Property & Casualty
When a fire, car accident, serious injury or other complex coverage issue occurs, it can be a confusing and emotional time. It’s important to initiate the claim process as soon as possible, but where do you start? Reporting your claim directly to your insurance carrier can expedite the process, and begin to move toward closure to the issue. At Neace Lukens, our claims team can help navigate you through the claim process, and act as your advocate when working with insurance companies.
When you notify us of a claim, we work with you to inspect losses and evaluate the situation. If the situation warrants, we’ll come onsite, and work either with or without an insurance carrier representative to inspect the claim. If needed, we’ll suggest a contractor or other vendors to evaluate damage and assist in the claim process. This could include property damage, serious injury or fatality.
When a claim situation arises, it’s especially important to be prepared and keep good records. Get contact information for everyone that you speak with, take notes on your conversations, and keep all associated paperwork together in a folder. Taking pictures and/or videos can also be helpful to document the loss. These steps can help you be more prepared and feel confident about the claims process. The Neace Lukens claims team is here to help and answer your questions, and provide support throughout the entire process. We work with you to try to get a favorable outcome for the claim.
If you have questions about an existing claim, or are looking for advice, our team of dedicated claims specialists can help. To learn more about Neace Lukens claims resources, or to contact the claims department, visit: Neace Lukens Claims.
Each month Neace Lukens will answer common insurance questions faced by our clients. To submit questions for consideration, contact us.
Not all claims can be prevented, so when a claim situation arises, it’s important to take advantage of the resources and tools available—including the Neace Lukens claims team. We act as your business partner and claims advisor to educate you on the ins and outs of reporting a claim, answers to commonly asked questions and more. Read on for answers to two common claims questions:
How do you determine if there are any coverage issues when damage is incurred?
When you file a claim, we start by reviewing your policy to determine the types of coverage afforded and available. We will work with your insurance carrier to submit the required paperwork, and also inspect the loss and review it to determine if there are any areas that could be interpreted in your favor. Our goal is to support you throughout the entire claims process, offering our expertise and knowledge to minimize harm, maximize compensation, and get you an outcome that is as favorable as possible.
How do contractual issues, such as hold harmless, waiver of subrogation and indemnification clauses impact who is responsible and for what?
Your policy of insurance is a contract. When you file a claim, there are other contracts and legally binding documents that can come into play. With these contracts, there may be certain contract language, including hold harmless, waiver of subrogation and indemnification clauses, which can impact your claim. Other terms and conditions could potentially be involved as well. The claims process is complex, even without contractual issues outside of the policy being involved. While we are not attorneys, the Neace Lukens claims team will review and evaluate the contractual and non-contractual factors involved in your claim to help you understand what’s going on, while advocating on your behalf with your insurance carriers.
If you have questions about the claims process, our team of dedicated specialists can help. To learn more or to contact us, visit: Neace Lukens Claims.
If you’re an owner operator or fleet owner in the trucking and transportation industry, you’re probably aware of the varied and wide-ranging insurance coverage needed to successfully protect your business. A fully comprehensive plan can protect your business, now and into the future. Insurance coverage to consider can range from workers’ compensation or liability policies to individual health insurance.
It can be frustrating trying to piece together these individual insurance products. With Neace Lukens TransGroup, we work directly with the insurance carriers for you, to create one simple plan that provides the solutions to all of your insurance requirements. We eliminate the need to work with multiple companies, and guarantee client satisfaction and affordable options for owner operators and fleet owners.
Whether it’s a fleet of limousines or semi-trucks, our talented TransGroup professionals offer:
• Trucker liability coverage
• Physical damage coverage
• Non-trucking liability
• Motor truck cargo coverage
• Workers’ compensation
• Occupational accidental insurance
• Individual health insurance
• Excess liability and bonding insurance
If you’re worried about gaps in your coverage, or would like to add increased coverage for your organization, we can help. To learn more, or to contact an agent, visit: Neace Lukens Property & Casualty.
Several Neace Lukens agents will lead sessions at the upcoming Certified Workers’ Compensation Counselor program, hosted by Allied Construction Industries in Cincinnati, Ohio. Maureen Gallagher, Mark Bizer and Mike Campbell will share their knowledge and expertise about experience modification and wellness in the workplace with program attendees looking to receive their Certified Workers’ Compensation Counselor designation.
