On first glance, the California Department of Motor Vehicles' recent proposal to ban the testing and deployment of driverless cars seems to err on the side of caution.

On closer inspection, however, the DMV's draft rules on autonomous vehicles rest on flawed assumptions and threaten to slow innovation that might otherwise bring enormous, time-critical societal benefits.

At issue is the requirement that DMV-certified "autonomous vehicle operators" are "required to be present inside the vehicle and be capable of taking control in the event of a technology failure or other emergency." In other words, driverless cars will not be allowed on California roads for the foreseeable future.

One problem with the human operator requirement is that it mandates a faulty design constraint. As Donald Norman, the technology usability design expert, has noted, decades of scientific research and experience demonstrate "people are incapable of monitoring something for long periods and then taking control when an emergency arises."

This has been Google's direct experience with its self-driving car prototypes, too. As Astro Teller, head of Google[x], told a SXSW audience in early 2015: "Even though people had sworn up and down, 'I"m going to pay so much attention,' people do really stupid stuff when they're driving. The assumption that humans could be a reliable back up for the system was a total fallacy!"

The ramifications are more than just theoretical or technical. The lives and quality of life of millions hang in the balance.

Americans were in more than six million car crashes last year, injuring 2.3 million people and killing 32,675. Worldwide, more than 50 million people were injured, and more than one million were killed. Human error caused more than 90% of those crashes.

It remains unclear whether semi-autonomous or driverless cars would better reduce human error and lower this carnage. Thus, it is important to encourage multiple approaches toward safer cars -- as quickly as possible. Instead, California has slammed the brakes on the driverless approach.

Another major problem with the human-operator mandate is that it slows testing and development of systems aimed at providing affordable transportation to the elderly, handicapped or economically disadvantaged. Millions of Americans either cannot drive or cannot afford a car. This hurts their quality of life and livelihood.

Driverless cars could enable Uber-like, door-to-door mobility-on-demand services at a fraction of today's transportation cost. This will require, however, efficient, low-cost vehicles that do not need (nor need to accommodate) relatively expensive human drivers. It also requires empty driverless cars to shuttle between passengers. The California DMV rules, as proposed, would not allow the testing or deployment of such vehicles or fleet services.

The immediate victim of California's proposed rules is Google. Google's self-driving car program is the furthest along in the driverless design approach that the new rules would rein in, and its current efforts are located around its headquarters in Mountain View, CA. Google's attempt to field a fleet of prototype driverless cars (without steering wheels) would certainly be dashed.

Other companies' efforts might be affected, too. Will Tesla owners, for example, need to get separate DMV certification to use enhanced versions of Tesla's autopilot feature? How about GM owners with Super Cruise-equipped cars? How will these rules affect Apple's car aspirations?

The longer-term victim is California.

Silicon Valley is becoming the epicenter of autonomous vehicle research. Not only are native companies like Google, Tesla and, reportedly, Apple investing heavily in this arena, but the race to develop the technology has compelled numerous traditional automakers to build their own Silicon Valley research centers.

If California regulators limit on-road testing and deployment, companies stretching the boundaries of driverless technology will inevitably shift their investments to more innovation-friendly states (or countries).

The proposed rules must now go through several months of public comment and review before they are finalized. California needs to take that opportunity to reconsider its course on driverless cars.

Talk about being in a room with a lot of smart people! Wow!

HITLAB, a healthcare innovation technology and teaching lab based in New York, just sponsored its second annual World Cup event at Columbia University for aspiring healthcare technology entrepreneurs and start-ups. The HITLAB staff, who blew me away with their creative energy, brought together the best and the brightest in academia, the business world, the insurance industry and the healthcare technology sector for this two-day event.

Out of 192 applicants, five finalists were selected to present potentially revolutionary technology and ideas on a wide range of global public health problems that have been around since the time Moses wore short pants and that someday soon may have the kind of impact Louis Pasteur and Steve Jobs did.

The beauty of these five finalists is that their solutions are so simple that even someone from Jersey City like me can easily understand. The health insurance industry and the malpractice insurance industry should stand up and take notice.

Noninvasix -- Keeping Babies Safe

For starters, what if we could reduce brain injuries in newborns by 90%? That is what the CEO of Noninvasix (www.noninvasix.com ), Graham Randall, PhD, MBA, based in Houston, is working on.  The technology is designed to monitor the levels of oxygen molecules in the brains of infants; lack of oxygen causes many permanent brain injuries. This technology was originally funded by the Department of Defense and the NIH, among others, to address traumatic brain injuries in wounded veterans and other adults. Randall's colleagues discovered a way to use this technology, known as an optoacoustic oxygenation monitor, to detect brain oxygenation levels in babies during active labor.

