The Path Forward A look back at the insights shared during the 2020 Out Front Ideas Virtual Conference
Hosted and edited by
Kimberly George and Mark Walls
Š 2020 Out Front Ideas
|
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Financial Strength Matters Because We Sell a Promise “Insurance is a ‘trust me’ product. There’s a long-term commitment here. Financial stability should give our clients comfort that, when they place their coverage with us, we have the financial ability to pay those claims that could materialize decades from now. We are rock solid. Safety National is going to be there to pay for the long term – not just for today, but for tomorrow.”
– Duane Hercules, President
Day 1 06
Industry CEO Perspectives
10
Q&A: Key CEO Takeaways
16
Navigating the Constant Evolution of Accommodation and Leave Laws
22
The State of the Commercial Insurance Marketplace
Duane Hercules and COO & CFO John Csik with members of Finance
30
Cyber Risk and Insurance Technology
34
Ask the Medical Director
Day 2 42
The Future of Risk Management
48
Mental Health Issues in the Workplace: A Mounting Threat
54
Adjusting and Adapting the Claims Handling Model
Proceed with Safety®
59
Ask the Claims Experts
60
Public Entity Challenges
Workers’ Compensation: Excess • Large Deductible • Large Guaranteed Cost • Defense Base Act • TEXcess® Commercial Auto • Commercial General Liability • Umbrella / Excess Liability • Public Entity Liability • Cyber Risk Loss Portfolio Transfers • Self-Insurance Bonds © 2020 Out Front Ideas
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Our goals with Out Front
Here are some themes we identified from The Path Forward:
Ideas are to facilitate
• Our industry proved its ability to be flexible,
industry conversations,
efficient and adapt to new technology and
The Path Forward
highlight industry leaders
processes more quickly than anyone would have imagined. We must continue to advance and not
and, most importantly,
default to the old way of doing things.
encourage you to think
• Long-term partnerships are important. They can help you navigate through challenging times. Be
about how we can work
careful not to chase short-term cost savings at the
W
hat began as a COVID-19 briefing series in
suggestions for timely topics. We heard as you
March 2020 culminated into “Out Front
shared your business challenges. We rallied
Ideas, The Path Forward,” a virtual conference held
speakers with unique experiences and points of
September 22 – 23, 2020. It was you, our audience,
view. And the conference agenda came together.
that requested this conference, which became an opportunity to take one of our weekly briefing topics focused on the path forward and continue
During the 12 learning and collaboration sessions – and with the help of some 40 speakers – we had
• Good communication, transparency and
positive change.
workforce well-being go hand in hand and are paramount to successful relationships with your
As we reflect on the conference, we believe our
employees and partners. These principles will also
goals were met. As a gift of appreciation for your
pave the way for successful business outcomes.
participation, we created this digital magazine
• Everything has changed. Benchmarks of the
numerous aha moments and head nods. It often
past are not relevant. You cannot consider your
felt as if we were attending an ideation workshop
path forward without considering your new
Back in January when Out Front Ideas published
designed specifically for the betterment of our
starting point.
our 2020 Issues to Watch, one of the issues in
industry, and for that we are truly grateful.
the conversation.
together to bring about
expense of losing these partners.
featuring articles from the main stage sessions and insights from the collaboration sessions. To our sponsors, Safety National and Sedgwick,
• Best in class is now the expectation. If your loss
focus was “rethinking industry engagement.”
control programs are not at the highest level,
We challenged the traditional conference model.
they will have a negative impact on your
A growing number of pay-to-present sessions
insurance purchasing.
thank you for making Out Front Ideas possible.
are delivered as advertisements rather than
• With rapidly evolving new business risks and
educational. With fewer buyers in the exhibit
rising insurance costs, risk managers must
Kimberly George and Mark Walls,
hall, sponsors have diminished returns. It was
demonstrate their value to the organization.
hosts of Out Front Ideas
abundantly clear that The Path Forward had to
This is your time to shine.
deliver fresh content with top-notch industry
Out Front Ideas is an educational series interactive forum
• Tort reform is needed nationally to address
designed to explore critical insurance industry issues. The
leaders and elevate conversations important to
increasing jury awards and to provide businesses
employers ‒ while also translating to the broader
with protections when reopening during this
Innovation at Sedgwick; and Mark Walls, VP Communications &
ecosystem of insurance, risk management and
pandemic. Without these reforms, certain
Strategic Analysis at Safety National.
workers’ compensation. We listened to your
businesses may become uninsurable in parts
Learn more about Out Front Ideas.
series is hosted by Kimberly George, Head of Healthcare and
of the country. © 2020 Out Front Ideas
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Industry CEO Perspectives
E
arlier this year, Out Front Ideas kicked off a weekly COVID-19 briefing series with a panel
of industry leaders who discussed the business continuity challenges they were facing as a result of the pandemic. During our recent virtual conference, The Path Forward, the same team shared current challenges related to COVID-19, how they are adapting to changes in their business and what we can expect to see going forward. The conference session offered insights from an insurance carrier, a third party administrator (TPA), an occupational health provider and an ancillary program provider. Our panelists included: Keith Newton Chief Executive Officer, Concentra Dave North Executive Chairman, Sedgwick Thomas Warsop Chief Executive Officer, One Call Mark Wilhelm Chief Executive Officer, Safety National
Š 2020 Out Front Ideas
|
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• In medical only and short duration lost time
During the session, the team shared the lessons
another step that has been impacted. The end of a
other partners face-to-face, this meant accelerating
learned and offered perspectives on what the future
workers’ compensation claim traditionally includes
the adoption of these tools to continue to
claims, administrative involvement and steps
holds for our industry. Through all of the changes,
determining that the injury was taken care of and
support their relationships and ensure ongoing
toward resolution can be streamlined.
what was clear was their ability to meet the
the individual was able to return to work. With the
communications.
challenges and successfully adapt, while supporting
changes impacting the work environment for many
their employees, customers and insureds.
people, it’s not that simple. “Those two final hurdles now take on way more complexity than ever
Current challenges
before,” said Dave North.
• Reinsurers are excluding pandemics and an alternative is needed for losses related to business
Patient engagement is another area that has
interruption, event cancellation and workers’
changed with the increased use and availability of
compensation claims arising out of a pandemic.
telemedicine. “There’s a lot of types of visits that
• Some people who are affected by COVID-19 will
create easier access for the patient versus coming
For Concentra, the challenges revolved around the best ways to handle the staffing associated
In the insurance industry, models are used
to a bricks and mortar,” said Keith Newton, Chief
need help for the rest of their lives, and the way
with practices, how to protect patient-facing
to determine predictions based on what has
Executive Officer at Concentra. As a result of the
they get that care and who pays for it is not clear.
colleagues and how to treat patients coming in,
happened in the past for events like a hurricane.
pandemic, Concentra saw telemedicine visits
The path forward
while managing the ongoing changes in local
There was no model that would help the industry
increase from 30-40 a day to 500-900 a day.
The panel shared the importance of looking at
regulations and mandates. Other considerations
predict the impact of COVID-19. Safety National
for the panel included the many things employees are dealing with personally, such as issues related to school schedules for their kids, how to manage
worked with other organizations to build a model to help them predict these losses. Mark Wilhelm, Chief Executive Officer at Safety National, explained,
the psychological impact. “It’s not just the logistics of getting people at home and connected and continuing to be productive,” explained Dave North, Executive Chairman at Sedgwick. “For injured workers, there is a concern that some of them who need care are not getting it because of the fear of leaving their home due to the virus. In addition, the hurricanes, tropical storms, fires and riots we’ve faced this year create challenges for injured workers getting to providers. “All of
“It wasn’t just new for insurance companies, it was new for TPAs, risk managers, actuaries, they all have their routines and procedures, all of which were upended with this event.”
those things have made it really challenging to manage the network to ensure injured workers get access to the care they need,” said Tom Warsop, Chief Executive Officer at One Call. Helping injured workers get back to their jobs after they recover is
of trying to return to what things were like before
COVID-19 have been introduced in multiple states
the COVID-19 pandemic began. Telemedicine is
and jurisdictions, shifting the burden of proof in
more widely available for doctor visits, and face-
workers’ compensation claims to the employer.
an environment at home that is not designed to be a long-term operation, their health and safety, and
where we are today and moving forward instead Rebuttable presumption provisions related to
to-face meetings with employees and clients can
Essential workers required to report to a facility
be replaced with video calls in many cases. With
outside of their homes and then diagnosed with
the significant changes that have occurred over
COVID-19 are presumed to have contracted the
the last several months for businesses and their
illness on the job. With this new legislation, one of
employees and customers, there have also been
the issues to consider is whether things like the
lessons learned about speed and resilience. “We’re
flu are going to compensable and presumed to be
probably much more agile and can make quicker
caught in the workplace. “There’s a whole Pandora’s
decisions and execute even faster than any of us
box of secondary effects that I think we’re going to
even thought before, and that can’t be anything
be dealing with going forward,” said Mark Wilhelm.
but good for our industry,” said Dave North.
As far as what needs to change as a result of
Listen to
the pandemic, the panel highlighted changes in key areas:
The Path Forward:
• Organizations need more help to prevent injury,
Industry CEO
What has changed and what needs to change? Similar to most other industries, the use of video communication tools has increased. For companies
prevent disease and the spread of disease.
