Cover Story

The New Frontier of Care

Our Teddy Award winners in 2013 raised the bar yet again.
By: | November 1, 2013 • 10 min read

After nearly two decades of presenting the Theodore Roosevelt Workers’ Compensation and Disability Management Award, you might think the process of judging the awards would be more or less rote. In fact, the opposite is true. It has never been a more exciting time to witness the transformation of the industry, and to bear witness to how far employers have come, not just in their programs, but also in the way they think about injury prevention and management, and the value of a safe and healthy workforce.

A difficult economic climate has driven employers to double-down on their efforts to prevent incidents and injuries, and to be ever more creative in their efforts to rein in workers’ compensation and disability costs. If necessity is the mother of all invention, then workers’ compensation risk management is as inventive a field as you’ll ever encounter.

“Managing a successful workers’ comp program requires constant creativity to keep the bar moving in the right direction,” said Yolanda Romero, director of workers’ compensation for the Southeastern Pennsylvania Transportation Authority (SEPTA). “We often come up with what we believe is a great solution, however, eventually the program plateaus and new tweaks are needed to keep the momentum going.” Romero, who served as a Teddy Award judge for a decade after SEPTA won a Teddy Award in 2003, appreciates the accomplishments of this year’s finalists and winners, and knows what they’re up against. “The key is to keep the creative juices flowing constantly,” she said.

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There isn’t enough time — or pages — to give you every detail of this year’s exceptional Teddy Award applicants, finalists and winners. So in the spirit of Fantasy Football, Risk & Insurance® has drawn together a “dream team” of injury prevention, workers’ compensation and disability management programs, to highlight the areas where these programs shine brightest.

A Golden Ounce of Prevention

The only good injury is the one that never happens — no one would argue the point. Zero workplace incidents or injuries remains the holy grail for many employers. But for most, that is a perpetually elusive goal. Over time, safety professionals and risk managers began to see that it wasn’t enough to give employees safety gear and train them to work safely. It wasn’t enough to conduct accident investigations or job hazard assessments. They needed to reach further.

That need has led employers into territories that were once considered fringe, including ergonomics, which was widely perceived as “new age voodoo” only two or three decades ago. Thankfully, that has changed. Boston-based Teddy Award winner Partners HealthCare is one of many organizations that now has a comprehensive ergonomics program with dedicated staff to conduct evaluations and address issues. Partners’ ergonomics staff responded to more than 900 service requests in 2012.

R11-13p24-27_01teddy2.indd“Managing a successful workers’ comp program requires constant creativity to keep the bar moving in the right direction.”
— Yolanda Romero, director of workers’ compensation for the Southeastern Pennsylvania Transportation Authority

PHC also obtained a National Institute for Occupational Safety and Health grant to fund its “Be Well, Work Well” project in collaboration with the Harvard School of Public Health: Center for Work, Health and Well-Being. The project’s aim is to assess and address the work environment as well as personal factors associated with increased risk for musculoskeletal disorders, and to promote ergonomic principles through small group and one-on-one training.

Stretching and core strengthening programs are now earning respect, when they were once thought of as a little over-the-top. But over time, participating companies began to see results in reduced injury frequency. Then others started taking a more serious look.

Arizona Public Service, the largest affiliate of Teddy Award finalist Pinnacle West Capital Corp., launched a pilot stretching and core conditioning program in 2011. The program gives employees the skills they need to improve balance and coordination in order to reduce injuries. The program also puts a focus on mental awareness and attention control — key factors in incident prevention. The program has resulted in a noticeable drop in strain and sprain injuries for the Phoenix-based energy holding company.

Worcester, Pa. civil construction company American Infrastructure has a stretching program that’s companywide. AI’s philosophy is that all employees are industrial athletes. That’s why everyone — from workers on job sites to office staff — participates in a morning stretching program. According to AI, the program serves a dual purpose. The stretching helps prime employees to be physically ready for the tasks ahead. It also helps prime them mentally, getting them thinking about working and moving safely right off the bat.

Another type of initiative that’s gaining traction in recent years is wellness programs. Once thought of as a “nice to have” that was more the purview of HR, wellness programs were perceived strictly as a means to reduce health care costs. Today, executives are catching on to the fact that healthier employees are not only less likely to get hurt, they also bounce back faster if an injury does occur, and have fewer complications related to comorbidities such as diabetes, obesity or heart disease.

That said, companies actively connecting the dots between wellness and injury outcomes are still somewhat few and far between. That’s another reason Pinnacle West earned the attention of the Teddy Award judges.

