Recently, our team attended the Silicon Valley Insurance Disruption symposium and were privileged to engage in a number of conversations with insurance industry leaders, and innovators in technology. One of the conversations I had with an individual revolved around social media and how it has changed our society; the way people communicate; and how people demand instant information and results. Think about digital disruption in marketing and selling insurance products, i.e., the millennial (on-demand) generation. The term “social media” means a lot of different things in the insurance industry. I like the concept of using social media in two distinct methodologies; one, strategically; and two, tactically for the business of insurance. For strategic purposes, your company can use social media to communicate to customers and potential buyers of your products with a concise and cogent message. In addition, you can monitor and respond to what customers are saying about your company. For the tactical application, social media can be used for the underwriting and claims business processes. For example, tracking catastrophic events, like significant earthquakes, fire storms and hurricanes; monitoring what people are communicating while these events are occurring is invaluable for your response planning. For risk management in underwriting, the proper information can be obtained in a robust social media analytics solution that can be leveraged for better decision making. See Also: Does Social Media Have a Place? The key is to use next-generation analytics with dynamic modeling. Privacy and the ability to obtain information from social media websites have been analyzed and debated by governments and business leaders around the globe. Actions have been taken to protect an individual’s privacy. So how do you correctly utilize social media analytics in your business process? Dynamic modeling! Dynamic modeling of social media data begins with identifying the proper source of information. Dynamic modeling provides answers to questions in the underwriting process and claims process while keeping in mind the insured’s interest and experience. Is the API (application programming interface) open to web crawls? Can you filter out the vast amount of noise in the data? (An open-end Google-type search is not the best way to begin). Can you control the overwhelming amount of information? How do you know what to look for? If your team knows the “why” and the actual focus of deterring the risk, you will be able to deliver to the customer a better product, with a competitive price in the marketplace. Now is the time to start moving forward with next-generation analytics and start being innovative in the marketplace.

