Enjoying a cool discussion of InsurTech carrier Lemonade, not too sweet, not too sour

Lemonade- it’s not just a drink anymore

TLDR How can an interview with an insurance startup founder go from discussing InsurTech and innovation, and end up focusing on the concept of a Ulysses Contract, Game Theory, Prisoners’ Dilemma, and the Nash Equilibrium?  Simple- find some time to talk with Daniel Schreiber, serial entrepreneur and now CEO of Lemonade Insurance.  It’s certain that additional perspective would have been added by Daniel’s co-founder, Shai Wininger, but we’ll focus on Daniel’s views for this article.

Lemonade has been under intense scrutiny since its entry into the insurance world in 2016, and Mr. Schreiber has been the guest of many interviews since then.  As is expected for any figure that resides in a legacy industry, finances and insurance ‘stuff’ have in general been the main topics of those discussions.  It seems all the questions related to insurance accounting and finance had been asked, and those at Lemonade have been rather public in getting out their ideas of what the industry should know about the company, so I was not interested in simply conducting another ping pong contest of convention versus innovation.  In planning for this Daily Fintech interview I thought I’d take a different approach- ask others what they would want answered by the CEO of this very public startup- so I crowd-sourced the questions.  More questions came than there would be time to ask, but the questions were shared with Daniel ahead of time so we figured we could sort out some key points.

Spring boarding off a recent optimistic posting by the firm’s Chief Insurance Officer,  John Peters  (read that here ), Daniel was asked of his impression of Lemonade in the insurance market- customer impressions, marketing, industry reaction, any factor that was meaningful.

The primary response- gratification that the insurance incumbency is tolerant but somewhat unimpressed based on ‘backhanded’ compliments, e.g., “they are good at PR,” “have a delightful APP,”, “they don’t ‘get’ insurance,” “Lemonade is not serious,” and the like.  Not ‘getting’ insurance is due to the app that is at the core of change in insurance, with invisible to the eye analytics, transformed user experience (UX), and predictive risk tools that are unavailable to traditional broker systems.  Not getting it means the firm’s approach is truly different/innovative.  And as time passed, the firm’s growth prompted comments such as, “if it grows like a weed it probably is one.”

The discussion led to a general touch on the first of the crowdsourced questions (answers quoted but paraphrased from Daniel’s remarks):

At the very beginning of Lemonade’s creation, what was the vision, who was the target customer, what value could you add to them?”

DS:         This, of course, touched on a primary reason for the firm’s existence- how could insurance be made available to customers in a way that was entirely different than the legacy system that was by some estimation, “A business that involves selling people promises to pay later that are never fulfilled?” (Urban Dictionary) .  Early on, per Daniel (and recounted by co-founder Ty Sagalow in his recently published book, “The Making of Lemonade”) , the founders of Lemonade worked to form an insurance company that aligned the interests of the carrier and the customers, in a fashion that was economically viable, applied cutting edge technology, and contributed to a common good.  Insurance is a need for most and is not a product that people yearn for, it is as is said, ‘sold, not bought’.  The vision was to be a 24/7 insurance company that delighted customers, and not one that irritated them.

“What early action do you regret was handled in the manner in which it was?”

DS:         At the initial launch of the company we announced Lemonade as being the ‘world’s first P2P insurance company’, a designation that posed immediate issues.  First off, the phrase only made sense within the insurance industry, insurance customers didn’t know what P2P was and didn’t really care.  In addition, those within the industry questioned the definition and if Lemonade was truly peer-to-peer.  Rather than wrestle with semantics and the distraction we backed off from that marketing.

An important aspect of the firm’s make-up is the charitable contribution (up to 40% of premiums.)  Shouldn’t contribution levels be detached from an arbitrary loss ratio result?

DS:         We are very proud of the amount of premiums that Lemonade has shared with charitable organizations on behalf of our policyholders.   2018 found the contribution to be approximately 2% of premiums.  It’s understood that Lemonade is not the only company to make charitable contributions, but compared with other companies Lemonade’s efforts represent not a bilateral, traditional approach where a portion of a company’s revenues are donated to a charity, Lemonade expresses a trilateral approach- the policyholder, the company, and the designated charity.  As discussed, Lemonade’s financial operating model allows for a set percentage of earned premiums to be set aside for operations, a portion for reinsurance backing, and the balance for payment of claims.  When claim/loss payments have a favorable performance versus the set aside, the balance is apportioned by group to the respective policyholders’ choice(s) of non-profit.  As a B Corporation, or Public Benefit Corporation, Lemonade is proud of its efforts to be a social good that is also an insurance company.  

“When it’s said in Lemonade’s press and marketing that traditional insurance companies make money by denying claims, which claims do incumbents deny that Lemonade would pay?”

DS:         Lemonade clearly understands that an insurance policy is a contract between the carrier and the policyholder, and the intention is not to say that in handling claims from customers Lemonade will pay claims outside of the policy provisions.  What is being said is that for both parties to the contract incentives matter, and alignment of interests matter, and actions follow the incentive structure.  If there is a reduced temptation for the carrier to deny claims because the outcome is to do good, and there is a reduced temptation for the insured to embellish claims for the same reason, then the dynamic of denied claims, or incentive structure affecting both sides is reduced and in fact there becomes an even closer alignment of interest to do good.  In actuality the principle is a foundation of Lemonade- the Ulysses Contract and Game Theory (author’s note- these concepts will be addressed in more depth in a future article).  Just as Ulysses ‘tied his own hands’ to the mast due to his knowing that the sound of the Sirens would tempt even him, Lemonade ties its financial hands by setting a designated amount for operations, reinsurance, and claims, and the remainder is contributed to good.  There is not a unilateral financial benefit to denying claims (or arbitrarily not paying claims) because any excess is not the company’s.  And, customer knowing that if they embellish claims they are in essence reducing that which goes for the common good.  So it’s not that Lemonade is paying or not paying claims, it’s that the company has its own Ulysses Contract to guide its behavior.

“There are fans of the firm’s Instagram vids- How did you come up with the idea, and what else is the company doing like that to propagate your overall message of transparency and social good?”

DS:         Those videos with the pink goo and others are from a variety of sources, primarily from Lemonaders within the company.  The goo was an idea from a product designer, for example.  If you recall the publicity driven by the Banksy art piece that shredded itself in front of an auction audience not long after that a Lemonade quality assurance staffer came up with a quick homage here .  We are unafraid to encourage these types of contributions.

“A recent Forbes article and LinkedIn article by Chief Insurance Officer John Peters mentioned Lemonade’s loss ratio tracking in the high 80% range, a significant improvement/trend from the prior year’s results.  Is the reported ratio result being ‘subsidized’ by ceding premium and loss cost amounts to the firm’s reinsurers?

DS:         Lemonade are the guardians of the insurance ecosystem as established by the company, and operations are to the benefit of all stakeholders.  there is no financial ‘game playing’ to meet an arbitrary result.  The firm’s reinsurance agreement sets excess limits where the reinsurer accepts responsibility for claim costs above the set threshold.  There is recognition that traditional measures are what the market sees and holds as comparatives but we figure if the original business model is followed the results will speak for themselves.

“You’ve done great stuff, is there one thing of which you are most proud?”

DS:         The ability to create an insurance system that delights customers, allows growth, and generates data sets where the system begins to feed off the customer and claim experience.  Seeing the loop succeed gives us great pride.  90% of FNOL processed by Bot, and 100% of sales?  Validates our founding thesis.

So many questions, and not enough time for them all.

As I reviewed our conversation, recent results/articles, and Mr. Sagalow’s book several things were apparent:

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  • The company is ‘all in’ on allowing the data analysis approach to continue its development,
  • Growth within markets is driven as much by external forces, e.g., requests from European countries, as it is by internal plans.
  • The firm’s start and development benefitted greatly from the founders’ past experience in startups and connections developed therein,
  • Lemonade is impatient- that in itself is innovative in the insurance industry.
  • The firm remains too new to have financial trends that aren’t subject to variance from reporting period to reporting period.  86% loss ratio can be celebrated today but the vagaries of growth in a new carrier and claim volume can produce unexpected results, and some interesting ceding to reinsurers.  (keeping things grounded with ongoing analysis by Adrian Jones and Matteo Carboneinteresting summary here )
  • Customers who have provided service surveys like the insurance products and service they receive from Lemonade, see Clearsurance’s survey summaries here
  • There’s pride in how charitable contributions have been an important piece of the firm’s entry into the market
  • The entry into the industry is not a sprint- a carefully run marathon is what the firm needs.  The P&C business is a trillion-dollar (US) business and Lemonade holds a very small part of that; its operating premise is still fragile
  • There is strength and opportunity in the firm’s digital approach to operations

The original intention was to interview a CEO and produce a summary of the firm through crowd-sourced questions.  The interview came off well, the questions were presented in volume, where the problem arose was in the expansiveness of the firm’s concepts, the great interest in the entry and growth of the firm, and the author’s inability to distill the available information into one column.  The discussion with Daniel Schreiber did not change my status of being a pragmatic optimist where Lemonade is concerned, but many questions were answered.

