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Changing Nature of Definition of Risk

As the foothold of innovation across industries grows stronger by the day, insurers are witnessing the advent of tech-based economies, and with them a fundamental shift in the very definition of risk. Every advancement stands to revolutionize how property, businesses and employees will be insured. Consider automated cars and workplace automation tools, such as Amazon warehouse robots, or the emergence of shared ownership business models, like Lyft and AirBnB. Traditional risk calculation models need to evolve to keep up with rapid change.

How shall insurers prepare for this shift? According to Valen Analytics’ 2019 Outlook Report, a key part of the answer lies in the need to weave data and predictive analytics into the fabric of their business strategies. The report, which employs third-party and proprietary data to identify key trends, revealed:

Insurers Are Heavily Relying on Advanced Use of Data and Analytics to Fuel Growth

Valen’s Underwriting Analytics study found that 77% of insurers are incorporating predictive analytics into their underwriting strategy. This marked an increase compared with the steady 60% of insurers during the past three years, demonstrating a clear emphasis by the industry on data-driven decisions.

While many factors have fueled the demand for sophisticated data and analytics solutions, one stands out. Insurers have a growing desire to reap a share of the underserved small commercial market, which represents over $100 billion of direct written premiums. Data analytics tools enable insurers to reduce the number of application questions, verify necessary information and ascertain risk much more quickly and accurately. This is particularly important in creating effective business models that align with the needs of small business owners.

The rise in insurers looking to employ advanced data analytics techniques has also resulted in the growth of data aggregation services and consortiums. With new primary customer data sources emerging, insurers have access to better insights on consumer risk and behavior. This has contributed to insurers’ appreciation of the predictive horsepower that large pools of data offer. In fact, Valen’s proprietary research found that the synthetic variables appended with consortium data are as much as 13 times more predictive than policy-only data. Synthetic variables are built from computations of more than one variable, made possible by leveraging large and diverse datasets.

See also: Understanding New Generations of Data  

Regulation and Innovation Must Go Hand-in-Hand

With a rise in advanced predictive analytics and robotic process automation in insurance, regulators are paying close attention to the industry. To ensure this oversight doesn’t stifle innovation, it is important that insurers build and document their analytics initiatives so they can be explained and understood by regulators. Being collaborative and responsive will help ensure that regulators can discern the small percentage of use cases that need to be reviewed for consumer fairness protection. In doing so, insurers have the opportunity to take the industry to Insurance 2.0 — the next phase in technology adoption and innovation.

Talent and Infrastructure Challenges

While insurers are looking to integrate data and predictive analytics into their business strategies, what will truly determine their success is their ability to hire and nurture the right talent. Unfortunately, the industry continues to suffer from a lack of the talent needed to support fast-paced innovation. Seventy-three percent of insurers surveyed indicate moderate to extreme difficulty in finding data and analytics talent, and the reasons haven’t changed over the years. While geographic location of the job is the primary reason cited by the survey respondents, more and more prospects are either looking for better compensation packages, are simply not interested in an insurance career or opt for opportunities in tech startups or data-driven companies in other fields.

Another roadblock for insurers is their dated IT infrastructures, which cause massive backlogs. While most insurers suffer backlogs of two years or more, others cannot identify how long their IT backlogs are.

See also: Insurance and Fourth Industrial Revolution  

Both of these problems go hand in hand. Clearly, there is a need to foster an innovation mindset, and, to do so, the industry needs a mix of new thinking and engaging work culture. Insurers should follow the footsteps of leading tech companies and cultivate a culture that appeals to high-level talent. By making small changes, such as embracing diversity and a remote workforce, insurers can make themselves attractive to the talent they need. This will build a workforce capable of overcoming IT infrastructural issues.

In short, to maintain a competitive advantage, insurers must not only put data and analytics at the forefront of their businesses, but also make strategic decisions on how best to employ them to enhance all aspects of their businesses, from customer service and information handling to risk calculations and claims processing.

How the Nature of Risk Is Changing

Back in 2001, famed technologist and futurist Ray Kurzweil boldly proclaimed that the human rate of progress was doubling. He added that, by the time the 21st century ends, the progress would feel like 20,000 years’ worth of transition instead of 100.

