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Risk Insider: Dan Holden

In Praise of the Hippo

By: | October 1, 2014 • 2 min read
Dan Holden is Manager of Corporate Risk & Insurance for Daimler Trucks North America (formerly “Freightliner”). He manages the risk management program in the U.S., Canada and Mexico. He can be reached at [email protected]

When I was a fledging claims examiner, I was taught the universal file mantra: “Res Ipsa Loquitor” (the thing speaks for itself). In claims terms, it means the file should tell the story.

Not a difficult concept if you think about it. I suppose a less classy version would be, “if it ain’t written down, it didn’t happen.” But Res Ipsa Loquitor is more than just jotting down crib notes in a file. It’s about documenting the direction in which you are headed and why.

A second, equally important mantra came from a former claims manager who said, “… if you were hit by a bus, someone should be able to pick up your file and know exactly where you left off.” He went on to say that could only be achieved through clear, copious, and comprehensive documentation.

As a senior workers’ compensation claims consultant, I often dinged examiners for poorly documented files and a dearth of a memorialized thought process. Occasionally, their response was akin to, “well, obviously you don’t know Alaska comp!” (or whatever state I was auditing).

“… if you were hit by a bus, someone should be able to pick up your file and know exactly where you left off.”

While I realize they were just being defensive, they missed the point entirely. I wasn’t criticizing them for something statute-related; I was simply telling them they failed the Res Ipsa Loquitor test which is the most critical common denominator in all the various ‘Best Practice’ file criteria available.

An employer always has the right to know how/why a certain decision was made. Pronouncements made by insurance companies and TPAs — which obviously effect the employer — should never be made in a vacuum.

In my claims manager days, I came up with a whimsical way for my staff to “visualize” the documentation process. I called it “HIPPO.”

HIPPO
History: What happened? Who/what/where/how?
Issues: How serious was the injury? Is there time-loss involved?
Plan of Action: What is the examiner’s initial plan? Is return-to-work possible?
Procedure: How will the examiner begin the compensability process?
Outcome: What is the examiner’s best guess at this point?

Obviously, HIPPO would need to be revisited from time to time as the file matures and becomes more complicated. And, of course, the compensability aspect of the claim would be much different than a plan of action for ongoing medical management.

But you get the drift. And, yes, I found little plastic hippopotamuses which I placed on their desks to help them remember!

For the younger generation, who seem compelled to use social media to document what they had for breakfast, perhaps this concept will come easier.

Then again, documenting what you ate is a far cry from explaining why you chose that particular food item; why it was the best choice over all others; why it made financial sense; and what gastronomical ramifications might ensure because of said choice. Bon appétit.

Read all of Dan Holden’s Risk Insider contributions.

More from Risk & Insurance

More from Risk & Insurance

Black Swans

Black Swans: Yes, It Can Happen Here

In this year's Black Swan coverage, we focus on two events: An Atlantic mega-tsunami which would wipe out the East Coast and a killer global pandemic.
By: | July 30, 2018 • 2 min read

One of the most difficult phrases to digest without becoming frustrated or judgmental is the oft-repeated, “I never thought that could happen here.”

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Most painfully, we hear it time and time again in the aftermath of the mass school shootings that terrorize this country. Shocked parents and neighbors, viewing the carnage, voice that they can’t believe this happened in their neighborhood.

Not to be mean, but why couldn’t it happen in your neighborhood?

So it is with Black Swans, a phrase describing unforeseen events, made famous by the former trader and acerbic critic of academia Nassim Nicholas Taleb.

We at Risk & Insurance® define these events in insurance terms by saying that they are highly infrequent, yet could cause massive damages. This year, for our annual Black Swan issue, we present two very different scenarios, both of which would leave mass devastation in their wake.

A Mega-Tsunami Is Coming; Can the East Coast Even Prepare?, written by staff writer Autumn Heisler, profiles an Atlantic mega-tsunami, which would wipe out lives and commerce along the East Coast.

On the topic of whether the volcanic island of La Palma, the most northwestern of the Canary Islands, could erupt, split and trigger an Atlantic mega-tsunami, scientists are divided.

Researchers Steven Ward, a geophysicist at UC Santa Cruz, and Simon Day of University College London, say such a thing could happen. Other scientists say Day and Ward are dead wrong; it’s an impossibility.

One of the counter-arguments is backed up by the statement that there has never been an Atlantic mega-tsunami. It’s never happened before and thus, could never happen here. See exhibit “A” above, re: mass school shootings.

Viral Fear: How a Global Pandemic Kills an Economy, written by associate editor Katie Dwyer, depicts a killer global pandemic the likes of which hasn’t been seen in a century.

Tens of millions of people died during the Spanish Flu outbreak of 1918.

Why it could happen again includes the fact that it’s happened before. The science on influenzas, which are constantly mutating, also supports just how dangerous a threat they pose to millions of people beyond the reach of antibiotics.

Should a mutating avian flu, for example, spread widely, we could see a 10 percent drop in GDP, mostly from non-physical business interruption.

As always here, the purpose is to do exactly what insurance modelers and underwriters do; no matter how massive the event, we create scenarios, quantify possible losses and discuss risk mitigation strategies. &

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