At the 2017 Business Insurance/CLM Workers’ Compensation Conference, a panel discussed the importance of having an advocacy-based claims model. The speakers included: Natalie Bailey – Attorney, Hennessy Roach PC Andy Condrey – Claims Operations Manager, Gray Insurance Company Jim Saccone – AVP, Sedgwick Everyone has a role in advocacy. The employer, TPA, carrier, attorney and all the vendors on a workers’ compensation program have to work together to truly support a culture of advocacy. The injured worker and the physician also have a role. For the injured worker, this can be a confusing and scary time. They are in pain
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At the 2017 Business Insurance/CLM Workers’ Compensation Conference, a panel discussed the problems with marijuana, opioids, and pain. The panel was: Jennifer Saddy – Director Workers’ Compensation, American Airlines Teresa Bartlett – SVP Medical Director, Sedgwick Bert Randall – Attorney, Franklin Prokopik PC Opioids The opioid crisis in the U.S. costs our society over $55 billion in 2011. This is not just the cost of the drugs themselves, but the workplace costs, healthcare costs and criminal justice costs. The US consumes 80% of the world’s opioid prescriptions and in 2015 there were almost 18,000 deaths in the U.S. due to
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At the 2017 Business Insurance/CLM Workers’ Compensation Conference, a panel discussed managing the risks of workplace violence. The panel was: Mark Baker – VP Risk Management, Hyatt Corporation Lance Ewing – EVP Global Risk Management and Client Services, Cotton Holdings, Inc. Stephen Kmiec – VP, Sedgwick Dan Kugler –  VP Enterprise Risk Management, Rev Group Inc. Every year workplace violence costs employers over $16 million and over 876,000 workdays. Workplace violence is the second leading cause of workplace deaths, behind transportation incidents. This is a significant issue for employers. Workplace violence can take many forms. Including: Active shooter Aggravated Assault
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At the 2017 Business Insurance/CLM Workers’ Compensation Conference a panel discussed using a captive to fund your workers’ compensation program. The panel was: Arthur Koritzinsky – Managing Director, Marsh James Poerio – Attorney, Poero and Walter Robert Davidson – Director of Underwriting and Consulting – ICG Captive A captive is a legally licensed insurance company with a limited purpose. It insurers the risks of the captive’s owners or companies affiliated with the owners through ownership, management, or control. Risk managers like captives because it gives them complete control over their program limiting the impact that changing insurance rates can have
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At the 2017 Business Insurance/CLM Annual Conference, a panel discussed the rise of specialty drugs, including anti-virals such as Truvada, Combivir and Kaletra, and how they are utilized in workers’ compensation claims. The panel included: Heather Carbone – Attorney, Boyd and Jenerette P.A. Kimberly Simmons – Property and Casualty Claims – Fidelity National Financial Martine Cumbermack – Attorney, Swift Currie McGhee Hiers LLP In 1990, there were only 10 specialty drugs on the market, mostly to treat rheumatoid arthritis, multiple sclerosis, cancer and growth disorders. By 2012, there were nearly 300 specialty drugs – and that number has continued to
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At the 2017 Business Insurance/CLM Annual Conference, a panel addressed the most repeated mistakes payers make in recognizing and pursuing matters with subrogation and third-party recovery potential. The panel was: Fran Brooks – Corporate Claims Training Specialist, PMA Companies Quinn Conaboy – Subrogation Supervisor, Guard Insurance Group Gary Wickert – Attorney, Matthiessen Wickert and Lehrer, SA Waiting Too Long To Involve Subrogation Specialist About 25% of the files the subrogation law firm receives come to them with less than 30 days until the Statute of Limitations will run out. If you have submitted demand letters to the third party and
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At the 2017 Business Insurance/CLM Workers’ Compensation Conference a panel discussed the controversial issue of polypharmacy from the perspectives of the medical community and the claims/legal community. The panel was: Greg McKenna – Vice President, Gallagher Bassett Bill Pipkin – Attorney, Austin Lewis Pipkin and Maddox LLC Dave Randolph  – Medical Director, Midwest Occupational Health Management Polypharmacy means taking a LOT of medications. In workers’ compensation, injured workers taking too many medications can be a significant cost driver on claim. Too often multiple medications are prescribed to treat symptoms rather than trying to get to to the root cause of
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At the 2017 Business Insurance/CLM Workers’ Compensation Conference a panel addressed key elements for employers with their pre and post accident process from the perspectives of a corporate claims manager, insurance claims specialist and defense counsel. The panel was: Judith Cole –  Corporate Claim Manager – K2 Industrial Services Company Stephanie Wood – Claims Manager, The Wendy’s Company Kristen Kaiser Kus – Attorney, Bryce Downey Lenkov LLC Melissa Donovan – Claims Specialist, Cincinnati Insurance Company Pre-accident The claim process actually starts with the employee on-boarding process. Your employee manual should contain information about reporting a workers’ compensation claim. Timely reporting
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At the 2017 NCCI Annual Issues Symposium, a panel of representatives from industry associations discussed a variety of topics impacting their members. The panel included: Roberto Ceniceros – Senior Editor, Risk & Insurance Magazine Charles Chamness – President and CEO, National Association of Mutual Insurance Companies (NAMIC) Sean Keveligan – CEO, Insurance Information Institute (III) Leigh Ann Pusey – President and CEO, American Insurance Association (AIA) What are some of the biggest issues you are monitoring right now that could impact the insurance industry? New regulations imposed over the years have very much inhibited the insurance industry’s ability to grow
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At the 2017 NCCI Annual Issues Symposium, Jonathan Haidt, Professor of Ethical Leadership from NYU Stern School of Business and noted author, discussed the important work done by our industry and our reason for doing it. The Triangle Shirtwaist fire in 1911 is credited with being the rallying point for the present workers’ compensation systems nationwide. People were morally outraged by this accident and the lack of compensation for all the victims. However, the reason change happened quickly after the Triangle Shirtwaist fire is because there was already significant momentum toward some type of a workers compensation protective system. Since
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