Archive for July, 2012

Beverly Slough: Florida congressional candidate whose success at home is a roadmap for national recovery

Perhaps the most amazing thing about America politics is how millions will get engaged in a presidential election that has little to do with them personally while completely ignoring what is happening in their own backyard.  While virtually everyone can name the presidential candidates, how many people can name their congressional representative, county commissioner or school board member?  Yet it is these people who have the greatest impact on our lives.

When I was young, my parents taught me that civics starts at home.   From the quality of schools to local zoning ordinances, it is the politicians who represent us locally that make the biggest difference in our lives.  Perhaps nowhere is this more evident than Florida, a vast swath of often over developed swamp that runs the political gamut like no state in the union.

Florida is also a state on the move, with robust economic recovery and newly formed congressional districts resulting from the continued influx of residents fed up with high taxes and poor infrastructure elsewhere.   In fact, Florida, with no income tax, has become the de facto destination for residents and business owners of New York, New Jersey and Maryland fleeing newly imposed taxes on success.

In particular, there is one race in Florida that deserves special attention; that being the newly created 6th district which stretches from Saint Johns County to Volusia County.   As a Floridian, I am probably somewhat unique in that I moved from Saint Johns County, just south of Jacksonville, to Volusia County, just north of Orlando.  As a parent, I also returned to Saint Johns County for one specific reason; the quality of the public schools.

While Saint Johns has always had a reputation for good schools, this has changed in recent years as the district moved the bar to exceptional.  In fact, since moving back to Saint Johns, the public schools have consistently been ranked number one in the state.  Forbes Magazine even cited the county schools as being among the top 10 real estate education values in the nation!

The move from ordinary to extraordinary did not come easily, nor did it come without effective leadership.  The catalyst for this success is Beverly Slough, the Chairperson of the Saint Johns School Board who is now running for Congress.  While many in Saint Johns are familiar with the tremendous vision that Slough has brought to her position, others in the newly created 6th Congressional district are not.

In addition to Saint Johns and Volusia, this congressional district encompasses Flagler and parts of Putnam County.   It is an area of strong family values, work ethic and patriotism which makes Slough the perfect candidate.   While she touts herself as a common sense conservative, those of us who have met Bev understand that her passion to do the right thing transcends party lines.   She is about results, which is precisely what is needed in Washington!

As the housing market boomed, it was Beverly who recognized that the good times wouldn’t last forever.  She spearheaded the drive to add numerous new schools ahead of need.    When the boom went bust, she oversaw a $40 million dollar reduction in the school budget without laying off one single teacher or cutting one single program for our kids.   Imagine that type of proactive, visionary leadership in Washington.

This will be a hard fought race, as she is competing in a field of a half dozen qualified candidates.   While her passion, vision and track record of accomplishment make her the ideal candidate, she cannot win without her supporters turning out in big numbers!

What Bev is seeking to accomplish is exactly what our founders intended.   She has succeeded at home, turning great schools into exceptional schools.   She has done that with a limited budget, never holding her hand out and asking the taxpayers for more.   To the contrary, she recognizes that she, too, is a tax payer and took proactive steps to push her government agency to live within their means.  Wow, imagine using that approach in Washington, D.C.

This election year is certain to be contentious, as it is a make or break year for our nation, which poll after poll suggests is headed in the wrong direction.   Hopefully, the voters now understand that elections have consequences and will diligently study the positions of all candidates rather than listening to hollow rhetoric of hope and change.

But it is equally important that steps be taken at the local level to put people in Congress who will take the action necessary to fix what is broken at the federal level, while concurrently working to improve the social and economic conditions within their local districts.

If you haven’t met Beverly Slough yet, take the time to learn about what she has to offer.   She is the kind of refreshing leader that our nation sorely needs to give us back the economic freedom and individual liberty upon which our great nation was founded.   To learn more, please visit www.beverlyslough.com.

