Frozen Turkey Thrown by Teenager Causes Severe Damage to Passenger and Vehicle

Thanksgiving is just around the corner! Although this isn't a happy holiday type story, it definately ties insurance and Thanksgiving together. Check out this article by Laurie Infantino about property damage and bodily injury caused by a Thankgiving turkey.
Written By:

Laurie Infantino, AFIS, CISC, CIC, ACSR, CISR, CRIS

President of Insurance Community Center

I saw the story on TV recently and my first thought was thank goodness this was not my son who threw the turkey. It is only because he had other mischievous plots in mind. The incident occurred on Long Island in Lake Ronkonkoma on November 13, 2004. The injured woman has just published a book on the accident titled, No Room for Vengeance, and has been featured on several talk shows. FOX News said the release of Ruvolo’s book comes just after a similar shocking story made news around the country, in which Manhattan mother Marion Hedges was severely injured after kids pushed a shopping cart off of a fourth floor walkway onto the ground below. It landed on Hedges.
The accident that injured Victoria Ruvolo occurred when a 20 pound turkey was thrown out of a moving car and smashed into her windshield. The driver was struck and immediately lost consciousness. Were it not for her friend, in the passenger seat, leaning over and grabbing the steering wheel, who knows how many people might have been killed. Ruvolo sustained serious injuries and required hospitalization for three months.

Police say they had pictures of the assailants, five teenagers caught on store surveillance tape buying the turkey at a supermarket. They bought the turkey with a stolen credit card. This was a somewhat unique set of circumstances. The driver was 19 years old. Too often these crimes go un-solved as people throw items from freeway overpasses, shot paint bombs or spray paint from guns blinding passengers and other such mischief.

This case was different, the five teenagers were arrested. The driver was arrested on charges of first-degree assault, reckless endangerment, forgery, criminal mischief and criminal possession of stolen property. The four other teenagers were charged with criminal possession of stolen property. A wonderful side note to this story is that Victoria received the Most Inspiring Person of 2005 from BeliefNet because of her appealing to the judge to NOT send the assailant away to serve a 20 year sentence. She insisted on offering him a plea deal. Cushing could serve six months in the county jail and be on probation for five years if he pleaded guilty to second-degree assault.
Now to the question of the hour—is this covered by insurance. We might try looking at the Homeowners Policy first but will not find coverage there for a loss that occurs from the ownership of usage of a vehicle. So now we look at the Personal Auto Policy and surprise—surprise. The policy states:

We do not provide Liability Coverage for any "insured":

1. Who intentionally causes "bodily injury" or "property damage".

The question will be did they “intend” to hurt someone by throwing the turkey or did they just throw the turkey as a prank. Courts will look very strongly at the “intent” of the act and in most cases will determine that it was not an “intentional” bodily injury. Clearly if the PAP responds in the manner we will look to our umbrella for excess limits. What is interesting is that the PAP appears to have a much broader response then the most current edition dates on the Homeowners Policy. Here is an example of the language the ISO 2000 edition contains:

E.1. Expected or Intended Injury “Bodily injury” or “property damage” which is expected or intended by an “insured” even if the resulting “bodily injury” or “property damage”:

a. Is of a different kind, quality or degree than initially expected or intended; or

b. Is sustained by a different person, entity, real or personal property, than initially expected or intended.

Questions about points discussed in this article? Tague Alliance can help answer any questions you may have, about this article, or about becoming an Independent Agent with SIAA.  Call the office at (760) 729-1143, or email at info@taguealliance.com

Workers’ Compensation Five Simple but Critical Tips

Some agents may find Work Comp a difficult line of business to write, but this article written by Diana B Henderson gives you some helpful tips to make writing this line of business easier.

Created by: Diana B. Henderson The founder and president of The Henderson Group, a workers’ compensation and disability management consulting and training firm in Newport Beach, California.  With more than twenty-five years of hands-on experience, she has worked in both the corporate and service provider communities.  She has worked at Aon Risk Services in a consulting role and Hunt-Wesson Foods as their National Workers’ Compensation Manager responsible for their in-house California workers’ compensation claims handling operation.  Diana consults to both public and private sector employers on a wide range of issues.  She assists in developing cost-effective approaches consistent with the client’s overall operating philosophy and employee relations objectives.  Diana is often utilized as a litigation consultant and expert.  She also develops and conducts highly interactive and comprehensive workshops.

