Hurricane Andrew’s devastation and lasting financial impact created a need for an alternate means to access capital and transfer risk. Enter the Bermuda market, and, on its heels, the insurance-linked securities (ILS) market. The latter has been growing steadily ever since the mid-1990s. Fast forward. and some traditional reinsurers now offer ILS fund management. Other reinsurers have purchased prominent ILS fund managers, as was most evident with the well-publicized Nephila acquisition by global re/insurance giant Markel. This recent mainstreaming had brought about all sorts of acknowledgment. However, while everyone was patting each other on the back, various catastrophes were occurring on a global scale. From earthquakes, floods and typhoons in Asia to hurricanes and fires in North America, the industry incurred increasing losses in 2018. Coupled with the 2017 loss creep, these losses have affected several ILS vehicles, and investors/fund managers are rethinking their respective capital allocation strategies in the coming renewal season. ILS plays an important role in providing efficient capital to insurers and reinsurers (through retrocession) that sponsor the deals, but it is not without risk. Recent developments in the marketplace have the collateralized funds space facing headwinds. For these important investment vehicles to continue as beneficial components of ceded reinsurance programs or investor portfolios, some things need to change. Perhaps the greatest contribution from ILS has been its ability to smooth pricing volatility in the regular reinsurance underwriting cycle. Every time there has been a large storm, or series of storms, reinsurers respond by raising prices in a phenomenon known as “payback.” This cycle went on for many years until the recent ILS “coming of age.” With an abundance of capital, reinsurers are pressured to keep their rates down to compete for shares of a given deal. Reinsurers are also able to take advantage of this downward pressure in pricing with their own reinsurance known as retrocession. Along with helping insurers/reinsurers access capital for additional capacity, ILS are a means for institutional investors to diversify their portfolios to non-correlated risk. What this means is that rather than their funds being tied to financial markets, where they’re subject to things like credit risk, the funds are tied to triggers from catastrophic natural disaster events. In addition to this diversification, the returns also make ILS an attractive investment to the sophisticated institutional investor. In the absence of considerable aggregate loss totals, these transactions are a “win win” for all parties involved. Followers of reinsurance industry news in 2018 know there’s no shortage of praise directed toward the ILS space. But a shift in attitudes occurred very recently, months or even weeks ago. The industry was so impressed with the resilience of the ILS market following the 2017 HIM losses (Harvey, Irma and Maria) and the “reload” of capital that followed. However, this “reload” of capital occurred prior to realizing the additional effects of the 2017 loss creep from the HIM storms. Loss creep occurs when the final loss amounts from an event aren’t known and the reserves must be increased due to changes in projections. Along with the 2017 loss creep, 2018 shaped up to be another year of catastrophic losses. The California wildfires, Typhoons Jebi and Trami in Japan and Hurricanes Florence and Michael in the southeastern U.S. all added to the problem seen in collateralized reinsurance deals. In a collateralized reinsurance transaction, collateral is put up by investors to cover the full limit of the reinsurance contract. As a result of the catastrophes piling up, much of the collateral on the deals has become “trapped.” While the final loss number is being determined, the trapped funds cannot be moved or re-allocated into new deals. We’re seeing that this has led to some fund managers having difficulty renewing core components of their portfolios. This could lead to reinsurers being more aggressive to take back their market share with traditional capital. Perhaps this is just a short-term correction, but one thing is for sure: The trapped collateral issue needs to be solved sooner rather than later. See also: Fixing the Economics of Securities Defense These recent changes in the ILS marketplace have only affected a few funds and strategies. According to market intelligence sources, most are renewing as planned. However, the changes highlight the potential for disaster down the road if nothing is done to correct these issues. In my mind, there is an excellent opportunity for sponsoring insurers and reinsurers to collaborate with the investor base and fund managers. Collaboration could lead to outcomes that better provide sponsoring organizations with the efficient capital/collateral that they’ve come to rely on while simultaneously providing investors with greater flexibility in the deployment of their capital. Insurers, reinsurers and institutional investors have demonstrated their needs for ILS, and it’s up to all parties involved to continually improve the space. Insurance-linked securities are the present and future of risk transfer, but recently their vulnerabilities are being exposed. The negative effects of trapped collateral threaten to disrupt more funds if enough capital is tied up. Thankfully, ILS experts are reportedly working diligently to solve this problem. ILS provides sponsoring insurers and reinsurers an efficient source of capital while providing diversification for institutional investors. I’m inclined to believe that, for these reasons, ILS arrangements are here to stay in some way, shape or form. Throughout this piece, I’ve put myself at the risk of oversimplifying a very complex subject. There are different types of ILS vehicles, fund strategies and investor types currently in existence. In fact, you’ll notice that I didn’t even touch on the potential impact of rising interest rates; that’s a discussion for another time. My hope is that these thoughts will provide additional dialogue on the headwinds facing the ILS space. These difficult times are a test and an opportunity for improvement that could lead to a more efficient, capital-rich market.

