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How to Remove Fear in Risk Management

Fear creates a culture that inhibits decisions on risk. Firms must move to SRM, or "sustainable" risk management.

Someone is looking over your shoulder, and you know who it is. If you're the CEO, it's your board and shareholders. On the factory floor or in the cubicles, it's the foreman or the supervisor. But just as often these days, the sources of anxiety and caution confronting risk managers may not be corporate employees at all. Rapidly shifting technology that is often difficult to understand and measure, unfamiliar demographics, expanding globalization, and ever more stringent regulatory compliance requirements are now part of an anxiety- producing stew that organizations' risk managers must understand and deal with. All these forces threaten a corporation's revenue, margins, profitability, and overall competitiveness more quickly and unpredictably than ever.

Consequently, if you are an internal auditor - the person responsible for assessing and helping improve the risk management process - your chair these days may feel more like a hot seat. Which of the decisions daily barraging a modern corporation should be the higher priorities? And how, in a business world of frequent disruption, will you, your superiors, and those who report to you weigh and mitigate the waves of serious risks facing the company nonstop? What are the most important metrics to use for any given risk issue? Can the company rely solely on its in-house staff to analyze and resolve unforeseen and often unforeseeable problems?

Just as important, how will the enterprise as a whole handle these issues and make necessary decisions? How does company culture get in the way of using risk management effectively, to reach the decisions that will help the company grow and become more competitive, and how can sustainable risk management (SRM) assist?

Company managers often are not encouraged to exercise independent judgment, even when they are the acknowledged experts. Without transparency and effective multilevel communications in their company, managers are likely to be wary of crossing unseen boundaries, suspect that hidden agendas are controlling important decisions, or feel isolated and unsure of the enterprise objectives that should help guide their decisions. Moreover, anxiety about making important decisions is common in organizations that don't give their decision-makers the tools and data required to make intelligent risk analyses. Without confidence that they understand the risks associated with a decision, and in a culture where the consequences of a bad outcome are punitive, managers understandably are likely to be cautious.

Behind employees' hesitation to make and express independent judgments or to make decisions can be a corporate culture of mistrust, caution, and covering one's backside. In other words, a culture of fear - fear of losing face, losing a contract, losing revenue, losing political advantage, losing a job.

A culture of isolation and timidity defeats collaboration, creativity, transparency, and the ability of a corporation to objectively analyze the broad range of risks it faces each day. It can render the internal audit function far less effective and useful than it should be and can be. In this environment, the internal audit function may mistakenly be seen solely as a means of uncovering errors, assigning blame, and enforcing penalties. Managers may be understandably reluctant to provide anything other than the most general and diluted information about their operations and decisions.

One need not wade through the scientific research about the impact fear has on decision- making to understand how destructive it can be. The brain has separate centers for processing fearful and rewarding experiences. As Dr. Gregory Berns, director of the Center for Neuropolicy at Emory University, has explained, "The most concrete thing neuroscience tells us is that when the fear system of the brain is active, exploratory activity and risk-taking are turned off." Good decisions in this state are unlikely. "Fear prompts retreat. It is the antipode to progress," said Berns. "Just when we need new ideas most, everyone is seized up in fear, trying to prevent losing what we have left."

In this way, fear can nullify or dilute a company's risk management processes. An effective SRM program, however, encourages and supports an environment that minimizes fear, reduces uncertainty, and increases transparency and confidence in decision-making throughout the enterprise.

Barriers to Solutions

It may seem that established tenets of good corporate governance already include rooting out the fear, indifference, lack of collaboration, and siloed decision-making that stand in the way of optimizing risk management. After all, most companies talk an excellent game when it comes to collaboration and open and honest risk analysis. Too few, however, have developed the internal mettle to tolerate it.

Starting with assessing corporate culture and change management practices, internal auditors can play an important role in transforming the boilerplate talk into sustainable programs. They can provide unbiased, to-the-point assessments, independent of internal politics. The problems they find and the solutions they recommend can be critical for a company seeking to develop the capacity for SRM. But whether from too much caution and resignation or just fear of change, many internal auditors say the structure of their jobs discourages them from alerting their companies to critical gaps in risk assessment and mitigation.

A recent global study by The Institute of Internal Auditors (IIA) Research Foundation spotlights some of the problem areas. Not even two-thirds of the surveyed chief audit executives (CAEs) said they consult with division or business heads when they develop audit plans. Only slightly more than half said they consult with audit committees. There may be many reasons for this audit-in-isolation phenomenon, but it commonly occurs in companies that do not value the risk management process and therefore do not prioritize it. The phenomenon occurs in companies where key players are not encouraged to speak up.

Just one-third of audit plans are updated three or more times a year, the study found. This means that CAEs may be overlooking important changes in the business environment. No wonder only 57 percent said that their internal audit departments were "fully aligned or almost fully aligned" with the enterprise strategic plan. This kind of exclusion signals that leadership does not embrace the people responsible for monitoring management of the company's risk and that the audit function is not seen as a critical part of the management process.

Our experience with clients reflects these findings and shows that risk management professionals themselves may be at least partially responsible for the isolation and erosion of their programs. They could assume, for instance, that the value and relevance of SRM are obvious and not consistently sell a program that's underway, neglecting to point out its continuing value, highlight its successes, and develop metrics that are easily understandable.

The program itself may not be as inclusive as it should be. Sometimes risk management processes are not designed to seek out and incorporate the views of front-line employees. Any effective SRM process, however, must reach into the depths of company operations. At the same time, employees at all levels often are not trained well in how to assess and evaluate risk. Employees may be able to calculate some risk in dollar terms without appreciating that they also should be looking at, for example, threats to customer satisfaction, employee safety, and regulatory and contract compliance.

Too often, as well, an unappreciated or ineffective risk management program does not account for the unique characteristics and business objectives of the corporation. Organizations sometimes employ a cookie-cutter approach to developing a risk management framework that's not calibrated to address essential and distinctive company attributes.