I look forward to further examination of the Game Theory concepts as applied by Lemonade in a future column/posting. 

My thanks to those who provided questions in addition to my own (and apologies that not all could be addressed in this article):

Ben Baker Billy Van Jura Anand R (Lucep) Nick Lamperelli Pat West

image source

Patrick Kelahan is a CX, engineering & insurance professional, working with Insurers,
Attorneys & Owners. He also serves the insurance and Fintech world as the
‘Insurance Elephant’.

I have no positions or commercial relationships with the companies or people
mentioned. I am not receiving compensation for this post.

Subscribe by email to join the 25,000 other Fintech leaders who read our
research daily to stay ahead of the curve. Check out our advisory
services
 (how we pay for this free original research).

 

The smartest investment for your innovative insurance play just might be in cultural awareness

It’s not just the tech concept…

TLDR Having the correct idea for underwriting, distributing, selling, adjusting, or scaling insurance may not be the right idea if the scheme is introduced or sold where the customer understands the plan but simply doesn’t accept it in cultural context.  How and where one sells an idea in the connected global insurance industry might just be more important that what is being sold.

I had a great discussion with a very clever InsurTech company this week, Uncharted, a digital insurance sales facilitation and distribution entrant focused on health benefits and business SME markets (check out their website in the link- I won’t do their concept the justice they can).  They are Singapore-based, building toward a global reach.  The firm’s Chief Commercial Officer, Mark Painter, held my attention regarding how the firm was building its sales and distribution tools with the intention of giving carriers and brokers options and efficiencies from point of sale right through home office underwriting, binding and admin of data.  Taking the teeth out of the unstructured data beast, so to say.  Mark (who’s a pretty savvy finance and insurance guy now working alongside Uncharted’s founder, Nick Macey) recounted a recent experience in introducing the Uncharted system into a southeast Asia market carrier’s system, excitedly advising that significant sales admin improvement for the thousands of field agents will or had been gained for the carrier.  That’s very cool.

But my follow-up question was: If the carrier’s products are traditionally sold by agents say, working off of scooters, meeting with small shopkeepers over tea, or noodles, and with the bound policy traditionally taking a few weeks to present to the insured, will an ‘instant’ policy innovation resonate with the known culture of doing business in the neighborhood?  Will an app-based policy hold the same ‘worth’ to that analog customer? It might if the businessperson is comfortable with the growing use of digital ecosystems, it might not if the owner is not. 

How the customer expects to transact business is the key- are you practicing innovation from the customer backwards?

Well this prompted a comparison discussion of what the firm is working with in Zimbabwe, where most residents/customers transact business through smart devices using EcoCash, a mobile payment platform hosted by local telco, Econet.  In this instance EcoCash has an approximate 80% market use penetration, and as such adding services to the ecosystem is an accepted practice.  A company looking to make inroads into the market would be wise to joint venture with or leverage the Econet ecosystem rather than try to make inroads through traditional agencies.  However- once established in the market the firm would be better able to bridge to traditional insurance channels for more complex covers, riding the market awareness built through use of local, accepted practices.  Know what and how the customer expects to transact business and go with that flow.  It ofttimes does not matter how wonderful your product or service is if the customers simply are not accustomed to how you market.  The correct answer is not always the best answer.

There are plenty of examples of companies ‘growing’ their insurance products organically through other business relationships built through understanding local needs.  Take for example the relationship of ride sharing platform Go-Jek and one of its investor firms, Allianz X.  The ride sharing startup was a target of Allianz’s investment, but Allianz also recognized with Go-Jek that the drivers needed insurance, and the two firms collaborated within the bounds of the business model and driver culture to make insurance available within the local reach of drivers.  Don’t be surprised if a similar insurance partnership approach isn’t carried into east Africa’s burgeoning ride sharing environment as the pair of firms extends its reach with their investment into Uganda-based ride hailing entrant, SafeBoda  (a timely share by you, Robert Collins ).  Innovation and marketing developed from business and local culture needs.

There are many examples of firms developing insurance innovations, many successful and many not so much.  The takeaway for the reader from this posting- the firms noted above are working to apply clever innovation based on good ideas, but also on integrating the ideas into what fits a respective market’s expectations, and what businesses and customers are accustomed to.  Ground-breaking innovation might succeed by circumventing that of which a market is accustomed, but in most cases a firm’s best investment is understanding what the locals want and how they want it, and simply following their lead.  Is your approach just a correct answer, or the right answer?

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Patrick Kelahan is a CX, engineering & insurance professional, working with Insurers, Attorneys & Owners. He also serves the insurance and Fintech world as the ‘Insurance Elephant’.

I have no positions or commercial relationships with the companies or people mentioned. I am not receiving compensation for this post.

Subscribe by email to join the 25,000 other Fintech leaders who read our research daily to stay ahead of the curve. Check out our advisory services (how we pay for this free original research).

Digital transformation for insurance or simply competitive advantage?

Just when I thought the Elephant that is insurance was fully accepted as an aggregation of many participants’ perspectives, along comes Digital Innovation, Digitization, and Data Culture discussions as another example of many parts making the whole.  What makes effective digital innovation/integration for an industry or firm, is digitization the root of InsurTech, who in the firm should be taking the lead on evolving the firm into a digital world, all questions that crossed my media feed this week.  On one day!  And a big question- does digital transformation stand on its own as a business initiative, or is it simply one other activity that comprises a firm’s efforts to maintain or grow competitive advantage?

As for the academic approach to digital transformation, I’ll consider two authors of articles that make good points and have solid basis from which to speak. I contend that in some ways the authors are also subject to the potential narrow path of each of the vision-challenged men in the fable- a conceptual grasp primarily of what is immediate and not in consideration of whole issue.  Through whose eyes are the issues being considered?  Customers’? Staff? Leadership? The public?

While there as many definitions of digital transformation as there are discussions about it, this example is a pretty solid one:

“we define digital transformation as the integration of digital technology into all areas of a business resulting in fundamental changes to how businesses operate and how they deliver value to customers. Beyond that, it’s a cultural change that requires organizations to continually challenge the status quo, experiment often, and get comfortable with failure.”  The Enterprisers Project 

(Consider though, that even this description does not embrace transformation from the customer-backwards perspective.)

Two authors who have a good grasp on digital transformation and its effects/integration on/in business provide us some bullet points:  Jim Marous, global authority on marketing and strategy for retail banks and credit unions in his article, “Becoming a ‘Digital Bank’ Requires More Than Technology”, and Claudio Fuentes, Product Manager at Pypestream, as noted in “5 requirements for building a strong data culture”

Areas or components that the authors suggest are needed or are present for effective digital transformation within an organization:

Digital Transformation Pathways

Good summaries, good advice, but are the bullet points actionable across the entire spectrum of insurance or banking businesses?  What if the subject firm is brand new, tech-based, with no analog process ‘baggage’ to wrestle?  The reality of digital transformation is that businesses need to consider the principle as part of being competitive within their respective industries, and in being responsive to what their customers need or expect.  Transformation for the sake of being fashionable might be considered a fool’s chase.

Consider the challenges for the Nigerian insurance industry- very low insurance product penetration, and lower than average acceptance among the population regarding the need/purpose of insurance products.  One hundred million potential insurance consumers, urban and extremely rural.  Does digital transformation make as much sense for that insurance market, when the delivery to existing customers is meeting their needs, and expanding penetration to the balance of the population can be effected through smart devices (much higher penetration of smart devices than insurance) and InsurTech players?  Are digital efforts potentially transformative to existing processes if the customers have no expectations of improvement?  Would it be focus and funds not well spent?  And if an industry is being built from ground up, there is little transformation to be had as any efforts are greenfield.  The point- it’s competitive advantage and customer responsiveness that should drive transformation or not.

(if you want to read a good summary of Nigeria’s FinTech/InsurTech activity and challenges, see Segun Adeyemi,  Where are the Digital Insurance Platforms in Nigeria? )

 A recent article by Richard Sachar, titled Who is Responsible for Leading Digital Transformation Within Insurance Companies  prompted a discussion with one of my favorite InsurTech connections, Thomas Verduzco-Weisel, wherein I opined:

“Better question, one might say- who is responsible for maintaining (or gaining) competitive advantage for a respective insurance organization? Digital transformation has been continuous since the advent of electronic data processing; it simply has a rallying cry now called ‘InsurTech’.   Customers may not know how (what methods) they want their insurance products delivered, but they do know what is important to them.  Keeping that pulse drives how the firm needs to maintain its edge, and then applying process, admin, or tech innovation to keep that edge will direct the firm in who/how/when/and with whom any transformation is needed. What if a firm’s culture, processes, staff, and delivery are driving growth and profitability now, should there be a transformation just to be fashionable?  Good business practices should drive any change, and by extension strategy at the senior level, tactics at operational levels, and all levels keeping track of how customers and staff are maintaining comfort with operations. “

(However, if there’s an urge to be fashionable, innovate/transform from the customer backwards.)

