December is the perfect month to predict the key insurtech trends for the year to come and to think of New Year’s resolutions: what specific trends to tap into to enhance the digital strategies. We believe these trends should relate to what an insurance carrier would like to accomplish, to what a winning insurance firm of the future would look like. We believe that that such winning insurance firms will have four essential elements. 1: They are always part of their customers’ lives Fast-changing customer behavior and new market dynamics make it essential for insurance carriers to increase the contact frequency and provide more value in these contacts. Fortunately, all sorts of connected devices offer an unprecedented entry into customers’ daily life. 2: They continuously build contextual ecosystems Adding value is about solving the real problem. People don’t want a mortgage; they want a nice house to live in. Insurance is usually just part of a solution, but rarely the entire solution to the real problem a customer is facing. To help solving the real problem insurers need to become more part of the context, and of the ecosystem of companies and organisations that play a part in that context. 3: They act ‘simply human’ With all sorts of new technologies being applied to digitise processes insurers run the risk of neglecting the feelings side of customer engagement. People crave for organisations that are human. The solution is to create ‘the best of both worlds’; to leverage technology to empower front liners. 4: They strive for operational excellence Digital transformation to improve operational excellence will continue to be top of the agenda in the years to come. And rightfully so. Yet, at the end of the day, digitalised processes and a lower cost base are table stakes. It is simply not enough to stay in sync with fast changing customer behaviour and new market dynamics. Operational excellence is essential, but it also a qualifier, not a winner. Engagement innovation needs to be built on top. This is where the previous three essential elements kick in. It is these four essential elements that drive our Top 10 Insurtech Trends for 2018; the key trends that set the Digital Insurance Agenda. We’ll illustrated each trend with insurtech solutions that featured at the 2017 DIA editions. Key words? Platforms and partnerships. Obviously, we’ll pay ample attention to this at DIA Amsterdam 2018 (May 16-17). Trend 1. Data-driven Services In order to really become part of customers’ daily lives new data streams from e.g. connected devices need to be turned into new insights and these new insights need to be turned into new propositions and services. This is where insurance carriers need to explore opportunities beyond their traditional primary process to really help solving the real problem that customers are facing. Many insurtechs are dedicated to supporting incumbents in these efforts. The Floow DIAmond Award winner The Floow (Sheffield, UK) designs telematics systems to make vehicles safer and cheaper for all. Their GoWithFloow (GWF) is a platform for car sharing. It is sort of the Airbnb in cars, including rating the owner or borrower of the car. But where the platform differs from other examples of car sharing and vehicle lending is the addition of The Floow telematics engine and scoring system which is integrated into the software. This means that when a driver borrows a car their behavior can be tracked using the smartphone-as-a-sensor capabilities. The Floow use this information to develop a score for the driver to help lenders decide who to lend their car to. The Floow is engaging with insurance companies to bring the proposition to market. This sort of capability will help meet changing mobility demands by creating a marketplace of vehicles. HeartShield HeartShield (Vienna, Austria) developed an artificial intelligence platform that uses patient data to recognize risk factors and determine whether someone is a potential candidate for a heart attack or heart failure in time. Instead of using 19th/20th century statistics, they allow computers to learn warnings signs autonomously using data from all sorts of devices that can measure heart rate; including smartphones, smart watches and clinical or portable ECGs. Peer-reviewed scientific papers show that the algorithms behind HeartShield outperform the best heart rate variability predictors in detecting heart disease, and is more reliable than blood test based risk scores in recognizing coronary artery disease. Trend 2. Invisible Insurance In banking we notice that more and more payments are becoming invisible. Think of machine to machine payments, of what Amazon is doing with Dash, and how you pay for a ride with Uber and for a song at iTunes. We see the same thing happening also in insurance. You purchase a product and there is already an insurance embedded in that. Customers purchasing the BMW i3 or the i8 are entitled to a seven-day free-of-charge, comprehensive car insurance from BMW Car Insurance. This is simply activated over the phone by the customer. Customers are then provided with an overview of insurance options available to them after their seven-day free policy has expired; all designed and backed by Allianz. Qover DIAmond Award winner Qover (Brussels, Belgium) have built an ‘Insurance as a Service’ platform to change the way insurance is designed, managed and distributed. Qover is a cover holder of Lloyd's of London and acts as a digital wholesaler of proprietary white label insurance. They target among others large non-insurance distributors; basically any business, from automotive brands and utility companies to ecommerce merchants and traditional retailers, to seamlessly integrate insurance into their products via open API's. See also: Insurtech: The Year in Review   Trend 3. Upstream Platforms Push strategies are becoming less and less effective. Pull is the name of the game. Pull is about understanding and solving the need behind the insurance solution and being present in that context. Insurers need to move upstream and be present in the context of specific life events and decisions, big and small. Pinganfang Ping An has adopted the strategy of the synergistic development of traditional and non-traditional businesses. Pinganfang.com for instance, is the largest real estate e-commerce platform in China and part of Ping An Group. Its business model integrates ‘real estate + internet + finance’ and seamlessly includes a wide range of financing services in the customer journey of buying a new home. Richard Sheng, director of branding & corporate communications Ping An Group in our book Reinventing Customer Engagement: “We are creating all sorts of portals in non-traditional domains such as home, health, car, but also food and entertainment. Each and every one of them are new business lines that create new value for themselves, as well as for Ping An. All these platforms have large numbers of users and interactions, and advanced data mining and precision marketing capabilities. When relevant, and at a logical moment, customers are brought into contact with Ping An's traditional banking and insurance activities. The new business lines are not only increasing their own value; by enlarging the total customer base and by allowing new synergies they also increase the value of the entire ecosystem of Ping An enterprises.” Abracar Abracar (Munich, Germany) was developed in 2016 as part of the Accelerator program of Allianz X and is the first spin-off of the incubator. The startup is Germany’s first professional car broker. They help car consumers to sell their car at the highest price without any effort. Abracar takes care of all steps of the selling process starting by creating a professional expert’s report, over 50 pictures, writing an attractive listing, filtering the potential buyers, negotiating the final price and preparing the contract. The car buyer benefits from the expert’s report, an Allianz warranty, financing solutions and competent consulting. Trend 4. Bancassurance Revival PSD2 is the new payment services directive by the EU. This directive makes it obligatory for banks to open up customer data to third parties. Originally, the intention was to increase the competition between banks to improve payment products, but it effectively creates opportunities to all sorts of third parties to provide new opt-in services to these customers. Although this is hardly on the radar screen of insurance carriers, we believe this will revamp the bancassurance model. Moving from bank partnerships for just distribution and using bank data in the marketing and underwriting processes to really being much closer to customers. When we interviewed Markus Pertlwieser, chief digital officer Deutsche Bank, at DIA Munich 2017 he agreed that the right PSD2 applications offer great opportunities to link insurance to a certain payment, making insurance much more individual and much more real time. Also at DIA Munich 2017, Vikas Chhariya, global head of digital partnerships AXA Group, mentioned Aadhaar, India’s national biometrics identity program, as an interesting platform. Banks need to comply, so that fingerprints will give hundreds of millions Indians access to financial services, including insurance. Strands Strands is a leading provider of Personal Financial Management solutions (PFM) for banks such as Barclays, BBVA and Deutsche Bank. PFM uses payments and other data to help bank customers understand their financial situation, give some tips how to better manage finances and prevent overdrafts, and improve wiser financial decision-making. PFM drives engagement between banks and their customers. Strands is actually a fintech rather than an insurtech. In the last few years the company has been investing a lot in the development of smart recommendation engines (using AI and Machine Learning) that continuously learn about the user financial behaviour and then proactively make contextual recommendations of financial products, including insurance. Let’s say you are 40 years old and you have no pension plan in place. Through a Siri-like PFM medium, the Strands PFM will intuitively decide to offer you a pension solution. SaveUp Munich Re’s Life Financial Solutions Business has developed a new variable annuity product concept called SaveUp. It's the first attempt to revolutionize the savings life insurance space in Europe, through new product offerings and an entirely new distribution channel via a smartphone app but it also supports distribution via banks. SaveUp is a simplified savings product suitable for online self-service sales and management via web and smartphones. It is packaged for young consumers as a guaranteed savings and investment offering, allowing them to participate in investment markets while maintaining the security of their chosen guaranteed amount. Trend 5. Innovation Multiplied In a recent study DIA academic partners Alexander Braun and Florian Schreiber (University of St. Gallen) argue that real innovations require more than just new technological improvements to unlock new economic value. It is about combinations of innovative new models. Now think about insurtechs working closely together, combining their ideas to come up with something that is even more innovative. Innovation multiplied. And that’s exactly what we already see taking place in the DIA community. KASKO + Picsure KASKO (London, UK) supports insurance companies by offering an API-powered agile insurance product platform that sits in between digital customer touchpoints and your legacy IT, taking internal IT off the critical path to product launch. Picsure (Munich, Germany) creates smart AI solutions for the insurance industry, in particular for object recognition, fraud detection and identity checking. KASKO and Picsure teamed up to create an innovative watch insurance product for Swiss insurer Baloise. Sentiance + Sureify Sentiance (Antwerp, Belgium) is a data science company turning IOT sensor data into rich insights about people’s behavior and real-time context. These insights enable insurance companies to understand how customers go through their everyday lives, discover and anticipate the moments that matter most, and adapt their engagement to real-world behavior and real-time context. Sureify Labs (Silicon Valley, USA) created a platform that engages a customer over their lifetime. Their Lifetime Platform is a set of cloud-based software applications that allow insurers to digitally engage with their policyholders via web, mobile and various personal health and device data sources. The platform drives customer loyalty, brand recognition and better customer experience. After winning the DIAmond Award earlier this year Sentiance won again at DIA Munich through their collaboration with Sureify. They demonstrated the wizardry of the Sentiance technology that extrapolates behavior insights from a diversity of mobile-user data, and then showed the full circle that Sureify provides by turning these insights into buying signals and engagement opportunities. Trend 6. Competitors Cooperate Innovation beyond digitising the current processes and thoroughly exploring the opportunities that insurtechs around the world have to offer require a certain scale. Only the few carriers have sufficient size and presence to do this all by themselves. Teaming up with other insurers is the solution. The ultimate in cooperation can be found in Germany. Twelve insurers, ranging from multinationals such as Allianz, Generali and Munich Re, to domestic players like Versicherungskammer Bayern, LV1871 and Nürnberger Versicherung, have all put money into WERK1; an incubator that already supports ten insurtechs, located in an old cookie factory in Munich. And because these insurers are convinced that it is about continuously developing a stronger ecosystem, they have launched Insurtech Hub Munich in July 2017. The Insurtech Hub Munich initiative is unprecedented, in terms that twelve insurance carriers, big and small, are working closely together with leading universities and research institutions, with the State of Bavaria and the City of Munich as well as with blue chip corporates from adjacent industries such as automotive, health care and cybersecurity. Our DIA database shows that 180 insurtechs have ties with Munich. To put that into perspective: California, where Silicon Valley is situated, host 160, according to Braun and Schreiber’s survey. In our view, that makes Munich the de facto insurtech capital of the world. The activities of Insurtech Hub Munich will strengthen that position even further. Trend 7. Network Effects Scale economies get an extra meaning. Scale benefits are not just about ever-growing efficiency in processes within the business. It's also about ever-growing added value through network effects. Network effects can for instance be created by leveraging the growth and activity of estLibraryablished allied platforms. PayPal, for instance, grew on top of eBay. Zhong An teamed up with Alibaba’s online shop Tao-Bao to create a shipping return policy seamlessly integrated into every transaction. They’re selling hundreds of millions policies. AXA Group engaged in partnerships with companies such as Alibaba, Uber and car sharing platform BlaBlaCar. Clearly a clever choice to profit from network effects. They’re all fast growing digital players; so AXA’s business with them will almost automatically grow as well. We mentioned in trend 2 that Qover is targeting large non-insurance distributors to seamlessly integrate insurance into their products via open API's. Also a perfect example of ‘how to create scale through network effects’. With insurtech becoming mainstream, the challenge is adoption at scale. Leveraging network effects is a great way to achieve this. Trend 8. Empathy Empowered According to many headlines algorithms are displacing human advisers, saving costs. We believe there is ample opportunity to create the best of both worlds by combining new digital technologies with human skills. To relate to their customers, financial institutions need to secure the feelings side. Humans inject emotion, empathy, passion, creativity, and can deviate from the procedure if needed. Deploying technology to empower human front liners such as brokers and agents results in better conversations, higher conversion and finally, greater solutions for customers. SaleMove SaleMove (New York City, USA) provides solutions for delivering a high-touch, in-person customer experience online. SaleMove enables for instance life insurance brokers to interact with their online customers in real-time through voice, video and collaborative browsing - leading to better conversations, higher customer satisfaction and increased conversions. Wefox DIAmond Award winner Wefox (Berlin, Germany) combines the personal advice of a traditional insurance business with modern app technology, thereby bringing together the evolved needs and expectations of customers, insurance brokers and insurance companies. Wefox’s long term vision is to pull the entire insurance industry, in particular brokers, into the digital age, leveraging to the max what digital has to offer. They are very successful with already more than 150.000 end customers and over 600 brokers in 3 countries. See also: Global Trend Map No. 2: Insurtech   Trend 9. Behavioral Economics The ongoing success of South African health insurer Discovery’s Vitality program is creating more and more awareness for intelligent combinations of data and behavioural economics. Adrian Gore, founder and CEO of Discovery, in our book Reinventing Customer Engagement: “If you promote healthier behaviour, you can offer more sustainable insurance. Behavioural science says that people need incentives to change. The Vitality program is a complete wellness system that tracks everything from physical activity to nutrition over the course of a person’s life. It combines engaging policyholders through personalized and regular interaction, motivating and incentivizing them to manage their wellness, live better and to make healthier choices through tailored programs.” Lemonade Lemonade (New York City, USA) offers homeowners and renters insurance. We like Lemonade so much because it is fully powered by artificial intelligence and behavioral economics. By replacing brokers and bureaucracy with bots and machine learning, Lemonade promises zero paperwork, instant everything and killer prices. Lemonade’s chief behavioral officer Dan Ariely helped designing systems and processes that ensure that the interests of the insurer and the insured are aligned. But also how behavioural economics reflects in Lemonade's daily customer experience. When we interviewed CEO Daniel Schreiber on the occasion of Lemonade’s first anniversary he shared: "Not just our business model but also the whole product flow is informed by behavioural economics. For example, we ask people to sign on the top of the form, not at the bottom. Behavioural research shows that asking people to pledge honesty first, results in forms that are actually more accurate." Insurers could benefit much more from psychology and social sciences. Dacadoo Consumer engagement is becoming more and more important in the health insurance industry. Dacadoo (Zurich, Switzerland) has developed a mobile health engagement solution enabling individuals to track, manage and benchmark their health and well being in an easy and fun way on their smartphones. The Health Score indicator moves up or down in real-time, depending on how body values, emotional wellbeing and activities change (exercise, nutrition, stress and sleep). To help individuals remain engaged, motivation techniques from behavioral science are used such as online gaming, social and collaborative features from social networks, and personalized feedback. Trend 10. Purpose Reboot New digital technologies are not only critical in repositioning the industry along customer-centric models but also offer insurance carriers the opportunity to reboot themselves as a force for good in the communities in which they operate. More and more insurers leverage insurtech to tackle important global challenges today and in the future. Connected devices and advanced algorithms are already improving patient care while simultaneously decreasing costs. Micro-insurance solutions are offering protection to low income populations that were previously considered uninsurable. Insurtechs strike the right chord among millennials that are dangerously under-insured. And insurtech innovation is helping to offset the damage caused by natural disasters such as hurricanes and floods. Allm Allm (Tokyo, Japan) is dedicated to reshaping healthcare by developing HealthTech medical communications platforms for healthcare professionals and the medical industry, using cloud technologies and smart devices. A more efficient communication and new innovative technologies help to improve decision making and can save more lives and reduce costs while improving customer experiences. Understory Understory (Minnesota, USA) is a smart weather hardware and analytics company that creates unprecedented details of how weather affects people and businesses. The data applications for Understory’s sensors are enormous, as US$ 485 billion of the US economy fluctuates with weather. With Understory’s white-labeled weather and home safety insurers can easily help their customers know what to do to prevent potential property damage. Neosurance Incumbents have difficulty connecting to millennials. As a result this segment of the future is hardly aware of the importance and necessity of insurance, with a high number of under-insured as a result. The average attention span of people is getting lower and lower and our daily lives seem to be made up of micro moments related to the use of smartphones. Neosurance (Milan, Italy) provides micro-insurance solutions for insurance carriers that want to address the ‘connected generation’. By gathering contextual data, the Neosurance is capable of identifying a potential specific insurance need for that customer and send a notification on the smartphone. The user can choose to activate the cover with 4 easy taps on the screen. A great way to get a whole new generation more familiar with the benefits of insurance. BIMA DIAmond Award winner BIMA (Stockholm, Sweden) provides insurance and underwriting to millions of low-income people via innovative partnerships with major mobile network operators and financial services businesses. They offer a range of affordable life, personal accident and health micro insurance products. BIMA partners with leading telecoms players such as Telefonica, Orange and Axiata Group. Consumers can pay for insurance via deduction of prepaid airtime credit. In just six years, the BIMA model has transformed the insurance landscape in the countries where they operate, proving that it is possible to reach consumers at the bottom of the pyramid at scale. BIMA has over 24 million registered customers in 14 countries across 3 continents, 93% living on less than $10 per day. Check out www.digitalinsuranceagenda.com for more info on DIA Amsterdam (16 and 17 May 2018).