Step 1 — Decide on the specific problems you are trying to solve within your organization. Carriers have a unique opportunity during this time of insurtechs. There are many great insurtechs out there that are solving problems for the industry. However, for a carrier to take true advantage of this opportunity, it first needs to identify specific problems within the organization that need to be solved. It doesn’t make sense to find insurtechs in the marketplace and then look to see how they fit within your organization. Both the insurtech's and carrier's time will be better managed if you first decide on specific challenges your organization is looking to attack. For example, have you decided that your organization needs to improve the customer experience during the claims process? Then seek out an insurtech that solves that specific problem. Don’t look to speak with insurtech companies just because insurtech is the hot topic right now. Match the insurtech companies to your issues, and both companies will benefit. Working with insurtechs will take a shift in the thinking and paradigms within the organization. Step 2 — Have a separate vendor procurement process for insurtechs. You must put yourself in the insurtech’s shoes for a moment. Have you ever gone through your company’s vendor procurement process? Is it a nine-month process for even the most sophisticated companies with unlimited resources and attorneys on staff? Here is what I can tell you as a founder and CEO of an insurtech company, Benekiva. We simply cannot spend the time or the resources to go through an extensive vendor procurement process. Don’t get me wrong. I am not suggesting that you skip the due diligence process on these insurtech companies. I am suggesting that you need to have a separate procurement process that is a bit friendlier if you want to work with these companies. See also: How to Partner With Insurtechs   Step 3 — Who is on your innovation team? We get the opportunity to speak at events all over the U.S. We often get asked, “How can carriers be more innovative?” Here are a couple ways:

1. Carriers can engage and work with insurtechs. However, before the carriers engage startups, the issues they need to solve are the long sales cycles and the vendor procurement process discussed above. Once carriers have tackled these issues, working with insurtechs can immediately inject some innovation into the carriers.
2. You can create an internal innovation team. This one is a bit more difficult. The question you need to ask yourself is, Who is on your innovation team? Many times, the people on these innovation teams are the folks who resist change. Often, we see the “quarter-century clubbers” on these teams. The quarter-century clubbers are the folks who have been in the organization for 20-25 years or longer. Don’t get me wrong, some of these folks can add value to the innovation team. However, some of these people challenge innovation. When you ask them, “Why do we do this process in this way?” the common response is, “That’s how we have done it since I have been with the company.” There lies the problem! You can’t expect to be innovative if you are not willing to have an open mind to a newer and better way.

My suggestion – add people to the innovation team who will challenge the status quo and who will interrogate the answer of “that’s how we have always done it” Step 4 — You must take a little risk. This is an easy one. Carriers need to take a little risk. WOW! There it is, I said it… Insurance carriers need to take a little risk in working with insurtech companies. I understand that carriers are risk-averse. However, I also understand that policyholders and beneficiaries are demanding a better customer experience out of carriers to earn their business. Startups are fast and nimble; most carriers are not. Carriers have a need and the capital; startups have the desire to succeed and can execute. When you can combine a carrier's needs and capital with an insurtech’s desire and execution, innovation WILL occur! See also: How to Collaborate With Insurtechs   Here is a challenge — Have you ever experienced your company's various processes? This would be a great exercise for many executives. Do not stage these experiences. Rather, be completely anonymous and go through your company's processes. Go through the processes on multiple devices. Be honest with yourself and ask – does this process suck? If the answer is yes at any point in your process, you need a better process. This is an opportunity to innovate…

