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Language and Mental Health (Part 3)

When it comes to mental health in the workplace, the words used to describe the conditions matter a great deal.

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[The other three parts of this series can be found here and here.] “Power is the ability to define reality and to have other people respond to your definition as if it were their own.” – Wade Nobles “Words are powerful. Old and inaccurate descriptors, and the inappropriate use of these descriptors, perpetuate negative stereotypes and reinforce an incredibly powerful attitudinal barrier.” – Kathie Snow Workplaces are microcosms of society and can be powerful change agents when they create caring cultures through attention to how suicide and mental health are discussed. It is difficult for us to write about language and mental health in a simple “Say this” and “Don’t say this” way, but we must strive to do better. Generally, clinicians dominate the discussion, but thoughtful language about mental health and suicide does not rest on diagnostic categories. Rather, it tries to communicate more clearly, accurately, individually and holistically about the experience. We must constantly look to find language that is dignified, empowering and inclusive as well as being as descriptive as possible. See also: The Daily Grind Is Good for the Mind   It is not easy to find “the best” language, but we can do better. 1. The terms that are used are often clinically based and clinically biased. The term “mental illness” puts the descriptor of a person in medical language, even though the person may not always wish to be identified based on a medical perspective. The medical model contributes to rampant oversimplification that looks like this: “All that has to be done is to get these ill people to seek treatment; they take a pill, and they are fixed!” Diagnosis serves the medical practitioner in treatment planning, but it does not provide good information or understanding about the whole person and encourages us to see a person only in terms of a medical condition. And diagnosis is often incorrect, so it should not be the focus of how we educate. Although it is very common for people who have received a label regarding mental health or substance use to have a significant history of trauma, the correlation is ignored in the language, and often in treatment too. Only the set of “symptoms” currently seen is addressed. The trauma is not. 2. The choice of words is not mindful. The word “suffering” is used often, as in “people who suffer from depression.” This paints a pathetic picture of nothing but suffering, which is a fallacy, while suggesting passive inaction. Another common term is “the stigma of mental health.” In fact, the stigma is an attitude of prejudice toward a group of people. See below for suggested alternatives to the term. 3. Terms promote “other than” thinking. The words “disorder” and “disability” inform us that those who fall into these categories are other than “ordered” or “able.” “Order” and “able” are the givens, the desirable things. “Dis” implies that a person described this way falls short. Consider this: the term “non-white” is not used to name a person who is other than Caucasian, because it would be deemed to be disrespectful. Unfortunately, we do not have a wording solution for mental health. 4. Better terms require more words. We are forced to use terms that represent dominant culture mindsets, even though they are just labels, not the “truth.” For example, a better way of saying “a person who has a mental illness” could be to say: “a person who has the experience of having been assigned a medical label in the category called ‘mental illness.’“ But this makes writing and speaking very cumbersome. 5. We do not have consensus around best language. Inside what is known as the recovery movement, we do not have consensus on best language, and that is okay. Let’s all keep thinking about this, talking to each other and pushing collectively toward better communication. The chart below provides some principles of progressive language. The suggestions that appear in the right-hand column are far from perfect, and we hope that they will continue to adapt and improve. To fulfill our desire to support self-determination, please note that if a person with the lived experience of a mental health challenge wishes to identify himself using language from the left-hand side of the chart below, we support that choice. (This is not an exhaustive list, and for reasons of space does not hold all the terms and usage that we wish would change.) Screen Shot 2016-09-07 at 3.39.29 PM Screen Shot 2016-09-07 at 3.42.16 PM Screen Shot 2016-09-07 at 3.42.53 PM Portions of this chart have been adapted with permission from Each Mind Matters, California’s Mental Health Movement, funded by counties through the Mental Health Services Act (Prop 63). See also: Why Mental Health Matters in Work Comp Words matter, especially where there is such a long history of marginalization, misinformation and mystery around daunting topics. When it comes to language related to mental health, we may not have all the right answers, but many of us are in the struggle to do better.

Sally Spencer-Thomas

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Sally Spencer-Thomas

Sally Spencer-Thomas is a clinical psychologist, inspirational international speaker and impact entrepreneur. Dr. Spencer-Thomas was moved to work in suicide prevention after her younger brother, a Denver entrepreneur, died of suicide after a battle with bipolar condition.


Donna Hardaker

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Donna Hardaker

Donna Hardaker is the director of Wellness Works, a groundbreaking workplace mental health training program of Mental Health America of California. Hardaker is a workplace mental health specialist and has been developing and delivering training and consulting services to organizations since 2003.

The InsurTech Definition of Insanity

It’s time to reinvent processes that were created as workarounds for things legacy systems can’t and won’t do. Rubber, meet road.

