Claims Defensibility Seminar

SPEAKERS

Steve, Randall, Joe, Craig

Joe  00:10

Today you’re going to hear from Randall Jones or regional underwriting manager for South and Southwest Region. Craig Ashcroft, our commercial claims manager based in Manchester, and Steve Williams, the managing director of the car business continuity risk management. three presenters this morning Randall will share some live claims examples which focus on the root causes of reported claims. And they’ll also share some comparative costs of those claims with or without risk control measures. Frankly, we were amazed at the marked differences. Steve Williams will share how the ABP system could have helped clients who’ve had el claims. And finally, Craig will outline our new claims defensibility initiative to help you our brokers engage your clients on the relevance of the risk management tools. So without further ado, I shall pass over to Randall.

Randall  00:57

Thank you, Joe. Good morning, everyone. But first part of this section is just looking at a couple of case studies, that we have live cases that we have on the books. First one is a woodworking assembly risk. Obviously, woodworking sector is heavy, particularly for El and many challenges for underwriters in that area. This particular company, they manufacture and assemble and store and distribute. So they have a number of hazards across the spectrum. Use heavy machinery, manual handling injuries, work related upper limb disorder injuries, and things like defective machinery is really important that that certain maintained risk assessments training a key issue and use of PPE. Now this client is a high user of EPP. In terms of four years, el history, they’ve had 27 reported incidents. Fortunately, 21 were notifications only which left six formal claims. Now because of the way they’ve been managing the risk, we’ve been able to successfully defend for those claims. And obviously save ourselves and the client a lot of money and effort. So this is a great example of a company that manages risk well, it uses the learning tools, particularly when a VP really well has a good reporting process and robust risk management procedures. Which means then that we’ve been able to defend claims quite successfully as you can see from that ratio there. Secondly, example is company involved in portaloo delivery. Again, quite a quite a heavy risk. Obviously, you’ve got the storage and distribution of the of the portaloos. So in terms of hazards, you’ve got the loading and unloading risk, which anyone who deals with El knows that’s always a source of many accidents and incidents, and needs really good management and training and adherence to following procedures to minimize claims, traffic management vendor sites, as well, as is another area that, you know, they need to focus on to control their losses. Now, they’ve had 13 reported incidents over three years, so less than the previous example, eight of those were notification only, meaning that five went forward as formal liability claims. But unlike the previous example, we were only been able to defend one successfully in terms of quantum we’ve paid out so 12 and a half 1000 indemnity spend plus nearly 4000 In Loss Adjuster fees. And you’ll see there’s a further 207,000 outstanding, so almost 225,000 pounds worth of VL claims, which you can imagine, is an expensive translation when you start underwriting that back towards premium. Now, as you said, they don’t use ABP at the moment. But this is a great example of a company that could do without intervention, and to encourage them to take that on board and use some of the facilities within it to help control the ER losses. The company does have a fairly good reporting process, but its risk management procedures really need improving. And the key areas there are sort of a lack of sufficient risk assessment, poor traffic management of the sites, and poor inspection maintenance policies have resulted in us having to pay a lot more claims than if they’ve had good robust procedures in place to help us defend them. Next slide, please.

Joe  04:51

Yeah, we’re just going to actually give a shout out to our marketing team on managing to find that image of an empty portaloo Randall, which is obviously issue very relevant to the case.

