Follow-up on previous post

Hit the link to see a recent column by Fresno Bee writer Dan Walters. I think if you read my previous blog and then read this article, it will clearly illustrate the situation that the Work Comp system is in here in California. Political pandering has muddled the real market condition and it will all be laid at the feet of whomever is elected Governor and Insurance Commissioner. Nobody will remember who was driving the train when the problem occurred, but they will remember who was driving when it finally wrecked.

http://www.fresnobee.com/2010/08/22/2050224/worker-comp-battle-looms.html#storylink=misearch

Guy Teafatiller
Commercial Insurance
guyt@vanbeurden.com
Kingsburg • (559) 634-7136
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WCIRB Suggests 29.6% Increase in Rates

It is unfortunate that the Commissioner of Insurance (Poizner) has repeatedly ignored previous suggestion of rate increases as it would hurt his chances of being Governor, but since he has ignored the warnings of the Workers Compensation Insurance Rating Bureau (WCIRB) (which is an apolitical, quasi-governmental actuarial department) it has come to consumers getting sticker-shock from a suggested increase of this magnitude.

I have always believed that Commissioner of Insurance should not be an elected office as much (insert all) of the time the person elected 1) Has no clue about how insurance works, even well after this person is elected, 2) Uses the office as a stepping stone to higher office (See Quackenbush,Garamendi, Poizner, etc.)  3) Seeks to pander to their constituency instead of disclosing the true facts about the state of the marketplace to the consumer.

Although Dale Debber makes arguments to the contrary, we have seen claims cost rise and frequency maintained which will push pricing up. You need not look any further than the past 3 years combined loss ratios of carriers in the state to end up with the same conclusion that the WCIRB came up with.

FLASH REPORT!

WCIRB Says 30 Point Rate Increase for Workers’ Comp

“It’s going to be in the ball park of 30%,” chief actuary Dave Bellusci tells Workers’ Comp Executive. “But I wouldn’t be surprised if it’s over.” Workers Compensation Insurance Rating Bureau (WCIRB) staff still has to finalize the calculations before preparing a pure premium advisory rate recommendation for the Governing Committee, it says, so the final numbers could still change a bit. But a 30 point increase is the general consensus of its Actuarial Committee. This comes against a backdrop where the WCIRB’s veracity and integrity are continuing to come under question.

“A 30 point increase is beyond all reason” says Dale Debber, principal of Compline and publisher of this newsletter, and recognized workers’ comp expert. “It will drastically affect California business deterring increased employment during these tough economic times. If taken, it will likely lower the collectable payroll, sales, and incomes taxes for the State California. Worse, this comes at a time when it will necessarily impact the legislature’s budget negotiations.” Debber says, “It will raise the prices of practically everything for all consumers.” The industry is trashing the Schwarzenegger reforms

Debber opines that WCIRB management has a history of putting accurate facts together in such a way as to lead others to an inaccurate conclusion. Compline, he says will soon publish a report studying these issues.

WCIRB says the current calculation does not include a separate element for the impact of the Almaraz/Guzman and Ogilvie decisions, as it is assumed that the impact of those cases is already in the underlying data. The WCIRB is sticking to its previous story and continues to peg that impact at 5.8%.

For its part, WCIRB says the industry’s experience is developing consistent with WCIRB’s prior recommendation, Bellusci notes, but says an increase over the prior filing is warranted due to another year of inflation and a lower than projected frequency decline in 2009. The latter point prompted the committee to alter its loss development methodology to base it on the 2009 trend data rather than a two-year average. The committee also tweaked the loss development methodology to account for an industry-wide slowdown in claims settlement rates, but is sticking with its current methodology for calculating loss adjustment expenses.

Guy Teafatiller
Commercial Insurance
guyt@vanbeurden.com
Kingsburg • (559) 634-7136
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Self Insured Group Goes Down

And might take its members with them.

The following is from a recent article from the Insurance Journal Online.

California Contractors Self-Insured Group Closes

By Patricia-Anne Tom
April 30, 2010

The California Office of Self-Insured Plans is revoking the certificate of the Contractors Access Program of California (CAP), a self-insured group of contractors, as requested by the group.

