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12 Ways to Use an Attorney in Workers Compensation Cases

Posted by David Ross on Wed, Oct 19, 2016

Tips for limiting your attorney costs in workers compensation insurance claims in Philadelphia, Reading, Lancaster, Harrisburg, Allentown, PA and beyond.Hiring a competent workers compensation defense attorney is not an exact science, but it is an important first step in the process of defending your business in a contested workers comp claim, which can impact the cost of your workers compensation insurance

Relying on an attorneys' reputation is a good starting point, experts say. But regardless how successful a lawyer is, the candidate must be familiar with the industry in which you operate. Your local bar association may be able to help advise you of an attorney’s field of practice.

But even after retaining an attorney, your risk manager or director of worker’s compensation might still want to consider the relationship as a trial run until the attorney’s responses to various case management guidelines are evaluated. Discuss fees and your expectations with the candidate, and make sure your attorney follows up any agreement with a written confirmation
 

How to Use Your Attorney Effectively in Workers Comp Cases

Remember, all lawyers charge fees and bills by the hour. Once you have retained defense counsel, it is imperative that you limit your attorney’s hours by using his or her services efficiently. Here are some suggestions that could save your business unnecessary legal costs:

#1. Communicate through e-mail whenever you ca
n. Limit messages to only the most necessary information. This method gives you electronic documentation for the claims file and is faster than formal letters sent through regular mail.

#2. Keep all telephone calls short by planning your discussion ahead of time. Gather the information you need and end the call as soon as possible. Be sure to document the conversation for the workers compensation claims file.

#3. Limit your attorney’s time by having your claims manager obtain the defense and claimant statements. Supply any required personnel records as well as all medical examination information. Make sure your attorney receives claim file reports and all investigation information.

#4. Require your attorney to ask your permission before doing any additional research or hiring a private investigator.

#5. Obtain a cost estimate for legal services from your lawyer and follow up on this with any revisions. You can use the estimate as a basis for a workers comensation legal reserve.

#6. Eliminate redundant mailing and copying costs. After the attorney has made an initial assessment and provided a plan of action, it is only necessary to comment on current activities. There should be no need to copy the claim file on subsequent depositions or interrogatories.

#7. Employ more than one attorney, if possible. The competition can generate better results, especially in litigation.

#8. Promptly obtain and provide information that your attorney needs to efficiently handle your workers comp case.

#9. Negotiate agreements and settlements whenever possible. Limit attorney negotiating to pretrial conferences, arbitration, and trial.

#10. When your attorney negotiates, set limits and authorities. And require a telephone request for additions to the first limits and authorities. Serve any subpoenas for the attorney, if possible.

#11. Ask your lawyer to bill you promptly and on a regular basis. Check the invoices carefully for accuracy—everything should conform to your written agreement and coincide with the information in the claim file records. Make sure that paralegal fees have not been submitted as attorney fees. Pay the invoices promptly to avoid late charges.

#12. Manage fee increases. Make it clear that fee increases should happen only after direct negotiation and agreement.

Any time your attorney is working on your workers compensation insurance case, the clock is running. Think about everything that comes under billable time—telephone calls, research, investigations, depositions, trial prep and the trial itself, just to name some of the activities—and you begin to realize the importance of controlling those hours as much as possible.

 

Want to Lower Your Workers Compensation Insurance Cost? 

Limit-Workers-Comp-Insurance-Legal-Costs.jpegTo learn more about controlling your workers compensation insurance cost, contact American Insuring Group online or call us at (800) 947-1270 or (610) 775-3848.

As a Trusted Choice independent insurance agency, we have the freedom to shop among many competing workers comp insurance providers, so you'll get the right insurance coverage at the right price. Call or click today to get started!

Tags: Workers Compensation Insurance, workers comp, workers comp insurance, PA Workers Compensation Insurance, workers comp costs, Commercial Insurance, Business Insurance

Concealed Weapons and General Liability Insurance

Posted by David Ross on Fri, Oct 14, 2016

Don't shoot yourself in the foot - consider your concealed weapons policy!

Tips for forming a concealed weapons policy and commercial liability insurance. Serving Reading, Philadelphia, Allentown, Lehigh Valley, Harrisburg, York, Lancaster, Pittsburgh, Erie, PA and beyond with quality general liability insurance for businesses for over 25 years. Contact us today.As a small business owner who allows customers and visitors on your property, you assume the responsibility of providing a reasonably safe environment for them. This responsibility includes warning them about any concealed dangerous conditions. In states with “concealed carry” laws, you might need to post warnings that your sales clerks are armed.

But what if one of your employees, legally carrying a concealed weapon, negligently (or deliberately) shoots a customer who is on the premises conducting business, and the client subsequently sues you for the injuries? Will your Commercial General Liability Insurance (CGL) policy cover this incident?