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Christopher Tidball is an executive consultant and the author of multiple books including Kicked to the Curb: 20 Essential Rules For Coming Out On Top When Your Life Has Been Turned Upside Down.  He has been featured in numerous media outlets including the Wall Street Journal, Kiplingers, CBS Market Watch, MSNBC and First Coast News.  He is a frequent contributor to trade publications and speaker on topics including his “Taking your organization from ordinary to extraordinary” series.  To learn more, please visit www.christidball.com or email chris@christidball.com

 

 

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July 31, 2012 at 7:57 am Leave a comment

Colorado Movie Massacre: First lawsuit filed by uninjured moviegoer

cetury_16_theater_gettyThe movie theater massacre that unfolded in Aurora, Colorado, is unfathomable to anyone of a sound mind.  Now that the dust has begun to settle, the all but certain onslaught of litigation has begun.  TMZ is reporting that the first lawsuit has been filed by Torrence Brown.  While Brown was not physically injured, his friend A.J. Bolk was killed after being shot in the chest.   Herein lies the litigation quandary facing our society in the aftermath of many tragedies.

Certainly, those who were injured or killed are due their day in court.   Without a doubt there is both criminal and civil culpability against accused killer James Holmes, who took the lives of a twelve innocent moviegoers, while injuring dozens more.  Many of the injured will require a lifetime of medical care for paralysis, traumatic brain injuries and other catastrophic conditions.   Certainly juries will convene and judgments will be obtained against the lone gunman, but the reality is that they will merely be symbolic.

While the intent of the Holmes defense team is not certain, the likely outcome could be lifelong incarceration,  the death penalty or in the event of a successful insanity plea, life in a state mental institution.   In any event, the culprit will have neither the will nor the means to pay as much as a penny on the inevitable judgments.   So what is the plan for the advocates of the injured and how could that impact claims organizations charged with defending those that they insure?

So, how will the victims, or in the case of Torrence Brown, being traumatized by the event, play out in court.   TMZ is reporting that Brown has hired Donald Karpel to represent him.   His three target defendants are:

1. The theater.  Karpel claims it was negligent for the theater to have an emergency door in the front that was not alarmed or guarded. It’s widely believed Holmes entered the theater with a ticket, propped the emergency door open from inside, went to his car and returned with guns.  The question is whether or not a reasonably prudent theater owner should have anticipated a madman would enter the theater through the emergency doors and attack a packed house.

2. Holmes’ doctors. Karpel says it appears Holmes was on several medications — prescribed by one or more doctors — at the time of the shooting and he believes the docs did not properly monitor Holmes.

3. Warner Bros. Karpel says “Dark Knight Rises” was particularly violent and Holmes mimicked some of the action. The attorney says theater goers were helpless because they thought the shooter was part of the movie. Karpel tells TMZ, “Somebody has to be responsible for the rampant violence that is shown today.”

Why isn’t Karpel going after the culprit himself?  Probably because he realizes that collection would be an effort in futility.   The reality is that Karpel, like many trial lawyers, understands that deep pocket defendants will often pay rather than face the uncertainty of a jury, even when there may be no negligence on their part.      This is part and parcel to what is wrong with the American judicial system, the most litigious and costliest in the world.

As trial lawyers plot their strategy, claims organizations faced with defending the inevitable litigation should give consideration to other potential targets.  What about Holmes’ parents who raised the madman?  Or the University of Colorado which gave him an educational grant which may have been used to purchase the guns?  Or the gun manufacturers, sellers and distributors?  While some of this may seem a stretch, it is not beyond the realm of possibility as victims seek compensation, which is certainly due, for their injuries.

The challenge for those defending these actions will be immense, in particular when the injuries sustained are serious.  But what about the defense of the claims from those who were not physically injured but are claiming mental anguish?  Or the inevitable lawsuits from those, not in the actual theater, but in close enough proximity to witness or hear the rampage?