As a business owner and employer, do you want to know how five simple but critical tips can help you impact your workers’ compensation costs?  

Impacting your workers’ compensation bottom line.

1. Timely reporting.  Whether compensable or questionable, timely reporting mitigates total claim cost.  Providing adequate and accurate information assists the claims handler in adjusting the claim and providing appropriate benefits.  Questionable claims need immediate attention so that the investigation activities are completed within the 90-day window for making a compensability decision.  The trigger for the 90-day clock to begin is the date you knew about the claim, not the day you report it to your insurance carrier. 

2. Take control.  Reforms included in SB899 provided an alternative mechanism for managing medical utilization and costs through the use of Medical Provider Networks (MPNs).  Consult with your carrier regarding the MPN implementation process.  Ensure that you display the requisite informational posters and distribute required notices and pamphlets.  Your insurance carrier or claims administrator should be able to provide these documents to you.  Just remember, absent the requisite poster and pamphlet, even the most basic form of medical control is lost. 

3. Return to work.  Incentives are available for providing permanent return to work opportunities.  Additionally, productivity, morale and the overall cost can be positively impacted.  Effective with injuries on or after January 1, 2005, if you employ more than 50 full time employees, the cost of a claim can be impacted either negatively or positively depending upon the ability to offer a return-to-work opportunity for an injured worker.  This is done via a 15% reduction or a 15% increase for each payment of permanent disability indemnity.  The reduction is applied if return to work is offered even if the injured employee does not accept the offer.  Conversely, the increase is applied if return to work is unavailable and/or NOT offered.

4. Stay engaged and connected.  Maintain and insist on high levels of communication with your injured worker and claims handler.  Continually monitor and review the status of every open claim.  Provide requested information expeditiously.

5. Use experts.  If you lack the expertise, do not hesitate to consult with experts to assist in managing this bottom line expense.  It is well worth the investment.

Diana B. Henderson The founder and president of The Henderson Group, a workers’ compensation and disability management consulting and training firm in Newport Beach, California.  With more than twenty-five years of hands-on experience, she has worked in both the corporate and service provider communities.  She has worked at Aon Risk Services in a consulting role and Hunt-Wesson Foods as their National Workers’ Compensation Manager responsible for their in-house California workers’ compensation claims handling operation. 
Diana consults to both public and private sector employers on a wide range of issues.  She assists in developing cost-effective approaches consistent with the client’s overall operating philosophy and employee relations objectives.  Diana is often utilized as a litigation consultant and expert.  She also develops and conducts highly interactive and comprehensive workshops.

Created by: Diana B. Henderson The founder and president of The Henderson Group, a workers’ compensation and disability management consulting and training firm in Newport Beach, California.  With more than twenty-five years of hands-on experience, she has worked in both the corporate and service provider communities.  She has worked at Aon Risk Services in a consulting role and Hunt-Wesson Foods as their National Workers’ Compensation Manager responsible for their in-house California workers’ compensation claims handling operation.

If you have any questions regarding this article or would like to contact Diana, she can be reached at The Henderson Group, 4590 MacArthur Blvd., Suite 500, Newport Beach, CA 92660.  The phone number is 949-417-5722.  Her e-mail address is Diana@TheHendersonGroup.net. 

Questions about joining SIAA? Contact Tague Alliance at (760) 729 - 1143, or info@taguealliance.com. Website: http://www.Taguealliance.com

Tague Alliance - New Office

Hello Everyone....

We have moved our Tague Alliance office to a more functional space and are very excited about the new digs. Our physical address is now: 380 S Melrose Drive, Suite 414 in Vista, CA 92081.

The Tague Team

Tague Alliance - Focus on Retention

This was a great post from MetLife Auto and Home and Tague Alliance felt that it was worth sharing:


Focus on Retention
As you enter the New Year, take some time to reflect on ways to improve your business model in the coming year. This may include expecting more than others think possible. One area of critical importance is customer satisfaction. Ask yourself, “Is your client the most important person on the premises?” A few simple steps can start you down the road to improved customer service.