Obviously, you would have to be found legally responsible for the injuries for the CGL to pay. And, while your liability might be debatable, you will be brought into any lawsuit by the injured customer. At that point, your insurer will be compelled to defend you unless there is some clear-cut exclusion in the general liability policy that would apply to the shooting occurrence. And that’s not likely.

 

What's the right policy for minimizing risk and protecting employees and customers?

Even though it’s probable that your business liability insurance policy will cover you against such claims, it could be a smart move to minimize this type of risk by being pro-active. For instance, requesting an exemption from the scope of the concealed-weapon law will give you the authority to ban weapons in the workplace. Make it your company’s policy for all present and future employees that guns are not allowed on the premises. That would eliminate the possibility of a lawsuit…wouldn’t it?

What if your employee is attacked?

Think about your employee being attacked and beaten at work after you have forbidden him from carrying a weapon. Looking at this from his perspective, couldn’t that employee file suit claiming that he was unable to defend himself because of your weapons ban? The injured worker could assert that he sustained a bodily injury and that you, as his employer, are legally responsible for those injuries.

The workers’ compensation exclusion and the employers’ liability exclusion in the general liability policy would need to be considered, but if the injury to the employee is not work-related - in other words, not arising out of and in the course of employment - the exclusions won’t apply. In that case, your general liability policy would respond with a defense since there is no exclusion in the policy to prevent such a response. But, of course, the duty to pay the claim would depend on your liability being established in a court of law.

Suppose you don’t ban weapons and one employee shoots another?

If one of your staff carries a concealed weapon to work and shoots a fellow employee, and it results in a claim against you, will an insurance policy provide coverage? Once again, the first thing to consider is workers compensation. CGL does not apply to any of your obligations under a workers’ comp law, or to bodily injury to one of your employees arising “out of and in the course of employment.”

If the shooting injury did not arise out of the employment, the general liability policy would respond to a claim against you, but if the injury arose out of the employment, you could look to workers’ compensation for coverage. But what exactly is "out of and in the course of employment"? State workers’ comp laws have yet to define this. It may have to fall to the courts to make this determination.

Properly screen employees during the hiring process

The list of potential problems that concealed weapon laws pose for you as an employer is quite long. Good risk management calls for preemptive actions. Banning weapons from your premises is a good start. And instituting hiring practices (pre-employment screenings, etc.) that yield levelheaded employees who won’t resort to violence to settle disputes is also necessary. All business owners can learn to live with concealed weapons laws, but none can afford to ignore them.

Contact Us for Your Commerical Liability Insurance Needs

Contact us about commecial liability insurance and your concealed carry policy.To learn more about Commercial General Liability Insurance, contact American Insuring Group online or call us at (800) 947-1270 or (610) 775-3848. As an independent insurance agency, we'll compare pricing and coverage among many competing carriers to get you the right commercial insurance at the right price. Contact us today!

 

Tags: Business Insurance Reading PA, Business Insurance Berks, Business Insurance Philadelphia Pa, Commercial Liability Insurance, Commercial Insurance, Business Insurance Allentown PA, Business Insurance, Pennsylvania Business Insurance

Workers Comp Claims and Functional Capacity Evaluations

Posted by David Ross on Sat, Oct 08, 2016

Tips for when to use functional capacity evaluations (FCE's) in a workers compensation insurance claim. We serve Philadelpnhia, Reading, Lancaster, Allentown, Lehigh Valley, Harrisburg, York, Camp Hill, Pittsburgh, Erie, PA and beyond with high quality, afforcable workers comp insurance.Employers and insurance companies have been using functional capacity evaluations (FCE) for over thirty years. In workers compensation insurance cases, the FCE is used to evaluate an employee's ability to perform activities related to his or her employment.

The FCE process compares the individual's health status, body functions, and structures to the demands of the job and the work environment.

 

What is the purpose of an FCE in workers’ comp?

An FCE's primary objective in workers’ comp insurance cases is to evaluate objectively an injured employee’s ability to return to work. By identifying functional restrictions and determining the degree of disability, the test is designed to increase the likelihood that an injured worker can safely return to work. The test can also uncover “symptom magnifications,” which, in layman terms, are exaggerated claims of incapacity and pain.

How does the FCE test work?

Experts with a background in industrial rehabilitation and social work administer the physical and cognitive tests. The tests measure the worker’s resilience and endurance. If the employee is unable to perform his pre-injury job, the testers attempt to determine if there are skills that are transferable to another line of work. The results of the testing, used in combination with opinions and other findings, are used to decide if the employee can return to work.

The FCE provides objective information in the following areas:

  • When to allow the employee to return to work
  • If the employee can return to the same job
  • The employee’s functional abilities on the job
  • The employee’s functional abilities away from work
  • A disability evaluation
  • A rehabilitation plan
  • The need for other medical treatments

There are two types of FCE

The Job Specific FCE evaluates an injured worker’s ability to work in a particular job. The test can be performed at a clinic or on the actual job site. The therapist will determine if the worker can safely perform the tasks of the job he held before the injury or if modifications of the required work will be needed.