Perspectives
that were used to meeting with customers and
© 2020 Out Front Ideas
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Q&A: KEY CEO TAKEAWAYS
What challenges are you facing? Mark Wilhelm
Keith Newton
Tom Warsop
Dave North
Chief Executive Officer
Chief Executive Officer
Chief Executive Officer
Executive Chairman
Safety National
Concentra
One Call
Sedgwick
• Insurance like most things is based on models. We predict
• Staffing is probably one of the biggest challenges. We are 50%
• Our general concern is that people who need care are not
• The pandemic is personal for our own colleagues. It’s not
things based on what’s happened in the past, like a hurricane
down on a year-over-year basis across our centers relative to
always getting it. People are still scared to leave their house,
just the logistics of getting people working at home and
approaching; we didn’t have that kind of a model for COVID-19.
patient volumes. That has rebounded in the last six months
going to see people/providers in tight spaces, getting into
connected and continuing to be productive; it’s the personal
It will take years to build. All the models insurance companies
and now is only about 10% down; we’re seeing employment-
a car with someone they don’t know to give them a ride.
things they’re doing in their own environment, they’re dealing
have need to be recalibrated.
related services rebound faster than workers’ compensation
Telemedicine has helped, but utilization never got above 20%
with the anxiety of when are their kids going back to school;
services.
of our total referrals before it started to come down.
what does their safety profile look like; how do they manage
• The blocking and tackling in claims work will go on, but it will take 12-24 months to get a decent handle on what our claims exposure may be. • We’ve also had to deal with payroll reductions, premium returns and investment income; investment income is a huge part of any long-tail carrier profit equation and it goes into the rate-making process. When interest rates go down and investment income goes down, it’s a double whammy both
• How to best protect patient-facing colleagues in practices
long-term operation, and the whole psychological impact.
has also been a challenge because every single day as the
like and how it’s going to impact our business. COVID-19
pandemic grew worse there seemed to be changes in local
has altered the long-term frequency curve of workers’
regulations and mandates related to the workforce and how
compensation – we’ve seen frequency coming down for a
and trying to find ways to help them get care, reimburse
to treat patients coming in. Initial PPE challenges have been
long time and the pandemic will accelerate that in the short
them for the care and transition back to work and all of those
overcome.
term because of unemployment. For the long term, the
things are impacted. There is even a brand new definition of
phenomenon of working from home is not going to go away
comorbidities – we used to think about diabetes and smoking
and that also has an impact on frequency.
and those kinds of things and today we think about the health
• Police, firemen, bus drivers, teachers – all are big segments
from an investment income standpoint and from our ability to
of our patient makeup. Managing through the dynamics of
discount losses.
what’s happened within these unique populations has been a
• We insure hundreds and thousands of policemen and firemen
an environment at home that was never designed to be a
• We are trying to figure out what the future is going to look
pretty significant challenge.
and with the civil unrest this summer, it has created claims that may involve post-traumatic stress disorder (PTSD); it will take years to understand the full scope of this issue.
• At the heart of what we do is dealing with injured workers
impact of COVID-19 on workers and their families, the impact
• Staying connected and interacting with clients, providers,
psychologically of the fact that they’ve been home for five or
payers and everybody involved remains a challenge – we’re
six months and how do they rationalize dealing with a work-
doing more on video chat; we’re learning on the fly how to stay
related injury and the economic impact on the family. The
connected and how to communicate much more effectively
burden on those people is greater than ever before.
than we ever had in the past using technology. It’s working,
• The end of a workers’ compensation claim, which was
but we’re having to re-learn some things that we thought we understood really well.
traditionally simply determining when the injury was taken care of and the individual returned to work, those two final hurdles now take on way more complexity as we figure out: • How do we rationalize and re-adjust a workers’ comp adjudication to realize it’s not just an injury that has a nice,
Staying connected and interacting with clients, providers,
defined code that we can figure out?
payers and everybody involved remains a challenge...
• How do we – in a compassionate, caring and understanding way – help individuals through their injury, then that final point of saying, “OK, you’re healthy,” when there are questions to consider like, “Where’s the job to go back to?” and “What are the other things that are impacting this?”
© 2020 Out Front Ideas
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Q&A: KEY CEO TAKEAWAYS
What has changed or needs to change as a result of the pandemic for our industry? Mark Wilhelm
Keith Newton
Tom Warsop
Dave North
Chief Executive Officer
Chief Executive Officer
Chief Executive Officer
Executive Chairman
Safety National
Concentra
One Call
Sedgwick
• Our business has been based on relationships; we insure high-
• Customer interactions: Typically, we’ve been a face-to-face
• The definitions of work and the workplace have changed
• Speed of adoption can be significantly faster than we ever
touch businesses/high-touch clients. We make a concentrated
salesforce as far as how we engage with employers, payers,
forever. Some of that’s work from home; we’ve thought about
thought before. Sedgwick’s new CEO, Mike Arbour, shared
effort to get in front of brokers and insureds; video calls are a
customers and partners. We had to transform; what’s changed
the work differently, we’ve spread it across teams in different
some thoughts to consider related to all the changes
substitute, but they’re not as good.
is the adoption and acceleration of a lot of the digital pathways
ways than ever before. We’re using technology to share tasks,
businesses have made – Can you imagine a few months ago,
of maintaining that engagement.
get them done faster and with higher quality.
if you were running a business and you had 12% or 15% of your
• Much like 9/11 when the reinsurers immediately excluded terrorism from the reinsurance they provided to companies
• Patient engagement: Across the Concentra footprint, about
workforce that worked at home and you decided to launch
• My company has historically focused on post-injury
a project to have 90% of your colleagues working at home?
like ours and many others, right now they’re excluding
50,000 patients a day walk through our practices; about
circumstances; we want to help injured workers get the care
pandemics; that’s something we’re then stuck with. There’s
20,000 of those are workers’ compensation-related (new
they need when they need it and that’s our mission. During
not a regulator in the country that would allow a front line
injury, follow-up, physical therapy or specialty visit). With the
the pandemic, what became very clear, very quickly was that
carrier to put a pandemic exclusion on. We need an alternative.
adoption of telemedicine at about this time last year, we were
organizations were going to need even more help than they
I expect alternatives to evolve like they did after 9/11, but it will
seeing about 30-40 a day through a centralized group and, as
have in the past to prevent injury, prevent disease and the
take time, and carriers are left to provide coverage on their
a result of the pandemic, that greatly accelerated the adoption
spread of disease. We created a whole new suite of offerings
own in the meantime.
of patients utilizing the service, probably seeing on a heavy day
that are even more critically important now as employers face
800-900 and on a slow day about 500 – greater adoption that
tough questions – how do you manage workplaces safety, how
and using the technology that has been developed for auto
I think is here to stay. However, in the scheme of things, that’s
do you prevent injuries, how do you prevent disease?
adjudication and self-reporting of workers’ compensation
You would assemble a massive multi-disciplinary taskforce, you’d probably spend a year or two studying it, determining all the reasons why you couldn’t – the obstacles, the customer interactions, the technology, and for almost all of us we did exactly that over a 5-7 day period. • In our business, when you think about adopting technology,
still a small component of the type and number of visits that
claims by injured workers and how that actually speeds up
are actually needed.
the process, I think we’re going to learn a lot of lessons. The challenge for all of us is to try to find ways to streamline the number of events in workers’ compensation where we apply administrative or bureaucratic involvement. We’re going to be looking for ways to really accelerate technology we’ve already invested in to bring the delivery of services even faster to those injured workers and care for them quicker than ever before, so
What became very clear, very quickly is that
I’m optimistic that there’s going to be a silver lining, if you will, through all of this.
organizations were going to need even more help than they have in the past to prevent injury and prevent disease and the spread of disease…
© 2020 Out Front Ideas
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Q&A: KEY CEO TAKEAWAYS
What is the path forward? Mark Wilhelm Chief Executive Officer Safety National • We are looking forward and looking past COVID-19. We have
Keith Newton
Tom Warsop
Dave North
Chief Executive Officer
Chief Executive Officer
Executive Chairman
Concentra
One Call
Sedgwick
• There has been a tremendous amount of ground gained during this time period; there’ve been hurdles knocked down,
a new risk to take into account in terms of pricing, but also in
regulatory requirements around telemedicine, for example.
terms of providing risk control coverage, benefits, etc.
What we can’t do is go backward. From an organizational standpoint, the pandemic has challenged us to look at things
• The communicable disease coverage we worried about in the past was a Legionnaires’ or an Ebola that we thought
in a different way. We’ve shown that we can be effective over
with American technology we could manage very well; we’ve
the last six months; we need to take some of those principles
been humbled in that regard by this pandemic and that’s
and apply as we go forward.
something that we’re going to have to adjust to from a pricing standpoint (and for protection of insurance and employees).
• Let’s continue to move forward and build upon what we have,
• Because of presumption legislation, are things like the flu
and continue to innovate. We’re on the front lines…and as soon as we can get the front line’s information back into the
going to be compensable and presume they were caught in
workers’ compensation ecosystem and to our partners and
the workplace?
insurers, the quicker they can make decisions in supporting their customer base. We continue to challenge ourselves as it relates to the technologies we deploy – how do we eliminate
• I think most organizations are putting more focus on injury
• In a lot of conversations, people reflect on where they were
and disease prevention.
from a business standpoint before the pandemic and they start talking about a return to normalcy that starts with where
• Telehealth is here to stay; it’s going to get better and better. It
they left off. I’m afraid that that’s not founded in good logic
will become more important to the management of networks
because the world looked a lot different five to six months
and to the provision of healthcare of all types including
ago than it does today. Whether you’re trying to get back on
workers’ compensation.
the path of your financial performance, or back on the path of
• There is a need to ensure that people who are affected by
returning your colleagues to work in a conventional setting, or
COVID-19 recover and get the care they need to manage the
even delivering services the way we used to, starting with what
rest of their lives. Some people recover from it and many have
was seems to ignore the significant change that’s occurred in
with no long-lasting effects, but that’s not true for everyone;
our society over the last several months.
there are lots of people that need help for the rest of their
• The path forward for me starts with today and tomorrow and
lives. The way they get that care and who pays for it is entirely
the next day, not so much looking back; things have changed.
unclear at the moment, so that has to be figured out, we have
The impact on everybody, even if you start thinking about
to work to make sure that happens.
normal things such as air travel and what we all do for a living,
the hurdles, the inefficiencies and all those types of things
there’s going to be a new normal in that, not a return to where
in the system to accelerate the velocity of information that’s
we were. As we go into the end of the year, which is usually
coming back?
a time to think about planning, forecasting and budgeting, we’re going to reset, not return to what was. • The reduction of claims, whether it’s down 5% or 10% or 15% or 20%, that’s not magically going to come back when some serum is developed that gives people immunization against this pandemic; the economic impact on our customers has been dramatic. For some of them, like in transportation and hospitality, it’s going to take years to return to what was.