I kicked off this series by detailing my argument for why physician quality is the single most important aspect of a claim — efficient and effective care is far more impactful than discounted care. Now, I want to expand on this idea by delving further into the relationship between the preferred provider network (PPO) and the exclusive provider network (EPO). First, let’s understand what is meant by EPO. The narrow definition of the term is a network that is the exclusive option for providers. In workers’ compensation, it most accurately describes programs like the MPN in California, the HCN in Texas or the PPP in Illinois. These are all examples of models where the insurer or employer can define an exclusive list of providers from which an injured worker must choose their doctors. In a broader sense, I think of the EPO as the listing of doctors and ancillary providers that are going to be included in elite programs. This includes the list of doctors you would want to use every time you create a workplace poster or the list of doctors used in any channeling program like initial triage. Think of it as the doctors you want to use any time you have the opportunity to either direct, contain or influence selection of a provider. Ideally, the goal of an EPO should be selecting the best available providers to drive improvements in outcomes. And improved outcomes should be at the heart of the relationship between PPO and EPO. Over the past decade, outcomes-based networks have become a well-adopted and proven model for dramatically improving a claim population’s overall costs, lost time and litigation, but many organizations struggle with the roll of PPOs in this model. They are also curious as to how to leverage the best of both worlds — PPO and EPO — to drive better outcomes and better pricing moving forward. Separating “Who” and “How” The idea of using both PPOs and EPOs to improve outcomes has been somewhat confounding to date. As discussed in Part One of this series, the primary goal of the PPO is to contract with as many providers as possible to drive the best purchase prices for medical and ancillary services. In the absence of any controls over care, the PPO serves its customers best by including poor-performing doctors, courtesy of more available discounts. With controls (and strategies to leverage those controls) for outcomes in place, however, the game changes, and the roll of the PPO needs to be reconsidered. See also: Why So Soft on Workers Comp Fraud?   In this environment, PPOs and EPOs coexist in an important balance. The EPO needs to determine “who” to work with, and the PPO provides the mechanism for “how” you work with them. Consider the following table: Hopefully, it quickly becomes clear that the “best of both worlds” model is not only achievable but also makes things like vendor selection and program management easier. Under this framework, the value proposition and role of the PPO is clarified: The PPO is the source of doctors who have been properly vetted through credentialing practices and contracted to provide care, typically at a favorable price. This function could be offloaded to your bill review vendor if it is positioned to resell networks, or you can take on the task of deciding which combination of PPOs gives you the best bench to select doctors from in each jurisdiction. On a case-by-case basis, you may find barriers with a certain jurisdiction or PPO vendor, so some research may be necessary to determine how to manage selecting a subset of providers from a list of preferred providers. Once you’ve built your bench of “available” doctors, the next step is to select the doctors that are going to be invited into the elite program, or EPO. The most effective method for selecting doctors for an EPO is outcomes-based. Depending on the program, it may be necessary to have processes and documentation for decisions related to the inclusion or removal of doctors from your elite programs. This is more important in situations where the decision to exclude a provider will prevent them from being able to treat your injured workers. Think MPN exclusion. It’s not really an issue when you are just selecting three doctors to be on a workplace poster. The core message is: Think differently about the purpose of your PPOs; they have a specific value proposition when you are working with an EPO strategy. Use the PPO to build your bench of available doctors, and use your EPO to decide which doctors are the ones you want your injured workers to use. See also: Healthcare’s Lessons for Workers’ Comp   The age of accountable care is upon us — in both comp and group health. Data science and access to big data has enabled a level of accountability that did not exist a decade ago. If you do not have a strategy for using quality as a primary factor in determining who should be seeing your injured workers, you are missing the boat. Having a framework for how to separate who you work with (EPO) from how you work with them (PPO) helps get you started on the path to an outcomes program or provides an easier perspective for how you manage and improve an existing program over time. Next Steps Once you have your framework in place, you need to determine the right balance of quality and quantity. To do this, quantify the difference between good and bad doctors. There are a lot of tools available to help you do this. Then, determine how many doctors you need of each type in a given geography to fully service workers. Next, eliminate those doctors whose outcomes don’t make the cut from your network. As long as you have enough good doctors available who can also provide a discount, there is zero benefit to having a deep bench. Once you make smart cuts, emphasizing quality over quantity, watch your savings and worker satisfaction with their care dramatically improve. Next up: outcomes strategies for each type of jurisdiction. In Part Three of this series, I will dive into three types of jurisdictional models and look at the differences between states. Stay tuned! This article was first published in Claims Journal.

