The Missing ERM Puzzle Piece
The risk management community has talked about the benefits of enterprise risk management (ERM) for years. But an honest assessment of most ERM efforts concludes that execution remains exceedingly difficult.
Finally, the latest breed of risk management information systems (RMIS) such as Willis DataWize, powered by Riskonnect, makes these much-talked-about benefits possible. DataWize empowers risk managers to support enterprise-wide needs, such as risk identification and assessment, crisis response and asset tracking in addition to traditional claim and policy information management.
The new capabilities increase a risk manager’s strategic value to their company and are even earning them board-level exposure through new reporting and dashboard capabilities. George Haitsch of Willis understands the importance of this, both as a former risk manager and through watching the efforts of past colleagues and current clients.
“I’ve seen the new RMIS systems have a significant impact on their deliverables and frankly on their careers,” Haitsch said. “A risk manager can facilitate a high-level conversation with insightful data and analysis, instead of walking into a meeting with a four inch thick TPA report and a spreadsheet on the cover.”
“It takes work off your desk. It frees up your time to do more strategic things. It’s hard to convey just how much the system alleviates many pain-points experienced by risk managers.”
— George Haitsch, Executive Vice President, North American Practice Leader, Willis Global Solutions
Not all RMIS technologies are created equal, nor can they have the same impact upon a risk manager’s success. Haitsch, now serving as practice leader, Willis Global Solutions North America, illustrated the point with a recent client meeting.
“I went into a meeting with a client who was a longtime user of another RMIS system, and when the client started to see the capabilities of Willis DataWize, an ‘ice-cold courtesy’ meeting turned into an ‘I gotta get that’ meeting in 30 minutes,” he said.
What won that risk manager over? Ultimately, it was the unique capabilities inherent in Willis DataWize–capabilities that would enable this client to transcend traditional policy tracking.
Some of the most important benefits Haitsch sees Willis DataWize, powered by Riskonnect providing his clients include:
Data Collection and Tracking: Any system is only as good as the data that it collects. Willis DataWize enables risk managers to easily configure fields and create custom web-based forms that can be completed by users in the field. Automated tracking, reminders and data controls help to ensure accurate, clean data. Information for renewals can now be collected in weeks, not months, and injury reports can easily be submitted in real time.
“It takes work off your desk. It’s almost as if the system is functioning as a member of your team,” Haitsch said. “It frees up your time to do more strategic things. It’s hard to convey just how much the system alleviates many pain-points experienced by risk managers.”
Underwriting Differentiation: One of the most important responsibilities of a Willis broker is to represent their clients to the underwriting community. “Willis is always working hard on our clients’ behalf to differentiate their risks to the underwriting community,” said Haitsch. Willis brokers leverage the quality data provided by DataWize to support those efforts.
“When a company can present detailed, timely information about their risk profile, it certainly helps build credibility and trust in the eyes of an underwriter,” Haitsch added.
Global Integration: DataWize unifies global organizations with one fully integrated system. Most RMIS tools cannot be integrated on a global risk platform. Previously, Fortune 50 users had to buy separate systems from different providers in Europe and patch them together. A risk manager must have a RMIS solution that matches their global footprint.
Board Level Reporting: Risk managers are utilizing DataWize’s easily configured dashboards and reports to produce highly valued information for executive management and directors.
“Board reporting components are simply spectacular!” asserted Haitsch. “The system is truly transformative to a risk manager because it enables them to provide the information that senior executives and directors crave. I’ve seen multiple clients become valued facilitators of board level strategic discussions.”
The Willis Approach
Willis’ primary goal is to empower its clients to be successful when it comes to risk, and it accomplishes this goal by remaining focused and partnering with leading companies to provide best-in-class complimentary service to their clients. The Riskonnect partnership, launched in 2010, demonstrates how providing enterprise-class risk technology helps Willis stand out from their competition.
“Board reporting components are simply spectacular!” exclaimed Haitsch. “The system is truly transformative to a risk manager because it enables them to provide the information that senior executives and directors crave. I’ve seen multiple clients become valued facilitators of board level strategic discussions.”
Ultimately, Haitsch appreciates Riskonnect’s positive response when his clients have asked for custom solutions and RMIS innovations. He said,
“They always want to get to YES.”
Haitsch knows that risk managers appreciate the value of people saying “YES,” from underwriters and TPAs to property managers – all the way up to executive leadership.
This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Riskonnect. The editorial staff of Risk & Insurance had no role in its preparation.
