Insurers protect against the unforeseeable. But according to Mary Trussell, partner, KPMG in the U.K. and lead author of KPMG’s Intelligent Insurer, it’s the insurance companies themselves that are now facing enormous unknowns — everything from rapidly shifting demographics to global climate change to the ways that consumers shop for insurance products. These factors and more are changing the way insurers do business, although often — as in the case of recent flooding on the East coast of the U.S. — it isn’t clear what insurers can or should cover, or what the government’s role should be in bearing part of the risk. In an interview, Neil A. Doherty, Wharton emeritus professor of business economics and public policy, spoke with Trussell about insurance in a world where the only “certainty is that there’s a lot of uncertainty.” Doherty is faculty director of the KPMG Global Insurance Institute, held annually at Wharton.

Download an edited transcript of the conversation here.