“Bet the Company” Cases

Maximize Coverage Or Lose Big
Claims Magazine August 2011
By Charles Hunter Mcree

What does a risk manager do when facing a “bet the company” case? This is a question with which no firm wants to grapple. Occasionally, risk managers must confront the issue, but they do not go it alone. Instead they face it with an insurance company.  read more..

The Not-So-Great Escape

Remembering the 1911 Triangle Shirtwaist Factory Fire
Claims Magazine August 2011
By Ken Brownlee, CPCU

Disasters, calamities, tragedies, or catastrophes—no matter what we call them, these events happen on a regular basis, and more recent occurrences tend to cancel out memories of the older ones. However, the March 25, 1911 Triangle Shirtwaist Factory fire in New York City has not been forgotten, as its 100-year anniversary this spring prompted public media to recall the horrific event. Perhaps it was because many of the deaths resembled those of the disaster on Sept. 11, 2001, when trapped victims jumped or fell to their fate rather than perish in the flames.  read more..

Proactively Managing Long-Term Claims

Florida Underwriter August 2011
By Kevin T. Glennon

Employers and other workers’ compensation/disability management payers tend to become complacent about long-term, complex claims. Many employees who suffer injuries or illnesses affecting more than one body system and requiring intense home health care stabilize and adjust to their “new normal.” After reaching that stage, it is easy for the patient and the payer to lay low for a while. If the claimant is not complaining, and there are no big-ticket bills, then it is easy to let sleeping dogs lie.  read more..

Maximizing Your Surveillance ROI

Florida Underwriter August 2011
By Steve Cassell

With insurance fraud ranked as the second largest economic crime in America (income tax evasion holds the top spot), surveillance is frequently used to help evaluate the legitimacy of insurance claims. Industry insiders estimate that carriers and TPAs spend more than $100 million a year on surveillance to investigate suspect and questionable claims.  read more..

Is Your Program Submission Complete?

July 29, 2011
By Phillip J. Gajewski

A comprehensive program submission includes these parts: Executive Summary, Distribution, Underwriting, Claims Experience, Program Experience, Actuarial Information, Agency Profile and Competitive Market Intelligence.  read more..

Ethics and Compliance in the Workplace

Demonstrate Your Program’s Worth
Claims Magazine August 2011
By Scot McLeod

With expanded regulations going into effect in many industries, including insurance, organizations must not only show that they have compliance and ethics programs in place, but also be able to demonstrate that their programs are working. The regulatory scrutiny of such programs is shifting from a focus on policies, procedures, and retrospective audits to proactive measures of effectiveness and desired results.  read more..

Physical Damage Auto Claims

Dealing With All of Their Moving Pieces
Claims Magazine August 2011
By Paul Rosenstein

In today’s claims environment, a physical damage claim is not handled solely by the adjuster. Rather, it is passed along a lengthy line of multiple parties inside and outside the claims organization. Staff and third parties, including tow companies, rental agencies, salvors, parts suppliers, other insurers, and glass companies, make up this “extended enterprise,” which consists of all the individuals that need to collaborate at some point during the process of settling a claim.  read more..