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Infographic: The Risk List

6 Non-Cyber Risks for Technology Companies

Tech firms face multiple perils in addition to cyber risks.
By: | July 9, 2014 • 2 min read

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The R&I Editorial Team may be reached at riskletters@lrp.com.
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Cover Story

Building Resiliency in the Face of Climate Change

Climate change demands that companies take a collaborative approach to risk management.
By: | June 2, 2014 • 10 min read
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Failing to prepare for extreme weather events cost the United States $1.15 trillion in economic losses from 1980 to 2010, according to the U.S Global Change Research Program (USGCRP). The more telling number comes from a study by Munich Re, which put insured losses for North America during the same period at $510 billion. No doubt government was forced to take on the lion’s share of the rest, but U.S. business also paid out of pocket for a fair amount of the remaining $640 billion in losses.

Here’s another sobering figure. A Business Continuity Institute study indicates that 40 percent of businesses affected by extreme weather for extended periods of time never recover or reopen. It’s likely that for much of the 60 percent that stay open, full recovery is a long and painful process.

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The forces behind these events are gaining steam and they are indiscriminate. From December 2013 through February 2014, drought-stricken California recorded its warmest winter on record. Across the rest of the country, including the South, winter storms were merciless, dealing at least a $15 billion blow to U.S. businesses.

Let the politicians bicker all they want about who or what is to blame for climate change. USGCRP projects another $1.2 trillion in losses through 2050. So for those with boots on the ground and a business to run, it doesn’t matter who’s to blame. Climate change is not a future risk, it’s a right-now risk, and the only question that matters is, “Now what?”

Some of the answers to that may surprise risk managers and other business leaders.

The Chocolate Elephant

Here’s what’s on the table. According to the most recent report from the United Nations’ Intergovernmental Panel on Climate Change, ice caps are melting, sea ice in the Arctic is collapsing, water supplies are coming under stress, heat waves and heavy rains are intensifying, and coral reefs are dying. Coastal communities are under double threat from sea-level rise and from increased acidity as the waters absorb the carbon dioxide given off by cars and power plants. Organic matter frozen in Arctic soils since before civilization began is melting, decaying into yet more greenhouse gases.

Video: A description of the IPCC findings.

Slowing these trends may be possible, but reversing them is not. Therefore, the altered climate — with its attendant storm frequency increases, droughts, wildfires, intense rainfalls, storm surges, the “polar vortex,” the rising sea level and the rest of it — is ours to keep.

Evidence of this mounts daily. Just within the days surrounding the 2014 RIMS conference, wildfires ravaged states on the East and West coasts, tornadoes ripped a path across the South Central United States, and severe floods battered Florida and Alabama. That convergence of calamities no longer seems to strike anyone as shocking. In the years and decades to come, these events are expected to increase in both frequency and severity. In other words, welcome to the new normal.

Superstorm Sandy tested the mettle of many, and served as a wake-up call to those who underestimated the complexity of the climate risks they face. Organizations were brought up short by just how underprepared they really were — and what that could mean to their bottom lines. Risk managers, both public and private, are beginning to parse out what climate change really means and what its total implications are for the organizations they serve.

That task can seem daunting. There are multiple perils involved, which have an exponential impact on possible exposures.

“One of the challenges of climate risk is that for most people, it’s the chocolate elephant — it’s just too big to eat,” said Chris Smy, managing director and global practice leader with Marsh’s environmental practice. That makes it tempting to throw up one’s hands and say, “I can’t solve this.”

The threat seems both too large and too distant. Many reports and articles about climate change include the phrase “by the end of the century …” easily lulling leaders into thinking of it as something that need not be addressed right now, especially when matters such as cyber risk seem so much more immediately pressing.

 Chris Smy, managing director, global practice leader, Marsh

Chris Smy, managing director, global practice leader, Marsh

But the increased frequency and severity of extreme weather events is apparent. At the same time, we’re seeing populations gravitate toward cities, and scientists have concluded that cities are warming at a faster rate than rural areas. These facts alone make for a dangerous combination. The population shift toward urban areas also means that many companies don’t have the option to avoid doing business in exposure-prone areas. They need to be where the customers are.

“You have more frequency and severity, and that is exacerbated by more people at risk and more assets to be damaged,” said Bob Petrilli, head of North America, Swiss Re Corporate Solutions. “It’s a triple whammy — it’s multiple economic issues coming together to make things that much worse.”

