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Medical Malpractice Reform to Rein in Frivolous Lawsuits

In his State of the Union address yesterday, President Barack Obama stated his willingness to look at ideas to reduce healthcare costs, including ‘medical malpractice reform’ aimed at reducing frivolous lawsuits.
It has been reported that medical malpractice reform could save $17 billion through 2020 and a bill recently introduced into the House capping non-economic damages and limiting attorney contingent fees is sure to draw interest.
I have watched medical malpractice costs and trends and over the past few years, the industry has seen medical malpractice insurance costs decrease and stabilize. However, with recent reports of a rise in claim frequency and severity, liability costs are likely to start increasing. So are we also at the point of seeing our malpractice insurance costs trend upwards as well?
Some states have already enacted tort reform. Both proponents and opponents of reform will look to those states for statistical evidence of malpractice reform reducing costs and supporting economic growth. No doubt these discussions will be challenging. Some cost savings such as declines in insurance rates, litigation costs and a reduction in the number of lawsuits are easier to quantify than other practice related benefits such as physicians moving away from the practice of defensive medicine and return to practice in high risk specialties. No doubt we will see lobbying efforts for both sides of the issue – the key will be retaining the rights of the consumer to receive compensation for legitimate medical injuries.
Once we agree on a course of action, let’s just make sure that any medical malpractice reform bills sent to the President for signing does not include any earmarks!

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Insuring the Cloud

 
Early in 2010, I was introduced to Michael Abrahamsson. Michael is the CEO of Ilait, a market leading cloud computing and hosting wholesaler based in Sweden and a Board Member of Eurocloud. Iliat was looking into expansion and deployment of their services into the US and Michael had been referred to me for assistance with placing insurance. Working with Michael and uncovering some of their issues allowed me an opportunity to dive deeply into risk associated with cloud computing and the challenges this exposure could bring.
Insuring cloud computing exposures can be difficult for several reasons, beginning with underwriters who may not be familiar with or understand the nuances of this technological development. Nevertheless, both providers and users of cloud computing are exposed to risks that require careful consideration and appropriate risk management.
Cloud computing providers’ services typically consist of Software as a Service (SaaS), utility computing, web services, platform as service, managed service providers, service commerce platforms, and internet integration. In a 2010 report from the Cloud Security Alliance the most significant threats to cloud computing providers were:

Abuse and Nefarious Use of Cloud Computing

Insecure Application Programming Interfaces

Malicious Insiders

Shared Technology Vulnerabilities

Data Loss/Leakage

Account Service & Traffic Hijacking

Unknown Risk Profile

These are many of the same exposures to risk shared by most technology organizations, but the nebulous nature of cloud computing makes loss mitigation a challenge. Exposure to loss comes in the form of business interruption/service interruption, data privacy breach/loss, and other financial loss due to the performance of service/product. Insuring a provider of cloud computing services can be extremely difficult. Communicating how an organization effectively manages their risks is what enables Parker Smith & Feek to offer our clients the most competitive premiums available.
In addition to providers, cloud computing users also have substantial exposures to loss. First, it is critical to understand that outsourcing cloud computing services is not the same as outsourcing or transferring risk. Secondly, service contracts may include a hold harmless provision within the indemnity agreement that strongly favors the service provider. Furthermore, it may be difficult to require adequate professional liability/E&O insurance limits from the provider, given the significant number of parties that may be affected by a provider loss. Finally, a user organization will be held responsible for State and Federal Laws related to data privacy and compliance to HIPAA, SOX, PCI and FISMA (for more information on data privacy you can read my article here).
Given the multiple and significant exposures to loss, it is important that users understand and address those exposures through risk management solutions that may include contractual transfer of risk and/or insurance coverage. An indemnity agreement written or approved by legal counsel is the first step to a strong risk management strategy. If the user is responsible for PII (Personal Identifiable Information), a comprehensive data privacy insurance policy should be seriously considered. Of course, is also important to select a cloud computing service provider with strong security controls in place. Risk management, including the implementation of strong contractual risk transfer, will help facilitate insurance placement and lower insurance costs for insuring cloud exposures.
Cloud computing is here to stay. The scalability, cost, and efficiency factors will inevitably lead to greater use. Unfortunately, due to the significant amount of data being computed/ stored within the cloud, it will always be a target of fraud and abuse. Taking the proper steps to mitigate potential loss – transferring risk contractually and/or through insurance coverage – will not only reduce risk to an organization’s balance sheet. It will also make it much safer to harness the power of the cloud.

