Do I really mean survival? I do. There’s not a bit of exaggeration there. I firmly believe—based on extensive qualitative and quantitative research and the many interviews and discussions I’ve conducted with insurance industry leaders—that analytics represent the industry’s best path to success and survival in a rapidly transforming world. Certainly, virtually every insurance carrier is using analytics in one or more parts of the enterprise—but it is not nearly being used to its full potential. Very few carriers can honestly claim to have a data-conscious culture or say they are applying innovative modeling techniques. What the industry needs now are well-defined strategies and tactics for immediate implementation to enhance the customer experience (including claims), increase accuracy in underwriting and pricing, optimize operations and boost profitability. Simply put, insurers need to immediately implement a meaningful and robust analytics strategy. That is why we are holding the 3rd Annual Insurance Analytics USA Summit (March 14-15, Chicago), to provide insights into how to transform the way an organization uses analytics. The lessons from experts about how to prepare the organization for analytics success include:

• Become an analytics powerhouse: Gain executive buy-in for analytics implementation, build a team to use effective analytics to solve critical business challenges and create a culture of data-centricity throughout the organization.
• Keep all eyes on the customer: Develop a 360-degree view of the customer; integrate data from disparate sources across the organization to develop a more thorough view of the customer; glean insights for application through underwriting, pricing, marketing, claims, resource management and fighting fraud; design and deliver an exceptional customer experience; and effectively use segmentation and personalization to improve customer lifetime value.
• Effectively use new and external data: Drive actionable insights from the explosion of big data and new data sources, including telematics, social media and texts.
• Transform your product lines using analytics: Embed analytics throughout underwriting and pricing to optimize products and improve profitability at each stage of the value chain through accurate risk assessment.

This summit is a must-attend event for executives who are responsible for insurance analytics strategies from insurance carriers (P&C, commercial, specialty, health and life) as well as executives and others responsible for virtually any part of the insurance enterprise. I hope you'll join me and 250-plus industry executives at the Insurance Analytics Summit.