The General Purpose FCE is used if the employee no longer has a job to which he can return or if the job functions have not been determined. The results of this test will be used to find out the worker’s ability to work at specific jobs that may become available in the future.

When should you use an FCE?

It probably goes without saying that you won’t need to use a functional capacity evaluation in every one of your workers’ comp cases. But the tests should be utilized in any case in which the injured worker’s functional ability is at issue. You would certainly consider using the evaluations when the employee claims not to be able to return to work because of restrictions, education, or non-transferable skills. If the worker is requesting retraining benefits or looking for permanent total disability, an FCE would be warranted.

Choose the right time to seek an FCE

If your employee is currently at a point in the healing process where additional medical care will be needed, the FCE will not help the defense of the workers comp insurance claim. But if you suspect that your employee is malingering, the tests may help to detect the symptom magnification mentioned above. The report from the tests could lead to a quick settlement or bring about an advantageous result in litigation.

Finding the right evaluator

Choosing an expert comes down to looking at a few vital factors:

  • Professional reputation
  • Education and background
  • Ability to write a plausible FCE report
  • Capability to provide trustworthy testimony
Don't Overpay for Workers Comp Insurance - Contact us Today!

Contact us for help in acquiring the right workers comp insurance, and to learn more about FCE claims.To learn more about workers compensation insurance, contact American Insuring Group online, or call us at (800) 947-1270 or (610) 775-3848. We're independent agents who with access to many competing providers.

We'll match up your needs with the companies who can provide reliable workers compensation insurance at a competitive price. Call or click today to get started!

Tags: Workers Compensation Insurance, workers comp, workers comp insurance, PA Workers Compensation Insurance, workers comp costs, Commercial Insurance, Business Insurance

Contractor Insurance and Mold Remediation Services

Posted by David Ross on Tue, Sep 27, 2016

Contact us to add mold remediation coverage to your Contractor Insurance policy. Serving Reading, Philadelphia, Lancaster, Allentown, Lehigh Valley, Harrisburg, Pittsburgh, Erie, PA and beyond with reliable business insurance for over 25 years.Attention: restoration contractors! You may have lucrative opportunities from an unlikely source—mold. Yes, the fungus that grows in moisture-laden areas of many old homes has created a demand for professional mold remediation services.  Done right, you can grow your mold remediation business while controlling your contractors insurance rates. 

Mold is one problem that homeowners cannot just ignore. Not only does it look disgusting, but it can also weaken the walls, ceilings, floor, and foundation of a house. And it presents a substantial risk to the health and safety of its inhabitants. 

Income vs. Risk

But along with the possibility of additional income, mold has created new risks for businesses that work on water damage restoration, mold removal, or construction. By implementing a mold risk management strategy, however, contractors can participate in these business openings without endangering their company with uninsured liability.

A recent history of mold and insurance

Around 2001, the number of insurance claims for mold damages soared, as did the income for restoration contractors. Unfortunately, the insurance industry had not expected this rush of claims, and they had not priced them into their policies. In response, insurance companies were compelled to begin issuing mold exclusions and limitations. While these exclusions are not standardized, almost every type of property and liability insurance policy has them.

Liability exposure increases for contractors

Without contractors insurance to help resolve their mold problems, some property owners tackled the mold themselves (bad idea!) or sought out mold remediation experts. But these experts are not the only contractors who come up against mold on a regular basis. Restoration contractors, plumbers, and electricians also encounter mold on their job sites. Even though they have not been hired to eliminate a mold issue, these contractors should always inform the property owner when they discover mold. So, why should this put any contractor at risk?

Disgruntled homeowners often blame their contractor

In an ironic twist, many homeowners began filing lawsuits against the contractors who pointed out the mold to them. This shoot-the-messenger mentality put contractors at risk of liability. The Commercial General Liability Insurance (CGL) policy, usually a protective tool for a contractor, has the same pollution exclusion clause as the homeowner’s policy. This exclusion states that the insurance does not cover any bodily or property harm caused by the escape, dispersal, or release of pollutants.

Is mold a pollutant? There is no universal agreement on this from the courts. Some have found the policies to be vague in their definition of pollution, while other courts have defined mold as an airborne pollutant.

Contractors are advised not to expose their business to chance

Contractors need to protect themselves against potentially devastating lawsuits. There are now insurance policies that specifically cover mold and pollutants. Contractors Pollution Liability (CPL) can be added to your CGL to cover liability for these pollutants and provide an unambiguous definition that includes mold or fungi.

CPL is probably the best available policy for contractors wanting to avoid liability when they discover mold on a job site. And there are other methods contractors can use to manage their mold risks.

