Sponsored Content by Sedgwick

3 Ways Data Can Drive Meaningful Risk Reduction in the Public Sector

Data has become an increasingly valuable tool for risk management and underwriting. That’s why more public entities are looking to harness their data to drive down losses.
By: | October 8, 2019

It has been 33 years since Time magazine touted the headline “Sorry, America, Your Insurance Has Been Canceled.”

In the 1980s, insurance premiums were skyrocketing with no clear reprieve in sight. The industry was facing a liability insurance crisis, and the availability of certain coverages for public entities waned, leaving many without general liability.

“The risks were too high for the industry to keep insuring at that time,” said Jody Moses, Managing Director, Public Entities, Pools and Associations for Sedgwick.

“So, public entities self-insured their risks — property, general liability, workers’ compensation. They formed pools or self-insured on their own.”

The move has proven to be a good thing for this thriving sector; now, Moses said, public entities have a huge opportunity to take the knowledge and data they’ve collected over the last three decades and use it to better protect themselves against growing risks.

From airports to municipalities, public libraries and schools, public entities “face every risk conceivable,” said Moses.

“But they also have all this data from each facility. They have information on top drivers of loss and the cost of risk.”

Data collection and analysis has continued to play a huge role in the insurance industry, enabling carriers to better assess risk and underwrite policy. The challenge for public entities, however, is in learning how to best use that data.

Here are three ways in which public entities can harness their data to their advantage.

1) Utilizing data across multiple jurisdictions enables risk management to identify risk mitigation strategies that work and prevent future loss.

Jody Moses, Managing Director, Public Entities, Pools and Associations, Sedgwick

Each public entity has its own set of data that measures its exposures, risks, previous losses and proven results.

They have their own data that helps them make decisions about what’s going on in their agency,” said Moses.

With data at their fingertips, risk managers can also enact change, identify what’s driving their losses and implement strategies and risk prevention tools. But there’s another way public sector risk managers can boost their programs – including data sets from outside jurisdictions.

“Public entities are one of the most open sectors to sharing information,” said Moses. “With the exception of personal identifiers or data expressly excluded by HIPAA, there’s virtually nothing proprietary in the public sector when it comes to data.”

Measuring data against other similar agencies in the same or similar jurisdictions is a huge opportunity for a public entity’s risk management department, because harnessing data across a larger pool helps them benchmark progress on a larger scale.

“Risk managers can make better risk decisions by being able to view this data,” said Moses.

The challenge is in creating a common way to pull data across public entities. Moses said being able to aggregate all that data and demonstrate what the costs are to public entities can only be accomplished with a standardized data collection process.

“The goal is to get reliable, clean and credible data,” she said.

2) Public entities are in a unique position to impact policy and legislation.

New regulations and laws come into effect every day. Each new move by legislative bodies can impact public entities, and so this sector has a unique opportunity to influence policymakers when decisions are in flight.

“There is a need for public entities and risk managers to get involved in telling their story to policymakers,” Moses said. “Data can tell that story.”

Yet learning how to harness the data to tell the story is proving challenging. For example, almost every jurisdiction has initiated legislation to include or expand existing injuries and illness that would be presumed to be compensable as it relates to safety personnel.

In order to speak with the legislature about the projected increased costs to public entities and ultimately the tax payers associated with the proposed legislation, public entities had to sort through their data to tell their story.

But it wasn’t an easy road to get there.

“As we move forward, risks are getting even more severe and more challenging, and the need to tell a credible story is ever more pressing,” said Moses. “Data science, and the use of data, has become such an integral piece in helping policymakers understand the reality of these risks.

“The voice of the public is not going to be heard unless public entities can tell the story credibly with the data they’ve aggregated,” she added.

3) With time, public entities can utilize their data to predict and prevent loss.

The idea of predictive analytics is powerful, especially in areas like workers’ compensation.

Real-time data can show how public sector workers are performing and determine if there are potential places for injury. With analytics, public entities can reduce exposure or prevent future losses from occurring.

