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Monthly Archives

December 2012

DOES YOUR LIABILITY POLICY HAVE THE RIGHT ‘COVERAGE TRIGGER?’

By Construction Insurance Bulletin

A “coverage trigger” is an event that causes your Liability policy to pay a claim. There are two basic types of “triggers”: occurrence and claims made.

An “occurrence” trigger means that the policy will cover any injury or damage during the policy period. For example, if a roof that you installed four years ago collapsed last week, injuring five people, the occurrence trigger will apply and the policy will pay. It doesn’t matter when the roof was built or when the claim was filed – only when the actual injury took place.

A “claims-made” trigger, as the name suggests, focuses on the date the actual claim is made. Underwriting and rating provisions might limit how far into your past the policy provides coverage. However, the key question is: “did the claim come in during the policy period?” If so, a “claims-made” Liability policy will pay. Using the example of the collapsing roof, it doesn’t matter when the roof was built or when the event took place, the trigger won’t apply until the claim is filed.

If this claim is made during the current policy period, your insurance company will pay it. However, suppose the claim isn’t made for several weeks; and by the time it arrives, your current coverage has expired and you’re into a new policy period? In this case, the “claims-made” policy will pay the claim, since it was made during the new period.

One type of trigger isn’t necessarily better than the other. However, it’s almost always wise to keep the current type in order to provide relatively seamless coverage.

If you’re offered a Liability policy that offers broader coverage or more attractive pricing – but has a different trigger than your current insurance – consult with us before you make a decision. The only way to be sure you get the protection you need at a fair price is to consider all possible underwriting considerations and how the change in trigger might affect your liability needs.

CRISIS PLANNING – DON’T WAIT

By Construction Insurance Bulletin

Natural disasters can do significant damage to construction firms. Some suffer direct hits, while others endure massive service demands and shortages of help and supplies.

Although you might escape massive destruction and distress, what other events might cause your company to suffer a crisis? IT failure? Burglary or vandalism? Professional liability? Fire? Loss of market?

Whether disaster strikes as a catastrophic or stressful disruption, the best way to prepare for them is crisis management. Now is the time to develop a plan that will allow you and your staff to mobilize the right resources in the right order quickly to get you up and running as smoothly as possible.

How do you develop such a plan? What’s the process? Who should you include? How often should you review and update it?

We can help by providing risk management advice and recommendations, together with materials and resources tailored to your needs and exposures. Although insurance might not solve all your post-crisis problems, it can certainly provide a solid foundation for your planning should the worst happen.

Don’t wait for a crisis to uncover the gaps in your current preparations. Start now.

DON’T PAY THOSE SMALL CLAIMS YOURSELF!

By Construction Insurance Bulletin

When you face what appears to be a minor claim, have you ever been tempted just to handle it yourself? After all, the loss is minimal, and you’re “saving” your insurance coverage for when you really need it. Some contractors also feel that filing too many small claims could increase the risk of losing the policy, or driving up their premium.

However, there’s more to consider. Bear in mind that every policy contains language to the effect that “No insured will, except at that insured’s own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent.” This means that that if you pay a small claim yourself, and anything goes wrong, the insurance company can say, “You’re on your own.”

For example, suppose someone walks through your job site and steps on a nail. It appears to be a minor puncture wound, and you agree to pick up the cost of an emergency room visit. You might feel that you’ve closed this incident quickly. However, a few weeks later, the injured person calls to say they have a raging infection in their foot and the doctor is checking them into the hospital for what proves to be a long and expensive stay.

If you then report this claim to your insurance company for the first time, will they step in and take over, or tell you that since you never informed them of the incident they’re not responsible? Even if the insurance company pays the claim, you’ve run an unnecessary risk.

What you should have done – as the policy wording suggests – is to inform your insurance company immediately and ask its consent for you to pay the claim. This approach would have made a substantial difference because notifying the company of the claim fulfills your obligations under the policy.

