February 2011

Temporary Total Disability Period Increases Nationwide

Temporary Total Disability Period Claims In a recent workers compensation study by NCCI , the total disability period for injured workers indicated the Temporary Total Disability (TTD) period had increased sharply over the last three years. I decided to check a few numbers their study produced to see if there

Broad Form Hold Harmless Clause

Term Of The Day – Broad Form Hold Harmless Clause This is the most dangerous of the three types of Hold Harmless agreements. Broad form hold harmless clause means the subcontractor applying for an insurance policy: Assumes all related liability for accidents Its own negligence General contractor negligence Combined negligence

Is Unfunded Self Insurance Good Risk Management Technique?

Unfunded Self Insurance Is High Risk Unfunded Self Insurance can lead to a company actually folding if there are enough claims that were never placed in a budget. These insureds do not usually have an accounting of the reserve funds required to meet future claims. The money is never really

Premium Audit Question On Offsite Data By Premium Auditor

A Premium Audit Question On Employer Data Privacy A great premium audit question came in from one of our blog readers last week.   One of our readers who handles the accounting for a large multi-state construction company asks “Can the insurance premium auditor take private company data off-site to

Oklahoma Workers Comp Overhaul Will Not Replace Current System

Oklahoma Workers Comp Overhaul Continues Old System The Oklahoma Workers Comp overhaul will have little effect to the current system. Oklahoma’s Workers Comp system is where I was trained many years ago. Being from Oklahoma, I always try to monitor the Workers Comp situation there. Why I write about different

Catastrophe Cover

Workers Comp Catastrophe Cover = Massive Losses Workers Comp catastrophe cover deals with massive losses.  Self Insured Employers may sometimes use a highly recommend risk management technique for Workers Compensation losses. Catastrophic excess insurance can save a company’s insurance budget or may even save the company in case of a

Ambulatory Care

Term Of The Day – Ambulatory The definition of ambulatory care is any medical care delivered on an outpatient basis. Increasing numbers of medical conditions can be managed without admission to a hospital. Many medical investigations can be performed on an ambulatory basis, including blood tests, X-rays, endoscopy and even biopsy

Operational Risk Management (ORM)

Term Of The Day – Operational Risk Management A continual cyclic process which includes risk assessment, risk decision making, and implementation of risk controls, which results in acceptance, mitigation, or avoidance of risk. I thought it would be best to cover two very simplistic models for ORM. The US Department of

Vis Major

Term Of The Day – Vis Major Vis Major means act of God or an unavoidable accident or calamity. Almost all insurance policies have a Vis Major clause in them. It can be the basis for a denial of insurance coverage.   ©J&L Risk Management Inc Copyright Notice

Workers Comp SEB Supplemental Earnings Benefit

SEB Supplemental Earnings Benefit One to the blog, and we do like to see comments, asked about the SEB or Supplemental Earnings Benefit, which seems to be a Louisiana term for Temporary Partial Disability (TPD) benefits. The definition for SEB is   If you can return to work, but your medical

Workers Comp Self Insureds LDF Is Experience Mod

Workers Comp Self Insureds Have an LDF The LDF (Los Development Factor) equates to the E-Mod for self insureds.  I have posted a few times in the past on Self Insureds thinking they are out of the Workers Comp E-Mod system. Actually, nothing could be further from the truth. I

North Carolina High Claims Cost – Quite Controversy

North Carolina High Claims Cost Shocker Many of you responded to last week’s note on the  North Carolina High Claims Cost from the 16 states surveyed by the WCRI – Workers Compensation Research Institute. I was unable to let quite a few of the comments go through, as specific insurance

Retention

Term Of The Day – Retention 1) Assumption of risk of loss by deductibles, noninsurance, or self-insurance. Retention can be unintentional when exposures are not identified, or intentional. (2) In reinsurance, the net amount of risk the ceding company keeps for its own account.   ©J&L Risk Management Inc Copyright

Personal Risk Management (PRM) Definition

Term Of The Day – Personal Risk Management Personal Risk management focuses on how individuals can protect their wealth by risk management. The two areas of most concern are the insurance industry’s consumer products and employee benefits: Insurance: Auto insurance (Deductibles, liability, collision, comprehensive) Health insurance (Deductibles, co-pays, etc.) House

BCAR

Term Of The Day – BCAR BCAR = Adjusted Surplus / Net Required Capital AM Best invented this term. It is a test of the insurance carrier’s Balance Sheet. Having an unhealthy balance sheet is one of the steps for an insurance carrier to start down the path of insolvency.