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My New Year’s Resolutions

New Year’s resolutions are a tradition in our house. For years we have all shared our personal resolutions – goals, dreams, minor objectives we each had for the coming year. Some fairly ethereal, some specific and measured. More than anything, it was a chance for us to engage as a family and talk about the previous year and what it was we wanted to change or improve.
We had a good time doing that again this year, and as our children have gotten older (now 30 and 26) naturally, their resolutions have changed as well. While it wouldn’t be appropriate for me to share theirs, but I thought I would pass along mine. That way, those who know me can help me see that I make progress!
A realization I have had is that I seem more distracted, especially to my family – less in the moment as my wife has said. This isn’t a recent comment, but something that has gradually increased over time. Part of the challenge seems to be that I spend so much time looking backward and forward – somewhat the nature of business, I suppose. The backward gaze comes from trying to interpret monthly, quarterly and annual business performance, determining what history is so that it can be communicated, explained, and adjustments can be made for improvement. (I’m also someone who spends too much time reviewing personal mistakes or transgressions.) The forward looking time involves the continual planning and projecting that goes on in business where inevitably your calendar stretches out months ahead of you and your strategic plan years.
What can be lost is the now. What’s happening right now and do you take the time to focus on it, to enjoy it, and to be in the moment as a leader, colleague, father and husband? That’s what I have determined I want and need to do better. So, here are my self-imposed guidelines for doing a better job of living in the moment.

Failure is a part of life. If you don’t ever fail you aren’t challenging yourself. Accept that it will occur and when it does accept it, own it, fix it (to the extent you can) and move one. ‘Now’ needs your attention.

It is critical to plan for the future. We all need to know where we are going. But, don’t let your calendar rule your life. Leave plenty of ‘white space’ each week so that you can do critical thinking, stay current on your reading, and just walk around and engage your colleagues and your family. Don’t over plan your life.

Living in the moment. What are the keys to doing this effectively?

a. Practice active listening. When you do engage someone at work or home – do it completely. Focus on them, remove all distractions (turn off your phone, the TV, etc) and listen! Good listening also means you ask lots of questions – clarifying questions that allow you to better understand what is being told to you, what’s important, and to get at the root of the issue – which often doesn’t immediately present itself. Don’t jump to conclusions or immediately rush to problem solving.
b. View each encounter you have with the knowledge that learning is going on. What do you want to learn about, what is it that you are hearing, and when you are communicating, what learning are you conveying? What’s your voice tone and body language and what are those physical manifestations telling people that may be in contrast to your words?
c. Practice predictability and remove volatility from your communications. To be in the moment you need to have family, friends and colleagues able to communicate with you without undue fear of your reaction. See a and b above.
d. Finally – enjoy. This is as simple, and as difficult, as just looking around and appreciating that each moment is unique. You will never have this exact experience again.
Here’s to successful completion of your resolutions for 2011.
Greg

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After 5,460 days and a lot more memories, I say goodbye

