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EXPRESS “What You Don’t Know Can’t Help You!” … Eddie K. Emmett, Editor / Publisher
INSURANCE EXPO 2013 “Rebooting Insurance Offices!” July 11 – 13, 2013 Sonesta Gwinnett Place in Duluth, GA Why Should You Attend?
New Location … New Experiences
It's 3 days of non-stop action and education designed especially for the Independent Insurance Industry.
You spoke and I listened. You wanted a place that could host the South’s Best Insurance Industry Trade Fair, the Best Continuing Education Classes, the Best Insurance Agent Party and the Best Hotel Rates … all under one roof … and at affordable prices.
Get up to 15 hours Continuing Education! Each day features at least 3 hours Ethics CE! If you tour the Trade Show, read FYI Express newsletters and FYI Express e-mails, you have automatically earned 3 hours Association CE!
You got it! Sonesta Gwinnett Place (formerly Marriott Gwinnett Place) will be the place to be on July 11-13.
But wait … there’s more!
Single, Double, Triple, Quad Rooms are only $94.00 if reserved by June 27, 2013.
Free Trade Fair, Free Hospitality Suites, Free Pool Party … we’ve got it all.
Agent / CSR Online registration at http://ie13-agent.eventbrite.com Exhibitor / Sponsor Online Registration at http://ie13-rep.eventbrite.com FYI EXPRESS
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Insurance Expo 2013 Continuing Education Agenda th
Thursday, July 11th
Friday, July 12
9:00 a.m. – 12:00 p.m.
9:00 a.m. – 12:00 p.m.
“Localize, Mobilize, Socialize”
“Insurance for Insurance Agents”
3 hours Ethics CE
3 hours P&C CE
Internet Marketing & Social Media enables independent agents to establish consistent client communication but it must be done ethically. Eddie K. Emmett shares all of the free tips ‘n tools in what has been described as “the best CE seminar I’ve ever attended!” CE Sponsored by AccuAuto.
Test your knowledge of the types of insurance needed and the uninsurable legal traps faced by your agency in this fast-paced CE seminar based on the popular “Jeopardy” game show. Sponsored by Rick Pegram, Director for LegalShield. Want a “sneak peek” at the topics? Check out this four minute YouTube video I made from the PowerPoint Presentation. http://youtu.be/pctgD4XTZng
1:00 p.m. – 3:00 p.m.
FREE CE Commissioner Hudgens and his staff will bring you up to date on the plans for GA’s Insurance Industry This CE is free to everyone but you must register online at http://ie13agent.eventbrite.com since seating is limited to the first 240 registrations.
1:00 p.m. – 3:00 p.m. Industry Roundtable Discussion I’ve invited the “Head Honchos” to share with you their thoughts on where this industry is headed and how you can maximize the opportunities. 3:00 p.m. – 5:00 p.m. Free Trade Show 75 Exhibit Booths, 250 Company reps … all there to thank you for your business or show you why you should have a mutually profitable relationship.
3:00 p.m. – 5:00 p.m. Free Trade Show 75 Exhibit Booths, 250 Company reps … all there to thank you for your business or show you why you should have a mutually profitable relationship.
Attend Roundtable plus Trade Fair and earn 3 hours Association CE Credit (max 3 hours per year) 5:00 p.m. – 9:00 p.m.
Attend DOI Update and Trade Fair and earn 3 hours Association CE Credit (max 3 hours per year) 5:00 p.m. – 6:00 p.m.
Salsa Pool Party Bring your swim suits and enjoy drinks, hors d’ouveres, and beach / salsa music as we take you to an exotic paradise. th
Welcome Reception in Sonesta Pub
Saturday, July 13
Come enjoy your share of a $500 bar tab awarded to the Exhibitor you voted “Best in Show”.
“Localize, Mobilize, Socialize”
Then let’s find the Hospitality Suites in the Sonesta Gwinnett Place!
IE2013 Attendee Invitation
3 hours Ethics CE (repeat from Thursday) Internet Marketing & Social Media enables independent agents to establish consistent client communication but it must be done ethically. Eddie K. Emmett shares all of the free tips ‘n tools in what has been described as “the best CE seminar I’ve ever attended!” CE Sponsored by AccuAuto. More info at www.fyigeorgiaviews.com
Register Online at http://ie13-agent.eventbrite.com IE2013 ATTENDEE REGISTRATION INFO Everyone is invited to enjoy the IE2013 Continuing Education Seminars that were created especially for Independent Agents & CSRs. Get up to 15 hours CE … each day features at least 3 hours Ethics CE.
GEORGIA ONLY CE IE2013 CE seminars qualify for CE only for Georgia’s licensed agents. But agents from our neighboring states are invited to enjoy them anyway! Therefore, 50% discounts will apply to anyone from outside of Georgia or just doesn’t need CE. You’ll get great information by attending the seminars but you won’t get CE credit.
Don’t need CE? Many Attendees have asked for a Special Non-CE Registration Package for themselves and their CSRs. You spoke and I listened! Attend for 50% discount and enjoy “news, views and opinions” for Independent Agents from Independent Agents! You’ll get great information by attending the seminars but you won’t get CE credit. IE2013 ATTENDEE REGISTRATION FORM Please fill out a separate Registration Form for each Attendee. (Feel free to copy) Instead of filling out the following, you may just include your business card(s) when you mail in the registration if your card has all of the following info: Name: ____________________________________ First Name (or Nickname) for Badge: ____________
IE2013 ATTENDEE REGISTRATION INFO ___ ONE-DAY REGISTRATION = $49.00 Choose either: ___ Thurs ___ Fri Pay only $49 for that day's activities: Morning's 3 hours CE, Trade Fair (Thurs & Fri), & Afternoon's 3 hours Ethics CE. Don’t need CE? 50% discounts will apply! ___ NON-CE REGISTRATION = $25.00 ___ TWO-DAY REGISTRATION = $89.00 Both Day’s Package (up to 12 hours CE) is only $89 for that day's activities: Morning's 3 hours CE, Trade Fair (Thurs & Fri), & Afternoon's 3 hours Ethics CE. Don’t need CE? 50% discounts will apply! ___ NON-CE REGISTRATION = $45.00 ___ MORNING CE = $25.00 Choose one: ___ Thurs
___ Fri ___ Sat
__ AFTERNOON CE = $25.00 Choose one: ___ Thurs
___ Fri
Everybody can’t leave the office at the same time? Don’t want to close it completely down? Feel free to combine your registration with fellow employees and still get the multi-day discount price! Total check attached =
$ _______
Please make check payable to FYI: Insurance Views and News & mail it with completed form(s) to: FYI: Insurance Views and News 200 Russell Court, Canton, GA 30115
Agency: ___________________________________
Questions? Contact me at (770) 312-2342; Mailing Address: ____________________________ (City) ________________ (State) ___ (Zip) _______
Fax (770) 783-8226 or e-mail to: eddie@fyiexpress.com
Ph :(_______) ______________________________ Fax :(_______) ______________________________ E-mail: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
Enjoy a “mini-vacation” at Sonesta Gwinnett Place for only $94.00 per night Click here for Online Registration IE2013 Attendee Invitation
More info at www.fyigeorgiaviews.com
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Arnold v. Neal, A12A2464, Georgia Court of Appeals (March 5, 2013)
TTIPS Insurance Regulation Committee Newsletter Submissions Brian T. Casey Trey Sivley Locke Lord, LLP
Arnold was injured in a motor vehicle accident caused by Neal and offered to settle for the limits of liability under Neal’s automobile policy and a limited liability release with specified conditions (no indemnification language except regarding Medicaid liens and no denial of liability). The Court found an enforceable contract existed between Neal and Arnold because Neal’s insurer responded to Arnold with correspondence agreeing to settle Arnold’s claim for the policy’s limits, correspondence containing a limited release that adhered to Arnold’s settlement conditions, and delivery to Arnold of a check for the policy’s limits upon which the claims adjuster handwrote “full + final settlement of any and all claims.” The Court rejected Arnold’s argument that the handwritten language on the check deviated from the conditions of the offer and constituted a counteroffer by Neal. The Court examined the release language alone and found it clear and unambiguous and that it reflected the parties’ intention, and it was not a counteroffer as argued by Arnold.
