Brokers Balking at Cyber Insurance
Cyber crime, espionage and other “malicious cyber activity” cost the United States anywhere from $24 billion to $120 billion each year, according to a joint report by McAfee and the Center for Strategic and International Studies. That price tag comprises loss of intellectual property, sensitive business information and personally identifiable information (PII), reputational damage, and the costs of fixing security systems and recovering from data breaches.
As businesses become more dependent on technology, hackers likewise grow more sophisticated in their attacks, exposing businesses big and small to debilitating breaches.
Cyber crime, espionage and other “malicious cyber activity” cost the United States anywhere from $24 billion to $120 billion each year.
Entities as big as the New York Times, JPMorgan and Target have suffered hits, but research suggests that smaller, mom-and-pop shops make easy targets for cyber thieves looking to cash in on stolen debit and credit card numbers.
“It doesn’t matter what size company you are or what industry you are,” said Tim Francis, enterprise cyber lead, Travelers. “You should consider yourself a target.”
“From some things I’ve read,” said Marty Frappolli, senior director of knowledge resources at The Institutes, “the average cost of a data breach is more than $5 million, and the FBI is on record saying that most small businesses won’t survive a cyber attack.”
High-profile attacks have raised awareness about cyber liability, both among the business community and regulators. Forty-six states, the District of Columbia, Guam, Puerto Rico and the Virgin Islands all have laws requiring private or government entities to notify individuals of PII security breaches.
And yet the development of cyber insurance products and take-up by smaller and medium-sized businesses remains somewhat stagnant. Shouldn’t companies be scrambling to get coverage for one of their scariest business threats? Somewhere between the awareness of cyber risk and actually purchasing insurance against it, there’s a dangerous disconnect. Indications are that brokers may be the weak point.
Are Brokers Balking?
In internal research conducted by one major underwriter, a survey of both brokers and insurance buyers found that buyers expressed interest in purchasing cyber coverage, but hadn’t followed through mainly because their brokers hadn’t engaged with them or educated them about the topic.
Correspondingly, a much lower number of brokers claimed that their clients had a need, under-reporting the interest their customers had expressed. Taking the responses of both groups together, the underwriter concluded that a significant number of brokers may not fully understand cyber exposures or the insurance solutions on the market, and therefore are shirking the topic altogether.
A survey conducted by Marsh at their annual Communications, Media and Technology conference revealed similar findings. While 69 percent of attendees indicated increased concern about cyber security and liability over the past year, few had made moves to tighten their risk management.
Just 13 percent thought cyber risk was a matter for the risk management function, with most believing that the responsibility should fall to the IT department. Only about one-fifth of respondents said that their organization currently purchased cyber insurance, and only 11 percent of them felt confident that their coverage met their needs.
Clearly, there is a communication gap between buyers and the insurance community, and the onus falls on brokers to bridge it.
Emerging, Evolving Risk
Brokers could be side-stepping cyber coverage for several reasons. First and foremost, novelty and constant change.
“[One broker] felt that she couldn’t present the cyber quotes to her clients because she really couldn’t explain how the policies were different.”
- Nick Economidis, underwriter, Technology, Media and Business Services, Beazley
“Cyber risk, even though it’s been around for decades, is still an emerging, evolving risk,” Frappolli said. Exposures are ever-changing, and insurance solutions must change as rapidly to address them.
Lack of standardization in terminology also contributes to the confusion.
Nick Economidis, underwriter for Beazley’s Technology, Media and Business Services group, said he “met with one insurance broker who said that all the policy forms were different, and it was hard to understand how they compared to each other.
“She felt that she couldn’t present the cyber quotes to her clients because she really couldn’t explain how the policies were different,” he said.
Greg Gamble, director, Management and Professional Risk Group, Crystal & Co., said that while coverage is standard, policy wording varies among the 15 or so carriers that offer it.
“In that regard, it’s confusing because we have to make this understandable to our customer base and articulate it back to them in a way that makes sense.
“I would agree that there could be more standardization among carriers,” Gamble said, “but I don’t think that’s coming anytime soon because carriers have a lot of private ownership of their policies. They have people who’ve spent a tremendous amount of time developing those products, and they label agreements and write the policies their own way, and I don’t think they’re focused on coming together with industry standard categories of coverage.”
Tough Regulatory Environment
Varied state regulations also factor into non-uniform policies. Different legislatures have different notification standards, which affects what a company can stand to lose through notification costs alone.
