Whenever we're faced with a challenge or an opportunity, we tend to respond with thoughts about what should we do and how should we do it. We seldom think to ask the who questions. Who is likely to be an ally, an obstacle or an unknown? In my decades of studying strategic relationships for return on impact, it's rare to find executives investing time in truly understanding the flow of influence in their own or target organizations they seek to work with.

The result of overlooking this strategic step can be costly. Let me give you an example.

A few years ago, I flew to Chicago for a meeting with a group of executives. We had done our preparation, in light of the importance of this multiyear, multimillion-dollar project. Reviewing the attendee list, I saw one name I didn't recognize-who was this individual? When the meeting began, everybody introduced themselves with a briefing on their goals. One person chose not to sit at the conference table, but in one of the chairs against the wall. While everybody else talked, he quietly, very diligently, took notes. I became more and more curious. At the end of the meeting, the obligatory exchange of business cards took place. Everyone else had titles on their cards, VP and EVP and so forth. This one person's business card was the only one without a title. By that time, I just about couldn't contain my curiosity. I asked around and learned he was the "special adviser to the chairman of the board."

Apparently, the project we were working on was not only a priority for the executives at the table, but of interest to the board, as well. The chairman had sent this fellow to the meeting to report back directly to him. Three months later, a number of the people who had been around that conference table were no longer with the firm.

Mr. Special Adviser could be found nowhere on that organization's org chart, but his political clout is self-evident. The moral of this little story is that you ignore influence in an organization at your peril.

If I'm putting a $10 million project in front of a decision-maker, the last thing I want is someone I don't know, someone I haven't even known existed, influencing that project. I've learned from experience that, as bizarre as it sounds, too often the greatest political power or influence in an enterprise has nothing to do with the titles on its org chart.

Map the political influence structure

 

I've developed tools to help me avoid surprises from unacknowledged flows of influence, and I suggest you do, too. Create for yourself, for each organization or initiative in which you invest your relationship capital, a political road map.

Here is the shocker! It's not an app, it won’t run on your smartphone or tablet, and it doesn't use a satellite orbiting the planet. In our hyperconnected digital world, we're losing sight of the fundamentals. Think of this recommendation as learning how to write cursive when everyone else is working with Siri! (By the way, I've also researched a dozen or so called "enterprise relationship management" technologies - most are myopic at best, moronic at minimum. They're so busy trying to give you fancy graphics that their assumptions are flawed, for instance about the quality of a relationship.

Here is what you will need for this exercise: three colored markers, a straightedge, a whiteboard, some index cards and tape. Start by drawing sources of information flow. (For each individual, draw a rectangle the size of your index cards: You will add information here in the next step, using cards to keep your roadmap flexible.) Do not map the explicit power structure, but what you've observed about the influence structure so far.

Next, use your colored markers to color-code each relationship on your chart:

• Green: This person is an ally who has been visibly supportive in the past and "gets" what you are trying to do;
• Yellow: This person is neutral to your initiatives or is an unknown. Is he on the fence? Could she be swayed? Try to capture some aspect of his or her position from observable behavior;
• Red: For whatever reason, this person opposes what you are trying to accomplish. I'm also curious here whether he can be neutralized or eliminated to minimize my risk profile with the specific initiative or project.

Use your index cards to write comments and impressions about the individuals you have just color-coded. Note your questions as well as your observations. If something they've said gave you these impressions, write their words as accurately as you can recall them.

When done with this step, tape the cards to the whiteboard next to individuals' names.

At this point, your influence chart should begin to generate insights. Step back and listen to what it is telling you. Who do you need on your side? Who can you ignore? Who is already an advocate who puts wind in your sails? Add index cards with your observations.

This is the time to apply a process I referred to as strategic relationship triangulation in my book, Relationship Economics. For any piece of information critical to your political success with these relationships, you must find three independent sources to verify, validate or void the critical assumptions you are making about each person or piece of information. It's homework time. Use your relationship network and other "biz-intel" sources to triangulate the assumptions on your influence road map. Rework the position of individuals in relation to each other as new insights emerge or old ones are voided.

Relationship triangulation can help you understand the most influential sources within a team, a department, an organization or an entire industry. Who are the real decision-makers, and who works most closely with them? Knowing this enables you to much more effectively customize how you develop relationships and add value for each individual.

Does this process take a lot of effort? Yes. Is it necessary? It would be naive to think you don’t need to build a political road map based on solid research. Could your time and effort be better spent focusing on outcomes? Only once you have a solid understanding of the relationships you need to help you achieve those outcomes. Don’t treat this task as a "one and done." The chart need will frequent updates as the situation evolves.

This political roadmap allows you to quickly visualize your relationships and, specifically, your relationship assets and liabilities. Further, it helps you see whether you have enough support to accomplish your goals, or where you need to invest time and effort to build that support. When you can see who is an ally and who is an enemy, you can plan your next steps. "What can I negotiate? What can I exchange? Do I have something of value that they want?" It’s called "politics" for a reason—this kind of “horse-trading” is what our elected officials do.