Reduce Your Risk With an Arsenal of Protection

  • Choose your customers wisely: If your client is aware of a mold problem and knows the insurance company won’t cover it, you may want to walk away from this job.
  • Document your work: Leave nothing to chance. Use photos, notes, and witnesses to corroborate your findings.
  • Treat your customer with empathy: Approach your client with a plan of action that shows you understand his problem and will work with him to solve it.
  • Protect yourself: Adding CPL to your contractors insurance will complete an arsenal that will mitigate your mold risks.

Get Help For All Your Business Insurance Needs 

Contact us for all your mold remediation, contractor insurance, and business insurance needs in Philadelphia, Reading, PA and beyond.To learn more about Commercial General Liability and Contractors Pollution Liability insurance, or for any business insurance need, contact American Insuring Group online or call us at (800) 947-1270 or (610) 775-3848. We offer insurance from over 25 competing carriers, so we're sure to find you the right insurance at the right price. Call or click today!

Tags: Contractor Insurance, Commercial Insurance Allentown PA, Commercial Liability Insurance, Commercial Insurance, Commercial Insurance Reading PA, Business Insurance, Commercial Insurance Philadelphia PA, Mold Remediation Insurance

Protect Your Construction Investment with Builder’s Risk Insurance

Posted by David Ross on Tue, Aug 30, 2016

Builders risk insurance is a form of contractor insurance. Be sure to know what is covered and not covered. We serve Philadelphia, Reading, Lancaster, Harrisburg, Allentown, the Lehigh Valley, Erie, Pittsburgh, PA and beyond.Having a freshly constructed building for your business is exciting. It’s the culmination of an undertaking that involved the acquisition of land, working with an architect, hiring a construction company, and picking out the furnishings. After you have completed the project, you will have added a significant investment that you will undoubtedly protect with a well-designed insurance program.

But what about the risks that the project will be exposed to while construction is underway? Many of the risks to your finished building--fire, theft, vandalism, and other hazards--are the same threats that can haunt the construction phase of the project. Damage to work that’s in progress or to the construction equipment, for instance, can make it impossible to stay within budget or to remain on schedule.

Builder’s risk insurance provides valuable protection

Builder’s risk insurance, a form of contractors insurance, offers specialized coverage that protects your insurable interests in the construction or renovation of a building or structure if those items should sustain physical loss or damage from a covered cause.

But the term “builder” can be misleading since insureds can include the ultimate owner or a lending institution in addition to the contractor who is doing the construction work.

Understand your policy’s provisions

The various options available under builder’s risk coverage depend on the policy’s provisions. These provisions will include the causes of any loss and risks against which you are being insured. The wording should be studied before the construction contract is signed to avoid any coverage problems during construction.

Many builder’s risk policies take a broad approach to the property to be covered, indicating that the coverage applies to all property intended to become a permanent part of the construction, installation or erection of the project. Other policies may refer to covered property as “buildings or structures in the course of construction, erection or fabrication.” If this is the policy’s wording, you need to remember that although a building is a structure, not all structures are buildings. Since a building is usually considered to be an occupied structure, if the construction project involves a structure, identify it as such, and confirm the insurer writes the provisions of the policy with the structure in mind. 

Know which losses are covered by your builder's risk insurance

It’s common for a builder’s risk policy to provide coverage for certain items. The list includes:

  • Scaffolding
  • Temporary structures
  • Construction forms
  • Cribbing

Some insurers cover these automatically, and some will subject them to a limit. Others may require you to add their values to the policy limit. In most cases, the contractor’s equipment—ditch diggers, bulldozers, etc.--is not covered. For these items, an equipment floater is recommended.

Know which risks are not insured

Insurance companies write most policies on an all-perils basis. In other words, coverage applies to physical loss or damage from any cause of loss, unless the loss is limited or results from an explicitly excluded peril. The “non-fortuitous” loss is excluded even though it might not be expressly stated. This is a loss that is expected to happen or has been caused intentionally. It is not accidental and therefore not a loss that will likely be covered by insurance.

Commonly excluded are losses brought about by the following:

  • Ordinance or law
  • Nuclear hazard
  • Earth movement
  • Flood
  • Civil authority
  • Contamination

Also generally excluded are losses from criminal, fraudulent, dishonest or illegal acts; mechanical breakdown; loss of use and consequential losses; wear and tear; pollution and steam boiler explosion, which can be covered by a separate breakdown policy.

Keep in mind that you must tailor builder’s risk insurance coverage to the specific risks associated with your project and to the expectations of all project stakeholders.

Get the Right Builder's Risk Insurance Policy

Contact us for help in selecting the best builder's risk contractor insurance for your businesss.We can help you create a policy that meets the needs of your construction project. As independent insurance agents, we're free to shop among competing providers to help you obtain the best insurance solution at the right price.

To learn more about builder’s risk insurance, contact American Insuring Group online or call us at (800) 947-1270 or (610) 775-3848.