At the time, Kurzweil’s statement sounded a bit dubious. But with how rapidly technology has transformed over the last two decades, it now seems that the world’s ability to change quickly was drastically underestimated.

We live in an age defined by acceleration, and this incredible pace of change has exceeded many industries’ capacity to handle it. Changes that once took an entire generation for people to adapt to now takes 10 years. The possibilities of this rapidly changing landscape are endless, and so is the risk that comes with it.

The Far Reaches of Risk

It should come as no surprise that risk evolves alongside technology transformation. Advancement is a double-edged sword. It can simultaneously create a greater level of safety for the status quo and change the very nature of risk, forcing insurers to build new coverage solutions to address previously unforeseen concerns.

For instance, autonomous vehicles might be safer drivers than humans, but they’re also vulnerable to cyberattacks and malware. In many cases, driverless cars are blurring the lines of established risk categories. For proof, just take a look at the sharing economy. It’s less than a decade old, yet it’s raised major questions in terms of how coverage works. Are Uber or Lyft vehicles classified as work or personal? And does the coverage shift throughout the day as drivers turn their ride-sharing service on and off? Insurance companies have to find answers for these types of problems on a daily basis.

See also: How to Adapt to the Growing ‘Risk Shift’  

It’s an understandably complex and intimidating concept for many insurance leaders. However, while progress may be rapid, it’s not entirely unpredictable. The future can be bright for those who remain engaged with the changing landscape of risk. Here’s what those leaders can expect:

1. Humans will gain a deeper understanding of risk.

While technology’s race toward the future provides ample opportunity for confusion, it also provides the tools to parse that confusion and come to a better understanding of risk. Telematics, machine learning, data analytics and more all give insurers much greater insight into how risk touches every aspect of life.

Commercial auto insurers are testing the waters of telematics to explore how they can be applied to evaluate individual driving behaviors. Companies can examine individual driving habits to see how those routines inform the kinds of services and discounts they can offer customers. Instances like these are only going to become more common. This type of granular data sharing will have a direct impact on how coverage is constructed and provided in the future.

2. The way humans and technology relate to risk will change.

As automation continues to be integrated into daily life, coverage will have to properly account for and balance the effect computers and humans each have on rates.

Amazon has more than 100,000 automated and robotic systems integrated into its operations working with human employees to maintain efficiency. The online retailer has almost certainly had to consider how to provide coverage for its employees while they work in tandem with heavy machinery, something companies in similar situations will also have to consider.

Regulation for this is still being crafted. Insurers will need to make sure they continue to stay up-to-date on how and when machines can take over from humans and how that will affect risk.

3. Customer service will look a little different.

Thanks to the Internet of Things, insurers will be able to learn about incidents in real time and process claims before a policyholder even gets involved. These instantaneous notifications are clearly useful for insurance companies, but, used correctly, they can also be a major selling point for consumers.

Machine learning could have a similar impact on customer service. It can be used to pinpoint a highly customized plan for every individual without the customer having to do most of the groundwork.

See also: Insurers Grappling With New Risks  

This age of acceleration is intimidating, and it certainly shows no signs of slowing down. Leadership, however, should look at all this innovation as an opportunity, not a threat. Insurers can leverage tech to improve the customer experience from quote to claim, and, as technology advances, so will the tools that help insurers understand risk.

There’s no denying that infrastructure, demographics and risk are all changing at breakneck speed. To keep up, insurers must not just follow change — they need to grab it by its horns and embrace the new before it becomes old hat.

How Digital Platform Smooths Operations

In a 2009 interview with Insurance Journal, Juan Andrade of The Hartford ranked “improving operational efficiency” third on a list of essential priorities for P&C insurers, below both customer retention and a systematic sales approach.

This ranking made sense 10 years ago. At that time, Andrade’s top two priorities were customer connections and insurance sales, but digital means of providing either one had not fully developed.

Today, however, all three of these top priorities can be addressed through a digital platform — and placing operational efficiency first on the list has the power to boost the other two.

Digital operations management “is not only about technology,” says Eddy Lek at Schneider Electric. “It requires a holistic approach to transform operations; implementing changes to the existing business and operations models and training employees to effectively operate with new tools – [e]mpowering the workforce to leverage technology for greater efficiency.”

