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Posts by: Marc Lanzkowsky

  1. Medicare Secondary Payer Enhancement Act Being Introduced in Congress Could Address Many Concerns of Section 111 Reporting March 23, 2010

    Posted in Medicare Secondary Payer, SPOT on Ops.

    Dealing with MSP Can Feel Like Walking Into a Maze The Medicare Secondary Payer Enhancement Act of 2010 (HR 4796) is a new piece of bi-partisan legislation introduced on March 9, 2010. It is designed to streamline Medicare Secondary Payer reporting and provide some finality for insurers required to reimburse Medicare for “conditional payments” of […]

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  2. The 5 Essential Components of Defense Attorney Reports That Can Improve Claims Costs and Outcomes March 14, 2010

    Posted in Commentary, My SPOT, SPOT on Costs.

    Why are Attorney Evaluation Reports sometimes so light? I was recently conducting an audit of claim files and had the opportunity to review a significant number of Attorney Evaluation reports from a variety of law firms. Like many other things in life, some were better than others. What seemed to be most glaringly consistent was the inability of counsel to truly provide an assessment of exposure and what the case is worth. Every counsel evaluation report should contain 5 basic components that I outline and attorneys should be required to provide their actual valuable opinion. [More…]

    7 comments
  3. Considering Forming a Captive? Maximize Your Claims Benefits In 3 Steps March 10, 2010

    Posted in SPOT on Ops.

    The Benefits Of Forming A Captive Are Great – IF – You Set It Up And Manage It Correctly The use of captives as an alternative means for managing risk is growing rapidly  (read a nice overview of captives at the Captive Counsel Law Group). Changes in laws, increasing tax benefits and control over assets […]

    1 comment
  4. Saying “I’m Sorry” Can Reduce Exposure to New Claims March 5, 2010

    Posted in Commentary, Medical Malpractice, My SPOT, SPOT on Costs.

    It may seem counter intuitive, but with the right technique a heartfelt apology can help lower claims costs and exposures There is a wave of civility sweeping through the world of risk management as a way to lower exposure and reduce costs: Apologize. Maybe mom was right when she stood there and said “now say you’re sorry.” In fact, there are some very impressive statistics in the area of medical malpractice around the simple use of an apology. Regardless, there is a proper way to apologize while protecting rights and some policy considerations to consider.

    3 comments
  5. 7 Considerations When Drafting Claims Guidelines March 1, 2010

    Posted in Best Practices, Compliance, SPOT on Issues, SPOT on Ops.

    Claims departments employ professionals that want to do a good job for policy holders as well as the company, and claims guidelines should help foster those goals. Before drafting guidelines there are a few things that should be considered and we, along with our fellow blogger Phil Loree, suggest 7 things a company should consider when drafting claims guidelines.

    5 comments
  6. Thinking Outside The Box: Litigation management program initiatives can substantially lower costs February 25, 2010

    Posted in Litigation Management, SPOT on Costs.

    Managing litigation is an easy way to save extra expense costs on claims files. A strong litigation management program designed to help foster improved communication, and streamline defense of insureds, benefits all parties involved. As I wrote about the cost savings benefits of out-of-the-box claims handling, using new and forward thinking strategies for litigation management is an excellent way to save money. Using specialized vendors, claim handlers can further control legal costs as well as enhance their defense.

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  7. 3 Essential Report Types That Insurance Executives Should Use To Analyze Their Claims February 23, 2010

    Posted in SPOT on Ops.

    Today’s modern claims systems have a wealth of knowledge about every aspect of claims operations. With the right reports it should be easy to get a basic snapshot of how effective your claims are being managed, and how well your business is doing. With all that information where is one to start? What are the key metrics that should be reviewed by claims and business executives to better understand their operations? We give three specific report types that claims executives should review on a regular basis to get a valuable snapshot of their organization.

    1 comment
  8. Important Update: Medicare Secondary Payer changes production date to January 1, 2011 February 18, 2010

    Posted in Medicare Secondary Payer, SPOT on Issues, SPOT on Ops.

