The American P&C industry, for instance, has seen its “combined ratio”, which expresses claims and costs as a percentage of premium revenue, steadily creep up from 96.2% in 2013 to 97.8% in 2015, and to an estimated 100.3% for 2016 (ie, a net underwriting loss). Henrik Naujoks, a partner with Bain & Company, says this has left such insurers facing a stark choice: become low-cost providers, or differentiate themselves through the services they provide.