Understanding the Total Cost of Risk

In today's business landscape, the ability to quantify risks in financial terms is crucial. With this information, the business can focus appropriate resources to mitigate enterprise-wide risks by shifting the risk to another company or by reducing the risk through improved operational efficiency.  While businesses inevitably bear the costs of risk in their operations, the question is, what is the monetary value of managing these risks, and how can they…

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Embrace the Audit 

Best Practices for claims departments to maximize the effectiveness of an audit  With commentary and insight from Rick Sabetta and Barry Bloom As a Claims Supervisor I reacted very poorly to my first workers compensation claims audit.   I went through the familiar stages that one does when first audited:  Anger (at how anyone could question my decisions or results)   Denial (that someone in my claims unit had made mistakes)  Negotiations (over…

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Claims Managers Skills & Training

by Bill Zachry, SCIF Board Member and Barry Bloom, Managing Partner, The bdb Group  “As the claims manager goes, so goes the office.”  The most important job in a workers’ compensation claim office is the claims manager.    Most companies strive for consistency and accuracy with regard to benefit provision.  They work hard to achieve these results while trying to maintain a low cost of claims administration.  To accomplish these results, they establish policies…

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The Top Actions Employers Can Take to Manage Their Workers’ Compensation Program in 2024

Management Engagement:  The approach and attitude that senior management takes regarding injury prevention, safety, employee welfare, interaction with injured workers, and treatment of claims partners are primary determinants of successfully managing the workers' compensation program.  Hiring the Right Employee:  Hiring qualified and engaged employees is essential for reducing the risk of workplace injuries and subsequent workers' compensation claims. In today’s employment market this can be a particular challenge.  Safety and…

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A MATTER OF ETHICS 

The actor Leslie Howard, who played Ashley Wilks in the Gone with the Wind movie, was killed during World War II when the airplane on which he was a passenger was shot down.  After the war it was discovered that the English had broken the Enigma code and they knew that his plane was going to be targeted by the Luftwaffe.  The British Military did not warn the plane or…

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2024 Reminders for Claims Operations

I would like to thank all of you who have diligently read our “Simple Ideas” papers during the past year. I admit that a few of the papers we sent out were actually not “simple”. These papers are either focused on improving outcomes for the injured workers while reducing costs for the employers, or are designed to help bring you up to speed on the latest technology which will impact…

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Simple ideas for a complex system – Injury prevention in our new world post pandemic / the great resignation

  Studies are regularly published which indicate that a high percentage of injuries occur during the first year of employment.   With the current churning of workers due to the great resignation it is important for employers to focus on their new employees (and long-term employees who are performing new jobs at the same employer) as an opportunity to reduce claims frequency.    The reasons for a higher claim frequency during the…

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Simple Ideas for a complex system -Zooming into the future

One of the keys for companies to survive and prosper during the pandemic was to embrace new technology. Many companies pivoted from mandating all their employees show up every day to utilizing Zoom, Microsoft Teams, or other video conferencing programs to hire, train, maintain their corporate culture and encourage interaction and creativity.  Originally, I was skeptical about the process of hiring, training, and managing new claims examiners remotely.  The productivity…

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THE LUCA BRASI THEORY

In the movie You’ve Got Mail, Meg Ryan asks why all men use quotes from The Godfather.  The answer is quite simple. The book and movies teach lessons of business and life, and they are easy for men to understand.  There are many good business theories and life experience lessons that came from the movie. How to deal with business partners: "I will just make him an offer he cannot…

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Using Actuarial Information To Improve Claims Outcomes 

Introduction  Actuaries require accurate and timely information for them to calculate the reserve loss development pattern as well as the ultimate exposure for losses.   Even though management may not always be happy with the information, knowing the correct ultimate exposure is always ultimately good for the insurance company or the employer.    Due to company silos, process or ignorance, most claims operations do not regularly engage with the actuary process.    Quality…

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