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The definition of insanity is doing the same thing over and over and expecting different results, right? The reality behind, and perhaps even the origin of, this statement is the simple fact that change is hard. This is especially true in the antiquated, paper- and process-laden insurance industry, which has resisted any kind of fundamental upgrade for decades. In the meantime, other industries have raised the bar of consumer expectations to a level where it is now unreasonable for the insurance industry to not respond. In identifying what is needed to improve self-service opportunities, access, prices, personalized product variations and, in turn, the entire customer experience overall, insurers inadvertently shone a spotlight on the industry’s enormous technology gap. And, having made significant money in fintech, the investment community is driving considerable interest in insurtech. See also: The Formula for Getting Growth Results   Insurers are ramping up to take back control from the mentality of the “way it’s always been done” and “if it ain’t broke don’t fix it.” There are three things that insurers can do to change the insurtech definition of insanity, including evaluating and overhauling processes, establishing a transformation team and doing a little mythbusting. Reinventing the Wheel First things first. Take a good hard look at your processes, keeping in mind that, without a change in process, there will be no change in results. It’s time to reject, revamp and reinvent processes that were created as workarounds for things legacy systems can’t and won’t do. The insurance industry has accepted changes already in the last several years that no one could have predicted 10, 15 or 20 years ago. And, the on-demand economy is pushing further changes in product definition – what is billable and in what increments, who owns information, where it should be stored and who should have access. The processes that drove the insurance industry yesterday do not have a carte blanche license for tomorrow. Rubber, meet road. Empowered AND Accountable Second, choose the right transformation team. This may be made up of internal insurance domain subject matter experts (SMEs), of IT professionals with a working knowledge of the existing infrastructure and even of external insurtech vendor partners offering expertise with emerging technologies. But be aware that, as important as the makeup of the team is the mandate of the team; the transformation team must be both empowered and accountable for decisions and results. The right people will rise to this challenge instead of shying away from it. The insurance industry must collectively do a better job of creating an innovation environment where failure is a learning experience and not a cause for dismissal. Shiny Bubbles? Third, insurers must become futurists, fortune tellers and mythbusters. Sound unlikely? Admittedly, this is probably not going to happen, but in the absence of true foresight (or ownership of a Ouija board), insurers must avoid getting enamored of the next big thing or shiny object. In the past, technology vendors have been criticized heavily for throwing big advertising and marketing dollars behind vaporware, or going to market with half-finished products and using insurer customers as unsuspecting development partners. This trend is no less prevalent in the new insurtech revolution or among startups, as opposed to incumbent insurance technology vendors. Desire to take advantage of the latest technology trend or to jump on the insurtech bandwagon should not outweigh prioritization of technology initiatives with tangible business value, or due diligence to determine if a product is actually present behind the marketing and advertising curtain. See also: Matching Game for InsurTech, Insurers Resistance is Futile Maybe the industry is taking the first step in a recovery program. Insurance has recognized there is a problem to be solved, and, by and large, there is acceptance that “resistance is futile.” Few insurers will maintain that the status quo must stand, technology advances must not be incorporated, products must not be made more flexible and processes must not be changed. Technology can help the industry meet the demands of modern consumers, attract new talent, protect policyholder data, provide mobile access and on-demand products and relate better to Millennials but only if evaluated and implemented quickly and responsibly, and in conjunction with substantive process change. Those who don’t believe this to be true, and who are insistent on continuing to resist change, are likely to be victims of their own insanity.

Andy Scurto

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Andy Scurto

Andy Scurto is Guidewire’s head of products, InsuranceNow, and manages strategic direction. He founded ISCS (acquired by Guidewire), where his deep understanding of both insurance and IT led to the development of products with uniquely rich flexibility and capabilities.

Healthcare: When a Win-Win Is Lose-Lose

While wellness at work was a noble notion and one that made sense to many on the surface, it’s time for HR executives to 'fess up and move on.

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“Workplace Wellness Programs Are a Sham“ is a good article in Slate by L.V. Anderson. This is a must read for people who remain true believers that workplace wellness will improve worker health. “The idea behind wellness programs sounds like a win-win," Anderson writes. Alas, history is full of “win-win” ideas that were destructive, costly or ineffective. She describes the infamous “doublespeak” of Safeway CEO Stephen Burd’s description of success with Safeway’s wellness program. Anderson writes, “As it turns out, almost none of Burd’s story was true.” (Regular readers of my blog will know I’ve written about the Safeway nonsense before.) For decades, everyone knew that an annual physical was a great way to stay healthy, but various studies, including the famous New England Centenarian Study, have exposed that as a myth, too. See also: A Proposed Code of Conduct on Wellness   Antibacterial soap, anyone? Sounded like a great win-win, no? The FDA finally outlawed it. In my book, An Illustrated Guide to Personal Health, written in 2015 with UNLV Professor Robert Woods, Chapter 4 was titled, “Avoid Antibacterial Soaps and Gels.” Why? “Overuse of antibacterial soaps and gels can reduce the effectiveness of antibiotics you may need someday…. They are helping create antibiotic-resistant germs.” Back to wellness failures. Companies in the U.S. have spent huge dollars trying to keep employees healthy through methods that are shams. It’s time to move on. I immodestly include the following quote from Anderson’s article: “You might think of Al Lewis, Vik Khanna and Tom Emerick as the Three Musketeers in the fight against wellness programs.“* Al and I are co-authors of the Amazon best seller, Cracking Health Costs. It describes flaws in typical corporate wellness schemes, which while profitable to wellness vendors are useless at best and can actually be harmful to workers health at worst, not to mention the inconvenience and costs of going to doctors for all that screening. Concerns about wasted productivity, anyone? How can wellness programs harm worker health? One way is by promoting gross over-testing and excessive screening by tools that have very high error rates and rates of false positives, e.g., PSA screens. One good byproduct of dumping your wellness program is to avoid all the costly and burdensome reporting ACA requires. Yet another good byproduct is letting your employees do their work at work instead of spending non-productive time every year in wellness lectures, filling out health risk assessments, reading wellness-related emails and brochures, etc., etc., ad nauseum. How can “wellnessophiles” in companies truly believe that their employees don’t already know that smoking, overeating, lack of exercise and excessive consumption of concentrated sugars are not good for them? Do wellness proponents truly believe that the employees’ doctors haven’t already addressed those issues…not to mention public service announcements, health classes in high school and so on? Do proponents think their employees who smoke have never noticed warning labels on cigarette packs? I meet a lot of people from various walks of life. Occasionally, I ask them if their employer has a wellness program and, if so, what do they think about it. The typical first reaction is they roll their eyes. The most common comment is that the company’s wellness program is “just another [insert unflattering adjective here] HR program.” That’s usually followed by comments best described as lampooning the programs, as in “you’re not gonna believe this but…” type of comments. Interestingly, I meet HR executives who admit their wellness program are ineffective and costly, yet they cling to them. They usually give one of two reasons. One is that they don’t want to admit that their program is a big waste of money. Another common rational is some version of “Too many of our employees are unhealthy; we gotta do something.” (I put that in roughly the same category as, “the beatings will continue until morale improves.”) That line of thinking is bureaucracy at its worst. You would never spend your own money that way…or maybe they would?  Hmm. I get asked, if not wellness then what? My reply is anything that might actually save money or get better care for your workers, e.g., centers of excellence and direct contracting with providers. There is some promising work on reference-based pricing and better pharmacy management. Also, I believe we may have a surge of international medical travel in the future, too, especially to places like Health City Cayman Island (HCCI), about an hour’s flight from Miami and one of the best-quality hospitals and clinics in this hemisphere. I have visited HCCI a number of times and met a number of their surgeons. They are excellent. See also: EEOC Caves on Wellness Programs   I tried various forms of wellness in my career of running large sell-insured plans. I tried to make them work, but in the end none of them were effective, and some actually drove up health costs in a way a steely-eyed CFO would quickly understand. For about half my career, I reported through the CFO chain, not HR. CFOs really get the numbers and ask the tough ROI questions. HR executives, take note: You can increase your status and respect if you just get out of wellness. Again, it’s time to move on. While wellness at work was a noble notion and one that made sense to many on the surface, it’s time to “fess” up to your bosses. They will appreciate your message and appreciate the reduction of wasteful spending. Tom Emerick’s latest book is An Illustrated Guide to Personal HealthFor further information on this topic, see the They Said What blog by Al Lewis and Vik Khanna.

