What Is A Workers Compensation Insurance Experience Rating?
I attended a workers compensation related seminar this past week on the subject of insurance and more specifically, the infamous “experience rating.” Five minutes after the seminar began, I was reminded how complicated the subject is when it comes to the statistics and calculations of experience ratings. I figured it would make a good insurance blog topic if I could somehow weed out the x’s and o’s and put it into layman’s terms on what it all means to you, the business owner who has an experience rating tied to your workers compensation insurance policy.
What is an experience rating?
California’s workers’ compensation experience rating system is a rating system intended to provide employers a financial incentive to reduce work-related accidents. It’s a method for adjusting premium rates to reflect an individual employer’s claims history. Essentially, it predicts an employer’s future losses based on past experience and compares the loss or claims history of one company to all other companies within the same industry/classification.
Employers may receive discounts off their premium for good claims records or may be surcharged for their poor claims records.
There are approximately 500 different business classifications used to describe the various types of businesses in California. Businesses assigned to your SIC (standard industry classification) are relatively similar to your business, however, there are differences which can have an impact on workers’ compensation claims costs. To address these variations and encourage workplace safety, experience rating adjusts the premium you pay either upward or downward based on a comparison of your company’s history of payroll and claims to what is expected for businesses of similar size within the same industry classification. This comparison results in your “experience modification.” An experience modification greater than 100 results from less favorable loss experience compared to the average of other similar businesses, and vice-versa, an “ex-mod” less than 100 results from more favorable loss experience compared to the average of other similar businesses .
Experience rating places more emphasis on the frequency of injuries than on the severity. An employer with one large loss ($100,000) will pay less for future insurance than an employer with 10 smaller lost time claims of $5,000 each – a total of $50,000 in losses. Experience rating cushions the blow of a large loss, but hammers employers with frequent losses.
What is the need for experience rating?
- To provide a direct financial incentive for employers to reduce accidents and encourage safety– This allows employers to develop loss control programs and establish safety programs which create premium incentives.
- To distribute the cost of insurance equally among employers in an industry classification– The reality is there is no “average” employer for a given classification code. The experience modification takes this into account to encourage the emphasis on loss control. Differences in management practices and methods of operation are reflected in final premium.
Who gets experience rated?
All California employers meeting minimum qualifying premium (Qualifying premium for 1/1/2011 is $16,700 and is amended annually). This accounts for approximately 120,000 employers in CA. Qualification is automatic and mandatory.
So what does this mean?
The science to determining your experience modification is pretty complicated. What you need to know is you want to keep your experience modification down, as it will bring your workers compensation premium down. To do help do this, you should develop loss control and safety programs to control work related injuries. It starts with you. Your management practices and methods of operation are reflected in your final workers compensation premium. If you don’t know where to start, contact your agent or carrier. Insurance carriers will help customize a loss control program for your business. They want to control loss just as much as you do.
Resources: WCIRB California; State Compensation Insurance Fund
–JK
Safety First: Ladders
Yesterday I received a call from a client, a contractor, reporting that one of his employees fell off a ladder and broke his elbow on the job on Monday afternoon. As the employer, he did the right thing in seeking immediate medical care for the employee at the nearest medical facility. He obtained as much information as he could about the injury and supporting info from the employee’s personnel file including name, address, phone, DOB, SS#, date of hire, and wage info. We called in the claim this morning to the carrier and a claim adjuster is now working with our insured to guide him and the employee through the treatment process.
Safety In The Workplace
Statistics show that falls from ladders injure over 20,000 workers annually. Some injuries result in permanent disabilities and even fatalities. If you’re working in a job capacity that calls for ladder use, be sure to make ladder safety a high priority for your employees. By following these safety guidelines, you can help prevent ladder accidents.
Safety starts before the ladder is even mounted.
- Before using any ladder, check its condition. Make sure there are no broken, cracked, or missing rails and that rungs are not slippery from grease or oil.
- Check for damage or corrosion on metal ladders.
- If a ladder is in poor condition, don’t use it. Report the problem so it can be tagged and repaired.
- A competent person should periodically inspect all ladders and remove damaged ladders from use until they are repaired.
When choosing and using a ladder, keep the following in mind:
- Choose the appropriate type and size ladder for the job, including correct fittings, and safety feet.
- Near electrical conductors or equipment, use only ladders with non-conductive side rails.
- Set the ladder on solid footing, against a solid support.
- Place the base of a straight ladder out away from the wall or edge of the upper level about one foot for every four feet of vertical height.