Any kind of organizational sea change—a merger or acquisition, a large-scale restructure, any new line of business, any succession planning any geographic expansion requires a political road map at this level of detail. These are all highly disruptive events to most businesses.

Frankly, I see too many people blindsided by disruption because they simply failed to maintain an accurate road map of the political terrain they are trying to navigate.

By the way, if you're looking for the science behind these ideas, Google "social network analysis." You may be surprised to learn that it has nothing to do with Facebook, Twitter or YouTube!

Nour Takeaways:

1. Because influence doesn't show up on org charts, you need to invest the time and effort to visualize that information for yourself.
2. You are welcome to use my system of color-coding and notes, or develop a system that works for you that shows the flow of influence we call "office politics."
3. Rigorous triangulation allows you to trust your insights-which are invaluable when dealing with disruption.

Independent medical exams (IMEs) are widely used throughout the workers' compensation insurance industry. However, as with any tool, you generally need a good carpenter or mechanic to get the best results. Because of the time required to arrange these medicolegal exams and because of the complexities of determining causation, pre-existing conditions, degree of impairment, etc., most insurance companies and third-party administrators (TPAs) outsource this function, which generates findings that can be used in the formal claims adjudication process.

The problem with outsourcing IMEs is that it typically removes from the process the only stakeholder who actually knows the injured worker: the employer.

The employer can make better decisions about whether to request IMEs -- which are very expensive -- by looking for red flags that, in many cases, only the employer could know about.

The most basic reason is if there is a legitimate question as to whether an injury or illness was caused by a work-related accident or industrial exposure. Red flags that might indicate the need for an IME include: The accident/injury wasn't witnessed by other employees; reports of how the injury occurred are vague; or the injury was not promptly reported. Other triggers that only the employer would know include: a history of disciplinary, attendance or other HR issues; prior work history and the possibility that the employee is working a second job; or participation in sporting and recreational activities outside the workplace.

Other flags could be: Healthcare providers indicate that the employee may not be able to return to work, based on subjective complaints, or have proposed treating plans that are open-ended, with no clear-cut goals.

Other key issues that should be identified early in the claims process are: pre-existing conditions; any unauthorized medical treatment; any treatment by known "provider mills"; all litigated or potentially litigated claims; any potential subrogation opportunities; any doctor shopping; prescriptions for opioids; recommendations for elective surgery, such as on the back or for carpal tunnel issues; and any plain, old-fashioned tips from other employees.

IME providers often miss three fundamental questions: Can this injury or illness be caused by the workplace? Under what circumstances? Did these circumstances exist in this case?

Medical providers performing IMEs often make decisions in a vacuum, with little, if any, input from the employer. Leading medical experts who routinely perform IMEs state they are often "flying blind" and would have conducted a whole different physical exam or diagnostic testing if they only had more information. They tell me that they often have no idea why an IME has been scheduled. Miscommunication is common, and prior medical reports are often delayed or even lost.

IMEs should be conducted within a well-planned strategy at both the local level and the corporate level, between an employer and its insurer or TPA. The success or failure depends on active involvement and strong communications by all involved, including employers, IME providers, injured workers and insurance carriers and claims administrators.

As noted in previous articles, employers may consider using an OSHA-sanctioned "contemporaneous" medical exam - conducted at the moment of injury/illness notification but done outside the workers' compensation system. Employers may consider this approach when they suspect a difficult or potentially litigated claim in states where they have little control over the choice of medical provider or face other jurisdictional or claim-specific challenges.

Employers, whether they are fully insured or self-insured, should ask detailed questions about how IMEs are handled on their behalf. Most insurers and TPAs outsource some, if not all, of the process of scheduling and arranging IMEs. There are dozens of questions I would ask about IME panel selection and quality assurance, including; credentialing, board certification, training, continuous education, experience, expertise, reputation, affiliation with university-based teaching hospitals or sports teams, along with knowledge and utilization of AMA impairment guidelines, evidence-based treatment protocols and application of disability guidelines from state workers' comp, the Americans with Disabilities Act  (ADA) and others.

The only true stakeholder in what can be a very expensive, time-consuming and frustrating process to obtain quality IMEs is the employer. It is the employer that should be asking about "other" workers' compensation costs and whether IMEs, which often include "hidden" costs, are actually having a positive outcome in successfully denying, closing or settling difficult and contentious workers compensation claims.

The 80/20 rules applies in both workers' compensation and healthcare -- 20% of claims will generate 80% of the costs. Employers need to have strategies in place both early and often to help confirm the relationship between reported injuries and illnesses and the workplace.

The employer's ability to obtain credible and authoritative medical opinions is key to containing workers' compensation costs from medical, indemnity (lost-wage replacement), permanent disability awards and administrative, legal and other fees.

Employers need to take a much more active role in ensuring high-quality healthcare while addressing waste, fraud and abuse in the system. Employers should avoid fishing expeditions but rather use these expensive tools wisely and put them in expert hands. If you are going fishing, make sure you have the right bait, deck hand and captain.

IMEs can be a great tool or waste of time and money. It's more up to you than you think.

