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Wanted: Workers' Comp 'Warriors'

The job of workers' comp manager often falls short of the respect and impact it deserves. Let's redefine the role as a "warrior."

Employers need to define and fortify the position of workers' comp manager. It is a sad reality that this job often falls short of the impact and respect it deserves. It owns no distinct professional standard as compared with the role of risk manager, HR manager, safety engineer or even production supervisor, and the role is often added to those positions as an afterthought. Worst of all, employers freely allow vendors (third-party administrator or broker) to assign this job's process and tasks. I say we retire the current notion of the "workers' comp manager" and unleash the "workers' comp warrior."

Why? Because "warrior" recognizes what should be the employers' daily fight against a WC system that puts data-driven process and so-called efficiency above personal service and intervention. The term "warrior" does not imply a negative position that simply fights fraud and bad actors... Rather, this is a noble fight that seeks the best and fastest route to employee healing and return to productivity.

Consider that "healing and return to productivity" as an endeavor has been dumbed down by our industry. Vendor preferences in the name of best practices would have you believe the task is met by simply reporting a new loss and leaving the employee at the whim of the claims and managed-care team. In reality, healing and return to productivity is an extremely complicated and personal process that is easily thwarted by the insult and cross-purposes of a claims team seeking "fast track" method while a managed-care team seeks "savings" based on a rigged system of medical reimbursement. Our industry-wide elephant in the room -- churning WC claims -- evidences a dire lack of ability to "heal and return to productivity."

A WC warrior fights to ease the gauntlet for employees. She proclaims the hub-position in a turning wheel of WC action while establishing vendors and other aspects as spokes. Other wheel-spokes include employee expectation and responsibilities, supervisory role, top management support and resources, experienced-based allocation of costs, return to work (RTW) culture, medical providers, cooperation, etc. No two employer-wheels are completely alike, but all need a workers' comp warrior at the center. No single vendor can re-create or support such a turning wheel. Most critically: In practical application, no employee skips the ride to a quality medical healing and return to productivity; however, any ill-intended employee who jumps off early is easily spotted.

Quick Tip: Raise the Bar and Redefine an Employer-Based "Warrior" Position

Key aspects of a "workers comp warrior" include:

- Emphasis on employee advocacy above all else

- Technical knowledge and experience in all the processes and interactions of WC

- Claim-by-claim insight otherwise not available via the common process

- Solutions, options and strategies tailored to each situation

- Real-time interaction, not adhering to adjuster diaries

- Inclusive program with company-wide involvement and awareness

- Learning opportunities seen in a poor claim outcome

- Accepting inevitable frustrations without blaming adjusters, doctors, state laws or employees

- Not falling for the perfect-world bubble that a broker or other vendors might try to claim exists


Barry Thompson

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Barry Thompson

Barry Thompson is a 35-year-plus industry veteran. He founded Risk Acuity in 2002 as an independent consultancy focused on workers’ compensation. His expert perspective transcends status quo to build highly effective employer-centered programs.

2 Studies of Why Wellness Fails

Wellness vendors contend better information can correct unhealthy lifestyles, but the roots of those lifestyles are far too complex.

Henry David Thoreau famously said, "Most men lead lives of quiet desperation..."

People who lead desperate lives don't make good subjects for wellness programs, nor, for that matter, lifestyle advice from doctors. Below are two real life examples of ordinary people I've chatted with about matters of personal health. After both of these conversations, I was quite humbled.

Case 1

I had a chance conversation with a pleasant but overweight woman I'll call Donna, a cashier in a big city grocery store, who was about 50 years old. We were having a nice chat, and I asked her if she had opportunities to exercise after work. Donna said that, after being on her feet all day, she had to go home and put her feet up. That prevented her from having much of a social life, too. Donna said she would never have a better job, that she'd never buy a new car, nor afford vacations or holiday trips. Her rent was so high, it was all she could do to makes ends meet. Donna said her only fun in life was buying a take-home pizza and a six pack of beer once or twice a week. Take that away, and Donna said she had nothing. Truthfully, and sadly, in my heart I could not blame her.

Case 2

A few years ago I had a lengthy cab ride in Baltimore and struck up a good conversation with the cab driver, a friendly, middle-aged man I'll call George. He asked what I did for living, which resulted in a good chat about personal health. George smoked, had high blood pressure and diabetes and was overweight. He said he'd tried to get those things under control but just couldn't. The interesting part of the story is why he couldn't control his health risks. George said he'd lived in Baltimore all his life and had the same set of friends since grade school. One night a week, they'd go bowling, eat huge meals and drink way too much beer. Also, once a week or so they'd go to a sports bar and do the same thing. George truly believed he'd have to give up his lifelong friends if he were to cut out that lifestyle. He knew it was slowly killing him, but he just wasn't willing give up. It was hard to blame him either.