Sometimes risk reporting to the board and top executive levels may be so extensive and detailed that no one reads the reports. Or risk reporting may be so superficial that its assessments and proposed solutions carry little weight. When risk management is not seen as a source of continuous improvement for the organization, risk management funding may be erratic or inadequate, its staffing just an afterthought, and its placement in the corporate hierarchy too isolated to be effective.

Working Toward a More Viable Program

An SRM program protects and advances the organization's primary business objectives. To do their job effectively, risk management leaders must be included as members of the executive management team. Their inclusion helps to ensure that consideration of risks is incorporated into every significant strategic decision.

It is also possible that a company and its leadership simply are not prepared for the important cultural shift required to champion SRM. All too typically, executives are experts at shifting blame, pointing fingers, and covering their reputations when something goes wrong or hard decisions must be made.

SRM requires a no-blame environment, a collaborative process in which personnel work together to assess and solve problems without fear that their careers will suffer or they will lose the confidence of their peers. A frank and constructive assessment of an operational failure, for instance, is possible only when, instead of trying to find fault, the evaluation concentrates on solutions to keep the failure from happening again. This collaborative approach is not common enough in modern corporations.

Why SRM Is Worth It

The benefits of developing an open, fearless, and transparent SRM program ripple through every level of the enterprise. The program helps ensure that the company can perform with confidence and agility in the face of unpredictable events and shifting economic conditions. It supports the development of accurate, timely, and relevant metrics that reduce uncertainty in decision-making. It provides an effective process for dealing with emerging technologies, surprising moves by competitors, market uncertainties, natural disasters, and even internal scandals. When the program is working, the board, C-suite executives, and managers at all levels understand the kinds of risks the company must deal with and then use that awareness when making their decisions.

An active and embedded SRM program, visibly supported by leaders, regularly refreshes the managers' awareness and stimulates their insights concerning the shifting market and business conditions that pose the greatest risks to the company's operations. Employees work collaboratively with their supervisors and are asked to help solve missteps rather than being blamed or punished for them.

SRM offers continuing opportunities to save costs and improve productivity. It can reduce operational and material losses and waste and spotlight process improvements. SRM more closely aligns people, assets, processes, and technology with the organization's business strategies. It also reassures the board and other stakeholders that compliance issues are being addressed and that company assets and reputation are being protected. The results - which we see time and again - include increased growth, improved profitability, and higher staff morale.


Marc Dominus

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Marc Dominus

Marc Dominus is a management consultant and practitioner who excels at enterprise risk management (ERM) implementation, enterprise risk assessment (ERA), executive facilitation, training and management workshop design.

New Insurance Models: The View From Asia

Innovative companies in Asia are, for instance, selling return insurance for items bought on Alibaba or marketing via a WeChat app.

Recently, I chaired the 4th annual Asia Insurance CIO Technology summit in Jakarta, Indonesia. The experience brought me into contact with an entirely different set of insurers and insurance technology players. I was rewarded with a fresh view on the challenges and opportunities of insurance during an era of disruptive innovation, as well as a new perspective on how Asian insurers are creating and launching products, defining new channels and new models to out-innovate the competition.

I should state at the outset that Asian insurers aren't doing everything differently than North American and European insurers. It is a global era. In many ways, their competitive issues are similar. We are all having the same conversations. As I considered the similarities, however, it made the small differences stand out. Just as Asia is hours ahead of the Western world throughout the day, I had the strange feeling that I was listening to the ends of conversations that are only beginning in other parts of the world. Because populations, cultures, use of digital technology and the nature of businesses vary, I thought I would share a short list of insights from my eavesdropping in an effort to shed light on how disruption is being embraced elsewhere and how it could ripple through the industry. I'll center my thoughts on models, mandates and marketing.

Models

Everyone is discussing models. Business models. Technology models. Distribution models. Transaction models. There is good reason. It's a model v. model world, and Asia-Pacific insurers know that the model is the center of a business. For the outer layer to be responsive, the business model can't be a slow-moving leviathan. Disruption has the disturbing tendency to render perfectly good models obsolete. Creating a responsive, obsolescent-proof business model is of great interest to Asian insurers, which are responding to radically different consumer expectations and competitive models than in prior decades.

Traditional insurers at the conference (as well as challengers) are aggressively rethinking the insurance business model. Some believe that insurance will be run more in an open ecosystem, becoming more fragmented and niche-focused, building on the micro concept. If an insurer can embed products in other business models/industries, especially those with high-frequency transactions, then they capture the opportunity for both a new distribution channel and a new product. New Distribution Channel + New Product = New Market Opportunity.

These are areas where insurers can see quantum leaps in growth, yet they are also the areas where insurers are most susceptible to start-ups beating them to the punch.

Mandates

Three clear mandates stood out above all others for Asian insurers - the role of CIOs, the necessity of new cyber security solutions and a new, enterprise-wide look at analytics.

For CIOs, the clarion call was for a rapid advancement and widening of scope for their role within the insurance organization. CIOs must become change agents and grow in influence. They must be active in technology review and adoption, more collaborative with CMOs regarding digital platforms and data sharing and more effective at translating business vision into system and process transformation.

Cybersecurity is a never-ending mandate that also seems to never have the perfect solution. It was universally agreed-upon that today's security measures have the frustrating trait of being mostly temporary solutions. Blockchain technology (currently in use by Bitcoin, among others) was discussed as a more permanent solution for many security issues. Blockchain use makes transaction fraud nearly impossible. Verification of transaction authenticity is instant and can be performed by any trusted source, from any trusted location.

On a broader note, however, it was conceded that security is no longer just an IT issue, but it is a board-level, organization-wide imperative because security concerns the full enterprise. Boards must fund and address cybersecurity across three aspects: confidentiality, availability and integrity.

Enterprise-wide analytics was another organizational mandate. Some Asian insurers are moving toward using end-to-end analytics solutions that cross the enterprise in an effort to gain a single client view and execute a targeted pipeline, with unified campaigns and advertising. Analytics will also give them risk- and assessment-based pricing, improved predictability for loss prevention and better management of claims trends, recovery and services.

