Risk Management Takes A Commitment From Everyone

These days, it seems all we hear about in the risk management arena is the advent of enterprise risk management. Now, I am sure that the qualification of risk management on all levels of an organization has great merit, and that the quantification at each level is very important.

The issue I have is the same issue that any good risk manager has with this premise: Risk management, to be effective, must be identified at all levels of the organization, or it won't work. It has always been like this, way before we started calling it "enterprise risk management." If your company does not have an awareness of the need for risk control in the backroom as well as the boardroom, then production needs will outweigh all concerns, and preventable losses will occur.

An owner and chief executive ask me why I thought the company wasn't making any money. I replied that the organization was motivated by production at all costs. "Well," came the reply, "if we don't have production, we have no company." I replied that it was not the production side of the equation that concerned me, it was the "at all costs" part that was troublesome.

Only with a top-down commitment can a risk management program succeed at all levels of the organization. The risk manager who has that commitment in words and deeds will be able to elicit systematic changes in the production chain, leading to a healthier workforce and reduced costs. If not, then let's face facts—at that point, all you're really doing is insurance.

Tell Me Your Insurance or Claims Horror Story - Win a Signed Copy of the Book!!

You know what I'm talking about-- dealing with a car accident, your neighbor's tree falls on your house or perhaps you added a teenager to your auto policy.

Tell me your insurance nightmare story. And, as impossible as it may sound, please edit out the profanity. I get it...

In the comments below, tell me your insurance or claims horror story...

The top two stories win a signed copy of Hide! Here Comes the Insurance Guy, the powerful new book that has taken the business and insurance industries by storm


Yes, It's True - I Am An Insurance Guy on Purpose

Why I Wrote a Humorous Book On Insurance


When you mention the term "insurance guy" or "insurance gal", many different images come to mind.

You may think of these well tailored, professional types who stroll through those beautiful downtown insurance company offices, off to wherever those people go to do whatever it is they do.

Or perhaps you envision the slightly harried insurance adjuster or appraiser who comes out to look at your car when it gets smashed up.

You know the one I’m talking about-he comes out with a camera around his neck, a clipboard in his hand and at least one pen in his shirt pocket.

It doesn’t matter how much damage is on the vehicle; he always looks at you and says "Where was it hit?" He feels around, takes a couple of pictures. For some reason, he always rubs a mark of the roof with his thumb.

He then gives you an estimate, and disappears, calling out "any questions, call your adjuster". As you leave, you hear faintly in the background: "Where was it hit?"

Maybe you think of your insurance agent, whom you call when you add another car to your auto policy, and she says she needs the check today, so if you could meet her at her son’s cello recital at the elementary school at 3:15.
You pull up next to her Escalade and hand her the check. You decline an invitation to see the show, resisting the urge to tell her you have other things to do, like making a living.

If you work in the insurance industry, it doesn’t matter what you tell folks. All of them think one thing-he works in insurance; he does insurance; he must SELL insurance.

I am a member of a lesser known community of professionals that choose to interact with the insurance community on a full time basis. I’m that guy in your organization who always seems a little disheveled, slightly distracted and just a tad odd.

I am a risk manager.

"Hey," you might ask "What does that guy do?"
"He’s the risk manager," is the reply. "He does the insurance. Whatever you do, don’t talk to him. Nobody ever talks to him. If you do, he’s going to bore you with all that insurance nonsense, and since people rarely ever talk to him, he won’t let you get away. Some folks say he’s brilliant, but I’m not really sure. No one really knows what he’s talking about, so they leave him alone. Actually, in a big company like this, that alone makes him a genius. He hangs out with the IT guy. Go figure."

I am a risk manager. I work for a company, trying to make sure that all the risks and loss exposures a company has can be afforded, and for those exposures that cannot be afforded without a negative financial impact on the organization, I purchase insurance.

