Health Care Risk Management

Discretion Advised

Hospitals balance safety with necessary public care in high-risk departments.
By: | September 14, 2016 • 8 min read

Life-saving health care can be unpredictable, controversial and skirt the frontiers of science.

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Due to its very nature and the research methods it employs, this vital work sometimes attracts the attention of special interest groups, protestors and even criminals. That’s why health care risk managers need to balance access to care with the security issues some departments pose.

Animal testing, reproductive services and departments that house nuclear materials can all draw attention from those who would shut those operations down if they could, or at the very least, harm a hospital system’s reputation.

Take, for example, family planning.

After a deadly shooting at a Colorado Planned Parenthood office, an abortion doctor named Diane Horvath-Cosper gave several press interviews where she vowed to continue with her services and advocate for family planning rights at her Washington, D.C., hospital.

Soon after the news stories aired, she was called in to see the chief medical officer.

Sean Ahrens practice leader, security consulting and design, Jensen Hughes

Sean Ahrens
practice leader, security consulting and design, Jensen Hughes

The executive asked Horvath-Cosper to stop talking to reporters because he did “not want to put a K-Mart blue light special on the fact that we provide abortions,” she later said.

Horvath-Cosper did stop her media interviews. And then she filed a civil rights complaint against the hospital. She alleged the hospital discriminated against her for expressing her moral conviction on abortion. The hospital should instead bolster security, the complaint said.

The hospital did hire a security guard and install cameras. Yet it didn’t follow through on many other suggested measures, such as installing shatterproof glass or an intercom system, she said.

The Need to be Discreet

This case highlights the difficulties hospitals face when they need to be protective of their operations to avoid drawing attention from vocal activists or violent actors.

Today’s health systems are often vast networks offering not only medical care, but also advanced research, retail stores, pharmacy and social services. Each hospital network is searching for ways to prop up revenue while providing cutting-edge care ahead of the competition.

But before adding new business lines, experts caution that hospital administrators weigh all reputational and security risks they may attract, and continually reassess those risks based on a changing environment.

Once risk managers know the risks and plan for them properly, they should be able to weather most storms.

The University of Washington is pressing on with the construction of a new underground animal research facility adjacent to its hospital despite continuous protests by animal rights organizations.

This spring, members ofNo New Animal Lab” shut down construction for a day when two protesters chained themselves to an excavator working on the site. Several people were arrested for criminal sabotage.

The protesters even went to the vacation home of a construction company executive in Fort Lauderdale, Fla., and scrawled chalk messages all over his driveway that accused him of killing puppies and kittens.

“Even though you may keep it quiet, the reality is people will know; those interest groups will know and they will target you as far as media and protests,” said Jeff Young, president of the International Association for Healthcare Security & Safety (IAHSS).

“Whether abortion or animal research, there are very active groups out there that protest hospitals on a regular basis,” he said.

Conduct Regular Assessments

The hot-button issues in hospital settings aren’t limited to family planning or animal research.

Today’s state-of-the-art teaching hospitals usually house nuclear materials; they’re conducting gene trials and banking dangerous disease samples while hunting for cures.

That is a whole new risk as far as environmental factors, accidental disbursement or terrorism if the samples get into the wrong hands.

Jeff Young President, International Association for Health Care Security & Safety

Jeff Young
President, International
Association for Health Care Security & Safety

Some hospitals have even quietly set up onsite “forensic” units dedicated to the care of dangerous prisoners and the mentally ill.

Often these ancillary departments coexist unseen in health care complexes. But if promoted, they may attract bad actors seeking to steal valuable items or cause harm to the public.

Hospitals must provide an extra layer of protection for the staff and public who may venture into these high-risk areas, and also make sure high-risk materials or people don’t get out.

“An organization needs to consider that risk even before they decide to go in that area,” Young said.

To properly prepare, risk managers must strategically work with co-workers and service providers to manage these reputational risks. They need to conduct regular assessments to stay ahead of changes in the community and fortify security.

“There needs to be a communication plan and a media plan to respond to those outside groups that will comment or protest against the services that will be provided,” Young said.

Then there must be a thorough security assessment.

The University of Washington is pressing on with the construction of a new underground animal research facility adjacent to its hospital despite continuous protests by animal rights organizations.

“Really good hospitals do their assessment, they find things and they audit that assessment every year to see if there are changes and if they are cost-effective,” said Sean Ahrens, practice leader for security consulting and design at Jensen Hughes.

