Historically, the recovery and remittance process has been a very manual and time-consuming procedure for both vendor and client to understand where each stand in the subrogation management workflow.  Traditionally, checks are received by a vendor, opened, applied, and forwarded on monthly to the client with the fee retained. 

Continue reading "Subrogation and the Need for Transparency with Vendor Records"

Through discussions with the subrogation industry, auditing has been a known concern amongst carriers and third party administrators as it relates to the processing of recovery payments. A picture emerges of a system in which it’s almost impossible to follow the money and the lack of transparency makes it incredibly confusing or not even asked to understand who is recovering what for whom.

Continue reading "Seeing An Audit Trail Through Subrogation Paperwork"

Maytag Recalls Refrigerators Due to Fire Hazard

WASHINGTON, D.C. - The U.S. Consumer Product Safety Commission, in cooperation with the firm named below, today announced a voluntary recall of the following consumer product.

Name of product: Maytag®, Jenn-Air®, Amana®, Admiral®, Magic Chef®, Performa by Maytag® and Crosley® brand refrigerators

Units: About 1.6 million

Manufacturer: Maytag Corp., of Newton, Iowa

Hazard: An electrical failure in the relay, the component that turns on the refrigerator’s compressor, can cause overheating and pose a serious fire hazard.

Incidents/Injuries: Maytag has received 41 reports of refrigerator relay ignition, including 16 reports of property damage ranging from smoke damage to extensive kitchen damage.

Description: The recall includes certain Maytag®, Jenn-Air®, Amana®, Admiral®, Magic Chef®, Performa by Maytag® and Crosley® brand side by side and top freezer refrigerators. The affected refrigerators were manufactured in black, bisque, white and stainless steel. They have model and serial numbers printed on a label located on the top middle or left upper side of the refrigerator liner and have the following model and serial number combinations:

Refrigerators with freezers on the bottom are not included in this recall.

Sold at: Department and appliance stores and by homebuilders nationwide from January 2001 through January 2004 for between about $350 and $1600.

Manufactured in: United States

Remedy: Consumers should immediately contact Maytag to determine if their refrigerator is included in the recall and to schedule a free in-home repair. Consumers should not return the refrigerator to the retailer where it was purchased.

Consumer Contact: For more information, contact Maytag toll-free at (866) 533-9817 anytime, or visit the firm’s Web site at www.repair.maytag.com

With headlines like this no one can afford to recognize and pursue every possible recovery avenue. The nation's top P/C firms saw a 67.7% drop in net income from 2007 to 2008, hitting a seven-year low. Those figures, compiled from a Highline Data report on sector earning in 2008, show the top 100 P/C firms netted only $15.8 billion last year compared with $48.8 billion the year before. The report finds the sector in its weakest position since right after the Sept. 11, 2001, attacks. NU Online News Service, Mar. 5, 2:43 p.m.

Continue reading "Further evidence of the importance of subrogation"

Catalina Lighting Recalls Halogen Clamp Lamps Due to Fire and Burn Hazard; Sold Exclusively At Staples Stores

WASHINGTON, D.C. - The U.S. Consumer Product Safety Commission, in cooperation with the firm named below, today announced a voluntary recall of the following consumer product. Consumers should stop using recalled products immediately unless otherwise instructed.

Name of Product: Halogen Clamp Lamps

Units: About 2,000

Manufacturer: Catalina Lighting Inc., of Miami, Fla.

Hazard: The UV glass lens on the lamp can crack, exposing the halogen bulb, posing a fire and burn hazard.

Incidents/Injuries: Catalina Lighting has received 65 reports of broken lenses. No injuries have been reported.

Description: The halogen clamp lamps, also known as architect’s lamp, have 150 watt halogen bulb, an articulating arm, and a clamp desk lamp that adjusts up, down and swivels. Only lamps with model number 13456-US and lot numbers C06081581V185, C06081582V185 and C06081584V185 are included in the recall.

Sold at: Staples retail stores nationwide from July 2008 through October 2008 for about $50.