Tom Emerick

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Tom Emerick

Tom Emerick is president of Emerick Consulting and cofounder of EdisonHealth and Thera Advisors.  Emerick’s years with Wal-Mart Stores, Burger King, British Petroleum and American Fidelity Assurance have provided him with an excellent blend of experience and contacts.

Can Risk Management Even Be Effective?

Despite a lot of concern, the concept of risk management remains vague. Here is a summary of the four required components.

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Lately, everyone from government agencies to regulators to corporate board members seem to be talking about the need for more effective risk management. The challenging part is that, despite the guidance provided in ISO 31000:2009, the concept of risk management effectiveness remains vague. This article attempts to summarize the basic components of effective risk management, which should help risk managers to respond to the challenges set by regulators and shareholders. The team at Institute for Strategic Risk Analysis in Decision Making (ISAR) and www.risk-academy.ru has been studying risk management for more than 15 years, and we firmly believe that effective risk management is only possible when all four criteria below are met. Each of these criteria is based on ISO31000:2009, the most widely used risk management standard in the world (translated and officially adopted in 44 of the 50 biggest countries based on the GDP). 1. Integrating Risk Into Decision Making One of the most important tests of true risk management effectiveness is the level of risk management integration into decision making. ISAR research shows that companies achieve long-term advantage if they are capable of systematically integrating risk management into planning and budgeting decisions, investment decisions, core operational business processes and key supporting functions. Just consider an example of a large investment fund, which makes investment decisions only after an independent risks analysis and does simulations to test the effect of uncertainty on key project assumptions and forecasts. Another example is a large airline, which makes strategic decisions based on several quality alternatives with a risk assessment performed for each alternative.
For us it's very important that risks are taken into account when investment decisions are made. That's why risk assessments are mandatory for all investment decisions. Risks are identified and evaluated by both the project team and the back-office departments, including legal, finance, scientists, strategy and others. This ensures a more objective and independent risk analysis when making investment decisions.
--Konstantin Dozhdikov, Head of Risk, RUSNANO

 2. Strong Risk Management Culture

Human psychology and the ability of business managers to make decisions in situations of great uncertainty have a huge impact on risk management effectiveness. Nobel laureates D. Kahneman and A. Tversky, have conducted some exceptional research in the field of risk perception, showing that most people, consciously or subconsciously, choose to be ignorant to risks. Robust risk management culture is therefore fundamental to effective risk management. Take for example a large petrochemical company, which used online and face-to-face training to raise risk management awareness and competencies across all staff levels. The company also allocated resources to integrating risk management principles into the overall company culture. Another example is a government agency, which documented transparent discussion and sharing information about risks as one of the corporate values, which were later communicated to all employees. See also: Risk Management, in Plain English
Training is one of the most important factors in the development of a risk management culture. Risk management can become an effective tool as soon as every employee understands what is it and how it applies to their personal area of responsibility. There are many different kinds of risk management training. It could be risk induction training offered to all new employees. Induction training should include a short explanation of the risks that might arise, information about a useful tool risk management and how to use it when making day-to-day business decisions. It is also useful to conduct separate specialized risk management training for department heads and key managers in order to help them integrate risk analysis into key business processes. The main thing is to remember that training is not supposed to be a one-time measure and, on the contrary, should be offered on a regular basis. Training sessions can be led by your company's own risk manager or an external party, but either way the trainers must possess relevant competencies and qualifications.
--Lubov Frolova, Head of Risk , Tekhnodinamika
3. Disclosing Risk Information Another criterion for effective risk management is willingness and ability of an organization to document and disclose risk-related information both internally and externally. A mature company not only documents the results of risk analysis in the internal decision making processes but also discloses information about risks and their mitigation to relevant stakeholders, where appropriate, in external reporting or on the company website. Because actual risk information may be sensitive and contain commercial secrets, the focus of disclosure should not be  on the risks themselves but rather on risk management framework, executive commitment to managing risks and culture of the organization. Many organizations tend to treat this formally, often copying and pasting risk management information in external reporting from year to year without any update. Remember that disclosure of risk management information allows companies to both make and save money. For example, the insurance market reacts positively to a company's ability to disclose information about the effectiveness of its risk management and control environment, offering a reduction in insurance premiums. Banks and investors also see risk disclosure in a positive light, allowing companies to lower their financing costs. One large mobile network operator takes risk reporting particularly seriously. Its approach changed after an IPO. To this day, risk reporting as part of the annual report is not just a recount of the typical risks within their industry sector, but a reflection of key risk management changes and achievements over the last period. Risk reporting is composed of two parts: 1) A general description of events linked to risk management within the company; and 2) A description of key risks facing the company over the year. In the first part, risk managers give a detailed description of significant risk management events that occurred within the company that year. For example, there could be a description of how closely the company is aligned with the ISO 31000:2009 principles, or how the company has strengthened its risk culture. The second part describes common risk categories facing the company. This should point out the typical risks in the industry sector as well as the most significant risks identified over the past year. Additionally, the description of each risk should include the status of mitigation actions taken to manage the risk, their effectiveness and the anticipatory measures that the company intends to take in the future.  4. Continuously Improving Risk Management The final criterion for effective risk management has to do with the continuous improvement of the risk management framework and the risk team itself. One investment fund was able to do this with the help of regular assessment of the quality and timeliness of its risk analysis, annual risk management culture assessments and periodic review of risk management team competencies. For example, professional risk management certification helps to boost risk team competencies. One of the reasons behind the need for constant risk management improvement is rapid development of risk management discipline. The ISO 31000:2009 standard is currently being reviewed by more than 200 specialists from 30 different countries, including experts from Russia and members of ISAR. Some of the suggestions for the new version of the standard include the greater need for integration of risk management into business activities, including decision making, and the need to explicitly take into account human and cultural factors. These changes could have a significant impact on many modern non-financial organizations, raising questions about their risk management effectiveness. See also: Risk Management: Off the Rails?   Risk management, just like any other element of corporate governance, must be integrated into the overall management system of the organization. The ISO 31000:2009 international standard explicitly talks about the need for risk management to be adaptive, dynamic and iterative. As organizational risk maturity improves, so will the tools used by the organization to manage risks in decision making. Professional risk managers should not only develop risk management processes for the organizations but also improve their own risk management competencies. As I am writing this, work is being undertaken on the update of both of the most widely adopted risk management standards (ISO 31000:2009 and COSO:ERM 2004). New versions are expected to be available in 2017 and promise to revolutionize our current understanding of risk management, not necessarily in a positive way. My experience shows that participating in international conferences, training sessions and certification programs constitutes a good way for risk managers to keep themselves in top professional shape. I hope I will see you at the G31000 conference in Dubai on Oct. 12-13, 2016:www.g31000conference2016.org, where I will be presenting on the topic of risk management maturity. We recommend executives and risk managers evaluate the current level of risk management maturity using the criteria for effective risk management presented in this article. If at least one of the puzzle pieces is missing, it is probably a bit premature to talk about effective risk management.