Dr. Ezekiel Emanuel wrote a contrarian opinion piece in the Jan. 8, 2015, issue of the New York Times titled, "Skip Your Annual Physical." Dr. Emanuel is an oncologist at the University of Pennsylvania and was an adviser to the Obama administration regarding the design of health reform. He is also the brother of Rahm Emanuel, a former presidential chief of staff.

As you can guess from the title of the opinion article, Dr. Emanuel believes that annual physicals are not worth having because they do not reduce mortality. He cites a Cochrane Review study to back up his statement. Click here to read a summary of the study by the American Association of Family Practice.

Dr. Emanuel's comments bring the following question to mind: How is one to have the evidence-based screenings recommended by the U.S. Preventive Services Task Force (USPSTF) without an annual physical?

Here is a list of some of the USPSTF screenings and interventions that studies have shown to be of value by reducing morbidity or mortality that could be accomplished at an annual physical:

1. Screening for Type II diabetes
2. Screening for hypertension
3. Screening for lipid disorders (e.g. high cholesterol)
4. Screening and counseling for alcohol abuse
5. Screening for cervical cancer every 3-5 years
6. Screening for obesity
7. Potential use of aspirin for the prevention of heart attack
8. Counseling on folate vitamin supplements for all women capable of pregnancy to prevent neural tube defects
9. Counseling overweight and obese patients to improve their diet and exercise habits

Source: American Association of Family Practice

Many of these conditions are not rare.  For example:

• 9.3% of the U.S. population has diabetes-of whom, 9 million are undiagnosed (Click here for ADA source). Assuming a U.S. population of 300 million, 9 million is 3% of the population, so three in 100 screenings would find undiagnosed diabetes. In a company with 1,000 employees, screening for diabetes would result in identifying 30 new cases of diabetes.
• 29% of the adult U.S. population has hypertension-17% are undiagnosed (Click here for CDC source). 17% of 29% is about (again) 3% of the adult U.S. population, so three in 100 screenings would find undiagnosed hypertension. In a company with 1,000 employees, screening for hypertension would result in identifying 30 new cases of hypertension.

An annual physical is a great way to address these nine proven screening tests and interventions that will lengthen life and reduce suffering. This is only a representative sample from the USPSTF.  There are actually more than nine. You would not "technically" need an annual physical, but you would have to have some other mechanism for having these screenings and interventions performed.  A similar point is made by the American Academy of Family Physicians in its review of the Cochrane study. However, the use of the doctor's office as the setting for the screening means that if an abnormality is found (i.e. diabetes, hypertension, etc.), then the doctor can prescribe an intervention.

To skip an annual physical and to not have the screening performed some other way-and followed up on-is hazardous to your health

"What do you want to be when you grow up?" I used to get that question all the time. I would say I wanted to be a doctor, a lawyer, a successful businessman. I always had an answer, but I never had a plan. I would have benefited a lot from having the person follow up and ask me, "How are you going to get there?"

"How did you get into the insurance industry?" If you ask 10 insurance agents that question, nine times you get the same answer, "I just fell into it. I had no plan to be in the insurance business."

I've spent most of my insurance career working and dealing with agents, and, while they have action items to grow their businesses, almost all of them don't have a formal planning process. Instead, they react to issues the day they are confronted by them.

It's natural to wait and react. But the best organizations in any industry always have a plan. They don't react; they act with discipline and focus.

This article can provide you with a road map for designing your current-year business plan and your long-term plan.

A plan has to be something basic that you can live by during the year -- not a 25-page document that gets put in a desk drawer and forgotten. Instead, it's a short document that sets forth the path you want to take for your agency in a given year. Plans change. They always do, based on what actually happens. But having a plan allows you to be in control of your business.

Is it too late to have a plan this year? No. There is still plenty of time. Here’s a model I've used to develop several successful business plans.

1.         Start with an assessment of your business year-to-date. How's your year going compared with last year? Is production up? How about profitability? Spend time analyzing your book of business and understand the difference between your results for the year-to-date period this year vs. last year. This shouldn't take too much time.

2.         Identify your gaps. Profitability might be up but new business production down. Why is new production down? Is it taking more leads to generate a sale? Is a new competitor pulling business away from your agency? Understand your situation. Focus on the big issues.  Nothing is ever going to be perfect, including your business.

3.         Develop solutions. This is the toughest part of any planning exercise. It's usually easy to identify a problem. It takes a lot more thought to come up with a solution, especially one that requires you to change the way you conduct your business. Try to identify little changes you can make. Pick a new lead source and experiment with it first. If it works, then incorporate it into your day-to-day operations. Implement several small changes at once. I call them "initiatives." They are more like experiments. If they don't work perfectly, that's okay, because can always learn something new about your business that you can apply to your next initiative.

Let's say new business production has fallen. It is taking your agency more leads to close a sale. One way to increase production is to increase the number of leads. That will probably increase costs because you have to purchase more leads or need additional staff to generate new leads. That will hurt your agency's profitability.

Yet, that's what most people do. I call it the "Do What You're Doing, Just Do It Better" strategy. It typically fails.

