407-445-2414 info@wrmllc.com
Fight workers compensation fraud with facts

Fight workers compensation fraud with facts

Employers are on the front lines of nipping one particular sort of workers compensation fraud in the bud: the incident that never happened or one that is being exaggerated, according to panelists on a session on fraud at the 38th annual International Risk Management Institute Construction Risk Conference.

Weighing in on what employers can do to prevent fraud at the onset of a claim, especially on a construction site where the landscape alters daily and the workers — witnesses — on the site can change from day to day, the first step is to gather facts with an effective reporting system and immediate documentation, the presenters said Monday at the conference in Houston.

“It’s important when these claims occur to collect information, because it might not be there when you go back to get it,” said Melissa Schultz, co-founder of Chicago-based SitePatterns LLC, which markets incident-reporting software for the commercial construction industry.

Simplified and immediate incident reporting is a must, said Ms. Schultz, who spent several years on construction sites in risk management and workers compensation.

“You want to make sure (your system) is asking the right questions … You don’t want (the form) to be 15 pages long. You want something they can complete, easily fill out and is easy to understand,” she said. “It’s important that you get those reports early and review them.”

Witness statements are just as important, as subcontractors who witnessed the incident might not be working on-site later on when an employer needs more facts on a claim that is likely being inflated, according to presenters.

“Pay attention to the witness statements,” said Patrick Duggan, Chicago-based vice president of risk for Power Construction Co. LLC. Mr. Duggan said employers sometimes go back to investigate when a simple claim becomes more complex — with a surgery looming or a plaintiff’s attorney asked for a large lump sum — and it’s sometimes too late to gather facts.

Ms. Schultz said to make sure witnesses are separated and provide accounts individually — as stories start to sound “more similar” the closer the witnesses are before reporting.

Making it routine for site safety coordinators and other supervisors to take photographs of scenes is another step, she said. “Job sites changes quickly … if you go back days later to take photos, chances are it will not look the same,” she said.

She recalled one claim where a subcontractor reported that he fell down a staircase. A supervisor was able to take video of the stairwell with his phone immediately after the incident. Weeks later the injured worker’s attorney called with a claim that the stairwell was full of “gushing” water, she said.

“I gladly shared that video with that attorney,” Ms. Schultz added.

Incident-reporting culture on-site is another factor in preventing fraudulent claims, she said. “You want to make sure you communicate the process regularly,” she said. “You want to make sure that you remind the field how to fill out that report.”

Supervisors can become more used to the incident-reporting process and can think of it as “more than just checking the boxes,” she said. “They start anticipating the things you will need,” she added. The supervisor who took video of the stairwell, for example, did so immediately without having been asked to do so, she said.

Brian Koch, Chicago-based partner/shareholder with Wiedner & McAuliffe Ltd., said early documentation, including photographs, can also work in reverse: helping to prove a legitimate claim that an employer deemed possibly fraudulent, thus cutting down on legal costs.

He told the story of a subcontractor who was injured within his first few hours on a job site — sometimes a telltale sign of fraud, but not in this case, he said. A photograph of a tear in some anti-slip skids on the floor helped show how the worker did, in fact, trip. Attorneys saved the company “a lot of energy and expense” in seeing what happened immediately with photos taken of the site as evidence — part of a claim that the worker would have likely fought if the employer had denied it, according to Mr. Koch.

Author: Louise Esola
Source: Business Insurance

Top 5 Cannabis Legalization Issues for Employers

Top 5 Cannabis Legalization Issues for Employers

5 Cannabis Legalization Issues for Employers

1. Tolerance

Many employers are wondering what level of tolerance they should implement for cannabis use in the workplace. What do they do if an employee is impaired on the job?

It’s important to recognize that just because marijuana is legal does not mean employees can be impaired in the workplace. Just like alcohol, it is not acceptable for an employee to be under the influence on company time, and this is very clear in the new laws.

However, zero tolerance may not be the best route unless employers can absolutely prove that sobriety is a bona fide occupational requirement. Otherwise, a dismissed or disciplined employee could file a human rights or wrongful dismissal lawsuit — and they may win. Employers should check with their lawyers for a case-by-case analysis of tolerance levels.

