The News For The Day Is On Captives

I was a little slow to understand how captives worked when they first were written a few years ago. I do not want this post to sound like "I told you so." Check the prior posts on captives. Has the day of atonement arrived for this type of insuring agreement?

The IRS - as I said in a prior post - is not going to let what they consider an immediate tax deduction for Workers Comp reserves established for future losses of an affiliated company. This never had really sounded quite right to me. How could a tax deduction be earned for money that HAS NOT been paid for Work Comp losses? The IRS is never going to let a tax deduction occur for a FUTURE event such as a captive making a claim payment.

The IRS passed the rule in September 2007. They are holding hearings on this rule on Feb 29th in Washington, DC. Some of the captive managers have quit writing captives. Will there be some type of retro-tax? Who would be responsible for the retro-tax payments?

Workers Compensation has become a complicated insurance product. The post-Feb 29th ruling by the IRS could make this even more complicated.

Next Up - What number should a safety person be the most concerned with for WC?

Claims Q&A

We were caught up in a huge Workers Comp consulting project and I have neglected the blog page. OK, so here is the next installment of Claims Q&A with Kevin Quinley.

Claim Auditing Questions . . .

In doing claim audits, are there recurring issues or problems you see with claim-handling?

There are two that we see the most which heavily affect the outcome of a WC file. Those two are Immediate First Contact and Poor Communications. Often we see where an adjuster writes the injured employee, employer, and treating physician a form letter and then documents that there was immediate three point contact. Talking with the employer, doctor, and employee about their WC claim ASAP is a great way to start the proper communications in the file.

The other related area is adjusters working the file, but not making any contacts with all or at least some of the parties involved. Good communication is the main job of the adjuster. If this is not done as shown by a trend by an adjuster or by a TPA/Carrier, we become very concerned.

What are the most common findings or observations? See previous question.

How should claims people prepare for an audit before undergoing one?

Quit stressing when they hear their files are being audited. Some file audit firms consider a very nervous adjuster as a “red flag.” There is nothing that can be done to do a “quick-fix” on the files. The one thing that I recommend is to be friendly and smile at the initial meeting. Do not EVER put the auditor on the defensive if they ask you a question. Auditors that are on the defensive tend to be more subjective in their file appraisals.

Are there “red flags” you look for when doing a claim audit?

We do heavy statistical analysis on the 33 areas that we look at for trends. If there is a trend by adjuster or insurance carrier, then we red flag that one area. This happens very rarely except in one area. Over-reserving or under-reserving the files is a red flag that we notice very quickly. We do stat analysis to confirm our findings. The numbers speak the loudest.

Over the years, do you sense any differences in skill among the claims profession in general? Is claim service getting better or worse?

Claims adjusting has followed a definite trend. It is how the industry or a certain carrier decides on the file loads for adjusters. An overloaded adjuster cannot do the job that the insureds are relying on them to do on their files. When the industry/carrier trend is to lighten loads, the file handling improves proportionally.

For a firm looking to tame its workers compensation claim costs, what is the ONE thing they can do to deliver the greatest return on investment?

Time Management training pays big dividends. Stress management seminars seem to help. The old “claims roundtable” is also a great meeting to have for adjusters to discuss difficult files. We can tell the difference on file reviews between trained and untrained adjusting staffs. The one word is training.

How do workers compensation claims people avoid getting burned out?

As mentioned before, they must remember that they ARE NOT claims adjusters. That is their job. In other words, leave it all at work. That is the secret to surviving in claims. Forget the files when you walk out the door every evening.

In a blind taste test, can you tell much of a quality difference between TPA claim services and insurer/staff claim services? Comment, please.

Yes, when we compare files where a carrier also functions as a TPA. Flat-fee files seem to receive less attention.

If there is indeed a “brain drain” of seasoned claims people retiring, how can companies counteract that trend to salvage acceptable levels of expertise?

There are carriers that do a great job of training incoming recruits. They also weed-out recruits that will not make it in the adjusting world. Liberty Mutual has an outstanding training program. Training and screening will fight the brain drain.

What are employers’ biggest complaints about workers compensation claim service?

As I mentioned before, it is poor communication. They often do not know what is happening on their files. I always tell employers to request online claim access as they can follow the files without having to disturb the very busy adjusters.

What is the ideal caseload for an adjuster handling lost-time workers compensation files? Comment.

Oh, this is a loaded question. It depends on the state, but I would say 100 for a claims trainee, 150 – 175 for an experienced adjuster, and 200-225 for a Senior Adjuster. In my career, I have had to handle 250 files in 7 jurisdictions/states at one time. I juggled it very well until I burned out from fighting fires.

