Archive for January, 2009

Health Wonk Review’s first 2009 edition; plus, podcast on cardiac workers’ comp claims

Friday, January 9th, 2009

This year’s first edition of Health Wonk Review is posted at The Health Care Blog. Host Brian Klepper has done an excellent job culling out what he describes as “… the far-ranging insights, jabs, diatribes, rants and enthusiasms of this edition of Health Wonk Review, which features analysis and exegesis as entertainment.” Because HWR took a brief hiatus over the holiday, this issue is even newsier and meatier than the norm, so some good Friday reading.
And for another way to spend your Friday afternoon, we note that Ma-based plaintiff attorney Alan S. Pierce of Legal Talk Network has produced an interesting podcast on cardiac injury claims which features Dr. Julian Aroesty, a cardiologist from Beth Israel Deaconess Medical Center. The discussion centers on causation, liability for the employer in workers compensation, and subsequent work restrictions for return to work. Heart attacks are one of those tricky areas of workers compensation that may or or may not be compensable depending on circumstances. Because of the gray areas, it is an issue that frequently results in litigation. In listening to Dr. Aroesty, it certainly brings to mind the interplay between general health and wellness and the relationship to work-related injuries. Dr. Aroesty states that many patients have symptoms of heart disease before an event occurs but often don’t recognize them as such because the symptoms don’t take the form of sharp pains. It would seem that providing basic health information related to common high-risk health conditions such as heart disease, obesity and diabetes would be in the best interests of employers to maintain a productive, healthy work force and to reduce the risk for potential workers comp and disability claims.

West Virginia Builds a Pool

Tuesday, January 6th, 2009

We have been following the developments in West Virginia, where a once monopolistic state for workers comp insurance has been transformed into a competitive market. The well-designed transition began in 2006 with the creation of BrickStreet Mutual Insurance Company, which for a couple of years offered the only available insurance to employers. Last year other carriers entered the state; Bricksteet, faced with competition and a reduction in market share, had to lay off some staff. Now they are shedding some bad risks.
Gary Burton, BrickStreet’s President, announced that the carrier is dumping about 1,000 risks, most of which will end up in the state’s new assigned risk pool. These accounts sport combined ratios (losses compared to premiums) in excess of 200 percent. Burton mentioned one with a whopping ratio of 14,000 percent: akin to $140,000 in losses for $1,000 in premium. From an underwriting perspective, those numbers might have been acceptable for a subprime mortgage, but they don’t work very well for conventional insurance.
West Virginia’s new assigned risk pool will be managed by NCCI, a natural choice as they already administer pools in 20+ states. The servicing carriers are Travelers, Liberty Mutual and American Mining. Employers unable to secure coverage in the open market are likely to pay significantly higher premiums in the pool.
Thus far, West Virginia’s transition to a competitive market seems to be going smoothly. The pain has been distributed across the board: to a population of workers that had long viewed comp as an entitlement, to employers in favored industries who long benefitted from suppressed rates for coverage and to some of the former state employees who ran the old, rather bloated system. No one would describe the new approach to workers comp as perfect, but the competitive market appears to offer a reasonable balance between the often conflicting interests of workers and employers. The creation of an assigned risk pool for poorly performing employers is simply one more necessary step in the eternal search for an effective and equitable system.

Cavalcade of Risk and news notes for the New Year

Monday, January 5th, 2009

Happy new year to all our readers! While we were taking a short holiday break, Louise at Colorado Health Insurance Insider was toiling away to produce a special New Year’s Eve Cavalcade Of Risk. There’s some good reading there, it’s good way to ease your way back into some of the health care issues that lie before us in the coming year.
Here are a few other news stories that crossed our radar:
Insurance and the economy: market will harden – a recent report by Advisen LTD. alerts commercial insurance buyers that rates in all lines should be expected to rise in the fourth quarter of 2009 or first quarter of 2010, and the hard market is likely to last “longer than normal.” The report states that workers compensation premiums may begin rising as early as midyear in 2009. Underwriting losses and poor investment returns are putting pressure on rates: “In the current economic environment, where credit markets are essentially frozen, capital to create new insurance and reinsurance capacity may be in short supply.” Another recent report by Willis Re concludes that reinsurance pricing is likely to rise as capital becomes scarce. And A.M. Best has recently stated that the U.S. property-casualty industry has posted its first year-end underwriting loss since 2005, with a combined ratio of 105.4% for the first nine months of 2008, as compared to 92.2% in the prior year.
WC crystal ball – our friend Joe Paduda offers his 2009 predictions for workers comp managed care – well worth checking out. He follows with an in-depth post on why big comp networks won’t do the smart thing.
CT coverage verification – The Connecticut Workers’ Compensation Commission has created a new online service that will enable a workers comp verification to learn if a business operating in the state has coverage. Direct link to the service: CT coverage verification service.
Work fatalities – while most of us celebrated with family over the holidays, many families grieved the loss of workers who died on the job. The Weekly Toll tells the story of those losses. If you haven’t visited in awhile, stop by to see the new design. It’s a grim and very personal reminder of how important it is that we all stay committed to workplace safety as a top priority for the new year, something that may be increasingly hard as training and safety budgets get squeezed in this difficult economy.
Cool tool – Google’s has a new, free 411 service that is fast and easy to use. Dial 1-800-GOOG-411 from any phone. State what you’re looking for and GOOG-411 will connect you with the business you choose. If you are calling from a mobile device, the service can even send you a text message with more details and a map. Simply say “Text message” or “Map it.” Learn more at Goog411. Thanks to Jann from Standard Publishing for this great tip.