Marketing

Insurers are rapidly moving from product-driven to customer-driven strategies and from traditional distribution channels (such as agents) to an array of channels based on customer choice. At the same time that Asian insurers are looking at relevant business models, they are diving deeply into how marketing tactics may completely shift from a central hub to a decentralized "micro" model. The industry spark has been a short list of both established insurers and start-ups that are capturing new business through new marketing methods, new partnerships and new market spaces.

ZhongAn, for example, is selling return insurance for anything bought on Alibaba. Huatai Life is promoting unit-linked policies on JD.com and selling A&H insurance via a WeChat app. PICC Life has found a distribution partner in Qunar.com, an online travel information provider. These examples require a completely different, high-volume, interaction-based, data-rich, small-issue marketing plan. That kind of marketing will prove to be of great value to insurers that have added flexible, transaction-capable core insurance systems...that are cloud-based to scale rapidly.

Aggregators are now commonplace in insurance, and Asian insurers are looking at how this channel will affect their business, as well as how to use aggregators as a tool for competitive advantage. GoBear, currently selling in Singapore and Thailand, was given as a prime example of how aggregators represent the future of insurance shopping. GoBear isn't just an aggregator. It is an innovator, revamping the concept of insurance relationships. GoBear Matchmaker, for example, will allow a prospect to pick insurance but also allow the insurer to pick prospects/clients. GoBear Groups will leverage groups/crowd sourcing.

What do these M's add up to?

Insurance business models, mandates and marketing are all ripe for inspection and change. In some ways, Asian insurers are in a better position for these ground-shaking industry changes because so many of them recognize the stakes involved and the cultural shift required to thrive. Asian populations and culture are ready to embrace technology solutions to meet consumer demands. As all insurers globally address their models, mandates and marketing, it will be fascinating and educational to see how quickly the different markets adapt and are emerging as innovative leaders and how these regional innovations will influence other regions as they turn into global solutions.

One thing was clear to me in my time in Jakarta - Asian insurers are optimistic, active and excited about the road ahead.


Denise Garth

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Denise Garth

Denise Garth is senior vice president, strategic marketing, responsible for leading marketing, industry relations and innovation in support of Majesco's client-centric strategy.

Are Softer Skills for Analysts Neglected?

Ever since Google made “data scientist” the sexy job title for the decade, suppliers and users have obsessed over analysts' technical skills.

Are you neglecting the development of softer skills in your analysts? Based on conversations with customer insight leaders, including at the very pleasant DataIQ Talent Awards, it would seem you are. When I shared the experience of Laughlin Consultancy, that training for analysts in softer skills is our most popular service, these leaders were not surprised. But if there is such widespread support for the idea, why haven't businesses invested in this training sooner?

People have suggested a number of theories:

  • Underinvestment in these teams or in training during lean times
  • Softer skills not valued by some geekier analysts or leaders
  • Skepticism from line managers (especially CMOs) as to what value such training would deliver
  • Just too busy!

All these are understandable challenges or excuses, and more than one resonates with me from my time creating and leading large customer insight teams. Perhaps there is another reason, as well. In my new line of work, I get to speak at industry conferences, read data/analytics/research publications and scan the plethora of blogs or social media comments on this topic. What becomes clear when consuming these is that the "buzz" or fashion is to focus on the technical. Ever since Google made "data scientist" the sexy job title for the decade, both suppliers and users have obsessed over technology and technical skills.

Following the comforting old maxim, "it's what you do with it that counts," I worry about this fetish with all things techie. As an Apple addict, I can empathize with the attraction of new shiny technology and beautiful design. However, I'm sure we'd all agree that commercial leaders should be focused on outcomes, not tools.

This recent fascination with "big data" or "predictive analytics" or "data scientists" is also worryingly reminiscent of what happened during the customer relationship management (CRM) bubble. When that term was in vogue, businesses were falling over each other to "do CRM," which a number of large technology suppliers made sure equated with buying a CRM system. Not surprisingly, with hindsight, most of these CRM projects failed, and systems did not repay that hefty price tag.

Given that most of us are keen to avoid repeating mistakes, it's a pleasure to report that more and more switched-on businesses are realizing that they can't just hire technically competent graduates and get the insight their business needs.

So, what do I mean by softer skills? Maybe not precisely what you might come up with, but I hope the list below is familiar. Laughlin Consultancy's most popular service in the first half of 2015 was the delivery of a "consultancy skills for analysts" training course that includes theses elements:

Have you invested in training like that for your analysts? What results have you seen?

Another way to think about this issue is, what distinguishes your top talent from those analysts who prove to be just so-so? My experience is that it's capability in these softer skills. Over the years, I've met or employed hundreds of analysts, and while many may be a whiz at coding or have mastered model building in SAS, few are great communicators who really get what the business needs. Those who did master the skills I've outlined above went on to not just be effective consultants within their business; many are now leaders themselves.

Is that your experience, or would you identify other training needs for your team?


Paul Laughlin

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Paul Laughlin

Paul Laughlin is the founder of Laughlin Consultancy, which helps companies generate sustainable value from their customer insight. This includes growing their bottom line, improving customer retention and demonstrating to regulators that they treat customers fairly.

Broad Array of Roles for Disability Coverage

Advisers focus on protecting personal income, but disability insurance can play a role with key employees, loans, divorces and more.

In the world of disability insurance, most financial advisers think of personal income protection. This is only the beginning of the possibilities that the adviser may be able to provide to safeguard clients, their businesses and assets. There are many products available within the disability insurance realm and diverse opportunities to provide your expertise.

Diversity of Product:

Key Person

The most valuable asset in a business is the people. Imagine if one of your key executives had an illness or an accident and was unable to work and continue creating revenue and profit for your company. What effect would this have on the bottom line? How would you replace the lost revenue?

Retirement/Deferred Compensation

At a closely held, family owned business, benefit plans favoring the family and the senior management are important for retention and reward. Over the past year, a non-qualified deferred compensation plan is put in place for the top 10 executives. What happens if one of the executives becomes sick or hurt and is unable to work and contribute to the plan? Can the plan be funded? If yes, how?

