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Self-funded employers are able to take control of plan spend through many different strategies. We dive into some of these top strategies related to pharmacy, condition management, and medical consumerism. Click here to watch the webinar now!

Discover how Guide Re is different than other captives in the marketplace and why it’s the best option for employers looking to outperform the market. Click here to watch the webinar now!

Learn about the advantages of a basic captive model in relation to the current marketplace due to volatility and constraints of other funding arrangements. Click here to watch the webinar now!

A recent study by the ATA found a staggering 62% of trucking companies experience delays exceeding 30 days in resolving claims through standard insurance carriers. That translates to an average loss of $15,000 per day  due to operational disruptions and equipment downtime. Feeling like you have little control over the process? You're not alone. But one of the biggest frustrations trucking company owners are feeling is the lack of claims data. A recent Institute of Risk Management (IRM) survey found a concerning 71% of risk managers in the transportation industry reported receiving limited or no access to detailed claims data from their standard insurance providers. Without this data, you lack the ability identify trends and implement effective loss prevention strategies. Captives Offer a Solution: By joining a member-owned group captive, you unlock a powerful set of claims management advantages that allow you to unlock your business’ greatest potential. Faster Resolution:  Captive members get access to a more streamlined and personalized claims approach, leading to quicker settlements and less disruption. Direct Influence:  You have a greater say in how claims are handled, potentially reducing costs, and minimizing frivolous lawsuits. Actionable Insights:  Members receive detailed data on your specific claims experience. This empowers you to identify trends, develop targeted loss prevention programs, and ultimately influence future premiums. But not all captives are alike. At Cottingham & Butler, we've championed trucking captive programs for over 35 years, helping the best trucking companies mitigate risk, efficiently manage claims when they happen and ultimately lower their costs. Let Captives unlock your business’ greatest potential. Don't let the standard market dictate your claims experience. Let us help guide you towards finding the right solution for you, that empowers you with control, transparency, and potential significant cost savings. Contact your Cottingham & Butler Representative today.

As we navigate the increasingly litigious landscape of risk management, we'd like to highlight trends related to  nuclear verdicts and their impact on captive insurance . The below insights and trends can help inform your strategic captive insurance decisions moving forward: Escalating Severity and Frequency of Nuclear Verdicts : Studies show an upward trend in nuclear verdicts, with a record number of "mega" nuclear verdicts ($100 million or more) in 2022 and 2023. The median nuclear verdict was $21 million, with product liability cases peaking at $36 million in 2022 - a 50% rise over a decade. This trend underscores the need for captive insurance solutions that can provide higher limits and more flexible coverage options to address the growing risk of extreme verdicts. Volatility and Rebound of Nuclear Verdicts : The frequency of nuclear verdicts dropped significantly during the COVID-19 pandemic but quickly rebounded to near pre-pandemic levels by Q3 2021. This volatility highlights the need for captive insurance solutions that can adapt quickly to changing litigation landscapes. Captives can offer the flexibility to adjust coverage and limits rapidly in response to such fluctuations in verdict trends. Long-Term Upward Trend : Excluding the pandemic years, there's an upward trend in the frequency of reported nuclear verdicts at all levels over the 10-year study period. This persistent increase underscores the growing importance of captive insurance in providing adequate coverage for large verdicts.  Source:  US Chamber of Commerce Institute for Legal Reform   Cottingham & Butler's captive insurance programs, backed by dedicated claims adjusters, have achieved a 99% renewal rate across our 12 captives with 380+ members. This success emphasizes the value of specialized claims management in today's challenging legal environment. Why is a dedicated claims adjuster crucial? Expertise in Large Claims : Specialized knowledge needed to navigate complex, high-stakes cases Proactive Risk Management : Proactive identification of trends and potential high severity cases and implementation of early resolution strategies Tailored Approach : Provides personalized attention to each client and for each case, potentially reducing the likelihood of nuclear verdict Cost Control : Expertise can lead to more efficient claims handling and potentially lower overall costs Click here to get in touch with our captive experts!

