Fit for Duty
When evaluating Teddy Award applicants, one of the qualities judges look for is a program that’s built to last, with a commitment to continuous improvement.
So it’s no surprise that Miami-Dade County Public Schools (M-DCPS), a 2013 Teddy Award winner, is still aggressively pursuing strategies to reduce its injury frequency, claims costs, medical costs and lost time.
Case in point: Through regular reviews of claims data, M-DCPS identified a significant volume of claims where comorbidities were compromising the recovery of injured workers, and negatively impacting the severity of claims.
A wellness-focused injury recovery program called Rebuilding Me had been in place since 2007, but it was not having the desired impact on recovery outcomes. Rather than scrap the program, though, M-DCPS wanted to revive it.
The Rebuilding Me program focused on the Transportation department, which had the highest concentration of employees with comorbid conditions such as obesity, diabetes and hypertension.
“We finally thought — we need to take this to a different level,” said Rosa Royo, supervisor, workers’ compensation for M-DCPS. “This isn’t really doing what we want it to, and we need to put some money into it.”
Together with partners Gallagher Bassett and Coventry, M-DCPS rebranded and re-energized Rebuilding Me, what Royo calls a “targeted loss prevention program.” The pilot for the relaunch focused on the Transportation department, which had the highest concentration of employees with comorbid conditions such as obesity, diabetes and hypertension.
“They have range of motion issues, they have strength issues, weight is a real problem,” said Royo, noting that 87 percent of the department is overweight or obese.
An angioscreening of 650 employees revealed that only 98 had blood pressure within the normal range, while 250 tested abnormal and the other 302 registered as morbidly high. The comorbid conditions were taking a toll on claims cost and duration.
Even for something as minor as an employee whacking a knee against a steering wheel, said Royo, “You’re taking someone who’s very heavy and you’re immobilizing the joint. So maybe now you have a pulmonary embolism. You go from what would have been a $500 claim and now it’s a half a million dollar claim.”
Clamoring for More
Rebuilding Me includes the use of dedicated nurses to conduct one-on-one sessions with injured workers who are at increased risk for lost time based upon their health and wellness conditions.
It also features fitness classes, nutritional education and ergonomic awareness activities. The core Rebuilding Me team — comprised of Royo, Naomi Kuker of Gallagher Bassett, and Caroline Sauve of Coventry — is present at all events.
Strength and range of motion are key targets for the program. Royo related a story about an employee who showed up for a class and did an entire workout while clinging to a pillar. A short while later, she approached Royo and said, “Look I can raise my leg now.”
“That’s exactly what the program is for,” said Royo. “If you happen to lose weight, great. But it’s that range of motion and strengthening and those kinds of issues that we were really trying to address.”
“We’re spending $100,000 a year on this. But that wouldn’t even pay for one shoulder repair.” — Rosa Royo, supervisor, workers’ compensation, Miami-Dade County Public Schools
The response has been gratifying, said Royo. The initial pilot was conducted one day a week at the North East transportation depot. But soon, she said, “I had people chasing me in the parking lot saying, ‘You need to come more!’ ” It now runs three days a week with two trainers, and they have maxed out their available space and are seeking space for expansion.
M-DCPS has a solid program running now in five of its eight bus yards, with a sixth launching in January. At another location where lack of space has been a challenge so far, the workers’ labor union is clamoring for the program to be put in place.
The unions, in fact, wholeheartedly support Rebuilding Me, especially now that new U.S. Department of Transportation rules on medical fitness for duty could disqualify workers with significant health risks.
“Some of their members were at peril for losing their jobs,” said Royo. “This is a way for us as an employer to say, ‘We don’t want to throw you away. We don’t want to fire you. Here’s an opportunity for us to help you with this.’ ”
Well Worth the Cost
Because Rebuilding Me is a voluntary program, Royo and her team look for creative incentives to get people through the door initially, including lots of small branded swag items like sunglasses and lip balms.
But once an employee has committed to the program, the incentives ramp up. Employees get a towel after completing their first workout, and a T-shirt after the fifth. By the time they reach their 75th workout, they’re rewarded with a hybrid bicycle worth more than $400.
