montana workers’ compensation montana state fire chiefs conference october 2011 great falls,...
TRANSCRIPT
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Montana Workers’ Compensation
Montana State Fire Chiefs Conference October 2011 Great Falls, Montana
Jeff GriffinTammy Jeffries
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A report on Firefighter Injuries and Current
Coverage Issues
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Four Goals
1. Evaluate the risk of injury to Firefighters
2. Montana Law
3. Current coverage practices
4. Challenges
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Should Risk Leadership Be a High Priority in your
Organization How big is the problem of accidents
and injuries?• Injuries and accidents to Fire Department
employees is estimated to cost over 2.7 billion dollars a year nation wide
• Studies indicate that for every dollar an insurance company will spend in 2011 on the Public Entity claims, the Public Entity will spend an additional $4.00 in hidden costs
• Criminal Charges - The new challenge for Public Entities
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If it is PREDICTABLE It is PREVENTABLE
Regulations and standards are only thestarting point of a quality Risk Leadershipprogram.
• 7.5% of all injuries and suits are attributed to “things”
Focusing on the Human Factor is the key to a successful Risk Leadership program. • 92.5% of all injuries have one common thread!
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Property Workers’ Compensation
LiabilityFundamentals of Exposures
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NFPA FIREFIGHTER FATALITIES IN THE US
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NFPA FIREFIGHTER INJURIES IN THE US
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Understanding the Power of the Near Miss
• Near Miss Relationships
1 Serious
59 Minor
600 Near Misses
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Understanding the Power of the Near Miss
• Near Miss Relationships
1 Serious
59 Minor
600 Near Misses
Cultural Drift
Flawed Behavior
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RATES FOR 2008-2009 CLASSCODE 7710
•Alabama 3.55
•Alaska 4.54
•Arkansas 3.79
•Colorado 3.66
•Connecticut 5.02
•Georgia 3.63
•Hawaii 2.76
•Idaho 3.36
•Illinois 10.43
•Indiana 1.88
•Iowa 21.99
•Kansas 4.09
•Kentucky 2.99
•Louisiana 3.46
•Maine 5.18
•Maryland 4.62
•Mississippi 5.44
•Missouri 4.64
•Nebraska 9.25
•Nevada 9.93
•New Hampshire 9.99
•New Mexico 4.00
•North Carolina 3.41
•Oklahoma 4.95
•Oregon* 2.45
*Composite
0.99
•Rhode Island 3.99
•South Carolina 4.56
•South Dakota 10.58
•Tennessee 10.37
•Utah 1.31
•Vermont 6.30
•Virginia 2.77
•West Virginia 4.24
•Wisconsin 11.15
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If it is PREDICTABLE It is PREVENTABLE
Regulations and standards are only thestarting point of a quality Risk Leadershipprogram.
• 7.5% of all injuries and suits are attributed to “things”
Focusing on the Human Factor is the key to a successful Risk Leadership program. • 92.5% of all injuries have one common thread!
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Workers’ Compensation
• Common-law principle – the employer was responsible for the injury or death of an employee resulting from a negligent act.
• Achieve two goals - • Provide medical care and income to
workers injured on the job & death benefits to families of workers killed on the job.
• Protect employers from costly and unpredictable lawsuits by workers.
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Montana History
• 1909 - State Accident Insurance and Total Permanent Disability Fund
• 1911 – Montana Supreme Court declares it unconstitutional
• 1915 – Montana Legislature enacts a comprehensive Workers’ Compensation Act
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“Exclusive” or “Sole” Remedy
• MCA 39-71-411 Employer is not subject to any liability
whatever for the death or personal injury to an employee covered by the Workers’ Compensation Act or for any claims for contribution or indemnity asserted by a third person from who damages are sought on account of such injuries or death.
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Quid Pro Quo
• Exchange of rights• Employees by relieving them of the
responsibility of proving employer negligence
• Employers by relieving them of liability from common-law suits involving negligence
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Volunteer Firefighters
• Volunteers are not “employees”• No remuneration –they don’t receive a
salary• Volunteer hours means – time spent in
training, response time and on employer’s premise
• Not mandatory
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Subsequent Injury Fund
Concurrent Employment39-71-118 (7) (c)
“Employment in which the employee was actually employed at the time of the injury and would have continued to be employed without a break in the term of employment if not for the injury.”
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Exclusions to Benefits
• Owners:• Sole proprietor• Partners
• Non- subject Corporate Officers
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Private Carriers
• Reluctant to insure Volunteers• Pay benefits based upon wages where
they don’t collect the premium• Collect premium based upon an hourly rate• Exposure – high risk
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Wage/Benefit Calculations
• National Council on Compensation (NCCI) – Class Code 7704• Assumed wage - $300 per year• Minimum wage - $7.35 per hour• Assumed wage - $100 per year or $7.35/hr
• Varies from Insurers – Private, Risk Pools, State Fund
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Independent Contractor Test
• 39-71-120 (1): An “independent contractor” is one who renders service in the course of an occupation and:(a) has been and will continue to be free from
control or direction over the performance of the services, both under contract and in fact; and
(b) Is engaged in an independently established trade, occupation, profession, or business.
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Current Coverage Practices
• Montana number of fire service agencies
• National 300• Projected 400
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Montana number of firefighters covered by
workers’ compensation
Covered Number of firefighters
Paid ≈ 700 ≈ 700
Volunteer 3600 5100
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Purchasing Workers’ Compensation
Purchasing Supplemental
≈
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Purchasing Both Workers’ Compensation and
Supplemental
Bare
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Challenges
• The Law vs. common practice• What a court might do• What your liability carrier would do
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Challenges
• The cost of workers’ compensation
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Challenges
• Coverage Issues
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Challenges
• Identification of agencies with little or no coverage
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Challenges
• A possible legislative fix
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Challenges
• Can MFCA’s have an impact on cost
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Montana Workers’ Compensation
Montana State Fire Chiefs Conference October 2011 Great Falls, Montana
Jeff GriffinTammy Jeffries
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