Digital transformation is as fashionable a concept as is InsurTech, and needs to be approached within business context.  There is no question that if transformation is undertaken prudent businesses should follow a framework as suggested by Messrs. Marous and Fuentes.  But before jumping into the fashionable approach, is any transformation being undertaken as a standalone concept, or as part of a firm’s competitive or growth strategy? Have to consider the entire beast, not just one facet or part. And as my fine colleague who knows of such things, Karl Heinz Passler,  states, Stop Confusing InsurTech With Digitalisation.

Digital transformation makes sense where it makes sense, and when undertaken, it makes sense to consider what all the organization’s stakeholders need.

image source

Patrick Kelahan is a CX, engineering & insurance professional, working with Insurers, Attorneys & Owners. He also serves the insurance and Fintech world as the ‘Insurance Elephant’.

I have no positions or commercial relationships with the companies or people mentioned. I am not receiving compensation for this post.

Subscribe by email to join the 25,000 other Fintech leaders who read our research daily to stay ahead of the curve. Check out our advisory services (how we pay for this free original research).

InsurTech adherents must see- the Elephant is insurance

A common approach to InsurTech- describing insurance by parts, not the whole

I’ve noted in the past that InsurTech is not dissimilar to the fable of six blind men describing an elephant solely on touch- each man ‘sees’ the elephant from the perspective of his narrow exposure to a very large creature. One sees a rope because he has grabbed the tail, another a tree because he’s grabbed a leg, another a snake due to the feel of the trunk, and so on.

InsurTech is that similar situation- many firms ‘touching’ the initiative from a narrow perspective. Not blind, surely, but not from a vantage of ‘seeing’ the entire concept. Of course it would be very daunting to try to grasp the industry from all angles, and very expensive too.

So,
there are the individual firms describing their unique parts- underwriting,
pricing, distribution, administration, claims, agencies, customer acquisition,
etc. And designing and/or applying technology- artificial intelligence
(AI), machine learning, IoT, algorithms, data science, actuarial science,
behavioral economics, game theory, and so on. Using technology and new
methods to help them see their part of the beast that is insurance innovation.

We get caught up in the thinking that InsurTech is a discrete concept– because each involved player has his unique approach to defining how change will be effected (and we can’t have multiple terms to describe what the movement is.) In the end each is convinced the efforts being made in their firm are defining the term. A recent article penned by Hans Winterhoff, KPMG Director, 3 Lessons European Insurers can Learn from Ping An, provides suggestions for legacy insurers based on successes Ping An has had in the China insurance market. The author makes three apt points but as with simply grabbing the Beast’s trunk and calling the animal a snake, is Ping An’s approach to insurance innovation the best InsurTech perspective for mature insurance markets?

Can the best innovative methods be applied to incumbent markets if a carrier’s staff are not engaged adequately in the evolution? 

Legacy markets are populated with customers who are content with the Beast that is insurance, and in spite of some years of InsurTech efforts the market penetration of innovative companies remains low.  Not that these customers don’t deserve the latest and best methods (surely most would trade the bureaucracy and cost of existing health care for the ease of service provided by a Ping An kiosk), but change must also come from within insurance company organizations.  If one looks at Fortune magazine’s best large employers by employee survey and finds two of the insurance market’s biggest employers, Allstate and Geico, not in the top 500 firms, one must consider absent employee engagement then innovative change may be inhibited for those major companies and their customers.

Virtually
every week there is a significant conference of InsurTech enthusiasts,
thousands of attendees per month, all seemingly with an idea of what InsurTech
is, where it’s going, and how they will capture innovation lightning in the
bottle they have designed. There are some very smart persons who are seen
as champions of the effort, and these persons publish/travel/post and remind
the industry of where it has been and where it’s going. They are adept at
describing the beast in terms that most can understand, and in terms that help
the holder of the ropy tail to see that there also is a snaky trunk, and that
the two parts are of the same beast.

What
is cool about how the InsurTech movement is evolving is that a solid
recognition is being realized by most (not all) that InsurTech is comprised of
multiple, important and integral parts, and even if your firm is not working
with idea A, it can leverage the knowledge in developing idea B. We pick
at the theories others espouse, nay say, comment, maybe even doubt or
criticize, but at the same time all the knowledge is to the common goal-
improving a product for the existing and as yet unidentified insurance
customers.

And
without belaboring the theme, we can be reminded that the elephant is not
InsurTech; the elephant is insurance. InsurTech is the trappings with which the
elephant is enhanced. And the elephant is the contractual agreement that
comprises insurance, and the elephant’s handler must be the customer. 

Let’s
all describe the beast well from our unique perspective, with the understanding
that in the end the elephant’s handler- the customer- must be why we are touching
the beast at all.

 

image source

Patrick Kelahan is a CX, engineering & insurance professional, working with Insurers, Attorneys & Owners. He also serves the insurance and Fintech world as the ‘Insurance Elephant’.

I have no positions or commercial relationships with the companies or people mentioned. I am not receiving compensation for this post.

Subscribe by email to join the 25,000 other Fintech leaders who read our research daily to stay ahead of the curve. Check out our advisory services (how we pay for this free original research).

Not so fast, InsurTech- long-tailed and unique claims are the Kryptonite to your innovation super power

Nothing to fear, InsurTech Man! It’s just a busy claim!

Artificial intelligence, machine learning, data analysis,
ecosystem insurance purchases, online claim handling, application-based insurance
policies, claim handling in seconds, and so on. 
There’s even instant parametric travel cover that reimburses costs-
immediately- when one’s planned air flight is delayed.  There are clever new risk assessment tools
that are derived from black box algorithms, but you know what?  Those risk data are better than the industry
has ever had!  Super insurance, InsurTech
heroes!  But ask many insureds or claim
handlers, and they’ll tell you all about InsurTech’s weakness, the kryptonite
for insurance innovation’s superheroes (I don’t mean Insurance Nerd Tony Cañas)- those being-   long-tailed or unique claims.

If insurance was easy you wouldn’t be reading this.  That is simple; much of insurance is
not.  Determining risk profiles for
thefts of bicycles in a metro area- easy. 
Same for auto/motor collision frequency/severity, water leaks, loss of
use amounts, cost of chest x-rays, roof replacement costs, and burial costs in most
jurisdictions.  Really great fodder for
clever adherents of InsurTech- high frequency, low cost cover and claims.  Even more complex risks are becoming easier
to assess, underwrite and price due to the huge volume of available data
points, and the burgeoning volume of analysis tools.  I just read today that a clever group of UK-based
InsurTech folks have found success providing comprehensive risk analysis
profiles to some large insurance companies-  Cytora
that continues to build its presence.  A
firm that didn’t exist until 2014 now is seen as a market leader in risk data
analysis and whose products are helping firms who have been around for a lot
longer than 5 years (XL Catlin, QBE, and Starr Companies)  Seemingly a perfect fit of innovation and
incumbency, leveraging data for efficient operations.  InsurTech.

But ask those who work behind the scenes at the firms, ask
those who manage the claims, serve the customers, and address the many
claim-servicing challenges at the carriers- is it possible that a risk that is
analyzed and underwritten within a few minutes can be a five or more year
undertaking when a claim occurs?  Yes, of
course it is.  The lion’s share of
auto/motor claim severity is not found within the settlement of auto damage, it’s
the bodily injury/casualty part of the claim. 
Direct auto damage assessment is the province of AI; personal injury
protection and liability decisions belong in most part to human interaction.  Sure, the systems within which those actions
are taken can be made efficient, but the decisions and negotiations remain outside
of game theory and machine learning (at least for now).    There have been (and continue to be)
systems utilized by auto carriers in an attempt to make uniform more complex
casualty portions of claims ( see for example Mitchell) but lingering ‘burnt fingers’
from class action suits in the 1980’s and 1990’s make these arms’ length tools trusted
but again, in need of verification.

Property insurance is not immune from the effects of
innovation expectations; there are plenty of tools that have come to the market
in the past few years- drones, risk data aggregators/scorers, and predictive
algorithms that help assess and price risk and recovery.  That’s all good until the huge network of
repair participants become involved, and John and Mary Doe GC prices a rebuild
using their experienced and lump sum pricing tool that does not match the
carrier’s measure to the inch and 19% supporting events adapted component-based
pricing tool.  At that intersection of ideas,
the customer is left as the primary and often frustrated arbiter of the claim
resolution.  Prudent carriers then revert
to analog, human interaction resolution.  Is it possible that a $100K water loss can
explode into a $500K plus mishandled asbestos abatement nightmare?  Yes, it’s very possible.  Will a homeowner’s policy customer in Kent be
disappointed because an emergency services provider that should be available
per a system list is not, and the homeowner is left to fend for himself? The
industry must consider these not as outlier cases, but as reminders that not
all can be predicted, not all data are being considered, and as intellectual
capital exits the insurance world not all claim staff will have the requisite
experience to ensure that which was predicted is what happens.