Instead, focus on new tactics. Change the way you are conducting your business. Experiment, experiment, experiment! Try different initiatives. You will typically know if they are working fairly quickly. Don't be afraid to stop doing something if it is not working. Move to the next idea and continue to iterate.

In our example, a new initiative might be to target a specific group of potential customers based on criteria you develop that makes them attractive customers. Another initiative might be to develop an affinity group that you can then target for new business. If the initiative works, you can incorporate it into your business. If it doesn't -- and you will typically know within 30 to 60 days -- move on.

4.         Create check points. You can't expect what you don't inspect. Track your agency's results on a daily, weekly and monthly basis. Meet with your staff consistently. You want to create a culture of accountability.

5.         Be transparent. You need to share your plan with everyone at your agency. Make sure your team is incorporating the overall plan into their day-to-day duties. Have you properly communicated and delegated specific initiatives to your staff? Is your customer service rep up-selling? Is your receptionist setting appointments when the office is quiet? If people don't know what you are trying to do, they will just do what they think you want them to do.

6.         Stay focused. Plans fail when people lose focus. Your job as the leader of the organization is to keep the organization on the right path. A well-defined plan provides the framework to make sure you are staying the course. It enables you to make sure everyone is doing what needs to be done.

Nothing lasts forever. Yet it is surprising how few agency owners have a long-term plan for their business. Most agencies die a slow death, keeping the agency owner a prisoner of her own business as the staff leaves and she tries to hold on to renewal commissions as long as possible.

I attribute this common situation to the fact that most agency owners don't have a long-term plan for their agency and for their personal life. In the early years of an agency, everything is focused on producing new business. As the agency matures, the service requirements of operating a P&C agency create daily challenges that keep the agency owner's attention occupied. It's easy to procrastinate until it's too late.

Stop reading this article. Grab a pen and paper and answer the following question: How do you want to leave your business? As a thriving organization that survives you? A business you can pass on to your children? To your junior partners? A business that you can sell? What's your vision for the future of your agency?

Spend some time today and put together your plan for the long-term future of your agency. Knowing where you want to be tomorrow, today, will make it more likely you will end up where you want to be.

In January 2014, SMA published the research report, Google and Insurance: Far-Reaching Implications, which hit a nerve in the industry. We followed up in August 2014 with the research report, The Shifting Competitive Landscape: A New Breed of Industry Challengers, which generated even more discussion. We noted in both reports that the future of insurance is changing more rapidly than we expected. And for those insurers operating with the long-standing, wait-and-see attitude, we cautioned that ignoring the pace of change and putting off the use of emerging technology would put companies at risk. We strongly encouraged insurers to track and assess these trends, along with other outside industry influences, and to put together a strategy that would move them toward their vision as a Next-Gen Insurer.

Now it is January 2015, and our expectations for Google have come to pass. Google is getting approval for selling insurance on its Compare site in a large number of states via a number of different insurance partners. As we predicted in the reports, companies like Google would not underwrite the risk, but they would be the primary point of contact for the customer relationship, making insurers the providers of the insurance product within Google's ecosystem.

Some in the industry may discount this as just another aggregator site from which to search, compare and select insurance, but that would be foolish. This move has much bigger implications for insurance. It represents a major disruption by a recognized innovative giant that brings an outside-in approach to customer engagement and empowerment. And the move demands that insurers re-imagine and reinvent a technology-enabled future.

This is just the beginning. Other industry companies from retail, automotive, technology and more are looking to leverage their influence, their offerings and their platforms to extend their customer relationships and experiences, which will either force traditional companies out – or force them to change. In particular, the technology companies have critical business attributes that are underpinning their rapid growth and influence:

• Customer Engagement. They are leading the re-imagination of customer engagement models across all industries, setting higher bars for customer expectations.
• Customer Demographics. These companies are part of the daily lives of customers from baby boomers to Millennials, representing a merging of the traditional with the future to create a new generation of insurance customers.
• Digital Businesses. The companies all emerged as digital-based businesses, creating customer-driven, user-friendly business and operational models that have now become the table stakes in the digital revolution.
• Innovation Leaders. Innovation is also table stakes. The investment and commitment of resources to innovation dedicated to driving new products, services and partnerships are redefining industries.
• Data Masters. These companies have enterprise data management strategies and capabilities that position them as market leaders equipped with game-changing insights.
• Capital-Rich. They have access to internal and external capital for acquiring or investing in new technology companies that can expand market reach, deepen customer engagement and put them at the leading edge of the digital and technology revolutions.

In a world of rapid change, the new competitors, emerging technologies, advancing innovation and fading industry boundaries are intensifying the challenge to traditional insurance business assumptions. How insurers respond to these changes - with a fresh set of views that combine both inside-the-industry and outside-the-industry perspectives - will very likely influence their future.

Google and other industry challengers are moving at breath-taking speed and on a high level, with innovations and capabilities emerging regularly, either through their own development or through acquisitions and partnerships. With each new capability, they are redefining everyday lives by how technologies are used and then creating products and services that leverage those technologies. And more companies outside insurance will follow, not only to compete but to capture the customer relationship and thrive in this new technology-enabled world.

While Google's move was expected, it is the coming, unexpected moves from unexpected challengers that will intensify the challenge to traditional insurance.

