Download

Digital Innovation: Down to Business

Are we ready to talk real traction in volume and customer value from innovation that goes beyond just a great concept?

|
When presenting at DIA last year, I commented on just how far the industry has come in recognizing the opportunities for insurtech and adopting smart digital techniques in such a short time. According to Celent’s most recent innovation outlook for insurance, 69% of the insurance innovation leaders surveyed have been pursuing an innovation agenda for somewhere between two and three years, with 11% having only just started. To me, this stat implies that we are no longer at the start of something. Instead, we’re slap bang in the middle of a movement. See also: Global Trend Map No. 6: Digital Innovation  And with that added maturity, I guess it should come as no surprise that the questions obsessed about by the industry are no longer focused on "how to engage with insurtech?" "what internal capabilities do I require?" or "will they eat my lunch?" and instead more directed toward understanding the source of value and execution. Simply speaking, conversations today are far more focused on “show me the money” than they were back in 2015. For example, the global head of innovation at a client recently shared with me that they’ve “fixed procurement,” “fixed internal development,” “reskilled the team” and “embedded their innovation capabilities back into the business (to sit more closely alongside strategy execution).” Consequently, this client has become far fussier about potential partners. If an insurtech does not have any jaw-dropping, protected IP, then they’re unlikely to even get enough air-time to press play on their Prezi or pencil drawing app (of which there are quite a few to choose from now) before the door is slammed in their face. Although this client’s story may not yet be representative of the industry as a whole, given that many are still struggling with aligning their organization behind new innovation capabilities, it highlights a shift in the general direction. Aligned with this shift, there also seems to be a more concerted effort to move innovation capabilities back within the business (as can be seen in this chart). Graph: Please indicate if you are utilizing any of the following innovation tools/techniques at your company (choose all that apply). Source: Celent – Insurance Innovation Outlook 2018: Practitioners Predictions, n=29 chief innovation officers, innovation leads, digital leads). Of course, central teams still play an important role. Often, they are the only places where more radical forms of innovation can be experimented with (helping to insulate them from the day-to-day pressures of running an existing business). However, when considered altogether, the gradual shifts away from what can sometimes feel like an opportunistic mode of engagement (characterized by serial “proof of concept” projects, often sponsored by central teams), toward something more locally aligned, deliberate and focused on real customer value feels like a step forward. See also: 3 Ways to Leverage Digital Innovation   Are we now at the point where innovation is truly back with the business and we’re ready to talk real traction in volume and customer value that goes beyond just a great concept? I can’t wait to see! This article was originally published here.

Cloud Takes a Starring Role

Cloud is set to be used in a whole new way by streamlining processes, connecting to advanced technology and consuming more data.

Eight years ago, I was giving a talk on cloud at a conference. The first thing I had to do was explain what the cloud is. It’s a new world, isn’t it? Cloud is no longer for the digital giants, the insurtechs and the early adopters. Today, it would be difficult to go through a whole day without using cloud computing. Insurers’ core systems (policy, billing, and claims) are no exception. Cloud-hosted core systems are no longer a niche item: 59% of the new P&C core systems that insurers purchased in 2017 will be deployed in the cloud. On-premise deployment is by no means obsolete, but more and more it will be only a fraction of insurers’ technical environments. Increased speed to market, fast implementations, seamless scalability, easy access to new technologies, robust safety standards and, in some cases, streamlined software upgrades have all attracted insurers to core in the cloud. What comes next, however, is where the real opportunity lies. The digital world is all about making connections – between people, technologies, services, data and data sources, etc. – and doing so at top speed. Whether your core systems are in the cloud, hosted by a solution provider or run from your own server room, you have to be able to call out to external services for data and transactions. New computing trends are pushing the abilities of core systems even further. Cutting-edge artificial intelligence services (think “rent-an-AI”) are only available through the cloud. For example, if you wanted to incorporate advanced natural language processing into your core systems, you would not simply install IBM Watson on your existing servers. Microservices, which are isolated processes that can be plugged into an existing technical architecture, fulfill their true potential by calling out to advanced, external services like blockchain and IoT data platforms. Then there are the possibilities offered by computing in the cloud. Serverless computing allows insurers to leave all server management and resource provisioning to the cloud provider for increased processing power, decreased latency and real-sized costs. It represents an evolution in the way that we consume and use cloud. For insurers looking at huge new sources of data, like wearable devices, serverless computing is a must. These are the real benefits of cloud computing. Core systems in the cloud can take advantage of some of these new computing trends more easily, but all have an opportunity to leverage the cloud to advance their technological capabilities. The insurance industry is poised to use cloud in a whole new way by streamlining processes and upgrades, connecting to advanced technology and consuming more data. The more benefits that insurers reap from cloud computing, the more cloud computing will become table stakes.

To learn more about the latest computing trends and how they will affect insurers’ core systems, please see our recent report, The New World of Core Systems: How New Computing Trends Will Transform the Core Systems Paradigm.


Karen Furtado

Profile picture for user KarenFurtado

Karen Furtado

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

How to Be Agile in Today’s D2C Era

Insurers are limited by legacy systems that track only certain types of customer data — and can’t crunch available data efficiently.

