2016 NWCDC

The Claims Experience, Reimagined

For Disney's Tim East, the way forward is to change the way we think about — and talk about — workers' compensation.
By: | November 30, 2016 • 3 min read

Fast approaching its centennial anniversary, The Walt Disney Co. witnessed an extraordinary amount of change, with more dips and twists than any of its own amusement park rides.

Tim East, a director of corporate risk management for the company, has been on that ride with Disney for more than four decades. He says it boils down to three things: Change is going to come at us. Change is hard. But, ultimately, change is good.

“Change is going to be an unrelenting force,” East said on Wednesday in the opening keynote address of the 25th National Workers’ Compensation and Disability Conference® & Expo in New Orleans.

It requires the workers’ comp industry to adapt, and to make a solid commitment to continuous improvement, he said.

The change can begin with language.

“Dairy products and chopped meat go through processes. People should not be processed.” — Tim East, director of corporate risk management, The Walt Disney Co.

Employers have been advised for years to refer to their people as “injured workers” rather than claimants. But East took that concept further, noting that Disney refers to its claims adjusters as workers’ comp representatives.

“The worst thing we can call somebody is a loss adjuster,” he said, because it sends a message to injured workers that they’re just numbers in need of adjustment.

“The labels you give people reflect how you think about them,” said East.

But that point extends beyond people. The claims process, for instance, should be reframed as the claims experience, he suggested.

“Dairy products and chopped meat go through processes. People should not be processed,” said East.

It also shifts perceptions when employers stop talking about return to work, and start talking about “recovery while working.”

East went so far as to say that we should drop the term workers’ comp altogether, and start calling it worker recovery – an idea he credits to blogger Bob Wilson, president and CEO of WorkersCompensation.com.

If we make that change, said East, we shift the entire perception of the goal of workers’ comp, placing the emphasis where it more rightly belongs.

Walking the Advocacy Talk

East supports an advocacy-based claims model, with the goal of building trust and holding organizations accountable for results beyond cost containment.

“We’ve become so focused on red flags, that we can’t see the people behind the red flags – people that need our help,” East said.

Some in the industry might be surprised by other employee-focused recommendations East had to share, including eliminating unwarranted fraud investigation, clamping down on the overuse of utilization review, and engaging in fewer of what East calls “cheap denials” of claims.

He also advises employers to do everything within their power to make sure that injured workers have access to actual people who can answer their questions.

“Why is it so hard to talk to a human being in the workers’ comp industry?” he asked, noting that the No. 1 complaint he hears from union leaders is that injured workers can’t get to a real live person.

 

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

2018 Risk All Stars

Stop Mitigating Risk. Start Conquering It Like These 2018 Risk All Stars

The concept of risk mastery and ownership, as displayed by the 2018 Risk All Stars, includes not simply seeking to control outcomes but taking full responsibility for them.
By: | September 14, 2018 • 3 min read

People talk a lot about how risk managers can get a seat at the table. The discussion implies that the risk manager is an outsider, striving to get the ear or the attention of an insider, the CEO or CFO.

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But there are risk managers who go about things in a different way. And the 2018 Risk All Stars are prime examples of that.

These risk managers put in gear their passion, creativity and perseverance to become masters of a situation, pushing aside any notion that they are anything other than key players.

Goodyear’s Craig Melnick had only been with the global tire maker a few months when Hurricane Harvey dumped a record amount of rainfall on Houston.

Brilliant communication between Melnick and his new teammates gave him timely and valuable updates on the condition of manufacturing locations. Melnick remained in Akron, mastering the situation by moving inventory out of the storm’s path and making sure remediation crews were lined up ahead of time to give Goodyear its best leg up once the storm passed and the flood waters receded.

Goodyear’s resiliency in the face of the storm gave it credibility when it went to the insurance markets later that year for renewals. And here is where we hear a key phrase, produced by Kevin Garvey, one of Goodyear’s brokers at Aon.

“The markets always appreciate a risk manager who demonstrates ownership,” Garvey said, in what may be something of an understatement.

These risk managers put in gear their passion, creativity and perseverance to become masters of a situation, pushing aside any notion that they are anything other than key players.

Dianne Howard, a 2018 Risk All Star and the director of benefits and risk management for the Palm Beach County School District, achieved ownership of $50 million in property storm exposures for the district.

With FEMA saying it wouldn’t pay again for district storm losses it had already paid for, Howard went to the London markets and was successful in getting coverage. She also hammered out a deal in London that would partially reimburse the district if it suffered a mass shooting and needed to demolish a building, like what happened at Sandy Hook in Connecticut.

2018 Risk All Star Jim Cunningham was well-versed enough to know what traditional risk management theories would say when hospitality workers were suffering too many kitchen cuts. “Put a cut-prevention plan in place,” is the traditional wisdom.

But Cunningham, the vice president of risk management for the gaming company Pinnacle Entertainment, wasn’t satisfied with what looked to him like a Band-Aid approach.

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Instead, he used predictive analytics, depending on his own team to assemble company-specific data, to determine which safety measures should be used company wide. The result? Claims frequency at the company dropped 60 percent in the first year of his program.

Alumine Bellone, a 2018 Risk All Star and the vice president of risk management for Ardent Health Services, faced an overwhelming task: Create a uniform risk management program when her hospital group grew from 14 hospitals in three states to 31 hospitals in seven.

Bellone owned the situation by visiting each facility right before the acquisition and again right after, to make sure each caregiving population was ready to integrate into a standardized risk management system.

After consolidating insurance policies, Bellone achieved $893,000 in synergies.

In each of these cases, and in more on the following pages, we see examples of risk managers who weren’t just knocking on the door; they were owning the room. &

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Risk All Stars stand out from their peers by overcoming challenges through exceptional problem solving, creativity, clarity of vision and passion.

See the complete list of 2018 Risk All Stars.

Dan Reynolds is editor-in-chief of Risk & Insurance. He can be reached at [email protected]