5 Simple steps that can make a difference in your retention (by Larry Moffett)

Review your agency's 3-year retention numbers
This simple act will give insight on how your customers view your agency. Is your retention level in the 90 percent range or in the 70’s? The lower the retention percentage, the more probable customer satisfaction is an issue. Often, when we think about customer satisfaction, we think in terms of “over the top” service. That’s great, and a worthy goal to strive for. But, “over the top” service probably won’t happen in most agencies on a consistent basis. What is possible and attainable is for the agency to render service that will resonate with their clients. Generally, this can be achieved with little or no investment. Customer satisfaction is achieved not through programs, but by changing behaviors and attitudes. Customer satisfaction increases when agencies intentionally focus on areas that truly resonate with clients. Educating front-line staff—training and coaching them to adopt skill sets that resonate with customers—pays big dividends.

Determine how your agency measures up

Reliability - if the level of service dependable? Are the clients' concerns addressed and questions answered in a reasonable timeframe?
Assurance - does the service build confidence?
Empathy - do the people giving the service communicate they care?
Responsiveness - are customers needs uncovered and addressed?
Tangibles - pay attention to the things your customers see and feel. Do staff and surroundings appear professional and inviting?

Take control of factors that can influence customer satisfaction
Multi-policy: Customers who have more than one policy with the same agency/company, such as auto and homeowners insurance, are more likely than clients with mono-line policies to be satisfied with their policy offerings. “Bundled clients” renew policies at an 11 percent higher rate than “single policy” clients.
Get it right the first time: Customers are more satisfied when they only have to contact their agent once to resolve an issue. Satisfaction declines significantly with each additional client-initiated contact.
Return calls: When call backs to clients are required, agents who call back as promised get consistent high satisfaction ratings.
Time is critical: Clients who file physical damage claims expect prompt service. Same-day response to the first notice of an accident, followed by a settlement within a week and repairs completed within two weeks, characterize best practice. Some data suggests satisfaction with claims handling drives 44 percent of the overall impression of the insurer.

Policy reviews
Clients who have their policy needs reviewed each year report satisfaction levels that are significantly higher than those who do not. Customer surveys reveal that nearly half of those surveyed report that they have not been offered an annual policy review by their agent. Unless a customer files a claim, offering the client a “risk review” is one of only a few opportunities an agent has to build trust with the customer. Otherwise, the sum of their interaction is limited to paying their bills and reviewing periodic policy changes.

Stay focused and enjoy the benefits
High levels of customer service mitigate price; good service helps shift the focus away from price. Our friends in retail learned long ago that the better the service, the higher the prices they can charge for their products. The bottom line is that happy customers directly equate with agency financial performance. Every customer lost has an impact on the bottom line

Tague Alliance is focused intently on R.P.G. - Retention, Profit, Growth! Growing is made much more difficult when your agency retention is lagging. For every client and policy that you keep, it is one less that has to be found, quoted, and sold.

Snowmobile Safety

Do you have any clients that take winter trips to the snow? If you clients have snowmobiles, here is a good article to share with them. It's a great lead in to get the opportunity to quote the business!

Bounding over trails through woods, over fields and across frozen ponds or lakes with cold blasts of air whipping around are all part of the fun that thousands and thousands of people enjoy during winter in their snowmobiles. Snowmobiling’s fun should not mask the fact that it still involves the use of fast, heavy vehicles that, in collisions, can cause severe injuries and damage to property. Some models of snowmobiles and all-terrain vehicles operate at speeds that rival automobiles. Unlike autos, they are open vehicles, lacking the structural protection of even the smallest auto; therefore the danger to snowmobile users is far higher.

The danger of being injured while operating snowmobiles is compounded by some important factors. Snowmobiles are operated over rough terrain with obstacles that are often hidden by snow. They are operated in areas where the drivers are not familiar with paths or trails. Novices and older operators with poorer reflexes are attracted to recreational snowmobiling and these vehicles are often used very late at night, in remote areas. Another consideration regarding use of snowmobiles is that operators also combine driving with drinking and alcohol intensifies the other dangers.
Naturally there are practices that can help lower the chances of being in a serious accident. Snowmobile operators should:

Avoid solo snowmobiling - having another person around in case of an accident is probably the greatest safety practice.

Properly maintain the snowmobile to insure safer operation

Dress in appropriate safety gear and clothing, including water-repellant apparel

Operate snowmobile at speeds that are appropriate for conditions and terrain

Do not drink alcohol while operating a snowmobile

Use marked trails and don’t stray off of them

Carry a first aid kit, as well as other emergency equipment, especially tools, flashlights, compass, matches, etc.

Avoid crossing bodies of water as breaking through ice is a major peril (drowning is a chief source of snowmobile accident fatalities).