Direct-to-consumer (D2C) sales have shaken up multiple sectors, from retail consumables to insurance sales. While D2C sales of property and casualty insurance have the potential to improve customer satisfaction, increase upselling and boost retention, moving into the D2C space also poses challenges for insurers that have invested heavily in more traditional models. Here, we look at some of the biggest challenges D2C poses, the opportunities available and how P&C insurers can improve their direct appeal to consumers without losing their traditional strengths. The Challenge of D2C D2C models are threatening traditional participants in a number of industries with their ability to adapt, innovate and streamline — skills that are tough for established players to exercise quickly,Groceryshop cofounder Zia Daniell Wigder notes. “Ultimately, monopolistic players are stuck in a paradigm that is very profitable, but that leaves them with reduced ability to innovate and form direct, meaningful relationships with their customers,” Widger writes. While Wigder’s analysis focuses largely on retailers, many of the same challenges of D2C competition apply to P&C insurers. In particular, P&C insurers need strong connections with customers. These relationships boost customer retention and provide key insights into behavior and risk that play an essential role in the development, pricing and deployment of insurance products. And the D2C model makes customers want to build relationships with companies. As Ben Sun, general partner at Primary Venture Partners, tells Wigder, “New D2C brands emerging today understand these challenges and have built platforms that directly attack those vulnerabilities and provide consumers something of real value -- either a far superior shopping experience, higher-quality goods, cheaper products or greater convenience.” An outstanding shopping experience, better coverage, lower prices and increased convenience are high on the wish lists of those seeking P&C insurance — and, when D2C models can provide them, they become more attractive than their predecessors. See also: Why More Don’t Go Direct-to-Consumer   Even newcomers to the insurance market, however, face hurdles that sectors such as retail do not. Jay D’Aprile, executive vice president at Slayton Search Partners, says the complex web of legal regulations surrounding insurance creates additional hurdles for companies planning to either start on a D2C model or include a D2C option among their approaches. Fortunately, these challenges also present opportunities. D2C Opportunities for Insurers A 2016 Timetric report on D2C innovation in insurance found that the prevalence of internet technology in consumers’ lives — and the transparency that brings to every industry — has shifted the balance of power from insurers to consumers in our industry. Most insurance companies’ customers now demand fast, efficient, digital-centric access to insurance information and products. Often, a shift in the balance of power can feel like a cloud with no silver lining. Yet the power shift actually creates a number of opportunities. Expanded (and Tailored) Product Offerings Concerns over “choice paralysis” have long led P&C insurers to maintain a relatively small catalog of offerings. Insurance is complex, and a longstanding belief that too many options would cause customers to walk away has resulted in a reduced number of product offerings. While too many choices can be overwhelming, the existence of many choices, alone, isn’t typically the problem. “There is no upper limit to the number of options you can provide customers. With our private exchange, companies are offering 30 or even 300 choices to customers with a great experience,” Liazon cofounder Alan Cohen says. The trick, he adds, is to present options in a way that customers find intuitive to navigate. Personalization, packaging that clearly indicates differences in value and information access to support customer decisions allow D2C companies to lead customers easily through any number of choices. What does this mean for insurers? As technology helps insurance companies develop new products more quickly, P&C insurers are no longer limited from the customer side when it comes to tailored offerings. It becomes easier for insurers to provide precise, personalized coverage — and doing so simultaneously feeds customers’ desires for personalization and specificity, boosting their likelihood of returning to the insurer. Increase Employee and Customer Satisfaction at the Same Time In a 2016 report, Liazon found that companies using a D2C approach to both customer-facing products and employee-facing information tripled their employee satisfaction and doubled their customer satisfaction. How? In both cases, the D2C approach made the product in question — whether it was auto insurance for customers or health insurance for employees — easier to access. Questions could be answered more quickly, often with a quick browse on a website or mobile app. Selecting benefits or coverage was easier and more transparent and felt more personal. Companies that use these tools to collect customer or employee data have seen big boosts from their D2C approach, as well. “By leveraging analytics, we can deliver promotions and offers more efficiently to our consumers,” former High Ridge Brands CEO James Daniels explains, “and build our brands using owned media assets including our millions of Facebook Fans, email subscribers and website visitors vs. solely relying on paid media channels and at-shelf promotions.” How to Innovate D2C provides opportunities to increase agility, not only in the sale of P&C insurance products but in the way an insurance company understands customers, analyzes risk and does business. Technology provides the key. An agile insurance business in a D2C world “typically requires a multi-channel approach, including web, mobile, social, email and phone,” D’Aprile said. “Interaction on each of these plains must be tracked coherently to cater to the increasingly non-linear customer journey.” And, as Daniels noted, tracking customer interactions matters. Currently, insurers are limited by the systems they’ve build to track only certain types of customer data — and by legacy computer systems that can’t crunch available data efficiently. To get ahead of this problem, insursers will need to explore more expansive ways to capture and understand customer data. A strong D2C platform is only part of the equation. “If DTC is not a strategy that is deeply ingrained across the entire enterprise, customers will quickly see it for what it is: a smoke screen,” D’Aprile said. “Fancy technology cannot overcome operational siloes and uncoordinated business functions.” See also: Why Are Direct-Sales Carriers Winning? While D’Aprile mentions a multichannel approach as one solution to this problem, increasingly savvy customers who interact with insurers through multiple channels may come to read “multichannel” as a smokescreen, as well, because the experience in each channel is still different, BOLT’s CEO Eric Gewirtzman says. An omni-channel approach puts the customer experience, insurers’ access, agents’ information and data analytics under a single umbrella, maximizing the agility of the entire system while offering customers the personalization and speed of a D2C approach, according to CRM software provider Ameyo. Omni-channel allows for more agility in a D2C world — whether or not an insurer wishes to prioritize D2C insurance sales.

Tom Hammond

Profile picture for user TomHammond

Tom Hammond

Tom Hammond is the chief strategy officer at Confie. He was previously the president of U.S. operations at Bolt Solutions. 

Health: 3 Ways to Win Over Millennials

Health insurers need to win millennial small business owners through an emphasis on cost, transparency and digital experiences.