CVSA’s Operation Airbrake Program's next scheduled campaign will occur from August 25-31, 2024. In 2023, 18,875 commercial motor vehicles were inspected during this campaign, with 2,375 of those being placed out of service for brake-related violations. Properly functioning brake systems are crucial to safe commercial motor vehicle operation.   This webinar will bring in an inspector from the Ohio Department of Safety to prepare you for this campaign, and to bring education on what you as a carrier and/or driver can do to prevent these types of violations not only during this campaign but in your daily operations as well. LEARNING OBJECTIVES Helping fleets prepare for the CVSA Operation Brake Check By identifying issues with brake lining and pads Learning about the components the inspectors will check. Discussing the importance of a proactive vehicle maintenance program. Reducing roadway crashes caused by braking systems on commercial motor vehicles. Click here to download the presentation slides.

Fall protection is critical in the construction industry to prevent serious injuries and fatalities. OSHA’s Subpart M outlines fall protection requirements, and employers must select measures compatible with the work being performed. Assessing the specific work context and choosing the appropriate equipment to keep workers safe is paramount to reducing construction-related worker fatalities LEARNING OBJECTIVES Selecting the right equipment (anchor points, harnesses, lanyards) Assessing work contexts Best practices for gear inspection Click here to download the presentation slides.

The construction industry is booming. It's a time of optimism and a testament to the enduring strength and ingenuity of the American contractor. But beneath the surface of bustling business, a challenge looms — a challenge that threatens to crack the foundation of this very progress: rising insurance costs are putting a stranglehold on construction companies.   Data Dive: The Perfect Storm According to a recent study , construction spending is projected to grow by 6.2% in 2024, fueled by infrastructure investments and a rebounding commercial sector. Yet, this very growth creates a perfect storm for insurance: Skyrocketing Costs:  The Associated General Contractors of America (AGC) reports that construction insurance premiums have increased a staggering 23% year-over-year in 2023. Our latest P&C Market Report highlights that we’ve experienced 25 consecutive quarters of marketplace rate increases from 2018 to the present and are expected to stay at elevated levels for the foreseeable future. This puts a massive squeeze on already tight profit margins. Hard Market Blues:  We're experiencing a classic "hard market" – a period of rising premiums and stricter underwriting guidelines. Companies with even minor risk factors may experience challenges in securing coverage or have limitations placed on their policies. Additionally, specialty lines of insurance, such as key coverages like cyber and pollution liability, have become increasingly scarce and expensive. Litigious Landscape:   The phenomenon of "social inflation," caused by the continuous escalation of jury awards, is significantly inflating claim costs across many industries. This trend is particularly concerning in the construction sector, where accidents and injuries are inherent risks. As litigation becomes more prevalent and settlements soar, construction companies face mounting pressures on their insurance claims, putting further pressure on financial burdens and raising overall operating costs.   The Standard Market Challenge In this turbulent environment, the traditional insurance market is struggling to address the unique needs and challenges faced by construction companies. As a result, many are seeking alternative insurance solutions that offer greater customization, innovation, and responsiveness to their specific circumstances. Here's why:   Limited Coverage:  Standard policies often have exclusions or limitations that leave critical gaps in coverage, exposing companies to significant liabilities. Lack of Control:  Construction firms have little control over premium pricing or policy terms. They're at the mercy of the market's whims. Reactive, Not Proactive:  Traditional insurance focuses on responding to claims after they occur. Captives, on the other hand, empower companies to proactively manage risk.   Captives: Your Custom Risk Management Solution There is a reason more best-in-class construction companies are turning to captives– they offer a dramatic shift in how you manage risk. Imagine this: instead of being at the mercy of traditional insurers with potentially inflexible policies and rising premiums, captive insurance allows you to be an owner and decision-maker in your own insurance company.   