SUMMER 2013 | VOL. 2, NO. 3
Final Offer: Competition Improving Workers’ Comp? Burke’s Law: Single Claim Clauses Tender Doctrine in Workers’ Comp
You know what happened. We’ll tell you why.
Getting to the truth: It’s what Donan has done for its customers since 1947. To find out how, call 800-482-5611 or visit donan.com.
800-482-5611
donan.com
opening note
EDITORIAL
Having it All
O
ne question often asked of women but not of men in the business world is: Can you have it “all”?
Is it possible to have both a successful career as an insurance professional and a family? That’s something men never get asked, according to a panel of women insurance industry executives who were also asked their views on what women and the insurance industry can do to improve gender diversity in the executive ranks. Four successful insurance executives discussed the critical factors for success for women in the insurance industry in a podcast jointly produced by the event’s sponsor, the Insurance Industry Charitable Foundation (IICF), and Wells Media Group’s Insurance Journal. During the hour-long podcast, IICF Women Executive Roundtable: Gender Diversity in the P/C Insurance Industry, IICF CEO Bill Ross interviewed Pina Albo, president of the reinsurance division at Munich Re-America; Trish Henry, executive vice president, government and industry affairs, ACE Group; Joan Woodward, executive vice president for public policy at Travelers and president of the Travelers Institute; and Seraina Maag, chief executive for XL Insurance North America Property & Casualty. Having it all depends on many things, according to the panelists. “[I]t depends on what your definition of ‘all’ is,” said Albo. “Apart from that, I don’t even know if aspiring to have it all is the right thing.” Henry has no doubt that women can have it all. “I think you certainly can have a good marriage and be a good parent and also have a significant career. You can do those two things at once, absolutely,” she said. Having it all — or trying to — is a choice for some. The idea of someone choosing not to have it all is fine with Albo. “[W]hether you are male or female… you should not get too consumed with the notion of getting ahead. You are more likely to be successful if you do something you enjoy and you are good at it rather than doing what you think you should do in order to get to that next level in your career,” she said. But Woodward of Travelers said she is concerned about the number of young women who leave their careers because they believe they can’t have it all. “I think it’s the responsibility of senior women, even those without children, to absolutely tell young women they can have both, a family life and a career at the same time,” Woodward said. She said statistics have shown recently that many younger women are dropping out of the work force in the financial services sector when they hit their ’30s. This worries her. “It’s very troubling to me, actually. I’m a firm believer in telling people. Then they may choose not to have it all. They may not really want to work. They really might decide they are going Andrea Wells to stay at home and that they would be happy doing that. But I Editor-in-Chief awells@claimsjournal.com think to tell people you can’t when they haven’t even tried is not the right way to go about that,” Woodward said. To listen to the IICF Women Executive Roundtable in its entirety, or in segments, visit: http://www.insurancejournal.tv.
Is it possible to have a career and family?
4 Claims Journal | Summer 2013
Editor-in-Chief Andrea Wells | awells@insurancejournal ClaimsJournal.com Editor Denise Johnson | djohnson@claimsjournal.com Vice President Content Andrew Simpson | asimpson@insurancejournal.com Insurance Journal East Editor Young Ha | yha@insurancejournal.com Insurance Journal Southeast Editor Michael Adams | madams@insurancejournal.com Insurance Journal South Central Editor/Midwest Editor Stephanie K. Jones | sjones@insurancejournal.com Insurance Journal West Editor Don Jergler | djergler@insurancejournal.com Insurance Journal International Editor Charles E. Boyle | cboyle@insurancejournal.com MyNewMarkets.com Associate Editor Amy O’Connor | aoconnor@mynewmarkets.com Columnists Burke Coleman, Steven Plitt Contributing Writers Mitch Neuhaus, Brian Retson, Mark Walls
SALES
V.P. Sales & Marketing Julie Tinney (800) 897-9965 x148 jtinney@insurancejournal.com Claims Journal/Southeast Howard Simkin (800) 897-9965 x162 hsimkin@insurancejournal.com West Dena Kaplan (800) 897-9965 x115 dkaplan@insurancejournal.com South Central Mindy Trammell (800) 897-9965 x149 mtrammell@insurancejournal.com Midwest Lauren Knapp (800) 897-9965 x161 lknapp@insurancejournal.com East Dave Molchan (800) 897-9965 x145 dmolchan@insurancejournal.com New Markets Sales Manager Kristine Honey | khoney@insurancejournal.com Classified Advertising (800) 897-9965 x125 lnguyen@insurancejournal.com
MARKETING/NEW MEDIA
Marketing Administrator Gayle Wells | gwells@insurancejournal.com Advertising Coordinator Erin Burns | eburns@insurancejournal.com (619) 584-1100 x120 New Media Producer Bobbie Dodge | bdodge@insurancejournal.com Videographer/Editor Matt Tolk | mtolk@insurancejournal.com
DESIGN/WEB
Vice President/Design Guy Boccia | gboccia@insurancejournal.com Vice President/Technology Joshua Carlson | jcarlson@insurancejournal.com Design and Marketing Executive Derence Walk | dwalk@insurancejournal.com Web Developer Jeff Cardrant | jcardrant@insurancejournal.com Web Developer Chris Thompson | cthompson@insurancejournal.com
IJ ACADEMY OF INSURANCE
Director of Education Christopher J. Boggs | cboggs@ijacademy.com Online Training Coordinator Barbara Whiffen | bwhiffen@ijacademy.com
ADMINISTRATION
Chairman Mark Wells Chief Executive Officer Mitch Dunford Accounting Manager Megan Sinclair | msinclair@insurancejournal.com
FOR QUESTIONS REGARDING SUBSCRIPTIONS: Call: 1-800-897-9965 ex. 144 or You may subscribe or change your address online at
www.claimsjournal.com/subscribe Claims Journal, the National Property Casualty Claims Magazine is published quarterly by Wells Publishing, Inc. 3570 Camino del Rio North, Suite 200, San Diego, CA 92108.. Subscription Rates: Free to qualified readers. Disclaimer: While the information in this publication is derived from sources believed reliable and is subject to reasonable care in preparation and editing, it is not intended to be legal, accounting, tax, technical or other professional advice. Readers are advised to consult competent professionals for application to their particular situation. Copyright 2012 Wells Publishing, Inc. All Rights Reserved. Content may not be photocopied, reproduced or redistributed without written permission. Claims Journal is a publication of Wells Publishing, Inc. Postmaster: Send change of address form to Claims Journal, Adam Dunford, 3570 Camino del Rio North, Suite 200, San Diego, CA 92108. Article Reprints: For article reprints: For reprints of articles in this issue, contact Rhonda Brown at 1-866-879-9144 ext. 194 or rbrown@fostereprints.com. Visit insurancejournal.com reprints for more information.
C0NTENTS
SUMMER 2013 | VOL. 2, NO. 3
CLAIMS REVIEW 6 Employers — The Real Problem Behind Workers’ Comp Fraud
SPECIAL REPORT 16 Managed Care: Should Treating Psychosocial Factors Be the New Normal? 18 2013 Job & Salary Survey: More Money, More Work 26 2013 Education & Training Directory 6
IDEA EXCHANGE 10 Burke’s Law: Characterizing Separate Claims as Single Claims for Policy Coverage 12 Essentials: The Selective Tender Rule Rejected in the Workers’ Compensation Context 14 Retain Employees, Attract New Talent with Modern Core Systems 38 Final Offer: Will Competition Drive Improvement in Workers’ Comp?
16
12
CLAIMS DEPARTMENTS 4 Opening Note 8 People 9 Business Moves 15 Dollars & Sense 24 Snapshot 37 Web Exchange 38
On The Cover Job & Salary Survey Summer 2013 | Claims Journal 5
CLAIMS REVIEW | NEWS & TRENDS
Employers — the Real Problem Behind Workers’ Comp Fraud
By Denise Johnson
W
hile changing fraud trends affect other lines of coverage, the opposite holds true in workers’ compensation. As organized crime rings become the norm in staged auto accidents and cargo thefts, the three main types of workers’ comp fraud remain unaffected by the latest trend. According to several state agencies, the three main types of workers’ comp fraud are: 1) Injured worker fraud — The worker may not have been injured at work or injured at all or could be exaggerating symptoms. This can also include unfair benefits fraud or doing activities inappropriate for an injured worker. An injured worker can also commit disability fraud if he or she is caught working at another job while on disability.
6 Claims Journal | Summer 2013
2) Healthcare provider fraud — A izes in workers’ compensation law and company may overcharge for medicivil litigation, said that employer fraud cal services or bill for treatment never has been a problem in his state for sevperformed. This can also include billing eral years. both the workers’ comp carrier and According to a 2000 Department of medical carrier for the same treatment. Labor estimate, which examined audits 3) Employer fraud — This occurs of firms in just nine states, between 10 when an employer percent and 30 percent underreports payroll ‘Employees are being of employers misclassior misclassifies fied some employees. employees in order to misclassified and The lawyer and pay less premium. adjunct professor at proper premiums North Carolina Central aren’t being paid.’ Employer Fraud University School of Among the three, Law said the construcemployer fraud is arguably the most tion industry, in particular, contributes expensive for insurers. to the problem Though some states — Florida, Cali The main problem is that employees fornia, Texas and Ohio — aggressively are being misclassified and proper prefight all types of workers’ comp fraud, miums aren’t being paid, said Jernigan. other states do not. “For instance, you’ve got a roofer. Leonard Jernigan Jr., founder of N.C.You’ve got 100 workers, and 80 of them based Jernigan Law Firm which specialare actually doing the roofing work and
that the employees are creating the fraud problem that’s driving up costs.” But that’s not the case, said Jernigan. He cited a study by Texas Mutual Insurance Co. that found that employee fraud cost about $450,000. On the employers’ side, the cost was $9 million arising from seven or eight cases. “When I broke it down, it was $2,500 per individual claim on the employee fraud and it was almost $1
million per employer,” Jernigan said. Employer workers’ comp fraud costs states millions, too. Washington’s L&I’s Fraud Prevention and Labor Standards program assessed $24.6 million in unpaid employer premiums plus penalties during fiscal year 2012. Jernigan said insurers should conduct more audits of policyholder employee classification. CJ
e x p er ien c e Confidence in Every Report Amset’s reports are the benchmark for accurate determination of cause and liability — confidently leading to prompt, cost efficient settlements. Experts in electrical engineering | mechanical engineering | fire/explosion origin & cause | vehicle fire investigation |
National Problem The problem is nationwide, according to Jernigan. “For the growth and the number of people who are actually in the workforce, I think it’s a massive problem,” he said. Jernigan said he tracks and reviews cases and often it’s not the employees driving up workers’ comp costs. “When you look at the insurance side, for years everybody’s gotten the perception
cost analysis | data recovery | salvage services | evidence storage | laboratory exams | electronics restoration
experience Amset
RU
STED PAR
ER TN
AMSE T
T
20 are clerical, and you’ve got the numbers reversed. You’re paying your insurance company for 20 actual roofers and 80 clerical people,” Jernigan said. Another example is when an employer fails to procure workers’ comp coverage. “I have a civil case ... with a logging company. The logger had this machine called a fellerbuncher that cost about $194,000. This thing threw this projectile out and injured my client. When we were taking the guy’s deposition, the logger, although he paid $194,000 for this piece of machinery, he didn’t have any of his workers covered by workers’ comp. Obviously, he had the ability to pay for it. They just don’t pay for it, because nobody’s cracking the whip,” Jernigan said. Large construction companies are just as likely to misclassify employees as small ones, he said. “It’s not just mom-and-pop operations, by the way… these are big-time construction projects,” said Jernigan. Workers often don’t have workers’ comp coverage because employers classify those workers as independent contractors, he says. “I think you’re seeing it more now because of the economy. People are sort of cutting back on things, and they’re realizing they can not pay workers’ comp [premiums]. It reduces costs to do business. When they’re in competitive bids, they may get the bid and the others don’t,” he said. In North Carolina, where employers that fail to obtain coverage are not pursued, companies aren’t worried because, “whatever happens; the fine’s not going to match whatever they save.” Workplace injuries don’t spark tougher oversight either. Jernigan said that even after an incident involving a worker injury, there isn’t aggressive enforcement.
