WARNING: Football Helmet and Pads Could Make You Hot!!
In late January, the widow of NFL player Korey Stringer settled her liability claim and lawsuit with the NFL following her husband’s heatstroke death at the Minnesota Vikings training camp in the Summer of 2007. Stringer’s wrongful death lawsuit alleged that the NFL had not done enough to ensure that the equipment used by players protected them from heat-related injuries and deaths.
Strnger’s string of lawsuits included an earlier medical malpractice suit against the hospital that treated the lineman after e collapsed in the 100+degree heat. That lawsuit had already been settled.
But the lawsuits are not over. Still open is a claim and product liability lawsuit against Riddell Inc., the maker of the football helmet and pad. Apparently these products were defective because they lacked warnings to the effect that wearing helmets and pads in hot temperatures could be dangerous. Incredible!
Come to think of it, this could open the way to further litigation. Examples:
• Suits against General Motors for not putting written warnings on accelerator pedals.
• Litigation against Harley Davidson, for not designing motorcycles with roll-bars.
• A potential class action against Sarah Lee for irresponsibly baking with BUTTER for the last 30 years.
As Super Bowl Sunday approaches, hazards abound. That’s the bad news.
The good news: there are deep pockets to sue!
Recent studies show that Super Bowl Sunday brings a spike in drunk driving accidents and stomach ailments due to the mix of booze and bar food.
Further, doctors report that people who drink too much during the game and fail to go to the bathroom develop urinary retention, possibly warranting later catheterization. Come to think of it, most of the target audience for those Flomax commercials may be off making a head call at the very moment the ads air!
Other Super Bowl mishaps include:
• A guy getting so drunk he broke his teeth trying to open a beer bottle
• Fans who strained their backs while jumping up to cheer
• An upset fan so ticked off with his team’s performance, he tossed his TV set out the window of his third-floor window.
And we haven’t even gotten to the scourge of wardrobe malfunctions!
All these folks might form a class action lawsuit against the NFL, alleging that the League failed to warn them of the various hazards attendant with watching the game.
I just hope my cardiologist has adequate medical malpractice limits in case my ticker goes haywire while I’m watching that sexy PETA commercial …
Friday, January 30, 2009
Tuesday, January 27, 2009
Safe US Airways Landing May not Avert Claims Splash and Courthouse Dash
When I first heard of the miraculous landing of the US Airways Flight 1549 jet in the Hudson River two weeks ago, my first reaction was, “Oh boy – here come the lawsuits.” True confessions from a hard boiled cynical claims person. Even though each passenger survived the landing due to pilot “Sully” Sullenberger’s heroics, I assumed lawsuits would be filed. Grounds might include soft tissue injuries from the bumpy maritime landing, to mental anguish from fearing a crash to exposure to cold during the rescue process.
Now it looks like I may have been premature in my suit-happy assumptions. (See, “Savvy US Airways Pilot May Have Grounded Lawsuits,” http://www.insurancejournal.com/news/national/2009/01/23/97196.htm
Some say that the pilot may have not only averted a tragedy, he may have averted lawsuits. Moreover, flying into a flock of geese might be termed an “Act of God.” Still, I figured lawyers would find some theory of liability, like a different jet engine design would be more impervious to bird strikes, or that the aircraft lacked equipment to detect bird flocks or that the airport authority knew of the bird peril but failed to alert the airline. God forbid that there be no deep pocket to sue! This is, well, un-American!
Pundits are having fun with the splash, though, some suggesting that . . .
• US Airways’ new marketing slogan should be, “One if By Land – Two if By Sea!”
• Each flight will now have an on-board cruise director as well.
• To generate revenue for the cash-starved airline, US Airways might consider charging $25 apiece for each personal flotation devices used.
• All on-board music courtesy of the group, “Flock of Seagulls.”
Since all passengers and crew survived, we can now chuckle . . . at least until the Summons and Complaints are served.
Too bad the aviation lawyers cannot sue the geese, especially since it is rumored that the birds were distracted in flight by text-messaging each other … Alas, no liability coverage on the geese. (This coverage gap may be an issue befitting the Loyal Order of the Blue Goose, come to think of it.)
