Workers Compensation fraud is a widespread and serious problem that’s not only illegal, but leads to higher insurance premiums for all businesses – including yours.
According to industry experts, Comp-related scams often involve one or more of these “red flags.” Although no one sign should necessarily be cause for alarm by itself, two or more should raise suspicions and could trigger an investigation of the claim:
- Monday morning report of injury. The alleged injury occurs first thing on Monday, or late Friday afternoon, but is not reported until Monday.
- Change in employment status. The reported accident occurs immediately before or after a strike, job termination, layoff, end of a major project, or the conclusion of seasonal work.
- Suspicious providers. The claimant’s medical provider or legal consultant has a history of handling dubious claims.
- Lack of witnesses. No one else saw the accident and the employee’s description does not support the cause of the injury.
- Conflicting descriptions. The employee’s account of the accident doesn’t match with the medical history or injury report.
- History of claims. The employee has filed a number of questionable or litigated claims.
- Refusal of treatment. The claimant declines a diagnostic procedure to confirm the nature or extent of the injury.
- Late reporting. The employee delays reporting the incident without a reasonable explanation.
- Elusiveness. The allegedly disabled employee is hard to reach.
- Instability. The claimant changes physicians, addresses, or jobs frequently
If one of your workers files a claim that has some of these warning signs, be sure to let us know. We’ll work with you and your Workers Comp carrier to check it out.
The chances are that your company relies heavily on one or two people – such as a partner, operations manager, or foreperson – whose knowledge, expertise, or overall contributions are essential. If death put this person out of the picture, where would you find the financial resources to keep you up and running?
The answer: a Key Person Life Insurance policy under which your company receives all or most of the proceeds. This term can also apply to other coverages used for business continuation purposes, including: 1) Buy-Sell or Shareholder Insurance, to reimburse partners or investors; 2) Debt Protection; and 3) Revenue Protection. You can use the funds to replace lost income due to the unavailability of the key person and to recruit, develop, and train a replacement.
The policy’s cash value might be available to your business through a withdrawal or loan, if needed. You can also split the premium and death benefit between the firm and the spouse or partner of the key person to ensure that she or he receives replacement for the person’s economic value to the family (However, these premiums are not tax deductible).
What’s more, Key Person coverage provides a financial asset that enhances the creditworthiness of your company for commercial lending, by ensuring that the business will stay up and running if the key person is out of the picture.
The amount of coverage you need will vary – say, from $100,000 to $500,000 – taking into account what your budget allows versus how much the business would need to survive while you’re bringing a replacement up to speed.
As always, our agency stands ready to advise you at any time.
Chances are that you’d never buy a new truck or front-end loader without trying it out to make sure it could do the job. Do you do the same for the vehicle’s operators?
Safety experts recommend that any employee who will be driving a truck should receive a road test of his or her driving skills before being hired. The examiner should be fully qualified to operate the vehicle, and familiar with the prospective operator’s past experience. The test should include all the necessary skills:
- use of all controls; traffic operations (including backing, parking, slowing, stopping, passing, and turning)
- general driving habits, such as alertness, stamina, and patience
- driving rules and regulations pertaining to the vehicle
- handling the necessary actions/equipment for loading and unloading the vehicle
For each skill or knowledge area, the applicant should receive a pass/fail grade. Each area of weakness should lead to further training or a corresponding limitation in the scope of the operator’s approved activities. Keep records and scores of these tests as documentation in the event of an accident or claim resulting from a driver’s actions.
For more suggestions on the format or content of driver exams, contact your trade association, state department of motor vehicles. Don’t forget the benefits of a solid driver training and testing program in keeping your Commercial Auto insurance rates under control.
Your drivers are taking your vehicles and your insurance coverage on the road every time they get behind the wheel. Wouldn’t it be a good idea to make sure that they’re capable of protecting both?
For more information, feel free to get in touch with or one of our agency’s risk management professionals.
You want your disaster plan, also known as a “business continuity” plan, to be complete, accurate, functional, up to date, and able to meet your recovery objectives. To ensure that you meet these goals, there’s no better way than a “live test.”
You can create buy-in among managers and staff by providing a test scenario that’s specific, realistic, detailed, and comprehensive.
Consider this real-world example: A television communication company in Miami was completing its disaster plan when it learned that a powerful hurricane was headed straight toward Southeastern Florida. Fortunately, because the business had several days’ warning, it was able to implement the plan rapidly and communicate it to employees. Although the company was prepared for the worst, the storm struck to the south and west, near Key West.
Although there was no significant damage in the Miami area, the exercise tested important components of the plan, such as the ability of the business to:
- protect equipment and strengthen the building in a timely and orderly manner
- activate and maintain an alternate transmission site
- test backup electrical generation and other equipment under adverse weather conditions
- communicate emergency technical instructions to affiliate stations throughout the Spanish and Portuguese speaking world
- sponsor a shelter for emergency storm personnel
- release and recall staff in an orderly basis
A post-disaster meeting led to a number of refinements in the plan. Most important, the exercise confirmed the ability of the company to maintain important business activities at a pre-established acceptable level, with minimal impact to its customers and revenue stream.