The best data point analysis cannot fully anticipate how
businesses operate, nor how unpredictable human actions can lead to claims that
have long tails and large expense.  Consider
the recent tragedy in Paris with the fire at the Cathedral of Notre Dame.  Certainly any carriers that may be involved
with contractor coverage have the same concerns as all with the terrible loss,
but they also must have concerns that not only are there potential liability coverage
limits at risk, but unlike cover limits, there will be legal expenses
associated with the claim investigation and defense that will most probably
make the cover limits small in comparison. 
How can data analysis predict that exposure disparity, when every claim
case can be wildly unique?

It seems as underwriting and pricing are under continued
adaptation to AI and improved data analysis it is even more incumbent on companies
(and analysis ‘subcontractors’) to be cognizant of the effects of unique claims’
cycle times and ongoing costs.  In
addition, carriers must continue to work with service providers to recognize
the need for uniform innovation, or at least an agreed common denominator tech
level.

The industry surely will continue to innovate and encourage those InsurTech superheroes who are flying high, analyzing, calculating and selling faster than a speeding bullet.  New methods are critical to the long-term growth needed in the industry and the expectation that previously underserved markets will benefit from the efforts of InsurTech firms.  The innovators cannot forget that there is situational kryptonite in the market that must be anticipated and planned for, including the continuing need for analog methods and analog skills. 

image source

Patrick Kelahan is a CX, engineering & insurance professional, working with Insurers, Attorneys & Owners. He also serves the insurance and Fintech world as the ‘Insurance Elephant’.

I have no positions or commercial relationships with the companies or people mentioned. I am not receiving compensation for this post.

Subscribe by email to join the 25,000 other Fintech leaders who read our research daily to stay ahead of the curve. Check out our advisory services (how we pay for this free original research).

How does One Consume an Ocean of Data? A Meaningful Sip at a Time

So many data, so many ways to use it, ignore it, misapply it, co-opt, brag, and lament about it.  It’s the new oil as suggested not long ago by Clive Humby, data scientist, and has been written of recently by authorities such as Bernard Marr in  Forbes wherein he discusses the apt and not so apt comparison of data and oil.  Data are, or data is?  Can’t even fully agree on that application of the plural (I’m in the ‘are’ camp.)  There’s an ongoing and serious debate on who ‘owns’ data- is possession 9/10 of the law?  Not if one considers the regs of GDPR, and since few industries possess, use, leverage and monetize data more than the insurance industry forward-thinking industry players need to have a well-considered plan for working with data, for, at the end of the day it’s not having the oil, but having the refined byproduct of it, correct?

Tim Stack of technologies solutions company, Cisco, has blogged that 5 quintillion bytes of data are produced daily by IoT devices.  That’s 5,000,000,000,000,000,000 bytes of data; if each were a gallon of oil the volume would more than fill the Atlantic Ocean.  Just IoT generated bits and bytes.  Yes, we have data, we are flush with it.  One can’t drink the ocean, but must deal with it, yes?

I was fortunate to be able to broach the topic of data availability with two smart technologists who are also involved with the insurance industry, Lakshan De Silva, CTO of Intellect SEEC, and Christopher Frankland , Head of Strategic Partnerships, ReSource Pro and Founder, InsurTech 360″.  Turns out there is so much to discuss that the volume of information would more than fill this column- not by an IoT quintillions’ factor but a by a lot. 

With so much data to consider, it’s agreed between the two that
understanding the need of data usage guides the pursuit.  Machine Learning (ML) is a popular and
meaningful application of data, and “can bring with it incredible opportunity around
innovation and automation. It is however, indeed a Brave New World,” comments
Mr. Frankland.  Continuing, “Unless you
have a deep grasp or working knowledge of the industry you are targeting and a
thorough understanding of the end-to-end process, the risk and potential for hidden technical debt is real.” 

What?  Too much data, ML methods to
help, but now there’s ‘hidden technical debt’ issues?  Oil is not that complicated- extract, refine,
use.  (Of course as Bernard Marr reminds
us there are many other concerns with use of natural resources.)  Data- plug it into algorithms, get refined ML
results.  But as noted in Hidden
Technical Debt in Machine Learning Systems
, ML brings challenges of which
data users/analyzers must be aware- compounding of complex issues.  ML can’t be allowed to play without adult
supervision, else ML will stray from the yard.

From a different perspective Mr. De Silva notes that the explosion of
data (and availability of those data) is, “another example of disruption within
the insurance industry.”  Traditional methods
of data use (actuarial practices) are one form of analysis to solve risk problems,
but there is now a tradeoff of “what risk you understand upfront”, and “what
you will understand through the life of a policy.”  Those IoT (or, IoE- Internet of Everything,
per Mr. De Silva) data that accumulate in such volume can, if managed/assessed efficiently,
open up ‘pay as you go’ insurance products and fraud tool opportunities.

Another caution from Mr. De Silva- assume all data are wrong unless you prove it otherwise. This isn’t as threatening a challenge as it sounds- with the vast quantity and sourcing of data- triangulation methods can be applied to provide a tighter reliability to the data, and (somewhat counterintuitively,) with the analysis of unstructured data with structured across multiple providers and data connectors one can be helped to achieve ‘cleaner’ (reliable) data.  Intellect SEEC’s US data set alone has 10,000 connectors (most don’t even agree with each other on material risk factors) with 1,000s of elements per connector, then multiply that by up to 30-35 million companies, then by the locations per company and then directors/officer of the company. That’s just the start before one considers effects of IoE.

In other words- existing linear modeling remains meaningful, but with the instant volume of data now available through less traditional sources carriers will remain competitive only with purposeful approaches to that volume of data.  Again, understand the challenge, and use it or your competition will.

So many data, so many applications for it.  How’s a company to know how to step
next?  If not an ocean of data, it sure
is a delivery from a fire hose.  The
discussion with Messrs. De Silva and Frankland provided some insight.

Avoiding Hidden Debt and leveraging clean data is the path to a “Digital Transformation Journey”, per Mr. Frankland.  He recommends a careful alignment of “People, Process, and Technology.”  A carrier will be challenged to create an ML-based renewal process absent involvement of human capital as a buffer to unexpected outcomes being generated by AI tools.  And, ‘innovating from the customer backwards’ (the Insurance Elephant’s favorite directive)  will help lead the carrier in focusing tech efforts and data analysis on what the end customers say they need from the carrier’s products. (additional depth to this topic can be found in Mr. Frankland’s upcoming Linked In article that will take a closer look at the challenges around ML, risk and technical debt.)

In similar thinking Mr. De Silva suggests a collaboration of business facets to unlearn, relearn, and deep learn (from data up instead of user domain down), fuel ML techniques with not just data, but proven data, and employ ‘Speed of Thought’ techniques in response to the need for carriers to build products/services their customers need.  Per Mr. De Silva:

“Any company not explicitly moving to Cloud-first ML in the next 12 months and  Cloud Only ML strategy in the next two years will simply not be able to compete.”

Those are pointed but supported words- all those data, and companies need
to be able to take the crude and produce refined, actionable data for their operations
and customer products.

In terms of tackling Hidden Debt and ‘black box’ outcomes, Mr. Frankland
advises that points such as training for a digital workforce, customer journey
mapping, organization-wide definition of data strategies, and careful application
and integration of governance measures and process risk mitigation will  collectively act as an antidote to the two
unwelcome potential outcomes.

Data wrangling- doable, or not? 
Some examples in the market (and there are a lot more) suggest yes.

HazardHub

Consider the volume of hazard data available for consideration within a jurisdiction
or for a property- flood exposure, wildfire risk, distance to fire response
authorities, chance of sinkholes, blizzards, tornadoes, hurricanes, earthquakes
or hurricanes.  Huge pools of data in a
wide variety of sources.  Can those
disparate sources and data points be managed, scored and provided to property
owners, carriers, or municipalities? 
Yes, they can, per Bob
Frady
of HazardHub, provider of
comprehensive risk data for property owners. 
And as for the volume of new data engulfing the industry?  Bob suggests don’t overlook ‘old’ data- it’s
there for the analyzing.

Lucep

How about the challenge sales organizations have in dealing with customer requests coming from the myriad of access points, including voice, smart phone, computer, referral, online, walk-in, whatever?  Can those many options be dealt with on an equal basis, promptly, predictably from omnichannel data sources?  Seems a data inundation challenge, but one that can be overcome effectively per Lucep, a global technology firm founded on the premise that data sources can be leveraged equally to serve a company’s sales needs, and respond to customers’ desires to have instant service.