Let’s continue to move forward and build upon what we
• I’m looking forward with our team and with our business partners. I’m thinking about what the world looks like going
have, and continue to innovate.
forward starting today, and what can we do with the lessons learned. I’m thinking about the resilience of our workforce, the customers that are looking for a higher level of services with a new definition of touch, and a new way of adopting technology that we’ve all been working so hard to develop.
© 2020 Out Front Ideas
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Navigating the Constant Evolution of Accommodation and Leave Laws
W
ith laws constantly in flux and the added complication of COVID-19, employers are
looking for guidance and best practices on how to navigate this challenging and ever-changing space. To help navigate the complexities, three well-known compliance experts discussed the current state of ADA, FMLA and workers’ compensation laws. Our panelists included: Bryon Bass Senior Vice President, Workforce Absence at Sedgwick Jeff Nowak Attorney and Shareholder at Littler Adrienne Paler Director, Total Health & Productivity Management, Integrated Disability and Absence Management at Sutter Health Š 2020 Out Front Ideas
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Recognizing employer challenges
When an employer doesn’t do this, that’s when we
the employee perform their job. If an employee
Creating an interactive process
Employers strive to bring together workers’
typically see trouble. For example, an East Coast
presents a request that won’t help them be
Through our experience, we’ve found the best
compensation laws and leave types to ensure
bank filled the position of a pregnant employee
effective in doing their job, an employer doesn’t
practice of creating an interactive process between
employees get the care they need. However,
who needed surgery during her pregnancy and
have to make the accommodation. For example,
the employer and employee is the way to avoid
compliance continues to be one of the toughest
didn’t return in the 10 days the employer specified
providing assistive equipment for the employee
litigation and keep the employee on the job while
challenges employers face, especially because
because she was unable to. Or, consider the
requesting to use a cane at work would be a
still being productive at work. This starts with the
regulations don’t always speak in agreement. That’s
national retailer that wouldn’t let an employee with
reasonable accommodation.
employer doing their homework:
why it’s critical to have highly knowledgeable in-
a medical issue return from leave with a reasonable
house experts and partners who fully understand
request of using a cane at work. Instead of
the laws and can interpret them in a simplified way
accommodating, the retailer forced the employee
for employees to understand and utilize.
to remain on leave.
“Ultimately, it’s about applying the right benefits,
When we see issues like these get litigated with the EEOC, it’s important to remember that it
• Start with understanding the employee’s “ask.”
Litigation watchouts
employer’s workplace for three to five years.
behaviors that often lead to litigation:
employee and ensure
“It’s all about putting
1. Poor communication
we’re delivering against
reasonable, modest, yet
the program correctly.”
effective, accommodations
— Adrienne Paler Another employer challenge is staying in compliance with the EEOC, which looks to
in the workplace to help an employee stay on the job.” — Jeff Nowak
employers to make every reasonable effort to keep the employee at the workplace rather than terminated or put on leave. Employers can successfully manage this through an interactive process where the employer and employee determine the best path to keep the employee on the job.
day-to-day aspects of their job and the resulting challenges. Learn about their essential job functions and find out their concerns, barriers and needs.
We find that there are three common
way, to benefit the
• Recognize the employee is the expert at the
almost always comes with a consent decree, which essentially allows the EEOC to review the
at the right time, in right
We find this is often missed or not acted upon.
What’s considered a reasonable accommodation? We often get asked this question by employers. We define it as: assistance or change to the way a position is performed and/or the work environment to help the employee perform all the essential
• For employers in a union environment, it’s also important to understand the collective bargaining agreement and what you’re able to do. • Talk with the employee’s supervisor. Sometimes
Failure to communicate with the
an employee waits too long to request their “ask,”
employee while on leave or when the
and there may be some productivity issues to
employee has poorly performed and
understand and work through.
there’s belief of a contributing reason.
• Revisit policies to see if there is a way to allow for an exception.
2. Ignorance Knee-jerk reaction that an employee
As employers have conversations with the
can’t perform with the requested
employee and their supervisor, it needs to be
accommodation.
documented. This includes the employee request, their essential job functions and information from their healthcare provider. The path forward also
3. Unwillingness Closed to making a change and being
needs to be documented to ensure alignment.
creative on how the job is performed.
After the plan is put into place, employers should follow-up with the employee and their supervisor to
functions of their job. The courts further define it
see how the accommodation is working, if it needs
as an accommodation that is effective in helping
adjusted and if the job is getting done. © 2020 Out Front Ideas
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The COVID-19 impact
follow up. This is critical to resolving friction, helping
Many employers are struggling with the significant
avoid ligation and finding a resolution that keeps
number of new employment protections due to
the employee in their position while still being
COVID-19. We continue to see more developments
productive for the business.
in this area, including: • Families First Coronavirus Response Act (FFCRA) with federal protection extending paid sick leave to smaller employers with less than 500 employees. • Continued explosion of state and local laws for public emergencies, including COVID-19, that involve return to work, business closure and even mask use.
Paler shared some practices that have reshaped Sutter Health during COVID-19:
1. State the obvious: if you’re sick, don’t come to work. Gone are the days of pushing through it.
• While ADA regulations haven’t necessarily changed because of COVID-19, we are seeing more leave issues like high-risk employees being afraid to come to work or those struggling with school closures. We’re also seeing a rise in litigation. Nearly 750 have been filed regarding this pandemic, with California leading the way and New Jersey, Florida and New
Every industry and organization is faced with the same 2. Get people comfortable with new norms like symptom and temperature checks.
failure to accommodate and failure to provide leave. Employers can help solve for this. Often we see employees getting frustrated and feeling
challenge due to the impact of COVID-19: What does getting “back to business” look like and how will we move forward? Sedgwick can be your partner in figuring this out, together.
3. Empower employees to speak up
01 REOPEN
with concerns and determine how you respond and at what speed. From temperature check programs to readiness reviews of facilities and support programs for your
York not far behind. The most common areas include unsafe work environment, issues related to
YO U R “ B A C K T O B U S I N E S S ” T O O L K I T
workforce, we have designed a suite of services that will help your business respond quickly and
4. Get creative with flexibility. For example, consider adjusted
03 RECOVER
three key phases: reopen, return, recover.
schedules and sabbaticals to allow employees to care for their children.
like they’re not being heard. To overcome this,
C O N TA C T U S F O R A F R E E C O N S U LTAT I O N
employers need to establish trust at the beginning
Sedgwick’s back to business concierge process is designed to walk through your needs and
by understanding the need and creating a plan that can work for the employee without harming the employer. This goes back to the interactive process we shared earlier: Listen, communicate and
02 RETURN
safely as COVID-19 restrictions evolve. Our solutions are designed to fit your specific needs through
determine a coordinated strategy for progress. Let’s create a plan for your organization.
TEL: 844.997.1892 (weekdays, 7am to 7pm Central) WEB: sedgwick.com/backtobusiness
© 2020 Out Front Ideas
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© 2020 Sedgwick
The State of the Commercial Insurance Marketplace
I
n a survey of frequent Out Front Ideas attendees, one of the biggest concerns raised by risk
managers was the rapidly evolving insurance marketplace. These challenges started back in 2018, but COVID-19, civil unrest and other events have accelerated this change. At the Out Front Ideas virtual conference, a panel discussed these challenges. Our guest speakers were: Daniel Aronson U.S. Casualty Practice Leader, Marsh John Csik Chief Operating Officer & Chief Financial Officer, Safety National Lori Goltermann Chief Executive Officer, Aon U.S. Commercial Risk & Health Solutions Joseph Peiser Executive Vice President, Global Head of Broking, Willis Towers Watson Š 2020 Out Front Ideas
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U.S. commercial casualty market
The COVID-19 pandemic raised an entirely new
compensation market that already had a built-in
Exclusions have also increased in this market.
Social inflation has been impacting civil jury verdicts
set of risk management concerns. Businesses
premium audit function.
What started as COVID-19 exclusions expanded
for several years. Juries have been displaying anti-
were shut down. When would they fully reopen?
business and anti-government bias, and they have
What impact would these shutdowns ultimately
been desensitized to large awards. The combination
have on the business? In addition, risk managers
of these factors is leading to record jury verdicts
faced new risks in their existing operations. Sit-
around the nation, even in cases with questionable
down restaurants started offering delivery. Many
liability. Umbrella excess liability and auto liability
employees shifted to working in different roles.
to pandemic exclusions and then to exclusions
U.S. property marketplace
on all communicable diseases. Carriers are trying
The U.S. property market is experiencing its 11th
to eliminate any potential uncertainty regarding
quarter of rate increases. Natural disasters like
their exclusion of coverage of business interruption
wildfires have been very impactful. Additionally,
relating to disease outbreaks.
there have been over 18 named storms this 2020 hurricane season. Civil unrest and damage from
Global insurance markets
The carrier marketplace experienced a change in
riots have also heavily impacted the commercial
Many businesses have global exposures or
There has also been a significant impact on
appetite. Some carriers walked away from certain
property market.
access to Lloyd’s marketplace for some of their
directors and officers (D&O) coverage. In 2019,
industries. New exclusions emerged, such as
there were over 400 lawsuits filed against public
communicable disease, which took away coverage
company directors, and that number is expected
for much more than COVID-19. For example, a
again in 2020. Public company D&O coverage saw a
communicable disease exclusion eliminated
74% price increase in the second quarter of 2020.
coverage for Legionnaires’ disease, which was
have been the most impacted by this jury behavior.
previously covered. Many carriers eliminated some
400 lawsuits filed in 2019 against public company directors
communicable disease endorsements. There was much uncertainty around the impact on claims due to COVID-19. What would the claims ultimately look like across multiple lines? What policy coverage period would apply? In medical malpractice, many coverage triggers required
That number is expected again in 2020
74% D&O coverage price increase in the second quarter of 2020
insurance coverage. The challenges seen in the U.S.