Those are two true stories of people trapped in a lifestyle they can't or won't willingly forfeit. Huge numbers of people are in the same boat.

Some people are going to comply with doctor suggestions on lifestyle without any help at work. But, if Thoreau is right, there are many people out there like Donna and George.

Bad lifestyle choices can be terribly complex. They virtually never arise from the lack of the kind of information that wellness vendors push as the solution.


Tom Emerick

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Tom Emerick

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

7 Reasons to Major in Insurance

A major in risk management and insurance pretty much guarantees a job right out of college, while giving you lots of flexibility for the future.

1. 100% Employment: One of the big reasons to go to college is to make sure you're employed in a good career after you graduate. The insurance industry is predicted to continue growing for decades, and the existing risk management and insurance (RMI) programs only feed 15% of its needs each year, which means if you graduate with an RMI degree you'll be a hot commodity! RMI programs had 100% employment, even through the 2008-2012 recession.

2. An RMI degree is basically a focused business degree: Majoring in business is a very popular choice already, but it's a very general degree that usually takes a few years to really get you a solid career. RMI degrees are usually housed by a university's school of business and have all the usual classes you'd get in a business degree (accounting, finance, marketing, statistics, management, etc) with the addition of a few RMI specific classes. What this means is that even if you change your mind and decide you don't want to work in insurance (which you won't), you can still easily get the same jobs that you would have been getting with a general business degree.

3. It is preparation for a career making a difference: If you love making a difference in the world, you'll absolutely love the insurance industry! Even though we get a bad name in the press sometimes, the reality is that we are here to help people and businesses get back on their feet when unexpected things happen, and being a part of that is very rewarding. Also, many carriers offer time off to volunteer and to study for insurance designations.

4. Insurance is an incredibly stable career: The economy will continue in its ebbs and flows, and that means every few years people will lose their jobs when the economy contracts. Some very popular careers like banking, consulting and real estate are usually among the worst-hit when the economy slows. Insurance is incredibly stable because pretty much regardless of what happens in the overall economy, people and businesses continue to need insurance. This means career stability for you!

5. You'll have more vacation than most of your friends: Most insurance carriers start you up with around 18 days of vacation a year. That means much more time off than most employees just starting careers in other industries.

6. Your senior year will be a LOT less stressful: RMI majors are expected to continue to be in high demand and feed only a portion of the insurance industry's need for new talent, which means that a lot of RMI majors have accepted great job offers by December of their senior year, a good five months before graduation, and senior year is a lot more fun when you don't have to worry about finding a job afterward.

7. You're pretty much mathematically guaranteed to be in demand: The current makeup of the insurance industry workforce is very mature, meaning that 1 million insurance professionals, 43% of the workforce, are expected to retire in the next 10 years. In addition, the industry is growing and is expected to create 400,000 jobs. RMI majors are already pretty much immune to unemployment; they will be in increasingly high demand right around the time you graduate!

You pretty much can't go wrong by majoring in RMI! There are not a lot of RMI schools out there, so click on the map below to open an interactive map of RMI schools. Schools marked in red have a full RMI major while schools marked in green have an RMI minor or concentration.


Tony Canas

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Tony Canas

Tony Canas is a young insurance nerd, blogger and speaker. Canas has been very involved in the industry's effort to recruit and retain Millennials and has hosted his session, "Recruiting and Retaining Millennials," at both the 2014 CPCU Society Leadership Conference in Phoenix and the 2014 Annual Meeting in Anaheim.

Scammers Taking Advantage of Google

Gmail and Google Drive are wonderful for communicating and collaborating. They’re also ideal tools for hacking into your computing device.

Some 500 million people use Gmail and Google Drive. I'm one of them.

Gmail and Google Drive are wonderful for communicating and collaborating. But it turns out they're also ideal tools for hacking into your computing device.

Bad guys on the cutting edge have discovered this. And their success so far indicates attacks manipulating Google's productivity platform-and similarly exploiting other popular cloud-based business tools-are destined to progress.

This development should not come as a big surprise. Cyber criminals are quick to recognize fresh opportunities created by our headlong rush to use cloud services and mobile devices without giving due consideration to security and privacy.

Intelligence about the latest iteration of hacking comes courtesy of security startup Elastica.

Flying under the radar

Researchers at Elastica this summer discovered scammers using Gmail accounts to send messages crafted to fool recipients into downloading corrupted PowerPoint presentations stored on Google Drive. Scammerswere thus able to slip the malicious PowerPoint file past malware detection filters.

Video: Viral Gmail, YouTube alerts spreading via email

Another tactic discovered by Elastica involved scammers opening free Gmail accounts from which they sent out spoofed messages tricking recipients into visiting a website they controlled that was hosted on Google's own servers. Because the bad guys' website was hosted on Google servers, it was deemed trustworthy, making it easier for them to trick visitors into divulging account logons.

