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Wednesday, February 22 2017

New technologies are improving workers’ compensation programs in everything from communications and training to health care delivery and claims, according to experts.

Tom Ryan, market research leader for Marsh’s Workers Compensation Center of Excellence, speaking during a recent Marsh broadcast, identified several areas of workers’ compensation that can benefit from technology:

  • In communications with employees. Information critical to prevent injuries and claim updates can be provided to employees via smartphone mobile applications.
  • In sharing workforce training via an employer’s intranet or through smartphone applications.
  • In delivering care to injured workers through telemedicine and via mobile apps that can direct injured workers to preferred medical providers.
  • In managing claims by providing customizable email alerts, such as notifications when prescriptions are ready.

Wearable technology is also having an impact. Wearables can monitor employee movements and alert co-workers of danger, as well as monitor fatigue, body temperature and repetitive motion. The information can be used in training, fraud prevention and wellness programs, Ryan said.

Construction industry wearables include high tech vests and helmets that have lights or vibrate to alert employees of potentially dangerous changes in surroundings.

Some firms are equipping forklifts to sound an alarm or flash lights to warn employees and the public. Many pieces of equipment require both hands to operate and can be fitted with vibrating sensors to alert the operators of changes in their surroundings.

Joseph Molloy, vice president of workforce safety at Northwell Health, offered a case example of improvements his firm realized after it created a centralized workforce safety department and revamped its employee injury reporting system.

Previously, injuries were reported to different parts of the company. He said employees were confused throughout the life of an injury on whom to report to and what to report. Completion of forms by employees was inconsistent, he said, and penmanship was an issue. For example, asking where an accident occurred resulted in answers that ranged from an address to a building floor to a hospital.

Molloy said Northwell used technology improve its incident reporting rate. The company added automated forms and connected employee data so that the forms could be partially pre-filled. It also added multiple ways to report an incident, including a mobile app and an 800-number. Completed employee reports of injury were then sent to the supervisor, safety officer, human resources, Broadspire (its third party claims administrator) and to its workforce safety department that triages cases to determine potential nurse case management opportunities.

According to Molloy, the new system has resulted in more employees being placed in transitional return to work assignments and a positive response from employees.

Molloy said the keys to success when implementing these types of changes include engaging senior leadership and sharing the mission’s method and rationale for the change.

Donna Sides, senior insurance manager and workers’ compensation supervisor with Bank of America, offered another case study showing how technology can improve workers’ compensation programs.

Bank of America implemented a telenursing program for insured employees. This included a dedicated 24/7 reporting line that allowed injured workers to speak to a registered nurse and directly report a claim.

The nurse assesses the medical history, injury, pain level, obtains an accident description and offers a first aid type of treatment recommendation. If additional treatment is warranted, the nurse will direct employees to an in-network provider where allowed and then schedule the appointment. Call notes are uploaded to the Bank of America claims system and are viewable by adjusters.

Sides said the use of telemedicine at Bank of America has resulted in higher network penetration, lower claims severity and lower claims costs.

According to David Lupinsky, vice president at CorVel Corp., telehealth was originally created to bring healthcare to rural areas. Now it brings healthcare to employees and allows employers the ability to create virtual clinics which, in turn, drives greater productivity. Telehealth also removes the need for a larger provider network, he said.

Lupinsky said telehealth is a viable option for employers of all sizes, meaning they no longer need to make a large investment in onsite clinics. While it is not for every case, telehealth can take care of 40 percent of claims, he said.

Tuesday, February 21 2017

The Florida Division of Workers’ Compensation has formed an online insurance company database to assist Florida business owners with obtaining workers’ compensation coverage that protects employees from the impacts of on-the-job injuries. According to a statement from the Florida Department of Financial Services, the new online database, called the Coverage Assistance Program (CAP), allows employers to search for insurance companies that are actively offering workers’ compensation policies for their industry type.

“Ensuring that Florida businesses have proper workers’ compensation coverage is crucial to the success of the entire workers’ compensation system,” said Tanner Holloman, director of the Division of Workers’ Compensation. “Employers can use the information provided in the CAP to inform conversations with their insurance agents and to help facilitate a smoother, faster policy purchasing process.”

The Division of Workers’ Compensation works to ensure that injured workers have access to medical care, that claims are adjusted and reimbursed efficiently, and that health care providers are compensated fairly for electing to participate as a workers’ compensation care provider. The Division also aims to provide the resources necessary to help all participants in the process remain in compliance with Florida workers’ compensation laws.

Friday, February 17 2017

U.S. motor vehicle accident deaths last year topped 40,000 for the first time since 2007 as cheap gasoline and a healthy economy encouraged motorists to drive more, according to new estimates released by the National Safety Council.

Roadside fatalities last year hit 40,200, a 6 percent gain from 2015 and up 14 percent from 2014, according to the group. The trend reflects similar findings by the National Highway Traffic Safety Administration, which in January reported an 8 percent rise in deadly crashes in the first nine months of 2016 compared to the prior-year period.