One broker reported that over 91% of their clients
commercial insurance market are also being seen
had seen commercial property rate increases this
internationally. The U.S. has seen the highest rate
year. Even without losses, these increases have
increases, but Australia has also seen significant
been around 25%. Those with losses are seeing rate
rate increases. Other international locations
increases over 35%.
are also seeing low double-digit rate increases across multiple lines. These are driven by large
91%
losses worldwide, including natural disasters and shareholder lawsuits against directors and officers. Carriers are also pulling back on capacity in certain
of clients incurred commercial property rate increases
countries. The low interest rates globally are having a
reporting in the policy term, so healthcare providers reported thousands of claims as a precautionary measure. During all this, carriers started to grow concerned about the financials of their clients. Did they have
significant impact on carrier rates. With declining
25%
investment income, carriers have to raise rates just to stay even. Lloyd’s has been transforming for the last few
estimated increases
years. Lloyd’s acts as a de-facto regulator for the
sufficient collateral posted to cover potential losses?
individual insurance syndicates that operate in their
Some businesses struggled to pay premiums
market. They started a series of reforms in recent
because of decreased revenues. Exposures changed dramatically almost overnight. New insurance regulations intended to provide premium relief to businesses created complications in the workers’
35%
years designed to increase profitability and are also limiting their capacity. Thus, companies who are renewing late in the year could face capacity
increase for those with losses © 2020 Out Front Ideas
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Changing terms and conditions
Collateral considerations
Changing insurance policy terms and conditions
As mentioned previously, carriers have significant
are also being seen around the world. One big
concerns about whether the collateral they are
lesson in all the litigation around whether COVID-19
holding is sufficient to cover potential losses below
closures are covered under business interruption
their attachment point on high-deductible policies.
claims is that words matter.
COVID-19 has presented an unprecedented credit
It is also crucial to make sure you have concurrent wording in your insurance coverage towers. This is increasingly challenging as carriers move away from allowing manuscript or broker-driven policy language and only allow the use of their policy forms. Brokers need to work closely with their clients and the insurance carriers to develop policy language that addresses the concerns of all parties. Any change to any layer of the coverage tower harms the entire tower as many higher layers take a “follow form� approach. Not all policy language is appropriate for all insureds, and this can lead to
risk event. Usually, such events are limited to certain geographic areas or industries, but the challenges of COVID-19 impacted most businesses. It has created significant financial uncertainty around businesses. Credit risk underwriters with carriers look at debt ratios, cash flow and business operations to develop a credit grade for each policyholder. That grade is used to determine what percentage of the projected losses below the attachment point need to be collateralized on a deductible policy. There is almost always a percentage of the projected losses that are not fully covered by collateral.
increased litigation over claims. Brokers and carriers
The collateral determination process needs to be
need to make sure that the changing terms and
transparent. What factors are being considered by
conditions do not eliminate coverage for the day-to-
the carrier? What is the financial outlook for the
day operations of a business.
policyholder? The more information shared, the
Because of all the complexity in the marketplace
better the decision-making on both sides.
right now, brokers must have the time to work with
One of the challenges of COVID-19 was that it
the insured and the carrier to work out any policy
required carriers to analyze the collateral they
language challenges. The broker needs to have
were holding on their entire book of business in a
experts reviewing the policy language. Insureds
short period. Carriers focused on what accounts
need to make sure they are fully describing their
had the most significant risk in terms of funds not
business operations. Carriers need sufficient time
collateralized and the impact of COVID-19 on
to digest all this information and get approval for
their industry.
any proposed wording changes. Having a long-term relationship with your broker and carrier can be very helpful under these circumstances.
One big lesson in all the litigation around whether COVID-19 closures are covered under business interruption claims is that words matter.
While reviewing financial statements is important, collateral decisions in this COVID-19 marketplace Š 2020 Out Front Ideas
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required much more information. Are the
more risk in more predictable insurance lines?
policyholders able to access any state or federal
Are there potential uninsured or underinsured
government relief funds? Are they issuing new
exposures?
debt to increase their liquidity? What changes have they made to their payroll and expenditures? How many months of their operations can they fund with available cash? Carriers also want to know the policyholder’s view of their future. What are their expectations for reopening and their business volume returning to prior levels? There has been an increased volume of business bankruptcy because of COVID-19. However, for the most part, these have not been a surprise to carriers. These businesses struggled going into the pandemic, and the additional stresses in this environment were more than they could financially handle, necessitating restructuring
Data and analytics can assist with this analysis. Every company today is different than what it was six months ago. All the risk models are based on a risk profile that has likely changed. Companies need to know what has changed and what they expect to further change in the future. Best-in-class loss control and business operations
The path forward
are now the expectation, not the exception. If you do not have this, it will be challenging to
The theme of the Out Front Ideas virtual conference
from home. This shift will change the way that
get carriers interested in providing coverage. It
was “The Path Forward,” so we asked our guests to
businesses recruit and retain talent and how they
is important to highlight all your safety and loss
comment on what they see as the path forward for
develop their culture.
prevention activities and demonstrate how you will
our industry.
operationalize those across your enterprise.
Relationships are more important than ever before.
Video conferencing is a crucial tool to maintain
It is a mistake to sacrifice a long-term business
Consider the use of more insurance options, such
business relationships. You can video conference
relationship for short-term premium savings. Look
as captives and facultative reinsurance coverage. Advice for risk managers
with underwriters worldwide, making it much
at the bigger picture and make sure you partner
Clients need to understand their appetite for risk
It is imperative for brokers not just to deliver bad
easier to maintain these relationships than
with carriers that can meet your needs in the short
and their tolerance for volatility.
ever before.
and long term.
It is also important for companies to consider
Unless there is meaningful tort reform, the
Finally, transparency goes a long way to eliminating
the bigger picture of their employee health and
challenges in the insurance marketplace will
uncertainty and making your business partners
The timeline for preparing for renewal has changed.
wellness and the impact that has on both their
continue. As long as claims continue to grow
comfortable. Now is the time for risk managers to
Six months before your renewal is not too early
health insurance and workers’ compensation costs.
exponentially, rates will also continue to grow.
shine and show the impact they are having within
to start thinking about how you will approach it.
As workforces are evolving and workers are pushing
Carriers, brokers and their clients need to partner
their organization.
Risk managers need to involve their company
off retirement, that aging workforce is impactful to
together to pursue tort reforms across the country.
leadership to not only help develop messaging for
your claims.
under bankruptcy.
news to clients. They need to have a game plan on how to approach the situation.
the insurance marketplace but also to manage their expectations in terms of budgets.
We have shown we can continue to conduct business without in-person meetings and with many workforces working from home. What will
Companies need to look at things at a more
businesses look like in the future? Companies are
enterprise level instead of just line by line of
reconsidering which people will ultimately return
insurance coverage. Should they consider retaining
to the offices and which will permanently work © 2020 Out Front Ideas
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Cyber Risk and Insurance Technology
B
y now, no one is a stranger to the terms, “cybersecurity” and “automation.” But how
have they evolved in the last few years? In the collaboration session, “Cyber Risk & Insurance Technology,” Leah Cooper, Managing Director, Global Consumer Technology, Sedgwick, and Spencer Timmel, National Director of Cyber & Technology Insurance, Safety National, discussed best practices in cyber risk management and the state of the cyber insurance marketplace. If you weren’t able to join the conversation, here’s a quick recap about the latest insurtech and claims processing trends and solutions.
© 2020 Out Front Ideas
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01
02
Key takeaways: Ransomware
Key takeaways: Automation
• Ransomware attacks are on the rise and hackers aren’t just targeting large companies. The risk of a data
• Many organizations are diving headfirst into automation tools to ensure different scenarios are predicted
breach can occur within any organization — big or small. Spencer says the reason that smaller entities are
with confidence, minimize repetitive tasks and more. We’re closely monitoring artificial intelligence
being hit more frequently is because hackers are looking for the “path of least resistance.” Consider public
(AI) and how it applies to the insurance industry to keep up with the trends. Leah and Spencer spoke
entities that may be smaller in size but have just as much sensitive data as other companies, including tax
about the use of robotics to process information. For example, a bot can be programed to mimic human
information and credit card transactions. They don’t always have the budget for IT security, but they’re no
activities and figure out where a document should be routed.
longer flying under radar in terms of attention. • Just a couple years prior to COVID-19, most ransomware demands were less than $10,000. Today, that number can be up to seven figures. The process for retrieving data has also changed. In earlier years, hackers locked an organization down — freezing it until they received payment through methods like Bitcoin. Now it’s more technical, as hackers remove sensitive information, trading it and not giving it back until they get paid. If your organization is large enough, you may not feel like you have a choice other than
The world of automation is constantly evolving — rules-based engines being one of the latest developments, which allow you to build complexity into processes without hard coding.
to abide by their terms. And while encryption is helpful, it’s not the solution. Multi-factor authentication is the number one way to prevent these types of attacks. Ransomware, as well as malware, are now also finding their way into organizations’ backups, sitting dormant with a timer that will activate when systems are backed up. • Insurance comes into play for ransomware demands in terms of payment and negotiation, but also in navigating the incident alongside leaders in the organization. Insurance can help in hiring and paying for attorneys as well as forensic investigators to figure out the type of ransomware and who the threat was intended to go after. If malware shuts down an emergency room and the hacker gains access to patient records, patient care is at risk. The demand may be half a million dollars, and the stakes are high. But in a scenario like this, there are concerns about whether the hackers have the credibility to return the data once a price is negotiated.
• Several other tools we’re seeing on the market have become so sophisticated with sliding scales for predictive modeling, showing you various confidence thresholds of the likelihood of different scenarios. In addition, one system can ping another system for data. This can be used for simple things like validating addresses or more complex like assessing claims to determine if an attorney should be involved. Another development we’re keeping a close eye on is auto-adjudication, using advanced AI to pay or deny insurance claims without having to manually review each one.
An approach to automation is dependent on three things: 1. Claim triage A process of determining severity and complexity. 2. Eligibility Factoring in coverage on the front end. 3. Validation AI needs to pull out required information, such as repair estimates and billing dates.
