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Almost 900,000 Homes at High Risk of Wildfires, CoreLogic Reports

Despite extensive, persistent drought in the western United States, 2014 saw notably low numbers of wildfire incidents, both for total number of fires and acreage burned. According to CoreLogic, there were 63,345 wildfires in 2014, which ranks second only to 2013 as the lowest annual number of wildfires over the past 20 years. In comparison with 2013, which was the second lowest annual total acreage burned in the past 10 years, the 2014 season saw even lower numbers, with 3,587,561 acres burned by wildfires.

More intensive response to small fires and ignitions, increased overwinter snowpack and timely precipitation during wildfire season, and greater efforts to boost public awareness and homeowner mitigation efforts have all contributed to more effective control over wildfires, the company pointed out. But responding agencies, homeowners and insurers should not allow the decline to translate into a sense of security.

“Even though we haven’t seen the type of wildfire activity over the last few years that seemed to be thematic in the 2000s, there have been record setting wildfire events even during the recent periods of overall reduced wildfire numbers,” the report said.

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“With continuing residential growth in the West, the opportunity for fires to find homes and businesses is going to increase as well. This is why it has never been more important to know where wildfire risk is located and understand the likelihood of it occurring.

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Across the western states, the highest risk areas can be found:

Western US Wildfire Risk

Based on CoreLogic wildfire analysis, there are 897,102 residential properties in the region that are currently located in High or Very High wildfire-risk categories, with a reconstruction value of more than $237 billion. In the Very High risk category alone, there are just over 192,000 residences with a reconstruction value of more than $49 billion. “Taking into consideration the combination of risk factors both inside and outside the property boundary to assess numeric risk score, more than 1.

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1 million homes in the U.S. with a total reconstruction value of more than $268 billion fall into the highest wildfire risk segment of 81-100. This total is more than five times the number of homes that fall under the Very High risk category,” CoreLogic reported.

The company also broke down the statewide totals for potential exposure to wildfire damage, in reconstruction value per risk category:

CoreLogic: Total Potential Exposure (Reconstruction Value) to Wildfire Damage by Risk Category

Check out the full report for more details on the risks of wildfire damage.

Highway Traffic Deaths Preventable with Better State Laws

A report on highway safety urges state legislatures to examine safety laws and take proactive steps to enact effective rulings. The Advocates for Highway & Auto Safety report “2015 Roadmap of State Highway Safety Laws: Lethal Loopholes,” found that more than 5.6 million crashes in 2013 caused about 32,700 fatalities and 2.3 million injuries. Motor vehicle crashes cost society $871 billion, based on 2010 data.

Federal action and safety requirements can address part of the problem, but state laws have direct impact on promoting safer driver and occupant behavior, according to the report, released in January. An example of the difference state laws can make is with seat belt use, which has been shown to save lives. In 2013, states with primary enforcement seat belt laws for front seat passengers had a 91% belt use rate, while states with secondary enforcement laws had an 80% belt use rate, according to NHTSA data. A study conducted by the Insurance Institute for Highway Safety (IIHS) found that, when states strengthen their laws from secondary to primary enforcement, driver death rates decline by about 7%.

“In 2015, Advocates urges state leaders to close lethal loopholes in their highway safety laws,” Jacqueline S. Gillan, Advocates president, said in the report. “The emotional, economic and societal cost of inaction to improve safety is too high especially considering we know what steps can be taken. Complacency and lack of action have resulted in a dangerous and deadly patchwork of laws across the nation. Lethal loopholes in traffic safety laws are literally killing us—we can and must do better.”

Key facts, according to Advocates:

  • 32,719 people were killed in motor vehicle crashes in 2013—a decrease of 3% from 2012. Automobile crashes remain a leading cause of death for Americans between the ages of five and 34.
  • About 2.3 million people were injured in motor vehicle crashes in 2013.
  • In 2013, almost half (49%) of passenger vehicle occupants killed were unrestrained.
  • Crashes involving young drivers (aged 15 – 20) resulted in 4,333 total fatalities in 2013.
  • 4,668 motorcyclists died in 2013. Though this is a decrease from 2012, this death toll accounts for 14% of all fatalities.
  • 1,149 children age 14 and younger were killed in motor vehicle crashes in 2013.
  • 300 children aged four through seven were killed in motor vehicle crashes in 2013.
  • More than 3.5 million people have been killed in motor vehicle crashes in the U.S. since 1899.
  • The more than 5.6 million police-reported motor vehicle crashes in 2013 had a societal impact in excess of $870 billion. Thirty-two percent of this figure ($277 billion) is economic costs including property and productivity losses, medical and emergency bills and other related costs. Dividing this cost among the total population amounts to a “crash tax” of $897 for every person, every year.

To meet basic safety recommendations, Advocates said states need to adopt 327 new laws:

  • 17 states need an optimal primary enforcement seat belt law for front seat passengers.
  • 33 states need an optimal primary enforcement seat belt law for rear seat passengers.
  • 31 states need an optimal all-rider motorcycle helmet law.
  • 19 states need an optimal booster seat law.
  • 174 graduated driver licensing laws need to be adopted to ensure the safety of novice drivers; no state meets all the criteria recommended in the report.
  • 42 critical impaired driving laws are needed in 39 states and D.C.
  • 11 states need an optimal all-driver text messaging restriction.