The millennial generation - which generally refers to individuals born between 1980-1996 - continues to fascinate businesses. Millennials are now the biggest cohort in the workforce and are opening the majority of small businesses. That means they hold a lot of power, both through the products and services they purchase and by way of social influence. Companies are motivated to understand millennials and win them over. That is not an easy task, considering that millennials show high levels of distrust in major institutions and most businesses. The health insurance industry, which struggles with public opinion more broadly, has a long way to go in terms of gaining millennials' business and trust. Below are three factors they should consider to convince millennial decision-makers that health insurance is an important purchase. Costs are a bigger concern than for other generations Millennials are more concerned with costs than other generations. Many young adults are saddled with student loan debts, while, at the same time, salaries have largely stagnated, and costs of living continue to increase. Millennial business owners understand these struggles because many of them have experienced them personally. Many millennials would rather go without health insurance than enroll in an unaffordable plan, especially because they are often relatively healthy and may not see an immediate need for healthcare services. To convince millennial business owners that health insurance makes sense for them, health insurers will have to prove their value. Insurers need to persuade millennial business owners of the short-term and long-term benefits. Insurers should create targeted, relatable ads that emphasize coverage of preventive services, which can reduce costly healthcare services down the road. Millennials treat health and wellness as a daily, active pursuit, so this message may resonate well with them. Small businesses should also view health benefits as an appealing incentive to attract and retain millennial talent. See also: How Millennials Are Misunderstood   Transparency is crucial for millennials While costs are important, millennials also place a high value on other brand characteristics like transparency. Considering the high levels of distrust among this generation, it makes sense that millennials want clear and honest information. In a dense and complicated industry like health insurance, companies can benefit from making information as simple as possible. It is especially important to be clear about pricing structure so potential customers can quickly understand what plan benefits include and don’t include. Insurance providers should also use social media and other channels to communicate with millennials and make it clear that they care about members. According to Ambassador, 71% of consumers are more likely to recommend a brand after having a positive experience with them on social media. They prefer digital experiences Millennials grew up with technology and are comfortable using the internet and their smartphones for all sorts of things, from banking to shopping. Taking care of their health is no exception - millennials are more likely to engage with insurers digitally and use telehealth services than older age groups. Millennials are coming to expect these capabilities, and some companies are doing better than others. For example, millennials’ retail expectations are based on the experiences they have with Amazon, Spotify, Airbnb and others. Insurers that focus on providing more streamlined digital services, like e-commerce marketplaces, online portals and subscriptions to mobile health solutions, will be in a better position to win over millennial consumers. See also: Taking Care of Small-Medium Business Conclusion To appeal to more millennials, health insurers will have to adapt their business strategies to prove their value, increase transparency and provide more digital offerings. Millennials are skeptical and cost-conscious, but they also care about their health a great deal. By meeting or exceeding millennials’ expectations, companies can gain loyal customers and increase the number of millennials who are insured.

Sally Poblete

Profile picture for user SallyPoblete

Sally Poblete

Sally Poblete has been a leader and innovator in the health care industry for over 20 years. She founded Wellthie in 2013 out of a deep passion for making health insurance more simple and approachable for consumers. She had a successful career leading product development at Anthem, one of the nation’s largest health insurance companies.

Microinsurance and Insurtech

Insurers used to define microinsurance policies as social responsibility projects. With insurtech, the picture is changing rapidly!

Until insurtech, insurance companies were defining microinsurance policies as social responsibility projects. With the magic touch of technology, the picture is changing rapidly! Microinsurance is a type of micro financial activity, which protects low-income people and communities with low premiums and limited coverages against risks. The main objective is providing financial protection for all low-income members with pooling risks and financial resources. The target customer group is quite big, as well. More than 2 billion people are potential customers of micro insurance worldwide. Microinsurance enhances financial security and peace of mind, supports social security systems in poor or developing countries and provides a high-level risk management system. For long-term investors, microinsurance stabilizes and develops financial markets in developing and poor countries and provides considerable liquidity for critical times. See also: Microinsurance: A Huge Opportunity   Four features are crucial for penetration by microinsurance:
  • Premiums should be affordable for low-income households
  • Products should be very basic and easy to understand and cover limited risks
  • Underwriting, claims and collection processes should be operated with high effectiveness
  • Products should be distributed effectively and with minimum distribution cost
With insurtech, the picture is changing rapidly! Insurtech is converting microinsurance into a very profitable area. The first rule of insurance, the law of large numbers, is now valid for microinsurance business. The number of insureds is widening, and this makes claims more stable and predictable for insurance companies. The first impact of insurtech in micro insurance is on UW processes. Because of the low premiums, operational efficiency is the key of success in projects. Insurtech allows insurers to have their own automated UW decision-making processes for fast and low-cost policy production. The key to success, management of operational risk, is reduced significantly. The products are simple, do not require any financial literacy and are very user-friendly. Target customers purchase policies without location restrictions via digital distribution channels. Premium collections, claims notifications and all compensations activities are performed with digital tools that were developed and perfected by insurtech. See also: A ‘Nudge’ Toward Microinsurance   For now, microinsurance projects mainly focus on personal accident, health and agricultural activities, but new products are being developed promptly. With all its components, like artificial intelligence, machine learning, chatbots and the Internet of Things, insurtech is becoming the new leverage for microinsurance -- not just diversifying and absorbing risks for individuals, but also providing very strong preconditions for other productive activities for policy owners.

Zeynep Stefan

Profile picture for user ZeynepStefan

Zeynep Stefan

Zeynep Stefan is a post-graduate student in Munich studying financial deepening and mentoring startup companies in insurtech, while writing for insurance publications in Turkey.

The bible of the internet

sixthings

Mary Meeker laid out her annual report on the state of the internet and e-commerce last week, and I waded through the full 294 slides so you don't have to. (The full report is here—http://www.kpcb.com/internet-trends—for those who want all the detail.) The report by Meeker, a partner at venture capital firm Kleiner Perkins, has become the bible for internet followers and, as usual, contained some surprises.

To me, the most startling number was that sessions on mobile shopping apps surged 54% last year (use of mobile apps overall rose just 6%). The 54% covers all types of products, many of which are easier to buy on a mobile phone than insurance is, but, still: The time for a robust mobile strategy was yesterday (minus about a year and a half).

It was also striking to see that 6% of all online product purchases began with something that someone saw in a social media feed. The figure represents all product sales online, so the applicability to insurance needs to be sorted out, but the 6% is triple the percentage from just two years earlier, suggesting that there is upside for those promoted product placements. 

As always, the report showed a continued surge in online commerce—up 16% in 2017, even faster growth than the 14% increase in 2016. The online share of the value of total consumer purchases in the U.S. reached 28%, up from 20% in 2013. When people were asked how they conducted their 10 most recent transactions, 60% occurred digitally.