TECHNICAL CONSULTING 847-229-1155 | 888-98-AMSET | AmsetUSA.com
AMSET16633.indd 1
6/10/13 11:02 AM
Summer 2013 | Claims Journal 7
DEPARTMENTS
people Laura Cali
Kevin Bresnahan
John Kinney
Oregon Insurance Commissioner Lou Savage is leaving the division to work on legal reform in emerging democracies overseas. Laura Cali, the division’s chief actuary and manager of product regulation, will replace Savage effective July 15. Savage was initially appointed as a temporary replacement to head the insurance division, then agreed to serve in the permanent position a year ago. The division hired Cali in mid-2011 as a casualty actuary specializing in workers’ compensation and medical malpractice. Then a consulting actuary for Towers Watson in San Francisco, she started her career at Liberty Mutual’s home office in Boston, building rating models for workers’ compensation and general liability lines of business. CMIC, a doctor-owned medical professional liability insurer serving New England, named Kevin M. Bresnahan as director of claims. Bresnahan brings 20 years of experience to his role. He comes to CMIC from Discover RE/Travelers, a property casualty insurer, where he served in several claims management roles, most recently as claims manager of the national accounts unbundled claim unit. Prior to joining Discover RE/Travelers, Bresnahan was a partner in the law firm of Russo, LaRose and Bresnahan where he served as staff counsel attorney at Hanover Insurance responsible for all aspects of insurance defense litigation including trials, alternate dispute resolution, discovery and coverage opinions. Conn.-based The Hartford named John Kinney chief claims officer and president of Heritage Holdings. In this role, Kinney will lead The Hartford’s property/casualty and group benefits claims operations and its more than 5,000 employees, reporting to Doug Elliot, president of commercial markets at The Hartford. Kinney, who joined The Hartford in 2003, most recently led the company’s property/casualty field claims organization, responsible for workers’ compensation, automobile, property and general liability claims handling and claims customer support. His previous role at Heritage Holdings focused on complex claims, including asbestos, silica, environmental damage and other latent injury long tail claims. Prior to joining The Hartford, Kinney held various legal positions in The Travelers Cos.’ special liability group.
8 Claims Journal | Summer 2013
David Morse & Associates (DMA) named Lee Wright as assistant vice president of its specialty claims division, which focuses on high exposure, complex liability losses and is composed entirely of claims specialists with insurance defense litigation experience; most have law degrees. The division handles individual assignments and claims administration from 20 locations in 15 states, and specializes in construction defect, professional, products and employer liability. The division also handles mandatory settlement conferences and mediations nationwide for a flat rate. Wright most recently held the position of assistant vice president, senior claims consultant with XL in Los Angeles and construction defect litigation manager for Harleysville Insurance in Nashville. His prior experience includes handling litigated transportation claims for St. Paul Insurance and general liability, products, auto and employer’s liability litigated claims for Travelers. OneBeacon Technology Insurance (OBTI), a member of OneBeacon Insurance Group, appointed Dana Lenahan as assistant vice president, technology claims, reporting to OneBeacon Vice President of Claims Theresa Gooley. In this role, Lenahan is accountable for all claims related to the technology book of business. Lenahan succeeds Judi Lamble, who was recently promoted into an expanded role within OneBeacon’s claims organization. Lenahan comes to OneBeacon with 12 years of corporate litigation experience gained with law firms in Minneapolis and Indianapolis, most recently with Nilan Johnson Lewis, where she specialized in complex litigation for clients in the pharmaceutical and medical device industries. Selective Insurance Group named George Neale as senior vice president, chief claims officer by Selective Insurance Group. Neale joined Selective in April 2013. Prior to that, he served as executive vice president, chief claims officer for commercial insurance for Liberty Mutual. Selective Insurance also promoted Michael Zondory to vice president, property and catastrophe claims. Zondory joined Selective in 2011 as assistant vice president, large loss property claims. Before that, he served as property general adjuster for the Hartford Insurance Company. Zondory holds the Property Claims Law Associate designation. CJ
DEPARTMENTS
Business Moves Copart, Salvage Parent Copart, a global online vehicle auction company, acquired Salvage Parent Inc., which conducts business primarily as Quad City Salvage Auction, Crashed Toys, and Desert View Auto Auction. Combined the businesses operate at 39 locations in 14 states. Quad City operates 23 facilities in 10 states, primarily in the north-central and northeast U.S., and stores, processes and auctions predominantly salvaged cars on behalf of the insurance industry. Crashed Toys operates 10 facilities in six states, primarily in the north-central U.S., and stores, processes and auctions salvaged motorcycles, boats, jet skis and other power sport crafts. Desert View operates six California facilities and stores, processes and auctions charity cars. Southport Lane, Imperial Fire & Casualty Southport Lane, a New York Citybased private equity firm, completed its acquisition of Louisiana-based Imperial Management Corp. along with its largest subsidiary, Imperial Fire & Casualty, in an all-cash transaction. Additional terms of the transaction were not disclosed. Imperial Fire & Casualty provides personal auto, commercial auto, personal property and flood policies. Imperial Fire & Casualty has been led by H. Marcus Carter Jr., president/CEO, and John Emmett Brignac Jr., chairman, of Imperial Management Corp., both of whom will continue to serve as directors.
services, and streamline the traditional carrier/vendor communication process. HCC Insurance Holdings Texas-based HCC Insurance Holdings, a specialty insurer with offices in the United States, the United Kingdom, Spain and Ire-
land, hired Francis P. Tricamo Sr. to lead the company’s new construction property risks division based in New York. The new division will further expand the Company’s specialty focus by developing its underwriting capability in builder’s risk insurance. CJ
There isn’t a cause we can’t uncover. Utilizing a rewind approach, our professional engineers and registered roofing consultants reconstruct events to reveal causes. Areas of expertise include: civil, structural, mechanical and electrical engineering. To find out why, call 800-482-5611 or visit donan.com today.
Symbility, Donan Donan, a nationwide forensic investigation firm, has signed a multi-year agreement to integrate Symbility Solutions, a provider of cloud-based and smartphone/ tablet-enabled claims technology for the property/casualty insurance industry, into its operations. As part of the agreement, Donan will implement Symbility’s Claims Connect, a property/casualty claims workflow management software that will increase the speed and efficiency of communications around forensic claim investigation DONAN16484.indd 1
3/21/13 9:58 PM
Summer 2013 | Claims Journal 9
IDEA EXCHANGE | burke’s law
Characterizing Separate Claims as Single Claims for Policy Coverage by insurers and insureds to advance their positions.
By Burke Coleman
D
etermining whether claims made under an insurance policy are multiple claims or a single claim is an important exercise that can have significant coverage implications relating to coverage dates, policy limits and other policy considerations. Claims-made insurance policies are typically triggered only if a claim is first made against the insured and reported to the insurer during the policy period. Many policies state that all claims based on the same wrongful act or any related wrongful acts will be considered a single claim, and will be deemed to be made when the earliest claim is first made. Using this legal fiction, the provision offers a defined mechanism for determining when a claim is made. But the identification of separate claims as a single claim can result in interesting legal maneuvering as the parties attempt to gain or Insurers and insureds limit coverage based on how the characterization should be mindful of of the claims affects the single claim clauses. policy terms. Two recent cases highlight the significance of characterizing a claim as a single claim or separate claims and the use of such a characterization
10 Claims Journal | Summer 2013
Brecek & Young v. Lloyd’s In Brecek & Young Advisors v. Lloyds of London Syndicate 2003, No. 12-3011 (10th Cir. May 13, 2013), an insured had been involved in three arbitration claims stemming from similar facts. The first two claims occurred prior to the policy period but the third occurred during the policy period and was timely reported to the insurer. The policy provided defense coverage for arbitration claims but with a $50,000 retention per claim for the insured. The third arbitration involved 26 individual claimants and, in an effort to reduce its coverage obligations, the insurer argued that 26 claims lacked a sufficient factual nexus and therefore each claim should be treated separately, subject to its own retention. In the alternative, the insurer suggested that if all the claims were found to be interrelated, then they would also relate to the two previous arbitrations and all three arbitrations should be considered a single claim. As a single claim, the three arbitrations would relate back to the date the first arbitration claim was made (prior to the policy period) and would not be covered by the policy. The trial court rejected both of the insurer’s arguments, finding that the claims in the third arbitration were sufficiently related to constitute a single claim so that only a single $50,000 retention applied, and finding that the third arbitration did not relate back to the first two but was a separate claim, timely reported during the policy period. On appeal, the insurer focused on arguing that the third arbitration related back to the first two and, as a single claim, was made prior to the policy. The 10th Circuit Court of Appeals reviewed the standard used by the trial court which suggested that “interrelated wrongful acts” provisions should be strictly and narrowly construed. The appellate court noted that both parties agreed that the term was unambiguous and, unlike many other cases, the term was defined by the policy. The court disagreed that the term should be read narrowly at the expense of the contract’s plain language and, applying the plain language, determined that the three arbitrations were connected by common facts and constituted a single claim. As a single claim made when the first arbitration claim was made, the third arbitration was pulled outside of the policy period and
beyond coverage. The insurer successfully avoided coverage by characterizing the three arbitrations as a single claim made before the policy took effect. Omeros v. Carolina Casualty Similar legal maneuvering based upon the classification of separate claims as a single claim occurred in Carolina Cas. Ins. Co. v. Omeros Corp., No. C12-287RAJ (W.D.Wash. Mar. 11, 2013). In the case, an employee filed an anti-retaliation claim against his former employer. The company sought coverage from its insurer and properly reported the claim during the policy period. After the policy period, the employee amended his complaint to include a qui tam action. The insurer argued that no coverage was available for the second action because it was reported after the policy expired. The company countered that the claim related back to the initial claim and, as a “single claim,” the two claims were timely reported during the policy period when the first claim was made. Asserting an alternative argument, the insurer suggested that if the claims were found to be a single claim then they should be treated as a single claim across all the policy’s provisions and exclusions. The insurer maintained that because the policy excluded the initial anti-retaliation claim, the qui tam action, as part of the single claim, must also be excluded. The court found that the two claims stemmed from interrelated wrongful acts and were effectively a single claim that was timely reported with the first claim during the policy period. Addressing the insurer’s alternative argument, the court held that “although wrongful related acts are deemed a single claim for purposes of determining if the claim was made within the policy period, they are not a single claim for purposes of applying policy exclusions that are unrelated to the claimsmade nature of the policy.” The court reasoned that the single claim label is a product of specific policy language applying only to the notice provision and allowing for a clear mechanism for determining if the claim is made within the policy period. But the rest of the policy does not necessarily accommodate this characterization. Despite the insurer’s
creative argument, the exclusion of the anti-retaliation claim did not mandate the exclusion of the qui tam claim. Whether a claim can be characterized as a single claim is an important and difficult issue. Insurers and insureds often use the legal fiction of the “single claim” to avoid coverage, manipulate coverage dates, implicate policy limits or retentions and affect other policy provisions. Insurers and
insureds should be mindful of single claim clauses and the impact such a characterization can have on insurance coverage and obligations. CJ Coleman is legal counsel and compliance manager for Demotech Inc. Demotech provides actuarial consulting and Financial Stability Ratings (FSRs) for property and casualty insurance companies and title underwriters. Email: bcoleman@demotech.com.
EVEN IF THE TRUTH IS BURNING. Our Certified Fire Investigators provide rapid response to and methodical investigations of residential, commercial and vehicle fire scenes. Call 800-482-5611 or visit donan.com today to find out more.