Any hacker can tell you that once you get someone to download a corrupted file, or get them to navigate to a website you control, the rest is comparatively easy. At that point, the target is a half-step away from being owned.

Keys to the (data) kingdom

"In the cloud environment, the username and password become all-powerful; almost all these applications use some sort of username and password as a way to get in," says Eric Andrews, Elastica's marketing vice president. "Once you have that, you can do anything you want. You can get all the data. You can get all the files. So a lot of these attacks that are going at the cloud apps are all about trying to get somebody's username and password."

These fresh hacking opportunities are being presented not just by Google but by each and every one of the most popular cloud-based email, productivity tools, file-sharing and customer-relationship tools.

"Office365, Dropbox, Salesforce, all of these apps are very, very convenient and have a lot of great business utility," Andrews says. "But there is this kind of lurking concern. You don't really know if your company's data is safe. You don't know if other people can get to it. This move to the cloud really has a fundamental ripple effect through all security functions."

Gmail more widely used

In abusing Google's services, cyber criminals are taking advantage of the fact that Gmail has become a de-facto backup email throughout the business world. It is widely used by well-intentioned workers, in companies of all sizes, who are hustling to work more productively.

No one is surprised anymore to receive an email from the private Gmail account of a supervisor, colleague, partner or customer-or even an administrative message from Google. A trust exists. And this creates a perfect environment for spoofing.

Likewise, free or cheap Google Drive file storage makes for a perfect repository to set up phishing attacks and distribute malicious web links.

In a case recently dissected by Elastica, the bad guys sent phishing emails out to victims who they guessed would have an interest in controversies surrounding Tibet's Dalai Lama. The enticement: Click to a link to a corrupted PowerPoint presentation hosted on Google Drive.

Aditya Sood, chief architect at Elastica's Cloud Threat Labs, describes how the social engineering aspect of the attack then unfolds:

"There are no attachments in the email. Basically, it's just a direct link to the Google cloud service, which hosts the PowerPoint presentation. When the user retrieves that link, the user won't be able to view this PowerPoint presentation. So the user then is going to download that file onto the local machine. Once the user opens it on his local machine, the PowerPoint presentation actually extracts two files. One, the INF file, contains a launch code for the second, a GIF file. The GIF file downloads malware to the end user system."

Gmail and Google Drive are powerful, flexible, reliable, easy-to-use and free. Yet, it turns out that these are the very characteristics that make them ideal tools for cyber criminals to infect computers. In essence, the bad guys are simply adopting infection-techniques that proved highly effective in the desktop environment to new opportunities presenting themselves in the cloud environment.

These bad guys no longer have to trouble themselves with creating malicious email attachments, nor do they have to worry as much about spreading tainted Web links that can be quickly detected and blacklisted. And as long as the trust remains high in Gmail, Google Drive, Office 365, Salesforce and other top cloud services, social engine trickery remains easier than it really ought to be.

"Attackers don't have to invest too much time or money in gaining credentials or compromising servers to attack people," Sood says. "They simply create one Gmail account and then, basically, abuse the Google publishing functionality."


Byron Acohido

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Byron Acohido

Byron Acohido is a business journalist who has been writing about cybersecurity and privacy since 2004, and currently blogs at LastWatchdog.com.

The Rise of Big (Bad) Data

Workers' comp often has errors in reporting, and if bad data is used in a big data strategy the result is merely big bad data.

The workers' compensation industry has created and stored huge amounts of data over the past 25 years. The copious amount of data has led to a new phenomenon in our industry, similar to most others-the concept of big data. The goal is to corral, manage and query the industry's big data for greater insight.

Big data is a general term used to describe voluminous amounts of data, whether unstructured or structured. It’s that simple.

Unstructured data is a generic term used to describe data not contained in a database or some other type of prescribed data container. Examples of unstructured data are claim adjuster and medical case manager notes. The data can also include emails, videos, social media, instant messaging and other free-form types of input. Gaining reliable information from unstructured data is significantly more difficult than from structured data.

Structured data is that which is housed in a specified format in a predefined container that can be mined for information. Structured data is designed for a specific purpose so that it can be accessed and manipulated.

The workers' compensation industry has both forms of data. However, structured data is more available for mining, analyzing and interpreting.

To evolve ordinary data to big data in workers' compensation, data from multiple silos must first be integrated. The industry uniquely maintains claim-related data in separate places such as bill review, claims systems, utilization review, medical case management and pharmacy or pharmacy benefits management (PBM).

While integrating data is an achievable task, other issues remain. Unfortunately, much of the existing data in this industry has quality issues. Data entry errors, omissions and duplications occur frequently, and if left unchanged will naturally become a part of big data. Poor data quality is amplified when it is promoted to big data.