Now I have some sense of how Cal Ripkin and Brett Farve felt after their consecutive games played streaks ended at 2,632 and 297 respectively. In a few days I will formally retire from Parker Smith and Feek after 5,460 days of service and the feeling is clearly bitter sweet. It’s been a period of solid growth and success for our company as our annual gross revenues now easily exceed $300 million. Just doing some quick math indicates that during my tenure at Parker, Smith & Feek we processed over $3 billion in gross premiums- an extraordinary number for a regional broker.
In my personal view, retirement has never been a destination, just a passage to another stage. Hopefully a stage where one has sufficient resources and health to make new choices and pursue interesting challenges and opportunities.
Passages can take many forms, and looking back briefly I recall three that were indelible to me on my personal journey. The first occurred at a very early age when my family left a war torn homeland and found their way through Soviet warships out of Tallinn’s harbor and across the Baltic Sea to islands off of Finland and then on to sanctuary in Sweden. Growing up there on a farm is an untold benefit to a young boy.
A few years later, and after the second World War had ended, our family was on the move again as we crossed the ‘pond’ from Bergen, Norway to America, New York State and a land of unbelievable opportunities. A new language, schools, friends, a welcoming community and a new home were all part of that next stage. The years flew by: high school, academics, sports, competing, losing, winning, college, graduate school, career choices, marriage, children, divorce, parenting and providing are all part of one’s personal growth.
Then some twenty years ago I found my way to the Pacific Northwest and the next passage. Parker, Smith and Feek provided a new challenge, and an extraordinary opportunity. A culture that valued individual initiative and team outcomes, a long tradition of high expectations and continued growth, and a community of talented colleagues that worked toward defined and common goals. Clearly it’s been a pleasure to have been part of a team that has perpetuated and improved on a business model that is closing in on its 75th year of business. The future is always hard to foresee, but the values that guide one are immutable. My best to you all, and that next stage beckons.
Jaan

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Happy Holidays To You All

As the year winds down, I am once again reminded how much our employees do for our community. I work with a lot of caring, generous people who spend the year focused on taking care of client’s needs and helping others on their team.
However, no matter how busy they get or how crazy work can be sometimes, they never fail to reach out and help those that are less fortunate than us. We have a tradition of reaching out to others in our community, but that spirit is not driven by Management. It is driven by our employees who feel that part of who we are is giving to others in need.
This spirit of giving and generosity is truly humbling. I am proud of all of our employees and thank you all for your loyal service this past year.
Happy Holidays to you all.

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Happy Holidays from Parker, Smith & Feek

Are Requests for Proposals Unhealthy?

A colleague in our Communications Department recently shared with me an article titled “Why Requests for Proposals Are Unhealthy.” Since responding to Requests for Proposals is a big part of my job, I read this with interest. The article’s author suggests that Requests for Proposals (RFP’s) are unhealthy for both buyer and seller because the RFP process commoditizes products and services and “… reduces differentiation, even if it pretends to ask for differentiation.” He further argues that once a product or service is reduced to a commodity the only differentiator between you and your competitors, is price.
It was not clear which industry this author represented, but based on some of his examples, he most likely represented a company that frequently responded to RFP’s where the low bidder was selected no matter what. AND, he didn’t like the antiseptically level playing field that price-driven RFP’s created; he wanted to give his pitch, in person, directly to the buyer. Anyone, in any industry, who has responded to an RFP and was not the low bidder and therefore not selected, will emotionally agree with this argument.
My industry has been commoditized almost since its inception. We all hear the daily ads extolling us to save money on insurance, from the mouths of a gecko, duck, caveman, etc. For the individual insurance buyer, price is everything. But for businesses, the stakes are different. Seasoned businesses know that price is important, but not everything. For this audience, an RFP may be the key to unlock the differentiators between competitors that are not price driven.
An RFP seeking the lowest bidder may mask the talent and creativity a broker can bring to a business’ insurance program. It may also ignore the broker’s ability to lower a business’ cost of risk. In selecting an insurance broker, the so-called “conceptual proposal” – no price quotations – can expose differences in experience, industry knowledge, similarities in serving like clients, background and expertise of the individual service teams, and the broker’s innovation in designing a comprehensive, cost effective insurance program. RFP responses act as the “resumes” that tee-up the finalists who are qualified to do the work and have demonstrated their experience in doing so for others. RFP’s are successful screening devices which generate interviews, and interviews are the forum where buyers can evaluate, face to face, the potential “fit” for long term relationships.
As one whose career has been in the insurance industry, and who has responded hundreds of RFP’s for our firm, I believe RFP’s have their place and are not toxic to buyer or seller. Well-crafted RFP’s give the buyer answers that can clearly differentiate a broker’s strengths and weaknesses. RFP’s give the broker a chance to showcase how they can provide service, innovation and value. We never shy away from presenting a competitive price for our work, we just look for opportunities to illustrate the differentiators that make our firm unique.