The future continues to unfold before our eyes. We must assess the influencers of change and develop vision and strategies for a new future. We must begin to break down our legacy assumptions and open our eyes wide to the possibilities of a very different future - a future with new competitors and blurred lines between industries. A future that re-imagines and reinvents the business of insurance.

ISO 31000 (Risk Management) and its supporting publications encompass an impressive to-do list of risk management guidelines for organizations. However, if an organization selectively pursues some of the ISO guidelines and ignores others, highly undesirable events -- even tragedies -- can occur. This is what happened with the Titanic.

ISO 31000, section 4.2, suggests we align risk-management efforts to our objectives. White Star Lines, the Titanic's builders, fulfilled this requirement. The objectives were to create a luxury liner at the lowest costs, in the least amount of time, and maybe even break the speed record for an Atlantic crossing. These were admirable goals. The Titanic also followed ISO 31000, Section 5.5.1.b., by "taking or increasing the risk in order to pursue an opportunity." The builders did so because they believed their risks were not extraordinary and could be controlled. This is a common judgment error.

THE PURSUIT OF OPPORTUNITIES, NOT AN ICEBERG, SANK THE TITANIC

The individual risk opportunities that Titanic pursued were not terribly unusual, but collectively they created a perfect storm fueled by three main, linked, cascading risks:

1. Ship design shortcomings influenced by cost-cutting efforts
2. Flaws in rivets
3. Mistakes in the operation and evacuation of the vessel

ISO 31000, Section 5.4.2, warns us that "Risk identification should include examination of the knock-on effects of particular consequences, including cascade and cumulative effects." The World Economic Forum, in its 2014 Annual Global Risk Report, highlights cascading and connected risks many times as a serious threat. The report also stated the need for better efforts to deal with such threats by supplementing traditional risk management tools with new concepts, methods and tools.

What are cascading risks?

Cascades can be beneficial, neutral or destructive. We define cascading risks as a series of interacting risks that emanate from leadership (aces) through the work culture (kings) and work processes (queens) that create bad performances (jacks) and negative feedback loops (jokers) back to leadership. Leaders then either apply learnings in creative ways or ignore the cascade signals, which can lead to disasters. Detailed cascading risk analysis can aid in minimizing such risks.

Cascade #1 That Threatened the Titanic - Inadequate Design

The Titanic’s design was not unsinkable, as was widely publicized at the time. It had many "watertight compartments," but they were open at the top, like an ice cube tray. It had far too few lifeboats, a result of cost-cutting efforts during the design phase. It had a double bottom, but that did not extend up to the waterline, where the iceberg sideswiped the ship. This design flaw was quickly corrected on the Titanic's sister-ship, Britannic, which was still under construction at the time of the Titanic's sinking.

The Titanic's builders claimed that it was constructed considerably in excess of the Lloyds registry safety requirements. Therefore, they never saw the need to seek Lloyd’s registry approval. However, Lloyds disputed that claim publicly after the Titanic sank.

Cascade #2 That Threatened the Titanic - Bad Rivets

The Titanic required 3 million rivets to hold her together. Archives tell us that, at that time, there was a shortage of riveters and the necessary materials to create high-quality wrought iron rivets. White Star's competitors converted to 100% steel rivets, which were much stronger.

The Titanic used steel rivets in the straight section of the hull but not in the front, where the iceberg hit -- wrought iron rivets were easier to rivet by hand than steel rivets in those sections. The recovery of the Titanic's wreck from the sea floor confirmed the low quality and brittleness of the rivets in the impact areas. Higher-quality rivets would have kept Titanic afloat longer and saved more passengers.

Cascade #3 That Sank the Titanic – Operation and Evacuation Errors

The Titanic was cruising near top speed, which was very risky on a moonless night through an area with active iceberg warnings. Just hours before the disaster, the captain canceled a lifeboat drill for no apparent reason. It was suspected that the captain was attempting to break a cross-Atlantic speed record. That recklessness and the collision with an iceberg sealed the Titanic’s fate. Her brittle rivets in the impact area popped off and allowed water to rush into the hull. The Titanic sank in less than three hours. 1,502 people perished after a disorganized evacuation filled the far-too-few lifeboats to just 61% of capacity.

Conclusion

Although ISO 31000 attempts to protect us from ourselves and the outside world, we cannot be selective in what we implement. We need to follow all of the guidelines and even test areas that we believe are safe. We must also heed ISO's challenge to examine cascading and cumulative effects. Effective risk-based thinking must include cascade effect thinking.

Risk managers make many decisions - building valuation, vendor management, employment issues, budget allocation, to list a few. However, in our rapidly changing society, managing risk is more than simply choosing the best insurance package or retention level. We must monitor our world to watch for emerging societal risks that can abruptly increase our day-to-day challenges.

What is an emerging risk? I'm going to borrow a definition from Donald Donaldson of LA Group in Montgomery, Texas. He defines emerging risk as: "A new loss exposure for which a risk treatment has not been identified, or an existing exposure that is evolving and becomes difficult to quantify." The Organization for Economic Co-operation and Development (OECD) describes "emerging constructs" as "major trends or new and persistent threads of behavior driven by a particular alignment in incentives or a technological innovation." Whether you define societal risks as emerging risks or constructs, many challenges lie ahead for today's risk managers.

