Top Emerging Risks for Insurers
Large books of low-volatility policies, normally covered by primary insurers, could be packaged by others into securitized risk pools.
Large books of low-volatility policies, normally covered by primary insurers, could be packaged by others into securitized risk pools.
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Donna Galer is a consultant, author and lecturer.
She has written three books on ERM: Enterprise Risk Management – Straight To The Point, Enterprise Risk Management – Straight To The Value and Enterprise Risk Management – Straight Talk For Nonprofits, with co-author Al Decker. She is an active contributor to the Insurance Thought Leadership website and other industry publications. In addition, she has given presentations at RIMS, CPCU, PCI (now APCIA) and university events.
Currently, she is an independent consultant on ERM, ESG and strategic planning. She was recently a senior adviser at Hanover Stone Solutions. She served as the chairwoman of the Spencer Educational Foundation from 2006-2010. From 1989 to 2006, she was with Zurich Insurance Group, where she held many positions both in the U.S. and in Switzerland, including: EVP corporate development, global head of investor relations, EVP compliance and governance and regional manager for North America. Her last position at Zurich was executive vice president and chief administrative officer for Zurich’s world-wide general insurance business ($36 Billion GWP), with responsibility for strategic planning and other areas. She began her insurance career at Crum & Forster Insurance.
She has served on numerous industry and academic boards. Among these are: NC State’s Poole School of Business’ Enterprise Risk Management’s Advisory Board, Illinois State University’s Katie School of Insurance, Spencer Educational Foundation. She won “The Editor’s Choice Award” from the Society of Financial Examiners in 2017 for her co-written articles on KRIs/KPIs and related subjects. She was named among the “Top 100 Insurance Women” by Business Insurance in 2000.
With the NFIP expiring tomorrow, it's time to not only privatize flood insurance but to require that everyone get it.
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Sean Harper is the co-founder and CEO of Kin Insurance, an independent property insurance company that uses big data and machine learning to provide quick, fair and accurate insurance coverage for homeowners.
The author helped family recover from the California wildfires. The experience with both personal and commercial lines was eye-opening.
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Karlyn Carnahan is the head of the Americas Property Casualty practice for Celent. She focuses on issues related to digital transformation. Carnahan is the lead analyst for questions related to distribution management, underwriting and claims, core systems and operational excellence.
While some technology is noise, it can help especially in claims management and risk control.
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Mark Walls is the vice president, client engagement, at Safety National.
He is also the founder of the Work Comp Analysis Group on LinkedIn, which is the largest discussion community dedicated to workers' compensation issues.
Kimberly George is a senior vice president, senior healthcare adviser at Sedgwick. She will explore and work to improve Sedgwick’s understanding of how healthcare reform affects its business models and product and service offerings.
As a reporter at the Wall Street Journal, I was taught to watch for news that companies would try to bury by releasing it over holiday weekends and to make sure that the news got all the coverage it deserved – maybe even a bit more, just to teach the company a lesson.
In that spirit, I’d like to tee up a discussion on the report on climate change that the U.S. government released on Friday, as so many of us were lounging on a couch, semi-comatose after the friendly gluttony from Thanksgiving support the night before. The report is getting plenty of coverage – somehow, the news media seems vigilant about not letting the Trump administration bury inconvenient news – but is missing what I think is a key element: the role that the insurance industry can play in adjudicating the debates that have already begun about the accuracy of the gloomy climate forecast.
The report has the potential of a Nixon-goes-to-China moment, even though so many conservative commentators went on the Sunday interview shows to say the equivalent of, “No, Nixon didn’t go to China,” or even, “China, what’s China?” in reacting to the new report. (I’m thinking mostly of those who argued that the legions of U.S. government scientists in the 13 agencies that produced the massive report were somehow paid by outside interests to manufacture claims of climate change. I’m not sure how that would even work.)