The reason big data is so attractive is that it provides the quantity of data necessary for reliable analytics and predictive modeling. More data is better because analysis is statistically more valid when it is informed by more occurrences. Nevertheless, greater volumes of data cannot produce the desired information if it is wrong.

Predicting that a devastating earthquake will occur in the next 25 years does not generate urgency. Likewise, knowing "clean" big data will be needed to remain competitive and viable in the future does not inspire aggressive corrective action now. But it should.

Correcting smaller data sets is easier than trying to fix huge data sets. It may not even be possible to adequately cleanse big data. Moreover, preventing erroneous data before it occurs is an even better approach. Data quality should be valued. Those responsible for collecting data, whether manually or electronically, should be held accountable for its accuracy. Existing data should be evaluated and corrected now to create complete and accurate data.

Doing so will speed migration to big data without drowning in big bad data.


Karen Wolfe

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Karen Wolfe

Karen Wolfe is founder, president and CEO of MedMetrics. She has been working in software design, development, data management and analysis specifically for the workers' compensation industry for nearly 25 years. Wolfe's background in healthcare, combined with her business and technology acumen, has resulted in unique expertise.

Of Robots, Self-Driving Cars and Insurance

Even if fully self-driving cars don't arrive for 10 to 15 years, could robots replace people as drivers in the interim?

I've recently returned from the World Economic Forum annual meeting of the "new champions" in China, where the subject of innovation was high on the agenda. I was relieved to learn that robots can effectively work alongside humans instead of necessarily replacing us (and we can thank the dexterity of our fingers, of all things).

But the meeting got me thinking. With all the current investment into self-driving vehicles (SDVs), could robots ever replace us as drivers?

I deeply care about any developments in motor technology that might affect the risks that our customers are exposed to, and in Zurich we are dedicated to helping them manage these risks. Consequently, we are very interested in the potential for making road usage safer for everyone.

On-board sensors (telematics) and SDVs could be disruptive for society, and they will have a dramatically positive impact in saving lives, reducing accidents and injuries and increasing productivity, as well as benefiting the environment and road infrastructure. However, I expect that it will take at least another 10 to 15 years before SDVs move from controlled tests to a first adoption on some public roads. So, while this is an emerging technology trend to watch out for, it is not the most imminent.

Insurers will play a critical role in ensuring the success of this new technology, both for individuals and businesses, and will continue to protect them against unforeseen events. Given the potential to increase vehicle safety and change the basis of insurance from individual liability to product/vehicle designer liability, SDVs will significantly affect assessment and pricing of current and emerging risks. Specifically, insurers have a very important role to play in the dialogue about SDV liability, which needs to be resolved before SDVs can further evolve.

We will see more innovation in the next 20 years than in the last 100, with the introduction of autonomous vehicles and the connected traveler steering the future of the industry: SDV technology will evolve, rather than arrive fully formed, as assisted-driving (ADAS) technologies are adopted over time. The speed and extent of change will be influenced by regulators, insurance associations and cross-industry bodies, in addition, of course, to customer's needs and acceptance.

At WEF, the Chinese premier Li Keqiang said that his country is moving to a "growth model driven by [both] consumption and investment," and digitalization will be a key enabler. I believe it will also add bottom-up demand to Li's goal of "promoting the development of private banks, financing guarantee and financial leasing" and more open markets (including in insurance!).


Domenico Savarese

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Domenico Savarese

Domenico Savarese has been the global head of proposition development for personal lines and the global lead of telematics for Zurich Insurance since 2013. Savarese has served as program director for Zurich Insurance, head of finance and deputy head of PMO for Kuoni Travel and engagement manager for McKinsey.

Top 10 Ways to Spook Policyholders

As long as policyholders don't like or trust carriers and agents, we need to stop giving customers tricks and start offering treats.

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What are you afraid of this Halloween? That your customers might disappear like ghosts? That your competitors might pick them off like vultures? That it's all going to drive you batty?

Your fears may not be unfounded, given public perceptions about insurance carriers, agents and brokers. Many people don't find the industry trustworthy. (Just more than 50% trust the financial services industry as a whole, according to Edelman's 2015 Trust Barometer.)

Many also view the industry as overwhelmingly complex. And most are not satisfied with their current providers. (Only 29% of property/casualty and life insurance customers surveyed by Accenture said they are satisfied, according to an August 2015 report.)

The current environment is, in a word, frightful.

To overcome these demons, insurance industry leaders must start addressing them at the source. To that end, and in the spirit of All Hallow's Eve, below are the Top 10 ways that insurance providers spook their customers. (Read on...if you dare!)

10. Respond to customer requests like a zombie.

Are your responses to customer inquiries heavily scripted like they came out of some low-budget horror movie? Might your customers feel like, no matter what they say, they get form letters and teleprompter-like messages in response?

Remove active listening, critical thinking and personalized problem-solving from your front line and you miss a huge opportunity to impress your customer. If your front-line personnel perform like zombies, you can guarantee that customers will run from them.

