Out Front Ideas - Recap

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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

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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?”

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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…

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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.

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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

challenges with the Lloyd’s market. |

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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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27


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.

© 2020 Out Front Ideas

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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

Š 2020 Out Front Ideas

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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

© 2020 Out Front Ideas

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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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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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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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