The social and mobile trends, on top of the general growth of online commerce, suggest to Meeker that companies will increasingly sell directly to consumers—but that companies must target their efforts well. She reports that many of the best mobile apps, for instance, used video and "gamification" and that successful offers were increasingly personalized.

Amazon may, though, soak up much of the increase in e-commerce: Already, 49% of product searches in the U.S. begin at Amazon, and most of the searchers never leave the site.

Although Meeker didn't specifically address insurance, some observations in the report suggest both opportunities and challenges for the industry.

On the plus side, she said the world is moving more toward subscription models, rather than sales of individual products—and subscriptions sound a lot like automatically renewable insurance policies. The number of gig workers available to help inexpensively with, say, parts of the claims process—a la those employed by our friends at WeGoLook—reached 5.4 million in the U.S. last year, up from 3.9 million in 2016. The cost of cloud computing fell 11% last year, on top of the 10% drop the year earlier. 

On the challenges side, profits are increasingly being competed away. The price for an offline good fell 1% since the start of 2016, and the cost of an identical good online declined 3% over the same period. In addition, some insurance costs were negative outliers in her general economic analysis. While prices have been falling for almost every category of household expenditure in the U.S. for decades, the percentage of household income devoted to pensions and insurance climbed from 7% in 1972 to 8% in 1990 and now to 10% in 2017. The percentage devoted to health insurance went from 5% in 1972 to 5% in 1990 and now to 7%. 

Either we take advantage of the opportunities presented by digitization and meet the challenges, or ... perhaps Amazon or some other tech giant will.

Have a great week. 

Paul Carroll
Editor-in-Chief

P.S. As advertised last week, we finalized the agreement between our Innovator's Edge information platform and SAP. Here is the announcement: http://insurancethoughtleadership.com/press_release/ie-sap-partner/


Paul Carroll

Profile picture for user PaulCarroll

Paul Carroll

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

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

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

Employee Wellness Plans' Code of Conduct

All honest and competent vendors of wellness programs need to incorporate this pledge into their operations and contractual obligations.

The Employee Health Code of Conduct calls for employee wellness programs to commit to the improvement of employee health while avoiding harmful practices. Quizzify is proud to be the first wellness program to embrace the code, and the Employee Health Code of Conduct will be a contractual term in all contracts moving forward. See also: A Wellness Program Everyone Can Love We urge all honest and competent vendors to follow our lead and incorporate this pledge into the fabric of their operations and contractual obligations. The Employee Health Program Code of Conduct: Programs Should Do No Harm Our organization resolves that its program should do no harm to employee health, corporate integrity or employee/employer finances. Instead, we will endeavor to support employee well-being for our customers, their employees and all program constituents. Employee Benefits and Harm Avoidance Our organization will recommend doing programs with/for employees rather than to them, and will focus on promoting well-being and avoiding bad health outcomes. Our choices and frequencies of screenings are consistent with U.S. Preventive Services Task Force (USPSTF), CDC guidelines and Choosing Wisely. Our relevant staff will understand USPSTF guidelines, employee harm avoidance, wellness-sensitive medical event measurement and outcomes analysis. Employees will not be singled out, fined or embarrassed for their health status. Respect for Corporate Integrity and Employee Privacy We will not share employee-identifiable data with employers and will ensure that all protected health information (PHI) adheres to HIPAA regulations and any other applicable laws. See also: The Value of Workplace Wellness   Commitment to Valid Outcomes Measurement Our contractual language and outcomes reporting will be transparent and plausible. All research limitations (e.g., “participants vs. non-participants” or the “natural flow of risk” or ignoring dropouts) and methodology will be fully disclosed, sourced and readily available.

Breaking the Cycle of Litigation in WC

We were promised protection from litigation and ended up with a system that facilitates it instead. Three changes are needed.