Randall  05:05

Okay, so in terms of some of the work we’ve been doing, particularly undertaken by our claims department, so we’ve done an analysis of all the claims notified since January 2019, which is when the old fusion, Arista became part of arch and moved from an nga to becoming an actual composite insurer. And we looked at the sort of key causes of, of the year losses. And the top three here we’ve summarized. So the key one is, and this is a staggering number, is a lack of risk assessment accounted for 40% of all el incidents, being paid and 28% of the pay Quantum. So that’s, that’s quite a powerful number. Second up was unsafe systems at work that accounted for 25% of the incidents being paid and 20% of the paid Quantum. And thirdly, was defective work equipment. And that was 20%, the incidents and 13% of the pay Quantum. So you can see quickly there, those top three account for BC 85% Of all the El incidents that we’ve had in so even if companies just focused on those three, and particularly the first one, then they would significantly reduce their chances of suffering year losses. There’s also been a separate piece of work undertaken by arch arch have a global analytics team, and they spent the last 14 months analyzing all the policy information that we’ve written over the 20 years of our existence as fusion and Arista. And a lot of that work is going to translate into some of our underwriting. But one of the key things relevant to this particular presentation is that the, the, the information coming back time and again, is that if if a case has had a claim, they are more likely to have another claim than a case that hasn’t had a claim. And similarly, the case has had a large loss is more likely to have a large loss than a case that hasn’t, which sometimes goes against the old underwriting adage, you quite often look at cases and think, well, that particular case has had this large lawsuit and probably be fine for years now. But the analysis proves that to be to the contrary. So therefore, it’s absolutely key that we try and minimize losses as best we can, and ideally prevent them as well. So we then tap on that analysis, VR claims, we then had a look at what impact EPP was having. And again, some power from them was came out of this. Basically, 74% of the clients that had el claims weren’t set up in a PP. And that equated to nearly 80% of the total losses incurred. The avenged in fact was the average loss size of clients not set up with a BP compared to those that were was 32% Higher. So obviously that comes back to the ability to be able to defend or get contributory negligence in and in particular, when insurers got robust procedures in place. That certainly helps reduce quantum and other losses that occurred. All of them basically 100% could have been prevented or the impact reduced by using a BP. As we saw on the previous slide, 40% of the claims had a root cause of inadequate risk assessments. Now they’re critical in in any health and safety process and a key deliverable in a BP. Two things really off the off the back of that one a BP can help develop the risk assessments. But more importantly, or as importantly, proactively monitor them, and ensure control measures have been maintained so that they don’t fall out a date. They’re not just done as a one job and then put on the shelf, and then have the claims for inadequate risk assessments. 90% of clay clients were not registered for a BP. So some fairly compelling stats there as to the impact of positive impact that ABP can have on EL defensibility.

Joe  09:16

I think you’re absolutely right around that last bullet. So is everything 100% of them could have been prevented or reduced by the use of a VP. That’s telling in itself, isn’t it but also that last bullet on there, that 90% weren’t registered. So we’ve got to work smarter with our brokers to get clients engaged to use the system once they’re registered, and they see the power and usage of it. And we can explain it. I think they won’t be disappointed but 90% weren’t registered to those claims. We’ve had quite high numbers now. Are we now passing over to Steve I think Randall is that right, Steve? Next.

Steve  09:50

Hi, good morning everyone. So I do apologize in advance. I’ve got a very small dog that goes off like a hand grenade every now and again when And the noise disturbs her. So if she starts barking during the presentation, I do apologize in advance, I won’t be able to mute quickly enough. So I’m gonna go through very quickly, key deliverables within arch business protection that would allow clients to address the kinds of issues that random is just highlighted. But before I do that, I think it’s probably worth for those of you who are not entirely familiar with what arch based protection is. So arch business protection is a suite of online risk management systems. So this is not a library of information. This is not somewhere to just record information. These are management systems that allow businesses to control manage, maintain review, risk in their business on a day to day basis, whether that’s a single side business or a multi site business. Such is the functionality within arch business protection, because those clients who use arch based protection or be calm, when when we exist as a standalone, can generally put a quantifiable value to what the systems deliver in terms of improve management, time efficiency around reporting, improve business functionality. So these are these are big boys toys that businesses use to manage and control risk in their businesses. Okay. So they really are powerful, powerful systems. The other thing I also want to mention two other things. So attributes protection is kind of three components to it. So firstly, the management systems, which allow businesses to manage and control the risks. Secondly, is the ability which may be relevant for some for some clients to bolt on, on site risk consultancy, that might help them for instance, review their risk assessments are undertaken gap analysis. So further support there, that’s a that’s an additional pay for service. But the third piece, which I think is the biggest differentiator for arch over any of its competitors, is the unlimited remote support that arch policyholders get from the arch bpda BP engagement team. So as many times as a client needs help with their risk assessments would relearning or whatever it is training a new manager, the starting, that is there at the end of a telephone zoom call or whatever it is in the new world that we live. So this is not not a piece of kit, the client gets and has to work out what to do with it, they have unlimited support to engage in those systems. And that makes a big difference, because these things can often represent change in the business. So enough of the high level explanation, let’s kind of get into some of the into some of the specifics. So as randos already mentioned, risk assessment is a massive part of where these claims undefendable claims are coming from, and is a huge component within art business protection. So not only does ABP allow a client to develop their risk assessments, but in developing their risk assessments, the system also provides guidance on the typical control measures you might put in place to deal with the different hazards that clients would identify. So it would, for instance, be prompting the client to think about safe systems of work as a control measure as additional training as guarding. There’s also guidance there on what controls the client might consider so so really what that’s doing is helping the client think perhaps outside of the box, in terms of Yeah, okay, I hadn’t thought about training. So that’s helping the plant with the hierarchy of controls for those who are familiar with with that. So that’s really big deliver. The second big, big issue is and if you talk to many business owners, they don’t like the fact that their safety controls aren’t operating. But how do you know that your safety controls on operating? How do you know that you’re not complying with the control measures you’ve defined in your risk assessment. And this comes from the, as Randall mentioned, the proactive monitoring of those risk assessments. So a client can set up they have a risk assessment or manual handling or cost or whatever it is, and they want, they want those control measures checked on a monthly basis to make sure that they’re in operation. So once that is set up in IBP, that system just ticks away sending the email to whoever has been assigned to monitor that risk assessment and in monitoring that risk assessment. It produces a percentage of performance score compliance. So again, for any of those of you understand lead and lag indicators, in terms of performance metrics, These are lead indicators telling you where your problem is going to be, they’re not claims or incidents, that tells you there’s been a problem, this tells you where the problem is coming from. So this performance monitoring actually actually allows clients to get ahead of the curve in what might be about to generate an employer’s liability claim. The system also allows for any corrective action where a control measure isn’t being addressed to be recorded immediately in the risk assessment and assigned to individuals. And that becomes a trackable activity. And there are also alerts in the system, which will tell managers when a risk assessment isn’t performing or when an action hasn’t been completed. So this is real kind of monkey on the back stuff that gives the business instant and live transparency around their their their activity. And as a final point, within the learning system, there is what we call the self assessment module. So elearning isn’t just about here’s a trading course. And here’s the test. There’s also a self assessment module in a BP in which employees actually report back to the business on their own work and environment around a set of questions. So that self assessment module will actually also help identify at a more granular level, where control measures aren’t for instance, working. So it would, for instance, identify if an employee exposed to push substances doesn’t know where the Material Safety Data Sheets are, for where they’re working, which could give rise to an incident and certainly could give rise to an undefendable claim. Because don’t forget, in claims defensibility scenario, the claimant has to prove negligence on behalf of the company. Okay. So so that’s that’s how ABP deals with the the lack of of risk assessments. Next slide, please, Joe,

