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Workers Comp Lessons from Major League Baseball

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NEW ORLEANS—Bringing workers compensation under central control and greater oversight has drastically changed the cost and efficacy of one of Major League Baseball’s biggest expenditures. Here at the final day of the RIMS conference, Anthony Avitabile, vice president of industry risk management for Major League Baseball, shared some of his insight on implementing a unified workers comp program to reduce expenses while offering better services.

Although not every business has the high-profile brand or famous talent of a professional sports team, MLB’s example offers some valuable lessons for how large companies with different facilities or franchises can reduce workers comp spend and enhance treatment for employees.

Before 2003, clubs operated individually, placing workers comp insurance independently.

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To do so, they called upon varying philosophies related to program structure, medical provider relationships, and off-season indemnity for minor league players who were out of work during a key earnings period outside of the game. Every franchise was fending for themselves when it came to procuring coverage and securing treatment for players. Since 2003, the league has required compliance with a group policy, featuring group insurance purchasing, unified philosophies, and greater information sharing about injuries, expenses and treatment standards. In the year before Avitabile’s program was put into place, total costs incurred peaked in 2002 at about .

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3 million, while costs in 2013 were down to .

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8 million.

Critical components of the new program include a drastic effort to understand and review losses across all franchises, what he called a “relentless” effort to manage the process in every club, incentivizing good behavior and results, and instituting universal standards in the approach to coverage. The league made a unilateral decision to dedicate the greatest spend to best-in-class service providers, for example, concluding that return to maximum medical improvement offered the biggest long-term savings. Seizing on the competitive nature shared throughout the league, Avitabile also issues one-page annual scorecards for the CFO and other executives in the individual clubs and review at an organizational level. These show performance relative to other clubs, highlighting top cost drivers and key ways to improve. A workers compensation quality council was also formed to focus on provider agreements, review complex questions regarding released players, and evaluate and implement in-house physical therapy and rehab operations.

Leveraging the full size and reputation of the league also offered substantial savings in negotiating with providers, which Avitabile cited as one of the biggest areas of savings when managed in advance of any injuries. Partially thanks to volume and ensured prompt payment backed by the organization, these pre-negotiated rates are typically below workers comp state medical fee schedules. Some of his tips for negotiating these provider agreements include:

provider agreement negotiation

Bringing some services in-house also offered considerable savings while maximizing reliable access to top treatment and consistent protocols. The league-wide move to in-house physical therapy instead of third-party treatment, for example, brought total incurred PT and rehab costs down from about $1.6 million in 2002 to approximately $340,000 in 2012.

Risks and Questions Surround 3D Printing Technology

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NEW ORLEANS—One of the most promising new technologies to hit the wider market in recent years, 3D printing is poised to revolutionize manufacturing as we know it. Otherwise known as additive manufacturing, 3D printing allows users to print almost anything they can dream up, including toys, machine parts, clothing, food, and prosthetic (as well as actual) body parts. There even companies that can print a lifesize, 3D model of your unborn fetus using ultrasound scans.

Of course, as with any new technology, there are many risks to consider and just as many unanswered questions about how to address those risks. At an educational session this morning at the RIMS 2015 Annual Conference & Exhibition, Cynthia Slubowski, head o f manufacturing at Zurich, Lisa Cirando, and attorney with Jones Day and Toni Herwaldt, risk manager at Kraft Foods, provided a risk checklist, outlining at the wide range of risks and questions facing those in the 3D printing space and those whose industries will be impacted by this new technology:

Product risk. Since 3D printing changes the traditional manufacturing model, industries will need to determine who owns a 3D printed product and in the event of an accident how will liability be apportioned?

Technology risk. Who owns the software and designs used to create products, particularly when users can make endless customizations?

Operations risk. How will 3D printing impact power supplies (the printers generate a lot of heat during operation), and how will the possible toxicity of ingredients and their byproducts be addressed. In addition, what are the business interruption and transportation risks?

Cybersecurity risk. How do you protect you designs and formulas? How do you prevent counterfeiting?

Environmental risk. How do you address exhaust, housing and disposal issues?

Contract risk. What kind of risk transfer or licensing agreements do you want to have in place?

Insurance risk. Do you have the appropriate coverage and where will it be coming from?

Strategic risk. How do you handle reputation and intellectual property issues? What happens to your product development lifecycle management?

Supply chain risk. Does your supply chain risk increase or decrease?

Market risk. What differentiates your product? What happens to your geographical risk?

10 Insurance Tips for Risk Managers

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NEW ORLEANS—Most companies will at one time or another face coverage issues and lawsuits. In order to identify and avoid insurance-related issues and disputes before they arise, risk managers should take advantage of proven strategies for resolving difficult claims, advised Darin McMullen, attorney with Anderson Kill, P.C. at the RIMS 2015 Annual Conference & Exhibition here.

