By Chris Demeter, Senior Loss Control Consultant
Have you ever forgot to put on your safety glasses and hammered a few nails into a board? How about sanding that old dresser and not wearing a dust mask? Truth be told, I have before I realized the importance of using the proper PPE.

While PPE use can help prevent injuries and illnesses, engineering controls should be the primary method used to eliminate or minimize hazard exposure in the workplace. However, it may not be possible to eliminate all hazards through engineering design, guarding, or administrative controls. In these cases, the use of PPE is necessary.

If PPE is to be used, employers must implement a PPE program. The program should address the hazards present, the selection of the proper PPE, maintenance, proper use of PPE, the training of employees, and monitoring of the program to ensure its ongoing effectiveness.

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Back in February of 2015, the MTMIC Board of Directors, after reviewing the 2014 company results declared a members dividend of $2.5 million. This dividend was actually two parts: $1.5 million to be paid to members with an outstanding loss ratio and $1 million paid to all members. Checks were issued and delivered in March and early April. If you have read a few newsletters from 2015, you may recall that I wrote about how much fun it was delivering checks and how I looked forward to a “repeat” in 2016.

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Well the “repeat” has arrived! I am pleased to report that on February 18, 2016 the Board of Directors completed a review of 2015 MTMIC results. After carefully reviewing company financial results for 2015, they determined that a member’s dividend of $3.5 million would be paid in March of 2016. This is a terrific result for our members and also for MTMIC. The $3.5 million is once again made up of two parts. A member’s loyalty piece of $1.4 million. Last year it was $1 million. Also, a second dividend of $2.1 million for accounts with an outstanding loss ratio. Last year the loss ratio piece was $1.5 million.

Since the board meeting, the staff has been putting together the systems to make sure that all the checks are issued properly and that the distribution process is efficient. We expect to start delivering the checks to members on March 7th. Last year it took about four weeks to complete the process and we anticipate it will be similar this year.

The member dividend is one of the most important benefits of being an MTMIC policyholder. We are not a large commercial company where the profits go to outside investors or other stockholders. Our 824 members receive the rewards from the company operations. Last year while we were pleased with the $2.5 million, being able to increase it for this year will make it even more fun. Like last year, we will take some member pictures for an upcoming MTMIC newsletter. We discovered it was pretty easy for a member to smile once you hand them a check.

On behalf of the Board of Directors, the management team and staff at MTMIC congratulations on having a terrific 2015 year which made this dividend possible. We will see you soon.

By Donna Motley, Vice President of Claims

Our office will periodically receive telephone calls from insureds with questions concerning the occupational clinic they utilize, i.e. where should they send employees, does MTMIC have to approve the clinic, what clinics are near their facility, are some clinics better than others, should bills for service be sent directly to the insured or MTMIC, etc.? Our advice is always the same: an employer should develop a relationship with an occupational clinic that is close to their facility. You should be able to call your clinic and talk “one on one” with the staff – including the physicians. In most cases, they will welcome the opportunity.

MTMIC’s Claims Department reviews all medical records and bills related to work injuries. At the end of last year, a couple of issues arose on a couple of claims that involved 4 Concentra Occupational Clinics. Two cases involved continued treatment without authorization, another involved a physician refusing to comment on “causal relationship” and the last involved Concentra’s billing department changing their mind about a verbal compromise agreement in a litigated case. As I had recently attended a seminar sponsored by Concentra, I was aware of their alleged treatment and procedure philosophies. SO, I contacted the Concentra Medical Director and Concentra Director of Sales. The Medical Director, who is a doctor, called me to discuss the particulars of the cases. We did not necessarily agree on what constitutes proper protocol, but he asked that I follow up our conversation with written proofs. Which I did. (I had also consulted legal counsel to assure I was accurate in my interpretation of the Workers’ Compensation Act on which I based my contentions – and I was.) After going back and forth a couple of times, I am happy to say we have been able to amicably resolve all issues.

A couple of weeks ago, Kimberly Davis and I met with the Concentra Medical Director and the Sales Director to discuss the Workers’ Compensation industry and the roll each of us assume. All parties felt it was a very positive and enlightening meeting. There are 16 Concentra locations in the Metropolitan area and 2 locations in Grand Rapids. I know a vast number of our insureds utilize Concentra’s services. A Concentra advantage – they employ 28 specialty doctors that include Orthopedic Surgery, Hand Surgery, Physical Medicine & Rehabilitation, General Surgery, Neurosurgery, Spine Surgery, Hand Plastic Surgery and Foot & Ankle Orthopedic Surgery. This means we can usually obtain a quicker referral to a specialist. All of the specialty physicians have their own practice and treat outside of Concentra as well. They are not “just a clinic doctor”.