The Certified Workers’ Compensation Counselor designation prepares insurance agents to clearly navigate the complex world of workers’ compensation. This course educates agents on the issues surrounding workers’ compensation to better manage workers’ compensation outcomes and keep costs low for clients.
The Certified Workers’ Compensation Counselor Program is held May 13 – 15, 2013 in Cincinnati. To learn more about this program, visit: Certified Workers’ Compensation Counselor Program. To learn more about Neace Lukens workers’ compensation services, or to contact an agent, visit: Neace Lukens Property & Casualty.
If your organization is involved in the forest products industry, whether it’s a rough lumber mill or secondary lumber operation, it’s important to have a sound insurance plan in place. The right plan works to assess and control your insurance risks to ensure long-term success for your organization. If you’re a part of the forest products industry, adding forest industry coverage to your policy can help protect your organization and its assets both now, and into the future.
At Neace Lukens, our skilled advisors create customized plans to protect your financial property. We provide expert analysis to create and customize the best insurance program for you, building the right coverage based on your business plan. We work with organizations in industries like logging and lumbering, to trucking, to pallet and furniture manufacturers and beyond, to help provide the answers to meet today’s forest industry insurance challenges. We partner with numerous insurance carriers that offer a wide variety of products to develop unique programs to meet your needs for your workers’ compensation and property insurance policies.
Already have forest industry coverage? Our team of property and casualty professionals can work with you to review your existing coverage and identify potential areas of risk. If you’re interested in adding forest industry coverage to your insurance policy, please visit Neace Lukens Property and Casualty to learn more or to contact a Neace Lukens agent.
Neace Lukens will present three sessions at the upcoming Ohio Health Care Association Annual Convention and Expo, April 29 – May 2 in Columbus, Ohio. The Ohio Health Care Association Annual Convention and Expo features four full days of educational sessions and an exhibit hall. If you’re involved with the long-term care or assisted living industry, or working to navigate the Affordable Care Act, be sure to join the Neace Lukens team at any of their presentations:
The Affordable Care Act Pay or Play
Tuesday, April 30 at 8:30 a.m.
Presented by Scott Heiser, Senior Vice President
The Affordable Care Act is a complex and ever-changing reality of business today. With all the revisions and updates since the Affordable Care Act has passed and deemed constitutional employers struggle to navigate this tangled web. Our presentation will provide employers a detailed description of the Pay or Play mandate, how to calculate the potential impact on your business and strategy moving forward.*
Infection Control: Where We’ve Been, Where We Are, and What’s to Come
Wednesday, May 1 at 10:00 a.m.
Presented by Angela Reese, RN, BS, RAC-CT, C-NE, LNCC
This presentation takes the best practice infection control definition and purpose, and demonstrates how far we have come in using that definition to prevent infections of today. Looking toward tomorrow and the world’s goal of eradication of superbugs, the presentation uses the components of a best practice infection control program and the regulatory influences of F441 to describe what it will take to move avoidable infection to the unavoidable column.
Recognize the Warning Signs: Managing the Environment of Care
Thursday, May 2 at 8:30 a.m.
Presented by Angela Reese, RN, BS, RAC-CT, C-NE, LNCC and Kim Robson, ARM
Long term care and assisted living facilities are being challenged with providing safe care to a changing resident population. Residents of today are presenting with different needs than residents of yesterday and the future is unpredictable. Facilities are seeing a considerable difference in age, more complex needs, and a larger population with behavior health concerns. The shift in the resident population has exposed providers to new risks and survey concerns. The best risk management and survey related outcomes start with recognizing the changing resident population, identifying potential liability issues, and implementing strategies to proactively manage the environment of care.
Stop by our booths on the expo floor to meet the Neace Lukens team. You’ll find Neace Lukens at booth 200 and RMS at booth 124.
Are you attending the Ohio Health Care Association Annual Convention and Expo? To learn more or to register, visit: the OHCA convention website. To learn more about the senior living services offered by Neace Lukens, visit: Neace Lukens Senior Living. To learn more about the clinical risk management services available, visit: Neace Lukens Clinical Risk Management.
