This episode of The ShiftShapers Podcast is called “Finding The Right Stop-Loss Partner” and today, host and Chief Transformation Strategist David Saltzman is joined by Mehb Khoja, President of Medical Risk Managers, Inc. to discuss the topic from the perspectives of both employers and MGU’s.

Mehb explains the lag times experienced between incurring and paying claims, shares his insights on why it is not advisable to swing back and forth from fully-insured to self-insured, and defines what lasering is and its significance in this industry.

What You’ll Learn From this Episode:

  • 01:56 Mehb’s position in the industry
  • 08:41 Advisers chasing the lowest stop-loss cost
  • 11:51 Lag times between incurring and paying claims
  • 16:18 Advising clients and switching back to fully-insured
  • 19:07 Lasering defined and predictions of growth

Quotes:

08:48 “I would, in any situation like this, advocate for a long-term partnership whether it’s with us or with another carrier, another MGU, simply because stop-loss claims are going to be volatile by nature and you’re looking to the stop-loss carrier or the MGU to help you with some volatility protection. And sometimes, the stop-loss carrier’s going to win, and sometimes the employer is going to win. And all in all, you want to make sure that you’re purchasing coverage at the right level and that you’re building a long-term partnership as you would with any other benefit carrier.”

12:03 “There’s really no downside in that very first year of self-insurance. The downside is in the subsequent year if you still have the same type of contract. So, for example, if ten employers select 12-12 coverage in the first year, and renews with a 12-12 coverage in the second year, there is a significant gap in coverage and that gap comes from claims that are incurred in the first year of self-funding but paid in the subsequent year.”

14:03 “When you’re thinking about large claims though, these are more complicated situations. This is somebody having gone to a surgical center or a hospital to have a catastrophic condition evaluated treatment on… so let’s take, for example, a transplant. And so, in that situation, the transplant claim, because of the size of the claim, it may go through various levels of scrutiny and review before the employer or the administrator is ultimately billed for the charges. And so, because of that, it is common to see lag time on larger claims be somewhere between 4 to 12 months.”

17:56 “Absolutely. I would say though, more importantly is, an employer shouldn’t be going back and forth between self-insured and fully-insured. I think if you’re of an appropriate size and you’re thinking about moving towards this direction of self-insured, you’re really going to evaluate the philosophical decision to go that way. And once you’ve made that decision that you want to be self-insured, you really don’t want to be hopping back and forth, back to fully-insured carriers.”

19:25 “Lasering is the ability for the stop-loss carrier to identify known claimants, known exposures, and to either exclude them from coverage or include them at a higher rate. And so, what does that mean? Let’s say the employer wants to select coverage at $100,000 per person per year. And during the medical underwriting and clinical underwriting process, it’s discovered that there’s an individual who is going to need a transplant next year. From the carrier’s perspective, that’s a claimant that’s already known and from their perspective, insurance coverage is to protect from the unknown.”

21:54 “I think the stop-loss industry is going to grow. It has been growing significantly. The current market is about $25 billion. And that’s up from about 10 to 12 billion just 6 years ago. And really, the driver of that has been the ACA and now what we’re starting to see is a lot of interest in self-funding from smaller employers who were previously fully-insured and those employers are going to need stop-loss coverage. So we’re going to see some organic growth coming from that market.”

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This episode of The ShiftShapers Podcast is called “Finding Happiness When Success Isn’t Enough” and today, host and Chief Transformation Strategist David Saltzman is joined by Freda Doxey, Founder of the A Wise Coaching and Counseling Company. Freda begins by sharing some of her tools and techniques to deal with the stresses of 2020.

She goes on to explain the differences between internal and external stress and breaks down the 3 parts of internal stress: What am I thinking? What are the emotions attached to it? And what do I believe?

And to round up the episode, Freda explains the need for a coach and its particular differences with a mentor and a sponsor. She also answers the crucial question of how to find life’s happiness when success is not enough and the roles of helpfulness, satisfaction, and mindfulness in this equation.