Contract Fulfillment

The board of a company just signed the largest contract in company history for a new CEO. The contract has financial guarantees, performance bonuses and the other usual language. What happens if the CEO becomes ill or has an accident and is unable to perform his duties? The company is on the hook for the financial guarantees. Should this be funded out of company cash flow or have the liability transferred through a disability insurance policy?

Loan Protection

There are more than 21 million small business loans valued at more than $600 billion. Business loans are taken out for business-related expenses, such as:

  • Purchase or expansion of a practice or business
  • Purchase of a large piece of equipment
  • Facility renovations
  • An increase in working capital or build-up of inventory
  • Purchase of a building or land for a business

It may make sense to provide disability insurance to cover the business loans in the event the business owner has a disabling accident or illness. There are separate insurance policies or riders to a traditional policy that provides benefits to cover the loan or loan payment obligations.

Impaired Risk

Perhaps a client will not qualify for traditional or even non-traditional coverage because of an extensive medical history. Impaired risk coverages can work for pre-existing medical conditions.

Diversity of Opportunity:

QSPP Can Prevent Dysfunction and Disruption

  • Could you continue to pay a disabled employee's salary from your business?
  • How long could you afford to pay a salary?
  • Would the payments you pay be deductible to your business?

It is the American dream: turn a simple idea into a start-up and, through innovation, hard work and the right people, grow that start-up into an industry leader. It may seem obvious that a business owner would want to do everything to protect the people who help grow the business. As the business grows, however, offering everyone the same protection in the case of injury or illness may become difficult. Owners have a tendency to focus on partners, executive staff and key employees. This is a completely logical line of thinking, but without a Qualified Sick Pay Plan (QSPP) in place, it could put the business at high risk.

A QSPP is a formalized plan determining who will be paid, how much will be paid and how long salary will be continued when employees are unable to work because of an injury or illness. The plan can have different determinations for different classes of employees within the company. It can also be self-funded, or funded through an insured product, such as disability income policies.

Why a QSPP?

There are two key reasons: tax implication of benefits paid and potential precedent. The Internal Revenue Code states that wages paid to a disabled employee may not be deductible as a business expense unless they are paid under a salary continuation program. Without a program in place, any payments made are not deductible by the business and are fully taxable to the employee.

The implementation of a plan allows a business to deduct wages paid to employees who cannot work, and an employee can receive qualified benefits tax-free. The absence of a QSPP could result in the IRS disallowing benefits paid to an employee as sick pay. This would have serious tax implications on the employer and the employee.

An even greater danger to an employer is the existence of benefit payment precedent. It may seem completely logical to continue the salary of key employees responsible for revenue growth, but, without a QSPP, any sick pay for any employee creates a precedent of the same pay for all employees. Any variation between employees could be viewed as discrimination. To eliminate this risk, it is important to create a formal, written plan stating any differences of salary continuation length or frequency between classes of employees before an employee needs to use it.

How Is a QSPP Implemented?

A QSPP requires two components: a plan resolution and plan letters to employees.

A plan resolution is drafted and executed by the company's board. This resolution defines the classes of employees, how benefits will be paid and how long they will be paid.

Plan letters communicate the information to the employees. They can be class-specific.

How Can Benefits Under a QSPP Be Funded?

This is an important consideration. A QSPP can be fully self-funded, fully insured or a combination. If a plan is fully self-funded, the company can be burdened with all of the responsibility of determining who cannot work and how long they can't work and of paying benefits from company accounts during a time when, depending on the person who cannot work, the company may need the funds the most. Additionally, the FASB 112 Accounting Rule makes a company become an insurance company by requiring it to carry the present value of future claims as a liability on the balance sheet if it chooses to self-fund a salary continuation program. Two implications of FASB 112 are:

  • Companies with self-funded disability programs must set aside all the money upfront
  • This requirement can significantly reduce profits while increasing liabilities

Under a QSPP plan with disability income insurance, the insurance company determines when your employees cannot work, the insurance company determines how long they cannot work and the company pays smaller, regular payments for the benefit during a time when all employees are actively at work. A fully insured plan not only takes much of the liability away from the employer, but it also allows the company to predict future plan costs. Disability income insurance premiums are level for the life of the policies. Three tax shelters of an insured salary continuation program are:

  • Premiums paid are deductible as a fringe benefit expense (IRC Section 162(a)).
  • Employer premiums are not included in employee’s taxable income. (IRC Section 106).
  • A special tax credit may be available for employees that are permanently and totally disabled (IRC Section 22(b)).

In working with the son of the owners of a medium-sized technology security firm, I learned that Mom and Dad would take care of the son if anything were ever to happen. As a financial adviser, what do we do now? A conversation about the company benefits and what the parent/owners wanted to have happen with their family and their employees created an opportunity. By educating the clients on sick pay plans, we were able to provide better recommendations to the owner (parents) for the benefit of the son and the other employees while keeping the firm in legal compliance.

Divorce Settlements

Most if not all settlements include division of assets and liabilities owned by the parties. Additionally, when appropriate, especially if there are children involved, there is an alimony agreement. What happens to the continuing alimony payment if the payer becomes sick or hurt and unable to earn the income to make the support payment?

With the divorce rate at 50% or higher for U.S. marriages, there is an opportunity to protect a spouse and provide the children a source of income used for living and educational expenses. The solution is to place a disability insurance policy on the payer, with the spouse as beneficiary.

Occupational Diversity

Students, coaches, umpires, golf professionals, chefs, race car drivers, comedians and musicians, to name just a few, are thought to have a hard time obtaining disability income insurance. They are not hard to insure if you are able to go a little deeper within the traditional markets or outside to the non-traditional markets.

Our hobbies sometimes position us to have access to people in these diverse occupations. One of my hobbies is to watch, listen and learn from professional speakers. It has been a privilege to spend time with some of the all-time greats. I am always amazed at their accessibility if you step forward and participate. Once, I hosted Chris Gardner, who became nationally know for his life story through the movie "Pursuit of Happiness," where his role was played by Will Smith. As Chris and I began building a relationship, he learned about our firm, and it became evident that no one had spoken to him about protecting his flow of income from a disabling accident or illness.