- Be sure straight ladders are long enough so that the side rails extend above the top support point by at least 36 inches.
- Single cleat job-made ladders should be 15 to 20 inches wide with ladder cleats uniformly spaced 12 inches apart.
- Never try to increase the height of a ladder by standing it on other objects, such boxes or barrels, or by splicing two ladders together.
- Portable ladders should be tied, blocked or otherwise secured against movement.
- Keep ladders away from doorways or walkways, unless they can be protected by barriers.
- Keep the area around the top and base of the ladder clear. Don’t run hoses, extension cords, or ropes on a ladder; these may create obstructions.
- To avoid slipping on a ladder, check your shoes for oil, grease, or mud and wipe it off before climbing.
- Climb the ladder carefully, facing it and using both hands. Use a tool belt or hand line to carry materials.
- Most ladders are designed to hold only one person at a time. Two persons may cause the ladder to fail or be thrown off-balance.
- Don’t lean out to the side when you’re on a ladder. If something is out of reach, get down and move the ladder.
- Ladders should never be used sideways as platforms, runways or scaffolds.
- Choosing and using ladders wisely is a step in the right direction.
Source: State Compensation Insurance Fund
–JK
Why Am I Being Asked For A “Waiver of Subrogation” On My Insurance?
Ever heard of the term, “waiver of subrogation”? Sounds pretty foreign, doesn’t it? Well it kind of is. If you’re a business owner with liability insurance, you may have had a request from a client or landlord at some point asking for a certificate of insurance with a “waiver of subrogation” for general liability, workers compensation and/or auto liability. I’m actually writing this post because it’s something that I have been working on this week trying to place a new client with an insurance carrier. This client happens to be a self-storage facility.
You see, this self storage facility houses a beer distributor. One of the conditions of writing insurance for this client (the storage facility) with this particular carrier, is to have the tenant (beer distributor) provide a “certificate showing that the insured is named as an additional insured on the General Liability policy with waivers for both the GL and auto. Minimum $1 million limits.”
What does Waiver of Subrogation mean?
The definition of ‘Waiver of Subrogation” is: “The relinquishment by an insurer of the right to collect from another party for damages paid on behalf of the insured. A waiver of subrogation is often referred to as “transfer of rights of recovery.” A waiver prohibits an insurance carrier from recovering the money they paid on a claim from a negligent third-party.
For example, suppose you own a building which burns down due to the negligence of a third-party. Normally you could sue the negligent third-party for causing your building to burn down. If your fire insurance company pays off your claim, however, the insurance company is then “subrogated” to your claim against the negligent third-party. This means your claim against the negligent third-party is treated as having been assigned to the insurance company, which may sue him/her to recover the amount it paid you on account of the fire loss.
Many, but not all, general liability policies allow you to waive your rights of subrogation as long as it is done in writing and prior to a loss. Some contractual agreements, such as some facility rental agreements, require you to waive your right of subrogation (and therefore your insurance company’s rights) against them in the event of a claim.
The good news is that you, the insured, doesn’t have to worry too much about what this terminology means should you get a request from a client or landlord. Simply forward to your insurance agent/broker and be sure to bounce any questions that you may have off them. Our job is to be your insurance partner and deal with these types of insurance requirements or questions you have.
–JK
Car Flies Off Ramp Into A Local Nail Salon
I was in the office Friday just before the lunch hour when I saw a Twitter news feed, “#BREAKINGNEWS: Car crashed into nail salon in Rolling Hills Estates along Deep Valley Drive – 5 minor injuries reported.” Seeing this was no more than a couple of miles from the office, I took a drive up the hill to check out what was going on, and I brought the camera with me. Here’s what I found:
It turns out an elderly woman driving up a ramp in the Rolling Hills Estates parking lot, crashed through a guard rail and went airborne before plunging into this nail salon. The 2001 Infiniti landed completely inside the Peninsula Center business. Somehow, the woman’s gray Infiniti missed hitting four other people as it embedded itself inside the building. .
From seeing the premises first-hand, it’s remarkable that nobody was seriously injured or even killed!
The crash crushed furniture and demolished tables inside. City building inspectors were expected to check the salon for structural damage. Here are a few still photos:
Looking at this video and pictures, it’s evident that this salon will be out of commission for some time. However, if the business is adequately insured, the business owner shouldn’t have to worry much. The following coverages should keep the business alive:
- Building and Business Personal Property: Coverage to help pay for the cost to repair or replace property, including inventory, office furniture or fixtures damaged by the accident. Not only is the business covering their own contents, but think about the building owner carrying a policy to cover the building itself.
