of regulated entities. This regulation requires each company to assess its specific risk profile and design a program that addresses its risks in a robust fashion. Senior management must take this issue seriously and be responsible for the organization’s cybersecurity program and file an annual certification confirming compliance with these regulations. A regulated entity’s cybersecurity program must ensure the safety and soundness of the institution and protect its customers." It important to note both regulatory agencies are concerned with evaluating enterprise-wide cybersecurity risk – which, in turn, leads us back to the enterprise-wide risk management “plumbing” and risk governance processes and how the ERM-InfoSec interplay can be helpful in achieving organizational risk management objectives. As an example, we can consider how to use the NIST-CSF (National Institutes of Standard and Technology - Cybersecurity Framework) as a starting point for an enterprise-wide cyber risk identification exercise. The NIST framework offers a diagnostic approach for assessing an organization’s technical cyber risk profile (the current state) versus desired risk tolerance and outcomes (the target state). Separately, using a similar approach, ERM can be assessed through commonly adopted risk maturity evaluative frameworks. One such framework is the RIMS Risk Management Maturity model (RIMS-RMM). This model shares several diagnostic themes with the NIST CSF, including evaluations of risk identification, risk culture, risk resiliency and risk governance. (National Association of Insurance Commissioners, 2014) See also: How Insurtech Boosts Cyber Risk   The common themes between several functional topics within the two frameworks create an opportunity to explore the corollaries between the two frameworks. Scores can be mapped and linked, effectively creating an integrated overall score, by applying relativity factors that capture the directional relationships between the two frameworks. For instance, how might low technical cyber risk scores, such as weak DLP oversight, inform and potentially change the ERM score addressing risk (data) governance? When properly integrated, the NIST CSF and RIMS RMM provide a synchronized view on data governance, privacy and enterprise-wide cybersecurity performance. An integrated analysis, such as a combined NIST CSF plus RIMS RMM approach, helps an organization accelerate their ERM and InfoSec risk management performance and increases risk awareness. In turn, increasing risk awareness leads to becoming more risk astute. When an organization is more risk astute, it is maturing in its risk management thinking, as evidenced by positive return on risk investments and system-wide risk mitigation solutions prioritized and finely attuned to best support organizational growth and profitability. Most importantly, they are increasing their cyber resiliency while deploying strategic cyber risk management. The company that successfully integrates a robust cyber risk management approach and its ERM framework is at a distinct competitive advantage. Not only is such an organization effectively managing its resources and expenses; it is linking cyber security to its business goals, enterprise risk profile and strategic vision.

Who's ready to sign up for "a suite of legacy planning solutions for high-net-worth individuals that offers wealth accumulation, asset diversification, wealth distribution, business continuity and exclusive access to 'proprietary investment advisory service'?"

If you're like me, your eyes glazed over during that long list of similar-sounding services that followed "individuals." Why not just end the description there and come back later to whatever is relevant? [The company is real, but I see no need to name it and embarrass it.]

Maybe you're excited about "a radical new solution: a modular, trainable, award-winning, ready-to-use Artificial Intelligence construction kit."

Or, like me, maybe you're wondering what that construction kit constructs. And why do we need so many modifiers?

Perhaps you thrill to hear about a startup that will "identify, develop and adopt emerging technologies...that are fast, reliable and right for our customers."

But maybe you'd be happier if the writer left the thesaurus in the desk drawer and chose a single word each time, rather than three. Something like: "We work with emerging technologies to help our customers operate faster." By the way, what's with specifying that you're going to do something right for your customers? Might you ever admit to doing something wrong for them?

As you might imagine, we took company descriptions seriously during my days at Wall Street Journal, where I developed my curmudgeonly feelings long ago. Let me suggest some traps to avoid, based on my experiences there.

We needed to describe every company immediately after naming it, but article ledes rarely exceeded 25 words, so you couldn't have a long description if you hoped to communicate anything other than the company name and description in the first sentence. Besides, long descriptions are unreadable, and you try to engage people with the lede, not scare them away. (A friend once got punchy late in the day and filed a short item that began, "Playboy Enterprises Inc., the purveyor of fun and frolic...." Fortunately, I read even the short items as they passed through me on the national desk, and I fixed the description, or my 17-year career at the WSJ might have been a two-year career.)