Tags: Builders Insurance, Contractor Insurance, Commercial Insurance, Business Insurance

Reduce Risk with Product Liability Insurance

Posted by David Ross on Sat, Aug 20, 2016

The McDonald's hot coffee lawsuit is a powerful reminder of the need for businesses to have proper product liability insurance. We provide product liability business insurance to Philadelphia, Reading, Lancaster, Harrisburg, Lehigh Valley, Allentown, Pittsburgh, Erie, PA and beyond. Call us today.In 1992, 79-year old Stella Liebeck filed a lawsuit against McDonald’s for serving coffee that was too hot. In a product liability case that became known as the “McDonald’s Coffee Case,” the Albuquerque woman sued for injuries she had received after spilling coffee on herself. The basis of the lawsuit centered on insufficient warnings on the cups. After a trial and appeals, the parties settled out of court for an amount of less than $600,000.

This serves as a powerful reminder that having the right commercial insurance in the form of product liability insurance can help cover unpredictable claims.

The damages awarded in this claim, and others like it, include medical costs, compensatory damages, economic damages, and, in some instances, attorneys' fees, costs and punitive damages. While a large company like McDonald’s was in no danger of being financially damaged by the lawsuit, product liability claims can and do put smaller companies out of business.

Product liability is not difficult to understand. Simply put, your small business is responsible for the safety of the goods it provides. And that can be true even if you’re not the manufacturer. No matter where you are in the supply chain, you can be at least partially responsible for consumer safety.

If you are responsible for any of the following, you could be held liable:

  • Design
  • Distribution
  • Retail
  • Wholesale

Be aware of the claims your company could face

There are three types of products "claims" a company may encounter:

  • Manufacturing or Production Flaws: Some part of the production process created an unsafe defect in the product. Included here are dangerous chemicals found in goods imported from China.

  • Design Defect: The design of the product is inherently unsafe. Remember the Pinto owners’ lawsuits against Ford in the 1970's?

  • Defective Warnings or Instructions: The product was not properly labeled or had insufficient warnings for the consumer to understand the risk. The McDonald's coffee case is an example.

Your company’s survival depends on getting your products into the hands of consumers. But you must manage your product liability risk while you’re doing that. What’s the answer?

 

Product liability insurance protects your business

If your company offers any products to the consuming public, then you need product liability coverage. In many cases, some form of this coverage will be present in the standard commercial general liability or business owners' policy. You will need to confirm this with your insurance professional. Having a clear understanding of your business insurance coverage is essential.

Here are some things to know about your coverage options:

  • General Liability Insurance can help pay your defense costs if a customer sues you because of bodily harm or property damage that your product causes.

  • Product Liability Insurance covers the manufacturer's or seller's liability for losses or injuries to a buyer, user or bystander caused by a defect or malfunction of the product, and, in some instances, a defective design or a failure to warn. You can add this coverage as part of a commercial general liability policy.

  • Recall Insurance helps cover the costs of a recall. Some business owners add it as a rider to their general liability or product liability insurance. It can contribute to paying for client notifications, product disposals, and other costs associated with a recall.

Take steps to mitigate your risk

In addition to being adequately insured, here are some ways to minimize your risks:

  • Inspect any retail stock for defects
  • Make sure warning labels are easy to read
  • Clean and inspect your equipment often
  • Review product instructions for accuracy
  • Have a system in place to track products from the factory to the store

 

Contact us to get the best product liability insurance to protect your businessGet the Right Product Liability Insurance 

Product lawsuits and recalls can drain your company’s bank account. Talk to us about protecting your business with a Product Liability Insurance policy that will help you manage your risks. We're independent insurance agents who are free to shop among many competing insurance providers to get you the absolute best deal on quality insurance coverage.

Contact American Insuring Group online today, or call us at (800) 947-1270 or (610) 775-3848.

Tags: Commercial Liability Insurance, Commercial Insurance, Business Insurance, Product Liability Insurance

6 Proven Methods to Reduce Workers Compensation Costs

Posted by David Ross on Tue, Jul 19, 2016

Reduce your workers compensation costs by following 6 easy steps. Serving Philadelphia, PA, Lancaster, Lebanon, Allentown, Reading, Erie, Pittsburgh, Harrisburg and beyond with affordable, high quality workers compensation insurance.Maybe you’re like many employers who believe that workers’ compensation insurance is just one of those unavoidable costs of doing business and an expense over which you have little control. Good news: controlling your workers comp costs isn’t as difficult as you might think!

The following six steps could help you reduce your workers comp insurance costs by 20% to 50%, depending on how many of them you have already initiated. 

#1. Build your workers compensation program on a solid foundation

You cannot get your program underway unless everyone in your company is on board. Everyone on the management team must be committed to understanding their specific roles and the responsibilities of everyone throughout the company. This commitment from your key employees includes a thorough knowledge of how the workers’ comp system works; an understanding of experience modification rates, the formulas that produce them, and proper classification of employees is a good place to start.

