tuesday, march 7, 2017 dallas, tx 3:45–5:00 p.m. workers
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Tuesday, March 7, 2017Dallas, TX
3:45–5:00 p.m.
WORKERS COMPENSATION LITIGATION MANAGEMENT:BREAKING THE HABIT
Presented by
Bijan BijarchiVice President, Risk Management Practices
York Risk Services Group
Albert A. NavarraPartner
Sapra & Navarra, LLP
Workerscompensationclaimsmanagementefficacyhasadirectimpactonseverity
andoutcomes.Theaverageincurredvalueofalitigatedclaimisinmostinstancesmorethan10timesthevalueofanon-litigatedone.Thissessionwillexploreadif-ferentapproachtomoreaggressivelymanaginglitigatedclaimsinordertomini-mizeexposureandbringthefiletoconclusionsooner.1
opyright © 2017 International Risk Management stitute, Inc.
www.IRMI.com
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Bijan Bijarchi Vice President, Risk Management Practices
York Risk Services GroupBijanBijarchiisvicepresidentoftheRiskManagementPracticesdivisionofYorkRiskSer-vicesGroup.Inthisrole,hefacilitatesqualityofservice,analytics,andclientsatisfactionforthebroadspectrumofYorkclients.Hismorethan25-yearcareerinriskmanagementencompassescross-functionalandcross-industryexperienceinclaimsmanagement,salesandaccountmanagement,andvocationalrehabilitationcounseling.Hehasheldleadershippositionsinclientservicesandthird-partyadministratoroperations,wherehesuccessfullydroveinitiativestopromoteeducationandtrainingofaccountmanagersandclients,andhehaschairedseveralClientAdvisoryCoun-cils.Mr.BijarchiearnedhisbachelorofbusinessadministrationdegreefromtheUniversityofSanDiegoandholdstheAssociateinRiskManagementdesignation.Albert A. Navarra
PartnerSapra & Navarra, LLPAlbertNavarraisanattorney,boardcertifiedinCaliforniaWorkers’CompensationLaw,andauthorofTheElementsofConstitutionalLawandtheJoyofArgument,anAmazonBestSeller.Mr.Navarraandhislawpartner,AmbikaSapra,arethecreatorsof“BreakingtheHabit®,”arevolutionaryandaward-winninglitigationstrategy.
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“Breaking the Habit” ®Less discovery, more knowledge and speed
Presented by:Ambika Sapra & Albert Navarra,
Sapra & Navarra, LLP
Bijan BijarchiYork Risk Services Group
#IRMI2017
Axis mundi“Every Microcosm, every inhabited region, has a Centre; that is to say, a place that is sacred above all.” Mircea Eliade (1907-1986)
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Geocentric modelAristotle (384 - 322 B.C.)Ptolemy (A.D. 100-170)
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HeliocentrismCopernicus (1473-1543)Galileo (1564-1642)Kepler (1571-1630)
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Cosmological principleNewton (1642-1727)Einstein (1879-1955)Friedman (1888-1925)
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ObservationSome very smart people have been very wrong about some very important things.
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IntrospectionWhat is the center of your universe?
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Insured modelThey fund everything.
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INSURED
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But how does the Insured see you?A commodity
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Moats, synergies, and market share“In general, insurers do not benefit from favorable competitive positions. Industry competition is fierce, and the products are essentially commodities.” (Morningstar, September 30, 2016)
We don't view the insurance industry as inherently moaty, and we believe there are few synergies to be realized across lines.” (Morningstar, June 9, 2016)
Eighty-nine percent of carriers have less than 1% market share. (WCIRB)
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How to not be a soybean• Make more than a marginal difference for the insured• Change actions to change results• Break certain traditions
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Traditional litigation strategy1. Depose claimant2. Schedule medical-legal exams3. Depose doctors4. Supplemental medical reports5. Join carriers pre-settlement6. Get MSAs pre-settlement7. Delay settlement and trial
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Code of Hammurabi (1750 BC)• Respect for evidence.• Parties can bring their case before a
judge and provide evidence and witnesses to back up their claims.
• Example: “If any one bring an accusation of any crime before the elders, and does not prove what he has charged, he shall, if it be a capital offense charged, be put to death.”
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"Breaking the Habit" ®Strategy: • Close discovery as soon as possible.• Limit the amount of evidence and claimant’s ability to prove claim.• Increase legal knowledge of defenses and litigation skills.• Accelerate settlement or trial.
Outcome: Sixty-seven (67) percent reduction in average cost per case and cycle time.
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In theory…
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In theory, there is no difference between theory and practice.
But, in practice, there is.
-Yogi Berra
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Some things have to change
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Making it work
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Unified approach• Adjusters must change the rules
they learned• Push for MMI reports and move once
they come in• Push to close if the claim is denied
regardless of medical status
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Making it work
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Unified approach• Risk Managers / Insureds must be willing
to settle and resolve claims faster• Delegate authority to close• Focus on what’s relevant for closure• Partner with your TPA to get it done
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What Makes Change Worth While?
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Results Make Change Worth While
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Avg. Cycle Time
Pre B-T-HWith B-T-H
020,00040,00060,00080,000
100,000
Avg. Settlement
Pre B-T-H
With B-T-H /ADMITTEDWith B-T-H /DENIED
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Constellation of starsCarrierTPABrokerMedical networksInvestigatorConsultant
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INSURED
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Discussion
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