I’m sure you are as tired of reading about Zenefits as I am of writing about it, but, as much as I may want to, it’s hard to turn away from a train wreck in progress. Wendy Keneipp and I have spent more time reading, writing and talking about Zenefits than we care to admit. We have spent time analyzing its model, discussing how to compete against the company and breaking down its impact on the industry. But this past week has had us shaking our heads at its arrogance and recklessness. I would like to promise this will be my last article about Zenefits, but, well.... No doubt you have recently read about Zenefits' allegedly selling insurance without proper licenses, and we have now learned the company “may have” (according to new CEO David Sacks) taken shortcuts on at least some of the licenses it did have. May have?! At least take real ownership of the failures, Mr. Sacks! According to several online articles, the shortcut Zenefits "may have" taken involved writing a program called Macro, which made it appear as if individuals were completing the 52 hours of online training required by the state of California to obtain a license when, in fact, they weren’t. According to a BuzzFeed.com article, those wannabe brokers were then required to sign their name, under risk of perjury, certifying they had completed the required training when, in fact, they hadn’t. The lack of conscience, level of arrogance and number of culpable “leaders” required to execute on something like this is absolutely mind-blowing. It was bad enough when we thought this was simply a misguided company, confused as to whether it was a tech company or an insurance broker, but that possibility pales in comparison with the malicious company it is proving to be. Zenefits garnered untold positive press for disrupting an industry and for becoming the fastest-growing SaaS (software as a service) company in Silicon Valley history, but now we are learning just how ugly the reality was behind that thin veil of success. More than disrupting an industry, Zenefits has built an organization that is disrupting people’s lives—and not in a positive way. Here are the victims: INVESTORS I don’t have a lot of sympathy for this group because they provided the currency that fueled Zenefits’ reckless behavior; they are clearly part of the problem. It was investors who perpetuated a RIDICULOUS valuation and, in doing so, put untold pressure on the company to grow at a rate that would somehow validate the investors' irrational exuberance over the Zenefits machine. But, in addition to fueling the behavior, the investors are also victims; they invested in an illusion. They had every reason to believe their investment would be protected by legitimate (albeit misguided) business practices. It should have been reasonable for investors to assume the growth they were witnessing—and using to substantiate their investment—was being driven in a legal manner. It wasn’t. We have already seen Fidelity cut the valuation of its investment in half. What will be the final financial toll on other investors once the dust settles? How much of investors' collective $500,000,000 will be lost? CLIENTS Zenefits' clients are potentially victimized in two ways. The first potential problem they could run into is having policies canceled as a result of having been written by non-licensed brokers. While I’m certain this is a possibility, I think it is unlikely the carriers would want to take that black eye. What is a more certain, yet difficult to measure, victimization is the fact that Zenefits' clients did not have access to adequate advice and guidance in making policy decisions in the first place. It would be one thing if Zenefits was simply in the online gaming business (as an example). If it was, the model would be to allow customers to download a free game and then make money by selling additional services/features. Essentially, if the game sucks, oh well. Unfortunately, Zenefits chose to play a much more serious game in a highly regulated industry. Zenefits' model infringes on two of the most critical aspects of client’s lives: their financial and medical well-being. When Zenefits takes this responsibility as carelessly and recklessly as it has, it puts people’s financial lives at risk. Even worse, Zenefits could put people's (literal) lives at risk. That may sound overly dramatic, but protecting the financial lives of its clients (employers and employees alike) and ensuring clients have coverage in place that provides for the right medical attention at time of need, is at the core of what this industry does, has always done and must continue to do for its clients. For Zenefits, insurance is merely an afterthought, a means to an end, a way to finance the technology it touts as “free.” The company really should be ashamed for hijacking something so critical to people’s well-being and using it so carelessly. ADVISERS This may surprise you, but I also see the young advisers of Zenefits as victims. While I have been more than willing to share my criticism of their inexperience in the past, I believe these are mostly well-intentioned young professionals. The Zenefits leadership team sold these young men and women on a vision that is simply proving to be an illusion. They were sold on the idea of disrupting an industry, being a part of a “unicorn” organization doing something that hasn’t been done before. Who wouldn’t buy into something like that? Now, don’t get me wrong; while inexperienced in the business world, these young folks still had a personal responsibility to know right from wrong. They had to know they were cheating when they skirted the 52-hour requirement. And, they had to know the personal risk they were taking when they signed their name claiming to have completed training they hadn’t. Bad on them for not taking a stand. But, even worse on the leadership team for putting them in that position. I can hear the arguments against me on this point, and I don’t necessarily disagree. However, anytime someone in a position of authority uses their power to coerce and take advantage of a subordinate, there is a level of victimization. NOW WHAT? Of course, I don’t know how the rest of this story is going to play out, but I have my suspicions. I don’t see how David Sacks can be allowed to remain as CEO. He has received great praise for the email he sent to the Zenefits employees, and he is being hailed as the leader who will correct all of what ails Zenefits. Maybe he will be, but I have serious doubts. The positive media response to his succession scares me. Not that I think Parker Conrad should have remained CEO, but because the change seems to be providing Zenefits a free pass—if not in the eyes of regulators, at least in the public eye. Outside our industry and Silicon Valley, most people have no idea about how this company has been operating. I guarantee you that Zenefits is about to take its marketing and sales machine to a much higher gear. And there are countless business owners oblivious to the potential danger of a purchase through Zenefits who are awaiting promises of easier HR, shiny user interface and no cost. These business owners need, and deserve, to be protected by the regulators put in place to provide such protection. In my opinion, Sacks, as the chief operating officer, was as culpable for Zenefits' failures as anyone. As the executive in charge of all things operational, how could he not have known about the lack of licenses or the fraudulent acts taking place under his nose? And, if he somehow didn’t know, that is simply another kind of failure on his part. How can he be allowed to remain? I also don’t see how state insurance departments can allow Zenefits to earn another dollar off another insurance policy. The company has left too many victims in its wake, and I believe it is about to go on an even more aggressive hunt for even more “victims.” How can Zenefits be allowed to remain in the insurance business? It’s time for Zenefits to transform its business model, get out of the insurance business and operate as the technology company it has always been; it’s time for the company to start putting people ahead of growth. After all, done properly, taking care of people first ensures growth will take care of itself. And, if you can’t take care of people and turn a profit, you don’t deserve to be in business. I’m not holding my breath, however. As a self-described “hyper-growth addict,” Sacks has to manage his addiction with the demands and responsibilities of his new role—a role in which he will have to balance the demands of leading a company in a highly regulated industry (requiring attention to detail and ethical behavior above all else) against the demands of delivering an acceptable return for investors who have entrusted him with $500 million of their money. Early results are not very promising. Stay tuned. I’m certain there’s more to come. A version of this article was originally published on Crushing Mediocrity. The article appeared here at Q4intel.com.

As Iowa’s insurance commissioner, I meet with many innovators whose work affects the insurance industry. A major topic we discuss is the continual debate of innovation vs. regulatory oversight. This debate will be front and center during the Global Insurance Symposium in Des Moines when federal regulators, state regulators, industry leaders and leading innovators come together for discussions on the "right" way to bring innovation into the insurance industry. I see three schools of thought in the debate:

• Those who want nothing changed because insurance regulation has worked for more than 150 years
• Those who suggest oversight by insurance regulators isn’t needed because innovations and market forces don’t require the same type of scrutiny that regulators have performed in the past
• Those who feel that regulations and oversight are needed but that regulators should move quickly to keep up with emerging technological developments

Innovation is happening, and regulators realize it. No one, including regulators, can stop technological advances. Luckily, I have found that my colleagues who regulate the insurance industry desire to see innovation succeed because it will, generally, enhance the consumer experience. The focus of regulators is to enforce the laws in our states and to protect our consumers. It is that constant focus that ensures a healthy and robust market. And it is that focus that allows the market to work during an insolvency of a carrier, as Iowa witnessed recently during the liquidation of CoOportunity Health. But wanting to work with innovators doesn’t mean insurance regulators are going to turn a blind eye to how innovations and new technologies within the industry are affecting consumers. I do not believe the fundamentals of the insurance business need to be disrupted. Innovations within an industry that is highly regulated, complex and vital to our economy and nation need to occur within the confines of our regulatory structure. Innovators who are attempting to disrupt the insurance industry outside the bounds of our regulatory structure and who are not following state regulations will likely face significant problems. So, just as Goldilocks finally found the perfect fit at the home of the three bears, insurance regulators are working diligently to find the perfect fit of the proper regulation to protect consumers for innovations and the technology affecting the insurance industry.   Regulators want the insurance business to continue to innovate and adapt to meet customer needs and expectations. Improving the customer experience through technology, quicker underwriting and increasing efficiency adds to the value of insurance for consumers. I know many smart people are working on creative projects to do these types of things and much more. The insurance business is arguably becoming less complex because technology simplifies and evens out that complexity. Many existing insurance companies will face challenges as data continues to be harvested and as digital opportunities become more obvious. The continuous innovation in the industry is both positive and exciting. However, insurance carriers face incredible issues, and, therefore, the regulators who supervise these firms must clearly understand the complexity of the industry and the external factors that weigh upon the industry. A few issues industry participants must deal with:

