If you love football, then you know how frustrating it is to be a football fan. Every offseason, you get excited about the potential for the coming season. Before the season begins, you read all of the articles and watch the analysts.

They all say, "This is the year." Your team added some of the top defensive players in the league. You're convinced the team has solved its offensive woes, too. Your team added a star wide receiver, and the running back is looking great in training camp.

Then the season starts, and your team suffers loss after loss. You question how professionals can spend so much time and money on the sport yet fail to improve. As the season continues to sputter, more and more people call for the team to fire the coach. At the end of the season, they fire the coach and hire a new star coach from a great team.

"Next year," you and the rest of the fan base tell each other.

The next season begins and your team still loses. Year after year, the cycle repeats itself.

When it comes to innovation, insurance company claims departments have a lot in common with your favorite underachieving football team. Top talent in every department. Great recruits from top companies. Lots of talk about the newest technology. But each year you get the same results.

How can you solve this problem?

The One Thing

In "The One Thing," Gary Keller shares several lessons we should apply to the insurance claims industry. He does so by simplifying the decision-making process. Whether you're the general manager of a football team or an insurance claims executive, you can apply Keller's lessons to your situation.

The Six Lies Between You and Success:

1. The idea that everything matters equally;
2. Multitasking;
3. Lack of discipline;
4. The belief that willpower is always on will-call;
5. A balanced life;
6. The idea that big is bad.

These "Six Lies" insurance claims departments. Claims professionals will get what they put in each day. If that's emailing about hundreds of claims, then claims professionals will get routine claim maintenance. They will not achieve innovation. By making routine claim maintenance the priority, claims departments are falling victim to the six lies standing between the claims department and innovation.

The Four Thieves of Productivity:

1. Inability to say "No";
2. Fear of chaos;
3. Poor health habits;
4. An environment that doesn't support your goals.

While I can't make any assumptions about whether there are poor health habits in your claims departments (unless your claims professionals are gorging on the vendor-sponsored food!), I can assume that the four thieves should resonate with you.

Insurance claims professionals do what they do because that's what everybody has always done. No one has ever been terminated for saying "yes" to a responsibility. People who follow the status quo feel safer than people who hinge their success on a business transformation. As a result, claims departments are productive at claims maintenance, but they often leave much to be desired when it comes to innovation.

The Focusing Question

Keller condenses the entire book into what he calls "The Focusing Question."

What's the one thing you can do now such that by doing it everything else will become easier or unnecessary?

Good questions are the path to great answers. By combining a small focus with a big goal, the "Focusing Question" provides you with the ideal starting point to achieve something great.

Claims innovation requires starting with "The One Thing" today: giving your best claims manager responsibility for transforming the claims department. While this may sound drastic, it truly is "The One Thing" that will transform an insurance company. I've seen it. With a strong leader dedicated to this project, executives will breeze through the process of selecting vendors, identifying key requirements, troubleshooting workflows and handling anything that stands in the way of true innovation.

Once "The One Thing" is addressed, many tasks will follow: assigning a good leader from the IT department, engaging an outside consultant and supporting the department with future-focused software. But until executives dedicate their best claims manager to "The One Thing," claims departments will suffer from unnecessary obstacles.

Claims departments and football teams will keep underachieving until they get their franchise quarterbacks. You can hire all the star free agents and coach your teams to change, but if your quarterback spends his time focusing on the same old plays, get ready for another year with the same results.

Who will be your company's Tom Brady?

Terrorist and other mass violence attacks, which occur with alarming regularity around the world, can threaten your people, operations and assets. Many companies look to insurance — mainly property terrorism and political violence coverage - to help manage the financial impact of these risks, which can include property damage and business interruption losses.

Terrorism Insurance or Political Violence Coverage?

Property terrorism insurance provides coverage for the physical damage and business interruption that can result from acts that are motivated by politics, religion or ideology. Political violence insurance provides coverage related to war, civil war, rebellion, insurrection, coup d’état and other civil disturbances.

Choosing which coverage - or combination - is best for your organization can be tricky. The line between what is considered "terrorism" and what is considered "political violence" is often blurry. For example, should attacks by particular groups be classified as acts of terrorism, or another form of political violence?

To help determine the best insurance program to manage these risks, here are a few things to think about:

• Ensure the limits of insurance that you buy provide enough protection for multiple loss scenarios.
• Review the location of your assets to determine the appropriate insurance solution.
• Understand the policy terms, conditions and limitations of terrorism and political violence insurance.
• Work with your advisers to understand your property and employee exposures so you can make an informed decision or mitigate potential losses.

Addressing the Risks

Along with insurance considerations, of course, you need to ensure the safety of your employees with integrated and well-practiced crisis and continuity plans in the event of a disaster. Events from terrorist attack to natural catastrophes can cause significant business interruption (BI) losses. Steps to take to manage BI risk include:

• Develop and test business continuity plans.
• Conduct scenario testing.
• Coordinate BI insurance with other coverages, including political violence and terrorism insurance.
• Be prepared to gather appropriate information in the event of a claim, including recording damage via photographs and video.
• Maintain separate accounting codes to identify all costs associated with the potential damage.