I recently shared an article discussing the fact that the workers’ compensation system is not functioning as designed, with some key data points that show just how badly the industry is missing the mark when it comes to litigation. In a nutshell, workers’ comp was created to reduce the need for litigation, and yet it has become a highly litigious market. This translates to enormous, unnecessary costs for companies while not benefiting the injured worker. Before we get into addressing the problem, we need to determine how it became a problem to begin with. Why do workers feel the need to hire a lawyer? I engaged in a little informal research on the matter. I found a number of common trends in the reasons attorneys say they were hired to represent injured workers: 1. Insurance company denied claims. 2. Insurance company denied a treatment. 3. Injured worker was afraid he/she wasn’t going to get needs met (mostly referencing necessary care or financial impact). 4. Injured worker was afraid he/she would lose a job. 5. Injured worker wasn’t sure how to get what he/she needed. 6. Friend/coworker told the worker that he/she needed to get an attorney after being injured. 7. Lack of communication from carrier/employer/TPA. 8. Overbearing communication from carrier/employer/TPA. The first two seem obvious. People rarely like to be told no — that is a trait we all develop early in life and tend to keep over the years. Beyond denials of claims when a case is righteous and defensible, there will be battles to be fought over compensability and reasonable, necessary care. See also: The State of Workers’ Compensation   The next three all have the common thread of fear. Reducing fear and anxiety should be a central goal of claims operations and employers. Effective communication is essential to eliminating these issues. Reason #6 can best be mitigated by addressing the other reasons better and improving the overall brand of our industry. That brings us to the last two. One says not enough hand-holding, and the other says excessive hand-holding. Although these seem contradictory, they are essentially the same thing; we aren’t engaging the individual how the person wants to be engaged. For example, as a former marine and athlete, I have had my share of injuries and know how to manage my care and recovery. Just stay out of my way, and I will be back on my feet faster than my doctor could predict. But, another person with a different life experience would be just the opposite. I don’t want you to call me all the time, but if you don’t reach out to the other person (and often) you have a problem. The combination of these points shows that a one-size-fits-all approach to engaging claimants can cause (expensive) problems. We Need to Make Changes I’d make the case that state legislatures need to be engaged; we were promised protection from litigation and ended up with a system that facilitates it instead. Unfortunately, there is not a quick fix, and we need to address the aspects within our control to stop the bleeding where we can. Attorneys are not within our control, although we may wish they were. I don’t begrudge the attorneys — they are doing their job, and everyone has a right to do their jobs to the best of their abilities. But we are making their job easier by making simple and addressable mistakes. Inserting lawyers into the claims process translates to thousands of dollars in unnecessary costs. We should know (or at least honestly believe) that injured workers don’t want to go the legal route unless they feel they have no other options. So now, what can we do about it? I would suggest we need to take action in three areas. First, take steps to reduce the perceived need for litigation. This should include leveraging new capabilities in artificial intelligence (AI) that can assess risk of litigation as well as provide new insights into claimant sentiment. Using these types of signals to drive the way you engage injured workers will allow you to focus extra communication, hand-holding and empathy on the claims that need it without adding excessive claims handling costs to all your claims or “over communicating” when too much communication is bad. Second, when the fight does occur, use intelligent processes for picking the right attorney. AI and business intelligence solutions can help identify not only the attorneys with the best overall results but also which is the right attorney for this instance. Benchmark your panel of attorneys in the same manner an outcomes-based network benchmarks physician performance as a first step, and then develop the nuanced approach to claimant-matching over time. Third, develop more sophisticated “fight-or-flight” signals using predictive analytics so that you know what the likely costs/outcomes are if you cooperate, settle or draw a hard litigation line when the fight starts. Excessive litigation occurs when it’s easy and profitable to litigate, so the harder and less profitable we make it the fewer “excessive” cases we will see over time. In summary, I refuse to believe injured workers are typically looking to score big with a vicious lawsuit directed at their employer or claims company. I am not saying it doesn’t happen, just that there is no way that that is the behavior driving the costs and the bad outcomes, and it certainly is not that common in research to date. Most people just want to be treated fairly and get better. See also: Workers’ Comp: the Best of Both Worlds   While I am not the first person to make this case, what is new are the technology options that unlock the capabilities to make a change. Most AI and machine learning models are still early in their sophistication and application, but the tools do exist to make more informed decisions and drive processes and engagements that can change the game. But first, we need to devote our resolve to tackle this issue head-on; we need to make the commitment to integrate and experiment with new approaches to how we address the underlying causes that are 100% within our control. As first published in WorkCompWire.

Greg Moore

Profile picture for user GregMoore

Greg Moore

Gregory Moore is the former chief commercial officer of CLARA Analytics, a division of LeanTaaS and a leading predictive analytics company for workers’ compensation.

Prior to joining CLARA Analytics, Moore founded Harbor Health Systems, which he led for 16 years.

The First Quarter in Insurtech Financials

A detailed look at Lemonade, Root and Metromile shows both the promise and the short-term challenges for insurtech startups.