My thinking on company descriptions evolved when I became the No. 2 person in the Chicago bureau in the early 1980s. We covered a host of food companies, and it didn't help readers much to just describe Esmark as a "food conglomerate," especially when that was the same identifier used with Consolidated Foods (such a helpful name). I began to have reporters list a few of the products from each company—e.g., Sara Lee desserts for Consolidated Foods—to help readers get a feel for it.

In the end, I evolved a two- or three-step process that could help all of us understand startups faster and stop scratching our heads after reading a news item: 

• Have a super-short description—maybe two to seven words—that you use in first reference.
• Develop a clause that you can use at the start the second paragraph. So, the lede would be begin, "Esmark, a food conglomerate, said...." The second paragraph would start, "Esmark, which makes x, y and z...." This clause, while longer, still has to be simple. You'll lose people if you have a bunch of ideas embedded in it, nested inside each other with commas, or use it to provide a list of complicated ideas, as in my example on legacy-planning solutions.
• Go ahead and produce a full paragraph on what you do and put it at the bottom. (At least at the WSJ, we had readers trained to skip there once they had ingested all the news they wanted and needed a bit of background.) But skip the jargon. Use short sentences. And give us a for-instance: "Our company/product lets customer X do something (very specific) that he/she/it couldn't do before, producing Y benefit."

While you're thinking about descriptions, I'll ask you to indulge me in four smaller ways:

• Cut way back on the word "new." You can't create an old product or technology, so why do you keep telling us you've created a new one? "New" only makes sense if you could put "old" into the sentence and have it still read right.
• Cut way, way back on "proactive." Verbs are actions, so you don't need to tell us that you're "actively" working with clients or whatever. Yet "active" turned out not to sound strong enough to corporate writers, and they tacked "pro-" on the front, even though the prefix's meaning overlaps so much with "active." Business writers wanted us to know that they are actively, actively taking action. Please don't. "Proactive" only makes sense if you're drawing a sharp contrast to something reactive.
• Don't ever describe something as a "value-add." If it isn't adding value, why are you doing it? If there's actual value, then why not take four or five words and specify what that is?
• Stop with the word globs. For reasons that have never made sense to me, business writers often take a bunch of ideas and smash them together as modifiers for a noun, forcing readers to untangle the word globs to understand who is doing what to whom when and why. Just a couple of prepositions here and there and the occasional verb would let the ideas flow in their natural sequence and be much easier to read. A simple example: A startup described the "business insurance application process." Isn't it easier to grasp "the process of applying for business insurance"? It is for me.

There, I feel much better now after the venting. I hope you do, too. If you know someone who could benefit from this advice on writing (and there are a lot of them out there), please pass this commentary along. Thanks.

