• Home
    • Workers Comp Audit Stress Reducer – Use It For Your Next Premium Audit
  • About Us
    • Cutting Workers Comp Costs – About Our Company
    • President – Expert James J Moore AIC MBA ChFC ARM
    • OSHA Risk Manager – Glen DuLac – Added To Fulfill Customer Service
  • Work Comp Consultants
  • Free Info
    • Definitions
    • Free Speech
  • Testimonials
  • FAQ
  • Free Manuals
  • Six Secrets
  • Blog
  • Contact Us

J&L Risk Management Consultants

Work Comp expert witness reserve reviews premium audits for employers

icons
Call us today! 1-800-813-1386
WORKERS' COMPENSATION PREMIUM REFUNDS POSSIBLE.
Home » Archives for February 2016

Archives for February 2016

Workers Comp Policy Includes Five Important Parts To Remember

February 24, 2016 By JL Risk Management Consultants

A Workers Comp Policy Is Similar To All Insurance Policies

A Workers Comp policy has five parts to it. Each part of the policy is important.  Some are more important than others, but all part of a policy should be read, even if it is slightly boring.

All Insurances Workers Comp Policy Icon

StockUnlimited

The five parts of the policy can be more easily remembered by the acronym DICEE:

Declarations

Insuring agreement (Inclusions)

Conditions

Exceptions

Endorsements.

The Declarations page can be thought of as the meat on the sandwich- unless you are a vegetarian.  The most important parts of the policy are here.   The Declarations are sometimes called the Dec Page.

If you sign a Workers Comp policy or any other policy without reading the Dec Page, you may be in for surprises down the road.  Unless your company has a large number of locations or classification codes, it will only take a few minutes to read it over.   A highlighter is the best for paper.   Most PDF readers will also allow you to highlight any passages.

Woman Workers Comp Policy Signing Paper

StockUnlimited

If you find anything on the Dec Pages that you question, then highlight it and contact your agent.  If you follow this link > Dec Page, then you will be able to see what is included in it

 

The other part of the Workers Comp policy that we receive the most questions concerning is the Endorsements.    Endorsements can be added during the policy year (with a few exceptions) that can change the policy.  Follow this link to read more concerning Endorsements.

Any time that you receive an Endorsement it should be read in full.  If you do not understand the Endorsement, contact your agent.   We have seen up to 30 endorsements in one policy year on a larger account.   Think of the Endorsements as an Appendix that modifies that policy.

These two areas of the policies seem to cause the most concern with employers.  You may also Google any term that you see in a policy as there are multitudes of explanations online or use the search box on our blog home page.

©J&L Risk Management Inc Copyright Notice

Filed Under: Insurance Policy Tagged With: Appendix, Dec Page, DICEE

Mobile Site Is Fixed – Dates Corrected – Full Access To 1,625 Articles

February 18, 2016 By JL Risk Management Consultants

Cutcompcosts.com – J&L Risk Management Fixes Mobile Site

Our mobile site was malfunctioning.  Thanks for the many emails letting us know something was amiss. We researched the problem and corrected it.  We were using date suppression software to allow for easy searching that totally whacked the mobile system.  At the sacrifice of our URL’s, we decided to keep the mobile website. 

Picture of Man Checking Mobile Site with Cell Phone

StockUnlimited

All the article dates were showing on January 1, 1970.   I am guessing that the default date is what WordPress defaults to when no clear date is provided. 

If you have not tried it, check out our mobile site on your smartphone, Ipad, or similar device.   Just open cutcompcosts.com and it will default to the blog.    We have been mobile compliant for a year.

We decided to keep the interface very simple to use.  Please drop a note to [email protected] if you have any suggestions for improvements.

If anyone would like to know the provider we use for our mobile site, please email me for the company name and website.    I try not to advertise any services directly in the articles. 

Update 2020 – J&L decided to switch to a provider that makes the site much easier to read – prose style.

©J&L Risk Management Inc Copyright Notice

Filed Under: mobile Tagged With: advertise, mobile site, software

Hawaii Monopolistic State Fund – Shocking Possibility

February 17, 2016 By JL Risk Management Consultants

The 50th State May Create Hawaii Monopolistic State Fund

The idea of a Hawaii Monopolistic State Fund may not just be a subject tossed around by Workers Comp aficionados.   A new piece of legislation referred to as House Bill 2715 may change the Hawaii WC landscape permanently.   Please remember  HB 2715 is quite a few steps from being enacted including surviving a veto by the Governor.