There are many diverse opportunities for you as the adviser to protect your client's flow income, business entity and valued assets. Think beyond personal disability insurance and help your clients understand their needs to secure their financial foundations.


John Nichols

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John Nichols

John F. Nichols is a nationally recognized disability benefits consultant, the creator of disability products and administration systems and an expert witness in disability proceedings. Nichols serves as president of Disability Resource Group, a national insurance agency that he founded in 1999.

2 Key Tools for Innovation in P&C

The tools can improve communication between insurers and agents, removing problems holding the industry back for decades.

Imagine this: two separate kingdoms, the kingdom of P&C insurers and the kingdom of agencies and brokers. Within each kingdom, each insurer and agency is represented by its own little house, and every little house has a door. Each door can open both ways and represents a way to communicate and share data - and these kingdoms need to share lots of data.

The only way to send data between houses is to build deep trenches. Building a trench is difficult, expensive and time-consuming. And the P&C insurer must dig the trench to each agent or broker, then knock on every agency's and broker's door to see if they will open it and allow data to be shared.

In the world I have described, insurers are very busy building these trenches to the agencies and brokers. Insurers spend a great deal of time, money and resources. Yet, when the insurers finally get to knocking on all the doors, they find that some agencies have their doors wide open and are ready; that some will open their doors eventually; but that others have no desire to ever open their doors.

What's more, many insurers won't fund the trench digging, so agencies may want a connection but are left without the trench.

For the kingdoms of the insurers and of the agents and brokers, the system is not built for success.

What I just described is reality. Insurers and agencies have to share data for policies, billing and claims. But the cost, risk and payback are deterrents. Even the will to communicate is not always there.

The formalities and costs to share data are what I described as trenches. Missing or incomplete "trenches" result in missed opportunities, inefficiencies, misinformation and misunderstandings. For example, what an insurer might view as a small book of business not worth investment might be a huge book for some agencies. Sometimes, the lack of understanding between the two "kingdoms" can be astounding.

Yet we continue to go down this path, just as we have for many, many years.

We have an opportunity to rethink our situation. Two key tools of innovation can bridge the gap between insurers and agents: ideation and crowd sourcing. These may sound like buzz words, but, by allowing varied groups to have a voice in solving challenges, ideation and crowd sourcing can allow decision makers to see data trends across segments of organizations. More importantly, ideation and crowd sourcing can offer solutions to challenges for little to no investment through the ideas of people who wouldn't otherwise necessarily have "a seat at the table."

We know what we hear from agents: that, as we described in the "two kingdoms," sometimes there are agent houses with no trenches even being built to them. We also know that insurers sometimes find that, even after all the work of establishing trenches, some agents keep their doors closed. Utilizing innovation tools to communicate these pain points and search for a better method of business is a great step forward.

But what can insurers do right now to solve the challenge of the two kingdoms?

In the short term, insurers can demand that all leading vendors of agency management systems and policy administration, billing and claims management systems have adapters built in and ready for plug and play for all lines of business and transactions. This would improve implementation time, reduce investments and essentially remove the "closed doors" problem facing insurers.

In the long term, invest in ideation and crowd sourcing to redesign the connections between insurers and agencies. Listen to the pain points and notice trends. Crowd sourcing will offer powerful data to build a better system. Start posing questions to your own organization like, "How do we leverage the cloud and big data concept to rethink the 40-year-old point-to-point integrations?"

You'll be surprised at the results and how meaningful making small changes can be. Let's do it.


Deb Smallwood

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Deb Smallwood

Deb Smallwood, the founder of Strategy Meets Action, is highly respected throughout the insurance industry for strategic thinking, thought-provoking research and advisory skills. Insurers and solution providers turn to Smallwood for insight and guidance on business and IT linkage, IT strategy, IT architecture and e-business.

A Word With Shefi: Carbone at Bain

He raves about the potential of the Internet of Things but cautions that innovators need deep insurance knowledge to take advantage.

This is part of a series of interviews by Shefi Ben Hutta with insurance practitioners who bring an interesting perspective to their work and to the industry as a whole. Here, she speaks with Matteo Carbone, with Bain Financial Services in Italy, who says the Internet of Things "has introduced more changes than the sector has seen in the last 100 years."

To see more of the "A Word With Shefi" series, visit her thought leader profile. To subscribe to her free newsletter, Insurance Entertainment, click here.

Describe what you do in 50 words or less:

I advise financial services groups mainly on innovation within their business models. My field is insurance, and I've spent the last couple of years handling digitalization of traditional channels: inventing technology-based value propositions, generating customer experience strategies and bringing the omni-channel approach into the insurance business.

Name an emerging technology you are most excited about:

Internet of Things - it's a game changer! From connected cars to "domotics," to wearables to connected machines; all the things that are creating tremendous opportunities to price risk, handle claims differently and deliver new services. In the last couple of years, this technology has introduced more changes than the sector has seen in the last 100 years.

Name one similarity and one difference between American and Italian insurance shoppers:

The customer preference for human interaction at the purchase stage within the customer journey is the same in both countries, and so is the digitalization wave, which is obliging insurers to create an omni-channel customer journey around their traditional, physical point of sale.

One important difference is the role of banks in insurance distribution. In Italy, bancassurance accounts not only for more than 80% of the life market but also for 16% of the P&C personal lines market, excluding auto. Currently, banks are looking to play a more relevant role in the auto insurance distribution.

Name a challenge you have faced working in insurance:

You have to really know the intimacy of this strange industry to be able to innovate it. It's a technical business, so you cannot advise an insurer without knowing the deep aspects of the industry.

A memorable consulting gig:

Without a doubt, it was two years ago advising Renova Group on the acquisition of Octo Telematics, a global leader in insurance telematics solutions. It was amazing to help Renova discover the value of telematics for the insurance business.

Your favorite news source:

As for me, LinkedIn is the primary source. Each day, I check five to 10 insurance news websites yet the best insights come from my LinkedIn network of insurance professionals around the world. I consider the daily sharing of ideas with them an incredible asset.