Here, we look at how a digital platform improves operational efficiencies for P&C insurers. We also discuss how insurers can identify the top challenges they face and ask the right questions to ensure they implement digital tools that address those challenges effectively.

The Digital Future and Its Challenges for Insurers

Property and casualty insurers have seen stormy weather in the past few years, literally and figuratively. The need to respond to claims from the 2017 hurricane season, decreasing auto coverage purchases combined with rising claim costs and other factors have resulted in losses across the board, according to a Deloitte report.

Customer needs and demands are changing, as well, as Insurance Journal’s Michael Kasdin notes. For instance, younger adults drive less, reducing demand for auto insurance policies and increasing interest in newer, more adaptable tools like pay-per-mile auto insurance. Gig economy work like driving for Uber or Lyft or listing rentals with AirBnB has changed needs in auto and home insurance, as well.

See also: Digital Playbooks for Insurers (Part 4)

According to Kasdin, insurtech is poised to address many of these problems. Yet concerns about cybersecurity and anticipating the “right” place to invest in digital platforms and similar tools continue to stall many insurers, as Nate Anderson, Pascal Roth and Pierre-Henri Boutot described in a Bain & Co. brief.

To address sinking premiums, rising claims and the retention of a customer base shifting rapidly away from old standards of expectation in insurance, insurtech stands out. Improving operational efficiency via digital platforms can improve P&C insurers’ ability to address all three threats simultaneously.

Digital Tools for Operational Efficiency

A recent Audit and Risk Committee Forum survey by PwC found that 44% of insurance leaders surveyed believe that “most existing insurers will not survive, at least in their current form.” And one of the biggest causes of their demise will be operational inefficiency.

Currently, operational inefficiencies in P&C insurance are commonly found in “repetitive, business rule-driven work,” according to February 2018 PwC white paper. While other inefficiencies exist, the sheer volume of repetitive, rule-driven work sets insurers apart from many other industries.

For decades, such work has demanded human intervention because no machinery existed to ensure that the rules were followed and that the task was done correctly each time. Today, however, machine learning, AI and similar tools make it possible for insurance companies to automate much of this work for increased efficiency.

“It’s always important to realize that 55% to 60% of all the cost within any given agency is going to be personnel cost,” Andrade told Insurance Journal in 2009. “The key here is making sure that your people, your employees are being as productive as they can.”

Digital platforms offer new ways to ensure employee productivity. In an automated world, insurance companies can reevaluate the contributions each agent and employee makes based on the value added to the process, providing a powerful new way to determine and eliminate inefficiencies.

How Efficiency and Customer Retention Meet on a Digital Platform

The February 2018 PwC report noted that when it comes to insurtech, most P&C insurers are still thinking in an “outward”-facing mode. They’re embracing digital platforms primarily for the platforms’ ability to connect them with customers who increasingly demand easy digital communication, online purchasing and consistent points of contact.

Meanwhile, Ben Kerschberg at Forbes identifies three “pillars of change” for digital platforms: customer service, operational processes and business processes. In other words, digital platforms do have the power to improve operational efficiencies in customer service — but customer service is only one of three pillars of opportunity. Insurers who focus here miss the two opportunities to greatly improve operational and business efficiency, as well.

Five years ago, big data was big news. Today, it’s a given in most businesses. The ability to analyze vast amounts of data to spot meaningful trends and changes can revolutionize risk analysis and operational efficiency in insurance, but insurers must first have the digital platform necessary to capture and analyze data.

Customers are willing to provide more data to get seamless digital service. They’re also willing to pay more for service on a strong, integrated digital platform — up to 21% more to get, it, according to Ameyo’s Shaista Haque.

A digital platform also makes it easier for insurers to streamline service, not only to customers but also within the organization itself. For instance, when products are developed in a streamlined digital environment, much of the inefficiency caused by in-person meetings, incompatible or un-editable digital documents, checking details or numbers by hand and other prolongations of the product development cycle can be minimized or defeated. This increased internal efficiency improves the ability to provide customers with products that meet their changing needs on a timetable that encourages customers to adopt them.

See also: Digital Insurance 2.0: Benefits  

Questions to Ask When Seeking the Right Digital Tools

Insurtech developments appear almost daily, which can leave insurance leadership feeling overwhelmed. What are the best tools for the particular challenges you face? How can you identify top inefficiencies, and how will you know you’re choosing the right digital platform capabilities to optimize them?