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01 02 03 04 05 Ask the Medical Director
D
uring the Out Front Ideas virtual conference, one of the collaboration sessions featured the
expertise of two leading industry medical directors. The collaboration leaders for this session were: Dr. Teresa Bartlett, MD Chief Medical Director, Sedgwick Lisa Haug Director of Medical Management, Safety National
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The discussion focused on a variety of challenges.
their office and billing thousands of dollars to
to increase absorption in the skin, which can be
awake the next day and additional medications
Some highlights included:
cover their costs. It’s important to realize that
very dangerous and has a high risk of side effects
to help him function properly. When addressing
01
PLTs do not require a prescription in a majority
when combined together. For example, Capsaicin
each drug category and seeing what was
of cases, which makes it even more baffling and
is OTC, but the new product is eight times the
given to the patient holistically, we realized the
concerning to see so many providers dispensing
concentration and it has the potential to burn
therapy was not working from a quality of life
these high-cost medications when less expensive
your skin; the FDA had a warning, if you had a
and health perspective.
alternatives exist.
sleeve over it, can increase the absorption.
Topical drugs and spend increases • Over the past few years, we have seen a decline in opioid prescribing as well as compound prescribing. With declines in spend for both of these, the collaborator team indicated seeing a trend or increase in topical spend in the industry. • The drastic increase in topical has less to do with the volume of topical prescribing and much more to do with the average cost of the medications being prescribed/dispensed; many products have been averaging between $1,000 and $5,000 for one prescription. • As an example, diclofenac gel is a common antiinflammatory topical that can cost anywhere between $30 and $50 – now available overthe-counter (OTC). However, some providers are prescribing other high-cost formulations of topical diclofenac, such as Pennsaid 2% solution, which can cost thousands of dollars for a 30-day supply. • Another issue is the use of private-label topicals (PLTs). These are typically medications made up of a combination of topical products to treat pain (examples include lidocaine, menthol, capsaicin, methyl salicylate). Even while these products can be found in similar combinations OTC at very little cost, physicians are dispensing PLTs out of
• We see a lot of this activity happening in states like FL, GA, IL and PA, to name a few. • Overall, the problem with high-cost topicals is that they do not provide the expected value for injured workers and only inflate costs as certain prescribers ignore less expensive topicals that contain the same ingredients. • It’s critical to have a formulary in place or third party pharmacy prescriber. Because topicals
• Opioid case – In this case, decreasing some of
• PLTs are in formulations and strengths that are
the medication actually helped the patient with
not FDA approved; it’s kind of like topicals have
pain. With pain under control, they were not
replaced the dangers of compounds in a lot of
needing hypnotics to fall asleep.
ways, with a niche and a revenue stream.
• Highlighting some of those issues in front of the
02
judge can be helpful sometimes. • When we talk about a case from a legal perspective, we really don’t talk about it from a
Dangers of opioids
financial perspective. The goal should be to do the right thing and what is healthy for an injured
• Dr. Reema Hammoud Pharm.D, BCPS, AVP
are very expensive, going through non-network
clinical pharmacy at Sedgwick, has testified in
worker to get them back and restore their life; the
pharmacies can add to the costs. It also helps to
front of judges about the dangers some of these
money will follow, but your focus needs to be on
have clinical support.
medications can pose to someone’s life. She
doing the right thing.
• Safety National indicated their pharmacy benefit
noted two cases – one was on the dangerous
• For the patient to be in a good state of mind
manager (PBM) is seeing out-of-network private
combinations we typically see like opioids and
and not altered from the medications, and have
labeling of topicals costing between $1,300-$1,700
benzodiazepine plus hypnotics; the other was
functional improvement, that’s always our focus.
a month versus $250 if the topical is in-network
related to a psychotropic.
through the PBM. They encourage use of a PBM
• Psychotropic case – Often, prescribers are afraid
and getting out in front of the physicians by
to change psych medications because they
utilizing field nurses to have that conversation.
appear to be working well for the patient or
• Those PLTs are not usually compounded
the patient has aggression and the prescriber
medication; they are from some type of
is reluctant to make a change. In this case,
pharmaceutical company or dispensed at
the medications were not actually good for
a doctor’s office or pharmacy. One of the
the patient. Beyond the side effects, the
problems is the concentration of the drug in
combination of medications were creating new
them; it’s really high. Oftentimes patients are
problems, which required the patient to take
using multiple topical products and they tend
more medication, such as stimulants to stay
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03 Using psychedelic drugs to treat depression and PTSD • Psychedelics were listed as a schedule 1 drug several years ago; they are hallucinogenic and work by altering the conscious mind; they bind on the serotonin receptor very similar to antidepressants, but they also cause visual
The only exclusion is patients with schizophrenia and bipolar disorder. The thought is that if they have a disorder; if somebody has this or a family member that has this, the risk of after-effects of this drug could be higher. This approach could get FDA approval next year.
04 Medical marijuana and
hallucinations and help patients go deep and
Safety National approach
explore their inner self. Often, we categorize other
• Safety National’s approach is on a case-by-case
05 Sedgwick’s approach for COVID-19 treatment • On the vast majority of our claims, we’re not seeing much treatment, they’re either in the hospital or at home not feeling so great, maybe on albuterol or a steroid. • We are going beyond the headlines to see what the data really says about hydroxychloroquine, the steroids, the antibodies and the vaccine; we spend
drugs as psychedelics, such as cannabis or MDMA,
basis and it depends on the injured worker.
a lot of time looking at the data, and there is so
but the classic psychedelics (LSD or others) are
Working with a physician and with knowledge
much we don’t know yet.
the drugs we’re starting to see again.
that we know medical marijuana is not FDA-
• When you think about PTSD, you think about a
approved; we’re concerned about the long-term
terrible event and that event gets imprinted on
effects of marijuana. We had an injured worker
the brain, and that’s why people keep reliving.
who had a high MED, who was on a long history
Every single day, throughout their waking
of opioids, so in order to wean him off we offered
hours, they’re in that moment and it’s really
to pay for medical marijuana. He is still receiving it
painful for them. If these psychedelics are used
and it has been effective. The key is that you have
in conjunction with a psychotherapist, they can
to work with the physician; they look at all of the
help an individual talk through how that imprint
medical records to identify the proper dosage.
was put there incorrectly. Under a therapist’s
One concern expressed that medical marijuana is
guidance, psychedelics may help remove that
not always in the purest form.
imprint from the reality of every day. • A patient has to be enrolled; there is a period of
• There isn’t a purest approach; you’re under the influence no matter whether marijuana is medical
prep/talk to therapist. This particular study has
or not. It’s a safety-first initiative; without any
two therapists and the patient wears a shade;
regulations and formularies in place, there are
they almost always experience a bad trip. The
no tools in the industry to help us get out of a
hope is that the therapists will guide them
previous use case, so you could be stuck with
through it and they will overcome the imprint on
one for a very long time; the treatment is not
their brain and get out of it; then they sit with the
inexpensive and it might not get them back
therapist again, who monitors them afterwards.
to work. © 2020 Out Front Ideas
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ASK THE MEDICAL DOCTOR
Questions from attendees Are you still seeing a large volume of long-tail
Are PBMs getting good responses for mail
Why don’t we use our pharmacists to also write
What does everyone think about the changes in
high opioid use claims and what tools are you
order versus retail? Any suggestions for how to
independent medical exam (IME) questions?
the guidelines on COVID-19 aerosol spread
using to help those claims progress?
effectively advocate for that change?
• Sedgwick makes this distinction all the time
and testing?
• From a Safety National perspective, we are
• Sedgwick has been doing that for a while,
• In recent days, the CDC accidentally published
because it’s not just, “Should this be covered?” –
noticing a decline; it’s trending in the right
especially with COVID-19 we made a big effort on
we ask very specific medication questions that
a new guideline where they’re claiming the
direction in that aspect.
our side to look at our PBM and ensure we were
physicians should answer during the IME. They
COVID-19 virus is airborne, and then they walked
converting things over to home delivery where
don’t look at the dosage and the frequency; they
it back saying it was too soon. If they say it’s
these conditions and pay for just reasonable
we could. Still, there is a general lack of desire to
just look whether the drugs/drug categories are
aerosolized, then that means 6-foot distance is
and necessary medical; sometimes examiners
go to mail order, but we work with our examiners
reasonable and necessary and sometimes it just
no longer good enough, maybe the mask is no
interpret that as anything on the claim they have
and pharmaceutical teams to educate injured
comes back “yes.” When you ask very pointed
longer good enough, so all the other guidelines
to pay for. We use utilization review and we try to
workers on the benefits of mail order when it
questions, the IME comes out a lot differently.
from the CDC have to change to go along with
help them realize that we’re paying for things that
makes sense.
• Usually, the judge says you have to accept
are causing harm, and not in the best interest of the injured worker.
• Not everybody can be on home delivery for
what the science is showing them.
• The medical directors suggested highlighting
• Hydroxychloroquine is an existing treatment
facts about the injured worker – this is the current
medications that are not supposed to be taken for
disease state, this is what they tried; look at the
used for malaria so they tried it and different
a long time. Most of our patients are on opioids
facts first and what the guidelines say; examine
drugs came out after, antiviral drugs they’re trying
or benzodiazepine; you don’t want to just auto-
the patient and tell us what you think is right.
for COVID-19. Literature is coming out every day,
refill those medications or ask the provider to
but the guidelines are not updated as quickly
add an extra refill if it’s opioids or a Schedule
as the data is coming out; it changes every day/
II medication that’s not written for three or six
every hour. We look at symptom management
months. We can only convert people who are on
first; if somebody is hospitalized, they will get
chronic medication, and even from that chronic
anything they need. It’s more difficult to manage
section, we have to see what makes sense.
symptoms in an outpatient setting. If they need inhalers or oral steroids, cough suppressants or Tylenol/Motrin, our COVID-19 formulary makes sure they get those right away and there is no prior authorization needed.
© 2020 Out Front Ideas
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The Future of Risk Management
I
t seems like 2020 should be the year of the risk manager. Facing new challenges every day,
the decisions they make now could impact the reputation of their organization for a lifetime to come. COVID-19 and civil unrest have presented a unique set of challenges that have facilitated collaboration between departments within an organization, forcing even the most siloed risk management model to rethink its approach.