The risk assessment should account for the hospital’s environment and surrounding community and also anticipate future changes, Ahrens said.

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Every employee has to be aware and on the lookout for problems, and know what to say and how to react if they encounter a problem, said Maureen Archambault, regional managing director of health care services at Arthur J. Gallagher & Co.

It’s not just going to be to an administrator or security guard encountering problems, she said. Training needs to reach all employees working in the hospital.

“It’s great to have a plan. But if people can’t follow it and don’t understand it, it’s not going to happen,” Archambault said.

Safety drills in partnership with community first responders are also vital practices to test and teach security procedures, she said.

One challenge in risk prevention strategies is that extra security recommendations are often seen as an increased cost. And the hospital needs to decide if their community is comfortable with the presence of armed guards.

“Security obviously has a benefit, but it’s always seen as a cost,” Ahrens said.

Administrators need to view security personnel as cost savers, he said. If a security guard is added in the emergency room and an attack never occurs, administrators may ask if the extra personnel was a cost or a valuable deterrent.

“Having a security presence in the emergency department potentially precludes someone from bringing a weapon, but we’ll never know for sure,” Ahrens said.

Young, with IAHSS, emphasizes that security personnel also should be viewed as part of the patient care team.

“I’m a health care worker; I just happen to do security,” Young said.

“Everything we do in health care security, we should be able to track back to patient care or patient experience,” Young said.

Every hospital is unique, so there is no generic template to follow. Whether in a city or rural community, the environment inside and outside the hospital dictates the controls that are put in place, Ahrens said.

“There are so many things going on in hospitals, they are no longer safe havens and it seems to be escalating,” Archambault said.

Hospitals allow public access 24 hours a day. The halls are teeming with patients, visitors, vendors, doctors, nurses, office workers and students.

“Having a security presence in the emergency department potentially precludes someone from bringing a weapon, but we’ll never know for sure.” –Sean Ahrens, practice leader, security consulting and design, Jensen Hughes

While off-hours visitor restrictions reduce the population, the hospital still needs to remain welcoming to all who need it. Extra security layers should not prevent access to care.

“It used to be a safe haven but now we are seeing more and more of the outside influences coming within the walls of the hospital,” Young said.

Sealed Source Materials for Dirty Bombs

High-risk radioactive material is also stored in hospitals and could be targeted by terrorists.

Medical uses for the material include treating cancer patients, purifying blood, or conducting tests and research.

To prevent dispersal once the material is used, it is typically sealed in a stainless steel, titanium or platinum capsule called a sealed source.

The concern is that terrorists could obtain sealed source containers to make a “dirty bomb.” So hospitals must reinforce security and supervision in the area where the material is used or stored.

The National Nuclear Security Administration (NNSA) identified about 1,500 U.S. hospitals and medical facilities with high-risk radiological sources that contain approximately 28 million curies of radioactive material and are candidates for security upgrades.

A 2012 government survey found that NNSA spent $105 million to help 321 hospitals complete security upgrades, such as remote monitoring systems, surveillance cameras, enhanced security doors, iris scanners, motion detectors and tamper alarms. This program continues through 2025.

While the government encourages extra security and offers some assistance to pay for it, the program isn’t mandatory and some hospitals passed on the offer, leaving potential vulnerabilities.

Insurance support

Many hospitals struggle to obtain the right balance of insurance for these high-risk areas.

The Terrorism Risk Insurance Act (TRIA), created in 2002, is triggered by a government-certified act of terrorism, including use of unconventional weapons, also known as nuclear, biological, chemical, or radiological (NBCR) weapons.

The challenge many hospitals face in terms of TRIA is that an active shooter event may not be ruled a terrorist act by the U.S. government.

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That leaves the hospitals without coverage for damage to visitors, patients or staff.

One newer product is stand-alone violence and malicious acts coverage, said Archambault. This is different from terrorist coverage created after the Sept. 11 attacks.

Stand-alone insurance provides a much broader coverage without government certification.

Another solution that has been discussed for a number of years is allowing insurers to accumulate tax-deferred catastrophe reserves.

“We need to be asking, ‘What are the specific differences in exposure and what special insurance products aim to address it?’ ” Archambault said. &

Juliann Walsh is a staff writer at Risk & Insurance. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

Insurance Executives to Watch

2018: Year of the Underwriter

Our 2018 Insurance Executives to Watch drive a renewed focus on underwriting.
By: | December 14, 2017 • 16 min read

In insurance, perfect storms come in all shapes and sizes.  Consider this one, as we all must.