- Business Income and Extra Expense Insurance (AKA – Business Interruption Insurance): Coverage that reimburses a business owner for lost profits and continuing fixed expenses during the time that a business must stay closed while the premises are being restored because of physical damage from a covered peril, such as a fire. It also may cover financial losses that may occur if civil authorities limit access to an area after a disaster and their actions prevent customers from reaching the business premises.
On the flip side of the coin, let’s hope the driver of the car carried an appropriate amount of liability insurance as you can bet the insurance company for the nail salon and the building owner will be looking to subrogate their losses as a result of the drivers negligence (The legal process by which an insurance company, after paying a loss, seeks to recover the amount of the loss from another party who is legally liable for it).
As with any other insured, do you think this business owner ever thought this would happen to them? If you own a business, don’t think it can’t happen to you. Don’t wait to carry business insurance coverage. Cover your business now and always expect the unexpected.
–JK
Ten Steps You Can Take To Lower Workers Compensation Costs
Hurt On the Job
Workers’ Compensation insurance can get costly and is a big pain in the butt for some businesses. In fact, the costs to carry coverage can even threaten the existence of some small businesses, especially in states such as California. The good news is that the insurance market is currently “soft”, meaning lower rates than we have seen in the past five plus years. However, it’s pretty much a guarantee the pendulum is just beginning to turn and we’re going to see work comp rates creeping upwards again as healthcare costs have skyrocketed, among other things.
Workers Compensation premiums are based in part on some things which you have little or no control, such as the type of industry your business is in, or the region or state you’re located. But rates are also based on things you do have some control over, such as your claim history and payments.
Here are 10 steps you can take to help lower your Workers’ Compensation costs:
- Match the applicant carefully to the job: Base the match on the applicant’s skills and abilities. Your careful hiring practices can go a long way toward reducing your costs. The Department of Fair Employment and Housing offers brochures to help guide you in conducting job interviews. Note: Discrimination because of a handicap is unlawful.
- Make safety a priority on the job every day: A safe workplace can lower your claims costs. It is far less expensive to prevent an accident than to pay for one.
- Fix dangerous conditions: When you become aware of a hazard on the job site, take appropriate corrective measures. Your failure to do so could result in a “Serious and Willful Misconduct” suit against you. This suit carries severe penalties that you would pay, not your insurance carrier.
- Train Supervisors: Workers’ compensation law includes supervisors in the definition of “employer.” When a supervisor fails to follow the law, it counts against you. Make sure your supervisors know all that is required of employers.
- Report employee injuries: As soon as you are aware of an injury, notify your insurance carrier by completing and sending the Employer’s Report of Occupational Injury or Illness form. The report requires you to provide information that includes the nature of your business, the type of employee injury or illness, and how it occurred. Your complete statements in each of these sections are necessary for determining the appropriate benefits. For example, information about your employee’s work hours and salary is necessary for computing benefit payments.
- Provide the employee claim form: You must provide the employee with a Workers’ Compensation Claim Form within one working day of learning of an injury. The employee should return the completed form to you. When you receive the employee’s claim form, make sure you sign and date it. You must then immediately forward the original to your carrier. The first indemnity payment is due within 14 days of your knowledge of a disabling injury. Failure to provide timely benefits may result in a penalty. The penalty may cost you, the employer, if findings indicate that you did not file the claim form with your carrier on time.
- Exercise medical control: Be sure to refer all of your injured workers to your carrier’s Medical Provider Network (MPN) physician. If you do not know of a physician or medical facility, contact your agent or carrier. Be sure to post notices with the name, address, and phone number of your medical provider so your employees know where to go in case of an injury. If the employee has previously notified you in writing of his or her personal physician, the employee has the right to be seen by that physician.
- Communicate with your employees: Show them you care about their well-being. If an employee sustains an injury, stay in touch throughout the recuperation period.
- Consider a Return To Work program: A Return To Work (RTW) program can help bring your injured employee safely back to work as early as possible. You adjust the transitional job to accommodate the employee’s improving condition until he or she can return to his or her usual duties. You reduce your costs; your employee can return to a self-supporting status; everybody benefits.
- Maintain records: Your personnel files can be of great assistance to your carrier in dealing with some cases. Information about an employee’s job description, wages, previous work history, recreational activities, any current work problems, and previous injuries is essential when fighting disputed claims.