In the face of these challenges, a dialogue has begun among both corporations and public entities about the concept of resiliency and how to achieve it. What “resilience” means will be different for every company. But it must encompass both the means to minimize exposures and to plan for all contingencies, as well as a clear roadmap to recovery.

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Assessing exposures surrounding climate risk is a more acrobatic exercise than some risk managers are accustomed to. It will take a deep dive into the “what ifs” of each possible peril, looking beyond clear property risks and into anything that could impact a company’s supply chain, as well as a thorough examination of factors that could create business continuity disruptions. For diligent companies, that sounds like standard best practices, but climate risk gives it a new flavor many have not yet tasted. What if the increased frequency of storms, over time, erodes the reliability of power delivery to one or several of my facilities? Could storm surge threaten any of the key bridges we use to transport products out or bring raw materials in? What if there’s a lack of potable water in the city where my key factory is located, or their food supply is sharply diminished by drought conditions? What if threats to the food or water supply create new diseases that incapacitate a large percentage of my workforce in that region?

“One of the challenges of climate risk is that for most people, it’s the chocolate elephant — it’s just too big to eat.” — Chris Smy, managing director and global practice leader, Marsh

That’s not to say that companies need jump on every risk identified. It’s a matter of eliminating the element of surprise. “The horizon may be different,” said John Marren, director of global risk and insurance management for CSL Behring, at a session at this year’s RIMS conference, “but we wanted to have it all on the radar.”

A New Discussion

As companies confront the real problems posed by climate risk, the more they will be faced with the reality that individual companies cannot effectively mitigate every aspect on their own.

“What we’re finally starting to notice is a shift toward this idea of comprehensive risk management,” said Alex Kaplan, vice president, global partnerships for Swiss Re. “It’s not just about your own resilience but it’s also about the community around you. For instance, if you have, say, a corporation that’s based in a city. They could have state-of-the-art technology and could be insured to the teeth, but the city around them ends up collapsing.”

A poignant and very real example of this, said Kaplan, is the Toyota plant in the Turkish city of Van. “It was up to the most incredible standards of seismic protection. So when they had an earthquake in 2011, the factory was virtually unscathed.” However, Kaplan explained, 600 people in the surrounding community were killed, 6,000 buildings were destroyed and 60,000 people were left homeless. “So even though Toyota was physically OK, none of its workers could get to work. And frankly, even if they could get to work, they probably had bigger problems to worry about.”

The corporation with the best risk management, the best strategy and the best risk transfer still has to be aware of where they’re located and what around them could also be impacted and prevent them from moving forward, said Swiss Re’s Petrilli.

Bob Petrilli, head of head of North America, Swiss Re Corporate Solutions

Bob Petrilli, head of North America, Swiss Re Corporate Solutions

“A corporation can’t really survive and thrive unless it’s in a location that has a resiliency plan, and if you’re not talking about that together, then you’re never going to get there,” he said. “This public-private partnership type of approach and thought process is relatively new to our industry — but I think it is critically important.”

These ideas — which are spreading slowly — represent a fundamental shift in how climate risk is perceived.

“Many of us in the industry have been focusing on not just the idea of resiliency but on this overarching concept of enterprise risk management, but it’s also broader, it’s global, it’s about interconnectedness,” said Lindene Patton, chief climate product officer at Zurich.

However, she added, “People are not accustomed to thinking that broadly.” So, no doubt, there are some that are going to balk at such a bold departure from tradition. Put in perspective, though, it’s only a logical step for companies that are already engaged in their communities from a corporate citizenship standpoint.

“Corporations like to be integrated with the communities they’re in, they support things within the community to raise their own stature,” said Petrilli.

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“But they probably haven’t in the past met with the city or the municipality from a risk management standpoint to discuss things like ‘What if this? What would we do?’ Once that dialogue starts, it becomes more of a ‘We’ve all got a dog in this fight’ conversation.”

Experiencing the pain of losses will increasingly drive organizations toward this perspective.

“A corporation can’t really survive and thrive unless it’s in a location that has a resiliency plan, and if you’re not talking about that together, then you’re never going to get there.” Bob Petrilli, head of North America, corporate solutions, Swiss Re

A good example, said Marsh’s Smy, is how, since Superstorm Sandy, there’s been a lot of activity in the New York tri-state area around trying to prepare, as a region, for repeat events of that magnitude.

“There’s an opportunity for organizations to engage with local government,” he said.