“I’ve been fortunate enough to work with Chick-fil-A when we were a traditional risk organization, and when we moved over to the enterprise risk management model,” said Steve Figliuolo, Enterprise Risk Management at Chickfil-A. “I’m really fortunate that we have moved over
During the Out Front Ideas virtual conference, Steve Figliuolo joined moderator Mark Walls, Vice President Communications & Strategic Analysis at Safety National, and panelists, David Stills, Global Risk Management Executive at Sedgwick and Tamika Puckett, Chief Risk Officer for the City of Chicago, to discuss their evolving roles and what the future of their industry looks like.
to the enterprise model in the last couple of years because it has made our process seem seamless.”
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Developing the enterprise-level model
deeply ingrained within an organization’s structure,
protective equipment they would need for each of
image on whether or not it’s safe to be a resident
Changing a siloed risk management approach
but breaking down those barriers helps expose
their stores, noting that they were questioning early
here,” Puckett said. “We’ve created a business-
may be met with resistance, but with the amount
areas of opportunity for each department. Quite
on, “When this comes here, what are we going to
based committee to address health and safety
of uncertainty facing each department currently,
often, this collaboration provides a platform for
do to be prepared?”
needs and concerns of the community, and we’re
understanding correlated risks and developing
departmental leaders to discuss big-picture
a unified strategy are key to the stability of
opportunities.
company that’s succeeding or even surviving in this environment has some level
departments, a number of sister agencies, 35,000
a pandemic and ongoing civil unrest. The fickleness
or more employees and a workforce that is 95%
of an audience often makes transparency the best
unionized, so siloing is a way of operating here,”
approach in maintaining the character of
Challenges of the insurance marketplace
Puckett said. “The way I’ve addressed it is to step
an organization.
Risk managers currently face one of the most
perform a traditional risk assessment to identify
Stills said. “Previously
a strong focus.” Stills offered further advice to risk managers that are currently building a unified risk management strategy. “You can also help break down the silos in your company where information and planning related to risks are limited to certain people, particularly around new business ventures and offerings.” He suggests offering solutions by using the tools that you have as an insurance purchaser to influence the buying decisions. Risk managers that work within the public entity sector face the challenge of breaking down silos
of work to do, but we will continue to do the things we’ve been doing.”
challenging markets that most have seen in the
back and take a full assessment of the city and
In coordinating with labor union leaders, the City
division, but it was still
to operate and remain in the city. We still have a lot
course of a company’s reputation, especially amid
enterprise-wide areas of opportunity.”
didn’t have an enterprise risk
community so they can reopen safely and continue
“Chicago is the third-largest city in the country, 34
of enterprise risk function,” working for Walmart, we
Reputational risk The volatility of social media can easily change the
an organization.
“It’s accurate to say that any
creating consistent guidelines for our business
of Chicago has pushed to create pilot programs to make changes across the organization strategically. “What I’ve found after meeting with labor union leaders was that a lot of the changes we suggested to improve efficiencies were things that were already desirable to them,” Puckett said. The pandemic has further exposed the dangers of a traditional siloed approach. Embracing a
“A good name is rather
past decade, if not their entire careers. Concerned with the future of claims impacted by ever-
to be chosen than great
changing presumptions, some are waiting to see
profits,” Figliuolo said. “In
the effect on their policies.
this pandemic, we wouldn’t
“I’m waiting with bated breath to see what type of tort reform we may see and how it will impact our
have been able to leverage
workers’ comp policies, general liability policies,
some of those relationships
and what that trickle-down effect is going to be,” Figliuolo said. Considering alternatives to their
without the reputation
traditional insurance purchases, Figliuolo also
we have.”
noted that it’s making them think differently as a company. “Maybe we want to start self-insuring
collaborative model allows for a shared vision and
Deciding to close down dining rooms early on,
reveals the risks hidden in each department, which
Chick-fil-A wanted to ensure the safest experience
has become vital to the health and safety of both
for their guests.
certain lines or find a different avenue to find that coverage. There may be opportunities available that we didn’t look at before because the need
employees and guests.
wasn’t there.”
Dealing with significant civil unrest, the City of Figliuolo and his team at Chick-fil-A had war
Chicago has pushed to keep its residents and
room sessions early on that enabled different
businesses feeling secure, focusing on encouraging
departments to speak to how they would be
citizens to remain in the city. “We have the
affected. The collaboration allowed them to begin
reputation of the Chicago Police Department,
preparing in early March for the amount of personal
which has had a huge impact on the city and its © 2020 Out Front Ideas
As a solution to rising insurance rates, many public entities, especially larger municipalities, have decided to forgo purchasing insurance, opening them up to a multitude of risks.
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45
In opposition to this approach, Puckett said, “I encourage the purchase of insurance and an assessment to determine what levels do we need insurance and what levels do we need to retain the risks.” Having similar concerns regarding rebuttable presumptions, Puckett noted that the city is self-
“This is new territory, so don’t throw away your common sense. Remember that the endgame isn’t
insured for 100% of those costs.
to buy or not buy, but to
Faced with the challenge of determining whether
protect your company’s
or not to purchase coverage, Puckett added, “There is an assessment that we perform to determine whether or not it’s beneficial to add in an excess
balance sheet and reduce their volatility.”
layer. Additionally, we purchase other insurance
The path forward Knowing that this industry will forever be
The restricted market has forced some difficult
for our property, and we purchase a liability policy,
He also stressed the importance of communicating
changed due to the pandemic and civil unrest,
conversations between risk managers and their
which is not common with most public entities
with leadership to manage expectations around
many organizations have already started
leadership. Conditioned to previously depressed
I’ve worked for. That’s one where historically in the
premium capacity retention and potential
planning how they will prepare when faced
rates, risk managers are facing harder decisions
municipal sector, we have taken the risk of hoping
exclusions. “If an insurable risk is going to
with further uncertainty.
when it comes to purchasing insurance.
that it doesn’t happen.” With the city having a
experience significant change in retention or limits,
history of claims and payouts related to police
your company needs to know this in the planning
Concerned with further civil unrest with a
“Be disciplined on your insurance purchases,” Stills
liability, which has currently become a national
stage as they’re considering what other risks and
contentious election in November and the future
said. “Understand the efficiency of your insurance
concern, Puckett noted that they occasionally have
initiatives to take on for the year,” Stills said.
of COVID-19, Puckett’s committee is refining new
based on model losses and look at prior losses.”
to dip into their excess policy.
policies and procedures, staying abreast of new
Stills also discussed the importance of offering
legislation and making adjustments based on new
Many risk managers are also dealing with extremely
solutions and having recommendations backed by
CDC guidelines. There have also been considerable
challenging renewals with restricted capacities,
analytics and modeling, noting that considering
adjustments to technology to be able to serve
significant rate increases and constricted terms
a holistic approach to your program will leave you
constituents. With a $1.3 billion deficit, Puckett
and conditions.
less vulnerable to market swings. While choosing
also addressed how they are working to retain
a different carrier may also offer cost savings, Stills
employees without any layoffs or furloughs. “Our
Having purchased insurance for one of the largest
added, “Think twice about jumping ship on a loyal
budget chiefs are working very hard to balance the
employers in the country, Stills offered some
carrier. There’s value in long-term relationships.”
budget and not create additional debt in the future.
sage advice.
With a considerable amount of uncertainty regarding the future, many companies are rethinking their operations completely. While questions remain unanswered, risk managers are preparing for all possible outcomes. “From chaos comes clarity,” Figliuolo said. “Even if organizations don’t have a formal risk management department, they’ll realize every decision they make
Through the use of enterprise risk management
is risk management—decisions of cause and effect.”
and breaking down those silos and pulling all the
From chaos
comes clarity
impacted parties into timing on decision making is the way we’ve been able to manage so far and how we’ll continue to manage moving forward.”
© 2020 Out Front Ideas
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47
Mental Health Issues in the Workplace: A Mounting Threat
W
orkplaces across America have recently instituted safety measures like social
distancing, face masks and remote work arrangements to protect their employees amid the coronavirus pandemic. While these precautions address the emerging physical health risks, employers should take a holistic view and also consider employees’ mental health — especially during such stressful times. On September 22, two foremost experts on employee well-being — Kimberly George, Head of Healthcare and Innovation at Sedgwick, and Darcy Gruttadaro, Director of the American Psychiatric Association Foundation’s Center for Workplace Mental Health — explored what they dubbed the “mounting threat” of mental health issues in the workplace during a “fireside chat” session at the Out Front Ideas virtual conference.
© 2020 Out Front Ideas
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49
In particular, Gruttadaro highlighted some of the
Its advice for employers includes:
Center’s research and resources designed to help
• Show empathy for those facing difficult
organizations meet their employees’ mental health needs. The Center, Gruttadaro said, was established about 15 years ago to address disparities in mental health coverage, promote employer engagement, and demonstrate the benefits of workplace mental health programs for employers and employees
circumstances.
According to the Center, “employers can make a positive difference for all employees and their organizations by focusing in [the following] four key areas.”
• Use virtual meeting tools to keep employees connected. • Promote the benefits available to employees through their medical plan and EAP.
01
02
Leadership
Adapt to change
Leaders should offer calm reassurance, set a
Employers should review their policies and
positive tone, show empathy, and make mental
practices to see whether amendments are in
health a visible and safe topic.
order to keep people healthy and safe during the
alike. The Center’s three main areas of focus are
As the COVID-19 pandemic wore on into the
raising awareness about employee mental health
summer, Gruttadaro and her team considered
concerns, helping employers create healthy
whether employers were doing everything they
workplace cultures, and improving employee
could to support employees and their families.
access to care through benefit design, employee
Building on a recent finding by the U.S. Census
pandemic. They should also explore opportunities
assistance programs (EAPs) and other means.
