Proactive & flexible
Terex director of risk management Dave Wingo tells on the frontline how its global TPA program through Broadspire® is positively impacting its approach to employee healthcare claims.
When German employees were badly injured in an auto accident in the U.S., Terex and its TPA advisors Broadspire took immediate action to ensure they received the best possible treatment and repatriated them back to Germany and their families. This is in spite of confusion at the time over which policies would respond to the claim.
“Bottom line, a number of coverages from travel accident to auto liability could respond,” says Wingo. “But because of the initial facts and the confusion over which program would take the lead, Terex with Broadspire, amended and prioritized the claim management protocols to address and ensure that medical, investigation and other resources were brought to bear to ensure these guys are getting the right care.”
“Ad hoc changes to prioritization of protocols to bring suitable resources to bear (i.e. field nurse care) is not something we would have been able to do when dealing with our coverages among various carriers,” he continues. “A lot of times carriers are too concerned about what coverage will apply and protecting their bottom line than to mitigate the overall loss. In these circumstances, when you know that someone will pay, either the company via deductible or the insurance carrier, the focus should be on mitigating the claim, looking after our team members, and then figuring out who’s going to be participating in the claim.”
Beyond the HR benefits of such an approach, the ability to be flexible and proactive in response to workplace injuries is not a purely philanthropic exercise. It also helps to mitigate claims and maintain a healthier workforce. This is important for a major employer like Terex Corporation. The Connecticut-based organization employs over 20,000 people and has major business segments that include material processing and mining equipment, aerial work platforms and cranes.
“The TPA allows us to take a different approach in comparison to the insurance company model,” explains Wingo. “This flexibility and proactive approach is a critical aspect that allows us to be holistic in how we’re dealing with numerous issues in claims.”
“On workers’ compensation versus employers’ liability, in collaboration with your TPA in India or Italy, many times, local operations will approach the incident as a business accident claim while it may be better served to address it as an employer liability claim,” he continues. “You have the flexibility to do that with a TPA like Broadspire, because they handle our claims for many lines, allowing us to adapt and adjust to meet the regulatory requirements as well as to meet the requirements of bringing better and more consistent solutions to our team members and overall claims management.”
He offers a textbook example where an expensive piece of machinery catches on fire, subsequently igniting a customer’s warehouse. “The third party liability will respond to the building while the piece of machinery, that is no longer ours but our customer’s, is left out in the cold.”
“With the TPA, and how we have set it up with Broadspire, we can offer our customer a more holistic solution. Broadspire will not only deal with the warehouse claim but also the claim for the machine. Thus, allowing our customer to deal with one claim adjuster with one claim organization and not two adjusters with different strategies to adjust the claims.”
Rehabilitating injured workers
Taking immediate action to support injured workers can mitigate claims and build trust. In the U.K. this has extended to a medical management, or rehabilitation scheme, currently being carried out in partnership with Broadspire. This will supplement any medical care provided via the National Health Service with private rehabilitation care to help speed up recovery and return to work.
“In the U.K. we have many carriers who say, ‘let’s just wait until the claim comes in’,” explains Wingo. “But you can have an incident and the claim might not be reported for 24 months. It’s important at the time of the incident or shortly afterwards to do the due diligence of a TPA going out and surveying and investigating the incident.”
“Depending on the circumstances of the incident, we also engage Broadspire’s rehab services throughout the U.K. with the focus to support team members by providing additional rehab to augment the governmental medical services without having the team member to put forth a claim,” he continues. “We believe by implementing this rehab program we’ve mitigated and reduced the cost of our claims.”
“And it’s given our injured workers a more positive view on things,” he adds. “They begin to understand that this is a proactive service to help them recover instead of waiting weeks or months to get proper rehab services. We strongly believe that if we do something in the first 24-48 hours, our team members will have a better chance of full recovery than waiting until the claim comes in several weeks later.”
But there were doubts when the initiative was first broached with Terex’s HR department. “They thought risk management was nuts!” laughs Wingo. “They said, ‘basically you’re going to invite a bunch more claims and this is going to be ridiculous’. The whole idea of being proactive in providing care and services at the critical time, to augment the socialized medical system, seemed to be spending more money, but in fact reduces the overall cost. Now our HR is very supportive.”
“There were no big banners or announcements when we got started,” he continues. “We slowly but surely introduced the service, telling an injured worker ‘somebody is going to check on you to see what additional resources you need to get better’. We also had a nurse call and not a claims adjuster. If you have a claims adjuster they’re thinking, ‘This is going to be a claim’; but if it’s a nurse, they think, ‘This is somebody who is actually going to take interest in me’.”
In fact the scheme has been so successful that similar approaches are to be rolled out in Germany and Italy, where Terex has significant concentrations of staff. “We listen to our clients and develop customized solutions to fit their global needs,” says Mike Hoberman, chief client officer, Broadspire USA. “We take great interest in making sure our clients receive top quality care and use our extensive claims and clinical resources to drive innovative approaches for all types of claims.”
Data has been a significant enabler, allowing the organization to aggregate and analyse its global claims data to spot trends and pinch points. In the past, one issue was the high incidence of Vibration White Finger among staff working at a Terex facility in Motherwell, Scotland.
Vibration White Finger is an industrial injury which typically affects people who operate hand-held vibrating power tools, such as chainsaws, grinders and pneumatic drills for a number of years. “Through the data and information we gathered, we decided to change the type of tooling at our Motherwell operation and subsequently improved the overall situation there,” says Wingo.
“When it comes to data and how we are aggregating the data, Broadspire includes some of our older programs, thus, allowing us to bring past and present data together,” he continues. “We also take our data and put it into our enterprise system which enhances our ability to make better business decisions. It also allows us to spot trends.”
“We are using this approach to data analytics in the U.S. in terms of how we’re dealing with workers’ compensation, particular injury and also for auto accidents,” he adds. “We’ve also realized that because we have different segments, there are different trends within each individual segment.”
“So, for instance one division has more of the small machinery, and they are typically dealing with soft tissue issues. But for large cranes it was more of the traditional accidental injuries. So we were able to facilitate changes in some of those operations because the data and analytics showed us where we needed to focus.”