In their rush to jump on the big data bandwagon, many organizations have lost sight of a much simpler yet effective source of customer insight: “small data.” Big data is about synthesizing, mining and analyzing mounds of seemingly unrelated information to derive actionable insights about your customer. It’s a complex science but one that can be leveraged to understand and engage customers in new, surprising and sometimes even creepy ways. (Consider the well-documented case where retailer Target figured out that a teenage girl was pregnant before her father even knew—merely by analyzing her purchase history data. See “The Challenges Around Big Data and the Lessons to Be Learned.”) In contrast, small data is about listening to and observing your customers intently, picking up on simple cues that allow you to better personalize and customize your interactions with them. Small data doesn’t require supercomputers to decipher. It’s not really a new concept, either—it’s just a new moniker for a tried and true approach that the best sales and service people have employed for decades, if not centuries. That might make small data sound quaint and old-fashioned, but don’t be fooled. Using it can actually enhance your business’ customer experience in very material ways, without the expensive overhead associated with big data solutions. See Also: To Go Big (Data), Try Starting Small To get a flavor of how small data can influence your customer experience, consider these examples of the strategy put into practice: • Delta Airlines’ 800-Line Greeting Presuming a customer calls Delta from a phone number the airline has on record, the 800-line voice response system will skip the standard pleasantries and prompt you with a question such as “Are you calling about your delayed flight?” If the answer is yes, then Delta immediately routes the caller to an automated service or a live representative who can help, obviating the need to navigate through a series of menu options. Once the incoming phone number is identified, Delta’s systems check to see if the customer has reservations coming up, or if perhaps a flight that day has been delayed or canceled. That’s not a terribly complex undertaking from a data perspective, as it is a relatively simple look-up exercise, rather than a full-blown analytics task.  Yet it yields a much better and more efficient customer experience, particularly at a time when passengers may be frazzled about unexpected changes in their travel plans. • Ritz-Carlton’s Personalized Guest Experiences The Ritz-Carlton luxury hotel chain is renowned for its ability to create highly personalized guest experiences. If the Ritz in Boston learns that a guest is allergic to feathers, then the Ritz in Dubai—half a world away—will de-feather that same guest’s room prior to arrival. How does the company do that? Ritz staff are trained to listen carefully for guests’ likes, dislikes and general preferences. These are small pieces of data (such as a favorite newspaper or snack, or a preferred room location) that Ritz-Carlton employees dutifully record in a customer database dubbed “Mystique.” They’re also trained to consult that database prior to a guest’s arrival and act on any relevant information they find. This helps ensure that any previously captured small data is used to create an unusually customized guest experience during subsequent visits. These two examples are from outside of the insurance industry, but the approaches they illustrate are easily transferable. It’s simply a matter of putting your antennae up and looking for small pieces of data that can be used to deliver a more personalized, relevant and anticipatory customer experience. Consider the small data that’s available to insurance carriers—data that, if captured and capitalized on, could generate some very positive customer impressions: • Children’s Ages By recording information about a customer’s children during an initial needs analysis, insurers can engage the policy owner to assist in stressful parenting periods, such as when a child approaches driving age. While identifying households with youthful drivers isn’t a new idea for insurers, using that information to strengthen the customer relationship is. Historically, such data has been used by insurers to address situations where a new, uninsured driver may be behind the wheel (to adjust premiums). However, the identification of a youthful household driver shouldn’t just be an exercise in rate adjustment. It’s also an opportunity for the insurer to demonstrate the value it provides—in this case, by communicating relevant information to parents that helps them navigate a difficult family transition (e.g., determining what resources are available to teach their son/daughter how to drive or how they can best ensure their child’s safety while they learn to drive). Using small data in this way creates a customer experience that appears strikingly prescient to the policy owner, essentially addressing their concerns and questions before they even have a chance to raise them. • Sales For certain types of commercial lines coverages, insurers have visibility into business performance measures for their clients (such as sales), which are recorded annually via premium audits. Here again, as with youthful drivers, the industry has traditionally used such data exclusively to adjust premium rates for coverages that are tied to these business metrics. But this small data can be far more useful. Consider the first time a commercial lines customer crosses over the $10 million revenue threshold. That’s a milestone that would be reflected in the small data most insurers collect, yet few do anything with it, other than raise premiums. Imagine if that customer received a handwritten note from his insurer (or agent) a month after renewal, congratulating him on reaching that milestone. Imagine how that small token of recognition would make the customer feel. Business owners, after all, don’t really care about their business insurance—but they do care about their business. When their business grows, that affords an opportunity to celebrate alongside them, to give them a “pat on the back” that they likely weren’t expecting from their insurance provider but will remember fondly. • Recurring Information Requests At Ritz-Carlton hotels, if a guest requests the same newspaper, snack or room location visit after visit, the staff will notice and use that small data to shape the customer’s future stays. There is an analog for this in the insurance industry. Consider the reports and other information materials that a policy owner requests year after year—e.g., a commercial insured requesting updated certificates of insurance for her core set of clients, or a corporate risk manager requesting loss reports sorted by site. Every recurring information request represents a piece of behavioral small data that can be used to customize the policy owner’s future experience. Imagine if a policyholder didn’t even have to make those information requests, just as the Ritz-Carlton guest who’s allergic to feathers need not request a feather-free room. Imagine if an insurance provider, based on a policyholder’s prior history of information requests, offered all of those reports and certificates to the customer at precisely the right time each year. That would be the epitome of a more personalized and effortless customer experience, all made possible simply by acting on a piece of small data. Small data may be less glamorous than its more buzz-worthy big data counterpart, but it’s no less important. Big data has its merits, but as the “shiny new object” that every company covets it has unfairly eclipsed the value of simpler and more straightforward sources of customer insight. Better understanding your customers and her needs doesn’t always require intense data crunching and sophisticated analytics. Often, what’s really needed is just a watchful eye, an attentive ear and the discipline to act on whatever insights you uncover. Because when it comes to creating a positive, memorable and personalized customer experience, small data can have a really big impact. This article first appeared at Carrier Management.

Being a newlywed is awesome. I reflect on that season of my life as one filled with joy and anticipation. Sure, that first year of marriage was full of challenges, enormous adjustments and unexpected changes, but on the whole it was great. We found such relief in finally being married and out of engagement. Engagement is a funny time. You often take on new priorities and responsibilities you’ve never had before (like part-time event planner), and that can wear on you and the relationship after awhile. Engagement is meant to be a temporary phase in life, and most friends I know, myself included, have been thrilled to see an end to it — the lists, planning, preparation, etc. In the midst of all of the planning and celebrating, the topic of money is often overlooked (aside from the wedding budget). Yet studies tell us money is a top cause of conflict and divorce among couples. Money can be hard to talk about. Our culture has made money-talk a taboo subject, which can make it all the more difficult to start talking about money (regularly) with another person, especially if you were used to keeping your money matters private for so many years. Here are a few money mistakes I see newlyweds make. Regardless of how long you’ve been married, though, it’s always important to check in and make sure you’re not letting the important things fall by the wayside. 1. Forgetting to Update Important Plans and Documents When you start a job and enroll in your employer’s various benefits, you are prompted to assign beneficiaries to things like your 401(k), group life insurance, even an emergency contact in some instances. Getting married means it’s time to review these beneficiary designations. You should also review current insurance policies and see if you need to add your spouse to the plan or review your coverage entirely. If you are both on individual health insurance plans through work, it’s worth comparing the cost of keeping your individual plans versus one of you joining the other’s plan. It’s possible you’ll save money by being on the same plan. When evaluating the cost, consider monthly premiums, deductibles, co-insurance and co-pays. If you happen to have estate-planning documents like wills, health care proxies, living wills, etc., these documents also warrant review and updating when you get married. 2. Overlooking the Need to Get Organized I know, it’s one more administrative thing that’s not fun to think about or act on, but it is important to be organized. If you don’t talk about it, habits will naturally form, and you’ll likely end up with unnecessary confusion and stress, which can lead to conflict. Don’t be scrappy with your finances. I survive by being scrappy as a parent (I’m a mom of two toddlers). But this ability doesn’t translate as well with finances. Try this: Sit down and list out all the accounts each of you have and then talk about which accounts you want to join, leave separate, combine, close, etc. Simplicity is a wonderful thing. Decide which account(s) you’ll use for routine expenses, where you’ll keep your emergency savings, longer-term savings and investments. Even if you plan to keep accounts separate, have this conversation so it’s intentional and there’s no confusion about how bills and shared expenses will be handled. You can also make your credit reports a part of this process — so you both have an understanding of each other’s credit history, and create a plan for building better credit, or maintaining your great credit if you have it. If you’re not familiar with your credit reports, you may find them to be overwhelming at first — here’s a guide to deciphering your credit report. You can get your free credit reports once a year from each of the three major credit reporting agencies, and you can get a free credit report summary on Credit.com, updated monthly. 3. Avoiding Money Talks Money is a leading cause of conflict and stress for couples, which can be enough to discourage some people from discussing the topic at all. If you learn to talk about money early on (especially when times are good and emotions aren’t running high), you’ll be prepared when money issues arise. Talking about money feels like creating a new habit. Sometimes you just have to start doing it, even before you’re comfortable doing so, and allow the habit to take shape. Here are a few starting points for your conversations about money:

• Your history with money (What lessons about money did you learn as a child?)
• Current stress points with money
• Goals you hope to achieve with your money
• Expectations for your current lifestyle and how you want to use your money
• Spending habits (Where do you spend money the easiest, with most resistance?)

A Word of Encouragement Financial unity and stability with your spouse is a process. You don’t have to have all the answers or all of the kinks worked out from the beginning. If you and your spouse have different approaches to money, (how you spend versus save, what you value, etc.), this doesn’t have to mean never-ending conflict. It’s possible you both need to learn to compromise, and pushing each other toward a middle ground may be the healthiest thing for both of you. And that’s one of the great benefits of marriage — the messy but beautiful process of refining each other and growing together in ways you never could alone. This article originally appeared on Credit.com and was written by Julie Ford.

Non-standard physicians and surgeons are practicing doctors who have had claims frequency or severity issues or board actions or have been previously or are currently on probation. It can often be difficult for non-standard physicians to find affordable malpractice insurance coverage because they are considered a higher risk by insurance companies. Typically, a doctor remains in the non-standard market for about five years, provided once they enter the non-standard market they have kept themselves clean. In this post, we examine the top five reasons doctors become non-standard physicians. #1 Claims – The common reasons for claims filed against physicians include: poor communication, poor bedside manner, erroneous documentation and failure, delay or change in diagnosis. To reduce the likelihood of lawsuits and claims, physicians might take just a few minutes of extra time to answer all questions and address all concerns. Patients and their families will walk away feeling as though they had all the information, even if a bad outcome occurred. They will be much less likely to seek the counsel of an attorney. Click here to read our blog post Top 5 Reasons Doctors Get Sued. #2 Lack of informed consent – Informed consent should occur with every patient encounter. Patients must be informed on the details of their options, especially when care involves an invasive or new, cutting-edge procedure. Top breaches in informed consent that lead a doctor to the non-standard market include the use of non-FDA approved medications, and new or innovative procedures. Physicians should engage with a risk management consultant to learn best practices and get risk management advice specific to a particular practice specialty, especially those that are considered high-risk. #3 Substance abuse issues – While physicians are about as likely to abuse alcohol or illegal drugs as any member of the general public, they are more likely to misuse prescription drugs. The motivation for this often initially includes the relief of stress or pain or to stay alert when suffering from sleep deprivation. Physicians often work strange hours and long shifts, especially in the ER. The cycle often begins by using medication to stay awake and alert to manage the stress and the hours. These stresses combined with easy access to medications can lead to substance abuse issues. #4 High-risk practice profile – Physicians in a practice with higher claim ratios automatically fall into the category of “high risk.” Examples of high-risk specialties include: bariatric surgery, OB/GYN, neurosurgery, plastic surgery and pain management. These specialties are either composed of high-risk and invasive procedures such as in the case of surgeons or they are prescribing medications that are new or dangerous, such as with weight-loss or pain-management clinics. Physicians in these practices will most likely have to remain in the non-standard market throughout their entire careers. #5 Poor record keeping – Following a bad outcome or an adverse event, the first thing that the patient’s attorney will request is a copy of medical records. These will be scrutinized. Any incorrect or conflicting information contained within the medical record will prove problematic for the physician’s case. Accurate and thorough record keeping proves especially challenging for older physicians, who may have been away from practice for some time and re-enter wanting to pick up where they left off. Or perhaps they are just resistant to change. Medical clinics are now using electronic medical records (EMR), which provides a more streamlined and accurate system of record keeping; they even have informed consent forms built right in. From a risk management perspective, EMR is highly encouraged. Bottom Line – Physicians should consult a clinical risk management expert for help in developing strategies to decrease the risk of becoming a non-standard physician. Thorough protocols covering documentation, informed consent and communication will all prove invaluable in risk reduction. It’s also important that doctors are honest about their personal bandwidth when it comes to patient load capacity, stamina for extended work hours, overall physical and emotional health and stresses that may be coming from personal circumstances. These factors are important to consider and if not tended to can lead to events that have a long and lasting impact on a doctor’s ability to practice medicine.

