Tag Archives: insurance carrier

Obamacare: Where Do We Stand Today?

The healthcare industry is changing – same old headline. Since we’ve been in the industry, the “unsustainable” cost increases have been the talk every year, yet somehow we have not reached a tipping point. So what’s different now? How has ACA affected the healthcare industry, and more specifically the insurance companies?

The drafters of ACA set up a perfect adverse-selection scenario: Come one, come all, with no questions asked. First objective met: 20 million individuals now have coverage.

Next objective: Provide accurate pricing for these newly insured.

Insurance companies have teams of individuals who assess risk, so they can establish an appropriate price for the insurance protection. We experience this underwriting process with every type of insurance – home, life, auto. In fact, we see this process with every financial institution, like banks, mortgage companies and credit card companies. If a financial institution is to serve (and an insurance company is a financial entity), it has to manage risks, e.g., lend money to people who can repay the loan. Without the ability to assess the risk of the 20 million individuals, should we be surprised that one national insurance carrier lost $475 million in 2015, while another lost $657 million on ACA-compliant plans?

If you’re running a business and a specific line has losses, your choices are pretty clear – either clean it up or get out.

See Also: Healthcare Quality and How to Define It

Risk selection is complex. When you add this complexity to the dynamics of network contracting tied to membership scale, there is a reason why numerous companies have decided to get out of health insurance. In 1975, there were more than 2,000 companies selling true health insurance plans, and now there are far fewer selling true health insurance to the commercial population. Among the ones that got out were some big names – MetLife, Prudential, Travelers, NYLife, Equitable, Mutual of Omaha, etc. And now we’re about to be down to a few national carriers, which is consistent with other industries – airline, telecommunications, banking, etc.

Let’s play this one out for the 20 million newly covered individuals. The insurance companies have significant losses on ACA-compliant plans. Their next step – assess the enrolled risk and determine if they can cover the expected costs. For those carriers that decide to continue offering ACA-compliant plans, they will adjust the premiums accordingly. While the first-year enrollees are lulled into the relief of coverage, they then get hit with either a large increase or a notice to find another carrier. In some markets, the newly insured may be down to only one carrier option. The reason most individuals do not opt for medical coverage is that they can’t afford it. If premiums increase 15% or more, how many of the 20 million have to drop coverage because premiums are too expensive? Do we start the uninsured cycle all over again?

Net net, ACA has enabled more people to have health insurance, but at prices that are even less sustainable than before. ACA offers a web of subsidies to low-income people, which simply means each of us, including businesses, will be paying for part or all of their premium through taxes. As companies compete globally, this additional tax burden will affect the cost of services being sold. As our individual taxes increases, we reduce our spending. While ACA has the right intention of expanded coverage, the unintended consequences of the additional cost burden on businesses and individuals will have an impact on job growth.

While it’s hard for anyone to dispute the benefits of insurance for everyone, we first need to address the drivers behind the high cost of healthcare, so we can get the health insurance prices more affordable. Unfortunately, ACA steered us further in the wrong direction. Self-insured employers are the key to lead the way in true reform of the cost and quality of healthcare.

InsurTech Forces Industry to Rethink

Actors in the insurance industry put the whole sector under universal suspicion in the minds of customers.

Customers want to be able to identify with a company. This can only be achieved by successful branding campaigns that target establishing a relationship between the company and the consumer. If consumers agree with the values a company stands for, they are more inclined to trust the company. Young companies have the advantage of a fresh start; while traditional insurance carriers, as well as traditional insurance agents, are suffering a decline in reputation and need to win back trust, young companies can position themselves as an alternative to an unpopular industry and therefore benefit from unbiased consumers.

See Also: A Mental Framework for InsurTech

In a way, InsurTech start-ups can provide a more personal service than traditional agents can, making use of marketing and branding advertising, as well as social media presence and availability. This becomes increasingly important as customers will use a vast variety of channels to interact with their insurance agent — brick-and-mortar agents will have a hard time keeping up.