• Perpetual low interest rates that make it difficult for insurers’ investment yields to match up with liabilities;
• Catastrophic storms that may wipe out an entire year's underwriting profit in a matter of hours;
• Increasing technological demands within numerous legacy systems;
• International regulators working toward capital standards that may not align with the business of insurance in the U.S.

I believe regulators, insurance carriers and innovators can work together to harmonize and streamline regulations in an effort to keep up with market demands. However, the heart of insurance regulation beats to protect consumers. Compromising on financial oversight and strong consumer protections is not up for negotiation. Ensuring companies are properly licensed and producers are trained and licensed is critical, and ensuring companies maintain a strong financial position is equally critical. Innovators who wish to bear risk for a fee or distribute products to consumers will need to comply with insurance law. Additionally, innovators looking to launch a vertical play into the industry through a creative service, model or underwriting tool need to make sure they do not run afoul of legal rules and provisions that deal with discriminatory pricing and use of data. It is a lot to absorb for an entrepreneur, but it is not impossible, and the upside may very well be worth it. I absolutely encourage companies looking to innovate in the insurance industry to proceed, but I urge them to do so both with the understanding of insurance law and the role of the regulator and with strong internal compliance and controls. Innovators and entrepreneurs who proceed down the right path are the most likely to have regulators excited to see them succeed. Insurance is still a complex industry. Can and should it be made simpler? Yes. I believe that, through innovation and continued digital evolution, it will. Should the industry focus on how to continue to enhance consumer experience and put the consumer in the center of everything? Yes, and I know that is occurring within many new ideas and businesses that are beginning and evolving. Insurance, at its core, is a business of promises. It is an industry that has passed the test of time, and I believe, through innovation and continual improvement, it will remain strong and vibrant for the next 100 years. If you are an innovator or entrepreneur and are looking for a program to learn about how to address insurance regulatory issues within your business as well as the role of a state insurance regulator, I would again encourage you to attend our 3^rd Global Insurance Symposium in Des Moines, Iowa. This is the first conference where innovation and regulatory issues truly converge. This is your opportunity to learn from state insurance regulators, the Federal Reserve, the U.S. Department of Commerce, seasoned insurance executives, start-up entrepreneurs (the second class of the Global Insurance Accelerator will have a demo day for the 2016 class), venture capital investors and leading innovative thought leaders. No other meeting has assembled a group like this. Everyone will benefit from the unique learning experiences, and, more importantly, relationships will emerge. Register here today!

I Block, Therefore I Chain? What is, and what isn’t, a "blockchain"?  The Bitcoin cryptocurrency uses a data structure that I have often termed as part of a class of "mutual distributed ledgers." Let me set out the terms as I understand them:

• ledger – a record of transactions;
• distributed – divided among several or many, in multiple locations;
• mutual – shared in common, or owned by a community;
• mutual distributed ledger (MDL) – a  record of transactions shared in common and stored in multiple locations;
• mutual distributed ledger technology – a technology that provides an immutable record of transactions shared in common and stored in multiple locations.

