60 Tips in 60 Minutes: Meet the Panelists of an NWCDC Perennial Favorite

Meet the panelists of one of NWCDC's most anticipated sessions, '60 Tips in 60 Minutes – Avoiding Medical Mismanagement’s Claims Fallout.'

By: Emily Spennato | October 2, 2019

When a professional athlete is injured during a game, they’re not even off the field before their trauma is professionally assessed. It’s part of the way that teams protect their valued assets and start planning for recovery immediately. Employers across a broad spectrum of industries can benefit from a similar approach.

Medical mismanagement in the claims process is a hot-button topic at this year’s National Workers’ Compensation & Disability Conference® and Expo.

NWCDC will have prominent industry professionals that know how important it is to utilize cost-containment business strategies pre-injury.

Mismanagement hazards can be anything from knowing when to get an X-ray, to knowing the proper use for medical cannabis.

Seven leaders of top workers’ compensation programs across the country will convene for “60 Tips in 60 Minutes – Avoiding Medical Mismanagement’s Claims Fallout,” to discuss 60 of their best strategies for avoiding improper handling of a claim and ultimately healing workers faster.

The session will take place on Friday, November 8 from 8:30 a.m. to 9:45 a.m.

Kicking off the final day of the conference will be panelists Marcos Iglesias, Kim Radcliffe, Dawn Watkins, Anas Al-Hamwi, Monica Manske, Phil Walls, led by moderator Stuart Colburn.

Marcos Iglesias

Marcos Iglesias, vice president, chief medical director, Travelers

Dr. Marcos Iglesias, vice president and chief medical director, Travelers, is a physician executive with over 25 years of vast experience including workers’ compensation and disability treatment, evaluation and insurance leadership. He develops innovative disability management solutions that focus on early intervention to return workers to the active, productive, and uncompromised conditions that they were in pre-injury.

Iglesias was also a panelist at last year’s NWCDC, speaking on the complex science behind marijuana and the complications that come with using it for medical and recreational purposes.

“How do you apply [existing research] when you have studies that are 10 years old or even 20 years old? It’s a different drug altogether,” he told R&I in 2018 about the outstanding marijuana debate.

Stuart Colburn

Stuart Colburn, shareholder, Downs Stanford

Attorney Stuart Colburn is a shareholder of law firm Downs Stanford. Together with Iglesias, Colburn presented last year’s popular session, “Marijuana, Workers’ Compensation and Disability: What’s the Science and the Law?”

“Federal law says you are not allowed to pay for marijuana or use marijuana. And yet we have 6 states that require an insurance company to pay for or reimburse an injured worker for marijuana,” Colburn said to R&I prior to the conference. “How do we resolve that conflict for an employer and an insurance company?”

Colburn will act as the moderator for the “60 Tips in 60 Minutes” session.

He has extensive experience in all phases of dispute resolution before the Division of Worker’s Compensation and in district courts across the state of Texas.

He is active in the workers’ compensation community, championing many projects including the education of attorneys, adjusters and employers for workers’ compensation and bad faith allegation. He is certified by the Texas Department of Insurance as a continuing education provider.

To prove his commitment to service, The State Bar of Texas Workers’ Compensation Section awarded Colburn “The Barb-wire Award” for his contributions to workers’ compensation.

Kim Radcliffe

Kim Radcliffe, senior vice president, clinical operations, One Call

Kim Radcliffe is a 10-year employee of One Call, starting as vice president of clinical operations for Align Networks (now One Call Physical Therapy) in 2006, becoming president of physical therapy in 2014.

Now as senior vice president of clinical, Kim leads a multi-specialty team of experts to focus on comprehensive, patient-centric and injury-specific oversight to ensure the delivery of efficient care and desired results.

“It’s critical that there is some effort at standardization using proven evidence-based recovery paths.So whether it’s a knee injury or a finger injury, the treatment modalities and the providers involved will be different, but the phases of recovery are the same,” said Radcliffe about recovery approaches in April 2019.

She is credited with the creation of Align Networks Gold Standard Review program, a clinical oversight program that monitors quality of care, treatment patterns, utilization and appropriateness of care.

Anas Al-Hamwi

Anas Al-Hamwi, senior director, health & safety and injury management, Walgreens

Anas Al-Hamwi is the senior director of safety & injury management in Operations for Walgreen Co., the Retail USA division of Walgreens Boots Alliance, the global healthcare organization headquartered in Deerfield, Illinois.

Al-Hamwi is responsible for keeping the company’s employees and customers safe and provide quality treatment and resources for injury recovery.

He is a member of the Risk Management Society, Claims and Litigation Management Alliance, and was recently added to the Board of Directors for the National Safety Council, a nonprofit organization with a mission is to eliminate preventable deaths at work, in homes, communities, and on the road through education and advocacy.