The marriage of “insurance” and “technology” — “insurtech” — continues to attract investment among P&C insurers, and startups specializing in insurance technology products are popping up all over. In fact, investment in insurtech reached $853 million in the first quarter of 2017 — a 50% increase over the same period in 2016. While, to date, most insurtech products have focused on the distribution and sale of insurance, there is great opportunity for new insurtech innovations to offer superior customer service, which translates to loyal customers — the brass ring in a highly commoditized market. Insurtech enables fast and personalized experience, any time and anywhere Customers want to know that they will be looked after if any issues arise — even after a policy purchase. This means succeeding at a full range of customer interactions and touchpoints, from addressing customer questions about their bills, to working with a customer during the claims process. Customers expect these interactions to be personalized, fast, efficient and on their own terms. At the same time, insurers are looking to automate some processes, thereby increasing time savings and freeing employees to focus on more complex activities. Altogether, this is why technologies like artificial intelligence and chatbots have found a following in insurance. See also: Insurtech: An Adventure or a Quest?   Artificial intelligence, for example, enables personalized customer service from the initial interaction to processing a claim — often without any human interference at all. Artificial intelligence can analyze a customer’s profile and recommend insurance products best-suited for the customer. And, by removing human intervention, the potential for error decreases. Chatbots, too, are gaining favor for their ability to do things like schedule an appointment or process a payment, any time and anywhere. Whatever a chatbot can’t help with can be elevated to a human, but just eliminating these types of simple tasks from employees’ to-do lists can be a boon to their productivity. Industry is evolving To be sure, traditional insurers are embracing insurtech to augment and improve their customer service. Insurtech distributors, too, are realizing the need to evolve and offer more than just great purchase experiences. In personal lines insurance, for example, distributors understand they must provide more than a great buying experience, so they are becoming insurers as a way to better control the customer experience. Metromile, for example, which became an insurer in 2016, recently launched a new automated claims service, which enables a more seamless claims experience. Now, Metromile more easily assesses whether a claim can be quickly processed and paid. Improving customer service can be daunting, especially for traditional insurers that sell multiple products in various customer segments through a variety of channels. In a highly commoditized market, however, the customer experience is the all-important differentiator. By investing in insurtech innovations, insurers will find they have a leg up on the competition and will reap the rewards of satisfied, loyal customers.