If you've got your own snowmobile, make sure it's insured! We can provide you with the best snowmobile policy available. And our companies don't require that you have a homeowners or renters policy.

Contact Tague Alliance with any questions about placing stand alone snowmobile business!

COPYRIGHT: Insurance Publishing Plus, Inc. 2010

Tague Alliance - We Have Been Saying The "Hard Market Is Coming"

Tague Alliance members need to be prepared for what a Hard Market brings: disruption to our books of business, more pressure on carrier appointments and production, a sharper focus on profitability and book quality, and policy rewrites. The Hard Market is disruptive and every few years the insurance cycle shifts. In our estimation, 2012 will be the transition year and possibly very disruptive.

The silver lining is that many more people will be shopping their insurance which creates more new businesses opportunities for our members. On the flip side, proactive client management is the name of the game to ensure you are retaining the majority of your client base.

Be prepared so your agency can take full advantage of the changing market place.

Below is a great article which provides some insight into the first nine months of 2011 and how the industry is doing.

Specialty Insurers Lead Way in 2011, but Industry Underwriting Results Down

By Phil Gusman, PropertyCasualty360.com

November 22, 2011

26

NU Online News Service, July 21, 1:41 p.m. EST

Specialty commercial insurers continue to lead the way for property and casualty insurers’ underwriting results for this year’s first nine months, but results overall are down sharply compared to same period in 2010, according to a Fitch Ratings analysis.

Fitch says underwriting results for a group of 47 publicly traded P&C insurers and reinsurers it follows have deteriorated so far this year, posting an aggregate combined ratio of 105.3 compared to 96 a year ago. Fitch adds that 32 of the 47 companies posted underwriting losses for the year’s first nine months compared to 15 companies in 2010.

“These lackluster underwriting results led to anemic profitability for most GAAP filers,” says Fitch. “Fitch’s universe reported an operating profit of $8.1 billion year to date, versus $24.2 billion for the same period in 2010.”

Fitch adds that the group reported a net profit of $9.7 billion during the year so far compared to a net gain of $26.4 billion last year.

Catastrophe losses are partly to blame, with losses for the group more than doubling to $28 billion for the first nine months this year compared to last year. Additionally, realized investment gains are lower, totaling $4.2 billion in the current year so far compared to $5.9 billion in the first nine months of 2010.

While all lines are feeling the effects of the weather and economy, specialty commercial insurers have seen the best results of commercial-lines sub-segments, which Fitch says is a trend that has continued over the past several years. “The group’s aggregate combined ratio rose by 5.9 points to 98.1, but was still the only segment in Fitch’s analysis to produce an underwriting profit,” Fitch says.

The segment benefitted from favorable loss-reserve development, which trimmed 5.9 points from the aggregate combined ratio, but that favorable development is down from the 6.4 points trimmed in the first nine months of 2010.

The benefit of reserve releases across the industry is down for 2011 so far compared to 2010. The overall impact has been 2.8 points trimmed from the industry’s aggregate combined ratio in 2011 compared to 3.5 points in the first nine months of 2010. Fitch says the vast majority of underwriters in its group continued to report favorable development, but the rating agency cites Hartford Financial Services Group and HCC Insurance Holdings as two notable exceptions that saw unfavorable reserve development.

For personal lines, the aggregate combined ratio jumped from 95.7 to 102.4 as the sector was hit by Hurricane Irene on the East Coast and heavy tornado activity and winter-storm losses earlier in the year.

Reinsurers saw their aggregate combined ratio climb to 117.3 from 93.1 a year ago due to first-half catastrophes such as earthquakes in New Zealand and Japan, Australian floods and U.S. storms. Reinsurers did report a third-quarter underwriting profit, Fitch says, as Hurricane Irene losses centered more toward primary writers.

Commercial diversified insurers’ combined ratio is 104.6 for the year so far, compared to 96.6 at this time last year. Fitch says only two insurers in its group for this sector—ACE Ltd. and Hartford—produced accident-year combined ratios under 100.

Pointing to trends over the year so far, Fitch says capital generation is at a standstill, loss reserve releases are moderating, catastrophe losses are compounding and there has been a sharp drop in return on capital. However, Fitch notes that signs of a pricing shift have materialized.

