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The Impact of Collaboration in Cyber Risk Insurance

Former FBI Director Robert Mueller once said, “There are only two types of companies: those that have been hacked and those that will be. Even that is merging into one category: those that have been hacked and will be again.” This is the environment in which risk managers must protect their businesses, and it isn’t easy.

Cyber risk is not an IT issue; it’s a business problem. As such, risk management strategies must include cyber risk insurance protection. Until recently, cyber insurance was considered a nice-to-have supplement to existing insurance coverage. However, following in the wake of numerous, high-profile data breaches, cyber coverage is fast becoming a must-have. In fact, new data from The Ponemon Institute indicates that policy purchases have more than doubled in the past year, and insiders estimate U.S. premiums at around $1 billion today and rising.

But is a cyber policy really necessary? In short, yes. As P.F. Chang’s China Bistro recently discovered, commercial general liability (CGL) policies generally do not include liability coverage to protect against cyber-related losses. CGL policies are intended to provide broad coverage, not necessarily deep coverage. Considering the complexity of cyber risks, there is a real and legitimate need for specialized policies that indemnify the insured against cyber-related loss and liability.

The fact is, cyber risk is a problem all its own.

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The cyber threat is pervasive, and attacks are increasing exponentially. Cyberattack trends are also shifting constantly. An attack can come from multiple directions and in multiple forms, targeting different information and outcomes: an attack launched by a hacker group intent on making a political statement, malware that enters the network through a third-party service provider to steal credit card information, or a data breach perpetrated by a trusted insider seeking competitive intellectual property (IP).

In this complex, dynamic threat landscape, the ability to accurately assess risk becomes a monumental undertaking. If we accept that every organization has been hacked or will be again, it’s clear that prior incidents are no longer relevant or legitimate indicators of a company’s risk. Similarly, stagnant security checklists required by many insurers are hardly representative of actual, ever-changing cyber risk. Traditional risk assessment methodologies that rely on these elements to determine pre-binding risk simply have no place in today’s world.

Risk Assessment for the Cyber Era

The industry needs assessment methods consistent with the changing threat landscape. That means real-time, active assessment of an entity’s entire business ecosystem including upstream and downstream threats, as well as the often overlooked insider threat. What this provides is a holistic understanding of an entity’s vulnerabilities, high priority risks and security maturity.

In the current cyber environment, it’s implicit that every organization will be the victim of a cyberattack and that there will be some cyber loss as a result. Thus, savvy underwriters are looking beyond mere ticks on a checklist to determine insurability; rather, they’re looking for security maturity and cyber resilience.

The more cyber resilient an organization, the faster it can identify a cyberattack, stop it and recover from the impact. Data loss is expected. It’s the severity of the data loss that will impact the company’s business, damage its brand and customer loyalty and erode investor confidence.

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Those organizations that can quickly and effectively minimize the risk and get back to business are generally considered a safer bet.

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This is where organizations can realize the benefits of holistic cyber insurance assessment. All too often, critical data is uncovered after a breach occurs. By implementing a proactive risk assessment before an attack occurs, the organization can gain in-depth intelligence about its highest priority risks before an incident, not years later when it’s too late to do anything about it. A pre-binding assessment provides the right data at the right time to inform risk management decisions and align resources with an organization’s highest priority risks.

Additionally, organizations that adopt continuous proactive assessment and ongoing risk mitigation demonstrate mature security practices, which indicate an organization’s ability to return to regular operations faster following a cyber incident.

Partners Against Cybercrime

Historically, there has been an antagonistic relationship between the insurer and client, but in the wake of catastrophic data breaches, these two sides are now finding common ground. For instance, several insurance brokers today are requiring a holistic, pre-binding risk assessment before a company can receive a policy. This benefits both the insurer and the pre-insured by providing invaluable insights about the company’s security, often revealing unexpected weaknesses and new priorities. Some policies also tie risk assessment to financial incentive to encourage ongoing risk mitigation. This becomes a virtuous circle situation for the insured, as it gets the benefit of reduced premiums after risk maturity has been measured, which allows the company greater insight and the ability to be proactive about reducing security risks.

For decades, the bargaining power has been with the insurer. With a revised approach, and in keeping with the demands of today’s cyber landscape, the relationship between insurer and insured has become collaborative as both sides work together to identify and mitigate risk. In this way, cyber insurance becomes an avenue for companies to improve cybersecurity, not to simply offset risk.