So many people want to blame the injured worker for the high cost of workers’ compensation; they say the worker doesn't want to get better. But consider these two patients, limping into two different medical clinics with the same complaint. Both have trouble walking and appear to require hip surgery. The first patient is examined within the hour, is X-rayed the same day and has a time booked for surgery the following week. The second sees the physician after waiting three weeks for an appointment, then waits eight weeks to see a specialist, then gets an X-ray, which isn't reviewed for another week, and finally has surgery scheduled for six months later, pending the review of a utilization board, which will determine the employee's remaining value to his employer. Why the different treatment for the two patients? The first is a Golden Retriever taken to a veterinarian. The second is an injured employee entering the workers’ compensation system. Maybe we need to send our injured employees to a good vet! The No. 1 cost driver of a workers’ compensation claim is that the injured worker is not getting better. But the sad reality is that the injured worker isn’t even given an honest opportunity. Everyone just wants to kick the can down the work comp road, believing the best way to save money is by limiting treatment opportunities. Look at back pain, which is the most expensive industrial injury and the most common cause of disability in patients under 45 years of age. More than five million Americans are disabled by back pain, and more than half of those will develop a permanent condition. Studies show that direct healthcare expenditures exceed $20 billion annually, and indirect expenditures associated with back-related injuries are greater than $30 billion. Disorders of the musculoskeletal system are the most common causes of absence from work in both men and women between the ages of 30 and 65. Back pain is the dominating subgroup and is the second leading cause of workplace absenteeism. See Also: How Should Workers' Compensation Evolve? There are plenty of statistics showing the direct costs associated with occupational back injuries average $37,000. Indirect costs range from $147,000 to $300,000. It therefore follows that if an employer could redirect its resources and attention to the aggressive treatment of the acute back pain patient, with a view to preventing chronicity, the company would be able to reduce costs. In fact, we have a proven system that has direct and indirect cost savings; however, it requires the employer to take control of its workers’ comp group and change the way business is being done. Unfortunately, only a small minority of employers play at the tip of the spear and way too many employers who sit on the sideline and expect everyone else to take care of the issues. So, we are challenging you, the employer, to get in the game, change your team line-up and win the game of managing your workers’ compensation division. Here’s how: Once the injured employee enters the world of workers’ compensation as either a medical, indemnity or future medical claim, the healthcare professional becomes one of the key decision makers in the employee’s recovery and return-to-work. Usually, the professional helps the injured worker recover through minimum symptomatic treatment protocols authorized by utilization review boards and return to her job in a modified duty capacity with appropriate restrictions. The employee comes back to work, with restrictions, and in most cases the safety supervisor or human resources person assists in monitoring the employee to verify that the healthcare professional’s recommendations are being reasonably accommodated. In a perfect world, this scenario may work. The employee recovers, the medical bills are paid and the work tasks are re-evaluated. However, in most cases, once the employee is injured, delayed treatment ensues, the injured worker develops co-morbidities associated with his injury, an applicant’s attorney gets involved and the reserves then begin escalating. At this point, any optimal solution becomes a distant thought. The only player who has the incentive to change the game is the one paying the bills… the employer!! How can an employer change the workers’ compensation cycle to bring about solutions for all the players involved? It takes moral courage to change your team line-up and manage your claims better. Can it be done? Absolutely, and we’ve done it. Employers have historically taken an adversarial approach to workers’ compensation claims even though the law is on the employee’s side. It makes sense to immediately engage the injured employee and set the expectations for recovery. This is part of the overall strategy to create a claims handling “team” that will align with the core competencies of the business environment. Setting the team line-up to implement an active approach to claims management will be a game changer. As an employer, here’s an outline of what this would look like:

1. Identify your team members; business unit manager, risk manager, safety professional, claims examiner manager, claims examiner, medical director, healthcare providers, nurse case manager, legal counsel and medical fitness consultant.
2. Have a prominent seat at the workers’ compensation round table, whether you are fully insured or a self-insured employer.
3. Know the workers’ compensation claim life cycle and your role in influencing outcomes.
4. Be sure the claim examiners on your files know and understand the employer’s risk management goals and objectives.
5. Have essential job functions (EJFs) for all positions readily accessible for the healthcare professionals and claims examiner.
6. Perform quarterly claim review meetings on all open and recently closed claims. The meetings should include your entire workers’ comp team, so discussions can progress around treating the whole person and not just the affected body part. Remember, at some point a body part adds to the potentially new claim of cumulative trauma.
7. As the employer, limit the claim examiner case load to 100 claims or less per examiner. This allows for more in-depth understanding of claim resolution solutions in addition to claims handling by regulatory deadlines.
8. Make sure your insurance broker supports your desire to incorporate a medical aftercare program managed by a medical fitness organization that understands the workers’ compensation process and your strategic claims management system.