What You’ll Learn From this Episode:

  • 03:46 Stress in sales: Differentiating internal and external stress
  • 08:20 3 parts of internal stress
  • 12:50 Boundaries and saying no in sales
  • 15:49 Knowing your focus and delegating
  • 18:45 Finding happiness when success is not enough

Quotes:

04:07 “So with stress, it can be internal or external. And in sales, because I did sales as well with Dale Carnegie, it can be internal where you put the pressure on yourself. And it is that stress sometimes that is not managed well that creates a place where we do not perform well, and our people who we try to sell to can pick up on any internal stress.”

04:35 “Now, external stress, we will always have. Whether it’s from family or from the manager or from the company, you can always have external stress because the business model is simply, do more, faster, with less resources. So you’ll have the external. Once we learn how to manage the internal stress, then we can easily manage the external stress. But most of the times, we do not differentiate between the external and the internal.”

08:20 “And here’s the thing, there’s three parts to the internal stress, alright? So the first part for everyone who’s listening is, what am I thinking? You’ve got to analyze. How am I thinking and what am I thinking? Not so much why, but how and what. Second thing is, what are some of the emotions that attach to that particular thought that I am having? And here’s the core: what do I believe?”

12:50 “When I line up my schedule, when I decide where I’m going to go, what I’m going to do, I’ve got to be able to say no that this is not going to be most effective for me. And the more comfortable we get, we’re seeing how ‘no’ actually free us up to the yesses and life.”

18:56 “The insatiable desire. And that simply means along the same lines, you’re just talking about, will I ever be satisfied? And here’s the key that I taught to be satisfied: number 1, it’s not in things and stuff. Success is not measured by the things that we have. And here are some of the things: status. Status can be educational. It could be the number 1 top salesperson. It’s not measured in that.”

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In this episode of the ShiftShapers Podcast, host and Chief Transformation Strategist David Saltzman is joined by Jim Hoitt, Senior Vice President at Captive Division at Berkeley Accident & Health.

Jim shares his in-depth knowledge and insights into the world of Captives and discusses its 2 models and the nature of each. He also takes a deep dive into the kinds of companies that benefit the most from a Captive, from their shared goals to the ideal company size to their financial commitments.

But Jim also discusses the major plus sides to the arrangement which include providing the best healthcare for companies at a lower cost, absorbing losses and mitigating risk factors to help ensure success across models. He also explains the key role an adviser plays in all of this and how the ultimate goal is to provide guidance and filter the best-fit companies.

What You’ll Learn From this Episode:

  • 03:35 Explaining the 3 layers: Retained, shared & risk transfer layers
  • 06:34 The heterogeneous vs homogenous models
  • 10:25 Company profile: Who benefits the most from Captives?
  • 15:27 Starting a Captive arrangement
  • 18:24 The adviser’s role in starting a captive

Quotes:

02:14 “A Captive health arrangement is a financial arrangement for which an employer that decides to self-fund their health plan, buys medical stop-loss to back stop the assets of the health plan and then forms or joins a captive and the captive acts as a reinsurer to that medical stop-loss. Ultimately, what it creates is a kind of called financial envelope that wraps around the health plan and collaborates and shares with a number of employers to give them a mitigation to the concept of self-funding.”

02:49 “A Captive is a financial mechanism where a non-risk taking entity, an entity that doesn’t typically take risk, can participate and share in risk as if they were an insurance company. And when we talk about benefits captives, we talk about the ability to use medical stop-loss to participate in a Captive and provide a number of different financial values for the health plan.”

07:56 “They (heterogeneous model) don’t necessarily need to be like-minded in the benefit offering, in the co-pays, in plan designs, in the third party administrators and the PBM that supports the plan, but they should certainly like-minded and consistently focused with the other members on the results they’re seeking and the willingness to collaborate and have better results and ultimately provide great care but manage the cost across the health plan.”

08:34 “On the homogenous model, there is certainly an immediate affinity amongst the members. It’s our direct opposite. We’ve got a number of employers that are in a same industry for potential purposes. We’d also say there’s some homogenous to when we have a number of employers that are in one particular regional area and they share a community in terms of a greater community in terms of employment and a town and a particular part of a state, for example purposes.”

17:32 “I’d say those two elements, being focused on self-funding, having a clear risk management vision, and then then the third element, I would say, would be that they need to kind of be all in. They need to have somebody at their agency, whether it’s themselves or a part of their team that is really the quarterback on this because it’s certainly not the easy button. The easy button is still fully-insured.”