Interestingly, the 2008 Satoshi Nakamoto paper that preceded the Jan. 1, 2009, launch of the Bitcoin protocol does not use the term "blockchain" or "block chain." It does refer to "blocks." It does refer to "chains." It does refer to "blocks" being "chained" and also a "proof-of-work chain." The paper’s conclusion echoes a MDL – “we proposed a peer-to-peer network using proof-of-work to record a public history of transactions that quickly becomes computationally impractical for an attacker to change if honest nodes control a majority of CPU power.” [Satoshi Nakamoto, Bitcoin: A Peer-to-Peer Electronic Cash System, bitcoin.org (2008)] I have been unable to find the person who coined the term "block chain" or "blockchain." [Contributions welcome!] The term "blockchain" only makes it into Google Trends in March 2012, more than three years from the launch of the Bitcoin protocol. And the tide may be turning. In July 2015, the States of Jersey issued a consultation document on regulation of virtual currencies and referred to "distributed ledger technology." In January 2016, the U.K. Government Office of Science fixed on "distributed ledger technology," as does the Financial Conduct Authority and the Bank of England. Etymological evolution is not over. Ledger Challenge Wuz we first? Back in 1995, our firm, Z/Yen, faced a technical problem. We were building a highly secure case management system that would be used in the field by case officers on personal computers. Case officers would enter confidential details on the development and progress of their work. We needed to run a large concurrent database over numerous machines. We could not count on case officers out on the road dialing in or using Internet connections. Given the highly sensitive nature of the cases, security was paramount, and we couldn’t even trust the case officers overly much, so a full audit trail was required. We took advantage of our clients’ "four eyes" policy. Case officers worked on all cases together with someone else, and not on all cases with the same person. Case officers had to jointly agree on a final version of a case file. We could count on them (mostly) running into sufficient other case officers over a reasonable period and using their encounters to transmit data on all cases. So we built a decentralized system where every computer had a copy of everything, but encrypted so case officers could only view their own work, oblivious to the many other records on their machines. When case officers met each other, their machines would "openly" swap their joint files over a cable or floppy disk but "confidentially" swap everyone else’s encrypted files behind the scenes, too. Even back at headquarters, four servers treated each other as peers rather than having a master central database. If a case officer failed to "bump into" enough people, then he or she would be called and asked to dial in or meet someone or drop by headquarters to synchronize.  This was, in practice, rarely required. We called these decentralized chains "data stacks." We encrypted all of the files on the machines, permitting case officers to share keys only for their shared cases. We encrypted a hash of every record within each subsequent record, a process we called "sleeving." We wound up with a highly successful system that had a continuous chain of sequentially encrypted records across multiple machines treating each other as peers. We had some problems with synchronizing a concurrent database, but they were surmounted. Around the time of our work, there were other attempts to do similar highly secure distributed transaction databases, e.g. Ian Griggs and Ricardo on payments, Stanford University and LOCKSS and CLOCKSS for academic archiving. Some people might point out that we weren’t probably truly peer-to-peer, reserving that accolade for Gnutella in 2000. Whatever. We may have been bright, perhaps even first, but were not alone. Good or Bad Databases? In a strict sense, MDLs are bad databases. They wastefully store information about every single alteration or addition and never delete. In another sense, MDLs are great databases. In a world of connectivity and cheap storage, it can be a good engineering choice to record everything "forever." MDLs make great central databases, logically central but physically distributed. This means that they eliminate a lot of messaging. Rather than sending you a file to edit, which you edit, sending back a copy to me, then sending a further copy on to someone else for more processing, all of us can access a central copy with a full audit trail of all changes. The more people involved in the messaging, the more mutual the participation, the more efficient this approach becomes. Trillions of Choices Perhaps the most significant announcement of 2015 was in January from IBM and Samsung. They announced their intention to work together on mutual distributed ledgers (aka blockchain technology) for the Internet-of Things. ADEPT (Autonomous Decentralized Peer-to-Peer Telemetry) is a jointly developed system for distributed networks of devices. In summer 2015, a North American energy insurer raised an interesting problem with us. It was looking at insuring U.S. energy companies about to offer reduced electricity rates to clients that allowed them to turn appliances on and off -- for example, a freezer. Now, freezers in America can hold substantial and valuable quantities of foodstuffs, often several thousand dollars. Obviously, the insurer was worried about correctly pricing a policy for the electricity firm in case there was some enormous cyber-attack or network disturbance. Imagine coming home to find your freezer off and several thousands of dollars of thawed mush inside. You ring your home and contents insurer, which notes that you have one of those new-fangled electricity contracts: The fault probably lies with the electricity company; go claim from them. You ring the electricity company. In a fit of customer service, the company denies having anything to do with turning off your freezer; if anything, it was probably the freezer manufacturer that is at fault. The freezer manufacturer knows for a fact that there is nothing wrong except that you and the electricity company must have installed things improperly. Of course, the other parties think, you may not be all you seem to be. Perhaps you unplugged the freezer to vacuum your house and forgot to reconnect things. Perhaps you were a bit tight on funds and thought you could turn your frozen food into "liquid assets." I believe IBM and Samsung foresee, correctly, 10 billion people with hundreds of ledgers each, a trillion distributed ledgers. My freezer-electricity-control-ledger, my entertainment system, home security system, heating-and-cooling systems, telephone, autonomous automobile, local area network, etc. In the future, machines will make decisions and send buy-and-sell signals to each other that have large financial consequences. Somewhat coyly, we pointed out to our North American insurer that it should perhaps be telling the electricity company which freezers to shut off first, starting with the ones with low-value contents. A trillion or so ledgers will not run through a single one. The idea behind cryptocurrencies is "permissionless" participation -- any of the billions of people on the planet can participate. Another way of looking at this is that all of the billions of people on the planet are "permissioned" to participate in the Bitcoin protocol for payments. The problem is that they will not be continuous participants. They will dip in and out. Some obvious implementation choices are: public vs. private? Is reading the ledger open to all or just to defined members of a limited community? Permissioned vs. permissionless? Are only people with permission allowed to add transactions, or can anyone attempt to add a transaction? True peer-to-peer or merely decentralized? Are all nodes equal and performing the same tasks, or do some nodes have more power and additional tasks? People also need to decide if they want to use an existing ledger service (e.g. Bitcoin, Ethereum, Ripple), copy a ledger off-the-shelf, or build their own. Building your own is not easy, but it’s not impossible. People have enough trouble implementing a single database, so a welter of distributed databases is more complex, sure. However, if my firm can implement a couple of hundred with numerous variations, then it is not impossible for others. The Coin Is Not the Chain Another sticking point of terminology is adding transactions. There are numerous validation mechanisms for authorizing new transactions, e.g. proof-of-work, proof-of-stake, consensus or identity mechanisms. I divide these into "proof-of-work,"  i.e. "mining," and consider all others various forms of "voting" to agree. Sometimes, one person has all the votes. Sometimes, a group does. Sometimes, more complicated voting structures are built to reflect the power and economic environment in which the MDL operates. As Stalin said, “I consider it completely unimportant who in the party will vote, or how; but what is extraordinarily important is this — who will count the votes, and how.” As the various definitions above show, the blockchain is the data structure, the mechanism for recording transactions, not the mechanism for authorizing new transactions. So the taxonomy starts with an MDL or shared ledger; one kind of MDL is a permissionless shared ledger, and one form of permissionless shared ledger is a blockchain. Last year, Z/Yen created a timestamping service, MetroGnomo, with the States of Alderney. We used a mutual distributed ledger technology, i.e. a technology that provides an immutable record of transactions shared in common and stored in multiple locations. However, we did not use "mining" to authorize new transactions. Because the incentive to cheat appears irrelevant here, we used an approach called "agnostic woven" broadcasting from "transmitters" to "receivers" -- to paraphrase Douglas Hofstadter, we created an Eternal Golden Braid. So is MetroGnomo based on a blockchain? I say that MetroGnomo uses a MDL, part of a wider family that includes the Bitcoin blockchain along with others that claim use technologies similar to the Bitcoin blockchain. I believe that the mechanism for adding new transactions is novel (probably). For me, it is a moot point if we "block" a group of transactions or write them out singly (blocksize = 1). Yes, I struggle with "blockchain." When people talk to me about blockchain, it’s as if they’re trying to talk about databases yet keep referring to “The Ingres” or “The Oracle.” They presume the technological solution, “I think I need an Oracle” (sic), before specifying the generic technology, “I think I need a database.” Yet I also struggle with MDL. It may be strictly correct, but it is long and boring. Blockchain, or even "chains" or "ChainZ" is cuter. We have tested alternative terms such as “replicated authoritative immutable ledger,” “persistent, pervasive,and permanent ledger” and even the louche “consensual ledger.” My favorite might be ChainLedgers. Or Distributed ChainLedgers. Or LedgerChains. Who cares about strict correctness? Let’s try to work harder on a common term. All suggestions welcome!

