Posts Tagged ‘risk management’

Cavalcade of Risk #191: Your Daily Shower Can Kill You

Wednesday, September 4th, 2013

We’re happy to be hosting Cavalcade of Risk #191. Risk is a topic that we think about a lot, so a recent post about risk on the group blog Metafilter caught our attention. It pointed to Jared Diamond’s excellent essay, The Daily Shower Can Be a Killer. The author shares a risk management lesson that he learned in 50 years of field work on the island of New Guinea: the importance of being attentive to hazards that carry a low risk each time but are encountered frequently. He notes:

“Studies have compared Americans’ perceived ranking of dangers with the rankings of real dangers, measured either by actual accident figures or by estimated numbers of averted accidents. It turns out that we exaggerate the risks of events that are beyond our control, that cause many deaths at once or that kill in spectacular ways — crazy gunmen, terrorists, plane crashes, nuclear radiation, genetically modified crops. At the same time, we underestimate the risks of events that we can control (“That would never happen to me — I’m careful”) and of events that kill just one person in a mundane way.”

The Metafilter post also included a link to this fun video on the topic of risk management. I nominate it as the Cavalcade of Risk official theme song.

With that preamble on risk management, we delve into this week’s submissions.
Life Insurance – First up to bat, we offer a nod and shout out to Hank Stern of InsureBlog, our fearless leader who has been managing the Cavalcade’s biweekly efforts for close to 200 issues now. Kudos and thanks, Hank. He poses the question: What if you’re diagnosed with cancer while buying new life insurance? Well, as it turns out, there may actually be a decent chance of obtaining coverage. Read how in Underwriting Cancer.
ACA spin vs. reality – Louise Norris of Colorado Health Insurance Insider is on the front lines when it comes to implementing ACA in the real world so we always take particular note of her opinions on the matter. In her post
Early Renewal Provides a Good Alternative for 2014, she takes on some of the misinformation and spin from both the right and the left that can make things confusing for consumers. She cites misinformation about the Aetna plan as one example of spin not matching reality.
Technology – Our colleague Bob Wilson can always be counted on to offer a unique and often humorous take on things at his eponymously named blog Bob’s Cluttered Desk. He notes that mobile technology is making tremendous advances that will speed treatment and lower medical costs, which is critical for those of us paying the bills and managing claims — but he questions the wisdom of having Siri as a Medical provider, and whether she can be trusted to stay on the straight and narrow.
Oral Chemotherapy Parity – David Williams knows his stuff when it comes to the ins and outs of the business of healthcare, and if that is on your radar, there is no better guide than his Health Business Blog. This week, he talks about the oral anticancer parity law, noting that while it’s not necessarily a bad idea to require health plans to charge the same out-of-pocket costs for oral anti-cancer drugs as they do for infused products, the law has unintended consequences, including rolling back co-pays on generic chemo meds used for other indications
Investing – At the blog Mom and Dad Money, Matt Becker says that investing in the stock market carries with it a very large risk, one that is rarely talked about in the financial media. In his post The Real Risk of Investing in the Stock Market, he challenges some of the conventional wisdom about investing, noting that success and failure may not be the only outcomes we should measure.
Risk of incarceration – Here at Workers’ Comp Insider, we recently assessed the risk of jail time for workers comp lawbreakers and advise any claimants with felonious intent to steer clear of Wyoming. Corporate malfeasants, not so much…
That’s it for this week’s Cav. The next host — two weeks from today — will be Nancy Germond at Insurance Writer Blog.