The only thing that seems certain is that the lawsuit filed by Torrence Brown may be the first, but it will be far from the last.   As the cases play out and more target defendants are identified, others will certainly fall into line.   The biggest question is whether the person ultimately responsible will ultimately be held accountable in civil court.

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Christopher Tidball is an executive claims consultant and the author of Re-Adjusted: 20 Essential Rules To Take Your Claims Organization From Ordinary To Extraordinary.    He is a twenty year insurance industry veteran having served in multiple leadership capacities.   To learn more, please visit www.christidball.com or email chris@christidball.com

July 25, 2012 at 6:27 am Leave a comment

What’s that injury claim really worth?

Talk about a broad question.   Where did it happen? How did it happen? What are the damages?  Who was at fault?  These are just a few of the myriad of questions that adjusters must answer during the course of their claims investigation.  After all, a person getting a paper cut while on the job will have a far different value than a person getting rear ended by a semi. 

Far too often, we try to fit square pegs into round holes.  The reality with injury evaluations is that no two are the same.   Consider the fact that if one hundred different juries were to consider the exact same set of circumstances, they would likely arrive at one hundred different outcomes.  Hence, the subjectivity of injury evaluation. 

That said, there are steps that should be taken throughout the course of the claims investigation to get to the right outcome.  At the root of all claims, are two essential elements; liability and damages.  If a person is at fault for an accident but there are no damages then there is no claim.   Likewise, if a person sustains damages in a loss but there is no liability on the part of the other party then there is no claim.   Of course, life in our litigious society can never be that simple.  

Consider the case of the person sustaining injuries after getting rear ended at a stop light.   It would seem that damages would be owed by the tortfeasor who struck them from behind.   But, what if the accident occurred at midnight and the person claiming injuries was driving a vehicle with faulty tail and brake lamps?  What if that person wasn’t the actual owner of the vehicle? 

To effectively resolve claims, it is incumbent upon the adjuster to concurrently investigate both liability and damages.   The reality is that shared fault, or comparative negligence, is very common.  According to Jury Verdict Research, a national organization that tracks such data, rear end auto accidents accounted for only 45 percent of auto cases adjudicated, with the remainder comprised of intersection collisions, lane changes, chain reactions, and parking lot scenarios. In other words, a lot of claims where there was shared liability.

As an insurer, you certainly shouldn’t expect to set a benchmark that high, as very few claims actually make it to trial. What you can do, however, is bank on the fact that if fewer than 35 percent of your collision claims are closing without comparative fault, then money is being left on the table.

So what can carriers do to drive these results?  In my experience, the ultimate success was the result of training, management and calibration.  To drive these results, we utilized software based solutions that gave us the necessary reporting to drill down to every level of the organization.   Leveraging a mix of basic claims 101 with outcomes based technology allowed our organization to focus on the most basic concepts of duties owed and duties breached. This should be spelled out by adjusters as part of their liability assessment that should occur in each and every file they handle. 

First and foremost, adjusters must understand the concepts of comparative negligence and the appropriate negligence in the jurisdictions where they handle claims.   In every claim, there must be an assessment of duties owed and duties breached by all parties.   Understanding duties is critical, but so is the practical application.   For example, a person making a left turn in front of oncoming traffic is not always completely at fault.  What if they gained control of the intersection?  What if they crossed multiple lanes of traffic?  What if the damages are towards the rear of their vehicle?  What if the other party was speeding, texting or talking on the phone?  These are the very types of questions that should be asked of all parties during the claims investigation.  

As discussed in Re-Adjusted: 20 Essential Rules To Take Your Claims Organization From Ordinary To Extraordinary, it is incumbent upon adjusters to effectively ask the who, what, where, when, why and how in every claim.  Managers and claim leaders then need to take steps to proactively manage both behavior and outcomes.  