Next Up - Workers Compensation News

Out Of Action On The Blog

OK, so I have been out of action on the blog for the holidays. Business has picked up tremendously, so the Workers Compensation blog has been suffering. I will not go over the best designation for claims or reserve reviewers today.

I will instead add in the Work Comp Claims Productivity Q&A session with Kevin Quinley of Claims Caffeine. Kevin asked very good questions. The address to join Claims Caffeine is https://login.yahoo.com/config/login_verify2?.intl=us&.src=ygrp&.done=http%3a//finance.groups.yahoo.com%2Fgroup%2Fclaims_caffeine%2Fjoin

You must get a lot of email. How do you manage it and stay on top of it?

I do not try to answer every email as I receive it. I set aside three times in the day where I answer emails. If you are accustomed to Outlook, you can direct certain messages into certain Outlook email folders. For instance, if it comes from a high priority sender, the email message will go into the High Priority box.

I also use Maven Beacon teaches typing to hone my typing skills. There are many levels of instruction on a typing teacher program such as this.

Do you use a Blackberry or PDA as a productivity tool?

No, but I use a LG AX490 cell phone to surf the web and to answer and send emails. That phone is the only one like it in existence. It has a full keyboard built in right on top of the number pad.

What are your biggest interruptions and how do you manage them?

My biggest interruptions are phone calls that could have been handled by an email. We try to contact adjusters by email only as that saves the adjusters’ time and the notes are easily added to their file documentation.

You must travel a good bit. What tips do you have for readers on how to save time and stress during business travel?

Airports are slammed with passengers and will be for many months to come. You are likely not going to get to your destination on time. Accept that fact and the stress will lower quickly. A real time saver is to print the boarding passes out the day before you fly. Always join any and all frequent traveler programs. Even if you do not use the airline, hotel, car rental etc that often, you will be treated better than without a frequent traveler #.

If you drive a large amount of the time, try to listen to Books on CD/Tape as a great diversion. My favorite is the 7 Habits of Highly Effective people. There is some incredible advice on settling files in that Book on CD. The chapter on win-win is a great one for claims people.

If you could offer just one productivity tip, what would it be?

DO NOT stress out. Study after study has shown that one loses about 40% of their productiveness under stress. You are the expert, so be the expert.

Do you use a daily To-Do list? If so, how long is it usually?

Yes, I use a To-Do list on Outlook. I actually switched from the Outlook task list to using just the Calendar as the tasks just have to be calendared and that takes two steps to do the same thing. My To-Do list has a rolling average of twenty items.

How do you set your day-to-day priorities amidst shifting work demands?

Many years ago I was sent for two days of training conference on setting priorities. The bottom line result:-
· AA –Do it immediately
· A - Do it that day
· B - Do it that week
· C - Do it that month.

Each priority will move up the line during the daily routine. Some priorities could move down the line. Keep working on the top 20% (AA and A). If you can get through the A’s and start working on the B’s, there will less fires to put out in your daily routine.

How do you find time to keep current on professional reading and developments within your field?

I subscribe to about twenty different e-zines (all free of charge). I read the headlines and then print or copy and paste the document to my desktop in a folder called reading material to read at the end of the day. If I cannot find time to read them at least I read the headlines.

What is the one thing you wish you had known starting out in your business that you know now?

QUIT STRESSING. Claims is a &$^#* job if you let it stress you out. Keep calm and remember that claims adjusting is a job. Never refer to yourself as a claims adjuster. Leave the job at work.

Based on how you see claims people work, how do you think they could work smarter?

Keep the stress level low. Do not take the job home with them. I see too many adjusters just freak out on an audit of their claims. Guess what? Most of the time they are doing a good job. You are the experts, so act like and be the experts.

Return all calls, emails, and all other communications within 24 business hours. You do not have to have an answer. Call/email and say I just wanted to let you know I am working on it and I will get back to you by a certain date or when a certain thing happens. As the old saying goes – when you are silent, people will expect the worst.

Bottom Line – quit stressing, be confident, do your 24 hour contacts, and communicate.

Next Up - Workers Comp Claims Auditing Q&A from Kevin

A Comprehensive List of Insurance Designations

I sometimes hear comments that there are no insurance designations for a certain area of insurance that would help someone with job advancement. The following list should remove any doubts as to that fact.

In my next post, I will point out some of the important ones for a claims, reserve, or premium reviewer.