*From the OHCA Convention & Expo website
With Earth Day around the corner, April is a great time to think about protecting your business from potential fallout from environmental-related incidents by adding pollution liability insurance to your policy. Pollution liability insurance, also known as environmental liability insurance, is usually not included in your general liability policy. This type of insurance protects businesses of all sizes, from small manufacturers or contractors to major conglomerates, from dangerous or toxic environmental exposures including chemicals, petroleum based products, lead, asbestos, mold, silica and more.
So why should you add pollution liability insurance to your policy? According to Chubb, pollution liability insurance can help protect your organization against legal indemnities, divestiture issues or accidents. This type of insurance provides first party and third party cleanup along with bodily injury and property damage caused by pollutants.
Simply put, pollution liability insurance is another good way of limiting your organization’s exposures. Unintentional acts of pollution could result in bodily injury, property damage or lawsuits from the Environmental Protection Agency which would not be covered by traditional General Liability Policies.
With much of the world’s attention focused on environmental accidents and regulations, it’s a smart investment to add pollution liability insurance to your policy so that your business is protected in the event of a toxic chemical spill or your operations cause the release of a toxic substance.
Looking to add pollution liability insurance to your policy? Contact the Neace Lukens property and casualty team to learn more and see how you can help protect the environment and add another layer of protection to your business. To learn more or to contact an agent, visit: Neace Lukens Property and Casualty.
Each month Neace Lukens will answer common insurance questions faced by our clients. To submit questions for consideration, contact us.
If you’re involved in construction or handle workers’ compensation for your organization, chances are you’ve had your fair share of experience with mod worksheets and wrap policies. Read on for answers to two workers’ compensation questions:
How does the new workers compensation mod formula affect me?
The National Council on Compensation Insurance (NCCI) has announced plans to make a change in the experience rating formula, with changes transitioning throughout a three-year period. The first stage of the transition takes effect with each state’s approved rate and loss cost filing on or after Jan. 1, 2013.* When you’re impacted by this change depends on what state(s) you’re operating in, since the effective date is different by each state. The new plan really credits return to work and claims avoidance (otherwise known as safety plans).
In most cases, mods will stay flat or increase slightly (which will increase your premium). Reconciling your mod sheet will become even more important. There are things you can still do to minimize the impact, including reviewing any open claims, verifying payroll amounts and setting up a mod management plan.
I’ll work on a wrap plan for a larger contractor starting next month. What does this mean for my workers’ compensation?
Owner Controlled Insurance Programs (OCIP) are known as “wraps” and are frequently used for large commercial projects and residential construction projects.** If any worker is injured on the job, the wrap insurance company will handle the claim. You need to be sure you know who that company is and how to contact their claims department in the event of an injury. Even though the claim is handled by the wrap insurance company, the loss will still count against your experience mod.
When the project is complete, make sure you have contact information for the company handling the OCIP workers’ compensation on hand. Any questions on claims payments will need to go to them. Keep up with your workers’ compensation claims until they are closed and keep records of final payment to match to your experience mod worksheet. Also, keeping good payroll records is essential, since payroll is a big part of your experience mod—and inaccurate payroll records can cause your mod to go up.
If you have questions about your workers’ compensation insurance policies or programs, our team of dedicated specialists can help. To learn more or to contact us, visit: Neace Lukens Property & Casualty.
In 2000 and 2008, the Office of the Inspector General initiated and supplemented compliance program guidance to engage the private health care community and curb fraud and abuse in areas of quality, employee performance, financial waste, and legal risks and liability. Now, in 2013 the Center of Medicare and Medicaid announced their intention to propose regulations to implement section 6102 of the Affordable Care Act, the compliance and ethics program.
The Center of Medicare and Medicaid has not announced a release date for implementation, but it should be announced on the next Unified Agenda. This agenda outlines a timeline for regulatory priorities that are under development. According to the Center for Medicare and Medicaid, the statute speaks for itself, but they will not be enforcing this requirement until regulations are enacted.