20:15 “If we do think of the Captive as essentially a bank account that allows funds to come in across a spectrum of employers, allows losses to seed in across those same spectrum of employers and allows those employers to then participate in the remaining premium balance. Or the opposite side of it. If there was some additional needed funding for it, they share in that risk together. That’s the mitigation that helps their health plan.”

22:50 “I think the first step is to consider what it is about that particular employer that makes them a good fit for it so when we kind of sort out the employer type is, do they have a willingness to treat their health plan as if it were another portion of their business, to treat it as if it’s something that really… that they can impact and want to be involved with? So I think it’s making sure that the employer is the right characteristics for the program.”

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In this episode of the ShiftShapers Podcast, host and Chief Transformation Strategist David Saltzman sits down with Jeremiah Solven, Founder of the Conquer Academy.

Today he shares his unique mindset which he honed when he was in his Ranger unit, the Badmuthers, and explains how a triangle of leadership, personal performance, and character are at the core of this mindset.

With this mindset, Jeremiah pursues his best version of himself and this is what he teaches to his students as well.

What You’ll Learn From this Episode:

  • 02:53 Jeremiah’s triangle: Leadership, personal performance & character
  • 06:10 A Badmuther mindset
  • 08:44 Tragedy and wrestling with feelings of failure
  • 13:26 Growth by taking the harder path
  • 16:18 Being a force of good & a culture of leadership

Quotes:

03:27 “I draw this out like a triangle. If you have the left side of the triangle is your leadership, the right side of the triangle is your personal performance, and then the bottom of the triangle is your skills and your character. What you’re trying to do in life is you’re trying to get to the top.”

06:57 “And one of the things we decided to do is, we said hey, we can’t control the outcome but what we can control is the process and the culture. And our identity as a platoon, I just said we were named after, our name was the Badmuthers. So we, as a culture, we embodied that and what a Badmuther meant was violence of action, professionalism, and grit. These are like the tenets of our culture.”

11:38 “And that was my last Ranger mission so I had to figure out what to do with that information. And I realized that night, years after wrestling with that night, that the common theme with everybody was that they embodied a Badmuther mindset. They didn’t stop moving forward. And so I felt like we lost. We actually won.”

15:10 “So how do you develop a Badmuther mindset? It’s by always choosing the harder path. So every time you get to a crossroads in life, you have an uphill option and a down. If you pick the uphill every single time, life gets easier. But the problem is that, for some reason as humans, we gravitate towards the easy path.”

18:07 “And so I couple all that into my coaching program. And I said, you know what I’m going to teach these things and my goal is just to bring more good in the world because it’s a simple goal. It’s simple but it’s not easy. And so I can tackle that for the rest of my life, chase it for the rest of my life and it’s almost like chasing perfection. It almost never happened, but the pursuit of it is intoxicating.”

Resources:

“All In” book by Chester Elton Adrian Gostick

https://conqueracademycoaching.com/tactics

https://www.instagram.com/jeramiahsolven/

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In this episode of the ShiftShapers Podcast, host and Chief Transformation Strategist David Saltzman chats with Brian Clark to discuss the company’s perspective on Life settlements.

Brian is the Director of Business Development at Reliant Life Shares and he shares details on how companies handle life settlements, from paying out death benefits to undertaking risk to dealing with government regulation.

Brian also shares how individual investors can participate in this market and changing the mindset around life settlements to see the real value it has to those who need it.

What You’ll Learn From this Episode:

  • 02:11 Life settlements: a life insurance company’s perspective
  • 04:52 What investors get
  • 07:34 Insurance company views and risks involved
  • 10:49 Regulation
  • 13:59 For investors: How to access the market
  • 18:36 Common objections: Finding the value of life settlements

Quotes:

03:21 “Now once it’s sold, the investor group is waiting for the death benefit payout and, in our case, we open up investment on fractional basis to investors, individual investors, because historically the buyers of this have been big players like the Warren Buffetts of the world, Blackstone, national pension funds, big banks, etc but what we do is help individual investors participate in this asset class.”

04:08 “And that’s the true diversification that I think an exposure to life settlement investing can bring to investors when they’ve already got stock risk, they’ve already got real estate risk. And in this low-interest-rate environment we find ourselves in, especially now, what choice do you have?”