Savvy Health Solutions has worked strategically with employers as part of their claims management team and addresses the whole person by focusing on improving overall strength and flexibility, postural responsiveness to activities of daily living and a motivational element that embeds the components of the program into sustainable lifestyle changes. Savvy has found that, the sooner an employee begins the program, the quicker the employee is returned to full duties, and the claim is closed:

1. The safety person, now having a more comprehensive understanding of musculoskeletal issues, can revisit the company’s job hazard analysis for accuracy and completeness. This technique breaks each job down into individual tasks to identify hazards and focuses on the worker, the task, the tools and the work environment. The analysis is also a key component for compliance with OSHA’s injury and illness prevention program requirements.
2. The claims examiner is educated on the work environment. With fewer claims to handle, the examiner can spend extra time on the job to better understand the work environment from an employee’s perspective. Essential job functions and job hazard analysis have more meaning once seen in action. Claims examiners will begin to understand how people do the work, in addition to meeting the expectations of the Department of Workers’ Compensation in managing a claim.
3. A team approach helps the claims examiner to think more like a business person. Outside consultants, like Savvy Health Solutions, help the employer see a new way of claims resolution and prevention of further injuries.
4. The effectiveness of the workers’ compensation team can be measured with metrics created as part of your annual insurance renewal process/contract or as part of your third party administrator contract renewal.

Too many internal silos and “leaving it to the claims experts” can run against a culture of treating employees with respect and dignity when injured. The employer needs to be the key stakeholder in the process, having the same key performance indicators (KPIs) for workers’ compensation as it is done for safety metrics and profitability. This methodology is counterintuitive to the typical workers’ compensation claims handling structure. Success starts with the employer and involves every single team member, business unit manager, risk manager, safety professional, claims examiner manager, claims examiner, medical director, healthcare providers, nurse case manager, legal counsel, insurance agents and brokers and medical fitness consultants. Developing a winning line-up with your team will improve your ability to control costs and reach a desired outcome for the employee first, and then the organization. Because when the injured employee recovers from his injury, restores normal function and improves quality of life, then everyone wins.

[Part 1 of this series focused on why language matters in mental health advocacy and on suicide prevention in the workplace. This article explores wording related to suicide that we want to see change. Part 3 will look at wording related to mental health.] We are often asked: What is the best way to talk about suicide? “Died by suicide” Much of the language related to suicide death comes from a stigmatizing history. The term “committed suicide” originated when suicide was thought of as a sin or a crime, instead of as a fatal outcome of a set of thoughts, often a result of a mental health condition. The phrase is still the most common way for people to describe a death by suicide in the general public, the media and even in the mental health sector. We can ask ourselves: Does someone die by committing a car accident? By committing cancer? Certain terms are commonly used to describe whether a person has died or not: People talk of a “successful” suicide or an “unsuccessful” attempt. The use of the word "successful" is highly insensitive to the tragedy of a death by suicide. Similarly, we hear the term “completed suicide” to refer to a death by suicide. In North American culture, we place a positive value on success and on completion, so we suggest a certain amount of good when we refer to a suicide as successful or complete. When talking about suicide in general, test language by substituting the word “cancer” for the word “suicide.” If the result sounds odd, chances are the phrase has come from a stigmatizing origin. For example, we wouldn’t say “the cancer was successful”; we would say “a person died from cancer.” Thus, “died by suicide” is the best option we have to describe suicide death. See Also: The Daily Grind is Good for the Mind We should talk about suicide by viewing it through the same lens we use to look at cancer, car accidents and other causes of death. We can seek to apply a public health advocacy approach, rather than a blame-the-victim approach, which is a result of the use of archaic language. “A person who is thinking of dying by suicide” When we label people, and group them according to an identifier, we are seeking to simplify who they are. It is a short-cut language strategy that also short-cuts understanding and connection. In suicide, there is often a label: “a suicidal person”; “he is suicidal.” Using our rule about swapping “suicide” for “cancer”: Are you cancerous, or are you a person who has cancer? We prefer: “a person who experiences suicidal thoughts,” “a person who is thinking of dying by suicide.” For most who die by suicide, we believe their choice would have been to live if they could have found a way out of the mindset of dying. Unbearable psychological pain may be accompanied by very strong internal commands to die. This experience is not the usual type of rational choice in the way we commonly think about choice. People often say “a person chose to die by suicide.” Inside this thinking, there is a sense of absolving of responsibility anyone other than the person who died, which we understand. It is very difficult to grasp that a person has died by suicide, and we often seek solace in language that implies that the person acted completely freely. We wish to undo this type of phrasing that implies that true “choice” is part of the picture. We prefer that people do not use the word “choice” when talking about a death by suicide. Also in the language of suicide, we find phrases that imply that a person who has made a suicide attempt is manipulative and is just “seeking attention.” The phrase “suicide gesture” has an implication that intent is not genuine. We prefer: “an action with suicide intent.” “Precipitating events” When a person dies by suicide, and we wish to talk about what led up to their death, we often talk about “triggering events.” The word “trigger” is problematic because of its strong connection to firearm use. Also, by calling something a triggering event, the phrase denies an opportunity for people to have mastery over the impact of the event. It is preferable to use a more objective term to describe prior events and challenges. We prefer: “precipitating events.” Clarity around “survivor” The term “suicide survivor” is confusing. Depending on how it is used, this phrase may mean a loved one left behind when a person dies by suicide. At other times, the term means someone who has survived a suicide attempt. Thus, the preferred terminology for people who are left behind is: “a person who is bereaved by suicide,” or “a person who is surviving a suicide loss.” People who attempt suicide but do not die can be referred to as: “a person who attempted suicide and survived.” In addition, the field of suicide prevention also seeks the expertise of people who have lived through a suicide crisis and did not have an attempt. Sometimes these folks are included under the umbrella of “people with lived experience of suicide.” In conclusion, “messaging matters” in suicide prevention and suicide grief support. For more best practices, review “The Framework for Successful Messaging by the National Action Alliance for Suicide Prevention": http://suicidepreventionmessaging.actionallianceforsuicideprevention.org/.