Pinnacle West has taken an active approach to employee health and wellness, launching its internally branded “Health Matters” program. The Health Matters program includes free screenings and assessments for employees, helps them assess their risk for disease and helps them develop personal wellness goals and plans. Employees are invited to utilize online weight loss coaching, smoking cessation programs, discounts on gym memberships, a vast library of healthy recipes and more.

Pinnacle West also recognizes that it’s not enough to tack a flyer about available wellness programs on the company bulletin board. That’s why the company is actively tracking employee participation in its programs, setting annual target goals for participation in each stage of the program and devoting resources to getting the Health Matters message out.

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American Infrastructure’s wellness efforts are every bit as laudable. “Our focus,” the company wrote in its application, “has become not only to be America’s safest construction company, but America’s healthiest construction company as well.” Their commitment is clear. The company offers biometric testing for blood pressure, heart rate, cholesterol levels, blood sugar and more, and urges all employees to “know your numbers.” Employees can take their numbers and sit down with health coaches to develop action plans for improving their health. Among other initiatives, AI’s programs include a stepping program that helps employees track their steps throughout the day. Stepping challenges with prizes attached help keep people motivated. The company has also had great success with weight loss challenges.

“We’ve always been a company that goes beyond compliance. We wanted to take our safety culture to the next level,” said Bryan Schwartz, AI’s risk manager.

Working Toward Recovery

Incredible strides have been made in the area of return-to-work. Armed with a better grasp of the effect of lost time on both injury durations and the company’s bottom line, employers are more committed to keeping injured workers on the job and productive.

“Our focus has become not only to be America’s safest construction company, but America’s healthiest construction company as well.”
— American Infrastructure

Progressive companies are breaking free of the old mind-set of creating rigid transitional duty positions to accommodate work restrictions, and trying to fit all injured employees into those frameworks. Instead, they’ve shifted focus to the employee rather than the position, and on building customized transitional work around the injured employee’s capabilities.

Teddy Award winner PetSmart’s approach to return-to-work sets the right tone. All transitional duty jobs at PetSmart can be combined or modified to meet the needs of the associate’s restrictions. That focus helps guide managers to keep an open mind about transitional duties, and to look closely at what the injured employee is capable of doing. Injured employees at PetSmart are able to perform any number of essential store functions, from taking grooming appointments to helping with animal adoptions through in-store affiliate PetSmart Charities.

Teddy Award finalist Eisenhower Medical Center in Rancho Mirage, Calif., has taken a comprehensive approach. Three years ago, the organization took on the arduous task of assessing and cataloguing every job description, every essential and nonessential function of each position, and the skills or capabilities needed to perform each one of those functions. Initially, this database has been used to help identify the tasks most likely to cause injury. It is also used to guide treatment to help an employee resume the essential functions of his or her job faster. But during the recovery process, the database provides an invaluable, detailed body of information that helps the risk management and medical staff efficiently customize transitional positions based upon an injured employee’s specific abilities, and make adjustments smoothly as recovery progresses.

Solutions Large and Small

At Partners HealthCare, the best care for an injured employee is easy to find. The health system maintains eight Occupational Health Service clinics, staffed by occupational health nurse practitioners (OHNPs) experienced in evaluating and treating injured employees. OHNPs are the key point of contact for each case, coordinating treatment protocols, incident investigations and return-to-work plans. Dedicated claims specialists support the OHNPs. In turn, administrative assistants support the claims specialists — ensuring that they don’t become mired in paperwork and can focus on the needs of each injured employee. The OHS clinics are overseen by four medical directors — each one a board-certified and experienced specialist in occupational and environmental medicine.

Such a solution is unquestionably state-of-the-art. But the fact is that most employers outside the health care field don’t have the resources to follow that model. Nevertheless, plenty of employers are pulling out all the stops to get their people the care they need. Teddy Award-winning Miami-Dade County Public Schools, for example, uses a 24/7 call center for receiving notice of injuries. Injured workers are immediately directed to the best nearby specialty physician using a geo-access tool that identifies the providers nearest the injured worker’s location.

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Other employers are finding ways to maximize the resources they do have. And sometimes, the simplest and smallest of changes are the ones that will make the biggest impact. Phoenix-based PetSmart’s tetanus program is a perfect example. Because of the nature of its operations, PetSmart employees face significant risk exposure from animal bites. That means that an injured employee might need a tetanus shot in addition to treatment of the wound. As such, every bite, no matter how minor, required an office visit to ensure that the employee’s tetanus status was up-to-date.

But all of that changed when PetSmart began tracking the status of employees’ tetanus shots. With stores armed with that small, but vital piece of information, employees with minor injuries could be treated with standard first aid and sent back to work, with no need for a provider visit. This one small inexpensive change has made a tremendous impact on the company’s bottom line.