Gary Hankins, MD, who is the vice chair of the American College of Obstetrics and Gynecology Task Force on Neonatal Encephalopathy and Cerebral Palsy, said, "This technology has the potential to eliminate up to 90% of cases of hypoxic ischemic encephalopathy and subsequent permanent injuries such as cerebral palsy." The problem with simply using current technology such as a fetal heart monitor-which dates back 40 years-is that it does not accurately measure the levels of oxygen in the brain. In fact, 80% of results are indeterminate or unknown. The new technology can help prevent brain hypoxia (or lack of sufficient oxygen) at birth, which is responsible for 23% of neonatal mortality in the world.

This technology may also help revolutionize obstetrics. OB-GYN physicians have the highest rate of malpractice insurance, with reported annual premiums as high as $200,000 in some states. More than 75% of OB/GYN physicians have been sued for malpractice, with an average of 2.7 lawsuits per physician. Most lawsuits relate to neurologically impaired infants, whose issues get blamed on the doctor during delivery. It has been reported that as many as 50% of OB-GYN physicians have cut back on their practice because of the fear of malpractice claims. Many have moved their practices to states that have less expensive premiums because of legislative caps on liability.

Hospitals, healthcare systems and health insurers should also take notice because the rate of unnecessary surgery has been widely believed to be too high since I walked the hallowed halls of Columbia University 34 years ago. C-section rates have, in fact, nearly doubled over the past 10 years from 17% to 34% of all births in the U.S. The World Health Organization (WHO) recommends C-section rates in the range of 10-15%. The Joint Commission on the Accreditation of Hospitals now requires hospitals to report C-section rates, and many health insurers now pay a bundled rate for deliveries and not a separate, higher rate for C-sections. Many health researchers believe the high rate of unnecessary C-sections is because of the fear of malpractice lawsuits, and Graham Randall believes that false positives from fetal heart monitors also play a huge role. C-sections are the most common surgery in the U.S., with 1.2 million performed each year, and they carry risks such as blood clots and surgical infections to both mother and baby.

Ceeable -- Preventing Blindness

Chris Adams, the CEO of Ceeable, based in Somerville, Mass. (www.ceeable.com), won this year's World Cup competition. "I am here to prevent blindness," he said. Ceeable was formed in 2014 to commercialize a mobile digital eye exam platform that was co-invented with Dr. Wolfgang Fink at Caltech with assistance from scientists at NASA, the University of Arizona, the Doheny Eye Institute at UCLA and the Jet Propulsion Laboratory in Pasadena.

This mobile field test is a perfect example of the potential for telemedicine. Current technology, used by ophthalmologists, optometrists and eye care clinics in strip malls across America and around the world are expensive, and not very mobile. Today's eye exams are tedious. (Bats have much better eyesight than I do, so I have experience with tests.) The equipment typically costs $35,000 and weighs roughly 100 pounds.  By contrast, Ceeable only needs a tablet with a touch screen and the Internet to perform a 3-D early detection for glaucoma, muscular degeneration disease, other causes of vision problems and the actual onset of blindness.

The test is user-friendly and can be performed anywhere in the world. The test can even be performed at home, which is brilliant. Although health insurers pay for eye exams at no cost under the ACA, patients are typically limited to two visits per year. With this inexpensive mobile device, people at risk can perform tests as often as they like.

More than 285 million people worldwide suffer from diseases that cause blindness, such as diabetic retinopathy, glaucoma and age-related macular degeneration. The Ceeable technology is now deployed in vision clinics in the U.S., Mexico and Russia and will soon be available in developing countries.

Rubitection -- Managing Bedsores

Sanna Gaspard, the CEO and founder of Rubitection, based in Pittsburgh, received her PhD from Carnegie Mellon University, and her start-up has developed a handheld diagnostic device and software system to modernize the detection and management of bedsores. Rubitection has been part of Project Olympus at the Carnegie Mellon incubator program.

When I met her, I interrupted her within 60 seconds and said, "I get it." My mother ended up in a nursing home when she was overcome with organic dementia. She became so fragile from old age that the nurses could hardly touch her skin without it turning black and blue. They also had to check her frequently for bedsores. 

Turns out I didn't get it about bedsores at all. What I didn't know, until Gaspard told me, is that bedsores can be life-threatening. Complications from bedsores, such as infections, kill 60,000 people every year in the U.S. The average cost to treat bedsores in acute cases is $43,000 each and may reach $70,000; there are more than 2.3 million bedsore cases a year in the U.S., costing $11 billion in total.