If you are suffering from an injury or illness that is preventing you from working, it’s likely you have lost a livable income, and you may be facing the threat of economic hardship. Many people, who are unable to work due to a serious illness or injury, are able to receive Social Security benefits as compensation. But, according to John C. Shea, a disability lawyer in Richmond, VA, applying for Social Security benefits is often a long and arduous process, whether because you are gathering all of your medical documents, making sure you ask all the right questions or patiently waiting to hear if you qualify,. The Waiting Period and Financial Help Once you have applied and are waiting for a response as to whether you qualify for benefits, the Social Security Administration (SSA) reports that the decision process can take anywhere from three to five months (keep in mind that the process can take even longer if you’re initially denied and file an appeal). Waiting nearly half a year is not “financially doable” for most individuals. Here are some helpful tips for getting financial help while waiting for SSA’s answer:

• Are You Able to Work?: In some cases, individuals seeking SSDI benefits may be able to work, but there limitations on how much you can earn. Chances are, your illness or injury may limit your ability/length of time to work, anyway. If you’re interested in working, even very part-time while applying for SSDI benefits, it’s a good idea to talk to SSA; to avoid any extra issues or confusion, consult with a disability lawyer.

• Apply for Supplemental Programs: If your life is put on hold due to a life-changing illness or injury, unfortunately, your needs and expenses won’t take a break. Groceries and other utilities are life essentials but are often big financial expenses. If you’re running into financial problems, rather than skipping bills and risking having your heat or electricity shut off, consider applying for energy assistance and take a look at programs like SNAP for food assistance.

• Creating a Budget and Cutting Expenses: Downsizing on your monthly budget may be one of the easiest ways to save you some money while waiting for SSDI benefits. Although you may not want to give up certain “luxuries” like cable television or your costly cell phone plan, making some budget cuts here and there may save you hundreds of dollars a month. It’s also a good idea, while planning out your budget, to look ahead as much as a year. While SSA’s decision may take a few months, you may encounter some discrepancies that lengthen the process.

Accept Assistance Asking for and accepting help can be difficult, especially if you’re struggling to come to terms with a lengthy illness or injury. If a friend or family offers to help you, strongly consider accepting the offer. Whether you insist on treating the help as a loan or a gift, the offer can help keep you financially afloat while you wait for your benefits.