Entrustment: Risk on the Road

Wednesday, October 3rd, 2012

When risk managers scan the virtually infinite horizon of risk, they often overlook the single greatest exposure in the working world: driving cars and trucks on the roads of America. Today we approach the issue through the back door, wherein an individual killed in an accident was deemed not be in the course and scope of employment. It might be the backdoor, but it still leads to the same conclusion.
Linda Gadbois was a cook for the California prison system. She suffered a work-related injury and was sent to a doctor. When this doctor proved unsatisfactory, she was allowed to choose another medical provider from a list. After completing her appointment in May of 2008, she headed back to work. She was involved in an accident: Gadbois was killed; the other driver, Kenneth Fields, was seriously injured. Under the theory that Gadbois was “in the course and scope” of employment, Fields sued Gadbois and the state of California, her employer. No need to ask why: the state’s pockets were significantly deeper than those of the late Gadbois.
Going to Work
Field’s case rested on the interpretation of the “coming and going” rule: was Gadbois, leaving a medical facility after work-related treatment, inside or outside of employment? The court noted that she had requested the second treatment on her own. Her employer did not require her to drive to the appointment, nor was she required to drive as part of her employment. As a prison cook, the essential job functions were limited to her cooking: how she got to work was not her employer’s concern.
As a result, the fifth district appeals court concluded that the state was not liable for any injuries Gadbois caused while on her way to work. Field’s suit against the state was dismissed; the status of his suit against Gadbois is not known, though presumably he collected up to the limits of her personal auto insurance policy.
It is worth noting that Gadbois’s death was not compensable under workers comp. Gadbois was paid for the day of her death in accordance with a death benefit policy that covers all workers who die on a regular work day, whether at work, on the way to work, or on paid vacation or leave. Gadbois received her full salary for the day of the accident, but received nothing from workers’ comp. Had she received death benefits under comp, Fields would have had a stronger case.
Drivers: Good, Bad and Indifferent
While the specific circumstances proved Gadbois to be the exception, many people do drive in the course and scope of employment: obvious examples would be tradesmen, salespeople on the road and people whose customers are visited in their homes. But the circle of drivers must be expanded to include any and all employees who run errands or perform any aspect of their jobs in company cars or in personal vehicles.
Some employees do this company-related driving on a regular basis; others only sporadically. But any employee driving “in the course and scope” of employment is a representative of the employer. Whether consciously or not, the employer has endorsed the driving skills of employees whose work involves driving. Even if the employee is in a personal vehicle, the employer has, in effect, entrusted them with the keys. This “entrustment” may well comprise the riskiest part of the working day.
Basic Management
How should employers manage this risk? It’s really quite simple. Any and all employees who drive – or who might possibly drive – while working should be required to submit annual copies of their driving records. If there is a cost in obtaining the records, the employee should be reimbursed. The employer should review the records carefully and place restrictions on any employees with marginal or poor driving records. Indeed, the employer may well find that some employees who drive while working do not hold valid licenses. If these unlicensed drivers have accidents while working, the employer is on the hook for anything that happens.
In addition, employees should be required to report any moving violations, on or off the job. A speeding violation on the weekend might not preclude an employee from driving during work, but a formal warning would be appropriate.
Finally, prudent employers should have written policies on limiting the use of cell phones while driving and, needless to add, prohibiting texting. These policies should be enforced, with appropriate documentation and disciplinary action for any violations.
The risks of driving permeate our lives. When we drive in the course of work, the risks are shared by employee and employer alike, even if the latter is oblivious to the exposure. For the savvy manager, a well organized approach to the risks of driving goes a long way toward containing the ever-present perils of the open road.

Cavalcade of Risk Plus Frisky Risk Management

Wednesday, May 16th, 2012

The latest edition of Cavalcade of Risk, hosted by Dennis Wall at Insurance Claims and Issues, is up. It’s the risk-free option for checking out a potpourri of interesting posts related to risk.
And while we are on the topic of risk, let’s give a Bronx cheer for Jamie Dimon, CEO of JP Morgan Chase, for the work of his risk management team. The bank’s $2 billion plus loss was the result of “sloppy” and “stupid” trading, a “mistake” which involved “bad judgment,” and which caused losses that are “very unfortunate” and that come at an “inopportune time,” but which in any case are not “life threatening.” The risk management team is supposed to prevent such problems, not perpetrate them. Oh, well, that’s just the risk you take when your frisky risk managers manage risk.