Why go it alone when you have a partner waiting to help?

THERE’S NO SUCH THING AS ‘ACCEPTABLE’ FRAUD

By Construction Insurance Bulletin

The Coalition Against Insurance Fraud did an extensive study to learn why public tolerance of insurance fraud seems to be increasing. The coalition commissioned a national research firm to conduct a series of consumer focus groups, as well as a telephone survey of 602 households.

Respondents offered three main reasons for committing insurance fraud: 1) To save money or reduce costs; 2) to complete work that they couldn’t otherwise afford; and 3) to “get back” at insurance companies.

Although respondents acknowledged that fraud leads to higher premiums, they believed that premiums would keep rising even if fraud were eliminated. They also said that even though the public has a moral obligation to report fraud, most wouldn’t report a fraudulent act themselves. When asked why some people resist committing fraud, the most common reasons were a strong sense of right and wrong or a fear of being caught and punished. Respondents said insurers could discourage fraud by rewarding customers for good behavior, such as providing rebates or credits for not filing claims for a period of time and aggressively pursuing customers who do commit fraud.

Fraud costs U.S. businesses billions a year. Do your customers and employees recognize that fraud is increasing your costs of doing business – and thus your prices? Have you implemented polices that let your employees and subcontractors know that you won’t tolerate fraud and will prosecute it actively when discovered?

For resources and materials to help you combat fraud and curb the costs of fraudulent acts on your business and insurance program, give us a call. We’re here to help!

INTERNAL SURVEILLANCE CAMERAS CAN REDUCE COMP FRAUD

By Workplace Safety

Security cameras in the workplace can help employers stave off fraudulent Workers Compensation claims – as long as the companies using them are careful not to violate employees’ privacy.

CEC Entertainment Inc. (Irving, TX), which operates Chuck E. Cheese’s restaurants, reduced fraudulent Comp and Liability claims significantly after installing surveillance cameras in 2009 and 2010. Says CEC Director of Sales Management Jeff Strege, “We’ve made a number of claims literally vanish once we produce the video footage to show that what the claimant said didn’t really happen.”

Commercial insurance broker Marsh Inc. recommends that such businesses as retailers, manufacturers, transportation companies, and financial institution use cameras to monitor workplace safety and evaluate potential injuries as a way to monitor and validate incidents that could generate costly claims. What’s more, adds Paul Braun of Aon Risk Consulting, employees who know that they’re being taped will be less likely to try claims scams.

Using surveillance video can run afoul of privacy laws that prohibit companies from filming employees inside of restrooms, and require them to post signs informing workers that they’re under video surveillance. In general, says Thomas Martin, CEO of Martin Investigations & Security Services (Lima, OH), “Where your eyes are allowed to see, the cameras are allowed to see.”

Although cameras can’t film all areas of a company, employers should look closely at Workers Comp claims that happen outside the cameras’ view. Notes Martin, “If you have pretty much 75% coverage, and they happen to fall and claim an injury in the other 25%, it becomes very suspicious that (the injury) wasn’t recorded.”

Insurance and security experts generally agree that the cost of installing and maintaining video monitoring systems in the workplace is well worth the investment in discouraging or preventing phony – and costly – Comp claims.

We’d be happy to offer our recommendations on video surveillance security firms that can help meet your needs.

EMPLOYEE HEALTH AND WELLNESS: THE HEART OF THE MATTER

By Workplace Safety

Cardiac disease kills or disables more Americans than any other condition – and costs businesses billions a year in lost productivity and profits. There’s no better time to have a heart-to-heart talk with your employees about how to reduce their risk of suffering a cardiac episode.

Spend some time on the symptoms. Make sure that employees can recognize the signs of a possible heart attack – whether in themselves or a co-worker. Common symptoms include: 1) chest discomfort, mainly in the center of the chest, that lasts for more than a few minutes or goes away and returns; the discomfort might feel like an uncomfortable pressure, squeezing, fullness, or pain; 2) discomfort in other areas of the upper body, including pain or discomfort in one or both arms, the back, neck, jaw, or stomach; 3) shortness of breath often accompanies chest discomfort, but can also occur before chest pains; and 4) other symptoms, such as breaking out in a cold sweat, nausea, or light-headedness.

