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In the past two decades, nearly 200 rural hospitals across the United States shuttered their doors, leaving millions of residents without local access to essential healthcare services. Hospital closures not only impact injured workers, but they also place additional pressure on rural industries. Farms, ranches, factories and energy producers rely on a healthy and stable workforce to attract talent and maintain productivity.
The physical and/or emotional injury in a workplace injury or illness is just the start of any workers’ compensation claim. Managing injury claims is a complex process. Carriers are continuously improving their injury management processes. If adjusters fail to consider Social Determinants of Health (SDOH), they often inadvertently delay the claim process. This may mean failing to close claims where comorbidities or other issues, such as transportation problems or lack of access to nutritious food, delay healing.
According to the Centers for Medicare and Medicaid Services (CMS), “It is estimated that 50% of all health outcomes can be attributed to SDOH, while clinical care impacts only 20% of county-level variation in health outcomes.”
My passion for insurance has thrived for over 20 years. From humble beginnings as an auto-field adjuster to eventually serving as a Director of Corporate Risk for a private equity group. I’ve been involved in overseeing the challenges of insurance coverage across renewable energy, construction, aviation, information-technology, agriculture, beverage manufacturing, senior living, real estate, education,…
The insurance industry has always been cyclical, going through periods of “soft” and “hard” market conditions that can last several years. Today’s agents have been thrust into what the insurance industry has historically called a “hard market.” However, this market cycle seems a bit different than those in the past and perhaps may not soften as quickly as we’ve seen in some cycles.
When insurers receive a claim or suit from an insured or third party, they must first make sure that subsequent actions by all parties are in accordance with the conditions required by the policy and applicable laws and regulations. Violating such conditions and guidelines can lead to unintended consequences. For example, courts could refuse to uphold claims denials and possibly recognize bad faith suits, instead. Or an insurance department could find that the insurer broke a law and subsequently impose regulatory penalties. This article discusses how to avoid such outcomes by discussing important, but basic, dos and don’ts, illustrated through real-life examples.
Andrew is a seasoned expert with over two decades of battle-tested experience under his belt. Andrew’s success is no accident; it stems from a profound understanding of the idiosyncrasies of his clients’ businesses. He combines numerical precision with compelling narratives, a rare skill that transforms inadequate business income claim offers and outright denials into substantial…
I serve as the Principal of Insurance Claims and Litigation Consultants, LLC, a firm that provides expert witness services and testimony on claims and lawsuits involving insurance coverage, bad faith, underwriting, agent-broker liability, regulatory issues and good faith claims handling practices. I also provide consultation and oversight of pre-suit and litigated coverage matters that potentially…
Lezlee Liljenberg, entered the insurance business in 2004 as she started her first agency from ground zero, growing the business to over $6 million in revenue in less than 12 years. Ms. Liljenberg holds a BA in Journalism/Public Relations and a MA in Political Science/Public Administration from the University of Texas at Arlington. She is…
Brenda Powell Wells holds both a Bachelor of Business Administration and a Ph.D. in Risk Management and Insurance from the University of Georgia. She holds the Chartered Property and Casualty Underwriter (CPCU), Accredited Advisor of Insurance (AAI) and Construction Risk Insurance Specialist (CRIS) designations. She also holds a graduate certificate in Business Analytics from East…