The healthcare industry is changing – same old headline. Since we’ve been in the industry, the “unsustainable” cost increases have been the talk every year, yet somehow we have not reached a tipping point. So what’s different now? How has ACA affected the healthcare industry, and more specifically the insurance companies? The drafters of ACA set up a perfect adverse-selection scenario: Come one, come all, with no questions asked. First objective met: 20 million individuals now have coverage. Next objective: Provide accurate pricing for these newly insured. Insurance companies have teams of individuals who assess risk, so they can establish an appropriate price for the insurance protection. We experience this underwriting process with every type of insurance – home, life, auto. In fact, we see this process with every financial institution, like banks, mortgage companies and credit card companies. If a financial institution is to serve (and an insurance company is a financial entity), it has to manage risks, e.g., lend money to people who can repay the loan. Without the ability to assess the risk of the 20 million individuals, should we be surprised that one national insurance carrier lost $475 million in 2015, while another lost $657 million on ACA-compliant plans? If you’re running a business and a specific line has losses, your choices are pretty clear – either clean it up or get out. See Also: Healthcare Quality and How to Define It Risk selection is complex. When you add this complexity to the dynamics of network contracting tied to membership scale, there is a reason why numerous companies have decided to get out of health insurance. In 1975, there were more than 2,000 companies selling true health insurance plans, and now there are far fewer selling true health insurance to the commercial population. Among the ones that got out were some big names – MetLife, Prudential, Travelers, NYLife, Equitable, Mutual of Omaha, etc. And now we’re about to be down to a few national carriers, which is consistent with other industries – airline, telecommunications, banking, etc. Let’s play this one out for the 20 million newly covered individuals. The insurance companies have significant losses on ACA-compliant plans. Their next step – assess the enrolled risk and determine if they can cover the expected costs. For those carriers that decide to continue offering ACA-compliant plans, they will adjust the premiums accordingly. While the first-year enrollees are lulled into the relief of coverage, they then get hit with either a large increase or a notice to find another carrier. In some markets, the newly insured may be down to only one carrier option. The reason most individuals do not opt for medical coverage is that they can’t afford it. If premiums increase 15% or more, how many of the 20 million have to drop coverage because premiums are too expensive? Do we start the uninsured cycle all over again? Net net, ACA has enabled more people to have health insurance, but at prices that are even less sustainable than before. ACA offers a web of subsidies to low-income people, which simply means each of us, including businesses, will be paying for part or all of their premium through taxes. As companies compete globally, this additional tax burden will affect the cost of services being sold. As our individual taxes increases, we reduce our spending. While ACA has the right intention of expanded coverage, the unintended consequences of the additional cost burden on businesses and individuals will have an impact on job growth. While it’s hard for anyone to dispute the benefits of insurance for everyone, we first need to address the drivers behind the high cost of healthcare, so we can get the health insurance prices more affordable. Unfortunately, ACA steered us further in the wrong direction. Self-insured employers are the key to lead the way in true reform of the cost and quality of healthcare.

It's the nature of our industry that commercial insurance carrier appetites are constantly evolving. As business landscapes shift to accommodate emerging risks, insurers must continuously refine their specialties, products and services. It's a necessary part of risk transfer; yet it can be confusing for a carrier's distribution partners. Because commercial insurance agents and brokers deal with dozens--and sometimes hundreds--of different carriers, they often find themselves struggling to stay abreast of shifting appetites. Brokerages of all sizes struggle to overcome the hurdle posed by "appetite clarity," and carriers and managing general agencies (MGAs) struggle to find a simple method to demystify the situation. See Also: Next Generation of Underwriting Is Here Carriers and MGAs need to evaluate opportunities to leverage online search tools that can integrate into an agent's daily workflow and enable insurers to communicate appetite. Such tools, like IVANS Market Appetite, operate similar to current search engines. At the start of the search process for a market for new and renewal business, the tools provide agents with an instant list of carriers, MGAs and wholesalers with appetite for the specific risk. These tools can help underwriters overcome the "three major hurdles of underwriting": Hurdle #1: Changing Appetites The carrier or MGA says: "We made substantial changes to our appetite more than a year ago to move away from an industry segment that wasn't in our specialty wheelhouse. Yet I'm still seeing a high volume of submissions in that category that I'm having to decline. It's hurting my conversion ratio and confusing my brokers." Problem solved: It takes significant time for changes in appetite to be effectively communicated through a carrier’s network. This requires changing every piece of collateral, market guides and online postings and redistributing the updated assets. Many times, appetites change again in the time it takes to update these assets, exacerbating the issue. Carriers and MGAs need to leverage online tools that instantly communicate their latest appetite, ensuring products are visible to agents when they begin to search for a market where they can submit their risk. Consistent appetite visibility through online tools also improves carrier and MGA staff’s productivity by increasing the number of in-appetite inquiries and reducing time spent reviewing submissions of no interest, while enabling carriers and MGAs to focus more time on returning quotes and building relationships. Hurdle #2: Limited Relationships "I am worried that my competition has a broader network of brokers than I do. I truly value the partners I do have, but I would like to grow my book, and I wish I were seeing more new risks." Problem solved: Even with formidable communications and relationship strategies, carriers can be complex to navigate from the outside, and brokers who have strong relationships with one division may overlook the opportunity to bring an alternative submission type to another business unit. Online market search tools enable underwriters to get in front of brokers and agents that they haven't interacted with before. Hurdle #3: Unwanted Submissions The carrier or MGA says: "I wish I had more time for new business. I spend hours reviewing submissions that ultimately need to be declined. On top of that, I have a thick stack of renewals to get through. There has to be a less time-consuming way to get more profitable new business into my book." Problem solved: Carriers' and MGAs' time, and brokers' time, is exceedingly valuable. IVANS found that 60% of submissions in commercial insurance go unquoted – resulting in significant time wasted on non-revenue-generating activities. Online market search tools increase in-appetite submissions to drive better submissions in the pipeline, allowing carriers and MGAs to focus on the most profitable lines of business and industries. As the market changes, these tools ensure consistent representation of carriers' and MGAs' latest appetite, so submission mix remains strong as agents are continuously kept informed.