Warn employees not to ignore any possible symptoms. Even if they’re not sure it’s a heart attack, they should still have it checked out. Fast action saves lives. A delay in getting treatment can result in permanent heart damage that can greatly reduce the ability to perform everyday activities – or even result in death.

Emphasize prevention. Let your employees know that they can help reduce the risk of suffering heart attack by taking a few basic steps:

  • Don’t smoke. It doubles your risk of heart attack. However, soon after you stop smoking, your risk drops to that of a lifelong nonsmoker.
  • Eat healthy. Choose nutritious foods low in cholesterol and saturated fat, focusing on fresh fruits and vegetables, whole grains, and low fat and nonfat dairy products. Avoid junk food and sugary snacks.
  • Get some exercise. Find an activity that you enjoy and do it regularly.

WORKERS COMP CLAIM SETTLEMENTS: MAKING LIFE EASIER

By Workplace Safety

Workers Compensation claims can be complex, posing a variety of challengers to employers and claims adjusters alike.

These guidelines for handling claims can go far to make life a lot easier for everyone.

  • Get the main contact for the claim involved from the get-go. Make sure that he or she is ready to provide the adjuster with all the facts and information, including the employee’s file, wage records, details about the injury, and any statements from witnesses.
  • Be sure that the main contact responds to the adjuster in a timely manner.Making the adjuster leave messages, send e-mails, and/or wait for a long time will only make things worse. The key to a successful and easy claim is to get back to the adjuster with the needed information, preferably on the same day, but ideally within the hour.
  • Have a specific medical clinic or doctor that treats injured workers. When injured employees visit their own doctor it not only makes the process more complicated, but also creates an air of suspicion because neither the employer nor the adjuster knows this health-care provider.
  • Make sure that the medical clinic is familiar with the employer and understands what light duty options are available to injured workers. This will give the doctor the opportunity to suggest alternative tasks for the employee instead of taking him or her out of the workplace altogether.

Remember, the sooner and more effectively you settle Workers Comp claims and get these injured employees back on the job, the better for them, the higher your productivity – and the lower your premiums!

The professionals at our agency stand ready to advise you on handling Comp claims. Just give us a call.

STAYING OFF OSHA’S HIT LIST

By Workplace Safety

The Occupational Safety and Health Administration (OSHA) has a list of companies that face inspection and enforcement – and your company might well be on it!

Here are five ways to evaluate your chances of getting a visit from OSHA:

  1. Check your own injury and accident rates. Use the OSHA Form 300 log and Form 300A Summary to review your accident statistics, injury and illness logs, and incident rates, particularly your Days Away, Restricted, and Transferred (DART) rate, and Days Away from Work Injury and Illness (DAFWII) rate.
  2. Look at OSHA trends in citations and violations for your industry. Go to the OSHA Web site athttp://www.osha.gov/pls/imis/citedstandard.html and browse through the regulations that cover your industry for the number of citations under a particular regulation
  3. Compare your incidence rate with those of your competitors. You can find the history of your competitors’ inspections on the OSHA site at http://www.osha.gov/oshstats/index.html. The database also contains the list of citations by regulation number.
  4. Determine whether you’re making the news. OSHA inspectors respond to media stories about an organization, even if the coverage is positive. If a news agency wants information about you, carefully screen any comments or photographs you provide. Even a positive story can sting you inadvertently when it comes to workplace safety and health.
  5. Monitor what’s new with OSHA. Keep an eye on the agency’s Special Emphasis program (http://search.usa.gov/search?affiliate=usdoloshapublicwebsite&query=Special+Needs+Program&x=34&y=8) for targeting certain high-hazard industries.