||||||||
The three independent U.S. insurtech startups whose 2017 full-year results we profiled -- Lemonade, Root and Metromile -- continue to grow rapidly in early 2018. But so far that has meant more red ink: Results that are bigger and blacker remain elusive. We’ve again analyzed publicly available financial results called statutory statements. The same caveats from our 2017 full-year analysis remain, and again we use only public data to write this post, which reflects only our personal opinions. Our prior statements regarding the three companies also remain – we think highly of their management teams and long-term potential. All three have a lot of runway and time to perfect their business models. We think they will. We produce this analysis not to critique their management. We want to help investors, entrepreneurs and traditional industry insurers to understand what is happening in insurtech through a lens of insurance fundamentals and facts rather than dogmatic opinion-mongering. Overall observations Top line: bigger. All the three companies are growing at rates associated with successful early-stage startups. For a time, these rapid growth rates may sustain their impressive, rumored valuations. Root nearly tripled its top line in the last quarter, apparently without spending too much on customer acquisition, and now has closed the gap on Lemonade. We suspect that this narrowing may surprise a few people, considering the differences in the two companies’ “share of voice.” (Admittedly, we also give Lemonade a lot more attention, in part because its business model is less straightforward.) Bottom line: redder. Underwriting results have continued to be consistently poor, even excluding expenses, which are influenced by scale and inter-company agreements. This is true even considering paid losses relative to premiums earned. It has been suggested that some of the poor underwriting results are because of exceptionally prudent or cautious reserving, but we find little evidence that reserving practices explain the high loss ratios. Auto and renters are well-modeled, short-tail lines of business where large absolute differences in estimates are less common than in lines where losses take longer to become known. In between: A quarter doesn’t make much difference in insurance. Detailed breakouts of spending are only published annually. The most notable change: Lemonade materially reduced the potential giveback and made an accounting change that reduces the expenses reported by its insurance company. Lemonade Insurance Co. used to pay its parent a flat fee of 20% for various services rendered by the parent and affiliated companies. In March, this was raised to 25%, retroactive to 1/1/2018. The higher fee increases the slice going to Lemonade’s non-regulated entities by a quarter. Furthermore, Lemonade Insurance Co. no longer reports the true cost of the services provided by the parent, meaning that its expenses for 2018 will appear lower than they actually are. (We explain this later.) Lemonade Insurance Co. Love ‘em or hate ‘em, there’s something for you in Lemonade’s first quarter results. The gross loss ratio (excluding loss adjustment expense) of 116% is still almost double what it should be to have a sustainable business, but it is within the last year’s quarterly range (from 104% to 144%). A quarterly loss ratio with a small book like Lemonade’s ($2.9 million gross earned premium) is still quite sensitive to individual losses and reserve assumptions. The company reported $207,000 of gross adverse development in the quarter, which added seven points to the gross loss ratio. Premiums earned continue to grow rapidly. Texas is actually Lemonade’s largest state, followed by California and then New York. Lemonade’s other eight states combined produced less premium in 1Q18 than New York. In the last quarter, direct written premiums have almost doubled in New York, but the growth in California and Texas has slowed to around 40%, quarter-to-quarter. This is extraordinary growth even if it is slowing. Lemonade has pointed out that it looks at different measures that aren’t published in yellow books – which we suspect include indicators of the sustainable long-term growth rate in the major states as well as seasonality factors in its renters’ insurance book. Reinsurers continue to subsidize the company’s losses: Reinsurers incurred $3.53 for every $1 in premium they received in the most recent quarter. The aggregate XOL reinsurance contract normally runs another two years (through 6/30/2020), illustrating why reinsurers that back startups also consider having equity participation. See also: Touching Customers in the Insurtech Era  A homeowner’s company would typically aim for numbers something like the following (which are from a leading homeowner’s insurer), plus or minus a few points: Compare with Lemonade’s numbers: The Giveback Lemonade’s giveback is one of the company’s most intriguing features. Customers join cohorts, and, if any premium remains after paying the cohort’s claims, fees and reinsurance, that money goes to a designated charity. Lemonade says that this “giveback” was 10% of “revenues Lemonade recognized” from its launch in 2016 until mid-2017. Another is coming in mid-2018. Lemonade has hinted at “an exponentially larger giveback in years to come.” We’re not so sure. There are two big headwinds. First, Lemonade raised the fee paid from its cohorts to the parent company from 20% to 25%, effective 1/1/2018. Such arrangements are common in the insurance industry and are approved by regulators, but not always gladly. Sometimes profit is moved to an affiliated agency that doesn’t have to pay claims, while losses remain in the regulated insurer. The second headwind against the giveback is that Lemonade’s cohorts have to pay for reinsurance, the cost of which is almost certain to rise in 2020 if the company continues ceding several times more losses than premiums. The giveback will probably remain – someone’s cohort will have very low losses – but the combined effects of a bigger fee to the parent and more expensive reinsurance could greatly reduce the giveback “in years to come.” This matters because the giveback is the crux of Lemonade’s business model for both its investors and customers. As CEO Daniel Schreiber has explained:
“If there is underwriting profit it is donated to non-profit - if it isn't and there are insufficient funds the reinsurers have a bad day, not Lemonade. "The 20% is insulated - we take 20% in good years and in bad and that is not really impacted by loss ratios - so we are indifferent to the level of claims.”