For more information on these topics, read Marsh's 2015 Terrorism Risk Insurance Report and our political risk insurance report, Strong Capacity Drives Buyer's Market for Political Risk Insurance.

For decades, the insurance industry has led the world in predictive analysis and risk assessment. And today, with the treasure trove of big data available from historical processes, IoT and social media, insurance companies have the opportunity to take this discipline to a whole new level of accuracy, consistency and customer experience.

The actuarial models that were once driven solely by large databases can now be fueled with tremendous quantities of unstructured data from social media, online research and news, weather and traffic reports, real-time securities feeds and other valuable information sources as well as by "tribal knowledge" such as internal reports, policies and regulations, presentations, emails, memos and evaluations. In fact, it is estimated that 90% of global data has been created in the past two years, and 80% of that data is unstructured.

A large portion of this data now comes from the Internet of Things -- computers, smart phones and wearables, GPS-enabled devices, transportation telematics, sensors, energy controls and medical devices. Even with the advancement of big data analytics, the integration of all this structured and unstructured data would appear to be a monumental achievement with traditional database management tools. Even if we could somehow blend this data, would we then need thousands of canned reports, or a highly trained data analytics expert in every operating department to make use of it? The answer to this dilemma may be as close as our smartphones.

Apps that Unleash the Power

As consumers, we are no stranger to the union of the structured and unstructured datasets. A commuter, for example, used to rely on Google Maps to get from his office to his home. But with the advent of apps like Waze, not only can he get directions and arrival times based on mileage and speed data, but can also combine this intelligence with feeds from social media and crowd-sourced opinions on traffic. Significant advances in the power of in-memory processing, machine learning, artificial intelligence and natural language processing have the potential to blend millions of data points from operational systems, tribal knowledge and the Internet of Things -- using apps no more complicated than Google Maps.

Using apps that harness the power of artificial intelligence and machine learning can provide far superior predictive analysis simply by typing in a question, such as: What are the chances of a terrorist act in Omaha during the month of December? Where is the most likely place a power blackout will occur in August? How many passenger train accidents will occur in the Northeast corridor over the next six months? What will be the effect on my fixed income portfolio if the Federal Reserve raises short term interest rates by .25 percentage point?

Using a gamified interface, these apps can use game theory such as Monte Carlo simulations simply by moving and overlaying graphical objects on your computer screen or tablet. As an example, you could calculate the likely dollar damages to policyholders caused by an impending hurricane simply by moving symbols for wind, rain and time duration over a map image. Here are some typical applications for AI app technology in insurance:

Catastrophe Risk and Damage Analysis

Incorporate historical weather patterns, news, research reports and social media into calculations of risk from potential catastrophes to price coverage or determine prudent levels of reinsurance.

Targeted Risk Analysis (Single view of customers)

With the wealth of individual information available on people and organizations, it is now possible to apply AI and machine learning principles to provide risk profiles targeted down to an individual. For example, a Facebook profile of a mountain climbing enthusiast would indicate a propensity for risk taking that might warrant a different profile than a golfer. Machine learning agents can now parse through LinkedIn profiles, Facebook posts, tweets and blogs to provide the underwriter with a targeted set of metrics to accurately assess the risk index of an individual.

Underwriting

Each individual assessor has his own predilection to assessing risks. By some estimates, insurance companies could lose hundreds of millions of dollars either through inaccurate risk profiling or through lost customers because of overpricing. AI apps provide the mechanics to capture "tribal knowledge," thereby providing a uniform assessment metric across the entire underwriting process.

Claims Processing

By unifying unstructured data across historical claims, it is possible to establish ground rules (or quantitative metrics) across fuzzy baselines that were previously not possible. Claims notes from customer service representatives that would previously fall through the cracks are now caught, processed and flagged for better claims expediting and improved customer satisfaction. By incorporating personnel records when a major casualty event occurs, such as a severe storm or flood, you can now dispatch the most experienced claims personnel to areas with the highest-value property.

Fraud Control

Integrate social media into the claims review process. For example, it would be very suspect if someone who just put in a workers' compensation claim for a severe back injury was bragging about his performance at his weekend rugby match on Facebook.

A Powerful Value Proposition

The value proposition of artificial intelligence apps for better insurance industry underwriting and risk management is too big to ignore. Apps have been transformational in the way we intelligently manage our lives, and App Orchid predicts they will be just as transformational in the way insurance companies manage their operations.

This article is an excerpt from a white paper, "Capturing Hearts, Minds and Market Share: How Connected Insurers Are Improving Customer Retention." In addition to the material covered here, the white paper includes specific recommendations on how to improve retention.

To download it, click here.

Insurers currently operate in a challenging environment. On the financial side, premiums are stagnant and interest rates low, and many cost-cutting measures have already been enacted. On the other hand, customer empowerment is growing. Customers are finding the information and offers they need to switch providers more freely than in the past - customers whom insurers can ill afford to lose.