Some lawyers have recommended a “low-tolerance” policy: addressing the concern if and when it appears and only moving forward to dismissal when there is a repeat violation. Consider this: an employee goes out for lunch one day and has a couple of drinks before returning to work. If this becomes a regular occurrence and lowers performance, it may be necessary to have a conversation and move towards termination if the situation doesn’t change. However, the employee would likely not be immediately dismissed for a one-time occurrence. The same idea may be applicable to marijuana use.

In addition, employers must consider the use of medical marijuana. Cannabis consumption with a prescription has been legal since 1999 for the treatment of various disorders and conditions. While medical marijuana in the workplace may not be new, employers must be careful not to discriminate against these users with new tolerance policies. They must accommodate medical marijuana to the point of “undue hardship”. Consider asking these employees what accommodations they need and what tasks they are able to perform, and make any necessary changes to their duties.

2. Safety

In particular circumstances, employers do have the right to implement a zero-tolerance policy. In “safety sensitive” positions, such as those involving driving or the operation of heavy equipment, employees must be strictly sober for the protection of themselves and others. In these situations, employers can place a ban on cannabis consumption (similar to alcohol consumption) during work hours or in a designated time period before work begins.

Once again, employers are required to accommodate medical users. For example, an employee could be transferred to a different role that is not safety sensitive.

3. Drug testing

Testing for cannabis impairment has not been fully addressed by the government prior to legalization. There are a few key issues in this area:

  • THC (the component of marijuana that makes a user impaired) stays in the body much longer than other substances such as alcohol. Its presence in the body does not necessarily mean that the user is currently impaired.
  • The Charter of Rights and Freedoms would likely prevent any kind of random drug testing in the workplace from being lawful. This would be seen as an invasion of employees’ privacy rights.
  • Drug testing is currently only permitted in very specific employment situations, where safety is a key issue or there are reasonable grounds (for example, if there has been an incident or there is a strong reason to believe the employee is under the influence).

Until there are federal regulations in place to resolve these uncertainties, employers should be very cautious in implementing marijuana testing. In the meantime, they can use assessments of behavior and conduct in place of a hard test. If an employee is regularly underperforming and showing signs of impairment, it may be time to have a conversation. For a more in-depth discussion on drug testing in the workplace, check out this Huffington Post article.  

4. Creating new policies

An employer should consider implementing new workplace policies to address the legalization of marijuana. 
After carefully constructing a tolerance policy considering all of the above factors, employers must ensure it is well-known. For example, employees could receive training on the new policy and marijuana use. The policy should also be displayed and distributed to each employee, perhaps through email.

The tolerance policy must clearly define what is acceptable and what behaviors may be grounds for disciplinary action or dismissal. Doing so ensures the employer will have a strong defence if and when actions are necessary.

Cannabis consumption must also be considered in other workplace policies, such as smoking in designated areas on company property and scent-free policies.

5. Marijuana Stigma

Many members of Canadian society may stereotype marijuana users. These users are assumed to look and behave in a certain way. Now that recreational cannabis is legal, these ideas may become stronger.

As an employer, be careful not to make assumptions about employees. While some managers may not agree with marijuana usage, it is now legally permitted. This means employees cannot be judged on their personal choice as long as it doesn’t impact their ability to do their job. There won’t necessarily be any of the attendance or performance issues that employers fear. Take these situations on a case-by-case basis, similar to any other performance problem.

In certain face-to-face professional settings, employee marijuana consumption may create reputational issues. In these circumstances, employers must carefully construct tolerance policies to find the balance between employees’ choices and customer opinions.

Whenever new legislation comes in, organizations as well as the rest of society must go through an adjustment period. While adapting to marijuana legalization, employers should consult with lawyers before making policy decisions or changes.

By carefully considering new policies and employee safety, employers are prepared to face the risks of cannabis legalization. Ideally, severe issues will not arise and employers can mainly continue as normal. But as in any risk situation, it always pays to be proactive.