Box office bonanza: Your summer guide to risk management & the movies

Tuesday, July 26th, 2011

NIOSH Science Blog’s recent blog post is taking on Hollywood – specifically, the summer’s blockbuster Horrible Bosses, an irreverent and risque dark comedy in which abused and aggrieved employees decide to murder their psycho bosses. We’d make the case that real life bosses can compete with the ones that Hollywood dreams up any day.
Complaining about bosses is an age-old tradition, but few take the concept of boss bashing literally. According to NIOSH, “The situations portrayed in the movie are not typical–worker-on-worker (or boss) violence accounts for only about 8% of workplace homicides. More than half of all workplace homicides occur in retail or service settings such as conveniences stores, taxicab services, and gas stations with the majority of these homicides occurring during a robbery.” The post author uses Horrible Bosses as a springboard to introduce and discuss the very real issue of workplace violence. It includes an array of links to related posts about professions that are particularly vulnerable to violent events, such as school personnel, taxi drivers, pharmacists, nurses.
This isn’t the first time that The NIOSH Science Blog has turned to Hollywood to illustrate health and safety issues. They’ve previously featured an entertaining pair of posts: Occupational Safety & Health in the Movies and OSH at the movies: the sequel. In the latter, the post author lists the Top 11 Films Depicting Occupational Safety & Health Issues, the Top 7 Films with Occupation Safety & Health Issues During Production, and the Top 10 Films in [a risk-related] Special Category.
Other online forums have tackled the issue of risk related issues in Hollywood from various angles:

  • RiskVue features the
    Top Movies No Risk Manager/Insurance Professional Should Miss
    , saying that, “The simple fact is risk managers and insurance professionals lack solid role models in the entertainment industry. Nevertheless, plenty of films have delved deep into the principles of risk and insurance management, offering lessons, guidance and a form of entertainment that only those in the industry can truly appreciate.”
  • A blog post at Consumer Insurance Blog deals with risks, hazards and liability issues involved in filmaking and production: Risk, insurance, & the movies. The post notes some of the risk issues involved in film making, which can include such disparate hazards as wild and trained animals, technology glitches, actors who have to leave the set mid-production to go to rehab, and weather related events that may delay production schedules or pose danger to the cast, the crew and the props.
  • Risk Management Magazine featured an article On Making Movies, highlighting insurane issues involved in the filmmaking industry. “The role of entertainment insurance is to determine the relevant risks of a project and create the necessary cushions and options to deal with whatever may come. Sometimes the crisis is large, such as that faced by A Simple Plan; other times it is one that requires minor alterations. An innovative and creative energy among all interested parties, from the director to the insurer, is vital to bringing audiences the kinds of movies so perfect in design, one cannot help but believe every minute.”

Here at WCI, our focus has been on TV. We are still awaiting the debut of that wacky TV sitcom Workers’ Comp. We haven’t heard about it since the report of the April filming – presumably the show will air in the fall. We are a tad skeptical and we aren’t the only ones:

Investigation report for the cruise from hell

Thursday, September 9th, 2010

Yesterday’s scary cruise ship video provoked quite a bit of interest, both in terms of our posting and also on the web at large. A few interesting follow-on links and stories have surfaced in the last day, which give added dimension to the story, particularly from a risk management perspective.
The 58-page Pacific Sun investigation report (PDF) adds more details about the event itself and the aftermath. It states that 69 passengers and 8 crew were injured, with 7 injuries considered major. Most injuries were the result of falls and contact with unsecured furnishings. Part of yesterday’s video footage was filmed in the Outback Bar and Grill, where the highest number of injuries occurred – involving at least 13 passengers and crew.
Some of the report highlights include:

  • Photos – pages 9, 12, 13, 15, 19, 21, 23-4 and 25
  • Safety issues directly contributing to the accidents – page 47
  • Actions taken – page 49
  • Recommendations – page 50

The report states:

“As a consequence of this accident, Princess Cruises has taken action to: supply its bridge teams with night vision glasses; improve deck officers’ training in the risks associated with heavy weather; and review the securing arrangements for its vessels’ satellite communications equipment.
Princess Cruises has been recommended to: review the role of active stabilisers in ensuring passenger safety; review the risk of injury from moving furnishings and objects, and develop suitable means of securing such items for heavy weather; develop a standard for securing furnishings and equipment in public spaces; and develop its heavy weather guidance and instructions to include actions to reduce the risk of injury to personnel.
MAIB has recommended that the Cruise Lines International Association and the Passenger Shipping Association develop a guide on industry best practice based on Princess Cruises’ standard for securing furnishings. The trade associations have also been recommended to promulgate the lessons learned from this accident to their members.”

For more reports on safety issues related to the cruise industry, Cruise Junkie makes for some fascinating reading. The site bills itself as “your resource for the other information about the cruise industry, including reports on accidents, health issues, illness outbreaks, sinkings, groundings, disabling events, and persons overboard reports. It includes events broken down by cruise line and by ship. The site presents information from passenger reports and events that have made it into the public domain.