The National Safety Council, a nonprofit safety advocacy group, also released survey findings showing that 47 percent of motorists are comfortable texting while driving. Some 10 percent of drivers reported driving drunk, and 43 percent of them were involved in a crash while impaired, the group said. The survey also found that 16 percent said they don’t wear seatbelts on every trip, while 25 percent are comfortable speeding on residential streets.

“These results underscore how our complacency is killing us,” Deborah Hersman, chief executive of the National Safety Council, said during a press conference Wednesday. She added that a 3 percent rise in vehicle miles traveled fails to fully explain the 6 percent rise in deaths seen last year.

To stem the tide, the group renewed a call for a total ban on mobile phone use behind the wheel, even hands-free systems. It also called for mandatory ignition interlocks for convicted drunk drivers, a three-tiered driver licensing system for all new drivers under 21 and other steps to curb crashes.

The group also estimated that crashes cost about $432.5 billion last year, including those stemming from motor vehicle deaths, injuries and property damage.

The National Safety Council measures roadside deaths differently than NHTSA. The group counts traffic and non-traffic deaths within one year of an accident. NHTSA counts only traffic deaths within 30 days of a crash.

Monday, February 13 2017

A U.S. weather forecaster on Thursday said La Niña has faded and neutral conditions are likely to continue in the coming months, though it noted some chance that the El Niño phenomenon may reappear as early as the Northern Hemisphere spring.

The Climate Prediction Center (CPC), an agency of the National Weather Service, in a monthly forecast said that neutral conditions have returned and are favored to continue through at least the Northern Hemisphere spring.

La Niña emerged last year for the first time since 2012. The phenomenon, characterized by unusually cold ocean temperatures in the equatorial Pacific Ocean, are linked with floods and droughts.

Even though neutral conditions are most likely, there is a chance of the appearance of El Niño as early as March to May 2017, the forecaster warned. That would be less than a year after the last El Niño faded, having brought serious crop damage, forest fires and flash floods.

Tuesday, February 07 2017

Recent Florida Supreme Court decisions and ongoing abuse in Florida’s insurance market have led a ratings company to change the criteria it uses when rating insurers in the state. The announcement comes as insurers get ready to announce their 2016 annual reports that could indicate unfavorable results for many.

Ohio-based Demotech — which rates 397 companies nationwide, 57 of which are in Florida —said Monday that it has suspended ratings guidelines it uses in Florida due to what it is calling an uncertain operating environment in the state.

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The ratings firm says no Florida insurers it rates are in danger of failing but there are about 10 to 15 that could see downgrades in March.

Demotech said it will eventually revise its general guidance but, in the meantime, it is advising carriers individually to ensure they are adequately capitalized to handle the now uncertain operating environment.

“Pricing insurance policies is a prospective process. Carriers and their actuaries price tomorrow’s policies based upon the claims and experience from yesterday and today,” the ratings agency said in a statement. “When changes occur in claims procedures, practices, and protocols, the utility of historical experience is diminished. Similarly, with insurance policies issued for 12-month periods, court decisions that markedly change claims procedures, practices, and protocols mid-term are problematic to carriers, insurer rating agencies, and actuaries.”

The uncertain operating climate that concerns Demotech refers to Florida’s escalating assignment of benefits crisis that has caused the number of litigated water loss claims to skyrocket over the past few years, particularly for the state-run insurer Citizens. The problem has begun affecting Florida’s private market insurers as well, with many pulling out of areas of the state where the abuse is the most rampant and filing for rate increases.

In addition, two court cases decided at the end of 2016 that Demotech said reversed “industry claims procedures that remain intact in other operating environments” will create unanticipated challenges for insurers that Demotech said it now needs to take into consideration to properly rate companies operating in Florida.

“Claims procedures, processes, and protocols utilized in the past must be replicable in the future if loss experience is to be predictable and claims handling scalable,” Demotech said in a statement. “The [AOB) situation in Florida is unlike any other in the United States and two recent court decisions, Johnson (September 2016) and Sebo (December 2016), have also revised claims procedures, practices, and protocols from the industry standards that previously existed to a ‘Florida only’ standard.”

The state high court’s ruling in December in the case of American Home Assurance Co. v. Sebo overturned a lower court’s decision that sided with the insurer. The case stemmed from a 2007 concurrent loss claim, where the Florida Supreme Court instead ruled for the homeowner in the case (Sebo). Lawyers specializing in insurance law said at the time that the case could lead to the reopening of past claims where coverage was denied.

In the other case, Johnson v. Omega Insurance Co., the Florida Supreme Court disagreed with a lower court’s ruling that Omega wasn’t responsible for paying the insured’s attorney’s fees because it didn’t act in bad faith when it wrongfully denied benefits for the insured and later paid the claim. The Supreme Court said that though the insurer righted the situation, it was at fault for initially denying the claim and therefore should be responsible for the insured’s attorney’s fees.

Demotech said “no carrier can be prepared for the impact of the Johnson and Sebo cases, which were less than 100 days apart, being superimposed on the challenges associated with an AOB protocol unlike that of any other jurisdiction.”