Here's how captive insurance empowers construction firms in the current economic landscape:   Cost Control & Predictability:  Break free from the cycle of rising premiums dictated by the volatile insurance market. By retaining surplus funds within the captive, you gain greater control over your insurance costs and potentially achieve significant savings. This financial relief can be a game-changer in a tight economic environment. Tailored Coverage, Not a One-Size-Fits-All Approach:  Unlike traditional policies, captives can be designed to address the specific risks inherent to your construction operations – from builders' risk to workers' compensation. This ensures you are adequately covered for the risks that matter most. Enhanced Control & Proactive Risk Management:  Captives empower you to be a part of your claims management processes and risk mitigation strategies. This proactive approach allows for faster response times, potentially leading to lower claim payouts and improved risk prevention strategies that keep your operations on track.   Key Considerations The prospect of moving to a captive can be exciting, offering the potential for greater control and cost savings. But before diving in, it's crucial to lay a solid foundation. Here are some key considerations for construction companies exploring the captive insurance option: Risk Assessment: Think of a risk assessment as the blueprint for your captive program. A thorough analysis will identify and quantify potential exposures specific to your construction operations. This in-depth understanding allows you to choose a captive program that effectively mitigates risks and optimizes costs in the current economic climate. Regulatory Expertise: Captive insurance programs are subject to specific regulations depending on the chosen domicile. Partnering with an experienced captive provider like Cottingham & Butler ensures you have the expertise to navigate these regulations. This frees you to focus on your core business activities, confident that your captive program is compliant. Financial Strength: A healthy financial standing of all members is vital for the long-term success of your captive. Partnering with an advisor with expertise in financial analysis and risk assessment is key. They can help you establish optimal capital structures for your captive, ensuring it has the financial strength to weather any storms. Claims Management: Within your captive, you should have a dedicated claims team directly invested in your company's success. Imagine a claims partner that functions as an extension of your risk management team, working diligently to ensure fair and efficient claims resolution, minimizing losses as if it were their own money on the line. This alignment of interests fosters a proactive approach to risk management, ultimately benefiting your bottom line.    Investing in Your Future: Partnering for Success   At Cottingham & Butler, we've been working in the trenches alongside construction companies for decades, and we understand the unique challenges you face. That's why we specialize in helping construction companies leverage member-owned group captives to build a more secure future.   Our Expertise, Your Advantage Cottingham & Butler isn't just another insurance broker. We have a distinguished captive track record dating back to 1993, managing 12 successful captive programs with over 360 members. We specifically have a member-owned group captive dedicated solely to best-in-class construction companies, ensuring you only share risk with people like you. Our industry-leading 99% renewal retention rate speaks volumes about the value we deliver.   Selective Membership, Exceptional Results We understand that a captive's success hinges on a strong foundation. That's why we meticulously select members with a like-minded focus on safety and results, a positive loss history, and financial stability. This selective approach, combined with our in-depth captive knowledge, has resulted in loss ratios significantly lower than the industry average.   In short, by partnering with Cottingham & Butler, you gain access to: Decades of Captive Management Experience:  Leverage our proven track record to implement a captive solution that optimizes your risk management strategy. A Selective and Collaborative Community:  Benefit from a network of like-minded construction executives who share best practices, fostering long-term success. Industry-Leading Loss Ratio Performance:  Our deep understanding of captive structures and selective membership approach lead to demonstrably lower risk profiles for your captive.   Ready to build a more resilient future for your construction business? Contact our captive experts today and discover how Cottingham & Butler can help you leverage the power of captive insurance.