If you’d like advice on testing your company’s business continuity plan before disaster strikes, just give us a call.
You need Employment Practices Liability insurance (EPLI) to protect you from lawsuits filed (justly or unjustly) by anyone who you employ, have employed, or even considered employing.
Before you buy this essential coverage, be sure to ask these questions:
- Who is insured? This should include the company as an entity, along with officers, directors, and every type of employee (full-time, part-time, temp, leased, loaned and seasonal). The importance of this becomes clear if you’re ever sued for a sexist slur made by temporary receptionist to a job applicant.
- What claims does the policy cover? You want coverage for every eventuality: monetary damages, all types of legal proceeding from criminal to regulatory, settlements, judgments, lost pay, defense fees and punitive damages.
- How does the policy define “wrongful employment practices” beyond the obvious (sexual harassment and racial discrimination)? Make sure that you have coverage for violations of federal, state, local and common law on employment discrimination;, deprivation of career opportunities; defamation; retaliation, negligent job evaluation, and failure to have an acceptable written employment policy.
- What does the policy exclude? EPLI should include wrongful practices that might have taken place before you bought coverage – so you don’t have to worry about a suit by that disgruntled vice president you fired three years ago for pilfering paperclips.
A word to the wise: use EPLI as a last line of defense. Risk management for your business should include diversity and sensitivity training. The U. S. Equal Employment Opportunity Commission offers a wealth of free training resources, guides, compliance information, and links to free training throughout the nation.
As always, we stand ready to offer you our professional advice, free of charge.
Nearly six million traffic accidents occur in the U.S. every year – more than 16,000 a day (or one every 10 seconds).
If your company owns, operates, or uses motor vehicles – or if you have employees who use their cars for business purposes – you need Commercial Auto Insurance to provide financial protection against losses from mishaps that occur behind the wheel.
This valuable policy provides these coverages:
- Bodily Injury Liability pays the cost of bodily injury to others from accidents for which you are responsible. If you’re sued, it also pays your defense and court costs.
- Property Damage Liability picks up the tab for property damage to others for which you are responsible, as well as defense and court expenses.
- Personal Injury/Medical Payments usually covers medical and funeral expenses for bodily injury from an accident that involves an insured vehicle.
- Collision pays for a covered vehicle that is damaged by a collision with another vehicle or object.
- Comprehensive Coverage pays for a covered auto that is stolen or that is damaged by causes other than collision or reckless driving.
- Uninsured/Underinsured Motorists covers injuries and, in some cases, property damage, when you’re involved in an accident with another person who either doesn’t have Auto Insurance or carry enough coverage.
Before you purchase or renew your Commercial Auto Insurance ask yourself these questions: 1) how much Liability Coverage you should buy, and 2) how large of a deductible should you choose?
We’d be happy to help you choose the most cost effective policy for your needs. Just give us a call.
The more heavily your business relies on electronic technology, the greater your vulnerability to cyber criminals.
Criminal activity conducted through the Internet impacts businesses of all sizes. One study found that companies with 100 or fewer employees accounted for 72% of data breaches worldwide.
Today’s cybercrimes put your grandmothers’ spam email list to shame. According to a nationwide study by Ponemon Institute, the median annual cost of cybercrime for a large company in 2011 came to $5.9 million.
Cybercrime covers a variety of activities, from malicious codes and hacks in which private client or company information is made public or stolen, to disruption of normal operations. Perpetrators include rogue employees, “hacktivists” seeking to make a political statement, or third parties seeking financial gain.
Businesses, such as coffee shops, that allow customers on their premises to use Wi-Fi face unique risks. In one case, a Hollywood producer sued the owner of a restaurant offering Wi-Fi access after a customer used the network to download a film for bootlegging.
To help protect your business against potential losses from cybercrime, here are some recommendations:
- Review your specific exposures. For example, if you allow people outside the company to use your WiFi, this can increase your exposure.
- Focus on the human element in data security by offering employees effective training and specific guidelines.
- Re-evaluate your guidelines frequently.
- Evaluate the potential risks of adopting new technology.
Last, but not least, make sure that you carry adequate Cyber Liability Insurance.
Our agency would be happy to tailor cost-effective coverage to your needs, and help you develop and implement a comprehensive program for managing your exposure to cybercrime.
In the California case, Richie v. AutoNation, an employee out on CFRA (FMLA) was fired by his employer when he was found to have been working at a restaurant he owned during his leave period. The company’s leave policy prohibited outside employment during leave. The court ruled in favor of the plaintiff, stating that FMLA/CFRA (the California equivalent) has a process to follow in shortening FMLA leave if you believe that an employee no longer qualifies for it. You cannot create your own rule or process and, in a sense, do an end run around FMLA protections. The court ruled that because job reinstatement is mandatory, the only way to stop leave properly is by following the CFRA process and questioning the medical opinion of the employee’s doctor.