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Parker, Smith & Feek Launches Dedicated Healthcare Reform Website

With the passing of the Healthcare Reform bill we have seen an inundation of information and misinformation provided by media outlets; to the confusion of many.

Our clients asked Parker, Smith & Feek to create one resource that they can use to follow only the most important announcements. With that in mind we have created www.healthcare-reform-explained.com. A resource dedicated to only the most important Healthcare Reform issues.

Visit it at: www.healthcare-reform-explained.com
 

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One of the best things about the holiday season..

I can’t believe how fast this year has gone. We are already eight days into December, and already I have attended four Holiday functions this month, with many more coming before the Holidays.
Our last wellness event for the year has just started, with our “Maintain through the Holidays” challenge where the goal is to maintain your current weight through this holiday season. One of the best tips I saw during this campaign was “Staying healthy at Parties”, so I thought I should share it with you.
One of the best things about the holiday season is spending time reconnecting with loved ones and catching up on all that has happened in the past year. Parties and potlucks abound and wouldn't be complete without the sharing of good food or drinks. By paying attention to what you consume at these events, you can make choices that will leave you feeling just as recharged as you are from the conversation. Click here to download the Choosing Your Party Food tip sheet
Fit Tip – "Maximize Your Efforts" – Different types of exercise burn different amounts of calories. What is getting burned in your 30 minute workout?

Jogging: 372 calories burned

Swimming: 300 calories burned

Walking: 261 calories burned

Weight Training: 261 calories burned

Ice Skating: 237 calories burned

Skiing: 228 calories burned

Calories based on a 160 lb. person. Provided by Worksite Wellness
Wishing you all a healthy and fun Holiday season.

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Winter has come early…

Winter had come early to the Methow Valley. When we arrived last Friday night at our weekend cabin near Mazama we were disappointed to see that there wasn’t a flake of snow in the valley, but by the time dinner was over and we let the dogs out to stretch their legs, it was coming down hard and the ground was covered. We awoke Saturday morning to a six inch blanket. Winter, and the Holidays, have arrived.

Later on Saturday the sky lifted and we could see the top of Goat Peak and the Forest Service fire lookout. It reminded us of a wonderful hike this past summer. Two and a half miles from the trailhead, with 1,400 feet of elevation gain, the lookout is a perfect half day trek. Besides the beautiful scenery, successful hikers get to visit with the Forest Service employee who has manned the lookout every summer for 16 years – Bill Austin, commonly known in the Valley as ‘Lightning Bill’, aptly named for all the times his lookout has been struck during lightning storms.

Bill is one of those people you meet and instantly realize is unforgettable. He genuinely enjoys visitors and you can’t make the hike there without touring his lookout. While I’m not sure I could spend even a week doing what Bill does, there is definitely a sense of peace and serenity that’s instantly appealing, sitting on top of this mountain at 7,000 feet, with a sweeping 360 degree view of the Methow Valley. As you chat with Bill you begin to think – maybe he’s the one who has figured life out and found his own equilibrium and sense of balance and harmony.

With all our technical innovations today, it seems a bit incongruous that we still spot forest fires the old fashioned way, by posting strategic lookouts. There isn’t anything particularly high tech about what Bill does – he just keeps watch and reports fires as they develop. One modern wrinkle for Bill, though – he’s adopted social media. He has a Facebook page where you can follow his work on almost a daily basis. He also photographs his visitors and posts the pictures. We were honored to have our photo on his page this past August.