Picture of Hawaii Monopolistic State Fund Map

123RF

The shocker is that all the states that have decided to switch from a monopolistic state fund to more of a regular insurance market discovered paydirt for the employers.   Nevada and West Virginia are among the successful transitions from monopolistic to  the regular marketplace.

You can find the Hawaii Monopolistic State Fund bill here >   HB 2715 .  It is a .PDF file.   It may be worth downloading to follow along with my analysis or to read on your own.   The first part of the bill is original.   The second part amends older legislation.

My curiosity overcame me and yes, I had to read this complete bill.   Some of the more interesting passages from the bill are:  (my comments are in italics)

Page 1 Line 12 – The workers’ compensation law includes certain statutory  presumptions that place on the employer the burden of producing substantial evidence to the contrary to rebut a claim for a covered work injury. Despite this presumption, recommended medical treatment or vocational rehabilitation plans are delayed or arbitrarily and capriciously denied; approved services provided by medical or other healthcare professionals go unpaid; and there is a reluctance to accept workers’
compensation cases for fear of being denied reimbursements, all of which contribute to a dysfunctional health care system that cannot rehabilitate the injured worker.

Woman Pulling Hawaii Monopolistic State Fund A Giant Briefcase

StockUnlimited

A state fund is going to solve this concern or add to it? 

Page 7 Line 15 – An employer with two or more lost-time claims greater than $10,000, and a loss ratio greater than 1.0, over the immediately preceding three years shall be placed in the high
risk division.

That is not the definition of a high-risk employer.

Page 8  Line 16 The contingent liabilities of members provided in section 431:4-317 may be separated so that members assigned to the high risk division have a further contingent liability for deficits in the high risk division; provided that no contingent liability shall be in the aggregate for more than five times the annual premium rate of the member’s policy nor for a term of more than one year.

Does this mean a 500% addition to an employer’s premium?  Ouch – if I am reading that passage correctly.  

Interestingly enough,  the bill has been voted on twice.

©J&L Risk Management Inc Copyright Notice

Filed Under: Monopolistic State Funds Tagged With: aficionados, Hawaii, house bill 2715, rehabilitate, state fund

James J Moore To Conduct Insurance Academy Webinar February 25th

February 11, 2016 By JL Risk Management Consultants

Webinar – Destroy Your Competition Using Workers Comp Loss Runs

James J Moore, AIC, MBA, ChFC, ARM founder of J&L Insurance Consultants, J&L Risk Management Consultants, and Cutcompcosts.com will conduct  an Insurance Academy© Webinar on February 25, 2016 at 1:30 PM Eastern Time.   The link to sign up for the webinar is here.

Logo Of James J Moore J&L Risk Management ConsultantThe webinar titled – Destroy Your Competition Using Workers Comp Loss Runs is an hour long (including 10 minutes for questions) look at how claims loss runs can be viewed as a treasure trove of information that will put agents ahead of the competition in the area of devout customer service.

These techniques can be implemented whether the client is a first-dollar insured; large-deductible, self-insured, or other type of insurance program.

According to the presenter – “Workers Comp loss runs have long been ignored or briefly scanned for information.   Many areas of loss runs jump off the page to the trained eye. ”    Mr. Moore also commented “The webinar is not only for agents.  Claims adjusters, underwriters and most insurance personnel will find the webinar helpful in this oft ignored area.”

List James J Moore Vector

StockUnlimited

The general topics are:

  • Online vs. paper loss runs
  • Verifying the minutia
  • Status reports
  • Loss run timing
  • All-or-none reviews
  • Top 13 adjuster responsibilities
  • Claims reserving cycle
  • Authority levels
  • Number secrets – Elvis’s Gold Cadillac Conundrum
  • Stair-stepping
  • Under-reserved vs Over-reserved
  • Loss run example(s)
  • Three main cost areas
  • Time and expense billings
  • Fines
  • Rehabilitation and bill review charges
  • Team Approach

Loss run examples will be supplied to cover the aforementioned topics with specific examples. A claims veteran of 28 years with a working knowledge of adjusting in over 45 states will walk the participants through a process that can easily be followed long after the webinar.

According to Mr. Moore, “This webinar will be a great accompaniment to the upcoming team building strategies webinar in July 2016.”

©J&L Risk Management Inc Copyright Notice

Filed Under: James J Moore Tagged With: Elvis's Gold, minutia, oft ignored area, webinar

Answers To Workers Compensation Questions – Outside US

February 11, 2016 By JL Risk Management Consultants

Answers To Workers Compensation Questions

The answers to workers compensation questions below are from this Cutcompcosts article from last week.   The theme is Workers Compensation Outside the US.   Follow the link to the original article for the questions.  Thanks.   The pic has nothing to do with WC.   I just liked it. The pic is from a local animal rescue conservatory that I visit often- that is the famous Arthur the Tiger.