When you are not working for Bain & Company you are most likely…

My work is my hobby. I enjoy my work, and it is normal for me to think about work even when I am doing other things. However, if I have to identify my main hobby, it is fitness. I am definitely addicted to the gym.

If you weren't working in insurance consulting, what profession would you be in?

I would probably be managing my family's historical winery.

Prosecco or Champagne?

Champagne! I'm in love with Krug Clos Du Mesnil; their first vintage was produced the year I was born.

Favorite quote:

"Work hard, play harder."

Which term best describes you…

  • Driverless or in control? In control
  • Elon Musk (dreamer) or Warren Buffett (doer)? Warren Buffett
  • Risk-averse or risk-taker? Risk-taker

Shefi Ben Hutta

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Shefi Ben Hutta

Shefi Ben Hutta is the founder of InsuranceEntertainment.com, a refreshing blog offering insurance news and media that Millennials can relate to. Originally from Israel, she entered the U.S. insurance space in 2007 and since then has gained experience in online rating models.

Returning Insurance to Its 19th Century Roots

Insurers should once again require those at risk to undertake cost-effective loss-reduction measures. Back to our roots!

As we celebrate the Wharton Risk Center's 30th anniversary, we are at the same time envisioning the future of risk management. In this spirit, I would like to make the case that the insurance industry return to its 19th century roots by requiring those at risk to undertake cost-effective loss-reduction measures as a condition for insurance coverage. Back to the future!

This is the way that factory mutuals operated when they were founded in the mid-1800s, and some insurers still do today when marketing commercial policies. Firms were given an insurance policy only after they were inspected and shown to be safe. Insurance premiums reflected the best estimates of the risk; improvements were rewarded with lower premiums, reflecting the expected reduction in future claims. Firms that did not continue to keep their factories operating safely were warned that their insurance policy would be canceled unless they took corrective action.

Insurance could play a similar role with respect to providing coverage to the residential sector where, today, limited attention is given to encouraging homeowners to invest in loss-reduction measures. Premiums should reflect risk, and risk information should be communicated in a transparent manner so decision makers have accurate signals. Those at risk should also be made aware of the reduction in premiums they could receive.

Public-private partnerships are necessary for dealing with insurance against some extreme events. Low-income individuals residing in hazard-prone areas are likely to demand financial assistance if their premiums are subsidized and the increase in the cost of their insurance raises issues of affordability. Even in situations where insurers are allowed to charge risk-based premiums, they may still feel that some hazards are uninsurable without public-sector involvement if catastrophic losses would cause their surplus to be reduced to an unacceptable level and perhaps lead to insolvency.

The National Flood Insurance Program (NFIP) offers an opportunity to creatively address these issues with regard to flood hazards. The Federal Emergency Management Agency (FEMA)'s technical mapping advisory council has already begun focusing on ways to design flood maps that reflect risk, and several reports by the National Research Council are addressing ways the flood insurance program can be modified in advance of its renewal in 2017. More specifically:

  • Updated flood maps will allow insurers to more accurately assess the hazard. If private insurers can charge risk-based rates, they would have an economic incentive to market flood coverage.
  • The public sector could provide financial assistance to low-income homeowners to address issues of affordability and encourage them to undertake cost-effective measures to reduce their risk. One way to do this is through a means-tested voucher program tied to low-interest loans. Well-enforced building codes and seals of approval would provide an additional rationale for undertaking loss-reduction measures.
  • A multi-year insurance policy tied to the property would prevent policyholders from canceling, as many do today when they have not made a claim for several years. Property owners would be provided with stable annual premiums and would know that they were protected against water damage from floods and hurricanes.
  • Reinsurance and risk-transfer instruments marketed by the private sector could cover a significant portion of the catastrophic losses from future floods. Some type of federal reinsurance would provide insurers with protection against extreme losses.

The broader challenge we face is developing long-term strategies that provide short-term rewards so that change is politically viable. There is a growing interest by policy makers and other stakeholders in ways that insurance can encourage individuals, firms, communities and countries to undertake protective measures.

Insurance has an opportunity to play this role in the residential sector by going back to its basic principles that were adopted almost 200 years ago from the commercial side of the house: encourage or require investments in loss-reduction measures today while providing claims payments should one suffer a severe loss.

The full Wharton risk newsletter is here.


Howard Kunreuther

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Howard Kunreuther

Howard C. Kunreuther is professor of decision sciences and business and public policy at the Wharton School, and co-director of the Wharton Risk Management and Decision Processes Center.

5 Unique Risks for Radiologists

Radiologists are second only to neurosurgeons in claims paid. The average claim for a radiologist lands at a whopping $426,000.

As part of our role as specialists, we wanted to learn more about the risks specific to radiologists, so we reached out to Karen Kruer, RN, CPHRM, and Michelle Foster Earle, ARM, president of OmniSure Consulting Group. Here's what we learned.

Radiologists are second only to neurosurgeons in claims paid. Their average claim lands at $426,000. Radiology is a unique field of medicine, as it operates in an arena where other physicians cannot: seeing inside the body as a part of the diagnostic process. This specialty also brings a unique set of risks. These are the top five, together with suggestions for reducing risk.

# 1. Error in diagnosis - Of all the lawsuits filed against radiologists, error in the following five diagnoses most commonly leads to lawsuits:

- Breast cancer

- Nonvertebral fractures

- Spinal fractures

- Lung cancer

- Vascular disease

To decrease error in diagnosis, radiologists should have policies and procedures in place to ensure that with every procedure they obtain a complete patient history, know exactly what they are looking for, request further testing if there is any question and review the diagnosis with the ordering physician.

# 2. Procedural complication - There will always be an increased risk when an invasive procedure is performed, and radiology includes many, such as the injection of dye and the insertion of wire stents. However, noninvasive procedures may also increase the risk of complications. Consider an MRI on a patient with metal piercings or devices such as a pacemaker. The best tip for avoiding an adverse outcome is to ensure that a thorough screening is always done before any procedure. For example, the radiologist should know the reason an imaging procedure was ordered, as well as patients' medical histories and what medications they are taking. Radiologists are trained to look inside a person's body, but they can also benefit from looking at the outside by putting into place a thorough intake process. Ensuring that support staff is competent and well-trained also goes a long way toward reducing the risk of procedural complications.