The lookout has been abandoned for the season and we know, based on Bill’s Facebook postings, that he is spending the winter (Bill is a seasonal Forest Service employee) working at a Carleton laundry. No doubt waiting for summer and his return to his post.

When we were in the lookout we asked Bill to point out the area where our cabin is located. “Right there”, he said, pointing. “And I always keep a close eye on your neighborhood.”

Thanks, Bill, and Happy Thanksgiving. I’ll look forward to summer and your return to Goat Peak. I sleep better knowing you are there, watching.

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With L&I seriously undercapitalized – what do they do now?

In my post last month I wrote about the November 2 ballot initiative in Washington State – I-1082. I-1082 sought to end the Washington Department of Labor & Industries (L&I) monopoly on workers’ compensation insurance by allowing private insurers to compete with L&I. Washington is one of only four states in the country with a monopolistic systems.
The State Auditor had reported last year that L&I was seriously undercapitalized and risked insolvency if rates were not significantly increased. L&I has been increasing rates steadily for years, while the rest of the country has seen decreases in rates. Many of us believe Washington’s workers’ compensation woes have had a great deal to do with the mismanagement of claims and especially the disturbing trend of offering pensions to injured workers’ in far greater proportions than comparable states.
We thought this was a powerful message and there was great value to everyone in creating competition. However, I-1082 was solidly defeated by the voters. In retrospect, there were several reasons that conspired in the defeat of the initiative:

The average voter has little concept of workers’ compensation insurance. It was very difficult to explain the basic issue. It just wasn’t on most people’s radar.

We were out-messaged. The ‘No’ side had several effective advertisements, including one featuring AIG as the force behind the initiative. As King 5 News pointed out, AIG was not involved at all in the campaign, which was largely lead by local businesses that were concerned about rising costs.

The Washington Insurance Commissioner, Mike Kreidler featured in a frequently run advertisement on TV indicating that if passed, he would have no control over the insurance companies and that workers’ would suffer. According to the Commissioner, I-1082 would somehow be different than the other insurance products provided in Washington and would beyond his ability to regulate. This would not have been the case.

Finally, we were outspent by 3-1, making it difficult to counter all the negative and misguided messages on TV and radio.

In an effort not to damage the ‘no’ campaign L&I delayed the announcement of their 2011 rate change from September, when traditionally done, till after the election. The reason was obvious. They were rightly concerned about the negative press associated with asking for the big increase needed to shore up their dwindling reserves.
L&I just this week announced they are seeking a 12% overall rate increase for next year. This amounts to a substantial tax increase to businesses and to workers’, as most employees in Washington pay 25% of the premiums.
Unfortunately, the defeat of I-1082 will not change the basic issue. Claims are not being effectively managed and the State is in the precarious position of having to continue to increase premiums at a time when most businesses cannot afford to pay more. As feared, the central message became highly politicized and voters, either through a lack of understanding, or through fear spread by those who opposed I-1082, have guaranteed the status quo.
Washington will continue to be out of step with the vast majority of the country where open competition not only protects businesses, but does an excellent job of caring for injured workers in a safe and cost effective manner.

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Six Chubb subsidiaries suspended from writing new business

Today, we were notified that the Office of the Washington State Insurance Commissioner has suspended six Chubb subsidiaries from writing new business/clients in the State of Washington for nine months. Please click here to review the notice from the Insurance Commissioner's office. The order is effective November 18th, 2010.

The suspension is based upon a Washington State Department of Insurance audit that found Chubb had not properly followed their Washington State Insurance filings when it came to documenting why they (Chubb) provided credits to certain policy holders. As an admitted insurance carrier in the State of Washington, Chubb is required to file specific rating plans that then need to have full documentation associated with the use of these discretionary credits.

This suspension does not effect any current insurance program you have with Chubb. Chubb has the ability to appeal the decision. We do not know at this time whether Chubb will pursue an appeal or not.

If you have any questions, please contact your Account Executive.

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