WHEN: Thursday September 16, 2010, 8:00 a.m.-12:00 p.m.

WHERE: The Hartford,  5801 Owens Drive, Pleasanton, CA 94588

A new study by the Centers for Disease Control and Prevention says the total annual cost amounts to nearly $500 for each licensed driver in the U.S.

The study in the journal Traffic Injury Prevention found that the one-year costs of fatal and non-fatal crash-related injuries totaled $70 billion (71% of total costs) for people riding in motor vehicles, such as cars and light trucks, $12 billion for motorcyclists, $10 billion for pedestrians, and $5 billion for bicyclists.

CDC researchers said they used 2005 data because, at the study time, it provided the most current source of national fatal and non-fatal injury and cost data from multiple sources.

The data is for injuries only and does not include costs of vehicle or property damage.

The study also found:

• Costs related to fatal motor vehicle-related injuries totaled $58 billion. The cost of non-fatal injuries resulting in hospitalization amounted to $28 billion, and the cost of injuries to people treated in emergency departments and released was $14 billion.
• More men were killed (70%) and injured (52%) in motor vehicle crashes than women. Injuries and deaths among men represented 74% ($74 billion) of all costs.
• Teens and young adults made up 28 percent of all fatal and nonfatal motor vehicle injuries and 31 percent of the costs ($31 billion). These young people represented only 14 percent of the U.S. population.
• Motorcyclists made up 6 percent of all fatalities and injuries but 12 percent of the costs, likely due to the severity of their injuries. Pedestrians, who have no protection when they are hit by vehicles and are also often severely injured, made up 5 percent of all injuries but 10 percent of total costs.

CDC’s Injury Center supports strategies for prevention such as graduated driver licenses, child safety seats, primary seat belt laws, enhanced seat belt enforcement, motorcycle and bicycle helmet laws and sobriety checkpoints.

The Insurance Institute for Highway Safety (IIHS) has details on state-specific safe driving policies and a state-by-state comparison.

“The coverage is designed for the professional exposures of a construction manager, whether offered through an at-risk or agency contract, as well as trade subcontractors with or without direct design exposure,” said Scott Rasor, head of Construction for Zurich’s North America Commercial business division. “The policy covers third-party claims against a contractor. If the contractor is providing design-build services and incurs first-party losses due to the designer’s negligence, the contractor can access this policy’s limits when the subcontracted designer’s professional liability limits are not adequate or available.”

The policy can be composed of three coverage parts:

1) Third-party professional liability that includes defense, mediation credit, and domestic and global coverage

2) First-party professional liability that includes:

• Excess coverage of the underlying professional liability policy if the contractor incurs losses, such as cost overruns, schedule delays and rework due to the negligence of a subcontracted design professional
• The ability for an insured contractor to recover incurred losses, regardless of whether there has been a claim by a project owner or third party
• Providing difference in conditions coverage of losses to the extent that the policy is broader than the architect or engineer’s underlying professional policies, subject to a self-insured retention

3) Contractor’s pollution liability is available on either a claims-made or occurrence basis

Other key enhancements include:

• Damages may include direct damages (cost to repair) and economic loss arising from professional services as part of construction means and methods
• Rectification coverage may be provided to indemnify an insured for necessary expenses incurred to correct a design defect in the works
• Mitigation of loss may be provided to indemnify an insured for necessary expenses incurred to address a pollution condition

Program options include intermediate and large deductibles, customized limits and sublimits based on a customer’s risk appetite and industry-leading capacity with liability limits up to $50 million.

As reported by WorkForce.com (full article: http://www.workforce.com/section/00/article/27/30/48.php_

A pregnant welder who was transferred from her job can pursue pregnancy discrimination and Americans   with Disabilities Act claims, a divided (2-1) federal appeals court has ruled in largely overturning a lower   court decision.