Steve  17:01

Yeah. Thank you. Okay, so training, interested in training didn’t appear very highly in the number. But obviously, if you added up the quantum on an earlier slide, lack of training, obviously gives rise to a disproportionately higher amount of quantum on those slides. So there’s a number of different areas within within AVP, that helps a client deliver, training and have adequate training documentation. So I’ve already mentioned about the elearning system. And also the fact that training is highlighted within the control measures within the risk assessments, and whether that’s elearning or other training. So elearning delivers great awareness training. It’s quick and easy to deliver, and very effective. The case study that random mentioned, we know that there are very, very high user of the learning. And anecdotally, you know, the client will say, employee, so actually, I’ve had an accident, but I know I’ve been trained in this. So you know, I’m not gonna be putting in a claim. So elearning is a powerful delivery mechanism. But there are other bits as well. So within the health and safety management system, we have what’s known as the Training Center, and that allows the client to build up a training matrix of the relevant training that needs to be delivered across the different jobs within that organization. So it builds up a competency matrix. So that helps manage the implementation and recording of the training. So it’s not just making sure the training happens, but it creates a robust record that the training did occur. And that might also be uploading certificates, for instance, flts certificates, or what happened, all of those records can be put into the system. So sometimes the training exists, but no one can find the training record. So you know, the trouble with paper is paper is perishable. I always think it’s kind of bizarre, isn’t it that a fire risk assessment might be the one thing you need to prove that you’ve done when you’ve had a fire, but it’s probably the one thing that won’t survive the fight. So, you know, digital having a digital record, we all get digital, we all understand data these days. You know, it’s key to having those records there. But a new feature we added earlier this year, is again, highly relevant. And again, talking to talking to clients would have prevented claims being paid. And that’s what we call safe system. safety briefing storage, you’ve kind of skipped forward on the slide. Thank you. So safety briefings is a new feature that allows a client around any Risk Assessment Checklist, method statement or say system of work, and we’ll come on to those two in a moment is to actually deliver say on a tablet, a safety briefing to the employee. So let’s just say for instances, it’s the new COVID-19 risk assessment. So they can pull up the COVID-19 risk assessment on the tablet, talk their employees through the control measures and what needs to be done. And then they can actually create a record that each employee signs using the mousemat on the tablet to say that they have received and understood that training. And that record is date timestamp, and is immediately uploaded into the training center as a record. So, you know, again, there’s no paper, it’s instantaneous, it’s just happened. So a really, really important feature. And as I say, that can be used around any risk assessment. But it could also be used around a checklist. And that checklist might be to deal with, say defective equipment, which we’ll come on to later. Or it might be a safe system of work or a method statement, which we’ll come on to now as well. So if I can have the next slide, please. So unsafe systems of work. So again, another big deliverable within the Navy peace Health Safety Management System, is the ability is fully templated structured methods statement and safe systems of work that the clients can use to then develop these as as safety documentation. And they contain all the relevant links to the method statement includes links to the risk assessments, PPE, etc, etc, that is required. And these can all be communicated to employees, and again, the signed and received training record using the safety briefings functionality that I’ve just mentioned. But in addition to that, another area which we again improved earlier this year. Method methods time safe systems of work can also be audited and checked, using the checklist functionality that we have. So clients can actually build a checklist around, say, a method statement, and actually perform that check on a weekly monthly, whatever basis to ensure that those control the safe system of work is actually being adhered to. And those checklists, again, like the risk assessment, generate a percentage performance score. So again, you know, if we have any clients on the line, the big question is, how compliant? Are you on a day to day basis around your safety controls? Now an EVP user could say, Yeah, you know what, last month, we were 95%, in the month before we were 92%. That’s how compliant we are around our safety controls. And again, like the risk assessment that I mentioned earlier, if you’re using checklists, again, we can, we can document corrective action that needs to be undertaken, where there are non compliances with a with a safe system or method statement isn’t being complied with. And that all becomes trackable action in the system. And again, alerts can be sent to key people within the business say, This isn’t happening. And finally, kind of defective equipped work equipment, lack of inadequate inspection, maintenance, again, back to the the back to the checklist functionality here. Really, really powerful in terms of performing ongoing checks within the business. And one of the other things that the checklist allows the client to do is it allows it to, if they want to set the checklist up so that the person doing the check in has to submit evidence of what they’re checking. So don’t just tell me that you’ve done it, show me that you’ve done it. And that’s a really important way of moving culturally away from it’s just a box ticking exercise, tick, tick, tick, tick, then I want to see evidence of the God in place, I want to see evidence of this. So that’s a really powerful feature that allows a business to build the right kind of mentality and culture within its organization that we don’t just tick boxes to say we’re compliant. We’re doing this to actually make sure that those protections are actually in place and operative. So again, just on that as well, the risk assessment monitoring, you know, if it’s, if it’s a poor risk assessment for a piece of equipment, would again, provide a further Monitoring Mechanism around defective equipment and pick that up, as well as again, the the elearning self assessment piece will also have strands in there that would pull up where there is defective work equipment in the workplace. Okay, so that’s, that’s, that’s me done. Thank you very much. So, Joe, I think.