#2. Pay attention to your hiring process

Competent employees tend to be safety conscious workers who are less likely to incur workers comp claims. Make sure your system for hiring brings the best into your company:

  • Good interview techniques and thorough background checks will help you identify potential problems.
  • Carefully review the applicant’s resume, paying attention to gaps in employment history. Ask the applicant to explain these gaps. Probe for information about the applicant’s attendance record during previous jobs.
  • Conduct a complete background check after you have obtained written consent from the applicant.

#3. Make workplace safety a top priority

Safety needs to command equal status with production and quality. Train new employees to perform their jobs safely. Wellness initiatives, which reportedly return three to four dollars for each dollar invested, must be included here. Safety and wellness programs are critical in preventing claims from ever happening. Continually remind your employees to practice safety by posting reminders in common areas and holding meetings to discuss any issues affecting your staff.

#4. Set up a post-injury system

Studies of temporary and permanent disability claims reveal that timely medical treatment reduces expenses. Require employees to report all injuries, no matter how minor they may seem, and then ensure that injured employees receive prompt medical attention. Make sure that your company’s communications systems and post-injury response systems are in place and that you have an effective return-to-work program and policy that monitors your injured employees’ recovery and helps them get back on the job as quickly as possible. These are the core components of your workers’ compensation management program.

#5. Manage workers’ comp insurance claims efficiently

This might begin with using surveillance to prevent workers’ comp fraud. You’ll need to decide whether to request an independent medical examination (IME) and when to use various vendors. Planning for settlements and Medicare set-asides are important aspects of managing your claims. Your claims adjuster, armed with detailed account handling instructions, is also vital in managing claims efficiently.

#6. Control medical costs

Medical and pharmacy costs are rising at an unprecedented pace. Managing these expenses will take a substantial bite out of your workers’ comp bill. Building relationships with a medical provider, using a medical advisor, and utilizing a nurse case manager to monitor complex cases are all steps to be considered here. Also, be aware of the dangers to your injured employees from prescription drug overdose, which has become the biggest killer in the country.

No one benefits when employees get hurt on the job. With focus and effort, you can make workplace injuries less frequent, less severe, and less costly.

 

Contact us for help in lowering the cost of your Pennsylvania workers compensation insurance.Reduce the Cost of Workers Comp Insurance: Get Help From American Insuring Group! 

Contact American Insuring Group online or call us at (800) 947-1270 or (610) 775-3848 for help in lowering the cost of workers compensation insurance for your business. 

Tags: Workers Compensation Insurance, workers comp, workers comp insurance, PA Workers Compensation Insurance, workers comp costs, Commercial Insurance, Business Insurance

One or Both? Business Liability vs. Commercial Property Insurance

Posted by David Ross on Thu, Jul 07, 2016

Can you get away with business liability or commercial property insurance, or does you business need both? Contact American Insuring Group for all your business insurance needs in Philadelphia, Allentown, Reading, Lancaster, Harrisburg, Pittsburgh, Erie, PA and beyond.Experienced small-business owners know that it’s wise to expect the unexpected. Bad things often happen without warning.

Different insurance policies protect their businesses from surprises in different ways, and it’s important to understand the coverage that is included and the differences between the policies.

Comparing business liability and commercial property insurances is a good place to start! 

Business liability insurance protects you from lawsuits

Anything that your business is legally responsible for is called a liability. When you cause someone a loss, you are legally responsible for replacing the loss, usually with money. And that’s where lawsuits come into play. Business Liability Insurance helps you pay for the cost of lawsuits and other expenses for which you are legally responsible.

For example, let’s say you own a machine shop that mass produces parts for an automobile manufacturer, and one of your parts is recalled because it wasn’t made to specification. What happens now? You’re likely to be sued for your mistake or for negligence, which means you will need to hire lawyers and prepare yourself for the possibility of a lengthy trial. You could amass huge costs.

Since small businesses don't have that kind of money, they invest in business liability policies that offer insurance coverage that includes:

  • Attorney fees
  • Out-of-court settlements
  • Judgments from losing the lawsuit
  • Other court and legal fees

Business liability insurance also helps you deal with the responsibilities you have to the people who come into contact with your business:

  • Employees
  • Customers
  • Suppliers
  • Partners
  • Vendors

Types of commercial liability insurance

It's important for you to know that there are various kinds of business liability insurance that cover different types of lawsuits:

  • General Liability Insurance covers physical injuries, slander, libel, infringement, and property damage lawsuits when someone outside of your business sues you.
  • Workers’ Compensation Insurance covers lawsuits related to injuries and illnesses in the workplace.
  • Professional Liability Insurance, sometimes called Errors and Omissions Insurance, covers lawsuits related to your work. It typically pays for your legal expenses when a client claims your work was negligent.
  • Employment Practices Liability Insurance covers lawsuits arising from wrongful termination, discrimination, or unpaid benefits.