The Cost of Savings: Checking Medical Bill Review Charges

Here’s a provocative question for all the risk managers out there: what did you pay last year in workers compensation medical bill review charges?

Stumped? The answer may be more elusive, and more expensive, than it would initially appear.

Medical bill review is an essential service typically performed by an insurer, claims administrator, or outside vendor. The service provider reviews medical bills related to claims and audits the bills for accuracy, duplication of charges, and reasonableness. The costs for these services are allocated claim expenses, meaning they get charged directly to the claim file. This makes figuring out what you’re paying more difficult, as bill review charges tend to blend in with other expenses and bills.

Bill review charges are typically calculated in two ways. First, for each bill, there is a standard review charge. This could be a flat rate or calculated by the number of lines. Second, for bills that are outside of medical provider networks and are negotiated, a percentage of the savings are charged.

This last piece is critical, because it means that charges for a single bill review can be thousands and sometimes even tens of thousands of dollars.

Here’s an example. Suppose an employee injures his back and is forced to have surgery, but does so at an out-of-network facility. The hospital bills $200,000, an amount it has no illusions of receiving. As part of the medical bill review process, the bill is negotiated down to $50,000, netting a savings of $150,000. The charge for the bill review is a percentage of the savings, typically between 20-30%. If we assume conservatively that the rate is 20%, in this example, the charge for the bill review service would be $30,000. For self-insureds and those with large retentions, this a cost paid directly out of pocket.

This example highlights two important facts. The first is that network penetration is of prime importance—when a patient is treated at an in-network facility, the bill is generally reduced to the pre-negotiated rate at no cost to you. Second, the medical billing process in this country has created an immensely profitable enterprise for skilled medical bill reviewers.

This is not to say that paying a percentage of negotiated savings is unfavorable to a risk manager. This system aligns the interests of the bill reviewer and the party paying the bill. The more the bill reviewer can lower a bill, the more you save, even if you are ceding a percentage of that savings to claim handling expenses.

And to be fair, the above scenario is more of an anomaly than the norm—in most cases both the savings and fees are much lower.

Still, the entire medical billing strategy employed by hospitals is rather discomforting. In what other industry are bills sent out and routinely negotiated down by 50, 60, or even 75%? Certainly, there are financial motives for hospitals, many of which are owned by private equity firms, to bill higher amounts than they ever expect to receive. Not only will the unsuspecting recipient occasionally unwittingly pay the full amount, higher bills allow hospitals increased write-offs for charity care and other unpaid services. And while fee schedules in some states have attempted to address this problem, this has further contributed to hospitals and insurers, each employing competing billing experts with the respective goals of maximizing and minimizing amounts paid for the same services.

The net result is higher processing expenses for everyone.

Accepting the fact that the medical billing system in this country is the way it is, let’s return to the ,000 medical bill review charge.

As risk managers, we need to continuously be concerned with our expenses. At the same time, these fees represent only a percentage of savings, and theoretically, the higher the bill review charge, the higher the savings. But the knowledge of that fact may not be enough to eliminate the sticker shock. Because medical bill review services are so essential, the only recourse is a better negotiation of fees—paying a lower percentage of savings is a good start, and a hard cap on the maximum charge for a single bill is even better. Of course, the first step is sitting down with the data and figuring out how much you’re actually paying.

That way, when someone asks you the question about how much you’re paying, you’ll not only have the answer, you’ll also have a plan to make it less.

Zero Tolerance Needed to Stop Construction Injuries

Photo by Caroline McDonald

NASHVILLE–For David B. Walls, president and chief executive officer of Austin Industries, construction safety became a lifelong mission the day he had to answer to the father of a worker killed in an accident.

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“Why did you kill my son?” he asked Walls over and over.

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“Those words haunted me,” Walls said during his keynote address at the IRMI Construction Risk Conference here. “Nothing I could do would bring him back.” Tragic events such as this are “defining moments,” he said.

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“But we need to get passionate about safety without experiencing a fatality.” Walls explained that the construction industry has a long way to go, with the worst record for fatalities, according to the U.S. Bureau of Labor Statistics.

Organizations, he added, should focus on the physical work environment and the company culture. They also need to realize that a world-class safety program leads to higher quality throughout the organization.

One prerequisite is strong leadership. A good leader takes the time to really listen to people, admits to making mistakes and shares recognition for a project well done with employees, he said. This person also should be consistent in addressing safety issues and assertive enough to stop workers from continuing on a job if unsafe conditions are evident.

An effective leader needs to be accountable and hold the entire team accountable when it comes to safety. For example, workers need to know that breaking certain safety rules could cost them their job. After all, he said, “you have a moral obligation to get employees home to their families each night in a safe condition.”

Walls recommended frequent discussions of company successes as well as failures. Weekly dialogues of near-misses, for example, can raise awareness about how they could have been prevented and encourage safe behaviors. Posting the safety records of contractors “makes them improve quickly,” he said. Walls advocates for both classroom and thorough on-the-job training.

Safety managers and employees also need to focus on what they might be overlooking, the “sins of omission.” For example, he said, “what are you not doing that you could be doing to save lives?” The litmus test, he added, would be for a manager to ask him or herself, “Would I let my child work here?”

Asked by an audience member how to get the necessary buy-in from a CEO, Walls advised, “Get the CEO to walk the job and see the hazards. Go to the job site and see where someone fell and where the accident took place. Two to three people a day are dying in this industry and it is unacceptable.”