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Florida Adjusters Win Free Speech Case Against 48-Hour Solicitation Rule

Author DavidMalloy , 7/9/2012
From http://www.insurancejournal.com

Insurance Journal - Property Casualty Industry NewsA 2008  Florida law establishing a 48-hour moratorium on public adjusters has been ruled unconstitutional by the Florida Supreme Court on grounds that it restricts commercial speech.

The decision was a blow to the insurance industry and Chief Financial Officer Jeff Atwater, who appealed a lower court ruling that was unanimously upheld by the state’s highest court. Public adjusters serve as advocates for policyholders while negotiating insurance claims. The overturned law had prevented them from getting involved in insurance cases for at least 48 hours after the occurrence of an event.

The association representing Florida public adjusters applauded the ruling.

“The ban on solicitation is a violation of public adjusters’ free speech rights — and more importantly, an unfair rule that put policyholders at a disadvantage,” said Harvey Wolfman, president of the Florida Association of Public Insurance Adjusters. “Thanks to this ruling, we can help more policyholders in those critical first hours when they need it most.”  

Atwater’s office, however, did not quibble with the ruling.

“The office respects the Supreme Court’s authority and its ruling in this case,” said Atwater spokeswoman Alexis Lambert, who added that Atwater’s role in the case was one intended to support consumers.

The insurance industry, however, sided with Atwater’s challenge largely because many commercial insurers provide their own adjusters to assist in claims.

“CFO Atwater and the Office of Insurance Regulation provide safeguards for hurricane victims that they will be treated fairly by the adjuster dispatched by their insurance company,” said Sam Miller, vice president of the Florida Insurance Council, an industry group. “There is no need for a public adjuster who must be paid by the policyholder. Unlike legal fees in lawsuits against insurers, fees for a public adjuster come from the insurance settlement.”

Public adjusters have been held to increased scrutiny in recent years, largely as a result of thousands of claims that drifted in over a five-year period in the aftermath of Hurricane Wilma in the fall of 2005. The scrutiny also has resulted from sinkhole claims in the greater Tampa Bay area that have slammed commercial carriers and the state-backed Citizens Property Insurance Corp.

The Florida Legislature passed the law four years ago to create the waiting period before property owners would be able to receive any information from public adjusters about potential damages in the aftermath of a storm.

“The statute unconstitutionally restricts the commercial speech of public adjusters because it is not narrowly tailored to serve the state’s interests in ensuring ethical conduct by public adjusters and protecting homeowners,” the court said.

The lawsuit was originally brought by in October 2009 by public adjuster Frederick W. Kortum against Atwater’s predecessor, former CFO Alex Sink. A trial court ruled in favor of the state, but that decision was then overturned by the 1st DCA and affirmed by the Supreme Court ruling.

PMC supports Kids Chance

Author DavidMalloy , 6/13/2012

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Kids’ Chance of Virginia was founded in 2011 by a group of companies involved in the Virginia workers compensation market. The goal was to build on the success of state chapters in other states who are actively awarding college scholarships to deserving children whose family have been greatly impacted by workers compensation related injuries.

Kids’ Chance of Virginia is unique in that all facets of the industry can participate together in a worthy cause. This includes both insurance companies and self-insurance groups, as well as attorneys, medical providers and industry vendors - such as claims, loss-prevention and audit service companies. Kids’ Chance of Virginia provides a valuable outlet for cooperation to allow children of injured Virginia workers the opportunity to pursue their education goals.

The first Kids’ Chance organization was founded in Georgia in 1998. Virginia’s chapter is the newest and welcomes new members looking to contribute or participate. For more information, click here.

Kids’ Chance of Virginia is a registered 501 ( C ) 3 Non-Profit Organization.


Ask the Workers' Comp Expert: Internal Investigations Can Reduce Claims, Costs

Author DavidMalloy , 6/4/2012
Ask the Workers' Comp Expert: Internal Investigations Can Reduce Claims, Costs
by Robert G. Jones, Vice President, PMC Insurance Group

Recent "Ask the Expert" columns addressed certain aspects of return-to-work programs. Today, we address strengths and flaws within a workers’ compensation program focusing on reducing the number of claims and overall cost.

The number of lost time claims is a key metric and should be reviewed at least annually. If this number exceeds 25 percent of total claims, further investigation is recommended. Another important metric is the number of claims that are litigated. If this number exceeds 20 percent of all claims, a comprehensive internal investigation is necessary. Business owners experiencing significant numbers of lost time and/or litigated claims need to examine the root cause(s) driving these adverse claims results.