This decision reminds us that ignorance of legal requirements is no excuse. In this case, the company argued that it had a good faith defense because it was not aware of this limitation on managing leave. The court essentially said “So what? It’s a mandatory statutory obligation, which you can’t avoid.” As a different court stated, “A showing that an employee is unable to work in the employee’s current job due to a serious health condition is enough to demonstrate incapacity. The fact that an employee is working for a second employer does not mean that he or she is not incapacitated from working in his or her current job.”
Some additional notes:
- The decision reminds us that an employer’s policy on secondary employment during FMLA leave must be the same as that for employees who are not on FMLA leave. Otherwise, the policy itself violates the law.
- Second, the court overturned an arbitration decision in this case which allowed the court’s good faith defense. Although review of arbitration is very limited, the court will step in if the arbitrator misapplied the law.
- Finally, whether it’s FMLA leave, ADA accommodation leave, use of PTO or sick pay, etc., if you doubt the veracity of any employee’s story (i.e. they were playing soccer or lifting pianos this weekend), you must follow the proper procedures so that you don’t find yourself trapped like AutoNation did in this case.
Your workplace is sacred. It’s where you do business, sure, but it’s also where you forge important relationships, where you find your purpose in the world, and where you communicate to others how much they mean to you. Use fall as an opportunity to keep that workplace functioning at a high level with this mini-guide.
1. Check the Roof
Protect your office by keeping your roof sound. Call in a professional to check for problem spots, and advise on maintenance or repairs before winter sets in.
2. Clean Out Communal Spaces
You’ve heard of spring cleaning? Fall cleaning is a good idea too. Before holiday decorations and treats start rolling in, do a thorough sweep of common areas. Remove trash, old decorations and food, and wipe down surfaces. Refresh candles and plants for a clean, healthy vibe.
3. Pick Up Hazards
Pick up equipment and branches from walkways and parking lots before they get disguised by snow and become real hazards.
4. Tune Up the Furnace
Don’t chance a winter burnout. Instead, maintain your furnace ahead of time so you’ll be toasty warm all the way until spring.
5. Check Your Insurance
Your insurance only helps you if it fully covers you in case of emergency. If you’ve recently upgraded your premises, done renovations, added vehicles or otherwise improved your business (i.e. made it worth more), you need your insurance to reflect that. Talk to an agent today.
6. Lay in Emergency Supplies
A radio, space blankets, food, candles and flashlights are all good supplies to have on hand in case of power outage or storm.
7. Stock Up On Shovels
Okay, so you don’t need a whole army of shovels … just enough to efficiently clear off walkways and create paths to the parking lot in the case of a freak snowstorm.
8. Put Plants to Bed
Your landscaping appreciates a turndown. Prune perennials, scatter mulch and give the lawn a final mow before locking up your yard tools for the season.
9. Turn Off Outdoor Faucets
Nobody wants to greet spring with a busted water main. Turn off outdoor faucets so pipes don’t freeze and crack or burst.
10. Say Hi to Clients and Customers
Fall is a great time to connect with clients and customers, especially if you sell products or services that relate to the holidays. Say hi and stay on their radars!
Nothing keeps business humming along and employees happy like a healthy workplace. When people can count on coming to work and staying safe, being covered by great insurance, and having the best chance of fighting off the nasty bugs of the season, your work will blossom. Here are five ways to help make that happen.
1. Encourage People to Get a Flu Shot
When the flu starts going around, it tends to knock a lot of people down all at once. You can help minimize this by encouraging people to get their flu shot. Sometimes you can even have a medical professional in to deliver shots to anyone that wants them, in which case you should model getting one yourself. Some people have strong opinions about the efficacy of the flu shot, however, so don’t be overbearing.
2. Enroll Everyone on Time
Health insurance usually renews every year, and that renewal is preceded by an open enrollment period in the fall. This isn’t the case for all policies, but for most. Whether you’re responsible for enrolling everyone, or you allow employees to pick the plans that suit them best, make sure that everyone knows enrollment is happening and you meet all necessary deadlines.
3. Remove Hazards from Yards and Roads
Pick up fallen branches, put equipment away and rake up slimy leaves and grass trimmings before snow falls. Otherwise, walkways and lots become hazardous precursors to workers’ compensation claims. That’s not what you want, is it?
4. Have Emergency Supplies on Hand
Food, space blankets, candles and a radio are all crucial additions to your emergency kit. Take safety seriously!
5. Prepare for Inclement Weather
Maryland doesn’t have the worst winters around, but neither does it have the easiest. Chances are good we’re going to get considerable rain and at least some snow, as well as ice and sleet. It’s a good idea to have a snow shovel and de-icing agent on hand just in case you get hit with a big storm while at work, and need to clear a path for people to get home.
Your workplace is about more than simply making money and padding out your bottom line; it’s about protecting the people that matter to you. You can do a better job of that if you follow the above health tips. So good luck, and get going!