In May 2018, insurance company Aflac revealed that it had been the target of a successful cyberattack that led to a data breach and the possible exposure of customers’ sensitive personal information. The attack occurred via a hack of independent contractors’ email accounts. Similarly, in 2014, Anthem, a health insurer, experienced the largest theft of customer data from a U.S. healthcare institution in history to that date. This hack was executed using a phishing attack, through which the attackers gained access to valuable customer data. As a result of this hack, close to 79 million customers had their sensitive data, like Social Security numbers and addresses, jeopardized. The Anthem cyberattack is just one of a number of attacks targeted toward health insurers in recent years. Insurance companies, like other financial services organizations, are, of course, a primary target for cyberattacks. Adversaries are looking to profit from their attacks, so hacking insurance companies can serve that end. Cyberattacks targeted toward this industry have stolen customer data and used that data to commit profitable fraud schemes. Beyond concerns about cost – which, of course, are significant – insurance companies have added worries when it comes to digital security. Given the extremely sensitive nature of data collected and used by insurance companies, cybersecurity measures are particularly important for these firms, especially those looking to gain and keep trust with consumers. In addition, regulations on the industry require a greater level of protection than many other industries to remain compliant. As a result, cybersecurity has become an essential part of doing business in the insurance industry. Across the industry, firms are stepping up their game when it comes to cybersecurity. These companies are deploying more and more resources toward cutting-edge technologies like machine learning, artificial intelligence and orchestration. See also: Quest for Reliable Cyber Security  An important question to consider, though, is to what strategic ends are these cutting-edge technologies being put. Are they simply bolstering traditional methods of cybersecurity, or are they being used for methods of cybersecurity that are innovative, instead of simply faster or more efficient versions of the same product? The Incident Response Approach to Cybersecurity Traditional cybersecurity approaches are focused on reporting about intrusions, in what is known as an “incident response.” What this means is that an adversary – commonly referred to as a “hacker” – finds some way to gain access to a target and compromises it. The target can be accessed through vulnerabilities in web frameworks, internet browsers or internet infrastructure such as routers and modems. Regardless of the method used, once an attacker is discovered, the forensics about the attack, including basic information known as Indicators of Compromise (IOCs) like IP addresses, domain names or malware hashes, are shared across the cybersecurity community. These IOCs are then used broadly to thwart future attacks. The problems with this approach are twofold: Like a canary in a coal mine, someone has to be a victim first so that IOCs can be derived and shared with others; additionally, blocking IOCs has a very short half-life. Most adversaries subscribe to the very feeds that companies subscribe to to quickly learn if they have been exposed. All an adversary has to do is come from a new IP address or recompile its malware so that it has a new hash value (both of which are extremely trivial) and its attacks will sail through defenses that depend on IOCs. This after-the-fact methodology consumes a lot of resources and generates a lot of seemingly valuable metrics, but it is ultimately flawed. Cybersecurity teams and adversaries are trapped in an endless loop where the adversary always has the advantage. As hackers repeatedly gain access to valuable systems and data using the same methods, cybersecurity teams continue to chase after them to secure compromised systems. While a great deal of effort is put toward understanding as much as possible about the adversary and his methods, only a small amount of that understanding is used, and only to perform the very basic actions described above. Adversaries continue to play chess, strategizing about how to slip past cybersecurity teams unnoticed, while those same teams act as though the game is more like tic-tac-toe. Very little cybersecurity effort is put toward addressing the methods used by adversaries; instead, security teams are locked in a pattern of waiting for inevitable attacks, trying to minimize the damage they cause, ensuring that remediation occurs as quickly as possible and blocking only exactly identical attacks. Planning for the Future of Cybersecurity As is readily apparent, these current, standard methods of cybersecurity are fundamentally flawed. Incident response only helps prevent attacks that exactly replicate past ones. To stem the flow of cyberattacks and to truly protect against them, the cybersecurity industry needs to embrace a paradigm shift. Rather than rely solely on the incident response and recovery methods that have been used for many years, a more sophisticated approach is needed. It will need to be designed to successfully recognize adversary methodology (and all the manners in which an adversary attempts to obfuscate its methodology) before attacks occur and at a meaningful scale. This kind of approach, when paired with incident response tactics, could provide true security to vulnerable, critical networks. If the cybersecurity world wants to halt dangerous, costly attacks, there is a great need to shift attention toward prevention. Instead of seeking discrete, static IoCs based solely on what has already occurred, cybersecurity analysts can instead use the intelligence they have derived about adversaries’ methodologies – commonly referred to as tactics, techniques and procedures (TTP).  From these TTPs, analysts can identify the general form and components of an adversary campaign. In addition, they can determine abstract indicators like how the adversary is attempting to hide his actions.  A cybersecurity tool would be able to recognize possible adversary TTPs and indicators that describe a threat (or threatening behavior) in general terms. The system would then act on any traffic that met this pattern before it reaches inside a network, as the attack occurs, and do so in a way invisible to adversaries. Using this basic model, a cybersecurity tool could truly prevent common exploits before they were executed and could even predict and protect against future, not-yet-seen exploits. In addition, this prevention plus response method of cybersecurity enables teams to truly take advantage of cutting-edge technologies in ways that change the game, instead of simply adding speed (and cost). See also: Best Practices in Cyber Security   A TTP-based cybersecurity tool would work in concert with existing incident response, internally focused cybersecurity efforts, adding a layer of prevention over the top of this vital but flawed process. With these two methods employed hand-in-hand, cybersecurity teams can make headway in reducing the number of attacks and can more quickly and productively respond to attacks that do prove effective.

My favorite video in a very long time is this one, of a man staging a slip-and-fall fraud at his workplace—while a security camera records every moment. He says in the article, "I didn't do it. It was a mistake." But huh? The video shows him dumping ice on the floor and lying down next to it, after which he filed an insurance claim for his "injuries." 

This sort of video is good news for insurers, which are always fighting fraud, which are trying to prevent accidents and which have a new friend: increasingly ubiquitous cameras and sensors. 

When a 19-year-old allegedly held up a bank in Austin in December, he quickly found himself caught up in such a digital web. Security cameras spotted him climbing on a rental scooter to make his getaway. The scooter, of course, has a GPS sensor in it so the company can find it at night and recharge it, so authorities knew where the scooter went next. The scooter also has to be able to charge the user, so the authorities knew who had taken it. They then checked his cellphone, and, sure enough, he was near the bank at the time of the robbery. 

Who needs Columbo when you have all those tools?

Car thefts have dropped by a third since 2000 in the U.S., partly because of new anti-theft devices but also partly because so many cars now have tracking devices that let stolen cars be found immediately. Car insurers now have access to sensor data that they can use to challenge the narratives of potential fraudsters, and cameras are increasingly capturing video of accidents on roads. 

In the home, smart doorbells see who is there and may scare off intruders, or at least discourage  them from taking packages left outside. Wearables and electronic assistants like the Amazon Echo and Google Home have been used to unravel alibis. ("No, sir, your wife was not still alive at such-and-such a time, as you claim.") Such sensors will surely be resources for insurers.

Big data and artificial intelligence will also help both police and insurers spot the sorts of criminal rings that stage accidents and thefts to collect major settlements. 

Now, the law of unintended consequences is still in force, so the spread of cameras and sensors won't play out quite as any of us suspect. In a book published five years ago, Chunka Mui and I posited that the spread of cameras could drive a lot of innovation, and we were right—but not quite. For instance, we said that police would routinely wear body cams, and they do. But the cameras haven't proved to be quite as important as evidence as we expected they'd be—context and framing turn out to be important enough that juries sometimes dismiss what they see on video. The cameras also haven't changed police behavior as much as we had expected.

Still, we're clearly headed in the right direction with cameras and sensors, limited just by our inventiveness in deploying them.