“There are new laws coming through at the federal and state levels. European law is changing,” said Chris Keegan, senior vice president, Willis. “The ways in which technology is being used is changing, which can make those laws out of date very quickly.
“A lot of people are hoping for federal level simplification. We’ve seen Congress trying to put that in place for the last four or five years but they never seem to be able to get that legislation passed,” he said.
Notification laws can easily throw brokers for a loop.
Ken Goldstein, worldwide cybersecurity manager, Chubb Insurance, said it can be hard to keep track of who needs to be notified of a breach in which state. Some laws require attorneys general to be notified in states where customers were affected, and some require that credit monitoring agencies be alerted, depending on what type of information was disclosed.
“Different industry segments have different legal and regulatory requirements,” Goldstein said. “Identifying these exposures will ultimately help agents and brokers figure out how to protect clients from an insurance perspective.”
Not all brokers struggle with the changes, though. Larger brokerage houses and carriers have teams dedicated to researching, assessing and developing products responding to cyber risk. Brokers that have that in-house specialized expertise at their disposal have a much easier time finding the right solutions for their clients.
“There are only about five brokerage houses that have people with that level of expertise.”
- Chris Keegan, senior vice president, Willis
But indications are that the community of experts among brokers remains too small.
“There are only about five brokerage houses that have people with that level of expertise,” Keegan said. “For some of the other houses that don’t have that internal specialized expertise, they may struggle to get the consulting and policy advice that clients need.”
That explains why take-up is much lower among small and mid-sized businesses: They generally don’t have the same resources as large companies to work with the handful of big brokerages with in-house experts.
Some carriers also offer tools like breach cost calculators and risk assessment portals that allow brokers to estimate the financial impact of notification, data cleanup and business interruption. But those resources might not be enough. According to Travelers’ Francis, carriers could do more to work with and educate brokers on their coverages.
“One of the ways the industry can be working to address this issue is having carriers that not only deliver products, but are experts in the products they’re selling,” he said. Carriers should be helping brokers understand each account’s unique level of exposure and the insurance solutions available. “That collaboration right now is as important as, or more important than, the insurance product that is the end delivery,” he said.
“For smaller and mid-sized businesses, there really is great opportunity for the agents and brokers to fill that knowledge gap,” said Frappolli of The Institutes. “I would say that best-in-class agents are doing this for their clients. There’s always an opportunity for the broker to be not just somebody who sells you an insurance policy, but somebody who is your de facto risk manager.”
Solutions in Education
There are ways brokers can educate themselves on the evolving cyber environment, beyond reading journals and attending webinars. Conferences, for example, provide easy access to expert speakers, said Mark Greisiger, president of NetDiligence, which hosts twice-yearly educational forums on cyber risk.
“Both the speakers and attendees are the insurance companies, and their inside lawyers sometimes. We have retail and wholesale brokers attending. We have risk managers and CFOs who buy the insurance there, and various state and federal regulators. Many top security experts who can help customers safeguard their data come and speak as well,” he said.
“We also see a lot of smaller brokerage groups coming, because they need that technical expertise,” Greisiger said.
According to Willis’ Keegan, the industry can expect to see a lot of growth in take-up in cyber coverage among smaller clients in the next two to three years.
Brokers that can capitalize on that demand and independently stay up to speed on changing exposures will reap the rewards.
Coping with Cancellations
Airlines typically can offset revenue losses for cancellations due to bad weather either by saving on fuel and salary costs or rerouting passengers on other flights, but this year’s revenue losses from the worst winter storm season in years might be too much for traditional measures.
At least one broker said the time may be right for airlines to consider crafting custom insurance programs to account for such devastating seasons.
For a good part of the country, including many parts of the Southeast, snow and ice storms have wreaked havoc on flight cancellations, with a mid-February storm being the worst of all. On Feb. 13, a snowstorm from Virginia to Maine caused airlines to scrub 7,561 U.S. flights, more than the 7,400 cancelled flights due to Hurricane Sandy, according to MasFlight, industry data tracker based in Bethesda, Md.
Roughly 100,000 flights have been canceled since Dec. 1, MasFlight said.
Just United, alone, the world’s second-largest airline, reported that it had cancelled 22,500 flights in January and February, 2014, according to Bloomberg. The airline’s completed regional flights was 87.1 percent, which was “an extraordinarily low level,” and almost 9 percentage points below its mainline operations, it reported.