Paul Carroll
Editor-in-Chief 

New technologies mean disability income protection (IP) claims managers can enhance and expand the support and services they offer. Digital solutions can also be used to improve the claims experience. TrackActive is a company that has developed an artificial intelligence-driven engagement platform that provides early, cost-effective and scalable interventions for rehabilitation and prevention of musculoskeletal conditions and other chronic disease. To find out more, I spoke with TrackActive co-founder and CEO Michael Levens. RC: What drew you to the disability insurance business? ML: We launched a product called TrackActive Pro. It links up patients with musculoskeletal conditions to clinics and physiotherapists. People using our service to support insurance claims suggested we go direct to insurers. They said it would reduce the friction they felt in making and processing their claims – the form filling and episodic, continuing interactions with the insurer. So, we developed a fully digital sister product called TrackActive Me. RC: Have you encountered any challenges so far? ML: Disability carriers don’t own the physiotherapist or the health professional; they just buy services from them. So how we get our product into the insurance value chain is very important. Insurers already have excellent claims management processes. However, these rely heavily on paper, which means we have to show that our digital offering can add value or even improve upon them. RC: What are the benefits of TrackActive Me to the IP insurer and for the claimant? ML: Engaging health professionals comes with a cost, and it’s continuing each time a claimant sits with one to process a claim. The quality and impact of the digitized version of our service compares very favorably; it’s as effective as going to see a health professional, and the prescribed exercises can be accessed on demand. The idea of a physiotherapist in your pocket that allows for remote monitoring is a stepping stone toward self-management. If things are working less than optimally, the user can easily opt in to seeing a health professional in person, via TrackActive Pro. Blending service and product like this is important. See also: Putting Digital Health to Work   RC: Must insurers think and act differently to use a digital tool? ML: Yes, it can be difficult for insurers to visualize a digital version of an analogue process. For a start, TrackActive Me is very self-managed. While we have taken down an implementation barrier by making it simple for claimants to get and to use, we have removed some control of the process, too. Insurers can give the tool to their claimants, or a health professional can bring them on board after they have gone through their primary treatment. RC: What is your message to IP insurers who are thinking about digital alternatives? ML: It’s easy, really. We want to engage with companies willing to see that new digital process are not only capable but will enhance their offering. Companies that want to join the dots between the digital and the analogue. Those that have an open mind to technology and want to look at ways the current model can be enhanced. The ideal working approach is collaboration to help the technologies of startups mature in ways that fit best with the needs of IP insurers, before plugging them into existing systems by using open application programming interfaces. Technology will reduce the amount of manual work involved in assessing an IP claim. There are long-term benefits for insurers, as well, in the rich customer data that will be generated. Analysis of the data will provide predictive intelligence to help deliver better value and service to new claimants. It will help to anticipate claims and give focus to providing effective interventions. Ultimately, IP claims solutions delivered using AI or other digital means will save process costs that can then be passed on to customers in the form of reduced premiums. Meanwhile, a more frictionless and transparent solution to managing customers’ recovery in claim stages will significantly add to customers’ satisfaction.

Can you imagine a world where the open ecosystem dream is a reality? A world where our collective insurance platforms talk to each other? A world where the industry moves faster and better by working together? Oasis and Simplitium, along with a host of others, including SpatialKey, are on this path. While the dream feels idealistic, it is possible. Making data more portable between platforms—interoperability—is not something novel. It’s just fundamental and increasingly vital for long-term survival whether you’re a re/insurer, broker, MGA or solutions provider. We all have a stake in this conversation, and a responsibility to move our industry forward. Industry demand for an open ecosystem is overwhelming. We increasingly depend on ecosystems, and we need greater interoperability to overcome inefficiencies and redundancies. Matthew Jones of Simplitium provides three key stepping stones we must embrace for greater interoperability:

1. Avoid a monolithic "one system does all" approach
2. Minimize the number of catastrophe risk modeling platforms, while maximizing choice in models across multiple vendors
3. Design systems so that the possibility of change is embedded

Leading organizations are already heading down this path. Lloyd’s recently announced that after losing £1 billion in 2018 it's looking to drive efficiencies, and one way is through “an ecosystem of products and services that all market participants have access to.” One size does not fit all—and a monolithic approach has proven unsuccessful time after time. Rapid innovation in risk management requires systems that are flexible, scalable, designed for change—and built in close collaboration with those who serve the industry. See also: The Insurance Lead Ecosystem   Interoperability drives efficiency Across our industry, we need to find ways to drive efficiency gains by making data more portable between core systems. If premium is scarce, then finding ways to eliminate waste in the system is not just how you save money, but rather how you make it. Consider this: How much time do analysts spend keying information into different systems of record? Or, underwriters for that matter. Now, think about how much that costs your business. According to McKinsey, underwriters spend 30% to 40% of their time on administrative tasks like rekeying data or manually executing analyses. It’s inefficient and redundant and increases the risk of error, yet it’s a standard in our industry across every insurance workflow. This creates a massive amount of waste. Now, imagine if analysts could pass exposure data seamlessly from system to system —with just the push of a button. We work with clients to perform these types of integrations all the time at SpatialKey. Core systems must talk to each other so that insurers can reap efficiency gains while leveraging the best that each chosen provider has to offer. Modern technologies and well-designed solution architectures allow us to integrate disparate value-driving systems easily—and the only thing in our way is us! The market is advocating cooperation for the greater good. There will be more commercial opportunity and innovation generated through “coopetition” than by trying to knock each other out of the market. Solutions providers must find ways to differentiate that aren’t in opposition to the industry they serve. Interoperability is “perfectly possible” You may think it’s not possible—that the type of interoperability I’m advocating for requires too much change. To quote Dickie Whitaker of Oasis: “Don’t think it’s impossible, because it is perfectly possible.” He goes on to say at a climate change conference last year: “What’s important in solving these big problems is not to be beholden to our existing culture. Our existing view. Our existing experience. We’ve got to look to others that may be able to reframe the problem in a way that actually gives us insight into solving [it].” So, if you’re not leveraging or supporting creative partnerships and ecosystems, perhaps it’s time to consider that they present a “perfectly possible” path to interoperability. See also: Building Ecosystems Requires Guts   Let’s make the open ecosystem dream a reality We’re in an era where your solutions are only as powerful as your connections. Interoperability is the name of the new game. We must make systems do a better job of talking to each other. Doing so is a step change for the industry. And, while an open ecosystem may appear to be a dream, it’s already well on its way to reality. Like we’re seeing with Lloyd’s and elsewhere, purposeful change happens when the status quo is no longer sustainable. It’s time to reach out to your partners and tell them what you need to be successful. Discuss your requirements for interoperability. Drive change that inspires innovation. Edward de Bono, an authority on creative and “lateral” thinking, said, “The system will always be defended by those countless people who have enough intellect to defend but not quite enough to innovate.” Will you defend the status quo or innovate the future? The choice is yours.