So what does this mean for senior living and assisted living facilities? If the Office of the Inspector General investigates a healthcare organization for possible fraud before the new compliance and ethics program regulations go into place, they can use absence of a facility plan to show that the provider does not take their obligations seriously. Creating a facility plan is important, regardless if the Center for Medicare and Medicaid enforces it, because the law went into effect on March 23, 2013.
In the near future, Medicare and Medicaid payments will be based on payment for quality outcomes instead of the number of procedures and tests as it is now, according to the Office of the Inspector General. The Center of Medicare and Medicaid, through the Office of the Inspector General, is encouraging all long term care organizations to establish and maintain effective compliance programs with the goal to improve the quality of care and services. The risk for not developing a comprehensive compliance program is to become a target of governmental investigation and potential penalties.
As a provider, you still have time to develop a compliance program and demonstrate a good faith effort to comply with the applicable statues. The Affordable Care Act grants strict preference to alternative payment methods if the healthcare organization delivers quality care with efficiency and lower costs. This can lead to savings in healthcare dollars and greater reimbursement for quality care if healthcare organizations meet reporting deadlines and take reform efforts seriously. The need to complete a compliance program is significant.
Looking for help developing a compliance program? Neace Lukens CORE Solutions will work with you to make sure that your organization is on the right track. Our team of clinical risk management professionals has worked with long term care organizations on compliance programs for more than 16 years and can create a customized plan, no matter if you’re just starting out or already on the path to compliance. To learn more or to contact an agent, visit: Clinical Risk Management.
*Information from The Center for Medicare and Medicaid, the Accountable Care Act section 6102, and the Office of the Inspector General
(This is an installment of Risk Management 101, a series of blog posts exploring Neace Lukens’ Risk Management offerings. To learn more about Neace Lukens’ approach to Risk Management, please click here.)
Safeguarding your business from disaster is a necessary precaution. While you practice drills and prepare procedures, disasters are just a factor that you cannot control. However, you can mitigate the damage a disaster could have on your organization with fully comprehensive insurance coverage.
While we looked at mainly environmental and weather-related insurance coverage last week, read on to learn about other coverage areas to consider:
1. Have you filled out a business income worksheet?
Property insurance is recognized as covering your ‘bricks and mortar’ and your ‘stuff’. While it’s true that your building and contents are covered, the equally important business income coverage is often overlooked or under appreciated. While your building is being rebuilt, you’ll still have ongoing expenses that must be paid, like the mortgage or lease, utilities, salaries and property taxes. A business income worksheet takes a little time to understand and complete properly, but if you ever need the coverage, you’ll be very glad you did it correctly. Also, be sure to check into the insurance requirements of all vendor and payer sources.
2. Are you covered by an extended period of indemnity?
After a disaster, your income is likely to suffer for months. A mini-mart’s sales may return to pre-loss levels within a couple of weeks after reopening but other organizations, including senior living facilities, can take much longer to recoup. Don’t shortchange yourself—discuss the extended period of indemnity option with your agent.
3. Have you considered extra expenses?
Extra expenses are the costs you incur immediately after a loss, which help minimize damages to get you back in operation sooner. Expenses could involve moving costs to relocate contents from a damaged structure and storing them at an offsite location until rebuilding is completed. You may need to lease temporary space for a short period of time with unfavorable lease terms. You may need to pay extra to expedite shipping of a key item that will get you back in business sooner or pay overtime. Worksheets are available to help get you thinking. Resist taking shortcuts or you could end up paying for it when you can least afford it.
4. Is your property insurance appropriate?
Lightning can be beautiful in the distance but deadly up close. Even if it doesn’t cause a fire at your building it can wreak havoc on sensitive electronic equipment. Surge protectors will help in many cases, but they aren’t 100 percent effective. If you suspect damage to some of your electronic equipment following a storm, check all your equipment out as soon as practical. Loss of some equipment can be inconvenient, loss of other equipment can be life threatening. Check with your agent to be sure your property insurance coverage is appropriate. You may want to consider an inland marine policy for some items rather than relying on traditional property insurance.
Have you taken steps to protect your business from a disaster? Talk to your insurance agent and discuss these coverage areas before your next insurance renewal to make sure your business is safeguarded from disaster. To read part one of the disaster planning installment, click here. To learn more about protecting your business or to contact an agent, visit: Neace Lukens CORE Solutions.