Crisis Management

Plan to Survive

Employers are still slow to take the necessary steps to ensure that their organizations are prepared for violence.
By: | January 25, 2016 • 11 min read
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You’re at your desk, engrossed in a report. From somewhere on the other side of the building, you hear a loud muffled noise. Furniture-moving mishap? Backfiring car? It barely registers in your mind until you hear it again.

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Then you hear screams. The icy grip of fear tightens your chest. There’s a shooter in the building.

Your vision blurs for a moment as you try to decide in that split second what to do next. Fifteen minutes from now, you will either be a survivor, or you will be a statistic.

Armed killing sprees have long been a troubling fact of life in the U.S. and elsewhere. As far back as August 1966, Charles Whitman opened fire from the clock tower of the University of Texas at Austin, killing 16 people and wounding 31.

The massacre shocked and horrified the world in 1966. But in 2016, our capacity for shock has been dulled by the increasing frequency of the type of violence we now commonly refer to as active shooter incidents.

In 2015, there were 330 incidents in the U.S. in which four or more people were shot or killed using firearms, resulting in 367 deaths and 1,317 injuries. Incidents at schools, universities and public spaces took up most of the media attention until December, when an employee of the Inland Regional Center in San Bernardino, Calif., left work and returned with his wife and a small arsenal of firearms. Fourteen people were killed, and 22 were wounded. Suddenly employers that gave workplace violence only a passing thought began asking “What if it had happened here?”

The question is long overdue. The FBI reports that 45 percent of active shooter incidents occur at places of business, making them the most common target for these attacks.

Be Proactive

There are multiple categories of active shooter or other workplace violence situations. The San Bernardino shooters are alleged to have had ties to terrorist factions, but acts of political terrorism in the workplace are rare. Acts perpetrated by unstable individuals are far more common, as are domestic violence incidents.

active shooter chartWithout question, there are situations where a target is chosen at random, and there is absolutely no way an employer could have seen it coming. But more often there are signs or signals along the way — red flags, both subtle and obvious, that were brushed off or even deliberately ignored out of a reluctance to create conflict. That is a mindset that desperately needs to change, say experts.

“Many of the incidents that we see could have been avoided because there were clear precursors,” said Sean Ahrens, Aon Global Risk Consulting’s Security Consulting practice leader. He adds that “incidents where there’s a straw that broke the camel’s back are happening more and more.”

The culture of silence happens for a variety of reasons. Coworkers don’t speak up for fear they’ll be branded as troublemakers. Employers worry they will be accused of defamation or discrimination if they take a hasty action against an employee.

In the well-intentioned quest to create a solid, documented case for taking action, sometimes employers wait too long. The results can be tragic.

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Experts agreed that risk managers must work to cultivate a “see something, say something” culture. To increase the chance of being able to identify a burgeoning threat, experts strongly advise employers to have a means in place for employees to report concerns anonymously.

Sean Ahrens, security consulting practice leader, Aon Global Risk Consulting

Sean Ahrens, security consulting practice leader, Aon Global Risk Consulting

“Employers should afford as many ways as possible to communicate this information,” said Ahrens. That could an online email form, an anonymous hotline, a third-party hotline, or whatever methods make the most sense for the organization.

From there, an internal threat assessment team can gather further intelligence and decide how to proceed or attempt to de-escalate the situation. Simply terminating an at-risk employee isn’t necessarily the smart play, and could actually make things worse. Crisis management experts can be a useful resource for employers working to avoid a misstep.

The Survival Plan

The bottom line for risk management is that there is no iron-clad means to eliminate the risk that your workplace will experience an active shooter event. Even the best preventative measures have to be backed up by a solid emergency plan paired with response protocols spelling out what needs to happen during an event.

Communication is the first line of defense. A clear warning can give everyone out of the line of fire a better chance of evacuating safely. The simplest method is using overhead audio such as a P.A. system.

“Don’t use codes, just plain English,” said Ahrens. Be straightforward: “There’s an aggressor in the building near the Northwest stairwell. We’ll provide updates when available. Evacuate now if you can, or shelter in place.” Then provide continuous updates, he said.

Other environments may require additional measures. A noisy manufacturing floor or warehouse, for example, may need to use a strobe light to alert workers to turn off machines so that they can hear the emergency message.