So why don’t most Enterprise Risk Management system work?  Simply, they don’t “manage” risk, they just record it.  Manage is a verb not a noun. It is activity not an item.  Making a list might be adequate for those who want to check off regulatory compliance, but it’s does not produce a ROI. They don’t manage threats To manage threats you need to actively monitor risk drivers and influences thru lead and lag KRIs in real time.  Reporting systems aren’t much use if they’re telling you after the event. By the time it shows up on a heat map it’s not a risk, it’s an incident.  Simply moving your risk management from spreadsheets to a cloud risk register does nothing to pursue an active defence against threats. To create a workable system, you need to take your risk registers, work out what causes those risks to worsen (drivers and influences), and what lead/lag KRI to use to monitor the movement of those drivers and influences.  You then need to set up a real-time system for collecting those KRIs and alerting the appropriate people who can act on the threats immediately. They don’t tell you HOW it will affect Objectives The common practice of recording what objectives might be affected by a risk does nothing to assist in achieving or optimizing those objectives.  The real purpose of risk management is to navigate the myriad of influences on the objective’s outcome as they occur, i.e. it is an interactive real-time activity. Risk Management’s primary purpose in the strategic and tactical planning phase is to identify the best course to market and thereby optimize resources (time and capital).  This requires specifying HOW risks and actions interrelate and compound effect on one another.  This highlights two things.  For ERM to work it must integrate both risk and actions, and it must know HOW variations in either compound effect. Once these are in place they can easily be used to monitor progress in achieving objectives. Workflows and Issue reporting become inputs to risk drivers and influences which in turn automatically update risks. With a real-time aggregation of risks (roll-up), alerts can be sent to interested parties when the risk threshold of any objective is threatened. See also: The Current State of Risk Management   They don’t improve the quality of decision making By definition complex systems (the business world) are chaotic (see Chaos Theory), where small variations alter outcomes, like the weather and the winner of the Melbourne Cup.  But risk management was never about predicting the future. It’s about providing advice on the effects of possible decision outcomes and being prepare for any adverse effects. But here’s the real rub.  For ERM to be useful it has to employ Predictive Analytics and machine intelligence.  In my defence, Predictive Analytics doesn’t actually predict the future, it just highlights obscure facts. It provides true decision making collateral on possible opportunities and threats in any scenario, from which “informed decisions” can be made, instead of “gut feel” guesses.  It helps mitigate decision bias and raise ramifications sometimes overlooked in the heat of a problem. Obviously many ERM systems have numerous other failing, such as a single hierarchy for aggregating or “rolling-up” risks (wouldn’t it be nice if the world was that simple), and not including Incident Management in ERM to create a closed feedback loop, which drives evolution and effectiveness.  But the single most important thing is to use your risk collateral as part of the day-to-day operational decision making and not to just let it stagnate in risk registers being reviewed annually.