Using my education, which includes a master's degree in sociology, and my experience as a risk management professional, I forecast 10 social risks emerging -- in some cases swiftly -- in 2015 and beyond.

1. Europe, Asia and North America face increased risk of "sleeper cell" terrorist attacks. As attacks increase, so will hate crimes against all Muslims. In response to such attacks, formerly moderate Muslims may become increasingly radicalized. Houses of worship will become much more difficult to insure as hate crimes increase.

2. U.S. police forces will face pressure. They will come under increased scrutiny by the public because of societal tensions, social media and a general distrust of authority. The use of body cameras and ramped-up training will increase, in part to satisfy the demands of insurers, which bear the brunt of adverse claims actions.

Increased terrorism may cause police departments to devote more resources to tracking down and isolating suspects. This may, for a time, tip the scales in favor of police forces. However, an increased focus on terror training leaves police with fewer resources to investigate property and day-to-day crime that we now rely on them to handle expeditiously. Losses will increase and further erode the public's confidence in the police. The belief that the police are here to protect only the rich and powerful may spread, adding to the public’s growing distrust of authority.

Homeowners' carriers may find themselves facing unusual risks as more homeowners arm themselves or buy personal protection dogs. Zdenek Blabla, owner of Alpine K-9, imports Czech Border Patrol protection dogs for his clients. "In the past year, I've sold several German shepherd dogs to special forces combat officers who don't want to leave their families without protection during their activation," he says. "They understand probably better than anyone the dangers we face in today’s society."

3. Policing agencies across the nation will face increased recruitment and retention difficulties because of a less robust candidate pool and the need for officers who are better-qualified to interact with diverse communities. For years, U.S. police chiefs complained of their inability to attract highly qualified recruits. According to one textbook on policing tactics, "Poor recruitment and selection procedures result in hiring or promoting personnel who cannot or will not communicate effectively with diverse populations, exercise discretion properly or perform the multitude of functions required of the police." It is clear that today's U.S. police forces face significant and growing challenges.

4. Schools will focus more on instructing schoolchildren how to protect themselves in risky situations. Examples include how to cooperate with the police in a routine traffic stop or other police intervention, what to do in a hostage situation and "duck and cover" exercises for students in newly emerging earthquake zones. This increased focus on situational awareness will drain resources from already depleted public school funding, ultimately reducing the time spent for the actual education of students.

5. Corporations that rely heavily on suppliers both here and abroad will closely analyze their supply chain risk. With political disruptions likely to increase supply line disruptions, risk managers must analyze sole-source and global suppliers and ensure the organization's insurance will respond appropriately to these unique risks. As recently as 2014, one major university referred to supply chain disruption from civil unrest as "not a major concern." Given the recent disturbances in Oakland, CA, New York City and Ferguson, MO, civil unrest is a growing concern for risk managers worldwide in 2015.

6. Employers will realize the need to increase security while also purchasing kidnap and ransom coverage for employees who travel abroad or face domestic terrorism threats. The Charlie Hebdo massacre starkly revealed that Stéphane Charbonnier's bodyguard was completely unprepared for that brutal attack. Business owners will face the need for improved security measures at their homes and businesses, as well as when their family members travel.

7. Communities will experience an increase in social unrest, driven by social media “flash mob” actions or spontaneous reactions after incidents with racial or equality overtones. Other controversial issues, such as environmental measures and other governmental actions, will trigger increased public discord and civil disruption.

8. Continued weather swings will result in property damage and loss of life from natural disasters. With more money allocated to fight the new wave of terrorism both at home and abroad, fewer federal dollars will be available to help weather-ravaged communities. As we saw after Hurricane Katrina, civil unrest follows when authorities cannot provide adequate protection.

9. Poverty, income disparity, unemployment and dissatisfaction among today's youth will increase globally. Expect corporate leaders, including top insurers, to more candidly discuss poverty and income disparity, unemployment and dissatisfaction among today's youth in America, the Middle East and Europe. Graham E. Fuller, author of The Future of Political Islam, discussed this concept in 2003: "The great question for most Middle Eastern societies is who will be able to politically mobilize this youth cohort most successfully: the state, or other political forces, primarily Islamist?" We must not underestimate the ways that unemployment and poverty may lead to the radicalization of youth both here and abroad.

10. Pandemics will threaten local medical resources' ability to provide adequate medical care. Flu epidemics, tuberculosis, measles and other contagious diseases will make medical management much more onerous. An aging population with chronic conditions will place additional stress on available medical resources. According to the World Health Organization, there is an "emerging global epidemic of diabetes."

Are these predictions exaggerated? I don't think so. That advanced degree I mentioned earlier tells me that I have not overstated these predictions; they are credible and approaching quickly. As societies become more complex, yet increasingly related, breakdowns anywhere in the global chain can cause disruptions worldwide.