DONAN16485.indd 1
3/21/13 10:02 PM
Summer 2013 | Claims Journal 11
IDEA EXCHANGE | Coverage Corner
Essentials: The Selective Tender Rule Rejected in the Workers’ Compensation Context
I
n the liability insurance context, the issue of allocating defense costs and indemnity payments arises between insurers on a regular basis. In the insurance context, equitable contribution permits the allocation of costs and indemnity where there is more than one potentially responsible insurance company. The doctrine of equitable contribution applies if an insurer undertakes a common obligation of another insurer and the doctrine presupposes the existence of two or more contracts of insurance that render the respective insurers equally liable for the discharge for a common obligation. See Steven Plitt & Jordan R. Plitt, Practical Tools for Handling Insurance Cases, (Thomson Reuters 2011). Equitable contribution permits By Steven Plitt reimbursement to the insurer that paid on the loss for the excess it paid over its proportionate share of the obligation so as to accomplish substantial justice by equalizing the common burden shared by coinsurers and to prevent one insurer from profiting at the expense of others. The doctrine of equitable subrogation applies only in those situations where coinsurers cover the same insured for the same particular risk at the same level of coverage. Equitable contribution is not allowed in the minority of jurisdictions which have The targeted tender adopted the doctrine has never been targeted tenapplied in the context of der doctrine. The states of workers’ comp. Illinois and Washington have generally adopted the targeted tender doctrine. See, e.g., John Burns Const. Co. v. Indemnity Ins. Co., (2000) (holding that the insured “had the right to choose which insurer would be required to defend and indemnify” and refusing to give effect to the “other insurance” clauses in the insurance contracts); Mutual of Enumclaw Ins. Co. v. U.S.F. Ins. Co., (2008) (finding that because an insured “chose not to tender to” one insurer, that insurer “had no legal obligation to defend or indemnify” the insured). However, a majority of courts have rejected the targeted tender doctrine. See, e.g., American States Ins. Co. v. National Fire Ins. Co. of Hartford. In this case, the court found the right to equitable contribution existed independently of the rights of the insured and was applicable. 12 Claims Journal | Summer 2013
The targeted tender doctrine has never been applied in the context of workers’ compensation. Even in the states of Illinois and Washington which have adopted the targeted tender doctrine generally, neither state has applied the doctrine to its workers’ comp insurance. Tender Doctrine and Workers’ Comp The question of whether the targeted tender doctrine should be applied in the workers’ compensation context was recently addressed by the Utah Supreme Court in Workers’ Compensation Fund v. Utah Business Ins. Co. (Utah 2013). In this case, Utah’s Workers’ Compensation Fund (WCF) brought a contribution action against a private workers’ compensation insurer, asserting that the private insurer was solely or jointly liable for benefits paid by the WCF in connection with a catastrophic injury that occurred while both the WCF policy and a separate private insurance policy were in effect. The private insurance company, Utah Business Insur-
ance Co. (Utah Business) argued that contribution was not appropriate because the injured worker tendered the workers’ comp claim to the WCF and that under the targeted tender doctrine, Utah Business could not be responsible for equitable contribution. The Utah Supreme Court held that the targeted tender doctrine was inconsistent with Utah’s workers’ compensation law. The court in Workers’ Compensation Fund began its analysis by recognizing that workers’ compensation in Utah was a matter of “clear and substantial public policy” and was of “overarching importance to the public,” citing Touchard v. La-Z-Boy Inc. (2006). Under Utah’s statutory scheme, an insurer becomes liable on a claim as soon as the employee informs the employer of the accident for which the claim is being made. In that regard, the Utah court found that an insurer is liable for accidents occurring during the coverage period whether or not the employer formally tenders a claim to the insurer. Describing Utah’s workers’ comp statutes, the court observed that the central purpose of the workers’ comp statutes was to ensure that employees were covered in the event of an accident. To accomplish that goal, the statutes created a highly regulated workers’ compensation scheme with bright-line rules: (1) insurers of record were liable on claims until coverage was cancelled by agreement with or notice to the employer and the Utah Labor Commission’s Division of Industrial Accidents, and (2) insurers were liable for injuries reported to employers regardless of whether employers formally tendered claims to the insurers. The targeted tender doctrine was inconsistent with this purpose. The targeted tender doctrine is premised on the right of the insured to choose whether and to whom to tender a claim. Under Utah’s workers’ compensation regime, no such right existed. Under the workers’ compensation scheme, all insurers on record with the Division were automatically liable for claims reported to employers. Therefore, the workers’ compensation regime foreclosed the adoption of a targeted tender doctrine in the context of
workers’ compensation. The Utah Supreme Court concluded that in cases involving dual workers’ compensation coverage, the only equitable and fair way to apportion the loss is to divide it equally. “Where multiple [workers’ compensation] insurance carriers insure the same insured and cover the same risk, each insurer has independent standing to assert a cause
of action against its coinsurers for equitable contribution when it has undertaken the defense or indemnification of the common insured,” citing American States Ins. Co. v. National Fire Ins. Co. of Hartford (2011). CJ Plitt is a nationally recognized expert in insurance law. He has authored numerous insurance treatises and articles. He has a national expert witness practice. Email: SP@ kunzlegal.com
BECAUSE THERE IS ALWAYS MORE TO THE STORY. Our expert team of engineers investigates appliances and components at one of the nation’s largest forensic laboratories. Reports include determination of failure mode and evaluation of subrogation potential. Call 800-482-5611 or visit donan.com today to find out more.
Services offered nationwide through Fixed-Price Mail-In Program. DONAN16589.indd 1
5/8/13 8:33 AM
Summer 2013 | Claims Journal 13
IDEA EXCHANGE | BEST PRACTICES
Retain Employees, Attract New Talent with Modern Core Systems
L
et’s face it: The insurance industry is not known for its stellar technology score card. For example, many insurers are still limping along with clunky, outdated core systems that limit productivity, hinder customer satisfaction and frustrate users. But these are not the only disadvantages insurers encounter by relying on dusty old systems. They also stand to lose out on attracting new, vibrant talent — and even retaining the employees they’ve got. sionals can innovate, collaborate and expand beyond levels they Modern Technology previously thought possible. These are some of the attributes While the current unemployment rate new candidates are hoping to find in the core system in which may indicate some desperation, most lookthey work each day. ing for a job (or a job change) likely still An ideal modern core system is also context-driven; that is, require the basics — competitive salary, the right person has instant access to all relevant information opportunity for growth and benefits — based on who they are, what they’re doing and when they need before deciding to take a new position. it. This idea of “context” is especially important in today’s insurIn the insurance industry, whether or ance environment, where tomes of data exist with no organized By Brian Reston not a company has deployed a modern core way to mine it for information specific to the task at hand. system is also a major consideration, especially since the typical Without the ability to put data in context, insurance professionlegacy system’s drawbacks are the stuff of nightmares. Potential als must rely on only the data and tools they can readily access, employees who are new to the industry might not know that which means leveraging internal data, past experiences, and a they have a preference for modern core systems, but even they patchwork of external data from vendors, industry groups and will quickly figure it out. As any industry veteran will confide, government. For those new to the company or insurance, this working hard to meet rising demands with an inflexible, inefcan be daunting. ficient system can drive away even the most loyal Context-driven core systems Modern core systems emerge as the best way to help insuremployees who find they can no longer cope with the aggravation and stress. ance professionals make informed deliver significant Indeed, fabled stories of legacy systems’ complexdecisions — and making informed deciity, inefficiency and inability to scale to meet a com- tangible benefits that sions means an employee, new or existing, is empowered for success. These pany’s growing, dynamic needs are plenty, and they can be measured in systems take a three-pronged approach carry over to tech-savvy candidates and employees. dollars and cents. to data: connecting data sources, curatFor these workers at the forefront of technological ing them for context, and funneling progress, intuitive interfaces and immediate access it all through an easy-to-use application. The context is then to context-driven information are not just nice to have. They are delivered instantly by that application into the daily workflow, expected. The archaic, cumbersome systems of the days of yore making it accessible when needed. are a complete mystery — one they won’t stick around to solve. Clearly, a modern core system that incorporates these functionalities makes for a happier employee base and lower Defining the Ideal Core System turnover, and makes the decision easier for a potential candi So, what is it about a modern core system that attracts and date focused on finding a long-term employment opportunity. helps to retain top talent? There’s no question that modern core systems deliver For many insurance companies, a system that automates significant tangible benefits that can be measured in dollars processes is the Holy Grail. And truly, this capability is imporand cents. But deploying a modern core system can also deliver tant. Not only is efficiency achieved, but by automating tasks, strategic benefits; namely, the ability to attract top talent by the insurance professional is better able to focus on higherstanding out in a market where the playing field is increasingly level, value-added tasks that can lead to other types of benefits leveled by technology. CJ like better cross-sell conversion, improved fraud detection, higher recoveries, and so on. However, by focusing singularly Retson is product marketing manager at Guidewire Software, a global provider of softon automation, a fundamental attribute is ignored: flexibility. ware products to property/casualty insurers. Email: bretson@guidewire.com. When flexibility is built into a core system, insurance profes-
14 Claims Journal | Summer 2013
DEPARTMENTS
Dollars & sense
33,775
The number of metal theft insurance claims for copper, bronze, brass or aluminum, according to a new report released by the National Insurance Crime Bureau (NICB). NICB found that 32,568 of those claims, or 96 percent, were for copper theft alone. The report, which reviewed metal theft claims from Jan. 1, 2010, through Dec. 31, 2012, revealed a 36 percent increase in claims when compared with claims reported between Jan. 1, 2009, and Dec. 31, 2011.
34%
The percentage increase in average insurance payment for a motorcycle injury claim after Michigan passed a new law requiring only riders younger than 21 years old wear helmets. The payment
was $5,410 in the two years before the new law; now the average payment is $7,257, according to a recent study by the Highway Loss Data Institute. continued on page 35
300%
The percentage increase in opioids between 2002 and 2011 tracked by the California Workers’ Compensation Institute.
$100,000
The total cost of a workers’ compensation injury claim found when prescriptions for certain opioid painkillers were prescribed, according to a recent study of more than 12,000 workers’ comp claims processed by Lansing, Mich.-based Accident Fund Holdings. According to the study, claims were almost four times as likely to have a total cost of $100,000 or more compared with claims without any prescriptions.
SO, DON’T UNDERESTIMATE THE PROBLEM. OR THE SOLUTION. Our forensic technicians perform on-site investigations of residential and light commercial HVAC units to determine the cause and extent of damage. Call 800-482-5611 or visit donan.com today to find out more.
11,000
The number of deaths attributed to drowsy driving from 2000 to 2010, according to federal statistics. DONAN16487.indd 1
3/21/13 10:09 PM Summer 2013 | Claims Journal 15
SPECIAL REPORT | managed care
Should Treating Psychosocial Factors Be the New Normal? E
ver wonder why some injured workers return to work relatively quickly while others with similar injuries linger off work much longer or maybe never return to work? Ever wonder why some employees seem to cope with pain so much better than others with the same diagnosis? So have many others, which is why there have been numerous studies on these issues over the past 20-plus years.
Psychosocial factors — a new buzzword in workers’ compensation — refer to a patient’s psychological and social issues that affect their recovery from the physical or biological injury. While many patients develop psychological problems as a result of their injury, they might have psychosocial issues from day-one that interplay on their recovery. There has been a recent trend by some in the workers’ compensation arena to pay close attention to these factors from the onset of a claim up until the end. These insightful individuals have come to understand that treating the physical injury only and ignoring the other issues in the injured worker’s life can be short-sighted. Instead, they look at the psychological and social aspects of the worker and attempt to determine which of these things might affect their recovery. If apBy Mitch propriate, they will apply the necessary Neuhaus resources to address the problems and, hopefully, speed up the recovery and return to work. Tools Questionnaires have become a popular tool to look for and identify issues that might have a bearing on an injured employee’s recovery time from a work injury. These can vary from a five-question Screener and Opioid Assessment for Patients with Pain (SOAPP) to a more detailed Orebro Musculoskeletal Pain Screening Questionnaire. These assessments typically are used to identify employees that are at high risk for responding poorly to the common medical treatment regimen. Not only can these questionnaires be used in the 16 Claims Journal | Summer 2013
early stages of a claim, but they can also be used later with a goal of addressing psychosocial factors as soon as possible before the recovery is sent off course. Some of the areas that these questionnaires measure are: • Pain attitudes, beliefs and perceptions; • Perception of work; • Mood/affect, catastrophizing; • Behavioral response to pain; and • Activities of daily living (ADLs). These questionnaires attempt to identify the probability that injured employees might develop problems during their recovery process. Examples of factors that might contribute to an employee’s risk for recovering poorly are: • History of drug or alcohol abuse; • Work dissatisfaction; • Family, legal or financial problems; • Low expectations of recovery; • Disabled spouse or young children at home; • Low wage earner; and • History of depression or moodiness. Low- and moderate-risk individuals can usually be managed with proper education but high-risk candidates might require additional resources to prevent them from becoming
long-term chronic Psychosocial factors refer handler’s arsepain or disability nal, addressto a patient’s psychologipatients. The intent ing an injured of the process is to employee’s cal and social issues that identify and manage psychosocial affect their recovery. the cognitive, behavissues and ioral and psychosoapplying the cial factors that interfere with recovery appropriate resources to manage them is from the employee’s physical impairment. one that has rarely been used in the past One treatment protocol that is gaining but is becoming more popular today. This traction in the workers’ compensation are- is arguably due to the favorable results na is Cognitive Behavioral Therapy (CBT). delivered. Likewise, CBT is also becoming This treatment focuses on techniques to change thinking patterns that might adversely affect the patient’s response to pain, such as getting the injured worker to change their view of an injury from overwhelming to manageable. It might also teach behavioral skills like relaxation or biofeedback in an effort to assist them to self-regulate psychosocial stimulation as well as pain. These tools can teach injured workers to monitor maladaptive thoughts and substitute them with positive thoughts. Most importantly, it should be used to convince the employee that treatment is relevant to their problem, and that they need to be actively engaged in the process. If they don’t buy into the treatment regimen then the results can be poor, regardless of the appropriateness.
more common to control some of these issues once identified. Claims handlers that are not currently employing this approach might be well served to investigate this further. Examining psychosocial factors could prevent claims from veering off track or assist in helping others to get back on track. CJ Neuhaus is vice president, claims at Safety National, a provider of excess workers’ compensation to self-insured employers and groups. Website: www.safetynational.com.