“Our offices look really funny right now, because we’ve got stacks of scales and Fitbits and bicycles.”
That may make it sound like an expensive program to pull off, but Royo is quick to put the cost in perspective.
“We’re spending $100,000 a year on this,” she said. “But that wouldn’t even pay for one shoulder repair.”
The team is highly invested in the program’s success. They work to ramp up excitement within the Transportation centers, and created an online social media presence as well, through Instagram (@rebuildingmemdcps). The Instagram feed includes photos of events and classes, nutrition and fitness tips, recipes and motivational messages.
Royo hopes to build on the program’s success and popularity and keep it growing in order to maximize the impact.
“The hypertension issues, the weight issues, the musculoskeletal issues … I know this program can’t address all of these things as much as we’d like, but the better the penetration, the better the outcomes we’re going to have,” she said.
“We always try to do something that is innovative in our program, and I really think that this is special.” &
Read more about the 2016 Teddy Award winners:
Bringing Focus to Broad Challenges: Target brings home a 2016 Teddy Award for serving as an advocate for its workers, pre- and post-injury, across each of its many operations.
The Road to Success: Accountability and collaboration turned Hampton Roads Transit’s legacy workers’ compensation program into a triumph.
Improve the Well-Being of Every Life: Excela Health changed the way it treated injuries and took a proactive approach to safety, drastically reducing workers’ comp claims and costs.
The Family That’s Safe Together: An unwavering commitment to zero lost time is just one way that Harder Mechanical Contractors protects the lives and livelihoods of its workers.
More coverage of the 2016 Teddy Awards:
Recognizing Excellence: The judges of the 2016 Teddy Awards reflect on what they learned, and on the value of awards programs in the workers’ comp space.
Fit for Duty: 2013 Teddy Award winner Miami-Dade County Public Schools is managing comorbid risk factors by getting employees excited about healthy living.
Saving Time and Money: Applying Lean Six Sigma to its workers’ comp processes earned Atlantic Health a Teddy Award Honorable Mention.
Caring for the Caregivers: Adventist Health Central Valley Network is achieving stellar results by targeting its toughest challenges.
Advocating for Injured Workers: By helping employees navigate through the workers’ comp system, Cottage Health decreased lost work days by 80 percent.
A Matter of Trust: St. Luke’s workers’ comp program is built upon relationships and a commitment to care for those who care for patients.
Keeping the Results Flowing: R&I recognizes the Metropolitan Water Reclamation District of Greater Chicago for a commonsense approach that’s netting continuous improvement.
Withstanding the Storm
The impact of a hurricane or severe windstorm can be devastating.
The risk of damage to your property is even greater if you’re in a hurricane-prone state like Florida, as in the case of Miami-Dade County Public Schools (M-DCPS).
Between 2004 and 2014, M-DCPS, which owns $10 billion worth of property, received more than $30 million in assistance from the Federal Emergency Management Agency (FEMA) for damage caused by windstorms or hurricanes.
But last year, FEMA published new guidance that essentially reduced funding for properties that had received assistance in the past. If damage was caused by the same peril, FEMA would reduce its assistance by the amount required for the previous disaster, regardless of the deductible.
That’s where Scott Clark, the recently retired risk and benefits officer of M-CDPS, stepped in. To plug the gap, Clark drew up a three-year program with Swiss Re based on a parametric model of coverage.
The new “storm policy,” effective from May 1, provided a limit of $10 million per loss, with a three-year aggregate limit of $20 million. The policy is triggered by wind speeds in excess of 87.5 mph on a weighted basis.
M-DCPS is believed to be the only public entity in the U.S. that has purchased such coverage to address its FEMA shortfall.
This was in addition to a rolling three-year base windstorm property policy that provided a 10 percent to 15 percent no-claims bonus for every storm-free year, net of commissions.
“The problem was that at the time we didn’t have the ability to secure coverage for every property, and we were already spending $25 million to $30 million on property insurance as it was,” said Clark, who is a former Risk and Insurance Management Society president and director.