The staying power could come because this report wasn’t issued by a Democratic administration but by an aggressively anti-regulation administration that has trashed the idea of man-made climate change – yet produced a report that said there could be a 9-degree Fahrenheit rise in temperatures by the end of the century and that 10% of the U.S. economy could disappear, unless drastic changes are made.
While insurance pricing doesn’t have much to say about what will happen 80 years from now, it does have a lot to say about what will happen in the short to medium term. We won’t stop the debates about the science in the report. Debates will also rage about how much burden the U.S. should shoulder in stopping or reversing climate change. (What if China and India don’t do their part? What about the jobs that could be lost between now and the end of the century because of efforts to halt climate change? Etc.) But there’s a dollars-and-cents issue that comes into play now as insurance underwriters diligently assess risk.
I say we let our voice be heard, pointing out where risks associated with climate change are rising, leading to more frequent and severe claims--as well as where they aren’t. So, I’d appreciate any feedback on what’s actually happening with property rates and claims. Does loss experience for homeowners in hurricane zones suggest an increase in danger? If so, do today's rates reflect that increased exposure? How much? What about rates for homeowners near drought-ravaged forests? Or for those homes along the coast who would be vulnerable to rises in sea levels?
In other words, are underwriters already factoring increased exposure into their models and rates, or does the industry regard climate change fears as overblown? And what do reinsurers, as the aggregators of all this real or perceived risk, say?
Responding in a comment at the bottom of this post is probably the best way to share, so everyone can see what you have to say. But you can also respond just to those of us at ITL by replying to this email. You can be sure I’ll follow up as soon as I have anything smart to say.
Have a great week.
Paul Carroll
Editor-in-Chief
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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.
The opportunity to catch up to or even lead the industry remains open to all. Untapped digital possibilities in insurance abound.
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Donna Jermer is vice president, distribution lead for RGAX. She is setting and building the strategic foundation for development and execution of RGAX’s innovative distribution initiatives.
How can insurers issue policies and collect premiums if they have no faith in the drug testing process that employers use?
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Have you ever experienced your company's claims process? This would be a great exercise for many executives.
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Brent Williams is the founder and CEO of Benekiva, a configurable SaaS platform for claims and servicing for life, annuity, and living benefits carriers.
He previously spent more than 20 years in the life insurance industry, starting as an advisor.
To learn more, download Benekiva's Modern Claims Blueprint.
As small and medium-sized businesses continue to leverage customer data, they will drive the next wave of cyber insurance adoption.
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Employers must take a comprehensive approach and view workers’ comp programs in the context of their overall human resource programs.
Most employers, both large and small, consider workers’ compensation “the cost of doing business.” The vast majority of employers that are not covered under federal regulations such as the Longshore and Harbors Workers Act are 100%-controlled by individual state laws, court systems and dispute resolution procedures. The history dates back to over 100 years ago as the “exclusive remedy” for injuries and illnesses “arising out of, and in, the course of employment.” It was also designed as a “no-fault system.” On paper, it is a simple system to understand. In reality, a simple claim can be a potential landmine and can be lost in a myriad of bureaucratic red tape, attorney involvement and litigation through state court systems.
Although workers’ comp costs are typically viewed as strictly a risk management or safety responsibility, the only way for an employer to truly contain both direct and indirect costs is to take a comprehensive approach and view workers’ comp programs in the context of their overall human resource programs. This requires an integrated, pre-planned, post-injury program design along with clearly defined policies and procedures using tools available under both state workers' comp laws and federal disability laws. This includes the Americans with Disabilities Act (ADA), Family Medical Leave Act (FMLA), Occupational Safety and Health Administration (OSHA) recordkeeping regulations and other potentially specific federal rules and regulations such as medical exams covered under the Department of Transportation (DOT).
See also: The State of Workers’ Compensation
Two of the most common cost drivers for employers is late reporting of injuries, known as lag time, and poorly designed return-to-work programs. Although both issues involve the core of workers’ comp cost management, neither is really dictated by state workers’ comp law. In fact, state workers’ comp laws and the treating providers working under those laws can be severely detrimental in efforts to improve prompt reporting and return-to-work programs.