Q: Some American pharmaceutical companies are well-known for pricing drugs at whatever the market will bear. In oncology, some specialty drugs seem to have price tags completely unrelated to the proven effectiveness of the drug. Your company has been taking a lead in confronting this problem. What do you envision as possible solutions? A: New oncology therapies carry astronomical price tags—most people know this. Receiving far less attention is the question of actual therapeutic value. Drug manufacturers spend billions on advertisements and PR, but unfortunately, real-world patient results are frequently unimpressive. Two recent articles in BMJ make this point, 1) No evidence of benefits for popular oncology therapies and 2) Do cancer drugs improve survival or quality of life? Why do high-cost oncology therapies with questionable results continue to be prescribed? Let’s examine a situation my company is dealing with right now. VIVIO Health received a request for neratinib, an FDA-approved extended adjuvant therapy for early-stage HER2 positive breast cancer. Our system analyzed all available performance data from sources such as the FDA, ICER and NICE. The drug approval was based on a newly created surrogate endpoint called invasive Disease-Free Survival (iDFS), which only scored 94.2% vs. 91.9% in the placebo arm. Even worse, 29% of the patients dropped out of the trial due to adverse side effects, 16.8% for diarrhea alone. Not surprisingly, the FDA committee patient representatives voted against approval. See also: 'High-Performance’ Health Innovators   Neratinib’s manufacturer PUMA Biotechnologies provided data on the current standard of care, trastuzumab, showing a disease-free survival (DFS) rate of 89%. Interestingly, the use of iDFS as an endpoint led to an increase in the placebo arm of ~3%, which is larger than the neratinib-to-placebo arm difference of ~2%. Ultimately the creation of a new endpoint made a larger impact than the therapy itself. The trial design itself had been altered so many times; the FDA suspected the trial had been "unblinded" and attempted to determine statistically whether unblinding had occurred. Even with these highly questionable results, the FDA approved neratinib in July. After being shown the questionable data and asked, “Why neratinib?” the requesting oncologist explained that it’s an FDA-approved drug and that “MD Anderson is giving it to everyone.” Granted it’s hard, but physicians should have the courage to do the right thing. In the context of high-dollar, high-tech therapies and billion-dollar windfalls for pharma execs like Puma CEO Alan Auerbach, physicians must be America’s frontline ensuring that only the right therapies get to the right patients. Using neratinib as an example, here are seven steps every physician should consider before prescribing oncology therapies:

1. Police endpoint games. Don’t allow drug companies to define arbitrary and meaningless endpoints for your patients. Prescribe medications with objective data on meaningful endpoints such as life expectancy. Anything less should be considered experimental at best, and pharma should pay for that.
2. Do the math. In the case of neratinib, a 2% probability of potential benefit means that for every two patients who might be helped, 98 are subjected to real side effects or other harm. In the neratinib trial, this equates to the "lucky" 33 out of 1,420 total patients, which is quite a needle in the haystack.
3. Consider the actual cost. Spending $5 million per patient "helped" with such uncertain outcomes makes no sense.
4. Consider societal opportunity cost. Spending money on therapies that don’t work diverts dollars away from developing therapies that do.
5. Stop listening to key opinion leaders (KOL). Dig deeper and make your own decision. A KOL’s opinion isn’t data and is too often wrought with conflict.
6. Require companion tests. Don’t prescribe low-probability therapies without some form of a companion diagnostic and insist that the drug company provide it for you.
7. Prescribe therapies as if you’re the patient and you’re spending your own money.

See also: U.S. Healthcare: No Simple Insurtech Fix   Physicians, you hold the key to changing the cost curve for ineffective therapies. Drug companies will get the message when you refuse to prescribe treatments that don’t work and cost too much.