Businesses in the manufacturing sector contribute significantly to the economy by utilizing raw materials to create a wide range of finished products. In recent years, this industry has experienced considerable growth and has capitalized on recent legislation that provided substantial funding and tax incentives. The Infrastructure and Jobs Act, the Creating Helpful Incentives to Produce Semiconductors (CHIPS) and Science Act, and the Inflation Reduction Act have collectively stimulated private-sector investments in the manufacturing sector. Professional services firm Deloitte reported that as of July 2023, annual construction spending in manufacturing stood at $201 billion, representing a 70% year-over-year increase. This increase in spending sets the stage for additional industry growth in 2024. In the manufacturing industry, changing regulations and evolving market dynamics will continue to bring changes in the future. Other trends to watch include digital transformation, supply chain challenges, labor shortages, and liability from per-and polyfluoroalkyl substances (PFAS) in products. Monitoring the latest sector developments and appropriately adjusting operations and risk management practices to respond to these shifts is essential, as each has significant impacts on the success and public perception of a business. Digital Transformation Manufacturers will continue to embrace digital transformation and technology adoption in 2024. Businesses will look to these tools to improve their operations by enhancing productivity and forecasting and mitigating supply chain disruptions. One tool that is gaining increasing traction is generative artificial intelligence (AI). Generative AI is a type of AI that receives data inputs and creates new content (e.g., text, images, audio) based on that data. Generative AI can be used to create optimal product designs, improve quality control, address supply chain issues and enhance predictive maintenance. Generative AI can also help manufacturers promptly respond to client requests and questions. Manufacturing businesses are also increasingly utilizing technology, including AI, augmented reality and virtual reality, to build industrial metaverses. Such digital spaces can create virtual representations of physical locations that manufacturers can use to design and test products or train employees. Key components of an industrial metaverse are digital twins, which are digital replicas of physical objects that can receive data from their physical counterparts in real time. This data can inform virtual model simulations, which generate information that can be applied to the physical object to improve its performance. In addition, smart factory initiatives are also being utilized to increase network capacity, reduce delays in network communication and enable high-speed data processing. Such solutions often permit manufacturing businesses to minimize downtime on the production floor and elevate performance. Furthermore, manufacturers are implementing robotics, theInternet of Things (IoT) and blockchain to improve their businesses’ efficiency and overall performance capabilities. Technology undoubtedly has several benefits, but it’s worth noting that its use can introduce various risks. For instance, the increased connectivity via the IoT and reliance on digital systems can expose manufacturers to cyber threats like data breaches, ransomware attacks and sabotage. Also, collecting and processing large amounts of data raises concerns about privacy compliance and the protection of sensitive information. Other risk considerations include dependency on technology, workforce displacement, regulatory compliance challenges, ethical implications and data integrity concerns. Proactive planning, cybersecurity, talent development, regulatory collaboration and ethical considerations are vital for the safe integration of manufacturing technologies. Supply Chain Challenges Although supply chains are showing signs of normalizing, disruptions remain a significant risk due to various external threats, such as natural disasters, geopolitical tensions, trade disputes and unexpected events like the COVID-19 pandemic. According to Deloitte, the average delivery time for production materials was 87 days in August 2023. This was down from a peak of 100 days in July 2022 but still not back to the pre-pandemic average of 63 days. To mitigate supply chain risks and help ensure supply chain resiliency, manufacturing businesses have employed several tactics, including: Leveraging technology—Manufacturing businesses have implemented workplace technology to enhance supply chain visibility and resilience. Deloitte reports that 76% of manufacturers are adopting digital tools for improved supply chain transparency. Examples include work instruction software and digital ecosystems, which can streamline supply chain workflows, ensure regular communication with suppliers, provide status updates on material shipment processes and deliver notifications regarding possible disruptions. Some manufacturers have also started using AI, metaverse technology and digital twins to strengthen their supply chains and find efficiencies. Strengthening relationships—Manufacturing businesses are more likely to receive additional support when navigating supply chain issues by building strong relationships with their suppliers. For example, businesses with solid supplier connections may benefit from solutions like modified shipment routes and prioritized access to high-demand materials as they become available. Diversifying suppliers—Some manufacturing businesses have added redundancies to their supply chains by investing in several suppliers for the same materials instead of relying on a small selection of primary suppliers. With