Turner v. Williamson, A12A2534, Georgia Court of Appeals (March 5, 2012) On March 5, 2013, the Georgia Court of Appeals reversed the denial of Dylan Turner’s motion to enforce a wrongful death settlement for an automobile policy’s limits. Following a jury verdict against him for wrongful death, Turner appealed on the grounds a settlement agreement had been reached between the parties. The Court agreed, finding that Turner’s insurer had unequivocally accepted a settlement offer submitted by the Williamsons, despite Turner’s insurer having sent a release form to the Williamsons containing additional terms to the Williamsons with a request that they “please” sign it. The Court found that Turner’s sending the release form did not alter the fact that a meeting of minds occurred with regard to the terms of the settlement and the release form was precatory rather than mandatory. The Court also decided that a prior settlement offer submitted to the Williamsons by Turner’s insurer had not unequivocally been accepted by the Williamsons and therefore was unenforceable as the terms of the limited release contained in that offer had not been disclosed to the Williamsons and they rejected provisions of the release when it was provided to them.
Amica Mut. Ins. Co. v. Gwinnett Cnty. Police Dep’t, A12A1068, Georgia Court of Appeals (February 26, 2013).
Brian T. Casey
A home insured by Amica was damaged when the Gwinnett County Police Department arrested an aggravated assault suspect at the home pursuant to a warrant. Amica reimbursed the homeowner pursuant to the homeowner’s insurance policy, and then brought a subrogation action against Gwinnett County and the Gwinnett County Police Department, asserting a claim of inverse condemnation under the theory that the damage by the Police Department constituted a taking of property for which the county owed compensation under Georgia’s eminent domain law, which waives sovereign immunity. The trial court dismissed the action and Amica appealed as to the County only. The appellate Court affirmed the dismissal, holding that the exercise of police power is distinct from eminent domain, and as a matter of law, the County was entitled to sovereign immunity against a claim based on damage caused by an exercise of police power to promote the health, morals, and safety of the community.
LOCKE LORD, LLP (404) 870-4638 bcasey@lockelord.com.
Trey Sivley LOCKE LORD, LLP (404) 870-4657 tsivley@lockelord.com.
FYI EXPRESS
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May, 2013
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More “News, Satire & Opinions for Independent Agents from Independent Agents� at www.fyigeorgiaviews.com
4.
T a k e t he Te l e ph o n e D o c t or I . Q . Q ui z
by Nancy Friedman, The Telephone Doctor
Long ago a good friend once told me, "Nancy, the training your company provides is common sense that's actually NOT very common!" There's a lot of truth to that statement. Yet years later, rudeness and low service levels still plague businesses in every industry. We hope you enjoy taking this customer service quiz to test how common your common sense is.
Chewing gum at work is: A.
OK.
B.
A bad breath refresher.
C. 5.
A mirror at my desk will: A. B.
Nancy Friedman Customer Experience Expert on Sales and Service Request your Demo DVD now! Call: 314.291.1012 Or click here Visit our new site: www.nancyfriedman.com Get our customer service tips by following us.
C.
7.
"How can I help you?" belongs:
B. In the message taking scenario.
3.
When I'm not able to help a customer, I should: Tell them honestly & thank them for their business and hang up.
B.
Give whatever information I can, right or wrong. Wrong information is better than no information.
C.
Get help immediately and advise the person help is on the way.
Everyone needs a refresher.
B.
I need a lot of help.
C.
I never learned any.
Internal customer service means: A.
Be nice to others who come into my office.
B.
The customer is giving me a stomachache. Treating my co-workers as customers.
A.
Leave my phone number twice and slowly.
B.
Leave a good clean joke to keep them smiling.
C.
Not leave a message...just call back till I reach them.
9. Irate callers/customers are important to our company because: A.
It's fun to handle those kinds of calls.
B. At least we get a second chance to make it right.
When I'm having a bad day, I should: A.
Give me bad luck if it breaks.
A.
C. Nowhere. I'm not able to help anyone.
A.
Remind me to smile BEFORE I pick up the phone.
8. When using voice mail and leaving a message I should:
A. In the initial greeting.
2.
Keep my ego in check.
6. Basic customer service skills are important to me because:
C. 1.
Downright rude and obnoxious. Fugetaboutit!
C.
Not bother coming into work.
B. Leave my troubles at the doorstep like the song says.
10.
C. Tell all my co-workers my troubles to get it off my back.
I finally get to yell back.
Asking questions of the customer will: A.
Aggravate them.
B.
Show I'm interested in helping.
C.
Be considered being too nosy.
I.Q. Quiz Answers on page 8
FYI EXPRESS
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May, 2013
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Correct answer is B. Anything after your name...erases your name. And on initial greetings, your name is very important. You have answered the phone to help them. It's a given. Those words are best used in a message taking scenario.
6. Correct answer is C. We need to treat our coworkers as well as we're going to treat our external customers. Remember: We Are Customers To Each Other. We sure don't need any internal conflicts between co-workers and departments.
1. Correct answer is C. Be sure you let the customer know that help is on the way. That's the most important part.
7. Correct answer is A. Voice mail was meant to take an effective message. Give details and speak conversationally so the person receiving the message will enjoy it. Effective messages have concrete information - dates, times, names, situations. Leave your phone number - twice and slowly. Make voice mail work for you...not against you.
2. Correct answer is B. We need to leave our troubles at the door. Arguments with a spouse or a bad hair day is your problem. Telephone Doctor calls that "emotional leakage." That's getting angry at Peter and taking it out on Paul. Not fair, not right and no fun.
8. Correct answer is B. Getting a second chance is golden. And irate callers, while certainly not pleasant, can be the challenge of the day. And they can be satisfied.
3. Correct answer is C. No gum at work - ever. End of subject. If you have bad breath - use mouthwash. 4. Correct answer is B. The old Telephone Doctor adage..."smile BEFORE you pick up the phone," is the way to make every phone call, or customer contact, a great one. Remember, it's hard to be rude when you're smiling.
9. Correct answer is B. Listening and questioning skills are very important to excellent customer service. Nancy Friedman, president of Telephone Doctor, is a featured speaker at association and corporate meetings. For an information packet on Nancy, please email Donna.Bryan@telephonedoctor.com or call 314.291.1012.
5. Correct answer is A. Everyone can use a brush up course. There's a great saying: "When you're through learning...you're through." Never stop taking those little basic skill lessons you're offered. Even if you do know it all...look how good you'll feel about that! FYI EXPRESS
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-- They write their own marketing material, rather than get it written correctly so that it converts readers into clients.
Small business owners: Do not let this happen to you By: Jim Connolly I want to share something with you, which is responsible for the demise of so many small businesses. I’m also going to show you how to avoid it happening to you. I witnessed an independent coffee shop self-destruct recently, just as the owner planned it to. Yes, although the owner said he wanted his coffee shop to succeed, his planning was all about failing. He literally (not figuratively) planned for failure.
-- They ‘save money’ by having a crappy website that loses them business, rather than pay for a great site, which attracts clients. -- They let their business plateau for months or years, rather than invest in the help they need to go to the next level. -- They do 100% of the easy stuff, rather than 100% of what’s required.
Planning to fail The owner set the business up in such a way, that his risk and financial investment was as close to zero as possible. That way, if it failed, his losses would be minimal. So… -- The scruffy looking building he moved into, stayed scruffy. He refused to fix it up or pay someone to. He said he thought it wasn’t important, even though he was serving people food and drink! -- There was no investment in advertising or promotion. As his coffee shop was located in a small town, at the quietest part of the high street, no one knew the place was there. -- He set the business up legally, so that there would be very little liability when the business failed and very few costs. He wasn’t going to lose his home or go bankrupt when the worst happened. This is smart, unless, as in this case, it was used as a comfort blanket to stop him from trying to succeed. -- With no investment in making the business work and no penalty for failing, he did indeed fail – and extremely fast. You see, whilst he was playing at being in business, his hungry competitors outworked him and outsmarted him. Business today is extremely competitive and competing retailers are working damn hard to make their businesses work. Going into that marketplace, without the willingness to work hard or invest the money required, he could never have succeeded.
The lesson here? Business has never been more competitive than it is today. As we navigate the worst economy in living memory, it’s not enough to do the easy stuff. Everyone does the easy stuff. It’s easy! It takes courage to invest the time, effort and money required for our business to succeed, but the alternative is to ‘half try’. The demanding marketplace and our hungrier competitors will ensure that ‘half try’ attitude can’t prevail.