Bureau that the number of people experiencing
to create employee connections while people are working remotely. Leaders should be open
signs of depression and anxiety has nearly tripled In recent months, the Center has published two
during the pandemic, along with the results of
well-received guides that address mental health
a PwC survey identifying employees’ multiple
needs during the current pandemic. In the
concerns about returning to the physical workplace,
spring, they issued Working From Home During
the Center published Employee Mental Health
COVID-19 for the millions of Americans who quickly
& Well-Being During & Beyond COVID-19, which
transitioned from working at an office/job site to
introduced the LEAD model.
to modifying their personal leadership styles and showing their own vulnerability.
03
04
Effective communication
Double down on
Companies should commit to regular check-ins
reminders for new telecommuters, such as:
mental health coverage,
access to care
source of information. It’s better to tell employees
Employers should share mental health and
• Set a daily schedule.
promote employer
what’s known about the return-to-office plan than
well-being resources with employees, focus on
• Maintain connections at a distance to stave off
engagement, and
not to tell them anything.
strengthening prevention and early intervention
working remotely in order to curb the spread of the virus. The guide — which has been viewed online more than 180,000 times — offers concrete
feelings of isolation. • Stay physically active. • Continue treatment and medication for any previously diagnosed physical or mental health conditions.
...address disparities in
with employees, listening and being a trusted
efforts, promote EAP engagement, and work with
demonstrate the benefits
benefit plan administrators on improving employee
of workplace mental health
health and substance use care — including tele-
access to timely, affordable and effective mental behavioral health options.
programs for employers and employees alike. © 2020 Out Front Ideas
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51
• Leverage technology. Online services like
More helpful resources
Issues of access to mental healthcare are a
To close the session, George challenged employers
significant concern. Many providers don’t
to treat mental health holistically, much like the
Talkspace may help employees get professional
participate in insurance networks, so patients’ out-
workers’ compensation and occupational medicine
help faster than through an EAP referral.
strategies to help employers raise awareness
of-pocket costs are high. Further, because of high
industries have with musculoskeletal issues.
Gamification and apps that can be personalized
about depression and improve workplace
demand, it’s common for mental health providers
Taking a multi-faceted approach to addressing
— like Happify, Headspace and Calm — can
mental health.
to have a 3-6 month waiting list for an appointment
workplace mental health — including factors like
boost employee engagement. And especially
or to not be accepting new patients. To address
safety, technology, engagement and access to
while many people are working remotely, online
Shepell, the monthly index measures the
these issues, the Center joined forces with other
care — will benefit not only employees, but
collaboration and meeting tools are critical to
mental health status of employed adults in the
influential organizations to develop the Path
employers and their operations as well. As
helping employees stay connected and feel a
U.S., Canada, UK and Australia, compared to
Forward initiative*. The collaborators developed five
Gruttadaro said, “It is good for the bottom line for
sense of belonging.
benchmarks collected in the past three years.
top-priority, evidence-based strategies to improve
employers to support their employees who need
early detection and access to behavioral healthcare:
mental health assistance.”
1. Improving network adequacy for behavioral
*The Path Forward initiative is not affiliated with the Out Front
health specialists.
Ideas “Path Forward” virtual conference.
2. Expanding adoption of the collaborative care model of integrated care. 3. Implementing measurement-based care in behavioral health. 4. Improving and sustaining momentum on telebehavioral health.
Advice for employers • Begin with the basics. Let employees know you
• Right Direction – Free tools and actionable
• Mental Health Index – Provided by Morneau
• Mental health calculators – Tools to help quantify the impact of employee depression, alcohol use
M E N TA L H E A LT H M O N D AY
and substance use on organizations’ healthcare, absenteeism and lost productivity.
Face-to-Face
• Suicide rates by industry and occupation – Compiled the Centers for Disease Control and
Wellness gift packages
Prevention (CDC).
care about their mental health. Share information
• Talk Saves Lives – An educational program
about the early warning signs of depression and anxiety in your internal newsletter, on the
produced by the American Foundation for Suicide
• Small gestures can make a big difference.
Prevention that includes research on prevention
intranet and at employee health fairs. Make your
Implement regular check-ins with your remote
workplace a safe space to talk about mental
teams, like “mental health Monday” or a
Gruttadaro and George hope one good thing that
health; work the correct terminology into the
virtual daily touch-base over morning coffee,
comes out of the pandemic is the normalization
organizational conversation in order to reduce
to compensate for the loss of face-to-face
to reversing the addiction crisis by improving
of tele-behavioral health. Estimates reflect that
the stigma.
interaction during the pandemic. Send wellness
treatment, ending stigma and influencing policy.
5. Ensuring mental health parity compliance.
up to 90% of care in mental health is currently
• Don’t reinvent the wheel. Many organizations
and what people can do to fight suicide. • Shatterproof – A national organization dedicated
gift packages to employees’ home addresses to
• Notice. Talk. Act. at Work – The Center’s
reinforce that the company cares about their
forthcoming e-learning module for people
well-being.
managers, covering the warning signs of
being delivered virtually. If that momentum can be
struggle with how to begin addressing mental
sustained, one caveat is ensuring that the quality
health, but there’s no need to start from scratch.
of care is comparable to that of face-to-face mental
For inspiration, use the Center’s database of case
health treatment.
studies — searchable by industry, geographic
Support resources, like the EAP, are often viewed
with employees in distress, and what to do to
location and employee count. Consult with your
as an HR function. Train front-line managers on
most effectively help. A pocket guide for quick
benefits provider/EAP for more ideas on broader
what to watch for in their employees and what to
reference, along with a readiness guide, will also
mental health and well-being campaigns.
do when someone needs mental health support.
be provided.
employee mental illness, how to speak genuinely
• Make mental health part of the safety culture.
© 2020 Out Front Ideas
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53
Adjusting and Adapting the Claims Handling Model
I
n this session, an expert panel explored the shortterm changes that have occurred in the industry
during the pandemic — and considered the longterm impacts we all should anticipate. To explore this topic, Sedgwick’s managing director of client services, Kathy Tazic, and an expert employer panel, dove into the changes they’ve seen throughout COVID-19, and how they see changes continuing our path forward. Panelists included: Virginia Baba Senior Manager, Claims and Risk Management, PetSmart, Inc. Nathan Fraley Corporate Claims Manager, The Kroger Co. Debra Howie System Director, Workers’ Compensation Claim Operations, CommonSpirit Health Faith Mason Senior Manager Workers’ Compensation Claims, Comcast NBC Universal © 2020 Out Front Ideas
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The impact of — and reaction to — COVID-19
are having to enforce the policy and deal with
And like so many essential businesses, Comcast’s
system, right now their claim review process is
“The dogs are loving it!” Our animals may be
aggressive — or in some cases, even violent
technicians are adjusting to entirely new protocols
much the same as it’s always been: have regular,
reacting well to all the extra time we’re spending at
— reactions. In response, some businesses are
on how to interact with customers, and with
ongoing discussions with adjusters. Reach out
home, but for the rest of us, this pandemic has been
rewriting their ethics and integrity policy to include
each other.
when there’s a concern. Continue to have strategy
a changing force in how (and where) we work, what
these types of events, so employees feel better
we prioritize and the way we communicate.
prepared and equipped to manage these types of scenarios.
For retailers like Kroger, working from home was
calls. And remember that there’s often more than With locations across 21 states, CommonSpirit
one answer.
Health needed to focus on getting a handle on all those different jurisdictions, presumption laws
PetSmart places high value on the in-person
a real adjustment. While their employees are
Faith, a senior manager with Comcast, shares
and legislation that was (and is) changing nearly
experience. “We view our adjusters as part of
appreciating the flexibility and a slightly more
that the most dramatic COVID-related change
every day. “Flexibility is crucial,” Debra echoes,
our family,” Virginia says, explaining how her
casual environment, the organization has focused
she’s experienced has been her own approach to
“as is recognizing when it’s necessary to pivot in
organization sees adjusters as the company’s face
on the mental health side of things. Missing that
managing her team. Remote work has demanded
order to stay efficient and focused.” She thinks the
to its injured associates. Because they’re needing
in-person interaction employees are so used to,
a much more upfront style, along with increased
greatest upside for her organization has been the
to do much of the work virtually right now, they’ve
they’re making the most of video chats, virtual
transparency and flexibility.
development of new relationships among different
shifted to doing two-day claim reviews rather than
departments — finally!
one, to prevent fatigue. It’s a little tougher to look at
happy hours, regular check-ins, even games. Nathan predicts that, going forward, we’ll probably see a lot more work from home, but acknowledges that managing time at home can be a tough adjustment. His advice? Take a lot of walks. For Virginia and the team at PetSmart, fewer stores open and the majority of corporate employees working from home has meant a notable decline in general liability claims. One unexpected downside? A rise in “buy online, pick up in store” (BOPIS) claims — signs were blowing over and carts were rolling away and damaging vehicles in the parking lot. It led the group to enhance its safety policies — and to start thinking long-term, because BOPIS has
“Home and work used to be very separate; it’s almost impossible to maintain that right now. We’ve got kids in the background. Puppies popping up. Spouses wandering into the room. For me, it’s been all about learning to be more
a screen all day than a person. Specific challenges to claim reviews COVID-19 has provided an opportunity for us to ask
Likewise, Comcast has adjusted its approach by
ourselves: what can we do, going forward, to make
scaling back, discussing maybe 10 claims in an hour
these reviews even more effective, and make the
and a half or so, rather than 20 or more. And they’re
process and its outcome more successful?
using that time to really engage the team through “mental check-ins,” diving into what the adjusters
With more than 500,000 employees, Kroger has
are going through right now.
never really done “typical” claim reviews with all the travel, etc. Now they’re hosting virtual monthly
Accessibility of services
settlement calls through Teams or WebEx. Since
The panelists each had unique takes on how to
they can’t talk through every claim, Nathan
not only address today’s challenges of returning to
explains, they’re focusing more on those claims we
work, but turn these challenges into opportunities
need to discuss, maximizing efficiency — a “just the
to take into the future.
present with my team — and
facts” approach to moving forward.
look like come winter?
clearer on what they need
At CommonSpirit, they’ve never quite felt that
treatment for employees with non-COVID-related
One challenge for many employees throughout the
from me.”