We might even be as successful in heading off problems as a friend of mine was many years ago when he was the victim of the world's briefest carjacking. He was living in a dodgy neighborhood in Washington, D.C., as a young editor in the Wall Street Journal bureau there. He was pursuing a dream of becoming a licensed auto mechanic (the only student with a degree from an Ivy League university, or from the Sorbonne, that the school had ever seen) and had an old car that he kept around as a challenge. At a stoplight, a guy came up to the driver's window, pointed a gun at my friend and ordered him out of the car. The thief engaged the clutch, and the car lurched forward and stalled. The thief tried again. Same result. A third time. Still no go. My friend, knowing just how dodgy his clutch was, was still standing nearby as the thief jumped out of the car, threw the keys at my friend and ran off.

May all our problems be resolved so quickly.

Paul Carroll
Editor-in-Chief

I’ve worked in the insurance industry for nearly 20 years, and I’ve (mostly) been pleased with how the industry collaborates, working together to solve problems and serve the global economy. As former Willis Re CEO John Cavanagh said in an interview with Insurance Thought Leadership, “Nothing flies, floats or gets built without insurance....Insurance plays a significant role in society, and we need to protect that.” Indeed, the insurance industry is a small world that plays a big role in protecting society at large. Create fusion, not friction Together, we’re charged with tackling the world’s challenges—from the worst of human nature to the worst of mother nature—and the only way we will succeed is by working together. Aristotle said, "The whole is greater than the sum of its parts." We can accomplish far more together than we can by working in silos. Focus on being the best at what you do, and bring that together with the best that another organization has to offer. That is insurtech. And, collaboration is not only necessary if we are to fulfill our promise to society, but it is the future of insurance. No one can go it alone in this industry. In the midst of uncertainty and change, we can be counted on to come together in crises. Can’t we? During last year’s catastrophes, specifically hurricanes Michael and Florence, I observed that not everybody was playing nice in the sandbox. Without a doubt, collaboration is happening in the industry, especially among carriers and insurtechs. It didn’t take long for incumbent re/insurers to buy into the value of teaming up with insurtechs. In fact, 83% of insurtech deals involve a re/insurer as an investor, according to Ernst & Young research. But, while many are exchanging the best of what they have to offer, some of our industry’s largest catastrophe modelers and data providers are still holding their data close to their vest. See also: Is Insurtech Wave Hitting a Riptide?   We (solution providers) can do a better job As a provider of geospatial insurance analytics software, we see collaboration as key to our business model here at SpatialKey. In fact, “play well with others” is one of our corporate values. We make great software, but we’re not a modeler or data provider. It’s simple: We need data companies, and they need our solution to more broadly reach insurers (and showcase the best of their data). But, this exchange is not happening with some data providers like it should be. We can do a better job of coming together to serve our mutual customers (re/insurers, MGAs, brokers), especially during catastrophes when they need it most. This means sharing the best of what we both have to offer (data and analytics) to the benefit of our insurance clients. Making data readily accessible and easily digestible helps insurers speed their response to insureds and start making a real difference for those affected by an event—right when they need it most. Insurers need easy access to trusted data To that end, these data providers need to fulfill their commitment to deliver trusted data and models, first. And help, not hinder, by making their data readily accessible and usable. I’ve witnessed first-hand the frustration felt by insurance professionals who need access to expert data right now. Insurers are working hard—scrambling and struggling to get information and make use of it. Not only do they need easy access to trusted data, they’re challenged with operationalizing sophisticated data. Collaboration gives insurers an easy path to expert data, and solves many of the challenges they face in times of crises, such as:

• Fast access to quality data — a streamlined way to access multiple perspectives from trusted authorities (e.g. for hurricane, bringing aerial imagery together with inland and surge flood extents and depths, as well as wind footprints with wind speed information)
• Operationalizing data — loading and getting increasingly sophisticated data into usable formats
• Interpreting data/models — understanding the nuances and how to apply the model for business use
• Easily integrating data into workflows — putting data at the fingertips of business users when they need it, without the need for GIS expertise

Opportunity gained or lost? It’s not only carriers who are faced with the necessity to embrace some level of transformation. The premier data providers in our industry may, too, benefit from exploring how technology through collaborative partnerships can transform their own business models. Catastrophe events, like those witnessed in recent years, present an opportunity for data providers to demonstrate their expertise and get their data into the hands of a broader insurance audience—through platforms other than their own. Insurers look to them—put their trust in them—and now they need them to collaborate in ways that make their data more readily accessible and consumable. See also: Insurtech: Revolution, Evolution or Hype?   Data providers: It’s time to play nice with others The solution is simple. Partner with insurtechs to give insurers an easy path to your data. Your time to shine is during crises. You can shine by sharing your valuable data with a broader audience and on a platform that enables carriers to more easily consume and interpret what your data is trying to tell them. Let’s fuse the best of each of us for the benefit of all who need our solutions most.