Set aside the line about being “indifferent to the level of claims.” The 20% is not insulated – it has already gone up – and reinsurers usually seek “payback” if they have a bad day. Payback means higher reinsurance fees such that, over time, reinsurers make at least a modest profit margin. That means a bad day may be coming for Lemonade, though perhaps not until late 2020. What would happen to the company’s vaunted social mission and behavioral incentives if the economics stop adding up? Lemonade has the cash to weather a lot of bad days and maybe even a pivot or two. The company confirmed its shareholding structure in the first quarter, and the figures support (but do not precisely confirm) the rumored $600 million valuation when Softbank and other investors put in $120 million. In the past weeks, Lemonade’s Policy 2.0 initiative has generated a relevant debate and raised challenges to regulators, who will have to examine the policy and deal with claims disputes. Ambiguity in an insurance contract typically is interpreted against the insurer, which could make it that much harder to get the loss ratio down. Lemonade remains a challenging company for regulators, and traditional agents are lining up to kill any regulatory flexibility given to insurtechs. Lastly, we comment on a quiet but meaningful accounting change. The 20% fee paid by Lemonade Insurance Co. (now 25%) was far less than the actual cost of the services received. Lemonade Insurance Co. used to report consolidated figures that gave a true representation of the cost of running its operation. No longer. Effective in 2018, the consolidation is gone, and perhaps $3 million of expenses seem to be missing in 1Q18 – highlighted in yellow above. In terms of disclosure, throughout 2017, Lemonade used the language shown below. The highlighted language is the key bit that is missing in 2018. Now in 2018: Transparency…. Root Insurance Co. Root has grown explosively, with gross premiums written having trebled since 4Q17, for a run rate exceeding $30 million. $2.9 million of $7.9 million of gross premiums written were in Texas, with Ohio and Arizona also chipping in more than $1 million each. Potentially most impressive is that Root apparently has achieved its growth without massive advertising spending. If ad spending as a percent of total expenses remained constant this quarter compared with last year (a big “if,” because overall expense are rising rapidly), then Root has greatly cut its ad spending as a percent of the premium. See the bottom line of Exhibit 2. As with Metromile and Lemonade, Root’s loss ratio remains unsustainably high, but the company’s $51 million fundraising round in June gives it a few years of runway to make improvements. Following our previous article, the CEO of Root commented that his company’s loss ratio was high in part due to prudent reserving. Indeed, Root was the only of the three startup insurers to report favorable development in the quarter, to the tune of $239,000 of gross positive development, which would cut almost 10 points off the 2017 gross loss ratio. (In reality, Root cut about seven points from the 1Q18 loss ratio, because prior year results aren’t restated when reserves develop.) There could continue to be favorable development, but so far the 2017 loss ratio would be cut from 138% to 128% -- still well above a sustainable level. Further, the company in 2017 paid $1.36 of losses for every $1 of premium earned (on a net basis). Root’s reinsurance comes up for renewal at the end of June 2018 and currently consists of a 50% quota share and $1M XS $100K tower, which limits volatility in results. Metromile Insurance Co. Metromile, the oldest and the biggest of the three, continues to grow premium – achieving an impressive plus-25% quarter-to-quarter, nearing an $80 million run rate. California continues to be the largest state for Metromile, accounting for $11 million of $19 million of direct premium written this quarter, as compared with $5 million of $10 million in the first quarter of 2017, which suggests that the company relies on one state but has room to expand. The company appears to be losing money in each state. As with other insurtechs, distribution has been easier than profitability. The gross loss ratio including LAE at 104% remains close to the results posted in 2017 but above a sustainable long-term rate. For comparison, Progressive’s personal lines loss & LAE ratio was 74% in 2017 (30 points lower), with a combined ratio of 93%. The gross loss ratio is affected by $1.5 million of adverse development at Metromile, which added about eight points to the loss ratio this quarter. Does loss ratio scale? We have been surprised to hear some investors comment that they expect loss ratios to decline with scale and to consider them as any other costs on the insurance income statement. There are some elements of loss ratio that scale, but only in a limited way, i.e. a few points, not cutting the loss ratio in half.
  • Claims: Taking claims in-house at the right time can reduce the loss & LAE ratio. TPAs get paid to manage and settle claims, which isn’t always exactly what carriers or MGAs want. (Claims is a moment of truth that drives loyalty, and insurance fraud is real.) Bigger insurers also have better ability to drive favorable pricing with repair shops, contractors and outside adjusters.
  • Portfolio management: Scale can enable the company to be more selective about risks underwritten, thus avoiding the worst risks. It’s hard to manage a portfolio (i.e. cut the worst risks) when also growing it rapidly from a small base.
  • Underwriting: Scale can help the company understand its own loss experience and adjust its underwriting accordingly. When companies start, they assess what risks are good or bad using industry data and place bets that certain segments are more attractive, thus targeting those segments or distributors that target them. As the company gathers data on the performance of its own book, through time and scale, the company can adjust underwriting and pricing to attract customer segments that perform particularly well for its particular business model. Again this has a trade-off against growth.
  • Mathematics: The law of large numbers will cause actual loss ratios to converge closer to the expected loss ratio. This isn’t really the loss ratio scaling down, but rather limiting the probability of a single really bad loss poisoning a year’s results.
However, when an insurer says that “we are indifferent to the level of claims” and then turns in a loss ratio that is double a sustainable level, investors should ask themselves, “What if they really are indifferent?” See also: Why Financial Wellness Is Elusive   Conclusion We have been grateful for the positive feedback on our first article covering 2017 results, with both startups and incumbents featuring highly on the list of companies whose employees read the article. So far, 2018 results do not lead us to change our conclusions from 2017. The three companies we’ve analyzed have several years of cash on hand, during which time they will probably continue to grow rapidly. They will probably improve their loss ratios, and expense ratios will scale down. The question is whether the figures get to a sustainable level. We won’t know for a few years whether these daring start-ups are really ground breakers or just expensive follies – as long as they are not acquired in the meantime. We’re cheering for them and think that we will see rapid growth and also profitability improvements in future quarters. We were asked a few times about other companies, particularly in non-U.S. markets. Many countries have similar filings to the U.S. statutory filings, but we’ve not published anything on them yet. Also, agencies and brokers typically do not file public financials. We have begun to observe a trend, such as with Next Insurance, of insurtech agencies converting to carriers or at least exploring the idea seriously. There are many reasons why this makes sense at a certain point in a company’s development, and it will provide more insurtech carriers’ financials to analyze in years to come. To be notified of future articles, please follow Matteo and Adrian Jones on LinkedIn or subscribe to Insurance Thought Leadership's Six Things weekly newsletter. You can also find us at the leading conferences, including: Adrian: Plug and Play Summer Summit in Silicon Valley, InsurTech Insights in London, Rendez-Vous de Septembre in Monte Carlo and InsureTech Connect in Vegas. Matteo: InsiderTech London, Connected Insurance Summit in London, InsurTech Insights in London, NAIC Insurance Summit in Kansas City, Rendez-Vous de Septembre in Monte Carlo, Annual North America Re/Insurance Conference in New York and InsureTech Connect in Vegas.