Years and years of ample capacity and manageable losses resulted in commercial insurance pricing floating further and further downward. Everywhere you looked, but especially in property, underwriters were not able to hold the line on price.

And then it came. The third quarter of 2017. Unprecedented Caribbean storm activity aligned with a whopper of an earthquake in Mexico and wildfires that scorched hundreds of acres in California’s pricey wine country.

By some estimates as much as $100 billion in insurance industry surplus was wiped from the books in a matter of weeks, at a time when carriers were charging the lowest premium prices relative to the risk in many years. Big carriers like Chubb and AIG saw 3Q losses of more than $1 billion.

As he takes the reins at AIG, no less a figure than Brian Duperreault has christened 2018 the year of the underwriter. Across the industry, entire lines of business are being rewritten in this transitioning market.

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“The severity of the recent catastrophic events forced AIG and all market participants to reassess appropriate pricing for the risks assumed,” Duperreault said.

Data and analytics receive lots of attention and resource investment, but as Duperreault and other 2018 Insurance Executives to Watch stated recently, data and analytics are just tools to be wielded in the hands of experienced underwriters, for which there is no replacement.

“No one has commented more on the importance of data analytics and technology in our industry than me,” Duperreault said during a third quarter earnings conference call with analysts.

“However, it is the underwriter, properly armed with this information, that is the central control point of our business. So, it is important that we get the balance back. Our use of technology and data will complement seasoned underwriters with the skill sets to evaluate the business on a risk by risk basis,” Duperreault said.

Duperreault also signalled that he planned to re-examine his company’s approach to the use of reinsurance.

“You know it is not my style to take large limits and retentions of risk,” he said. “We will also partner closely with reinsurance as they provide another valuable set of eyes into our book.”

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A Worthy Competitor

Dawn M. Miller, ARM, ERMP, CEO, AXA Insurance Company

As a competitive figure skater, AXA Insurance Company (U.S.) CEO Dawn Miller glides across the ice with grace and artistry, making it look easy.

In truth, her skill demonstrates a powerful athleticism stemming from years of honing her craft — sometimes falling, but always getting up, smarter for the lessons learned.

This grit-and-poise combo served Miller well during her career, which started at OPIC, followed by Willis, then onto AXA P&C  as global head of business development, and next leadership roles at AIG. She served with AIG as head of client engagement across 47 EMEA countries, as well as shouldering market-facing roles in Europe, the Gulf Region, Africa and the U.S.

“I apply lessons learned on the ice in business,” Miller said.

“Fail fast, I say. You will have setbacks but learn from them and move forward. Focus on what you do well and refine it.”

The next step for this worthy competitor? Leading AXA’s U.S. commercial insurance business as it develops client and stakeholder partnerships, raises the profile of multinational insurance programs and helps global clients face risks in new or unknown territories.

“This opportunity suits AXA Group given the size and breadth of our global network and the leading position of the U.S. market as a [foreign direct investment] destination,” Miller said.

Important also, Miller said, is AXA’s shift to a partnership focus.

“AXA’s global ecosystems allows us to craft solutions that empower clients. One example is AXA’s ‘Give Data Back’ data-sharing initiative that uses data as a tool to help clients know and understand risk.”

For 2018, Miller predicts, “The U.S. commercial market will begin to harden with a double-digit increase mainly due to an increase in the retrocession market, which will likely drive companies to seek alternative and enhanced modeling approaches.”

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Staying Ahead of Risk

Jeff Grange, President, North American Specialty Insurance; Global Credit and Surety Practice Leader, QBE

Since joining QBE in 2013 as president of specialty insurance, Jeff Grange tripled the division’s business in an effort to establish a national brand. Now the insurer is hoping Grange can bring his magic to its Global Credit and Surety Practice.

“We have to deliver products and services in a global context, but we also have to keep an eye on the future. We need to be ready to address risks as they emerge,” Grange said.

That effort may be hindered, though, by an aging and dwindling insurance workforce, the rapid pace of technological change, and the industry’s tendency to react rather than anticipate those changes.

Grange plans to tackle all three challenges.

“We combat those trends by partnering with STEM (science, technology, engineering and mathematics) organizations. With the rise of data analytics and the Internet of Things, the underwriter of the future will look a lot like today’s STEM student,” Grange said.