Shepherd Network

As for the 5 quintillion daily IOT data points- can that volume become meaningful if a focused approach is taken by the tech provider, a perspective that can serve a previously underserved customer?   Consider unique and/or older building structures or other assets that traditionally have been sources of unexpected structural, mechanical or equipment issues.  Integrate IoT sensors within those assets, and build a risk analytics and property management system that business property owners can use to reduce maintenance and downtime costs for assets of any almost any type.  UK-basedShepherd Network has found a clever way to ‘close the valve’ on IoT data, applying monitoring, ML, and communication techniques that can provide a dynamic scorecard for a firm’s assets.

In each case the subject firms see the ocean of data, understand the
customers’ needs, and apply high-level analysis methods to the data that
becomes useful and/or actionable for the firms’ customers.  They aren’t dealing with all the crude, just
the refined parts that make sense.

In discussion I learned of Petabytes,  Exabytes, Yettabytes, and Zottabytes of data.  Unfathomable volumes of data, a universe full, all useful but inaccessible without a purpose for the data.  Data use is the disruptor, as is application of data analysis tools, and awareness of what one’s customer needs.  As Bernard Marr notes- oil is not an infinite resource, but data seemingly are.  Data volume will continue to expand but prudent firms/carriers will focus on those data that will serve their customers and the respective firm’s business plans.

Image source

Patrick Kelahan is a CX, engineering & insurance professional, working with Insurers, Attorneys & Owners. He also serves the insurance and Fintech world as the ‘Insurance Elephant’.

I have no positions or commercial relationships with the companies or people mentioned. I am not receiving compensation for this post.

Subscribe by email to join the 25,000 other Fintech leaders who read our research daily to stay ahead of the curve. Check out our advisory services (how we pay for this free original research).

Parametric Insurance- The Least Known Best Response to Unfortunate Happenings

What if a policyholder could be immediately paid when an event or circumstance occurred, with no claim to file, no investigation other than confirmation that the triggering circumstance did happen?  This type of payment does happen now- consider travel insurance hybrids that provide benefit for delayed flights, and pay immediately based on a delay parameter. Could the same be accomplished for natural disasters, failure of crops, or other situations that can be set as a parameter?  Yes, it can.  Welcome to the world of parametric insurance.

Insurance is a known product- in return for payment of a premium a policyholder can expect (within the terms of the insurance contract) indemnification for a covered loss.  The loss occurs, a claim is made, the claim investigation proceeds, an estimate of loss is made, and a claim settlement is paid.  Outside of health and life cover this is the typical framework of the contract that is insurance.  The value of the insured property is determined at policy inception, a premium is generated based on underwriting guidelines re: probable loss characteristics for covered perils, and the insurance contract is bound.

A nagging problem with that centuries old framework is the need to prove a value of property, to experience an occurrence or claim, prove the claim, and wait for indemnification- if the claimed damage is covered by a policy.  There are many perils that are not covered by most policies, e.g., flood, earthquake, long-term effects of weather (drought), wear and tear, and so on.  Additionally, in some circumstances the nature of the damage exceeds the ability of individual policyholders to adequately respond- of particular note flooding, cyclones, earthquakes and agriculture issues where damage is a regional problem that simply requires regional response.

Parametric insurance, or, “a type of insurance contract that insures a policyholder against the occurrence of a specific event by paying a set amount based on the magnitude of the event, as opposed to the magnitude of the losses in a traditional indemnity policy” (NAIC) is becoming the insurance option that allows a policyholder a payment for an occurrence or circumstance that can be defined and established at the inception of coverage.  An apt example of a parametric option is provided by Jumpstart, a firm that will make payment to U.S. policyholders when a seismic event occurs and reaches a ‘peak shaking intensity’.  The firm simply monitors US Geological Survey data, when a trigger event occurs the firm identifies policy holders within the affected area and sends them a payment.  No claim action needed by the customers- the agreed parameter occurrence happens, the policy pays.  Traditionally an earthquake would need to damage covered property, the respective property owner would need to have earthquake coverage (an optional cover in most jurisdictions), a claim be filed, investigated and settlement made.  Indemnification for damage.  Parametric products simply promise payment if an agreed parameter is met- in Jumpstart’s case a ground shake of a certain magnitude.

One must keep in mind that parametric insurance is not intended to be a full ‘indemnification style’ coverage- it’s meant as a first payment option for traditionally covered perils, and an alternative/immediate recovery source for perils that may otherwise not have practical insurability.  Prudent insureds may even layer parametric cover onto traditional policy coverage, almost to act as a hedge against a large deductible.

Applying the method to the market is not as simple as generating the policy- there must be an identified, measurable trigger for the respective policy, and the carrier needs to be able to conduct that ages-old act- apply probability of risk to the potential payout.  What makes that exercise more direct than with indemnification policies is that there is a specific trigger, and there is an agreed payment.  If X occurs, amount Y is paid.  Claim adjustment expense is administrative cost only, and customers may not even have to report or confirm the triggering event as the carrier may have methods in place to automatically confirm the triggering event.  Consider if the parametric agreement is captured as a smart contract in a distributed ledger format- perhaps an inroad into Blockchain as an equal to other methods in administering insurance?  (see Etherisc )

So what uses are there for parametric cover?  Not everyone is in a high frequency earthquake zone, and awareness of parametric cover is relatively low.  If we look to the current placements of the cover there can be an understanding of where the industry sees opportunities.    Travel insurance options have been noted, and exemplify how the cost of inconvenience can be reimbursed. There are insurance organizations that have established themselves as industry experts, e.g., Swiss Re, who have initiated parametric plans in collaboration with individuals and governments in many areas for:

  • Earthquake
  • Cyclone
  • Crops  (Better Life Farming) – also includes comprehensive agricultural advice
  • Wildfire

And the firm’s thought process does go beyond individual policyholders to regional parametric programs that partner with government agencies, for example, Sovereign Insurance (options for regions across the globe), or other organizations such as Hiscox Re ILS with ongoing involvement  in a variety of initiatives including the linked Philippines plan.

Broad spectrum parametric programs have been in place for some years to assist governments in more prompt recovery from disasters:

  • Caribbean Catastrophe Risk Insurance Facility (CCRIF)- provides post-disaster assistance to nineteen Caribbean and Central American countries, is funded by various governments and government organizations, and makes payments to participants’ governments for earthquake, hurricane and excess rainfall triggered events
  • African Risk Capacity (ARC)- planning and guidance program that also funds/administers a primarily agriculture parametric cover for participating countries

And in addition- there are initiatives being developed as this article is written where counties in China are being used as model plans for regional parametric cover, particularly earthquake-prone areas and regions subject to landslides (see Insurance Asia News ).

Are there also funding opportunities for parametric insurance, both from a provider and recipient standpoint?  One would think so as this cover fills a gap for recovery, and, in combination with existing schemes for catastrophe and disaster bonds capital can be encouraged to make a foray into parametric plans.  Insurance linked securities (ILS) that have taken some hits during the last few years with unexpectedly frequent and unexpectedly severe cost events might have more stability functioning within a more predictable loss environment of parametric programs.  Improvements in data collection, analysis, AI and immediacy of event data have all contributed to the increasing viability of the programs.

So the unexpected benefit and under-publicized parametric insurance industry may be the best hedge for many against uninsurable (in a traditional sense) perils, and for almost anyone that needs a source of immediate payout when a trigger event occurs.  Picture the coastal towns of the U.S. after a major hurricane as recipient of a parametric cover distribution, a ‘prime the pump’ amount to give some immediate recovery light for residents, or tsunami victims whose livelihoods have been washed away receiving funds to re-establish businesses, or wildfire victims who need immediate distributions until primary insurers can catch up.  Yes, insurance payments can be made without the burden of proving a claim- set the trigger point/parameter, and count on the underutilized benefits of parametric insurance.

Image Source

Patrick Kelahan is a CX, engineering & insurance professional, working with Insurers, Attorneys & Owners. He also serves the insurance and Fintech world as the ‘Insurance Elephant’.

I have no positions or commercial relationships with the companies or people mentioned. I am not receiving compensation for this post.

Subscribe by email to join the 25,000 other Fintech leaders who read our research daily to stay ahead of the curve. Check out our advisory services (how we pay for this free original research).

 

US Health Care: The $2.8 trillion opportunity

US health

 

Reposted from April 2018, as it is Chinese New Year for Zarc Gin, our regular Insurtech Expert based in China.

A couple of weeks ago, there were rumors of Walmart purchasing U.S. Health Insurer Humana.

I’ve written about the U.S. healthcare market a few times and thought this news was rather interesting.

As I started researching this topic,  I decided to take a look at the U.S. healthcare market a bit more broadly.  

During my research on Walmart and Humana, I uncovered some interesting facts and figures which help to further shape my opinion on the opportunities I see in the future of the U.S. healthcare industry.  

While the initial sections are numbers focused (be prepared for a lot of numerical data!), I do touch on technology as well later on.  

As such, I have structured this week as follows:

  • Getting a bigger slice of the $3,300,000,000,000 pie
  • What do all these (potential) mergers mean?
  • How Technology can help
  • Amazon vs. Walmart – which ‘category killer’ will it be?