As with any type of insurance, contact your insurance agent or carrier if you have questions on your workers’ compensation coverage, or if you need help controlling your costs. Insurance carriers have just as much incentive as you to prevent and/or mitigate loss, so there are risk control options to help.
–JK
What is Inland Marine Insurance?
Without prior knowledge of ‘Inland Marine’ insurance, you might think this is some kind of boating insurance or something. Ironically, it’s not. Marine insurance is a type of property coverage that has a long history behind it.
Marine insurance came into existence in the early days of shipping when merchants relied on bodies of water such as oceans, rivers, and canals as their main routes of transportation.
Source: Cunnington & Associates Inc
Then the twentieth century came along, and with it, a whole new system of transportation: planes, trains, and automobiles. With this, the demand for insurance to protect goods in transit over land came into existence. This is where inland marine insurance was born.
Inland marine is one of the most varied types of Property & Casualty insurance with many unique and unusual exposures. It is a form of property insurance, but the distinction between property and marine coverage can be very confusing. As a general rule, property coverage is designed to cover stationary property, property that predominately remains at a “scheduled” premises, and property not considered “unique.” Inland marine coverage is intended for property that may be moving from location to location, property off premises at new locations, temporary locations, or work locations, and/or subject to “unique” causes of loss that traditional property policies do not cover.
The four major types of inland marine coverages written today are:
- Property being transported
- Buildings under construction (builders risk)
- Computer equipment and data
- Contractors equipment
There are numerous other inland marine policy coverages written to handle expensive and unique property situations. They include:
- Accounts Receivable
- Bailee’s Coverage (for property of others accepted for cleaning, repairing, etc)
- Camera and Musical Instruments
- Exhibition Floater
- Equipment Dealers
- Fine Arts
- Furriers Block
- Jewelers Block
Does your business need Inland Marine Insurance?
Depending on the type of small business you own, this coverage can be essential to protecting business property. Consider any items you place in your car or truck daily to get your work done or the valuables, including data, you own or are responsible for. Most property policies limit or exclude coverage for these items.
Or maybe you are in the construction trade or are building an addition to your office. Inland Marine Insurance can protect the building materials—and a contractor’s tools and equipment.
If you clean, repair, service or perform work on property of others, Inland Marine Insurance can work for you. It can cover losses to goods that occur at your premises, while being transported to or from your premises or in storage.
These are just a few examples.
As you can see, marine insurance means a lot more than what it sounds like from the surface. Don’t let the term “Marine” fool you. It’s not just some kind of boating insurance. Rather, inland marine insurance is one of the most varied types of Property & Casualty insurance on the market that shouldn’t be overlooked.
–JK
Insurance Claims Tips for Retailers
Unfortunately, even the best-run retail stores can experience accidents, thefts or other losses. While an insurance policy provides important protection in case of a covered loss, retailers can take some simple steps to protect their business before and during the claim process.
Have Important Information Ready
Inspect and inventory your property. As a matter of standard business practice, take a full inventory of all your property — both stock and other business property.- Take photos or videos to supplement your written records. Being able to verify ownership of your inventory and other property is key to any property claim.
- Inspect your property regularly to document conditions both inside and out, and document your findings. Maintain a file of original purchase invoices.
- Keep insurance information handy. Keep your insurance policy number and contact information for your insurance carrier’s Claims Department in an easily accessible place, both at your business and somewhere off premises.
If You Need to Make a Claim
File the Claim. Claims professionals are experienced in helping businesses recover from a loss. They can provide helpful advice and guide you through the claims process.
In the Event of a Theft
- If your business should experience a theft, taking note of the details can make your claim a much smoother process.
- Notify the police. Be sure to obtain the case or complaint number and the precinct or department information.
- Gather alarm company information. If you have an alarm company, obtain the contact information and note the make and model of their system.
- Gather surveillance information. If you have surveillance camera tapes or videos, retrieve the tapes as soon as possible.
- Make a list of claimed items. List stolen property and their values. Locate support documentation and original purchase invoices.
- Assign a spokesperson. Determine who is the most knowledgeable insured to discuss this loss with the insurance company, make sure they have or can get the needed information and can act as the contact person for your business.
- Secure the premises. Protect your premises from further intrusion by boarding up broken glass, repairing locks, etc.
In Case of a Medical Accident
- Get medical help. If there is a medical emergency, get immediate medical help for any injured person. If there is doubt whether medical help is necessary, err on the side of caution.