Insurance can cover mass-shooting exposures

Insurance can cover mass-shooting exposures

Active shooter coverage available in the market can cover a wide variety of potential liabilities for employers whose workers, customers and others are impacted by such an incident, experts say.

Laura Zaroski, Chicago-based area senior vice president, law firms practice, for Arthur J. Gallagher & Co., said active shooter coverage, which primarily comes out of London, with a handful of domestic insurers, can include counseling, medical disability expenses for victims, funeral expenses, death benefits, and “loss of attraction” coverage, when a mass shooting results in a loss of revenue because people are no longer coming to the location of the incident.

She spoke during a session at the Professional Liability Underwriting Society’s conference in San Diego on Thursday as attendees were still absorbing the news of the shooting in a Thousand Oaks, California, bar Wednesday in which 12 victims and the gunman died.

Ms. Zaroski said other coverages include the cost of upgrading a building and its security, damages to a building, relocation costs and sometimes the cost of a teardown following an incident

Thomas Lookstein, New York-based head of financial and professional line claims for Starr Adjustment Services, a division of the Starr Cos., said one question that should be addressed is whether these policies have terrorism exclusions.

Marchelle M. Houston, senior vice president, bond and specialty insurance, for The Travelers Cos. Inc., said another potential claim is kidnap and ransom, where people are unable to leave a facility during an incident. You have to look at the host of allegations and policy terms and conditions to determine other insurance issues as well as exclusions, she said.

“We shouldn’t just be waiting for an event to do it for the first time,” said Ms. Zaroski also. “Let’s learn what to do and handle the situation before it arises.”

With the number of shooting incidents increasing, “more and more lawsuits are being brought against employers” in their wake, said Claudia A. Costa, a partner with Gordon Rees Scully Mansukhani LLP in New York, who moderated the session.

The U.S. Occupational Health and Safety Administration’s general duty clause states employers must have a place free of recognized hazards, and active shooting incidents are considered such a hazard, said Ms. Costa, adding her firm has been involved in defending some of these cases. Claims filed against employers in active shooter situations include negligence and failure to train workers, she said.

Other charges, she said, include negligent hiring and retention, which was an issue in the 2003 naval yard shooting in Washington that left 12 dead.

In that case, complaints from fellow employees that the shooter heard voices in his head were not addressed, and there had been a prior incident in which the shooter had shot through his ceiling to the apartment of a neighbor, she said. Bullying was cited as a factor in the 2015 San Bernardino shooting, in which 14 people were killed, said Ms. Costa.

Why Data Literacy Is Your First Step to Business Intelligence

Why Data Literacy Is Your First Step to Business Intelligence

In college, I had a short-lived and hilarious dream that I could learn to play lacrosse. I suppose I was attracted to the glamour of running wind sprints for two hours while being hit with titanium poles.

Alas, the dream was not to be. When I showed up to my first pick-up game, I had no idea what a “slide” was, didn’t realize “clamping” had anything to do with face-offs and had no idea where “the box” was.

I lacked lacrosse literacy.

The problem’s the same with business intelligence software. Except, data literacy is the key factor.

If you want your employees to use the $3,000-per-license business intelligence software you bought, they need to be data literate first. Otherwise, that BI tool will be as useless as a lacrosse stick was in my hands.

Why data literacy is your first step to business intelligence

Fortunately, Gartner research can help you and your team get data literate. They’ve come up with multiple strategic suggestions that you can implement at your business.

What Is Data Literacy?

Data literacy means you “speak” data the way you might speak any other foreign language.

“Gartner defines data literacy as the ability to read, write, and communicate data in context, including an understanding of data sources and constructs, analytical methods and techniques applied, and the ability to describe the use case application and resulting value.”

(Full research available to Gartner clients.)

In plain English, data literacy means you know what data you’re tracking, why you’re tracking it, how to read that data, and how to use that data to save or make money.

Data Literacy Is the Gateway to Business Intelligence

At its heart, business intelligence software is a data-wrangling program.

BI software programs organize all your data sources (website data, CRM data, email data, financial and POS data) and let you see how those data sources interact (for example, did sales increase when you changed the colors on your website?).

