Service Spotlight

Workers’ Comp Patient Transportation

In this Q&A, the VP of one workers’ comp service provider shares how to soothe a common pain point for injured workers: Getting to appointments on time.
By: | February 5, 2018 • 6 min read

Traditional transportation services meant to deliver injured workers to and from medical appointments may be at best inefficient, and at worst, antiquated. Both injured workers and payers want more control and transparency while also saving time and money.


Historically, third party providers are limited in flexibility. In this Q&A, Linda Colsen, vice president and national product leader at One Call, shares how the industry can soothe transportation pain points.

R&I: What’s wrong with traditional transportation in workers’ comp?

First and foremost is time, particularly when there has been an issue with a missed appointment. Odds are, you don’t learn about a missed appointment until well after it has been missed. The process to reschedule an appointment in itself can be a headache. When adding in the time factor, an injured worker could be looking at days or in some cases, weeks later than the original appointment.

The second factor is the cost. In the perfect scenario, you need two drivers: one to take the injured worker to their appointment and the second to take them home. Until recently, however, there

Linda Colsen, vice president and national product leader, One Call

hasn’t been an effective solution to send a second driver to retrieve the injured worker from their appointment and transport them back to work or home. With traditional third-party transportation providers, payers end up spending a lot of dollars on wait time, which means paying a driver to sit in the parking lot while the injured worker is at their appointment.

Lastly is visibility, and specifically, a lack of visibility —knowing if the injured worker got picked up on time, if they overslept, if they’re on their way to the appointment and if they arrived on time.

R&I: How do these transportation challenges impact outcomes?

Without real-time visibility, delayed transportation may mean missed appointments, which means the injured worker doesn’t get the care they need. Rescheduling the appointment and another ride creates more logistical challenges for claims staff, case managers, injured workers and healthcare providers. Ultimately, missed appointments mean slower recovery and more stress for injured workers and higher costs for workers’ compensation payers. Transportation troubles leads to costly and subpar outcomes for everyone involved.

R&I: What can the industry do about it?

Technology has given us real-time, on-demand ride hailing services. For the average consumer, they offer more convenience and comfort for significantly less than a traditional cab. A real-time ride request reduces downtime because it can use drivers who are nearby. It also allows users to track their driver and cancel or reschedule a ride easily as well as log their ride history. We asked ourselves, ‘Why can’t we use this in workers’ comp?’

One Call decided to leverage this technology with the creation of RelayRIDE, which may be used for any injured worker needing transportation to medical appointments. Real-time visibility enabled by the RelayRIDE technology means the One Call team can monitor ‘live’ trips in progress and take steps to mitigate issues, such as driver cancellations, by quickly scheduling the trip with another driver. This active trip monitoring means injured workers receive the treatment they need quickly, which may result in a shorter claim life.

R&I: How does it work?

We partnered with Lyft in August 2016, originally utilizing their services to handle the more difficult, rush cases.


Over the course of the partnership, we have developed our proprietary web-based application, which connects directly to Lyft through an open application programming interface (API). This allows One Call to seamlessly utilize RelayRIDE to fulfill ambulatory transportation referrals if the request is in a Lyft coverage area.

Once a ride has been scheduled, One Call initiates a series of text messages to inform the injured worker of their transportation arrangements. They provide details about their upcoming ride such as driver identification, vehicle information and ride tracking. These text messages also enable injured workers to request a return ride with the press of a button on their phone. Wait time charges are eliminated for rides fulfilled through RelayRIDE as each leg of the trip is handled independently. At the end of their ride, they are able to provide instant feedback by rating their ride experience and driver.

One Call has a team dedicated to monitor rides in real-time through RelayRIDE. Through this active monitoring, our team is alerted to potential issues and can be proactive in addressing transportation issues that historically resulted in missed appointments. We will immediately notify the medical provider if an injured worker is a “no show” or if a late arrival is anticipated, which ultimately reduces the administrative burden on our customers’ to make multiple follow-up calls.

