The Role We Must Own
Unfortunately, campus shootings are not a new issue and the recent (or seemingly continual) spate of incidents reinforces the need to take a holistic approach to the risk, i.e., it is not a law enforcement issue alone.
I’m not talking about the need to include a variety of campus personnel and stakeholders in the planning, response and recovery processes, this is self-evident and well-established.
Rather, in this case the term “holistic” is best applied to considering the place of mental health professionals, such as Behavior Intervention Teams (BITS) or campus counseling teams (mental first aid) in collaborating on emergency management (prep, response & recovery) and with stakeholders/administration and academics. Everybody has a stake in trying to mitigate the risk.
Most people wouldn’t argue with the point that the root cause of the vast majority of campus violence incidents is one of acute mental illness and the aforementioned feelings of desperation.
Here are two definitions of “holistic”:
Philosophy – characterized by comprehension of the parts of something as intimately interconnected and explicable only by reference to the whole.
Medicine – characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the physical symptoms of a disease.
Recently when speaking with mental health professionals about emergency preparation and response, I had an epiphany … this being that the mental health component of preparation, response and recovery had not been a focus or even present in the emergency planning conversation.
As such, I made a commitment that one of my big pushes going forward was to make sure I would be an advocate for having campus mental health professionals at the table when discussing campus risk mitigation and crisis response.
In the words of Patrick Prince of Prince & Phelps Consultants: “No one wakes up one morning and decides, ‘I think I’ll go shoot up a campus today’.”
Rather, it is generally a lengthy mental process as one devolves from feeling that they have a gripe to feeling totally disenfranchised, disrespected, desperate, lonely and angry.
There are points along the way wherein there is a chance for intervention to address the risk and perhaps even assist the person of interest.
Most people wouldn’t argue with the point that the root cause of the vast majority of campus violence incidents is one of acute mental illness and the aforementioned feelings of desperation. We must remember that the perpetrator was once someone’s baby, friend, schoolmate, etc. and likely was not born with homicidal ideations.
Herein lies the opportunity for mental health professionals to mitigate the risk by assisting in the identification of people at risk, collaborating on intervention techniques and perhaps even treatment.
Further, it is incumbent upon an organization to stress the values of empathy, respect, dignity and looking through a holistic and not personally prejudiced paradigm.
We all have a chance to mitigate the risk by being decent human beings and not being afraid to reach out to appropriate persons to address a concern when observing disturbing behavior. “It is not my problem,” or “ I do not want to get involved,” are not responsible alternatives.
Ask yourself this.
“Are you a potential solution or a potential victim?”
Compassion in the Age of Uncertainty
It is the political season, so we hear many different plans for fixing the economy, creating jobs and other aspirations.
Here is one we can’t forget about.
While we host some of the leading health research and medical facilities in the world, the decline of our population’s health is one of our most pressing issues.
Recently, we were saddened to learn of research by Drs. Meara and Case, reported in the New York Times, demonstrating an increase in mortality among middle-aged (45-54) white Americans. The trend was most severe among those with just a high school education.
Economic uncertainty is strongly correlated to the increase in mortality rates.
This is a reversal of decades of improvement in American mortality rates. Thankfully, that improvement continues for all other population groups and ages.
Workers in this age group, at the height of their careers, could be considered the backbone of our American economy.
As employers and experts in risk and health, we’ve learned about co-morbidities such as diabetes and heart disease and how they dramatically add complexity, length of treatment, and cost to worker injuries.
Yet, the cause of the increased mortality in this group, according to the research, is a dramatic increase in substance abuse, including prescription drugs and heroin, in addition to alcoholic liver disease and suicides.
The linkage between prescription drug dependence and workers’ compensation injuries and treatment is well known, but what about those other causes?
In this segment of 45-54 year old whites with no more than a high school education, significantly more pain was reported than in the past. Fully a third of this group reported chronic joint pain over the 3 year period, and those with the least education reported the most pain and the worst health generally.
Other research has demonstrated that the US has fallen behind other wealthy nations in life expectancy, which brings us back to the economy.
Economic uncertainty is strongly correlated to the increase in mortality rates. In fact, those individuals with the least education who reported the most pain and worst health also reported the greatest financial distress.
During this period of 2011 to 2013, household income for households headed by a high school graduate fell by 22 percent, when adjusted for inflation. The explanation for the increase in mortality attributable to suicide and substance abuse is a combination of pain with mental distress!
What can we take from this to help us be more compassionate employers? The most influence organizations can have on employee well being is through the work culture and environment.
Well being and engagement drive business results. Wellness is a combination of physical and emotional health, financial well being, and positive social connection.
Where once wellness initiatives were limited to the corporate offices, we’ve found that employers have expanded initiatives throughout their operations. All around us, wellness programs and opportunities are being expanded to financial well being and employers have long encouraged positive social interactions at work.
Wellness is a critical and urgent imperative for our times, improving health while saving employers on costly worker injuries and health care and improving productivity and results. This will go a long way toward making the overall economy healthier.
Managing Construction’s True Risk Exposure
When it comes to the construction industry, the path to success is never easy.
