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This week I spoke on a panel with other CEOs in our industry where we looked at the future of our business and projected where we could be in 10 years. I talked about how my daughter and I shared the common interest of watching every moment of the Olympics we could during the past two weeks. As we watched, we frequently saw a new ad from Apple, titled “The Human Family” that just reinforced to me where we need to be as an industry. The ad was filmed with Apple’s iPhone 6, showcasing its brilliance. Many credit the iPhone with transforming mobile communication and computing. Combining ease of use with the expanse of the internet, it provides a platform for the discovery and delivery of digital content.
human-family

An obvious analogy to insurance…

Or at least a vision.

The iPhone is one of the most sophisticated pieces of mobile technology on the planet – necessarily so, in many ways, because the designers want the consumer experience to be simple. When it arrives in its elegant yet effortless packaging, you are eager to tear open the thin layer of clear plastic that is attached without seams and slide open the box that serves as a nest, cradling the technology waiting to be awakened. No manuals, no hassle, a “Hello” in whatever language you prefer – and even charged for immediate use.

The technology behind the screen is complex, made even more so by the fact that it wants to do the work for you. No 34 keys, not even a traditional 10-key phone pad. Just ONE button. One home button to access the expansive capabilities you know exist but don’t want to fully understand – and Apple doesn’t make you. It is content to deliver advanced communication and internet access through one button and an endless selection of apps to satisfy even the most avid consumer.

But we are in insurance, much more complicated and detailed and sophisticated than a phone. We need regulations and forms and policies and waivers and authorities and plan descriptions that require pages and pages of detail. As a consumer, you would be disadvantaged without the voluminous material we send you, usually through the U.S. Postal Service on pieces of paper.

Or so we have convinced ourselves.

Employers have invested in a broad range of programs from preventative to wellness to specialty care and assistance to traditional benefits. They provide all of this to the employee in the form of detailed and often confusing instructions for each so the employee can sort it out as needed. No simple package cradling the program to awaken. No program charged for immediate use.

What if we had one home button? What if the questions and 800 numbers were replaced with, “Hello, how are you feeling today? I’m sorry to hear that. Are you able to go to work today? Would you like to see your doctor today? We care about you today…”

Behind the home button we mask all of the complexity that is the current state of healthcare and plan designs. We sort out for the employee, based on their feedback, what plans or programs can help them and who pays for it. But to the employee there is a single, simple, elegant access to the well-intended but extremely complicated insurance and benefits world.

One home button. That is the vision.

WCI 2016 Conference Centers for ExcellenceDave North, president and CEO, Sedgwick

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We are just a few days away from the 2016 Workers’ Compensation Educational Conference which will be held on August 21 – 24 in Orlando. Once again, I am looking forward to the opportunity to host a panel that is exploring a very important industry topic – Using data to drive operational solutions.

As a parCofE logo_3 w tagt of the Centers for Excellence two-day track, we will kick off with this important topic which will include my fellow panelists Dr. Adam Seidner, National Medical Director, Travelers and  Cliff Belliveau, Vice President, Business Intelligence, myMatrixx.

Using data to drive operational solutions

Our session will dive into how claims management is a data driven business and employers have more powerful tools to manage their programs than ever before.  Insurance carriers, TPAs, and service providers are embracing big data strategies to improve both experience and outcomes for their stakeholders.  The key to creating effective operational solutions is isolating and harnessing the data and information needed to achieve the best performance.  Team scorecards, company dashboards, and prescriptive analytics are only a few of the tools and techniques being applied to develop strategies, direct resources, and evaluate results currently in the industry.  Moreover, machine learning and artificial intelligence are further driving advancements in today’s automated technology world.

Technology continues to move forward at a jaw dropping pace. The advances just since last year’s event would have taken five years or longer to evolve in the past. So how do you harness data to drive operational solutions within your risk and claims program? While this panel doesn’t have all the answers we are all immersed in the use of technology and data to solve issues for some of the most complex organizations in the world. We will share some insights into what you should be considering right now to meet the demand for solutions.

I want to encourage you to post your questions or suggestions here or tweet them @Sedgwick so our panel can be prepared to comment on what is most important to you. .  I look forward to seeing you Tuesday, August 23rd at 1:00 p.m. for the opening session.

Scott Rogers EVP, Casualty Operations, Sedgwick

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In a previous blog post, I covered how a person can become infected with the Zika virus.  The pathways for infection include:

  • Bite from an infected mosquito.
  • Sexual intercourse with a person infected with the virus.

Prevention is critical; safety tactics include using DEET insect repellant, wearing protective clothing, eliminating standing water, avoiding impacted geographic areas, and using condoms.