“So we started looking at the alternatives and that is where we brought in Swiss Re. They came up with a solution that would monitor wind speeds across all of the ZIP codes that our properties were in.
“Provided there was a sustained wind speed of 87.5mph in that area and we could provide out of pocket expenses, the policy would be triggered and pay out $10 million per loss.”
“The problem was that at the time we didn’t have the ability to secure coverage for every property, and we were already spending $25 million to $30 million on property insurance as it was.” — Scott Clark, recently retired risk and benefits officer, Miami-Dade County Public Schools
He added: “Over the last years, since there have been no significant windstorms, year after year we have made savings of 10 percent to 15 percent in the property marketplace through the no-claims bonus.
“On top of that, we have seen a 10 percent to 12 percent increase in the total insurable value of our properties, translating into an overall saving of 20 percent every year.”
“Scott is one of those amazing people who can jump from topic to topic,” said Kathy Silver, vice president at Insurance Consultants. “One minute he can discuss a complex health insurance problem, then walk into a property insurance meeting and not miss a beat. He consistently challenged himself and the people he worked with to consider new solutions and ideas.” &
From Drones to Defects: Planning for Construction’s Top Challenges
The construction industry is firing on all cylinders. New projects spring up every day, but not all go according to plan.
Three out of every four construction projects fail to finish on time. Every party involved – owners, designers, contractors and subcontractors – expects perfection, with the final product delivered on schedule and on budget. Those expectations leave little room for uncertainty, so even a small hiccup can have ripple effects that disrupt a project for everyone.
“There’s often a big disconnect on the front end of project planning,” said Doug Cauti, Senior Vice President, National Insurance, Chief Underwriting Officer, Construction, Liberty Mutual.
Proactive risk mitigation is also important to manage emerging challenges facing the construction industry ‒ drone regulations are evolving, commercial auto losses are rising, and so is uncertainty about which party might be held responsible for a construction defect. Without the proper planning, these issues can easily be overlooked and result in major losses and project disruption.
Liberty Mutual’s Doug Cauti discusses key challenges facing the construction market.
“Key risk management strategies have to be aligned among all parties from the beginning to minimize these uncertainties.”
Before construction begins, there are actions that project owners, designers and contractors can take to address these challenges and better protect their projects and businesses:
Drones can be useful tools on construction sites, providing an extra set of “eyes” for large commercial projects or tall buildings. They provide a real time aerial glimpse of works in progress, giving supervisors an added perspective to spot potential flaws, assess safety hazards, and check on workers. But many challenges remain in the safe — and legal — operation of drones.
Liberty Mutual’s interactive infographic highlights risks related to managing drones at construction sites, and also includes a pre-planning drone use guide and a pre-flight checklist that includes making sure to review the latest drone regulations.
How construction buyers can manage the insurance implications of using drones in their operations.
General contractors and project owners need to stay up to speed on FAA regulations, which changed in August, 2016.
“For one thing, operators need to have the drone in sight at all times,” Cauti said.
“And you need to make sure any operators are appropriately licensed and trained, that the drones are regularly maintained, and that the machines don’t impede on others’ safety and privacy.”
Clear flight paths and work zone boundaries can minimize the risk of a drone striking another property, or worse, a person. Operators should also know how to conduct an emergency landing if the drone suddenly loses power. It’s also important to consider how you are going to manage and use drone footage. Advertising liability can be a concern if third party images are captured and released. Know who is in charge of the data collected, who has access to it, and how you are going to protect it.
“If the contractor owns the drone, it takes on more liability. The contractor should review its insurance policies to make sure the coverage will respond to that risk,” Cauti said.
“As an insurance carrier, we may have a role to play in those proactive discussions. We are uniquely positioned to help project stakeholders see their risks and work to minimize them.”
— Doug Cauti, Senior Vice President, National Insurance, Chief Underwriting Officer, Construction, Liberty Mutual Insurance
Contractors and project owners can protect themselves through enhancements to their commercial general liability policies or through separate aviation policies, he said.