Concerns Claims handlers sometimes have concerns over adding a psychological component to the claim process. While this might be a legitimate concern, if handled appropriately, it can be avoided. There are two current procedural terminology (CPT) codes that can resolve the issue, CPT 96150 (the initial assessment of the patient to determine the biological, psychological and social factors affecting the patient’s physical health and treatment problems) and CPT 96152 (the intervention service provided to modify psychological, behavioral, cognitive and social factors affecting the patient’s physical health and well-being). No psychiatric diagnosis is required for the psychologist or psychiatrist to receive authorization for treatment or payment, and the unwanted psychiatric claim is avoided. While there are many tools in the claim Summer 2013 | Claims Journal 17
SPECIAL REPORT | Job & Salary Survey
Web Resource:
To listen to a podcast interview with Quinley Risk Associates’ Kevin Quinley visit: www.insurancejournal. tv/videos/9855/
18 Claims Journal | Summer 2013
Compensation Up As Adjusters Struggle With Heavy Caseloads, Staffing By Denise Johnson
I
n an economy where many haven’t seen a salary increase in years, claims adjusters are enjoying increases from 4 percent to 6 percent, which at least beats inflation. The average annual salary for claims adjusters nationwide is $73,000, according to the Claims Journal 2013 Job & Salary Survey. The survey results are based on responses from 647 participants in 46 states during April and May 2013. This is the second annual survey. The survey also confirms that staff adjusters make more than independents. The survey results reveal a stable and mostly satisfied workforce of aging adjusters who are less worried about keeping their jobs than they are about their caseload and about what they say is a lack of employer commitment to hiring experienced adjusters to replace the many who may soon be retiring. 10% 15%a Most adjusters work in an13%office but growing number also work from a home office. Almost 62 percent say they are satisfied with their overall compensation, according to the 2013 survey. More than 80 percent of adjusters work
between 35 and 50 hours per week. Nearly for their employer. There was a 6 percent increase among independent adjusters and 54 percent of respondents get 21 or more days off. a 3 percent jump among company staff as Despite the differences in salary, all management figures remained the same as last year. of the compensation increases reported — ranging from 4 percent to more than Adjuster Caseload Conundrum 6 percent — beat the current estimated The number of files handled by responinflation rate of 2 percent. dents varied widely, likely dependent on Staffing continues to remain stable. Claims department staffing remained level the line of insurance and adjuster experience. in 2012 with the majority of respondents Only 6 percent of adjusters had settle(73 percent) indicating they do not expect ment authority of $500,000 or more, while their claims departments to increase staff a combined 58 percent had authority up to size in 2013. $50,000 suggesting companies are cautious The majority of adjusters indicated it is continued on page 20 unlikely staff size will increase in 2013. Respondents agreed overall that staffing is a problem. Adjusters’ Claim Load One stated that “industrywide, I think staffing has al Adjuster Independent ways been too low in claims.” Adjuster The survey also found that Under 50 21% 38% while reduced staffing and 50-75 11% 19% increased work remain top 21% 41%among 7% claims11% 15% 12% 56% 5% 8% 17% 76-100 16% 7% 13% complaints adjusters, most continue to 101-125 10% 9% like their jobs. 126-150 13% 5% In fact, there was an 151-175 7% 9% increase since last year’s 176-200 6% 1% report in adjusters report 200 plus 16% 12% ing that they like working
Years of Experience Company Adjuster
Independent Adjuster
7%
10% 13%
41%
15%
5%
11%
55%
57% 17%
12%
6-10 16-20
8% 13%
15%
21%
0-5 11-15 21 plus
Company Management
0-5 11-15 21 plus
6-10 16-20
0-5 11-15 21 plus
6-10 16-20
Summer 2013 | Claims Journal 19
57%
SPECIAL REPORT | Job & Salary Survey
Worried About Their Job Company Adjuster
Independent Adjuster
18%
23%
77%
Yes
Yes
Where Adjusters Work
continued from page 19 despite adjusters’ years of experience. Kevin Quinley, founder and principal of Va.-based Quinley Risk Associates, says that the experience of the adjuster, complexity of the case, line of coverage, administrative support, technology and best practices are all factors that can affect an adjuster’s caseload. “More experienced adjusters…generally, you expect them to shoulder higher case loads than newbies,” Quinley said. Claims managers should be cautious, however, because the number of years of experience may not match the adjuster’s ability to grasp new concepts or complex claim scenarios. Quinley said some adjusters plateau after a certain number of years, so it’s important to not only look at the
20 Claims Journal | Summer 2013
82%
No
Yes
No
Business Lines Represented 16% 66% 19% 2%
Workers’ Compensation Auto (Personal and Commercial) Home Commercial General Liability Inland Marine
number of years of experience but also at the individualized capabilities of the employee. Administrative tasks like file set-up and photocopying can bog down adjusters, something that should be taken into consideration when assigning claims. “We need to be creative in how we develop solutions to alleviate some of the workloads for front line adjusters and supervisors,” offered one manager. Best practices and mandatory service standards can breed lower quality file handling for adjusters carrying a heavy workload, Quinley said. Twenty-four-hour contact on new claims, returning calls the same day, and detailed file documentation can impose an added-time demand that claims management hadn’t considered.
Average Salary Raise Company Adjusters Independent Adjusters Company Management
18%
82%
No
Work at Home Work in the Office Combination of Both Other
Company Management
29% 55% 43% 50% 23%
“When these are embedded in mandatory service standards they can dilute a claim rep’s ability to control and work the caseload,” he said. Quinley said it’s crucial for management to monitor adjuster caseloads to maintain file quality, staff morale, turnover and to control leakage. More importantly, it can save the company from bad faith claims. Based on an analysis by Demotech Inc., the official research partner of Claims Journal, the claims industry overall remains dominated by seasoned employees. Claims departments in the West and Midwest — at 29 percent each — generally employ less experienced adjusters, while 93 percent of East Coast insurers employ adjusters with six or more years of experience.
Average Annual Salary 9% -13% 6%
Adjuster Independent Adjuster Company Management
$73,339 $79,187 $110,730
When Employees Telecommute The majority of adjusters — 66 percent — continue to work in an office environment, according to the Claims Journal survey results. Almost 16 percent work from home, but a greater number of survey respondents — 19 percent — conduct work both at home and at an office. According to Chris Tidball, casualty claims consultant with San Diego-based Mitchell International, whether a claims department embraces telecommuting depends on the company and the culture. “There are pros and cons to everything. But I do think that depending upon the culture, there are carriers out there that are embracing it, and there are probably 5% 19% 33% some that are somewhat resistant to it,” 33% said Tidball. Whether the idea of telecommuting is accepted or not may also depend on the line of coverage. “I think that you find a lot of remote adjusters that are really PD [property damage] focused. For example, it might not make sense to open up a claims office in Montana. If you’re a large national carrier, you have policyholders there or in other remote locations. It might be cheaper to actually have an adjuster on your payroll that can do multiple assignments, as opposed to say hiring independent adjusters,” Tidball said. Some obstacles to telecommuting: employees need to have self-discipline and not be easily distracted. It’s also tougher to manage people, Tidball said. How a claims department’s best prac-
Companies With Talent Management Programs Adjuster Yes 44% No 56%
Independent Adjuster 20% 80%
Management 49% 51%
Talent Management Programs With Career Path Plan Adjuster Yes 41% No 59%
Independent Adjuster 19% 81%
10%
3%
14%
31%
34%
18%
Talent Management Programs With Educational Opportunities Adjuster Yes 61% No 39% tices affects its telecommuting policy is debatable. “How does telecommuting impact behaviors as opposed to working in an office? As you’re looking at your best practices, you have to take that into consideration. I may have to have some actual best practices in place that I wouldn’t have if everyone was in the office. It could be as simple as, what’s your Internet policy? You don’t want your people sitting at home on Facebook
Management 48% 52%
2%
14%
Independent Adjuster 30% 70%
34%
32%
Management 62% 38%
all day,” Tidball said. He said there might be stricter guidelines around Internet access, phone usage and the hours worked. There could be privacy concerns related to telecommuting, he said. “There could be. If you think about HIPAA, for example, if you are a medical claim rep, you’re working at home, you’re processing medical bills. You have people’s personal continued on page 22
Age Range Company Adjuster
10% 5% 19%
Independent Adjuster
18%
3%
14%
Company Management
18%
2%
14%
33% 33%
Under 30 41-50 Over 60
31-40 51-60
34%
Under 30 41-50 Over 60
31%
31-40 51-60
32%
Under 30 41-50 Over 60
34%
31-40 51-60
Summer 2013 | Claims Journal 21
18%
SPECIAL REPORT | Job & Salary Survey
Females vs. Male in Claims Industry
Males
Females
17%
22%
78%
83%
Yes
Yes
No
No
Claims Department Staff Changes in 2012 Adjuster Increased Staff Size 27% Decreased Staff Size 27% Stayed the Same in 2012 compared to 2011 46%
Independent Adjuster 26% 13% 61%
Adjuster Settlement Authority Adjuster Under $25,000 35% $25,000-$50,000 23% $50,000-$100,000 17% $100,000-$500,000 19% $500,000 plus 6%
Independent Adjuster 32% 15% 20% 16% 17%
Employee Job Satisfaction: Who Likes Their Job Comparison 2012 to 2013 Adjuster 2012 Yes 84% No 16% 2013 Yes 87% No 13% 22 Claims Journal | Summer 2013
Independent Management Adjuster 88% 12% 94% 6%
91% 9% 91% 9%
continued from page 21 information up on your computer screen from morning to night. By law, that can’t be shared with anybody. You do have to be cognizant that if you get up from your computer, you hit the control-alt-delete. Because even if it’s an accident, someone comes, your child or your spouse, they jump on a computer and either hit ‘send’ by accident and it goes to somebody else’s inbox...You could have problems there,” said Tidball. Another factor to consider is whether telecommuting affects job promotions. “I think it can. Nothing replaces face time with executives in an organization. They may hear about great things that people are doing. But a lot of those promotions come from those interpersonal interactions. Because they want to know that the future leaders embrace the culture, they have the personality to do the job, they have the professional acumen,” said Tidball. Another consideration is education and how adjusters learn on the job. “One of the things to consider is how we, as professionals, grow. Just thinking back on my own career, like many adjusters, we get hired, we go to claims school, we build those relationships that carry on for years. We move into a claims office. We often learn things from the people around us,” Tidball explained. “In claims school, you learn the textbook way of doing things. For example, I was trained in Cleveland, Ohio, but my first claims job was in an office in South Central Los Angeles. It’s a much different environment. The way claims are handled in that Southern California environment isn’t necessarily what’s taught in the textbook. I learned a lot of that from the people around me. In a remote location, it’s very difficult to learn that,” Tidball explained. “From a learning phase, being in the office during those critical, formative years, I think, is very important.” Talent Management Though there has been much discussion surrounding the aging claims workforce, employees report that many employers do not have talent management programs in place. A little over
half of the respondents to the Claims Journal 2013 Job & Salary Survey reported their company does not have a talent management program in place. Managers are most concerned with the “lack of incoming talent” and with companies that aren’t willing to spend money to attract and retain experienced employees. “Retirements will leave a void of experience which is not being replaced,” one manager said. In those companies that offer a talent management program, 61 percent said that it includes educational opportunities, but 59 percent said that the program does not include a career path plan. This, despite survey figures which indicate that while management age remained the same as last year, claims staff has gotten older. Talent Management Concerns As more employees appear to be staying put, companies may neglect their talent and retention strategies “out of a false sense of security,” according to a global talent survey, Talent 2020, released by Deloitte in 2012. However, the report warns that organizations’ top performers are also those with the most employment opportunities. “Instead of addressing broad concerns over high turnover rates, employers now face a more targeted challenge,” said Bill Pelster, principal and U.S. Talent Services co-leader, Deloitte Consulting LLP. “Companies must adjust their talent management initiatives to focus on retaining employees with the critical skills required to advance their business in today’s turbulent marketplace, as they pose the biggest flight risk.” Claims Journal survey respondents say they are worried that the claims talent pool is continuing to shrink as senior staff retire at a quickening rate. “Retaining key employees is not simply a human resources function,” said Pelster. “Instead, retention starts with the C-suite and extends through virtually every level of management, down to line managers and supervisors. Strong leadership is one of the most important factors in differentiating between an employee who is committed to their current job and one who is constantly searching for the next career opportunity.” CJ
Claims Management Top 2013 Concerns Technology Rollout Budget Tightening/Layoffs Senior Personnel Retiring Lack of Education Funds
46% 56% 32% 14%
Average Overall Compensation Increase Company Adjusters Independent Adjusters Company Management
4% -5% 6%
Talent Management Tips
T
alent management programs are geared toward attracting, recruiting and retaining top talent. Deloitte teamed with Forbes Insights for its fourth report in the Talent 2020 series, surveying employees across major industries and global regions, to explore the changing priorities and needs of employees at global and large national companies. Based on the results and Deloitte’s analysis of the talent market, Deloitte identified three recommendations for managers: • Engage employees with meaningful work or watch them walk out the door. Employees value meaningful work over other retention initiatives. A majority (42 percent) of respondents who have been seeking new employment believe their job does not make good use of their skills and abilities. • Focus on “turnover red zones.” Employee segments at high risk of departure, or “turnover red zones,” are employees with less than two years on the job and Millennial employees (those aged 31 and younger). • When it comes to retention, leadership matters. More than six in 10 employees (62 percent) who plan to stay with their current employers report high levels of trust in corporate leadership. Other factors such as trust in leadership, effective communication and a company’s ability to execute on its strategy can also differentiate between an employee who is committed to his or her current job or an employee who is searching for the next opportunity, according to Deloitte. CJ
Summer 2013 | Claims Journal 23
CLAIMS REVIEW | SNAPSHOT
Before and After: Seaside Heights, N.J.