Alexei Sidorenko

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Alexei Sidorenko

Alex Sidorenko has more than 13 years of strategic, innovation, risk and performance management experience across Australia, Russia, Poland and Kazakhstan. In 2014, he was named the risk manager of the year by the Russian Risk Management Association.

Health Startups Go After 3 Pain Points

Innovators addressing user pain points can influence how plans are selected and healthcare is consumed, but the levers are not easy to move.

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In my last post, I outlined the four dimensions that are defining the opportunities for health insurtech innovation: the health of the American people, marketplace trends, the role of regulation and the players. Incumbent health insurers are pursuing legacy tactics to compete in the ACA world. There are big M&A approved (Centene/Healthnet) and facing regulatory challenges (both Aetna/Humana and Anthem/Cigna). Many are increasing premiums. Others are leaving the public exchanges (notably, United Healthcare withdrew earlier this year, and Aetna just announced its withdrawal from 11 of the 15 exchanges). Innovators addressing the root of user pain points can influence how plans are selected and healthcare is consumed. The levers are not easy to move. Success requires compliant ways of combining big data analytics and personalization with user-centric digital experiences. The headline of a recently published New York Times article, Cost, Not Choice, Is Top Concern of Health Insurance Customers, would seem to state the obvious. Yet insurers have expressed surprise at the policy mix and which plans are proving to be most popular. Carriers participating in the public exchanges report poorer actual performance than anticipated in premiums (lower) and claims (higher). Users are gravitating toward lower-cost plan options and show a trend to self-select into higher-cost plans when they know a big health care expense looms. This is not just an issue for incumbents. Oscar, among the most visible innovators in the US health insurance marketplace, reported a $105 million loss in 2015. Lack of scale is a challenge, but the company has also been affected by the user decision-making dynamics affecting established carriers. See also: Matching Game for InsurTech, Insurers   The results suggest (at least) three pain points: 1. People don’t see value because they don’t understand what they are buying.
  • When people think something is too expensive, it is because either they cannot afford it (i.e., it really is too expensive) or the perception of value does not justify the price.
  • Reportedly one in seven employees do not understand the benefits being offered by employers, of which health insurance is by far the biggest piece.
2. People are being held accountable for health decisions that they are not equipped to handle.
  • Faced with a complex set of choices and opaque information, it is no surprise that many go for the easy option: saving money now.
3. People don’t always make rational decisions.
  • A basic primer in behavioral economics will tell you that emotion, bias and other limitations -- not rational analysis -- drive decisions and that people discount perceived upside relative to downside. There is not enough upside to pay more in the short term.
Players who manage to affect these behavioral drivers stand to gain. Here are examples of companies working the issues. Connecting disparate sources of data PokitDok creates “APIs that power every health care transaction.” They aim to enable data connectivity across the silos that in today’s world require manual navigation. They define an ecosystem including Private Label Marketplaces, Insurance Connectivity, Payment Optimization and Identity Management. The company closed a $35 million B round last year. PokitDok is a pure technology play. Achieving their vision could be the “holy grail”: better economics and better patient experiences and outcomes without owning underwriting risk. Helping employers It hasn’t been lost on the startup world that 150 million employees purchase health care via employers, which is why many companies are focused on improving the benefits buying experience and promising to help employers lower costs. The ACA requires that all companies with more than 50 employees offer health insurance. This aspect of the regulation, coupled with the fact that health benefits expense has risen steadily, provides a specific and large innovation space. Competitors include: Lumity, who reported raising $14 million last fall, acting as an insurance broker. The company claims to be “the world’s first data-driven benefits platform for growing businesses” promising to simplify benefits selection for employers and employees. Employees are asked to provide health data, which are compared with aggregate profiles using proprietary algorithms. The big question: Will employees see enough benefit to share potentially sensitive information? Zenefits, recovering from widely publicized regulatory issues, has new leadership. The company acts a broker, and focuses on small businesses. Collective Health is targeting a wide range of businesses via “ready-to-go,” “configurable,” and “advanced” solutions. The employee experience components of the offering are aimed at helping users make better-informed decisions with less hassle. SimplyInsured aggregates health insurance plan options for small businesses to make comparisons easier, and aims to automate processes presumably essential to creating a viable cost structure for serving this segment. See also: InsurTech Need Not Be a Zero-Sum Game   A number of benefits consultants including Aon and Towers Watson (the latter via their acquisition of Liazon in 2013) offer larger employers private exchange capabilities – these include portals for employee benefits enrollment enabled by data analytics and a friendly user interface. They act as or engage brokers to create benefits plans tailored to employers’ goals. Such portals can be helpful to employees, and check a box for employers seeking to improve the benefits experience, not just reduce expenses. Health Advocate, founded in 2002, is the largest example of a relatively new industry positioned to help patients navigate an increasingly complex system towards the right care and reimbursement. The question being raised around these solutions – although as the de facto advocate within my own family I’d love to have a professional advocate to whom I could outsource – is whether they are a workaround adding yet another layer of expense to an industry that earns among the worst customer satisfaction scores of any. As an employer, however, it’s a benefits option that could be valuable given the stress of managing the health care process many employees undergo. Motivating people to adopt healthier habits Vitality, reported on in an earlier post, is a cobranded platform offering deals and rewards designed to motivate people who take steps towards better health. Hancock offers the HumanaVitality program, integrating Vitality’s rewards program into the insurance relationship. If people see near-term benefit to behavior change this could be a good use case upon which to build. Facilitating patient payments to providers Patientco is a “payments hub” supporting “every payment type,” “every payment method,” “every payment location.” Focus is on efficiently increasing revenue for providers, secondarily to improve the payments experience for patients. The company provides the ability to integrate its solution with other health technology solutions. Providing better experience capabilities to carriers Zipari is a customer experience and CRM platform providing a product suite including enrollment, billing, and a 360-view of members across engagement channels. The company targets is product line at insurers, both direct-to-consumer and group or employer channels. See also: Be Afraid of These 4 Startups The multiple miracles that would have to occur for a quick fix make it unlikely that we will see a simple, logical health insurance experience any time soon. We are relatively early in what is likely to be a long game. But, insurtech innovators and even more mature companies operating within and around the sector are demonstrating the capacity to go after the possibilities that data, technology and the ability to see creative solutions offer to mitigate the pain.

