Is this Worker's Comp?

Employee is injured while driving for coffee: Is he due worker’s compensation?


In most states, employees can earn worker’s comp coverage for injuries that occur “in the course of normal employment”. That can be a fuzzy term- you be the judge:

The Case

A plumber for a plumbing company drove to a work site, but the person he was meeting wasn’t available for 45 minutes. He decided to drive to a deli five miles away to get a cup of coffee. On the way, he was involved in a traffic accident and broke both legs. The worker’s comp carrier awarded him 100% benefits. The employer appealed, saying the accident didn’t arise “in the course of employment”. Was he due worker’s comp?

The ruling:

A state appeals court rejected the company’s argument and awarded the benefits. It said the plumber engaged in “exactly the kind of brief activity which if embarked on by an inside employee working under set time and place limitations, would be compensable”.

The lesson:

When off-site employees are injured in accidents during slight diversions (such as coffee breaks), courts will probably say they’re equivalent to an on-site worker diversions, meaning they’d be eligible for worker’s compensation benefits.

Also, notice that this said a “State” appeals court. As always, worker’s comp cases are handled by the individual state. Each state applies the law a little bit differently.

You may not know EXACTLY where your employees are at all times. However, if they are out working for you, your company will generally be held responsible for any injuries they receive. That’s why it is so important to continually communicate safety and personal responsibility to all your employees.

Bobby Bland PWCA, CIC
Commercial Risk Service

Pick cholesterol-lowering foods

When it comes to bringing down LDL (bad) cholesterol, it appears foods like soy protein, nuts and plant sterols have the upper hand. According to a study in The Journal of the American Medical Association, people with high cholesterol who combined such foods and incorporated them into their diets had a greater reduction in LDL cholesterol than those who followed low-saturated-fat diets that focused on high fiber and whole grains alone.

Researchers found that the cholesterol levels of those who followed the low-saturated-fat diets dropped 3%, while those consuming the cholesterol-lowering food saw a decrease of up to 14%. The best answer- combine a heart-healthy diet of low-saturated-fat and add in the protein and nuts.

Remember- the cholesterol is not the root of the problem- it is a result of the problem. The way you eat and how active you are in your lifestyle is the key. Once those areas improve, your cholesterol will improve along with it!

Bobby Bland PWCA, CIC
Commercial Risk Service

Feds Require Consumer-Friendly Health Plan Briefs.

Don’t have the slightest clue what your health insurance covers?

The Obama administration says that’s going to change. Officials announced Thursday that starting later this year private health plans will have to provide consumers with a user-friendly summary of what’s covered, along with the key cost details such as copays and deductibles.

Just six pages long. No fine print.

And because the summaries will use single standard format, it will allow “apples to apples” comparisons among health plans that aren’t possible now. That will help working spouses trying to pick between employer plans, as well as people who buy coverage directly from an insurance company.

“If an insurance company offers substandard coverage in some area, they won’t be able to hide in dozens of pages of text,” said Medicare chief Marilyn Tavenner, who also oversees implementation of President Barack Obama’s health care law.

Insurers and business groups were unhappy, calling it another costly new regulation under the overhaul. Consumer groups said the new summaries won’t be perfect, but called them a strong start. Employees should start seeing them during open enrollment season this fall.

Obesity if out of control in the U.S.

As everyone knows, our healthcare costs are escalating at a huge rate in this country. One of the largest driving forces is the rate of growth of obesity in all states. First of all, let’s establish what leading an obese/overweight lifestyle can lead to:

---Heart disease and death
---Joint and tendon problems
---Stroke
---Depression
---Diabetes
---Cancer

Get the idea?