Medical expenses resulting from bedsores are not reimbursable under Medicare if they developed after someone was admitted to a facility. The facility has to eat the costs.

Current technology that monitors for bedsores is very expensive and difficult to use. The current standard of care is typically a manual skin palpitation and visual inspection. The Rubitech Assessment System (RAS) provides a reliable early detection handheld device for patients at risk with bedsores, helping to address a global public health problem that I didn't even know existed beyond discomfort and pain for the patient. Rubitection www.rubitection.com came in a well-deserved second place.

Now I get it.

Homeward -- Getting the Medication Right

Joe Gough, president and CEO of Homeward Healthcare in Toledo, Ohio www.homewardhc.com, told how his six-year-old son was misdiagnosed at a hospital emergency room and was sent home with the wrong medication. All his vital signs crashed. Luckily, his life was saved upon readmission, and today he is a healthy young man. Many others are not so fortunate.

Again, I immediately could relate to misdiagnosis and incorrect medications. My dad was diagnosed with congestive heart failure, and his cardiologist told me he had two months to two years to live. Several months later, I got a call: "You have to come home because your father is in the hospital, and we need to amputate both his legs because he is not getting enough blood circulation down there. We need you to tell him."

I hopped on the next flight. When I told my dad the situation, he had the perfect answer: "Throw me out the window now."

Turns out he was on all the wrong medications, and the poor circulation in his legs was actually more because of blockage in his carotid artery. The plan to amputate his legs would have done nothing to save his life. I got him admitted to a new hospital with a new cardiologist. My dad got to live a couple more years before he finally took his first day off from work, at his funeral. We buried him with both his legs.

So, I get misdiagnosis, wrong medications and poor discharge planning.

Gough and the researchers at Homeward Healthcare have created interactive software for hospitals, patients and payers that the patient can control on a touchscreen tablet from her bedside. Multimedia, real-time discharge planning that includes a patient dashboard will produce better outcomes, free staff time and resources and vastly improve communications.

Gough had begun his presentation by telling us that most people toss their discharge instructions as they walk out the hospital door -- but no more. His technology has great potential to reduce hospital readmissions. A key component is a psychosocial assessment to determine who is at risk of not following the discharge plan.

There are also reminders about the correct use of proper medications, and I get the need for that, too. Patients must own their care plan. My oldest brother, upon release from a hospital a few years ago, was told he needed to lose weight and stop smoking. The first thing he did when he got home was have a large bowl of ice cream and a cigarette. I threw his discharge plan in the waste basket.

It is estimated that $26 billion is spent annually from readmissions. The reduction of readmission rates is now a major initiative under both Obamacare and the Joint Commission on Accreditation of Hospitals. The Homeward Healthcare technology is now being used in 23 hospitals, and I am told nurses doing discharge planning just love it.

Ristcall -- a Mobile, Smart Watch Nursing Station

Srinath Vaddepally, the CEO and founder of Ristcall, with offices in both Philadelphia and Pittsburgh, has designed a wireless, wearable smart device for both hospital patients and nurses. I like to think of it as a mobile smart watch nursing station.

The idea for this technology, designed with researchers from Carnegie Mellon, came about when, as a hospital patient, Vaddepally fell in his hospital room and could not reach the call button on the bed. Turns out 70% of all patient falls in a hospital occur in the patient's room, with 40% occurring while walking to the bathroom. The average cost to a hospital for a patient fall is $20,000 per case, and the annual reduction in Medicare reimbursements can reach $200,000.

Ristcall (www.ristcall.com) has a great point. How do you call a nursing station if you are lying on a floor and can't reach the call button? In addition, how can you reach a nurse who is busy caring for multiple patients and is not at the nursing station?  Even when you ring the traditional call button, the nurse has no idea why you are calling; he has to walk to your room to find out.

As I told Dr. Michelle Odlum, a postdoctoral research scientist at the Columbia School of Nursing, nurses rock! They are the heart and soul of our healthcare system, but they are often overworked, and they don't have eyes in the back of their heads.

Now, with the help of Project Olympus-which provided incubator space at Carnegie Mellon-nurses can soon have a real-time alert for all traditional patient requests. Nurses will be able to rock even more.

If you are a healthcare technology entrepreneur, I highly recommend applying for this award or sponsoring next year's HITLAB World Cup Summit. It will be held once again at Lehner Hall at Columbia University in New York, from Nov. 28 to Dec. 2, 2016.

For more information, visit www.hitlab.org.