After a long, deep recession of historic proportions, the sector is finally on the mend. But as opportunities to win new projects grow, experience shows that more contractors go out of business during a recovery than during a recession.
Skilled labor shortages, legal rulings in various states that push construction defects onto general liability policies, and New York state’s labor laws that assign full liability to project owners and contractors for falls from elevations that injure workers are just some of the established issues that are making it ever harder for firms to succeed.
And now, there are new emerging risks, such as the potential for more expensive capital, should the Federal Reserve increase its rates. This would tighten already stressed margins, perhaps making it harder for contractors and project owners to invest in safety and quality assurance, and raising the cost of treating injured workers.
Liberty Mutual’s Doug Cauti reviews the top three risks facing contractors and project owners.
“Our customers are very clear about the challenges they are facing in the market,” said Doug Cauti, the Boston-based chief underwriting officer for Liberty Mutual’s construction practice.
“Now more than ever, construction risk buyers – and the brokers who serve them – are leveraging our team’s deep expertise to find solutions for complicated risks. This goes way beyond what many consider the traditional role of an insurance carrier.”
Other leading risks facing contractors and project owners.
Given the current risk environment, firms that simply seek out the cheapest coverage could leave themselves exposed to these emerging risks. And that could result in them becoming just another failed statistic.
So what is the best way to approach your risk management program?
Understanding the Emerging Picture
Construction firms have been dealing with multiple challenges over the last several years. Now, several new emerging risks could further complicate the business.
After an extended period of historically low interest rates, the Federal Reserve is indicating that rates could rise in late 2015 or sometime in 2016. That would surely impact construction firms’ cost of capital.
“At the end of the day, an increased cost of capital is going to impact many construction firm’s margins, which are already thin,” Cauti said.
“The trickle-down effect is that less money may be available for other operational activities, including safety and quality programs. Firms may need to underbid and/or place low bids just to get jobs and keep the cash flow going,” Cauti said.
“Now more than ever, construction risk buyers – and the brokers who serve them – are leveraging our team’s deep expertise to find solutions for complicated risks.”
— Doug Cauti, Chief Underwriting Officer, Liberty Mutual National Insurance Specialty Construction
“Experience shows us that shortcuts in safety and quality often lead to more construction defect claims, general liability claims and workers’ compensation claims,” Cauti said.
Currently, the frequency of worker injuries is down on a national basis but the severity of injuries is on the rise. If those frequencies start creeping up due to less robust safety programs, the costs could grow fast.
And if this possible trend is not cause enough for concern, the growing costs associated with medical care should have the attention of all risk managers.
“Five years ago medical costs represented 56 percent of a claim,” said Jack Probolus, a Boston-based manager of construction risk financing programs for Liberty Mutual.
“By 2020, that medical cost will likely grow to 76 percent of an injured worker’s claim, according to industry experts,” Probolus said.
Rising interest rates and rising medical costs could form a perfect storm.
Focusing on the Total Cost of Risk
For risk managers, the approach they utilize to mitigate the myriad of existing and emerging risks is more important than ever. The ideal insurance partner will be one that can integrate claims management, quality assurance and loss control solutions to better manage the total cost of construction risk, and do it for the long term.
Liberty Mutual’s Doug Cauti reviews the partnership between buyers, brokers and insureds that helps better manage the total cost of insurance.
In the case of rising medical costs, that means using claims management tools and workflows that help eliminate the runaway expense of things such as duplicate billings, inappropriate prescriptions for powerful painkillers, and over-utilization of costly medical procedures.
“We’re committed to making sure that the client isn’t burdened in unnecessary costs, while working to ensure that injured employees return to productive lives in the best possible health,” Probolus said.
The right partner will also have the construction industry expertise and the willingness to work with a project owner or contractor from the very beginning of a project. That enables them to analyze risk on the front end and devise the best risk management program for the project or contractor, thereby protecting the policyholder’s vulnerable margins.
“We want to be there from the very beginning,” Liberty Mutual’s Cauti said.
“This isn’t merely a transaction with us,” he added. “It’s a partnership that extends for years, from binding coverage, through the life of the project and deeper as claims come in and are resolved over time,” he said.
In other words, it’s a relationship focused on value.
Today’s construction insurance market – with an abundance of capacity – can lead to new carriers entering the market and/or insurers seeking to gain market share by underpricing policies.
“We see it all the time,” Liberty Mutual’s Cauti said.
Where does this leave insureds? Frustrated at pricing instability, or by the need to find a new carrier. And wiser, having learned the wisdom of focusing on value, that is the ability to better control the total cost of risk.
“Premium is always important,” notes Liberty Mutual’s Cauti. “But smart buyers also understand the importance of value, the ability of an insurer to partner with a buyer and their broker to develop a custom blend of coverages and services that better protect a project’s or contractor’s bottom line and reputation. This is the approach our dedicated construction practice takes.
Why Liberty Mutual?
For more information on how Liberty Mutual Insurance can help assess your construction risk exposure, contact your broker or Doug Cauti at [email protected].
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.