Most insurance companies understand that the industry has a looming obstacle to overcome, but they are not doing anything to prepare for this shift. A recent PricewaterhouseCoopers survey suggests that 74% of insurers view financial technology innovations as a challenge. While they might understand the potential of fintech, only 28% of industry players are working to collaborate with fintech companies. There is a definite disconnect between thoughts and actions. Moreover, a paltry 14% of insurers participate in accelerator and incubator programs, where potential is ripe for partnerships. As innovations ranging from AI to the sharing economy steer insurance toward disruption, the companies that drag their feet ultimately risk being left behind. A perfect combination of technology and data certainly has the potential to revolutionize insurance. In the coming years, leaders in insurance will lean on technology like bots and AI to help the industry flourish. Because insurance already involves so many algorithms, underwriting will soon reach levels of precision that were hard to imagine only a few years ago. See also: How to Embrace Insurtech Culture Cape Analytics, for example, is using technology to spot high-risk roofing in a sea of aerial images. Company data indicates that homes in the U.S. have an 8% likelihood of having a roof of either poor or severe quality. This is huge news for insurers — when a building has a low-quality roof, the possibility of a claim is 50% higher, and the resulting payout is generally larger. When insurers can gauge roof conditions in advance, they are in a better position to provide an accurate quote and avoid unexpected losses. The insurance industry has offered more uncertainty than peace of mind in years past, but innovation and digitization have the power to change that. Regardless of how this change happens, future insurance industry disruption will revolve around customers. Digitization in consumer finance has given industry players a wealth of data, but this evolution has yet to make a real difference in the lives of consumers struggling with the same financial problems that have plagued generations. New payment methods, robust financial applications, and a variety of shiny gadgets are great, but insurtech must tackle consumer concerns directly if they want to become true customer advocates. Technology has already left an indelible mark by making insurance cheaper, but cost savings are only the tip of the iceberg. Insurtech can make insurance products more attractive and easier to understand, which will increase the likelihood that customers recommend these products to friends and family. Improving experiences at an individual level might seem minor, but it has the added benefit of ensuring the broad swathe of underinsured customers in Europe and the U.S. are better-protected against risk. See also: Finding Value in Insurtech (Part 1)   Running toward insurtech rather than away from it will help companies cater to underserved markets and create disruptive offers. Many insurance companies are calling on insiders with industry knowledge — whether they are underwriters, actuaries or claims professionals — to become more involved and identify meaningful opportunities to solve problems. Instead of trying to catch up to emerging trends, insurers can use the potential of insurtech to leapfrog their competitors. With new technologies like the autonomous vehicle, medical advances and robotics becoming a viable reality, disruption in the insurance space is inevitable — even if it comes from outside of the industry. It is time for insurance executives to think ahead and embrace innovation as the heart of their strategies while determining how extensively they would like to work insurtech into their operations. The insurtech revolution is coming, and the companies that truly embrace this change will be poised to make the most of future disruptions.

Though they are often opponents, plaintiffs’ lawyers and insurers are rarely enemies. They may agree only to disagree, arguing with vigor—and countering objections to their arguments—on behalf of justice, as they define it; as they implore a jury to ratify it; as they ask a judge to certify it; as they appeal to the public to accept or reject it. But they are also professionals, which means they can separate the law from the litigants. They can talk to each other and learn from one another, so they may help not just their respective cases but the broader cause of safety and fairness. Insurers should host a summit between themselves and plaintiffs’ lawyers, because the former can better understand the concerns of the latter. Where they can do good, they should achieve it. Where they can pursue goodness, they should do it. Where they can negotiate in good faith, they should renew their faith in the good they can accomplish together. See also: Insurance and Fourth Industrial Revolution   According to Wayne R. Cohen, a professor at The George Washington University School of Law and a Washington, DC, injury claims attorney, talk is not cheap; but it is cheaper than battling for months or years in court. He says: "Dialogue is neither an expression of weakness nor an effort for the weak-minded. It takes discipline to listen to your adversary, in contrast to talking over what your adversary has to say. By showing respect, each side may improve its chances of finding common ground without losing territory, so to speak." I agree with Professor Cohen, not because I think every summit can solve every problem, but because I know we can solve some problems with a summit. If nothing else, a summit can clarify where insurers and plaintiffs’ agree, while it can reveal where a gap is too great to bridge and too dangerous to cross. Put another way, or to put it the way Winston Churchill said it: “Jaw, jaw is better than war, war.” It is better to talk, when the parties in dispute are not too disputatious to abandon reason and too eager to fight, than it is to lose so much over what may be so little. It is better to reduce the chances of war, by which I mean litigation, unless the avoidable, in theory, becomes the inevitable, in reality. Until that time, insurers should talk to plaintiffs’ lawyers. They should talk by exchanging ideas, not insults, because the essence of diplomacy is the attempt to reach a solution. Whatever complicates that attempt, be it words or deeds, be it threats or acts that threaten to disrupt these proposed talks—whatever each party can do, for the talks to continue, it should do. See also: Innovation: ‘Where Do We Start?’   Let the parties talk, so we can talk about—and praise—their attempt to do the right thing. Let them talk about what is right, based on their attempt to see it; based on their attempt to will it. Let them talk, please.