At American Infrastructure, one small change that has had a huge impact was a simple color change. As with other companies across a variety of industries, AI’s new employees faced a higher risk of injury than their more experienced counterparts. AI reasoned that ideally, everyone should be looking out for the well-being of new hires, not just their immediate supervisors. But it’s easy to lose track of who’s who on a busy job site. That’s why the company opted to purchase bright green hard hats for new recruits. That way everyone remains constantly aware of the location of employees who might need help, some extra guidance or a safety reminder.

Promising Teddy Award applicant Kimco Staffing of Irvine, Calif., faced a massive obstacle with workers seeking treatment outside of the company’s medical provider networks (MPNs) and receiving excessive and unnecessary treatments. Workers’ comp judges widely disregarded the company’s attempts to enforce its MPN rules if an injured worker claimed to be unaware of the requirement. Kimco took the solid first steps of providing the MPN requirements to each employee, at the time of hire and at the onset of each claim — and requiring employees to acknowledge it in writing. But then the company went one step further, heading off any doubts by taking a picture of each employee holding the signed document. Courts are now more inclined to honor Kimco’s MPN policy, and to release Kimco from the burden of paying for unauthorized treatment.

In addition, companies such as American Infrastructure and PetSmart are also leveraging the power of newer technologies, using iPads for everything from safety module training to capturing pictures of hazards instantly to distributing critical incident metrics to regional and district managers in the field.

Risk & Insurance® congratulates this year’s Teddy Award winners and finalists on their exceptional efforts to create safer workplaces and provide the best possible care for their injured team members.

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at mkerr@lrp.com

More from Risk & Insurance

More from Risk & Insurance

High Net Worth

High Net Worth Clients Live in CAT Zones. Here’s What Their Resiliency Plan Should Include

Having a resiliency plan and practicing it can make all the difference in a disaster.
By: | September 14, 2018 • 7 min read

Packed with state-of-the-art electronics, priceless collections and high-end furnishings, and situated in scenic, often remote locations, the dwellings of high net worth individuals and families pose particular challenges when it comes to disaster resiliency. But help is on the way.

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Armed with loss data, innovative new programs, technological advances, and a growing army of niche service-providers aimed at addressing an astonishingly diverse set of risks, insurers are increasingly determined to not just insure against their high net worth clients’ losses, but to prevent them.

Insurers have long been proactive in risk mitigation, but increasingly, after the recent surge in wildfire and storm losses, insureds are now, too.

“Before, insurance was considered the only step in risk management. Now, our client families realize it is one of the many imperative steps in an effective risk management strategy,” said Laura Sherman, founding partner at Baldwin Krystyn Sherman Partners.

And especially in the high net worth space, preventing that loss is vastly preferable to a payout, for insurers and insureds alike.

“If insurers can preserve even one house that’s 10 or 20 or 40 million dollars … whatever they have spent in a year is money well spent. Plus they’ve saved this important asset for the client,” said Bruce Gendelman, chairman and founder Bruce Gendelman Insurance Services.

High Net Worth Vulnerabilities

Laura Sherman, founding partner, Baldwin Krystyn Sherman Partners

As the number and size of luxury homes built in vulnerable areas has increased, so has the frequency and magnitude of extreme weather events, including hurricanes, harsh cold and winter storms, and wildfires.

“There is a growing desire to inhabit this riskier terrain,” said Jason Metzger, SVP Risk Management, PURE group of insurance companies. “In the western states alone, a little over a million homes are highly vulnerable to wildfires because of their proximity to forests that are fuller of fuel than they have been in years past.”

Such homes are often filled with expensive artwork and collections, from fine wine to rare books to couture to automobiles, each presenting unique challenges. The homes themselves present other vulnerabilities.

“Larger, more sophisticated homes are bristling with more technology than ever,” said Stephen Poux, SVP and head of Risk Management Services and Loss Prevention for AIG’s Private Client Group.

“A lightning strike can trash every electronic in the home.”

Niche Service Providers

A variety of niche service providers are stepping forward to help.

Secure facilities provide hurricane-proof, wildfire-proof off-site storage for artwork, antiques, and all manner of collectibles for seasonal or rotating storage, as well as ahead of impending disasters.

Other companies help manage such collections — a substantial challenge anytime, but especially during a crisis.

“Knowing where it is, is a huge part of mitigating the risk,” said Eric Kahan, founder of Collector Systems, a cloud-based collection management company that allows collectors to monitor their collections during loans to museums, transit between homes, or evacuation to secure storage.

“Before, insurance was considered the only step in risk management. Now, our client families realize it is one of the many imperative steps in an effective risk management strategy.” — Laura Sherman, founding partner, Baldwin Krystyn Sherman Partners

Insurers also employ specialists in-house. AIG employs four art curators who advise clients on how to protect and preserve their art collections.

