By Donna Motley, Director of Claims

Communication in our industry is crucial. We have at our disposal multiple ways to communicate, telephone, computer (e-mail), faxing, even the old fashion form of “written” communication. In the Workers’ Compensation arena, we still need “written” proof of a claim. As you are aware, the Employers Basic Report of Injury (Form 100) must be submitted before we can physically set up a claim file. Obviously, the form needs to be completed properly in order to fill in the fields required by the computer. Claim information is tracked by the State of Michigan – hence the required fields.

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As a MTMIC policyholder and mutual company member, it is important I give you management updates on the company similar to my reports to the MTMIC Board of Directors. Our mid-year review is a perfect time for a MTMIC 2014 update business plan goals such as sales, loss control visits, claims activity, underwriting service and company investment status. All of these are important service standards for MTMIC policyholders.

When reviewing with the Board I use a “Green Light”, “Yellow Light” and “Red Light” approach. “Green Lights” signifying that we are on target with our goals and barring some significant change, we will meet these business goals. “Yellow Lights” informing the Board that the goal is in jeopardy and that management is refocusing and moving resources to achieve these goals. “Red Light” meaning the goal for some business reason is no longer valid or costs of the goal have exceeded the budget and the goal needs reassessment.

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By Donna Motley
Director of Claims

The cost of insurance, any kind of insurance, is not cheap. As premiums escalate, there appears to be a new “buzzword” – FRAUD. While the notion of fraud is not new, more and more people are starting to get angry and show interest in putting a stop to it. Some states (not Michigan) have started movements to prosecute those committing insurance fraud. I read recently that Michigan’s automobile premiums had the largest increase in the U.S. in 2013 because of claims paid outside of property damage. That would mean the bulk of payments were for “alleged” injuries and medical care.

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By Glenda Moyle
Premium Accounting Manager

Every year after the final audits are completed we have a few companies who have a significant audit balance due. As much as you hate paying these surprise audits we dislike collecting on them.

One way to avoid this would be to take a look at your estimated payrolls and compare it to your actual payrolls. You can find your estimated payrolls on your current declaration page broken down by class code.

If you find that your actual payrolls are above your estimated payrolls and you wish to revise them please contact me at glenda.moyle@mtmic.com/blog or you can call me at (800) 274-5606 X1315 with any questions you might have.

ByRuth Kiefer, ARM
Loss Control Manager

I’d like to take a moment to explain the reason why my staff and I take safety very seriously when we survey your facilities. Our time doing this job has taught us one thing, that when things go wrong, they are quick and unforgiving. During our safety walkthroughs of your facilities, we try to encourage you to address certain hazards, we may sound like broken records at times, and there is a clear and fateful reason why we do. Injuries and deaths occur all the time in our industry. It is real. We see it first hand, we investigate it, we analyze the data, and we crunch the numbers. It may be just a story that you read, a highlight on the nightly news, but these are real people, that could have been your own employee. Or perhaps have been one of your employees.

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While I normally provide our newsletter with current issues in Michigan Workers’ Compensation, this month is different. I am asked regularly about MTMIC ownership and governance. These are great questions for a small, specialty driven workers’ compensation carrier like MTMIC. For our first 30 years of operation, we operated as a Self-Insured Fund. Since January 1, 2007, we have been licensed as a member owned mutual insurance company. Everything we do is based on what is in the best interest for our member owners and we have no outside investors that direct our pricing decisions or we pay fees to. I report to the 10 member Board of Directors, many of them have a long history with the company. The ten Board members include:

6 – Business Owners
2 – Chief Financial Officers
1 – Human Resource Vice President
1 – Retired Business Owner

Their firms cover the range of 10 to 400 employees. Some have business in other states and a couple have business in other countries. Needless to say, my “bosses” have a wide and vast range of skills and experiences. My focus and the company course is set by the Board. In the next few newsletters you will see profiles of these important people as they are an integral part of the MTMIC success story.

In fact this is a time to give you an early invitation of the Members’ Annual Meeting which is Thursday, October 16th. This year the meeting is at The Inn at St. Johns in Plymouth and lunch begins at 11:30. MTM Board members and the entire staff attend the meeting. Feedback from members who have attended previous meetings is that it was time well spent. In the next couple months, I will have more meeting details.

By Travis Halstead, Loss Control Consultant

As the warmer months are quickly approaching, many of your facilities will be directly affected by the increasing temperatures. As you do not have the ability to close your facility for the summer, it is essential that we try to identify the symptoms of heat related illnesses and ways to prevent them. Through proper training and some other proactive steps, there will be a better chance of reducing the possibility of your employees being exposed to heat stress.