One Call decided to leverage this technology with the creation of RelayRIDE, which may be used for any injured worker needing transportation to medical appointments. Real-time visibility enabled by the RelayRIDE technology means the One Call team can monitor ‘live’ trips in progress and take steps to mitigate issues, such as driver cancellations, by quickly scheduling the trip with another driver. This active trip monitoring means injured workers receive the treatment they need quickly, which may result in a shorter claim life.

R&I: Have you seen any benefits from this program yet?

Lyft drivers have provided more than 100,000 “rush” rides this year. These are rides for non-emergent ambulatory appointments.

For us, visibility and transparency are the biggest benefits. Claims managers and nurses can see active rides and ride history through the web portal. They know right away if a driver didn’t show or is delayed. They can act immediately to either arrange a new ride or to reschedule the appointment. They’ll know if a patient missed an appointment and can reach out to them sooner rather than later. It removes some decision-making steps for the patient and cuts out some of the cost and liability of using a traditional transportation service.

R&I: What are other key benefits of using a modern ride-sharing service?

By helping patients keep their scheduled appointments, it can prevent expensive emergency room visits. The system can also track appointment history and mileage for reimbursement purposes. The transparency and accountability components may also reduce likelihood of fraud.

R&I: What about from the patient’s perspective?


Approximately 98 percent of American adults have internet access. This program is reaching patients where they are at that moment and creating a seamless experience for them; they can request, track, or cancel a ride and see their history through the online dashboard. If they don’t want to log on and schedule a ride themselves, they can text “N” to our dispatchers who will send a driver for them.

The program will also send text reminders to patients 20 minutes before their driver is set to arrive, so they can be ready to go.

R&I: Are there other ways that technology can address challenges in worker’ comp?

Live video conferencing is increasingly playing a role in workers’ comp. Most of the conversation is centered on telemedicine —connecting doctors and patients when in-office visits aren’t feasible. But we’re applying video consultation to a different challenge: language barriers. Patients with Limited English Proficiency (LEP) may struggle to communicate with their medical provider, and if they can’t understand their treatment plan they are far less likely to stay engaged in their recovery.

RelayTRANSLATE is our technology-enabled video interpretation solution that is part of a broader program we’re developing called RelaySOLUTIONS, which also includes RelayRIDE. Through RelayTRANSLATE, the injured worker can request on-demand interpretation in their chosen native language, and the platform will connect them with a live person who can interpret for them via video. This is absolutely critical to achieve better outcomes for patients. &

Katie Dwyer is an associate editor at Risk & Insurance®. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

Risk Scenario

A Recall Nightmare: Food Product Contamination Kills Three Unborn Children

A failure to purchase product contamination insurance results in a crushing blow, not just in dollars but in lives.
By: | October 15, 2018 • 9 min read
Risk Scenarios are created by Risk & Insurance editors along with leading industry partners. The hypothetical, yet realistic stories, showcase emerging risks that can result in significant losses if not properly addressed.

Disclaimer: The events depicted in this scenario are fictitious. Any similarity to any corporation or person, living or dead, is merely coincidental.


Reilly Sheehan, the Bethlehem, Pa., plant manager for Shamrock Foods, looks up in annoyance when he hears a tap on his office window.

Reilly has nothing against him, but seeing the face of his assistant plant operator Peter Soto right then is just a case of bad timing.

Sheehan, whose company manufactures ice cream treats for convenience stores and ice cream trucks, just got through digesting an email from his CFO, pushing for more cost cutting, when Soto knocked.

Sheehan gestures impatiently, and Soto steps in with a degree of caution.

“What?” Sheehan says.

“I’m not sure how much of an issue this will be, but I just got some safety reports back and we got a positive swipe for Listeria in one of the Market Streetside refrigeration units.”



Sheehan gestures again, and Soto shuts the office door.

“How much of a positive?” Sheehan says more quietly.

Soto shrugs.

“I mean it’s not a big hit and that’s the only place we saw it, so, hard to know what to make of it.”

Sheehan looks out to the production floor, more as a way to focus his thoughts than for any other reason.