A historical challenge in workers’ compensation has been creating the best possible approach to communication: consistently reinforcing transparency, putting the injured employees’ needs first and reassuring them that their claims team is working in their best interests. Employers today, more than ever before, are engaged in the workers’ compensation process and, in partnership with Sedgwick, have developed efficient healthcare and treatment solutions that provide the highest quality of care. They have also developed return-to-work programs that not only accommodate potential injury-related restrictions and ensure compliance with state and federal employment laws (e.g. Americans with Disabilities Act) but that also encourage employees to come back to work as quickly as possible. This approach ultimately results in an improved experience and outcome for all parties. The responsibilities of claims and managed care professionals encompass many activities that already assist with this process, but there is an emerging need to take employee care above and beyond the standard claims management efforts. This expanded approach involves being an advocate for the employee by listening, communicating, providing information and proper medical care, explaining how this complicated process works—and being there to assist them at every turn. From the time an injury occurs to the moment the claim is closed, the examiners, the nurses and the colleagues who assist the employee all serve important roles that can have an impact on the outcome of the claim. It’s through their experiences that our industry can see the value of employee advocacy and the advantages it can bring for all parties involved. Exploring the Shift in Philosophy  There seems to be a change in the philosophy of employers as it relates to workers’ compensation injuries. Today, businesses are more interested in making sure their injured employees get everything they need to recover, and they are willing to spend the money and do all the right things as a part of their responsibilities as an employer. Instead of questioning claims, they are more focused on restoring the health of their employees. To do this successfully, employers must work closely with claims administrators to develop and implement a process around employee advocacy. This may include assigning a trained, knowledgeable member of the claims team to guide employees through the process or connecting them with a nurse who can assist with their medical concerns. There are different options based on the individual employer’s needs, but each one is designed around the same objective: improving injured employees’ health and well-being. Surrounding the Employee With Support The employee advocate typically performs an outreach to the employee after receipt of the first report of injury. The advocate is someone who asks how the employee is doing and offers a sympathetic ear. The advocate is also someone who has information on their claim and is connected to all of the resources available to assist the employee. This initial call can offer several advantages, including:

• Reassuring the employee that the employer cares and that the employee is not going to lose his job for filing a workers’ compensation claim;
• Providing guidance to the injured employee that could prevent a minor claim from becoming something major;
• Answering initial questions to resolve possible issues that could lead to litigation—if the employee needs additional information, the advocate can get what she needs and call back; and
• Keeping everyone calm at the outset of the injury and having a positive impact on the employee’s attitude.

In this role, the advocate becomes the employee’s key contact and will make sure the employee does not feel alone in this process. The topics for the advocate’s outbound calls may include explaining workers’ compensation; setting expectations related to claim investigation, medical bills, prescriptions, benefit payments and return to work; or explaining the roles of the adjuster or nurse case manager assigned to the employee's claim. Providing Specialized Clinical Advocacy Clinical resources may be needed for an employee based on his injury. This type of advocacy includes a phone call from a registered nurse who will ask the employee how she is doing, answer her medical questions and direct her to the best provider for her injury. At this time, the nurse may also identify any psychosocial issues or other concerns that may affect the employee’s ability to recover or return to work, and the nurse may then direct the employee to behavioral health or return-to-work specialists. Benefits and Proven Results When employees are injured at work, this can be an unsettling time for them—filled with many questions. Providing upfront communication and a healthcare team focused on their well-being can make the process better for everyone. Employer benefits include reductions in litigation, medical costs and lost time. With the average cost of litigated workers’ compensation claims about 65% more expensive than non-litigated claims, reassuring employees and keeping them as happy as possible throughout the claims process can have immeasurable value. We have experience working with several employers that have implemented successful advocacy programs. One is a retail company that has an advocate who contacts every employee on the first day of an injury to see how they are doing. This company's goal was to reduce litigation, and it has accomplished that through this process. The company feels having someone reach out gives each employee a sense of security, as well as the reassurance that he won’t lose his job due to filing a claim and the feeling that he is part of a system that protects him. Focusing on the Employee Examiners, nurses, assigned advocates and other members of the claims and managed care teams all work together to ensure the injured employee has the best possible outcomes. Having a team to surround the employee with care and recovery solutions provides significant dividends related to the continuation of productivity and employee morale—and it can positively influence the overall view of their employer.