We have also been given a list of each Center Medical Director, Center Therapy Director, Center Operations Director and Center Sales Manager for each Concentra location. We have been encouraged to call any of the Directors at any time to discuss any issue that may arise. They encourage open communication between the employee, employer and insurance carrier. They agreed that employers should invite the clinic doctor to walk through the employer’s facility and look at individual jobs and functions being performed so they better understand an injury and how to treat same.

Overall, Concentra seems earnest in providing quality care and working with employers and employees for a successful outcome in returning the employee to work. What started out as a service complaint resulted in a closer working “partnership”. We will soon be touring a Concentra facility and so can you!

As we closed the 2015 accounting year and start work on the 2015 dividend for presentation to the MTMIC Board of Directors in February, it is interesting and helpful to know the company history and culture that history built. MTMIC dates back to 1976 when the Detroit Tooling Association (DTA) took advantage of en
abling legislation which permitted employers in the same industry to establish a group self-insurance fund.

At the time the Fund was formed the cost of Workers’ Compensation was exponentially increasing on an annual basis and becoming a negative influence on the ability of the tooling industry to remain viable in Michigan. The DTA Workers’ Compensation Fund was established to service the needs of the local tooling industry and it soon became the Michigan Tooling Association Workers’ Compensation Fund (MTAWCF) as membership grew outside of the local area.

The Fund was governed by a Board of Trustees representing the tooling community. With their direction, the MTAWCF developed programs which resulted in millions of dollars in reduced insurance premiums while providing dividends to the members of the Fund through effective cost control, improved safety and vigilance against fraudulent claims. Does that sound familiar today?

By 2006 the tooling environment was changing and management attempted to restructure the program to reflect that changing environment. The State of Michigan however would not permit the Fund to broaden the definition of “tooling” to include the many manufacturing operations currently involved; this limited the ability of the Fund to grow and change with its members.

Many months were spent determining the best course. At the end, Management and the Board of Directors agreed that a mutual insurance company would provide a structure similar to the Fund, and allow for the continued success and growth of the group. In 2007 the change was made and MTAWCF became Manufacturing Technology Mutual Insurance Company (MTMIC).

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MTMIC is still governed by a Board of Directors elected from among the policyholders. The policyholder body has, as expected, grown to include many aspects of manufacturing and related industries as the growth of the organization has accelerated over the ensuing period. However, the culture from the Fund of effective cost and loss control, aggressive claims management and one on one service for our members carries over to MTMIC today.

Now for the MTMIC management team, back to working on YOUR dividend. More on this member benefit in the next newsletter.

By Donna Motley, Vice President of Claims

What is meant by “late reporting”? Typically, we like to receive notice of injuries (via the Form 100 – Employers Basic Report of Injury) within a week of the occurrence. The earlier a report is submitted, the earlier we can set the claim up in our system. Then, if there are telephone calls regarding medical treatment, we will at least have the basic information. The “basic” information required to set up a claim is the employee’s name, address, social security number and date of birth. Obviously, we need to know the type of injury and body part involved. We also require the employee’s date of hire, occupation and the date the employer was notified of the injury. These are mandatory fields to obtain a claim number. You can submit an injury report without knowing the current medical status, treatment plan or whether or not the employee will be losing time from work. We can obtain that information once the claim has been established.

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By Travis Halsted, Loss Control Consultant
fire-hydrantAs the winter months are upon us, so is the use of furnaces, personal heaters, propane heaters and a plethora of other heating devices. These heating devices can often cause safety concerns, especially those regarding
potential fire factors. This concern brought about thoughts of other fire hazards that we see during loss control visits and how to possibly remedy those hazards. During our loss control visits, we attempt to identify potential and present exposures for that particular facility. As each facility is different and may complete different processes, the hazards found will vary. Possibly, one of the most effective ways to avoid fires, is to aim at strategic fire prevention.

How can fire prevention be strategic you ask? By recognizing the hazards, putting procedures in place, auditing those procedures and continuing education for new and existing employees, your workplace will strategically reduce the likelihood of a fire. Fire hazards can be found within office settings, maintenance areas, industrial production floors, paint booths, plating facilities and other types of environments. This often leads companies to question what they can do to properly prevent fires. The topics below are just some of the items that I often make recommendations about during the loss control visits. These particular topics could greatly assist in fire prevention.

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By Glenda Moyle, Premium Accounting Manager

This is just a reminder to all of our Policyholders that our audit company, The Aprise Group, will be doing the final audits again this year. They have been our audit company for the past 25 years. Once your policy expires, they will be contacting you within 30 days to set up an appointment to do the audit. If you have any questions, please contact me at glenda.moyle@mtmic.com/blog. Thank you for being a member of the MTMIC.