As risk management professionals, we must do more than simply purchase a coverage portfolio to protect our assets. We must understand and prepare for the societal risks that present unlimited challenges to America’s organizations.

'Tis the season for health insurance open enrollment, which can mean only one thing: My blood pressure is going up.

Health insurers talk a lot about how they're my "wellness partner," helping me "live a healthier life" and "empowering me to make good decisions." But I find all they do is make me ill... sick with annoyance.

That's perhaps best evidenced by the annual health insurance open enrollment process, when insurers put on a master class in exactly how not to treat your customers.

My open enrollment journey began with a letter from my insurer, indicating that my current health plan would no longer be available next year. However, the letter explained, the company had already selected a replacement plan that would best meet my needs.

Of course, the company neglected to tell me what that plan was. Perhaps the company felt that adding an element of mystery and suspense to the process would make it more exciting?

A few weeks later, the company graciously revealed its plan selection in a second notice. It picked a coverage option that was nearly twice as expensive as my current one – with a narrower provider network, to boot. It seemed like a selection that best met the company's needs, instead of mine.

So off to the Internet I went to research my alternatives. That alone was an adventure, given how many insurers' health plan websites appear to have been designed by crazed, blind hermits.

My personal favorite was one major insurer's site, where about half the links to health plan details yielded the dreaded "404 Web Page Unavailable" error. I guess the company really wasn't interested in getting my business (or anyone else's).

After evaluating other offerings, it was time to figure out what my options were with my current insurer. Naturally, the company's online plan descriptions triggered more questions than they answered – which meant I'd have to contact the insurer's 800-line service center (also known as Dante's Ninth Circle of Hell).

All I wanted was to speak with someone who could help me. But that was clearly setting the bar too high.

Once I navigated the labyrinth that was the 800-line menu, I was subjected to a series of pre-recorded messages, including one that felt less like a call center greeting and more like an oral history of the Affordable Care Act.

Then there was the 20-minute wait until a representative was available, with the on-hold music periodically interrupted by an ironic recorded assurance that the company "values my time."

The company valued my time so much that it made sure to consume a lot of it. That first call lasted more than two hours and included 10 transfers, because nobody seemed to be the "right person" to help me. You'd think I was asking about some arcane plan feature, but all I had were some straightforward questions comparing networks and benefits across two of the company’s plans.

Each service representative I spoke with began the conversation using the same scripted phrase: "What would you like to accomplish today on this call?"

"I'd like to not get transferred," was the reply I started using about an hour into the odyssey. "That's my goal on this call." The vast majority of the people I spoke with were unable to satisfy even that simple request.

Oftentimes, I found I knew more about these plans than the enrollment representatives themselves. I even resorted to walking one of them, step by step, through the company's own website materials, when the rep insisted the plan I was considering had no out-of-network coverage. (It did, and the rep finally concurred.)

Even after this first marathon call ended, I was compelled to call again... and again and again.

In some cases, it was to follow-up on information that enrollment representatives had promised to send me but never did.

In other cases, it was just to ask the exact same questions of another person, because I had absolutely no confidence in the responses I was getting. I would pose the same question to three representatives and get three different answers. That's how my insurer empowers me to make a good decision?

My experience is not uncommon; health insurers routinely bring up the rear in cross-industry customer satisfaction rankings. It raises the question, though: How much unnecessary expense are these companies incurring as a result of all this incompetence?

If health insurers simplified their products a bit, if they made their information materials a little clearer, if they trained and equipped their staff better - how much consumer confusion would they mitigate? How many incoming calls, e-mails and tirades would they preempt? How much operational savings could they pass on in the form of more affordable coverage?

In a health insurance marketplace that's becoming increasingly consumer-directed, many insurers have taken to the airwaves to highlight how they enrich our lives and improve our well-being.

But you can't advertise your way to a good customer experience. If health insurers are serious about improving my well-being, they can start by creating an open enrollment process that's more satisfying than it is sickening.

This article first appeared at LifeHealthPro.

Case management nurses can unwittingly hinder the control of workers' comp claims. Consider the perfect storm of "assumptions" leading to disaster: An adjuster receives a claim requiring extended treatment, makes the standard screen-clicks to assign a nurse and logs the claim in the diary. The employer assumes the case is being scrutinized and treatment is being managed. The adjuster assumes it is okay to ignore the case for a while. The nurse takes the initial claim information at something approaching face value.

In these situations, many nurses act but don't interact. They assist with referrals and expedite the collection of medical information. Unfortunately, they may not use their clinical acumen on critical issues like compensability, diagnosis, causal relationship, return to work (RTW) and treatment plans. We should note that nurses must balance caseloads and respect their company's requirements for speed. As such, they might feel justified in expediting what appears to be a common assignment.

When it comes to referrals, a well-intentioned nurse can cause disaster. I have experienced all of the following: a claimant alleging breathing issues referred to a "sick building expert"; a claimant with negligible head trauma to a "closed head injury specialist"; a claimant alleging jaw pain to a "TMJ dentist"; and the ever popular referral of a claimant with mysterious pains to a "chronic pain specialist."