By employees being exposed to extreme heat they are more apt to heat stress. While workers that are 65 years of age or older are at a greater risk of having heat stress, other individuals that are overweight, have heart disease or high blood pressure, or take medications may also be easily affected by extreme heat.

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It is June; and impossible to believe that nearly half of 2014 is gone. You might remember me, I am Gary Wood; I was the COO of the MTMIC and the Administrator of the MTA Workers’ Compensation Fund from 1998 to 2013. Last year I made the decision to step back when I recognized two things; 66 is more than a number and after 15 years there needed to be a new stimulus for growth.

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Experience Modifications have been used for decades as a method to adjust employer’s workers’ compensation premiums based on their own loss experience. Good experience would earn a credit experience modification, an experience modification below 1.00. Loss experience higher than anticipated in the rate results in an experience modification greater than 1.00. This is all old news. So what is new? Three inquires in the last 6 months from our policyholders about their experience modifications. That by itself is not usual. What was unusual is that all three had a significant panic in their call. In each case, the insured’s largest customer was letting them know that future work was being discontinued because their experience modification was above 1.00. (more…)

Early in 2014, MTMIC obtained its first independent rating organization evaluation. The rating agency is Demotech, Inc. of Dublin, Ohio and has nearly 30 years of insurance industry rating experience with a proven track record. Their review included analysis of MTMIC financials, investments, claims history, actuarial reports, reinsurance and staff experience. On April 22nd, Demotech, Inc. distributed an industry press release summarizing their review with an announcement that MTMIC was assigned an “A” (Exceptional) 2014 Financial Stability Rating

We, the MTMIC staff, are proud of our Demotech, Inc. rating in that it confirms what we know about the strength of MTMIC.

By Donna Motley, Director of Claims

Late reporting of employee injuries can be costly in multiple ways.

We received a claim on August 16, 2013 for a July 3, 2013 injury date – approximately 6 weeks after the injury allegedly occurred. The employee said they “bumped” their elbow on a part. The diagnosis was “post traumatic olecranon bursitis”. The employee did not lose time from work. The employee treated for the condition on July 3, 2013 (the day of injury), July 8, 11, 22, 29, and October 8, 2013 when they were discharged from care.

Notice there were five visits with the medical provider before we even received the injury report. Per the Workers’ Compensation Act, the W/C provider/insurance carrier exclusively directs all medical treatment for the first 28 days! In this particular case, we lost that opportunity. Could we have shortened the length of this claim and thereby the amount spent – very likely!

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…that you can now receive an email from us notifying you when a claim is received in our office and when that claim is closed? In order to receive the email alerts from us, please log in to the Client Portal at www.mtmic.com/blog. Select the Contacts tab and enter the email address of the individuals that would like to get the email alerts. For additional information, contact Patty Allen at patricia. allen@mtmic.com/blog.

By Glenda Moyle, Premium Accounting Manager

MTMIC is updating our Officer Exclusion procedure. Effective immediately, renewal policyholders will NOT have to fill out a new Officer Exclusion form. We will automatically renew the officer exclusions unless we hear different from the company or the company’s agent. Polices for new companies will still require the Officer Exclusion form. We hope you find that the elimination of the Officer Exclusion form on renewals will improve efficiency and effectiveness of the renewal process.

Just as a reminder, it is very important that you double-check your documents from us and let us know of any corrections that need to be made.

This month I will deviate from my normal Workers’ Compensation issues and use my column to welcome a new MTMIC Board Member, Karen Schluckebier. Karen became a Board Member in March and attended her first MTMIC Board meeting April 17th. The Board Members and the management team are delighted that Karen joined our Board. She brings some skill sets that are valuable to the Board and helpful to the management team. The following is a short bio on Karen:

Karen has worked for the Rogers Group in Clare, Michigan since 1999. The Rogers Group is a multi-company group including StageRight, Filcon, Rogers Athletic, World Sporting Good, and Tranquil Systems International. She currently holds the senior manager position as Director of Human Resources with human resource responsibilities for all Roger Group companies. Karen has played a key role with acquisitions and other risks to the company. Karen has worked in the area of human resources including training & development since 1985. (more…)

On June 5, 2014
9:00 am – 11:00 am

This FREE Coffee with MIOSHA event at Vis Ta Tech will include representatives from administration, wage and hour, general industry and construction. This is a great opportunity connect with MIOSHA to have your questions answered and meet MIOSHA staff. MIOSHA will also provide information on program services and resources.