AAAM American Academy of Actuaries Member
AAI Accredited Adviser in Insurance
AAMS Accredited Asset Management Specialistsm
AAPA Associate, Annuity Products and Administration
ACA Associate of the Conference of Consulting Actuaries
ACAS Associate, Casualty Actuarial Society
ACII Associateship of the Chartered Insurance Institute
ACLA Automobile Claim Law Associate
ACLS Automobile Claim Law Specialist
ACP Associate Compliance Professional
ACS Associate Customer Service (LOMA)
ACS Associate Customer Service (IIC) ACSR Accredited Customer Service Representative 28
AEP Accredited Estate Planner
AFA Associate Financial Advisor 31
AFC Accredited Financial Counselor
AFSB Associate in Fidelity and Surety Bonding
AFSI Associate, Financial Service Institute
AFSR Accredited Financial Services Representative
AIAA Associate, Insurance Agency Administration
AIAF Associate in Insurance Accounting and Finance (IIA)
AIAF Associate in Insurance Accounting and Finance (LOMA)
AIAM Associate in Insurance Account Management
AIC Associate in Claims
AIDM Associate Insurance Data Manger
AIE Accredited Insurance Examiner
AIIC Associate of The Insurance Institute of Canada
AIM Associate in Management
AIP Associate in Insurance Production
AIRC Associate, Insurance Regulatory Compliance
AIS Associate in Insurance Services
AIT Associate in Information Technology
ALHC Associate, Life and Health Claims
ALMI Associate, Life Management Institute
Alternative Investments Certificate
AMIM Associate in Marine Insurance Management
AOHST Associate Occupational Health and Safety Technologist
APA Accredited Pension Administrator
APA Associate in Premium Auditing
API Associate in Personal Insurance
APM Associated Professional Member
APR Accredited Pension Representative
ARA Associate, Reinsurance Administration
ARC Associate in Regulation and Compliance
ARe Associate in Reinsurance
ARM Associate in Risk Management
ARM-P Associate in Risk Management for Public Entities
ARPM Associate in Risk Pool Management
ASA Associate of the Society of Actuaries
ASF Associate in State Filings
ASLI Associate in Surplus Lines Insurance
ASP Associate Safety Professional
AU Associate in Underwriting
AWMA Accredited Wealth Manger Advisor
BCE Board Certified in Estate Planning
BPA Business Process Advisor
CAIB Canadian Accredited Insurance Broker
CAM Chartered Asset Manager
CAP Chartered Advisor in Philanthropy
CAS Certified Annuity Specialist
CASL Chartered Advisor for Senior Living
CCIB Canadian Certified Insurance Broker
CCLA Casualty Claim Law Associate
CCLS Casualty Claim Law Specialist
CCMP Certified Case Management Professional
CCP Certified Compliance Professional
CEA Certified Estate Advisor
CEBS Certified Employee Benefit Specialist (Canada)
CEBS Certified Employee Benefit Specialist (US)
CEP Certified Estate Planner
CERA Chartered Enterprise Risk Analyst
Cert CII Certificate in Insurance
Cert PFS Certificate in Financial Planning
CFA Chartered Financial Analyst
CFE Certified Fraud Examiner
CFP Certified Financial Planner
CFP CFP Certification Curriculum
CFP Certified Financial PlannerTM Professional Education Program
CFS Certified Fund Specialist
CHC Certified Housing Counselor
ChFC Chartered Financial Consultant
CHST Construction Health and Safety Technician
CIAM Chartered Insurance Agency Manger
CIC Certified Insurance Counselor
CIDM Certified Insurance Data Manager
CIE Certified Insurance Examiner
CIMA Certified Investment Management Analyst
CIP Chartered Insurance Professional
CIPM Certificate in Investment Performance Measurement
CISR Certified Insurance Service Representative
CLCS Commercial Lines Coverage Specialist
CLF Chartered Leadership Fellow
CLTC Certified in Long-Term Care
CLU Chartered Life Underwriter
CMA/FAD Chartered Market Analyst/Financial Analyst Designate
CMFA Certified Manger of Financial Advisors
CMFC Chartered Mutual Fund Counselorsm
CMS Compensation Management Specialist (Canada)
CMS Compensation Management Specialist (US)
CPC Certified Pension Consultant
CPCU Chartered Property Casualty Underwriter
CPDM Certified Professional Disability Management
CPIA Certified Professional Insurance Agent
CPIB Canadian Professional Insurance Broker
CPIW/M Certified Professional Insurance Woman/Man
CPM Chartered Portfolio Manager
CPSR Certified Professional Service Representative
CRM Canadian Risk Manager
CRM Certified Risk Manager
CRPC Chartered Retirement Planning Counselorsm
CRPS Chartered Retirement Plans Specialistsm
CSA Certified Senior Advisors
CSF Certified State Filer
CSFP Chartered Senior Financial Planner
CSP Certified Safety Professional
CTEP Chartered Trust and Estate Planner
CTS Certified Tax Specialist
CWM Chartered Wealth Manager
DAE Diversified Advanced Education
DHP Disability Healthcare Professional
DIA Disability Income Associate
Dip CII Certificate of Insurance Practice/Diploma in Insurance
Dip PFS Diploma in Financial Planning
EHBA Employee Healthcare Benefits Associate
EPLS Estate Planning Law Specialist
ERMP Enterprise Risk Management Professional
Essential of Investment Consulting Certificate
FAIQ Financial Advisers International Qualification
FCA Fellow of the Conference of Consulting Actuaries
FCAS Fellow, Casualty Actuarial Society
FCII Fellowship of the Chartered Insurance Institute
FCIP Fellow Chartered Insurance Professional
FCLA Fraud Claim Law Associate
FCLS Fraud Claim Law Specialist
FFSI Fellow, Financial Service Institute
FIIC Fellow of The Insurance Institute of Canada
FLHC Fellow, Life and Health Claims
FLMI Fellow, Life Management Institute
FSA Fellow of the Society of Actuaries
FSPA Fellow, Society of Pension Actuaries
FSS Financial Services Specialist
GBA Group Benefit Associate (Canada)
GBA Group Benefit Associate (US)
GBDS Group Benefits Disability Specialist
Graduate Financial Planning Track - American College - CFP
GSP Graduate Safety Practitioner
HCAFA Health Care Anti-Fraud Associate
HCSA Healthcare Customer Service Associate
HIA Health Insurance Associate
HIPAAA HIPAA Associate
HIPAAP HIPAA Professional
INS Program in General Insurance
Introduction to Investment Consulting Certificate
ISC Investment Strategist Certificate
ITP Insurance Training Professional
LLIF LIMRA Leadership Institute Fellow
LPCS Legal Principles Claim Specialist
LTCP Long-Term Care Professional
LUTCF Life Underwriting Training Council Fellow
MFA Master Financial Advisor
MFM Master Financial Manager
MFP Master Financial Professional
MHP Managed Healthcare Professional
MMA Medical Management Associate
MS Master of Science Degree Program
MSFS Master of Science in Financial Services
MSM Master of Science in Management
MSPA Member, American Society of Pension Actuaries
OHST Occupational Health and Safety Technologist
PCLA Property Claim Law Associate
PCLS Property Claim Law Specialist
PCS Professional Customer Service Program
PFA Professional Financial Advisor
PISA Professional Insurance Sales Association
PLCS Personal Lines Coverage Specialist
QKA Qualified 401(k) Administrator
QPA Qualified Pension Administrator
QPFC Qualified Plan Financial Consultant
REBC Registered Employee Benefits Consultant
RF RIMS Fellow
RFS Registered Financial Specialist
RHU Registered Health Underwriter
RIS Retirement Income Specialist
RMPE Risk Management for Public Entities
RP® Registered Paraplanner
RPA Retirement Plans Associate (Canada)
RPA Retirement Plans Associate (US)
RPLU Registered Professional Liability Underwriters
SCLA Senior Claim Law Associate
SILA-A Securities & Insurance Licensing Administrators Associate
SILA-F Securities & Insurance Licensing Administrators Fellow
STS Safety Trained Supervisor
WCCP Workers’ Compensation Claims Professional
WCLA Workers Compensation Claim Law Associate
WCLS Workers Compensation Claim Law Specialist