H
urricane Sandy was the second costliest hurricane in United States history. Potvin Partners, Satellite Imaging, shows satellite imagery of Seaside Heights, N.J., before and after the destructive hurricane. The second image was taken one day after the event on Oct. 31, 2012. This service provided more than 30,000 square kilometers of post Sandy imagery for clients. CJ
After
Before
Volunteer • Give • Make an Impact Join IICF Week of Giving October 12-19, 2013
Bring your talent and energy Help your community • Join other insurance professionals Sign up your volunteer team at IICF.org/volunteer. Week of Giving funds will support the IICF-Sesame Workshop early childhood literacy initiative, Every Day is a Reading and Writing Day. Text INSURANCE to 50555 to donate $5* or donate at IICF.org. *Standard message and mail rates apply. For full terms visit www.mGive.org/T. The Insurance Industry Charitable Foundation is a registered not-for-profit organization under section 501(c)(3) of the IRS code. Federal Tax ID #20-1240972.
IICF16632.indd 1
24 Claims Journal | Summer 2013
6/10/13 9:11 AM
How much are these common claim-handling weaknesses costing you?
What issues challenge your staff and what to do to eliminate them.
ValeInfo.com/errors
No manager wants their appraisers, adjusters and estimators passing out blank checks, but if their claim-handling skills aren’t sufficient, the misapplications, oversights and errors they commit could be just as costly. For example, the difference between repairing or replacing a set of kitchen cabinets when adjusting a fire loss can be anywhere from $3,000 to $12,000. And that’s just one example of the kind of misjudgments we see both beginners and experienced professionals make all too often. In fact, we’ve identified five types of weaknesses including: (1) policy interpretation; (2) basic practices; (3) core knowledge; (4) estimating proficiency and (5) technology application that challenge even the most efficient and profitable claims departments. To see which issues are the biggest obstacles for your staff and what to do to eliminate them, call us or visit our website today.
ValeInfo.com /errors Call Toll-free (USA & Canada) 800-233-7095 www.valetrainingsolutions.com A member of the Cunningham Lindsey Group
where learning is engaging
Your complete resource for online continuing education as well as comprehensive mastery programs for: Automotive and Property Damage Estimating • Property, Casualty and Workers’ Compensation Adjusting • Tractor-Trailer, CA EQ, PDR and other specialty courses.
SM
2013
GUIDE TO CLAIMS
EDUCATION & TRAINING C
laims Journal is pleased to publish the 2013 Guide to Claims Education and Training. This exclusive resource directory has been designed to help claims professionals find educational and training opportunities to enhance their professional growth.
Education and training providers, including insurance schools, associations, various vendors and instructors submitted information on their course offerings, online educational capabilities and correspondence education directly to Claims Journal. While this directory is only a snapshot of the vast array of education and training courses available to the industry, we hope you find it helpful when searching for the right provider for your organization. We look forward to expanding and enhancing this guide in the future and welcome your feedback on how we might improve it. Please send any comments or suggestions about the guide to editorial@claimsjournal.com. To submit a listing, e-mail Kristine Honey at: khoney@claimsjournal.com.
Organization: 360training.com Contact: Tricia Sharpton Email: tricia.sharpton@360training.com Address: 13801 N. MoPac, Austin, TX 78727 Phone: 866-360-TRNG ; Fax: 512-441-1811 Website: www.360training.com
Organization: AdjusterPro Contact: John O’Brien Email: info@adjusterpro.com Address: P.O. Box 1087, Fort Scott, KS 66701 Phone: 214-329-9030 ; Fax: 214-580-5519 Website: www.adjusterpro.com
Educational Offerings: Professional Ins. Designation Programs, Individual Courses Online Courses: yes Correspondence Courses: yes
Educational Offerings: Professional Ins. Designation Programs, Individual Courses Online Courses: yes Correspondence Courses: no
Course: Insurance CE Start Date: Any Time Location: All States Category: Insurance CE Designation: No Designation
Course: Texas All-Lines Adjuster PreLicensing Start Date: Any Time Location: Classroom or Online Category: Property Casualty Insurance Designation: No Designation
Course: Pre-License/Exam Prep Start Date: Any Time Location: All States Category: Insurance Pre-License Designation: No Designation
Course: Florida Certified Adjuster (CA) Designation Start Date: Any Time Location: Classroom or Online Category: Property Casualty Insurance Designation: No Designation
Course: Texas Insurance Adjuster License Start Date: Any Time Location: All States Category: Insurance Adjusters Designation: No Designation
26 | CLAIMS JOURNAL- Summer 2013
Course: Indiana Independent Adjuster PreLicensing Start Date: Any Time Location: Classroom or Online Category: Property Casualty Insurance Designation: No Designation
Organization: Affordable Continuing Education Contact: Jessie Booth Email: Jessie@SuccessCE.com Address: 2 Corporate Plaza Dr., Ste. 100 Newport Beach, CA 92660 Phone: 949-706-9197 ; Fax: 949-706-9439 Website: www.AffordableCE.com Educational Offerings: Professional Ins. Designation Programs, Individual Courses Online Courses: yes Correspondence Courses: yes Course: Contemporary Insurance Topics Start Date: Any Time Location: All States Category: Property Casualty & Life/Health Ins Designation: P&C and L&H Insurance Agents Course: Personal Lines Total Coverage Start Date: Any Time Location: All States Category: Property Casualty Insurance Designation: P&C Insurance Agents Course: Flood Insurance Start Date: Any Time Location: All States Category: Property Casualty Insurance Designation: P&C Insurance Agents
Organization: Affordable Educators (California CE and Prelicense Training) Address: 41890 Enterprise Cir. S, Ste. 100 Temecula, CA 92590 Phone: 800-498-5100 Website: www.ceclass.com
Educational Offerings: Professional Ins. Designation Programs, Individual Courses, Undergrad Ins. Courses/Programs (Accredited) Online Courses: yes Correspondence Courses: no
Educational Offerings: Individual Courses Online Courses: yes Correspondence Courses: yes
Course: Life & Health Pre-Licensing Start Date: Any Time Location: Many States Category: Life, Health, Benefits Designation: Licensing Exam Prep
Course: Ins. Marketing Issues (Includes Ethics) Start Date: Any Time Location: CA Category: Ethics Designation: No Designation
Course: Property & Casualty Pre-Licensing Start Date: Any Time Location: Many States Category: Property Casualty Insurance Designation: Licensing Exam Prep
Course: Preferred Practices Start Date: Any Time Location: CA Category: Property Casualty Insurance Designation: No Designation
Course: Property Pre-Licensing Start Date: Any Time Location: Many States Category: Property Casualty Insurance Designation: Licensing Exam Prep
Course: Under Forty Organization Annual Meeting Start Date: Sept 12-14, 2013 Location: Rockport, ME Category: Property Casualty Ins, Surplus Lines Designation: CIW, CMGA Course: Automation & Technology Conf. Start Date: Mar 1-4, 2014 Location: Orlando, FL Category: Property Casualty Ins, Surplus Lines Designation: CIW, CMGA Organization: ClaimSchool Contact: Barry Zalma Email: zalma@zalma.com Address: 4441 Sepulveda Blvd. Culver City, CA 90230 Phone: 310-390-4455 ; Fax: 310-391-5614 Web: www.claimschool.com, www.webce.com & adbanker.com
Educational Offerings: Individual Courses Online Courses: yes Organization: American Association of Correspondence Courses: yes Insurance Services (AAIS) Location: At Your Location Contact: Joseph S. Harrington, CPCU Email: joeh@AAISonline.com Course: California Fair Claims Practices Address: 1745 S. Naperville Rd. Regulations Wheaton, IL 60189 Start Date: Any Time Phone: 630-681-8347 ; Fax: 630-681-8356 Organization: Agency Management Resource Category: Agency Management Website: www.AAISonline.com Group Designation: No Designation Contact: Jackie Abeyta, CE Compliance Mgr Email: jackie@agencymanagement.com Educational Offerings: Educational materials Course: Insurance Fraud and Weapons to Address: 950 Reserve Dr., Ste. 140 for individual insurance line programs Fight Fraud™ Roseville, CA 95678 Online Courses: no Start Date: Any Time Phone: 916-757-6150 ; Fax: 916-780-6181 Correspondence Courses: no Category: Agency Management Website: www.agencymanagement.com Designation: No Designation Course: A variety of materials to support the Educational Offerings: Agribusiness & Farm use of AAIS products Course: Insurance Claims For the Property Insurance Specialist Designation Program Start Date: Any Time Owner or Mortgage Holder Online Courses: no Location: All States Start Date: Any Time Correspondence Courses: no Category: Property Casualty Insurance Category: Other Designation: No Designation Course: Agribusiness & Farm Insurance Specialist Parts 1, 2 and 3 Organization: American Association Start Date: Multiple of Managing General Agents Organization: Crawford & Company Location: Multiple Contact: Jeffrey D. Henry Contact: Joel Sybert Category: Property Casualty Email: Jeff@aamga.org Email: www.kmcondemand.com, Address: 610 Freedom Business Ctr, Ste. 110 www.kmcondemand.com/ptc King of Prussia, PA 19406 Course: Agribusiness Conference Breakout Address: 1001 Summit Blvd. Phone: 610- 992-0005 ; Fax: 610- 992-0021 Sessions Atlanta, GA 30319 Website: www.aamga.org Start Date: Multiple Phone: 404-300-1251 Location: Multiple Website: www.crawfordandcompany.com Category: Property Casualty Educational Offerings: Professional Ins. Designation Programs, Individual Courses Educational Offerings: Professional Ins. Online Courses: yes Designation Programs, Individual Courses Correspondence Courses: no Organization: America’s Professor Online Courses: yes Contact: Dr. Jack Morton Correspondence Courses: no Email: info@americasprofessor.com Course: AAMGA University West Address: 1819 Holborn St., Ste. E Start Date: Aug 15-16, 2013 Missoula, MT 59802 Location: Newark, NJ Phone: 800-870-3130 ; Fax: 406-549-8560 Category: Property Casualty Ins, Surplus Lines Website: www.AmericasProfessor.com Designation: CIW, CMGA Course: California Ethics Requirement Start Date: Any Time Location: CA Category: Ethics Designation: No Designation
Summer 2013 - CLAIMS JOURNAL | 27
Guide to Claims Education and Training Course: Property Technical Cert (PTC I) Start Date: Any Time Location: All States Category: Property Casualty Insurance Designation: PTC Course: Workers’ Compensation Program I-IV Start Date: Any Time Location: All States Category: Workers’ Compensation Designation: Other Course: Basic Work Comp Virtual Classroom Start Date: See Website Location: Virtual Category: Workers’ Compensation Designation: Other
Organization: Focal Insurance Organization: HMI Contact: Brenda Austin Contact: Douglas Malawsky Email: focalinsurance@aol.com Email: dougm@hmiadvantage.com Address: P.O. Box 175, Pomona, NY 10970 Address: 107 Edinburgh South Dr., Ste. 205 Phone: 845-354-2036 ; Fax: 845-354-4779 Cary, NC 27511 Website: www.focalinsurance.com Ph: 919-460-5445, x 25 ; Fax: 877-796-4626 Website: www. hmiadvantage.com Educational Offerings: CE & Pre-Licensing Courses (Classroom & Self Study) Educational Offerings: Individual Courses Online Courses: no Online Courses: no Correspondence Courses: yes - self-study Correspondence Courses: no
Course: P&C & Personal Lines Pre-Licensing Start Date: Apr 8–Jul 26, ‘13 (Rockland, NY) Jul 15 – Aug 2, 2013 (Westchester, NY) Jul 15 – Aug 2, 2013 (Queens, NY) Aug 12 – Aug 30, 2013 (Brooklyn, NY) Category: Insurance - P&C; Life Accident & Health & Annuities Organization: Discovery Detective Academy Designation: Agent/Broker’s License Email: ops@discoverydetectivegroup.com Phone: 480-951-6545 Website: discoverydetectiveacademy.org Educational Offerings: Individual Courses Online Courses: yes Correspondence Courses: no Course: Professional Investigator Start Date: Any Time Location: Many States Category: Risk Management & Safety Designation: ARM-Associate in Risk Mgmt Course: Fraud Investigations Start Date: Any Time Location: Many States Category: Risk Management & Safety Designation: ARM-Associate in Risk Mgmt
Organization: Haag Education Contact: Ryan Holdhusen Email: education@HaagGlobal.com Address: 4949 W. Royal Ln, Irving, TX 75063 Ph: 214-614-6500 ; Fax: 214-614-6501 Website: www.HaagEducation.com Educational Offerings: Individual Courses Online Courses: yes Correspondence Courses: no