these diversifying strategies, businesses can increase the likelihood of maintaining access to essential production materials even if their primary suppliers are experiencing disruptions. Nearshoring and reshoring—In addition to diversifying their supply chains, some manufacturing businesses have also begun engaging in nearshoring and reshoring. Nearshoring involves shifting production from overseas countries to nearby countries, while reshoring entails moving production back into a business’s home country. Businesses that implement these strategies may be able to minimize their risks of being impacted by global shipment delays and associated supply chain disruptions. Labor Challenges Recent legislation has provided funding that is expected to help generate job growth in the manufacturing sector. For example, the Inflation Reduction Act has spurred investments in clean energy, and the CHIPS and Science Act will inject significant funding into the manufacturing of semiconductors. However, although voluntary turnover rates are cooling, the manufacturing industry continues to grapple with skilled labor shortages. Deloitte reported labor mark tightness is expected to continue in 2024. Rising labor costs are also expected this year, even as inflation slows and prices stabilize. According to the Institute for Supply Management, wages and benefits costs are expected to rise 5.2% in 2024. Manufacturing businesses must take steps to address the labor challenges they may encounter. These measures may include diversifying outreach efforts at community events (e.g., job fairs) to encourage the next generation of manufacturing employees; leveraging training and apprenticeship programs to continue to expand new workers’ professional abilities; utilizing technology to streamline processes and improve efficiencies; providing comprehensive and ongoing safety training to new and existing workers of all experience levels; offering flexibility and more competitive wages and benefits; and attempting to bring employees who recently left the industry back to work through various incentives (e.g., flexible employment arrangements and career advancement opportunities). It may also be beneficial for manufacturers to explore underrepresented demographics to increase their talent pools and expand their searches by using talent recruitment agencies. Cultivating and maintaining a positive and safety-forward company culture can also help businesses attract and retain employees and reduce workplace accidents. PFAS A concern in the manufacturing industry is the presence of PFAS in their products. PFAS consist of a large grouping of over 7,000 chemicals that have been widely manufactured and distributed across the United States since the 1940s. Because PFAS don’t break down easily in the environment and bioaccumulate in the human body, they are known as “forever chemicals.”PFAS can be found in various products, including food packaging, nonstick cookware, household cleaners, firefighting agents, textiles, adhesives, furniture and auto parts. PFAS have been the subject of increased litigation and regulation over the past few years. Such scrutiny stems from the health and safety concerns of these substances as well as their environmental impacts. Specifically, according to the Environmental Protection Agency (EPA), exposure to certain levels of PFAS may lead to several adverse health conditions, including certain cancers, fertility issues, developmental delays in children, obesity, hormone interference and immune system dysfunction. PFAS are also found in soil and water and can build up in fish and other wildlife. Because of these impacts, businesses that manufacture PFAS or products containing these substances may face elevated liability exposures. For example, two types of PFAS, perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), are no longer allowed to be manufactured in the United States, and the EPA has prioritized addressing PFAS concerns. In October 2023, the EPA published a final rule requiring all manufacturers of PFAS and PFAS-containing articles that developed these in any year since 2011 to report information to the EPA regarding PFAS uses, production volumes, disposal, exposures and hazards. Additionally, the EPA recently noted that addressing exposure to PFAS will be one of its six National Enforcement and Compliance Initiatives during the fiscal years 2024-27. Several states have also established PFAS regulations. Altogether, these efforts can place several compliance requirements on manufacturers that develop or depend on PFAS in their operations. As manufacturers are being held increasingly responsible for PFAS contamination through regulatory action and litigation, it’s essential for them to take steps to minimize liability exposures—namely, by eliminating or limiting overall PFAS utilization, investing in alternatives and ensuring compliance with applicable legislation. Manufacturing businesses should review both their existing and prior insurance policies to determine whether they provide sufficient coverage for PFAS-related claims. Many insurance policies exclude coverage for incidents involving environmental pollutants or hazardous substances, and these exclusions may apply to PFAS. Based on their particular liability exposures, some businesses may wish to purchase specialized coverage (e.g., pollution liability insurance) to fill in any gaps. Regardless, businesses should consult trusted insurance professionals to secure proper coverage. Conclusion There are several trends impacting the manufacturing sector. By staying on top of these developments and mitigating their associated exposures, manufacturing businesses can effectively position themselves to maintain long-term growth and operational success.