For many carriers, the key to preserving customer relationships still lies in personal interaction, executed through traditional distribution and service models with tied agents and brokers. For some customer sets - those who strongly favor personal interaction - this business model works well. Yet a growing segment of customers, especially those 30 years old and younger, differ in some key aspects. While they still look for help and advice, they seek personal contact in the context of a holistic, omni-channel experience; they communicate and find information whenever, wherever and however they want. And even traditional customers appreciate if their agents have broader and faster access to the information and specialists they need on a case-by-case basis.

How can insurers keep - and even expand - these diverse customer sets, old and young alike? What factors drive retention and loyalty? To explore these questions, we surveyed more than 12,000 insurance customers in 24 nations about relationships with their insurers, what they perceive as valuable and in what ways they would like to interact and obtain new services going forward.

We found that while insurers understand well how to cover risks, they often fail to engage their customers on an individual basis. Even though insurance is complex, customers want to be involved, emotionally and rationally. When insurers act on this knowledge, customer share can rise.

The churn challenge

As a rule of thumb, the cost of acquiring new customers is four times that of retaining existing ones. To grow market share, insurers need new customers. But for the balance sheet, retention has a much larger impact.

For a long time, the insurance industry did not consider this lack of trust a problem. In the highly asymmetrical pre-Internet world, there was a necessary gatekeeper to information and knowledge about risks and coverages: the insurance intermediary. For insurers, the intermediary's trusted personal customer relationship was a guarantee of fairly reliable renewals and low customer churn - thus, keeping the most profitable customers.

The technological innovations of the digital age have altered this picture. Information asymmetry is diminishing. Although many customers still seek advice on insurance matters, the empowered digital customer does not need to rely solely on the gatekeepers of old for information. With communication being swift and ubiquitous, misinformation is quickly uncovered, leading to a steady erosion of trust, even with the personal adviser and insurer.

We have come to expect that only 43% of our survey respondents trust the insurance industry in general - a number that has stayed fairly stable since our first survey in 2007 - but only 37% trust their own insurers to a high or very high degree. Most customers are neutral, with 16% actually distrusting their providers.

As we have often seen in past studies, trust varies widely by market and culture. For example, only 12% of South Korean customers responded that they trust their insurers, compared with 26% in France, 43% in the U.S. and 51% in Mexico.

Low trust translates to high churn. Even though 93% of our respondents state that they plan to stay with their current insurers for their recently acquired coverage through 2015, almost a third came to that coverage by switching insurers. Why? Most commonly (for 41% of respondents), their old insurers couldn't meet their changing needs (see Figure 1).

The pattern of increasing customer empowerment and decreasing information asymmetry is continuing. New and non-traditional entrants to the insurance market are taking advantage of the opportunities of digital technologies. For example, Google recently launched an insurance comparison site for California and other regions of the U.S. This presents a real threat to both online insurers and traditional providers - not because of the comparison option itself, but because Google has collected a huge amount of information about each individual through his or her surfing habits, thus allowing better personalization and higher-value offers.

The three dimensions of retention

What do insurers need to do to increase trust and customer retention with the intent of improving both the top and bottom lines? The findings of our survey point to three courses of action:

• Know your customers better. Customer behavior is affected by experiences and underlying psychographic factors. Insurers need to know and understand customers better, not only as target groups but as individuals. Insurers also need to get their customers involved, rationally and emotionally.
• Offer customer value. As overused as the term is, a strong and individualized value proposition is exactly what insurers need to provide to their customers. Value is more than price; it includes many factors, including quality, brand and transparency.
• Fully engage your customers across access points. As Millennials become a significant part of the insurance market, speed and breadth of access has begun to matter much more than in the past. Insurers need to engage their customers as widely as possible, from in-person interactions at one extreme all the way to digital interaction models such as those made possible by the Internet of Things.

Customer perception and behavior

Ever since the Internet has become a viable way to shop for goods and services, much discussion has centered on the matter of price. In theory, insurance products are easy to compare, so shouldn't the cheapest one win out?

This view assumes that, aside from the price, all else is equal. If that were true, price would indeed be the sole tie-breaker. In reality, though, all else is never equal. Insurance is a product based on trust, for which perception matters. Perception, and thus customer behavior, is shaped by the individual customer's attitudes and experiences. Understanding a customer on an individual basis helps a carrier tailor these experiences by communicating the "right way."

To classify our respondents according to their attitudes, we used the same psychographic segmentation as in previous studies (see Figure 2).

One size seldom fits all

Overall, our respondents stated that the three most important retention factors are price (63%), quality of service (61%) and past experience (33%) - leading back to the price as the main tie-breaker. Yet a closer look across segments paints a more diverse picture: For a demanding support-seeker, quality is by far the most important (74%), while a loyal quality-seeker bases his renewal intentions on past experience more strongly than any other group (43%).

Assuming an insurer is targeting all these customer segments, it will need a diverse set of customer communication options, as each segment requires approaches tailored to its specific preferences (see Figure 3). This figure shows the five most-used insurance search options in the three segments where we are seeing the biggest shift among Millennials, who represent future customers.