Amy Radin

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Amy Radin

Amy Radin is a transformation strategist, a scholar-practitioner at Columbia University and an executive adviser.

She partners with senior executives to navigate complex organizational transformations, bringing fresh perspectives shaped by decades of experience across regulated industries and emerging technology landscapes. As a strategic adviser, keynote speaker and workshop facilitator, she helps leaders translate ambitious visions into tangible results that align with evolving stakeholder expectations.

At Columbia University's School of Professional Studies, Radin serves as a scholar-practitioner, where she designed and teaches strategic advocacy in the MS Technology Management program. This role exemplifies her commitment to bridging academic insights with practical business applications, particularly crucial as organizations navigate the complexities of Industry 5.0.

Her approach challenges traditional change management paradigms, introducing frameworks that embrace the realities of today's business environment – from AI and advanced analytics to shifting workforce dynamics. Her methodology, refined through extensive corporate leadership experience, enables executives to build the capabilities needed to drive sustainable transformation in highly regulated environments.

As a member of the Fast Company Executive Board and author of the award-winning book, "The Change Maker's Playbook: How to Seek, Seed and Scale Innovation in Any Company," Radin regularly shares insights that help leaders reimagine their approach to organizational change. Her thought leadership draws from both her scholarly work and hands-on experience implementing transformative initiatives in complex business environments.

Previously, she held senior roles at American Express, served as chief digital officer and one of the corporate world’s first chief innovation officers at Citi and was chief marketing officer at AXA (now Equitable) in the U.S. 

Radin holds degrees from Wesleyan University and the Wharton School.

To explore collaboration opportunities or learn more about her work, visit her website or connect with her on LinkedIn.

 

IoT: Looking Beyond the Usual Suspects

We have been happy with our sensors spewing driving and exercise data, but we have barely scratched the surface of the available IoT data sources.

