September 18, 2018

Archives for December 2013

Off-Topic: My Top 10 Books of 2013

As this is the last blog post of 2013, please indulge me an off-topic digression as I salute the top ten books I’ve read over the past year.  Over the past six years, I have read between 69 to 105 books per year. (This diabetes y viagra year, my total weighed in at 71, but I was not aiming toward any particular goal.) I do confess to being a enthusiastic reader as well as a book-aholic.

Bookaholic

I also confess that none of the following books directly address the profession of insurance claims adjusting. However, at least three of them are applicable to the context of adjusters.  Two apply to adjusters as thought workers who must generate ideas in order to excel at their professions. In addition, another book aimed at boosting productivity is chock-full of tips which can be embraced and adapted by adjusters to improve their effectiveness.

Therefore, without further ado and without

a drum roll, I humbly nominate my favorite 10 books from 2013:

            #1.  Learn, Create, Teach: A Guide to Building a Creative Life by Claire Lieu.  This book was an unexpected gem.  Don’t think that is doesn’t apply to you because you’re not a painter, sculptor, novelist or actor.  Any knowledge worker that has to generate ideas can use this book.  (See my expanded review on Amazon.)

            #2.  Blue Plate Special: An Autobiography of My Appetites by Kate Christensen.  Hard to put down  this autobiography of novelist Kate Christenson, who I term a “culinary cougar with oversized appetites.”

            #3.  Man Alive by Mary Kay Zuravleff.  Pediatrician gets struck by lightning and becomes obsessed with barbequing.  Sounds like a realistic novel premise to me!

            #4.  What the Most Successful People Do Before Breakfast by Laura Vanderekam.  I admit it — I’m a productivity geek.  As such, I couldn’t resist this book. 

            #5.  Sparta by Roxana Robinson.  Fiction comprises only about 15-20% of my reading, but this poignant portrayal of a Marine trying to re-integrate himself into mainstream life is compelling.

            #6.  Nine Inches: Stories by Tom Perrotta.  I’ve read ALL of Tom Perrotta’s books, so I’m a sucker for anything he puts out.  Some have termed him “the Steinbeck of suburbia.”  I was not disappointed by this collection of short stories. 

            #7.  One for the Books by Joe Queenan.  I wish I was clever enough to write like Queenan, who’s weekly Saturday column in the Wall, Street Journal is like a whipped cream dessert for the soul.  Queenan is not only a gifted writer, but a voracious reader who puts me to shame.  This stroll down his reading journey was manna for this book-aholic.

            #8.  Damn Few: Making the Modern SEAL Warrior by Rorke Denver.  I’ve long been fascinated by the Navy SEALS, well before the spectacular bin Laden raid thrust them back into the limelight.  If you are at all interested in the elite of America’s warrior class, you must read “Damn Few”!

            #9.  The Creative Habit: Learn it and Use it for Life by Twyla Tharp.  A great companion volume to “Learn, Create and Teach.”   

            #10.  Collision Low Crossers: A Year Inside the Turbulent World of NFL Football by Nicholas Dawidoff.  If you are an NFL fan — and even if you don’t like the New York Jets — you will love this book.  The author spends a year embedded with the Jets organization to give you an inside view of the exhausting but exhilarating job of coaching a professional football team. 

For all of you who read the weekly Claims Coach posts, I deeply appreciate your time and appreciate the insights of those who have commented upon posts and who have responded in different ways on LinkedIn and through direct outreach.

I wish you a happy New Years and a very successful 2014!

A Christmas (Coverage) Carol …..

What follows is a Christmas poem penned by my good friend, attorney Dan Kohane of Buffalo, NY.  Dan is a terrific insurance coverage attorney with whom I’ve worked over the years and a partner with Hurwitz & Fine P.C. in Buffalo, NY (www.hurwitzfine.com).  With his permission, I am sharing this bit of holiday verse with you to offer a chuckle and to bring holiday cheer as “The Claims Coach” winds down one year and begins to prepare for the new one!

Grinch

Christmas Coverage
or
A Policy for Saint acheter viagra pfizer nasl kullanlr Nicholas

Dan D. Kohane

With apologies to Clement Moore (or less)

 

`Twas the night before Christmas, and all through the land,
Few coverage advisors were still in demand.
The policies still showed on both desk and on screen.
My eyes only open with thanks to caffeine.

Most of the adjusters had left for the day;
And coverage lawyers had little to say.
It was surely the moment to turn out the light,
Shut down the computer, put work out of sight.