Those who succeed The smartest small business owners have already figured it out. They know that success comes from doing the things, which the majority is not prepared to do. They understand the meaning of, ‘Go hard or go home!’ -- They think big, because they know it’s the only way to make big things happen. -- They give it their all. -- They make commitments, then follow them through. -- They take action when it’s easier not to. -- They look for progress, not excuses. -- They make it as hard as possible for their business to fail. -- They work hard. Really hard. -- They know that shortcuts are almost always costly detours.
Giving a business 100% Every small business owner claims they give their business 100%. What many of them really mean, is that they give their business 100%… of the things they find easy to do. The things that require little risk. The things that keep them from leaving their comfort zones. -- They hire a cheap accountant, rather than a good one. No one can afford a cheap accountant. No one.
FYI EXPRESS
-- They automate their social networking accounts, rather than invest the time needed to build relationships with people.
-- They plan their work and work their plan. -- They refuse to starve their business of the resources it needs. -- They leave work each day, knowing they gave it their best. That’s the mindset you and your business are competing against. That’s the way the best people in every industry operate, including yours.
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-- in November 2011, the DOL completed 46 investigations of pizza and pasta establishments as part of an “ongoing enforcement initiative” in Long Island, New York, and recovered $2,341,507 in back wages for 578 employees. In addition, the agency assessed $202,315 in civil money penalties against employers for willful and repeated FLSA violations, including minimum wage, overtime, and recordkeeping violations.
Poor Pay Records Can Cost Employers Big Bucks Q&A By Robin Thomas, Managing Editor Editor's Note: These question and answer HR Matters E-Tips articles are taken from real questions submitted by our subscribers, a unique feature of the HR Matters Tools and Resource Center online service. See how it works. If you don’t have accurate records of your employees’ work time, your inadequate recordkeeping could cost you serious penalties. Find out what records you must keep and for how long. Q: We recently discovered that several of our managers were not keeping accurate records of work hours for nonexempt employees. Should we be concerned about these incomplete records? We are working on correcting the problem. A: Yes. While many employers may not think of recordkeeping violations as being a big issue, without proper records, you cannot be sure you are paying for all time actually worked, including overtime. As a result, you leave your organization vulnerable to both employee discontent and expensive wage and hour claims. (Download free Hours of Work model policy including HR best practices and legal background.) Both federal and state wage and hour divisions take recordkeeping very seriously and are including penalties for recordkeeping violations when they find overtime and other wage and hour problems. In addition, the federal Department of Labor (DOL) has implemented initiatives that make it easier for employees to track their work hours, including a calendar for employees to track their regular work hours, break time, and any overtime hours. As a result, you need to put a high priority on getting your recordkeeping in compliance. Here are some recent DOL settlements that illustrate how poor recordkeeping can factor into an expensive wage and hour investigation: -- owners of several New Jersey gas stations agreed to pay $3 million in overtime, back pay, and liquidated damages to over 400 nonexempt employees in March 2013. The employer was cited for, among other things, requiring employees to work “off the books” and failing to maintain adequate records of work hours. -- a Los Angeles firm agreed to pay $260,000 in back pay and liquidated damages to 57 nonexempt employees for willful violations of the Fair Labor Standards Act’s (FLSA) overtime and recordkeeping provisions in February 2013. FYI EXPRESS
-- in 2007, the DOL settled a case against a Las Vegas plastering and masonry company for over $1 million in damages involving more than 1,000 employees. In addition to finding overtime violations, the DOL also determined that the employer had failed to keep proper records over a two-year period. As the settlements above show, recordkeeping violations can be expensive. So, you need to make sure that you understand your obligations. The FLSA requires covered employers to maintain basic payroll and other records for each employee, and this is explained in the FLSA regulations at 29 C.F.R. §§516.1, et seq. The regulations do not specify any particular form of records. Below is an overview of the FLSA’s recordkeeping requirements. In general, employers should retain for at least three years, from the last date of entry, payroll records containing the following information: (1) Each employee’s name, as used for Social Security, and the employee’s identification number or symbol, if used in place of the name on any payroll record; (2) Home address and zip code; (3) Date of birth for employees under the age of 19; (4) Sex and occupation; (5) Time and day of the week when the employee’s workweek begins; (6) Regular rate of pay for any week when overtime is worked, hours worked each workday and total hours worked each workweek, total daily or weekly straighttime earnings, and total overtime compensation for the workweek (this requirement applies only to nonexempt employees); (7) Total additions to or deductions from wages for each pay period; (8) Total wages for each pay period, date of payment, and pay period covered by the payment; (9) Certain collective bargaining agreements, plans, and trusts; employment contracts; and notices of the Wage and Hour Administrator; and (10) Sales and purchase records for employees who are subject to minimum wage requirements. In addition, you also should keep supplementary basic records for all employees for at least two years. These records include: Continued on page 14
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May, 2013
www.underwritersinsider.com
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Poor Pay Records Continued from page 12 (1) Wage rate tables; (2) Work time schedules, time cards or sheets, and records of amount of work produced by each employee; (3) Order, shipping, and billing records; and (4) Records of additions to or deductions from wages paid. Note, too, that the record retention requirements stated in the FLSA are minimums. Most HR and legal experts suggest that employers maintain their payroll records through the worker’s employment plus five to ten years to ensure they are available if a claim is filed. (Download free Personnel Records model policy including HR best practices and legal background.) And, just in case you are not keeping accurate records, the DOL encourages employees to keep their own separate time records by providing the “Work Hours Calendar” for employees (online at http://www.dol.gov/whd/FLSAEmployeeCard/calendarR5 Web.pdf ). The calendar was launched in October 2010 “to help workers make sure they are properly paid at the end of the work week.” The Work Hours Calendar counsels employees to record when they arrive at work, actually start working, stop working, leave work, take leave, and take meal breaks and other breaks. It closes with what appears to be a call to action for employees to file complaints: “You work hard, and you have the right to be paid fairly. It is a serious problem when workers in this country are not being paid every cent they earn. All services are free and confidential, whether you are documented or not. Please remember that your employer cannot terminate you or in any other manner discriminate against you for filing a complaint with WHD.” The Work Hours Calendar even is available as a free Apple smartphone application for employees. These employee records could be used to determine overtime and other payment records. If an employer fails to keep proper records of work hours, the DOL often relies on employee testimony to establish the number of hours worked. So, for example, in Brown v. Family Dollar Stores of Ind., LP, 534 F.3d 593 (7th Cir. 2008), ruling in favor of an employee who brought a claim for overtime wages, the court found that she presented evidence that the employer's records were not in compliance with the FLSA and could not be trusted. The court therefore relied on her testimony regarding the store's operating hours and the holiday schedule to provide a "just and reasonable inference" of the uncompensated hours owed. As a final point, even if only one employee is alleging a single FLSA violation, it is important to remember that the DOL can – and often will – investigate all of your FYI EXPRESS
relevant records to search for other possible violations. And, if you are targeted as part of one of the DOL’s “ongoing enforcement initiatives,” all of your pay records may be fair game. In these situations, you may have to produce payroll and time records from the previous two or three years. Remember, too, if your organization is found to have violated the FLSA because you have inadequate records and cannot defend against an employee’s own time records, your organization likely would face not only back wage payments but also civil monetary penalties. And, just to make matters more interesting, the FLSA can impose personal liability for decision-makers, including fines and imprisonment for management employees found responsible for the violations. So, make sure your payroll records are in order and accurate. Content for your HR Matters E-Tips newsletter is developed from our flagship publication, the HR Matters Tools and Resource Center, featuring the Personnel Policy Manual System (PPMS). See how it works. Subscribers to the PPMS and HR Policy Answers on CD can find more information on recordkeeping requirements in Personnel Records, Chapter 901, note 12, and on the FLSA specifically in Hours of Work, Chapter 207, note 22. If you don't have access to the PPMS, but would like to have a free, no-obligation 14-day review, go to: www.ppspublishers.com/ppm-ez.htm Or just give us a call at 1-800-437-3735. YOU CAN TRUST PPS Information provided in HR Matters E-Tips is researched and reviewed by the HR experts at Personnel Policy Service as well as employment law attorneys. However, it is not intended as legal advice. Readers are encouraged to seek appropriate legal or other professional advice. Interested in using an article from HR Matters E-Tips on your Web site or in a newsletter? Please contact Robin Thomas, Managing Editor of Personnel Policy Service, Inc., to request permission. You can contact her by email at editor@ppspublishers.com. Please note that the information in every issue of HR Matters E-Tips is the original, copyrighted work of Personnel Policy Service, Inc., and is protected under U.S. copyright laws. As such, you may not reprint or publish in any format any article or portion of article from HR Matters E-Tips without the express permission of Personnel Policy Service, Inc.