Zika-CDC-poster_protect_yourself_from_mosquito_bites

United States Zika cases

Cases of Zika have been confirmed in 47 states, with 1,657 confirmed cases as of the end of July 2016. The virus is believed to have been acquired through travel outside of the United States. The highest concentrations of cases to date are in New York (449) and Florida (307). The only states without confirmed cases are South Dakota, Wyoming and Idaho.

Symptoms, testing and treatment

Most individuals infected with the virus will not have symptoms or will experience only mild symptoms that can include fever, rash, joint pain, conjunctivitis, muscle aches and headaches. The symptoms can last a few days or up to one week. The virus is detectable in blood and urine and can be tested by a health care provider. It is believed that once a person is infected, he/she is protected from future infections. There is no known treatment for this virus; the best approach is rest, supportive medications like acetaminophen and plenty of fluids.

Advice for those thinking about getting pregnant 

  • Women who have been infected with Zika should wait at least eight weeks before trying to get pregnant.
  • Men should wait at least six months after symptoms began before attempting unprotected sex.
  • Women and men who have traveled to a known Zika exposure area should wait at least eight weeks before trying to get pregnant.

Vaccines

There have been three vaccines developed for the virus that have shown complete prevention in monkeys and are now ready for human clinical trials. Phase I clinical trials have begun, and if all goes well these vaccines may be ready for phase II trials in January 2017.

Teresa Bartlett, MD

SVP, medical quality, Sedgwick

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CofE logo_3 w tag

Next week we will gather at what is now one of the largest events in the industry – the 2016 Workers’ Compensation Conference August 21 – 24 in Orlando. I want to add that, before the conference begins, a great group of Sedgwick colleagues will be taking part in the Give Kids the World service project on Saturday morning. This is an extremely rewarding opportunity for our industry to give back to the local community. For our colleagues, this helps extend our commitment that caring counts℠ at Sedgwick.

On Tuesday, Sedgwick is again proud to sponsor the “Centers for Excellence” conference track. This year’s theme is “Better Together” and the lineup of speakers is exceptional. As Steve Rissman, program chair for WCI, has said, this is a great venue to bring some of the best thought leaders together under one roof. Incorporating the ability to have open discussions and real-time input from conference attendees helps educate everyone on some of the most relevant and timely issues facing our industry.

As part of the Centers for Excellence, I will be joining a highly knowledgeable panel as we address the topic of “Talent Attraction, Training and Retention of the Workforce.” Many industries now face an aging workforce and our industry is at the forefront of this concern. We will be losing more talented contributors than ever before over the next decade.

We must cohesively as an industry work to attract, educate and retain a new generation of worker. Unlike the toothpaste commercial that says “4 out of 5 dentists recommend,” I feel comfortable saying that 9 out of 10 people in our industry could say they didn’t start out thinking they would work in the workers’ compensation or insurance industry – and yet, here we are today in very fulfilling and rewarding careers.

It is time to change the narrative and let the next generation know that our industry is a great place to work, rich with a wide range of opportunities for people from all walks of life. Every day, we can make a difference in the lives of those who need care during challenging times in their lives. Our panelists will discuss how we are individually approaching this challenge and will share what we believe are best practices to fill the looming talent gap.

We certainly need to reach untapped talent pools and look at new and creative methods. No longer can we put up a help wanted sign and just pick from the applicants. I encourage you to join us Wednesday, August 24th at 9:00 a.m., and in the meantime, leave your comments here to add to the discussion. In the spirit of seeking new ways to reach talent, you can also send your thoughts to us on Twitter @Sedgwick or join us on our Facebook page the day of the discussion as we live stream for those who will not be able to attend.

I look forward to seeing many of you in Orlando and, most importantly, sparking the discussion on how we can keep our industry healthy and offering rewarding opportunities into the future just as it has for all of us today.

WCI 2016 Conference Centers for ExcellenceDave North, president and CEO, Sedgwick

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CofE logo_3 w tagOn Wednesday, August 24 at 10 a.m., at the upcoming Workers’ Compensation Institute’s 71st Annual Workers’ Compensation Conference in Orlando, Florida, I will serve as one of four panelists on a Centers for Excellence forum discussion on bureaucracy in workers’ compensation. The session promises to be a lively discussion of the issues and causes of this bureaucracy and an examination of some possible solutions to rising workers’ compensation costs across the country.

Joining me on the panel will be three distinguished thought leaders from our industry:

  • Todd Brown, practice leader, compliance and regulatory, Medata.
  • Francine Johnson, senior director of state programs and product strategy, Fair Health.
  • Mark Walls, vice president, communications and strategic analysis, Safety National.