I lead a kind of lonely professional life. When I walk the halls, people know that if they talk to me, I may try to work insurance into the conversation. So they duck around a corner or dive under a desk. Some will even get on the phone to other departments:

"Joe? Hi. Hide! Here comes the insurance guy!"

Thus, Hide! Here Comes the Insurance Guy was conceived. In 1986, I was in an operations position at a regional car rental company. My boss got mad at me and decided to punish me by putting me in charge of claims.
As time went on, I became the full time risk manager. I remember when I fell into the risk-management role at the company I was working for at the time.
I almost had a nervous breakdown. Was it because of the pressure of handling insurance for the entire organization? Or was it because that same year, the company had decided to self-insure its entire fleet of 5,000 vehicles?

Nope. It was because I couldn't understand a single word they were saying!!

For every insurance professional who takes a position as a risk manager, there are nine or ten of us who fall into the job because a need develops as the organizations grow. That need may be filled by someone who has interacted with insurance companies, or like me, due to a short term anger episode.
Regardless, I only wished I could have found a book that explains how business insurance works and what a risk manager does.

All of the information on business insurance comes from the insurance industry. In fact, most companies rely on their insurance broker for insurance expertise.

But wait, aren’t they the ones who are selling you the insurance?

I am an anomaly in the insurance industry. I currently hold four insurance designations, including the Chartered Property Casualty Underwriting (CPCU) designation, which is considered the highest and most prestigious designation conveyed in the property/casualty insurance industry. Yet, less than 2% of CPCUs are risk managers and less than 1% work outside the insurance industry.

I am a risk manager, and although I am considered an insurance professional by the insurance industry, I have never worked in the insurance industry.

Hide! Here Comes the Insurance Guy is an approachable text on how to manage your insurance program to protect the assets of your company in a cost-effective manner. The book de-mystifies the process, and educates as well as entertains.
When was the last time you could say that about an insurance book?

If you are a risk manager, you will identify. If you are an executive, a business owner or just someone totally baffled by insurance (and you're not alone), it’s a must read.

Rick Vassar CPCU, ARM, AIS, ARM-P is the principal in The Vassar Group, LLC, in Sterling, VA, specializing in risk management and insurance consulting.
Copyright 2006 by The Vassar Group, LLC. All rights reserved. Reproduction in whole or in part without permission is prohibited.
Hide Here Comes the Insurance Guy – A Practical Guide to Understanding Business Insurance and Risk Management, 2006 iUniverse, Inc. ISBN 0-595-38608-6 (pbk) ISBN 0-595-83388-7 (cloth).

Risk Management Explained

Invariably as a risk manager, I am asked the question I would anticipate with fear and trembling:

“So, what exactly does a risk manager do?”

In earlier times, I would begin to explain risk control, identifying losses, insurance, risk retention, blah, blah, blah. After about 30 seconds, the puzzled look is replaced with the rather uncomfortable “eyes glazed over”, and I imagine that I begin to sound much like the parents in the Charlie Brown cartoons. Even my beautiful wife of over 16 years tells people that it has something to do with insurance… or something. She does show a remarkable interest in captives, and not due to their cash flow or tax implications. She just wants to go to Bermuda.

As a risk control specialist, I knew that there had to be a way to explain my chosen vocation without causing folks to run the other way the next time they see me. A loss exposure which affects everyone, male and female, with no accurate forecast of when and where it might occur, and the consequences of improper preparation coupled with an inadequate response could lead to catastrophic results.

Then it dawned on me. Smacked me right in the face, it did. A circumstance and situation every man has experienced or will experience in his lifetime:

“Honey, does this outfit make me look fat?”

You’re smiling, aren’t you? Admit it. You have either asked it, or had it asked of you. It is a question so fraught with peril and danger that it could lead to losses for years to come.