Remember, too, we encourage you to pass along any issue of the E-Tips by forwarding it to friends and colleagues. Page 14 May, 2013
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How’s Your Financial Knowledge? Yesterday, LIMRA published the results of a quiz it conducted, gauging Americans’ knowledge of basic financial and retirement topics. (LIMRA: A Third of Americans Fail Financial Literacy Quiz). As Americans are required to take greater responsibility for their retirement saving, LIMRA wanted to get an idea of the challenges they face understanding broad financial concepts. Our results show there is a great opportunity to help Americans improve their financial knowledge and make responsible decisions about systematic savings and retirement planning. We thought it would be interesting for our readers to take the quiz and compare their results to how the general public scored.
Answers on page 18 FYI EXPRESS
Page 16
May, 2013
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Check out the demo link at: www.insuresign.com/demo When is the Best Time to Buy Disability Insurance? If the Jeopardy! Game answer is: “The moment you start earning a paycheck,” then the question is: “When is the best time to buy disability insurance?” Research shows that even the workers who know this question and answer, don’t act on the information. According to the recent LIMRA/ LIFE Foundation 2013 Insurance Barometer Study 7 in 10 employed consumers agree that most people need disability insurance and half agree they need it “personally.” However, only 30% of workers actually own disability insurance, whether through their employer or an individual policy.
Opportunity Knocking! American Insurance Associates, Inc. in Norcross, GA has an opening for CSR. The basic criteria for the CSR position would be as follows: 1. Part or full-time 2. Georgia P&C license preferred 3. Prior experience with P&C insurance agency 4. Ability to provide automobile, homeowners, etc. quotes 5. Ability to follow-up on insurance leads
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FYI EXPRESS
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AutoTown Insurance Expands to Savannah, Georgia AutoTown Insurance (http://www.atiinsurance.com) announced today that it has expanded its retail presence by opening its first store in Savannah, Georgia. Located at 3125 Skidaway Road, Savannah GA, 31404, the new store highlights the company’s expansion plans outside of the Atlanta market. With the addition of this new insurance agency office, ATI continues to expand its Georgia footprint and continues being the largest independent, non-standard insurance agency in the state.
INSURANCE EXPO 2013 “Rebooting Insurance Offices!” July 11 – 13, 2013 Sonesta Gwinnett Place in Duluth, GA
Commenting on the opening, ATI President Dustin Walsey stated that “the new store is significant as we look to strengthen our presence throughout the state of Georgia and the Southeast. Savannah is a perfect spot to expand to other markets in Georgia and into South Carolina and North Florida.” ATI Chairman, Emanuel Fialkow added, "My family’s historic presence in Savannah is not the only reason to return there, but this is a logical step for the company and we look forward to serving that community. Our business of providing affordable insurance at a fair price will help the people of Savannah save money on their insurance and reduce the overwhelming number of uninsured motorists in Georgia. Over the next 12 to18 months, we will be opening additional stores in Atlanta as well as other cities in the Southeast.”
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When Selling is a Bad Idea
Okay, so what about the customer? He or she loses, too? How can that be? Yes, counter-intuitive. So, consider: 1. At best, lack of service. If there is little or no profit, the vendor is not able to provide the very best care and service. I don’t mean they don’t want to, but they probably are not able to! (See point #2 above.) 2. At worst, an out-of-biz vendor. Certainly if the seller won this buyer’s business based on low price, they are doing the same with others. They are not making a large enough profit and that spells disaster. Disaster for them. Inconvenience for the buyer.
by BOB BURG on 04/24/2013 · 0 COMMENTS “Competing on price alone is a race to the bottom, and it’s a race nobody wins.”
Of course, there’s nothing wrong with having the lower price. However, don’t make that their reason for buying. Sell on value with the bonus being that it’s also the lowest price. Rarely is that the case but, if it is, by all means, communicate it. How Do You Want to Be Positioned?
Why do I say that nobody wins when the salespeople compete on price alone? First, please allow a slight correction: there are huge super-store type places whose entire Value Proposition is indeed that they have the lowest prices. They do very well. And, their customers get what they want, as well. I’m talking about you, me, and the vast majority of businesses in our mainly free-enterprise based economy. By and large, focusing your presentation on having the lowest price is hugely counterproductive. And, truly, no one wins; the one who loses the sale loses in terms of not having the sale. The company and salesperson obtaining the sale loses. And, yes, even the customer loses. The first one above is obvious. But, why does the winner actually lose? 1. Live/Die by the Sword. Win the sale based on lowest price and you will most likely lose your customer the moment someone new comes along with an even lower price. If they buy from you on price, they’ll also leave you based on price. 2. Lack of Profit. Or, as Chubby Checker famously asked, “How low can you go?” If you go low enough, you won’t have enough profit to keep your business sustainable. Plus, you’ll be investing time, energy and service into an account that doesn’t pay for itself, keeping you from acquiring and properly serving other, more profitable accounts. Or, you might need to provide less service for accepting the low price, which will harm your customer, and cost you in effectiveness and reputation…and ultimately, new business. Reminds me of the person who says, “Well, sure, we lose money on every sale…but we make it up in volume.”
What it really comes down to is this:
When you sell on price, you are a commodity.
When you sell on value, you are a resource.
It’s quite understandable that the customer is going to try and obtain the lowest price possible, if they possibly can. Though, they’d be well-advised to heed the famous words John Ruskin when it comes to buying on low price alone. “It is unwise to pay too much, but it’s worse to pay too little. When you pay too much, you lose a little money — that is all. When you pay too little, you sometimes lose everything, because the thing you bought was incapable of doing the thing it was bought to do. The common law of business balance prohibits paying a little and getting a lot — it can’t be done. If you deal with the lowest bidder, it is well to add something for the risk you run, and if you do that you will have enough to pay for something better.” – John Ruskin, English critic, essayist, & reformer (1819 – 1900) I received a question from a reader of my blog: “What percentage of buyers do you think buy on price?” While I don’t have any figures, I’m not sure the question itself is correct. Why? Because, if you ask people what their determining factor is in the buying process, many (not all, but many) will tell you it’s price. Yet, the results are often quite different. Have you ever walked into a store determined to buy something simply on low price and come away with a better, more expensive product and were happy it worked out that way? Continued on page 26
FYI EXPRESS
Page 24
May, 2013
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Sell Your Customers’ Stuff
When Selling is a Bad Idea Continued from page 24
By Steve Beecham
Most people will answer yes. And, it was most likely the result of good salesmanship. No, not in selling a person something they don’t want or need (that’s not salesmanship – that conartist-ship). Rather, finding out if what the customer wants is really the cheapy brand or something of higher quality. And, a professional salesperson determines that by asking questions and listening.
Don’t you hate receiving phone solicitations, particularly the cold call version? This week someone randomly called me and tried to convince me to use her payroll service. I know you get calls like these during your day. The question is, are you one of the people making these calls? Are you the person who calls when it is convenient for you, demanding the attention of the person you are calling?
Of course, not everyone claims low price as their ultimate buying value. Personally, I tend to buy more on convenience. Others I know buy on style. Still, others buy on what they believe will most impress others. I’m sure there are other reasons, as well and I’m not judging any of them. I’m also not implying, or saying that any of them is the correct reason.
If you are, here is a fun way to beat the need to cold call: SELL YOUR CUSTOMERS’ STUFF!
I am saying that “low price” is often what people think is their determining factor when it usually isn’t. Best Not to Fall Victim to False Assumptions Automatically and reactively coming down on price believing that’s going to cause the prospect to buy is usually not the correct move. Sure, they’d like the lowest price they can obtain from you in exchange for the most value they can obtain from you. Who can blame them? All else being equal, that makes sense. For reasons already explained, however, we know that selling on price alone will hurt both you and your prospect. So, as a sales professional, don’t get sucked into thinking that what you automatically need to do is lower your price. After all, they’re not buying on price, even if they really believe that is their motivating factor. Bonus thought: If you are a “price buyer” then you will most likely believe your prospects are, too. Your inclination will then be to focus on low price. And, you’ll be surprised when they still don’t buy from you (unless you’ve luckily come across another true price buyer). The same for whatever type buyer you are. So, remember…your buyer is not you, and you are not your buyer. Find out what’s important to them, not to you. And sell based on what they value.