# 3. Inadequate communication - Thorough communication with both the referring physician and the patient is essential. Radiologists are referred to for help in diagnosing the disease process, so adequate communication begins first with close contact with the physician who ordered the test. It is important to understand the context of the test-specifically, why it was ordered-and to have a clear picture of the patient's health. When it comes to patients, the radiologist needs to make certain each patient is given the opportunity for informed consent. That means informing patients of the risks, benefits and any alternatives that can be chosen in lieu of the test.

Policies and procedures must be in place to handle critical test results. All staff must be informed as to which test results need to be called in to the referring physician immediately. One example would be that of a patient with headaches referred for a CT scan of the head, whose scan shows an aneurysm. Because this is obviously critical and time-sensitive, the results should be called in immediately.

# 4. Failure to recommend additional testing - Better safe than sorry-always err on the side of caution. For example, if a patient visits a radiologist for a mammogram because her physician felt a lump in the breast, and for some reason the radiologist cannot find the lump after a mammogram, should a more invasive test, such as a CT scan, be ordered? The answer is yes. Further testing should always be done. It can mean the difference between life and death (and a lawsuit or not). In the case of a dissecting aneurysm, for instance, if it is missed on the original X-ray and no further testing is performed, it is often too late to save the patient. This can be avoided by liberal recommendation of additional testing.

# 5. Failure to document - Documentation can make or break a case when attorneys become involved. Make certain everything is documented, including all test results, dates, times and subjects of all conversations with both the referring physician and patient. In the event of an adverse outcome where the court becomes involved, the ability to say and show all conversations is essential. Showing that the treating physician was spoken to, at this time and on this date and that the patient was given these recommendations is invaluable for risk reduction. For more information on the importance of documentation, visit this Ultra blog post.


Mark Walker

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Mark Walker

Mark Walker joined Ultra in 2008 and has spent his entire insurance career working with medical professional liability insurance for healthcare risks. Walker started his career as an underwriting trainee for St. Paul Insurance and worked his way up to regional underwriting director, where he managed $80 million in premiums.

The Gig Economy Is Alive and Growing

Although some dismiss the gig economy as a fad, a hard look at the numbers shows it's both large and growing, with profound implications.

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The "gig economy" has dominated headlines: The Obama administration is cracking down on companies that misclassify their workers, while presidential hopeful Hillary Clinton has advocated for strong employee protections regardless of job status. Yet, oddly, no one seems certain about the size and direction of the gig economy. Some say that more Americans than ever are working in temporary, ad-hoc jobs, while others claim that "gig economy" is a mere buzzword.

A close look at the data, however, indicates that the gig economy is indeed large and growing. Pushing this growth are Generation Xers, who typically prefer more flexible work arrangements, and Millennials, who often have no other choice. The gig economy is rapidly changing the country's economic landscape-for better or worse.

[caption id="attachment_13358" align="alignnone" width="232"]Development and internet service. Human resource and self employment - vector illustration Development and internet service. Human resource and self employment - vector illustration[/caption]

Experts often define the "gig economy" by equating it with so-called contingent employment. At its broadest, the Government Accountability Office (GAO) defines contingent workers as "all individuals who maintain work arrangements without traditional employers or regular, full-time schedules." Under this definition, anything from freelance work to a formal part-time job is considered contingent. At its narrowest, the Bureau of Labor Statistics (BLS) classifies contingent work simply as any position not expected to last longer than one year.

Media stories minimizing the size and growth of the gig economy typically cite the narrower BLS numbers. The last time the BLS conducted a total inventory of contingent workers (according to its own definition) was 10 years ago, when it published its 2005 Contingent Work Supplement (CWS). This report determined that in 2005, just 1.8% to 4.1% of the total workforce could be considered contingent.

While this inventory is now way out of date (Congress has refused to finance an update), the BLS does release monthly data on one conspicuous component of the gig economy: self-identified "self-employed" workers. Because this data series is very current, and because it shows a gradual decline over the past several decades, it is often cited by skeptics as proof that the so-called rise of the gig economy is overblown. After examining several BLS measures, Wall Street Journal reporters Josh Zumbrun and Anna Louie Sussman conclude that there has been no growth whatsoever in gig-economy employment.

But these BLS estimates leave out a sizable chunk of the true gig economy.Consider this: An agency temp, an on-call staffer and even a standard part-time employee all find themselves in an irregular work environment-and yet many are ignored by the BLS definition.

What, then, would the gig economy look like if we included all contingent workers? By looking at historical CWS data, the GAO found that a whopping 30.6% of laborers were contingent in 2005, up slightly from 1999. Further, by analyzing more recent General Social Survey (GSS) data, the GAO determined that this share grew to 40.4% as of 2010. (To be sure, some of this growth may be because of differences in the sample populations surveyed.) If anything, this hefty share underestimates the gig economy. Virtually no full-time workers would self-identify as contingent workers, but at least some alterna­tively employed individuals-such as a full-time Uber driver—consider themselves regular full-time workers.

The basic picture outlined by the GAO report is gaining acceptance. According to economic journalist Justin Fox, "It is fair to say that somewhere between 30% and 40% of American workers labor in something other than conventional full-time jobs." Fast Company agrees: "The sector of workers who don't have traditional full-time jobs-whether by choice or not-is a sizable and growing portion of the workforce." A more recent survey commissioned in 2014 by the Freelancers Union finds that 53 million Americans, or 34% of the workforce, are essentially freelancers.

Moreover, the gig economy is not only large-but also growing. While it's true that monthly BLS data show a decline in self-employment, other categories of gig work have surged. For example, the same data show that the part-time share of the workforce has risen by about 2 percentage points since the Great Recession. Similarly, we can surmise that independent contractors make up an increasing share of the workforce: According to research by the American Action Forum, the country added more than 2 million independent contracting jobs between 2010 and 2014, accounting for nearly 30% of all jobs added during that period. After looking at types of work by industry, economist Gerald Friedman estimates that fully 85% of net new jobs added since 2005 have been irregular.