Other aviation lawyers are having none of the “Act of God” spiel. By golly, there has got to be someone to blame! (Better still if they have liability insurance coverage.) I often quote the anonymous sage who once said, “Death is not the end; there remains … the litigation.”
When it comes to aviation mishaps, perhaps we can say the same about safe landings.
Now it looks like I may have been premature in my suit-happy assumptions. (See, “Savvy US Airways Pilot May Have Grounded Lawsuits,” http://www.insurancejournal.com/news/national/2009/01/23/97196.htm
Some say that the pilot may have not only averted a tragedy, he may have averted lawsuits. Moreover, flying into a flock of geese might be termed an “Act of God.” Still, I figured lawyers would find some theory of liability, like a different jet engine design would be more impervious to bird strikes, or that the aircraft lacked equipment to detect bird flocks or that the airport authority knew of the bird peril but failed to alert the airline. God forbid that there be no deep pocket to sue! This is, well, un-American!
Pundits are having fun with the splash, though, some suggesting that . . .
• US Airways’ new marketing slogan should be, “One if By Land – Two if By Sea!”
• Each flight will now have an on-board cruise director as well.
• To generate revenue for the cash-starved airline, US Airways might consider charging $25 apiece for each personal flotation devices used.
• All on-board music courtesy of the group, “Flock of Seagulls.”
Since all passengers and crew survived, we can now chuckle . . . at least until the Summons and Complaints are served.
Too bad the aviation lawyers cannot sue the geese, especially since it is rumored that the birds were distracted in flight by text-messaging each other … Alas, no liability coverage on the geese. (This coverage gap may be an issue befitting the Loyal Order of the Blue Goose, come to think of it.)
Other aviation lawyers are having none of the “Act of God” spiel. By golly, there has got to be someone to blame! (Better still if they have liability insurance coverage.) I often quote the anonymous sage who once said, “Death is not the end; there remains … the litigation.”
When it comes to aviation mishaps, perhaps we can say the same about safe landings.
Saturday, January 17, 2009
Practice Checklists: If Surgeons Can Benefit, Why not Adjusters?
This week a number of articles emerged about how simple surgery checklists improve patient care, save lives and reduce adverse patient outcomes. (For starters, see http://www.time.com/time/health/article/0,8599,1871759,00.html)
The idea is that before surgery, the surgical team as a group completes a checklist that includes
• Verifying the patient’s identity
• Confirming the site and type of surgery to be performed
• Confirming availability of backup blood supply “just in case”
• Post-surgery – accounting for ALL sponges used during the procedure
A recent study published by the New England Journal of medicine shows that the use of such checklists can cut patient mortality rates nearly in half and complications by over one third.
This has implications not only for medical malpractice risk management and claim defense, but may have broader implications for claims handling and management across the board.
For example, if surgeons can improve their own risk management practices by using checklists, perhaps a claim offices can as well. Does your claim office have as resources checklists readily available for of the claim staff, checklists that are customized to handling all of the various types of claims that come across you were desks?
Yes, I can anticipate retorts that good claims handling amounts to much more than just working from a punch list were a checklist. I also anticipate surgeons arguing that good medicine involves much more than simply working one's way down a punch list or a checklist.
Fair enough. Nevertheless, as a framework for surgical practice or adjusting practice, perhaps there is a kernel if not more than just a kernel of a sound idea here.
How many client lapses were botched assignments might have been averted had the adjuster had access to and used a thorough checklist that encompassed all of the major contours of claim handling?
If it works for surgeons, why not for claims adjusters?
The idea is that before surgery, the surgical team as a group completes a checklist that includes
• Verifying the patient’s identity
• Confirming the site and type of surgery to be performed
• Confirming availability of backup blood supply “just in case”
• Post-surgery – accounting for ALL sponges used during the procedure
A recent study published by the New England Journal of medicine shows that the use of such checklists can cut patient mortality rates nearly in half and complications by over one third.
This has implications not only for medical malpractice risk management and claim defense, but may have broader implications for claims handling and management across the board.