Insurtech came into its own in 2018. We saw insurtech startups successfully funded or acquired and established insurtech companies beginning to actually compete with legacy insurers. These insurtech trends will have a profound impact on the industry as 2019 unfolds. By 2025, insurtech will be everywhere — and many of the old habits of the insurance industry will likely be replaced by technological tools that offer better results, lower costs and happier customers. Insurtech Past: Hallmarks of 2018 The topic of insurtech was everywhere in 2018, and for good reason: Insurtech innovations have begun to disrupt every corner of the insurance industry, from underwriting to customer expectations. While established insurance companies dabbled in telemetrics, integrated their siloed computer systems or launched drones to assess damage claims, the biggest insurtech innovations and disruptions happened behind the scenes. Big Interest Meant Big Funding Over the past year, dozens of insurtech startups have attracted the attention of venture capital firms and independent investors. This has led to large and rapid investments in the industry, says Nathan Golia, Digital Insurance editor in chief. The first quarter of 2018 saw 66 insurtech funding deals secured; in the second quarter, 71 deals joined the list, Business Insider writer Lea Nonninger says. However, the overall funding amounts were smaller in the second quarter, indicating that 2019 may be a year in which new insurtech companies must prove themselves in the market rather than merely demonstrate their ability to excite investors. Established Insurtech Companies Outgrew Their Growing Pains The track record of older insurtech companies in 2018, however, provides a source of hope for emerging companies. Established insurtech businesses moved beyond their early struggles and into a place of industry stability and respect, Business Insider writer Sarah Kocianski says. Today’s most influential investors are choosing to invest not in brand new insurtechs, but in late-stage and follow-on funding rounds. This trend shows that the insurance industry has reached an inflection point, Deloitte leaders Garry Shaw and Sam Friedman say. This trend is likely to continue into 2019, increasing the pressure on insurtech startups to make good on their promises. See also: 3 Insurtech Trends Accelerating in 2019   Cyber Insurance Demanded Cyber Security Cyber security was a top concern for insurance in 2018. As a result, the market for online insurance products and services will continue to grow, Insurance Journal writer Michael Kasdin reports. This creates more pressure to keep customer and insurance company data safe from exploitation. In response to concerns about digital security, the National Association of Insurance Commissioners (NAIC) created the Insurance Data Security Model Law in 2017, Insurance Journal writer Don Jergler says. And several states have followed suit. In 2018, South Carolina enacted an insurance digital security law that closely paralleled NAIC’s model law. New York enacted a similar security law, and several other states are considering similar legislation in 2019. The question for insurance companies today is whether laws and regulations can keep pace with changing digital security demands, Clark Hill attorney Christopher M. Brubaker adds. Responsibility for staying ahead of security concerns may fall on the insurtech sphere, which will need to adapt in real time to protect both insurers and their customers. Insurtech Present: Rising Trends in 2019 Many of 2018’s trends will continue to grow and develop in 2019. Insurtech startups will likely continue to appear, and funding interest in these startups may stay strong for some time. Insurers seeking to learn from the growth of insurtech, however, would do well to keep their eyes on rapidly growing companies and the tools they’re embracing. Insurtech Moves From De-Siloing to Ecosystems In 2018, breaking down silos was still a major topic of conversation. As 2019 unfolds, however, the cutting edge of the insurtech industry is moving beyond mere de-siloing to embrace a fully integrated ecosystem model, McKinsey’s Simon Kaesler and Felix Schollmeier say. “Participating in ecosystems allows insurance players to add value through network effects – for instance, by leveraging allies’ already-established platforms – and to integrate insurance services into other products.” Ecosystem models improve customer communication, build trust and fit within the context of customers’ lives, Insurance Thought Leadership writers Roger Peverelli and Reggy De Feniks say. For instance, by working with a mortgage company, an insurer can position itself as a valuable ally to homebuyers when it comes to insuring the home they’ve worked so hard to purchase. APIs Take Center Stage An application processing interface, or API, allows computer programs to talk to each other without requiring the user to switch between the two programs, Petr Gazarov of FreeCodeCamp explains. From the user’s perspective, work is carried out within a single app or interface with which they’re familiar. APIs are already making inroads in fields like healthcare, where they allow legacy systems to communicate without human involvement. Insurance companies can leverage APIs to improve communication among previously siloed departments, says Caribou Honig, cofounder of InsurTech Connect. Honig predicts that APIs will become even more common in 2019. Insurtech Drives Mergers Mergers and acquisitions were a popular topic in 2018, and they’re likely to grow in 2019. Established insurance companies are picking up smaller insurtech businesses that have proven themselves in the market, Accenture analytics lead Sharad Sachdev says. “We’re already seeing big insurance firms acquiring small, innovative startups. The thinking behind this consolidation is very simple – that company could offer us a competitive advantage, and we would like to have that competitive advantage for ourselves.” As more insurtech startups prove themselves this year, established insurers will have more reasons to support them financially. Insurtech Future: What We’ll See by 2025 Changes on the horizon are poised to make the 2025 insurance landscape vastly different than today. Here’s where today’s insurtech trends may take insurance in the next six years. Artificial Intelligence Will Complement Human Intelligence Artificial intelligence (AI) is already being leveraged by a number of businesses to improve customer service, data analysis and similar tasks, PropertyCasualty360 writer Luke Cohler says. Today’s AI is still learning from us, however, and it often requires close supervision by humans to ensure it provides the promised benefits. In the coming years, this situation will likely be different. AI is advancing rapidly, and, by 2025, it may be so embedded into our daily lives that we’ll scarcely notice the support it provides, Google’s chief economist Hal Varian predicts. For insurance companies, the rise of AI will elevate communication unlike ever before. Specifically, AI will help providers better understand and handle claims on a personal level — all without diverting human attention to the conversation. Insurance Will Leverage Smart Contracts Blockchains, or distributed ledger systems, are already being used to improve security and data storage across the insurance industry. However, blockchains also offer the opportunity to create smart contracts, and it is here that insurance will benefit from the technology most, Insurance Thought Leadership writer Jay DeVivo says. See also: Insurtech: Revolution, Evolution or Hype?   A smart contract tracks when certain terms are fulfilled, then responds by triggering certain appropriate, predetermined actions, J.R. Gutierrez at CryptoVest writes. Because the contracts are stored on the blockchain, all of the document’s actions and parties are difficult to hack. For insurers, smart contracts can take steps like automatically responding to claims or adjusting coverage to match premium payments. This allows human workers to focus on the details that computers cannot accurately assess. Established Insurers Will Be Insurtech Companies The rising mergers and acquisitions trend between established insurers and insurtech companies is a response to the rising need to understand and leverage data, Insurance Journal’s Stephan Hochburger writes. Yet it is also only the first step in the digital insurance transformation. The merging of insurance companies and insurtech leaders will change the internal culture of the insurers that seek these relationships. As technology continues to embed itself within the insurance process, the line between established insurers and insurtech startups will blur. By 2025, insurance companies will be testing and launching their own tech tools, grown in-house. Insurtech companies will likely still exist, but they’ll be competing to innovate against both insurance companies and insurtech startups.