When the biography of a businessperson becomes a BizBio, when brains and Braun combine to create a pointillist portrait whose style evokes the ink drawings popularized by the Wall Street Journal, that is when nameplates cease to be vanity plates. That is when insurers become household names. Consider, then, the power of a BizBio: an image alongside a person’s name. Consider, for example, the power of the name and image of the American Express charge card. Consider the card’s expression of a charge to keep, of a gladiator who leads the charge on behalf of honor, integrity, strength and security. Consider the value of a BizBio for an insurance executive. See also: Integrity First: Digital Marketing Manifesto   Think of the invaluable quality of values, of knowing that people have a keepsake that celebrates the best leaders in a variety of industries, including technology, transportation and trade; and insurance, too. To be among the likes of Steve Jobs and Howard Schultz, to be in the company of men and women whose influence is historic, to be a person whose legacy influences popular culture and popularizes insurance, to be that person is a goal all insurers should strive to achieve. A BizBio confirms what many executives crave but few manage to convey: credibility. The credibility of a leader whose word elicits trust. The credibility of a leader whose work speaks for itself. The credibility of a leader whose legacy speaks to his life’s work. A BizBio encapsulates these points. It proves the point that excellence matters, that an executive sets an example for workers to equal and critics to extol. The example insurers need to make is one of connection: to connect with policyholders on a personal level. The connection between the contents of a BizBio and the content of a leader’s character: That connection depends on transforming insurance from an abstract concept to an accessible idea; that transformation depends on an insurer’s talent for translation, the felicity by which he turns numbers into words. Put another way, an insurer who works to ensure people understand him is an insurer who develops an understanding with his clients. He connects with people by listening to them. He listens to their concerns. He tries to address their concerns, even if he cannot assuage all their concerns. He communicates clearly—and often. See also: Marketing: A Plethora of Plagiarized Copy   An insurer who connects with policyholders is a leader. Whether he has a BizBio is less important than what he learns by reading a BizBio. If what he reads makes him a better leader—and a better listener—the benefits will accrue to his company, his clients and his industry. He will, in the end, have what it takes to have his own BizBio.

About 35 years ago in a political science class, Dr. Campbell stated, with tongue planted firmly in cheek, that “plagiarism is copying from one source, research is copying from more than one source.” By the good doctor’s terms, this is the best-researched article I’ve ever written. It has also been the easiest – because most of the work was done by people better-educated, wiser, more experienced and more respected than me. Robert Frost said, “Two roads diverged in a wood, and I – I took the one less traveled, and that has made all the difference.” My observation is that this world contains many managers but few leaders. I believe that leaders select “the road less traveled” and that managers walk the well-worn path. Both roles are necessary. The problem is that the individuals involved try to walk both paths and get lost in the woods! In times of abundance, you need managers to create and maintain processes – to inventory the excess. Count what you have. Control the status quo! Managers say, “If it ain’t broke, don’t fix it!” “Let’s not reinvent the wheel.” “We’ve always done it this way.” Managers are about efficiency – “doing things right,” as Peter Drucker said. Management is about HOW. Leadership is about WHY. In times of competition, war, discovery and conquest, we need leaders to grow people and create systems. Leaders identify a current reality and define a future ideal. They then mobilize, organize and energize their followers to build a bridge between these two points and then to cross that bridge. Leaders believe, “We have nothing to fear but fear itself.” “The buck stops here.” “I have a dream.” “If you start to take Vienna, take Vienna.” “Let’s roll.” Leaders are about effectiveness – “doing the right things,” as Peter Drucker said. See also: Play With Dolls, and Be a Better Leader   Today, there is much ambiguity in the role of leadership. Many people positioned as leaders are actually serving in a management role. Most of these people have what it takes to lead – unfortunately, they have been kidnapped by the status quo, the comfort zone, the urgent or the organization to accept the safer role of management. In my opinion, the role of a leader is easy to define but a challenge to create. The leader is:

• A Dream Catcher – the leader must have a vision of sufficient grandeur to attract and motivate followers and (s)he must have the commitment to that vision and a discipline to pursue it.
• An Organizational Architecture – the leader must build a foundation that will define and support the organizational infrastructure and operations. Every member of the organization should be able to view this foundation and infrastructure and determine if they fit. This foundation includes the vision, the values, the mission and the standards of the organization.
• An Environmental Engineer – the leader must remove toxins from inside the organization and protect the organization from poison in the environment in which it exists.
• A Coach – the leader must find or develop the people to build the infrastructure, design its systems and operate the processes. Coaches condition, develop, reward and discipline the team, write the game plan and scout the competition. Coaches know their team in the context of the game – when to substitute, when to kick a butt and when to pat it. They control the pace of the game and influence its outcome.

Leadership applied has been defined as follows:

• Max DePree said, “The first role of the leader is to define reality.”
• Henry Kissinger said “the task of the leader is to get people from where they are to where they have not been.”
• Peter Drucker suggests that “the one absolute of a leader is followers.”

Let me be so presumptuous as to offer a reason for the ambiguity existing in the role of leaders today - FOLLOWERS HAVE CHANGED! Yesterday’s world and its organizations were built by the generation that won World War II. (“To the victors go the spoils.”) These leaders were trained in the military for war. Command and control was their mantra, and it worked. They were built to lead or to follow as needed. Leaders in tomorrow’s world are the children of the WWII generation. We were the hippies. We challenged the system. We rebelled against command and control. We are more diverse in demographics (women, people of color, cultures, etc.). We believe in collaboration and consensus building. We were built to manage. As leaders of today (and tomorrow), our successors and we must realize the role we are in and meet the expectations and requirements of that role. If we are to lead an organization, our role is to DEFINE AND DEFEND THE VISION. WE MUST ADDRESS THE ORGANIZATIONAL WHY. THIS IS NOT ABOUT CONSENSUS. IT’S ABOUT OUR FOUNDATION AND FOCUS. When the WHY is defined, it must be made operational by processes, teams and managers. This is the time to seek collaboration and consensus. This is the HOW. (“There is more than one way to skin a cat.”) Diversity in leadership creates chaos. Diversity in teams that operate processes creates order by consensus and involvement. If you as leader or your organization as a group is struggling, you must remove any ambiguity – you must clarify the rules and roles. As leaders, establish the vision, values, mission and standards – THE WHY! Let the managers and their teams design and develop processes – THE HOW. See also: Don’t Lie to Yourself About the Future   Diversity in team building and creation of processes is important. It’s necessary to discuss, debate, dissent, define, etc. Once all voices have been heard and the group decides the best processes to achieve the mission, individuals as a group must COMMIT. In process design and development, diversity is great. In our purpose, we must be uniform in our focus and commitment and disciplined in our followthrough. Let these world leaders close this article for me! Winston Churchill, in describing meetings during World War II, said that groupthink leads to “…weak and faltering decisions, or rather indecisions. When you take the most gallant soldier, the most intrepid airman or the most audacious sailor, put them at a table together, what do you get? The sum total of their fears.” Margaret Thatcher said, “Consensus is the absence of leadership.” Lead on! Let’s roll.