“Fitch Ratings believes that this price reaction is well overdue,” the rating agency says, “but it remains unclear if momentum will hold for further pricing improvement that is necessary to return the broader market to adequate return on capital levels.”

Tague Alliance - New California Work Comp Laws

Tague Alliance and SIAA member agencies who write commercial insurance and specifically Workers Compensation Insurance in California need to stay somewhat current on the plethora of new laws that were recently signed into law by Governor Jerry Brown. Take a look at this great article from the Insurance Journal:

http://www.insurancejournal.com/news/west/2011/10/19/220793.htm

California Workers’ Comp Institute Compiles List of Bills Signed by Brown

October 19, 2011

The California Workers’ Compensation Institute on Wednesday released a review and compilation of 20 bills signed by Gov. Jerry Brown in 2001.

The bills include:

• AB 55, Gatto: Extension of the right of entertainment production companies to use payroll firms as the employer of record to pay taxes, union dues and workers’ compensation.

• AB 228, Fuentes: Allows State Compensation Insurance Fund a limited ability to cover out-of-state employees of California employers.

• AB 300, Ma: Sets new requirements for safety, training and sanitation for those engaged in the business of tattooing, body piercing or permanent cosmetics.

• AB 335, Solorio: Calls for benefit notice changes in the content and delivery of benefit notices and other injured worker information.

• AB 378 Solorio: Sets guidelines for dispensing compound drugs to injured workers, defines when such drugs are reimbursable and reimbursement amounts, and eliminates incentives for doctors to refer patients to pharmacies in which they or their families have a financial interest.

• AB 397, Monning: Requires contractors to show proof of workers’ compensation coverage or exempt status (if they have no employees) when renewing their license with the state.

• AB 436, Solorio: Authorizes a $4.3 million loan from the Uninsured Employers Benefit Trust to the State Public Works Enforcement Fund to enforce prevailing wage requirements on public works projects.

• AB 469, Swanson: Requires private employers to give a new written notice to nonexempt new hires, with detailed wage and employment information and the name, address, and phone number of the workers’ compensation insurance carrier.

• AB 507, Hayashi: Revises the “Pain Patient’s Bill of Rights” and removes Department of Justice’s authority to: 1) employ a physician to interview and examine patients about the prescription, possession, or use of controlled substances; 2) require the patient to submit to the interview and exam; and 3) allow the physician to testify in administrative proceedings.

• AB 585, Fong: Extends the work-related cancer presumption given to firefighters and fire and rescue services coordinators to active firefighting members of a fire department serving NASA.

• AB 878, Berryhill: Requires workers’ compensation insurers to report the cancellation of a contractor’s policy to the State Contractors License Board and makes the violation of workers’ compensation laws a cause for disciplinary action by the License Board.

• AB 1136, Swanson: Requires general acute care hospitals to set up safe patient handling programs with trained lift teams or lift support staff and back injury prevention plans by Jan. 1, 2013.

• AB 1168, Pan: Requires the state to adopt by Jan. 1, 2013 a fee schedule setting maximum fees for services by vocational experts used in workers’ compensation claims

• AB 1263, Williams: Prohibits former State Compensation Insurance Fund (SCIF) officers and directors from lobbying SCIF for two years after their employment ends, and requires that any consulting they do for SCIF be approved by SCIF’s board.

• AB 1425, Assembly Ins. Committee: Allows insurers to disclose with the quote (prior to acceptance) that a policyholder’s premium may be refunded on other than a pro rata basis.

• AB 1426, Solorio: Abolishes the workers’ compensation court administrator position and redistributes the duties to the Department of Workers’ Compensation administrative director and the appeals board.

• SB 457, Calderon: Requires the WCAB to determine, based on liens filed, reimbursement for benefits paid or services provided by self-insured employee welfare benefit plans, notwithstanding the Official Medical Fee Schedule, when payment for self-procured medical costs for a work injury or illness is awarded.

• SB 459, Corbett: Prohibits and sets penalties for the willful misclassification of employees as independent contractors.

• SB 684, Corbett: For policies issued or renewed on or after July 1, 2012, workers’ comp insurers must disclose when a quote is provided if they want to use arbitration to resolve disputes and make explicit that businesses do not have to agree to out-of-state arbitration/dispute resolution.

• SB 826, Leno: Allows the DWC to fine claims administrators up to $5,000 per year for violating workers’ compensation information system data reporting requirements and calls for an annual report showing claims administrator reporting compliance rates.