Risk Insider: Chris Mandel

Risk, Disrupted

By: | February 22, 2016 • 3 min read

Chris Mandel is SVP, strategic solutions for Sedgwick and Director of the Sedgwick Institute. He is a long-term risk management leader and a former president of RIMS. He can be reached at [email protected]

With increasing frequency, the world of risk and insurance is facing challenges that are leading to disruptive interventions from a variety of sources, the aggregate of which portends some significant shifts in an industry often viewed as being stuck in a lower gear.

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Well known and understood among underwriters is the challenge of the investment environment, which has been disrupted continuously since 2008 with returns being artificially suppressed by the federal government’s economic strategy. This fact only exacerbates the reality of the conservative investment limitations already imposed on the industry by regulators.

In the health care world, the Affordable Care Act has surely disrupted medical benefit plans. Most Americans have been accustomed to leveraging their benefits to protect their assets from catastrophic health events and, perhaps to an even greater degree, manage their day-to-day medical costs.

While one of the few clear benefits of the ACA is the catastrophe protection enabled by the removal of aggregate expense caps (previously the lifetime maximum was $1 million in many plans), many other changes brought about by the ACA have been at a minimum, disruptive. Common sense would suggest you can’t expand an exposure and constrain an underwriter’s ability to charge the appropriate premium for risk underwritten, without a significant negative impact on premiums. Underwriting disrupted.

Disruption has the potential to drive innovation and improve the industry for the better as players are forced to respond to with ideas and solutions that are often outside [the box].

We find ourselves inexplicably surprised that the $2,500 average savings promised by the administration has been anything but the reality. In fact, just the opposite is emerging for many who are not eligible for subsidies (estimated by the CBO to be over $300B in 2016).  Corporate medical/benefits budgets and planning continue to be disrupted while benefit levels are reduced and/or premium increases are increasingly common.

In the property/casualty world, two new exposures are fanning the flames of the unknowns for underwriters. First, social media risk emerges as a potentially more damaging source of loss than even more well-known and better understood exposure to hacking. The latest example is hot off the press with Kalobios filing for chapter 11 after its CEO used both regular and social media to trumpet his decision to exploit the pricing of a newly deregulated drug to the detriment of the customer. This rapidly led to disclosures of alleged criminal (yet unrelated) conduct, leading to the CEO’s firing and now the demise of another potentially great company.

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Total elapsed time from first negative media to bankruptcy: three months.

Another emerging exposure of growing concern is “domestic” terrorism. Since Ft. Hood, San Bernardino, the Boston Marathon and other assorted instances of targeted violence in recent years, domestic terrorism is becoming more “expected” than one would have hoped, yet the industry’s ability to predict the impact or severity remains limited.

Assessing and pricing exposures accurately where there is insufficient historical data to support conclusions is a challenge for an industry so heavily reliant on data to accurately price risk. Disruption looks to be evolving into a more frequent and accelerating characteristic of this industry.

While challenging, disruption has the potential to drive innovation and improve the industry for the better as players are forced to respond to with ideas and solutions that are often outside the typical considerations of an industry constrained by regulation and the vagaries of new and often poorly understood exposures. Accordingly, I see disruption as a necessary sign of likely progress ahead.

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]