Agency associations have been around for years, providing advocacy and resources for independent agencies around the country. Also known as agency networks, clusters or aggregators, these organizations play an integral role in the insurance ecosystem, building connections between agencies, carriers and partners to help both grow business and better serve the needs of customers. While many independent agencies have opted not to join these networks, sometimes deterred by the cost of membership, these organizations can provide valuable return on investment. At a recent event, I spoke with a network executive who said his agencies are seeing a nine-to-one ROI for independent agents. This ROI is impressive and further evidence of why agents should consider participating in these groups. The resources and access to carrier and vendor relationships deliver measurable value for independent agencies of every size. At the same time, carriers and vendors are also investing in network relationships. Investment in new programs like Vertafore’s, specifically aimed at championing the independent agent by working with industry associations, clearly underscore the value of these networks as part of the insurance industry. This kind of purposeful investment, putting the right people and the full support of the company behind it, is a strong endorsement of the association model. See also: 3 Ways to Boost Agency Productivity   Another hurdle for independent agents is that they’re simply too busy running the agency to investigate new opportunities. But as buyers’ expectations for price, convenience, service and product availability have grown, many independent agents have found themselves struggling to keep pace. They’re so busy scrambling with their heads down to keep up with their current business, they hardly have opportunities to look up and see what’s happening in the market around them. But as competition gets tougher and customers gain more flexibility of options, independent agents can’t afford to keep their heads down. Network membership can help here, too, introducing agents to resources, technology and services that can help them work more efficiently and identify new business opportunities to develop. If you’re on the fence about agency networks or skeptical of their value, here are four reasons you need to make joining one a priority this year:

1. Access to new carriers and products through aggregation. For small agencies, it can be tough to get appointments with carriers if you can’t support the volume of business they require. Trying to meet the quotas or milestones to keep multiple appointments can be difficult, and some carriers won’t work with agencies if they’re under a certain size. This can lock small agencies out of writing new business or securing new products their customers are demanding. Joining a network lets the independent agencies band together to hold those appointments and feed the appetite of the carrier at a much higher level.
2. Buying power with vendors. The industry is being driven by technology integration, not only as a means of serving customers’ expectations for a modern, tech-savvy experience, but also for efficiency and workflow productivity for the day-to-day operations at an agency. But those software and solutions can be expensive, especially for the small-volume licenses that small independent agencies would need. Vendors are eager to work with agency networks to offer more value and partnership. The vendors benefit from the access to new customers and agencies can take advantage of the latest solutions that may have been out of their reach if not for the collective power of the group.
3. Networking opportunities. Keeping yourself glued to the agency 365 days a year can be a mistake. Even when you’re busy serving clients, it’s also isolating you from market trends and developments that your counterparts are eyeing as opportunities. Agency networks offer networking opportunities to meet with and learn from your colleagues, to build relationships that can help solve mutual challenges or share creative solutions or strategies. Whether it’s an annual conference, a workshop group or even just a meet-and-greet, being involved in your industry community can open doors of opportunity through shared wisdom and resources.
4. Thought leadership and access to expertise. The network itself can be a source of knowledge, resources and expertise on relevant issues like how to run and grow your agency, how to make inroads into a new, niche market or how to manage mergers and acquisitions. Just like it aggregates carrier access and vendor relationships, the agency network can be a tremendous source for aggregated knowledge, providing thought leadership and counsel that can help member agencies grow business and access new markets and opportunities.

When looking for an agency network to join, choose one based on what it can offer to meet your needs. Don’t just consider what it will cost but, more importantly, what you will gain. Ask to talk to other members or vendors as a reference to get a broader perspective. The right network or association will be in a leadership position in the industry to provide information, resources and expertise to help you grow your business. It should work diligently on behalf of its members to build partnerships with carriers, vendors and tech services. See also: Expanding Into Small Commercial   While it’s easy to get stuck in the day-to-day routine of working IN your business, it’s critical for independent agents to also make it a priority to work ON your business. The biggest risk to agency success is inertia—simply staying in the same spot. With the rapid pace of technology development, market evolution and shifting consumer expectations, you can’t afford to get left behind. Getting involved in agency associations and networks is a smart investment that can help your business stay ahead of the trends to grow and thriv

