An opening general session earlier this week at the Workers' Compensation Educational Conference in Orlando laid out the challenges facing the workers' compensation system over the next 10-20 years, as seen through the eyes of one of the industry's top spokespersons, Robert Hartwig, president of the Insurance Information Institute (I.I.I.).

"I'll be focusing on the top five issues that are going to keep workers' compensation insurance CEOs awake at night," said Hartwig in an interview prior to his presentation. "I'm going to present some of the issues that are going to be the major cost drivers and determinates of profitability in this type of insurance going forward. These would be mega trends like the aging and 'fattening' of the workforce, which will drive up severity significantly. These are several emerging risk issues that are just coming onto the radar screens of some."

Hartwig also addressed what he calls the endless cycle of reform, fraud and abuse, followed by more reform, then inevitably more fraud and abuse that he says will always be an endless driver of costs and savings in the future. Hartwig also proposed his own ideas of where workers' compensation is headed in the face of rising medical costs.