Al-Hamwi earned a Doctor of Medicine Degree from Damascus University in Syria.

Dawn Watkins

Dawn Watkins, director, integrated disability management, Los Angeles Unified School District

Dawn Watkins is the Director of Integrated Disability Management for the Los Angeles Unified School District (LAUSD); the second largest school district in the nation.

Since 2006, she has led one of the largest self-insured workers’ compensation programs in California for approximately 70,000 employees.

In 2008, Risk & Insurance issued Watkins the “Risk Innovator” award for outstanding leadership and awarded LAUSD with a Teddy Award honorable mention for excellence in workers’ compensation.

“If an employee can’t get the care they need, we will step outside of the system. Our emphasis is on quality wherever it may be,” she told R&I in 2014.

Watkins holds a Bachelor of Science degree, a California Self Insured Administrators certificate, and multiple designations in risk management and human resources. She is a frequent speaker at risk management conferences and events.

Monica Manske

Monica Manske, senior manager workers’ compensation, employee safety and ergonomics, Rochester Regional Health

Monica Manske is the senior manager of workers’ compensation, employee safety and ergonomics at Rochester Regional Health. She is a 20-year human resources and risk management industry professional.

She spent ten years in the insurance industry before transitioning to the healthcare sector. Through her operational leadership she has overseen workers’ compensation, employee leave and benefit programs, as well as ergonomics and employee safety.

Manske and her team at Rochester Regional Health were recognized for their outstanding commitment to workers’ compensation with a 2017 Teddy Award. They won by taking a specific approach to safety, which will be a similar approach encouraged at NWCDC: engage employees to teach and encourage safe behaviors rather than punishing them for lapses.

Phil Walls

Phil Walls, chief clinical officer, myMatrixx

Phil Walls is the chief clinical officer for myMatrixx.

He is a clinical pharmacist with over 40 years of experience as pharmacy benefit management and workers’ compensation. He also has expertise in pain management, side effects of medications, managing overutilization, and drug abuse.

Walls was a champion in developing myMatrixx’s clinical program, Get Ahead of the Claim. The program is designed to mitigate risk early in the claim process and provide positive outcomes for injured workers while reducing cost for clients.

“Our approach to formulary management is what we refer to as phase of care,” Walls told Risk and Insurance in 2019.

“Where we’re looking at the point and time of the claim to help our clients make formulary decisions because what is appropriate right after an injury may not be appropriate six months later and vice versa.”

Walls is a published author and frequent speaker on clinical topics in workers’ compensation.

Secure your seat now for this can’t-miss-session, and never mismanage a medical claim again. &

About the National Workers’ Compensation and Disability Conference® & Expo:

As the largest National Workers’ Comp and Disability Conference for more than 25 years, NWCDC offers endless opportunities that will propel your workers’ comp and disability management programs forward. With the biggest Expo in the industry, you’ll be able to touch, compare and contrast the newest solutions from leading vendors in every category, and gain knowledge on-the-go at in-depth sponsored sessions on the show floor. Additionally, NWCDC offers valuable networking opportunities so you can make important contacts and share strategies with your peers.

You can also customize your learning experience with breakout sessions in six distinct program tracks: Claims Management, Medical Management, Program Management, Disability Management, Legal/Regulatory, and Technology. Plus, you’ll hear from Risk & Insurance’s Teddy Award winners for excellence in lowering workers’ comp risk.

Learn more about NWCDC and special savings for Risk & Insurance® subscribers here.

Emily Spennato is a former staff writer with Risk & Insurance.

How a Carrier Partner Can Help Navigate a Challenging Management and Professional Liability Market

A combination of a choppy economy with increased claims frequency and severity could lead to rate increases in the Management & Professional Liability market.

By: Risk & Insurance | April 3, 2024

Rates in the management & professional liability (M&PL) markets were on the rise from 2020 to early 2023 and are now falling rapidly.

M&PL divisions manage a number of different insurance products including management liability (D&O), professional liability (E&O), employment practices liability (EPL), fiduciary liability policies, cyber, etc. In 2023 and into 2024, a big influence on the marketplace has been the extremely aggressive and softening public company D&O market.

Though these rates have been softening for management liability, that may change over the next few years as companies continue to adjust their business models motivated by economic uncertainty. Layoffs were up nearly 200% last year, Forbes reported, even as other recession indicators, like the inflation rate, improved. A recession could lead to an increased claim activity and force carriers to raise rates.

“Whenever there is a meaningful downturn in the economy, we tend to see claim frequency pop up,” said George Schalick, Jr., senior vice president of the Management and Professional Liability Division at Philadelphia Insurance Companies (PHLY).