Besides reputation, the use of technological advances will be an essential determinant for the success of insurance agents. As consumers use more and more online sources or digital agents to manage their insurance policies, local insurance agents will become less important. A report recently released by consulting firm McKinsey includes a chapter on “the end of an era for the local insurance agent.” This sums up the future of traditional, analogue agents, whose business model will no longer be able to withstand innovative alternatives. In addition to digital solutions and mobile-first applications, traditional agents will face competition from insurance carriers that will focus more on establishing a direct relationship with their customers and will gradually factor agents out of the equation.

Technology and simplification are changing nearly every aspect of our lives. Customers have become increasingly used to managing everything from shopping to paying bills with the help of apps. Our always-on culture is bringing more customized options into the very personal areas of finance through technology. Therefore, managing insurance policies offline is beginning to seem like an unnecessary and tedious task. Comparing insurance online has been popular ever since the first portals came up, but the gap in consulting was harder to close. Insurance brokers watched the onset of insurance portals with ease, knowing those portals were unable to provide advice for the mostly helpless customer when it came to insurance.

However, the development and distribution of insurance apps that offer an easy-to-understand overview of complicated insurance products, as well as independent advice, led to fierce competition on the insurance market. Consumers don’t want to store tons of paperwork in large folders and block out their spare time to meet their insurance agent for coffee. As a result, these agents are losing customers to the innovative alternative. New players provide comprehensive services, replacing traditional broker services and thereby replacing traditional agents who do not have the resources to develop the tools necessary for better customer service. The new market players figure out what kind of solution consumers want and need, and they adapt accordingly. This can only be forced by pushing into the market and spending money — investors’ money that established companies usually do not have.

Providers of mobile-first insurance solutions drive change in the insurance industry with a clear focus on advisory automation and mobile service experience. Apps like Knip do not just use technological advances as an addition to traditional services; they change the business model the insurance industry is based on, following a consumer-friendly approach and making products more transparent. That benefit will be hard for traditional brokers and insurers to copy. They can implement technological features and develop their own apps, but their business is based on sales rather than advisory, which will make them lose customers to more innovative companies.

Both traditional agents and insurance carriers are pondering this development. Their inflexible organizational structures will be hard to overcome to provide more technology- and customer-oriented services. Sure, traditional brokers and advisers will still be needed as technology advances. Some people prefer to welcome their insurance broker in their home and would not dream of a mobile customer-broker relationship. Yet, this group will continue to shrink and become more specialized with time, something everyone working in this sector should be aware of. Only the best of the best of the traditional brokers will survive, be it because of their special expertise, their marketing and brand advertising success or their operational efficiency. Consumers are so used to digital products they will not hesitate to punish any provider that cannot or does not offer them such.

There are still some challenges ahead for start-ups and innovative companies; patience and persistence are crucial. As they are innovating in a very traditional industry, not everyone is excited about digital solutions — mostly because they don’t know what to expect. Informing and educating are important to overcome this fear. It might take a while, but it is starting to work.

See Also: InsurTech: Golden Opportunity to Innovate

What everyone needs to be aware of is that ignoring the development will not end it. Those who turn a blind eye to it now will end up being left behind. Ten years ago, online banking was something extraordinary. Today, it is hard to imagine life without it, and very few people still fill out transfer forms at their local bank. This development will continue with more innovative ideas and more technological progress. Insurance is undergoing the same process, and, a few years from now, it will be perfectly normal to manage policies online and via mobile. The insurance industry realizes it needs to adjust to customers’ expectations if it does not want to be left behind.

How Colleges Can Work With Insurers

If you sit down with just about any college administrators and ask about the vision of their university, you may witness a dramatic change as their voices fill with passion, reserve disappears and the entire tone of the conversation shifts away from being transactional. As an insurance broker specializing in higher education, I have witnessed this transformative moment many times. Unfortunately, the passion for the institution, its vision and its future does not always translate into the insurance submission and renewal process.

Many people, including some insurance brokers, view buying and selling insurance as a passionless transaction. Information about the college—such as financial statements, property values and loss experience—is gathered, tabulated into Excel spreadsheets and forwarded on to the underwriting arm of seemingly interchangeable insurance carriers. Underwriters review volumes of data about the college to decide whether the insurance company can comfortably provide a college with a certain level of insurance coverage in exchange for a fixed annual premium.

