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Scurich Insurance Services has been serving the Monterey Bay Area since 1924. Our mission is to partner with our customers and provide them superior service and value. We are a member of United Valley Insurance Services, Inc., a cluster of over 70 California Independent Insurance agencies, which produced over $530,000,000 of annual premium last year. At Scurich Insurance Services we understand your business and our community. Our customers look to us for comprehensive solutions. We have established relationships with more than 40 of the nation’s leading insurance providers, which allows us to deliver multiple, competitively-priced options and a team of experts to guide you through the process. When you need to file a claim, change a policy or process a certificate you can depend on Scurich Insurance Services to respond quickly to your request. SERVICES In order to provide value added benefits to our customers that go beyond the insurance policy Scurich Insurance Services offers the following additional services: Safety Programs – English and Spanish OSHA Compliance Safety Policies – English and Spanish Online OSHA 300 Log Safety Posters and Payroll Stuffers - English and Spanish Certificates of Insurance – If received before 3:30pm done the same day Risk Management Consulting Brokerage Services Represent most major insurance companies to better market your account. Safety tapes/DVD’s BUSINESS LINES Commercial Commercial Packages Business Auto Workers Compensation Umbrella Bonds Directors & Officers Professional Liability Employment Practices Liability Personal Auto Home Umbrella Recreational Vehicles Boatss Life & Health Individual Medical Individual Life Group Medical Group Benefits

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Posts tagged with Claims - Claims

THE ABC’S OF HOLD HARMLESS AGREEMENTS

Author TonyScurich , 10/31/2016
Bookmark and Share Because construction projects are complex operations involving a number of subcontractors under your supervision, onsite accidents or injuries resulting from their work can easily lead to litigation against you. To protect yourself against claims, losses, and expenses if disputes arise during the project, make sure that all subcontractors sign a “Hold Harmless Agreement” clause. The terms of these clauses will vary from state to state. In some cases, this clause will protect the contractor from claims by corporations or companies that did not sign the agreement. There are three types of hold harmlessagreements: Under the Broad Form, the subcontractor assumes all liability for accidents due to negligence of the general contractor, and combined negligence between the two parties. Because of its sweeping terms, this form is relatively rare – and some states prohibit it. With the Intermediate Form the subcontractor takes on all liability for accidents and negligence, but will not be held accountable for the general contractor's actions. It doesn’t matter whether the incident was the subcontractor’s fault. If both parties were negligent, the subcontractor assumes liability all for its acts or omissions. Intermediate form agreements are relatively common. A Limited Form agreement makes the subcontractor liable only for the proportional part of its responsibility for a mishap. Other parties – such as subcontractors – will be held liable under their hold harmlessagreement(s) for their corresponding part of the accident or negligence. The type of agreement that’s best suited for your needs will vary depending on the nature of the project and state laws. As always, we stand ready to offer you our professional advice.

Reclassifying Obesity Could Raise Comp Premiums

Author TonyScurich , 10/12/2016
Injured workers who gain weight due to inactivity or as a side effect of medication will probably receive higher workers comp benefits, thanks to the American Medical Association’s recent reclassification of obesity as a disease. That’s the conclusion of a recent six-year study of claims by the California Workers' Compensation Institute. According to the report, although this reclassification doesn’t have legal standing, the AMA’s positions often have a strong influence on lawmakers, regulators, and health care providers. Immediately after the decision, senators and congressmen introduced bipartisan bills requiring Medicare to cover more obesity treatment costs, including prescription drugs and intensive behavioral weight-loss counseling, which will give health care providers a financial incentive to use these remedies. Judging from the results of the California study, this means that businesses can expect to pay more for workers comp. The report found that the costs of comp claims that listed obesity as a “comorbidity,” or additional cause, were far greater than for claims without them. Medical benefits for comorbidity cases cost 81% more than for other cases, while indemnity payments averaged nearly 65% higher. More two in three claimants with obesity comorbidity received permanent disability, nearly five times the rate for the non-obese. Finally, the use of narcotic painkillers was significantly higher among overweight claimants. Obesity might even become a primary comp diagnosis for jobs such as long-haul trucking or office work that require employees to remain seated for extended periods. The bottom line: look for the management and financial changes stemming from the reclassification of obesity as a medical condition to create new challenges and incentives for health care professionals, businesses, and workers compensation insurance companies. We’ll stay on top of these changes to help make sure that your company has the coverage you need at a competitive rate.  