Gig employment is by no means a new reality. In fact, for most of American history, irregular work was the norm: In 1900, a staggering 41% of U.S. workers were farmers (the original "gig"), and many of the rest made a living as small-town self-employed business owners. To be sure, over the postwar era, such owner-producers made up an ever-dwindling share of the total. By 2000, fewer than 2% of workers were farmers, and big-box retail chains had marginalized mom-and-pop stores virtually to extinction. However, in the last decade or so, we've seen the pendulum start to swing back. In agriculture and retail, much of the growth has been at the bottom of the market, from the small-scale organic farmers surging in popularity to the do-it-yourselfers selling "artisanal" products with great success (see: "The New Frugality").

Meanwhile, since the 1980s, generational forces have been tilting the economy toward more gig-like work arrangements. Boomer young adults were the first to separate from the conventional 9-to-5 jobs that G.I.s and Silent enjoyed, preferring to "get by" rather than sell out. Xers took this attitude even further and continue to work piecemeal jobs by choice at a much higher rate than other generations (see: "More American Workers Are Temping and Part-Timing"). Additionally, the rise of the sharing economy afforded Xers the chance to work as little or as much as they wanted depending on their personal obligations and financial needs (see: "The Sharing Economy Grows Up").

Millennials, by choice or not, have similarly flocked to piecemeal, part-time gigs. Though some Millennials are undoubtedly the tech-savvy coders and entrepreneurs forgoing 9-to-5 jobs in favor of flashy startups, a much larger share would prefer the comfort of a full-time position. This generation joins their elders in this contingent labor force, though as "perma-temps" stuck in underemployment rather than part-time workers by choice.

The growth of gig work promises to have a profound impact on the economy at large. On the one hand, employers have less reason than ever to invest in their talent, and workers are no longer certain where their next paycheck is coming from. But on the other hand, this paradigm could create a flexible, streamlined economy in which wages adjust rapidly, leading to shorter and shallower recessions. If one thing is for sure, it's that the gig economy is real-and it's here to stay.


Neil Howe

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Neil Howe

Neil Howe is a historian, economist and demographer who writes and speaks frequently on generations, the economy and social change. He is the nation's leading thinker on who today's generations are, what motivates them and how they will shape America's future.

Healthcare Reforms Aren't Sustainable

Despite healthcare reform under the ACA, too many healthy people will drop coverage and leave too much risk. The market must innovate.

A recent NPR program celebrated the success of the Affordable Care Act (ACA). The benchmark was that many really sick people finally had coverage and that many poor people were now obtaining coverage because of subsidies or because of the expansion of Medicaid. If measured by participation, the healthcare reform under ACA is a success, with more growth anticipated.

Unfortunately, the long-term benchmark must be sustainability and outcomes, not participation. Government programs are often popular in the short term but not sustainable in the long term. The National Flood Insurance Program, Medicare, Medicaid, the VA, etc. will ultimately have to be "adjusted" because 100% of the taxpayers are funding these systems and a very much smaller percentage of us use them.

At some point, the non-users scream "enough already." "Other people's money" always runs out, and the $2.6 trillion-plus spent on healthcare is not evenly divided. 47% is spent on the sickest 5% of the population, and just 3% is spent on the healthiest 50% of Americans, according to "Healing a Broken Healthcare System," from the Louisiana Healthcare Education Coalition. Half of the people are hardly benefiting from the money they contribute under healthcare reform.

Our systems of healthcare and healthcare financing cannot be sustained as they are trending. Yesterday's system was not sustainable; neither is today's ACA. The marketplace must innovate. More government and more taxes are not the answer.

Obesity and diabetes are running rampant, and too many folks (especially young people) are living a sedentary lifestyle. This lifestyle adds to the "diseased population" and the future problems and costs.

Personal and family responsibility are a necessity. Nutrition (diet) and activities (exercise) are a start. Addressing the individual in all her elements -- mind, body and spirit -- is a must. Answers to this crisis are inside of us as individuals and populations -- not just at the doctor's office.

Providers and institutions delivering care must leverage technology for efficiency of operations and efficacy of results. Increased availability and utilization of naturopathic physicians, physician assistants, nurse practitioners, health coaches, nutritionists, counselors and tele-medicine will ensure increased patient engagement and ultimately satisfaction and enhanced results.

Preventive medicine for all and "bringing" care and prevention to populations who can't get to the marketplace available to most will improve lives and reduce costs. We need fewer dollars to be spent on prescriptions and invasive surgeries. It's okay for providers and payers to just say no to demands that are not in the consumer's best interest -- regardless of what the TV commercial suggests.

Genomics, improved diagnostics to ensure earlier interventions, a focus on extending life (versus delaying death), integrated/holistic care, marrying technology and touch and technology, natural medicine and other changes are in the works now.

Other hopes rest in vascular therapy, tailored and embraced wellness plans, systems that can intervene with populations in need during crises and tailored and personalized process management for chronically ill mental health patients. Accountable care, outcome-based payment mechanisms, new models of care and care delivery and consumer engagement (personal avatars facilitating our own motivation allowing us to design our own "road to well") are solutions now or yet to be introduced in the market of tomorrow. These are our future. Marcus Welby, M.D., is dead, but the healing and caring he delivered can live on.

This article was written in August. Last week, I received proof of the concepts. A friend received his renewal for his ACA policy. Coverage was reduced from a 70/30 co-pay (insurer pays 70%,) to a 60/40 plan, yet his premiums increased 31%. This is just the beginning -- it will get worse. When you insure a majority of sick people and you subsidize many of their premiums, you will get participation. When relatively healthy and unsubsidized policyholders receive prohibitive rate increases, they will discontinue coverage, and the insured pool suffers adverse selection. Did I mention that the situation will get worse?


Mike Manes

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Mike Manes

Mike Manes was branded by Jack Burke as a “Cajun Philosopher.” He self-defines as a storyteller – “a guy with some brain tissue and much more scar tissue.” His organizational and life mantra is Carpe Mañana.