So, until your employees are literate with the data your business intelligence tool wrangles, they won’t know how to wrangle their business intelligence tool.

The data literate person knows what data they’re tracking, where it’s stored, and how it fits together. That’s not all they know, though.

Data literacy is also a way of thinking in terms of data. The data literate person doesn’t just think in generic terms—such as did sales increase? They think in terms of data—did Q1 website conversions among women ages 18 to 34 increase as a result of that email campaign?

It’s like learning a foreign language: You haven’t really learned that new language until you start thinking in it, as well as speaking it.

How To Teach Your Employees Data Literacy

Most employees, however, probably don’t think in terms of data, which presents you with another challenge: How do you get your employees to start thinking in terms of data?

1. Employees need to know what data literacy is

Becoming literate in any new lingo is challenging … especially when people don’t know that lingo even exists.

Chances are, most of your employees aren’t even aware that data literacy is a concept. So if you want your employees to use your BI software, you’ll have to introduce data literacy first and explain why it matters.

And don’t just introduce the concept of data literacy once. Introduce it repeatedly.

No, “introduce repeatedly” is not an oxymoron. Since learning how to speak (and think) data is a major change, a single introduction probably won’t stick. They may forget at first, and that’s natural.

Case in point: As a one-time substitute teacher, I got several classes to make a major change by introducing that change gradually.

The English teacher I subbed for allowed cell phone use in her classes. Predictably, the students were learning next to nothing, though their Candy Crush scores were amazing, and they Snapchatted all their paper cuts. About a month into the gig, I decided to ban cell phones.

The change only worked because I introduced it gradually—I announced I would start the policy on a set date, explained why I was doing it, and reminded students to leave phones in their lockers.

If students brought their phones with them, they could put it in a plastic box at the front of the room when class started. If their phone rang while in the box, I’d leave it alone. If it rang while on them, I’d answer it in a loud and public fashion, and they’d go to the principal’s office.

Though the notion of spending even 45 minutes without their phones was horrifying for most of them, the policy worked well because I gradually introduced the concept of class without phones.

How to put this into practice:

There are multiple ways to introduce data literacy to your employees over a period of time.

At Capterra, our employees volunteer to lead “lunch and learn” sessions: brief, hourlong intros to topics that interest them. You could encourage data-savvy employees at your company to do the same.

You could also spend time at all-company or department meetings translating basic activities, or concepts, into data. Anything that breaks the data-ice is a good idea.

2. Employees need to speak data

Once employees know what data literacy is, they need to learn to “speak” data.

Gartner analyst Valerie Logan suggests you approach learning to speak data the same way you would any foreign language and even refers to the process as ISL or information as a second language. (Full Gartner research is available to clients.)

How to put this into practice:

Figure out which employees already speak data, and also who can translate data into plain English. These “data translators” can help employees who struggle to speak data.

Figure out what the language barriers are to speaking data: If business and IT folks don’t speak the same language, that’s a language barrier (or “interpretation gap,” as it’s also called).

There are multiple ways to break language barriers:

  • Keep a glossary of common terms.
  • Make sure C-level executives speak data so they can set an example.
  • Make sure your business goals are expressed in actionable language.

3. Employees need to speak data to each other

Practice makes perfect, so speak data regularly until it becomes a habit.

As Gartner analysts Alan Duncan and Lydia Clougherty Jones suggest, the best data-driven companies focus consciously on this goal. They don’t just speak data, they interact in terms of data. They use data as a way to build inter-team trust, presenting evidence and keeping an eye open for problems such as confirmation bias. (Full Gartner research is available to clients.)

At the same time, you’re learning terms such as “confirmation bias” and “cognitive filtering,” you can think about examples of this in your own work, and be on guard against these bad habits.

How to put this into practice:

Follow the example of foreign language conversation clubs. In the same way those clubs meet once a week to practice German or Amharic, get a group together for weekly or monthly coffee meet-ups where you talk data: what data you’re working with, how it interacts with other departments’ data, and what data you wish you had.