According to OSIP spokeswoman Erika Monterroza, the group, which has had as many as 266 members over its life, requested in October 2009 the revocation at the end of its insured term, which ended on Dec. 31, 2009. “The order for revocation was not finalized until March 29, 2010, but was approved effective Jan. 1, 2010, because the order isn’t issued until all members show proof that they are covered by other insurance or are no longer in business,” she explained. The group is still responsible for paying for claims that arose prior to Dec. 31, 2009.

CAP has faced regulatory action in the past because earlier reports indicated the SIP had insufficient funds to cover estimated future liabilities. California regulations require self-insurance groups to have deposits cover 135 percent of estimated future liabilities.

OSIP became aware that CAP had insufficient funds to meet the 135 percent requirement in the summer of 2009, Monterroza said. Groups are always re-assessed on future liabilities based on their annual report of claims. “At that time, we requested a deficit plan to make up the insufficiency,” she said.

In February 2010, OSIP said CAP indicated its liquidity problems were more significant. So, OSIP required that the group provide a weekly report of all its expense and claims paid, and any expenses above claims are required to be approved by the OSIP. Currently, CAP has deposits to cover 110 percent of estimated future liabilities, Monterroza said.

There has been conjecture by other media that OSIP was lax in its oversight of CAP, because CAP’s group manager CRM has had difficulties in other states, specifically New York, Monterroza added. However, “a lot of that conjecture is not accurate,” she said. “Where there were clear indications that there were issues by the company in other states, in California that has not been the case. Regulations for self-insurance plans in California are much more stringent than in other states.”

All of the requirements for regulatory actions and insufficient funds is designated by California Regulation Title 8, Section 15477, Paragraph B, points 1 through 7, Monterroza said.

End of Article

Many companies go to self insured group plans because they appear to be cost effective (premium savings) and they are basically “Sold Up” by a broker or administrator as a viable alternative to stand alone plans, or first dollar insurance. As you can read, there is a clause in all of these contracts (Joint and Several) that ties you financially to all the other members of the group. You are your brothers keeper in these plans. I highly suggest that you get information from a trusted Professional Work Comp Advisor prior to entertaining joining a group like this.

It is possible to pay $25,000 in premium into one of these plans, and then recieve a massive additional premium (or capital call) when they go under. This is the first failure in a while, but I assure you it will not be the last. CRM managed 5 different groups as SIP’s. 4 of them will cease operations as of 7-1-10, and one (CAP) has been seized.

CRM is also the Holding Company of Majestic Insurance Company that was recently downgraded to B++ with a negative outlook by A.M. Best Rating Service.

I will try and keep you up to speed on these developments in this sector of the market as the story (s) unfold.

Thank you for reading my blog.

Guy Teafatiller
Commercial Insurance
guyt@vanbeurden.com
Kingsburg • (559) 634-7136
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Speed Kills

I recently met with a trucking prospect whose experience mod took a serious increase from 99 to 128%. The cause of this issue was one smaller claim (total incurred of $3,600) that was left open with more than half of the incurred being reserves. Now, reserve levels should be looked at by your broker and the company at about 5 months into any policy period to make sure they are at their lowest possible levels prior to the information being sent into the WCIRB for modification calculation purposes.

Together we thought that the claim should have been closed long ago and the prospect gave me a Broker of Service letter so that I could go to the company and investigate what, exactly, was going on with this claim. This occurred 12 days before his renewal date with the very common insurer here in California.

Once we had access we requested the information along with a demand that this claim be closed for cause (that cause being that it was, in essence, settled with no further payment), as it should have been closed prior to the calculation date, but was just sitting on some claims examiners desk as a pad for his or her coffee mug.

I was able to get the claim closed before renewal and wrote him with a different carrier on renewal using the 128 modification. I then requested that said huge carrier report the corrected claims information to the WCIRB for recalculation purposes. You are allowed a recalculation when your incurred is reduced by at least 60% in any one calculation year (this claim being in his first calculation year and apt to effect his mod for 3 years in total). Which means that if your incurred (paid and reserves) are say $10,000 in a given year, and we can go back and close the claims for actual paid of $5,999 or less, then the law states that you are to be recalculated at a modification that is more indicative of your true losses. In this case the recalculation came back with a mod of 93.