08:01 “So, in general, my experience has been they don’t love it. However, I think insurance companies certainly can be seen and don’t want to be seen as telling a senior that they can’t access value in a policy above and beyond what the cash render value is because that would end up hurting that senior.”

08:40 “A lot of times, these are illiquid investments so liquidity should be obviously your primary concern when you consider any investment. The time horizon involved, a lot of times we operate with life expectancy estimates between 3 and 8 years, typically not shorter than 2 and not longer than 8 but a person with an 8-year life expectancy certainly could live twice that long or longer and so longevity risk really becomes a primary risk to the investment.”

16:36 “I’m not going to say that a healthy person cannot sell their policy but the younger the person is and the healthier a person is, typically the less they’ll command for being able to sell their policy because, let’s just use 2 extreme examples, if you were going to buy the life insurance policy off of a 24-year-old Olympian who’s in great health and great shape, I mean how long is that person going to live, right?”

17:06 “On the other end of the spectrum, if we somehow knew I had 5 minutes to live and I have a life insurance policy, obviously you might be willing to pay more for that approaching the death benefit value.”

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In this episode of the ShiftShapers Podcast, host and Chief Transformation Strategist David Saltzman chats with David Vivero, Co-Founder and CEO of Amino.

David shares his knowledge of consumerism in healthcare and discusses how consumers want transparency of information and choice, but not too much that it ends up frustrating them. He also talks about how Amino connects consumers to services they want and the engagement and ROI that employers can expect from offering this service.

What You’ll Learn From this Episode:

  • 02:23 Complex healthcare for consumers
  • 04:29 Getting the data
  • 10:03 Building the knowledge for the interface
  • 13:29 Directional vs absolute data
  • 15:05 Services that consumers require
  • 17:57 For employers: Engagement and ROI

Quotes:

03:29 “There’s a certain amount of complexity that we’re all willing to tolerate in our lives. And usually, we kind of reserve that for whatever our profession is and it just wasn’t enough for us to change the incentives in healthcare. We also had to change the interface to healthcare and that, unfortunately, took way too long for people to realize.”

03:59 “And frankly, a lot of observations from researchers and public policy people about how transparency frankly doesn’t work on its own in its first iterations so I think that we just didn’t really understand the nature of the new challenges that would be created once you rewrote the rules.”

07:57 “In order to do that, you need to have data that follows people over time that’s rich enough about those people to be able to isolate the sick patients from the not so sick patients and try to measure apples to apples across providers what they’ll do.”

14:25 “You can’t separate from the action you’re wanting a consumer to take which is we just want them to choose the higher value provider. We just want them to be aware of that difference and confidently step forward choosing a doctor or hospital or surgeon that is going to meet their needs without taking undue risk and without getting overly paid in a way that’s expensive to all of us paying that insurance premium.”

18:20 “We try to engage in a couple of ways which I think are quite highly differentiated. One is, we have built a product that was trained on tens of millions of consumers. And the interface, the experience. But we’re close on communication, the language that we’ve chosen, the value proposition, all of these are a package that is far more enticing than what has historically been presented to consumers as navigation, transparency, and a number of other things.”

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In this episode of the ShiftShapers Podcast, host and Chief Transformation Strategist David Saltzman sits down with cognitive neuroscientist Gleb Tsipursky to talk about why “trusting your gut” could be the worst business advice you could follow.

Gleb starts with breaking down the SWOT analysis and how this popular business tool actually feeds into cognitive biases and might not be producing the results you thought it would. He also gives tips on how to avoid personal cognitive biases and introduces 5 questions to ask yourself before a sale or another big decision.

What You’ll Learn From this Episode:

  • 02:06 Business advice
  • 05:37 Flaws of the SWOT Analysis
  • 07:58 Bias blind spots
  • 09:39 Dealing with your own cognitive biases
  • 14:14 Measuring probabilities of success
  • 17:11 5 questions to avoid decision disasters

Quotes:

07:02 “The SWOT Analysis involves listing your strengths, your weaknesses, your opportunities, and threats. And the people who are optimistic and overconfident: sales people, sales and so on, tend to list way too many strengths, way too many opportunities, not nearly enough weaknesses, not nearly enough [sic] threats.”