The business owner should review the following as a part of an internal investigation:
  • Is the hiring process effective in screening prospective employees? Background checks and drug testing at minimum. 
  • Are supervisors trained and accountable to build high performing teams that integrate workplace safety into job duties? Personal responsibility and employee morale are key components. 
  • How quickly are workers’ compensation claims reported to the insurance company? Within 24 hours is the goal. 
  • Are accidents and incidents investigated with findings documented and acted upon? How the business owner responds is an important component of organizational culture. 
  • Is communication with injured employees consistent and supportive? The goal being an early and successful return to work. 
  • Are wellness programs integrated into work activity? Tracking and communicating results reinforces the business owner’s commitment to a safe and healthy work environment. 

PMC Insurance Group’s only business is workers’ compensation. Our insurance professionals have extensive experience helping IIABNY members expand their marketing capabilities by providing workers’ compensation solutions for their clients, including offering guidelines to help business owners reduce the number of claims and overall cost.

Controlling Medical Costs

Author DavidMalloy , 4/11/2012
PMC Insurance Group Ask the Workers’ Comp Expert: Controlling Medical Costs
by Robert G. Jones, Vice President, PMC Insurance

Business owners continue to look for ways to contain and reduce expenses. Reducing workers’ compensation medical costs may be one overlooked area. The National Council on Compensation Insurance reports that medical services represent 60 percent of workers’ compensation claim costs. Historically, indemnity costs were the largest portion of claims.

To an extent, business owners can contain and reduce medical costs through prescription drug plans, medical provider networks and other proactive cost-containment measures. However, a key driver to lower claim costs is the absence of workers’ compensation claims. In past columns, we presented the business case for a zero injury workplace embedded within an organizational culture of safety and employee wellness.

A culture of safety and employee wellness is essential in sustaining a zero-injury work environment. That said, employees filing bogus workers’ compensation claims remain an enormously costly and challenging problem. Business owners must also take proactive measures to identify and aggressively dispute fraudulent claims. The key to Identifying them is consistent and ongoing communication with medical providers.

Containing and reducing workers’ comp medical costs is all about hiring the right employees. Drug screening, background checks, testing and accurate job descriptions help business owners avoid hiring employees with high claim risk potential.

PMC Insurance Group is IIABNY’s endorsed workers’ compensation specialist. Our insurance professionals have extensive experience helping IIABNY members expand their marketing capabilities by providing workers’ compensation solutions for their clients. Give Bob Jones a call at (440) 313-5002.  

Operating in the Continental US!

           Phone:  1-877-PMC-COMP | (781)-449-7744

Email PMC | Visit our website


Impact of an Aging Workforce on Costs

Author DavidMalloy , 4/9/2012
PMC Insurance GroupAsk the Workers’ Comp Expert: Impact of an Aging Workforce on Costs
by Robert G. Jones, Vice President, PMC Insurance

Much has been written and speculated about the impact of older workers and the presumed increased cost of workers’ compensation. The numbers of jobs held by baby boomers will more than double in the period from 1995 to 2020, due in part to older workers postponing retirement.

According to the National Council on Compensation Insurance, while the loss costs are higher for older workers due to the severity of their claims, those costs tend to be offset by higher premiums resulting from higher wages earned by older workers. Also, older workers file fewer claims than younger workers, which tend to offset their higher claim costs.

Research indicates that workers age 35 to 64 appear to have similar loss costs per worker. On the indemnity side, higher wages paid to older workers drive higher costs. For medical costs, older workers may require more treatments per claim, which drives total costs.

NCCI research indicates that frequency has fallen across all age groups, and differences in frequency by age have narrowed. Occupational mix does not present a material impact on frequency as in general workplaces keep getting safer for all occupations. Of note, the generation following baby boomers in the workplace is now proportionally a larger group. Currently, the impact of an aging workforce on higher loss costs is less than conventional wisdom had predicted.

PMC Insurance Group is IIABNY’s endorsed workers’ compensation specialist. Our insurance professionals have extensive experience helping IIABNY members expand their marketing capabilities by providing workers’ compensation solutions for their clients. Give us a call at (440) 313-5002.  

Operating in the Continental US!

           Phone:  1-877-PMC-COMP | (781)-449-7744

Email PMC | Visit our website


MA Workers Comp Rates Could Increase By 19.3 Percent

Author DavidMalloy , 4/2/2012
PMC Insurance Group The cost of employee compensation insurance for Massachusetts employers could rise dramatically later this year if rates proposed by insurers are approved by state regulators.

The Workers’ Compensation Rating and Inspection Bureau of Massachusetts, which represents companies that write workers’ compensation polices, asked the state to approve an average rate increase of 19.3 percent. Most businesses are required to carry workers’ compensation insurance, which covers the medical treatment, rehabilitation, and lost wages of employees injured on the job.

