Column: Roger's Soapbox

It Could Happen Here

By: | March 3, 2014 • 3 min read

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

Insurance 101: An insurance company must know the truth when accepting risks or paying claims. Companies therefore employ investigators to check every detail before big pay-outs are made.

Now, let us say that a couple of companies were to employ investigators who went too far in their quest for the truth. They broke laws. They failed to respect their customers’ right to privacy by intercepting mail, let’s say, and even hacking telephone calls and voice message recorders.

Advertisement




Let us say that the insurance companies then started denying claims to many of the elected politicians in the highest body in the land, because they had lied and cheated on their claims forms. Their fraudulent claims were made public. Some of the politicians were jailed.

By way of vengeance, the political parties decided to punish the insurers.

One of the leading insurers, let’s say, was a hated and reviled fellow who appeared to be using his political contacts to extend his business empire. (I have no one in the insurance industry in mind.) A wave of public indignation arose when the criminal habits of this fellow’s insurance investigators were made known. The guilty parties were apprehended and punished with significant jail terms. The hated fellow lost one of his businesses.

It might stretch your imagination, but let’s continue down this path. Let’s say that the public was so incensed about all this that a supposedly independent governmental commission was established to look into the insurance industry’s practices. The commission decided, on little evidence, that the industry was so badly run that existing laws, which had worked well for 300 years, were insufficient.

The commission proposed that the government be empowered to make special laws to rein in the insurance industry. Let’s say that government passed a law that anyone who sued an insurance company could do so without having to pay any of the legal costs. All costs of both sides in any case brought against an insurance company would be paid by the company, regardless of the outcome.

Say that movie stars, many with criminal convictions, came out in numbers to deride the insurance industry and to warn that it should not be allowed to continue to seek out the truth about claims, even legally, without prior approval from the government. Let us say that it was decided that any insurance company chief who objected to any of the new regulations or failed to obey government instructions should be jailed forthwith.

Advertisement




Now, finally, let us say that all this happened in the land that invented insurance and gave it to the world: Britain.

Far-fetched, you’re saying. Ridiculous. Couldn’t happen.

And yet it has happened. In the foregoing, if you substitute reporters, newspaper articles and publishers for investigators, claims and insurance companies, respectively, that’s exactly what has happened to the newspaper business in Britain in the past couple of years. Vicious new press regulations have been written by the opposition and some angry movie stars, and enacted into law by a feeble government with no sense of history.

Just because it’s absurd doesn’t mean it’s not true. R.I.P., freedom of the press in the U.K. Watch out insurance; you might be next.

Read more of the award-winning, irascible Mr. Crombie here.

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.

Advertisement




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.

Advertisement




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]