Demotech said it must now “undertake a review of its protocols to respond to the implicit albeit yet unquantified changes in the operating environment.”

Joseph Petrelli, president and CEO of Demotech, said the company has not yet determined what the new ratings guidelines will be, but it will be watching the Florida Legislature when it resumes in March and would certainly take any legislation that addresses these issues into account when establishing them.

“The operating environment in Florida is not the same as it was and is not the same as other jurisdictions so we need to respond,” Petrelli said. “We are not 100 percent certain what the evolution will be – it is a fluid situation. However, we know the situation is not better today than it was several months ago, and we need to have a suspension of guidance while these situations play out.”

Petrelli emphasized, however, that the changes do not mean the ratings company will no longer rate Florida insurers; rather it is looking at each company individually and providing guidance on how each insurer can prepare financially for the impact that increased claims could have on its surplus.

“We are still rating companies and doing everything that we currently do,” he said. “But [Florida insurers] now operate in a jurisdiction where the situation has changed. We don’t want to operate with one hand behind our back and too many things have changed for us to use the same ratings guidance.”

He said the companies Demotech rates currently have adequate reserves to handle losses from the catastrophe events of 2016, including Hurricanes Hermine and Matthew. However, those storms coupled with the changing market will have an impact on company balance sheets for 2016.

“[2016 catastrophes] eroded their surplus and after that had been eroded there was the Johnson and Sebo cases,” he said. “No one is in danger of going under, but that being said we have standards that are higher than just not going under.”

Demotech is encouraging the insurers it rates that experienced significant losses from 2016 storms and any other unaccounted for losses to take advantage of the Statutory Statement of Accounting Principles Number 72 (SSAP 72), which provides insurers with the opportunity to address financial matters before Feb. 28. Insurers can use the SSAP to infuse capital into their surplus to improve their year-end results.

Petrelli said there are about 10 to 15 Florida companies that could see downgrades in March, but the company will not issue any downgrades before then.

“We will be doing downgrades and upgrades in March in response to year end results – we have taken that position now. Even though we have a pretty good idea what those results will be, [insurers] have the ability to change those based on SSAP – so we are waiting for that to come out,” he said.

In addition, Demotech will be evaluating and implementing revised reinsurance evaluation procedures for all catastrophe exposed property insurance carriers countrywide prior to the start of the 2017 storm season. The company said the revised reinsurance evaluation procedures will be more stringent than the procedures in the suspended guidance. Accordingly, they may be phased in over time.

Demotech will continue to provide all carriers in catastrophe prone jurisdictions with “objective catastrophe reinsurance evaluation criteria and our initial thoughts on the review and analysis process of vertical and horizontal catastrophe reinsurance programs for the 2017 storm season in all jurisdictions.,” the company’s statement said.

Wednesday, February 01 2017

A U.S. flood insurance program that is drowning in billions of dollars in debt can be modernized to bolster its finances while curbing the public’s exposure to flood risks, a national coalition said in a reform proposal unveiled on Wednesday.

The plan by Washington-based calls for the National Flood Insurance Program (NFIP), to use cutting-edge technology that would more precisely determine flood-prone areas, and to price flood insurance premiums in accordance with those specific risks.

Other measures would include greater involvement by private insurers in the flood insurance market and offering incentives for communities to enhance and restore natural buffers against floods, such as wetlands and forests.

The proposal is among the first in a year that could usher in sweeping changes to the flood insurance program, whose authorization is set to expire in September. The program, operated by the Federal Emergency Management Agency (FEMA), is $24.6 billion in debt to the U.S. Treasury Department, a FEMA spokeswoman said. Most of the debt covered claims from Hurricane Katrina in 2005 and Superstorm Sandy in 2012.

It is unclear which lawmakers may take up the issue as Washington adjusts to a new presidential administration, or how much of the plan would be adopted. However, there is bipartisan support to modernize the insurance program and U.S. Senate and House lawmakers held several hearings last year about possible ways to do it.

The flood insurance program has been a political football in Washington for years, mainly because of the debt, which the government has said is impossible for the program to repay.

The program was temporarily extended 17 times between 2008 and 2012 and lapsed four times during the same period, a pattern that can create uncertainty in real estate markets, some U.S. lawmakers have said.

Federal law requires that homes in flood-risk areas have flood insurance before a mortgage can be completed. The federal program remains the only flood insurance available to the vast majority of Americans, although a small market for private flood insurance is now sprouting in some flood-prone states, such as Florida.

A 2012 law ultimately extended the program to September.

Another law in 2014 allowed FEMA to buy private reinsurance to cover the program if claims surge, among other measures. Last September, FEMA obtained more than $1 billion in reinsurance for 2017 from 25 reinsurers.

The push to further modernize the program has rallied support from diverse groups., for example, is composed of more than 30 organizations ranging from insurers to environmental groups. Members include units of insurers Chubb Ltd. and Swiss Re AG, Reinsurance Association of America, National Taxpayers Union, Union of Concerned Scientists and National Wildlife Federation.

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