Then the phone started chirping — startling my poise,
Not typical ring-tones, but an odd sounding noise.
It jingled like sleigh bells, instead of a “ding,”
I knew I must answer, despite everything.

A Christmas Eve caller? What could be the need?
But the sound of the music, would just not recede.
I was really not looking for Christmas Eve banter,
Imagine my shock when the caller was Santa!

“I need some advice, sir” said a somber Saint Nick,
“My Christmas Eve Policy is three inches thick.”
I don’t mean to bother, but I’m wrought with confusion
“I don’t understand this new ‘Gifting Exclusion.'”

“It carves out the nasties, the mean and the haughty.
It favors the good ones and leaves out the naughty.
My coverage appears to have holes like Swiss Cheese,
I’m afraid if I’m sued, I’ll twist in the breeze.”

“A products exclusion? A chimney one too?
“Elf employment exception,” I’m screwed through and through.
Just what IS still covered? I sure am confounded,
With all of these issues, I’m fear that I’m grounded.”

“With a sleigh full of sacks and reindeer all ready,
I’m starting to feel just a tad too unsteady.
My belly has acid, my knees are a’quiver
With millions and millions of toys to deliver.”

“I need you to help me, I fear a disclaimer.
This policy’s scary; I need you to tame her.
We must surely save Christmas, for good girls and boys,
(And Amazon won’t refund “squat” on the toys.)

The holiday challenged, I sure knew my mission
We needed to draft a new ISO version.
Santa needed an ally, a comrade, a fighter,
On the opposite side was a Grinch Underwriter.

I’m sure you’d imagine how hard it would be
To secure for Saint Nick a quick policy,
Without coverage gaps, so that Santa could fly,
To save Christmas Day, we were destined to try.

The person in charge of the coverage for Nick,
Had left the shop early, was feeling quite sick.
Perhaps it was sadness, or guilt or just gumption,
He thought he’d killed Christmas, a well-placed assumption.

In order to soften his hardening heart.
We had to play coy, we had to be smart.
We needed to dazzle that Grinch with our guile,
To show him the risk was sure worth his while.

Worse yet, betwixt and between stood a broker,
A bloodsucker culled from the mind of Bram Stoker.
Through him we must go, around or about,
He’d bring pressure to bear, he’s really got clout!

“It’s Santa,” we’d say, “who’d sue him for cash?”
“Another broker can get a better deal in a flash.
We’ll go to the market if a deal can’t be made;”
The Grinch saw his bonus beginning to fade.

From the cream of the crop, a new team we’d assemble,
To get Santa bound and to weaken his tremble.
We’d send out the e-mail, post Facebook and Twitter
We needed to find the best of the litter.

The other apt choice, as the time slipped on by,
Was to use those fine people, to

make him comply.
By plane and by car, by boat and by train.
We beckoned this family to join in refrain.

And gather they did, first a few then a score,
Lawyers and brokers and claims folks galore. 
More than a choir, it was surely a throng,
Together they sang us beautiful song.

And they reached that man’s spirit, his heart and his soul,
And in no viagra sans ordonnance time at all, they’d accomplished their goal.
“Give me my pen!”, the Grinch yelled to his clerk.
I knew then and there that our ploy it had worked.

“Exclusions begone! Limitations not there!
We’ll provide him his coverage, no need to beware.”
And so it was written, and Santa could jet,
And Christmas was saved, the best Yuletide yet.

On cold winter nights, when you’re hearing his jingle,
When the children are sleeping and in comes Kris Kringle,
Remember that coverage protected his flight,
Happy Christmas to all, and to all a good night!

 

5 Steps to Risk-Proof Company Holiday Socials

Looking forward to your company’s holiday party this year?  Are you doing anything

special to celebrate the past year of claims-handling successes and challenges? 

buzzkill-300x278

With the year-end holiday season, many insurers, TPA’s and related claim organizations eagerly await festive company-sponsored social events that reward workers, encourage bonding and provide healthy outlets for relaxation. 

While these events serve a positive purpose, parties, socials and similar events can create legal liabilities.  Employees leaving company socials after drinking immoderately may – while driving home — injure themselves or others.  Alcohol-induced settings may lower inhibitions as well, producing environments conducive to sexual harassment claims.  Poorly managed socials can create potential legal liabilities.

Bah humbug, you say?  Before decking the halls with boughs of holly, consider the following steps to ensure that holiday socials do not cause your company personnel and legal headaches.