It is worth noting that two members of the panel are former regulators. Todd Brown previously served as executive director of the Texas Workers’ Compensation Commission, and before joining Sedgwick I was chief of the California Office of Self Insurance Plans, overseeing and regulating the nation’s largest self-insurance marketplace.

Workers’ compensation is one of the most highly regulated lines of insurance. The bureaucracy surrounding this statutory system is driving up costs while arguably offering no real benefit to those injured on the job. Statutory requirements vary across all 50 states, causing payers added expense as they try to sort through the jurisdictional layers and requirements. Moreover, each form filed and payment made is subject to penalty for non-compliance. Compensation levels vary by state, as do information-reporting requirements. There is variation among the forms that must be filed and the notices that must be posted. Penalties can be stiff and the wording associated with the requirements vague, often forcing unnecessary litigation. The WCI discussion forum is designed to look at how these state variations affect employers today, as well as some of the solutions being considered to reduce the seemingly excessive bureaucracy plaguing the system.

In a recent conversation I had with Todd Brown he stated that a key solution to addressing the burden of regulatory compliance is to “refocus on the primary stakeholders and the primary purpose of the compensation system: employers and employees and the safeguarding of dispensing the appropriate benefits.” In his view, the greatest unnecessary cost driver in the system is “medical cost containment regulations that do not deliver quality care.”

Among the biggest challenges and cost drivers in workers’ compensation regulatory compliance are the many overlapping regulatory agencies, combined with a lack of consistency between jurisdictions in the reporting and forms used. There is also an ever-growing desire to collect more data to understand or justify regulatory actions and results.

The existence of overlapping regulatory agencies with no consistency in required data requirements or reporting formats between jurisdictions creates a very heavy burden and adds tremendous costs to the system. In many other aspects of our lives, there are uniform standards on which different jurisdictions can agree. For instance, electrical plugs are identical and work the same way across all 50 states; there’s no need to have a different type of plug in each state.

The WCI session also will examine some key tactics for improving and streamlining the regulatory systems, which would, in turn, reduce frictional costs associated with workers’ compensation. Attendees are encouraged to bring their best ideas for improving the workers’ compensation system and actualizing our shared vision for the future: a regulatory framework that makes sense and benefits injured worker outcomes.

I hope to see you there. If you have questions please leave them here and I will address at the conference.

Jon Wroten, senior vice president, regulatory compliance and quality
Sedgwick

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lightning-1395103July and August are the most dangerous months for lightning strikes in the United States. According to the Insurance Information Institute (I.I.I.), lightning strikes caused $739 million in homeowner insurance losses in 2014, up 9.7 percent from 2013. Florida had more homeowner insurance claims for lightning losses in 2014 than any other state, followed by Georgia and Texas.

Fire investigators have known for well over a decade that when lightning strikes a home built with corrugated stainless steel tubing (CSST), fires often occur. Electrical arcs melt holes in gas lines, allowing gas to leak; in the presence of an arc, fires result. A previous blog post discussed the potential fire risks associated with CSST.

It only takes one lightning strike to create a catastrophic loss for a homeowner or business. An independent fire forensic fire investigation is necessary to establish the origin and cause of a fire, even when lightning is suspected. Here are a few facts to consider regarding fires caused by lightning:

  1. Gas lines that come in contact with metal components used in building construction—such as metal flues, copper pipes and heating, ventilation and air conditioning (HVAC) systems—are more susceptible to fire because lightning current can transfer between the CSST and the adjacent metal. Fire investigators and fire protection engineers can analyze construction elements to assess code and building compliance standards, which can support subrogation and litigation.
  2. Since CSST is often installed in walls, below floors and in attic spaces, a fire can burn unnoticed until other building components ignite, resulting in a much larger and more damaging fire. Fire modeling can determine whether what was reported for a fire scenario could actually have happened. Forensic fire protection engineers can use models to predict the effects of a fire scenario, present the results using a three-dimensional graphical model, and demonstrate what occurred. Engineers can also evaluate the models of opposing parties in the event of legal dispute.
  3. Non-residential properties like offices, industrial/manufacturing facilities and other business properties are also subject to significant fire damage from lightning strikes. According to the I.I.I., these fires caused an annual average of $108 million in direct property damage between 2007 and 2011. Damage to a business property is compounded by the loss of revenue that results from having to shut down operations. Fire investigators and forensic engineers can inspect buildings and facilities to confirm that building codes and associated requirements are met. Specifically, engineers can assess installed fire suppression systems, fire detection systems and passive fire protection systems, such as fire walls, fire barriers, fire doors and fire resistance rated construction. These measures can significantly reduce losses in the event of a lightning strike.