Deb Miller, director of market development for business process solutions at OpenText, identifies four operational efficiency optimization strategies that are being employed by an increasing number of insurance companies:

  • Improving operational efficiency by driving for leverage across silos
  • Scaling to address demand for specific products and across a broader geographical range
  • Expanding distribution channels while improving or maintaining excellent customer service
  • Automating case management tasks to reduce time to resolve in claims, as well as reducing paper and other resource waste

Knowing which strategies to prioritize, however, means knowing where your particular organization’s inefficiency pain points lie. A McKinsey & Co. white paper recommends that managers seeking to improve operational efficiency ask questions like:

  • How are we delivering value to the customer? How do we do so efficiently?
  • How do we work? What are some better ways to perform that work?
  • How do we connect goals, strategy and meaningful purpose? How do we communicate these to our teams and to our customers?
  • How are we enabling people to lead at their fullest potential?

Questions like these can help insurers find inefficiencies. The answers can also help digital platform providers identify which tools will be most effective for a particular insurer.

How to Prepare for Self-Driving Cars

For decades, privately owned, privately insured cars have been so common that few people have questioned these models of transportation and the associated risk.

Property and casualty insurers deal with thousands of individual vehicle owners and drivers as a result. Insurers deal with those drivers’ mistakes, too. A study by the National Highway Traffic Safety Administration (NHTSA) estimates that human error plays a role in 94% of all car accidents.

The entire auto insurance industry is built on this humans-and-their-errors model. But autonomous vehicles stand to turn the entire model on its head — in more ways than one.

Here are some of the biggest changes self-driving cars are poised to make to the auto insurance world and how P&C insurers can prepare for the shift.

Vehicle Ownership

Most conversations about self-driving cars and insurance focus on questions of fault, compensation and risk.

In a 2017 article for the Harvard Business Review, however, Accenture’s John Cusano and Michael Costonis posited that an even bigger disruption to P&C insurance practices would be a change in patterns of vehicle ownership.

“We believe that most fully autonomous vehicles will not be owned by individuals, but by auto manufacturers such as General Motors, by technology companies such as Google and Apple and by other service providers such as ride-sharing services,” Cusano and Costonis writes.

Indeed, companies like GM and Volvo are already exploring partnership with services like Lyft and Uber, as keeping self-driving vehicles on the road as much as possible amortizes their costs more effectively.

Paralleling the autonomous vehicle/ride-sharing partnership trend is a decrease in vehicle ownership. Young adults and teens are less interested in owning vehicles than their elders were, Norihiko Shirouzu reports for Reuters. Instead, they’re moving to more walkable areas or using ride-sharing services more often, already putting pressure on auto insurance premiums.

See also: Time to Put Self-Driving Cars in Slow Lane?  

U.S. roads are likely to be occupied by a combination of human-driven and self-driven vehicles for several decades, Cusano and Costonis estimate. As ownership trends change, however, P&C insurers’ focus on everything from evaluating risk to branding and outreach will change, as well.

Connected closely to the question of ownership is a second question: Who is at fault in a crash?

Fault Ownership

NHTSA’s statistics on human error as a crash factor imply that reducing the number of human drivers behind the wheel would reduce accidents. A McKinsey & Co. report agrees, estimating that autonomous vehicles could reduce accidents by 90%.

Taking human drivers’ mistakes out of the equation means taking human fault out of the equation, too. But questions of human fault stand to be replaced by even more complex questions regarding ownership, security and product liability.

Several automakers have already begun experimenting with approaches that upend traditional questions of fault and liability. Concerned over the patchwork of federal and state regulations in the U.S., Volvo President and CEO Håkan Samuelsson announced in 2015 that the company would assume fault if one of its vehicles caused an accident in self-driving mode.

The statement appears to apply to Volvo’s vehicles during the development and testing phases, according to Cadie Thompson at Tech Insider. It is too early to tell whether the company will extend its acceptance of fault to autonomous Volvo vehicles that function as full-fledged members of the transportation ecosystem. Nonetheless, the precedent of automakers accepting liability has been set — and, as automakers continue to explore partnerships or other models of fleet ownership, accepting liability or even providing their own insurance may become part of automakers’ arsenal, as well.