For example, if surgeons can improve their own risk management practices by using checklists, perhaps a claim offices can as well. Does your claim office have as resources checklists readily available for of the claim staff, checklists that are customized to handling all of the various types of claims that come across you were desks?
Yes, I can anticipate retorts that good claims handling amounts to much more than just working from a punch list were a checklist. I also anticipate surgeons arguing that good medicine involves much more than simply working one's way down a punch list or a checklist.
Fair enough. Nevertheless, as a framework for surgical practice or adjusting practice, perhaps there is a kernel if not more than just a kernel of a sound idea here.
How many client lapses were botched assignments might have been averted had the adjuster had access to and used a thorough checklist that encompassed all of the major contours of claim handling?
If it works for surgeons, why not for claims adjusters?
Friday, December 19, 2008
Insurance Renewals: Seven Ways to Assess Claim Service
Great American Insurance Company is catching flak from some policyholder and legal quarters for a coverage stance it has taken on a Houston office fire. Three people died in a 2007 blaze and their estates are suing the building owners, who are insured by Great American. The insurer is disclaiming coverage based on the policy’s “pollution exclusion,” arguing that smoke is a pollutant and the smoke caused the fatalities. At issue is $25 million in claims. Is this a smokescreen or a legit coverage defense?
Those voting “smokescreen” seize on this vignette as an example of bad claim service and the need for insurance buyers to factor in quality of claims-handling when making insurance buying decisions. I will not endorse or excoriate Great American’s coverage stance. Rather, my focus is on how risk managers and insurance buyers can assess claims-handling quality in the buying equation.
Call me a cynic, but I wonder how many risk managers or buyers would still take an insurer’s price if the quote was low enough. Put differently, I wonder just how much – if at all – a “bad claims reputation” really weighs materially in buyers’ decisions if they can save dollars on coverage cost. Too often lip service is paid to claims-handing quality, but too often in the real world marketplace -- when push comes to shove -- it’s more often all about “getting the lowest quote.”
Premiums are expressed in dollars and cents. The cost is measurable. Financial rating agencies like A.M. Best and Moody’s provide quantitative assessments of financial strength.
Measuring quality of claim service? That sounds pretty warm and fuzzy. Here, however, are seven suggestions for risk managers and insurance buyers in trying to assess the quality of claims handling for a prospective insurance partner:
1. Ask for client references and contact information. (The obvious drawback here is that the insurer would have to be an idiot to give anything other than cherry-picked, glowing references.)
2. Have your insurance broker assess the industry perception and “scuttlebutt” about a candidate carrier’s claim service.
3. Check with the state Insurance Department regarding the number of complaints filed against a carrier. (In some states, you can do this on-line.)
4. Ask the insurer for the resumes of the claim professionals who would be handling your claims. If it balks or says it cannot determine who would be in charge of your claims, that is a bad sign.
5. Ask the insurer rep to give you three reasons why their claim service is better than the competition. If they bumble stumble or harrumph, move on to the next candidate.
6. Request a copy of any written customer/claim service standards that the insurer has that governs claim-handling procedures
7. Have an attorney do a quick Lexis-Nexis search on the carrier to gauge how often it is engaged in coverage litigation, the fate of such cases, the frequency of bad faith suits, etc.
Price-driven insurance buying decisions are not necessarily bad. However, some risk managers and buyers may find out that the coverage quote was cheaper for a reason. By the time they get stuck with crappy claim service or a farfetched coverage disclaimer, no one is likely to console them by reminding them that they got a 10% discount on the cost of coverage.
Measuring and assessing quality of claim service is probably never going to be as easy, measurable or quantitative and is comparing costs or financial ratings. Nevertheless, astute buyers can elevate the caliber of their due diligence in ferreting out this crucial component of the buying decision. Further, astute insurance companies and adjusting firms can assess these suggestions and proactively package their proposals to demonstrate a commitment to high caliber claim service.
And that’s no smoke job
Those voting “smokescreen” seize on this vignette as an example of bad claim service and the need for insurance buyers to factor in quality of claims-handling when making insurance buying decisions. I will not endorse or excoriate Great American’s coverage stance. Rather, my focus is on how risk managers and insurance buyers can assess claims-handling quality in the buying equation.