Although workers’ comp benefits and systems are strictly governed by state law, the injury or illness is also covered by several federal laws. One of the biggest paradigm shifts in the workers’ comp industry was the result of the Equal Employment Opportunities Commission (EEOC) ruling in 2014 that the Americans with Disabilities Act (ADA) “applies all the time whenever a medical condition has the potential to significantly disrupt an employee’s work participation.” (See ITL article "Is EEOC an Unlikely Friend on Work Comp," March 25, 2015)
This EEOC ruling took the workers’ comp industry by surprise. Work-related injuries and illnesses are now clearly governed under federal law under the ADA “as soon as notified,” “all the time” and the process is “continuous.” The EEOC stated the only relevant question is, “whether the disability is now, or is perceived as potentially having an impact on someone’s ability to perform their job, bring home a paycheck and stay employed.” Further, the EEOC stated that the ADA applies, “when a medical condition has the potential to significantly disrupt an employee’s work participation.” What workers’ comp claim does not have the potential to disrupt work participation?
The EEOC went much further and stated that the cause of injury is “irrelevant” and that everyone, treating providers, TPAs and employers, should keep that in mind. Further, the EEOC indicated the employer is 100% responsible for the continuing interactive process regarding potential job accommodations and return-to-work policies under the federal ADA law. The following EEOC comment was the knockout punch: “Physicians and TPAs may be putting employers at risk, even if not properly passed along, and would be especially troublesome if the treating physician was selected by the employer.” This means that under the ADA the employer is 100% responsible for job accommodations for the employee “who can perform the essential functions of their job with a reasonable accommodation.”
A truly integrated disability approach and interactive process is required because all medical-related absences, both occupational and non-occupational, are covered under the ADA. Remember, the injury and return-to-work process are covered under the ADA, but the benefits associated with an occupational injury are still covered 100% under state workers' comp law. Workers' comp remains the exclusive remedy for claimant medical and lost-wage benefits but is not the exclusive remedy for an employer to gather relevant information such as accident witness information or medical reports regarding cause of injury, comorbidities and pre-existing conditions that can be extremely relevant in the adjudication of a workers' comp claim down the road.
Jay Peichel, a principal at Keystone Risk Partners in Media, PA, was intrigued by the various ITL articles on ADA, DOT and OSHA and the federal laws’ relation to the workers' compensation process and how it may relate to the various barriers that can affect workers' compensation outcomes such as significant claim reporting lag, limited investigation, poor return to work process and ineffective med-legal determinations. Keystone designed a workers' comp survey and resultant proprietary scorecard as an assessment tool to quantify how current policies and procedures (including safety rules, accident reporting, supervisor training, medical management, use of provider networks, use of independent medical exams (IMEs) and medical second opinions and return-to-work programs) are integrated to take full advantage of state-specific workers' comp rules and regulation in coordination with federal disability laws such as the ADA, FMLA, DOT exams, when applicable, and OSHA recordkeeping regulations.
See also: How Should Workers’ Compensation Evolve?
Keystone saw this tool as a natural fit in their risk mitigation and analytics service platform and also their core platform of captive consulting, captive management and risk placement. Jay Peichel, who specializes in workers' comp claim analytics and benchmarking for his employer clients, said this new survey was “designed to help isolate hidden cost drivers in HR and workers' compensation programs. It also provides us the road map to provide recommendations and intervention points not in isolation but rather within an integrated process utilizing best practices in both workers' comp and disability cost management. Strategically, it links to our analytics platform and our ability to quantify the changes in outcomes and total cost of risk.”
The survey and scorecard are provided for a nominal charge by Keystone Risk Partners. For more information, contact Jay at jpeichel@keystonerisk.com.
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Dan is Director of Strategic Partnerships at First Managed Care Option (FMCO) in Morris Plains, NJ.