    The Centers for Medicare/Medicaid Services (CMS) have announced the following: CMS advises all NGHP RREs that the date for first production NGHP Input Files is changed from April 1, 2010 to January 1, 2011, effective immediately. Read the complete announcement at the CMS website in “What’s New.” This is clearly a welcome change and one […]

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  9. Absence of procedures to notify reinsurance is a basis for bad faith February 17, 2010

    Posted in Bad Faith, Best Practices, SPOT on Issues.

    Recently I was discussing bad faith and notice procedures with attorney Phil Loree Jr., an expert on reinsurance and arbitration issues and author of the the Loree Reinsurance and Arbitration Forum blog.  I thought this was a timely conversation as it reinforced the concepts regarding procedures and the potential risks when they are not in […]

    6 comments
  10. 5 Claims issues cited for non-compliance on market conduct exams & 3 tools to avoid them February 15, 2010

    Posted in Best Practices, Compliance, SPOT on Issues, SPOT on Ops.

    Insurance Market Conduct examinations are a regular part of the insurance business. Besides the stress of the exam itself, being cited for violations can result in costly fines. Regardless, many citations can be avoided. Every year, insurance compliance solutions provider Walters Kluwer releases its annual study of top ten reasons insurance companies are found to […]

    3 comments
  11. Blizzard Warning in the East! Can your claims department keep running if the office closes? February 10, 2010

    Posted in SPOT on Ops.

    The East Coast snow storm is a great reminder to be prepared for disasters and other reasons why your office would have to close. Do you have the plans in place to manage the next event? Does your claims system give you the ability to manage claims remotely? Can you manage claims remotely for an extended period of time?

    2 comments
  12. Improve bottom-line outcomes on claims by thinking outside-the-box! February 9, 2010

    Posted in Best Practices, SPOT on Issues.

    Claim handling is just as much an art as it is a science. Synthesizing facts and investigating losses requires, not only following process and procedures, but also the ability to look at new ways of solving established problems. Following best practices is of course an effective way to achieve consistently good claims results. Regardless, the […]

    1 comment
  13. Med Mal Update: Reasons for decrease in frequency and recent Illinois court decision to strike down damage caps February 5, 2010

    Posted in Medical Malpractice, SPOT on Issues.

    In response to my post, medical malpractice report shows increased severity despite lower frequency, I received a number of LinkedIn comments that I felt offered an interesting perspective on this topic. I have included some of that discussion below. Additionally below, I review the news that the Illinois Supreme Court has struck down that state’s […]

    1 comment
  14. Warning – Medicare Secondary Payer (MSP): Government sends strong message and goes after non-compliance February 3, 2010

    Posted in Medicare Secondary Payer, SPOT on Ops.

    If you are an insurance company or self-insured, and make payments on liability or workers’ compensation claims, be aware that the Federal Government has filed a lawsuit signaling their intent to be aggressive in seeking reimbursement. As reported in Business Insurance, this “case breaks new ground because CMS simultaneously named insurers, settlement beneficiaries and plaintiffs attorneys all in one lawsuit.” This case should alert all that if you make a payment on an injury claim, and fail to let the Government know about money they should be collecting, they will come after you.

    2 comments
  15. Failing to properly document files can be costly – It cost one insurance agency $5.83 Million February 1, 2010

    Posted in Best Practices, Commentary, SPOT on Ops.

    Files should speak for themselves. A recent California decision is yet another example of what can happen if you don’t document your files and maintain procedures. In this case – it cost $5.83 million.

    No comments
  16. Better claim reports can help improve producer/carrier communications (take our poll) January 29, 2010

    Posted in Customer Service, SPOT on Ops.

    Improved producer carrier relationships can be a competitive advantage to help increase profitability in tough economic times. According to the survey, a key differentiator for carriers to attract more business from their producers is in the areas of claims handling and technology. Most modern claims systems can create automated customized reports. Producers should be able to ask for specific reports and have them electronically scheduled for delivery. Better reporting will go a long way to improving relationships, and can only help increase profitability and enhance service to the policy holders.