What happens after the warning is broadcast will likely make the difference between life or death, which is why failure to train employees is not a valid option.

Michelle Colosimo, director, Black Swan Solutions

Michelle Colosimo, director, Black Swan Solutions

“Yes, you have to call 911,” said Michelle Colosimo, director of Black Swan Solutions, “but look how quickly these events can [unfold]. You now need to leverage your own employees to make sure that they’re doing the right things to help keep themselves safe.”

In 2012, the City of Houston produced a 6-minute video called “Run. Hide. Fight.,” funded by the Department of Homeland Security. The video has become the standard training model endorsed by the FBI and DHS for teaching civilians how to protect themselves and others around them.

Other training models have gained traction, such as “Avoid, Deny, Defend,” but most have same underlying message at their core:

    * Escape if you can do so safely
    * If not, then get to a location that can be locked or barricaded, if possible
    * Fight back as a last resort, using any improvised weapon within reach

“You don’t have a means in place to be able to take down that gunman,” said Colosimo, “nor do you want to be encouraging employees to try to take down that

gunman. So what are you doing to help educate and train them? Because it’s really up to the employee to make the right decisions.”

Some risk managers may find upper management squeamish about the phrase “active shooter training,” because their perceptions have been shaped by stories in the news about unannounced active shooter drills that traumatized employees.

The goal of drills is not fear, it’s understanding, said Mike Payne, organizational resilience manager at iJET International.

“You want to walk everybody through and talk everybody through what the expectations are, where the decision points are, and how to effectively respond.”

Jay Hart, director, Force Training Institute

Jay Hart, director, Force Training Institute

“This kind of training is very easy to get wrong. It’s very easy for it to be fear-based,” said Jay Hart, director of Force Training Institute. “I’ve noticed that’s what a lot of executives struggle with.”

Those same misperceptions may tempt some to provide training without drills, but that strategy is ill-advised, experts said, because in an emergency, there’s no accounting for how people might respond without a frame of reference.

Most will revert to habit – perhaps attempting to exit the building via their normal exit route, even though that route might be in the line of fire. Others may simply freeze in place.

“When chaos strikes and fear takes over, we’re typically not thinking clearly,” said John Stevens, senior vice president at Keenan.

“I think you’d be amazed by how many people would just sit at their desk and process that information.” agreed Ahrens. Drills help people move past that paralysis by ingraining the right behaviors and turning them into reflex or “muscle memory.”

“[They have to] go through the motions, pretend something is happening — make sure they actually have to take those steps necessary to protect themselves, kind of like a dry run,” said Colosimo.

“Give them all of the tools and the means necessary.”

Drills are important not only to help employees refine their instincts, she added, but also to identify potential flaws in the emergency response plan.

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“It may look great on paper,” she said, but when you actually test it, you may find that some escape routes are obstructed or that a particular route didn’t lead where you thought it would.

Keep in mind that there’s always the potential for some employees to react negatively to whatever training you provide. But Ahrens suggested putting it in perspective.

“You have people saying, ‘I can’t believe you showed us that, that training was over the top.’ But if they remember it during an incident, I think it’s worth the couple of people who don’t like it.”

Far-Reaching Repercussions

While employers are no longer burying their heads in the sand about workplace shooter risks, most are still a long way from being truly prepared.

“People are putting plans in place,” said Colosimo, “and maybe [some are] training

Mike Payne, iJET International

Mike Payne, organizational resilience manager, iJET International

people. But when you get to the drill level, specific to active shooters, those numbers are still low. And that’s what needs to change.”

Risk managers may still be struggling to get the buy-in they need, and the problem doesn’t necessarily revolve around the bottom line. Taking steps toward active shooter preparedness can involve some uncomfortable decision making, explained Payne, so “by not having a background in handling those types of risk decisions, it creates a level of denial. And while that is a response, it’s not the preferred one.”

To help the C-suite move past reluctance, experts recommend framing the language in terms of safety as well as presenting the bigger picture and the potential impact to the business.

To help the C-suite move past reluctance, experts recommend framing the language in terms of safety as well as presenting the bigger picture and the potential impact to the business.

While the frequency of an active shooter incident may be less than any other risk that a business faces, stressed Stevens, “the severity and the magnitude of the circumstance become greater than anything else they face because you’re dealing with human lives.”