Vis Ta Tech at
Schoolcraft Community College

18600 Haggerty Rd – Livonia, MI 48152
RSVP To: Jennifer Clark-Denson
clark-Densonj@michigan.gov

By Travis Halsted, Loss Control Consultant

As the season of melting snow begins and the use of air movement fans is once again seen, it is essential to determine how the risk of trips and slips resulting in falls in the workplace can be eliminated. According to the 2009 statistics from the Bureau of Labor Statistics, 605 workers were killed and an estimated 212,760 workers were seriously injured by falls to the same or lower level (Centers for Disease Control and Prevention, 2014). Occupational fall injuries result in approximately $70 billion spent annually between medical and workers’ compensation costs (Centers for Disease Control and Prevention, 2014). From these staggering numbers the need to prevent this type of injury is high on many safety committee lists.

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By Cindy Boyce, Senior Claims Adjustor

In the majority of Workers’ Compensation cases employees who are injured at work recover and return to work. In some cases employees do not return to work claiming that they are still disabled from the work injury. A small percentage will end up in court and enter into litigation by filing an Application for Hearing. Shortly after the Application is filed, it is processed by the Workers’ Compensation Agency and the employer will be served with an Acknowledgement and Notice of Hearing. Below are a few recommendations that will assist you in understanding the litigation procedure.

1. Once a claim is disputed, the employee may resort to filing an Application for Hearing.

When you are served with the Acknowledgement and Notice of Hearing, you will note the Magistrate assigned to hear the case, the hearing site and the date of the initial pretrial hearing. In most cases, the adjuster will also be served. However, it is recommended that you contact MTMIC upon receipt of the Application to confirm that we have been served.

Once we receive the Application for Hearing, we will retain an attorney to represent your company’s legal interests.

In most cases you will not be required to attend the pretrial or subsequent hearings unless we have notified you otherwise.

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Adverse Pricing Changes

A couple times a month our policyholders call me and ask me about adverse pricing. Their question is, “How did it happen to me, and what are the causes”? While this is not a frequent question, I have to say it is one where the customer is the most concerned and anxious for answers.

My answer to this question first starts with a review of company payroll/growth. Sometimes it is a simple review – the payroll for your company has gone up by 50%. There is no rate increase; your premium increased because your company and its payroll is growing. If there is no increase in payroll or the increase is minor, then we move to the two primary causes of adverse pricing/rate changes. Within these two causes, there can be an impact at your next policy renewal as well as an impact a year or two later.

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By Chris Demeter, Senior Loss Control Consultant

Flammable liquids are used in many different ways. They present unique hazards to the people that use them. Flammable liquids can cause a fire or explosion, and like many other substances, they can also cause serious health effects from overexposure.

Flammable liquids are liquids with a flash point of less than 100F. The flash point is the lowest temperature at which a liquid gives off enough vapor to form a flammable mixture with air. On the NFPA diamond label, a fire hazard rating of three or four denotes a flammable liquid. Other labels used to identify flammable liquids are red with appropriate wording and they usually contain a fire symbol.

The vapors of a flammable liquid often present the most serious hazard. The vapors can easily ignite or explode. Flammable liquid vapors are heavier than air and may settle in low spots, or move a significant distance from the liquid itself.

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Our 2013 financial results have been finalized with our actuary. The good news is that through loss control efforts and claims handling by our policyholders, MTMIC made a small underwriting profit for the year. A small underwriting profit is in line with a primary company goal of keeping our customer’s rates as low as possible. Additionally with some conservative investment of company funds, we added to that bottom line. Sometimes I am asked where do our mutual profits go? There are only two places: 1) a company surplus account and 2) policyholder dividends. Given the size of the profit, we have put the money in the company surplus account. This account provides a buffer if we have a year where the results do not generate a profit – that is, losses exceed our collected premium for the year.

In the workers’ compensation insurance business good results just don’t happen. It takes a wide range of people involved. It takes mutual policyholders who worry about loss control and their individual company claims experience. It takes professional insurance staff providing loss control support services to our policyholders. By the way, at MTMIC, we have one full time field loss control consultant for every 240 policyholders. This is a commitment and focus that no other Michigan insurer can match. Beside the focus of the staff, we provide safety training videos, training documents, ergonomic tools and written safety programs in the tool box to help our policyholders.

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