West Bend Mutual Insurance Company works with more than 200 Y associations throughout the Midwest. Each year, these Ys submit hundreds of insurance claims to West Bend. This year, we conducted a thorough analysis of each of these claims and held a live online seminar for our customers to discuss the results. To help make other Ys (and similar organizations) safe for their members and employees, we've decided to make the results public. What follows are the results of that analysis.
Download the Slides from Seminar
After receiving several requests we've decided to make the slides included in this article available in a PDF download. West Bend - State of Safety Presentation. (1.1 MB)
Understanding Frequency and Severity
When it comes to risk management, there are two primary types of organizations: 1) organizations that submit small, but frequent, claims; and 2) organizations that submit very few claims, but severe, claims. Which type of organization do you think an insurance carrier would prefer to work with?
The answer is: YMCA B. For some, this may seem counterintuitive. Wouldn’t an insurance company rather pay ten $1,000 claims than a single $12,000 claim? After all, they'd save $2,000 in a scenario like that. In general, no; if an insurance carrier had to choose they would almost always select YMCA B. The reason is...shock losses.
Frequent Claims Leads to Shock Losses
Most of the time there’s a very fine line between a small claim and a large claim. One more second or one more inch can change a claim from a minor fender bender to a catastrophic, multi-car pileup. When an organization has a history of many small claims, it’s fairly safe to assume a big claim will also occur. On the other hand, it’s entirely possible an organization with a single large claim was simply unlucky. They’ll likely sustain few claims in the future. Consider this shock loss from one of our Y customers in 2014:
As the graphic above outlines, West Bend's specialty lines division received its largest claim ever in 2014. This single claim is so large that you would need to add up the next 270 largest claims of the last four years to equal it. Because the claim hasn't been finalized, we're unable to share specifics, other than to say that a Y employee sustained severe, life-altering injuries while at work. The key point to take away from this story is that this claim legitimately could have come from any one of our customers. Shock losses like this happen...and they're less likely to come from an organization committed to reducing claims.
YMCA Insurance Claims (2011-2014)
Because we're more concerned about the frequency of claims, the statistics we'll be sharing in this post will focus on the claim counts. In many instances these charts would look vastly different if we were to consider the cost of the claims rather than the total number of the claims.
Claim Count by Line of Business
The chart below shows the breakdown of claims across the four major lines of business that West Bend provides to YMCAs.
One important note: West Bend does not provide workers’ compensation coverage to all of our customers. If we did, it’s likely the workers’ compensation percentage would be closer to, or even greater than, the liability portion. It can be natural to be more concerned about creating a safe environment for Y members and visitors (especially children); however, an organization dedicated to reducing risk management expenses should place equal weight on making the workplace safe for employees.
Seasonality of Insurance Claims at YMCAs
West Bend’s claim data paint a clear picture of the seasonality of claims at the Y. As you can see in the chart below, June and July are a hotbed for claims activity across all lines of business. This seasonal spike in claim activity isn’t a surprise, as most Ys become major hubs of activity with summer camp programs.
General Liability Claims in 2014
General liability claims account for almost half of all West Bend claims. In this section, we’ll highlight some of the most common and severe causes of loss. REMINDER: General liability claims are injuries sustained by members and visitors of the Y. These numbers do not include injuries sustained by on-duty Y employees.
Claim Counts by Cause of Loss
As you can see in the chart below, there are a wide variety of ways that a Y member can get injured while visiting. For brevity's sake, we'll focus on the five causes that are highlighted red.
Drownings and Near Drownings at the Y
We’re thrilled there were no recorded drownings at Ys insured by West Bend in 2014. This achievement is a testament to the commitment our customers place on providing people with safe and fun aquatic activities.
While there weren’t any drownings at our Ys in 2014, there were at least eight recorded near drownings. Without a quick response from a lifeguard, each of these could have resulted in a fatality. As the data above shows, all of these occurrences involved children under age 10, and, in all but one case, a lifeguard or swim instructor was the first to respond.
Deaths at the Y
Even though our Y partners didn’t experience a drowning in 2014, it doesn’t mean their employees weren’t tested. According to our claim analysis, nine Y members died following medical episodes that started at the Y.
As the graphic shows, West Bend did not make claim payments on any of these deaths. While the statistic may sound cold-hearted, it’s a powerful demonstration of the quality of the response by all of the Ys involved.
A thorough analysis by our claims team, medical professionals, and coroners determined our customers did not play a role in exacerbating any of these situations. In fact, considering that CPR was administered almost immediately in every situation and AEDs were used when appropriate, each person who passed away likely received the very best chance of survival at the Y.
A Cautionary Tale
But what would have happened if one of these organizations hadn’t provided a quick response? Could a Y have been found at least partially liable in the death of a visitor? The answer is yes. This happened to a West Bend customer several years ago.