These real examples all involved highly questionable claimants. Needless to say, medical expert "hammers" saw perfect "nails" in each claimant and fully validated the conditions and the causal relationship each alleged. By the time of the next adjuster diary, it was all over but for the increase in reserves.

The claimant can steal control of a case and contrive subjective medical issues if a nurse simply collects doctor reports and fails to interact. Countless WC case files exist where medical notes are simply pasted in by the nurse. (As far as I am concerned, this indicates adjuster/employer failure and not necessarily a poor nurse.)

I have witnessed nurse case managers decline to intervene in RTW efforts, and the corporate nurse care management entity can, conveniently, relieve itself of RTW responsibilities without affecting its fixed fee. I would argue that some level of RTW support from a nurse can and should exist on any given case in any jurisdiction.

Quick Tip: You and Your Adjuster Must Engage and Direct Nurse Assignments

A nurse should be vital in selecting providers for specialist evaluation or independent medical exams (IMEs). However, the nurse needs the insight and outlook that can only be gained by communication and planning. Engage the nurse and explain all the case issues and concerns. Compare providers and agree on who might be most appropriate. Agree on the specific background, insight and questions to be given to this provider. An early conference call should be mandatory.

The nurse should be an active member of the claim team, including adjuster, employer, defense counsel, Medicare medical savings account (MSA) vendor and, in certain cases, the special investigative unit (SIU). Nurse contributions should be vital to team decisions and strategy.

Make certain the nurse case management fee-structure allows extended work, as a claim might require. Reconfigure if necessary to ensure nurses can spend adequate time where needed.

A nurse should be asked to evaluate, comment and make suggestions based on all medical info collected. This insight can be used by the team to make tactical and strategic decisions.

A nurse is most useful for assessing the claimant on a personal level. The nurse should be sought for oral comment on impressions and gut feelings based on interaction with the claimant. Written assessments, which are subject to discovery in legal proceedings, need to be subtle and are not as meaningful. Therefore, conference calls on an interim basis are critical for gaining powerful nurse insight.

Nurses should absolutely support RTW efforts, either at most by collecting potential jobs from the employer and sharing these directly with the employee and doctor or at minimum by reminding the doctor that the employer has a RTW program and expects participation. Somewhere along this range of support should fit any jurisdiction.

Nurses are great tactical tools against unwieldy claimants. They can relay important details and extraneous issues to a physician that can affect causation determinations and reliability assessment of subjective symptoms. Nurses give doctors an "option B" of facts and background when doctors otherwise would only consider "option A," as relayed by a claimant. Without an "option B," doctors are more likely to give a claimant benefit of the doubt.

Most important: The power of case management nurses is wasted if you do not provide specific insight, direction and expectation for each claim assigned.

Insurance affects everything, and everything affects insurance. It is generally understood that insurance allows those who participate in the economy to produce goods and services without the paralyzing fear that some adverse incident could leave them destitute or unable to function. However, few people are aware of the extraordinary impact the industry has on state, local and national economies. Here are five ways that happens:

Driving Economic Progress

The insurance industry is a major U.S. employer, providing some 2.6 million jobs, according to the Current Population Survey from the U.S. Department of Labor.

Insurers contribute more than $413 billion to the nation's gross domestic product.

In 2013, property/casualty insurers and life insurers incurred federal and foreign taxes of about $20.6 billion. Insurance companies, including life/health and property/casualty companies, paid $17.4 billion in premium taxes to the 50 states in 2013, or about 2% of all state taxes.

Investing in Capital Markets

Insurance companies also help support the economy by investing the funds they collect for providing insurance protection. The industry's financial assets were about $6 trillion in 2013, including $1.2 trillion for the property/casualty sector and $4.7 trillion for the life sector.

In 2013 alone, property/casualty insurers' holdings in municipal bonds totaled $326 billion, according to the Federal Reserve. Life insurers held $1.8 trillion in corporate stocks and $2.2 trillion in corporate and foreign bonds in 2013, according to the Federal Reserve.

Supporting Resiliency and Disaster Recovery

Property/casualty insurers covered $35 billion in catastrophe losses in the U.S. in 2012 and $12.9 billion in 2013, according to the Property Claim Services (PCS) division of Verisk.

Supporting Businesses, Workers, Communities

Property/casualty insurers pay out billions of dollars each year to settle claims.  Many of the payments go to local businesses, such as auto repair companies, enabling them to provide jobs and pay taxes that support the local economy.

Life insurance benefits and claims totaled $586 billion in 2013, including life insurance death benefits, annuity benefits, disability benefits and other payouts. The largest payout, $249 billion, was for surrender benefits and withdrawals from life insurance contracts made to policyholders who terminated their policies early or withdrew cash from their policies.

Empowering Lenders

Specialized insurance products protect lenders and borrowers, shielding businesses such as exporters from customer defaults and facilitating the financing of mortgages and other transactions. These products include credit insurance for short-term receivables.

Credit insurance protects merchants, exporters, manufacturers and other businesses from losses or damages resulting from the nonpayment of debts owed them for goods and services provided in the normal course of business. Credit insurance facilitates financing, enabling insured companies to get better credit terms from banks.

For the full report from which this article is adapted, click here.