In addition to liability, there is the issue of damages.   What exactly should one do with the six inch thick demand from the trial lawyer featured on the back of the phone book?  Does the $500 dollar bumper ding justify the $20,000 dollars in medical bills?  It could, but it very well many not.  This is precisely why the damages evaluation is equally important to liability.  

There is no question that people do get hurt in accidents.  But, there are also people who are opportunistic by nature who will exaggerate claims.   Could the disk herniation have been caused by the sideswipe?  Could the torn meniscus have been caused by the slip and fall?  What about the at fault claim the party may have had a year ago where there was substantial damage?  What about the football injury from high school?  Again, questions that need to be investigated and answered. 

On top of that are the medical bills that may have been upcoded or unbundled.  Without the right technology to reprice the medical bills for coding errors and reasonableness, the claim will end up being overpaid. 

It is often said that the best offense is a good defense.  On the gridiron, hours are spent watching video of opponents so that a winning defensive scheme can be put together.  The same should occur in our claims offices, where the playbooks of trial lawyers and medical providers should be studied, understood and countered with an appropriate approach to achieve accurate settlements.     

Christopher Tidball is an executive claims consultant and the author of multiple books, including Re-Adjusted: 20 Essential Rules To Take Your Claims Organization From Ordinary to Extraordinary!  He is an industry veteran having overseen claims processes and practices for multiple top 10 P&C organizations.  To learn more, please visit www.christidball.com or e-mail chris@christidball.com

July 19, 2012 at 6:44 am Leave a comment

The importance of chain of custody and preservation of evidence

With spoliation of evidence claims on the rise, insurers need to be increasingly aware of steps that must be taken to preserve damaged property.   To better understand this, it is important to first recognize and understand the chain of custody.

The inception of the chain of custody is the point in time at which evidence is collected and the chain must be maintained until the evidence is disposed of.   Evidence comes in all shapes and sizes, and depending upon the nature of your claim must be cared for in a variety of different ways.   This chain ensures continuity in the accountability and is essential as any break in the chain may invalidate admissibility in court.

The chain of custody is a chronological written record of those individuals who have had custody of the evidence from its initial acquisition until its final disposition. These persons in the chain of custody must be identified and any person coming in contact with the evidence must be documented.

Ideally there will be an evidence custodian.   It is incumbent upon the custodian to be a steward of the evidence while documenting everything that happens through the lifecycle of the evidence process.   Even more critical is an understanding of the various state laws pertaining to evidence and spoliation thereof, which can leave the custodian liable for damages.

It is often advisable to utilize an independent Evidence Custodian as this will minimize charges of tampering with evidence.   By securing evidence in an independent location, all parties associated with the claim will have access to the evidence.

Another key part of the process involves the utilization of Evidence Receipts.   Evidence receipts are provided to those who deposit evidence.   The Evidence Custodian will always retain the original, a second goes to the person depositing the evidence and a third goes to a case file.   Having the ability to electronically retain this documentation and back up in an offsite, secured location is ideal.

The original chain of custody form becomes a voucher and is given a voucher number when it is presented to the evidence custodian. Number evidence vouchers consecutively from inception to the current date.   This original voucher should not leave the custodian with the exception of submission to a court of law as evidence.

An Evidence Sub voucher should be utilized to document any changes in the chain of custody that occur when the evidence leaves the evidence room.  Consider a situation in which a mold sample leaves the evidence room with the plaintiff attorney and is turned over to a toxicology expert for analysis, in which case a sub voucher would be utilized.  The number of the sub voucher should reflect the number of the original.

Disposition of Evidence occurs when the materials in custody are no longer needed at which time the property should be turned over to the proper owner or if unknown to an applicable insurer, state or federal agency.

By developing the proper protocols and understanding the ramifications of non-compliance, these simple steps can save organizations significant time and expense associated with spoliation claims.