Ultimately, Volvo seems unconcerned about major liability shifts. “If you look at product liability today, there is always a process determining who is liable and if there is shared liability,” Volvo’s director of government affairs, Anders Eugensson, told Business Insider. “The self-driving cars will need to have data recorders which will give all the information needed to determine the circumstances around a crash. This will then be up to the courts to evaluate this and decide on the liabilities.”

Meanwhile, in Asia, Tesla is trying another method: including the cost of insurance coverage in the price of its self-driving vehicles, according to Danielle Muoio at Business Insider.

“It takes into account not only the Autopilot safety features but also the maintenance cost of the car,” says Jon McNeill, Tesla’s former president of sales and services (now COO of Lyft). “It’s our vision in the future we could offer a single price for the car, maintenance and insurance.”

Doing so would allow Tesla to take into account the reduced accident risk of the autonomous system and to lower insurance premium prices accordingly. This might reduce the actual cost of the vehicle over its useful life.

The NHTSA has already found that accident risk in Tesla vehicles equipped with Autopilot are 40% lower than in vehicles without, and the company believes insurance coverage should reflect that, according to Muoio.

If P&C insurers don’t adjust their rates accordingly, Tesla is prepared to do so itself.

Future Ownership

Property and casualty insurers seem torn on how self-driving cars will affect their bottom line.

On the one hand, “insurers like Cincinnati Financial and Mercury General have already noted in SEC filings that driverless cars have the potential to threaten their business models,” Muoio reports.

On the other, 84% don’t see a “significant impact” happening until the next decade, according to Greg Gardner at the Detroit Free Press.

Other analysts, however, believe the insurance industry is moving too slowly in response to autonomous vehicles.

“The disruption of autonomous vehicles to the automotive ecosystem will be profound, and the change will happen faster than most in the insurance industry think,” KPMG actuarial and insurance risk practice leader Jerry Albright tells Gardner. “To remain relevant in the future, insurers must evaluate their exposure and make necessary adjustments to their business models, corporate strategy and operations.”

KPMG CIO advisory group managing director Alex Bell agrees. “The share of the personal auto insurance sector will likely continue to shrink as the potential liability of the software developer and manufacturer increases,” Bell tells Gardner. “At the same time, losses covered by product liability policies are likely to increase, given that the sophisticated technology that underpins autonomous vehicles will also need to be insured.”

See also: The Unsettling Issue for Self-Driving Cars  

Major areas of concern in recent years will likely include product liability, infrastructure insurance and cybersecurity.

Meanwhile, the number of privately owned vehicles — and individually insured drivers — on the road will likely continue to drop, placing further pressure on auto insurance premiums.

What should P&C insurers to do prepare? Cusano and Costonis recommend the following steps:

  • Understand and use big data and analytics. As Eugensson at Volvo notes, autonomous vehicles will generate astounding quantities of data — data that can be used to pinpoint fault. It can also be used to process claims more quickly and efficiently, if insurers are prepared to use it. Building robust data analysis systems now prepares P&C insurers to add value by analyzing this data.
  • Develop actuarial frameworks and models for self-driving vehicles. As Tesla’s insurance experiment and NHTSA data indicates, questions of risk and cost for autonomous cars will differ in key ways. P&C insurers that invest the effort into developing and using more sophisticated actuarial tools are best-prepared to answer these questions effectively.
  • Seek partnerships. The GM/Lyft and Volvo/Uber ventures demonstrate how partnerships will change the automotive landscape in the coming years. Insurers that identify and pursue partnership opportunities can improve their position in this changing landscape by doing so.
  • Rethink auto insurance. Currently, P&C insurers’ auto work involves insuring large numbers of very small risks. As our relationship to vehicles changes, however, insurers will need to change their approach, as well — for instance, by moving to a commercial approach that trades many small risks for a few large ones.

Autonomous vehicles are poised to become one of the most profound technological changes in an era of constant change. Fortunately, the technology to manage this change is already available for insurers that are willing to embrace a digital future.