Demand For Contractors Professional Liability Rises

Author TonyScurich , 8/12/2016
New approaches to building projects, as well as new techniques, are leading to increased demand for Professional Liability insurance for contractors. A few years ago, people would shake their heads at the idea of this coverage, asking how contractors could be held liable for professional risk when they don't provide professional services. However, there has been a blurring of the once-sharp lines between contractors and architects and designers, as more and more contractors are being drawn into the design process. Under the traditional "design-bid-build" method, a project would be designed, bids put out, and the project built. However, the spread of the "design-build" concept - which decreases the amount of time, and the cost, of the project involved - has meant that medium sized and large contractors often take the design responsibilities in-house, and even subcontract them to design firms. These contractors' biggest exposure is for claims filed against them for project delays and cost overruns. However, traditional General Liability insurance offers coverage only for Bodily Injury and Property Damage, and does not cover financial or economic losses. Contractors Professional Liability insurance fills this gap. Because these policies are relatively recent, only a limited number of insurance companies offer them. These companies haven't paid enough claims for underwriters to establish the underwriting history and set standard rates - which means that policies are usually negotiated on a case-by-case basis. The amount of insurance can be up to $50 million; if a contractor needs more capacity, coverage can be added through excess layers. If your firm is (or might be) taking on project design responsibilities, a comprehensive Contractors Professional Liability policy can help protect your pocketbook - and provide peace of mind. To learn more, just give us a call.

Prearranged Contracts Speed Disaster Recovery

Author TonyScurich , 7/13/2016
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If a catastrophe struck your business, who would provide such critical services as site clean-up, emergency power supplies, off-site redundant data storage, and alternative communication systems until you can get up and running again?

In this situation, having agreements in advance with restoration companies and other service providers can save you time, money, and headaches.

Although most companies recognize that such prearrangements can play a critical role in emergency crisis management planning, few take steps to develop specific relationships with their disaster service providers.

That can be an expensive mistake, says Michelle Cross, Boston-based National Practice Leader for Business Continuity at Wells Fargo Insurance Services USA. She points out that, "for any service provider to really provide quality, top-level, appropriate service, they have to know about your company, what you need, and what hazards you have on site."

Pre-planning can also reduce Business Interruption deduction and claims significantly by shortening downtime to services and operations after a disaster, notes Dave Boyle, head of Property Claims for Zurich North America (Schaumburg, IL).

A case in point: Starwood Hotels & Resorts Worldwide uses pre-arranged recovery agreements because many of its properties are in locations at risk for natural disaster. When Hurricane Katrina struck, the Starwood Sheraton was the only hotel in New Orleans that remained open during and after the megastorm. Says Stephen Truono, the company's Vice President of Global Risk Management and Insurance: "It's about having a plan, practicing that plan, and engaging the necessary critical vendors, such as providers of power, plywood, diesel oil and potable water."

Prearranged provider agreements are inexpensive and usually do not involve a fee until the time of service.

What's not to like?


Is Your Cell Phone Policy Up To Date?

Author TonyScurich , 7/8/2016
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If not, you have a problem. For the past several years, more and more states and cities have limited or banned driver use of cell phones. Warns the Web site DrivingLaws.org, "Although employer responsibility isn't specifically defined in the cell phone legislation, there have been an increasing number of lawsuits relating to employer responsibility regarding mobile cell-phone use [by] employees."

With motor vehicle accidents the leading cause of work-related injuries, using cell phones behind the wheel ups the ante for litigation in case of death, injury, or other third-party claims. What's more, drivers injured while phoning on company time will generally be eligible for Workers Compensation.

The first step is to create and implement a cell-phone use policy for employees driving company vehicles. Although this won't protect you completely from legal responsibility, it demonstrates your forethought and responsibility.