For instance, how does your website’s load time impact visitors and conversions? If sales and tech aren’t discussing how those data sets interact, you could be missing out on a possibly lucrative correlation. (Hint: shorter load time almost always means more visitors and conversions).

Discussion groups like this also help with another important goal: becoming data-driven. This is where business intelligence as a way of thinking comes into play. As you’re learning to speak data, treat it as an opportunity to learn how to think differently.

4. Employees need to speak data frequently

Ideally, brown bags and discussion groups will be your first step on the way to data literacy immersion.

Immersion’s the best way to learn to speak a foreign language, and speaking data is no different.

How to put this into practice:

Gartner analyst Valerie Logan recommends you speak data in everyday conversations, “from board meetings to team meetings.” If speaking data becomes a regular behavior, it’s more likely to stick. And when it sticks, you’ll be on your way to being data-driven.

As Gartner analyst Alan Duncan notes, becoming data-driven has more to do with behavior than technical know-how. That’s why HR should also be involved in your attempts to become data literate.

Duncan recommends having the HR department be a core stakeholder in business intelligence change management. Primarily, they can “adjust hiring practices to emphasize analytic literacy.” (Full Gartner research available to clients.)

The critical role of processes in your disaster recovery strategy

The critical role of processes in your disaster recovery strategy

Yet with the ever-increasing threats from both natural and man-made disasters – from the devastating fires and flooding in California last year through to the recent impact of Intel’s chip flaw that opened the door to potential hacking – is there anything more that IT departments can do to perfect how their organization both prevents and reacts to business disruptions?

Surprisingly, more than 1 in 3 businesses admit they don’t have a disaster recovery policy in place, a figure that is even higher amongst smaller businesses where an estimated 3 out of 4 are reported to have no contingency measures at all.

With our increasing reliance on technology and the reluctant acceptance that most technology is vulnerable to potential downtime, the CIO or IT manager is the obvious choice of leader to take responsibility for the whole disaster recovery plan, whether it’s due to a technical problem or other factors.

The ripple effect of abnormal events not only affects the IT department but can have serious repercussions on all daily operations including financial management, customer experience, HR, and workflow, etc.

Whilst CIOs regularly consult with other members of the C-suite on devising a risk management strategy, there are significant advantages to garnering the support of key employees across the whole organization, on a continual basis.

To ensure your disaster recovery plan anticipates every eventuality it’s essential to get ‘buy-in’ and input from all departments, so you can be confident that your plan is as informed, up to date and effective as possible.

Here are some recommendations on how to maximize the knowledge, creativity, and strength you can draw from key players across the organization.

Produce a clear mandate

During ‘business as usual’, a robust process management discipline and a strong process culture provides a firm foundation for teams to document and develop new and innovative ways of working and can help a company drive competitive advantage and innovation.

However, do employees know what processes to follow when the extraordinary occurs? Whether the Internet or phones go down, sensitive customer data is stolen, or severe weather stops them from getting into the office, clarity, and communication of disaster recovery processes is just as important as the plan itself. Every member of staff needs to know when and how to trigger a disaster recovery response, as well as be aware of who else is part of the team.

Part of the CIO’s remit should be to oversee the design and build of processes that are easy and clear for all personnel to find and follow, every day. In a disaster situation, it becomes imperative for staff to act with minimum delay, limiting the damage that could result from a disaster.

Build easy to follow checklists

One way of communicating unequivocally is to introduce simple checklists as advocated by US doctor, writer and speaker Atul Gawande in his book “The Checklist Manifesto”.

By getting the basics right, well-designed checklists have been proven to cut through unnecessary complexity and encourage transparency, leading to a 35% reduction in complications in hospital operations. These same fundamental principles can be applied to the corporate world where teams are responding to an emergency or extraordinary incident.

You also need to consider how and where to store this critical process information and make it easily accessible to all key staff.

Stage regular ‘fire drills’

Like most insurance policies you hope you’ll never need to claim on them, but you need to know that you’re fully covered. Regularly testing and modifying your disaster recovery processes will keep them up to date and make sure they work. Set up simulation exercises to rehearse what everyone’s roles are during a catastrophe.

