I love to teach the doctrines of workers’ compensation disability, especially those involving “traveling employees”, “deviation from employment”, and “the intoxication defense”. The factual situations that can arise are a pure joy to present and they never fail to get total class participation. It’s even more fun to watch reality as it proves that truth is indeed stranger than fiction…
Take, for example, the very recent case of Ronald Knight vs. the State of Washington, Department of Labor and Industries, where, on Monday, April 7th, the Court of Appeals for the State of Washington denied workers’ compensation benefits to a catastrophe adjuster who suffered a head injury on a South Texas beach while working Hurricane Ike. Here are the salient facts:
Rudolph Knight was a 23-year veteran catastrophe adjuster for State Farm, based in Seattle, Washington. In the fall of 2008 he was assigned work on assignment in Galveston, Texas after the area was hit by Hurricane Ike. On one of his days off, he drove to Galveston Island to, in his words, “survey the damage”, when he observed several men riding dune buggies on the beach and in the surf. He stopped to watch. That was the last thing he remembered until he awoke 24 hours later in a Texas hospital… Continue Reading
On April 3rd, 2014, in Lonnie Smith vs. Tippah Electric Power Ass’n, NO. 2012-CT-00502-SCT, the Mississippi Supreme Court reversed several lower court rulings that employee Lonnie Smith had intentionally injured himself in an attempt to commit suicide rather than go to prison for murder…and in so doing, the Court awarded Lonnie workers’ compensation benefits for his “accidental injury”. Some might say that this ruling is a stunning upset of an appropriate denial of Smith’s workers’ compensation claim…but is it? Should this result have been anticipated? Was any effort made to settle the case, and if so, did such an effort realistically consider the exposures in light of traditional workers’ compensation doctrine?
Last Thursday, the Mississippi Supreme Court ruled that a man serving a 12-year prison sentence for manslaughter will receive workers compensation benefits for injuries suffered when he was shocked by a power line at his former job, even though the employer argued that he intentionally hurt himself. Here are the salient facts: Continue Reading
It’s simply amazing to see the impact that state-mandated continuing education (“CE”) has had on the claims industry over the last few decades. One would think (and that regulators thought) such requirements would enhance the quality and professionalism of insurance claims practice. Unfortunately, my perception is that the effect has been somewhat less than successful, and that the intent of CE has certainly not been appreciated.
These days it seems that all I hear are adjusters complaining about their CE requirements. Initially I am inclined to be unsympathetic; yet, to be honest, when I think about today’s typical CE course, I believe there may be a certain amount of logic to their dissatisfaction. In fact, it actually may not be the “requirement” of CE that is the source of their frustration, nor, perhaps, the “cost”. But if either of these issues aren’t the cause, then what is?
A number of questions come to mind:
- Is it, in fact, the quality and/or relevance of the CE? My observation is that, in today’s “frugal” and busy claims environment, a large part of the industry depends on CE requirements to provide much of today’s claims training. Is it working?
- Is it the cost? I would find that hard to believe; yet I am often asked, “Where can I get some free CE?” Given the time and expense of developing quality claims training and education, I am amazed at just how “cheaply” one can secure CE (e.g. “24 CE for $39.95!” or “Unlimited CE for $99!”). Given the fact that most of this product is rarely even relevant to the job of an adjuster, or helpful in the least, is it even worth it? The saying, “You get what you pay for” comes to mind…
- Could it be that adjusters are just too busy and don’t want to be bothered? For some adjusters, this is something with which I can sympathize. Today’s claims operations ARE very busy. But that’s the job, isn’t it?
Actually, to this last question is there not a greater point to be raised? Continue Reading