If you spend some of your time selling your friends’ businesses you will be amazed at the referrals they will send you. My friend Clint has a ServiceMaster business here in Atlanta and I have been introducing him to my village of potential customers and contacts. I’m now on his sales team. In return he has been introducing me to his village of contacts. My friend Lance works for an exterminating company. I have been introducing him to property managers, restaurant people and others in my village. He has been doing the same for me. If you spend a portion of your day helping your friends make a sale, you are certain to accomplish two things. 1) Instead of cold calling, you now have a reason to call your warm/hot friends to ask them who they know that could use your friend’s service. They will then give you names of people to contact which gives you an opportunity to meet someone new. Now you not only have the chance to brag on your friend but also to tell them what you do. 2) If you help a friend make a sale or introduce them to people that they would like to meet, there is a high probability they will do the same for you. Be careful here and make sure you are introducing them for the right reason. If you are, the result will be reciprocity at its best. The bottom line is – it feels good to do business this way. And that’s something I don’t think many people would say about cold calling. http://www.bassackwardbusiness.com/sell-yourcustomers-stuff/
[Ed. Note: Bob Burg is coauthor of the International Bestseller, The Go-Giver. The book has been published in 21 languages and has sold over 250,000 copies. Check out this brief and entertaining, recently- released overview of the book at www.burg.com/tgg. And, of course, feel free to share it with others.]
FYI EXPRESS
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May, 2013
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I realize that if you are doing little or no prospecting, four hours is a big jump, so start with an hour or two and build from there. For 95% of you, following this one tip alone will give you all the prospects you’ll ever need.
Seven Keys to Filling Your Pipeline with Tons of Qualified Prospects by John Chapin
2) Be consistent.
While a lack of sales can be caused by something other than not having enough prospects, generally speaking, most salespeople who miss their numbers do so because they have far too few selling opportunities which is usually caused by having far too few qualified prospects. Following are some ideas to ensure you never have this problem again.
A big problem I see with prospecting is a lack of consistency. A salesperson does a ton of prospecting until he or she has enough business or appointments, then they stop prospecting. When business and appointments drop, they go back to doing a ton of prospecting again. In order to be good and stay good at prospecting and have a steady stream of prospects, you have to be consistent. Sure, there may be times when you’re out of balance, but even when you have plenty of business and appointments, block off some time to prospect.
Seven Ideas to Get all the Prospects You’ll Ever Need 1) Spend at least four hours a day prospecting. Yes, four hours, that’s not a misprint. In order to get a sufficient number of leads, you need to spend a significant amount of time prospecting. For most salespeople spending far too little time prospecting is their primary issue. If you’re wondering where you’ll find four hours in a day, the answer is simple:
3) Choose active rather than passive prospecting activities.
First, stop wasting time on unqualified prospects you’ll never convert. You know who these people are, you’ve been calling them for months, maybe even years. Either get rid of them immediately, or give them one final call and tell them this is the last time you can contact them, it’s do business now or never. Second, stop over contacting and irritating the qualified leads. As mentioned in a previous article, the reason salespeople tend to keep unqualified prospects in their funnel and harass and over-contact the qualified leads is because they have no one else to call. Spending a lot of time prospecting will give you an abundance of prospects and solve both these issues. Third, cut out all the busy work you do to avoid the hard work of prospecting. Most of us are very creative at coming up with ways to avoid hard work from cleaning up our desks and doing paperwork in the middle of the day, to scheduling doctor appointments and other personal items during prime calling times. Stop it! Finally, schedule your prospecting time and stick to the schedule. For example, block off 8 a.m. to 10 a.m. and 2 p.m. to 4 p.m. for prospecting and don’t allow anything to infringe on that time. FYI EXPRESS
Phone calls, knocking on doors, asking for and calling referrals, and networking are all examples of active prospecting because you control the contact. Mailers, social media, the internet, radio and television ads, and other similar marketing techniques are all passive because you have to rely on someone to contact you. When it comes to prospecting you want to be in control of the numbers and the only way to do that is through active prospecting. While it’s good to have aspects of both active and passive marketing in your prospecting plan, far too many salespeople put most of their effort into passive methods because they are easier and more comfortable. On the flip side, they are also far less effective than active prospecting. 4) Get better at prospecting. Of course you always want to be getting better in each area of the sales process and prospecting is no exception. When you get better at prospecting, you can make fewer calls and work less, while at the same time getting better, more qualified prospects. Read books and articles, listen to and watch programs of prospecting, and perhaps most important, find people who are highly successful at getting lots of good, qualified prospects, find out what they do, and then take the same actions. Continued on page 30
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May, 2013
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Seven Keys
Letters to the Editor
Continued from page 28
Sent: Thursday, May 02, 2013 5:21 PM
5) Do whatever you have to in order to get the prospects you need. You need to be committed to getting the number of prospects you have to get in order to be successful. If it takes six hours of cold calling and making calls on the weekend, that’s what you do. The bottom line is: you must be willing to make tons of phone calls, knock on tons of doors, and talk to tons of people in order to get the prospects you need. 6) Keep track of numbers and results. If you go to a networking event for four hours and talk to one or two average prospects, that is not a good use of prospecting time. If you get on the phone for four hours and get ten qualified prospects, that is a good use of prospecting time. You have to know where you’re effective and not effective and spend your time on the right activities. 7) Prospecting is a numbers game. The more people you talk to, the more prospects you will get. If you talk to enough people during the day, you will eventually bump into someone who says, “I need what you have”, or “I know someone who needs what you have.” If you’re going to get an abundance of prospects, you need to talk to an abundance of people. For access to John Chapin’s free monthly newsletter, go to: http://www.completeselling.com John is an award-winning sales speaker, trainer and coach. With over 24 years of sales he is a number one sales rep in three industries, and author of the goldmedal winning "Sales Encyclopedia".
Subject: Foremost stealing customers!! Eddie, I got this letter today and was wondering if you think we should have protection over this thing happening. The foremost rep said that they explain to the customer that they are losing an agent, but they do not tell them we could give them the same price with the AARP discount added. I know this is happening all around us and I really think the companies should not be allowed to rewrite the policy with the same company. Any input is appreciated. (Letter shown on page 31) Julie Crowe C J & Associates Insurance Agency, Inc 770-443-1978
770-443-6034 Fax
Hi, Julie. I agree with you but it's kinda like getting an agent of record letter signed. The least they could have done is remind the applicant that they will be losing your pretty face and it will be replaced by a faceless person who does not work, employ and pay taxes in your town. Do AARP and / or Foremost have a Facebook page? If yes, tell the world how you feel. Foremost did a number on Texas agents last month by reducing commission from 13% to 10%. eke Eddie K. Emmett
For permission to reprint, or if you have sales questions, e-mail: johnchapin@completeselling.com.
eddie@fyiexpress.com www.FYIExpress.com
John Chapin Complete Selling, Inc. Helping you find and get all the business you want Cell: 508-243-7359 johnchapin@completeselling.com www.completeselling.com
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May, 2013
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Zalma Insurance Fraud Letter The Essential Resource for the Insurance Fraud Professional A ClaimSchool ™ Publication, Written by Barry Zalma, Esq., CFE © 2013 ClaimSchool, Inc. & Barry Zalma Go to Zalma Books – E-Books and Articles by Barry Zalma – http://www.zalma.com/zalmabooks.htm Subscribe to e-mail Version, it's http://www.zalma.com/ZIFL-CURRENT.htm Go to my blog http://zalma.com/blog
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Younger respondents, especially young men, were much more likely to view claim padding as acceptable. For example, among males age 18-34, 23 percent agree it is all right to increase claim amounts to make up for premiums, compared with just 5 percent of their older male counterparts and just 8 percent of females aged 18-34. The IRC study, "Insurance Fraud: A Public View, 2013 Edition," also found that 86 percent of Americans agree with the statement "insurance fraud leads to higher rates for everyone," while 10 percent agree that "insurance fraud doesn't hurt anyone." Respondents showed support for fraud-fighting efforts. Two-thirds (66 percent) approved of legislation to limit attorney and medical provider access to police accident reports for the purposes of soliciting new clients or patients, a marked increase from 2002. Eight in 10 were willing to participate in claim processes that could help insurers detect and prevent fraud, such as examinations under oath (85 percent) or independent medical exams (80 percent). Eighty-two percent agreed that persons who commit insurance fraud should be prosecuted to the fullest extent of the law, although the consequences favored for specific fraud activities were generally less severe than in 2002. The 2012 results are from an online survey conducted in June 2012 among 2,005 adults countrywide. Survey results were weighted by known demographic distributions to ensure that the final results were representative of the total U.S. adult population. For more detailed information on the methodology and findings from this study or previous IRC studies of insurance fraud attitudes, contact David Corum, at (484) 831 - 9046, or by e - mail at irc@TheInstitutes.org. Copies of the study are available for $300 for an electronic version, or $400 for a printed copy. Visit IRC's website at www.insurance-research.org for more information.