Picture Of White Tiger Workers Compensation Questions Arthur The Tiger

Wikimedia Commons – ConservatorsCenter:

  1. Yes, China does have a Workers Compensation system.  The system is a monopolistic system as it is administered by the central government.  It is similar to our Social Security Disability system.  The benefit calculations are more complicated than the US.   The treating medical system seems to have an element of corruption throughout.
  2. The coverage is called USL&H (United States Longshore and Harbor Workers Act)  There are a different set of rules for this coverage.  In fact, the US Department of Labor has a complete chapter (Chapter 18) devoted to this coverage.  The states cannot modify the Federal Act.  The states, however, may have their own maritime WC laws on a state level.  Interestingly, certain employees have the choice of filing under the State Act, Federal Act, or in California, under both. 

    Conference of Workers Compensation Questions Group of business people

    StockUnlimited

  3. The Jones Act is very important to claims adjusters, underwriters,  and agents.  Inland navigable waters can be a river, lake, or other bodies of water.  Some Workers Comp agreements and policies may exclude this coverage.  The Jones Act is federal legislation that protects American workers injured at sea.  There is much confusion over where. Also referred to as the Merchant Marine Act of 1920, this law allows qualifying sailors who have been involved in accidents or become sick while performing their duties to recover compensation from their employers.  Pursuant to the act, negligence claims can be brought when an injury results from the careless acts of an employer or coworker. Ship owners can also be liable if an accident is caused by the unsafe condition of their vessel. And no matter how or why a sailor was injured, certain medical and living expenses must be paid.
  4.  The Defense Base Act (DBA) is a different set of Workers Comp rules/laws for persons in any branch of the Armed Forces while on base and certain subcontractors.   As the DBA can be complicated follow this link to a Cutcompcosts article on the DBA.

    Small Man Workers Compensation Questions Standing On Big Hand

    StockUnlimited

  5. Employers do not necessarily have to buy Foreign Voluntary Workers Compensation coverage.  However, it may be a good idea and will lower your WC risk as an employee that is injured in a far off venue may have basic coverage provided by their home state.   There are many complexities to an international WC claim that are not foreseen by local WC rules.  A few years ago,  J&L assisted an employer that had an injured employee in an island country.  The claims process became very messy as there was no voluntary coverage.
  6. No, Workers Compensation actually started by ancient Sumerians.  They even had Permanent Partial Disability payments (PPD)!  These laws were found on ancient tablets.   This predates the Wisconsin WC systems by thousands of years!
  7. Does NCCI, WCIRB, and the other rate bureaus have special rates for foreign workers or countries? Bonus – Google
  8. Do any countries provide 24-hour healthcare including WC for their citizens? Bonus – Google

On the last two answers to workers compensation questions, those I have left for you to explore.  Google them and analyze the results.   If you still cannot find the answers, drop me a note to [email protected]

I was going to finish the last two.  The article is longer than the concise articles I like to write in this blog.

©J&L Risk Management Inc Copyright Notice

Filed Under: China, Defense Base Act, Jones Act, USL&H Tagged With: conservatory, far off venue, maritime, navigable, sailors, Sumerians

Workers Comp Articles – Outside of US

February 5, 2016 By JL Risk Management Consultants

Workers Comp Articles

The 1,530+ workers comp articles on Cutcompcosts cover some of the topics outside the US.  I will try to cover more of those in the upcoming weeks.

Globe Workers Comp Articles Graphic

StockUnlimited

The last workers comp questions and answers were very popular.  Below are questions that pertain to WC outside of the US, so to speak.   The links are provided to links in the blog and to external sources.

  1. Does China have a WC system?   Are the benefits similar to the US? Would it be considered a monopolistic system?
  2. What is the WC coverage called if you are on navigable waters outside of or in the US?  Is there a different set of rules for this coverage?   Does each state have their own rules for this type of coverage?
  3. What is the Jones Act?  What type of injuries/locations does it cover? Why is it so important for adjusters and agents to understand this Act?
  4. Is there a set of WC laws/rules for men/women in the Armed Forces while on base? What is it called?  What is the main difference between regular WC and this coverage?
  5. If you have employees who travel internationally, do you have to buy international WC?
  6. Did WC actually start in the US? If not, then where and when?

    Woman Using Laptop Workers Comp Articles On Table

    Wikimedia Commons – Brian Kerrigan

  7. Does NCCI, WCIRB, and the other rate bureaus have special rates for foreign workers or countries?
  8. Do any countries provide 24-hour healthcare including WC for their citizens?