The power of emotional involvement

Our data show that appropriate communication with customers sets off a positive chain reaction. First, it increased the use of that type of interaction. Customers perceived the interaction as more positive, and ultimately this increased emotional involvement with their providers - the "heart share" of our study title. Finally, emotional involvement is strongly connected to customer loyalty, so increasing involvement from medium to high had a dramatic impact on the loyalty index (see Figure 4).

What is the right way to communicate and increase involvement? As seen in Figure 3, the answer is "It depends," so there is no one right approach for all customers. But using current technology - specifically, social media analytics - can help insurers improve involvement.

With this tool, providers can "listen" to various online sources, understand how they are seen by customers, uncover trends and quickly tie this knowledge to specific actions. Providers can combine the findings of social media analytics with psychographic segmentation and an individual customer's place within the segmentation; the latter gained via more traditional customer analytics. With this customer view, insurers can even go beyond the personalized knowledge their tied agents tend to have: As customer wants and needs change and they articulate it on social channels, insurers will know and can react in close to real time.

Social media analytics

Social media analytics is a set of tools that allow insurers to analyze topics and ideas that are expressed by their actual or potential customers through social media. This can be on an individual basis, or per customer group. Through social media analytics, insurers can apply predictive capabilities to determine overall or individual attitude and behavior patterns, and identify new opportunities.

This article is an excerpt from a white paper, "Capturing Hearts, Minds and Market Share: How Connected Insurers Are Improving Customer Retention." In addition to the material covered here, the white paper includes specific recommendations on how to improve retention.

To download it, click here.

It's going to take how much longer?! It's going to cost how much more?!!

If those sound like all too familiar expressions of frustration, in relation to your data journey (projects), you're in good company.

It seems most corporations these days struggle to make the progress they plan, with regards to building a single customer view (SCV), or providing the data needed by their analysts.

An article on MyCustomer.com, by Adrian Kingwell, cited a recent Experian survey that found 72% of businesses understood the advantages of an SCV, but only 16% had one in place. Following that, on CustomerThink.com, Adrian Swinscoe makes an interesting case for it being more time/cost-effective to build one directly from asking the customer.

That approach could work for some businesses (especially small and medium-sized busineses) and can be combined with visible data transparency, but it is much harder for large, established businesses to justify troubling the customer for data they should already have. So the challenge remains.

A recent survey on Customer Insight Leader suggests another reason for problems in "data project land." In summary, you shared that:

• 100% of you disagree or strongly disagree with the statement that you have a conceptual data model in place;
• 50% of you disagreed (rest were undecided) with the statement that you have a logical data model in place;
• Only 50% agreed (rest disagreed) with the statement that you have a physical data model in place.

These results did not surprise me, as they echo my experience of working in large corporations. Most appear to lack especially the conceptual, data models. Given the need to be flexible in implementation and respond to the data quality or data mapping issues that always arise on such projects, this is concerning. With so much focus on technology these days, I fear the importance of a model/plan/map has been lost. Without a technology independent view of the data entities, relationships and data items that a team needs to do their job, businesses will continue to be at the mercy of changing technology solutions.

Your later answers also point to a related problem that can plague customer insight analysts seeking to understand customer behavior:

• All of you strongly disagreed with the statement that all three types of data models are updated when your business changes;
• 100% of you also disagreed with the statement that you have effective meta data (e.g. up-to-date data dictionary) in place.

Without the work to keep models reflecting reality and meta data sources guiding users/analysts on the meaning of fields and which can be trusted, both can wither on the vine. Isn't it short-sighted investment to spend perhaps millions of pounds on a technology solution but then balk at the cost of data specialists to manage these precious knowledge management elements?

Perhaps those of us speaking about insight, data science, big data, etc. also carry a responsibility. If it has always been true that data tends to be viewed as a boring topic compared with analytics, it is doubly true that we tend to avoid the topics of data management and data modeling. But voices need to cry out in the wilderness for these disciplines. Despite the ways Hadoop, NoSQL or other solutions can help overcome potential technology barriers -- no one gets data solutions for their business "out of the box." It takes hard work and diligent management to ensure data is used & understood effectively.

I hope, in a very small way, these survey results act as a bit of a wake up call. Over coming weeks I will be attending or speaking at various events. So, I'll also reflect how I can speak out more effectively for this neglected but vital skill.

On that challenge of why businesses fail to build the SCVs they need, another cause has become apparent to me over the years. Too often, requirements are too ambitious in the first place. Over time working on both sides of the "IT fence," it is common to hear expressed by analytical teams that they want all the data available (at least from feeds they can get). Without more effective prioritization of which data feeds, or specifically which variables within those feeds, are worth the effort - projects get bogged down in excessive data mapping work.

Have you seen the value of a "data labs" approach? Finding a way to enable your analysts to manually get hold of an example data extract, so they can try analyzing data and building models, can help massively. At least 80% of the time, they will find that only a few of the variable are actually useful in practice. This enables more pragmatic requirements and a leaner IT build which is much more likely to deliver (sometimes even within time & budget).