By the time you get this, the holiday season will be over and I hope you enjoyed it with your family. At the same time, you’re already busy with 2016 business activities. We at MTMIC, are in that same situation. As quickly as possible we are closing out the financial numbers for December 31, while also working on business issues for 2016. I expect that the next newsletter will have a first indication of the actuarial and claims numbers from 2015. These numbers will presented to the Board of Directors in February for Member Dividend declaration.

For this newsletter, it seemed like a good time to reintroduce three key contacts at MTMIC. One of the hazards as President of doing this, is you can never only pick three. I will address more staff in a future newsletter. But for this newsletter, let me start the staff introduction process. The first is Glenda Moyle. Glenda is our Premium Accounting Manager and also handles the endorsements and certificates of insurance. Many of you have known Glenda for many, many years. I have to say our company personnel records from 30+ years ago are not that accurate. Glenda has been with us somewhere north of 35 years and is the encyclopedia of MTMIC. Any premium or endorsement questions, Glenda is the key player. What you may not know, is that Glenda is also the MTMIC Corporate Secretary. She covers lots of territory.

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By Ruth Kiefer, MSc, ARM, Loss Control Manager

Many of our manufactures and policyholders may or may not know we also have been servicing the printing industry for a few years now. During this time I have been asked on numerous occasions what does MIOSHA compliance look for in our industry? During one of our recent training events with MIOSHA, I had the opportunity to inquire about which standards MIOSHA refers to when they conduct a compliance visit in a Printing facility.

paint-cansHaving seen most of our workers’ compensation injuries related to inadequate LOTO (Lockout Tagout) procedures and where the majority of our members have the most questions; I directed our conversation to the LOTO requirements and what they are looking for. What I found out was in the 1990’s OSHA and ANSI came together as a board to interpret and clarify what actually applies to the printing industry, since there are a variety of printing presses with different technologies, and most of them spanning many years.

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By Donna Motley, Vice President of Claims

Screen Shot 2015-12-31 at 7.16.58 PMHAPPY NEW YEAR – 2016! A new year – new beginnings – new opportunities to change. How did your 2015 end? The Claims Department ended with a BANG! As if there aren’t enough challenges in our lives and in the work place. We contend with family, friends, health issues, school, our homes and work on a daily basis, and then, the HOLIDAYS arrive and add a lot more stress! Even though we may look forward to the holidays and consider it a “happy” time, it can be stressful, none the less. There is shopping to contend with, trying to get just the perfect present for everyone, entertaining, socializing, all adding up to an extra financial stress. People are using up vacation time and trying to get work caught up before being off for a day or more.

Is it any wonder our department sees a spike in claims at the end of the year? With everything going on, people are more pre-occupied and distracted. It is even more dangerous driving a vehicle because we are distracted by the bright lights and holiday displays along the way. Or maybe someone just left a holiday party where alcohol was served. All this on top of drivers using their cell phones while driving.

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First, I hope you and your family had a wonderful Thanksgiving holiday. The Karlen’s had the normal family get together. Weather cooperated, and we all arrived at the right place at the right time. That in itself, is something to be thankful for.

This is a busy time of year where we deliver renewals to over 300 members. During these deliveries and renewal discussions, I keep a list of frequently asked questions. Here’s one of the top three that you may find interesting. The question is, “What are the benefits of being an MTMIC member?” There are several answers to this, so here are a few.

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The State and Federal Labor Law Posters should be arriving in your mail at the end of the month so be watching for them!

By Chris Demeter, Senior Loss Control Consultant

What is a “near miss?” Webster defines it as: “A result that is nearly, but not quite, successful.” What does this mean to business? It simply means that a serious accident almost occurred.

Statistics tell us that for every 300-near misses there is one serious injury. According to the Bureau of Labor Statistics (BLS), more than threemillion recordable non-fatal injuries were reported in 2013. If we multiply each injury by 300, the result is 900-million near misses for 2013 alone.

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As you may recall, last March, the MTMIC Board authorized distribution of $2.5 million of profits to members. The dividend covered policy years 2010 – 2012. The dividend was comprised of two parts:

  1. Loyalty – how long have you been with MTMIC. All members with coverage during the covered or beginning during the “covered years” and still in force as of February 28, 2015 shared in this dividend part.
  2. Great loss ratios – accounts with outstanding loss ratios during the “covered years” shared in a second dividend. The end result was an average dividend of 19%. A total of 108 members received a dividend that exceeds 50% of their current annual premium. Yes, that is very cool.