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Christopher Tidball is an executive claims consultant and the author of Re-Adjusted: 20 Essential Rules To Take Your Claims Organization From Ordinary to Extraordinary.   His tips for personal and organizational success have been featured on MSNBC, CBS Market Watch, ABC, Yahoo Finance and in the Wall Street Journal and Kiplinger’s.   To learn more about optimizing your organizational results, please visit www.christidball.com or e-mail chris@christidball.com.

July 16, 2012 at 5:02 am Leave a comment

Subrogation workload: How much is too much

An often debated question among claims executives is how to properly staff an organization.   Arguably, one of the most challenging of the positions to properly staff is that of subrogation adjuster.  Given the varying degrees of complexities involving recovery operations, this can pose quite an organizational challenge.    So what should a claims organization do?

The simple answer to the question is that it depends;  but the first answer is never base staffing on pending.  It is a self fulfilling prophecy as there is little incentive to close files.   “Hey, if I get to 500 then I won’t get any new.”  Rather focus on new with an emphasis on disposition and quality.

Other critical questions that need to be answered are:

  • What type of subrogation is being pursued? Auto, Property and workers’ compensation will have different models.
  • What is the average tenure of the adjuster?
  • What is the complexity of the claims?
  • What percentage is insured versus uninsured?
  • What is the average time of referral from date of claim payment?

These are just a few of the factors that play into effectively staffing an organization.   In my experience managing claims organizations, and now working with a variety of insurance carriers, the best results are obtained with the following 9 box model and several critical questions.

1. Staff subrogation adjusters obtain the best results when limited to claims where insurance has been identified and the claimant carrier is a member of inter-company   arbitration.   In this subset, claims with no dispute should be placed into a Fast Track unit where at least 10/day should be no problem.

2. Claims with disputes should be placed into a more tenured unit, such as an arbitration unit, so that attempts to settle can be made and if unsuccessful the arbitration contentions can be filed.  Typically, these cases are more complex and assignments may be half of what Fast Track can effectively handle.

3.  Claims identified as uninsured, or as non Arbitration Forums members, are often best handled by business partners with an expertise in tougher collections who have the resources to effectively recover in this challenging environment.  During my tenure as a claims manager I found that keeping tougher collections in house simply doesn’t work as they are recognized by adjusters as impediments to other goals and often find their way off diary or to the bottom of the workbasket.   Getting these claims out the door on day one increases recovery exponentially and actually is cheaper for the carrier than handling them in house.

4.  Push for a 100 percent disposition ratio without sacrificing quality and pending doesn’t become an issue.  If you get 100 new, then you should close 100.  Provide rewards and incentives for better results.  A properly calibrated organization will increase both disposition and quality.

5.  Measure closed with no recovery to balance out disposition metrics, which when taken alone,  can drive bad behavior.   In post mortem audits it is not uncommon to find 15 to 20% of files closed prematurely and with a missed opportunity.

6.  Focus on quality over quantity.   Yes, production is important but it is equally important to have staff in place that can effectively investigate and aggressively negotiate settlements.  By having a solid QA process in your organization you are assured of substantially increasing your bottom line and the QA results should definitely be part of the annual PE, with each stakeholder being held accountable for results.

*****

Christopher Tidball is a claims consultant and the author of Re-Adjusted: 20 Essential Rules To Take Your Claims Organization From Ordinary To Extraordinary.   He spent more than than twenty years in various claims, process and executive roles with multiple leading insurance carriers, including Progressive, AIG and 21st Century.  He currently serves as a Senior Director with Mitchell International where he focuses on providing casualty solutions to the claims industry.  His proven success combines dynamic experience with Six Sigma methodologies to identify opportunities, optimize workflows, gain efficiencies and boost results.  To learn  more, please visit www.christidball.com.

July 10, 2012 at 8:56 am Leave a comment


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Chris Tidball is a claims and revenue management consultant and author of the "20 Essential Rules" series of self and organizational improvement books. You can ask him a question at chris@christidball.com

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