08:56 “The critical thing into bias, which is the practice of addressing dangerous judgment errors known as cognitive biases, is to develop healthy mental habits. So right now, a lot of the mental habits we have are unhealthy. Excessive optimism is a big problem.”

15:30 “There was a study of a thousand eighty-seven board members which fired their chief executive officers and we looked at, asked them, why they fired them. What were the reasons? One of the top five reasons was the nihilism where these leaders were completely denying negative reality about what was happening outside the company and inside their company.”

17:39 “There’s the small short technique that takes you a couple of minutes, you can use it before any sale or an important email to a client or anything like that. There’s another eight-step technique that you want to use for more serious projects, more serious sale, something that’s really important to you and other strategies if you want to lay out your plan.”

18:08 “First, what important information do I not yet fully consider? So what important evidence didn’t you take into account? This is critical because we tend to look for information and believe information with which we’re comfortable. We tend to look for information with a client who’ll agree to a sale. We tend to ignore information that the client is not responding to our emails.”

20:25 “How have you addressed all the ways this sale could fail or whatever project you’re working on? Imagine that the sale completely failed. Completely utterly failed. Now think about all the reasons why it failed. Maybe you haven’t addressed all the client’s concerns. Maybe you missed some of the client’s concerns that you actually could’ve taken a look at.”

Resources:

Never Go With Your Gut” by Gleb Tsipursky

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In this episode of the ShiftShapers Podcast, host and Chief Transformation Strategist David Saltzman chats with Lisa Rehburg, President of Rehburg Life Insurance Settlements. Lisa explains what a life insurance settlement is and how policy owners can actually sell their life insurance policies for cash.

Lisa goes on an in-depth discussion where she discusses the benefits to agents who will offer this, the legalities of life insurance settlements, and the growing appeal of this type of settlement to boomers who are now approaching senior age.

What You’ll Learn From this Episode:

  • 01:50 Life insurance settlement defined
  • 06:13 Benefits and roles of agents
  • 12:11 Case studies and opportunities for clients
  • 15:34 Carrier feedback to life insurance settlements
  • 18:19 Growing interest and appeal to boomers

Quotes:

01:54 “So basically, a life insurance settlement is the ability for a client to sell their life insurance policy for a lump sum of cash. There are investor groups who are willing to buy those policies, and clearly they’re obviously doing it for investment purposes, and they’re saying is that obviously the returns are good. The other thing though it’s a diversification tool for them.”

03:16 “So what we’re talking about is, in a settlement, client sells the policy. They receive lump sum of cash. The investor groups now become the new owner of the policy, the new payer of the premium and they receive the death benefit when the client passes.”

06:48 “It’s a very simple question to ask when you’re talking to them: do you have a life insurance policy you no longer want or need? Because I would like to go on a limb and say there’s probably a really good chance that one of those 500,000 seniors is probably an insurance agent’s client.”

08:41 “The shorter the life expectancy, the more money they’re willing to pay. The lower the premium, the more money they’re willing to pay. And like I said, it’s just a true numbers game.”

16:49 “I think life insurance is really important. I am not badmouthing life insurance companies at all because I think it’s very important for financial planning purposes. But I also believe that when a policy is no longer wanted or needed, a client should have the opportunity to sell that.”

Resources:

Grigsby v Russell – https://supreme.justia.com/cases/federal/us/222/149/

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In this episode of the ShiftShapers Podcast, host and Chief Transformation Strategist David Saltzman chats with Ryan Sachtjen, Co-Founder at WatchTower to discuss some 21st-century technological innovations that help advisors use more of their time facing clients and selling.

Ryan goes into intricate detail on common RFP issues today and how automating workflows of companies can positively affect the bottom line. He also discusses what the future holds for brokerage firms that could lead to significant shifts in industry.

What You’ll Learn From this Episode:

  • 02:03 Figure out scalability issue to maintain levels of customization
  • 05:18 Looking for the right technological solutions (SMB vs mid to large market)
  • 06:57 Brokerage firms: Investigating workflow problems
  • 08:52 RFP issues and automating workflows of larger companies
  • 13:39 Finding technology that fits the firm
  • 17:30 Technology to sell more and affect the bottom line
  • 22:10 The future of brokerage firms

Quotes:

05:17 “And what we see brokers doing, at least initially, is trying to figure out alignment within their own organization which has been very key of driving a level of success of specializing in different areas. And then looking for, once you’ve done that effectively, looking for the right technology solutions that fit their needs, right? And so they can be different.”