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Ever wondered what the Internet of Things (IoT) looks like? Well it’s not like the world of Pokemon Go – where virtual things push their way into the real world. The world of IoT is where real things are pushing into the virtual world, and the data these connected things provide is a heck of a lot more useful than any Pokemon you may catch. For all you hackers out there, this is your dream come true. For all you CIOs, I can hear you groan about yet another “attack surface” you need to police and lock-down. For those of us in the insurance industry, the IoT presents a very big opportunity. But what does it all mean? In our little Insurance world, we have been pretty happy (smug) with our sensors plugged into cars and smart watches spewing driving and exercise data. But we have barely scratched the surface of the available IoT data sources. If you go to thingful.net, you can drill down and look at the vast array of sensors. You’ll find personal weather stations, shopping center beacons, air quality sensors, river water level meters, building power supplies, ships, aircraft, radiation detectors -- a mind-blowing list of sensors that people have put into the wild and hooked up to the internet. See also: Insurance and the Internet of Things   So now I’ve got your attention. Let’s do a little survey of some of the more unusual suspects of devices being pressed into the service of underwriters and claim adjusters -- helping to reduce risk and improve lives. Let’s have some fun and do this in a “day in the life” style. A Day in the Life of IoT It’s Sunday evening. You’ve gone to bed, and you’re settling in for a good sleep. Part of the reason you are so relaxed is you have your new security system in place. Rather than having to wire up every door and window, this sentinel uses sound waves to determine if anything untoward is going on. If your spouse nudges you in the middle of the night and says, “Did you hear that? It must be a burglar! You go and check it out,” you can groggily reply, “The alarm didn’t hear anything, so go back to sleep!” Definitely worth its weight in gold. And what’s even better, insurers are giving premium discounts and incentives for the installation of such devices. So you blissfully snooze on, dreaming of all those savings. Rise and shine So there you are, enjoying your fantastic dream when gradually the light intensity increases and you wake. Groan; it’s Monday! The lamp next to your bed has been triggered by the sleep sensor strip under your mattress. This great night’s sleep has been fully recorded and automatically logged for your later analysis. Some insurers are now incorporating sleep into their premium discount models. According to the NHS, lack of sleep can lead to obesity, heart disease and diabetes, plus a range of other quality of life issues. You are a little smug – being paid to sleep – cool. See also: Coverage Risks From the ‘Internet of Things’ So the morning run is next. However, before you hit the track, you must “clean out the cocky’s cage” – brush your teeth. No problem, your connected toothbrush logs every swirl and stroke and the duration of your brushing. You hear your phone buzz with the alert on how you’ve missed the right molar at the back – oops! There is an insurer that offers discounts on dental insurance for sharing brushing data and following their dental health advice. Interesting to note that, beyond making you better social company, good dental hygiene reduces risk for heart disease, stroke, dementia, respiratory problems, diabetes, cancer plus a range of other issues. Running can be bad for business So now you slip on your running shoes. Inside, there are smart insoles that will log your run (just like all those boring wrist-bound trackers). They can also coach you to improve your running style by analyzing the data from pressure points on your feet and overall gait. Many insurers reward customers for being active, but not many are concerned that the chosen activity may cause other problems – it’s only a matter of time. What insurer would want to give discounts for running only to be hit with claims related to knee, hip and back problems due to poor running style? Fortunately, you’re a good runner and ready to hit the road. So you are just about to go out the door, when you remember you’d like to eat some hot soup for breakfast once you get back from your run. You head to the kitchen and put the soup on a slow simmer on the stove. Finally, you’re outside with your hot breath fogging in the brisk morning air – glorious. Your phone buzzes – what now! Your stove is warning you that you have left it on. Okay, no problem; you knew that. You reset the app alarm for 30 minutes – how long you expect to be running, so off you go. According to industry sources, the number one cause of household fires in the U.S. is from the stove being left on unintentionally. Some IoT sensors can automatically shut off the stove where the owner fails to respond. The cold air is invigorating as you jog down the road, but the thought of that hot soup waiting for you at home puts that little extra spring into your stride. Welcome home On return, you find the house still standing. No surprise, as your smoke detector is working, and your insurance company is making certain of it. More insurance companies are offering premium discounts for sharing detector data. A shocking statistic is that 60% of civilian fire fatalities in the U.S. occurred in homes without a working smoke alarm and that 70% of smoke alarms fail to operate because of missing or dead batteries. The soup and toast were wonderful. Now showered, dressed and energized you’re ready for work. Then the phone buzzes – “What did I have for breakfast?” You enter into a dialogue with your AI-powered diet coach. It inquires about your eating habits and discusses your personal weight and health targets. It closes out the conversation, encouraging you by letting you know what a good job you’ve been doing. Yay! BMI is already an entrenched factor for many insurance plans, so a personal dietary coach to help you eat healthy and achieve weight loss targets can assist to reduce premiums. Several companies are exploring the use of AI technology to effectively implement behavior change associated with dietary and exercise programs. Off to work Today, your car is in the workshop, so you take an Uber to work. As luck would have it, you get a Driverless Uber, so today has already turned out to be really geeky. See also: How the ‘Internet of Things’ Affects Strategic Planning Arriving at the construction site, you put on your work protection gear. Inside your gear, the wearable sensors plug you into the overall workforce management system for the site – your every move is now tracked. You know that safety always comes first. Since the new wearable system has been in place, accidents and injuries on the site have reduced significantly. Insurers are investing in and exploring the use of wearables and other related systems as a way of reducing workers’ compensation risk. The bottom line Had I had written this article five years ago, many would have scoffed at it as a work of pure fantasy. I am happy to say that all of the above cases are very real and do have insurance links. It goes to show that the range and depth of data available are rapidly expanding, and with it our ability to modify the risk equation. In our industry, that’s a big deal. So, next time someone says “IoT,” remember the big opportunity that goes beyond the usual suspects. You can be certain that someone out there is already thinking about how to exploit them. This article first appeared at The Digital Insurer.

Andrew Dart

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Andrew Dart

Andrew Dart is a partner with The Digital Insurer. He was previously the sole insurance industry strategist for CSC in AMEA and one of CSC’s “ingenious minds” globally. With more than 30 years of international insurance experience, Dart has worked in Asian cities, including Tokyo, Jakarta, Singapore and Hong Kong.

The Most Stressful Job in Insurance

HR is a profession living in the 1980s but trying to operate in a a business environment of the 2020s, or thereabouts.

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So we all feel we have a tough deal. Creating a product, reducing claims ratios, improving profitability – and even being the captain of the ship when all around us the waters are turbulent, and storms are on the horizon. But I wanted to share with you what I think is one of the most stressful jobs in insurance. And that is in the HR (human resources) department. Okay, so you are thinking that HR is a comfortable, backroom activity away from the heat of the insurance battle. But that’s not the case. The insurance battle -- if not much of the war -- relates to cost-cutting. And that means losing people. Often good people, because they are expensive. These industry experts are often let go quickly, with little warning and with poor compensation despite years of service. See also: 8 Things to Know About Insurance   Why should this create stress in the HR department? First, let’s get over the notion that HR is the employee’s friend. I remember when HR was the "trusted adviser" to the employee as well as representing the employer's interest – but now HR is firmly there to implement employment processes within the terms of employment law. Many senior professions entered HR because of their soft skills, but now they are "the hatchet men" who have to implement major change. No wonder they feel uncomfortable. (We won’t touch on why it seems to be the guys in HR who get the top jobs, and not the women. That’s a different blog entirely. Think "glass" and "ceiling.") Then there is the issue of social media. Many conversations within businesses are meant to take place in an environment of confidentiality, but disgruntled employees are sharing information -- often under an alias -- about their severance terms and conditions. In many cases, the HR department has little insight into what is being said about their performance and behavior; if they did, they would be horrified. See also: The Human Resources View Of Health Care Benefits Needs To Change   The reality is that HR is a profession living in the 1980s but trying to operate in a a business environment of the 2020s, or thereabouts. No wonder HR professionals feel disillusioned and under stress. Big stress. HR needs to adapt rapidly. HR professionals need to be able to manage social media analytics, especially sentiment analysis, and to be able to manage employees in same way that the marketing department seek to understand their customers. Until that happens, these key professionals will feel like victims of change rather than being the effective implementors. (Even as victims, of course, at least they’ll keep their jobs. After all, doesn’t someone have to turn off the lights at the end of the day?)

Tony Boobier

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Tony Boobier

Tony Boobier is a former worldwide insurance executive at IBM focusing on analytics and is now operating as an independent writer and consultant. He entered the insurance industry 30 years ago. After working for carriers and intermediaries in customer-facing operational roles, he crossed over to the world of technology in 2006.

Transformation of Roof Claim Processing

Drones and other new sources of data are creating unbelievable possibilities -- but may overwhelm companies with data.