Course: Haag Certified Inspector - Residential Roofs Start Date: Many Location: Many States Category: Property Casualty Insurance, Damage Assessment Organization: First Party Claims Conference Designation: Adjuster/Agent CE Credit Contact: David Barrack available for many states Email: info@firstpartyclaims.com Address: Potomac Falls, VA 20165 Course: Haag Certified Inspector Phone: 703-433-2520 ; Fax: 703-433-0369 Commercial Roofs Website: www.firstpartyclaims.com Start Date: Many Location: Many States Educational Offerings: Professional Ins. Category: Property Casualty Insurance, Designation Programs, Individual Courses Damage Assessment Online Courses: no Designation: Adjuster/Agent CE Credit Correspondence Courses: no available for many states Course: Advanced Interviewing Techniques Start Date: Any Time Location: Many States
Course: First Party Claims Conference Start Date: Oct 21-23, 2013 Location: Crowne Plaza Hotel, Warwick, RI Category: Property Casualty Insurance, Ethics Designation: Up to 15 CE Credits for Adjusters (multi-line). Open to accountants, agents, attorneys, brokers, engineers & others. 28 | CLAIMS JOURNAL- Summer 2013
Course: Composition Roofs Damage Assessment - 2 Hr Online Start Date: Any Time Location: Online Category: Property Casualty Insurance, Damage Assessment Designation: Adjuster/Agent CE Credit available for many states
Course: Adjusting for Tree Damage and Landscape Loss Start Date: Any Time Location: Many States Category: Property Casualty Insurance Designation: AIC – Associate in Claims - CE Credits for Adjusters Organization: IIAB of NY, Inc. Contact: Education Dept Email: edu@iiabny.org Address: 5784 Widewaters, Dewitt, NY 13214 Phone: 800-962-7950 ; Fax: 888-432-0510 Website: www.iiabny.org Educational Offerings: Professional Ins. Designation Programs, Individual Courses Online Courses: yes Correspondence Courses: no Course: New York Automobile Insurance Plan Certification Program Start Date: Any Time Location: Cities across New York Category: NYAIP Certification Course: E&O Loss Prevention Seminars Start Date: Any Time Location: Cities across New York Course: Accredited Adviser in Insurance Start Date: Any Time Location: Cities across New York Category: Property Casualty, Agency Mgmt Designation: AAI – Accredited Adviser in Ins. Organization: Independent Insurance Agents of Texas (IIAT) Contact: Stephanie Freitag, Education Mgr. Email: sfreitag@iiat.org ; educinfo@iiat.org Address: 1115 San Jacinto, Ste. 100 Austin, TX 78701 Phone: 800-880-7428 ; Fax: 512-469-9512 Website: www.iiat.org Educational Offerings: Professional Ins. Designation Programs, Individual Courses Online Courses: yes Correspondence Courses: no
Course: Certified Account Manager Program Start Date: see schedule online - iiat.org Location: Many Cities Category: Customer Service, Technical Knowledge Designation: CAM – Certified Account Mgr Course: Construction Risk & Insurance Specialist Start Date: see schedule online - iiat.org Location: Many Cities Category: Commercial Property Casualty, Property Casualty Ins, Risk Mgmt & Safety Designation: CRIS - Construction Risk & Insurance Specialist Course: Producer Development Program Start Date: see schedule online - iiat.org Location: Austin, TX Category: Agency Mgmt, Commercial & Personal P&C, Customer Service, Ethics, Risk Mgmt & Safety Organization: Infinity Schools Contact: Greg Mckewen Email: info@infinityschools.com Address: 1310 Esplanade, Ste. 317 S Redondo Beach, CA 90277 Phone: 800-600-2550 ; Fax: 424-247-9050 Website: www.infinityschools.com Educational Offerings: Individual Courses Online Courses: yes Correspondence Courses: yes Course: Unlimited CE Packages ONLY $36.95 Start Date: Any Time Location: Nationwide Category: Property Casualty Insurance Designation: Continuing Education & PreLicense Training Course: Ethics the Guide to Success Start Date: Any Time Location: Nationwide Category: P&C Insurance – 5 Credit Hours Designation: Continuing Education & PreLicense Training Course: Understanding Umbrella Coverage Start Date: Any Time Location: Nationwide Category: Commercial P&C -15 Credit Hours Designation: Continuing Education & PreLicense Training
Educational Offerings: Professional Ins. Designation Programs, Individual Courses Online Courses: yes Correspondence Courses: no Course: Insurance Success Seminars Start Date: May 14-16, Sept. 10-12, Nov. 5-7 Location: PA Category: Sales/Marketing Designation: CPIA – Certified Professional Insurance Agent Course: Pa. Licensing Exam Preparation Start Date: Varies by month Location: Pa. - Multiple Locations Category: Property Casualty Insurance
Organization: Insurance Educational Assoc. Contact: Patty Gibson Carlson Email: info@ieatraining.com Address: 725 W. Town & Country Rd., Ste. 430, Orange, CA 92868 Phone: 714-689-0161; Fax: 714-689-0112 Website: www.ieatraining.com Educational Offerings: Professional Ins. Designation Programs, Individual P&C Courses & Workshops Online Courses: yes - plus classroom, Telecourse and video Correspondence Courses: no
Course: Certificates of Insurance Start Date: Any Time Location: Anywhere Category: Property Casualty Insurance
Course: Online Self Study Start Date: Any Time Location: All States Category: Workers’ Comp, Agent/Broker Prelicensing, Disability Mgmt Designation: WCCA, WCCP, CPDM
Organization: Insurance Community Center and University
Course: Online Instructor Led (Tele-Learning) Start Date: Feb, May, Sep Location: All States Category: Commercial & Personal P&C, Risk Management, Claims Designation: AINS, ARM, CPCU, AIC, AU, WCCA, WCCP, CPDM, CPFI, ARPM, CCMP
Contact: Barbara Thorvilson and Laurie Infantino Em: barbara@insurancecommunitycenter.com Em: laurie@insurancecommunitycenter.com Address: 78-365 Highway 111, Ste. 388 La Quinta, CA 92253 Phone: 303-219-3586 ; Fax: 760-645-6285 Website: www.insurancecommunitycenter.com Educational Offerings: Individual Courses Online Courses: yes - Live Interactive Webinars Correspondence Courses: no Start Dates: See webinar calendar: http:// insurancecommunityuniversity.com/ CEWebinarsCalendar.aspx Course: Education Tracks - includes over sixty individual topics annually Location: Live Interactive Webinars Category: Commercial & Personal Lines, Employee Benefits, Agriculture & Contractors Insurance Designation: No, but does qualify for CE in several states
Course: Insurance Basics Location: Live Interactive Webinars Category: Ethics, E&O, Certificates and Additional Insureds, Real Estate Leases Organization: Insurance Agents & Brokers Course: Hot Topics and What’s New in the Contact: Jessica McWilliams Industry Email: iab@iabgroup.com Location: Live Interactive Webinars Address: 5050 Ritter Rd. Category: Cyber Liability, Discussion of Mechanicsburg, PA 17055 New Form Changes, Vacancy, Un-occupancy, Phone: 800-998-9644 ; Fax: 717-795-8347 Foreclosure, Insurance Topics in the News Website: www.iabgroup.com/education
Course: Classroom Training including On-Site Custom Classes Start Date: Feb, May, Sep -workshops continuous Location: CA, AZ Category: Commercial & Personal P&C, Ethics, Risk Management Designation: AINS, ARM, CPCU, AIC, WCCA, WCCP, CPDM Organization: Insurance Journal Academy of Insurance Contact: Chris Boggs Email: cboggs@IJAcademy.com Phone: 800-897-9965 ; Fax: 619-584-1200 Website: www.IJAcademy.com Educational Offerings: Individual Courses Online Courses: yes Correspondence Courses: no Course: Practical Workers’ Compensation: What You Need To Know Start Date: On Demand Location: Online Category: Property Casualty Insurance Summer 2013 - CLAIMS JOURNAL | 29
Guide to Claims Education and Training Course: The Proper Care and Feeding of Certificates of Insurance Start Date: On Demand Location: Online Category: Property Casualty Insurance
Course: Long Term Care Start Date: Any Time Location: All States Category: Life, Health, Benefits Designation: CIIP- Certified Insurance Industry Professional
Course: The Real Effects of Granting Additional Insured Status Start Date: On Demand Location: Online Category: Property Casualty Insurance, Sales/ Marketing
Course: Underwriting Start Date: Any Time Location: All States Category: Property Casualty Insurance Designation: CIIP- Certified Insurance Industry Professional
Course: Practical and Applicable E&O Tips Start Date: On Demand Location: Online Category: Agency Management Course: How to Read and Understand Any Insurance Policy Start Date: On Demand Location: Online Category: Property Casualty Insurance Organization: International Association of Insurance Professionals
Contact: Mark Adams Email: evp@iaip-ins.org Address: 9343 E. 95th Ct S, Tulsa, OK 74133 Phone: 918-294-3700 ; Fax: 918-294-3711 Web: internationalinsuranceprofessionals.org Educational Offerings: Professional Ins. Designation Programs, Individual Courses Online Courses: no Correspondence Courses: no Course: Certified Leadership Program Premier learning program aimed at developing essential leadership skills for career development. The program consists of 4 modules encompassing 17 course topics. Courses are offered in an instructor led environment or may be taken self study. Start Date: Any Time ; Location: All States Category: Property Casualty Insurance Designation: CLP - Certified Leadership Prof. Course: Professional Ethics Start Date: Any Time Location: All States Category: Ethics Designation: CIIP- Certified Insurance Industry Professional
30 | CLAIMS JOURNAL- Summer 2013
Course: Construction Risk and Insurance Specialist (CRIS®) Start Date: Any Time Location: All States Category: Risk Management & Safety, Sales/ Marketing Designation: CRIS® - Construction Risk & Insurance Specialist
Course: Management Liability Insurance Specialist (MLIS®) Start Date: Any Time Location: All States Category: Sales/Marketing, Prof. Liability, D&O, EPL and Fiduciary Liability exposures Organization: International Insurance Institute Designation: MLIS® - Management Liability Insurance Specialist Contact: Carl Van Email: CarlVan@InsuranceInstitute.com Address: 2112 Belle Chasse Hwy. #11-319 Course: General Insurance CE Gretna, LA 70056 Start Date: Any Time Phone: 504-393-4570 ; Fax: 504-393-4571 Location: All States Website: www.InsuranceInstitute.com Category: Commercial & Personal Lines, Life & Health Educational Offerings: Individual Courses Online Courses: yes Correspondence Courses: no Organization: International Society Of Workers Compensation Specialists Course: Exceptional Claims Customer Service Contact: Bill Reynolds Start Date: Any Time Email: bill@isowcs.org Location: All States Address: 6688 Joliet Rd., Ste. 253 Category: Customer Service Indian Head Park, IL 60525 Designation: CE Phone: 312-286-1956 ; Fax: 708-401-0755 Website: www.isowcs.org Course: Negotiation Skills for Claims Professionals Educational Offerings: Professional Ins. Start Date: Any Time Designation Programs Location: All States Online Courses: yes Category: Property Casualty Insurance Correspondence Courses: no Designation: CE Course: Certified Injury Prevention Specialists Course: Time Management for Claims Start Date: Any Time Start Date: Any Time Location: All States Location: All States Category: Workers’ Compensation Category: Property Casualty Insurance Designation: CE Course: Certified Claim Mgmt. Specialists Start Date: Any Time Location: All States Organization: International Risk Management Category: Workers’ Compensation Institute, Inc. (IRMI) Contact: Millie Workman Course: Certified Premium Audit Specialist Email: millie.w@irmi.com Start Date: Any Time Address: 12222 Merit Dr., Ste. 1450 Location: All States Dallas, TX 75251 Category: Workers’ Compensation Phone: 800-827-4242 ; Fax: 972-371-5120 Website: www.IRMI.com/CE Organization: Kaplan Financial Education Educational Offerings: Professional Ins. Contact: Louie Valencia Designation Programs, Individual Courses Email: Louie.Valencia@Kaplan.com Online Courses: yes Address: 1900 Ballpark Way Correspondence Courses: no Arlington, TX 76006 Phone: 800-824-8742 Website: www.kpsTexas.com
Educational Offerings: Insurance & Securities Courses/Programs (Accredited) Online Courses: yes Correspondence Courses: yes