For many people, apps are a part of our everyday living – from Uber, to conference schedules, to how we find our restaurants. They can also be part of our resilience toolkit. When we consider a comprehensive strategy to suicide prevention and mental health promotion, it’s helpful to segment approaches into “upstream” (preventing problems before they emerge through self-help), “midstream” (catching emerging problems early and linking people to least restrictive support) and “downstream” (helping people with more serious mental health challenges and suicidal thoughts) tactics. Thus, for this article, I have organized some of the most popular, best-researched and most innovative apps into these three categories. Upstream: Resilience Self-Help Apps

• Positive Activity Jackpot

Developed by t2health, this app uses the phone’s GPS system to find nearby enjoyable distractions. It comes with a clinician’s guide:

• Calm

Calm is designed for people new to meditation – starting with guided practices from three to 25 minutes in length and focused on a variety of topics from sleep to gratitude.

• Breathe to Relax

Another t2health app, Breathe2Relax, offers portable stress management focused on diaphragmatic breathing skill-building that helps with anger management, mood stabilization and anxiety reduction.

• MoodKit

Based in cognitive behavioral therapy, MoodKit helps people improve their mood by engaging them in over 200 mood-enhancement activities like thought checking and journaling.

• Pacifica

Pacifica is designed to help people who live with anxiety through soothing meditation and other personalized self-help strategies. Check out the science behind this strategy. See also: Impact on Mental Health in Work Comp   Midstream: Early Detection and Peer Support/Life Coach Apps

• Life Armor

Another t2health app, this brief assessment tool helps users manage emerging symptoms like depression, sleep deprivation and post-traumatic stress. Videos share personal stories from warriors and military family members.

• DBT Diary Card and Skills Coach

Through this app, users can master the skills of dialectical behavior therapy (DBT), known for its effectiveness in regulating emotions and interpersonal relationships. Users remind themselves of skills they are trying to develop and track skill use.

• TalkLife

Developed by folks at Harvard and MIT, TalkLife is a peer support platform that engages an online community when people just need someone who’s willing to listen. Posting can be done anonymously. Here is some research behind TalkLife.

• Koko

Also developed by researchers at MIT, this app provides help for people in all states of distress from bullying and harassment, or even thoughts of suicide and self-harm. Koko provides evidence-based supportive interactions with users while referring users in crisis to international lifelines for immediate help.

• Lantern

Lantern is a subscription service offering daily on-one-one coaching sessions and simple exercises combining cognitive behavioral therapy (CBT) and advice from real “professional coaches” trained in CBT. Recommended plans are personalized based on the user’s initial self-assessment. See also: Top 10 Ways to Nurture Mental Health   Downstream: On-Line Mental Health Services and Suicide Prevention Apps

• Virtual Hope Box

The original non-app version of the Hope Box was developed as a tool to help therapists in clinical practice work with their suicidal clients so they can find reasons for living. Clients would find something like a shoe box and fill it with future goals, pictures of loved ones, bucket list experiences and the like. When clients felt their suicidal intensity increase, they would bring out the box to remind themselves of these things. The Virtual Hope Box (VHB) does this and more. Still designed as something to augment treatment, the VHB helps people live through painful emotional experiences through distraction, inspiration, relaxation, coping, support and reasons for living.

• BetterHelp

BetterHelp is a monthly subscription on-line counseling app that matches people with licensed mental health professionals and gives them unlimited access to these therapists.

• My3App

My3app is a safety plan tool that helps people who are at high risk for suicide. It helps people develop a written list of coping strategies and sources of support. This app is based on content developed by B. Stanley & G. Brown (2008) and the Department of Veterans Affairs and is owned and maintained by Link2HealthSolutions, the administrator of the National Suicide Prevention Lifeline created in partnership with the California Mental Health Services Authority and was funded by the California Mental Health Services Act.

• MyVAApps — Safety Plan for Veterans

Part of the MyVAApps suite of apps, the Safety Plan app helps users create or co-create with their therapist a safety plan that outlines specific steps to take when they face crises, including connecting to Veterans Crisis Line.

• SAMHSA — Suicide Safe

This app is designed to help healthcare providers reduce patient suicide risk and is based on the SAFE-T Approach. I am interested to hear about your experiences with these apps! What else have you used? What do you find to be most helpful in managing your resilience, mental health and emotional crises?