9. Communicate in gobbledygook (or, on Halloween, goblin-dygook).

What do premium bills, policy contracts, claim settlement statements and other insurance communications have in common? Supernatural wizardry typically is required to decipher them.

Insurance professionals are steeped in the practices and language of their industry. As such, they often forget to translate their communications for easy public consumption. Instead, they convey their messages using jargon and acronyms that make their customers head for the hills.

8. Cut expenses and operate with a skeleton staff.

Particularly in times of economic distress, or increasing loss ratios, some insurers' first reaction is to slash investments in post-sale operations, because these areas are not viewed as driving revenue and therefore become easy targets when profits need to be propped up.

But while skeleton staffs might offer some immediate gratification in expense reduction, they also foster negative impressions that could snuff out your company's true brand.

Bare-bones operations translate into long wait times, inattentive service and visibly overworked and irritated employees-characteristics that are hardly the best ingredients for a great customer experience.

7. Embark on monstrous transformation projects.

Business transformation is overrated. It's good to have high aspirations and stretch goals, but you've got to eat the elephant one bite at a time.

Big, hairy, audacious projects have a tendency to be ill-defined and nearly impossible to manage. Plus, most companies suffer from "organizational A.D.D." and have trouble staying focused on a three-month project, let alone a three-year one.

Transformational projects make for good annual report copy, but they often fail to deliver meaningful improvements to employees and customers. Sometimes, all they deliver is disruption and dissatisfaction.

Yes, have a long-term vision-but never underestimate the power and efficiency of incremental advances toward that destination.

6. Never do a post-mortem.

In the whirlwind of daily business activities, people rarely take the time to dissect and diagnose customer annoyances.

Customer complaints present a wonderful opportunity to not just recover gracefully (and perhaps win back a policyholder's loyalty) but to also dig up the root cause of a problem and fix it, once and for all, so it never again rears its ugly head.

What's even rarer than post-mortems on customer complaints? Post-mortems on customer compliments. There's great value in pinpointing what person or process generated customer delight, so you can then figure out how to replicate that outcome more routinely.

Post-mortems can yield silver bullet-like learnings that forever eradicate customer frustrations or permanently institutionalize loyalty-enhancing business practices.

5. Create a workplace that sucks the lifeblood out of people.

To create happy and loyal customers, you need happy and engaged staff. If yours is a work environment where people don't feel appreciated, respected or well-equipped to do their jobs, then you're practically guaranteed to make their energy and passion disappear faster than a vampire at dawn.

And if you don't think customers will notice that difference in your employees, agents or brokers, then you really are hallucinating.

4. Don't tell customers what's lurking around the corner.

Creating happy, loyal customers is a lot about managing expectations. People's frustration-or delight-with a business is closely tied to the expectations they had of an interaction.

Customers don't like ambiguity or unpleasant surprises. If you don't tell them what to expect-how long they'll be on hold before speaking to a live person, how the claim adjudication process will unfold, what information they'll need to provide for a premium audit, etc.-then they're more likely to be annoyed when the interaction isn't as quick or straightforward as they anticipated.

3. Give customers tricks and never treats.

Do policyholders walk away from interactions with your company feeling good about the encounter? Do they get what they expected; do they feel like they got a good value?

For many insurers, the answer is no-thanks to coverage terms that are narrower than what customers reasonably expect, insurance teaser quotes that rarely match offered insurance rates and fine print that inevitably results in unpleasant surprises.

These are examples of insurers' tricks of the trade, and, while these practices may draw customers in momentarily, they certainly won't create a foundation on which to build loyal policyholder relationships.

Contrast that with the indelible positive impressions left on policyholders who experience treats-like insurance representatives who do what they say they're going to do, policy documents that describe coverage in plain language and premium bills that can actually be understood.

For the average insurance consumer, these are pleasant surprises and personal touches that they (sadly) have come to not even expect from carriers, agents and brokers. But when consumers do experience treats, they'll come back, again and again.

2. Avoid ownership and accountability like the plague.

A gruesome ailment has descended upon the business community, eradicating all vestiges of ownership and accountability. Customer calls are not promptly (if ever) returned. Commitments are not kept. Obligations are forgotten. (If you're like most consumers, you've surely experienced such rage-inducing frustrations, be it when dealing with the smallest local businesses or the largest multinational corporations.)

Here’s a little secret: What customers care most about isn't your company's stadium naming rights, funny commercials, Facebook feed or snazzy new mobile app. That's all for naught if your core insurance product doesn't work as advertised or your representatives simply don't follow through on their promises.

Want to create a brand experience that outshines all others? Start by nailing these basics and making sure your policyholders feel cared for.

And the No. 1 way that insurance providers spook their customers…

1. Put scary people on the front line.

Who's interacting with your policyholders on a daily basis? Is your front line composed of superheroes who go the extra mile for your customers or soulless automatons who frighten your customers with their discourtesy, uselessness and utter inability to get anything done?