Fire investigators and forensic fire protection engineers are experts in assessing all types of fires, whether natural or man-made, and aim to make things right for home and business owners. While it is impossible to prevent lightning strikes, you can rest a little easier knowing there are experts who can help with loss recovery when disaster strikes or assess your existing property to identify any potential existing hazards.

Please feel free to share your ideas and questions with us; the Unified Investigation & Sciences team is here to meet the needs of your organization.

Michael Reynolds, IAAI-CFI, FCLS   |   Director of Total Performance
Unified Investigations & Sciences, Inc., a Sedgwick company

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full-infographic-updatedDo you remember two summers ago when we all were participating in an ice bucket challenge? You were nominated, usually on Facebook to dump a bucket of ice water over your head while nominating others to do the same. If you completed the challenge you donated $10 to ALS association, if you refused the challenge you donated $100. This took Facebook by storm from movie stars, entire teams of people such as fire departments, office workers, hospital teams, church groups, presidents and more. Even I participated in it as I remembered a friend I had lost to ALS.  This challenge raised $115 Million for ALS and was essentially a zero cost fund raising event that took the world by storm and “went viral” on the internet within moments.

Amyotrophic Lateral Sclerosis (ALS) sometimes referred to as Lou Gehrig’s disease, is a devastating disease that involves the death of neurons that control voluntary muscles in the body. The mind is alert but the muscles become so weak that it renders a person unable to walk, sit up, eat, speak and eventually breathe.

There is good news coming out of that event from the summer of 2014. First because it was a worldwide event, it caused scientists to collaborate globally, which led to discoveries that were not possible in their own labs with only their patient population. Second, it led to the discovery and connection of the NEK1 variants in relationship to ALS. This was a gene sequencing study that identified ALS risk genes.  While a cure has not been identified, finding the cause and exact genes related to the disease go a long way toward identifying prevention and possible cures.

So if you poured that bucket of ice water all over yourself and nominated friends to do the same, stop for a moment and feel good about the discovery you contributed toward.

Dr. Teresa Bartlett, SVP, Medical Quality

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Blog_Behavioral-Health_7.27.16We see the benefits of behavioral health interventions to get people back to work after a workers’ compensation injury.  Frequently, though, it is has become a valuable service for helping people stay at work after an injury.  Consequences of an injury on the job, such as a change in working schedules that disrupt the home environment, financial struggles and on-the-job stress can influence an injured employee’s ability to keep working and comply with necessary treatment.

According to the American College of Occupational and Environmental Medicine, 10 percent of the workers who manage to stay at work after an injury later incur significant work absences and life disruptions that can lead to lengthy or permanent withdrawal from the workforce.

Behavioral health specialists can provide valuable coaching to injured employees to help with coping skills and direction during the difficult time after an injury.  I am going to describe two recent claim situations in which we were very happy to help injured employees after they returned to work.  In both of the situations I describe next, the claims examiner or a nurse case manager identified that there were stressors  in each of the injured employee’s lives that might interrupt necessary treatment and result in disability.

Kyle is a 35 year-old factory worker who had recently returned to work after an occupational injury.  He was working full time with light duty restrictions.  His telephonic case manager and claims examiner referred him for behavioral health services when it became clear that Kyle, a single parent, was struggling with parenting issues that were impacting his motivation to stay at work and continue with his treatment.  Kyle told the behavioral health specialist that he was planning to discontinue treatment and stop working to take care of issues related to his rebellious teenage daughter and his two younger children at home.  With his light duty restrictions, Kyle’s work hours changed almost daily based on the needs of the plant.  This was disrupting his child care arrangements and his ability to be available for his older daughter in the evenings.  The behavioral health specialist worked closely with Kyle over a three week period to encourage coping skills, advocate for a regular schedule, and help Kyle get connected with local resources to help with his daughter.  With this extra support, Kyle managed to remain at work during this time and continue with his treatment.

Bonnie is a 42 year-old retail store employee.  She suffered a low back strain when she was lifting a chair onto a display shelf.  She sought treatment and only missed one day of work.  Bonnie returned to work full-time with modified duty accommodations and continued medical treatment for her injury. Usually her job requires her to move around the store alternating the duties of cashiering, restocking shelves, and assisting customers in the fitting room.  During her modified duty, she was required to alternate shifts as a cashier and a greeter at the front of the store.  Coworkers expressed frustration with her manager that Bonnie’s modified duty assignment was putting more of the physically demanding work on them.  As a result, Bonnie felt “singled out” and ostracized by her peers.  She told her workers’ compensation claims examiner that it might be easier on her and less stressful if she were to ask her doctor to take her off of work until she recovered fully.  “I don’t know how I can make this work.”  The claims examiner quickly enlisted the help of the behavioral health specialist who validated her feelings and helped her develop some coping strategies for managing stress.  After a few weeks of coaching and support, Bonnie remained at work and fully recovered from her injury.