This plan should include guidelines for:

  • Training. Provide instruction manuals so employees know the features of their phones.
  • Safety. Remind employees not to dial or talk when driving conditions are hazardous, keep conversations short, tell the other person that the employee is calling while driving, and turn off phones whenever they pump gas or use jumper cables.
  • Making calls. Discourage cell-phone use behind the wheel and require drivers to pull over and stop when dialing.
  • Voice mail/caller ID. Make sure drivers' phones have these features so they can screen calls behind the wheel.
  • Accident/injury reports. Require employees to report any accidents or injuries resulting from cell-phone use while driving.
  • Discipline. Punish workers who violate these rules or local or state laws about using cell phones behind the wheel.

We'd be happy to help you develop a comprehensive policy for drivers' use of cell phones. Just give us a call.


Think Twice Before You Turn Down Workers Comp

Author TonyScurich , 7/6/2016
1 Most states allow company owners and executives to opt out of (or not opt in to) Workers Compensation insurance. But did you know that if you choose this option your Health insurance policy might well not pick up work-related medical claims? If you carry Health coverage through your company Group plan, you can usually arrange to be covered for work-related injuries under this policy - which then becomes "24-hour" coverage for you. However, many small business owners and managers are insured under the Health Plan of their spouse or parents - which almost always exclude work-related injuries. Let's say that you exempt yourself from Workers Compensation and have coverage under your spouse's Health insurance - and you suffer a serious injury in a work-related, at-fault auto accident. Once you have exhausted the Medical Payments coverage under the company's Commercial Auto policy, the chances are that you'll have to pick up the tab for the rest of your medical bills. You might even have to choose between limiting your treatment options or going bankrupt (unpaid medical bills are the nation's leading cause of bankruptcy). Even if you have "24-hour" insurance under your own Health policy, this coverage will not reimburse you for income lost during your convalescence. So, what's the solution? You might consider buying a Disability income policy - or decide to cover yourself under Workers Compensation, after all. As always, our agency stands ready to offer our professional advice. Just give us a call.  

The ABC'S Of Construction Liability Insurance

Author TonyScurich , 6/22/2016
No matter how large or small the job in the building trade is, it's always the best policy to carry insurance again liability for losses from injuries, accidents, or property damage during construction. Residential building contractors need a Liability policy to protect them from lawsuits from homeowners for construction-related losses, or from workers injured on the job. Make sure that your contract requires every sub to carry their own Liability insurance and exempt you from responsibility from damage they might produce during construction. The amount of coverage you need will depend on the size of the contract. As a rule of thumb, it's wise to have two or three times the size of the project budget. Commercial contractors usually carry millions in Liability insurance. Contractors with higher risk of damages (for example, roofers or contractors in highly specialized trades) often take out higher coverage. Your Liability policy will set coverage amounts (limits) for both each occurrence and overall (aggregate) values. Limits are also set for: 1) fire damage to property under construction; 2) medical expenses for injured workers on the jobsite who might not be covered under Workers Compensation; and 3) personal and advertising injury (claims that promotion or advertising caused a financial or personal loss to the owner of the home or building). While many contractors pay their Liability premiums up front, those with cash flow problems others prefer to finance them through an indemnity corporation with a down payment and monthly payments over six months to a year. As always, our insurance experts stand ready to help you find comprehensive Liability coverage at a rate you can afford. Feel free to get in touch with us at any time.

How Can Workers Prove Chronic Pain: Case Studies to Learn From

Author TonyScurich , 6/15/2016
Unfortunately, you can't actually see chronic pain. You can talk to someone who physically looks fine, yet is claiming they can barely stand up. Since pain is felt differently by different people, medical professionals and laypeople alike have difficulty categorizing and defining the more severe injuries. This leads to confusion and sometimes outright fraud. Let's look at how pain is defined by using a specific case study. A Question of Proof How injured do you have to be to claim injury? Do you have to be constantly writhing in agony or is it only when you make specific motions? These are specific questions that get a bit touchy. Recently, a man who filed for compensation claimed that he needed a wheelchair but was then shown to be out of his home shopping without it (and seemingly without pain) through video surveillance. They also had him on camera performing a number of other activities as well. He was arrested with the possibility of up to five years in jail. Since the amount paid out due to his injury was more than a half million dollars, it's certainly brought about some attention in his area of Florida. The man was a deputy there, and was injured when bending to get his laptop from the trunk of his police cruiser in 2007. After that, he went through surgery and stated that he couldn't walk, drive or bend, which has then been shown to be false by videos. He states that he had always been consistent in reporting his pain to be inconsistent because no two days are alike. He says that while the video may show him driving and running errands, he can only do so in limited ways. He claims his whole life is a mess, with his job ripped out from under him and expenses piling up. It's now up for the courts to decide who has the better claim and what will happen. Employer Tips  No employer wants to follow their employee around constantly to check up on their progress and verify the truth in their claims. Also, it's difficult to accuse someone who's experienced severe injuries of trying to game the system. However, sometimes it's necessary with the case of chronic pain to be more involved. Medical professionals have been shown consistently to raise costs without cause in certain areas where they have direct financial incentives to do so as well. Through questions and visits, you can start to see the character of the person behind the claim as well as the treatment they're receiving. If you do suspect foul play on either side, then your insurance company will be more than happy to help. After all, they stand to lose out on fraudulent claims too.