Commercial property insurance protects your company’s physical assets

When you buy commercial property insurance, assets like equipment, computers, supplies, inventory, offices, and other business property are insured against loss or damage. Your insurance will repair or replace property that was damaged by the specific events that are outlined in your policy, which can include:

  • Fire
  • Theft
  • Vandalism
  • Some weather-related damages
  • Explosions

For example, a fire does serious damage to a building that houses tens of thousands of dollars’ worth of your equipment. Much of the equipment is lost and the building itself needs major repairs. You will need to replace furniture and the cleanup costs will be substantial. 

A commercial property insurance policy will cover all of these expenses, and if you add Business Interruption Insurance coverage to the standard policy, you can cover the income you would lose if your business has to shut down when it suffers too much damage to operate normally.

 

Bottom Line: You need BOTH commercial property and business liability insurance policies!

Small businesses need both business liability and commercial property coverage, because they work together to make sure you have enough money to pay your bills when an incident or loss threatens your business. Either a lawsuit or property damage could wipe out your company’s savings, put you in debt, and require that any new revenue go toward legal bills or repair costs. Meanwhile, your business suffers.

Buy both types of coverage and save! 

The good news is that as a small-business owner, you might qualify for a lower rate if you purchase these two policies together. This insurance bundle, often called a Business Owner's Policy (BOP), offers this discount to qualifying small businesses.

 

Get help for all your business insurance needs right here

Business-Liability-vs-Commercial-Property-Insurance.jpgTo learn more about business liability and commercial property insurance from our independent agents, contact American Insuring Group online, or call us at (800) 947-1270 or (610) 775-3848.

As independent agents we're free to shop among lots of competing insurance carriers to find the best policy for your needs at the right price. Call or click today to get started!

Tags: Commercial Liability Insurance, Commercial Insurance, Business Insurance, commercial property insurance

Video Surveillance and Workers Comp Insurance Fraud

Posted by David Ross on Tue, Jun 28, 2016

Tips for  using video surveillance to reduce workers compensation insurance fraud in Pennsylvania and beyond.Employers have been using cameras and video surveillance in the workplace for many years. In fact, in a 2005 survey, over half of the responding companies indicated they used video surveillance to counteract theft, violence, or sabotage. 16% of those respondents used surveillance to monitor their workers’ performance.

Still others were monitoring their employees to help prevent workers’ compensation fraud—something that could pay dividends for their companies in terms of payouts and workers compensation insurance rates.

Staging a workers comp injury caught on video

A California workers’ comp insurer had three cases in 18 months where workers’ comp fraud was proven because of videos that showed the workers staging their injuries. The videos—two from restaurant kitchens and the other in a warehouse--show the workers rearranging furniture and objects, kicking the objects, then screaming out in pain. They were subsequently taken away in an ambulance.

The videos were proof that the injuries were faked, and after an investigation, criminal complaints were filed and convictions resulted in a matter of months. There was no impact on the company’s experience rating, or a corresponding premium increase, because the cases were handled quickly, and fraud was easily proved. 

Caution: Employers must respect the laws on workplace privacy

If employers want to use video cameras to monitor employees, they must have a legitimate business reason to do so. State privacy laws will usually determine the extent at which video monitoring is considered legitimate and lawful. Yet, cameras that also record sound may be in conflict with federal wiretapping laws, with or without an otherwise legitimate reason. Most laws that limit surveillance in the workplace pertain to those areas in which there is a reasonable expectation of privacy—restrooms and break rooms, for instance. Some states also prohibit the use of two-way mirrors in restrooms, locker rooms, and similar locations.

Once a company has ascertained a legitimate need to use video monitoring, employees must be notified of the cameras, and filming must be confined to public areas. Under these conditions, the surveillance is likely to be upheld by the court. But since filming can involve privacy rights, it is critical that employers not cross the line.

Certain employee activities remain private

Other activities may also be off-limits for employer surveillance. The National Labor Relations Act (NLRB) prohibits employers from using video cameras to monitor employees' union activities, including union meetings and conversations involving union matters. Employers are required to bargain with union employees before using video surveillance in the workplace. Also, video surveillance may not be used in a manner that is meant to intimidate current or prospective union members.

Some employees have challenged employer surveillance of their activities while on leave for a medical condition or workers' compensation injury. The courts sided with the employer and denied the challenges in cases that involved clear employee abuse of leave laws. (One employee took FMLA leave to vacation in Las Vegas, while another was caught on camera working out at a gym after claiming he was too injured to work). Aside from these flagrant examples, courts would likely rule differently if an employer's surveillance drifted into private activities and effectively deterred employees with a legitimate need from exercising their legal rights.

Workplace video surveillance guidelines

Employers use video cameras to monitor employees for a host of reasons, all of which could save their businesses money. But it is important to do it lawfully. Here are some general guidelines:

  • Make sure you have a legitimate reason to use surveillance
  • Do so only in public areas
  • Inform your employees that you have cameras in the workplace
  • Do not record their conversations
  • Refrain from taping union activity

Consider speaking with a labor lawyer in your area if you have additional questions or concerns. To find out more about your state's workplace privacy laws, contact your state labor department.