#1.  Offer cab fare reimbursement – no questions asked  A former corporate risk manager – an inveterate iconoclast — recalls, “About 20 years ago (after a holiday accident involving drinking and a company car) we started an annual `Rickshaw Rebate.’ We’d offer up to $20 reimbursement to any employee who went to a holiday party, had `too much’ and took a taxi, bus, ferry, train, or rickshaw home. No questions asked, nothing in the personnel file, just send a receipt. We didn’t have many takers, but didn’t have any holiday accidents either.”  

“The branch/office manager was not involved, hence an employee would not be embarrassed to submit a receipt. What we often got was a receipt for a van where multiple employees hired a van or limo with driver for a party, and split the cost between six or seven employees. That, too, was okay, as long as it kept them out of their own cars and off the highway.”

#2.  Hold Socials Off-Premises and Invite Families  If you must have a holiday social, hold it away from the plant, factory or office.  Include employees’ families – including children. A crowd’s demeanor changes dramatically with families present.  A calmer, more sedate atmosphere encourages sobriety and reduces the odds of driving while intoxicated.

#3.  Establish Drinking Maximums  Once an employer provides alcohol, liability expands.  Avoid this by setting drink limits in advance.  For example, at one function, a risk manager approved a two-drink maximum.  Employees didn’t know this until they arrived.  If they wanted to continue consumption, they had to stroll down to the bar next door.

Another office held a barbecue and free bar lasting all afternoon.  In strategic places around the building, though, were signs saying, “The police are aware of Friday’s function – please make sensible arrangements for getting home”.

#4.  Outsource the Alcohol Service Make sure that the company is not “serving” the alcohol.  In other words, any bar should be tended by an employee of the host establishment (hotel, restaurant or club).  Make sure all invitees are aware that their attendance is discretionary, not required. 

Make sure that an agent of the company or host is authorized to pay for cabs or rooms if someone seems to be too tipsy to drive, etc. Have someone else serve the alcohol i.e. restaurant hotel etc. If they use their own premises and do not want to rely on their own liability insurance, purchase a “host liquor policy” for the party.

#5.  Hold the party during the day and serve non-alcoholic punch.   No law says that such parties always must be at night.  Employee’s schedules are jam-packed during the holiday season.  Many workers might appreciate not having the stress of trying to cram an already busy schedule and dress up for a quasi-obligatory company social function which they’re too tired to enjoy fully.  Having the social on-site – sans alcohol — solves this problem and lowers the potential for post-party mishaps.

Company Christmas and holiday socials illustrate the occasional conflict between legitimate celebration and sober-minded risk management. The only way to eliminate risk with certainty is to avoid it entirely.   

To avoid problems from company-sponsored holiday socials, consider these seven tips.  Sound risk management can create an environment that fosters fun and conviviality, without the sponsoring company playing the role of Scrooge.

           

Responding to Opposing Counsel’s Demand, “Henceforth, all communications should be in writing…”

So you’re handling a bodily injury claim and you receive a letter from claimant’s counsel, which decrees, “Henceforth, we request that all communication with this office be in writing.”

Trust

As the adjuster handling the case, how do you respond?

Your reaction may be to resist allowing opposing counsel to dictate the terms of communication. Whoever determined that they unilaterally dictate the ground rules?  What if you have a quick question that might help move the case along? Do you comply or simply ignore this ground rule?

It chafes because the request may be overbearing. It sends the message that, “We don’t trust you.” 

The adjuster could agree. 

Alternatively, the adjuster could counter: 

            “Please explain why you will not be willing to communicate by phone” or …

            “I respectfully decline to play by such unilateral ground rules.  I would http://www.cialisgeneriquefr24.com/cialis-gratis/ prefer the option of communicating both by phone and in writing” or …

            “If you wish to confirm in writing the gist of any phone conversation, I am agreeable to that.  However, I do not agree to forgoing the use of telephone — a standard business tool that fosters discussion, negotiation and timely communication — in lieu of a formalistic `in writing only’ edict.”

It may behoove the adjuster to accept these terms and communicate in writing. There may be a silver lining here. By placing communication in writing, there may be less chance of miscommunication. There is a paper trail to show that the adjuster did communicate with opposing counsel and who said what.

Of course, misunderstandings can still occur in the context of written communication as well as telephone or in person communication. However, the odds are such communication glitches. Many be reduced when communication is reduced to writing.

Adjusters also be wary in thinking that such request signals an attempt of part of opposing counsel to “set up” the adjuster and carrier for a bad faith claim. I have attended seminars and webinars where defense attorneys cite this as one “signpost” that opposing counsel is trying to “set up” the adjuster and insurance company for a bad faith claim.  As such, this request or demand from opposing counsel can and should serve as a flashing yellow warning sign. 