Sheehan is jammed. It’s April, the time of year when Shamrock begins to ramp up production for the summer season. Shamrock, which operates three plants in the Middle Atlantic, is holding its own at around $240 million in annual sales.

But the pressure is building on Sheehan. In previous cost-cutting measures, Shamrock cut risk management and safety staff.

Now there is this email from the CFO and a possible safety issue. Not much time to think; too much going on.

Sheehan takes just another moment to deliberate: It’s not a heavy hit, and Shamrock hasn’t had a product recall in more than 15 years.

“Okay, thanks for letting me know,” Sheehan says to Soto.

“Do another swipe next week and tell me what you pick up. I bet you twenty bucks there’s nothing in the product. That swipe was nowhere near the production line.”

Soto departs, closing the office door gingerly.

Then Sheehan lingers over his keyboard. He waits. So much pressure; what to do?

“Very well then,” he says to himself, and gets to work crafting an email.

His subject line to the chief risk officer and the company vice president: “Possible safety issue: Positive test for Listeria in one of the refrigeration units.”

That night, Sheehan can’t sleep. Part of Shamrock’s cost-cutting meant that Sheehan has responsibility for environmental, health and safety in addition to his operations responsibilities.

Every possible thing that could bring harmful bacteria into the plant runs through his mind.

Trucks carrying raw eggs, milk and sugar into the plant. The hoses used to shoot the main ingredients into Shamrock’s metal storage vats. On and on it goes…

In his mind’s eye, Sheehan can picture the inside of a refrigeration unit. Ice cream is chilled, never really frozen. He can almost feel the dank chill. Salmonella and Listeria love that kind of environment.

Sheehan tosses and turns. Then another thought occurs to him. He recalls a conversation, just one question at a meeting really, when one of the departed risk management staff brought up the issue of contaminated product insurance.

Sheehan’s memory is hazy, stress shortened, but he can’t remember it being mentioned again. He pushes his memory again, but nothing.

“I don’t need this,” he says to himself through clenched teeth. He punches up his pillow in an effort to find a path to sleep.


“Toot toot, tuuuuurrrrreeeeeeeeettt!”

The whistles of the three lifeguards at the Bradford Community Pool in Allentown, Pa., go off in unison, two staccato notes, then a dip in pitch, then ratcheting back up together.

For Cheryl Brick, 34, the mother of two and six-months pregnant with a third, that signal for the kids to clear the pool for the adult swim is just part of a typical summer day. Right on cue, her son Henry, 8, and his sister Siobhan, 5, come running back to where she’s set up the family pool camp.

Henry, wet and shivering and reaching for a towel, eyes that big bag.

“Mom, can I?”

And Cheryl knows exactly where he’s going.

“Yes. But this time, can you please bring your mother a mint-chip ice cream bar along with whatever you get for you and Siobhan?”

Henry grabs the money, drops his towel and tears off; Siobhan drops hers just as quickly, not wanting to be left behind.


“Wait for me!” Siobhan yells as Henry sprints for the ice cream truck parked just outside of the pool entrance.

It’s the dead of night, 3 am, two weeks later when Cheryl, slumbering deeply beside her husband Danny, is pulled from her rest by the sound of Siobhan crying in their bedroom doorway.

“Mom, dad!” says Henry, who is standing, pale and stricken, in the hallway behind Siobhan.

“What?” says Danny, sitting up in bed, but Cheryl’s pregnancy sharpened sense of smell knows the answer.

Siobhan, wailing and shivering, has soiled her pajamas, the victim of a severe case of diarrhea.

“I just barfed is what,” says Henry, who has to turn and run right back to the bathroom.

Cheryl steps out of bed to help Siobhan, but the room spins as she does so.

“Oh God,” she says, feeling the impact of her own attack of nausea.

A quick, grim cleanup and the entire family is off to a walk-up urgent care center.

A bolt of fear runs through Cheryl as the nurse gives her the horrible news.

“Listeriosis,” says the nurse. Sickening for children and adults but potentially fatal for the weak, especially the unborn.