Lower Your Workers Compensation Insurance Costs

We'er a Trusted Choice Independent Insurance Agency for workers compensation insurance. We serve Philadelphia, Reading, Lancaster, Allentown, Lehigh Valley, Harrisburg, York, PIttsburgh, Erie, PA and beyond.For more information about workers compensation insurance, contact American Insuring Group online or call us at (800) 947-1270 or (610) 775-3848.

Our independent insurance agents will help you find the best policy to meet your needs, and do it at the right price. As an independent agency, we're free to shop among many competing insurance carriers, and to provide you with the best deal on quality workers comp insurance.

Call or click today to get started!

Tags: Workers Compensation Insurance, workers comp, workers comp insurance, PA Workers Compensation Insurance, workers comp costs, Commercial Insurance, Business Insurance

Opioid Abuse, Communication, and Workers Comp Insurance

Posted by David Ross on Thu, May 26, 2016

Opiod abuse can have a heavy impact on your business and your worker's compensation insurance rates.Opioid use and misuse by workers has become a major concern for employers and their workers’ compensation managers.

An increasing number of injured workers are being prescribed these powerful and addictive drugs to alleviate pain, but frequently the opioid use results in extended disability and additional medical issues for claimants. The overuse of these prescription painkillers is burdening the workers’ compensation system by increasing the cost of each insurance claim. 

These startling workers compensation insurance statistics attest to this:

  • Average cost of a claim without opioids: $13,000
  • Average cost of a claim with a short-acting opioid, such as Percocet: $39,000 (I.e., triple)
  • Average cost of a claim with long-acting narcotic, like OxyContin: $117,000 (I.e., 10x)

Adding to the costs, workers’ compensation insurers are now being compelled to pay for prescriptions of buprenorphine and naltrexone, two drugs that are used to wean workers off these addictive opioids.

Opiod Abuse: A Growing Problem

State governments, insurers, and an assortment of workers’ comp stakeholders have been obliged to contend with the issue of opioid usage by injured workers in varying degrees through myriad methods. But pinning down the problem has proved to be as difficult as correcting the problem of opioid abuse itself.

Utilization of statewide databases that track opioid prescriptions, finding and punishing overprescribing doctors, and stricter controls in management provider networks are some of the solutions states have adopted - or are considering - to tackle this complex problem.

And, as opioid abuse continues to grow, it’s gotten the attention of the Centers for Disease Control and Prevention. 

“It’s a big problem, and it’s a growing problem,” said Dr. Leonard J. Paulozzi, a medical epidemiologist with CDC’s National Center for Injury Prevention & Control, which has been studying the impact of opioid overdoses, and the problem of overuse. Paulozzi views the drug problem as being potentially more prevalent among the injured worker population.

“There’s an awful lot of back injuries in the workers’ comp population and subsequent surgery related to back problems, and back pain is one of the most common indications now of use of opioids in the United States,” he said. “And it’s being used frequently for back pain and it’s being used long-term for back pain.” 

Education and communication are essential

Workers’ compensation managers are fighting a prescription drug epidemic, and the stakes are high. Failure to wage an effective battle can lead to unfortunate consequences:

  • Increased costs from protracted disability, medical care, and treatment
  • Increased case valuation and settlement costs, which deplete financial reserves
  • Increased possibility of deaths and drug overdoses

In order for claims managers to be effective in controlling costs that result in higher workers compensation insurance premiums, they may need to seek outside help. Many are now forming partnerships with various Pharmacy Benefits Management companies that have specific expertise in effecting change. Communication is the first step:

  • Educate the injured workers directly about the importance of safe treatment
  • Communicate with physicians, explaining all concerns regarding opioid-based prescription drugs
  • Post bulletins warning of the dangers of prescription painkillers

Good communication yields encouraging results

Results from companies that have used this system of communication have been encouraging. One pharmaceutical company saw a reduction of almost 11% in opioid usage among their workers’ compensation clients. In addition, the percentage of injured workers using long-term opioids decreased by 2.6% during the same period.

The effort makes financial sense

All studies and efforts to curb opioid usage should have a positive effect on the all-important bottom line, since the medical portion of a workers’ comp claim may be open for several years and could be open for the lifetime of the injured worker. The claims management teams need to be proactive and willing to cooperate and collaborate with the pharmacy industry in educating everyone on this crucial issue.

Contact Us for Help in Getting the Right Workers Comp Insurance 

To learn more about workers compensation insurance, and to get the right insurance at very competitive prices, contact us online or call us at (800) 947-1270 or (610) 775-3848. 

Tags: workers comp, workers comp insurance, PA Workers Compensation Insurance, workers comp costs, Commercial Insurance, Business Insurance