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  17. Medical Malpractice report shows increased severity despite lower frequency January 28, 2010

    Posted in Medical Malpractice, SPOT on Issues.

    The Insurance Information Institute has just released a comprehensive look at Medical Malpractice outlining recent developments and industry trends (read more at Medical Malpractice: The Topic). This article breaks down the industry by looking at, among other things, market conditions and national developments. Key highlights include Damage caps can save $54 Billion in medical costs […]

    2 comments
  18. 5 expense reduction opportunities insurance CEOs should not overlook January 27, 2010

    Posted in SPOT on Costs.

    Increased profits come from efficient claims operations: Take a look at that annual reports of the top performing insurance companies and you will see a similar message from their CEO’s. Expense management and efficiency is a principal driver of profitability.In a tight market do less with more without sacrificing quality and significantly customer service is the edge needed to be a top performer. The claims department is the perfect place to lower costs and improve the customer experience at the same time. Here are 5 key areas that should be looked at for cost savings.

    No comments
  19. Are claim departments’ process and systems ready for the new “Freelance Nation” worker? January 26, 2010

    Posted in SPOT on Ops.

    Can claim departments handle the change in the American workforce. The insurance industry has struggled in recent years to attract and retain new talent, especially in claims organizations. In an effort to continually provide the best talent, as well as provide the best customer service, more of the “Freelance Nation” will need to be employed. To do this, claim organizations will need to employ strong procedures and up-to-date technology to ensure optimal performance from this more fragmented workforce. Are they ready?

    2 comments
  20. A checklist of the 8 critical issues to be concerned about when self-managing claims January 25, 2010

    Posted in SPOT on Ops.

    You self-insure, but how well do you manage claims? Companies make decisions to self-insure their risks for a variety of reasons from financing to claims control. Regardless of the reason, when handling claims in-house it is important to manage those claims in an organized manner to protect company assets. Insurance and reinsurance companies use loss experience to determine what to charge for coverage as well as how much coverage is needed

    1 comment
  21. Putting Puzzle Pieces Together and the Challenge of Creating a New Claims System January 22, 2010

    Posted in Claims Technology, My History.

    Creating a new claims system should be easy with no legacy, right? Not so fast! One of the great things about going to work for a start-up insurance company with a lot of venture money is the idea that you can build everything from scratch. No legacy of losses, a clean balance sheet, and no […]

    1 comment
  22. With old claims systems come old claims processes – You can’t change one without the other! January 21, 2010

    Posted in Claims Technology, SPOT on Costs.

    So you need a new claims system You know the darn thing doesn’t work or do what you want it to do so what’s next? You can’t just go out and buy a new system without understanding what your current process looks like. Over the years you have adopted your operation to your existing technology.  […]

    2 comments
  23. Why use a consultant? The second set of eyes! January 20, 2010

    Posted in SPOT on Costs.

    Ever try and organize your own closet? It should be so easy to get the thing in order yet for some reason it’s very difficult. That is until you bring in a closet organizer to arrange everything in easy to manage sections. Sometimes the only way to truly accomplish a task is to have a […]

    1 comment
  24. Start-up – Lets get down and dirty and pitch in on everything January 19, 2010

    Posted in My History.

    On day one as Vice President of Claims for Arch Insurance Company I found myself working in cramped space in Lower Manhattan where the CEO shared an office with others and the head of Professional Liability Underwriting found a happy home in an electrical closet. Arch was rapidly growing its underwriting and was binding new […]

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  25. Change comes quickly when you least expect it January 19, 2010

    Posted in My History.

    9/11 changed everything for a lot of people. I was at my desk at One Liberty Plaza across the street from the World Trade Center when the attacks occurred. I was literally shaken from my desk and the world would never be the same. There were significant emotional and physical issues to deal with. I […]

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