And another potentially heavy snowfall was forecast for last weekend, from California to New England.
The sheer amount of cancellations this winter are likely straining airlines’ bottom lines, said Katie Connell, a spokeswoman for Airlines for America, a trade group for major U.S. airline companies.
“The airline industry’s fixed costs are high, therefore the majority of operating costs will still be incurred by airlines, even for canceled flights,” Connell wrote in an email. “If a flight is canceled due to weather, the only significant cost that the airline avoids is fuel; otherwise, it must still pay ownership costs for aircraft and ground equipment, maintenance costs and overhead and most crew costs. Extended storms and other sources of irregular operations are clear reminders of the industry’s operational and financial vulnerability to factors outside its control.”
Bob Mann, an independent airline analyst and consultant who is principal of R.W. Mann & Co. Inc. in Port Washington, N.Y., said that two-thirds of costs — fuel and labor — are short-term variable costs, but that fixed charges are “unfortunately incurred.” Airlines just typically absorb those costs.
“I am not aware of any airline that has considered taking out business interruption insurance for weather-related disruptions; it is simply a part of the business,” Mann said.
Chuck Cederroth, managing director at Aon Risk Solutions’ aviation practice, said carriers would probably not want to insure airlines against cancellations because airlines have control over whether a flight will be canceled, particularly if they don’t want to risk being fined up to $27,500 for each passenger by the Federal Aviation Administration when passengers are stuck on a tarmac for hours.
“How could an insurance product work when the insured is the one who controls the trigger?” Cederroth asked. “I think it would be a product that insurance companies would probably have a hard time providing.”
But Brad Meinhardt, U.S. aviation practice leader, for Arthur J. Gallagher & Co., said now may be the best time for airlines — and insurance carriers — to think about crafting a specialized insurance program to cover fluke years like this one.
“I would be stunned if this subject hasn’t made its way up into the C-suites of major and mid-sized airlines,” Meinhardt said. “When these events happen, people tend to look over their shoulder and ask if there is a solution for such events.”
Airlines often hedge losses from unknown variables such as varying fuel costs or interest rate fluctuations using derivatives, but those tools may not be enough for severe winters such as this year’s, he said. While products like business interruption insurance may not be used for airlines, they could look at weather-related insurance products that have very specific triggers.
For example, airlines could designate a period of time for such a “tough winter policy,” say from the period of November to March, in which they can manage cancellations due to 10 days of heavy snowfall, Meinhardt said. That amount could be designated their retention in such a policy, and anything in excess of the designated snowfall days could be a defined benefit that a carrier could pay if the policy is triggered. Possibly, the trigger would be inches of snowfall. “Custom solutions are the idea,” he said.
“Airlines are not likely buying any of these types of products now, but I think there’s probably some thinking along those lines right now as many might have to take losses as write-downs on their quarterly earnings and hope this doesn’t happen again,” he said. “There probably needs to be one airline making a trailblazing action on an insurance or derivative product — something that gets people talking about how to hedge against those losses in the future.”
The Next Wave of Workers’ Comp Medical Cost Savings
Managing medical costs for workers’ compensation claims is like pushing on a balloon. As you effectively manage expenses in one area, there are bound to be bulges in another.
Over the last decade, great strides have been made in managing many aspects of workers’ compensation medical costs. Case management, bill review and pharmacy benefits management are just a few categories that produce significant returns.
And yet, according to the National Council on Compensation Insurance (NCCI), medical costs remain the largest percentage of workers’ comp expenses. Worse still, medical costs continue to be the fastest growing expense category.
Many medical services are closely managed through provider negotiations, bill review, utilization review, pharmacy benefits management, to name a few. But a large opportunity for medical cost containment remains largely untouched and therefore represents a significant opportunity for cost savings.
Ancillary medical services is a term used to describe specialty or supplemental health care services such as medical supplies, home health care, durable medical equipment, transportation and physical therapy, etc.
According to Clifford James, Vice President of Strategic Development at Healthesystems in Tampa, Fla., modernizing the process for managing ancillary medical services presents compelling opportunities for cost savings and improved patient care.
Source: 2014 Healthesystems Ancillary Medical Services Survey
“The challenge of managing these types of medical products and services is a cumbersome and extremely disconnected process,” James said. “As a result, it represents a missing link in an overall medical cost management strategy, which means it is costing payers money and patients the most optimal care.”
James singled out three key hurdles:
Lack of transparency
As the adage goes, you can only manage what you can measure.