Joe  24:14

Okay, thank you, Steve. So we’ve heard from Randall, talk about the learnings from our own review of email claims and what those causes and effects were in the costs. We’ve heard Steve talk about these solutions from ADP. I’m now going to pass over to Craig who will share how we’re trying to bring this light to life within arch. How can we make clean defensibility relevant for you, our brokers, but also our underwriting team, because at the end of the day, if we get this right, we will save on Ral spend and your clients won’t be paying as much money for their premiums. So I’ll pass over to Craig just to talk about our claims initiative,

Craig  24:49

Hello everyone. I’m just gonna spend a couple of minutes sort of out in the background and the process to this. So the background we The too many insurance companies, I think sit on information without really sharing it with their clients. What we aim to do is to help our clients avoid that next year claim, we want to help them and provide in a safe working environment for their employees. So what we looked at was a plan was to start to sort of review in detail all eHealth claims, the focus very much on recent incidents, because they the relevant there, they’re obviously more relevant in terms of how we can obviously assist the client. So and we saw, we looked at recent claims where we had to admit liability as well. So the first stage of this was to reveal those claims, we record them on a data sheet. And on a monthly basis, we have obviously provided that information to the branches. So we will speak to the branches, and we will provide them quite a detailed analysis of why these claims would not defendable and provide them with all the relevant information, whether it’s lots of reports or any of our findings as well. This key that we have that sort of level of communication, I think, you know, previously working in other insurance companies that communicate with claims and underwriting and risk was not there. This is clearly something that are very much focused on and the communication is key to this. So that’s the second stage there them, you know, the branch then in turn, reveals the claims for their region has a look into what is the next course of action. And that is that we’re state through the importance of envy engagement for the broker. So the branches will then engage with the brokers specifically about how ABP could have helped prevent that and to help defend that claim. And then, the last of all, all of us even said, and Randall said, you know, good uses of ABP will result in claims being defendable, and what the result of this the stage for what we hope to get from this would be, you know, engagement with the client then nabp webinar to show the claim the benefits of this system, and the ultimate aim is to prevent that next year. As Steve alluded to, and Randall in terms of all the analysis we’ve done, if you get any fame, you’re quite likely to get another one. But the fact is, you know, we’re not waiting until the newer and saying you’ve had X amount of claims and just not help that claim through that period. As soon as we identify we can help that client improve their email exposure. We will be reaching out to the brokers and providing our support to the client where they need it