Column: Roger's Soapbox

Empty Promises, Broken Trust

By: | March 5, 2018 • 2 min read

Roger Crombie is a United Kingdom-based columnist for Risk & Insurance®. He can be reached at [email protected]

The facts of the matter are simple enough. Friends — I’ll call them Jack and Jill — decided to sell the small local hotel they had run for years, found a buyer and set a sale date. In the period between the agreement and completion, the couple’s liability insurance had to be renewed. Jill explained to the broker about the sale and asked that the insurance be cancelled the day after the sale.

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A few days before the sale, their attached living quarters accidentally caught fire. Jack had to jump through a closed window to survive and spent time in the hospital.

With calm restored, Jill called the broker to ask how to proceed. She was advised the insurance had been cancelled, per her wishes, the day before the fire, a few days ahead of the sale. Jill explained those had never been her wishes.

The broker has not produced evidence, written or recorded, of his position.

The sale completed a month late, the fire damage having been repaired at Jack and Jill’s cost. They also footed the bill for potential profits lost during the month of repairs. They coped well, but the unilateral cancellation of the insurance coverage rankled.

My friends asked me for help with their attempts to claim. It’s been an education for all of us.

Their brokerage washed its hands of the whole affair. One cannot take action against a broker for claims denial. Jack and Jill therefore wrote to the company with whom we believed they had a policy. The letter went unanswered.

That the insurer and broker have to this day not issued a cancellation notice is surely suggestive. That the “little man” stands at a grave disadvantage is self-evident.

Later, realizing that the carrier had changed, they wrote to the correct insurance company, asking for claims forms. No reply still.

One avenue remained: In the UK, a Financial Ombudsman has been set up to resolve complaints between financial service providers and their customers.

The Ombudsman’s forms were duly completed and sent away. Jack and Jill now await a ruling. They don’t expect to win, because they see themselves as the “little people” fighting a faceless bureaucracy. If the Ombudsman rules in favor of the insurer, they would have to sue to keep their claim alive.

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That Jill would have cancelled the insurance in advance of the proposed sale makes no sense.

That the insurer and broker have to this day not issued a cancellation notice is surely suggestive.

That the “little man” stands at a grave disadvantage is self-evident.

Insurers generally have a bad reputation because they insist on sticking to the contracts signed by insureds.

In this case, if the insurer has done that, so be it. If the truth is otherwise, you might read about it in your newspaper one day. Either way, a lack of communication has occurred that boggles the mind.

People’s livelihoods and economic well-being depend on knowing where they stand. Jack and Jill didn’t, and they still don’t. How can that be the right way to do things? &

More from Risk & Insurance

More from Risk & Insurance

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]