In its most recent report, "Tomorrow’s World; the Future of Aging in the U.K.," the International Longevity Centre, a think tank focused on longevity, population and aging, painted a gloomy picture. The report says:

• That the social care system is crumbling, and social class will heavily affect the life experience of the aged.
• That housing and planning are inadequate to meet the needs of an aging population.
• That individuals are underestimating their life expectancy and are likely to run out of money in old age.
• That older people will suffer (and perhaps die) of different things: Where once the issue was heart and respiratory diseases, now it is likely to be illnesses of non-communication such as dementia.

It’s a worrying vision – one that perhaps is replicated in many other countries. The report recommends a bold 10-point action plan. It says: 1. Health must find a way to be more responsive and preventative. 2. Government must make progress in delivering a long-term settlement to pay for social care. 3. Savings levels for working age adults must increase. 4. The average age of exit from the workforce should rise. 5. The number and type of homes built should be increasingly appropriate for our aging society. 6. Government should make progress in facilitating greater risk sharing in accumulation of retirement income. 7. There is a need for a more informed older consumer. 8. Our aspirations for retirement must be about much more than us spending more hours watching television. 9. Businesses should better respond to aging. 10. The social contract needs to be strengthened between young and old. Doesn’t the life and pension insurance industry have a part to play in almost all of this road map? Is there any reason why the industry should sit on the sidelines? Here are five issues for the industry:

• Insurers need to continue the shift from being reactive to being proactive – and must share the benefits with policyholders. Stakeholder buy-in through effective communication and enlightenment is critical – and it is increasingly becoming urgent.
• Can insurers – on behalf of their policyholders, who are inevitably with them often for decades – influence issues related to home building and planning? I wonder how I would react if I really thought that my life and pension insurer was representing my interest to a point that it was lobbying about this type of stuff on my behalf?
• The need for cooperation between the private and public sectors reinforces the need for empathy by both government and private insurers toward each other, perhaps with tacit agreement that they (we) are all in this together.
• As the average age of workers increases, and some seek an alternative to watching TV or just trying to make ends meet, I wonder whether there is propensity for more workplace accidents. Isn’t there an employers liability/workers' compensation angle to consider?
• And, of course, how do we make life and pension insurance attractive to those starting their work life? Doesn’t the industry really need to make insurance both more relevant and fashionable?

Don’t insurers need to communicate better, engage differently, think more about the changing demographic footprint and generally step up the pace? All the innovation seems to be going into P & C insurance, but we can’t allow that to suck the energy from life and pension. After all, having a "connected bedpan" as part of the Internet of Things might be useful for some – but don’t we need to be bolder than that in our thinking?

This is the second of a two-part series, by David Toomey and me, on why healthcare cost growth has historically been much higher that general inflation.  In the last blog post, we outlined the complexity of the network negotiation process and the challenging dynamics among the insurance companies, the providers and the employers. The majority of employers have not seen financial data or interacted with providers enough to understand the quality and cost variation within a network. The big question looming is what to do around contract negotiations tied to network access, patient disruption and costs. David invited a half-dozen large, self-insured employers in a market to delve deeper into the clinical care and cost variation analysis. The intent was to share performance data with the employers, so they could understand the positive financial impact that could come from channeling members to higher-value providers. Reports showed that, within physician groups, there was wide variation in physician performance. But this took time for the employers to grasp because their businesses were focused on a consistent consumer experience—each cup of coffee made the same way with the same ingredients. After a basic grounding in the data, the next step was to have the employers meet with the largest systems and physician groups, so the companies could get a sense of these suppliers’ value propositions beyond just claims-based performance reports. The employers felt they were ready for the first meetings with a major health system that we will call “the provider,” which outlined its capabilities and introduced its mission statement as well as its commitment to patients. After the overview, the first employer question was, “Who is your customer?” The provider’s response: “The patient, of course.” Second employer question: “Who pays the bill?” The pr