The answers are going to be entered into the next article on Monday or Tuesday of next week.   Most of the answers are in the Workers comp articles on this blog.   The last two will be more difficult as there are no links supplied to the answers.

Please think of the test as having 16 questions  instead of eight.   Good luck and remember to use Google searches if you cannot find the answers on this blog.

Hint:   Question #6  was answered in the Q&A from earlier this week.

©J&L Risk Management Inc Copyright Notice

Filed Under: Defense Base Act, USL&H Tagged With: Armed Forces, DBA, navigable waters, no links supplied

Work Comp Answers – See Article From Yesterday

February 4, 2016 By JL Risk Management Consultants

The Work Comp Answers

The Work Comp answers to yesterday’s cutcompcosts.com article are as follows – if you have not read the previous article, it is advisable to do so as this article may not make sense as a standalone.  Links are provided to the associated articles

Concept of Work Comp Answers Q&A on Street Sign

123RF

  1.  What is workers comp called in Australia? – Compo
  2. Where did WC originate – think a long time ago and not in the US – Ancient Sumeria
  3. The best Workers Comp risk management technique is ____?   Can be more than one answer.    Properly managed field case managers/nurses is the one that I recommend overall.   A trusted industrial-minded initial treating physician is another.
  4. Who is always viewed as an impartial witness on WC claims? The treating physician
  5. How many states allow carrier reimbursement for medical marijuana?   Which state(s)?   One – New Mexico
  6. What is a PEO and define the term.  Professional Employment Organization
  7. What is the designation ChFC and the ARM-P?  Chartered Financial Consultant,  Associates in Risk Management- Public.   I have attained my ChFC and ARM, but not the ARM-P.    I may have to add the -P  some day soon.

    Finger Pointing Work Comp Answers Calling Icon

    StockUnlimited

  8. The normal waiting period for WC benefits is  _______?   Trick question?   There is no waiting period for medical benefits.  I did not say specifically indemnity benefits.
  9. What disease/injury has fallen over 50% due to WC safety measures?  Amazing.   Carpal Tunnel Syndrome (CTS) – and what a disabling injury this can become over time.
  10. The best thing to do to prepare for a Workers Comp audit is ________?   Be as organized as possible.
  11. Bonus – The first article on this blog is dated? ________
  12. Self-serving Super Bonus – What services do we provide as a company?

I did not provide the Work Comp answers for the last two as they were bonus questions.

©J&L Risk Management Inc Copyright Notice

 

 

Filed Under: ChFC Tagged With: Ancient Sumeria, ARM-P, Chartered, standalone

Work Comp Questions Top 10 Most Misunderstood Potpourri

February 3, 2016 By JL Risk Management Consultants

Top 10 Work Comp Questions From Our Readers

The top 10 work comp questions originate from the emails and calls we receive every month.   The answers to these are actually in this blog.    Answer them – then search for the bolded terms.   You never know, you may know the answers to all 10 or you may learn something about WC.

Picture Of Man Work Comp Questions Holding Question Mark

(c) StockUnlimited

These are 10 points each.   If you answer them in the comments, I will let you know if you answer all of them correctly.  You can email the answers.   You can also stay under the radar and just answer them on your own.

  1.  What is workers comp called in Australia?
  2. Where did WC originate – think a long time ago and not in the US
  3. The best Workers Comp risk management technique is ____?   Can be more than one answer.
  4. Who is always viewed as an impartial witness on WC claims?
  5. How many states allow carrier reimbursement for medical marijuana?   Which state(s)?
  6. What is a PEO and define the term.

    Call Center Woman Work Comp Questions Using Computer

    Wikimedia Commons – MÁV Zrt.

  7. What is the designation ChFC and the ARM-P?
  8. The normal waiting period for WC benefits is  _______?   Trick question?
  9. What disease/injury has fallen over 50% due to WC safety measures?  Amazing.
  10. The best thing to do to prepare for a Workers Comp audit is ________?
  11. Bonus – The first article on this blog is dated? ________
  12. Self-serving Super Bonus – What services do we provide as a company?

Feel free to answer these and post to the comments or just keep them to yourself and see if your answers are correct. Thanks.

The bonus question #11 adds on an extra 10 points.

The bonus question #12 adds 50 points- even more self-serving.

I wish you good luck in answering the Top 10 Work Comp questions and the two bonus questions.