Here's that article from Adrian Swinscoe, with links to Adrian Kingwell, too.

What's your experience? If you recognize the results of this survey, how do you cope with the lack of data models or up-to-date meta data? Are you suffering data project lethargy as a result?

As is the case in any professional group, individual medical provider's performance runs the gamut of good, bad and iffy. The trick is to find good medical providers for treating injured workers, avoid the bad ones and scrutinize those who are questionable. To qualify as best for injured workers, medical providers need proficiency in case-handling as well as medical treatment.

High-value physician services

The first step is to clarify the characteristics of the best providers, especially in context with workers' compensation. One resource is an article published by the American College of Occupational and Environmental Medicine in association with the IAIABC (International Association of Industrial Accident Boards & Commissions) titled, "A Guide to High-Value Physician Services in Workers' Compensation How to find the best available care for your injured workers" It's a place to begin.

The article notes, "Studies show that there is significant variability in quality of care, clinical outcomes and costs among physicians." That may be obvious, but it also verifies the rationale for taking steps to identify and select treating doctors rather than pulling from a long list of providers to gain the discount. The question is, what process should be used to select providers?

Approach

Although considerable effort from scores of industry experts contributed to this article, the approach they recommend is complex, time-consuming and subjective. In other words, it is impractical. Few readers will have the expertise and resources to follow the guide. Moreover, one assertion made in the article is simply wrong.

Misstatement

The article states that it would be nice to have the data, but that the data is not available. "Participants in the workers' compensation system who want to direct workers to high-quality medical care rarely have sufficient data to quantify and compare the level of performance of physicians in a given geographic area."

Actually, the data is available from most payers whether they are insurers, self-insured, self-administered employers or third-party administrators (TPAs). However, collecting the data is the challenge.

Data silos

The primary reason data is difficult to collect is that it lives in discrete database silos. The industry has not seen fit to place value on integrating the data, but that is required for a broad view of claims from beginning and throughout their course.

At a minimum, claim data should be collected from medical billing or bill review, the claims system and pharmacy (PBM). The data must be collected from all the sources, then integrated at the claim level to get a broad view of each claim. It takes effort, but it is doable. Yet, there remains another data challenge.

Data quality

Payers have traditionally collected billing data from providers, through their bill review vendor. The payer's task has been paying the bill and sending a 1099 statement to providers at the end of the year. All that is needed is a provider name, address and tax ID so the payment reaches its destination. It makes no difference to payers that providers are entered into their systems in multiple ways causing inaccurate and duplicate provider records. One payment is a payment. The provider might receive multiple 1099s, but that causes little concern.

What is of concern is that when the same provider is entered into the payers' computer system in multiple ways, it can be difficult to ascertain how many payments were made to an individual provider. Moreover, when the address collected by the payer is a P.O. box rather than the rendering physician's location, matters become more complicated. This needs to change.

The new request

Now payers are being asked to accurately and comprehensively document individual providers, groups and facilities so the data can be analyzed to measure medical provider performance. They need to collect the physical location where the service was provided and it should be accurately entered into the system in the same way every time. (Note: This is easily done using a drop-down list function rather than manual data entry.)

Most importantly, a unique identifier is needed for individual providers, such as their NPI (national provider identification). Many payers are now stepping up to improve their data so accurate provider performance assessments can be made.

High-value, quality medical providers can be identified by using the data. However, quality data produces better results. Selecting the best medical providers is not a do-it-yourself project. Others will do it for you.

In the era in which wellness vendors were still claiming a return on investment (ROI_ on wellness (and more and more are not), I asked a number of them how they calculated the ROI. Not one calculated the ROI in a way that a steely-eyed CFO would endorse.

Below is a partial list of costs that wellness vendors should be considering, but rarely if ever do consider. If you have a wellness program and want to look for an ROI, make sure these costs are included:

1. Wellness vendor fees
2. Communication costs
3. Investments in materials (e.g., Fitbit) and facilities (e.g., onsite fitness centers)
4. The cost of biometric tests and health assessments
5. The cost of program incentives (awards, premium reductions, etc.)
6. The wages and benefits of the company's wellness team members
7. The wages and lost productivity for employees to sit through biometric tests and wellness meetings, to read wellness memos and other communications and to fill out health risk assessments. (If 10,000 employees spend eight hours per year in wellness meetings, reading wellness emails, filling out forms, etc, at an average wage of $20/hour, the cost is $1.6 million.)
8. The cost of following-up on false positives from asymptomatic employees going to doctors for ill-advised tests. This one is not uncommon. (I've personally witnessed people who've had false positives on wellness exams and spent thousands of plan dollars just to explore false positives. The largest one cost a shade less than $70,000 to get an all clear. If you want to know the true cost of a wellness program, this impact can't be ignored.)

Further, wellness vendors claim improvements in productivity, but most say the gains cannot be measured. That is a fallacy. Vendors need only look at a client's wages as a percentage of sales (with a few minor adjustments). If that ratio is not declining, employee productivity is not improving.