See Also: A Practical Tool to Connect Customers

The information provided to an underwriter creates a story about the college. Depending on how the information is received and presented, the story can be positive or negative. To the underwriter, sometimes the insurance submission can be as horror-filled as a Stephen King epic or as romantic as a Nicholas Sparks novel. Of course, the insurance submission is not a work of fiction.

One of the first things that statistics students learn is that the same information (data set) can be used to draw multiple and sometimes competing conclusions. Where one person may see positive potential, another may see an organization in decline. The conclusions drawn from the data set by different insurers and underwriters reviewing the same information may vary significantly.


Though the information contained in a submission or application may be objective—meaning the information has not been altered or manipulated—the conclusions drawn from the information are less so. The underwriting process involves both subjective and objective analysis. And how the data is interpreted may have a significant impact on the underwriting decision and, ultimately, on the total premium an organization pays.

Using Data

According to a Harvard Business Review article, data can be used as a visual mechanism to direct the narrative surrounding a particular situation. The key is to:

  1. Identify the narrative or the core message the audience should walk away with;
  2. Identify your target audience and figure out what they are interested in—is the presentation to an underwriter, claims adjuster, insurance company executive, etc.?;
  3. Remain objective and offer a balanced viewpoint—your credibility will suffer if what is being said cannot be supported by the facts;
  4. Not censor the data—do not exclude unfavorable information, and this is especially important in an insurance setting as failure to disclose information can constitute insurance fraud; and
  5. Take the time to edit—not the data itself, but how the information is presented.

There are many different methods for presenting the narrative of an institution in the most positive light possible while still providing objective information. The first step to understand both the positive and negative elements. This allows the institution to showcase itself in the best light possible. A failure to fully engage in this process may leave the narrative open to misinterpretation, create questions about unexamined negatives and result in overlooking one or more positive elements.

Communicating the story of an institution involves a deep understanding of the goals and vision of the institution, and there is no one better to communicate that story than a passionate college administrator. However, understanding what drives your institution is not enough—and that is where administrators need to leverage key professional relationships. Selecting the right broker is a key step in driving the narrative forward. A professional partner brings market knowledge and the ability to help transform the narrative from numbers into a story that honors the vision of the administration.

Developing Key Relationships

The majority of colleges and universities work with one or more insurance brokers to engage with the insurance marketplace. At minimum, a broker working with an institutional client assists in (1) identifying insurable exposures, (2) preparing recommendations for coverage types and limits, (3) identifying potential insurers to approach, (4) developing the insurance submission, (5) negotiating pricing and coverage terms and conditions with the markets and (6) presenting the carrier quotes to the institution.

Institutions at every level can rely quite heavily on the services and recommendations of their insurance brokers. The broker can play a critical role between having a well-structured insurance program and having a potential mess of overlapping coverage, gaps in coverage, inconsistent coverage terms, out-of-balance limits and potential claims issues. The broker can also act as a key resource in communicating the organizational narrative to the underwriters.

There are four key elements a broker adds to narrative development:

  1. Market Knowledge: Insurance brokers keep abreast of developments in the marketplace, including insurer appetites: Like any company, insurers have target or preferred customers. Being in an insurer’s target class can provide premium discounts and coverage enhancements. Insurers typically understand the risk exposures associated with their target customers and are comfortable underwriting these risks and adjusting claims. For the insurance client, this means (1) access to expertise from an insurer that understands your institutional risk and (2) comfort in knowing the insurer has an understanding of institutional risk and will be unlikely to cancel or withdraw coverage in the event of a claim. Ultimately, it does not make sense to send an application to an insurer that does not understand or have a comfort level with higher education risks. Insurance brokers also keep abreast of market conditions. For the past few years, insureds have enjoyed relatively stable insurance rates and coverage offerings. It is currently the norm to see flat program renewals and even rate decreases in several key insurance coverage lines. However, it is unlikely that this trend will continue long -term, and it may be significantly affected by: 1) Mergers: The insurance market is changing as insurers look to increase market share and underwriting profit while minimizing exposure to catastrophic losses and unprofitable lines of business. 2) New Market Entrants: There has been an influx of third-party capital into both the insurance and reinsurance markets, resulting in lower insurance prices in the short term. The question is whether these new entrants are here to stay and whether capital levels have peaked.
  2. Underwriting Guidelines/Expectations: Understanding how underwriters use information is a key element of the narrative development. Different insurance carriers use underwriting information differently. Customizing the insurance submission to highlight critical (or essential) information that will be viewed favorably by the underwriters make a big difference.
  3. Risk Analytics: Analytical services provide a more complete picture of organizational risks, claims trends and opportunities for improvement. These services may include claims dashboards, benchmarking analytics, property valuation and catastrophic loss exposure analysis. This is really where brokers can distinguish themselves. Effective use of analytics allows the institution to home in on key risk and loss drivers and develop a risk management plan to address problem areas early. Early identification processes and plans can be communicated to underwriters as part of the application process. This can be critical for institutions with past losses, as it demonstrates steps to control future loss and an awareness of university exposures.
  4. Alternative Program Structures/Alternative Risk Transfer Options: Not every risk can be transferred, and not all risks are adequately covered by buying off-the-shelf insurance products and services. Taking control of the insurance conversation may require a needs-based assessment of academic, administrative and financial processes to determine optimal (1) coverage types/limits and deductibles/retentions, (2) feasibility of self-insured or captive programs, (3) needed coverage enhancements and (4) key contributors to loss/potential losses.

Tips for constructing and delivering your narrative

Start early. Waiting until a couple of months before program renewal does not provide a great deal of time to develop a cohesive narrative or to allow underwriters the time needed to develop a real understanding of the institution. In fact, it can be beneficial to begin the conversation with a prospective insurer years before moving coverage from a current insurer. This is important even if there is a comfort level with the current program structure and insurance providers. Organizational risks are not static, and insurance programs change over time. Engaging in regular dialogue with underwriters at different insurance companies allows multiple carriers to develop an understanding of the college/university’s operations and risks. Developing alternative carrier relationships provides a backup plan.

See Also: Are Customers Like Berliners?

Know and understand your institutional risks and objectives. This includes both the positive and negative aspects. It can be easy to focus on the positives, but, as with an ostrich hiding its head in the sand, that may result in overlooking key dangers to the continuity of the college itself. You should:

  1. Create an internal risk review team made up of a diverse group of institutional stakeholders, such as human resources staff, facilities/housekeeping, faculty, administrative staff, board of trustees, alumni and students.
  2. Engage an objective third party, such as a risk consulting firm, or use the institution’s insurance broker’s analytical team.
  3. Participate in peer-review activities by engaging with administrative and risk management personnel at other institutions. Participating in risk management round-tables and discussions such as those provided by United Educators, URMIA and other educational insurers/associations can assist in planning for common areas of concern.

Use the data as a guide. As much as insurance brokers may wish otherwise, underwriters are pretty savvy people and will usually catch on to most omissions. It is very hard to recover from a situation where the underwriter feels misled about the organization—there is a loss of trust, respect and partnership that is impossible to get back. Be open and objective about the current position of the college/university. But do not allow the negative information to be all the underwriter sees—provide mitigating information such as steps the college is taking to: (1) improve loss experience, (2) attract higher enrollments or (3) renovate aging infrastructures. Underwriters want to write business, and most of them are looking for a reason to say “yes.”

Do not rely solely on the insurance application. The application gathers the minimum amount of information that an insurance company needs to underwrite a risk. If the institution is working with an insurance broker (as most do), it is important to collaborate with the broker rather than just cede the submission development process entirely to the broker. A broker (regardless of how good she is) is never going to be as passionate about your institution as you are. Get to know your underwriters—go to lunch, meet them at conferences, attend a carrier networking event or even schedule periodic conference calls. If all your organization is to an underwriter is a few sheets of paper submitted 90, 60 or even 30 days prior to a renewal, you will not get the underwriter’s full attention or consideration. Engage your underwriters.