But, “until public entities get clean, consistent and standard data across multiple jurisdictions, it will be hard to accurately use predictive analytics,” Moses said.

“If public entities can bring their data together — not just one single public entity doing it on their own — but if everyone starts aggregating their public entity data, they can really start to implement strategies to reduce risk and cut losses.”

Gathering Clean, Useful Data Takes Partnership

One thing rings true: In order to benefit from data harnessing, public entities must invest in cleaning their data and using standardized methods across the board to capture each new piece of information as it comes in.

Public entities can participate in associations that are supporting efforts to enhance data and analytics. In fact, according to Moses, many of these agencies are already looking to partner with public entities.

PRIMA, the Public Risk Management Association, which is national and has local public risk and insurance management association partners, PARMA, the Public Agency Risk Management Association, and AGRiP, the Association of Governmental Risk Pools – all of these groups are really striving to partner with public entities,” she said.

Taking it one step further, public entities can partner with the right provider. Sedgwick has positioned itself as a partner that is passionate about public entities.

Sedgwick works with associations and public entity clients to really harness data. They provide technology that captures data for their public entity clients so they can best use it to make informed decisions.

“We ask the questions,” said Moses.

“We work with public entities to understand their goals, and then we help them design processes for collecting and utilizing data in a way that supports those goals and allows them to thrive. No other administrator has the scope and breadth of data that Sedgwick does, especially combined with years of experience supporting public entity clients. Our experts are well-versed in using data to inform decision-making, trigger action and improve outcomes, all with the complexities and requirements of public entities in mind.”

To learn more, visit www.sedgwick.com.


This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Sedgwick. The editorial staff of Risk & Insurance had no role in its preparation.

Sedgwick is the leading North American provider of innovative, technology-enabled claims and productivity management solutions, delivering a world of expert resources to a diverse client base through 10,000 colleagues across the U.S. and Canada.

More from Risk & Insurance

More from Risk & Insurance

Risk Scenario

The Betrayal of Elizabeth

In this Risk Scenario, Risk & Insurance explores what might happen in the event a telemedicine or similar home health visit violates a patient's privacy. What consequences await when a young girl's tele visit goes viral?
By: | October 12, 2020
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.


Elizabeth Cunningham seemingly had it all. The daughter of two well-established professionals — her father was a personal injury attorney, her mother, also an attorney, had her own estate planning practice — she grew up in a house in Maryland horse country with lots of love and the financial security that can iron out at least some of life’s problems.

Tall, good-looking and talented, Elizabeth was moving through her junior year at the University of Pennsylvania in seemingly good order; check that, very good order, by all appearances.

Her pre-med grades were outstanding. Despite the heavy load of her course work, she’d even managed to place in the Penn Relays in the mile, in the spring of her sophomore season, in May of 2019.

But the winter of 2019/2020 brought challenges, challenges that festered below the surface, known only to her and a couple of close friends.

First came betrayal at the hands of her boyfriend, Tom, right around Thanksgiving. She saw a message pop up on his phone from Rebecca, a young woman she thought was their friend. As it turned out, Rebecca and Tom had been intimate together, and both seemed game to do it again.

Reeling, her holiday mood shattered and her relationship with Tom fractured, Elizabeth was beset by deep feelings of anxiety. As the winter gray became more dense and forbidding, the anxiety grew.

Fed up, she broke up with Tom just after Christmas. What looked like a promising start to 2020 now didn’t feel as joyous.

Right around the end of the year, she plucked a copy of her father’s New York Times from the table in his study. A budding physician, her eyes were drawn to a piece about an outbreak of a highly contagious virus in Wuhan, China.

“Sounds dreadful,” she said to herself.

Within three months, anxiety gnawed at Elizabeth daily as she sat cloistered in her family’s house in Bel Air, Maryland.

It didn’t help matters that her brother, Billy, a high school senior and a constant thorn in her side, was cloistered with her.

She felt like she was suffocating.

One night in early May, feeling shutdown and unable to bring herself to tell her parents about her true condition, Elizabeth reached out to her family physician for help.