Sales is the name of the game, no matter the industry, but some professions should focus more on providing sound advice and less on promoting new and trendy products. Many benefit brokers fall into that latter category, and I say this as someone who has been in the insurance industry for 25 years. It used to be that group insurance brokers were more transactional. Get a good product at a fair price, provide some service, and your client is generally happy. Today, that same broker must create compliance initiatives, administer COBRA, FMLA, enrollment services, ERISA advice and some human resource functions. This new responsibility requires expertise beyond what's needed to get an insurance brokers license, yet, like most entrepreneurs, we adapt. We must, however, get back to basics. As group benefits brokers, we must turn our attention to the core mission of our profession today. That mission is strategic consultation and education for our clients, addressing the cost of providing healthcare in this country. It is, by far, the biggest driver of the increase in the cost of, and inability to afford, group health insurance. Certainly, maintaining an awareness of professional trends has its benefits, and often a new offering can make a big difference for clients, but advisers need to dial down the reseller role and concentrate on imparting guidance to address core issues. Next to payroll, the largest expense for most businesses is the cost of group health insurance. Yet many benefits advisers continue to go down the same old path by providing information on the same, tired, cost-shifting plans – this despite the fact that these plans's premiums are rising faster than the cost of living. See also: Benefits Advisers: It’s About to Get Real   Benefit brokers need to begin educating clients on what is really driving premiums. One significant lesson that should be learned upfront is that joining a large insurance purchasing group is rarely the solution for small to medium-sized businesses, because savings are short-term for most. The dominant problem facing health insurance prices is the cost of providing care. It won’t cost less for a small firm with a staff of 10 for an MRI or maternity stay simply because it is in a pool of 5,000 employees. Although these multi-employer plans may show short-term savings, unless there is a marked improvement in the risk pool, as with every other group collective purchasing arrangement for healthcare, it fails. And, oftentimes these plans are dangerous self-insured arrangements where the employer, and sometimes even the broker, has little knowledge of the potential risk. The need, from my standpoint, is for businesses to embrace measures that can result in less prohibitive healthcare costs, beginning with the use of telemedicine programs not owned by insurance companies. An eye-opening statistic from the American Medical Association indicates that over 70% of all emergency room, urgent care and primary care visits could be handled via telemedicine. This is a cost-effective alternative that will reduce the employers claims cost by a weighted average of $240 to $300 per visit. Offering telemedicine as a benefit not only decreases claims and keeps overall costs down, but the employees are less likely to miss work due to a medical appointment. An independent second opinion program is another avenue to trim costs, yet a mere 19% of health care consumers get second opinions. This is head-shaking as a study conducted in 2014 by the Houston Veteran Medical Center and the Baylor College of Medicine estimated that 12 million people in this country are misdiagnosed annually. The study went on to show a change in diagnosis by nearly 15%, as a result of a second opinion and as high as 26%. The course of treatment is changed an astonishing 70% of the time. An independent medical second opinion program can provide simplified access to high-profile medical centers/teaching hospitals, specialists, etc. in collaboration with a patient’s attending physician team, often for little to no cost. Result: Employees are less likely to miss work due to a misdiagnosis or follow-up appointments. Consider, also, that the third leading cause of death in the U.S. is medical errors. Offering employees a choice as to how they purchase prescription medications is another cost-efficient employer healthcare program. It fosters consumerism by deploying a comparative prescription drug environment and can lower cost for the consumer and the employer, sometimes substantially. Numerous online prescription drug programs can help members identify discounts, coupons and subsidies available for their high-tier prescriptions. Current and emerging technologies aggregate these programs so immediate access to potentially less expensive prescriptions drugs are identified and easily obtained by the patient. Also, some of these programs will have deductible and copayment assistance programs designed to keep people compliant with their medication regiments. Another easy way to reduce costs. Employers need to weigh the worth of group health insurance against self-funding; if choosing the latter, always offer a reference-based pricing option. This plan recognizes that insurance company payments to hospitals can be as much as 300% to 600% more than what Medicare would pay. Reference-based pricing plans might pay the hospital just 50% over Medicare. If an employer or local market isn’t ready for this aggressive approach, there is a solid opportunity to educate about reference-based pricing. See also: Reinventing Sales: Shifting Channels  Those of us in the insurance and benefits industry have the responsibility to shed light on strategies that address the real drivers of cost rather than simply regurgitating what we are told are current industry trends.