Manufactured in: China

Remedy: Consumer should immediately stop using the recalled lamp and contact Catalina Lighting to receive a free replacement lens.

Consumer Contact: For additional information, contact Catalina Lighting toll-free at (866) 949-8567 between 8 a.m. and 5 p.m. Monday through Friday or visit the firm’s Web site at www.catalinalighting.com

January 05, 2009 

Lasko, a company that makes portable fans and heaters, has been fined $500,000 for failing to report to the government that some of its fans could overheat, smoke, or catch fire posing fire and burn hazards. Nine people were injured and Lasko received 42 reports of fans overheating, smoking, melting, or catching fire between November 2002 and September 2005. The defect resulted in the recall of 5.6 million fans in 2006. The 2006 recall involved various models of Lasko, Galaxy, Air King and General Electric fans manufactured between January 1999 and July 2001, and sold through February 2004 at discount department stores nationwide for between $10 and $25. An electrical failure in the motor caused the fans to malfunction. Check the original recall notice for model numbers and photos.The Consumer Product Safety Commission, which announced the penalty, says that federal law requires firms to report to the agency immediately (within 24 hours) after obtaining information reasonably supporting the conclusion that a product contains a defect that could create a substantial product hazard, an unreasonable risk of serious injury or death, or violate any consumer product safety rule, regulation, standard or ban enforced by the CPSC. In agreeing to settle the matter, Lasko denies that it knowingly violated the law. Consumers who may still have the recalled fans should stop using them and contact Lasko to get a free fan cord adaptor, designed to shut off the fan motor if overheating occurs. Call Lasko at (800) 984-3311 or visit the firm's Web site.

We are three short weeks into the new year and the insurance industry is facing the same issues we were looking at in the last half of 2008 - a soft market and lower or stagnant investment income. Our clients share with us the freezing of budgets and how employees are not being replaced as they attrition out. Doesn't sound very promising, but I refuse to believe we only need to look at the bleak side of the situation when it comes to driving revenue for an organization. Although the soft market and premiums are not as good as we would like to see, I'd like to argue the third leg of the three legged stool is not being maximized as it should - the use of an effective subrogation strategy to enhance the bottom line.

I believe we would agree, in handling your personal checkbook, that if someone owed you a large sum of money that you would be aggressive in pursuing the money. Why should it be different for a company to treat those dollars, paid on behalf of their policyholders, to be handled differently? Claim payments obviously have a direct impact on the profitability of the company and the off-setting recovery of the dollars has an equal importance on improving profitability. Most organizations have some form of subrogation process, but that doesn't mean the process is being maximized, especially if the subrogation is being handled by the front-line claims staff. This is in no way to be derogatory to the those hard working individuals taking extraordinary care of settling claims for their policyholders, but I've been there - BI claims, total losses, and the myriad of other pressing claims keeps the adjuster from concentrating on the "closed file in the drawer" which needs a recovery. I'm not saying the file won't get handled, but time is money. Therefore, unless a staff person's full time job is to handle (and become an expert in) subrogation claims, recoveries won't be maximized. I also challenge each CEO, CFO, VP of Claims, or others familiar with the calculation of a combined loss ratio to determine how many policies would have to be sold in order to realize an increase of 10% (substitute any number here). Whether or not a company is handling their subrogation internally in a centralized manner or if they are outsourcing the subrogation function, subrogation recoveries should be considered a prime source of revenue. People aren't going to quit having claims. Not much that can be done about that. However, you can still maintain profitability through your effective subrogation strategy.

Feel free to contact me if you would like to receive a list of key measurement questions to determine the effectiveness of your subrogation process - kevin.may@acclaimresource.com.

November 18, 2008

Federal safety regulators have opened an official investigation on faulty tire valves that may have been installed as original equipment on more than one million 2007 Ford cars and trucks.

The valve stems in question were made for Dill Air Control Products of Oxford, N.C. by Shanghai Baolong Industries Co. in China. The National Highway Transportation Safety Administration started investigating the valve stems this past May after they were linked to a rollover crash of a 1998 Ford Explorer that killed a Florida man a year ago. Cracks in valve stems can cause tires to lose air, and such air loss at highway speeds can result in tire failure and a loss-of-control crash.