With more consumer-facing digital health products entering the market every year, we all jump on the bandwagon of hacking into our bodies and how they function. Adorned with smart watches, bracelets and pendants, we look into dedicated mHealth apps for valuable insights about our health status. Now, all kinds of care consumers can easily access their sleep, mood, cycle, temperature, blood glucose, heart rate and other vitals. We get used to monitoring the basic vitals for a better understanding of how the body responds to being deprived of the full night of sleep, which sparks curiosity on getting even more useful information. How about forecasting a disease developing in 10 years and rooted in our current lifestyle, finding a way to break the negative patterns and avoiding getting sick? While we are more than ready for this kind of superpower, it still takes significant time for the technology to hit this level of computing power and prediction accuracy. Luckily, the technology is already robust enough to give us a sneak peek into the emerging chapter in the preventive healthcare realm — scientific wellness. Wellness empowered by science Scientific wellness embraces a variety of population health data and an extensive range of techniques for its processing and analysis, including AI and machine learning. Scientific wellness enables a quantitative approach toward human health and creates highly personalized health profiles of individual patients based on their medical history, lab results, genome and metabolome, as well as patient-reported data from smart medical devices and wearables. The patient’s body is approached as a system with many variables that are analyzed and tracked to:

• Maintain a person’s wellbeing
• Predict hereditary diseases
• Reverse pre-disease states
• Reduce healthcare costs with personalized treatments

This approach strives to revolutionize wellness, which currently focuses on changing a patient’s behavior in diet and lifestyle according to rather scarce medical data and without substantial personification. Main components of scientific wellness Scientific wellness offers a systematic view of a person’s organism, comprising the following three elements: Cross-body insights The traditional approach to wellness and healthcare is reactive, focused mostly on fixing what’s already broken or about to break. Therefore, a patient’s biological systems are usually reviewed separately, based on symptoms and medical history. This approach fails to work in case of asymptomatic conditions or diseases with a wide range of symptoms that can fit different medical cases. And if a patient isn’t aware of some genetic diseases in the family, the patient may find out about a problem only upon early or even late development of symptoms. See also: Employee Wellness Plans’ Code of Conduct   Scientific wellness creates a multi-faceted review of different body systems that allows doctors to elicit patterns and understand a patient’s physiology, development and underlying risks for hereditary or non-hereditary diseases. The approach suggests harnessing the power of big data by acquiring a massive amount of information about an individual and carrying out the following procedures to extract actionable insights:

• Conducting the whole genome sequencing
• Analyzing blood, urine and saliva
• Evaluating gut microbiome
• Acquiring patient-generated health data from mHealth apps, smart medical devices and wearables

This approach can benefit population health in the future, too. Defining patterns across different conditions in individual patients allows clinicians to find common trends across populations, study the pathophysiology of diseases, elicit new diagnostic and prognostic biomarkers and contribute to preventive therapy development. Here’s where another data cluster comes in handy. Social media are actively researched as a data source for seasonal influenza predictions. Twitter can help to pinpoint trends for coming outbreaks up to 10 days faster than CDC’s Illness-Like Influenza Surveillance Network (ILINet). Further on, the personal disease susceptibility biomarkers can be analyzed together with the available data on previous outbreaks, assisting in epidemic control and prevention. A powerful high-tech alliance The other major component powering scientific wellness is a combination of approaches, technologies and computational tools for medical data quantification. For example, precision medicine that stands in the center of scientific wellness uses artificial intelligence and machine learning to accelerate genome sequencing. The trained algorithms streamline the search for known patterns and also find more underlying genetic correlations. But why limit AI and machine learning applications in healthcare to DNA analysis only? Scientific wellness challenges artificial intelligence with varied data, from medical images to monthly blood pressure trends or daily mood entries. Testing the AI against other patient data can reveal even more subtle dependencies in human bodies -- for instance, finding the balanced nutrition for a particular patient and help them avoid diabetes. Additionally, precision medicine starts adopting blockchain to facilitate processing of big data, increase medical data security and anonymize personal information for use in clinical reporting and population health research. Blockchain is perfect for the stack of scientific wellness technologies due to its secured and transparent nature. It allows all healthcare parties to become involved in healthcare democratization – as patient data becomes immutable and anonymized, clinical stakeholders, pharma companies, medical researchers, payers and patients themselves can collaborate across the care continuum and beyond. Population health data clouds Scientific wellness strives to support population health initiatives starting from individual patients. Each patient’s extensive and dynamic health profile is a distinct data cloud with billions of data points. They can be integrated to create a bigger picture in certain patient groups and uncover actionable insights about DNA-repair defects, particular conditions, susceptibility to developing morbidities and other health issues. See also: The Value of Workplace Wellness   By integrating these big data pools, we will be able to identify trends in transitions from healthy to sick states across rare and common diseases and unlock the opportunity for more effective preventive treatment. Population health will be more focused on therapy for rolling the condition back and stopping it from development, not the other way around. Another fad or near future? The reason why scientific wellness might become the next stage in healthcare evolution is that the technology level already allows analysts to dive deeper in patient data. Major healthcare software development providers, such as Itransition, prove it by pioneering and powering innovations in big data processing, precision medicine and medical image analysis. The multi-faceted approach to patient health status, data analysis technologies and unlocked opportunities for collaboration among all healthcare stakeholders creates an unprecedented area for preventive and reactive care delivery. It will be possible to predict genetic disorders developing at any age, avoid health deterioration in chronic patients and kick start preventive treatment creation. We can only welcome this scientific wellness era ahead and wish it becomes the next healthcare reality.