If a general contractor leases a drone through a third party, “they bear the responsibility of making sure the vendor is fully insured,” Cauti said. Vendors should have “non-owned” aviation coverage with limits suitable to handle the size of the risk.
Commercial auto losses challenge many business sectors, and construction is no exception.
More vehicles on the road and more miles driven, combined with fewer experienced commercial drivers, are driving up the frequency of accidents. On construction sites in particular, congestion created by closed roads, piles of materials and roving heavy machinery may lead to work zone accidents. Rising medical costs and repair and replacement costs of high-tech vehicles increase claim severity.
“I don’t see this trend reversing any time soon,” Cauti said.
Mitigating commercial auto losses begins with driver hiring practices.
“Pay attention to who you put behind the wheel,” Cauti said.
“Motor vehicle reports (MVRs) and driving history can alert employers to previous accidents or tickets. But there also needs to be regular communication with the drivers you do hire, and clear protocols in place that define expectations of how the job should be performed,” he added.
Ways construction buyers can manage rising commercial auto loss costs and better protect their fleets and employees.
Those protocols include requiring the use of seat belts, prohibiting cell phone use while behind the wheel, mandating scheduled breaks, outlining maintenance procedures, defining if company vehicles can be used for personal use, and establishing crash report procedures that delineate who to contact and what information to collect in the event of an accident.
Contractors can also monitor fleet performance through telematics systems. These on-board systems can track unsafe driving behaviors like hard braking, sharp turns, and speeding. But the data is only as good as the person analyzing it. Contractors and project owners should partner with an insurer who can use fleet telematics data effectively to pinpoint common causes of accidents and recommend specific risk mitigation strategies.
Liberty Mutual’s Managing Vital Driving Performance is one tool that leverages insureds existing telematics data to identify unsafe driving behaviors and accident patterns.
“Our risk control consultants can drill deeper into the data and interview drivers to identify patterns and find out the root causes of bad driving behaviors in the first place,” Cauti said.
For example, a post-accident interview with a driver could reveal that he had been skipping breaks and spending too many hours on the road, leading to fatigue and inattentive driving.
Identifying those connections enables consultants to make specific risk mitigation recommendations, such as adjusting drivers’ schedules and workloads to reduce overtime, or adjusting dispatch protocols so employers can ensure drivers aren’t working too many shifts in a short period of time.
Another uncertainty project owners, designers and contractors have to face is how insurance coverage will apply should a project end up in a dispute. “The struggle is around the definition of ‘faulty workmanship’ and who is responsible for the defect. Is it in the design or the build?” Cauti said.
“There can be a lot of finger pointing involved. This reinforces the need for contractors to have a systematic quality assurance (QA) program that adheres to best practices, and for every party to have a role in it.”
Elements of a QA program could include testing of construction materials, conducting regular walk-throughs and obtaining approvals from the owner at key phases, and final sign-off by the owner at the project’s completion.
How construction defects and the current legal climate are affecting projects.
Construction defect claims can affect a business’s reputation, profits, and ability to maintain insurance coverage. That’s why it’s so important to be vigilant about avoiding construction defects, whether you’re a designer, developer, owner or general contractor.
Ultimately, though, these risks should be addressed before ground is broken. Discussing these challenges and collaborating on loss prevention strategies up front reduces the likelihood that any “hiccups” will throw off project timelines or increase costs for the various stakeholders.
Pre-planning discussions also offer the opportunity for these parties to take advantage of carrier partners’ risk control services.
“As an insurance carrier, we may have a role to play in those proactive discussions,” Cauti said.
“We are uniquely positioned to help project stakeholders see their risks and work to minimize them.”
To learn more about Liberty Mutual’s solutions for the construction industry, visit https://business.libertymutualgroup.com/business-insurance/industries/construction-insurance-coverage.
 Managing Uncertainty and Expectations in Building Design and Construction SmartMarket Report
This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Liberty Mutual Insurance. The editorial staff of Risk & Insurance had no role in its preparation.