At this pool, lifeguards were on duty at all times and members had access to lap swimming throughout the day. In this particular case, a single swimmer was in the pool. Because the swimmer was there often and was very comfortable in the water, the lifeguard thought it would be okay to step away from the pool deck for a few minutes. While the lifeguard was gone, the swimmer suffered a massive heart attack and went under water. It took several minutes before the lifeguard pulled the swimmer from the bottom of the pool. EMS arrived and the swimmer was pronounced dead at the hospital.
A coroner later discovered the death was caused by a massive heart attack; there was no trace of water in the lungs. The coroner was confident nothing could have saved this person, even if the lifeguard had responded quickly, but because there was just the slightest possibility of survival with a quick response, a jury awarded the victim’s estate significant damages.
As you can imagine, the financial toll was only part of the damage sustained by this organization. Many news outlets picked up the story and the organization’s reputation suffered. All of this could have been avoided if the lifeguard responded quickly and effectively.
Medical Emergencies at the Y
In addition to the near drownings and deaths at the Y, there were a multitude of instances in which Y employees had to respond quickly to relatively severe medical episodes. These episodes included:
- Heart attacks;
- Strokes; and
You may think lifeguards are the only Y employees who must be prepared to save lives. West Bend’s claim analysis shows that isn’t true. Every Y employee must be prepared to use his or her training on a moment’s notice.
Allegations of Abuse at the Y
Discussing abuse, especially when it involves a child, is one of the most challenging aspects of our jobs. Absolutely nobody likes to think about the pain and suffering some children are forced to endure. Unfortunately, the reality is that allegations of abuse are real...and they happen at places like the Y.
In 2014, West Bend received 13 notices of possible abuse. The most notable trend in these cases is that there was no trend. These allegations covered the entire spectrum of abuse.
- Types of Abuse: The claims we received included cases alleging physical abuse, sexual abuse, emotional abuse and neglect.
- Abuse Dynamics: The claims also included virtually every major grouping of age and relationship. We received notices of child-on-child abuse and teenager-on-teenager abuse. We received allegations of employee-on-teenager abuse and adult-on-child abuse. And there were concerns from Y staff that a parent might be abusing a child.
- Veracity of Allegations: There was even a wide range of the perceived truth of these claims. Some of the allegations were later recanted by the accuser. In some cases official charges were filed. And, finally, in some instances, the abuse was even captured on surveillance cameras.
The point of this information is that abuse never looks like just one thing. We can't hope to prevent abuse with a single, straight-forward tactic. Everyone at the Y needs to be committed to abuse recognition and prevention.
Athletic Injuries at the Y
Athletic injuries are nowhere near as traumatic as drownings, death, medical emergencies, or abuse, but they do account for a large portion of general liability claims from the Y so they deserve our attention. Here's a breakdown of every single athletic activity claim we received in 2014, and, as you can see below, basketball is far and away the largest contributor of general liability claims from the Y.
It's worth noting that the extent of the injuries represented in this chart range from minor ankle sprains to severe compound fractures. As you'll recall from the frequency and severity discussion though, any one of these injuries could result in a significant injury if the right factors come into play.
Workers' Compensation Claims in 2014
Workers' compensation claims are generated when an employee at the Y sustains an injury while on duty. These claims can end up costing the Y a lot of money...and not just in medical expenses. If an employee is injured on the job and is unable to perform his or her job duties at the same level pre-injury, the Y may need to hire additional help to fill the void. It's in absolutely everyone's best interest to prevent worker injuries. Here's how Y employees were injured in 2014.
Claim Counts by Cause of Loss
Just like with the general liability claims, employees found a wide variety of ways to get injured while at the Y. In this section we'll highlight some of the most frequent causes of loss.
We won't be going into detail on the lifting, struck (by) object, or trip categories. All three result in a large number of claims, but, for the most part, preventing these injuries is simply a matter of slowing down and being more deliberate. The athletic activity and fitness activity claims, on the other hand, require systemic changes if we have any hope of reducing their impact.
Athletic Activity Claims
After tripping claims, getting hurt while performing some sort of athletic activity is the most common cause of workers' compensation claims. This has been the case year after year for our Y customers. It's important to point out that this category only includes athletic activity related to sports and camp programs.
As you can see in the bullet points above, Y employees are suffering a wide range of injuries in a wide range of athletic activities. Many of these athletic activity claims are relatively minor injuries like sprains and strains, but, as we've already discussed at length, any one of these minor claims could result in something more serious like a fracture, ligament tear, or concussion. When it comes to worker safety, there really aren't any small injuries.
The Impact of Injured Employees
The impact of an employee getting injured on the job goes far beyond the pain, the paperwork, and the claim payments. When an employee is restricted from performing their duties in any meaningful way it falls on their supervisor to find a way to fill the gap. Take, for example, a camp counselor that suffers an ACL tear while working. This employee will miss at least a few days for surgery and initial recovery. After that, the Y needs to find light duty work for the employee that doesn't jeopardize their recovery.