NHTSA says it has identified 37 complaints of cracked and leaking tire valves in 2007 models of Ford vehicles. The models identified include Grand Marquis, F-150, Mustang, Edge, Fusion, Expedition, Explorer, MKX, MKZ, Milan, Focus and Escape.

Eleven complaints allege that loss of tire pressure caused by a cracked and leaking valve resulted in under-inflated tires needing replacement. In addition, 23 of the 37 complaints said more than one valve was found to be severely cracked or cracked and leaking and needed to be replaced.

Dill informed NHTSA that as many as 30 million of the suspected valve stems have been distributed in the North American market. Soon after the original investigation was opened in May, one U.S. auto parts distributor, Tech International of Johnstown, Ohio, issued a recall on some of the faulty tire valves it had sold under the Topseal brand, also manufactured by Shanghai Baolong. Ford Motor Company uses valves stem supplied by Topseal as original equipment on its vehicles.

In documents on the newly-opened Ford probe, NHTSA says the original equipment snap-in tire valves may crack due to poor ozone resistance. "Air leakage from a cracked tire valve may result in tire damage, which could affect vehicle control," said NHTSA.

Most consumers will have a have a hard time figuring out with any certainty if they have any of the defective valve stems on their tires. That's because there is no visible identification of the valve once a valve stem is installed, The only way to to view the manufacturer's identification and part number found on the base of the valve is to remove the tire from the wheel and inspect it from the inside.

WASHINGTON, D.C. - The U.S. Consumer Product Safety Commission, in cooperation with the firm named below, today announced a voluntary recall of the following consumer product. Consumers should stop using recalled products immediately unless otherwise instructed.

Name of Product: Blue Ember Gas Grills

Units: About 47,000

Importer: Fiesta Gas Grills, of Dickson, Tenn.

Manufacturers: Keesung Manufacturing Co. Ltd. and Unisplendor Corp., of China

Hazard: The gas grills can be assembled improperly exposing the gas burner hoses to excessive heat, posing fire and burn hazards to consumers.

Incidents/Injuries: Fiesta has received 14 reports of grill fires. No injuries have been reported.

Description: The recall involves Blue Ember liquid propane (LP) or natural gas outdoor grills. The recalled model and serial numbers are listed below. The model and serial numbers are printed on a rating plate label on the rear of the grill. The cabinet style grill has two doors and is silver-colored and black or silver-colored and gray. "Blue Ember" is printed on the grill's hood.

Sold at: Various home centers and retailers nationwide from November 2007 through June 2008 for about $450.

Manufactured in: China

Remedy: Consumers should immediately stop using the grills, and inspect the burner hoses to make sure they have been properly assembled. If the hose is to the rear of the installed heat shield, the grill has been improperly assembled and consumers should contact Fiesta for replacement hoses, assembly instructions, and if necessary, for assistance in examining the grill.

Consumer Contact: For additional information, contact Fiesta toll-free at (866) 740-7849 between 7 a.m. and 5 p.m. CT Monday through Friday, visit the firm's Web site at www.fiestagasgrills.com (note: this is a .doc document), or email the firm at mnorman@fiestagasgrills.com

Will New Product Safety Law Be A Boon To Insurers?

BY DANIEL HAYS

NU Online News Service, Nov. 13, 3:25 p.m. EST

The new Consumer Product Safety Act may prompt some litigation by whistleblowers, but in the long run it should reduce claims

against insurers, according to an attorney who represents whistleblower interests.

That assessment of the law--which was disputed by a product liability lawyer-

-comes from Stephen Kohn, president of the non-profit National Whistleblower Center.

Mr. Kohn's viewpoint was rejected by Frank Citera of Greenberg Traurig in Chicago,

who heads firm's product liability practice group. He said he doubted whistleblower involvement will help insurers.