For the past few years, the innovation rate in the global insurance industry has run at peak levels, in good part because of digitization, which continues to be a pervasive influence—if not as disruptive as early projections. Initial expectations of a departure from traditional distribution channels turned out not to be the case. Clients preferred direct, personal contact when buying insurance products. While online channels have not generated major changes—for example, in the vehicle insurance sector in Italy (5% of premiums today are generated online, compared with 1% in 2012) —telematics has had a substantial impact. It represents 15% of all insurance policies today in Italy. (These policies did not exist in 2002.) Digital transformation is, of course, leaving its mark in four macro areas. First, consumer expectations: A Bain survey suggests that more than three out of four consumers expect to use a digital channel for insurance interactions. Second, product flexibility: The traditional Japanese player, Tokio Marine, for example, started offering temporary insurance policies via mobile phone, e.g., travel insurance limited to the dates of travel and personal accident coverage for people playing sports. Third, ecosystems: They are created when the insurance value proposition depends on collaboration with partners from other sectors. For example, when Mojio sells a dongle (at, say, a supermarket) that requires connection to an open-source platform to be installed in a car, third-party suppliers are able to extract driving data from that platform and create services based on it. Onsurance, for one, offers tailor-made insurance coverage based on the data collected. Fourth, services: Insurers today are moving away from the traditional approach of covering risks to a more comprehensive insurance plan, which includes additional services. Connected insurance: a telematics “observatory” to promote excellence  The fact that the Italian insurance market represents the best of international automotive telematics practices gave rise to the idea of creating an “observatory” to help generate and promote innovation in the insurance sector. Bain, Ania, Aiba and more than 25 other insurance groups are among its current participants. The observatory has three main objectives: to represent the cutting edge of global innovation; to offer a strategic vision for major innovation initiatives while reinforcing the Italian excellence paradigm; and to stimulate research and debate concerning emerging insurance issues such as privacy and cyber risk. The Observatory on Telematics Connected Insurance & Innovation, will focus not only on vehicle insurance (where Italy has the highest penetration and the most advanced approach worldwide), but on additional important insurance markets related to home, health and industrial risk, which, I am convinced, represent the next innovation wave. Italy is currently the best practice leader in connected insurance. Italian expertise in vehicle telematics is finding applications in other insurance areas, particularly in home insurance—where Italy is the pioneer—and in the health sector, where we recently launched our first products. InsurTech on the rise Another sector that has seen an increased number of investments in 2016 is InsurTech. Until last year, attention focused on many types of financial service start-ups. Today there is significant growth in investments in insurance start-ups: almost $2.5 billion invested in the first nine months of 2015, compared with $0.7 billion in 2014 [according to CB Insight]. Many new firms are entering the sector, bringing innovation to various areas of the insurance value chain. The challenge for traditional insurers will be to identify firms worth investing in, and also to create the means for working with those new players. The challenge is integration Ultimately, the main challenge for insurers will be to find ways to integrate the start-ups into their value chains. The integration of user experience and data sources will be key to delivering an efficient value proposition: It is untenable to have dozens of specialized partners with different apps in addition to the insurer’s main policy. It will be necessary to manage the expansion and fragmentation of the new insurance value chain. To come up with an answer to this problem, start-ups are generating innovative collaborative paradigms. One example is DigitalTech International, which offers companies a white-label platform that integrates various company apps and those of third-party suppliers into a single mobile front end, even as it offers a system for consolidating diverse client ecosystems (domotics, wearables, connected cars) into a single  data repository. Integrating and managing complex emerging ecosystems will be one of the greatest challenges in dealing with the Internet of Things (IoT) for the insurance industry. (A version of this article first appeared on Insurance Review.)