It was a real pleasure to meet these outstanding World Cup finalists and the HITLAB staff. I learned a great deal and made friends I feel I will now have for a lifetime.

Take your driver's license out of your wallet. Flip it over. Now look carefully at the back of it. There's no box to check for "identity donor." Yet when it comes to identity-related crimes, one of the greatest times of vulnerability is immediately after you die.

You can do everything right. You can use long and strong passwords and account-unique user names. You can check your financial accounts and monitor your credit on a regular basis, you can set up transaction alerts on your credit cards - even order a credit freeze - and then you die. Well, not entirely...

Include Identity in Your Estate Planning

A good identity thief can undo all your fraud precautions with a few phone calls. Most people don't think about this, because it's a wee bit late to refinance the family homestead - much less worry about interest rates - when you're dead. Regardless, the recently deceased continue to exist on paper, and this may be the case for some time. Meanwhile, many bankable facts - key among them your Social Security number and personally identifiable information - are just sort of there in the form of "zombie" purchasing power. An identity thief can use that purchasing power to drain your bank accounts, open new credit in your name and perpetrate all sorts of fraud that can harm your family and heirs.

Think of your post-mortem identity as a would-be extra on "The Shopping Dead." Now that you have that image in your head, take the time to arrange for the deactivation of your identity by making it part of your estate planning. This will mostly take the form of a to-do list for whomever will be handling your affairs, because nothing can be done till...well, you know, after the fact. There are many good resources, including this list from IDT911.

There are many different scams out there, ranging from the misappropriation of Social Security payments to the more old-fashioned practice of ghosting, whereby a person of approximately the same age assumes the identity of the deceased. In keeping with the proliferation of possible crimes, there are plenty of criminals out there who make a living in this post-mortem niche. They scan death notices in the local paper, read obituaries, even attend funerals and, make no mistake about it, can get a lot of shopping done with your available credit before the three credit reporting agencies and your current and future potential creditors are notified of your demise. Those same bad guys may also use your Social Security number to grab a big fat tax refund (if you're lucky enough to pass away during tax filing season).

How will they get the information needed to commit fraud? Sometimes the perpetrator is a family member, so he already has access. But more often, family members are distracted and distraught. There are visitors who come and go, unchecked, and of course the numerous demands of making final arrangements and dealing with matters of the estate. If there was a long illness, unsupervised healthcare workers may have had the run of the deceased's domicile - including the owner's most sensitive information. Maybe the wake was at the deceased's home, or people sat shiva there. The opportunities for fraud abound. Funerals, of course, provide a thief with a precise time to get what he or she wants. But instead of grabbing the television or the silver (too easy to miss), an envelope containing a financial statement or a copy of last year's tax return might go walkabout. From there, it's a race to apply for as much credit and buy as many pricy things for resale as possible before the money spigot coughs credit dust.

The Bigger Picture

Government agencies are famously slow to get the news of a person's undoing.

An audit of the Social Security Administration conducted by the Office of the Inspector General found approximately 6.5 million Social Security numbers belonging to people aged 112 or older whose death information wasn't in the system. Of those numberholders, only 13 people were still receiving payments; the rest consisted of "numberholders who exceeded maximum reasonable life expectancies and were likely deceased." The fact that their deaths were not recorded in Numident (the SSA's numerical identification system), and thus are also missing on the Master Death List, leaves plenty of runway for misconduct. According to the audit report, the "SSA received 4,024 E-Verify inquiries using the SSNs of 3,873 numberholders born before June 16, 1901."

On the off chance you missed the memo while diving for sunken treasure at the bottom of Loon Lake: Identity theft is now the third certainty in life, right behind death and taxes. When a loved one passes, there is a trifecta, which is why it's trebly important to protect against the threat of a different kind of life everlasting.

The constant beat of the major media drum often paints a grim picture of veterans and suicide. Sometimes, we wonder if these messages become a self-fulfilling prophecy. Consistent headlines include data such as:

• Approximately 22 veterans die by suicide each day (about one every 65 minutes).
• In 2012, suicide deaths outpaced combat deaths, with 349 active-duty suicides; on average about one per day.
• The suicide rate among veterans (30 per 100,000) is double the civilian rate.

Listening to this regular narrative, a collective concern and urgency emerges on how best to support our veterans who are making the transition back to civilian jobs and communities. Many veterans have a number of risk factors for suicide, contributing to the dire suicide statistics, including:

• A strong identity in a fearless, stoic, risk-taking and macho culture
• Exposure to trauma and possible traumatic brain injury
• Self-medication through substance abuse
• Stigmatizing views of mental illness
• Access to and familiarity with lethal means (firearms)

Veterans show incredible resilience and resourcefulness when facing daunting challenges and learn how to cope, but employers and others who would like to support veterans are not always clear on how to be a "military-friendly community."