However, a panel of the 6th U.S. Circuit Court of Appeals in Cincinnati upheld the lower court’s ruling in   Heather Spees v. James Marine Inc. and JamesBuilt L.L.C. that dismissed Spees’ claim that her subsequent   termination also constituted pregnancy discrimination.

According to the ruling, Spees was hired in 2007 to work as a welder at Paducah, Kentucky-based JMI’s James Built facility, which focuses largely on building deck and tank barges, towboats and dry docks for the river-shipping industry. At the time, only four of JMI’s 935 nonoffice positions were female and Spees was the only female assigned to the JamesBuilt facility.

She discovered she was pregnant shortly after she started the job. First she was transferred to the tool room on the day shift, which, unlike welding, does not require special training. About a week later, she was transferred to nights in the tool room. After her doctor said she needed bed rest for the remainder of her pregnancy, she was terminated and told the reason was “for being pregnant,” according to the opinion.

Spees sued in April 2008, alleging pregnancy discrimination on the basis of her transfer and termination, as well as disability discrimination.

In reversing the lower court’s ruling on pregnancy discrimination for the transfer, the majority on the appeals court panel said, “As a whole, the evidence is sufficient to raise a genuine issue of material fact as to whether JMI management, rather than undertaking an objective evaluation to determine whether Spees could perform the welding job while pregnant, instead subjectively viewed Spees’ pregnancy as rendering her unable to weld.

However, the court agreed that the summary judgment dismissing her claim that she was terminated because of her pregnancy was proper, because Spees voluntarily submitted a doctor’s note to her employer advising her to have bed rest for the rest of her pregnancy.

The case was remanded to the lower court.

The news that California’s Workers’ Compensation Insurance Rating Bureau (WCIRB) might ask for the increase came out of a meeting of the bureau’s actuarial committee. That committee makes a recommendation to the WCIRB’s governing committee, and then the governing committee makes the request to the states Department of Insurance. The governing committee is scheduled to meet next week, and will be considering the recommendation then, said the WCIRB’s communications director.

The Department of Insurance has rejected the past two rate increases the WCIRB has requested, a 24% increase request last July and a 23% request this past January.

That is part of the reason for the current 30% request. Other reasons are that medical costs have been rising, 12 percent per year since 2007, and that there was a less than expected fall off in the number of claims made in 2009, given the fact that so many jobs have been lost in the present economic recession.

Currently, health insurers may only rescind policies under very specific, limited circumstances defined by law and regulations. In the past, some insurers have exploited vagueness in these laws to improperly rescind health insurance policies, according to the Department of Insurance. The new regulations clarify the law to protect consumers from these illicit practices and set out specific steps insurers must take before they can legally rescind. All insurers must file revised health history questionnaires that comply with the new regulations and receive Department approval.

The regulations do the following:

• Prohibit insurers from rescinding policies when they are not in compliance with specified underwriting practices regulations.
• Restrict health condition and history questions on applications to those that are necessary for medical underwriting.
• Require all questions on health insurance applications be clear, specific and understandable.
• Require use of new and improved health history questionnaires approved by the Department before an insurer can rescind.
• Allow consumers to indicate that they are unsure of or cannot remember the answer to a particular health history question.
• Require that agents attest if they help applicants with a health insurance application.
• Prohibit confusing phrasing of application questions like double-negatives and certain compound questions.
• Require that consumers be given a copy of their application to check for discrepancies.
• Require that insurers not rely solely on self-reported health history when possible.
• Prohibit insurers from conducting certain rescission-focused investigations long after becoming aware of a possible misrepresentation or omission by the applicant. Also prohibits insurers from seeking information outside the scope of such an investigation.
• Require that insurers give consumers the opportunity to respond during rescission investigations, and that insurers must listen to consumer-provided information.
• Require that insurers identify and resolve any reasonable questions arising from the application. Insurers must document their effort to resolve these issues and make those documents available to the Commissioner.