For an excellent discussion on failures of wellness productivity claims click here.

The same principles apply to value on investment (VOI) claims, as well. Click here for an excellent review of what some call the VOI scam.

This post may be flogging a dead horse. So be it.

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 David Stegall, principal consultant with Risk Consulting & Expert Services, who often serves as an expert witness in insurance litigation.

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:

Risk Consulting & Expert Services is an insurance and risk management consulting firm providing services and counsel to commerce, industry and government on insurance, reinsurance and alternative risk transfer matters. I have more than 37 years of experience and often act as an expert witness in litigation.

What made you decide to start Risk Consulting & Expert Services?

After 30 years, I no longer had an interest in continuing to work within the industry as a purveyor of insurance.

And if it weren't for the appeal of working in insurance, what profession would you be in today?

Film and/or music production. I like the creative process.

Describe your typical client:

A litigation attorney with the need for an insurance or risk management professional who can offer a professional opinion on the usual and customary practices of the insurance industry or the required standard of care used within the industry and can explain that opinion to a judge and jury in plain, simple English.

Memorable court trial:

Very few cases go to trial, yet I recall the irony of testifying on a case regarding flood insurance at the Cameron Parish Court House in Louisiana, which is about a stone's throw away from the Gulf of Mexico.

Is there a carrier you would love to testify in court against?

I cannot answer that because I do not think of insurance companies as being either good or bad. They are only as good (or bad) as those individuals who are making decisions for them in a given instance, and even then the good (or bad) decision may be specific to that instant.

You have a talent for explaining complicated risk terms. In your experience, which P&C coverage is most baffling to consumers?

Water damage and flood. Flood is excluded in practically every insurance policy (except flood policies), and water damage may or may not be covered. Most people think of the terms synonymously, but they aren't. The simplest way to think of it is: If the water comes from above (without hitting the ground) it is covered (note that pipes are considered as being above). If the water comes from below (lake, river, stream, ocean), it is not covered. But please read your policy and ask questions of your insurance representative or call a consultant!

You have more than a few designations, one of which is the Chartered Property & Casualty Underwriter. Has the role of underwriting changed much from when you last practiced it?

There are fewer underwriters now, but they are extending specific yet limited underwriting authority to more general agents (or some form or position of limited underwriting authority) that specialize in a particular industry or product offering.

What emerging technology keeps you up at night from a litigation standpoint?

The same as everybody else: cyber risk. The risks are emerging at the same rate as the technologies.

Speaking of cyber, you recently published a whitepaper on "Cyber Risk & Insurance." The Ashley Madison hack is now correlated to at least two suicides; where do you think insurers should draw the line?

The same place they draw the line with the idea that, if you attend a baseball game, you might get hit by a foul ball. A person does take some risk by subscribing to any service or website - yes, there is an implicit, if not explicit, responsibility (in the form of statutes) to protect people's privacy but some activities carry innate risk that insurance can only partially address.

Favorite quote/s:

"Everything's Gonna Be Alright" (Muddy Waters and others) and "It is always getting too late and then it is." I hope I made that one up, but I'm sure I've heard it somewhere, and it resonated.

When you are not working, you are most likely…

Playing with my seven grandchildren or playing the harmonica.

What are you most excited about at the moment?

That I feel happy, healthy and terrific! A phrase made famous by a former insurance professional and fellow lover of Chicago, W. Clement Stone.

Howard Karp, a chef at the Waldorf Astoria and instructor at the California Culinary Academy who cooked for four U.S. presidents, once told me the secret of cooking: "It's all in the technique. There are no shortcuts."

Exquisite food comes from a highly trained, coordinated and cohesive kitchen operation that involves culinary skills such as slicing, dicing, searing and sautéing. Chef Karp added: "One must also understand the chemistry of cooking."dwdwdw He explained that the order and manner in which all the ingredients are "introduced to one another" makes all the difference.

Watching him cook a five-course dinner for a small group of us was like watching an artist paint a masterpiece. I never followed a recipe card again.

In my world, risks are a common ingredient and need to be handled just as expertly as the fish, meat and other ingredients that Chef Karp works him magic on. The risks to business ventures include:

1. Damage to reputation/brand
2. Economic slowdown/slow recovery
3. Regulatory/legislative changes
4. Increasing competition
5. Failure to attract top talent
6. Failure to meet customer needs
7. Business interruption
8. Third-party liability
9. Cybercrime/viruses
10. Property damage

Some organizational risk management programs I've seen follow a recipe of sorts that seems to have been passed down from one risk manager to another -- but only good wines and spirits improve with age.

Clearly, the prevention of accidents (workforce, property, fleet, customer, etc.) establishes the basis for sustained profitability. So, boards demand that senior management have robust involvement in the organization's enterprise risk management (ERM) efforts. Risk management departments cannot operate outside the business flow and related decision-making processes. Management silos have no place here. Decisions about risk must be driven across all operational aspects of the organization in a consolidated, standardized fashion to build trust and meaningful partnerships with operations.