Reinsurance Pool

 Term Of The Day – Reinsurance Pool Pooling risks from across a certain population can minimize premium variances between groups and premium fluctuations per group. A reinsurance pool covers the excess costs associated with high-risk insureds from numerous employer groups. A high-risk insured is one who is likely to generate

Missouri – TPA’s Fined Over $100,000 For Errors

Missouri Fines TPA Over $100,000 According to a recent press release from the Missouri Attorney General’s, Broadspire and Specialty Risk Services, settled with their office for over $100,000 total in fines. Missouri has taken a new tact on late reporting of injuries by referring the cases to the Attorney General’s

North Carolina Workers Comp – Shocker!

WCRI North Carolina Workers Comp The North Carolina Workers Comp paid per claim figures astonished many in the workers comp community.   When I first read the conclusion of a study published by The Workers Compensation Research Institute (WCRI), I thought there must be a mistake. For many years, Workers Comp

Personnel Risk Can Be Internal or External

Term Of The Day – Personnel Risk Refers to risks to a company’s operations that either concern or are caused by personnel. Personnel risk includes: Fatigue and exhaustion Accidents and illnesses Obsolete professional skills Personal or job-related disputes Unintentional human error Info leaks or theft Personnel risk analysis includes these

Retrospective Rating Requires Heavy Loss Control Efforts

Retrospective Rating Requires Great Work Comp Risk Management Retrospective rating is an individual risk rating plan that is an optional plan. Both the employer and the insurance carrier must agree to the Retrospective Rating Plan. This type of rating plan may be applied on either an interstate or intrastate basis.

Terrorism Risk Insurance Act (TRIA)

Term Of the Day – Terrorism Risk Insurance Act A Terrorism Risk Insurance Act of Worker Comp.Federal law signed into law by President Bush in 2002. . The Act created a federal “backstop” for insurance claims related to acts of terrorism. The Act is intended as a temporary measure to

How Long To Get Associate In Claims (AIC) Designation?

Term Of The Day – Associate In Claims The Associate In Claims designation (that I possess) is sponsored by the Insurance Institute of America (IIA). The AIC aids in overall claims handling proficiency. I do recommended it if you have chosen insurance claims as a career path.  A professional designation

Case Management – What Does The Term Mean In Workers Comp?

Term Of the Day – Case Management Case Management in the Workers Comp arena used to mean rehabilitation nurses or vocational experts that aid the injured employee in his/her medical care and return to work. Case Management now seems to have become a buzzword that can actually mean anything from

Comments and Emails on Term Of Day

Comments and Emails – Term Of The Day Thanks for the comments and emails from everyone on Workers Comp. We appreciate all the interest and feedback with our Workers Comp Term Of The Day that we post every workday. One question or feedback item that we sometimes receive is that

PEOs for Workers Comp – Are They Worth It? Answer – Most of The Time

PEOs Are Great For Workers Comp But Not Every Time Workers Comp PEOs (Professional Employment Organizations) have gained a great amount of attention lately. Are they a viable source of Workers Comp coverage for your business? The unregulated PEO’s of the past caused all state insurance departments to initiate more

Is IBNR (Incurred But Not Reported) Legal And How Is It Calculated?

IBNR – Incurred But Not Reported Is An Estimate  (Incurred But Not Reported) IBNR confused many in the WC community.  When a policy of insurance is written it will typically cover a defined (often 12 month) period from inception of the policy. When the policy is sold, a premium is

What is a Reinsurance Aggregate ?

Term Of the Day – Reinsurance Aggregate (a) The dollar amount of reinsurance coverage during one specified period, usually a year, for all reinsurance losses sustained during such period. (b) A limit of an insurance policy naming the most it will pay for all covered losses sustained during a specific

Annual Aggregate Deductible (AAD)

Term Of The Day – Annual Aggregate Deductible A collective type of deductible that can be used as a great risk management tool. The annual aggregate deductible (AAD) enables an insured to protect itself from numerous small claims by limiting the amount of deductible they pay per policy year. A

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