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“We’re surrounding ourselves with these young individuals who will help us stay on the leading edge of innovation and bring a fresh perspective to our traditional view of risk.”

Grange will also leverage QBE’s competencies in economic forecasting.

“We’re looking prospectively at sector risk, credit markets, country risk and the like,” he said.

Staying ahead of change will be critical. In 2018 and beyond, Grange sees CAT events, political uncertainty and country risk introducing some volatility in capacity and pricing.

The credit and surety markets, however, are currently on an upward trend, buoyed by continuing economic recovery in the U.S. and a stock market at its peak.

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Leading Through Engagement

Kathleen Savio, President of Alternative Markets, CEO designate, Zurich North America

Zurich Insurance Group announced in September the retirement of Mike Foley, who served Zurich North America as CEO since 2008. Kathleen Savio, current president of alternative markets, assumes the role this January.

While Foley is leaving some pretty big shoes to fill, Savio’s reputation precedes her: Zurich credits Savio for her dynamic community engagement.

“Helping is what we do, and community engagement and involvement is an extension of our purpose,” she said. “We cannot underestimate the impact we have in how our employees feel about coming to work each day. Everyone wants to be appreciated. Even on the busiest of days, I try not to forget that.”

And her community-centric attitude extends beyond the office walls. Savio serves as chair of the Z Zurich Foundation, a $100 million-endowed foundation that provides local grants supporting youth, mental health and community resilience.

“I’ve learned a lot about the positive impact we have on businesses and communities,” she said. “Insurance helps people and businesses get back up and running when faced with adversity.”

One example of such adversity would be the hurricanes that rocked the U.S. this summer and fall.

“The immense damage from Harvey, Irma and Maria demonstrated the importance of insurance in helping communities recover.”

Savio predicts losses from the storms could reach $100 billion, which is in alignment with industry estimates, driving property price movement upward in the coming months.

“Our focus is to help people and businesses be more resilient,” she added. In her new role, Savio will be dedicated to working with Zurich’s customers and distributors to prepare for similar events and other exposures.

“Our world is changing at a faster rate than we ever have seen before, and it won’t bypass the insurance industry or any of the industries and businesses that we protect,” said Savio.

“Together with my colleagues, I’m ready to lead Zurich North America through these challenges and opportunities.”

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Fighting Stance

Ed Moresco, President, Europe, Allied World

Following an acquisition and a significant reorganization, Allied World Insurance has entered an exciting new phase, one that will no doubt be marked by the same robust growth that has marked its history for the past 16 years.

As the insurer’s new head of European business, Ed Moresco comes across as confident about the company’s position in the face of global change and is more than ready to roll up his sleeves.

“If you look at Allied World as an organization, the term we like to use is that we punch above our weight class,” said Moresco. “We are quite often pitted against carriers that are maybe twice the size, three times our size just in terms of premium and market cap.”

The international operation, however, has not yet reached that level, which is where Moresco will focus his attention for the upcoming year and beyond.

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“We’re gaining relevance in the market, but we’re certainly not to the point where we’re critical to the space,” he said. “So our focus over the next two to three years is really to get to that point where we are viewed as a critical market.”

To get there amid an environment of global volatility, he said, his operations will remain focused on the organization’s strength in technical underwriting.

“We’ve lived that mantra and that ethos throughout our growth as an organization,” he said. “Staying close to the brokers and the clients and staying true to our technical underwriting will be critical, especially in these uncertain times.”

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At Warp Speed

Jonathan Zaffino, Executive Vice President, Everest Re Group

When Everest Re president and CEO Dominic Addesso addressed shareholders at the end of 2016, he took pride in pointing out recent hire Jonathan Zaffino, a Marsh & McLennan and ACE alumnus.

As president of Everest Insurance North America, Zaffino justified the hire by running all out in 2016, standing up nine business segments and bringing more than 100 products to market.

And his work isn’t done; Everest continues its expansion, fueling this by hiring more than 300 new colleagues in the last few years, as it transitions from a company focused on programs to a broader, global specialty company.

Zaffino, with the new title of executive vice president, Everest Re Group, is the one leading the transition in Everest Re’s insurance operations.

“We, as an organization, decided to be much more present, visible and capable in the broader definition of a specialty insurer. That included significantly expanding our capabilities in the direct broker business — both retail and wholesale,” Zaffino said.