Many insurers — especially regional players with deep ties to their local community — stress that customer service is a key differentiator for their business. Novarica’s position has always been that customer service and technology are not tangential, but rather they are one and the same: having quick access to agent and policyholder data, quoting and binding in real-time, and generating recommended contact opportunities are examples of the kinds of technology-enabled capabilities that take customer service to the next level. But key to providing great customer service is recognizing how customer expectations have changed in the last decade. Insurers must be ready to engage with consumers when and how they want across multiple channels for engagement. This has put considerable pressure on the insurance industry to figure out how to model themselves after other tech-driven industries in an affordable and scalable way. In the last year, chatbots have emerged as a viable option due to their ability to enable rapid customer service across a variety of low-touch applications 24/7. Moreover, chatbots are able to provide an added layer of support and consumer engagement without the need for additional staffing, freeing up human resources for higher-level tasks. See also: Chatbots and the Future of Interaction   Insurance use cases for chatbots include first notice of loss (FNOL), claims self-service, customer policy applications, policy endorsements and support, and agent interaction. These are great opportunities, not to replace other modes of interaction, but to supplement them for off-hours or for consumers who prefer a chat over a phone call. But chatbots are only as useful as the existing back-end functionality that supports them, and insurers can’t slap a chatbot interaction into their website or mobile app if they don’t also enable their core systems to provide real-time status updates or quotes via a web service. Just because a chatbot understands a user’s question doesn’t mean it can respond if the information isn’t available via machine, and an unsatisfying chatbot interaction is worse than none at all. The quick evolution of chatbot technology is a great option for a new channel, but it doesn’t let insurers off the hook to modernize and service-enable their entire infrastructure. Moreover, as discussed in a recent blog post on Progressive’s new chatbot, Flo, insurers need to understand appropriate use cases for chatbots: while some self-service functions are ripe for chatbot usage, others may require empathy that an algorithm can’t provide. The submission of a claim is often triggered by a traumatic life event for the consumer, such as a car crash or illness, instances calling for a human touch. For this reason, it is unlikely chatbots can completely replace human agents capable of offering empathy and reassurance to their customers during heightened emotional crises. As with any emerging technology, insurers should have specific, targeted use cases in mind for their initial implementations. Even if the end goal is to have chatbots available across all modes of support and service, such strategic projects start best with tactical investments. For more on this, see my recent brief, Chatbots in Insurance: Overview and Prominent Providers.

I'm going to borrow the approach taken by Chuck Schramm, a Chicago-area insurance agent with more than 50 years of industry experience and one of the premier insurance educators in the country. He has done a series of seminars that examine a single policy (commercial property, business auto, CGL, etc.) by providing several case study-based claim scenarios. Participants must determine for each claim whether the policy covers the damages and why or why not. It’s a wonderful way to learn HOW to read, understand and APPLY policy language to coverage and claim situations. Many insurtech startups and online comparative quoting systems take the position that auto insurance is little more than a commodity distinguished almost solely by price, that insurance buyers do not need professional representation by insurance agents nor advocacy at claim time because the product and process are so simple and there’s so much information available on the internet. Let’s dispel that ludicrous assertion with the following scenario…. Bubba owns a car insured in his name with the State Insurance Company. His wife, Bubbles, owns a car insured in her name with the National Insurance Company. Their adult daughter, Bubbette, and her six children live with Bubba and Bubbles, and Bubbette owns a car insured in her name with the ARP Insurance Company. All three insurers use the 2005 ISO PAP. See also: Geospatial Data: New Key on Auto   Using the ISO policy, determine who is covered for liability by what policy in the following claim scenarios AND why or why not are they covered. In other words, in each scenario, are the parties insureds under the policy, and, if so, does a liability exclusion apply? Claim #1:  One afternoon, Bubba drove Bubble’s car to the liquor store, ran a stop sign and had an at-fault accident. Bubble’s PAP   __ does   __ does not   cover Bubbles. Bubble’s PAP  __ does   __ does not   cover Bubba. Bubba’s PAP  __ does   __ does not   cover Bubba. Bubba’s PAP  __ does   __ does not   cover Bubbles. Claim #2:  That evening, Bubba drove Bubbette’s car to a local tavern and had another at-fault accident while returning home at dawn the next morning. Bubbette’s PAP  __ does   __ does not   cover Bubbette. Bubbettes’s PAP  __ does   __ does not   cover Bubba. Bubba’s PAP  __ does   __ does not   cover Bubba. Bubba’s PAP  __ does   __ does not   cover Bubbette. Claim #3:  Upon his arrival at home, Bubba and Bubbles separate, and Bubbles moves in with her mother that afternoon. That evening, Bubba asked Bubbles if he could borrow her now-repaired car again to take his new girlfriend to visit her mother and had yet another at-fault accident. Bubble’s PAP  __ does   __ does not   cover Bubbles. Bubble’s PAP  __ does   __ does not   cover Bubba. Bubba’s PAP  __ does   __ does not   cover Bubba. Bubba’s PAP  __ does   __ does not   cover Bubbles. I’ll post the answers within the next week, so make a note to check back later. If you simply can’t wait because you’re just too darned excited that you know the answers, feel free to email them to me, and I’ll respond. See also: Auto Claims: Future May Belong to Bots   If you find this kind of exercise valuable, let me know, and I’ll do others. Another one I have in mind for the PAP involves three people – Moe, Larry and Curly – two of them with PAPs and all involved in the rental of a car.