- Collect information. Obtain contact information of anyone who witnessed the incident to share with the proper authorities. Show genuine concern, but never discuss liability or fault. Take the time to observe the scene of the accident.
- Take a picture. Pictures of possible defects or other property damage can sometimes make a big difference in adjusting a claim. Take a picture or make a video of the place where the incident occurred. Note possible contributing factors, such as weather conditions.
- Protect the scene. Secure the scene of the incident to prevent people from entering the area. Redirect people away from affected walkways or parking areas.
- Secure a defective product. If a defective product is involved in the claim, protect it so that it can be examined later. Make sure no one can use, remove, tamper with or alter it.
No business expects to have to make an insurance claim. But by being prepared — both before and after the unexpected happens — you can help to protect your retail store and make your claims process as easy and straightforward as it can be.
These details are provided for information purposes only. It is not intended to be a subsitute for individual legal counsel or advice on issues discussed here. Readers seeking resolution of specific legal issues or business concerns related to the topic should consult their attorney and/or insurance representative.Baseball Is Here! Dodgers vs. Giants
For those that know me, I love baseball, especially the Dodgers. April is a great time of year, as it’s the start of another Major League baseball season. Although it’s only Spring, I associate it as the start of a long Summer.
It was a great start of the season for the Dodgers as they took three of four games from the weekend series against the Giants. I went to the game last night. Here’s a video I took of Matt Kemp’s two-run homer in the first as the Dodgers beat the Giants 7-5. Lot’s of games still to be played!
-JK
Dude, Where’s My Arm?
File this one under bad trips, the Montana Supreme Court ruled a Montana man is entitled to receive workers compensation insurance benefits after being mauled while feeding bears at an adventure park…….after smoking pot. Yep, the man got high before he stepped into a bear pen to feed the omnivores. Shouldn’t he be chillin’ on the couch be playing Madden or something instead?
The court ruled that the man was an employee who had been compensated and was “within the scope of his employment” while working at the park. His impairment wasn’t a “major factor” in his mauling since there wasn’t specific evidence about his level of impairment . Also acknowledged was the fact that grizzlies are “equal opportunity maulers.”
Some notable analogies from the judge: “when a grizzly bear is sighted on a trail in Glacier National Park, the trail is closed to all hikers, not just the hikers who may have recently smoked marijuana.” And, the owner “installed multiple electrified fence lines at the bear park to separate the grizzly bears from all customers, not just the customers who may have recently smoked marijuana.
On the flip side of the story, the park owner claimed the man was really a volunteer. It was discovered that the adventure park didn’t even carry worker’s compensation insurance.
Really? You own an adventure park with wild animals and don’t carry workers compensation insurance? I don’t know who’s more foolish, the guy getting high before feeding bears, or the owner of an adventure park, with a bear pen, who doesn’t carry workers compensation insurance?
Luckily for the baked bear feeder, he was able to recover some of his medical expenses stemming from the attack.
I’m not advocating smoking marijuana, but if you choose to, don’t step into a cage to feed wild animals! What a buzz kill.
–JK
Source – KXLU – Helena, MT
Why Buy Life Insurance?
A: Although not the only answer, life insurance is a good business succession plan
Would your business suffer if they lost a key person?
If you are a business owner, would you like to be in business with your partner’s spouse?
These are two questions that most often lead to the purchase of life insurance by a business. Replacing the value of a key team member can literally spell the difference between survival and demise of a business. This reinforces the need for Key Person Life Insurance.
Not only do most business people not want to be in business with their partner’s spouse, but the spouse doesn’t want to be in business. To provide dignity in a time of pain, and to allow the business to go on without controversy over who gets what and who is in charge – these are the reasons for a Buy/Sell Agreement funded with life insurance.
Do you have a life insurance insurance policy as a business succession plan? If not, here’s a good resource to start: ISUQuickLife.com
Or, call your agent to discuss.
–JK
About Me
I grew up in Fullerton, CA and graduated from Servite High School in Anaheim. I have my Bachelors degree from Loyola Marymount University in Los Angeles. I currently live in Tustin, CA.
Please contact me if you need help with any of the following lines of insurance for your business:
-Cyber / Data Breach
-Commercial Property
-Commercial General Liability
-Products Liability
-Workers Compensation
-Commercial Auto
-Umbrella/Excess Liability
-Errors & Omissions/ Professional Liability
-Employment Practices Liability
-Directors & Officers
-Life & Disability Insurance
Jimmy Kinmartin, CPCU 