Getting a bigger slice of the $3,300,000,000,000 pie

There have been a number of large potential mergers in the U.S. Health Insurance & healthcare space, including:

Albertsons and Rite Aid also happened this year which, according to this article, included 2,569 pharmacies (the other 1,932 of which were transferred to Walgreens as part of another deal.)

As I read more and more about these various deals, both qualitatively and quantitatively, it became more clear what was going on.  

And then, I read in this article, the following quote from Walgreens Chief Medical Officer Dr. Patrick Carroll:

Why not use those locations as a strategy for healthcare?

Then it all made sense.  Allow me to share.

According to the Center for Medicare and Medicaid Services (CMS) National Health Expenditure Data (NHE), NHE grew 4.3% to $3.3 trillion in 2016, or $10,348 per person, and accounted for 17.9% of Gross Domestic Product (GDP).

Healthcare expenses are $3.3 trillion in the U.S. alone.  That’s $3,300,000,000,000, folks.

I was curious as to what that $3.3 trillion broke down into, so I started digging deeper.  

Included in the CMS link above are tables that have a number of ways to analyze this expenditure data (24 different ways to be exact).  

If you are interested, please look for this link on the page:

Screen Shot 2018-04-16 at 4.17.39 PM

Table 4 in the Zip file had some really interesting data:

2016 NHE

Zooming in on that data, I found some even more interesting numbers:

Screen Shot 2018-04-16 at 4.55.00 PM

Of the $3.3 trillion being spent on Health related expenses, $2.8 trillion was being spent on Personal Health Care ($2,800,000,000,000).

That’s a lot of money.  

And of that $2.8 trillion, $2.2 trillion is being funded through Health Insurance.  

That doesn’t tell the whole picture though.

What do all these (potential) mergers mean?

In addition to the research I found above, I found some more stats which painted a much broader idea about the conclusions that I was beginning to draw.

US Health Insurer market share

According to Health Payer Intelligence, in 2016, the top 5 health insurers payers in the U.S. are:

  1. United Health Group – with $184.8bn in revenue and 70 million subscribers
  2. Anthem – $89.1bn in revenue and 39.9 million subscribers
  3. Aetna – $63.1bn in revenue and 23.1 million subscribers
  4. Humana – $54.3bn in revenue and 14.3 million subscribers
  5. Cigna – $39.7 bn in revenue and 15 million subscribers

With a population of 326m people in the US, these 5 companies have coverage for 162 million people (or 49.7% of the population).

Pharmacy market share

In terms of prescription revenues, the pharmacies in the US are split as follows:

Largest_US_Pharmacies_by_Total_Prescription_Revenues-2017

And in terms of number of pharmacies, the top 10 can be found here (according to SK&A Pharmacy Data):

Screen Shot 2018-04-16 at 6.50.01 PM

Pharmacy Benefit Manager market share

Pharmacy Benefit Managers (PBMs), according to Wikipedia, are third party administrators that ‘are primarily responsible for developing and maintaining the formulary, contracting with pharmacies, negotiating discounts and rebates with drug manufacturers, and processing and paying prescription drug claims’ and ‘As of 2016, PBMs manage pharmacy benefits for 266 million Americans.’ (that’s managing the prescriptions for 81% of the population…)

According to Statista, in 2016, the market share is as follows:

Screen Shot 2018-04-16 at 6.57.03 PM

Pulling it all together

Looking back at the potential mergers mentioned in the first section, we have a high possibility of:

  • Walmart (#4 in terms of number of pharmacy locations and #5 in terms of total prescription revenue), partnering with Humana (#4 Health Insurer in terms of revenue and # of subscribers, and which also happens to be the 4th largest PBM).  
  • Aetna (#3 Health Insurer in terms of revenue and # of subscribers) partnering with CVS (#1 in terms of number of pharmacy locations, prescription revenue and the largest PBM)
  • Cigna (#5 Health Insurer in terms of revenue and # of subscribers) partnering with Express Scripts (#3 in terms of prescription revenue and the largest PBM, tied with CVS).

Not to mention the fact that United Health Group (#1 Health Insurer in terms of revenue and subscribers) owns Optum Rx (third largest PBM).  They have upped their health care presence in the past few years by buying MedExpress Urgent Care, which has 203 locations.

One may think that Anthem (#2 Health Insurer in terms of revenue and # of subscribers) is missing out, but maybe they have some benefits to sitting on the sidelines and it’s no wonder there is some chatter relating to potential antitrust violations within these deals.

If I look at all of these facts and figures, it looks like these companies are aiming to build mini ecosystems for their customers, in an effort to start getting a bigger piece of the $3.3 trillion mentioned before…most specifically, the $2.8 trillion being spent on personal health care.

After all, if these companies can offer it all ‘in-house’; meaning prescriptions, simple doctor visits through their in-store clinics and a mechanism to have it paid for through Insurance benefits, then consumers may only need to go to hospitals for specialist visits and more serious ailments.  This should ultimately lower the cost of health care, while also shifting some of that $2.8 trillion to some different hands.

How Technology can help

Technology will play a key role in enabling this to happen.

Ecosystems

In an article a few months ago, I wrote about what I thought CVS and Aetna could learn from Ping An, which I consider to be offering the ‘gold standard’ in terms of healthcare Ecosystems.

From that article, I analyzed the Online to Offline (O2O) capabilities within their Ecosystem:

Online through use of the Good Doctor app, a policyholder can:

  • Search for, and book doctors.  This can be either online consultations or in-person (i.e. offline)
  • Have an online consultation with a doctor
  • Purchase medicine
  • Get access to information about various health topics – either general or specific to me
  • Monitor their own health plan

Offline, Ping An has developed a network of hospitals, physicians, pharmacies and more, which will allow the policyholder access to services they can’t get through the online platform

All of these players are aligning the essential businesses in order to build these ecosystems. The Insurers already have relationships with the hospitals as well, which should help in bringing it all together.

IoT

Florian Graillot, Insurtech influencer and partner at astorya.vc recently wrote a great article in Coverager on Digital Health.  A few points he mentions:

  • Wearables – ‘Technology started to enter in our lives with several players developing wearables focused on fitness, sport and wellbeing.’
  • Data – ‘By trying to collect more customers’ data, they (insurers) hope to better understand their needs and increase the level of engagement they have with them by adding numerous touch points.’
  • Teleconsultation – ‘To increase number of touchpoints and offer additional services, teleconsultation is now a must-have for most of insurers and mutuals’
  • Data Privacy and sharing – ‘To better predict and prevent diseases, technology requires a huge amount of data to be relevant, and we see many startups monitoring behaviors on a real-time basis. This raises the first challenge for both insurers and startups: make people agree to share their personal data.’

Having more information on customers and being able to ‘track’ their health, will help to fuel the ecosystem.  This will enable all the participants in the value chain (doctors, pharmacies and Insurers) to know more about their customers on a real time basis, hopefully helping with more preventative measures and ultimately bring costs down.  As Florian states, ‘Insurers need to develop an ecosystem of technologies and startups around them to address their current challenges: increase number of touchpoints with customers ; understand behaviors to better prevent risks ; and reduce costs of healthcare.

I highly suggest reading the full article.  

Blockchain

Health Insurance probably has the most amount of data being transferred than other lines.  This is due to the numerous amounts of players involved in the process as well as the amount of information on a customer that can be available.

Further, Health Insurance data is the most personal of personal data.  

As such, something like blockchain, to help with the transfer and security of data seems like a solution that can help.

A Blockchain Health Alliance including Humana, Quest Diagnostics, Multiplan, and UnitedHealth Group’s Optum and UnitedHeathcare units has formed recently in an effort to ‘improve data quality and reduce administrative costs associated with changes to health care provider demographic data’.

Further, CB Insights has done a study on ‘5 Blockchain Startups Working To Transform Healthcare’.

Which ‘category killer’ will reign supreme (if at all)?

When it comes to ‘category killers’, two of the biggest and most famous are Walmart and Amazon.

We have been focused on Amazon coming into Insurance so much.  I wrote about this earlier this year, when Amazon, JP Morgan & Chase and Berkshire Hathaway teamed up to announce that they would be partnering on ways to address healthcare for their U.S. employees, with the aim of improving employee satisfaction and reducing costs.

I am still bullish on the prospects of this venture and I know Amazon knows a thing or two about building an ecosystem and how to use data.  However, the potential of Walmart buying Humana does have me very intrigued.

They have a massive head start to Amazon in terms of building their healthcare ecosystem.  After all, it was only 3.5 years ago that they announced the goal ‘To Be The Number One Healthcare Provider In The Industry’.  This includes:

Further, earlier this week, Walmart announced a redesign of its website and Amazon ‘put a pause on its plan to sell prescription drugs to hospitals’.

Summary

OK, are you still with me?  I know this has been a long article.

This topic interests me because it has been the single most mind-boggling item for me to deal with since moving back to the U.S.  I can’t believe how complex the system is here as well as how expensive it is.