For me it came around the second year of my marriage to my aforementioned beautiful wife. I will forego the details of the actual encounter, and blame it on long term memory loss. I had been a risk manager for a little over a year, but it didn’t matter. I was in the middle of a disaster, I had not done any pre-event planning, and I really had not entertained the possibility of this loss exposure. I was in big trouble.

You see, ladies, there is no good answer to this question. If I answer yes, it begins a dialogue on weight, body image (“So, you think I’m fat?”) etc. If I say no, I risk being untruthful to my sweetie. She also goes out looking like the Michelin man in an outfit at least two sizes too small, which she will eventually rationalize, and then I’m really cooked.

So what do I do? I have to say that I was very proud of my response, which did not prevent a loss from occurring, but did help to reduce the loss significantly and prevent future losses of mammoth proportions. I looked her straight in the eye, pointed a finger at my midsection, and said:

“Does this shirt make me look stupid?”

Now don’t get me wrong. I was still in big trouble, but I was able to minimize my losses, as well as set the groundwork for future loss exposures. I explained that no, I didn’t think she was fat, and that even Olive Oyl would look fat in a too small outfit. I also explained that I love her too much to lie to her, and that she needed to know that she could trust me to tell her the truth. Then I gave her the one truth that is universal in this situation—

If you feel the need to ask this question… it does!! So don’t ask—CHANGE!!

So that is how I explain what I do. Identifying, controlling, reducing, preventing, and now contingencies based on loss history. This makes me sound much more exciting than I am, living a life in the reckless and carefree world of risk management. And wouldn’t you know, I had some guy ask me about loss control and the cost of risk in a social situation.

I told him about Bermuda.

Dude, Pay My Claim

I really don’t like dealing with my HMO. If I asked for a show of hands for all those who find interfacing with their health insurance company a pleasant experience, you would probably get the same response if you asked the same group if they enjoy sticking a needle in their left eye.

When my family must interact with our HMO/PPO, this task falls to me, since I have a little more patience, being “in the business.” My wife did try to call one time. I begged her not to, but she insisted, saying we should share this burden. I reluctantly agreed, gave her the number, and walked upstairs to change. I came back down 10 minutes later, and she was sobbing into the phone, yelling “I don’t want to speak to a supervisor, I just want an answer to my question!” Last time she volunteered for that duty.

I really don’t have much trouble with customer service at our PPO. When I was in college, I sold books over the telephone. You know, the kind that once they start, they never stop coming? We had little flip charts: If they say no, go to chart 2, if they say no again, go to paragraph four on chart 3. If they say yes, get their info, etc. I lasted one half of one shift, and never went back, but it gave me enough experience to imagine how my PPO probably works.

I call the toll-free number, and keep hitting zeros until I am queued up. I listen to the Muzak version of Christopher Cross’ “Sailing,” and I am connected to my rep, Ted. This is one of the largest health organization’s in the country, and I get...Ted.

I always get Ted.

CSR: Thanks for calling. How can I help you?

Me: This is Rick Vassar, My member number is—

CSR: Dude, it’s me, Ted. What’s happening?

I began to think that Ted was the only one who works there, and my suspicions were validated the day I unknowingly and accidentally hit the prompt to speak to someone in Spanish. I was put on hold, listened to some song by Carlos Santana, and just before the guitar solo, I hear:

CSR: Hola, como le puedo ayudar?

Me: Uh, this is Rick Vassar, my member number—

CSR: Vato, soy Ted.

Me: Ted, I don’t speak Spanish, can you help me?

CSR: Lo siento ese, vato. Tienes que llamar otra vez y que te pasen con los que hablan Ingles loco.

I hang up and call right back, hit zeros, and get the “Sailing” hook again.

CSR: Thanks for calling. How can I help you?

Me: Yes, this is Rick Vassar, my—

CSR: Dude, it’s me, Ted.

Me: Hi, Ted. Listen, I have this claim—

CSR: Sorry, dude. Not covered.

Me: Why is that?