Mr. Kohn's group next week is sponsoring a seminar to brief attorneys on new protections in the law for employees

who are fired for going public with product problems.

The Act--passed on Aug. 8 in an effort to improve the safety of children's toys, and keep toxic playthings from the marketplace-

-gives whistleblowers the right to bring an action for a jury trial to obtain reinstatement and compensatory damages for emotional

distress and loss of reputation, as well as attorneys fees.

Mr. Kohn said the Act--which covers 15,000 products, from bicycle helmets to blasting caps--may result in individual whistleblower suits.

But he argues that if the worker's disclosure keeps a defective product off the market before consumers are harmed, it could avert

hundreds of millions of dollars in injury claims, and class actions.

"This is in the long-term best interests of the insurance companies," he said, adding that insurers should be supportive of whistleblowers because,

"it's a money saver."

It would be counterproductive for insurers, according to Mr. Kohn, "if they don't support and educate employees as to their rights."

Insurers, he suggested, "should require companies to have a mechanism to obtain internal [employee] complaints as a requirement to be insured." For publicly-traded companies, he noted, there is already a requirement that they have an employee concerns program, "but that only covers fraud against shareholders."

Insurance companies, according to Mr. Kohn, are in the best position to make sure companies have mechanisms to

learn about defects before there is a big lawsuit.

The attorney said he is currently handling the case of an employee who was fired in 2001 for raising an alarm about

defective bullet-proof vests, which had material that was degrading.

Two years after his firing, a policeman was shot through the vest and another suffered permanent injury from a bullet that penetrated.

Two years later, the Department of Justice withdrew the vest from the market.

Mr. Kohn said insurers most likely covered the two failures, but his client's actions "probably prevented hundreds of injuries."

Mr. Citera said Mr. Kohn's notion was "a perverse viewpoint." The whistleblower component of the law, he said,

has been one of great concern to companies.

"I think the Act will be a bit of a boon for the plaintiffs' bar that ultimately would impact the insurance industry," he predicted. In a perfect world, he said, a worker on the assembly line who sees a defect would prevent the product from hitting the market sooner, "but historically employees reluctant to blow the whistle."

Mr. Citera added that it would be unlikely the average employee would be aware of protections afforded by the Act.

And, in the course of his experience doing product recall cases, Mr. Citera said he could not recall many employee warnings.

Ultimately, he said he thought whistleblower involvement will have little impact on cutting down products that don't comply with the Act.

U.S. Consumer Product Safety Commission

---

FOR IMMEDIATE RELEASE September 30, 2008 Release #08-413

Firm's Recall Hotline: (800) 925-6278 CPSC Recall Hotline: (800) 638-2772 CPSC Media Contact: (301) 504-7908

WASHINGTON, D.C. - The U.S. Consumer Product Safety Commission, in cooperation with the firm named below, today announced a voluntary recall of the following consumer product. Consumers should stop using recalled products immediately unless otherwise instructed.

Name of Product: General Electric Toasters

Units: About 210,000

Importer: Wal-Mart Stores Inc., of Bentonville, Ark.

Hazard: An electrical short circuit can occur between the heating element and the bread cage, posing a fire and electrical shock hazard to consumers.

Incidents/Injuries: Wal-Mart has received 140 reports of fires or sparks coming from the toasters or the toasters tripping the circuit breaker in consumers' homes. No injuries have been reported.

Description: The recalled toasters have a chrome steel body, a black plastic base and controls with either two or four openings in the top. The GE logo is located on the front of the toasters just above the controls. Model numbers 169115 and 169116 are included in this recall. The model number is printed on the bottom of the toasters.

4-Slice	2-Slice
169115	169116

Sold at: Wal-Mart Stores nationwide from September 2007 through July 2008 for between $17 and $28.

Manufactured in: China

Remedy: Consumers should immediately stop using the recalled toasters and return them to any Wal-Mart for a full refund or replacement toaster.