One of Zaffino’s challenging tasks is bringing together new hires from more than 70 companies and getting them to sing from the same songbook. The lyrics involve embracing the Everest underwriting culture, which — among other things — means finding the right price for the risk regardless of line, client or geography.

Historically, Everest Re has had the right underwriting formula, averaging more than $1 billion in net income from 2012 through 2016. Its combined ratio over that same period averaged an enviable 87.

But then came the third quarter of 2017 with CAT losses squeezing more than $100 billion in surplus out of the insurance markets. Zaffino, like others, knows he’s in a transitioning market, but Everest Re possesses a robust and highly rated balance sheet.

Over the past 20-plus years, the company demonstrated its firm grip on the long view. Zaffino’s task is to build on top of that formidable foundation, moving quickly to reposition the face of the insurance operation.

“We’re moving quickly because we see opportunity,” he said.

And where does he see the markets going in 2018?

“Prior to the third quarter CAT activity, we were seeing a lot of fatigue in certain lines of business,” he said.

“The property lines began to renew at flat pricing, commercial auto lines were receiving needed rate adjustments, and pockets of other lines also started to come under increased scrutiny.

“We believe that the general theme of rates adjusting upward is an accurate statement at this time, but we don’t believe it will be a linear march. The ultimate outcome will be sorted out line by line, geography by geography, risk by risk.”

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Guiding Global Growth in M&A

Rowan Bamford, Global Head of Mergers & Acquisitions and Tax Insurance, Ironshore

In the two years since Ironshore established its M&A and tax insurance unit, the insurer has doubled down on its effort to become a global leader in the market.

The original 10-person underwriting team is now a 40-person powerhouse of specialists spread across nine countries. Gross written premium increased from about $60 million in 2014 to $240 million in 2017 as Ironshore built up business in the U.S., Canada and Latin America.

Rowan Bamford, Global Head of Mergers & Acquisitions and Tax Insurance, is charged with extending that growth to emerging markets around the world.

Harnessing global growth without entering unprofitable markets prematurely — while keeping Ironshore’s product compliant with local laws and regulations — ultimately comes down to people and patience.

“Recruiting experienced underwriters and regional managers is critical,” Bamford said. “I have to fully trust that the people reporting to me can quickly adapt to the challenges inherent in new markets.”

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Due diligence is also key. Bamford puts in time on the road, meeting with legal experts to better understand the unique regulatory and political environments of each target market.

“That helps us understand the nuances of local markets and determine where our product will work and where it won’t,” he said. “We’re not scared to spend the time doing research, finding where we should be doing business and who the right people to guide us are.”

While M&A volume will be highest in the U.S., transactions in new territories will continue in 2018.

“The M&A market is growing at the fastest rate in the U.S., and the tax insurance market is likely to grow significantly next year. Companies are just as likely to look at prospects in Mexico City as in Kansas City. Offering our product legally in places where M&A insurance has never existed before will be both our challenge and our opportunity in 2018,” Bamford said.

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A Sense of Confidence

Brian Duperreault, President and CEO, AIG

Brian Duperreault made his mark in the insurance business by identifying companies and executives that possessed potential and then helping them develop that potential.

This same formula appears to be in play as Duperreault returns as president and CEO to AIG, the company where he spent the formative decades of his career.

“AIG has a great culture with a spirit of collaboration and collegiality that gives me great confidence that we’re going to get our plans done,” said Duperreault, who took over the reins at AIG in May.

Duperreault said he saw ample reason to praise his new teammates at AIG in watching them respond to the catastrophes that caused so much human pain in the third quarter of 2017.  Hurricanes Harvey, Irma and Maria, the wildfires in California and the earthquake in Mexico all exacted a withering toll.

“I have been extremely impressed with our employees’ responses to those disasters, whether they were located in the impacted areas or helping colleagues around the world,” Duperreault said.

Structurally, Duperreault said he wants to create better-defined businesses within AIG and clearer lines of accountability.

One high-profile example of that is with AIG’s excess and surplus lines company, Lexington. Rather than run excess and surplus business through the other branches of the company, Duperreault picked AIG stalwart George Stratts to run Lexington as more of a stand-alone company.

“He will be building on AIG’s strong core capabilities and history of innovation, along with focused distribution strategies to meet the needs of our clients and brokers in this niche segment,” Duperreault said.

Look for Duperreault and his fellow underwriters at AIG to raise prices in 2018.

“We have successfully begun to raise rates appropriately as a result [of Q3 losses] and we will continue to do so,” Duperreault said.