It is really an area that needs a lot of help.

I know some of these mergers as well as Amazon’s foray into the larger picture of U.S. Health Insurance are still hypothetical.  However, they are important to monitor for the future of healthcare for people living in the U.S.

In addition to these events from the large Health Insurance incumbents and tech players, I also wouldn’t discount some of the work that Oscar are doing, as well as AXA, which has recently entered an agreement with Oscar and also acquired Maestro Health.

Now that I have looked at the breakdown of spending a bit more, I do believe the companies spearheading these large mergers are aiming to provide their customers with preventative measures, ‘offline’ one-stop shops (clinic plus pharmacies) and online facilities (teleconsulting and pharmacy refill/delivery).  

This will ultimately help them with getting a bigger piece of the $2.8 trillion.

Let’s hope all these efforts also help to reduce that actual dollar amount from a consumer spend perspective.

Image Source

Stephen Goldstein is an experienced Insurance executive and Insurtech dealmaker with a core focus on growing revenue, launching go to market initiatives and advising industry leaders.

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Could Blockchain help the dysfunctional crop insurance sector in India?

At the Singapore Fintech Festival last week, the Indian Prime Minister Narendra Modi, delivered an amazing key note speech with Financial Inclusion at its core. During the speech he touched upon several of his achievements, including Aadhaar. In the last 4 years, he claimed the banked population in India has gone up from 50% to almost most of the country.

Modi speech 1

Image Source

I am a big fan of Modi. He has managed to achieve some major milestones with Aadhaar and meaningful steps for a country where 70% of its population still earns from agriculture. However, in times of natural disasters, in a country dealing with 1.3 Billion people, one ambitious and dedicated leader can only do so much.

Earlier this month, my home state in India, and some of the neighbouring states were hit badly by a storm named Gaja. Gaja in the regional tongue refers to Elephant. In my state, the most hit districts were the most fertile parts, that are called the delta region (of the river Cauvery). On top of human casualties (33) and about 75,000 being relocated, the storm hurt farmers massively.

coconut trees

Image Source – Whatsapp

Many farmers in the delta region had moved from cultivating paddy to coconuts as paddy is considered water intensive. This farming tactic has heavily hurt them, as coconut trees took 10-15 years to grow, and the damage caused by the storm was to their decade of hard work – which were not insured.

I come from that part of the world, and had the privilege of going to school and University with many, whose parents were farmers. One of them sent me texts post the storm, this is the summary.

Tall coconut trees were just twisted and broken right in the middle. Wind speed seem to have been around 100 kmph. Interior delta regions don’t get exposed to this level of winds. Usually Only the coastline takes the brunt.

People weren’t prepared and seem to have been caught by surprise. The last time something similar happened in the interior areas was in early 50s. But back then this area primarily had paddy cultivation.

Years of effort in tending to them (coconut trees), watering them.. at least for us it was just additional income. For many farmers we know, the 10k or 15k INR, they get out of these coconut farms every month is their only income.

I understand, this is not a weather news channel – so back to crop insurance and Blockchain.

So what has been done by the Modi government for Crop insurance?

In January 2016, Prime Minister Narendra Modi launched a revamped crop insurance scheme, his government’s flagship scheme for farmers, the Pradhan Mantri Fasal Bima Yojana (PMFBY).

How does the insurance work?

The premium is subsidized for farmers who own less than two hectares of land. Insurance coverage is for two aspects,

  • Yield protection, which protects the farmer from a lower yield
  • Weather linked insurance that covers for disasters and other weather irregularities

The claim is calculated on the basis of crop cutting experiments carried out by agricultural departments of respective states. Any shortfall in yield compared to past 5 years average yield is compensated. In essence – a very manual process.

The insurance is mandatory for farmers who take loan for their needs. For the rest of the farmers it is not.

crop insurance

Image Source

What has happened to the Crop insurance industry since then?

These were the key findings,

  • Number of farmers covered has increased by 0.42%.
  • Premiums collected from farmers has gone up by 350%
  • Claims paid out have increased marginally. But time taken to pay claims is already hurting farmers.

Points one and two clearly highlight where the monies are going – insurance providers are having the last laugh – at the cost of the farmers.

Also, If one season fails, and farmers  didn’t get their claim money in time for the next season, they don’t have funds to buy seeds for the next season. So timing of the release of claim money is critical.

There are several other issues with the current process that include lack of transparency, errors in setting yield thresholds, poor awareness amongst farmers, complex criteria and documentation.

What could we do in future?

Well, we seem to have got a silver bullet in Blockchain. I have written about how Blockchain can help crop insurance before, but will revisit some of those points again. In an Indian context, this is how I see it working.

  • Every farmer has an Aadhaar, so use the biometric identification.
  • When a farmer opens a bank account, make it compulsory to get them on an insurance
  • Explain the criteria, payment schedule and agree on thresholds and how they could change.
  • Create a simple data driven smart contract to list the criteria that would trigger a claim – without the farmer having to claim.
  • Source the required information on weather and soil dampness from satellite data
  • When there is a natural calamity, automatically trigger the claim, in near real time, using self executing contracts.
  • Last but not the least – have strict guidelines for crop insurance firms profit margins.

This would still need state/crop level data on yield thresholds, which is apparently decided by the local authorities post every season. But apart from that data point, most other information can be automated. The customer (the farmer) should have a frictionless experience.

They don’t have to understand insurance, they just need to know they are protected and taken care of when disaster strikes. Blockchain can create that trust in the process.

Once the confidence in the system comes back, number of farmers enrolling for the scheme will easily go up.

During the Singapore Fintech festival, Mr.Modi mentioned how Blockchain was a hot trend amidst VCs. If he had advisors for his financial policies, who were half as good as his PR team that wrote his speeches, the nation should soon see some relief from its dysfunctional financial services.


Arunkumar Krishnakumar is a Venture Capital investor at Green Shores Capital focusing on Inclusion and a podcast host.

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Life & Health Insurance is critical to our lives. Here is why.

headers

I’ve always been a Life guy when it comes to Insurance.  While there is a lot of interesting stuff on the Property and Casualty space (P&C), there is always interest (and a special place in my heart) for Life. It’s where I started and grew up in this industry and where I plan to focus for years to come.

A few weeks ago, I was speaking with my friend Andrew Johnston, (Global head of InsurTech Research for Willis Re).  He informed me that the Q2 2018 Quarterly Briefing (which is put together by Willis Re and Willis Towers Watson Securities, with data and graphs from CB Insights) would be focused on Life and Health. This got me very excited and I asked if I could review the report earlier this week before it was publicly released (under embargo of course), so I could be the first one to write about it.

Of the many research publications on Insurtech (not the daily/weekly ones I previously shared), the Insurtech Quarterly Briefing is one that I look forward to the most.

I look forward to it because it is a great combination of 1) numbers/investments 2) thought leadership, and 3) quality company profiles (aka – if a company is in this report, I know they are a quality company).  

This week, I summarize some key findings from the report along the lines of these three areas.  I do encourage you to read the full report here.  I’ve also included a link to all the previous Quarterly Briefings at the end of this article for reference.

Q2 Investment in Insurtech

Funding throughout the quarters

Investments by country

The quantitative analysis can be found toward the end of the report.  Some highlights from these numbers can be found below (taken from the report):

  • There were 71 InsurTech deals with a total value of $579 million
  • The deal count was 8% higher than in Q1 2018, with total funding amount down 20%
    • While deal volume is up from Q1, total funding is down 20% due to a lack of high-dollar transactions, like the seven $30+ million transactions we saw in Q1 (vs. the two $30+ million transactions in Q2 2018)
  • 71 transactions in Q2 2018 represents the highest transaction volume of any quarter to date
  • For Life and Health (L&H), the 27 transactions announced in the quarter were the highest amount since Q2 of 2017 and the second highest on record
  • 43% percent of P&C and 56% of L&H transactions in Q2 2018 involved B2B companies, compared with 35% and 47%, respectively, of all transactions since 2013
  • With a total of 34 investments, Q2 2018 set a new record for the volume of technology investments by (re)insurers and represents an increase of 26% and 6% from Q1 2018 and Q2 2017, respectively
  • Investment from international markets remains strong; transactions outside of the U.S. account for 58% of total transactions since 2013 and 62% in the quarter
  • There were 22 strategic partnerships between (re) insurers and technology companies in the quarter, which equaled the same amount seen in Q1 2018

Further, as noted in Willis Towers Watson Securities’ CEO, Rafal Walkiewicz’s forward, ‘Life & Health InsurTech has attracted more than $5 billion in funding over the last five years, 20% more than P&C over the same time period’.  Further, L&H ‘funding rounds leading to an average funding round size that is 45% larger than the average for P&C.’

What can be derived from these stats?

Firstly, seeing more investment in Insurtech outside of the U.S. should come as no surprise, especially from countries like China, India and the UK.  China has actually leapfrogged a few other countries to go second after the US last quarter – perhaps a sign of things to come?