It doesn't matter how advanced your customer relationship management systems are, how well-adorned your field offices are or how sophisticated your predictive analytics engine is. It all means nothing if the people interacting with your customers-agents, brokers, underwriters, servicers, auditors, adjusters and others-are not professional, responsible and genuinely helpful.

Lose the Spookiness

No right-minded insurance provider sets out to spook its policyholders. But that’s inevitably the outcome when companies lose sight of what’s important and valuable to the people they serve.

Are you haunted by the prospect of your policyholders defecting to a competitor? Do something about it before your worst nightmares become a reality. Use this Top 10 list as a guide to avoid the most common pitfalls, and, before you know it, you’ll be casting a spell on your customers that’ll have them coming back for more.

This article was first published on carriermanagement.com.


Jon Picoult

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Jon Picoult

Jon Picoult is the founder of Watermark Consulting, a customer experience advisory firm specializing in the financial services industry. Picoult has worked with thousands of executives, helping some of the world's foremost brands capitalize on the power of loyalty -- both in the marketplace and in the workplace.

Is Change Really Happening So Fast?

Some talk as those change has gone from zero to 60 (or 600) in no time flat, but my 37 years have seen a steady evolution.

Lots of people are saying these days that the insurance industry, after essentially not ever changing, is suddenly moving too fast to follow -- for instance, the recent ITL article, "Feeling Like a Keystone Cop." But in my 37 years in the industry, insurance has evolved continuously.

Insurers have changed from the days where syndicates consisting of individuals provided insurance coverage through the Lloyds market; today, China Re with a majority ownership by China's ministry of finance, has a syndicate at Lloyds. Today, a large number of insurers are owned by multinational conglomerates.

Other types of evolution include Berkshire Hathaway's use of insurance premiums as a means of financing its investment interests. Similarly, Fairfax Financial Holdings of Canada uses premiums collected from its insurance companies around the world to finance investment interests.

Financial services groups such as Suncorp Group in Australia now offer insurance through a number of brand names, such as Shannons (classic car insurance), APIA (Australian Pensioners Insurance Agency) and AAMI. Rand Merchant Insurance Holding Group of South Africa offers insurance in Australia under the name of Youi (https://www.youi.com.au).

In addition, some insurance companies, like Progressive, are taking a technology-only approach to offer motor vehicle insurance in Australia without a "brick and mortar" presence. Apart from the option of reporting a claim by phone, all other communications are through email or a web page. With this approach, Progressive in Australia will only attract those who use technology. Here is the link http://www.progressiveonline.com.au/car-insurance.aspx

People talk about Google, Walmart, Amazon and others possibly entering the insurance market -- again, this isn't something new. Brand names have been used by insurers for many decades. Coles, a large supermarket chain in Australia (https://financialservices.coles.com.au/insurance) (similar to a Safeway or Ralphs here in the U.S.), offers various insurance polices to its customers that are underwritten by Insurance Australia Group.

Whether Google, Walmart or Amazon actually decides to underwrite risks, act as channels for insurance or simply provide a means to compare insurer premiums remains to be seen, but, regardless, none of this is new. For example, InsWeb has offered car insurance price comparisons since the mid-1990s. Here is the link: http://www.insweb.com.

One thing that is certain, however, is that the insurance market will continue to be driven by price and service, especially service at the time of a claim. In his 2013 annual report, Warren Buffett made the following comment, "GEICO in 1996 ranked number seven among U.S. auto insurers. Now, GEICO is number two, having recently passed Allstate. The reasons for this amazing growth are simple: low prices and reliable service."

Over time, risk types change, and insurance coverage follows. Boiler explosion insurance for example, was a major type of insurance through the 1800s and into the mid-1900s. It still exists but is only a very small percentage of the insurance market.

We will see changes to vehicle insurance coverage when driverless vehicles appear on our roads, as mentioned in the recent ITL article titled, "Beginning of the End for Car Insurance." There are many risk coverage issues for potential exposures with driverless cars. Imagine if a child runs onto the street to retrieve a ball without looking (a common occurrence for those living in the suburbs). With advanced technology built into driverless vehicles, the vehicle would be programmed to make a decision about which action to take in the best interest of all parties (i.e. the child, occupants in the vehicle or nearby vehicles as well as pedestrians): (1) brake but still hit the child or (2) brake and avoid the child but possibly hit another object such as another vehicle or lamppost, injuring the occupants of the vehicles as well as nearby pedestrians.

All this will need to be addressed by laws and road rules when driverless vehicles are introduced, with insurance following on. Premiums and who pays are the least of the insurance complexities involved with driverless vehicles. If a manufacturer is required to obtain insurance coverage or volunteers to obtain insurance coverage, the premium would be factored into the price of the vehicle; otherwise. it would be paid by the owner of the vehicle. Regardless, insurers will receives premiums from one source or the other.