Now, look at these statistics on obesity. As you can see, it is out of control:
Year           Obesity trends
1994          16 states had at least 15% of population that were obese


1999          17 states had at least 20% of population that were obese

                 40 states had at least 15% of population that were obese


2004          9 states had at least 25% of population that were obese

                 46 states had at least 20% of population that were obese

                 50 states had at least 15% of population that were obese


2009         9 states had at least 30% of population that were obese

                22 states had at least 25% of population that were obese

                50 states had at least 20% of population that were obese

In 15 years, we have gone from 16 states that had at least 15% of their population that was obese to 17 states that had at least 30% of their population that were obese!!! Do you wonder why our healthcare cost are out of control?

Our conclusion--- let’s attack obesity in the workplace. Through information and education, as well as making it a priority, maybe we can do something about it! Let us help yo do something about it.

Bobby Bland PWCA, CIC
Healthy Lifestyles
Commercial Risk Service

Executive Liability risk rising for private and Non-profit firms

 

Though privately-held companies and nonprofit organizations are becoming more sophisticated in managing their executive risks, some misconceptions still persist with regard to the true nature of their liability exposures and the insurance products designed to guard against them.

More than ½ of every private or nonprofit firm doesn’t have Directors and Officers insurance for their executive employees and board members. Asked why they don’t buy the coverage, most of them say do not believe they need the coverage. This is simply misguided information. The reality is that executive liability claims can originate from a variety of sources, and they can harm a private or nonprofit organization of any size in any industry.  The majority of those claims are filed in defense of an employee practices lawsuit, but other sources of claims can include customers and clients, competitors, minority shareholders, lenders and donors, as well as fellow executives or board members. Additionally, the biggest misconception is that your General Liability policy will cover you in this scenario- this is simply not true! These types of instances are specifically excluded under almost all General Liability policies.

Customers, clients and competitors pose a significant risk to private and nonprofit companies. Industry observers have noted a recent increase in lawsuits among competing firms that accuse executives and board members of slander, defamation of character and comments disparaging their products or services. Also, litigation over the theft or infringement of intellectual property, trademarks and patents is generally frequent. Regardless of the service they provide, directors and officers of nonprofit firms can be sued by donors, beneficiaries or the government for breaches of their fiduciary responsibilities, mismanaging collected funds, acting beyond their chartered authority or violation of state or federal laws. Nonprofit and private business executives also could find themselves facing client accusations of harassment, discrimination, poor products or poor service, as well as accusations by competitors.

What is the answer to reducing this risk within your organization? You need to purchase Directors and Officers Liability coverage, whether you are a nonprofit organization or a privately-held family for-profit group. The exposures are the same. Depending on the size of your organization, I would recommend no less than $1 Million limits, possibly $2 Million. Also, when you purchase the D&O coverage, make sure to add the Employee Practices Coverage to the policy. This is only available for Nonprofit Organizations as a group policy. If you are a for-profit business, you will need to purchase a separate policy for Employee Practices Liability.

In today’s litigious society, it never hurts to protect your interests. Remember, liability is the only insurance coverage where the more you buy, the cheaper the rate gets!

Bobby Bland PWCA, CIC
Vice President
Commercial Risk Service

Healthy Lifestyles

Commercial Risk Service is proud to announce …

To say that we have a problem with Healthcare in this country is a ridiculous understatement! Every aspect of our healthcare system is faltering:

---Heathcare costs are continuing to rise every year (although this last year was the first one in a long time where the rate of growth actually was less!)

---Health insurance carriers are in a state of pandimonium, not knowing where to turn next. We are seeing consistent increases in monthly premiums, both for Group Benefits and individual family health insurance.

---Our Government has gotten more and more involved. Enough said- that’s enough to screw everything up just by itself!

Our politicians and everyone else wants to lay the blame on everyone else, but nobody is doing anything about it, other than driving up costs. The truth is that all of the problems listed above are merely symptoms of the real problem. I believe that our true problem is the deteriorating health of the peole in this country!!! We at CRS want to attack the problem, not the symptoms. We are introducing our “CRS Healthy Lifestyles” to do just that- improve the health of our clients and improve their knowledge of how to live a healthier, happier life.