CSR: Uh, no referral—

Me: Well, if you look at the evidence of insurance, on page seven, paragraph four, it states that coverage should be afforded without a referral.

Silence.

Me: Ted, what’s the problem?

CSR: I told them this was going to happen.

Me: What’s that?

CSR: They told me nobody ever reads the contract...

In the past few years, class actions have been filed against carriers alleging unequal and improper claims handling, offering incentives to doctors not to make referrals, direction of care being dictated by managed care professionals and skyrocketing premiums. In 2003, some of these insurers settled their cases with doctors, agreeing to allow doctors to be doctors, increasing sensitivity to the patients’ needs and speeding up claims payments. Meanwhile, each doctor received enough cash after attorney’s fees to buy a venti latte at Starbucks. Many of these insurers have used this settlement as a marketing tool, reaping free good press well in excess of the amount settled in this “landmark” case. In fact, one of these companies’ stock price has increased over 250% since the announcement of this settlement.

But nothing has really changed. HMOs are still denying claims on a less than equitable basis, and they are denying portions of claims that are not usual and customary (to that particular company), and the patient is the one left holding the financial bag.

As a risk manager, I have a little better handle on what a company can and cannot do, so I can show them how they steered off the path. But millions of people do not know what their rights are, pay what they are told to pay and make healthcare decisions based on economics.

I have been very fortunate to get most of my claims paid, and I would have to hope that things are getting better. In the meantime, I have one assurance that I can guarantee with the utmost certainty.

I have Ted.


Reprinted from Risk Management Magazine.
Copyright Risk and Insurance Management Society, Inc. All rights reserved.

Gardisal and the Reproductive Rights Agenda

In 1973, the Supreme Court, in Roe v. Wade, ruled invalid any law which would prevent a woman from terminating a pregnancy if she chooses. Let me say up front that I believe this to be the moral equivalent of thinning out the herd for most, since it seems to be one of the most fervent arguments of those who support this “right”.

What will we do with all these unwanted babies? Who will pay for them? The government can’t do it all. Besides, I have the right to choose whether I want to have this baby, and it’s none of your business.

Now, along comes Gardisal. Gardisal is being marketed as the newest miracle drug, a vaccine against the HPV virus, a sexually transmitted disease linked to cervical cancer.

Excellent! Great! Wonderful! Someone told me it could be the greatest medical breakthrough since Thalidomide.

You remember Thalidomide. It was the great miracle drug of the late 1950’s, used to relieve morning sickness and induce sleep in pregnant women. The side effects: Thalidomide stunted the growth of limbs and organs in the womb, and led to severe birth defects in the children of mothers who took Thalidomide.

Now, don’t get me wrong. I hope this stuff works, and if it is proven to be effective without any long term side effects, I will be the first to stand and cheer. The problem is that we just don’t know.

In West Virginia, Maryland, and Virginia, the states have introduced or are planning to introduce legislation that would make it mandatory for prepubescent females to receive this vaccine to protect them against the risk of HPV and in turn cervical cancer. This is where it gets really dicey.

As with many other drugs approved by the FDA, the long term effects are not known. If a parent should choose to have their child receive this vaccine, and it’s approved by the FDA, they can.

But to make it mandatory by statute is obscene. And where are the “pro choice” folks in this discussion. It appears they are lining up on the side of mandatory shots. If they aren’t, their silence on this issue is deafening.

Feminists should wise up. If you are for the right to choose, be for the right to choose. But if you are going to use the legislature and the courts to mandate your vision of the best interests of women, then your agenda is less rational and coherent than you have attempted to forward.

The long term effects of this vaccine have yet to be determined. Yet, the long term emotional and psychological effects of abortion on families in general and women in particular is well chronicled.

Disposable pregnancy (abortion) is forwarded, as is mandatory vaccination of females for sexually transmitted diseases. Yet the long term effects of these life decisions are not considered.

So, ladies, what is it:

Are you controlling the right to choose, or choosing the right to control?