06:24 “Because at the end of the day, the solutions that they want to be using are the ones that allow for them to spend the most amount of their time advising. That is the purpose. That is utilities which they serve. That is what they’re really good at. And so for them to be able to offload some of this other stuff and use technology to help leverage that, I think is a real difference. And you’re seeing a real shift in the market.”

09:30 “The pain points that we’re hearing from them really correlate to helping solve sort of their RFP problem. I have this obligation to my customer at some frequency of cadence which typically is in a renewal cycle of ‘I need to go make sure that what we have in place with the current insurance carrier is the right fit.’ And so my core function at this moment is to make sure that is true. And that typically results in RFP event, in RFP activity for these firms.”

15:52 “The challenge is, like you said, you don’t have necessarily the revenue to be as loose with our spent as you maybe could 10 or 15 years ago. And so, what I think those firms need to do is figure out what are those big impact technology items that they can implement reasonably speaking within their firm that really helps drive those efficiencies. And that’s a key and it’s a very sort of north star element that we have here is how do we help build technology that helps facilitate and be helpful to all of the parties because when that occurs, again, the outcome for the customer is improved.”

20:13 “I’m seeing there is a lot more urgency on actually the carrier side because a big issue here of what needs to happen is, there needs to be some investment on the carrier side to help optimize for this outcome of having things be sort of shared and communicated in more of a digital environment. And I would bet that, if you went to the leadership conference of a number of these carriers, one of the pillars of the four pillars of success for 2020 would be something along the lines of digital fill in the blank.”

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In this episode of the ShiftShapers Podcast, host and Chief Transformation Strategist David Saltzman sits down with Richard Turrin, independent fintech, AI consultant, and author of “Innovation Lab Excellence: Digital Transformation from Within” to discuss what an “Innovation Lab” is and how it creates significant impact to companies which embrace it.

He goes into further detail by discussing Skunk Works at Lockheed Martin and how this team is an example of a successful innovation lab. Richard also shares the basic tools of innovation and how companies, especially insurance companies, can apply them to their own systems. He finally talks about the strides China has made in terms of digitizing its own systems.

What You’ll Learn From this Episode:

  • 01:44 Introduction and struggles of an “Innovation Lab”
  • 05:19 Appealing to senior management
  • 07:09 Case study: Skunk Works (Lockheed Martin)
  • 11:00 Tools for innovation
  • 17:41 Implications on insurance
  • 20:45 Digitization in Shanghai

Quotes:

01:45 “An innovation lab is usually in a relatively large company and what it strives to do is to bring digital products to life within the company. And it’s a team, a specialized team of people that are all digitally savvy… people that can bring new digital technology into an existing business and make it flourish.”

03:32 “The first catch or the first problem for digital transformation is of course, getting management to accept it and to bring that digital culture into the institution. The second obvious problem is who’s going to do it. And this is again a place where real battles are fought between people like the chief information officer who’s head of IT and somebody who might be the chief innovation officer who’s the head of innovation and wants to change the IT.”

04:51 “There are… these three primary stakeholders: the senior management, the IT or the the innovation departments, and then the users. These are the three stakeholders and they’re all in some slight level of conflict with one another on what direction to go and how best to bring innovation to the company.”

12:35 “So the spanners, the tools… in most toolboxes are really simple: social, analytics, artificial intelligence, and blockchain. That’s what goes into most of the digital transformation technology that you’ll see put to work at any of the financial institutions.”

16:39 “The goal of much of our digital technology is to digitalize the IP of a company. Well, where does that IP reside? That IP resides in the brains of the workers. So if you’re going to build some new fabulous digital product that’s really innovative, and you’re an innovation team, you can’t build it alone. It’s never going to happen. You have to work directly with the people who are on the field, understand the business, because they have the IP that you’re going to digitalize.”

18:27 “If you’re trying to do more with less, digital is your best friend. No question about it. And most of the major insurance companies now have innovation labs. Now the question is, are the labs working on something or can they help you in a meaningful manner to help you solve the problem of drilling a hole in the right spot?”

Resources:

Innovation Lab Excellence: Digital Transformation from Within” by Richard Turrin

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