The regulations were approved by the Office of Administrative Law on July 19, 2010. A copy of the regulations may be viewed at http://www.insurance.ca.gov/0400-news/0100-press-releases/2010/upload/nr112rescissionregs.pdf

As the Insurance Department’s one and only designated statistical agent, as well as the one and only licensed rating bureau, WCIRB is a private company in control of a monopoly. It is appointed by the Insurance Department to work on the public’s behalf.

Nearly 16 years ago it agreed to curtail its secrecy practices and to conduct much of its operations in the public realm. But departmental instructions or orders, signed agreements and assurances aside, it remains common practice to this day to withhold information from the public. It was ordered to make data and meetings open and public by then-Commissioner John Garamendi. Robert Mike, its current president even signed an agreement promising the Insurance Department that it would make meetings open and information available to all interested parties. A link to that agreement is provided below.

Under the terms of a 1994 Committee Openness Proposal and the ratifying memorandum of understanding (MOU), WCIRB was required by the department to sign an agreement to make all written materials available to the public if it was providing those materials to its governing, actuarial, and/or classification and rating committee members for discussion in a meeting. Yet such materials, including PowerPoint slides, data briefs and other reports and presentations made by WCIRB staff to the committees are rarely provided to public members in attendance.

It is important to note that Workers’ Comp Executive has had its award-winning San Francisco-based editor Brad Cain consistently present at many, if not most, of these meetings for the past few years. Both he and Bess Shapiro tell us WCIRB has commonly refused to provide him materials, to allow him to take pictures, or to record audio or video of the proceedings.

WCIRB’s most recent Classification and Rating Committee meeting is a prime example of these repeated, egregious violations.

The committee’s July 27 agenda included six items on the public agenda, each of which related either to a staff document or a report from the manual subcommittee. Brad says these included proposals to carve out a new classification for land surveyors from the current consulting engineers classification, as well as a proposal to boost the wage differential for the dual-wage classifications maintained by WCIRB. Both stories we covered in the current paid-subscriber edition.

Brad’s request to Jack Hannan, WCIRB’s public information officer, for a copy of the reports and documentation being reviewed by the committee was denied. As a result, the public, the industry, the Legislature, and regulatory and executive branches of government are less informed and do not get a chance to analyze the dataor methodology, to comment, or to clearly understand how the end result was derived. We can report that something happened, but not why or what data were used to reach the conclusions. Thus others are prevented from testing the data.

In fairness to the WCIRB, Brad reports that the actuarial committee is “pretty good” about handing out most materials.

The latest violations also illustrate how WCIRB works in general. It violates the spirit of its agreement with the department by delegating much of the underlying work to individual subcommittees or special committees not named in the MOU or Committee Openness Proposal. WCIRB’s strict word-by-word reading of the memo is interpreted for secrecy and against transparency. Therefore, it doesn’t notice these critical meetings nor does it allow the public to attend.

In the case of the C&R committee, members were dealing with several reports prepared by or previously vetted by the manual subcommittee. Because these committees are not mentioned in the Committee Openness Proposal, WCIRB maintains a closed-door policy for its meetings. The end result is a sanitized version of an issue brought for public discussion and action at one of the standing committees, while much of the real debate and decision making takes place at the subcommittee or special committee level to the exclusion of all the interested and affected parties.

By its actions, WCIRB management demonstrates the literal analogy of foxes guarding the henhouse. Its governing board is made up of insurance executives from companies it analyzes plus a couple of public members. Management has placed its governing board members in the untenable position of either backing management policies or becoming the foxes.

But management doesn’t stop there: It has figured out how to keep the public members of its governing board in the dark as well. Here’s how they do it:

It’s not just the general public that is excluded from these subcommittee meetings. One of the two employer representatives appointed to WCIRB governing committee has asked for access to the claims subcommittee and was denied admittance to the meeting. That same member was also relegated to sit in the WCIRB lobby along with our reporter while the C&R committee met in executive session. Many of the same people who sit on the governing committee sit on the subcommittees and therefore have access to the underlying data not provided at the higher – public – levels.