©J&L Risk Management Inc Copyright Notice

Filed Under: Premium audit Tagged With: ARM-P, impartial, top 10

Email Subscription

Search this website:

Work Comp Premium Audit Work Comp Mod Expert work comp expert witnessWork Comp Expert ReservesWork Comp Claim File Audit ExpertWork Comp Expert Witness

About Me

My Photo

James J Moore
Raleigh, NC, United States

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:
• Risk and Insurance Management Society (RIMS)
• Entrepreneur Magazine
• Bloomberg Business News
• WorkCompCentral.com
• Claims Magazine
• Risk & Insurance Magazine
• Insurance Journal
• Workers Compensation.com
• LinkedIn, Twitter, Facebook and other social media sites
• Various trade publications

 

Archives

  • March 2021
  • February 2021
  • January 2021
  • December 2020
  • November 2020
  • October 2020
  • September 2020
  • August 2020
  • July 2020
  • June 2020
  • May 2020
  • April 2020
  • March 2020
  • February 2020
  • January 2020
  • December 2019
  • November 2019
  • October 2019
  • September 2019
  • August 2019
  • July 2019
  • June 2019
  • May 2019
  • April 2019
  • March 2019
  • February 2019
  • January 2019
  • December 2018
  • November 2018
  • October 2018
  • September 2018
  • August 2018
  • July 2018
  • June 2018
  • May 2018
  • April 2018
  • March 2018
  • February 2018
  • January 2018
  • December 2017
  • November 2017
  • October 2017
  • September 2017
  • August 2017
  • July 2017
  • June 2017
  • May 2017
  • April 2017
  • March 2017
  • February 2017
  • January 2017
  • December 2016
  • November 2016
  • October 2016
  • September 2016
  • August 2016
  • July 2016
  • June 2016
  • May 2016
  • April 2016
  • March 2016
  • February 2016
  • January 2016
  • December 2015
  • November 2015
  • October 2015
  • September 2015
  • August 2015
  • July 2015
  • June 2015
  • May 2015
  • April 2015
  • March 2015
  • February 2015
  • January 2015
  • December 2014
  • November 2014
  • October 2014
  • September 2014
  • August 2014
  • July 2014
  • June 2014
  • May 2014
  • April 2014
  • March 2014
  • February 2014
  • January 2014
  • December 2013
  • November 2013
  • October 2013
  • September 2013
  • August 2013
  • July 2013
  • June 2013
  • May 2013
  • April 2013
  • March 2013
  • February 2013
  • January 2013
  • December 2012
  • November 2012
  • October 2012
  • September 2012
  • August 2012
  • July 2012
  • June 2012
  • May 2012
  • April 2012
  • March 2012
  • February 2012
  • January 2012
  • December 2011
  • November 2011
  • October 2011
  • September 2011
  • August 2011
  • July 2011
  • June 2011
  • May 2011
  • April 2011
  • March 2011
  • February 2011
  • January 2011
  • December 2010
  • November 2010
  • October 2010
  • September 2010
  • August 2010
  • July 2010
  • June 2010
  • May 2010
  • April 2010
  • March 2010
  • February 2010
  • January 2010
  • December 2009
  • November 2009
  • October 2009
  • September 2009
  • August 2009
  • July 2009
  • June 2009
  • May 2009
  • April 2009
  • March 2009
  • February 2009
  • January 2009
  • December 2008
  • November 2008
  • October 2008
  • September 2008
  • August 2008
  • July 2008
  • June 2008
  • May 2008
  • April 2008
  • March 2008
  • February 2008
  • January 2008
  • December 2007
  • November 2007
  • October 2007
  • September 2007
  • August 2007
  • March 2007
  • February 2007

Recent Posts

  • Home Ergonomics Advice Reduces Workers Comp Costs
  • Workers Comp Predictive Analytics Changed Loss Run Reviews Forever
  • Workers Comp COVID-19 Vaccinations – Part of Return To Work
  • Workers Comp Test Audits – Pain or Preventative Measure
  • WCIRB 8871 Webinar – What California Insureds Need To Know
  • Workers Comp Website – 10 Things To Know When Switching Providers
  • Workers Comp Zoom Presentation – Top Four Hard Lessons Learned
  • Experience Mod Increases While Loss Runs Show No Changes – WTR?
  • Workers Comp Allocated Expenses – Who Pays For Which Bills?
  • Workers Compensation Presentations Kawasaki Technique
J&L Risk Management Consultants Inc
14460 Falls of Neuse Road,
Suite 149305
Raleigh, NC 27614
(800) 813-1386
▲Return to top of page
Copyright © 2021 J&L Risk Management Consultants, Inc.

Website Design by Redwood [ Design - Print - Web ]