David Warren and the Little Black Box

Monday, July 26th, 2010

David Warren died last week in a suburb of Melbourne, Australia. He was 85. You may never have heard of this aeronautical researcher, but his work has impacted anyone who travels by air. David Warren is credited with the invention of the black box. (A splendid obituary by Douglas Martin in the New York Times can be found here.)
In 1934, when Warren was just 8 years old, his father died in a plane crash. His last gift to his son was a ham radio set. After earning a PhD in chemistry from the Imperial College in London, Warren went to work for the Australian defense department, where he investigated a spate of civilian air crashes.
Thinking like a good risk manager, he recognized the need for better data at the time of the crash. He volunteered to work on developing a flight recorder system. His bosses were not impressed. One went so far as to say: “If I find you talking to anyone, including me, about this matter, I will have to sack you.”
His peers went on to note that if his idea had any merit, the Americans would have already made it (!). Preserving pilot conversations would yield “more expletives than explanations.” (The pilots, naturally, did not like the idea of a permanent record of their chatter.) It was only a visit by a high ranking British aviation official in 1958 that triggered a positive response. Warren was flown to England to show off his little black box (which, for the record, was and remains red or orange). The rest, as they say, is history – a history that has significantly enhanced our ability to understand exactly why a given plane went down.
Obscurity and Fame
We live in an age of instant (unmerited) celebrity: you can become rich and famous for doing absolutely nothing (did someone say Snooki???). The quiet Australian David Warren accomplished a great deal in his long life and managed to stay in the background. He was able to transform the painful loss of his father into safer skies for everyone. It will not surprise you that he never profited from his work. Even if his government had offered him all the profits from his invention, he says he would have refused. He quipped that if he were to profit from his good idea, he might also get billed for the ones that amounted to nothing.
The latest generation of black boxes are self-ejecting, encased in steel and insulated against fire. They provide more than 200 measurements and dump data 128 times a second. These technical wonders have their origins in the mind of young child tinkering with a radio set and dreaming of a father who never came home. We should all be grateful for the exemplary life of this humble man.

A Question of Language?

Monday, July 19th, 2010

The following guest post was submitted by Gary Anderberg, Phd, the Practice Leader For Outcomes and Analytics at Broadspire.
I was participating in a recent meeting of health, wellness, workers’ compensation and disability professionals. One of the issues on the table was information that the regs defining “Cadillac” plans may loop the cost of wellness programs, disease management and other health related productivity benefits into the total cost of the employer’s health plan for purposes of assessing penalties. If this intelligence is correct and if such provisions become effective, most large employer plans, so defined, will be subject to potentially expensive penalties, thus strongly incenting employers to relegate employee health care to the soon to be created exchanges.
This question stirred up a wide ranging discussion of how to frame the value of health and productivity programs for employers. For the last several years, most of the players in this space have been using the “investment” and “ROI” model, telling employers that they will reap rewards for astute investments in employee health and productivity. As a practical matter, returns on investment have been problematic to quantify. There is broad, intuitive agreement that a healthier workforce is a good thing, but what does it drive to the bottom line?
I suggested a different model — risk management. If trained, knowledgeable, productive employees are indeed a corporate asset — like trucks, buildings, airplanes, equipment, and so forth — then the health and well being of those employees presents a major risk exposure for the corporation in very immediate terms. We know that as the overall well being of a workforce declines, not only do absences of all types go up, but so do opportunity costs and the costs of poor performance and decision making. As absence rates and disability claims climb, more positions are filled by new employees with less experience and training than the absent workers. Mistakes get made, customers do not get the service they expect, and product quality suffers.
I suggested that, properly viewed, health plans, chronic disease programs and all types of effective wellness programs are really risk management tools in much the same way that fleet maintenance is a risk management tool. We assume that companies will maintain their eighteen wheelers and provide safety courses for their drivers, but the health and well being of the person behind the wheel is equally critical to the company’s risk exposure when a truck is on the road.
Every time a company hires a new employee, it takes on a new risk. For every employee on the payroll, from the CEO on down, there is a definite risk cost of employment which is based in large part on that person’s health and well being. So, are health, wellness and productivity programs investments with uncertain returns or are they critical risk management tools which allow the employer an important measure of control over the performance of a key asset — employees? It seems to me that these tools are vital to controlling employment costs and critical parameters of product and service delivery, especially in a world of very lean staffing and just in time management.
To my mind this is not just a question of which metaphor to use. Managing risk is real and the consequences of poor risk management are often dramatic and even tragic. I wonder how many companies would consider handing over the maintenance of their critical manufacturing and distribution equipment to a government program just to save a few bucks. But how many employers may be tempted to do the same thing if the soon to be created healthcare exchanges offer a short term dollar saving?
The words we use to frame decisions can carry massive consequences. If you think about the health and well being of your employees as a risk exposure to be effectively managed to minimize replacement costs and the expense of suboptimal performance and errors, what might you do differently? Think about it.