But the traditional corporate approach to reducing risks is one clever safety campaign after another. Risk management staff, especially those in workers' comp, obsess on frequency and severity -- cutting the number of claims and reducing reserves and settling claims. Risks are "managed" by things like: compliance enforcement; personal protective equipment (PPE); signs; and those safety contests. Risk management operations are often buried in finance, HR or legal departments.

But these loss controls, from my experience, are no match to the potential losses that may occur under a bureaucratic, disliked supervisor.

Senior management must raise its game and focus on the strategic components of risk, such as: alternative risk financing, market economics, reputational risks and human capital. In turn, management needs to know the true costs in each business unit. Relevant risk factors may be buried in a ream of statistics, but corporate executives need to know if their risk management program is making an impact. How is information collected, managed and disseminated? Are your analytics predictive?

After 38 years of directing risk management, I believe that organizations must embrace what some friends and colleagues are calling a culture of safety (COS). This is the pièce de résistance.

COS involves using embedded risk management teams in each business unit to send signals up and down the corporate ladder that loss control is much more than a motto or simple list of steps to take. COS requires developing loss-control programs that are a product of the DNA of a specific organization. COS builds strong, binding partnerships among business units that allow the development of a platform for data analytics, volatility analysis, forecasting and reporting that allow for continual improvement through ERM/Six Sigma. COS has demonstrated significant savings, in the tens of millions of dollars a year at a single company.

There are five essential stages to a viable culture of safety:

1. Awareness, repositioning of responsibility and analytics
2. Cultural sustainability through behavioral economics
3. Behavioral change through positive observations
4. Combined service, safety and engagement measures
5. Extended service, safety and engagement measures to the community

An organization should have a vision to assess knowledge, skills and abilities and work with HR to train employees to bring about new levels of expectations. Old safety methodologies focused on inspectors; audit and regulatory-based decisions; checklists and processes; task completions; and frequency-based decisions. COS, on the other hand, is behaviorally focused using coaches, trainers and outside consultants who partner with teams of employees who are already technically proficient and operational savvy. In addition, key performance indicators (KPIs) can help shape behaviors.

To deploy a viable COS, companies should consider using qualified outside experts as a diagnostic tool to identify and quantify risks using meaningful analytics. Companies need to know how they stack up against the competition. This type of analysis by reputable firms can provide practical insights for senior management and lead to the building blocks for a fine-tuned corporate risk strategy and an enhanced culture of safety.

One such consulting firm, Operant Solutions, inspired me to write this article with stories on risk management successes it presented at the RIMS Western Regional Conference in Lake Tahoe recently. (If you're interested in getting a copy of the presentation, you can contact Sue Antonoplos at 650-336-3144.)

I am inspired by the words of Julia Child: "Cooking well doesn't mean cooking fancy."

Overheard at "Insurance Disrupted 2015," held Nov. 18 and 19 in Palo Alto, CA, cosponsored by Silicon Valley Innovation Center and Insurance Thought Leadership:

From The Sun Also Rises, by Ernest Hemingway:

"How did you go bankrupt?"... 'Two ways. Gradually, then suddenly.'

Paul Carroll, CEO of ITL:

"Insurance has been in the 'gradually' phase of disruption; the 'suddenly' phase is here."

Tongue-in-cheek lines from others:

"The future always happens."

"Moving at the speed of insurance"

There were many loud-enough-to-be-heard, smart, rational and innovative voices calling for change to the historic model for insurance at last month's gathering of insurance disruptors in Palo Alto. Most encouraging is that these voices were coming from both traditional players and entrepreneurs behind an emerging insur-tech start-up sector.

Close to 200 of these folks (as well as several hundred more via live streaming) converged at an Elks Lodge of all places to share insights and ideas about how to create new business models, more compelling and engaging client experiences that meet overlooked marketplace needs, new products and new distribution methods. All are taking advantage of technological possibilities that may seem old-hat in other sectors, whose digital maturity is further along on the curve.

This post captures the main messages delivered by several dozen speakers and panelists during the event:

• Insurance businesses able to see themselves in the prevention business, not just in the protection business, will be the ones that thrive. The potential to shape strong, compelling offerings that help people anticipate and avoid risk has great, untapped commercial potential and holds the possibility of truly improving people's lives. But one of the biggest challenges for historically successful executive teams is being able to reframe a company's purpose away from its past greatness toward a different future. So many businesses end up dead or among the walking dead because they are unable to leave behind an outmoded definition of how they created value vs. what it now takes to succeed. Technology is just the enabler -- success is about mindset, vision, leadership and conviction.

• Value beyond the product sales transaction will create massive opportunity for those able to act upon the possibilities. Many examples exist of companies in other sectors (and are beginning to emerge within insurance) that add value before and after the transaction. Think of any brand you love because of the experience leading up to and following the actual purchase event. These same opportunities exist in the insurance sector. As one of my favorite, preeminent global innovators likes to say, "There's gold in them there hills."