Another evolving insurance coverage relates to a disability occurring from a work-related, motor-vehicle or non-work-related incident. While U.S. jurisdictions ponder whether coverage for a work-related injury or illness should be through a workers' compensation policy issued by a property/casualty insurer or through the opt-out option (a hot topic in the U.S. at the moment), Europe, Asia and Australia are focusing on what people with a disability can be doing and deciding on how best to achieve this, including funding. In this case, the evolution relates to who will pay the premiums. Will employers continue to pay for work-related injuries, or will individuals buy personal injury coverage to cover their recovery costs, no matter whether associated with a work-related, motor-vehicle or non-work-related incident?

In the evolution of insurance, technology has always played an important role in areas such as deciding which segment of a market companies want to attract, meeting reporting obligations and improving processing efficiencies. In workers' compensation, a number of U.S. carriers have chosen to outsource many of their claims functions, as I outlined in my last article. Whether this practice continues remains to be seen, but something needs to change in the way the workers' compensation insurer or its representatives (e.g.. third party payer) handle claims, because clearly what they are doing is not producing the desired outcome for the injured worker or the employer, and no form of state legislature or technology change will address this shortfall.

Products like IBM's Watson and Saama that are able to use unstructured data in addition to structured data to perform analytics are part of the technology evolution, and there is high probability of success. But we saw something along the same lines during the early 1990s, when all the buzz was about neural networks.

In closing, I don't feel as if I'm a Keystone Cop when it comes to professional development, either relating to insurance or the technology used now or offered in the future. I also don't think the major players in the insurance industry (like Berkshire Hathaway, Fairfax, Suncorp and others around the globe) feel they or their personnel are operating like Keystone Cops. If they were, I'm sure their share prices would not be as high as they are.


John Bobik

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John Bobik

John Bobik has actively participated in establishing disability insurance operations during an insurance career spanning 35 years, with emphasis on workers' compensation in the U.S., Argentina, Hong Kong, Australia and New Zealand.

A Better Question for Evaluating Tech

Most ask "why" or "why not" to incorporate new technologies into products. Shift the question to "how," and you'll make better choices.

Earlier this month, my colleague Monique Hesseling wrote about the power of asking the right questions in product development. That is just as important with new technologies.

As we have seen with social media and smartphones, what were once "emerging" technologies can become widely available and widely used in a very short time. Insurers have developed ways to use both of these technologies in new products and services, although plenty of untapped opportunity remains in both areas. But as new technologies continue to emerge, how do we, as an industry, continue to incorporate them into products and services?

The conversations about using new technology in insurance have typically centered on two questions: Why? and Why not? The Whys, as we shall call them, are reluctant to adopt new technologies because the status quo works (or works well enough). The Why Nots, on the other hand, jump at the opportunity to use new technologies because of their novelty and the desire to be among the early adopters, even when the benefits are not necessarily clear.

The problem with framing the conversation around adopting new technologies as a question of "why" or "why not" is that it focuses on personal beliefs and opinions. The best questions to ask about new technologies start with "how."

How can insurers take the technologies around us, whether they be established, maturing or emerging, and use them for competitive advantage? How can we get the most out of their use, and how can we use them to improve the customer (and employee) experience? How can new technologies be applied to products to make them better and to differentiate our company?

This year's SMA Innovation in Action Award winners gave us some good examples. For instance, John Hancock's Vitality Program is using mobile technology, "gamification" and wearable devices (a free Fitbit) to create a highly interactive relationship between life insurer and policyholder. Wallflower Labs is using the Internet of Things to provide brand new preventative services to a specific population of homeowners policyholders: those with aging relatives or young or special needs children, who face increased risk of house fires from the unsupervised use of ranges and cooktops.

Both of these initiatives gather data on policyholder behavior (fitness activities and cooking patterns) that insurers can use to offer premium discounts and leverage to create increasingly personalized life and homeowners products. Haven Life Insurance Agency has taken this thinking a step further by designing a term life product that uses big data and analytics to offer policies online with a 20-minute application process.

These award winners demonstrate just how much can be done toward creating products and modifying existing ones through the creative use of maturing and emerging technologies. John Hancock, for example, models effective decision-making with regard to incorporating new technologies into existing products by offering program members a free wearable device. Wearables can provide behavioral and physiological data that can be used to inform the calculation of life insurance premiums. The same wearables can provide policyholders with valuable feedback and the possibility of earning premium discounts. It's a win-win for the customer and the insurer.

All insurers looking to incorporate new technologies into their product development should invest in idea-generating processes that are focused on how a given technology can be deployed before deciding whether to pursue that technology. Insurers excel at calculating risks and benefits, after all. Once the potential uses of a specific technology have been determined, insurers can apply that expertise to performing sophisticated cost-benefit analysis on those options.