Do You Wonder Why There is So Much Fraud? Twenty-four percent of Americans believe it is acceptable to increase an insurance claim by a small amount to make up for deductibles they are required to pay. That is lower than the 33 percent found in 2002, according to new findings from an online Insurance Research Council (IRC) public opinion study. Additionally, 18 percent believe it is acceptable to increase a claim to make up for premiums paid in previous years when they had no claims, the lowest percentage since the question was first asked in a 1981 in-home survey. FYI EXPRESS
Barry Zalma, Esq, is available as a consultant, expert witness, arbitrator or mediator to assist counsel or parties concerning:
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Page 32
May, 2013
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Reports of Convictions From the Coalition Against Insurance Fraud – http://www.InsuranceFraud.org A Miami-area clinic recruited local transit workers to pretend they were hurt so the clinic could lodge false treatment claims, prosecutors charge. A Miami-Dade county bus driver let AZJ Medical Center bill for 135 visits and 758 treatments even though he only received handful of massages, prosecutors say. Another transit driver allegedly signed many blank medical forms so AZJ could bill for more than 30 phantom visits and treatments. The clinic made yet another suspected false claim for a transit worker who supposedly banged his elbow on — get this — a towel holder. AZJ allegedly bribed bus driver Nancy Maradey $6,000 to use her name for fake knee treatments and to recruit other workers. A therapy assistant allegedly received $45 for each "progress" form he signed for clients that he never treated. The claims were filed against AvMed, which administers Miami-Dade County's self-insured health plan. * The Eighth Commandment — don't steal — was no barrier to a pastor's auto con. The son of Kyung Soon Kim's business associate bought a Lexus but left to work in South Korea and never picked up the car. The Montgomery Township, Pa. man drove the Lexus for a year and rolled up 45,000 miles. His crony Kathleen Bangwhan Chung then told Liberty Mutual that someone stole it from the Melrose Shopping Center, in Cheltenham. The insurer paid out $42,053. But she actually had a cohort park the Lexus in the shoppingcenter parking lot, left the keys in the car and called 911 after Kim drove the car to his house. He then hid the Lexus in his garage for three years. Kim received two consecutive weekends in county jail, seven years of probation and 200 hours of community service.
* An agent fleeced actor Tom Hanks and his wife out of more than $800,000 by overbilling them for insurance. Southern California producer Jerry Goldman created false invoices on his letterhead for premium payments. He inflated the payments as much as 600 percent. When clients asked Goldman for copies of their policies, he redacted the true premiums to cover up the crime. Goldman was Hanks' and wife Rita Wilson's agent for 20 years. They relied on him for all manner of personal and business coverage. The scam surfaced when the couple retained a new agent, who discovered that premiums for some policies were extraordinarily high. Goldman pleaded guilty and could be locked away for up to 60 years when sentenced. FYI EXPRESS
* A St. Louis-area chiro spent a profitable time billing for creatively false treatments. Dr. Anthony Calandro went after 18 insurers in the $1-million ploy. His cons were limited only by his imagination. He'd take one or two X-rays but bill for eight or 12. He charged for whirlpool therapy despite not having a whirlpool. Billing for thousands of phantom cancelled or missed appointments was another money-maker. Calandro received 72 months in federal prison Tuesday. * It was hard to tell the living from the dead in mortician Jean Crump's inventive fake-death schemes to scam hundreds of thousands of dollars in life-insurance money. The Los Angeles-area woman invented "Jim Davis." Poor guy died from a heart attack, his bogus death certificate said. Crump also bought a grave plot and held a funeral to throw off investigators. She even weighted down Jim's casket with a mannequin, and cow bones and guts so funeral-parlor workers lugging Jim to his final resting place wouldn't grow suspicious. Crump also pulled off the fake cremation of a woman who'd died years earlier. Among the expenses were for a limo, body refrigeration and a casket. Crump and her cronies sought as much as $1.2 million in life and funeral insurance overall, but netted around $315,000. Crump doggedly stuck to her lies at trial. She still denied witnessing a crony sign a fake document even after being shown the videotaped transaction in front of the judge. She received 18 months in federal prison, and life in the Coalition's Insurance Fraud Hall of Shame. * A Maryland appeals court has upheld the criminal conviction of heart doc Robert McLean, who implanted useless stents in the heart arteries of more than 100 patients. He falsely billed insurers nearly $580,000 while working at a hospital in Salisbury. He'd received eight years and one month in federal prison. * Former cop Robert Iain Walker's auto scheme rolled over. The Price, Utah officer was having marital problems and wanted to unload his 2012 Dodge truck. He let his wife believe the truck had accidentally rolled down a steep hill and received extensive damage. She made the insurance claim, but Walker finally admitted he let the truck barrel down. He lost his job, received up to five years in prison and must repay the insurer $22,000. * A Russian student will be deported after serving a one-year sentence for over-insuring clunker cars and then wrecking them. Rustern Mukhametshin came to Anchorage, Alaska on a student visa. His visa expired but he stayed on to run his scam. He bought wrecked cars, made minimal or no repairs and registered them. Mukhametshin then insured the cars at a higher value as if they were in reasonable and normal condition. Next he crashed the cars and collected his inflated insurance dollars. His wrecks usually came late at night in a remote area to minimize witnesses. He also filed claims for phantom collisions. Mukhametshin and a crony collected more than $70,000 from Geico.
Page 34
Continued on page 36 May, 2013
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Reports of Convictions From the Coalition Against Insurance Fraud – http://www.InsuranceFraud.org
* Joseph Thomas Rebic said someone burglarized his car while it was parked for 45 minutes in a Tacoma, Wash. mall parking lot. The driver's door window was broken, and the trunk liner was damaged. The thief lifted several items, including a $179 GPS device, $1,189 Canon camera and lenses, and a bow and arrows worth $1,200, he said. The thefts totaled about $2,880 plus $350 for the car damage, Rebic claimed. But his con quickly tumbled. State Farm cancelled his claim after he failed to show up for an appointment with an investigator. The insurance department's fraud bureau then looked deeper. The mall's parking-lot video shows no one approaching the vehicle or stealing items after Rebic leaves. He pleaded guilty Wednesday and received 240 hours of community service.
* Lionel Scott Ellison’s sink con sank. The Billings, Mont.-area man said villainous burglars crept into his home, plugged up his sink and sprayed graffiti on his walls. The overflowing sink caused plenty of damage to his basement right below, he lied. But there was no evidence a plugged sink had caused the water damage. In fact, the damage was caused by a burst water pipe in the sink. He also spray-painted the graffiti himself. Ellison pleaded guilty but insisted he didn’t commit the crime. He received two years in prison deferred.
* Robert Steve Mills hawked phony policies to apartments, condo associations, bars, restaurants, trucks, taxi services, charter aircraft and other businesses. The Bonita Springs, Fla. man sold the coverage from Texas and American Samoa, through supposed “benefit associations.” The tour boat Ethan Allen was operated by one victim. It sank, killing 20 elderly tourists on a lake in upstate New York. The operator discovered his liability coverage was fake. Mills scored $2.5 million in stolen premiums from his shady dealings and received 10 years in federal prison Wednesday. Several cohorts also have been convicted.