A Test Case on Sanity of Drug Prices

In both traditional healthcare and pharmaceuticals, the phrase “value-based purchasing” is all the rage. Rightfully so, we want to spend our precious healthcare dollars on the care that is most valuable. In other words, we want to pay for care and drugs that are effective and not pay for those that aren’t. Like everything else, the shortest path to value is a truly competitive market. The gorilla in the room is that healthcare, and especially pharmaceuticals, severely lack this fundamental capitalist feature that we have benefited greatly from.

American healthcare dwells in never-never land. We have neither explicit price controls through regulation nor implicit controls through a functional market, resulting in the worst of all possible worlds: a system that’s entrenched, opaque and dysfunctional. It gets worse when we narrow our focus on the drug market. We don’t even understand what it is that we are purchasing because buyers neither spend much time understanding drug effectiveness in the real world nor tie effectiveness to payment. Instead, in an attempt to save dollars, employers, health plans and the government have turned to intermediaries, pharmacy benefit managers, to manage the problem on their behalf. PBMs’ efforts to manage pharmacy costs rely on typical buzzwords like “formulary management,” “prior authorization” and “step therapy.” And PBMs are, as Bloomberg News explains, “the middlemen with murky incentives behind their decisions about which drugs to cover, where they’re sold and for how much.”

See also: 9 Key Factors for Drug Formularies  

This leads us down an unintelligible labyrinth of perverse financial incentives, with zero transparency for the payer or patient on the actual costs, alternatives for therapy and individual outcomes. That’s a problem especially in specialty pharmacy, the fastest-growing sector of pharmacy spending. Only a few years ago, specialty drugs composed a reasonable-sounding 10% of our overall drug spending. Last year, it bloated to 38%, and by 2018 it will be an astounding 50%, which is an increase of $70 million a day!

Contrary to what we often think, there are better options even for many specialty drug therapies. Mavyret, manufactured by AbbVie, is the first example of a new brand name Hepatitis C drug that is actually better for patients and costs far less since Sovaldi hit the market at a price point of $1,000 a pill (never mind that you can purchase it for $4 per pill in India). Eighty percent of patients with Hep C can do an eight-week course versus alternatives manufactured by companies like Gilead and Merck, which generally require 12 weeks. Mavyret is the only drug that works for genotype’s 1-6 and has a list price that is less than half of what competitors charge, even after factoring in middleman shenanigans such as rebates. The final cost to cure a patient of Hep C is approximately $26,000. If that sounds high, consider that specialty medications for chronic conditions such as psoriasis are now $60,000 to $120,000 or more per year.

If you’re like most payers, our current system locks you into paying more for drugs for your members that are less effective than proven, cheaper alternatives like Mavyret. For starters, your PBM may only provide more expensive drugs on its formulary because of large manufacturer rebates, the majority of which they retain. Formulary decisions, of course, are not based on what is most effective for the patient or cheaper for you, the payer.

We feel the financial pain of this broken system every day, but it doesn’t have to be this way. Two decades ago, the internet revolution made the travel agency obsolete for most Americans. Uber and Lyft have done the same to parts of the transportation industry, and Amazon continues to do this to many others. What have these disruptive innovations taught us? That we might, in fact, be able to make better decisions ourselves, without non-value-added middlemen. It is time for this type of disruptive innovation to hit the pharmacy world.

Today’s system focuses on controlling suppliers through PBMs, which in reality just limit our choices and prevent the functioning of a real market. Instead, if we were to focus on value, we could use patient data to give us an objective understanding of whether the patient was getting the right outcome at the right price. This scenario represents an opportunity for better health outcomes and savings compared with the status quo. Here’s the catch: To enter this world, we have to start saying “no” to the current “travel agents” and their obsolete model.

See also: Opioids: Invading the Workplace  

In many ways, Mavyret is like the canary in the coal mine. If this drug isn’t successful – we know it is better for the patient, more effective and costs less – what signal does this send pharmaceutical companies? Don’t bother discovering better drugs that cost less because they won’t sell!

We salute AbbVie for doing what is right for patients and payers. America is the leader in driving innovation and investment in new drug discovery, and our inability to make the right choice not only reduces therapy choices for millions of Americans and their physicians but also for billions of others around the world who depend on us for leadership. Now is the time for payers to demand a functional market and stop overpaying for less effective therapeutic options.