Course: INS 415 - Risk Management Organization: Missouri Association of Start Date: Jan 2014 Insurance Agents Location: Springfield, MO Contact: Emily Koenigsfeld Category: Risk Management Safety Email: maia@moagent.org Designation: ARM – Associate in Risk Address: P.O. Box 1785 Management Course: Professional License Courses Jefferson City, MO 6502-1785 Start Date: Any Time Phone: 800-617-3658 Location: TX Website: www.missouriagent.org Category: Other Organization: National Association of Designation: Various Catastrophe Adjusters, Inc. Educational Offerings: Professional Ins. Contact: Lori Ringo Course: Real Estate Courses (TREC approved) Designation Programs, Individual Courses Email: naca@nacatadj.org Online Courses: yes Start Date: Any Time Address: P.O. Box 821864 Correspondence Courses: no Location: TX N. Richland Hills, TX 76182 Category: Other Phone: 817-498-3466 Designation: Various Course: Risk Specialist Series Website: www.nacatadj.org Start Date: Multiple Location: Jefferson City Course: Inspection Courses Educational Offerings: Individual Courses Category: Property Casualty Niche Markets Start Date: Any Time Online Courses: no Location: TX Correspondence Courses: no Category: Other Course: Errors and Omissions Seminars Designation: Various Start Date: Multiple Course: Various courses in conjunction with Location: Multiple our annual convention Category: Risk Management, Ethics Start Date: Jan 13, 14, 15, 2013 Organization: Katie School of Insurance Location: Panama City Beach, FL Contact: Jim Jones - Director Course: CIC Institutes Category: Property Casualty & Personal Email: jrjone2@ilstu.edu Start Date: Multiple Property Casualty insurance Address: Campus Box 5490 Location: Multiple Normal, IL 61790 Category: Agency Management, Property Phone: 309-438-3021 ; Fax: 309-438-7753 Casualty Insurance, Life, Health, Benefits Organization: National Flood Insurance Website: www.katieschool.org Designation: CIC – Certified Insurance Program - NFIP/FEMA Counselor Contact: L. Savino Educational Offerings: Professional Ins. Email: NFIPS2@aol.com Designation Programs, Individual Courses, Address: P.O. Box 210, Adelphia, NJ 07710 Undergrad Ins. Courses/Programs (Accredited) Organization: Missouri State University Phone: 732-625-TEACH Fax: 732-625-0828 Online Courses: no Contact: Dr. Stan Adamson Website: www.NFIPS.com Correspondence Courses: no Email: stanleyadamson@missouristate.edu Address: 901 S. National Educational Offerings: Individual Courses Springfield, MO 65897 Course: Ethical Decision-Making Online Courses: yes Phone: 417-836-6686 ; Fax: 417-836-6224 Start Date: Any Time Correspondence Courses: no Web: www.missouristate.edu/academics/details. Location: Many States aspx?id=81570 Category: Ethics Course: FEMA Flood Course Designation: Other Start Date: Call or Email to Schedule Educational Offerings: Undergrad Ins. Location: All States Courses / Programs (Accredited) Course: Leading Strategic Change Category: Property Casualty Insurance Online Courses: yes Start Date: Any Time Designation: Continuing Education Credits Correspondence Courses: no Location: Many States Category: Management Designation: Other Course: INS 313 - Commercial Insurance Organization: New Level Partners Start Date: Aug 2013 Contact: Nancy Langton Location: Springfield, MO Course: Developing Financial Acumen Email: nlangton@newlevelpartners.com Category: Commercial Property Casualty Start Date: Any Time Address: 100 Overlook Center, 2nd Fl Designation: CPCU – Chartered Property Location: Many States Princeton, NJ 08540 Casualty Underwriter Category: Insurance Finance Website: www.newlevelpartners.com Designation: Other Course: INS 211 - Insurance Educational Offerings: Individual Courses Start Date: Spring or Fall each year Online Courses: yes Location: Springfield, MO and Online Correspondence Courses: no Category: Personal Property Casualty Designation: Intro to Insurance Course: Commercial Lines Insurance Basics (25 course series) Start Date: Any Time Location: All States Category: Commercial Property Casualty Summer 2013 - CLAIMS JOURNAL | 31
Guide to Claims Education and Training Course: Personal Lines Insurance Basics (12 course series) Start Date: Any Time Location: All States Category: Personal Property Casualty Designation: New hire training Course: Business Skills for Account Managers (12 course series) Start Date: Any Time Location: All States Category: Customer Service Designation: New hire training Organization: Polestar Performance Programs Contact: Shari Norris Email: snorris@gopolestar.com Address: 1620 Central Ave., Ste. 202 Cheyenne, WY 82001 Phone: 888-934-2226 ; Fax: 866-313-9225 Website: www.gopolestar.org Educational Offerings: Individual Courses Online Courses: yes Correspondence Courses: no Course: Claims Broker Program Start Date: Any Time Category: Sales/Marketing - Carrier Designation: No Designation Course: Producer Development Program Start Date: Any Time Category: Agency Management Designation: No Designation Course: Underwriter Development Program Start Date: Any Time Category: Sales/Marketing - Carrier Designation: No Designation Organization: Professional Liability Underwriting Society Contact: Deb Ropelewski Email: dropelewski@plusweb.org Phone: 952-746-2580 ; Fax: 952-746-2599 Website: www.plusweb.org Educational Offerings: Professional Liability Ins. Designation Programs Online Courses: no Correspondence Courses: no Course: Registered Prof. Liability Underwriter Start Date: Any Time Location: All States (Self-study) Designation: RPLU; RPLU+ Course: PLUS International Conference Start Date: Nov 4-6, 2013 Location: Orlando, FL Category: Other 32 | CLAIMS JOURNAL- Summer 2013
Course: D&O, Med PL, Professional Risk Symposia Start Date: Check website for dates & locations Category: Other
Course: Ethics and the Insurance Agent (meets Ethics requirement) Start Date: Any Time Location: Many States Category: Ethics, Commercial & Personal P&C, Life/Health/Benefits Designation: No Designation Organization: Public Risk Management Association (PRIMA) Email: info@primacentral.org Organization: SNL Knowledge Center Address: 700 S. Washington St., Ste. 218 Contact: Maureen Hollar Alexandria, VA 22314 Email: center@snl.com Phone: 703-528-7701 ; Fax: 703-739-0200 Address: P.O. Box 2016 Website: www.primacentral.org Charlottesville, VA 22902 Phone: 434-951-7786 ; Fax: 434-984-8038 Educational Offerings: Individual Courses Website: www.snlcenter.com Online Courses: yes Correspondence Courses: no Educational Offerings: Individual Courses Online Courses: no Course: Risk Management for Public Entities Correspondence Courses: no (RMPE352) - B Start Date: Any Time Course: Life and P&C Insurance Statutory Location: Online Accounting & Reporting Category: Risk Management & Safety Start Date: Various throughout the year Location: New York, NY Course: Associates in Risk Mgmt. (ARM54) Category: Agency Management, Finance Start Date: Any Time Location: Online Course: Financial Analysis of Life and P&C Category: Risk Management & Safety Insurers Designation: ARM - Associate in Risk Start Date: Various throughout the year Management Location: New York, NY Category: Agency Management, Finance Course: Workers’ Compensation is a Time Bomb for Public Entities Course: Fundamentals of Insurance Company Start Date: Wednesday, May 15 Credit Analysis Location: Online Webinar Start Date: Various throughout the year Category: Risk Management & Safety Location: New York, NY Category: Agency Management, Finance Organization: Sandi Kruise Insurance Training Contact: Robert Kruise Organization: Society of Insurance Research Email: kruise@kruise.com Contact: Ed Budd Address: P.O. Box 786, Bonita, CA 91908 Email: sir.mail@comcast.net Phone: 800-517-7500 ; Fax: 619-421-8171 Address: 631 Eastpointe, Shelbyville, IN 46176 Website: www.kruise.com Phone: 317-398-3684 Website: www.sirnet.org Educational Offerings: Individual Courses Online Courses: yes Educational Offerings: Individual Courses Correspondence Courses: yes Online Courses: no Correspondence Courses: no Course: Unlimited CE Subscription, $39.95 Start Date: Any Time Course: 2013 Spring Seminar Location: All States Start Date: Apr 9-10, 2013 Category: Commercial & Personal P&C, Location: University Club - Chicago, IL Property Casualty Insurance, Ethics, Life/ Category: P&C and Health Health/Benefits, Risk Management & Safety, Designation: Research Surplus Lines Designation: No Designation Course: 42nd Annual Conference Start Date: Oct 13-16, 2013 Course: Long Term Care Partnership Location: San Antonio, TX Start Date: Any Time Category: P&C and Health Location: All States Designation: Emerging Issues & Research Category: LTCP, Life/Health/Benefits Designation: No Designation
Course: Chartered Property Casualty Organization: Sterling Education Services, Inc Organization: The Agency Trainer Underwriter (CPCU®) Contact: Elizabeth Kramer Contact: Vickie Morgan Start Date: Any Time Email: ses21@sterlingeducation.com Email: vmorgan@agencytrainer.com Location: All States Address: PO Box 3127, Eau Claire, WI 54702 Address: P.O. Box 11551, Pueblo, CO 81001 Category: Property Casualty Insurance Phone: 715-855-0495 ; Fax: 715-835-5132 Phone: 719-924-9454 ; Fax: 888-840-1250 Designation: Chartered Property Casualty Website: www.sterlingeducation.com Website: www.agencytrainer.com Underwriter (CPCU®) Educational Offerings: Individual Courses Online Courses: no Correspondence Courses: no
Educational Offerings: Individual Courses Online Courses: no Correspondence Courses: no
Course: Workers’ Comp Law & Practice Start Date: Multiple Dates Location: Many States Category: Risk Management & Safety Designation: Continuing Education
Course: Applied Systems Training Start Date: Any Time Location: All States Category: Agency Management Designation: Other
Course: Advanced Workers’ Compensation Start Date: Multiple Dates Location: Many States Category: Risk Management & Safety Designation: Continuing Education
Course: Training Assessments, One-on-One Training, Refresher Training and more! Start Date: Any Time Location: All States Category: Agency Management Designation: Other
Course: A Practical Guide to Workers’ Compensation Start Date: Multiple Dates Location: Many States Category: Risk Management & Safety Designation: Continuing Education Organization: Success Continuing Education Contact: James Burch Email: JBurch@SuccessCE.com Address: 2 Corporate Plaza Dr., Ste. 100 Newport Beach, CA 92660 Phone: 949-706-9453 ; Fax: 949-706-9439 Website: www.SuccessCE.com Educational Offerings: Professional Ins. Designation Programs, Individual Courses Online Courses: yes Correspondence Courses: yes Course: Personal Lines Total Coverage Start Date: Any Time Location: All States Category: Property Casualty Insurance Designation: P&C Insurance Agents Course: Homeowners & Automobile Ins. Start Date: Any Time Location: All States Category: Property Casualty Insurance Designation: P&C Insurance Agents Course: Surplus Lines Compliance Course Start Date: Any Time Location: All States Category: Property Casualty Insurance Designation: P&C Insurance Agents
Course: Accredited Adviser in Insurance (AAI®) Start Date: Any Time Location: All States Category: Agency Management Designation: Accredited Adviser in Insurance (AAI®) Course: Associate in Claims (AIC) Start Date: Any Time Location: All States Category: Claims, with multiple specialty tracks including personal auto & workers comp Designation: Associate in Claims (AIC)
Organization: The Institutes Contact: Customer Service Email: customerservice@TheInstitutes.org Address: 720 Providence Rd., Ste. 100 Malvern, PA 19355 Phone: 800-644-2101 Website: www.TheInstitutes.org Educational Offerings: Professional Insurance Designation Programs, Individual Courses Online Courses: yes Correspondence Courses: no Course: Associate in General Insurance (AINS) Start Date: Any Time Location: All States Category: Property Casualty Insurance Designation: Associate in General Insurance (AINS) Course: Associate in Commercial Underwriting (AU) Start Date: Any Time Location: All States Category: Commercial Property Casualty Designation: Associate in Commercial Underwriting (AU)
Course: Associate in Risk Management (ARM) Start Date: Any Time Location: All States Category: Risk Management Designation: Associate in Risk Management (ARM)
Organization: The National Alliance for Insurance Education & Research Email: alliance@scic.com Address: 3630 North Hills Dr. Austin, TX 78731 Phone: 800-633-2165 ; Fax: 512-349-6194 Website: www.TheNationalAlliance.com Educational Offerings: Insurance and Risk Management Designation Programs Online Courses: yes Correspondence Courses: no Course: School for Producer Development Start Date: Oct 13-25, 2013 Location: Irving (DFW), Texas Category: Commercial Property & Casualty, Sales/Marketing Designation: No Designation Course: Dynamics Sales Training Start Date: Any Time Location: Many States Category: Insurance Sales, Sales Mgmt Designation: No Designation
Summer 2013 - CLAIMS JOURNAL | 33
Guide to Claims Education and Training Course: Certified Insurance Service Representatives (CISR) Online & Classroom Start Date: Any Time Location: Internet/All States (1200+ per year) Category: Agency Mgmt, Commercial P&C, Customer Service, Personal Residential & Auto Designation: CISR – Certified Insurance Service Representative
Course: iWin Train the Coach - How To Run effective CRISP™ Sales Meetings Start Date: Any Time Location: All States Category: Agency Management, Sales Managers /Producers, Property Casualty/Risk Mgmt, Employee Benefits, Sales/Marketing Designation: No Designation
Course: Residential Estimating Start Date: Any Time Location: All States Category: Property Casualty Insurance Designation: No Designation