A Word With Shefi: Ashili at Smart Drivinc

This is part of a series of interviews by Shefi Ben Hutta with insurance practitioners who bring an interesting perspective to their work and to the industry as a whole. Here, she speaks with Shashaanka Ashili, founder of Smart Drivinc.

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

Describe Smart Drivinc in 50 words or less:

We are focused on developing crash-prevention technologies in affordable ways. Our solution for distracted driving is affordable, configurable, tamper-resistant and backed by intelligent evolutionary algorithms.

How did the idea develop?

In 2014, my wife’s car was rear-ended by a distracted driver. A non-fatal, four-car pileup resulted in a total loss of the car. Finding another car, with infants in the family, was a painful process. The unfortunate part is that the accident could have been prevented, had the driver been a bit more careful. That is the focus of Smart Drivinc – crash prevention.

What’s in a name?

Our solution is supported by smart technologies that make driving safer…hence Smart Drivinc.

Describe your typical client:

Our B2B clients are companies with employees on the road: sales workers, insurance adjusters, etc., for whom we reduce risk by preventing accidents. Our B2C clients are parents of novice drivers, for whom we provide peace of mind.

What does competition look like?

The space is crowded with all kinds of solutions, however, we are the only company that solved this problem in an affordable fashion and created a win-win ecosystem for end users and insurance carriers.

What’s on your to-do list?

The top of my to-do list includes forming collaborations with insurance companies. Our solution not only reduces accidents but also brings new customers to the table.

What are you most excited about with respect to Smart Drivinc?

At the end of the day, what matters and excites us most is providing peace of mind to parents and making our roads safer.

Why are you part of the Global Insurance Accelerator?

GIA occupies a niche, a space that has not been visible before. Combining insurance and technology in the Heartland is a brilliant strategy. For the past three weeks, we’ve met with the best in the industry and were offered unconditional support for our venture. I learned a lot from each individual meeting. GIA has created a mentor pool that is like a library where you can find answers to everything. The best part is they’re one call or one email away from us.

One takeaway:

Make no assumptions, stop “talking” and start “asking.”

Who else has been supportive of your cause?

CEO of MinMor Industries, Joe Morris, is one of our strong supporters. Thank you, Joe!

Biggest challenge:

By profession, I am a bio-optical systems guy, no relation to the insurance or the transportation industries. Developing contacts and traversing these sectors was my biggest challenge. Being selected to GIA solved this problem for us.

Where do you see Smart Drivinc in five years?

Our motto is “Crash Prevention,” and we have several products lined up to address this, with the goal of launching a product once a year. For instance, we are developing a suite of products to personalize one’s interaction with his/her car, starting with the actual purchase of the car, down to maintenance, insurance and even the sale of the car.

Best life lesson:

Believe in yourself; you will have some discouraging encounters.

auto insurance industry

$60 Billion Elephant in the Room

Research has found that one in four car crashes is caused by phone-related distracted driving. However, a recent LifeSaver study of agents suggests this figure to be a vast understatement. More than 60% of agents responded that half or more of all claims are now related to distracted driving.

It’s downright scary to think about the injuries, property damage and loss of life that results from distracted driving.

If our survey bears out on a national scale, the full cost could be north of $60 billion a year. And, of course, this cost is passed on to drivers in the form of increased premiums. In fact, we’re already seeing some major insurers (GEICOAllstate and Zurich) publicly conceding that they are feeling the pain from this fast-growing epidemic.

Assuming the annual cost to insurance companies ranges from $30 billion (if one in four accidents stems from phone-related distracted driving) to $60 billion (using the numbers from our research), a mere 10% reduction in distracted driving accidents would save insurance carriers and their customers several billion dollars annually, in addition to saving lives and drastically reducing injuries.

The infographic below highlights the cost of distracted driving to the insurance industry. It also offers some insight into the minds of insurance agents receiving these claims, as well as the habits of today’s distracted drivers. Take a look and let us know your thoughts in the comments below.