If approved, the rates would go into effect in September.

The substantial increase is necessary, the bureau said, because the cost of claims continues to rise, but the state has denied smaller requests in three of the past four years. The Division of Insurance rejected proposed increases of 2.3 percent increase in 2008, 4.5 percent increase in 2010, and a 6.6 percent increase in 2011.

“If these three small increases in rates had been granted by the Commonwealth,’’ said Paul Meagher, president of the Workers’ Compensation Rating and Inspection Bureau of Massachusetts, “we would not need such a significant rate increase now.’’

Richard C. Lord, president of Associated Industries of Massachusetts, the state’s largest employers’ group, said yesterday in a blog post that the rate request deserves consideration. He said he is concerned that without an increase, fewer companies will offer the insurance, making it harder for businesses to buy policies.

“Private-market coverage is harder to come by because the economics of workers compensation no longer add up for insurers,’’ Lord wrote. “The growing disconnect between costs and premiums has already prompted several insurance companies to scale back their activity in Massachusetts.’’

Massachusetts once had some of the highest worker compensation costs in the country, but following reforms in 1991, those costs have declined steadily, falling by two-thirds over the past 20 years. If a premium cost $100 in 1991, the current rate would be $33.21. If the new rate request is approved, that premium would rise to $39.62, according to the Workers’ Compensation Rating and Inspection Bureau of Massachusetts.

The bureau said insurers need the increase to cover the rising costs of health care and wage replacement, driven by higher salaries and the longer leaves that claimants are taking. The number of claims has declined, but not fast enough to offset the increases in medical and wage replacement costs, the bureau said.

“While we recognize that the current filing calls for a significant rate increase, it reflects the real costs of providing this kind of insurance,’’ said Meagher. “Without a rate increase, we will be unable to maintain a competitive market for workers’ compensation insurance in Massachusetts.’’

The proposed rates will be examined in hearings held by Joseph G. Murphy, the state insurance commissioner. Murphy said yesterday that his office intends to “take a long, hard look at the process. This is a large increase, and this administration is particularly sensitive to the cost of doing business in the state.’’

Murphy said he expects to schedule a public hearing by the end of March.  

This article is courtesy of programbusiness.com, Source- Boston Globe dated mar 2, 2012  
  

Call us today and put our expertise to work for you!

PMC Insurance Group (P) 877-PMC-COMP (P) 781-449-7744 (F) 781-449-7889
www.pmcinsurance.com info@pmcinsurance.com

1

To contact us, and for more information, please visit our CompleteMarkets storefront.

Internal Investigations Can Reduce Claims, Costs

Author DavidMalloy , 3/19/2012
Ask the Workers' Comp Expert: Internal Investigations Can Reduce Claims, Costs
by Robert G. Jones, Vice President, PMC Insurance Group Recent

PMC Insurance Group"Ask the Expert" columns addressed certain aspects of return-to-work programs. Today, we address strengths and flaws within a workers’ compensation program focusing on reducing the number of claims and overall cost.

The number of lost time claims is a key metric and should be reviewed at least annually. If this number exceeds 25 percent of total claims, further investigation is recommended. Another important metric is the number of claims that are litigated. If this number exceeds 20 percent of all claims, a comprehensive internal investigation is necessary. Business owners experiencing significant numbers of lost time and/or litigated claims need to examine the root cause(s) driving these adverse claims results.

The business owner should review the following as a part of an internal investigation:

  • Is the hiring process effective in screening prospective employees? Background checks and drug testing at minimum.
  • Are supervisors trained and accountable to build high performing teams that integrate workplace safety into job duties? Personal responsibility and employee morale are key components.
  • How quickly are workers’ compensation claims reported to the insurance company? Within 24 hours is the goal.
  • Are accidents and incidents investigated with findings documented and acted upon? How the business owner responds is an important component of organizational culture.
  • Is communication with injured employees consistent and supportive? The goal being an early and successful return to work.
  • Are wellness programs integrated into work activity? Tracking and communicating results reinforces the business owner’s commitment to a safe and healthy work environment.

PMC Insurance Group’s only business is workers’ compensation. Our insurance professionals have extensive experience helping IIABNY members expand their marketing capabilities by providing workers’ compensation solutions for their clients, including offering guidelines  to help business owners reduce the number of claims and overall cost.    

Call us today and put our expertise to work for you!

PMC Insurance Group (P) 877-PMC-COMP (P) 781-449-7744 (F) 781-449-7889
www.pmcinsurance.com info@pmcinsurance.com

1

 
To contact us, and for more information, please visit our CompleteMarkets storefront.