With today’s accelerated pace of business change, a month-old plan may soon become obsolete. Organizations need to monitor changes in general circumstances like impending legislation. They also need to be sensitive to company or market-specific conditions such as when a key person leaves and joins a competitor, a laptop goes missing or perhaps a product needs to be recalled.

As soon as a new threat appears on the horizon it needs to be factored into the overall disaster recovery strategy immediately.

Crowd-source ideas and share responsibilities

With a collaborative and collective approach that encourages everyone to work as a group, it’s simpler to both create and follow agreed checklists so you can minimize the impact of unforeseen circumstances.

Employees on the front-line are often best equipped to advise on what level of impact disruptions may have on themselves and other departments. For example, the service manager can give the most insight on the scale of a spike in customer enquiries after your IP network goes down.

By leading the charge for a proactive, constantly-evolving approach to disaster recovery, CIOs can be confident that the entire operation is fully prepared and protected for when the unexpected occurs.  Rather than panic-stricken employees bombarding you with support calls, instead there is state of relative calm as everyone already knows what they should do and can focus on executing an agreed plan.

Putting in the advance groundwork during quieter times not only leads to cooler heads during more turbulent times, but will also make a tremendous difference to your customers, employees and future business performance.

Source: CIO

Author: Ivan Seselj

Insurance market evolving to handle terrorism risks

Insurance market evolving to handle terrorism risks

While the number of incidents and casualties declined in 2017, a report released Monday by Marsh L.L.C. said terrorism is still a significant threat and that the insurance market is adapting to handle the evolving risk.

Marsh’s 2018 Terrorism Risk Insurance Report, which explores the state of the terrorism insurance marketplace, said that in the wake of recent events, terrorism insurers are expanding terrorism definitions to include active assailant events.

In some cases, the report said, insurers also are developing specialty products that offer first- and third-party business interruption protection for businesses that suffer lost income or revenue without the need for a direct property damage trigger.

Although fewer people were killed in terrorist attacks in 2017 than in 2016, the Marsh report said the means of attack and perpetrators have shifted.

“Past attacks were carried out primarily by specific groups against perceived high-value-high-profile targets,” the report said. “While that threat remains, many recent attacks have come against soft targets and been perpetrated by ‘lone wolves’ and small groups with no direct connection to known terrorist organizations. Weapons of choice now include vehicles, knives and other handheld devices.”

In 2017, the report said, pricing increased in five of the 17 industries surveyed by Marsh, with the sharpest increases being felt by hospitality and gaming companies, public entities and nonprofit organizations, which have been targets of terrorist acts in recent years.

Pricing declined in seven industries, the report said, most notably for energy and mining and construction companies, reflecting the generally positive conditions in the property insurance market prior to the 2017 Atlantic hurricane season.

Sixty-two percent of U.S. companies in 2017 purchased coverage embedded in property policies under the Terrorism Risk Insurance Program Reauthorization Act of 2015, or TRIPRA. Companies in the Northeast U.S. were most likely to purchase terrorism insurance, Marsh said.

The number of Marsh-managed captive insurers actively underwriting one or more insurance programs that access the TRIPRA increased 44% to 166 captives in 2017.

After incurring sizable ransomware losses in 2017, kidnap and ransom insurers are seeking to restrict coverage for cyber risks in their policies.

Terrorism insurance capacity remains strong, the report said, but pricing could increase as global insurance costs generally increase following natural catastrophe losses in 2017. January 2018 year-over-year pricing changes for a majority of reinsurance program renewals that included terrorism coverage averaged flat to an increase of 10% on a risk-adjusted basis, according to the report.

The Marsh report made several suggestions for businesses in the face of evolving terrorism risk, including continually reviewing and reevaluating their risk financing programs to ensure they have adequate protection for property, business interruption, workers compensation, general liability and cyber losses.

The report also encouraged businesses to effectively model their terrorism risk and to build and test robust crisis management and business continuity plans.

Author: Rob Lenihan

Source: Business Insurance