Fire Chief to Spend Year In Jail for Arson Patrick Foster of Quinton Township, New Jersey, the former chief of a southern New Jersey fire company who helped a property owner burn down an abandoned home and masked the arson as a training exercise was sentenced March 23, 2013 to 364 days in the Salem County Jail and two years’ probation. The 47-year-old pleaded guilty last December to arson and hindering apprehension or prosecution. He also resigned from the fire department and is barred from holding any public position or employment. State authorities say Foster sent fire company members to the abandoned house in December 2010 and had them douse the second floor with gasoline before setting it on fire. Foster admitted doing this to gain assistance from the property owner's son, who was the township's housing official. Prosecutors proved Foster wanted to obtain a certificate of occupancy in connection with renovations he was making to his own home. Foster also admitted that he hindered the investigation by lying to authorities, telling them his wife knew of an arrangement between him and the housing official regarding the fire and the certificate of occupancy. Prosecutors noted that it's illegal for firefighters to burn down a standard, existing structure for training purposes, citing the stringent requirements that must be met for "live-burn" training. They also said a permit is required for such training exercises, and no permit was obtained in this case.
FYI EXPRESS
* A heart doc deliberately misdiagnosed up to 80 percent of his patients with maladies to scam$19 million from Medicare. The New York City-based Jose Katz subjected patients to unneeded and potentially lifethreatening treatments. They had coronary heart disease and angina, Katz lied. He used pneumatic cuffs to compress blood vessels in the lower limbs to increase blood flow to the heart. Katz even prescribed the treatment when it exposed patients to risk of injury or death, prosecutors said. It’s the largest insurance fraud ever by a doc in New York or New Jersey, prosecutors say. The Cuban-born doc spent $6 million in advertising to lure Spanish-speaking patients. * Todd Paffrath’s jewelry heist had no sparkle. The third-generation jeweler from Willmar, Minn. filed a $15,528 claim for a diamond ring stolen from his store. He submitted an invoice, but an insurer’s appraisal pegged the value at $10,000 less than his claim. Paffrath then switched gears, saying the invoice was for a ring of similar value, not the ring itself. He quickly repaid the insurance settlement after the ring later was discovered at a pawn shop in a nearby town. He copped an Alford plea on Tuesday, admitting that he likely would've been convicted had the case gone to trial. Paffrath will serve three years of probation and pay a $1,000 fine.
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Continued on page 38
May, 2013
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Reports of Convictions From the Coalition Against Insurance Fraud – http://www.InsuranceFraud.org The former owner of a New York City-area cab fleet ducked $10 million in commercial auto premiums by lying that his vehicles were based in a lower-risk, lowerpremium location. Scott Eric Sanders owned numerous livery firms such as Always Available Private Car. He lied that the fleets were stored in rural Orange and Dutchess County, and used as lower-risk ambulettes and limos. He also illegally listed others as heads of his companies to hide his personal stake. The New York Automobile Insurance Plan, which insures vehicles that cannot find coverage in the private market, was a lead player in the investigation. Sanders was convicted Tuesday and faces up to 120 years in prison when sentenced in July. * Peter St. Laurent’s car collided with a jersey barrier near a highway exit to Nashua, N.H. one night. Progressive Insurance issued an auto policy to him about 1 ½ hours later. The car was towed to his mother’s home just a few minutes away. The next day St. Laurent told Progressive he crashed just after buying the policy. He withdrew the claim after investigators began probing his story. Too late. He received a year in state prison, suspended. The case was investigated by the state AG and insurance department’s fraud bureau. * Paying recruiters a small fortune netted chiro Scott Greenberg a larger fortune. The central New Jersey man forked over $100,000 in kickbacks to recruiters he hired to send him 164 patients. Greenberg then fraudulently billed auto insurers more than $650,000 for bogus treatment. New Jersey makes hiring or being a recruiter a specific crime. The court didn’t look kindly upon Greenberg, slapping him with six years in prison on Monday. Three of his runners have been handed sentences of up to four years. The state Office of Insurance Fraud Prosecutor played a lead role in the investigation and conviction. * The drywall con has dried up. Jaime and Lawrence Beroth both claimed they were injured at work and filed claims with the Washington state workers comp insurer. Both Beroths said they could no longer work. Jaime inhaled more than $100,000 in comp money and Lawrence $123,000. But acting on a tip, the agency caught the couple running a drywall business with few apparent medical limits. Jaime received all of 30 days of community service, and Lawrence 20 days.
FYI EXPRESS
* Two schemes tried to lift more than $36 million from Medicare and Medicaid. First, Louis and Verna Age paid recruiters to obtain Medicare beneficiary info. The Slidell, La. couple hired docs to sign referrals and certifications for worthless home-health services. Verna was head of nursing for South Louisiana Home Health Care. She falsified and ordered staffers to fake certification evaluations and other forms to make the home-health services seem medically needed. The Ages billed taxpayers$17.1 million before being federally convicted this week ... In the second scheme, Donald Gibson ordered, prescribed and authorized useless diagnostic tests and other procedures such as allergy tests, pulmonary function tests, vestibular tests, urodynamic tests and physical therapy. These tests were billed to Medicare and Medicaid for payment under Gibson's billing number. But the Richmond, Va. man’s crony Sunday Joseph Edem hid his ownership of the clinic by operating them under the names of others. Together they tried to steal at least $19.4 million. The cheaters in both cons will be sentenced later. * A federal court granted American Service Insurance summary judgment seeking non-coverage of crash losses because the policyholder allegedly lied about where he lived. The insurer issued Ferdy Garcia an auto policy. He was involved in a crash with numerous others less than three weeks later. ASI sued Garcia and the crash claimants. The insurer sought a declaration of non-coverage. It alleged Garcia was a New York resident who lied that he lived in Virginia when buying the policy. Pay stubs from his employer in Brentwood, N.Y. showed he worked 33 hours a week there. He couldn’t have lived in Virginia while working those hours in New York, the insurer contended. The U.S. District Court in New York agreed, granting summary judgment for ASI. [Am. Serv. Ins. Co. v. Garcia, No. 11-4664 (S.D.N.Y. Mar. 8, 2013)]
Zalma's Insurance Fraud Letter © 2013 by Barry Zalma, & ClaimSchool, Inc. 4441 Sepulveda Blvd, CULVER CITY CA 902304847 http://www.zalma.com http://zalma.com/blog
zalma@zalma.com
ZIFL is made available by the publisher for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using ZIFL you understand that there is no attorney client relationship between you and the publisher. ZIFL should not be used as a substitute for competent legal advice from a licensed professional attorney in your state.
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May, 2013
Georgia e gia Geo gia Georgia Georgia Geo gia Georgia Homeowners
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Wayne Hooper Reports: Fire! By Wayne Hooper
I began this article as a study on fire statistics because of the situation in Suwanee, Ga. in April, where a mentally disturbed person made a false call about a heart attack, then took some Gwinnett County fire fighters hostage. His home had been foreclosed on and was going up for sale. He made demands that he wanted his power, cable and Cell phone turned back on before he released the hostages! This turned out badly for the hostage taker, but when the shooting was over the firemen were physically ok. The media said the taking firemen hostage, who saves people, was very rare. I thought I would check some statistics and assumptions that I was taught in CPCU and my insurance courses to see if they were correct. I have always wondered where "Yahoo" and "Google" come up with these “gotcha” new articles that make you look for details. It appears you can find a Stat for almost any statement you want to make, even when it is not supporting your world view. My wife and I have these discussions daily. Property and Casualty insurance courses made the insurance based studies in the 1940's and 50's sound as if the trends were as predictable as the rising and setting of the sun. I now know this was all part of the professor's B--S--- to appear to be all knowing and able to statistically predict the future. I believed all of it until I had the chance to work in the real world of rate making. The reality was completely different. Rate making is part statistical, part luck, part market analysis and part artistic creativity. Some of the most profitable competitive programs to hit the market were created by someone who saw a market and had the good luck to not get wiped out in the first critical months of growth. One of the insurance assumptions in "Insurance 101" is the famous" 5 year cycle" for Property and Casualty business. The assumption is over a 5 year period the companies will make money with a certain amount of risk taking. FYI EXPRESS
The market will be more competitive as rates decrease to the point where the marginal players drop out due to losses and the rates increase to profitability over a 5 year period. The trick is to not follow the market to a point where you cannot recover when it returns. Your profitability can be improved by better risk selection through underwriting. Better risk selection has lead the industry to credit scoring, MVR's, Social media reviews, Car fax, physical inspections and Clue reports as the industry tries to squeeze as much profit out of the premium balanced on the cost return of gathering that information. This has been driven by the promises of the reporting companies to give you a snapshot of your customer's life. What the companies do with the information is not their problem, but they take credit in their marketing material for improving profitability. To get a better understanding I reviewed Georgia, South Carolina, North Carolina and FEMA's Fire statistics. The most comprehensive are FEMA's. See: http://www.usfa.fema.gov/statistics/ To save you the pain of sorting through hundreds of spreadsheet pages, as I did, let me summarize some trends and facts. These studies are all incomplete as many states do not ask for the same information. I.E., Mobile Homes are considered single family dwellings for statistic reporting but data captured by South Carolina shows that that in 2012, 25% of all fatal fires were in mobile homes. There are 1.8 million fires reported in the United States in a year. The fire and death rates have trended downward by 20-21% for the last ten years, injuries were down 33.1%, yet the actual value dollar loss was up 27.6% due to increased values. The indirect cost of a fire is estimated to be 8-10 times higher than the direct cost. The number of false alarm calls has dramatically increased in the last few years as the number of real alarms decline. (Somebody needs to go to jail!) Nearly 1 in 5 fires involves a vehicle. (They always seem to happen in Atlanta during rush hour!) The United States has the 4th highest death rate among the leading 25 industrialized nations. The fire fatality rate varies from region to region and State to State because of variations in climate, socioeconomic status, education, demographics, and other factors. Eight States, mostly situated in the Southeast, have death rates between 14 and 33 per million population per capita in 2011, the last year for which we have records. Continued on page 42
Page 40
May, 2013
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These arson numbers also show a definite spike in intentional fire claims when the mortgage industry collapsed and the economy took a down turn. I didn't copy the non-residential figures but they show a similar pattern.