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The property and casualty insurance industry is on the verge of a transformation. New sources of data are creating possibilities that were previously unthinkable and are changing ingrained business processes, but they are also overwhelming companies with data. One significant source of this coming inundation will be unmanned aerial vehicles and systems (UAVs and UASs, more commonly referred to as drones). Soon, insurance companies will send drones to inspect roofs to determine P&C claims. Gone will be the days of adjusters risking personal safety while climbing and walking roofs to gather data and assess damage. See also: Data and Analytics in P&C Insurance   Much attention has been paid to the new methods of data collection and acquisition. Less attention has been paid to how industry will make efficient and economic use of the new data. The advent of new collection technologies necessitates the development of new data processing methods and processes. Merely adopting new methods for collecting visual data will not lead to significantly increased efficiencies or improved bottom lines. Data handling and business processing improvements must be coupled with new collection technologies. The Constraints: Business, Technology and Regulations The industry has been understandably cautious in adopting new technologies that will upset decades of established practice. There are numerous sources for this reluctance, the most important of which include:
  • Scale: With the drone industry in its infancy, insurance providers have expressed concern that few (if any) drone operators could meet demand within specific markets, much less across large geographic areas. Demand for inspections could potentially far outpace the supply of drones and drone operators and could require some firms to contract with multiple operators, thereby adding unwanted layers of complexity to operations.
  • Lack of confidence in the underlying technologies: There is also considerable concern that drone technologies have not yet matured sufficiently for widespread adoption. As an example, only recently has satellite imagery begun to be used more extensively. Adopting this technology so early in its development could expose companies to unpredictable downsides.
  • Lack of turnkey solutions: Drone operators have limited or no ability to provide analytics for the image data acquired. Insurance companies either need to develop their own image analytics technology or engage yet another third party to extract meaningful information from the data.
  • New technology supplanting drones: Some companies are concerned that tying themselves to drone technology providers will set them on a path-dependent course that may prevent them from adopting and profiting from unexpected developments of new technology.
  • Out with the new, keep the old: In many cases, the objection to adopting drones is that the old ways work. Insurance companies have weathered numerous technology changes through the years and are not eager to jettison tried-and-true processes and relationships.
  • Regulations: Another major concern has been the highly uncertain regulatory environment. The Federal Aviation Administration’s initial approach was highly restrictive, requiring pilot licenses for operators and effectively shutting the door to potential market entrants. The new round of regulations, specifically Rule 333 and Part 107, will reverse the overly restrictive pilot license rule and allow competitors to enter the market and drive down prices.
Most of these issues are temporary. The regulatory environment is maturing and stabilizing to allow the growth of a new industry. Over a relatively short period, the market will sort out issues related to scale and availability, maturity of drone technology and whether a newer, superior technology could quickly supplant drones. The market pressures to adopt new technology will make it increasingly untenable to resist innovation. The issues that will continue to challenge the insurance industry are those related to analytics and business process integration, regardless of the regulatory environment, scale or specific data acquisition technology. The How: AI, Machine Learning and Business Platforms Drones are only the beginning of the story. They are merely the tool for collecting visual data, albeit with greater speed, safety, quality and depth than previously available. For an industry to make profitable use of this new source of data, however, visual data must be converted into meaningful information and must integrate seamlessly with all related business processes. Information must be extracted more efficiently from the data sources. Manually performing tasks such as damage detection will no longer be economically feasible given the volume of data and speed at which it will become available. Companies that harness technologies such as artificial intelligence (AI) and machine learning will significantly improve operations and establish clear advantages. Powerful algorithms will automatically detect damage sustained by a structure (for example, hail damage on a roof) as recorded by drones. These algorithms will be faster and more accurate than any human adjuster, able to perform in mere minutes (or less) what requires hours for humans to do, and the algorithms will be self-training and self-improving. However, data analysis still needs to be integrated with business processes such as settlement. A platform approach that combines data analytics with business processes, making the information instantly available to stakeholders, will be the most likely method of solving the problem. A fully integrated business platform would store, analyze and report data. It would eliminate reliance on multiple software applications and systems, bringing the full scope of business processes into a single, seamless package. In the case of roof damage claims, the platform approach would integrate detection of structural damage and determination of claim value, and it would issue a report and settlement payment for the homeowner, all with minimal human intervention and within minutes of receiving the visual data. Integrating advanced data analytics and business processes will allow companies access to real-time data and improve decision making with predictive analytics. See also: 2 Key Tools for Innovation in P&C   Platforms will also provide the infrastructure to connect insurance companies to drone operators, as well as policyholders. Platforms will provide a market exchange or job board for drone operators for hire across numerous markets, complete with their credentials and technical capacity. Insurance companies will be able to directly interact with their customers through platform technology. The Why: Increased Competitiveness, Improved Customer Relations and the Bottom Line The incentives to adopt new technologies are clear. Drones can acquire data more safely, faster, at lower cost and with higher quality than satellites or an army of adjusters. However, the industry will realize greater benefits from focusing on the analytics of the new data, rather than the specific method of collection and delivery of that data. Advanced analytics will drastically reduce the time to settle claims and will standardize the claims settlement process. Those quick to adopt the new technologies will gain early competitive advantages and efficiencies relative to their peers. Combining analytics and a computing platform approach that harnesses AI and machine learning will simplify business processes—replacing inefficient, disaggregated tools, software applications and systems—and improve decision making. Those that make this leap earlier than their peers will have the clear advantage. Faster, more accurate and more reliable claims settlement will lead to better business planning and risk management. Powerful computing platforms will allow insurance companies to employ predictive analytics that accurately and quickly determine business risks and provide tools for mitigating those risks. Improving the claims settlement process will yield improved customer relations. Home repairs, especially significant ones like roof replacement, are a major source of anxiety for homeowners. Reducing the time to completion of repairs through increased processing speed and standardized claims estimates will increase customer satisfaction and loyalty.

Ross Bohnstedt

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Ross Bohnstedt

Ross Bohnstedt serves as Senior Vice President, Market Development at Panton, Inc. Panton is leading the development of robust business platforms, analytics, and machine learning in the insurance sector. At Panton, Mr. Bohnstedt is responsible for identifying markets, business development, and closing the sales process.