What is the Program about:

CRS will work with you and your employees to create awareness of critical health issues that affect all of us in today’s environment. Some of the major health factors we will address will include:

• A better understanding and awareness for your employees of how to combat obesity and the horrible side effects it creates, which are consistently increasing your health insurance premiums.

• More awareness of the horrible effects of tobacco use, as well as overuse of alcohol, and the effect it has on your employee benefits.

• Increased opportunities for your employees to have 1-on-1 conversations with healthcare providers concerning their individual health issues.

• Opportunities for your employees to see how much you care about them as a person.

Tangible Goals of the HL Program:

• Reducing obesity and owerweight lifestyles for your employees

• Reducing demand for medical services over time

• Reducing absenteeism

• Reducing on-the-job injuries and Worker’s Comp costs

• Reducing disability management costs

• Ultimately, reducing premiums for Group Health and Worker’s Comp Insurance



Intangible Goals of the HL Program:

• Increased productivity

• Helps to recurit and retain the most effective and productive employees

• Improved Morale

• Project a message of good will to your employees and foster the message of self-responsibility



HL POINT OF ATTACK- OBESITY!!!

We want to go after all areas of health improvement. However, make no mistake about it- we believe that by focusing a lot of our time and effort on reducing obesity in our clients and their employees, we will show the most success. We have an epidemic on our hands as it relates to obesity in this country, and the healthcare issues that obesity and being overweight create are literally strangling our healthcare system.

The  HL Program is only getting started right now, but we believe that this program is the right way to attack our Healthcare issues. As our workforce becomes more and more unhealthy each year, we as employers lose more and more control over our benefits program.

Look for more information on this tremendous program in the near future!

How to Protect Yourself against Yourself

Many times we as business owners can be our own worst enemy. It is sometimes easier (and less expensive in the short run) to buy our teenage children a vehicle in the company name and let them drive it as much as they need (or just let them drive our expensive company-owned vehicle). This sounds like a good idea at first, but upon further examination, not so much!

We have had a couple examples of this lately- one specific incident especially comes to mind. One of our commercial clients has a son that turned 14 and got his learner’s permit. Instead of buying an old beat-up car to allow his son to learn the nuances of driving in this fast-paced world (which I highly recommend for every family), he let his son drive his company-owned vehicle (Dad was in the car with him, thank goodness!). As they were driving, his Dad told him to pull up to the building where the business was located (they don’t own the building, just leasing it). As the 14 year-old pulled up to the building, he pushed on the accelerator instead of the brake, and ran through the outside wall of the building, damaging the building and the vehicle. Ouch!!!

There are lots of issues here:

---Fixing the company vehicle will be paid for by his commercial auto policy- no problem. Except- having a 14 year-old driving your company vehicle will more than likely get the company non-renewed (or worse- cancelled) by thecarrier. At that point, it becomes more difficult and more expensive to find commercial auto coverage the next time around.

---Since the business owner is leasing the building and has care, custody and control of the building and he ran into his own building, his auto policy would not cover the damage to the building. That part of the claim was denied.

---In addition, since he has possession of the building, his General Liability policy denied coverage as well. As a matter of fact, none of his policies will cover the cost of the damage to the building (approximately $15,000-$20,000).

---The business owner has a Personal Auto Policy and a Personal Umbrella policy as well. However, neither policy will cover the claim either.

As a matter of fact, no coverage is available for fixing the damage to the building. This all stemmed from allowing a teenage driver to drive a company vehicle, remember. The business owner will probably have a lawsuit on his hands from the building owner, whose insurance will have to pay for the claim.

This could have been worse. What if the 14 year-old had been involved in an at-fault accident in the company vehicle and someone had died? This business owner could have been putting his entire business at risk just to let a 14 year-old drive for a little bit. It’s just not worth the risk. There are other, more reasonable alternatives.

The best practice is to call you insurance agent for solutions BEFORE you make these decisions rather than AFTER!!!

Bobby Bland PWCA, CIC
Vice President
Commercial Risk Service