In the aftermath, the fallout would likely be a tangle of workers’ comp and liability claims related to fatalities and potentially catastrophic injuries. Property damage could be extensive in some situations, and many organizations could face significant business interruption expenses. In addition, questionable security procedures or a failure to respond to threats made prior to an incident may expose employers to a Pandora’s box of employment liability actions.

“In the world we live in now,” said Ahrens, “courts aren’t going to recognize ‘We didn’t see it as a risk.’ ”

As if that wasn’t enough, some businesses could find themselves in violation of workplace violence prevention laws, which are on the books in several states. And many companies may not even be aware of their obligations under OSHA.

While there is no federal workplace violence standard, OSHA asserts that it has the authority to cite employers for failing to take steps to prevent workplace violence under the General Duty Clause, which requires employers to keep workplaces “free from recognized hazards likely to cause death or physical harm.” Courts have generally agreed.

In addition, some say, there are multiple OSHA standards related to emergency action plans and job hazard training that can be interpreted to apply to active shooter training. Those claims have not yet been legally tested. But if the frequency of incidents continues to climb, it may only be a matter of time.

Reputational harm is also a very real possibility — not just among customers, but among vendors. Some companies may choose not to do business with a company it perceives as having lax security measures. Not least of all is the company’s reputation among both existing and prospective employees.

“If you have a workplace where people don’t feel safe, they’re not going to come to work,” said Colosimo. “If they don’t come to work, your productivity is gone.”

Insurance recovery may not be as straightforward as some assume. In the wake of a workplace shooting, business interruption losses may or may not be covered depending upon policy wording.

Workers’ compensation typically will cover costs related to injuries or fatalities that occur at work. However, a targeted, personal attack on an employee with a clear motive that is unrelated to the workplace — such as an attack by a jilted spouse — could negate some workers’ comp claims because it falls outside of the “scope of employment.”

Workers’ comp costs can wreak havoc on employers and insurers. The California death benefit of $250,000 for a single dependent survivor was multiplied many times over for those that died in the San Bernardino attack. But those that survive such an event with catastrophic injuries can potentially cost 10 times that amount over the long-term.

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Until recently, there were no insurance products designed specifically for the risk of gun violence. But Willis Towers Watson now offers active shooter insurance. The coverage was intended for universities, but the company is now fielding inquiries from hotels, hospitals, and other institutions.

The policies, underwritten by Beazley, an affiliate of Lloyd’s, can cover up to $5 million of liability against claims that the company didn’t take the necessary precautions to prevent a mass shooting. It also covers the “on the scene” costs of a shooting incident, as well as any counseling or consulting expenses needed after the event.

What companies need to guard against is being lulled into false assumptions about the scope of the problem. After 911, there was a similar spike in interest in protecting workplaces from violence, noted Colosimo.

But eventually the interest waned, as the media moved on to fresher territory. Her hope is that it won’t require more incidents like San Bernardino to keep risk managers focused on what needs to be done.

“We’ve got to keep the momentum going because this isn’t stopping,” she said. “People have to be prepared.”

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at mkerr@lrp.com
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Risk Insider: Paula Vene Smith

No More Ivory Tower

By: | December 17, 2015 • 2 min read
Paula Vene Smith directs the Purposeful Risk Engagement Project (PREP) and is a professor at Grinnell College. Paula consults on risk in higher education, and has written Engaging Risk: A Guide for College Leaders. She can be reached at smithp@grinnell.edu.

Joe Allen didn’t need to bring in the pink elephants.

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As he launched our tabletop exercise, preparing to guide a group of campus employees through a fictional crisis scenario, Joe presented the ground rules:  “Even if I describe pink elephants rampaging across your campus, don’t object to the scenario. Accept my story as plausible and focus on the unfolding of procedures and judgments. What we’re working on is your level of emergency response.”

Several minutes later, though, no one would raise a doubt about the scenario given to us by Joe, an emergency operations planner visiting from Margolis Healy. The story featured a student threatening on social media to carry out a mass shooting on our campus.

For participants in the exercise, that prospect felt all too real.