Course: Casualty Adjusting Start Date: Any Time Location: All States Course: Certified Risk Managers (CRM) Category: Property Casualty Insurance Online & Classroom Organization: United Insurance Educators Designation: No Designation Start Date: Any Time Contact: Toni Amell Location: Internet/Many States (80+ per year) Email: mail@uiece.com Category: Risk Management & Safety Address: 8213 352nd St. East Organization: WISE Education, Inc. Designation: CRM – Certified Risk Manager Eatonville, WA 98328 Contact: Carla Coats Phone: 800-735-1155 ; Fax: 253-846-7536 Email: wise.education@verizon.net Web: www.uiece.com or www.CheapCE.com Course: Certified Insurance Counselors (CIC) Address: 1501 Cobblestone Ct. Start Date: Any Time Thorofare, NJ 08086 Location: All States (300+ per year) Educational Offerings: Individual Courses Phone: 800-577-9888 ; Fax: 856-384-8414 Category: Agency Mgmt, Commercial P&C, Online Courses: yes Website: www.wiseeducation.com Personal Lines, Life & Health Correspondence Courses: yes Designation: CIC – Certified Insurance Educational Offerings: Individual Courses Counselor Course: Dollars and Sense Online Courses: yes Start Date: Any Time Correspondence Courses: no Course: Certified School Risk Managers Location: Online or through home-study (CSRM) Online & Classroom Category: Life and financial planning Course: Atlantic City “Blitz” Start Date: Any Time Designation: No Designation Start Date: Oct 17 & 18, 2013 Location: Internet/Many States (60+ per year) Location: Caesar’s – New Jersey Category: Risk Management & Safety Course: FEMA National Flood Ins. Program Category: Commercial Property Casualty, Designation: CSRM – Certified School Risk Start Date: Any Time Ethics, Risk Mgmt & Safety Manager Location: Online or through home-study Category: Flood (PC) Designation: No Designation Organization: The Wedge Group Course: Partnership Long Term Care Policies Contact: Marja van Oijen Start Date: Any Time Email: marja@thewedge.net Location: Online or through home-study Address: 5729 Lebanon Rd., Ste. 144 Box Category: Long-term care selling requirement 410, Frisco, TX 75034 Designation: No Designation Phone: 214-446-3209 ; Fax: 972-999-0970 Website: www.thewedge.net Educational Offerings: Individual Courses Online Courses: yes Correspondence Courses: no Organization: Vale Training Solutions Course: iWin: Leader in Fully Integrated Sales Training & Management Solutions Contact: Tonya Magalei / Ami Thompson Start Date: Any Time Email: registrations@vale-ts.com Location: All States Address: 2424 E. Randol Mill Rd. Category: Agency Management, Sales Arlington, TX 76011 Managers /Producers, Property Casualty/Risk Phone: 817-633-4800 ; Fax: 817-633-2922 Mgmt, Employee Benefits, Sales/Marketing Website: www.vale-ts.com Designation: No Designation Educational Offerings: Individual Courses Course: 3-in-1 Workshop - Million Dollar Online Courses: no Producer™, The Wedge®, Red Hot Intros™ Correspondence Courses: no Start Date: Any Time Location: All States Course: Property Adjusting Category: Agency Management, Sales Start Date: Any Time Managers /Producers, Property Casualty/Risk Location: All States Mgmt, Employee Benefits, Sales/Marketing Category: Property Casualty Insurance Designation: No Designation Designation: No Designation
34 | CLAIMS JOURNAL- Summer 2013
DEPARTMENTS
Dollars & sense continued from page 15
43%
The percentage drop in train accidents between 2003 and last year. Train accidents fell 43 percent to 1,712, while the number of incidents at rail crossings dropped 34 percent to 1,960. The total number of deaths declined 19 percent to 705 over the decade, according to the Federal Railroad Administration.
8
The average number of teens (aged 16-19) killed in car accidents every single day during Memorial Day through Labor Day over the past five years combined, according to statistics from Tire Rack Street Survival, a national nonprofit teen driving education program. These months are the most dangerous time of year for teens to be on the road, according to the Insurance Information Institute. Motor vehicle crashes are the leading cause of death among 15- to 20-year-olds. More than half of teens who die in crashes are passengers, many of whom are not wearing a seatbelt. Studies have shown that a young driver’s chance of getting in a fatal accident doubles when a teen passenger is in the car. With three or more passengers, the risk quadruples.
60%
The percentage in total workers’ compensation claim costs Travelers estimates that make up medical costs. That percentage is expected to increase to 67 percent by 2019. CJ
We’ll tell you What “ it ” is. U.S. Forensic has built a strong reputation for providing concise, accurate answers to complex questions involving building failures, product failures, fires and automobile accidents. Our staff of over 50 professionals have assisted insurance companies, manufacturers, government entities and the legal community in evaluating the cause, extent and legitimacy of various claims, incidents and injuries.
T (888) 873-6752 F (888) 436-3092 www.usforensic.com
USFORE16413.indd 1
Advertisers Index
2/19/13 9:16 AM
Readers, browse, contact, or do product searches on any of our full page advertisers at: http://www.insurancejournal.com/adshowcase/ Amset Technical Consulting www.amsetusa.com
7
City of Hope www.cityofhope.org
39
Donan Engineering www.donan.com
3
Donan Engineering www.donan.com
13
Donan Engineering www.donan.com
15
Donan Engineering www.donan.com
11
Donan Engineering www.donan.com
9
Haag Engineering Co - Education www.haageducation.com
36
Haag Engineering Company www.haagengineering.com
40
IICF www.iicf.org
24
U.S. Forensic www.usforensic.com
35
Vale Training Solutions www.valetrainingsolutions.com
25
Weather Decision Technologies www.weatherforensics.com
2
Summer 2013 | Claims Journal 35
Save $7 * 5
off an with D y HCI cour se isco “CLM unt Code
JRN13 W”
*
* 0 $1our Onliondee e v a Sany 1- orh2D-Hiscount C
” 3W 1 N MJR “CL
off se wit r Cou
* Available only to eligible HCI-Residential or HCI-Commercial registrants. Cannot be combined with any other promotion or offer. Expires 12/31/13. ** Available for any Haag 1- or 2-hour online course. Cannot be combined with any other promotion or offer. Expires 12/31/13.
DEPARTMENTS
web exchange Video Highlights Tips for Adjusters Attending Mediation http://www.insurancejournal.tv/videos/9332/ During this year’s Combined Claims Conference, James Curry, a seasoned mediator and former in-house insurance defense counsel located in California’s San Fernando Valley, provided tips to adjusters preparing for mediation. Knowing the claim’s strengths and weaknesses and researching all parties are factors that can increase mediation success.
Podcast Highlights Cargo Theft Trends and Investigation Tips http://www.insurancejournal. tv/videos/9163/ In an interview with Claims Journal, Keith Lewis, vice president of operations at CargoNet, points out the hotspots and states where cargo theft occurs most and provides tips for adjusters investigating cargo theft claims. How Staged Accident Rings Were Busted in Mass. http://www.insurancejournal. tv/videos/9820/ In an interview with Claims Journal, Daniel Johnston, executive director of the Insurance Fraud Bureau of Massachusetts, discusses the fraud-fighting model implemented 10 years ago to reduce staged crashes in a number of Massachusetts cities and explains how investigative teams methodically busted over 1900 people involved these schemes.
time obtaining police reports, key documents that can prove crucial for making insurance claims and learning who has been arrested and for what. Police say a federal appeals court ruling in an Illinois case last year concluded law enforcement agencies cannot release information gleaned through motor vehicle records, including names, addresses, gender and other personal details. More Wisconsin agencies are pulling out their redacting pens before they hand out anything in hopes of avoiding lawsuits. It’s unclear exactly how many police departments across the state have adopted a redaction policy, but Sheboygan Falls Police Chief Steven Riffel said more agencies are doing it than not. The 1994 Driver’s Privacy Protection Act requires states to obtain consent before they release a driver’s personal information. The federal law was passed after an actress was killed in 1989 by a stalker who found her address through Department of Motor Vehicle records. City attorneys around the state have been advising police to haul out their redacting pens to make sure they’re not sued. And they’ve been following that advice. (Associated Press) The story generated comments from readers. Read a few of the comments below: Johannesburg Vera says: If the police reports are redacted, they are of no value and the public shouldn’t have to pay officers to produce worthless products. Adjuster says: So what is an accident report for? Why even make it if the parties cannot identify one another and the officer’s investigation is “redacted”? May as well not even make a report, as it has no purpose. CJ
ClaimsJournal.com Web Poll emotional distress be considered Should in pet liability claims? 2%
Undecided. (13 votes)
In a Reader’s View Wis. Police Become More Aggressive With Redaction People in Wisconsin who find themselves in car accidents, arrested or the victim of a crime are having an increasingly tougher
28% It depends on the factors leading up to the pet’s death. (217 votes)
33%
Yes, emotional distress should be considered. (257 votes) 37% No, emotional distress should not be considered. (283 votes) Total Votes: 770 votes Summer 2013 | Claims Journal 37
IDEA EXCHANGE | Final offer
Will Competition Drive Improvement in Workers’ Comp?
E
mployers are growing increasingly frustrated by the continued increase in workers’ compensation costs. Reform bills too often fail to deliver on promised cost savings, and the courts tend to keep expanding the scope of what is covered under workers’ comp. This growing frustration has lead many large national employers to seek alternatives to workers’ comp. Texas has allowed employers to opt-out of the workers’ comp system for several years. Approximately 30 percent of the employers in Texas have chosen that option with most large national retailers leading the way. These same large national retailers were among the leading advocates for the recently passed optout bill in Oklahoma. Other states are looking closely at the Oklahoma bill, and to Illinois businesses touting how much more business-friendly more discussion around opt-out in other By Mark Walls their states were. Illinois political leaders were upset, but this jurisdictions is likely next year. is the new reality of business. Is this the start of a trend towards allowing opt-out nation In the last three years, there has been significant workers’ wide? Is this the beginning of the end for workers’ comp in the comp reform bills passed in various states including California, United States? Not likely, but the competition from an opt-out Oklahoma, New York, Michigan, Kansas, Tennessee, Illinois alternative may spark a new wave of employer-friendly workand Florida.The governors of these states cited a desire to ers’ comp reforms nationwide. attract new businesses to the state as one of the Texas’ workers’ compensation system has been driving forces behind the legislation. Texas’ workers’ a leading innovator in controlling litigation, medcompensation ical treatment guidelines and pharmacy formuState Reforms laries. It is no coincidence that these innovations and Tennessee will be changing system has been a fromOklahoma happened in a state that has a workers’ comp a court-based system to an administrativealternative. If workers’ comp is optional and you leading innovator. based system. This leaves Alabama as the only want employers to stay in the state-based system state with a court-based system. This change will you need to make it more attractive. save employers significantly on their litigation ex It is also no coincidence that the recently passed Oklahoma penses, and it also should produce more consistent outcomes. New York’s reforms streamlined the assessment process, legislation included both an opt-out provision and a complete with the hope of lowering the state’s workers’ comp assessoverhaul of its workers’ comp system and benefits. Tennessee ments, which are the highest in the nation. also substantially reformed its workers’ comp system and ben California’s reforms made significant changes to their mediefits this year. And yes, not coincidentally, discussions of an cal dispute and lien resolution processes. These processes were opt-out provision were had and will likely be discussed again multi-billion dollar cost drivers for employers. If the reforms during the next legislative term. are successful, the savings for employers could be substantial. The trend toward employer-friendly workers’ comp reform Competition Leads to Innovation legislation is expected to continue. Competition with opt-out The lesson learned here is that competition leads to innovaoptions and competition for jobs is creating an atmosphere that tion and improvement. This is good for employers. is ripe for workers’ comp innovation and reforms. CJ And it’s not just competition from an opt-out alternative that can lead to workers’ comp reforms. States are also in comWalls is senior vice president and market research leader with Marsh’s Workers’ petition with each other for jobs. This was emphasized last Compensation Center of Excellence. He is also the founder of the 19,000+ member year when Illinois passed a significant tax increase. NeighborWork Comp Analysis Group on LinkedIn. ing states responded by immediately sending out information
38 Claims Journal | Summer 2013
COH16601.indd 1
5/20/13 8:32 AM
Summer 2013 | Claims Journal 39