What To Look For In A Workers Comp Claims Expert

Choosing a great Workers Comp claims review expert is some of the best strategically invested money in a company's budget. The main things to look for in your search are:

• Designations - such as AIC, ARM, CPCU, etc. Our next post will cover some of the designations. These designations are granted after a candidate passes national exams for a certain number of courses.
• Years of Experience - while this is a great indicator, we have performed review work after a so-called very experienced claims consultant that did not review the files very well.
• From One of the Big Companies - this is not an indicator of the level of service you will receive as it is down to the individual claims consultants in the companies that will service your account.
• Experience in a Certain State - this is not a big factor as one might believe. The main thing to remember is a claims consultant that has multi-state experience shows adaptability to different state systems.
• Prior Claims Adjusting Experience - there are some claims consultant companies that have no or few employees with actual claims adjusting experience.
• Statistical Backgrounds - this is critical for file by file reviews and is important for finding trends in the claims reserving
• No Conflicts of Interest - any person that may make a commission off your Work Comp policy may not be able to give an uninfluenced opinion.

I did not put these in any order of importance. The best of both worlds is to have a reserve/claims expert company that also reviews the premium calculations. A shameless plug - we are one of the few companies in existence that do both.

Up Next - Designations - What are they??

Our main Website is http://www.cutcompcosts.com/