Dr. Johnson had been Elizabeth’s doctor for a number of years and, being from a small town, Elizabeth had grown up and gone to school with Dr. Johnson’s son Evan. In fact, back in high school, Evan had asked Elizabeth out once. Not interested, Elizabeth had declined Evan’s advances and did not give this a second thought.

Dr. Johnson’s practice had recently been acquired by a Virginia-based hospital system, Medwell, so when Elizabeth called the office, she was first patched through to Medwell’s receptionist/scheduling service. Within 30 minutes, an online Telehealth consult had been arranged for her to speak directly with Dr. Johnson.

Due to the pandemic, Dr. Johnson called from the office in her home. The doctor was kind. She was practiced.

“So can you tell me what’s going on?” she said.

Elizabeth took a deep breath. She tried to fight what was happening. But she could not. Tears started streaming down her face.

“It’s just… It’s just…” she managed to stammer.

The doctor waited patiently. “It’s okay,” she said. “Just take your time.”

Elizabeth took a deep breath. “It’s like I can’t manage my own mind anymore. It’s nonstop. It won’t turn off…”

More tears streamed down her face.

Patiently, with compassion, the doctor walked Elizabeth through what she might be experiencing. The doctor recommended a follow-up with Medwell’s psychology department.

“Okay,” Elizabeth said, some semblance of relief passing through her.

Unbeknownst to Dr. Johnson, her office door had not been completely closed. During the telehealth call, Evan stopped by his mother’s office to ask her a question. Before knocking he overheard Elizabeth talking and decided to listen in.


As Elizabeth was finding the courage to open up to Dr. Johnson about her psychological condition, Evan was recording her with his smartphone through a crack in the doorway.

Spurred by who knows what — his attraction to her, his irritation at being rejected, the idleness of the COVID quarantine — it really didn’t matter. Evan posted his recording of Elizabeth to his Instagram feed.

#CantManageMyMind, #CrazyGirl, #HelpMeDoctorImBeautiful is just some of what followed.

Elizabeth and Evan were both well-liked and very well connected on social media. The posts, shares and reactions that followed Evan’s digital betrayal numbered in the hundreds. Each one of them a knife into the already troubled soul of Elizabeth Cunningham.

By noon of the following day, her well-connected father unleashed the dogs of war.

Rand Davis, the risk manager for the Medwell Health System, a 15-hospital health care company based in Alexandria, Virginia was just finishing lunch when he got a call from the company’s general counsel, Emily Vittorio.

“Yes?” Rand said. He and Emily were accustomed to being quick and blunt with each other. They didn’t have time for much else.

“I just picked up a notice of intent to sue from a personal injury attorney in Bel Air, Maryland. It seems his daughter was in a teleconference with one of our docs. She was experiencing anxiety, the daughter that is. The doctor’s son recorded the call and posted it to social media.”

“Great. Thanks, kid,” Rand said.

“His attorneys want to initiate a discovery dialogue on Monday,” Emily said.

It was Thursday. Rand’s dreams of slipping onto his fishing boat over the weekend evaporated, just like that. He closed his eyes and tilted his face up to the heavens.

Wasn’t it enough that he and the other members of the C-suite fought tooth and nail to keep thousands of people safe and treat them during the COVID-crisis?

He’d watched the explosion in the use of telemedicine with a mixture of awe and alarm. On the one hand, they were saving lives. On the other hand, they were opening themselves to exposures under the Health Insurance Portability and Accountability Act. He just knew it.

He and his colleagues tried to do the right thing. But what they were doing, overwhelmed as they were, was simply not enough.


Within the space of two weeks, the torture suffered by Elizabeth Cunningham grew into a class action against Medwell.

In addition to the violation of her privacy, the investigation by Mr. Cunningham’s attorneys revealed the following:

Medwell’s telemedicine component, as needed and well-intended as it was, lacked a viable informed consent protocol.

The consultation with Elizabeth, and as it turned out, hundreds of additional patients in Maryland, Pennsylvania and West Virginia, violated telemedicine regulations in all three states.

Numerous practitioners in the system took part in teleconferences with patients in states in which they were not credentialed to provide that service.