traditional claim reviews — spending days
issues, and were able to extend their return to work
preparing just to rehash everything you’ve already
policy from three months to six when it made
covered — was the best use of time. Because
sense. For them, telemedicine has been most
been successful. What will safety protocols need to
pandemic has been customers who are belligerent about wearing a mask in the store. Employees
Early on, CommonSpirit recognized a delay in
they’ve always given local leaders access to the © 2020 Out Front Ideas
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57
popular for minor cases. Because they’re in a lot of rural areas, the group had worked to implement telemedicine even before COVID-19; it hadn’t gained popularity before the pandemic and they haven’t
Key takeaways from the panelists
Ask the Claims Experts
Faith, Comcast:
As the claims industry continues to grow, so does the list of questions. In the collaboration session, “Ask the
We don’t know what our “new normal” will be, but we’re
Claims Experts,” Max Koonce, Chief Claims Officer Casualty, Sedgwick, and Mitch Neuhaus, Senior Vice
already working toward it — COVID has pushed us. We can
President Claims, Safety National, discussed the challenges related to workers’ compensation and general
seen much growth in its use since, but Debra still sees a lot of opportunity to take it further. Kroger also hadn’t used much telemedicine before the pandemic, but are really encouraging it now, as more of their employees are returning to work. Comcast, on the other hand, has seen a drastic increase in terms of employees choosing telemedicine for treatment — they have a heavy presence in most major cities and density brings
continue pushing claims reporting. And we can embrace that this experience is forcing more advocacy and empathy. COVID made me a better, more open manager; it’s made me more present and more transparent with my team, and more
Key takeaways
Keeping our fingers on the pulse
receptive to my team’s needs.
It may be years before we know the full impact that
The workers’ compensation and liability claims world is
COVID-19 has had on the claims industry, but it’s
constantly evolving, but we’re keeping a close eye on the
important to cover all your bases during that time. If you
following topics.
a real fear. They’ve partnered with Concentra for their telemedicine program and are directing employees to those resources; the telerehab solution in particular has been popular, especially with technicians. Faith believes it’s important for
Nathan, Kroger: Let’s stay mindful. This virtual world will continue. More emails,
more so to continue meeting the workforce where they are. Like so many, Comcast’s workers range from junior to more seasoned, and they want different things. “As the world changes, we need to
have a COVID-19 claim, avoid making assumptions or
more texts. It’s easy to miss nuance with digital interactions, so
delaying the process. Taking care of the claimant as soon
be sure to reflect empathy in every conversation, no matter how
as possible will lead to a quicker settlement. Another
it’s taking place.
factor to consider amid the pandemic is the development
the industry to continue offering these additional avenues for reporting and treatment, and even
liability claims. If you weren’t able to join the conversation, here’s a quick recap.
Debra, CommonSpirit Health:
shoppers to wear masks in order to enter the building.
Conversations were easier when we were all together; in claims,
If someone trips in the store, they may get creative and
we suddenly have a huge remote workforce. We need to figure
blame their mask for limiting visibility and making it
out creative ways for our claims teams to continue having those
difficult for them to see their feet. But liability concerns
casual, one-off conversations we used to have when we were getting a cup of coffee. Make your team turn their video on! Virginia, PetSmart:
3. Potential civil litigation in regards to COVID-19 claims. 4. Concern of nuclear verdicts impacting liability claims. 5. Structured settlements dependent on interest rate selling more difficult.
COVID-19 has affected all aspects of our lives, with our
6. The impact on claims management operations,
health becoming a particular challenge. Fortunately,
including stalled litigation, increasing costs of existing
the era of telemedicine has empowered people to get
distribution centers, where it was slow-moving, and
— we’re trying to perform a regular work day in less-than-ideal
of workers’ compensation. Telehealth has always been
in stores, where they had a capacity issue without
work spaces. For us, telecommuting and working from home
a convenient alternative to visiting a doctor in person,
will probably never be the norm — we’re performing well and
but in a COVID-19 environment, it’s allowed patients
making the most of it, but we miss the connectedness that ties
to practice physical distancing while still receiving
into our mission and vision. We miss each other — and the pets
consultations for everything from mental and physical
— too much.
including property, liability and PTSD claims.
and discount factor – lousy interest rates making
Not everyone has the perfect space at home to make this work
organization has telePT on its five-year road map.
2. Challenges that may come out of recent civil unrest,
aren’t the only thing to consider.
PetSmart had just rolled telemedicine out to its
theirs to build confidence in telemedicine, and the
How the pandemic has impacted overall claims management operations.
of liability claims. Many retailers, for instance, require
change with it,” stated Faith.
much private space. Virginia says it’s still a goal of
1.
claims due to delays and an uptick in COVID-19 claims
back on track, virtually — further improving the world
for essential industries. 7. Presumption laws – are they truly a risk controlled by the employer?
therapy to ergonomic evaluations.
© 2020 Out Front Ideas
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Public Entity Challenges
D
uring the Out Front Ideas virtual conference, one of the collaboration sessions focused on
public entity employers. The collaboration leaders for this session were: Ariel Jenkins Assistant Vice President Risk Services, Safety National Jody Moses Managing Director, Public Entities Pooling & Associations, Sedgwick Jeff Rush Workers’ Compensation Program Manager, California JPIA Jim Thyden Insurance Program Manager, California JPIA Š 2020 Out Front Ideas
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61
The discussions focused on a variety of challenges
can create significant challenges in securing
Social inflation
faced by public entity risk managers. Some
coverage as the carriers will favor the public
• Juries are tending to view trials as opportunities
highlights included:
entities with lower exposures. This could leave
to punish corporations and governmental entities.
and higher costs for services provided. Layoffs are
higher-risk public entities without coverage.
With the significant current anti-government
inevitable if this is not addressed with relief from
sentiment, it is very difficult to get a fair trial
state or federal government.
Property insurance • In the public entity sector, carriers are leaving the marketplace and those that remain are reducing overall capacity and policy limits.
• It is worth considering changing your insurance renewal dates so you will get more attention from the marketplace. In addition, you should
• Public entity budgets have been severely impacted by COVID-19 with lower tax revenues
with a jury.
• Smaller public entities do not have full-time risk
• Another challenge for public entities has been
managers. That means they were unprepared for
start working on your renewals several months in
increasing the statute of limitations for bringing
the challenges of a pandemic and their response
advance so you can secure coverage before the
certain claims such as sexual assault/sexual
is hampered because of inadequate resources.
capacity of the marketplace starts to
molestation. This means that new claims are
become limited.
arising that happened years ago. This makes
This is an increasing problem with people working
these claims very difficult to investigate and
from home using their own equipment which
their risk tolerance. As claims costs increase,
defend. It also means that the insurance coverage
may be inadequately protected.
carriers are looking for public entities to take
that was in place is likely inadequate based on
damage and tightening definitions of what is
larger retentions. Higher retentions can also lower
today’s jury environments.
excluded as a riot.
your insurance costs.
• Less capacity and higher losses are leading to higher rates and premiums. • Some carriers have left the California market because of wildfire risk. • Civil unrest is also impacting property renewals. Carriers are limiting coverage for civil unrest
• Nonconcurrent terms pose an increasing
• It is also a good time for risk managers to examine
• Law enforcement liability cases are particularly
the policy coverage and exclusion terms are not
plaintiff. Juries seem to feel there are no justified
consistent throughout the layers of your insurance
shootings by police. COVID-19
coverage and can create unintended gaps in your
• Risk management requires diligence. Shared
when it’s coming from other areas and damaging
rates, having everyone renew on the same date
already understaffed because of challenges in recruitment. Increased retirements will only make this situation worse. • With inadequate staffing, the chance of mistakes
• Public entities are also concerned about civil
Most states have not taken any action to limit
• With diminished market capacity and increasing
• Many police and firefighter agencies are
COVID-19 claims.
that risk, written separately.
uses a 07/01 renewal date.
increase in police officers and firefighters seeking
down business have led to a lot of first responder
lawsuits pertaining to the spread of COVID-19.
• Most of the public entity insurance marketplace
PTSD from all these things, we could see a large
workspace, lack of PPE, and an inability to shut
property. They are restricting or charging extra for
Renewal dates
• Between COVID-19, injuries from civil unrest and
disability retirement.
towers. This issue is being seen in multiple lines of
starting to write coverage in terms of smoke risk
presumptions for first responders.
challenging. No matter what the evidence may show, the jury will usually award something to the
• Carriers in areas without direct wildfire risk are
First responder retirements • Many states have passed legislation creating PTSD
challenge for risk managers. This happens when
insurance coverage.
• Cyber breaches have increased during COVID-19.
and injuries increases.
such litigation. • Many states have passed legislation or issued executive orders indicating COVID-19 is presumed to have been contracted in the workplace with first responders.
© 2020 Out Front Ideas
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Day 1 Watch the recording
Watch the recording
Watch the recording
The Path Forward: Industry CEO Perspectives Industry CEOs discuss how the
Navigating the Constant Evolution of Accommodation and Leave Laws
The State of the Commercial Insurance Marketplace
workers’ comp industry has
A compliance expert panel
A broker panel discusses
been forever changed, how
discusses the current state
widespread changes in
businesses are adapting to
of ADA, FMLA and workers’
the commercial insurance
that change, and what we can
compensation laws,
marketplace, including workers’
expect for the path forward.
including how they apply
compensation, liability, auto
to COVID-19 cases.
and group benefits.
Watch the recording
Watch the recording
Watch the recording
The Future of Risk Management
Mental Health Issues in the Workplace: A Mounting Threat
Adjusting and Adapting the Claims Handling Model
This session will highlight
been many short-term changes
methods and resources that
to claims handling. Hear how
employers can use to support
the model could and should
their workforce through
permanently evolve to be more
these challenges and keep
efficient and effective.
Day 2
A panel of risk managers discusses the impact of current unprecedented safety challenges and how they expect risk management to evolve moving forward.
Due to COVID-19, there have
them engaged.
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We’re united in changing the world from the ground up, with heart speak, hugs, and gifting. We’re a group of people with a common belief that we can do our part to make a positive impact on the world and change it for the better. We’re a community that is made of individual
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