Can Insurtech Rescue Insurance?

Are insurtechs all marketing talk, without substance, or can they solve the industry's value, complexity and trust problems?

||
Is insurance broken and in need of rescue? That was the question I recently asked myself while hiring a rental car to visit the infamous "White Line" mountain bike trail in beautiful Sedona, AZ. When I discovered the full Hertz insurance cover was going to cost me double the price of the actual car hire, I couldn't help but relay my shock to the salesperson. She proceeded to tell me about customers' typical reaction to the accompanying insurance cover purchase, and three things, from the conversation, stuck in my mind:
  1. Many customers opt not to take the liability cover even though it leaves them quite exposed.
  2. A surprisingly high percentage of customers ask for a refund on their insurance payments, at the end of the rental period, if they didn't need to make a claim!
  3. Customers are generally very distrustful of the insurance product they are buying. Customers are often unsure whether it will actually cover their needs if they have to make a claim.
To my mind, this random conversation captured three big problems the insurance industry currently faces: Problem #1: Consumers often don't value insurance Insurance is quite an unusual product. Except for maybe a coffin and a fire extinguisher, it's the only purchase I can think of that you make but hope to never have to use. Let's face it. Buying insurance is usually an uninspiring "grudge purchase." Tedious paperwork, arcane questions, having to think about what can go wrong in your life. Is it any wonder that the experience is up there with a visit to the dentist? Of course, the reality is that should your home be destroyed in a storm or should you be involved in a car accident deemed to be your fault (especially with third-party injury) insurance can be the saving grace preventing potential financial ruin. Problem #2: Consumers don't always understand insurance After going through the pains of considering the potential financial impact of personal tragedy, you are rewarded with the product: a paper contract. Not just any old paper contract, but a long-winded, very conditional and often confusing document. How exciting! Again, is it any wonder that insurance customers can't or don't want to take the time to understand the precise nature of what some deem to be the world's most boring product? Problem #3: Consumers generally don't trust insurance companies  To highlight the trust issue, I turn to the most popular definition of "insurance company" from the crowd-sourced Urban Dictionary:
Insurance Company: "An affiliation of pirate-gamblers who accept bets called premiums. The dollar amounts of the premiums are non-negotiable, but the amounts of the claim settlements, should the company lose the bet, are rarely delivered without argument."
While the quoted source may be a parody, I believe the underlying inclination signifies the typical level of distrust that consumers have of insurance. See also: Where Will Unicorn of Insurtech Appear?   Don't get me wrong. I believe insurance plays a critical role in our lives, and insurance companies can provide a great service as well as a very rewarding career path. But, when it comes to the general consumer view of insurance, there seems to be an issue. Ask 10 random people on the street to describe "insurance" in three words, and you can be nearly sure at least one person will allude to issues of distrust Insurtech to the rescue? So what is the industry doing to solve these problems? It appears that the nimble insurance technology startups (insurtechs) are playing a large part in leading the way in attempting to overcome these issues. Below are three insurtech companies focused on addressing these issues and arguably changing the insurance world for the better: Solution # 1: Improved Value - Metromile Telematics has been around for a few years now, particularly in Italy, the U.K. and the U.S. Onboard car technology is used to monitor and potentially assess the driving behavior of each individual driver, thus moving insurance from a pooled pricing model to a more individual specific model, one where the underlying policyholder risk is more closely monitored. These telematics technology devices (also known as a “black box”) are able to pick up a number of diverse driving metrics such as:
  • mileage
  • location
  • time of day
  • driving frequency
  • behavior around hazardous zones
  • speed
  • rates of acceleration
  • braking habits
This information can then be considered in a more accurate and individualized pricing model, one that potentially allows the previously trapped (i.e pooled) policyholder to break free from his or her age or gender (non-EU) status, etc. and prove worthy as a safe driver that is a good risk and unlikely to have an accident and hence claim. Low-mileage drivers, as well as young male drivers, can benefit, and this is the market that Metromile has targeted. The usage-based customization of insurance certainly seems to be keeping customers happy, with policyholders reporting they feel like they are getting a fairer deal. After all, should a low-mileage, safe driver really be subsidizing a riskier driver just because they share common old-school rating factor characteristics? Metromile has been forging ahead with this lifestyle app-based continuous digital engagement model since 2011. And the company shows no signs of slowing down. In late 2016, the company raised a further US$150 million in funding through which it acquired a carrier enabling the company to now underwrite its own policies. Solution #2: Simplicity and Understanding - Trov The Trov promise:
"As simple as Tinder and as beautiful as Airbnb" — Scott Walchek: CEO of Trov
Trov provides on-demand insurance for personal items that can be toggled on and off via a few simple taps from your phone. The company aims to give the mobile generation easy protection that they can enjoy "without worrying about rigid policies and confusing fine print."  In addition, Trov seems to be jumping on the personalized cover bandwagon - treating policyholders as individuals instead of an average risk within a cohort. The flexible app gives customers the option to tweak their cover toward their own personal circumstances. As one customer put it: "Why pay for an expensive insurance plan designed to cover your worldly belongings when all you really care about is your mountain bike and your laptop?" 
"Protect just the things you want - exactly when you want - entirely from your phone" — Trov website
This simplicity and flexibility seems certain to appeal. I personally like the idea of being able to quickly and easily protect my mountain bike by getting temporary insurance for the times when I do actually take it out and use it. And if a claim is required, it's all handled via an in-app chatbot. Insurance for the smartphone generation indeed! While I do wonder how Trov counters fraud (given the ability to so easily turn the cover on and off), as we are living in the age of convenience, it would seem that this model is sure to appeal beyond just tech-savvy millennials. Solution #3: Enhanced Trust - Lemonade Lemonade is the poster child of insurtech, or at least the king of savvy insurtech marketing. When the company shouts about paying a claim in three seconds, using AI not actuaries and bots not brokers, it certainly makes one stand up and take notice. Lemonade began selling insurance nearly two years ago and has now amassed a sizable level of funding and following. The companyy promised to bring trust back into the insurance world - the way it should be and how it was in the beginning. The tools of their trade: behavioral economics and artificial intelligence. The promise to the customer: simplicity, convenience and affordability. But back to the trust issue. How is Lemonade approaching it? The business model attempts to disrupt the cycle of distrust between the insurer and the insured. This is done by separating the pool of risk capital from the company's own 20% flat fee. Essentially this model aims to remove the incentive for the insurer to minimize claim payouts on the basis that doing so will not affect its bottom line (the remaining 80% claim pot gets paid out to small peer groups under a giveback scheme, after some unavoidable expenses such as reinsurance cover). Basically, the deal is: Trust us to pay out your claim quickly, with minimal fuss and without any sneaky "catching you out in the fine print" shenanigans, and we will trust you to only claim if it's genuine.
"Knowing that every dollar denied to you in claims is a dollar more to your insurer brings out the worst in us all… Since we don’t pocket unclaimed money, we can be trusted to pay claims fast and hassle-free. As for our customers, knowing fraud harms a cause they believe in, rather than an insurance company they don’t, brings out their better nature too. Everyone wins." — Dan Ariely, chief behavioral officer at Lemonade
The behavioral implication, with the removal of potential conflict, is that the enhanced two-way trust will drastically reduce fraudulent claims. This, combined with the operational cost efficiency savings from AI and technology will allow the company to have happy customers and still make a sustainable profit. At least that's the theory. See also: Convergence in Action in Insurtech  Now, while I love what they are doing, I'm not entirely convinced their model is altogether different from some of the smaller mutuals, especially those that still maintain some level of social bonds. Maybe I'm biased because Lemonade doesn't seem to like actuaries, but I also wonder whether the company's pricing, underwriting and risk management will allow its loss ratios to stay low enough to not affect their 20% flat fee over the long term. It takes some time for reality to test the theory, in insurance. So I, for one, will be watching the Lemonade space with interest. Conclusion So is insurance really broken and in need of fixing? Let's not forget what insurance is all about. In essence, insurance is about the pooling and sharing of risk. Swapping an uncertain, and potentially large, outgo for a small(er) more certain outgo (the premium). This is unlikely to change, and insurance companies obviously already do this. But, I do believe, there is a need to modernize, especially in relation to the customer experience. I don't see insurtech companies causing a complete revolution. But they are likely to play a big part in the evolution of insurance. What do you think? Does insurance need to evolve? Is insurtech the answer to the customer experience issues? Are these insurtechs all marketing talk and lacking substance? Will the asset-rich insurance incumbents ultimately lead the way in the unfolding tech world evolution? This post first appeared on the ProActuary blog here.

Mark Farrell

Profile picture for user MarkFarrell

Mark Farrell

Dr. Mark Farrell is a fellow of the Institute and Faculty of Actuaries (FIA) and senior lecturer at Queen’s University Belfast. He is program director of actuarial science and risk management at Queen’s Management School.