Call me a cynic, but I wonder how many risk managers or buyers would still take an insurer’s price if the quote was low enough. Put differently, I wonder just how much – if at all – a “bad claims reputation” really weighs materially in buyers’ decisions if they can save dollars on coverage cost. Too often lip service is paid to claims-handing quality, but too often in the real world marketplace -- when push comes to shove -- it’s more often all about “getting the lowest quote.”
Premiums are expressed in dollars and cents. The cost is measurable. Financial rating agencies like A.M. Best and Moody’s provide quantitative assessments of financial strength.
Measuring quality of claim service? That sounds pretty warm and fuzzy. Here, however, are seven suggestions for risk managers and insurance buyers in trying to assess the quality of claims handling for a prospective insurance partner:
1. Ask for client references and contact information. (The obvious drawback here is that the insurer would have to be an idiot to give anything other than cherry-picked, glowing references.)
2. Have your insurance broker assess the industry perception and “scuttlebutt” about a candidate carrier’s claim service.
3. Check with the state Insurance Department regarding the number of complaints filed against a carrier. (In some states, you can do this on-line.)
4. Ask the insurer for the resumes of the claim professionals who would be handling your claims. If it balks or says it cannot determine who would be in charge of your claims, that is a bad sign.
5. Ask the insurer rep to give you three reasons why their claim service is better than the competition. If they bumble stumble or harrumph, move on to the next candidate.
6. Request a copy of any written customer/claim service standards that the insurer has that governs claim-handling procedures
7. Have an attorney do a quick Lexis-Nexis search on the carrier to gauge how often it is engaged in coverage litigation, the fate of such cases, the frequency of bad faith suits, etc.
Price-driven insurance buying decisions are not necessarily bad. However, some risk managers and buyers may find out that the coverage quote was cheaper for a reason. By the time they get stuck with crappy claim service or a farfetched coverage disclaimer, no one is likely to console them by reminding them that they got a 10% discount on the cost of coverage.
Measuring and assessing quality of claim service is probably never going to be as easy, measurable or quantitative and is comparing costs or financial ratings. Nevertheless, astute buyers can elevate the caliber of their due diligence in ferreting out this crucial component of the buying decision. Further, astute insurance companies and adjusting firms can assess these suggestions and proactively package their proposals to demonstrate a commitment to high caliber claim service.
And that’s no smoke job
Saturday, November 22, 2008
“YES WE CAN!” may be new Plaintiff’s Bar Mantra Starting in January ….
For claim adjusters, the tort landscape is their battleground. It shapes and frames the rules of the game. Those rules can mean the difference between a boxcar reserve or a nuisance value number, between a defense verdict or a runaway award. A recent Business Insurance article (BI, 11/10/08, “Risk: Future of Several Issues Debated,” p. 25) cites three factors that may cause the Obama Administration to impact the tort landscape.
First Supreme Court appointments likely to be made within the next four years may influence areas of employment law.
Second, an Obama Administration may take a more circumspect view on Federal preemption. This arcane defense has huge financial implications for sectors including but not limited to pharmaceutical and medical devices. Preemption is the notion that, in some cases, Federal approval of a tightly regulated product renders that product immune from state tort claims saying that a product is defective. Billions of claim and defense dollars ride on this issue.
Third, Vice President-elect Joe Biden has been a consistent opponent of tort reform.
So, while the build-up for the January inauguration continues, claimants and members of the personal injury bar may ask, if only rhetorically, “Can we be more successful in pursuing claims starting in 2009?”
The likely answer is, “Yes we can!”
First Supreme Court appointments likely to be made within the next four years may influence areas of employment law.
Second, an Obama Administration may take a more circumspect view on Federal preemption. This arcane defense has huge financial implications for sectors including but not limited to pharmaceutical and medical devices. Preemption is the notion that, in some cases, Federal approval of a tightly regulated product renders that product immune from state tort claims saying that a product is defective. Billions of claim and defense dollars ride on this issue.