Yet when it comes to the broad range of products and services that comprise ancillary benefits, comprehensive data and benchmarking metrics by which to gauge success are hard to come by.
The problem begins with an antiquated approach to coding medical services that was developed in the 1970s. The coding system falls short in today’s modern health care environment due to its lack of product and service level detail such as consistent units of measure, quantity and descriptors.
As a result, a meaningful percentage of ancillary benefits spending is coded as “miscellaneous,” which means a payer has little to no visibility into what product or service is being delivered — and no way to determine if the correct price is being applied or if the item is even necessary or appropriate.
Source: 2014 Healthesystems Ancillary Medical Services Survey
“It’s a big challenge. Especially when you consider that for many payers, it’s difficult to determine exactly what they are spending, or identify what the major cost drivers are when it comes to ancillary services,” James said. And when frequently over 20 percent of these types of services are billed as miscellaneous, payers have zero visibility to effectively manage these costs.
Measurement and monitoring
Often, performance that is monitored is given the most attention. Therefore, ancillary programs that are closely monitored and measured against objective benchmarks should be the most successful.
However, benchmarks are hard to determine because multiple vendors are frequently involved using disparate data and processes. There isn’t a consistent focus on continuous quality improvement, because each vendor operates off of their own success criteria.
“Leveraging objective competitive comparisons breeds success in any industry. Yet for ancillary services there is very limited data to clearly measure performance across all vendors,” James said. “And for payers, this is a major area of opportunity to promote service and cost containment excellence.”
Source: 2014 Healthesystems Ancillary Medical Services Survey
If you ask claims executives about their strategies for improving the claims management process, a likely response may be “workload optimization.” The goal for some is to enable claims professionals to handle a maximum case load by minimizing administrative duties so they can leverage their expertise to better manage the outcome of each case.
But the path towards “workload optimization” has many hurdles, especially when you consider what needs to be coordinated and the manual way it frequently is done.
Ancillary benefits are a prime example. For a single case, a claims professional might need to coordinate durable medical equipment, secure translation services, arrange for transportation and confirm the best physical therapy plan. Unfortunately they often don’t have the needed time, or the pertinent information, in order to make quick, yet informed, decisions about the ancillary needs of their claimants.
In addition there is the complexity of managing multiple vendor relationships, juggling various contacts, and accessing multiple platforms and/or making endless phone calls.
“We’ve been called the ‘industry integrator’ by some people, and that’s accurate. We are delivering a proven platform connecting payers with providers and vendors on the ancillary medical benefit front. It’s never been done before.”
– Clifford James, Vice President of Strategic Development, Healthesystems
Modernizing the process
To the benefit of both payers and vendors, Healthesystems offers Ancillary Benefits Management (ABM).
The breakthrough ABM solution consists of three foundational components — a technological platform, proprietary medical coding system and a comprehensive benefits management methodology.
The technological platform integrates payers and vendors with a standardized architecture and processes. Business rules and edits can be easily managed and applied across all contracted vendors. All processes – from referral to billing and payment – are managed on a single platform, empowering the payer with a centralized tool for managing the quality of all ancillary providers.
But when it comes to ancillary products, the critical and unique challenge Healthesystems had to solve is the antiquated coding system. This was completed by developing a highly granular, product-specific coding system including detailed descriptions and units of measure for all products and services. This coding provides payers with the clearest understanding of all products and services delivered including pricing and all the necessary utilization metrics.
“We bring the highest level of transparency and visibility into all ancillary products and services,” James said, adding that the ABM platform uses an extensive preferred product coding system 15 times more detailed than any other existing system or program.
This combination of sophisticated technology, proprietary coding system and benefit management methodology revolutionizes the ancillary category. Some of the benefits include:
- Crystal-clear transparency
- A more detailed and comprehensive view into ancillary products and services
- An automated process that eliminates billing discrepancies or resubmittals
- Integrated and consistent processes
- Strategic program management
Taken together, the system leapfrogs over the existing hurdles while creating entirely new opportunities. It’s a win for vendors and payers, and ultimately for patients, who receive the optimal product or service.
“We’ve been called the ‘industry integrator’ by some people, and that’s accurate,” James said. “We are delivering a proven platform connecting payers with providers and vendors on the ancillary medical benefit front. It’s never been done before.”
To learn more about the Healthesystems Ancillary Benefits Management solution visit: http://www.healthesystems.com/solutions-services/ancillary-benefits