Picture this: The year is 2025. A call comes to the police station—someone has broken into a local home. A drone is deployed to the address and arrives within five minutes. The drone feeds video to the station and to the closest autonomous (driverless) police vehicle. The drone guides the police car to the location. The officer in the car (we’ll assume he’s human, for now!) isn’t actually driving; he’s an occupant, watching the drone’s video feed. He can see the suspect fleeing, and he researches other crimes in the neighborhood along with potential suspects. The drone estimates the perp’s height and weight, and the officer can see his clothing and a possible gun in his belt. The police officer communicates with other officers in the area to coordinate the capture. As the suspect runs, his description and location is fed constantly to all nearby police vehicles, and he is surrounded within 15 minutes of the initial call. This is far from fiction. The international consulting firm Frost and Sullivan predicts that 180,000 driverless cars will hit the U.S. market in 2020. That’s less than 1% of today’s annual new car market, but that’s just the beginning! Just about every major car manufacturer (as well as Google, of course) is developing autonomous vehicles, and the competition is getting  more intense as the demand for collision avoidance features grows. Just as drones are spreading (if not yet regulated), driverless cars will become widely accepted. Americans love to drive, but there are too many undeniable advantages to autonomous cars. The first one is safety. According to the U.S. Insurance Institute for Highway Safety  (IIHS), 94% of all car accidents are caused by human error. Nearly two million crashes could be avoided if human error were eliminated. That’s not to say that driverless vehicles won’t crash, but, as the technology improves, crash rates will drop like a rock. In 2025, if our roads are still packed with commuters, the occupants of many vehicles will be reading, answering emails, video conferencing and browsing the web. In other words, they’ll be working. A recent Morgan Stanley report predicted that driverless cars could add $5.6 trillion (yes, with a 'T') to the global economy because of the combination of a steep reduction in accidents and the dramatic increase in productivity. It is estimated that in 2035 autonomous cars will account for 25% of all cars. Back to the police force. As driverless cars evolve, routine traffic monitoring will drop, high-speed chases will slowly decline (with drone help) and smaller police forces will focus on more serious crime. Cameras will capture everything—both from the ground and the sky. Officers will become highly trained in electronic law enforcement. Efficiency will rule! Of course, these are just predicted outcomes. This policing panacea isn’t all roses; it will not eliminate the need for community relationships, direct contact with neighborhoods and personal contact in law enforcement. Furthermore, while vehicle collisions will fall, the cost and maintenance of autonomous cars will remain extremely expensive in the near future. Currently, it costs about $150,000 to equip a driverless car. But that cost will drop to $7,000 by 2030 and to $3,000 by 2035. Nothing’s perfect. Every emerging concept or technology brings unexpected challenges and unintended consequences. But it appears that autonomous automobiles will emerge soon, and it’s likely that some day we’ll say they are "here to stay.” For today, I guess I’ll have to drive myself home. What a chore.

As a technology investor, I spend my days scouring Europe in search of the next big thing.

London’s FinTech scene has been a profitable hunting ground of late. With the U.K. FinTech industry generating $20 billion in revenue annually, it is not surprising that $5.4 billion has been invested in British FinTech companies since 2010.

A daily journey on the Tube is a testament to how rich the FinTech scene has become, with the capital’s underground trains now wallpapered with ads for Crowdcube, Transferwise, Nutmeg and other innovative companies. And London has played host to FinTech Week, celebrating the contribution these firms are making to the capital’s evolving financial services industry.

But where are the insurance tech entrepreneurs?

It is frequently—and accurately—argued that it is London’s birthright to play host to the poster-children of FinTech because of the capital’s impressive legacy and world-leading position in banking.

Read more: London FinTech investment in 2015 has already surpassed last year's total.

The same can be said of insurance: The concept of modern insurance was solidified in Edward Lloyd’s coffee house in the 1680s. Yet there isn’t a day celebrating InsurTech— let alone a week of conferences, events and after-parties.

This is even though the insurance industry, with trillions of dollars of annual insurance premiums globally, is comparable in size to the rest of the financial services industry put together. Digital insurance should be an obvious target for technological disruption, especially as traditional insurers have struggled to adapt to the digital age en masse.

Recent research by Morgan Stanley found that consumer satisfaction with online experiences in the insurance industry is well below average, with only real estate and telcos finishing lower in the 16-industry league table. The big insurance brands have very little contact with their end consumer because of intermediaries such as offline broker networks, and, as a result, brand advocacy is often low. Put it this way: When was the last time you raved to your neighbor about your insurance provider?

Technology has the potential to drive worthwhile change in insurance. There are already a few success stories, but only a few. Insurance comparison engines such as Moneysupermarket, Compare the Market and Check24 have fundamentally altered how consumers discover their insurance providers. Black Box Insurance, based on telematics data, has become a mainstream product for young drivers, fueling the growth of companies such as InsureTheBox and Marmalade.

Read more:  These are the most influential people in FinTech

These are all fantastic firms, but there is not a long list beyond these examples.

So, why don’t we see more of this type of innovation? Insurance does have far higher barriers to entry than many other industries. To simply get an insurance company off the ground, it requires a colossal amount of cash to cover any potential claims. Additionally, regulation is tough, with good reason. The European Commission’s Solvency II Directive sets a high standard for the capital requirements for insurers to hit to be classed as an eligible provider.

This type of money is hard for a start-up to find. Having said this, very similar challenges are being overcome in retail banking, with challenger banks such as Metro and Atom obtaining banking licenses and putting regulatory capital in place. The successes that many have encountered in FinTech should buoy potential InsurTech entrepreneurs, as should the appetite of venture capitalists to invest in the insurance sector.

I don’t just speak for myself; insurance has excited many colleagues from other funds, especially as the industry is starting to give us some success stories. Slowly but surely, companies such as The Floow, BoughtByMany and QuanTemplate are demonstrating that technology can disrupt the insurance industry. London’s centuries-old legacy in insurance has created a talent pool that is, arguably, the best in the world. Combine this with the strong tech talent in the capital and you can see that the raw ingredients required to build extremely interesting companies are readily available. Additionally, certain large incumbent insurers are beginning to show interest in nurturing the capital’s potential InsurTech community. AXA is a particularly good example, having recently launched Kamet, a €100 million accelerator program aimed specifically at InsurTech entrepreneurs.

The combination of VC appetite, available talent and support from existing players demonstrates that London is a powder keg of untapped potential. The only missing ingredients, at the moment, are the world-beating entrepreneurs willing to put their ideas to the test.

FinTech has shown that London can lead the world in industries that are steeped in tradition and ripe for change. It’s time for InsurTech to step out of the wings.