The insurance industry has been talking about technological evolution for a long time. From the rise of insurtechs to implementing tools like client portals and e-signature, the need for digital transformation has been top-of-mind for all insurance professionals. But in 2018, the barriers have been removed, and this talk will finally evolve into significant action. The combination of competitive conditions, availability of cost-effective technology and numbers of independent agents striving for growth and better service creates the perfect storm to drive agent digital transformation. While embracing digital is integral to competing in the market, consumers still heavily rely on the human, one-on-one service that only agents are able to provide. Great customer service is foundational for all agents. Providing the ideal mix of technology solutions and personal interaction should be at the center of an agency’s planning process as it prepares to meet customer demands and increase growth and retention. See also: Insurtechs: 10 Super Agents, Power Brokers   As the year comes to a close, we analyzed current trends and patterns in the insurance industry and developed five predictions for independent agents in 2018: 1. All about the infrastructure: Insureds expect on-demand service. They want their agencies to be always-on and to be able to conduct insurance business whenever and wherever they like. Agencies need systems and processes that can efficiently handle their workload. They have to have strong and flexible digital infrastructure to grow and expand. This includes interactive websites with online chat and quoting capabilities, client portals and mobile apps, next-generation agency management systems and integrated call centers for 24/7 service. In the new year, agents will be evaluating their infrastructures and expanding capabilities and services for clients. 2. Move from closed loop to open access: Agents operate in many environments. They regularly visit multiple carrier websites, manage their workload in their agency management system and pursue prospects who are gathered in their customer relationship management system. Most of these applications are closed, meaning that information put into one system won’t automatically populate into another system. This forces agents to spend time on manual workarounds and double data entry. Agents will seek to partner with companies and implement tools that can bridge the gap between various systems and choose applications that are built on open structures, meaning they “talk” to one another. 3. Pursuit of the paperless agency: E-signature is nothing new, it has been around the industry for 20 years. However, many agents still don’t use it. But in 2018, a large number of agencies will take the plunge and finally implement e-signature and other e-document tools. With a desire to not only be more efficient but also to improve the sustainability of their operation, more agencies will shift to an all-digital mentality when it comes to sending, receiving and signing documents. But this can’t be done in a vacuum. Agencies will also collaborate with carriers and be informed by regulators to help make the shift to all-digital documentation. 4. Synergistic partnerships increasing access to sales analytics: The carrier/agent partnership is about to go beyond a provider/seller framework. Agents and carriers both have access to unique information that, when shared, can help both organizations grow. Agents gather sales data such as target market behaviors, web preferences and specific product interest that can help carriers improve sales and marketing efforts. Meanwhile, carriers have the technological infrastructure and expertise enabling them to provide education, training and best-practice programs that can help agencies improve their digital capabilities. These two entities will develop stronger partnerships that will enable both of them to improve sales. 5. Agents embrace artificial intelligence (AI): For agents who are still trying to find ways to implement interactive websites, e-signature, or client portals, technologies such as machine learning, robotics and artificial intelligence seem way outside of their current capabilities. But these tools are beginning to become more commonplace, and agents will appreciate their ease and benefits and might even realize they have already been using some sort of AI. From automatic fill on certain forms to using machine learning to move key prospects to the top of the workflow to installing chatbots on websites that can resolve claims and answer clients’ simple questions, agencies will convert from trepidation to the implementation of AI that will drive key processes. See also: Chatbots and Agents: The Dynamic Duo   2018 will be a transformative year for independent agents with many taking significant steps toward digital adoption. But even as agents embrace technology they cannot forget the human element. As more agents adopt these digital solutions, they will have to find the balance between technological evolution and one-on-one personal customer service.

The Internal Revenue Service is acting to help individuals who are eligible for Patient Protection and Affordable Care Act (Obamacare) health subsidies and who live in regions where exchange insurers do not offer bronze (lowest-cost) coverage, even as it moves ahead to nail employers failing to comply with Obamacare's employer shared responsibility rules (commonly referred to as the "employer mandate"). IRS New Individual Obamacare Relief Notice 2017-74  will provide that individuals who are not eligible for coverage under an eligible employer-sponsored plan and who lack access to affordable coverage should not be denied the use of the affordability exemption under § 5000A(e)(1) of the code and § 1.5000A-3(e) of the regulations merely because they reside in an area served by a marketplace that does not offer a bronze-level plan. Consequently, for purposes of the affordability exemption under § 5000A(e)(1) and § 1.5000A-3(e), if an individual resides in a rating area served by a marketplace that does not offer a bronze plan, the individual generally should use the lowest-cost metal-level plan available in the marketplace serving the rating area in which the individual resides. Notice 2017-74 will be in IRB 2017-51, dated Dec. 18, 2017. See also: Optimizing Financing in Healthcare   Employers Still Face Obamacare Penalties While the IRS has issued limited relief for individuals from the ACA's individual mandate penalties, so far it has remained steadfast in its refusal to grant employers corresponding relief from the ACA employer-shared responsibility penalties or other ACA penalties. Instead, IRS officials continue to make clear that the IRS intends to enforce the ACA employer-shared responsibility rules against employers with 50 or more full-time employees (including full-time equivalent employees). Under the Obamacare employer mandate rules, covered employers face significant federal tax penalties for (1) failing to offer minimal essential coverage to substantially all full-time employees and their dependents (the “A Penalty”), or (2) offering coverage that is either “unaffordable” or does not provide “minimum value” (the “B Penalty”) if a full-time employee enrolls in the health insurance marketplace and receives a premium tax credit. While many employers assumed President Trump's Jan. 20, 2017, executive order "Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal" would insulate them against enforcement of the employer mandate and other Obamacare penalties, the IRS doesn't see the executive order as barring its enforcement of Obamacare against sponsoring employers or their group health plans. In an April 14, 2017, IRS Chief Counsel letter, for instance, the IRS announced it does not interpret its discretionary authority under Obamacare to allow waiver of the employer mandate tax imposed under Internal Revenue Code Section 4980H against covered employers that fail to provide the affordable minimum essential coverage required by the employer mandate. In keeping with this interpretation, the IRS has announced that it will begin enforcement of the employer mandate tax liability for plan years after 2015 against covered employers that failed to meet the employer mandate. Of course, the employer mandate is not the only Obamacare provision that employers and their health plans need to worry about. In addition to the employer mandate, Obamacare imposed a host of patient protection and other federal mandates upon employer-sponsored plans, most of which apply to plans covering two or more employees. In addition to any benefit and other administrative penalties that otherwise arise under the Employee Retirement Income Security Act or the Social Security Act for violating these mandates, employers sponsoring plans that violate any of 40 listed mandates imposed by Obamacare or certain other federal laws also become liable under Internal Revenue Code Section 6039D to self-identify, self-assess, report on Form 8928 and pay an excise tax equal to $100 per person per uncorrected violation. The IRS, Department Of Labor and Department Of Health and Human Services have taken the position that the Jan. 20 executive order also does not bar enforcement of those Obamacare penalties. Accordingly, employers and their group health plans continue to face potentially substantial liability if their group health plan does not comply with Obamacare. See also: U.S. Healthcare: No Simple Insurtech Fix   In the face of these exposures, employers and their group health plan should carefully review their plans and their administration for compliance before the end of the plan year so as to be able to take appropriate and timely corrective action before penalties attach and while stop loss or other insurance is available to help mitigate the cost of these corrections. Employers preparing for health plan renewals also should review their group contracts and conduct due diligence to verify their group health plans terms and operations meet the mandates as they initiate new plan years. Employers also generally will want to review their compliance and take action to address any deficiencies against any vendors or advisers who may have culpability in the defective health plan design or administration. Prompt action against vendors who may be culpable for the design or administration defects is necessary to preserve potential claims for deceptive trade practices or other causes of action that an employer might have under state contract, tort or other law. Employers and health plan fiduciaries should consider engaging experienced legal counsel to conduct this review on behalf of the employer or other plan sponsor within the scope of attorney-client privilege so as to assess and address these potential risks on a timely basis.