As organizations look through the lens of climate risk as a way to assess their risk profiles, they’ll begin to recognize that there are areas they can’t control, said Smy, “and they may well decide, ‘We can no longer be a bystander.’ Once you reach that conclusion … then there’s action that can be taken.” That may take the form of lobbying for changes, investing money in nonprofits conducting resilience studies, seeking out public-private partnerships, or even investing in infrastructure.

“The more we talk, the more we get to the point where there is a joint approach to an event,” said Petrilli. “It kind of screams for some collaboration.”

At the very least, opening a dialogue will help flesh out the breadth of the exposures so that action plans can be developed around them. “What people are beginning to focus on is sharing information and on the idea of public-private partnerships,” said Zurich’s Patton. “[It’s about] trying to just define these externalities … Does the power work? Can you drive down a road? Can you get gasoline? Is the metro running? Those are all questions we’re not used to asking. We’re used to only worrying about the things that are under our control.”

For risk managers who find that the idea of community partnerships is a hard sell to the C-suite, Patton added that the benefits go beyond managing climate risk. Companies can approach their community’s climate risk issues much as they would any other public service project, she said. “Not something huge, not something that would go outside their economic model, but just a twist in the way that they’re interacting with their communities. It has all sorts of co-benefits that come with it … things like brand, value, advertising. It’s a way to rethink how they get their name out in the community” in a way which is moving toward resilience while delivering other benefits.

Strategic Planning

The nature of climate risk dictates that companies factor climate changes into corporate decision-making just the same way that companies might evaluate market conditions, tax implications, political instability or any other key exposure.

That long-range scope might not be the responsibility of risk management in some organizations.

“That looks a lot more like strategy,” said Marsh’s Smy. “That’s planning, more than managing day-to-day risk.”

Climate risk and resiliency, then, are the place where strategy and risk management are converging. Savvy business leaders will view decisions through the lens of resiliency in order to protect the organization’s interests.

Ultimately, said Smy, this can better position risk managers within an organization. “It creates an opportunity to address something that’s a strategic issue, at the board level, and I think that’s a great opportunity for risk managers to be thoughtful about it and not be kept in the box of insurance.”

“Resiliency is an opportunity for risk managers to elevate their place at the table,” said Andrew Thompson, global lead for catastrophe risk and insurance at Arup.

A true chief risk officer, said Zurich’s Patton, can act as an adviser to other parts of the organization, to help them think more broadly about the effects of climate risk on their decision-making process.

“The goal is to have people — as they’re thinking and planning — ask themselves, ‘Will this make us more or less resilient?’ ” said Max Young, communications director for 100 Resilient Cities, an initiative focused on building global resilience.

Corporate risk management has evolved into a sophisticated function in most corporations, said Petrilli. And now it is being further refined. “It has gone beyond insurance buying and into ERM,” he said.

“Resiliency is an opportunity for risk managers to elevate their place at the table.” — Andrew Thompson, global lead, catastrophe risk and insurance, Arup

“The board of directors needs to know not only what their operations are going to look like in the next year and the next cycle, but also that nothing is going to knock that off track.” And they also need to know that if an event does happen, there’s a well-thought-out plan in place that will maintain the company’s vitality. “That takes real strategic thinking,” he said.

Related R&I Coverage:

Climate Change Hits the Courts

Expanding the Definition of Expected Risks

The Emerging Tort Storm

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at mkerr@lrp.com
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Sponsored Content by Helios

Medication Monitoring Achieves Better Outcomes

Having the right patient medication monitoring tools is increasingly beneficial.
By: | September 2, 2014 • 5 min read
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There are approximately three million workplace injuries in any given year. Many, if not the majority, involve the use of prescription medications and a significant portion of these medications is for pain. In fact, prescription medications are so prevalent in workers’ compensation that they account for 70% of total medical spend, with roughly one third being Schedule II opioids (Helios; NCCI; WCRI; et al.). According to the U.S. Drug Enforcement Administration (DEA), between the years of 1997 and 2007, the daily milligram per person use of prescription opioids in the United States rose 402%, increasing from an average of 74 mg to 369 mg. The Centers for Disease Control and Prevention (CDC) reports that, in 2012, health care providers wrote 259 million prescriptions—enough for every American adult to have a bottle of pills—and 46 people die every day from an overdose of prescription painkillers in the US. Suffice to say, the appropriate use of opioid analgesics continues to be a serious issue in the United States.