And then there were none? The individual health insurance marketplace is endangered, and policymakers need to start thinking about a fix right now, before we pass the point of no return. Health plans aren’t officially withdrawing from the individual- and family-market segment, but actual formal withdrawals are rare. What we are witnessing, however, may be the start of a stampede of virtual exits. From a carrier perspective, the individual and family health insurance market has never been easy. This market is far more susceptible to adverse selection than the group coverage market. The Affordable Care Act’s (ACA) guarantee of coverage only makes adverse selection more likely, although, to be fair, the individual mandate mitigates this risk to some extent. Then again, the penalty enforcing the individual mandate is simply inadequate to have the desired effect. Then add in the higher costs of administering individual policies relative to group coverage and the greater volatility of the individual insured pool. Stability is a challenge, as people move in and out of the individual market as they find or lose jobs with employer-provided coverage. In short, competing in the individual market is not for the faint of heart, which is why many more carriers offer group coverage than individual policies. The carriers in the individual market tend to be very good ; they have to be to survive. In 2014, when most of the ACA’s provisions took effect, carriers in the individual market suddenly found their expertise less helpful. The changes were so substantial that experience could give limited guidance. There were simply too many unanswered questions. How would guaranteed issue affect the risk profile of consumers buying their own coverage? Would the individual mandate be effective? How would competitors price their products? Would physicians and providers raise prices in light of increased demand for services? The list goes on. Actuaries are great at forecasting results when given large amounts of data concerning long-term trends. Enter a horde of unknowns, however, and their science rapidly veers toward mere educated guesses. The drafters of the ACA anticipated this situation and established three critical mechanisms to help carriers get through the transition: the risk adjustment, reinsurance and risk corridor programs. Risk corridors are especially important in this context as they limit carriers’ losses—and gains. Carriers experiencing claims less than 97% of a specified target pay into a fund administered by the Department of Health and Human Services; health plans with claims greater than 103% of this specific target receive refunds. Think of risk corridors as market-wide shock absorbers, helping carriers make it down an unknown, bumpy road without shaking themselves apart. While you can think of them as shock absorbers, Sen. Marco Rubio apparently cannot. Instead, Sen. Rubio views risk corridors as “taxpayer-funded bailouts of insurance companies.” In 2014, Sen. Rubio led a successful effort to insert a rider into the budget bill, preventing HHS from transferring money from other accounts to bolster the risk corridors program if the dollars paid in by profitable carriers were insufficient to meet the needs of unprofitable carriers. This provision was retained in the budget agreement Congress reached with the Obama administration late last year. Sen. Rubio, in effect, removed the springs from the shock absorber. The result is that HHS was only able to pay carriers seeking reimbursement under the risk corridors program 13% of what they were due based on their 2014 experience. This was a significant factor in the shuttering of half the health co-operatives set up under the ACA. Meanwhile, individual health insurers have taken a financial beating. In 2015, United Healthcare lost $475 million on its individual policies. Anthem, Aetna, Humana and others have all reported substantial losses in this market segment. The carriers point to the ACA as a direct cause. Supporters of the healthcare reform law, however, push back. For example, Peter Lee, the executive director of California’s state-run exchange, argues that carriers’ faulty pricing and weak networks are to blame. Whatever the cause, the losses are real and substantial. The health plans are taking steps to stanch the bleeding. One step several carriers are considering is leaving the health insurance exchanges. Another is exiting the individual market altogether—not formally, but virtually. Formal market withdrawals by health plans are rare. The regulatory burden is heavy, and insurers are usually barred from re-entering the market for a number of years (five in California, for example). There’s more than one way to leave a market, however. One method carriers sometimes employ is to continue offering policies but to make it hard to buy them. Because so many consumers rely on the expertise of professional agents to find the right health plans, a carrier can prevent sales by making it difficult or unprofitable for agents to do their job. Slash commissions to zero, and agents lose money on each sale. While I haven’t seen documentation yet, I’m hearing about an increasing number of carriers eliminating agent commissions as well as others removing agent support staff from the field. (Several carriers have eliminated field support in California. If you know of other insurers making a similar move or ending commissions, please respond in the comments section). So, what can be done? In a presidential election year, there's not much to be done legislatively. Republicans will want to use an imploding individual market to justify their calls for repealing the ACA altogether. Sen. Bernie Sanders will cite the situation as yet another reason we need “Medicare for all.” Former Secretary of State Hillary Clinton, however, has an incentive to raise the alarm. She wants to build on the ACA. Having it implode just before the November presidential election won’t help her campaign. She needs to get in front of this issue now to demonstrate she understands the issue and concerns, to begin mapping out the solution and to inoculate herself from whatever happens later this year. Congress should get in front of the situation now, too. Hearings on the implosion of the individual market and discussions on how to deal with it would lay the groundwork for meaningful legislative action in 2017. State regulators must notice the endangered individual market, as well. They have a responsibility to ensure competitive markets. They need to examine the levers at their disposal to find creative approaches to keep existing carriers in the individual market and to attract new ones. If the individual market is reduced to one or two carriers in a region, no one wins. Competition and choice are consumers’ friends; monopolies are not. And when consumers (also known as voters) lose, so do politicians. Which means smart lawmakers will start addressing this issue now. The individual health insurance market may be an endangered species, but it’s not extinct … yet. There’s still time to act. There's just not a lot of it.