The Carson J Spencer Foundation and our Man Therapy partners Cactus and Colorado's Office of Suicide Prevention conducted a six-month needs and strengths assessment involving two in-person focus groups and two national focus groups with representation from Army, Air Force, Navy and Marine Corps and family perspectives.

When asked how we could best reach them, what issues they'd like to see addressed and what resources they need, here is what veterans and their advocates told us:

• "I think that when you reach out to the vets, do it with humor and compassion...Give them something to talk about in the humor; they will come back when no one is looking for the compassion." People often mentioned they preferred a straightforward approach that wasn't overly statistical, clinical or wordy.
• Make seeking help easy. A few veterans mentioned they liked an anonymous opportunity to check out their mental health from the privacy of their own home. Additionally, a concern exists among veterans, who assume some other service member would need a resource more. They hesitate to seek help, in part, because they don't want to take away a resource from "someone who may really need it." Having universal access through the Internet gets around this issue.
• "We need to honor the warrior in transition. The loss of identity is a big deal, along with camaraderie and cohesion. Who I was, who I am now, who I am going to be..." The top request for content was about how to manage the transition from military life to civilian life. The loss of identity and not knowing who "has your back" is significant. Several veterans were incredibly concerned about being judged for PTS (no “D,” for disorder - as the stress they experience is a normal response to an abnormal situation). Veterans also requested content about: post-traumatic stress and growth, traumatic brain injury, military sexual trauma and fatherhood and relationships, especially during deployment.
• The best ways to reach veterans: trusted peers, family members and leaders with "vicarious credibility."

Because of these needs and suggestions, an innovative online tool called "Man Therapy" now offers male military/veterans a new way to self-assess for mental health challenges and link to resources.

• http://mantherapy.org/
• http://mantherapy.org/#/richs_list
• Videos highlighting veterans' stories of hope and recovery:
  • Tony: https://www.youtube.com/watch?v=gAYLotW27Bo
  • Also see stories by Logan, Kyle, Chad and Paul here: http://mantherapy.org/#/more_videos

In addition to mental health support, many other things can be done to support veterans:

• Hire a veteran. Because they make excellent employees, and it's one of the best ways we can help support their mental health and their transition back into civilian life: https://www.hireheroesusa.org/why-hire-a-veteran/
• Conduct financial management and planning: http://www.military.com/money
• Provide service dog support: https://freedomservicedogs.org/

We owe it to our service members to provide them with resources and support and to listen carefully to the challenges and barriers that prevent them from fully thriving. Learn how you can be part of the solution instead of just focusing on the problem.

'Twas the night before mediation
And all through the firm
Not a creature was stirring,
Not even a worm

But then one lawyer
Asleep on a couch
Shot up, hit his head
And said with an "Ouch"

Oh my, I've got
That mediation tomorrow
I didn't do a brief
Much, much to my sorrow

Then what to his exhausted eyes should appear
But a mediator with news of good cheer

You don't need it fancy
You don't need it long
Just give me some clues
So the time's not spent wrong

Just send me an "e"
It's all confidential
Tell me the issues
What's the dollar potential?

With that she was gone
The lawyer banged out a brief
He'd be ready tomorrow
Oh what a relief.

This holiday season
When your time seems too short
Turn to mediation
And stay out of court.

Happy Holidays!