Coping with Cancellations
Airlines typically can offset revenue losses for cancellations due to bad weather either by saving on fuel and salary costs or rerouting passengers on other flights, but this year’s revenue losses from the worst winter storm season in years might be too much for traditional measures.
At least one broker said the time may be right for airlines to consider crafting custom insurance programs to account for such devastating seasons.
For a good part of the country, including many parts of the Southeast, snow and ice storms have wreaked havoc on flight cancellations, with a mid-February storm being the worst of all. On Feb. 13, a snowstorm from Virginia to Maine caused airlines to scrub 7,561 U.S. flights, more than the 7,400 cancelled flights due to Hurricane Sandy, according to MasFlight, industry data tracker based in Bethesda, Md.
Roughly 100,000 flights have been canceled since Dec. 1, MasFlight said.
Just United, alone, the world’s second-largest airline, reported that it had cancelled 22,500 flights in January and February, 2014, according to Bloomberg. The airline’s completed regional flights was 87.1 percent, which was “an extraordinarily low level,” and almost 9 percentage points below its mainline operations, it reported.
And another potentially heavy snowfall was forecast for last weekend, from California to New England.
The sheer amount of cancellations this winter are likely straining airlines’ bottom lines, said Katie Connell, a spokeswoman for Airlines for America, a trade group for major U.S. airline companies.
“The airline industry’s fixed costs are high, therefore the majority of operating costs will still be incurred by airlines, even for canceled flights,” Connell wrote in an email. “If a flight is canceled due to weather, the only significant cost that the airline avoids is fuel; otherwise, it must still pay ownership costs for aircraft and ground equipment, maintenance costs and overhead and most crew costs. Extended storms and other sources of irregular operations are clear reminders of the industry’s operational and financial vulnerability to factors outside its control.”
Bob Mann, an independent airline analyst and consultant who is principal of R.W. Mann & Co. Inc. in Port Washington, N.Y., said that two-thirds of costs — fuel and labor — are short-term variable costs, but that fixed charges are “unfortunately incurred.” Airlines just typically absorb those costs.
“I am not aware of any airline that has considered taking out business interruption insurance for weather-related disruptions; it is simply a part of the business,” Mann said.
Chuck Cederroth, managing director at Aon Risk Solutions’ aviation practice, said carriers would probably not want to insure airlines against cancellations because airlines have control over whether a flight will be canceled, particularly if they don’t want to risk being fined up to $27,500 for each passenger by the Federal Aviation Administration when passengers are stuck on a tarmac for hours.
“How could an insurance product work when the insured is the one who controls the trigger?” Cederroth asked. “I think it would be a product that insurance companies would probably have a hard time providing.”
But Brad Meinhardt, U.S. aviation practice leader, for Arthur J. Gallagher & Co., said now may be the best time for airlines — and insurance carriers — to think about crafting a specialized insurance program to cover fluke years like this one.
“I would be stunned if this subject hasn’t made its way up into the C-suites of major and mid-sized airlines,” Meinhardt said. “When these events happen, people tend to look over their shoulder and ask if there is a solution for such events.”
Airlines often hedge losses from unknown variables such as varying fuel costs or interest rate fluctuations using derivatives, but those tools may not be enough for severe winters such as this year’s, he said. While products like business interruption insurance may not be used for airlines, they could look at weather-related insurance products that have very specific triggers.
For example, airlines could designate a period of time for such a “tough winter policy,” say from the period of November to March, in which they can manage cancellations due to 10 days of heavy snowfall, Meinhardt said. That amount could be designated their retention in such a policy, and anything in excess of the designated snowfall days could be a defined benefit that a carrier could pay if the policy is triggered. Possibly, the trigger would be inches of snowfall. “Custom solutions are the idea,” he said.
“Airlines are not likely buying any of these types of products now, but I think there’s probably some thinking along those lines right now as many might have to take losses as write-downs on their quarterly earnings and hope this doesn’t happen again,” he said. “There probably needs to be one airline making a trailblazing action on an insurance or derivative product — something that gets people talking about how to hedge against those losses in the future.”
Advocacy: The Impact of Continuous Triage
In the world of workers’ compensation, timing is everything. Many studies have shown that the earlier a workplace incident or injury is acted upon, the more successful the results*. However, there is further evidence indicating there is even more of an impact seen when a claim is not only filed promptly, but also effective triage is conducted and management of the claim takes place consistently through closure.
Typically, every program incorporates a form of early intervention. But then what? While it is common knowledge that early claims reporting and medical treatment are the most critical parts of a claim, if left alone after management, an injured worker could – and often does – fall through the cracks.