Consumer Contact: For additional information, contact Wal-Mart at (800) 925-6278 between 7 a.m. and 9 p.m. Monday through Friday, or visit the firm's Web site at www.walmartstores.com

Office of Information and Public Affairs

Washington, DC 20207

Locally, the big health care story unfolding is Provena is appealing a ruling by the 4th District Appellate Court denying its tax exempt status as a not for profit hospital. By way of background, several years ago, Provena engaged in a practice of "dunning" the indigent who received care at one of their facilities and then eventually requesting a bench warrant for the patient's arrest for not appearing in court. As bad as this sounds, the real discussion lies in what qualifies as charitable care such that the hospital's not for profit status can remain in good standing with the Illinois Department of Revenue and the Internal Revenue Service? There are many angles to consider but one I think bears the most scrutiny is can a metro area the size of Champaign-Urbana economically support two hospitals? Without passing judgment, is Provena willing to open its books and demonstrate where every single nickel is allocated? Where do its patients come from? What percentage have insurance or inadequate insurance? The list goes on and on. Stay tuned because the hospital industry is watching this very closley.

Every now and then even a cynic like me can simply stare in disbelief at the dysfunction in the health care marketplace. I recently read that Medicare is no longer going to reimburse providers for sevices that result in either malpractice or were by mistake. What other business on the planet can operate in this capacity and why, after 40 years of being LBJ's lynchpin program of his "Great Society" is this now just being addressed? "I am sorry, sir but I amputated the wrong leg. Now, your insurance coverage will only cover 50% of our billed charges but we can certainly work out an installment arrangement that fits your budget." Amtrack, the US Postal Service and Medicare are government run programs that suck off the American taxpayer like a malnourished infant. When everybody wakes up and realizes we all have been duped at our own expense and you are booking your cardiologist's 6 week European vacation, my heartfelt condolences are with you. Now, having spent many years working inside a health plan, I am acutley aware of the aristocracy which exists between physicians and the rest of "them." I can assure folks that unless and until both sides of the health care equation (payors and providers) are willing to sit down and openly discuss pricing mechanisms and the true cost of medical services, anybody who must access the health care system will be grist for the mill.

Continue reading "Novel Concept: pay for what you receive"

Although I'm not much of an "Olympics guy", I couldn't help but watch the swimming events, especially the accomplishments of Michael Phelps and Dara Torres. I was in awe of their commitment to accomplishing their goals even though both are on opposite ends of their careers (although I wouldn't count Torres out too soon). Both knew that in order to reach their goal, they would need to not only have a plan, but be committed to implementing it and staying with it for the long-run. It obviously wasn't easy, but they stuck with it and became the best they could be. If you think they accomplished this by themselves, think again. They had coaches, nutritionists, and a number of other individuals to keep them limber and motivate them towards their goal. It is the classic example of personal accountability with a team effort. I know each of their team members were also striving to be the best they could be and to reach their goals. Keep in mind, if it wasn't for one of Phelps' team-mates swimming a phenomenal leg, Phelps would have had 7 golds and 1 silver! Still not bad, but due to this team-mate's efforts, Phelps now holds a record 8 gold medals. Same applies for Torres (who was swimming in her first Olympics the year before Phelps was born). She has 12 medals over her career beginning with the 1984 Olympics!

There are a number of lessons we can take from Phelps and Torres:

1. The drive to excel comes from within:

- We will not accomplish our goals unless we are passionate about reaching the end result.

2. Planning is essential :

- We need to know how we will get from Point A to Point B.

3. Hard work is part of the process:

- We can't rely on someone else to accomplish our own goals.

4. Personal accountability is essential:

- Excuses don't cut it.

5. Teamwork is imperative:

- Our team is there to encourage us and lift us up when we struggle. They are there to keep us pushing towards the goal.

6. Celebrate the Successes:

- Enjoy the fruits of your labor. Celebrate when you reach the mark and then go set the next mark higher!

We each have a choice when we put our feet on the floor in morning as to how our day is going to go. This doesn't mean we will enjoy each issue we face, but it does mean we have a choice as to how we deal with them. Live your day passionately and celebrate YOUR "Olympic successes"!