Perhaps the best known and most striking example of this kind of direct insurer involvement are the fire teams insurers retain or employ to monitor fires and even spray retardant or water on threatened properties.

High-Level Service for High Net Worth

All high net worth carriers have programs that leverage expertise, loss data, and relationships with vendors to help clients avoid and recover from losses, employing the highest levels of customer service to accomplish this as unobtrusively as possible.

“What allows you to do your job best is when you develop that relationship with a client, where it’s the same people that are interacting with them on every front for their risk management,” said Steve Bitterman, chief risk services officer for Vault Insurance.

Site visits are an essential first step, allowing insurers to assess risks, make recommendations to reduce them, and establish plans in the event of a disaster.

“When you’re in a catastrophic situation, it’s high stress, time is of the essence, and people forget things,” said Sherman. “Having a written plan in place is paramount to success.”

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Another important component is knowing who will execute that plan in homes that are often unoccupied.

Domestic staff may lack the knowledge or authority to protect the homeowner’s assets, and during a disaster may be distracted dealing with threats to their own homes and families. Adequate planning includes ensuring that whoever is responsible has the training and authority to execute the plan.

Evaluating New Technology

Insurers use technologies like GPS and satellite imagery to determine which homes are directly threatened by storms or wildfires. They also assess and vet technologies that can be implemented by homeowners, from impact glass to alarm and monitoring systems, to more obscure but potentially more important options.

AIG’s Poux recommends two types of vents that mitigate important, and unexpected risks.

“There’s a fantastic technology called Smart Vent, which allows water to flow in and out of the foundation,” Poux said. “… The weight of water outside a foundation can push a foundation wall in. If you equalize that water inside and out at the same level, you negate that.”

Another wildfire risk — embers getting sucked into the attic — is, according to Poux, “typically the greatest cause of the destruction of homes.” But, he said, “Special ember-resisting venting, like Brandguard Vents, can remove that exposure altogether.”

Building Smart

Many disaster resiliency technologies can be applied at any time, but often the cost is fractional if implemented during initial construction. AIG’s Smart Build is a free program for new or remodeled homes that evolved out of AIG’s construction insurance programs.

Previously available only to homes valued at $5 million and up, Smart Build recently expanded to include homes of $1 million and up. Roughly 100 homes are enrolled, with an average value of $13 million.

“In the high net worth space, sometimes it takes longer potentially to recover, simply because there are limited contractors available to do specialty work.” — Curt Goetsch, head of underwriting, Private Client Group, Ironshore

“We know what goes wrong in high net worth homes,” said Poux, citing AIG’s decades of loss data.

“We’re incenting our client and by proxy their builder, their architects and their broker, to give us a seat at the design table. … That enables us to help tweak the architectural plans in ways that are very easy to do with a pencil, as opposed to after a home is built.”

Poux cites a remote ranch property in Texas.

Curt Goetsch, head of underwriting, Private Client Group, Ironshore

“The client was rebuilding a home but also installing new roads and grading and driveways. … The property was very far from the fire department and there wasn’t any available water on the property.”

Poux’s team was able to recommend underground water storage tanks, something that would have been prohibitively expensive after construction.

“But if the ground is open and you’ve got heavy equipment, it’s a relatively minor additional expense.”

Homes that graduate from the Smart Build program may be eligible for preferred pricing due to their added resilience, Poux said.

Recovery from Loss

A major component of disaster resiliency is still recovery from loss, and preparation is key to the prompt service expected by homeowners paying six- or seven-figure premiums.

Before Irma, PURE sent contact information for pre-assigned claim adjusters to insureds in the storm’s direct path.

“In the high net worth space, sometimes it takes longer potentially to recover, simply because there are limited contractors available to do specialty work,” said Curt Goetsch, head of underwriting for Ironshore’s Private Client Group.

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“If you’ve got custom construction or imported materials in your house, you’re not going to go down the street and just find somebody that can do that kind of work, or has those materials in stock.”

In the wake of disaster, even basic services can be scarce.

“Our claims and risk management departments have to work together in advance of the storm,” said Bitterman, “to have contractors and restoration companies and tarp and board services that are going to respond to our company’s clients, that will commit resources to us.”

And while local agents’ connections can be invaluable, Goetsch sees insurers taking more of that responsibility from the agent, to at least get the claim started.

“When there is a disaster, the agency’s staff may have to deal with personal losses,” Goetsch said. &

Jon McGoran is a novelist and magazine editor based outside of Philadelphia. He can be reached at riskletters@lrp.com.