CIn

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.

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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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Thank you.

Sapra & Navarra, LLPSnworkcomp.com

York Risk Services Groupwww.yorkrsg.com

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