The annual EY Insurance Executive Forum in New York City last week crystallized some thoughts about the complexity of the innovation journey that insurance and risk management professionals face. So, as we head into the holiday season, while kidding ourselves about watching our eating, here is some calorie-free food for thought:

I often say that I've been watching the same movie on digital transformation for more than three decades, since I started covering IBM for the Wall Street Journal in 1986 and saw it implode, followed by disruption to the whole computer industry, followed by Internet-driven upheaval for retail, journalism, music, you-name-it. But I now think that the path for insurance and risk management will be more complicated and not just because of the complex regulatory environment. One would be remiss to overlook a fundamental reality: The convergence of technological capabilities, business acumen, and risk management resulting in the reinvention of an industry has become highly refined and remarkably well capitalized.

There are really four plot lines happening simultaneously within insurance and risk management.

First, as usually happens, every part of the value chain is being reexamined. Distribution has been a particular focus for innovators, but underwriting, claims, operations and everything else are also up for grabs. Given that nearly 40 cents of every premium dollar go to expenses, including loss adjustment expenses, there is an awful lot of room for innovation at a time when every industry faces extreme pressure for efficiency. But one person's efficiency is another person's revenue, so the push is never easy. Based on innovators tracked via the Innovators Edge platform, nearly 2,000 firms spanning 178 countries are "insurtechs" focused on transforming some aspect of insurance.

Second, the core of the product itself is changing, even more than typically happens when, say, music goes digital or when something like car rides or hotel rooms become based on sharing, coordinated through a digital overlay from an Uber or Airbnb. Increasingly, innovators are finding new ways to manage risk and prevent losses, rather than just compensating for losses after they've occurred. New business models have only peeked their heads out thus far, but some are surely coming and will drive great change while creating great angst. The number of early stage technology firms that focus on areas we refer to as reinventing the actual risks managed by insurers—areas such as artificial intelligence, genomics, robotics and more—tops 68,000 worldwide, per Innovator's Edge.

Third, the nature of work is changing. This is happening in every industry as robotic process automation (RPA) takes over routine tasks. For insurers, the complication is that the change is happening at the same time that they're wrestling with the sorts of fundamental issues that other industries have been adjusting to for 15 or 20 years now. In many ways, automation should be welcome in insurance both because it cuts expenses and because it could reduce the pain that is surely coming as so many in insurance professionals reach retirement age. But the change will require adjustment and create uncertainty.

Fourth, customer expectations are being reset in ways that are shocking insurers. They are finding themselves forced to conform to the sort of expectations that Apple's "there's an app for that" and Amazon's one-click have created in consumers. Again, every industry has had to confront these new expectations from customers who just "aren't going to take it" any more, but the change is happening unusually quickly in insurance, which intuitively makes sense given the sheer volume of customer experiences being reinvented every day. Having groceries and recipes delivered weekly was unknown globally 24 months ago and now boasts a market cap exceeding $2B. The industry pretty much remained in a cocoon until a couple of years ago but now must snap into line, not with the fledgling Amazon of 20 years ago, but with the overpowering Amazon of today. When customers begin asking Alexa for a quote on their car insurance, the train will have long since left the station on a stellar experience coming from within the industry.

Personal computer pioneer Alan Kay says that "everybody likes change – except for the change part." And change in insurance looks like it will follow an unusually convoluted series of plot lines. That said, the entire EY team is to be applauded for creating an EY Insurance Executive Forum experience that was rich with lessons learned and powerful advice.

As a supporting partner on the 2017 event, here are our top 6 important things we choose to highlight from this year's conference: 

1. C-Suite insurance leadership need not worry about having the in-house talent to succeed executing a systematic approach to innovation. If sleep is to be lost over innovation and talent, then let the discomfort come with the issue of retaining that talent while the company contemplates a systematic approach to innovation. A strategy to identify and hire the talent that doesn't fit historic cultural norms is another priority requiring attention. This message came through loud and clear in remarks from Eric Steigerwalt of Brighthouse Financial, Andrew Robinson of Oak HC/FT, Donna Peeples of Pypestream and Progressive Insurance CEO Tricia Griffith.
2. A cornerstone of success for world class innovation-based growth strategies is having a C-suite who command truth, unfiltered honesty and constructive conflict. No better examples can be cited than the rapid fire, at times thundering, fact based presentation from ACORD's Bill Pieroni, the candid and humorous words of Wisconsin Commissioner Ted Nickel, and the quietly direct advice from Piyush Singh, founder of Terrene Labs.
3. The common thread that connected every speaker thriving amidst what many see as chaotic noise is the leveraging of constraints to drive innovation. The laser-like focus on a well-defined customer segment, a problem for that segment (also known as the Job To Be Done) and a well-developed solution yields growth. This convergence was embodied in the comments of Andrew Beal and Mike Consedine of the NAIC, Marcus Cooper of Zurich North America, and Gina Papush of QBE.
4. The core mission of insurance is to enable economies. Such is the role that insurers have played through history, from opening Europe to the shipping trade with the Far East, to the launch of a new nation in the 1750s, to transforming mobility in the 1920s. The opportunities to harvest exponential growth by enabling this innovation economy bring the equally compelling opportunity to literally make the world a better place. Lyft's Kate Sampson captivated the participants with her description of the culture of innovation at Lyft and the future of mobility. ITL's Chief Innovation Officer Guy Fraker shared this message with explicit optimism, as did EY's Global Insurance Lead, David Hollander, and Philip Edmundson of Corvus Insurance.
5. Innovation requires sponsorship of the CEO. However, what is often missed is the stark reality that consistent success of innovation lives and dies in the middle of established cultures. The conference offered more than a few speakers reinforcing this message including Barbara Turner of Ohio National, Terrance Williams of Nationwide and Charlie Mihaliak of EY. This notion of how best to harness and foster cultural diversity as part of an organization's strategy to grow through innovation, is a theme we at ITL believe is critically important.
6. Success in achieving growth by executing an innovation system is unique in the insurance industry. That said, best practices and valuable lessons learned can come from anywhere, which was echoed by innovation leaders Scott Sanchez of Nationwide and Dan Reed of American Family. Important, too, were the comments and experiences of industry innovator Barbara Humpton of Siemens, providing an outside-the-industry look at how organizations like Siemens approach and foster innovation.

We would love to hear any reactions/additions/corrections on the above. 

Cheers,

Paul Carroll and The ITL team