[Editor's Note: While my frequent co-author is writing here about how companies, in general, can use a powerful tool to drive change, all those involved in the insurance ecosystem should pay particular attention. The tool, which draws from two books that Chunka and I wrote together -- found here and here -- is most valuable in industries where it's clear that dramatic disruption is coming but where the form of that change isn't yet defined: the very definition of insurance these days. -- Paul]  “History will be kind to me,” Winston Churchill said, “for I intend to write it myself.” When it comes to corporate innovation, my experience is that history will indeed be kinder if leaders take the time to write it themselves—but before it actually unfolds, not after. Every ambitious strategy has multiple dimensions and depends on complex interactions between a host of internal and external factors. Success requires achieving clarity and getting everyone on the same page for the challenging transition to new business and operational models. The best mechanism for doing that is one I have used often, to powerful effect. I call it a “future history.” Future histories fulfill our human need for narratives. As much as we like to think of ourselves as modern beings, we still have a lot in common with our earliest ancestors gathered around a fire outside a cave. We need stories to crystallize and internalize abstract concepts and plans. We need shared stories to unite us, and guide us toward a collective future. Future histories provide that story for companies. The CEO of a major financial services company occasionally still reads to internal audiences parts of the future histories that I helped him and his management team write in early 2011. He says they helped him get his team focused on the right opportunities. As of this writing, his company’s stock has almost doubled, even though his competitors have had problems. To create future histories, I have executive teams imagine that they are five years in the future and ask them to write two memos of perhaps 750 to 1,000 words each. For the first memo, I ask them to imagine that the strategy has failed because of some circumstance or because of resistance from some parts of the organization, investors, customers or other key stakeholder. The memo should explain the failure. The exercise lets people focus on the most critical assumptions and raise issues without being seen as naysayers. There is usually no lack of potential problems to consider, including technology developments, employee resistance, customer activities, competitors’ actions, governmental actions and substitute products. Articulating the rationale for failure in a clearly worded memo crystallizes thinking about the most likely issues. To heighten the effect, I sometimes do some formatting and structure the memo like an article from the Wall Street Journal or New York Times. Adopting a journalist’s voice helps to focus the narrative on the most salient points. And everybody hates the idea of being embarrassed in such publications, so readers of the memo pay attention to the potential problems while there’s still time to address them. The second memo is the success story. What key elements and events helped the organization shake its complacency? What key strategic or technological shifts helped to capture disruptive opportunities? How did the organization’s unity help it to out-innovate existing players and start-ups? This part of the exercise encourages war-gaming and helps the executive team understand the milestones on the path to success. Taken together, the future histories provide a new way of thinking about the long-term aspirations of the organization and the challenges facing it. By producing a chronicle of what could be the major success and most dreaded failures, the organization gains clarity about the levers it needs to pull to succeed and the pitfalls it needs to avoid. Most importantly, by working together to write the future histories, the executive team develops a shared narrative of those potential futures. It forges alignment around the group’s aspirations, critical assumptions and interdependencies. The process of drafting and finalizing the future histories also prompts the team to articulate key questions and open issues. It drives consensus about key next steps and the overall change management road map. In a few weeks’ time, future histories can transform the contemplated strategy into the entire team’s strategy. Future histories also facilitate the communication of that shared strategy to the rest of the organization. Oftentimes, senior executives extend the process to more layers of management to flesh out the success and failure scenarios in greater detail and build wider alignment. Future histories take abstract visions and strategies and make them real, in ways that get people excited. They help people understand how they can contribute—how they must contribute—even if they aren’t directly involved in the innovation initiative. People can understand the timing and see how efforts will build. People can also focus on the enemies that, as a group, they must fend off. These enemies may no longer be saber-toothed tigers, but they are still very real and dangerous to corporations. “Future histories” unite teams as they face the inevitable challenges.

As a professional loss accountant with more than 20 years of experience with business interruption (BI) valuation, I can understand why policyholders struggle with finding a repeatable, efficient system that produces an accurate measurement of their BI exposure. Over the years, some of my clients recognized the issues with the traditional BI values approach, and decided to make a change. Unfortunately, too many companies continue doing what they have always done, even when there is a better way available.

Consider for a moment, just how important BI information is to your underwriter. The numbers you report give the underwriter the basis for writing coverage and calculating premium. Each renewal provides policyholders the opportunity to present their unique BI exposure. Unfortunately, this opportunity is often squandered because of a misunderstanding of business interruption values and the exposures they represent. The point of this article is to share a proven, alternative approach.

Understanding BI Values

First, there's the ratable value. It is the "big number" that is calculated for the business as a whole, assuming a 12-month, total shutdown of all revenue-generating operations. This worst-case and often unrealistic scenario is the information requested by the insurance company, usually in the form of a one-page worksheet. Without additional information, the underwriter will use this information to set limits and charge premium.

The ratable value calculated is somewhat meaningless, except that it establishes the base assumption that is used as the BI value in all other scenarios, such as unincurred cost categories. The ratable value is seldom a reflection of your exposures. Better ways to assess your exposures are to examine your maximum foreseeable loss (MFL) and probable maximum loss (PML) scenarios.

What Is Maximum Foreseeable Loss?

The MFL, as the name indicates, is the worst-case scenario. This is not as extreme as the ratable value scenario, but pretty close. The assumptions used here include a complete breakdown of protection and loss mitigating factors while you are hit where it hurts at the worst possible time. An example would be the loss of a unique distribution center to a retailer during the holiday shopping season -- say the distribution center that handles online orders goes up in smoke on Cyber Monday.