Clearly, the day is past when people could talk about the academic “ivory tower” as immune to the harsher forces of the outside world. University risk managers now accept the reality that mass violence can erupt on campus — just as it can in a prayer meeting, a movie theater or the staff holiday party.

To set priorities for action, colleges with enterprise risk management programs develop a list of risks with most dramatic potential to disrupt their institutions and damage their reputations.  And violent incidents do just that.

Clearly, the day is past when people could talk about the academic “ivory tower” as immune to the harsher forces of the outside world.

With a moment’s thought, one can easily come up with a short list of prestigious universities whose very name, unfortunately, has become synonymous with a notorious crime — perhaps taking place many years ago — that involved multiple victims.

The risk of playing host to a nationally prominent disaster such as befell Penn State or Virginia Tech can never be reduced to zero, even by applying the most effective methods of risk management.

But the heartbreaking reports of what occurred on those campuses produced ripple effects of governmental legislation, many new institutional policies and innovative preventive measures designed to reduce the likelihood of such events in the future.

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In late October 2015, the Iowa Board of Regents sponsored a first-ever statewide summit on campus safety and security. Representatives from dozens of institutions of higher education across the state gathered to present information and share discussion about Title IX investigations, threat assessment teams, violent incident response preparation (such as ALICE training), timely warning systems, bystander intervention and other topics.

The experiences described at the summit and questions asked by the audience showed that even in Iowa — a state not conspicuous for its high rate of violent crime — attention to these issues has become mandatory.

We all believe in pink elephants now. For those who lead colleges and universities, the threat of a violent incident, even the statistically unlikely prospect of a mass shooting on campus, has earned a solid place on the list of primary risks.

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Sponsored: Liberty Mutual Insurance

The Doctor as Partner

Consulting clinical expertise can vastly improve disability and absence management outcomes.
By: | January 4, 2016 • 6 min read

Professionals helping employees return to work after being on disability or a leave of absence face many challenges. After all, there is a personal story behind each case and each case is unique.

In the end, the best outcome is an employee who returns to the job healthy and feeling well taken care of, while at the same time managing the associated claim costs.

Learn what most employers want from their group disability and life benefits program.

While many carriers and claims managers work toward these goals, in the end they often tend to focus on minimizing costs by aggressively managing claims to get the worker back on the job, or they “fast track” claims, approving everything and paying little attention to case management.

Aggressively managed claims can leave many employees and their doctors feeling defensive and ill-at-ease, creating an adversarial relationship that ultimately hinders return to work and results in higher direct and indirect employee benefit costs for the employer. Fast track or non-managed claims can lead to increased durations, costs and workforce productivity issues for employers.

Is it possible to provide a positive employee benefit experience while at the same time effectively managing disability and lowering an employer’s overall benefit costs?

A Unique Approach

Yes.

Liberty Mutual Insurance’s approach to managing disability and absence management focuses on building consensus among all stakeholders – the disabled employee, treating physician, employer and insurer. And a key component of this process is a large team of consulting physician specialists, leading practitioners from a variety of specialties, highly regarded experts affiliated with leading medical universities across the country.

“About 16 years ago, our national medical director, Dr. Ed Crouch, proposed that if we worked with a core group of external consulting medical specialists – rather than sending most claims for Independent Medical Evaluations – we could do a better job making disabled employees and their attending physicians comfortable, and therefore true partners in producing better disability management outcomes and employee benefit experiences,” said Tim Kastrinelis, senior vice president, Distribution Partnerships at Liberty Mutual Benefits.

“In this way, our consulting physician and the attending physician are able to work with the disability case manager, the employee and the employer to deliver a coordinated, collaborative approach that facilitates a productive lifestyle and return to work.”

The result of Dr. Crouch’s initiative has produced positive results for the clients of Liberty Mutual Insurance. This consensus building approach to managing disability with consulting physician expertise has helped achieve industry leading client retention results over the past decade. In fact, 96 percent of Liberty Mutual’s group disability and group life clients renew their programs.

LM_SponsoredContent“By getting all stakeholders on the same page and investing heavily in consulting physician specialists, we have been able to lower claim costs and shortened claim duration for our group disability policyholders. …In the end, it’s a win-win for all.”
–Tim Kastrinelis, Senior Vice President, Distribution Partnerships, Liberty Mutual Benefits

A Collaborative Approach

In the case of complex disability medical health situations, Liberty Mutual’s disability case managers play a vital role in seeking additional expertise—an area where the industry’s standard has been to outsource the claimant for independent medical examinations.