Even if Evan hadn’t cracked open Dr. Johnson’s door and surreptitiously recorded her conversation with Elizabeth, the Medwell telehealth system was found to be insecure — yet another violation of HIPAA.

The amount sought in the class action was $100 million. In an era of social inflation, with jury awards that were once unthinkable becoming commonplace, Medwell was standing squarely in the crosshairs of a liability jury decision that was going to devour entire towers of its insurance program.

Adding another layer of certain pain to the equation was that the case would be heard in Baltimore, a jurisdiction where plaintiffs’ attorneys tended to dance out of courtrooms with millions in their pockets.

That fall, Rand sat with his broker on a call with a specialty insurer, talking about renewals of the group’s general liability, cyber and professional liability programs.

“Yeah, we were kind of hoping to keep the increases on all three at less than 25%,” the broker said breezily.

There was a long silence from the underwriters at the other end of the phone.

“To be honest, we’re borderline about being able to offer you any cover at all,” one of the lead underwriters said.

Rand just sat silently and waited for another shoe to drop.

“Well, what can you do?” the broker said, with hope draining from his voice.

The conversation that followed would propel Rand and his broker on the difficult, next to impossible path of trying to find coverage, with general liability underwriters in full retreat, professional liability underwriters looking for double digit increases and cyber underwriters asking very pointed questions about the health system’s risk management.

Elizabeth, a strong young woman with a good support network, would eventually recover from the damage done to her.

Medwell’s relationships with the insurance markets looked like it almost never would. &


Risk & Insurance® partnered with Allied World to produce this scenario. Below are Allied World’s recommendations on how to prevent the losses presented in the scenario. This perspective is not an editorial opinion of Risk & Insurance.®.

The use of telehealth has exponentially accelerated with the advent of COVID-19. Few health care providers were prepared for this shift. Health care organizations should confirm that Telehealth coverage is included in their Medical Professional, General Liability and Cyber policies, and to what extent. Concerns around Telehealth focus on HIPAA compliance and the internal policies in place to meet the federal and state standards and best practices for privacy and quality care. As states open businesses and the crisis abates, will pre-COVID-19 telehealth policies and regulations once again be enforced?

Risk Management Considerations:

The same ethical and standard of care issues around caring for patients face-to-face in an office apply in telehealth settings:

  • maintain a strong patient-physician relationship;
  • protect patient privacy; and
  • seek the best possible outcome.

Telehealth can create challenges around “informed consent.” It is critical to inform patients of the potential benefits and risks of telehealth (including privacy and security), ensure the use of HIPAA compliant platforms and make sure there is a good level of understanding of the scope of telehealth. Providers must be aware of the regulatory and licensure requirements in the state where the patient is located, as well as those of the state in which they are licensed.

A professional and private environment should be maintained for patient privacy and confidentiality. Best practices must be in place and followed. Medical professionals who engage in telehealth should be fully trained in operating the technology. Patients must also be instructed in its use and provided instructions on what to do if there are technical difficulties.

This case study is for illustrative purposes only and is not intended to be a summary of, and does not in any way vary, the actual coverage available to a policyholder under any insurance policy. Actual coverage for specific claims will be determined by the actual policy language and will be based on the specific facts and circumstances of the claim. Consult your insurance advisors or legal counsel for guidance on your organization’s policies and coverage matters and other issues specific to your organization.

This information is provided as a general overview for agents and brokers. Coverage will be underwritten by an insurance subsidiary of Allied World Assurance Company Holdings, Ltd, a Fairfax company (“Allied World”). Such subsidiaries currently carry an A.M. Best rating of “A” (Excellent), a Moody’s rating of “A3” (Good) and a Standard & Poor’s rating of “A-” (Strong), as applicable. Coverage is offered only through licensed agents and brokers. Actual coverage may vary and is subject to policy language as issued. Coverage may not be available in all jurisdictions. Risk management services are provided or arranged through AWAC Services Company, a member company of Allied World. © 2020 Allied World Assurance Company Holdings, Ltd. All rights reserved.

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