The factors used to measure the ratable value would be used in this scenario to determine the business interruption value. Certain assumptions may change depending on the duration of the loss scenario. For example, labor expense may be considered completely saved in the ratable value scenario because of the assumption that there is nothing left, but only partly saved in an MFL scenario.

What About the Probable Maximum Loss?

The PML is the same as the MFL, except that loss mitigation efforts and protections work properly. The PML also takes into account pure extra expenses used to retain customers. The PML can help with decision making on purchasing extra expense coverage.

What Happens in Underwriting?

Although I'm not an underwriter, I've typically seen insurance companies take an engineer's approach to MFL and PML scenarios that vary only in duration. This singular perspective does not account for the rest of the pieces of the puzzle. The other pieces are the finer details that actually occur during a claim. In a real claim, topics like seasonality, make-up and outsourcing would surely come up, but you won't see them on any BI worksheet.

The MFL and PML should be based on realistic loss scenarios and measured as if they were a claim. Simply applying the ratable value to loss-period assumptions produces misleading and inflated numbers. This is precisely why it is in your best interest to develop your own valuation method based on real scenarios.

Why Create Exposure Scenarios?

If BI values are based on assumptions, and you are using the worksheet, then the assumption is a 12-month loss scenario. Can you imagine a scenario in which your operations would only be affected for six months? The worksheet makes a blanket assumption of 12 months whether realistic or not. Coming up with various loss scenarios by location would flesh out a more realistic representation of the impact of each particular loss. The scenarios would also highlight high-risk locations along your supply chain, which could improve your business continuity planning.

An exposure analysis project is not only an accounting project; it's an integrated business exercise offering multiple benefits to an organization. The goal is to identify and examine loss scenarios and the resulting ripple effects.

It isn't necessary, nor is it practical, to anticipate every possible loss scenario. It's better to prioritize by perceived risk and probability. Then, develop a good sampling of loss scenarios from which you can determine the impact to operations and the mitigating actions that would be taken. Depending on the exposure, involve the appropriate internal personnel, e.g., operations, sales, business continuity, IT and accounting. The external experts you may involve are your broker, legal counsel and, of course, a forensic accounting firm that specializes in insurance work. Additionally, your company's business continuity plan (BCP) and incident response plan should be factored in. However your scenarios play out, the loss accountants can calculate the business interruption as though it were an actual claim.

As you can see, this approach would produce a more accurate BI value by location and overall. It's the right way to look at business interruption, so make it a part of your approach with underwriters.

A radical shift is underway in how insurance markets are going to be regulated in the UK. The shift will transform the relationship between insurers, regulators and the public.

"Big data" promises a more personalized, customer-centric way of doing business. Yet, as insurers gain access to unprecedented levels of information about the lives of consumers, there could be problems with privacy.

This ability to track everyday lives begins to resemble an idea put forward by the 18^th century reformer Jeremy Bentham. He envisaged a prison designed in the form of a ring, with a central tower from which prisoners could be monitored at all times, but in which those monitoring remained unseen. He called it the Panopticon. The idea underpinning Bentham’s design was that the monitoring would be so constant, yet so unknowing, that the prisoners would adopt more conforming behaviors.

Let’s think of a modern day panopticon, the ring filled not with prisoners but with millions of consumers, and a central tower full of firms gathering data about us. Data about our everyday activities would stream into that central tower, to be turned by the firms there into personalized products and services. A "digital panopticon."

Insurers are one such class of firm taking up position in that central tower. Underwriting and claims people would analyze all that consumer data, looking for patterns of behavior that signal a good or bad risk, an honest or dishonest claimant.

Then there's the UK regulator, the Financial Conduct Authority (FCA), talking about a new era of regulation based on a combination of data, technology and behavioral science. The FCA illustrated this new era in a recent review of the pay-day loan sector, drawing in vast amounts of loan data from firms and analyzing it to produce new rules on lending and servicing practice.

Insurance could be next on the FCA's list. Might the FCA start drawing in vast amounts of insurer data to analyze it for signs of consumer detriment? If so, does this mean the regulator is now constructing an observation tower of its own inside that "digital panopticon," one that sits within the insurance market's own tower? Are we seeing the emergence of "panoptic regulation"?

Such a "tower within a tower" could be a game-changing move. It could bring about a radical change in market attitudes toward ethics, fairness and culture. After all, the key idea behind the panopticon was for it to bring out better, more universal behavior, on the basis that what you were doing at any time might be under observation. Is the real future of regulation then simply the power derived from being in that innermost tower, using data to watch over a firm that could be yours, to watch over a person who could be you?

And if firms use predictive analytics to anticipate policyholder behavior, then could the regulator use its own predictive analytics to identify emerging patterns of misconduct? A regulator able to address misconduct before it became widespread would be powerful as well as controversial.