Secondly, a record number of investments from (re)insurers should also come as no surprise.  After all, just take a look at the number that have VC arms now.

Lastly, I was pleasantly surprised to see that there has been more investment into L&H vs. P&C since 2013.

At the many conferences and events I have attended, as well as the daily articles I read, there seems to be a slightly higher focus on what’s happening in the P&C space vs. the L&H.  I’ve even had some people from the P&C side tell me they think the L&H side is boring as compared to P&C.  

I would agree there are more products in P&C to enhance and innovate  (travel, home, renters, auto, business, gig economy, etc etc).

However, with L&H, we have the opportunity to help people live longer and healthier lives.  

How boring can that be? (italics inserted in place for cynicism I can’t express through just writing…)

Data, Customer Centricity and Advisory Services

3 pillars

Regardless of the line of business of focus for Insurtech initiatives, how to harness new sources of data, build more customer centric products and provide services above and beyond just paying claims are on the agenda of all (re)insurers and entrepreneurs.  

For L&H, as Mr. Walkiewicz points out, ‘the complexity of change occurring within the Life & Health insurance value chain is much greater than in other insurance subsectors and the potentially positive impact on the quality of life for the consumer is much more profound.’  

All three of these pillars can help to enhance the L&H value chain to help individuals live longer and healthier lives.  

ecosystem

Use of Data

Data areas of interest

As with other lines of business, there is a lot of data already existent within the L&H processes and more and more data becoming available.

The need and amount for medical information in order to provide preventative advice as well as to pay claims is very high and very messy.  How can this information be shared between doctors and patients to provide better care? How can this information be shared between hospitals and (re)insurers to pay faster claims?

There are new data sets being brought to the foray from use of wearables and genomic reports.  How will this data be used for underwriting (taking into account legal and ethical considerations)?  How will this data be used to provide better advice and engagement to customers?

And how will all of this data be incorporated into existing (legacy) systems, processes and analytics that the company undergoes?

dacadoo is one company helping with this, by creating a Health Score, similar to a Financial Credit Score.  Their solution helps with engagement of customers by providing personalized feedback on their lifestyle.  The Health Score also provides Insurers with a different data set to help them with underwriting and ongoing monitoring of premium rates based on the individual’s health choices.  

Atidot is a company helping on the data and predictive analytics side.  They are one of the only providers I have seen specifically focused on Life products.  Their solution targets three groups of individuals – CFOs and Actuaries, Sales/Distribution teams and Retention/Customer Care teams.  They help all of these teams with providing better insights on their in-force book of business as well as information to reach out to their policyholders (in the case of a cross-sell/up-sell or potential lapsation).  For full disclosure, Atidot has been a client of mine this year.

Customer Centric Products

products area of interest

For all Insurance products, the way in which consumers determine their needs (especially when purchasing digitally) can definitely be improved.  Further, the products that they buy can be more flexible in nature.

In P&C, we have seen UBI products, especially for Auto, which offer policyholders the opportunity to pay for the exact amount of miles that they drive.  The use of telematics will also help in providing policyholders discounts for driving better (and potentially premium hikes for driving poorly!).

For L&H, these types of products (UBI based) are a bit more difficult to imagine.  However, using the advanced data and analytics as described above can help with providing policyholders and Insurers with more information as individuals progress through their lives.  

As such, the process for determining the amount of coverage an individual needs at the purchase of their policy as well as throughout the term of their policy are of utmost importance.  Further, products should be built in such a way that are more flexible for policyholders and less onerous if they have a change in needs (i.e. limited additional invasive underwriting).

Anorak is a fully automated, fully digital Life insurance advisory platform looking to tackle the meaningful protection gap of nearly 8.5 million individuals in the UK who are currently uncovered or under-covered by Life insurance.  The process starts with a ‘check-up’, which is like a needs analysis for the individual on their current situation.  Once this is done, ‘impartial advice’ is provided on what type of cover the individual may need. Then, three policy options are provided to the individual.  Their product offers an API which can be integrated into price comparison sites, agencies, online retailers and more.

As a person that likes to focus on the needs of and suitability of products being recommended to an individual, I love what Anorak is offering.  

Ladder Life is a digital MGA that offers online Term Life Insurance.  Their tagline of ‘Life Insurance Just Got Easier’ can be seen through their quote and application process:

  • Consumer answers a brief set of questions (many responses are avoided through supplemental data).
  • Consumer receives an instant insurance quote with no obligation to purchase.
  • If supplemental information is needed, Ladder sends a medical professional to complete an exam (free of charge to the customer).

In most cases, the need for blood and urine samples for underwriting has been eliminated.  

Further, they offer a solution to allow policyholders to adjust their coverage as needs change (called ‘laddering’), without paperwork, meetings, phone calls, cancellation or penalty fees.

For those of you who have ever sold or bought Life Insurance, I hope you would agree that the process and flexibility outlined above are better than some of the ‘traditional’ methods.

Lastly, they have just launched the Ladder API and a partnership with Sofi, helping to provide a more extensive offering to the individuals in Sofi’s ecosystem.

Regard has designed products to address coverage gaps and rising out-of-pocket expenses that many customers in the U.S. face as more employers shift to high deductible Health plans.

This is a huge and increasingly larger problem for the U.S. health market.  

According to the report, Regard differs from many other InsurTech agencies in three important ways: (1) emphasis on institutional distribution needs as the starting point for product and technology vs. a direct to consumer strategy; (2) its position at the nexus of new specialty insurance products and proprietary technology vs. traditional products with off the shelf IT; (3) its ability to participate in premium income through risk retention in addition to MGA commissions compared to a commission-only revenue model.

Digital Advisory Services

advisory services area of interest

Insurance is in an age where we are transforming from a collector of premiums and payor of claims, to a service provider that helps individuals manage and prevent risk in their day-to-day lives.  

The solutions that are becoming available in the L&H space are helping with this to enable policyholders to connect with their doctors and hospitals as well as have 24/7 services through the use of AI and machine learning.  This will help to make L&H products more interactive for their policyholders with an ultimate aim of living longer and healthier lives.

Boundlss provides a AI-powered health assistant for L&H insurers.  Their platform helps to support individuals with their wellness goals and acts as a ‘personal trainer/health coach’ for users.  

The Boundlss platform collects, analyzes and aggregates data from over 400 wearables and mobile apps, allowing insurers to gain new insights into their member populations and their behaviors.

Further, if the AI engine does not provide a response that is sufficient for the individual, a human coach can be brought seamlessly into the conversation.  

Oscar is a fully licensed Health Insurer operating in New York, New Jersey, California, Texas, Ohio and Tennessee.  I’ve covered Oscar before when writing about my own Health Insurance purchase and I believe they are a company to watch for the years to come.  With their recent rise from Alphabet, you can ensure that building a digital ecosystem will continue to be at the forefront for this company.  I liken the ecosystem they are building to that of Ping An and believe they have begun to build a company that is focused equally on advisory services as it is on delivering a quality product.    

‘The Insurtech Grand Prix’

It would be remiss of me if I did not mention the thought leadership piece in the Briefing by Greg Solomon, Head of Life & Health Reinsurance at Willis Re International.  Greg is based in Hong Kong.   

In this, he uses the analogy of the Grand Prix to identify initiatives that are:

  • ‘In the Driver’s Seat’ – Insurers taking a lead in initiatives to better distribute and interact with their policyholders with examples coming out of South Africa and Asia.
  • ‘Rear-wheel drive’ – developments outside of the L&H sector that are changing the dynamic of how products are distributed and built for customers.  Examples here include the joint healthcare venture with JPMorgan & Chase, Berkshire and Amazon, online search and aggregator sites
  • ‘Emerging Tech: Towing Them Along’ – different technologies such as Machine Learning, AI, Blockchain, cryptocurrency and genetic testing, that could change/enhance many elements of the L&H value chain.  
  • ‘Along for the ride’ – tools like wellness platforms that help Insurers be alongside of their policyholders throughout the life of their policy.  

Summary

From this summary, I hope for two things:

  1. That you are inclined to read the whole report!  You can find the link here. There is a lot more information in there, especially deep-dives on the companies mentioned including interviews from their management team.
  2. That I was able to change some of the P&C folks’ opinions of L&H from boring to at least interesting!

I am pleased to see the amount of investment and transformation in the L&H space.  As with all other lines, it is long overdue.

The opportunity for our industry to be part of helping individuals live longer and healthier lives is extremely exciting for me (and should be for you, too).   

Previous Quarterly Briefings

Q1 2017

Q2 2017

Q3 2017

Q4 2017

Q1 2018

Stephen Goldstein is an experienced Insurance executive and Insurtech dealmaker with a core focus on growing revenue, launching go to market initiatives and advising industry leaders.

Get fresh daily insights from an amazing team of Fintech thought leaders around the world. Ride the Fintech wave by reading us daily in your email.