This may not seem huge to most people, but the two faxes and three phone calls made by a Professional Work Comp Advisor on his behalf saved this insured $16,500 in the first year, and nearly that amount for two additional years it would have affected his modification, resulting in a savings of $45,500 over the life of his calculation period.

The bottom line is that the time period in which problems are spotted and the correction is implemented and resolved, in some of these issues, can be as short as 18 days. You just have to have the right person looking at it, with the necessary information for them to do something about it.

If you have an issue, any issue concerning your workers compensation, get a certified Professional Work Comp Advisor to help you.

Thank you,

Guy Teafatiller PWCA

guyt@vanbeurden.com

Guy Teafatiller
Commercial Insurance
guyt@vanbeurden.com
Kingsburg • (559) 634-7136
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Return-to-Work Programs Always Work

The cost of not working with your medical provider to have a comprehensive, full pay, return-to-work program is always a lot more than most of my clients would predict. When a claimant is not offered modified or light duty during a claim, the life of that claim is extended greatly and the individual claims costs will rise, simply from the fact that you are allowing the insurer to pay that claimant’s wage.

In your basic claim, the cost in modification increases caused by the payout for both medical and indemnity (payroll) to a claimant will come back threefold on the employer, especially for smaller claims as they are calculated at 100% of their value (no discounting in the calculation). This translates into future increases in premium to the client.

The biggest resistance we see is, “We have nothing for them to do”. Surely your staff can get together and outline something for them to do, and if you have already talked to your MPN doctor about your program and get a good outline on what the claimant “Can” do, instead of a list of things they “Can’t” do, then you can come up with something. My clients in the past have even used non-profit organizations in the local community to get claimants back to any kind of work that they can do with the work restrictions placed on them by the treating physician.

Making sure that you can accommodate any kind of restriction within your program will, in the end, save you quite a bit of money in premium savings through modification reductions. So meet with your primary treating physician, and get a plan in place to keep your people on the job. If you would like help in this area, feel free to contact me at (559) 634-7136 or at guyt@vanbeurden.com.

Guy Teafatiller
Commercial Insurance
guyt@vanbeurden.com
Kingsburg • (559) 634-7136
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Quality Still Counts

Quality claims control (post injury) is and should be one of, if not the, main factor when purchasing California Workers Compensation Insurance in the current marketplace. It is important for business owners to carefully evaluate any new or financially suspect carrier to make sure that their modification (the controllable portion of your premium calculation) is not jeopardized for a one time savings in premium.

Why would you gamble a 10% one year savings and jeopardize a modification that saves you 42% each and every year? If the company that you go with (the cheapest) allows claims to go on and on, unimpeded, it will destroy your modification almost immediately. Claims from one year will affect your premium for up to 3 years. The running life of these claims is effectively 4 years.

The cheapest carriers may cut costs by eliminating various services, like effective cost containment in their claims division, in order to provide you with the lowest possible pricing. This elimination of services will adversely effect the cost of your claims, which will drive your modification higher in the long run.

So that one year’s 10% savings may end up costing you tens of thousands of dollars in premium over the life (3 year calculation period) of the claims costs generated that particular year. In a nutshell, I recommend that you take a long-term perspective regarding your total costs when  making your California Workers Compensation Insurance buying decision.

Guy Teafatiller
Commercial Insurance
guyt@vanbeurden.com
Kingsburg • (559) 634-7136
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Hello from Guy in Kingsburg!

Hello world!

I’ve been with Van Beurden since 1995. I started in the insurance business because I saw it as a career that I could commit myself to for the long term. I am a Certified Professional Work Comp Advisor, and I am pleased to provide my clients with unparralleled service.

I hope that 2010 will allow all my clients and prospective clients greater opportunity to profit in these tough financial times.

Guy Teafatiller
Commercial Insurance
guyt@vanbeurden.com
Kingsburg • (559) 634-7136
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Van Beurden Insurance celebrates 75 years.