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By Donna Motley, Vice President of Claims

I’ve written in the past about Fraud in Workers’ Compensation. Types of Insurance Fraud include: Welfare, Unemployment, Mortgage, Automobile, Healthcare, Medicaid, etc.

This year we had our tri-annual State Audit and one of the questions they asked was how we handle fraud. We would first have to define “fraud”. Webster’s dictionary defines fraud as: “intentional perversion of truth in order to induce another to part with something of value or to surrender a legal right”. Per the Insurance Institute of Michigan website, an example of (insurance) fraud (pertaining to Workers’ Compensation) is: exaggerating the extent of a minor injury to collect (W/C) benefits; billing insurance companies for medical services that were not rendered. I think we can take it further. What about alleging a work injury when the injury really occurred outside of work? Or what about the person who alleges their medication was “stolen” and they need another re-fill when the reality is that either they are addicted to the drug or they are selling the pills on the street? What about the person who claims they need “in home assistance” because they are too incapacitated to even make themselves a sandwich? Or how about the person that won’t let the Nurse Case Manager in the examining room so they can tell the doctor how heavy or repetitive their job is, or their pain level is a 14 on a scale of 1 to 10?

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labor-law-posterIt is that time of the year when you will be receiving sales calls informing you that there have been important changes on the State and Federal Labor Law posters.We are aware of those changes and are in the process of compiling these updates ~ please expect your new 2016 updated labor law posters to arrive at the end of December.

By Megan Brown, Vice President of Sales & Marketing

Annual Meeting 2015As a followup to all of the announcements and details of our Annual Meeting, I thought that it would be interesting to give you an idea of how it went. We had the largest turnout in our 39-year history and my goal is to carry this momentum into our 40th year. The agenda was packed with presentations from Denise Williams, a Performance Consultant from the University of Michigan who discussed distracted workers and the effects that it has on work productivity. Martha Yoder, the Director of MIOSHA provided proactive approaches to creating a safe and healthful worksite. John Karlen and Chris Doebler presented details on the company overview and financial status. During the meeting, MTMIC also signed the 2016 MIOSHA Alliance which assists our members in raising awareness of MIOSHA’s rulemaking and enforcement initiatives, provide training and education as well as enhance communication and outreach related worker productivity. The food was excellent, the company was great and the meeting ended on time. We hope that you will join us next year.

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posterIt is that time of the year when you will be receiving sales calls informing you that there have been important changes on the State and Federal Labor Law posters.

We are aware of those changes and are in the process of compiling these updates ~ please expect your new 2016 updated labor law posters to arrive at the end of December.

By Glenda Moyle, Premium Accounting Manager

surveyWell, we have started working on the January 2016 renewals. I have been working on these for over 30 years and it’s hard to believe that another year has sped by.

If you have an effective date in January, you should have already received your payroll renewal form asking for new estimated payrolls for the 2016 policy year. The goal is to accurately estimate payrolls which reduces the chance of a surprise audit of additional premium.

A common question I hear is what do we do if the payroll estimate form is not returned to MTMIC? Well, we use the higher of your 2014 audited payrolls or your current policy (2015 estimated) payrolls for your quote. It is never too late to send the form back to us. We can always revise your payment schedule.

If you need another copy of the payroll form please contact me at Glenda.moyle@mtmic.com/blog

By Donna Motley, Vice President of Claims

If you have ever been involved in litigation, you are aware that the legal process moves at a snail’s pace. Workers’ Compensation litigation is no different. The average litigated case takes approximately 2 years to resolve; that’s resolution without trial. If the case goes to trial, it would be even longer than 2 years. The Workers’ Compensation Agency has now put rules in place in hopes of expediting the process to “18 months”. As an employer, it is understandable how frustrating this can be – we feel your pain! Let me explain what happened on a recent case.

The “alleged” injury “allegedly” occurred on March 25, 2013. After a verbal altercation with a co-worker, the 52 year old employee walked off the job. The employee went to an emergency room the next day and returned to work on March 28, 2013 and proceeded to walk off the job again. The employer informed the employee to report to work on April 1, 2013 if they still wanted their job. Instead, the employee returned to the emergency room on March 31, 2013 and called the employer on April 1, 2013 to advise of the alleged work injury (first notice of claim).

The Claims Department was notified of the incident on April 11, 2013 – 17 days after the date of injury. The insured advised they wanted us to “take a hard line on this” claim. The employee alleged a back injury after lifting a box; names of witnesses were provided. Three witnesses were contacted, and no one knew anything about any type of injury the claimant may have sustained. Medical records were requested from the treating physicians.

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