With continued fiscal uncertainty, businesses potentially already burdened with pandemic-related claims should seek a carrier with a long history in M&PL products. They will provide much-needed risk management guidance and be better positioned to support their insureds during market fluctuations.

Why Insureds Might See an Uptick in M&PL Claims

George Schalick, Jr., Senior Vice President of the Management and Professional Liability Division, Philadelphia Insurance Companies

The current soft market might come as a bit of a surprise as it does not track with previous underwriting cycles and economic conditions. Afterall, many privately held and non-profit organizations struggled during the early days of the pandemic with shutdowns and rapidly declining revenues. But the Government assistance programs, like the Paycheck Protection Program loans, helped keep many afloat during the tough times.

“During COVID many organizations stopped doing business until they were able to sort out all of the health and safety challenges,” Schalick said. “They were forced to lock down, but then all the government assistance programs allowed them to keep people employed. The increased volume of claims we anticipated we would see coming from the lockdowns and restrictions that were imposed upon businesses in the U.S. didn’t manifest at first.”

“Just because there wasn’t an onslaught of reported claims at the beginning of the pandemic, doesn’t mean the circumstances that would give rise to a claim being reported didn’t occur. Courts and the judicial system were closed or slowed and now that they are back open, we’re starting to see the circumstances that occurred during the COVID lockdowns becoming claims today,” Schalick said. “Litigation is progressing.”

Added to the delayed pandemic litigation is a concern over newer claims that might be filed as the country inches toward an economic downturn. Though a recession was avoided in 2023, experts think a soft dip could occur in 2024, with 76% of economists saying there’s a 50% or less chance of an economic downturn this year — that almost always results in more management liability claims.

“During the Great Recession in 2008, we saw an almost immediate spike in claims because of the economic conditions and the pressure it placed on organizations. They were making personnel changes with significant belt tightening almost immediately.” Schalick said.

What’s in Store for M&PL Policy Rates in 2024?

Despite an uptick in claims and increased economic uncertainty, management liability rates haven’t increased, resulting in market-wide pricing levels that may not meet the increased pressure of rising settlements and jury verdicts.

“Rates are going the other direction and settlement values are not falling,” Schalick said.

The mismatch between rates, claim frequency and severity is, in part, because carriers experiencing the dramatic soft market in the public D&O market are seeking premium gain in the private and non-profit market.

“In the public company market, the rates have been decreasing significantly. The rates were increasing in the private, not-for-profit market, and rightfully so, but there’s a desire to supplement overall mid-size D&O for carriers who also write private not-for-profit, and they see that as an opportunity to aggregate premium,” Schalick said. “So the always competitive landscape in the private, not-for-profit market has dramatically increased in the last 18 to 24 months.”

Still, companies of all sizes and types should be concerned about management liability rates in the future. Legal system abuse is resulting in increases in both the amount of litigation and the size of verdicts plaintiffs are receiving.

Certain areas of the country are particularly vulnerable to this type of legal system abuse. As a result, insureds in these localities are likely to be vulnerable to rate increases.

“The environment is so positive for the plaintiff that forces premium increases so carriers are able to stay in that market long term,” Schalick said.

Why a Tenured Carrier Partner Can Help Insureds Navigate An Uncertain Market

It’s clear that insureds are facing an uncertain M&PL market over the next few years. Fortunately, carriers with a long history in the M&PL space will be there to offer stability.

Philadelphia Insurance Companies has been supporting this market for 35 years. PHLY is committed to offering long-term rate stability, even as economic and claims trends start to push premiums upwards. They have an appetite for all sorts of companies, large and small, for-profit and nonprofit alike.

“We’ve been at this game for a long time and are one of the most tenured underwriters in this space,” Schalick said. “We like to stay very consistent.”

PHLY has worked with both for-profit and non-profit on management liability policies. With dedicated M&PL teams throughout the company’s 13 regions, PHLY provides the support agents and brokers are looking for on behalf of their clients. The teams know their regions well and can respond to local trends. They’re also dedicated to making the renewal process as easy as possible for their partners and policyholders.

“We have real confidence in our results, so we focus a lot on making the renewal experience as painless as possible for all agents and insureds,” Schalick said.

The company is also investing in tools to help insureds avoid losses. Earlier this year, they launched a new online risk management platform, PHLYGateway, which offers resources for insureds on how to create an employee handbook and trainings on issues such as recognizing workplace sexual harassment and discrimination.

If insureds have questions, they can consult a Best Practices Help Line, provided via the platform. That way, they can get on the spot risk management guidance to help them prevent claims.

To learn more, visit: https://www.phly.com/mplDivision/managementLiability/default.aspx.

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

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