Wayne Hooper Reports: Fire! Continued from page 40 The following information is copied directly from the National Fire Incident Reporting System "CAUSES OF FIRES AND FIRE LOSSES
2003 -2011 DOLLAR LOSS
At 28 percent, cooking is the leading cause of fires. Incendiary or suspicious fires (arson) cause another 21 percent. These percentages (and those that follow) are adjusted, which proportionally spreads the unknown causes over the other 12 causes.
OVERALL Residential Building Causes
The two leading causes of civilian deaths are arson, at 28 percent, and smoking, at 18 percent. The leading cause of injuries is cooking (24 percent); followed by open flame (18 percent) and arson (17 percent).Arson is, by far, the leading cause of property loss, at 26 percent. RACE, AGE, AND GENDER CHARACTERISTICS OF VICTIMS Fire losses affect all groups and races, rich and poor, North and South, urban and rural, but the problem is higher for some groups than for others. AfricanAmericans and American Indians have much higher fire death rates per capita than the national average. African-Americans comprise a large and disproportionate share of total fire deaths, accounting for 24 percent of fire deaths—nearly twice as high as their share of the overall population. Approximately 50 percent more men die in fires than women. The reasons for this disparity are not known for certain. Suppositions include the greater likelihood of men being intoxicated and the more dangerous occupations of men (most industrial fire fatalities are males).Female fire deaths increase at age 75, and the 75 and older age group accounts for over one-quarter of female fire deaths (28 percent).Male fire deaths, by contrast, are higher in the late midlife years (40 to 54).We also know that men have more injuries trying to extinguish the fire and rescue people than do women. Mid-aged men (20 to 44) have the largest portion of fire injuries. Incendiary and suspicious fires are the leading cause of deaths in 2004; smoking is the second leading cause. Cooking fires are the leading cause of injuries, with incendiary and suspicious as the second leading cause.
Intentional
2003
631,900,000
149,600,000
2004
594,900,000
128,300,000
2005
651,300,000
145,800,000
2006
597,600,000
126,500,000
2007
523,600,000
101,200,000
2008
716,100,000
120,800,000
2009
615,900,000
86,100,000
2010
504,400,000
83,800,000
2011
481,500,000
86,900,000
OVERALL 1 & 2 Family Causes
People with limited physical and cognitive abilities, especially children and older adults, are at a higher risk of death and injury from fire than other groups. These two age groups accounted for 46 percent of the 2004 fire deaths and 22 percent of estimated fire injuries. " Spontaneous Combustion It has long been a joke in the insurance industry the definition of "spontaneous combustion" was caused by the insured’s insurance policies rubbing together. FYI EXPRESS
Playing with Heat Source
Years
Playing with Heat Source
Years
Intentional
2003
450,200,000
118,400,000
2004
460,700,000
88,800,000
2005
438,100,000
101,400,000
2006
437,600,000
90,000,000
2007
359,800,000
68,000,000
2008
543,100,000
85,800,000
2009
434,200,000
67,200,000
2010
391,000,000
64,000,000
2011
371,300,000
65,800,000
Continued on page 44
Page 42
May, 2013
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May, 2013
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OVERALL Multi-Family Causes Playing with Heat Source
Years
Intentional
2003
127,100,000
28,400,000
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2004
104,200,000
36,300,000
2005
175,900,000
40,400,000
2006
86,500,000
33,600,000
2007
142,000,000
31,000,000
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2008
155,200,000
33,800,000
2009
105,500,000
18,000,000
2010
91,400,000
16,600,000
2011
92,600,000
18,100,000
In summary, what I found is the 5 year cycle theory is not statistically valid but there is a definite boom to bust cycle in the P&C industry, but it's due competition, reinsurance availability, foreign currency exchanges rates, interest rates and corporate goals for market share. The fire incident numbers also indicate that arson increases as the economy decreases. (The government has not announced a decline in arson losses might indicate an improving economy! I also noticed being 75 year old Afro-American woman with limited mobility, using a space heater in a mobile home in the District of Columbia can be fatal combination based on the fire statistics. Not much better chance anywhere else. INDUSTRY NEWS From the Georgia Department of Insurance
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ALERT: Individuals who have conducted insurance transactions with Sapelo Insurance Agency located in Darien, Ga., or Avera Insurance Agency in Ludowici, Ga., are encouraged to contact their insurance company to verify coverage. If it is determined that coverage was never place with the insurance company on your behalf, we ask that you contact our Fraud Division at 800-6562289. ALERT: Southern Casualty Insurance Company was placed into liquidation on March 20, 2013. Click here for a copy of the Liquidation Order, Notice of Liquidation and Proof of Claim Form. Proof of Claim form must be properly completed, mailed, and postmarked no later than September 17, 2013. FYI EXPRESS
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Featured Articles For May, 2013 Paying Taxes on Household Helpers When you hire someone to work around the house or baby-sit your children, do you need to pay tax for them? Keep reading to find out. What to Do If You Haven't Filed an Income Tax Return If you're cringing because you haven't filed a 2011 tax return yet, don't worry. It's not too late, and it's not as hard as you may think. Don't Be Fooled: The Dirty Dozen Tax Scams for 2013 Although the 2012 tax season is officially over, tax scams unfortunately are not, and taxpayers who buy into illegal tax scams can end up facing significant penalties and interest and even criminal prosecution. Whether you've already paid your taxes, are waiting for a refund, or have filed an extension, here's the "dirty doze" list of tax scams for the 2013 filing season according to the IRS. Turn Your Vacation Into a Tax Deduction Would you like to legally deduct every dime you spend on vacation this year? The five strategies outlined in this article will show you how. TAX TIPS Ten Facts on Filing an Amended Tax Return Eight Facts on Late Filing and Late Payment Penalties Six Tips for People Who Pay Estimated Taxes Tax Rules for Children With Investment Income TAX DUE DATES May 10 Employers - Social Security, Medicare, and withheld income tax. File Form 941 for the first quarter of 2013. This due date applies only if you deposited the tax for the quarter in full and on time. Employees - who work for tips. If you received $20 or more in tips during April, report them to your employer. You can use Form 4070. May 15 Employers - Nonpayroll withholding. If the monthly deposit rule applies, deposit the tax for payments in April. Employers - Social Security, Medicare, and withheld income tax. If the monthly deposit rule applies, deposit the tax for payments in April. Click here to read the rest of the newsletter. Please call us at (678) 382-0444 if you have any questions. Metro CPA 2193 Northlake Pkwy, BLDG 12, STE 101, Tucker, GA 30084-4152 www.themetrocpa.com (678) 382-0444 FYI EXPRESS
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