One downside is that reducing all communication in writing takes more time than simply picking up. It also precludes the kind of back-and-forth dialogue or communication which can be useful to develop fact, determine liability or negotiate resolution of claims.

In addition, to the extent that claim negotiations are often a function of relationships built between the negotiators, reducing all communications to  writing thwart the development of genuine relationships. It gives rise to a greater temptation for posturing between the two parties in order to preserve the record for later assessment.

We have likely all heard the saying, “You can’t fight City Hall.”

Likewise, despite the downsides, adjusters may it better off in simply complying and not making an issue of it, if and when opposing counsel insist that all communication take a written form.  Don’t be paranoid, but take it as a sign that you may be being set up for a bad faith claim. Mind your P’s and Q’s.  Sweat the details to insulate yourself from a bad faith allegation.  Preserve the record and document the claim file in case months or years down the road, claim file has to be subpoenaed in connection with a bad faith case.

Paranoia?  Not necessarily. 

As one wit said, “Even the paranoid have enemies.”

Finally, when claimants call about the status of their file or to ask, “Where’s my check?!,” you can calmly inform them that all communications — per his or her attorney — must be in writing.

Q:  What has been YOUR response and reaction when you receive such a request/demand from opposing counsel?  Please post here OR directly to me offline at kevin@kevinquinley.com

Top Ten Thanksgiving Risks …

Sick of Turkey yet?

Funny Turkey

One occupational peril of being a claims person is that we see the potential for risks, accidents and claims everywhere. Our national day of thanks is no exception. While the holiday is meant to be a time of family reunion and gratitude for blessings in our lives, it has morphed into another pre-Christmas retail and consumer-buying orgy. In turn, this has spawned a host of turkey day related risks and perils which, as claim professionals, we should ponder:

1.  Fires from turkey fryers. Catching fire is not just a sequel to the first installment of the “Hunger Games” trilogy. It also results from turkey fryers. Fried turkey is delicious (or so I hear) but not so tasty are the aftereffects of hot spilled grease and fires which often occur in connection with these devices.

2.  Food-borne illness claims from eating under-cooked turkey or other foods left out at room temperature too long. You do not want guests getting sick from salmonella or some other pathogen. Your hospitality — not food borne illness — should be “the gift that keeps on giving.”

3.  Parking lot car collisions in crowded spaces. Maybe you’re one of those people who drives around and around, looking for the ideal parking space. Better still, park in one of the peripheral or remote areas and walk to the store front. Chances are, the extra exercise and burning of calories will do you good, particularly during the Thanksgiving weekend.

4.  Assault and battery claims from testy retail customers coming to blows while fighting and squabbling over merchandise.”Hey — I saw the PS4 system first!!!” Fortunately, in 2013 there appears to be no “it” toy that everyone must have, like the Beanie Babies of yore. Nevertheless, some coveted items are in short supply. Both Xbox and Sony are rolling out new game consoles, coincidentally time for Christmas release. Occasionally, tempers fray when door-busting consumers compete for one of the limited supply of merchandise that they MUST have. This spawns liability claims against retailers for failure to have adequate security.

5.  Increased premises liability claims for retailers dealing with high volume of customer traffic.  Slips, trips and falls increase. 

6.  Dram shop liability by restaurants and bars serving one-too-many to those who have clearly had enough.

7.  Assaults by family members upon each other while being cooped up in the same space due to family obligations. People, this is why they put NFL football on TV during Thanksgiving Day.   Starting at midday and ending at around 11:30 PM, you have a built-in reason to distract yourself from interacting with family members who you may only see once a year.

8.  Increased vehicular accidents from clogged roads and frayed nerves as drivers strive to go over the river and through the woods to grandmother’s house.  The National Safety Commission reports that Thanksgiving is the most traveled holiday period of the year with almost 90% of those traveling doing so by car. Of course, you can also travel by plane but…

oh well, never mind!

9.  Personal health risks from over-eating on Thanksgiving … and throughout the holiday season.  Tip: moderate your portions or run around the block a few times before tackling that slice of pumpkin pie topped with Cool Whip.

10.  Gambling losses .. IF you bet on the Detroit Lions, except in 2013, when they actually won for the first time in years!

If you successfully navigate Thanksgiving without stumbling on one of these risks, congratulations!

There’s always the

Christmas season!

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