OSHA announced its final rule that clarifies employees’ rights to authorize a representative to accompany an OSHA compliance safety and health officer (CSHO) during a walkaround inspection. The final rule was published on April 1, 2024, and becomes effective May 31, 2024. The Occupational Safety and Health Act (OSH Act) of 1970 provides employers and employees the right to authorize a representative to accompany OSHA officials during a workplace inspection. The recently announced final rule clarifies that, consistent with the law, employees may authorize another employee to serve as their representative or select a third-party non-employee. A non-employee representative may join the CSHO during inspections if, in the CSHO’s judgment, good cause has been shown that having the individual accompany the CSHO is reasonably necessary to conduct an effective and thorough physical inspection of the workplace. The final rule clarifies that a non-employee representative may be deemed reasonably necessary based on their skills, knowledge or experience. The final rule notes that third-party involvement may be warranted due to the third parties’ relevant expertise, experience with hazards or conditions in the workplace or similar workplaces, or language or communication skills. OSHA regulations require no specific qualifications for employers or employee representatives who are employed by the employer. OSHA determined these final rule clarifications facilitate workplace inspections by empowering employees to choose representatives who can effectively assist the CSHO during physical inspections. Employee representation during inspections is crucial for OSHA to gather essential information about workplace conditions and hazards. This rule making does not change the role of an employee’s third-party representative. The role of the representative is still only to accompany the CSHO to aid in the physical OSHA inspection and attend the opening and closing conferences. OSHA states the final rule’s revisions better align OSHA’s regulation with the OSH Act and enable the agency to conduct more effective inspections. In addition, the agency concluded this final rule creates a return to a more fair, balanced approach that Congress had originally intended. In response to this change, employers should review the new rule and allow employees to identify and select a trusted and knowledgeable representative to assist in facilitating a CSHO’s information-gathering in the event of an OSHA inspection.

When organizations face large-scale disasters or other unexpected losses, ensuring business continuity is often a top priority. Yet, various losses may make it challenging for organizations to avoid operational disruptions or temporary shutdowns. In these instances, even brief closures can carry costly consequences. That’s where business interruption (BI) insurance can help. Also known as business income insurance, this form of coverage can be purchased as a supplement to commercial property insurance or secured through a business owner’s policy, which refers to a bundled insurance package featuring property and liability coverage. In any case, BI insurance can offer much-needed financial protection when organizations’ usual business activities are interrupted due to covered losses. With this in mind, organizations should have a clear understanding of BI insurance and the key protections provided by this coverage. The following article highlights the value of BI insurance by offering an overview of this coverage and outlining additional policy features. BI Insurance Explained BI coverage generally includes financial protection for the various expenses that can arise if an organization is forced to pause its operations or temporarily close its doors due to direct physical damage caused by a covered loss. Examples of covered losses include a range of perils, such as fires, theft, vandalism and certain types of adverse weather (e.g., heavy wind and hailstorms). When these perils occur, BI coverage may help reimburse the following typical operating costs: Income that an organization would be earning if it were running normally Commercial mortgage, rent, lease, loan and tax payments due during a disruption Payroll expenses to maintain employees’ wages amid a closure Additional BI Policy Features While standard BI policies can help reimburse typical operating costs incurred following direct physical damage due to covered losses, organizations can also consider several other BI coverage options and endorsements. Here’s a breakdown of these additional policy features: Extra expense coverage—Such coverage can help pay for extra expenses that organizations reasonably sustain (beyond typical operating costs) amid disruptions to help them get back up and running. These expenses may include relocating to a temporary business location during the restoration process, expedited shipping fees for essential materials and supplies, and overtime wages for employees who are asked to work additional hours to minimize operational downtime. Civil authority coverage—This coverage can help organizations compensate operating expenses incurred duringgovernment-mandated business closures (e.g., citywide curfews, local evacuation orders or temporary road closures). Service interruption coverage—Such coverage can help reimburse operating expenses sustained from disruptions thatimpact organizations’ utility service lines or any plants, substations and equipment that supply these services (e.g.,electrical, steam, gas, water, sewer and telecommunication). Contingent business interruption (CBI) coverage—This coverage may offer financial protection for operational disruptions caused by covered losses among organizations’ suppliers and business partners. CBI coverage can bee specially useful for organizations that rely heavily on third parties to make critical purchases, deliver essential materials and supplies or conduct other key business functions. Conclusion BI insurance can make all the difference in helping organizations stay resilient amid unanticipated disasters and reduce the financial fallout stemming from related disruptions, thus allowing them to reopen their doors with ease and foster ongoing operational success. By reviewing the protection this coverage provides and considering additional policy features, organizations can tailor their BI insurance to their particular needs. Contact us today for more insurance solutions.