And very sadly, Cheryl loses her third child. Two other mothers in the Middle Atlantic suffer the same fate and dozens more are sickened.

Product recall notices from state regulators and the FDA go out immediately.

Ice cream bars and sandwiches disappear from store coolers and vending machines on corporate campuses. The tinkly sound of “Pop Goes the Weasel” emanating from mobile ice cream vendor trucks falls silent.

Notices of intent to sue hit every link in the supply chain, from dairy cooperatives in New York State to the corporate offices of grocery store chains in Atlanta, Philadelphia and Baltimore.

The three major contract manufacturers that make ice cream bars distributed in the eight states where residents were sickened are shut down, pending a further investigation.

FDA inspectors eventually tie the outbreak to Shamrock.

Evidence exists that a good faith effort was underway internally to determine if any of Shamrock’s products were contaminated. Shamrock had still not produced a positive hit on any of its products when the summer tragedy struck. They just weren’t looking in the right place.


Banking on rock-solid relationships with its carrier and brokers, Shamrock, through its attorneys, is able to salvage indemnification on its general liability policy that affords it $20 million to defray the business losses of its retail customers.


But that one comment from a risk manager that went unheeded many months ago comes back to haunt the company.

All three of Shamrock’s plants were shuttered from August 2017 until March 2018, until the source of the contamination could be run down and the federal and state inspectors were assured the company put into place the necessary protocols to avoid a repeat of the disaster that killed 3 unborn children and sickened dozens more.

Shamrock carried no contaminated product coverage, which is known as product recall coverage outside of the food business. The production shutdown of all three of its plants cost Shamrock $120 million. As a result of the shutdown, Shamrock also lost customers.

The $20 million payout from Shamrock’s general liability policy is welcome and was well-earned by a good history with its carrier and brokers. Without the backstop of contaminated products insurance, though, Shamrock blew a hole in its bottom line that forces the company to change, perhaps forever, the way it does business.

Management has a gun to its head. Two of Shamrock’s plants, including Bethlehem, are permanently shuttered, as the company shrinks in an effort to stave off bankruptcy.

Reilly Sheehan is among those terminated. In the end, he was the wrong person in the wrong place at the wrong time.

Burdened by the guilt, rational or not, over the fatalities and the horrendous damage to Shamrock’s business. Reilly Sheehan is a broken man. Leaning on the compassion of a cousin, he takes a job as a maintenance worker at the Bethlehem sewage treatment plant.

“Maybe I can keep this place clean,” he mutters to himself one night, as he swabs a sewage overflow with a mop in the early morning hours of a dark, cold February.


Risk & Insurance® partnered with Swiss Re Corporate Solutions to produce this scenario. Below are their recommendations on how to prevent the losses presented in the scenario. This perspective is not an editorial opinion of Risk & Insurance.®.

Shamrock Food’s story is not an isolated incident. Contaminations happen, and when they do they can cause a domino effect of loss and disruption for vendors and suppliers. Without Product Recall Insurance, Shamrock sustained large monetary losses, lost customers and ultimately two of their facilities. While the company’s liability coverage helped with the business losses of their retail customers, the lack of Product Recall and Contamination Insurance left them exposed to a litany of risks.

Risk Managers in the Food & Beverage industry should consider Product Recall Insurance because it can protect your company from:

  • Accidental contamination
  • Malicious product tampering
  • Government recall
  • Product extortion
  • Adverse publicity
  • Intentionally impaired ingredients
  • Product refusal
  • First and third party recall costs

Ultimately, choosing the right partner is key. Finding an insurer who offers comprehensive coverage and claims support will be of the utmost importance should disaster strike. Not only is cover needed to provide balance sheet protection for lost revenues, extra expense, cleaning, disposal, storage and replacing the contaminated products, but coverage should go even further in providing the following additional services:

  • Pre-incident risk mitigation advocacy
  • Incident investigation
  • Brand rehabilitation
  • Third party advisory services

A strong contamination insurance program can fill gaps between other P&C lines, but more importantly it can provide needed risk management resources when companies need them most: during a crisis.

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