All Claims Paths are Not Created Equal
Even with early intervention and the best intentions of the adjuster, things can still go wrong. What if we could follow one injury down two paths, resulting in two entirely different outcomes? This case study illustrates the difference between two claims management processes – one of proactive, continuous claims triage and one of inactivity after initial intervention – and the impact, or lack thereof, it can have on the outcome of a claim. By addressing all indicators, effective triage can drastically change the trajectory of a claim.
While working at a factory, David, a 40-year-old employee, experienced sudden shoulder pain while lifting a heavy box. He reported the incident to his supervisor, who contacted their 24/7 triage call center to report the incident. After speaking with a triage nurse, the nurse recommended he go to an occupational medicine clinic for further evaluation, based on his self-reported symptoms of significant swelling, a lack of range of motion and a pain level described as greater than “8.”
The physician diagnosed David with a shoulder sprain and prescribed two weeks of rest, ice and prescription strength ibuprofen. He restricted David from any lifting over his head.
By all accounts, early intervention was working. Utilizing 24/7 nurse triage, there was no lag time between the incident and care. David received timely medical attention and had a treatment plan in place within one day.
A critical factor in any program is a return to work date, yet David was not given a return to work date from the physician at the occupational medicine clinic; therefore, no date was entered in the system.
One small, crucial detail needs just as much attention as when an incident is initially reported. What happens the third week of a claim is just as important as what happens on the day the injury occurs. Involvement with a claim must take place through claim closure and not just at initial triage.
The Same Old Story
After three weeks of physical therapy, no further medical interventions and a lack of communication from his adjuster, David returned to his physician complaining of continued pain. The physician encouraged him to continue physical therapy to improve his mobility and added an opioid prescription to help with his pain.
At home, with no return to work in sight, David became depressed and continued to experience pain in his shoulder. He scheduled an appointment with the physician months later, stating physical therapy was not helping. Since David’s pain had not subsided, the physician ordered an MRI, which came back negative, and wrote David a prescription for medication to manage his depression. The physician referred him to an orthopedic specialist and wrote him a new prescription for additional opioids to address his pain…
Costly medical interventions continued to accrue for the employer and the surmounting risk of the claim continued to go unmanaged. His claim was much more severe than anyone knew.
What if his injury had been managed?
A Model Example
Using a claims system that incorporated a predictive modeling rules engine, the adjuster was immediately prompted to retrieve a return to work date from the physician. Therefore, David’s file was flagged and submitted for a further level of nurse triage intervention and validation. A nurse contacted the physician and verified that there was no return to work date listed on the medical file because the physician’s initial assessment restricted David to no lifting.
As a result of these triage validations, further interventions were needed and a telephonic case manager was assigned to help coordinate care and pursue a proactive return to work plan. Working with the physical therapist and treating physician resulted in a change in David’s medication and a modified physical therapy regimen.
After a few weeks, David reported an improvement in his mobility and his pain level was a “3,” thus prompting the case manager’s request for a re-evaluation. After his assessment, the physician lifted the restriction, allowing David to lift 10 pounds overhead. With this revision, David was able to return to work at modified duty right away. Within six weeks he returned to full duty.
With access to all of the David’s data and a rules engine to keep adjusters on top of the claim, the medical interventions that were needed for his recovery were validated, therefore effectively managing his recovery by continuing to triage his claim. By coordinating care plans with the physician and the physical therapist, and involving a case manager early on, the active management of David’s claim enabled him to remain engaged in his recovery. There was no lapse in communication, treatment or activity.
After 24/7 nurse triage is conducted and an injured worker receives initial care, CorVel’s claims system, CareMC, conducts continuous triage of all data points collected at claim inception and throughout the life of a claim utilizing its integrated rules engine. Predictive indicators send alerts to prompt the adjuster to take action when needed until the claim is closed – not just at the beginning of the claim.
This predictive modeling tool flags potentially complex claims with the risk for high exposure, marking claims that need intervention so that CorVel can assign appropriate resources to mitigate risk.
Claims triage is constant – that is the necessary model. Even on an adjuster’s best day, humans aren’t perfect. A rules engine helps flag things that people can miss. A combination of predictive systems and human intervention ensures claims management is never stagnant – that there is no lapse in communication, activity or treatment. With an advocacy team in the form of an adjuster empowered by a powerful rules engine and a case manager looking out for the best care, injured employees remain engaged in their recovery. By perpetuating patient advocacy, continuous triage reduces claim severity and improves claim outcomes, returning injured workers to the workforce and reducing payors’ risk.