Carefully evaluating workers’ compensation claims is crucial in helping your company save money and prevent fraud. Workers’ compensation is simply a form of insurance that offers employees medical coverage in the event they are injured during a work-related function. Depending on the state of residence, it may also give compensation for disabilities sustained or cover rehabilitation costs so the employee can return to the workplace quickly and smoothly. Workers’ compensation is crucial to protecting employees, but it is often a source of contention among employers because it comes with considerable gray areas. When is a claim compensable? How do we identify a fraudulent claim? How do we report a claim, and should we report all workplace injuries no matter how serious? This piece is designed to help you determine when —and if—an injury is covered by workers’ compensation. Requirements The claim must meet all five of these requirements in order to be compensable: Happened to One of Your Employees The first requirement is in place to ensure it is your employee filing the claim, not an independent contractor or vendor who works for themselves or a third party. Even if the incident occurs on your property, unless it is someone who works directly for you, the claim is not compensable. Resulted in an Injury or Illness Injury is not the only thing that can potentially be covered by workers’ compensation. Illnesses could also qualify as compensable claims, but only if they are related directly to the job. The illness also must be caused directly by the working conditions to be covered in a workers’ compensation policy. For example, a miner’s contraction of black lung would be compensable in all states. However, an employee in an office with a co-worker who smokes would not be eligible for workers’ compensation for treatment of illness due to secondhand smoke. Arose Out of Employment This requirement means there must be a direct connection between the injury and the desire or attempt to further the employer’s business. If the employer benefits in some way, whether monetarily or otherwise, from the employee’s activity, then the claim meets this qualification. Occurred in the Course and Scope of Employment The employee must be at work when the injury occurs. This includes any place or location mandated or expected by the employer. So, when an injury occurs at the employee’s physical everyday work site, that employee must prove he or she was injured while actively engaging in the furtherance of the employer’s business. There is a special provision called the “coming and going rule,” which maintains that benefits are denied for injuries received when traveling to or from work. Additionally, injuries arising out of transit from one work site to another, for instance when traveling to visit clients, are compensable. This provision also requires that the actions leading to the injury of the employee in question be prompted by the aspiration to further the employer’s business interests. Resulted in Impairment and/or Lost Wages The injury or illness in question must cause the employee to be impaired in some way and lose wages from not being able to complete his or her tasks completely. It is also a compensable incident if the injury or illness results in impairment but without lost wages or vice versa. Identifying a Fraudulent Claim Studies commonly show that roughly 90% of all workers’ compensation claims filed are legitimate. However, it is still important as an employer to watch for these red flags that may indicate a fraudulent claim: Filing multiple claims Longer absences than anticipated by the employee, combined with an unwillingness to return to work Unwillingness to be assigned to other, lighter jobs within the company or to complete partial duties Constantly missing medical appointments Employee will not provide the date, time, or location of the incident that caused injury Employee has no recollection of services provided for related medical bills Lack of witnesses to an accident or incident Employee cannot produce specific information about the nature of the injury Employee has a history of short-term employment If any of these red flags occur, it by no means makes the claim automatically fraudulent. These are simply guidelines to keep employers proactively evaluating the legitimacy of a workers’ compensation claim. For more information, please contact your Cottingham & Butler representative.