The Whys and the Why Nots will never agree on everything, but they can unite behind the question of How. That shifts the discussions around new technologies to evaluation and problem-solving rather than opinion and persuasion. Ask "How?" and reap the benefits.


Karen Furtado

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Karen Furtado

Karen Furtado, a partner at SMA, is a recognized industry expert in the core systems space. Given her exceptional knowledge of policy administration, rating, billing and claims, insurers seek her unparalleled knowledge in mapping solutions to business requirements and IT needs.

Predictive Tech Can Preempt Cyber Threats

To get out of reactive mode and actually preempt cyber attacks, we need to focus less on the "bullets" and more on the humans firing them.

In the ever-evolving landscape of cyber threats, for many organizations, simple detection and remediation is no longer enough. Some cybersecurity companies are now going one step further-providing predictive intelligence that can preempt threats.

In September, Triumfant became the latest to enter this growing field, through a partnership with Booz Allen Hamilton.

"If you're just offering prevention, you don't have a complete product. If you have detection and remediation, you're getting closer," Triumfant CEO John Prisco says. "When you add predictability, you're starting to get a fairly robust treatment of the problem."

More: How data-mining boosts network defense

Triumfant, founded in 2002, has been evolving in the way it provides endpoint protection. The latest iteration of its AtomicEye platform integrates Booz Allen's capabilities to reverse engineer an attack with the goal of attribution-looking for the source of the attack-and threat prediction.

"(Booz Allen) will accept the malware from us, detonate it in their lab and reverse engineer it," Prisco says. "They'll then use the information they have to try and determine attribution."

Although not all clients are interested in attribution, the capability is built into AtomicEye so files can be easily collected for the Booz Allen lab.

The AtomicEye platform detects malware by analyzing the computer's patterns against an established blueprint-an atomic fingerprint based on upward of a million data points that were collected previously to establish the baseline. Once malware is detected, the computer's operator clicks on a button to remediate the attack.

The offending file can be checked against threat intelligence databases, and, if it's not listed, that indicates the likelihood of a zero-day attack. The Triumfant platform becomes essentially a filter for potential future analysis.

"If it doesn't exist in the database, then it's a real candidate for Booz Allen to do analytical work on it," Prisco says.

Randy Hayes, Booz Allen Hamilton vice president, says his company is "uniquely qualified to deconstruct the threat in the lab" because it has been providing advanced malware analysis to the U.S. government for years. Booz Allen can use that experience to do things that no one can replicate for getting more actionable threat intelligence, according to Hayes.

"One of the biggest problems with cybersecurity right now is that there is too much focus on technology and automated solutions," he says. "What we need instead is more intelligence tradecraft to include more mathematics around behavioral analytics, which is what Triumfant does."

Prisco says what makes his company different in the threat intelligence space is the approach.

He says that typically, threat intelligence platforms would scan a computer for known offenders to see if those types of files exist on the machine. But because there could be millions of files uploaded to the cloud-based threat-intelligent platforms, scanning a computer for all of them would essentially make the machine inoperable, so the platform may scan for a select number.

He points out that's why, in a recent data breach report, Verizon was critical of threat intelligence platforms.

"It's difficult to get all the threat intelligence in the cloud fast enough to make a difference," he says.

AtomicEye, instead, detects the offensive file first, then scans it against the threat-intelligence database.

"That's much easier to do," Prisco says. "We're not trying to burden each computer and scan for each problem."

In other words, instead of using the typical signature-based detection, Triumfant uses statistical anomaly analysis to find malware.

"For a long time, the industry has been looking at malware variety and zero-day malware, trying to detonate, categorize and understand to enrich cyber intelligence," Hayes says. "However, because Triumfant's AtomicEye... is able to isolate and discover behaviors that would indicate the presence of malware on the network, we anticipate being able to get more actionable threat intelligence out to consumers."

In 2012, Gartner forecast that predictive analytics was the future of business intelligence, fueled by big data. In 2014, the research company said big data analytics would play a critical role in cybersecurity, as well.

Hayes says he's noticed a shift since that report came out in the way CSOs and CISOs are thinking-moving from post-incident to pre-incident threat intelligence.

He says the trend is in its infancy and has a long way to go "before it is fully baked," but it could help slightly close the gap the bad actors maintain over the good actors.

Part of the advantage of this approach is the strategic analysis that can help anticipate attacks.

"Human beings launch these attacks, not robots," he says. "If we focus on who is pulling the trigger, the motivation, the target and the intent, we will have a better chance of mitigating the impact of the attack. We need to shift the focus from the 'bullets' to the adversary and its target."


Byron Acohido

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Byron Acohido

Byron Acohido is a business journalist who has been writing about cybersecurity and privacy since 2004, and currently blogs at LastWatchdog.com.