But it doesn't end there; who is going to fill the opening left by the injured counselor? Will other counselors take on more children or will the Y be forced to hire someone new? Both options present financial implications, safety drawbacks, and paperwork for the Y.
Setting Priorities: Hiring responsible employees vs. hiring fun employees
Considering that the vast majority of these athletic activity claims occur during camp or youth programming, it isn't hard to imagine the potential for these reckless employees injuring children in their care. Consider the first claim listed in the image above; what happens if the employee who scraped their head on a basketball rim proceeded to fall on top of a young child? Or what if the Y employee that fractured their ankle while skating collided with a group of campers? These already stressful situations are amplified when a child's well-being is called into question.
Each Y must consider every employee's primary responsibility. Is a camp counselor's primary responsibility to ensure that all campers go home in one piece, or is it their job to make sure kids have the most fun camp experience possible? These things don't have to be mutually exclusive, but there are absolutely situations in which a counselor must decide between the two. After all, a counselor can't fully supervise children if they're busy showing off their athletic prowess.
Fitness Instruction Claims
Beyond employees getting injured while playing sports, West Bend is also seeing a trend develop with group fitness instructors getting injured on the job. As the chart below shows, group exercise classes account for the majority of fitness-related claims, and BodyPump classes in particular account for more than one in three injuries.
How Much is Too Much?
Many Ys have instructors that teach multiple classes every week. In many cases, these instructors are actually teaching multiple classes every day. While an instructor may be able to teach multiple Silver Sneakers classes or relaxing yoga sessions without issue, in general, intense fitness classes are eventually going to take a toll.
Y managers who oversee fitness class scheduling need to consider how many classes each instructor is teaching in a given week. If a class requires the instructor to fully exert themselves then there should be a recovery period built in to the schedule. With that said, the large majority of fitness classes can be taught effectively without the instructor actually exerting themselves in class. In fact, many classes may be even more beneficial to participants if the instructor is more focused on ensuring participants are using the correct form and technique.
Gender's Role on Workers' Compensation
Prior to starting this thorough claims analysis, we asked several of our customers to report the gender breakdown of their workforce. We wanted to establish a rudimentary benchmark for the proportion of workers' compensation claims submitted involving men vs. women.
According to the Ys we spoke with, the average gender breakdown was 70% female and 30% male. The narrowest split we encountered was 65/35 and the largest was closer to 80/20.
We started our analysis by identifying what the gender breakdown would be for each cause of loss assuming an even split across departments. The chart below shows what the 70/30 split looks like for each.
Obviously, some departments and job duties are going to be skewed towards one gender over the other. For example, it's safe to assume that most employees working in a childcare capacity will be females, while most employees working in a maintenance/facilities capacity will be male. We can actually see this play out in the chart below which shows the actual gender breakdown by cause of loss.
The dark yellows and blues you see in this chart represent the increase beyond the expected result. The dark yellow box you see in the "Slip" category, for example, shows that significantly more than 70% of these injuries are being sustained by women. Athletic Activity claims, on the other hand, show a split that is closer to 50/50, so we see a dark blue box representing the different from the projected 70/30 ratio.
Before we started this analysis we had hypothesized that men would account for a disproportionate number of work comp claims. The results of the analysis show that this simply isn't the case, however. The actual gender split of 72/28 is close enough to our projected result that we feel confident saying women that work at the Y are just as likely to be injured on the job as men.
Age's Role on Workers' Compensation
The final workers' compensation breakdown West Bend did was on the age of employees at the time of their injury. Unlike our gender analysis, we were unable to obtain a standard age breakdown for our Y customers, so we are unable to determine if these age ranges are proportionate to the population.
We can say is that these numbers didn't surprise us. We see a large portion of work comp claims in the summer months, and the bulk of employees hired during this time fall within the 19-24 category.
Property Claims in 2014
After general liability and workers' compensation claims, property claims are the next most common claim type.
The chart you see below shows the various causes of loss for property claims in 2014. The five causes at the top (shown in blue) represent circumstances caused by weather events. To a large extent, these claims are unavoidable. There are some steps that a business can take to mitigate the impact some of these claims have, but, typically, we're at mother nature's mercy.
More than any other line of business, property claims can change dramatically from one year to the next. In 2014, for example, we saw a large number of wind-related claims. In other years we might expect to see more frozen pipe claims or more damage caused by fires. The important thing for organizations to remember is that we must be prepared for all of these causes of loss.
Auto Claims in 2014
Auto-related claims from YMCAs in 2014 were relatively quiet. The majority of claims were either very minor fender benders that occurred in parking lots or minor collisions with deer. The single largest auto claim we experienced last year resulted from a tree falling on a parked vehicle.
We attribute these stellar results to Ys committing to training drivers and limiting dangerous activities. We couldn't be happier with these results.