Third, Vice President-elect Joe Biden has been a consistent opponent of tort reform.
So, while the build-up for the January inauguration continues, claimants and members of the personal injury bar may ask, if only rhetorically, “Can we be more successful in pursuing claims starting in 2009?”
The likely answer is, “Yes we can!”
Tuesday, November 18, 2008
Jay Leno Gets Comic Relief from Insurance Claims
Jay Leno’s opening monologue on November 17th included two insurance jokes.
One poked fun at NBC. Leno said that, if the raging Los Angeles wildfires got too close to the NBC studios, audience members should do nothing to quell the flames because, “NBC needs the insurance money!”
He also observed that, after an LA-area disaster response simulation on November 14th, scientists had now figured out a way to give citizens 30-seconds of notice prior to an earthquake. “Of course,” Leno quipped, “that won’t give you much time to do anything but it will give State Farm enough time to cancel your policy!”
Who knew that insurance claims provides so much comic relief?
One poked fun at NBC. Leno said that, if the raging Los Angeles wildfires got too close to the NBC studios, audience members should do nothing to quell the flames because, “NBC needs the insurance money!”
He also observed that, after an LA-area disaster response simulation on November 14th, scientists had now figured out a way to give citizens 30-seconds of notice prior to an earthquake. “Of course,” Leno quipped, “that won’t give you much time to do anything but it will give State Farm enough time to cancel your policy!”
Who knew that insurance claims provides so much comic relief?
Monday, November 10, 2008
Does Speed of Claim Processing Correlate with Customer Satisfaction?
At one point during the movie Top Gun, Tom Cruise’s character – Maverick – turns to his fighter pilot buddy Hondo and yells, “I feel the need for speed!”
Claim adjusters may merely climb into the cockpits of their company cars instead of an F-15, but many still feel the need for speed. They feel it from bosses, from corporate service standards, from policyholders, claimants and attorneys.
Does faster claim service correlate with heightened customer satisfaction? A question on a LinkedIn discussion group among P&C Claim Professionals got me thinking on this topic.
The type and texture of the claim may dictate greatly the correlation between speed of processing and customer service. For example, if it is a straightforward first-party property loss, speed and customer satisfaction may directly correlate.
The insurer that can handle that claim in 24 hours or so will likely get high marks from me in customer service and satisfaction.
If I am a commercial policyholder facing a complex third-party property claim with time element features and find that my adjuster, in the interests of speed, has settled a claim in three days I may be tempted to think I got screwed because the adjuster
(a) did little or no investigation and/or
(b) over-paid the claim to slam the file shut quickly.
The context of the claim may a factor in correlating speed vs. customer service; in some instances, those factors may be inversely related. It’s tempting to give a lawyerly “It depends” answer to the question. Depending on the type of claim, though, adjusters could say “Speed Thrills” while others could accurately say, “Speed Kills.”
Faster is better … except when it’s not.
Claim adjusters may merely climb into the cockpits of their company cars instead of an F-15, but many still feel the need for speed. They feel it from bosses, from corporate service standards, from policyholders, claimants and attorneys.
Does faster claim service correlate with heightened customer satisfaction? A question on a LinkedIn discussion group among P&C Claim Professionals got me thinking on this topic.
The type and texture of the claim may dictate greatly the correlation between speed of processing and customer service. For example, if it is a straightforward first-party property loss, speed and customer satisfaction may directly correlate.
The insurer that can handle that claim in 24 hours or so will likely get high marks from me in customer service and satisfaction.
If I am a commercial policyholder facing a complex third-party property claim with time element features and find that my adjuster, in the interests of speed, has settled a claim in three days I may be tempted to think I got screwed because the adjuster
(a) did little or no investigation and/or
(b) over-paid the claim to slam the file shut quickly.
The context of the claim may a factor in correlating speed vs. customer service; in some instances, those factors may be inversely related. It’s tempting to give a lawyerly “It depends” answer to the question. Depending on the type of claim, though, adjusters could say “Speed Thrills” while others could accurately say, “Speed Kills.”
Faster is better … except when it’s not.
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