Cavalcade of Risk, Picnic Edition, seasoned with a dash of risk management humor

Wednesday, July 14th, 2010

Jaan Sidorov dishes up a summer smorgasbord of risk at the 109th Cavalcade of Risk Picnic edition over at Disease Care Management Blog.
Speaking of risk, yesterday Business Insurance twittered: Among the accomplishments of the legendary George Steinbrenner: making George Constanza learn about risk management. Risk management isn’t a topic that surfaces in TV sitcoms too often, so we thank them for the reminder – check out a You Tube clip of Seinfeld’s classic segment on risk management.
As long as we’re having a bit of fun with risk management, let’s up the ante a bit by throwing in some actuaries and accountants. A newly discovered blog that we are happy to recommend – Actuary Info – features many interesting and deliciously nerdy posts. For today’s purposes, we call your attention to these two:
Actuarial Risk Management Humor: During the pause of a Risk Management conference, a professional risk manager, an accountant and an actuary were in the gents room standing at the urinals …
Actuarial Risk Management Puzzle Joke: Three actuaries and three accountants are traveling by train to visit a ‘Risk Management Conference’. At the station, the three accountants each buy tickets and watch as the three actuaries buy only a single ticket…

Cavalcade of Risk and a news roundup

Thursday, July 17th, 2008

Michael Cannon is hosting Cavalcade of Risk this week and he’s posted a diverse collection of risk-related links at The Cato Institute blog – good end of week reading.
Insurance reform – Is insurance due for a regulatory overhaul? The move to an Optional Federal Charter appears to be gathering steam. To help you stay informed on the topic of insurance reform, Networks Financial Institute at Indiana State University has recently launched an online Insurance Regulatory Modernization resource. It is designed to serve as a clearinghouse for resources relevant to insurance regulation and reform.
Health care debate – Kaiser Family Foundation has compiled Viewpoints: The Health Care Debate. This is a series of interviews with leaders of organizations representing health care providers, insurers, policymakers, employers, labor unions and consumers sharing their views on shortcomings in the nation’s health care system and how it could be improved. Interviews are available in video, podcast or transcript formats.
Prescription promos – Merrill Goozner notes that the pharmaceutical industry is trying to eliminate the practice of showering physicians with gifts and trinkets emblazoned with drug brand names. (We’ve previously discussed promotional efforts based on dining and pom poms.) Goozner suggests the voluntary ban should be broader, and notes that it doesn’t get to the most significant ways that drug companies influence doctors. He suggests additional practices that should be banned.
Kudos to Jottings By an Employer’s Lawyer – Michael W. Fox just celebrated his 6 year blogoversary yesterday – his informative and excellent law blog is one of our regular reads – we’re happy he keeps on keeping on. Congrats, Michael!
Physician humor – although we don’t think it is a medical specialty often called upon for work-related injuries, we can’t resist posting the Colorectal Surgeon Song (video). It’s a silly but amusing ditty performed by popular Canadian comic duo Bowser & Blue.

Cavalcade of Risk’s first edition of 2008

Thursday, January 3rd, 2008

Jonathon Pletzke of Consumer’s Health Insurance Book Blog does a fine job hosting this week’s back-to-work edition of Cavalcade of Risk – the first edition of the New Year. We’ll be hosting the January 16 edition here at Workers’ Comp Insider. Also, Health Wonk Review had a brief holiday hiatus but will be returning to its regular schedule a week from today with a stop at Bob Laszewski’s great blog, Health Care Policy and Marketplace Review.