Stakeholders throughout the workers’ compensation industry are seeking solutions to bend the curve away from misuse and abuse and these concerning statistics. Change is happening: The American College of Occupational and Environmental Medicine (ACOEM) and the Work Loss Data Institute have published updated guidelines to promote more clinically appropriate use of opioids in the treatment of occupational injuries. State legislatures are implementing and enhancing prescription drug monitoring programs (PDMPs). The Food and Drug Association (FDA) is rescheduling medications. Pharmaceutical manufacturers are creating abuse-deterrent formulations. Meanwhile payers, generally in concert with their pharmacy benefit manager (PBM), are expending considerable effort to build global medication management programs that emphasize proactive utilization management to ensure injured workers are receiving the right medication at the right time.

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A variety of factors can still influence the outcome of a workers’ compensation claim. Some are long-recognized for their affect on a claim; for example, body part, nature of injury, state of jurisdiction, and regulatory policy. In contrast, prescribing practices and physician demographics are perhaps a bit unexpected given the more contemporary data analysis showing their influence on outcomes. Such is the case for medication monitoring. Medication monitoring tools promote patient safety, confirm adherence, and identify potential high-risk, high-cost claims. Three of the more common medication monitoring tools include:

  • Urine Drug Testing (UDT) is an analysis of the injured worker’s urine that detects the presence or absence of a specified drug. Although it is not a diagnosis, UDT results are generally a reliable indicator of what is present (and what is not) in the injured body worker’s system. The knowledge gained through the testing helps to minimize risks for undesired consequences including misuse, abuse, and diversion of opioids. With this information in hand, adjustments to the medication therapy regimen or other intervention activities can occur. UDT can also be an agent of positive change, as monitoring often leads to behavior modification, whether in direct response to an unexpected testing result or from the sentinel effect of knowing that medication use is being monitored.
  • Medication Agreements or “Pain Contracts” signed by the injured worker and their prescribing doctor serve as a detailed and well-documented informed consent describing the risks and benefits associated with the use of prescription pain medications. Medication agreements help the prescribing doctor set expectations regarding the patient’s adherence to the prescribed medication therapy regimen. They serve as a means to facilitate care and provide for a way to document mutual understanding by clearly delineating the roles, responsibilities, and expectations of each party. Research also suggests that medication agreements promote safety and education as injured workers learn more about their therapy regimen, its risks, and benefits.
  • Pill Counts quantify adherence by comparing the number of doses remaining in a pill bottle with the number of doses that should remain based on prescription instructions. Most often, physicians request pill counts at random intervals or the physician may ask the injured worker to bring their medication to all appointments. As a monitoring tool, pill counts can be useful in confirming proper use, or conversely, diversion activities.

On a stand-alone basis, these tools rank high on individual merit. When used together as part of a consolidated medication management approach, their impact escalates quite favorably. The collective use of UDT, Medication Agreements, and pill counts enhance decision-making, eliminating gaps in understanding. Their use raises awareness of potential high-risk, high-cost situations. Moreover, when used in concert with a collaborative effort on the part of the payer, PBM, physician, and injured worker, they can improve communication and align objectives to mitigate misuse or abuse situations throughout the life of a claim.

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Medication monitoring can achieve better outcomes

The vast majority of injured workers use medications as directed. Unfortunately, situations of misuse and abuse are far too common. Studies show a growing trend of discrepancies between the medication prescription and actual medication-regimen adherence when it comes to claimants on opioid therapy (Health Trends: Prescription Drug Monitoring Report, 2012). In response, payers, working alongside with their PBM and other stakeholders, are deploying medication monitoring tools with greater frequency to verify the injured worker is appropriately using their medications, particularly opioid analgesics. The good news is these efforts are working. Forty-five percent of patients with previously demonstrated aberrant drug-related behaviors were able to adhere to their medication regimens after management with drug testing or in combination with signed treatment agreements and multispecialty care (Laffer Associates and Millennium Research Institute, October 2011).

In our own studies, we have similarly found that clinical interventions performed in conjunction with medication monitoring tools such as UDT reduces utilization of high-risk medications in injured workers on chronic opioid therapy. Results showed there was a decrease in all measures of utilization, driven primarily by opioids (32% decrease) and benzodiazepines (51% decrease), as well as a 26% reduction in total utilization of all medications, regardless of drug class. This is proof positive that medication monitoring can be useful in achieving better outcomes.

This article was produced by Helios and not the Risk & Insurance® editorial team.


Helios, the new name for the powerful combination of Progressive Medical and PMSI, is bringing the focus of workers’ compensation and auto-no fault pharmacy benefit management, ancillary services, and settlement solutions back to where it belongs—the injured party.
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