This could bring about a revolution in trust, for might consumer concerns about their personal data fall away, knowing that regulators are able to see everything insurers are doing with it?

The original panopticon proved too radical for the time and was never built. Yet something very similar is taking shape in the digital insurance market. The key question is: Is the insurance market and its regulators ready for the consequences that will flow from this?

To explore the concept of panoptic regulation in more detail, read this paper I wrote for the Chartered Insurance Institute earlier this year.

The second-worst-kept secret of the year, after the launch of Google Compare in the U.S., is Berkshire Hathaway announcing its plans to sell insurance directly to business owners over the web. Quelle surprise.

I recently spoke with a C-suite exec who told me that "direct" is a dirty word.

Perception is reality.

In reality, though, "direct" is a lousy term that doesn't do justice to the implementations that today's technology has to offer that are often in direct alignment with an insurance company's business model.

The conversation becomes uncomfortable to some once the word "middlemen" is introduced. It doesn't have to be.

There are two primary outcomes to direct selling: (1) eliminating the middlemen or (2) empowering them. For visualization purposes, consider the following three brands:

Quotemehappy.com occupies the left extreme of selling directly to consumers. A spin-off of Aviva since 2011, the online insurer only provides phone support if a customer has a claim. For all other inquiries, there is browsing. Then there are the Geicos of the world, where insurers offer the convenience of buying on the web with the assurance of speaking to an agent, when needed. To the right extreme, Plymouth Rock provides an example of an insurer that has a patent-pending technology that matches online quotes to agents either pre- or post-purchase. There are several other players occupying the comfortable middle with direct-to-consumer models that offer varying degrees of human interaction.

Typically the outcome is determined by the company's original distribution channel: whether offline, web or mobile. The table below further illustrates how versatile "going direct" can be:

• Geico, Policy Genius and Cuvva are examples of insurance companies that implemented a direct-to-consumer strategy from the get-go; here, direct is a no-brainer.
• Plymouth Rock and Quotemehappy.com via Aviva signal companies that implemented a direct-to-consumer strategy in an attempt to address a change in the market.
• Allstate acquired Esurance to buy its way into the direct market, and so did AmFam with the acquisition of Homesite.
• Also, AmFam invested in insurance comparison site CoverHound.

When all is said and done, direct selling is first and foremost a marketing channel that empowers the consumer. Sans proper marketing and messaging, the online insurance journey is transactional at best, and players risk commoditizing their product.

"Commodity." Now there's a dirty word for you.

With increasing frequency, I am seeing post-termination claims being filed against employers who otherwise are doing an excellent job providing a safe work environment and comprehensive safety training.

It is impossible to develop statistics on this kind of claim, but anecdotal evidence indicates that there are more of them being filed. A slow economy exacerbates this problem.

It is important that we find strategies that will limit the number of these claims for the following reasons:

1. They typically are litigated, so they are incredibly expensive.
2. They are discouraging and disheartening to an employer who has cared about the safety of the workers and treated them well.
3. The majority of these claims are without substance. "Fraudulent" is a term that should not be used loosely but is very often applicable here.

We never can completely wring fraud and abuse from the workers' compensation system. Soft-tissue claims are virtually impossible to prove or disprove, so we must rely on the injured worker to be honest. That means employers must do everything possible to influence employees to be honest.

Besides getting the terminated employee to sign a waiver that she is injury-free on her last day, here are a few additional recommendations:

• After a layoff has been announced, but before the termination has taken place, honor those people who have worked safely and injury-free during their employment with the company. Adding a small gift card is a way to thank them. By recognizing them and thanking them in a public setting, you show your appreciation, and lack of appreciation is one of the primary reasons that people file fraudulent claims.
• If the soon-to-be laid-off workers are part of a safety team or department, make sure that they are included in any awards or recognition that is given at the end of the measured safety time period.
• Indicate to the workforce that the company policy is to contest and deny any claims that are filed after a layoff or termination. Don't just threaten, do it.
• Gain agreement from your insurance carrier that it will contest any post-termination claim and not simply offer a settlement to have it go away.
• Contact the physician who is issuing the cumulative trauma report and let him know that you intend to contest his finding. Your insurance carrier should be your ally in exposing repeat offenders.

Remember that an injury that occurs after a layoff has been announced, but before the termination takes place, sets up any post-termination claim as legitimate.

Treating employees well and creating the strongest possible safety culture are the best defenses, but incorporating additional strategies can help prevent a discouraging and expensive post-termination claim.