Preventing disability and helping people deal with stressful situations in order to stay on track with their injury care is fulfilling work.  With early intervention, a listening ear and tips for dealing with stressful situations, we can sustain an injured worker’s confidence and keep individuals engaged with their colleagues, families and communities.

Mark Debus, Clinical Behavioral Health Specialist

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PokemonGo-wikipediaIs Pokémon Go a new technique to promote exercise in the fight against anxiety and depression?

It is common knowledge that exercise is a great way to improve not only physical health, but mental health as well. Depression and anxiety often improve with regular exercise, but the difficulty in prescribing exercise has always been how to motivate and sustain this aspect of wellness improvement – especially for those who may suffer from social anxiety or are not prone to exercise in the first place.

There is a new motivator on the rise called Pokémon Go, and it is taking the nation (and world) by storm. Despite the negative stories warning of potential liability risks, the augmented reality game is motivating many people to start moving.

When you have depression and/or anxiety, exercise may be the last thing you would consider doing. But once motivated, exercise can make a big difference in how you feel.  And for many who suffer from social or other forms of anxiety, finding the strength to motivate yourself may seem nearly impossible.

On the Pokémon Go website, the creators state:

“Get Up, Get Out, and Explore! Get on your feet and step outside to find and catch wild Pokémon. Explore cities and towns where you live—and even around the globe—to capture as many Pokémon as you can. As you walk through the real world, your smartphone will vibrate to let you know you’re near a Pokémon.”

For many of us who may not be gamers, this phenomenon – that literally took hold over night – was quite surprising. I have seen scores of people (not just kids and millennials) walking and interacting in parks and in town where it was virtually vacant days before. Even at work there seem to be more individuals and groups walking together at lunch time glancing at their phones.

On almost every social platform people are expressing a newfound interest in walking, even those who may not have made exercise their first priority in a long time. Concurrently, I am also seeing interest arise in the ideas around gamification from the wellness industry since the release of Pokémon Go.

Perhaps this is just another fad, but maybe Pokémon Go is the start of a new era where corporate-sponsored wellness programs include gamification to entice more people to become engaged.  From my vantage point, it seems we are at the dawn of something new – where gamification will be taken seriously as an engagement and exercise tool in the fight against anxiety, depression and obesity, as well as having an impact on overall wellness.

For years, employers have been promoting competitive or game-oriented challenges within their corporate wellness programs such as walking contests using old school pedometers or new age fitness devices to track steps and provide rewards. These can be successful for those motivated by fitness challenges.  However, building an exercise component into your wellness program by using gaming techniques that are founded in both the virtual and real worlds could be the additional aspect you need to motivate a larger community of employees to participate.

It will be interesting to see how gamification can be used to improve many aspects of both mental and physical health. Could Pokémon Go or some other augmented reality game be an asset to your employee mental health and wellness initiatives?

Kimberly George, SVP, Corporate Development, M&A, and Healthcare

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DavidDePaolo-trailblazer-In any industry, there are people who work in it and people who pass through it, and fortunately there are people who care for it. David DePaolo cared for us and for injured workers across America. Within a moment of meeting him at an industry conference years ago, I instantly knew he had a vision and passion for transforming workers’ compensation into a system from which all stakeholders could benefit.

Regrettably, David died this weekend at the age of 56 while riding his beloved motorcycle in the Malibu Hills. In his far-too-short life, he left an indelible mark on the workers’ compensation community. A workers’ comp attorney by profession, David worked tirelessly to elevate the discussion on industry issues through his popular blog, DePaolo’s World. He also founded WorkCompCentral, a respected news and educational service, and the Comp Laude Awards, a recognition program designed to showcase how much good emanates from the workers’ compensation profession. David was well-known for his regular speaking engagements at industry conferences and events, where he candidly shared his views and advocated for industry improvements.

Last time I spoke to David, he shared his vision for creating a program at Pepperdine University (where he earned his law degree) to train the next generation of claims professionals. Perhaps that vision can become a reality as a tribute to his outstanding legacy.

David made the pursuit of improving the workers’ compensation system his life’s work, and we are all better for it. All of us at Sedgwick send our sympathy to his family and many friends. We will miss his wisdom.

Dave North, President and CEO