Employment Practices Liability Insurance: Four Key Questions

Author TonyScurich , 6/8/2016
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You need Employment Practices Liability insurance (EPLI) to protect you from lawsuits filed (justly or unjustly) by anyone who you employ, have employed, or even considered employing.

Before you buy this essential coverage, be sure to ask these questions:
  1. Who is insured? This should include the company as an entity, along with officers, directors, and every type of employee (full-time, part-time, temp, leased, loaned and seasonal). The importance of this becomes clear if you're ever sued for a sexist slur made by temporary receptionist to a job applicant.
  2. What claims does the policy cover? You want coverage for every eventuality: monetary damages, all types of legal proceeding from criminal to regulatory, settlements, judgments, lost pay, defense fees and punitive damages.
  3. How does the policy define "wrongful employment practices" beyond the obvious (sexual harassment and racial discrimination)? Make sure that you have coverage for violations of federal, state, local and common law on employment discrimination;, deprivation of career opportunities; defamation; retaliation, negligent job evaluation, and failure to have an acceptable written employment policy.
  4. What does the policy exclude? EPLI should include wrongful practices that might have taken place before you bought coverage - so you don't have to worry about a suit by that disgruntled vice president you fired three years ago for pilfering paperclips.
A word to the wise: use EPLI as a last line of defense. Risk management for your business should include diversity and sensitivity training. The U. S. Equal Employment Opportunity Commission offers a wealth of free training resources, guides, compliance information, and links to free training throughout the nation. As always, we stand ready to offer you our professional advice, free of charge.  

Opioid Abuse: Employer, Beware!

Author TonyScurich , 5/27/2016
1 Misuse of powerful prescription painkillers, whether intentional or accidental, is a rapidly growing threat to employers throughout the nation. Opioid overdoses caused more than 16,000 deaths in 2010, the latest year for which data is available; and about 12 million people use prescription painkillers for nonmedical reasons. In addition to the human tragedy, opioid addiction creates a significant financial problem for both businesses - in terms of lost productivity - and their insurance companies. Nonmedical use of prescription painkillers costs Health insurers more than $70 billion a year; while narcotics prescriptions account for one-fourth of Workers Comp prescription drug expenses (costs that ultimately come out of employers' pockets). Government plays a significant role in dealing with this problem. The federal Department of Health and Human Services regulates Opioid Treatment Programs (OTPs) through the Division of Pharmacologic Therapies. On the state level, for example, California has followed the lead of Washington State by devising treatment guidelines to curb over-prescription and abuse of opioids. These measures include limiting opioid prescriptions to six weeks after surgery or injury and using non-opioid painkillers as a preliminary pain management measure in non-acute cases. However, these regulatory or legislative efforts can only go so far. No employer can afford to ignore the issue of opioid abuse among its workers - and your Workers Compensation manager is well-positioned to intervene in these cases by implementing a risk management plan that:
  • ensures that patients are treated early and effectively;
  • monitors and manages opioid prescriptions;
  • uses predictive modeling to tag potentially severe claims;
  • requires physician peer reviews for opioid prescriptions;
  • uses drug testing and screening workers prescribed with drugs;
  • provides post-addiction help; and
  • phases workers back into their jobs
We stand ready to offer our advice at any time.