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Corralling Intangibles

Mike Lebovitz, Senior Vice President, Innovation, FM Global

For many executives, the challenge in 2018 and beyond is clear and compelling. Grow the business. Make the business more profitable, etc., etc.

But for Mike Lebovitz, who heads a new innovation team at FM Global, the challenge isn’t in the known; it’s in the unknown.

Many business leaders accept that the world 10 years from now could be unrecognizable from what we know today, “But we have little idea how it’s going to be different,” Lebovitz said.

Now seven months into building his team, Lebovitz faces a two-headed challenge. On one side, he needs to add value to his FM Global teammates across the company in this era of rapid change. Rather than taking on the mantle of innovation, he needs to find a way to help the entire company keep pace.

“This group is about thinking differently, coming up with ideas, utilizing resources within the organization and people within the organization to bring in new ideas,” he said.

The other side of the challenge is assisting FM Global’s clients, the customers who, in fact, own the mutual insurer, to achieve their goals.

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“That is going to be our opportunity: to engage with our clients and understand their jobs to be done and help them do them faster, better, smarter,” Lebovitz said. To achieve this dual challenge, Lebovitz wants to recruit talent who understand that “in order to innovate you have to be able to fail.”

“I need people who understand science and technology, people who understand data and digital, people who understand business,” Lebovitz said.

“I’m looking for people that have the ability to fail, learn from it, and then move on to the next challenge,” he said. “If you’re not failing in innovation, you’re not taking enough risks,” he said.

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To Boldly Go

Seraina Macia, Executive Vice President and CEO, Blackboard

As mission statements go, “reimagining how commercial insurance is done” is an intriguing one, but it might sound like too lofty an ambition.

If anyone is capable of achieving it, though, it’s Seraina Macia, the executive vice president and CEO of Blackboard, a technology-focused subsidiary of AIG. Macia was previously the CEO of Hamilton USA and has held numerous executive positions at AIG.

“Seraina brings to AIG a rare combination of deep insurance expertise and an acute understanding of the role that technology and data analytics are playing in the ongoing evolution of our industry,” said Brian Duperreault, president and CEO, AIG. “Her perspective will be a valuable one to have on our leadership team.”

Under Macia’s direction, Blackboard will build upon the work of Hamilton USA, applying the cutting edge of technology to risk selection, pricing and claims-handling processes.

“We want to leverage emerging technology and data science to transform underwriting and claims by providing new tools and better information to the underwriter and claims adjusters to make better and faster decisions,” said Macia.

“This will help clients and brokers move faster and with more insight so that they can focus on what’s important: relationships, building business and reinvesting for growth.”

The name Blackboard represents a clean slate, and Macia says she feels blessed to have the opportunity to build a dynamic platform at a such a pivotal moment for the industry.

“Beyond 2018 and into the future, our aspiration is to put Blackboard at the forefront of innovation and technology in the insurance industry.”

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Filling a Multinational Void

Alfred Bergbauer, Vice President, Head of Multinational Underwriting, The Hartford

Recognizing a need for multinational solutions in the middle market, The Hartford embarked last year on a top-down initiative to expand their capabilities in global risks.

“Most middle market companies are uninsured, underinsured or improperly insured for multinational risks,” said Alfred Bergbauer, who came on board as The Hartford’s vice president and head of multinational underwriting last year.

“Eighty percent of middle market companies have international exposure, but half of them are never educated about international solutions by their broker. Educating that segment is our challenge and our opportunity,” he said.

The Hartford’s team of more than 1,000 underwriters, including 15 multinational specialists, work side by side with brokers to identify clients’ multinational exposure using specific criteria.

“We developed six critical questions for brokers to ask every client to determine their level of risk,” Bergbauer said. “Underwriters, brokers and insureds all have to be a part of the conversation.”

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In 2018, Bergbauer expects to be challenged by a perception that global business is cooling off, imperiled by nationalistic and protectionist movements around the world. Market research paints a different picture.

According to United Nations reports, foreign direct investment has steadily trended upward since 1990. In the last two years, though, U.S. investments have shifted away from emerging markets to more mature markets with established customer bases that mirror domestic buying behaviors.

In particular, investments by the small and mid-size segments have increased sharply.

“Watching the market indicated to us that we need to serve these smaller companies moving to establish presence in mature overseas markets,” Bergbauer said. &

The R&I Editorial Team can be reached at [email protected]