Thanks to a colleague of mine for pointing me here. This is a really good summary of some of the things going on right now in insurance, and indeed why the opportunity for disruption exists.

It covers many of the issues at a high level and deals with some of the misconceptions.

Bottom line, in line with the thinking here - opportunity exists for category defining companies.  We are already starting to see these.  Or as Aaron states - "The insurance industry is too large and built on systems too old for any outcome other than massive change."