Tips for Safe Winter Driving

Winter is suddenly upon us. In Buffalo, New York, four deaths have been attributed to a winter storm that dumped up to six feet of snow. The storm was blamed for three more deaths in New Hampshire and Michigan. Whether commuting to work, driving a long-haul truck or overseeing a fleet of vehicles, winter presents business hazards. To stay safe and on the road during inclement weather, experts advise keeping vehicles in top condition with frequent safety checks. The National Highway Traffic Safety Administration reports that “failure to keep in proper lane or running off the road” and “driving too fast for conditions” are the two of the most frequent driver behaviors causing accidents.

For safe winter driving, the NHTSA urges drivers to:

• Check your battery

• Check your cooling system

• Fill your windshield washer reservoir

• Check windshield wipers and defrosters

• Check floor mat installation to prevent pedal interference

• Inspect your tires

• Check the age of your tires

• Stay vigilant while driving

Long-haul truckers have special concerns. ShiftintowinterBC urges drivers to be on the lookout for black ice. Ice buildup on windshield wipers is a sign that conditions are favorable for black ice. Drivers should also slow down when approaching shaded areas, overpasses and bridges—portions of the road that freeze sooner than others. The organization recommends dropping speeds to match conditions, leaving more distance from the vehicle in front and pulling off the road if driving conditions become too extreme.

To avoid potentially dangerous situations, the Insurance Information Institute (I.I.I.) offers these winter driving tips:

  • Give yourself enough time to arrive at your destination. Trips can take longer during winter than other times of the year, especially if you encounter storm conditions or icy roads.
  • Bring a cellphone so that those awaiting your arrival can get in touch with you, or you can notify them, if you are running late. But avoid the temptation of using the phone while driving, as it can be a dangerous distraction—pull over first.
  • Drive slowly because accelerating, stopping and turning all take longer on snow-covered roads.
  • Leave more distance than usual between your vehicle and the one just ahead of you, giving yourself at least 10 seconds to come to a complete stop. Cars and motorcycles usually need at least 3 seconds to halt completely even when traveling on dry pavement.
  • Be careful when driving over bridges, as well as roadways rarely exposed to sunlight—they are often icy when other areas are not.
  • Avoid sudden stops and quick direction changes.
  • Be sure to keep your gas tank full. Stormy weather or traffic delays may force you to change routes or turn back. A fuller gas tank also averts the potential freezing of your car’s gas-line.
  • Keep windshield and windows clear. Drivers in cold-weather states should have a snow brush or scraper in their vehicle at all times. Your car’s defroster can be supplemented by wiping the windows with a clean cloth to improve visibility.
  • Do not activate your cruise control when driving on a slippery surface.
  • Do not warm up a vehicle in an enclosed area, such as a garage.
  • Keep your tires properly inflated and remember that good tread on your tires is essential to safe winter driving.
  • Check your exhaust pipe to make sure it is clear. A blocked pipe could cause a leakage of carbon monoxide gas into your car when the engine is running.
  • Monitor the weather conditions at your destination before beginning your trip. If conditions look as though they are going to be too hazardous, just stay home.

 

The Cost of Savings: Checking Medical Bill Review Charges

Here’s a provocative question for all the risk managers out there: what did you pay last year in workers compensation medical bill review charges?

Stumped? The answer may be more elusive, and more expensive, than it would initially appear.

Medical bill review is an essential service typically performed by an insurer, claims administrator, or outside vendor. The service provider reviews medical bills related to claims and audits the bills for accuracy, duplication of charges, and reasonableness. The costs for these services are allocated claim expenses, meaning they get charged directly to the claim file. This makes figuring out what you’re paying more difficult, as bill review charges tend to blend in with other expenses and bills.

Bill review charges are typically calculated in two ways. First, for each bill, there is a standard review charge. This could be a flat rate or calculated by the number of lines. Second, for bills that are outside of medical provider networks and are negotiated, a percentage of the savings are charged.

This last piece is critical, because it means that charges for a single bill review can be thousands and sometimes even tens of thousands of dollars.