However, Liberty Mutual empowers its disability case managers with the ultimate responsibility for the outcome of each claim. The claimant and the case manager stay together throughout the life of the claim. This relationship is the foundation for a collaborative approach that delivers a better employee benefit experience and enables the claimant to return to work sooner; which more effectively controls total disability claim and absence costs.

Sending a disabled employee with complex medical needs to an external specialist may sound like a cost-effective path, but it often comes at the cost of sacrificing the relationship and trust built between the employee and case manager. The disabled employee must explain their medical history to a new clinician, which he or she is often reluctant to do. The attending physician may be uncooperative as this move can appear to question his or her treatment plan for the employee.

As a result, the entire claims process takes on an adversarial atmosphere, building major roadblocks to the ultimate goal of helping the claimant return to a productive lifestyle.

Liberty Mutual takes a different approach. Nearly 100 physicians representing more than 30 medical specialties are available to consult with its medical and claims professionals, working side-by-side with case managers.

More than 95 percent of these consulting physicians are in active practice, and therefore up-to-date on the latest clinical best practices, treatment guidelines, therapies, medications, and programs. Most of these physicians are affiliated with leading medical universities across the country. “We recruit specialists from around the country, getting the best from such prestigious institutions as Harvard, Yale, and Duke,” said Kastrinelis.

These highly-credentialed physicians help case managers focus on providing the support needed for the disabled employee to successfully return to work as quickly as appropriate. Their collaborative work with the attending physicians provides the behind-the-scenes foundation that leads to a positive claimant experience, results in a better outcome for the claimant, and more effectively reduces total claim costs.

Coordinated Care Plan

When one of these consulting physicians reaches out to an attending physician, there’s an immediate degree of respect and high regard for his or her opinion. This helps pave the way to working together in the best interest of the employee, improving treatment plans and return to work results.

In this process, the claimant is not sent to yet another doctor; instead, the consulting specialist works with the attending physician to help fill in the gaps of knowledge or provide information that only a specialist would have. Although not an opportunity to direct care, these peer-to-peer discussions can help optimize care with the goal of helping the employee return to work.

The attending physician may have no knowledge of the challenges the employee faces in order to return to work. A return to work plan created in concert with the specialist, disability case manager, employer, and attending physician can set expectations and provide the framework for a proactive and effective return to a productive lifestyle.

“Our consulting physicians bring sophisticated medical expertise to the discussion, and help build consensus around a return-to-work plan, helping us more effectively impact a claim’s outcome and costs, and at the same time provide a better claimant experience,” said Kastrinelis.

“We can work more collaboratively with the attending physician, manage expectations, and shepherd the employee through the process much more effectively and in a much more high-touch, caring, and compassionate manner. Overall, we’re able to produce better outcomes as a result of this consensus building approach.”

Better Outcomes

“Our approach – including the use of consulting medical experts – helped us significantly reduce disability costs over two years for one large health service company,” notes Kastrinelis. “We cut average short-term disability claim durations by 4.2 days in that time, while increasing employee satisfaction with our unique disability management model and collaborative, partnership approach.

How did Liberty Mutual’s unique approach lower claim costs, reduce disability duration and improve the benefit experience for one customer?

“By getting all stakeholders on the same page and investing heavily in consulting physician specialists, we have been able to lower claim costs and shortened claim duration for our group disability policyholders,” said Kastrinelis.

“Plus, we, the employee, and the employer also get the bonus of creating a better employee benefit experience. This model has shaped our disability and absence management program to more aptly reflect our core mission of helping people live safer, more secure lives. In the end, it’s a win-win for all.”

How does Liberty Mutual provide a superior employee benefit experience?

Tim Kastrinelis can be reached at timothy.kastrinelis@libertymutual.com. More information on Liberty Mutual’s group disability and absence management offerings can be seen at https://www.libertymutualgroup.com/business-insurance/business-insurance-coverages/employee-benefits.

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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.




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Liberty Mutual Insurance offers a wide range of insurance products and services, including general liability, property, commercial automobile, excess casualty, workers compensation and group benefits.
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