• Does anyone really want to buy insurance? No. People buy insurance to solve an "end-game" problem. We are entering the era where winners will be those who show they understand this. It's about clients, not products. Client-centricity is too often a fashionable mantra, but in reality is relegated to lip service. Insurance grew up as a sector engineered to push product through a distribution system where the incentives were to push more product. The connection between client-focus and both a healthy P&L and balance sheet is well-established in other sectors, and is no less true here. Incumbents face cultural, infrastructure, regulatory, metrics and talent challenges to execute this shift. In contrast, start-ups unencumbered by legacy issues are hard at work pursuing client-focused business models with such intensity that there will be breakthroughs at scale. It's only a matter of how soon. The winners will combine digital technologies and advanced analytics and insight to define their future and not be tied to a rear-view mirror perspective.

• Think emergent knowledge, not big data. Does anyone really think they need more, bigger data? Frankly, as I meet with executives and discuss the challenges of competing in our world, no one complains about lack of data. A mentor taught me years ago that it's most important to know what questions to ask. In the big data era, too many people are going backward from the data, setting themselves up to amass as much as they can and then trying to figure out what to do with all of it. Meanwhile, they've increased their costs and security risks, and bogged down always-scarce analytics and IT talent in misguided exercises. Insurers possess via their actuarial capabilities some of the most analytically intense talent anywhere. Is it possible to redirect some of this incredible capability and use it to ask the right questions? Don't worry about obtaining more data. Assume any data you want will be available at some point. These sorts of mindset shifts will set insurance sector participants on the path to accelerating knowledge that will lead to new opportunities.

• The cloud is not about automation, The cloud is about the incredible possibilities enabled by data transparency and availability, and by the synthesis of formerly unimaginable kinds of disparate data accessible through increasingly improving user-interface layers powered by smart algorithms and machine learning. Insurers that approach the cloud as mere automation driving cost savings will be left behind, not only by competition but by clients who are becoming empowered by their own ability to get their hands on their data, and as a result gain more understanding and control over what their insurance needs really are, and how best to meet them.

• Data synchronicity can be an opportunity or a threat. Insurers have earned their keep by taking advantage of the fact that they had intelligence and insights that clients and distributors could never access. Think about it: The pooling of risk is built upon carrier ability to bring together disparate data about scale populations to foresee risks and price against the odds of them occurring. That advantage is eroding as data become more widely distributed and accessible. The habit of looking back at a decade's worth of data to assess risk and create actuarial tables will be replaced by constant testing in small chunks that drives continuous learning. Behavioral modeling will become real time, and acting with speed to execute on constant new knowledge will be the basis for competitive advantage.

• Usage-based insurance - UBI - is driving toward hyper-specialization and personalization in underwriting, sales and service. The industry will move away from the whole notion of insuring a pool, toward being able to price an individual based on her driving, health, property care and behavioral record, and insure her neighbor entirely differently. If the notion of pooling of risk goes away, the entire structure of the industry will evolve to something new. Don't just stay tuned. Tune in.

• The smart home, smart car, smart-everything-in my-life is creating data sources contributing to UBI capabilities, giving insurers the ability to help me anticipate and even prevent risk. The insurance sector in total probably knows more than just about anyone else about so many aspects of your life -- this is the sector's opportunity to realize or squander. The sensors becoming embedded in every aspect of our lives will have profound implications for every aspect of the insurance sector, many of which are not identified, yet alone understood. See first point above; insurers must shift to being in the prevention business, not just the protection business.

• Compared with Congress, whose overall approval rating is at about 14%, the industry's average Net Promoter Score of 46% may not look that bad. But it's a sorry state of affairs. One major carrier has an NPS that is actually negative, and others are in competition with the government for setting a low bar. One can only imagine the upside from raising the propensity to be recommended to others by current clients. Acting upon the points already shared above will directly contribute to achieving acceptable satisfaction levels. Action to create true multi-channel sales, service and claims experience aligned with how clients really behave will take focused work and investment. And time. It's time to start, now.

• In the U.S., a full 87% of people under 35 have no contents insurance. What is the societal risk of leaving a generation unprotected from the risks that invariably befall some among us? Insurance ownership has traditionally been part of the bedrock of an economically healthy society. If the under-35 crowd is not connecting with the traditional offerings of the industry, given the consequences, how will the industry step up and move to a position of relevance motivating enough for this important demographic to see it as worthy of a piece of their wallet?

• Will you be an insurer that leverages marketing and technology, or reframe your self-image to that of a technology and marketing company that happens to sell insurance? One of the greatest inhibitors of transformation is the inability to reshape your business model and all of its many elements to align with where the world is going, not to where the world has been. As yet another mentor taught me early in my career, "You are who you say you are." Who are you?

The future always happens. What I overheard in Silicon Valley suggests that for some it will happen to be an exciting time of growth and renewal. Others continue to scratch their heads. Many (understandably) feel a bit bewildered. The good news about being late to the game vs. peers in industries in the throes of disruption -- think media, music, retail and the insurers'dw cousins in banking -- is that there are meaningful models, execution paths and stories of success and failure that can enable leapfrogging in a position of leadership and strength toward what this sector will become.