Here’s an example. Suppose an employee injures his back and is forced to have surgery, but does so at an out-of-network facility. The hospital bills $200,000, an amount it has no illusions of receiving. As part of the medical bill review process, the bill is negotiated down to $50,000, netting a savings of $150,000. The charge for the bill review is a percentage of the savings, typically between 20-30%. If we assume conservatively that the rate is 20%, in this example, the charge for the bill review service would be $30,000. For self-insureds and those with large retentions, this a cost paid directly out of pocket.

This example highlights two important facts. The first is that network penetration is of prime importance—when a patient is treated at an in-network facility, the bill is generally reduced to the pre-negotiated rate at no cost to you. Second, the medical billing process in this country has created an immensely profitable enterprise for skilled medical bill reviewers.

This is not to say that paying a percentage of negotiated savings is unfavorable to a risk manager. This system aligns the interests of the bill reviewer and the party paying the bill. The more the bill reviewer can lower a bill, the more you save, even if you are ceding a percentage of that savings to claim handling expenses.

And to be fair, the above scenario is more of an anomaly than the norm—in most cases both the savings and fees are much lower.

Still, the entire medical billing strategy employed by hospitals is rather discomforting. In what other industry are bills sent out and routinely negotiated down by 50, 60, or even 75%? Certainly, there are financial motives for hospitals, many of which are owned by private equity firms, to bill higher amounts than they ever expect to receive. Not only will the unsuspecting recipient occasionally unwittingly pay the full amount, higher bills allow hospitals increased write-offs for charity care and other unpaid services. And while fee schedules in some states have attempted to address this problem, this has further contributed to hospitals and insurers, each employing competing billing experts with the respective goals of maximizing and minimizing amounts paid for the same services.

The net result is higher processing expenses for everyone.

Accepting the fact that the medical billing system in this country is the way it is, let’s return to the ,000 medical bill review charge.

As risk managers, we need to continuously be concerned with our expenses. At the same time, these fees represent only a percentage of savings, and theoretically, the higher the bill review charge, the higher the savings. But the knowledge of that fact may not be enough to eliminate the sticker shock. Because medical bill review services are so essential, the only recourse is a better negotiation of fees—paying a lower percentage of savings is a good start, and a hard cap on the maximum charge for a single bill is even better. Of course, the first step is sitting down with the data and figuring out how much you’re actually paying.

That way, when someone asks you the question about how much you’re paying, you’ll not only have the answer, you’ll also have a plan to make it less.

Zero Tolerance Needed to Stop Construction Injuries

Photo by Caroline McDonald

NASHVILLE–For David B. Walls, president and chief executive officer of Austin Industries, construction safety became a lifelong mission the day he had to answer to the father of a worker killed in an accident.

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“Why did you kill my son?” he asked Walls over and over.

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“Those words haunted me,” Walls said during his keynote address at the IRMI Construction Risk Conference here. “Nothing I could do would bring him back.” Tragic events such as this are “defining moments,” he said.

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“But we need to get passionate about safety without experiencing a fatality.” Walls explained that the construction industry has a long way to go, with the worst record for fatalities, according to the U.S. Bureau of Labor Statistics.

Organizations, he added, should focus on the physical work environment and the company culture. They also need to realize that a world-class safety program leads to higher quality throughout the organization.

One prerequisite is strong leadership. A good leader takes the time to really listen to people, admits to making mistakes and shares recognition for a project well done with employees, he said. This person also should be consistent in addressing safety issues and assertive enough to stop workers from continuing on a job if unsafe conditions are evident.

An effective leader needs to be accountable and hold the entire team accountable when it comes to safety. For example, workers need to know that breaking certain safety rules could cost them their job. After all, he said, “you have a moral obligation to get employees home to their families each night in a safe condition.”

Walls recommended frequent discussions of company successes as well as failures. Weekly dialogues of near-misses, for example, can raise awareness about how they could have been prevented and encourage safe behaviors. Posting the safety records of contractors “makes them improve quickly,” he said. Walls advocates for both classroom and thorough on-the-job training.

Safety managers and employees also need to focus on what they might be overlooking, the “sins of omission.” For example, he said, “what are you not doing that you could be doing to save lives?” The litmus test, he added, would be for a manager to ask him or herself, “Would I let my child work here?”

Asked by an audience member how to get the necessary buy-in from a CEO, Walls advised, “Get the CEO to walk the job and see the hazards. Go to the job site and see where someone fell and where the accident took place. Two to three people a day are dying in this industry and it is unacceptable.”