The Great Blockchain Dilemma

One driver of blockchain technology could be great for insurance; the other may be systemically toxic to everything insurance stands for.

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Many insurance companies have a deep sense they should be part of the blockchain movement, but they are not quite certain how to approach its implementation. Once you pull back the curtains, there appear to be two sets of mutually exclusive incentives underpinning the blockchain technology movement. One of them could be the greatest thing that has ever happened to insurance; the other may be systemically toxic to everything insurance stands for. A productive and sustainable economy requires stability — i.e., low volatility or no volatility. The insurance industry, by definition, must be able to identify predictable events over a long period. The value proposition of all insurance products depends on the ability to pool risk exposures appropriately and to lay off risk. These conditions limit the insurer only to those products where conditions are assured. The incentives of the insurance business seek to reduce volatility, categorize risk exposures appropriately and mitigate risks (where applicable). Anything less is called gambling. See also: Why Insurers Caught the Blockchain Bug   On the other hand, speculation may be needed to maintain efficiency and grow the blockchain. Speculation is often the sole basis of valuation for digital tokens and depends on high volatility to attract gamblers (for lack of a better term) to bridge the capitalization gap. Yet the creation and distribution of digital tokens is only a residual artifact of the blockchain use case, not the core use case. For the blockchain to maintain itself, the value of the digital token must exceed the cost of maintaining the blockchain. By contrast, a centralized organization would simply pay an IT department from operating revenue to maintain the system, whereas a decentralized organization, by definition, must be autonomous. The Great Blockchain dilemma is clear: Volatility and stability are mutually exclusive. The current blockchain/crypto-currency landscape is plagued by this dichotomy. Incentives are laid out to encourage speculation, yet the great vision of blockchain is one of a new economic paradigm ushering in an era of economic fairness and stability. Both of these things cannot happen at once. For example, investment banking and corporate decision-making is driven by quarterly profits. The incentives on Wall Street have become tragically short-term. The current view of blockchain is a miracle drug that can eliminate large swaths of human administrators while also increasing the performance of data structures. Not surprisingly, large banks have come together to form a consortium to define blockchain standards for transferring value within their industry. But this may be short-sighted. The hallmark of a great society is the ability to capitalize on its needs, not its arbitrage opportunities. While the case for creating a shiny new super currency is compelling, the primary objective should be to induce stability in the outcomes of events articulated on a blockchain. The value of the tokens must represent true human productivity of a physical nature. Otherwise, nobody else would be willing to perform work in exchange for it. With a broad social agreement, digital currency can achieve a state of mutual reciprocity and be traded widely across an economy without friction. See also: What Problem Does Blockchain Solve? Therefore, the highest and best use for blockchain technology is in the insurance industry and not necessarily the banking industry, because insurance can eliminate volatility. Properly deployed, blockchain technology can reduce the cost of capital by decentralizing risk. A developed economy is distinguishable from a less developed economy by the stabilizing force of insurance, not by the volatile nature of money.

Dan Robles

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Dan Robles

Daniel R. Robles, PE, MBA is the founder of The Ingenesist Project (TIP), whose objective is to research, develop and publish applications of blockchain technology related to the financial services and infrastructure engineering industries.

8 Things to Know About Insurance

Here are eight things you need to consider when assessing your insurance needs.

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Everyone knows the purpose of insurance is to protect individuals against unexpected financial losses in the event of illness, accident or death. That's not surprising. What is surprising is that the majority of Americans are uninsured. Are you insured? Are those near and dear to you protected against financial losses that could arise because of health-related problems? See also: Gig Economy: Newest Tool for Insurance   Here are eight things you need to consider when assessing your insurance needs. 1. What you have First, analyze what you have now. How much do you have in your savings account? Do you have a regular source of income to meet your monthly expenses? Have you made smart investments in properties or stocks? 2. Debt What debts are you currently running? Do you have personal loans, mortgage loans or any credit card payments due? How much of the amount is yet to be paid? What happens to the debts when something unexpected happens to you? 3. Health Do you suffer from any health issues like back pain, obesity, blood pressure or heart problems? If so, you might want to purchase insurance plans before things get worse. It makes sense to check out reliable sources and find out whether you need to go for genetic testing. A healthy person gets as much as a 20% discount on premiums. 4. Financial commitments Ask yourself how much money you should leave for your spouse and children to lead a stress-free life financially. How much will your loved ones require to meet their household and healthcare expenses? What are the significant future expenses they’ll need help with? Education, household and healthcare are the major expenses for a family. In addition, there will be other costs like vehicle repair and maintenance, home renovation and home appliances. 5. Childcare and home duties Childcare is another major scenario you need to consider when thinking about whether you should purchase insurance. How would you like your children to be cared for if you or your spouse met with a major accident, disability or death? If something happens to the parents, the life of the children may be bleak if there is no backup plan. The two best ways to offer protection to your kids are (1) having a caregiver to take care of them or (2) sending them to childcare. Try to come up with a rough estimate of how much that would cost. 6. Living expenses Regarding your personal expenses, ask yourself how much money you will need to take care of yourself when you’re affected by a threatening disease, illness or disability. Also, consider the additional medical and caretaker expenses. 7. Funeral expenses Well, let’s hope that nothing of this sort happens to anyone at a young age or even middle age, but, again, this is a scenario that needs to be considered when assessing one’s insurance needs. The hard fact about funerals is that they are pretty expensive ($3,000 to $5,000). 8. Timeframe In the event of illness, how long will you be able to survive without your working income? Again, this comes down to the savings you have at present and the returns from investments you’ve already made. If you haven’t made any, then it’s high time you purchased a suitable insurance plan to prevent any unexpected financial damage to you and your family. See also: What Do Bots Mean for Insurance?   Situations and financial status changes from time to time, so ensure your insurance needs are regularly reassessed and you are covered accordingly. If you’re not sure how to get started, getting in touch with an expert is the best way to go about it. Talk to multiple insurance agents and compare different plans before choosing one. Make sure you are always covered!

Joyce Mason

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Joyce Mason

Joyce is a blogger and content marketer who writes on topics related to insurance and finance. A writer by day and a reader by night, she takes pride in educating readers on the best ways to take an investment decision so they can lead a better life financially.