The MOU notes that the general public can be barred from these executive sessions but is silent as to any limits on other committee members attending. But WCIRB maintains that its constitution gives it this authority. WCIRB explains: “The WCIRB’s Constitution provides that a member of one WCIRB committee may attend a meeting of another committee only if the other committee is not meeting in executive session or the committee believes that the nonmember’s participation will assist the committee in its deliberations.” In other words, it can hide information from director-level people.

The bureau also has changed how it runs its C&R committee. Whereas it used to open in executive session and then proceed to the open meeting, it has now reversed the order.

It appears that the change is a response to information that Workers’ Comp Executive obtained while talking directly with carrier representatives who were waiting to appear before the committee on a disciplinary matter they were called for.

The committee now starts in open session, and when that is completed. it takes a break before going to closed session. As one WCIRB official noted, the change eliminates the need for anyone to wait around in the lobby during executive session. This also allows a carrier facing disciplinary action to come and go without any members of the public and/or media learning their identity.

And the notion of public meeting also appears to have limits. While the MOU is silent on the question of audio and video recordings during the public meetings, WCIRB has set policy that use of these recording devices is not allowed, but observers question why the public would be permitted to attend a public meeting and jot down notes but not be permitted to record the meetings.

Given the impact some of these discussions and decisions may have on employers’ rates, experience modifications, and their ability make decisions about their workers’ comp coverage, the department may want to rethink its Openness Proposal to bring in the light of day.

Here is a link to the MOU.

Here is a link to the story about public members Bruce Wick and Art Levine being excluded.

Legal Notice:
The editors have made efforts to ensure the accuracy of the information published in each issue. Opinions on financial, legal or other matters are those of the editors and others; professional counsel should be consulted before any action or decision based upon this material is taken.

Copyright 2010 Providence Publications, LLC. All Rights Reserved. The Workers’ Comp Executive may be forwarded, copied or distributed subject to the following conditions: (1) The full report including text, graphics and links must be copied without modification and all pages must be included; (2) All copies must contain Providence Publications copyright notice; (3) This document may not be distributed for profit.”

You are a contractor and you may hire a subcontractor for a specific task. FACT: most of our clients do that.

The subcontractor or one of their workers may get injured on the job. FACT: some of them get that.

QUESTIONS: Are you liable for workers’ compensation insurance? Are you liable for general liability insurance?

The answers to these questions could very well be yes, especially if the subcontractor is unlicensed and or uninsured.  You could be held liable for workers’ compensation benefits if the employee of an uninsured subcontractor gets injured while working on a project for you.

The subcontractor damages your work or the work of others. Your general liability policy could also be negatively impacted by having to cover claims from your uninsured

Here is a list of tips to help you to mitigate the risk of working with subcontractor:

- If certain jobs require a license, insist on seeing and writing in your records license numbers of all your subcontractors working on those jobs.

- Obtain Certificates of Insurance from all of your subcontractors, especially if they, in turn, subcontract portions of their work.

- Require that the Certificates of Insurance name their workers’ compensation, commercial automobile liability, and general liability insurance companies and list the liability limits for each of the workers’ compensation, commercial automobile liability, and general liability policies, respectively.

- You should also require that you be named as an Additional Insured on the subcontractor’s commercial automobile liability and general liability insurance policies depending on the type and extent of work the subcontractor performs for you.

If such documentation is not provided, you may be charged additional workers’ compensation and or general liability premium based on the contract price, payroll, or subcontractor cost to cover any liability that may exist. Worse, your policies may exclude coverage for work performed by uninsured subcontractors.

Unlicensed and uninsured subcontractors ultimately increase your cost of workers’ compensation and general liability insurance. You can help your own cause and those of your peers by not hiring unlicensed or uninsured subcontractors.