1. The purpose of insurance is to insure.

Don’t underestimate potential future problems and think of loss prevention and risk transfer rather than loss financing, he noted. Companies need to assess the types of risks they will face and make sure their program is tailored to meet these needs. Also important, he said, is making sure policies are designed to cover the losses the company will face on a day to day basis. For example, certain types of risks are seen in manufacturing and other risks are particular to an IT vendor. Risk managers need to examine any pitfalls or shortages that may exist in their current policies and seek legal opinions well in advance of renewal. They need to look at how exclusions might be interpreted as well, McMullen said.

Joshua Gold, also an attorney with Anderson Kill, added that risk managers’ jobs are more difficult than ever, with fragmentation in insurance programs existing, since many polices are purchased for a program. These may include directors and officers, product liability and cyber insurance. “There are products out there that try to assimilate them and make sure gaps in coverage are treated,” Gold said, adding that while the fine print in policies can be overwhelming, it can be key for proper coverage, especially when dealing with multiple lines, excess layers and towers of insurance.

2. Don’t limit insurance expertise to the risk management department.

All too often, “there are still going to be thorny claims and there still are going to be disputed claims, which are unavoidable,” McMullen said. He said that building expertise elsewhere within the company is critical to taking advantage of any and all available coverage. “We get the need for everybody to work together, but now, more than ever, this is important,” he said. Coverage should not just be delegated to risk or legal and collaboration is needed. For example, IT departments need to be included when planning for cyber coverage.

3. Lawyers and risk managers can be natural allies.

While there may be friction between departments in a company, legal generally recognizes the beneficial role risk managers play, McMullen said. He added that risk managers need to put any insurance-related communications in writing and assist in the analysis of policies and claims.

4. Insurance is an essential component of corporate resources and asset conservation plans.

Risk managers should purchase coverage with the intent of safeguarding the company’s own property and employees. They also need to recognize which mechanisms actually transfer risk and which do not.

5. Think insurance after a loss occurs.

This means looking to insurance coverage following all lawsuits, claim letters, product-related issues and financial losses. Risk professionals also need to analyze other sources of insurance that could possibly cover a claim.

6. Give notice of a claim or loss as soon as possible.

When faced with a claim or loss, McMullen advised risk managers not to hesitate to notify their broker, insurers and everyone in their tower of insurance as soon as possible.

7. When you make a claim, don’t accept “no” for an answer.

There is no downside to challenging an insurer’s denial of coverage. “You owe it to your company, you owe it to your organization to explore this and push back,” McMullen said, adding that determination and persistence often mean the difference between coverage and no coverage.

8. Find out where your company’s policies are.

Locate, collect and catalogue past insurance policies. Also acquire and keep policies of all entities related to your company.

9. Don’t panic if your insurer becomes insolvent.

If this is the case, McMullen advised risk professionals to file a proof of claim as a creditor and file a claim against the state guaranty fund in one or more possible jurisdictions. He recommended that they request the next layer of insurance companies to “drop down,” and also to consider litigation options.

10. Make sure your insurance team is conflict-free.

This means the team should be untainted–risk managers need to know where loyalty lies and if an attorney is representing both sides, McMullen said. “You want a conflict-free insurance team to take on the insurance company and to fight for the coverage that you are paying for,” he concluded.

 

Risk Management Storytime

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NEW ORLEANS—One of the biggest challenges for risk managers has always been how to engage the rest of the company in risk management activities. Too often, risk managers are considered the show-stoppers, feared by other departments for their tendency to be risk averse and shoot down every idea. So the challenge is to find a way to increase their risk awareness in such a way that they start to view risk as opportunity rather than a deterrent. According to Joachim Ademusi, director of IRMS Ltd., the key to embedding risk management into the culture of an organization lies in story telling—basically finding a way to present risk management in a context that they can relate to and even enjoy.

Speaking at an educational and interactive session at the RIMS 2015 Annual Conference & Exhibition, Ademusi stressed that risk is really a performance improvement tool. So with that in mind, it is important to change any negative perceptions about it. Risk managers should create an environment for creativity that allows all company personnel to take advantage of what risk management can do. This creative engagement requires risk managers to understand the needs and concerns of other departments and find ways to inspire them to consider risk and exchange ideas. This can be accomplished by changing the narrative that risk management is somehow bad. Ademusi recommended creating a contest among all employees to identify the risk management angles in a given scenario, with the winner receiving a gift card or some other monetary award. Or simply meeting with various individuals over lunch in an effort to better understand their concerns.

Ultimately, the idea is to make risk management less intimidating. By using stories, proverbs and parallels that don’t necessarily rely on risk terminology, risk managers can gain the trust of their colleagues and foster the understanding that good risk management will improve performance and benefit the entire organization. And once the organization embraces risk management and proactively seeks out their risk manager’s advice, Ademusi said that your career with truly become something special.