Placing You First Insurance Podcast by CRC Group
The Placing You First Podcast spans a diverse spectrum of insurance industry issues to keep you and your clients informed.
Placing You First Insurance Podcast by CRC Group
Navigating the Senior Living Insurance Landscape
Listen in as Lee McClure a Senior Healthcare Broker with Team CRC in Birmingham, Truitt Taylor, a Broker with CRC Group’s Jackson, MS office, and Rebecca Adelman, founder of Adelman Claims Management, discuss the terrain of the senior living insurance marketplace. Our guests discuss evolving litigation trends, from staffing quandaries to medication missteps, and lay out the blueprint for proactive claims management as well as other tools, insights, and strategies that can empower retail agents to help their insureds make more informed choices when it comes to their insurance programs.
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Hello everyone. Today, scott and I are joined by some of the best healthcare brokers we know. We've got Lee McClure, a senior healthcare broker from CRC Group's Birmingham Alabama office. We've also got Truett Taylor, an SVP and broker with our Jackson Mississippi office, and finally, last but not least, we have special guest Rebecca Adelman, founder of Adelman Claims Management, an organization providing claims and litigation management services for future care. Rrg, a risk retention group that offers professional, general and employee benefits, liability as well as other supplemental coverages for senior care providers across 32 different states. This is the Placing you First podcast from CRC Group.
Amanda Knight:Well, I think it's safe to say we've stacked the podcast today, Scott.
Scott Gordon:Yeah, absolutely. Thank you all for being here. So let's jump in with sort of a reader's digest version of what the senior living market is like in early 2024. Each of you kind of can you give us a one sentence summary that sort of sums up the market right now.
Lee McClure:Sure, this is Lee McClure. I'll go ahead, I think right now from a one sentence standpoint, I believe it's very unpredictable. You know a lot of new interns in the marketplace We've liked renewals are very challenging. Just rates and just the whole overall process is very unpredictable.
Truitt Taylor:And I would tend to agree with Lee. I'd probably use the word volatile. It's unpredictable and volatile. The claims are still there, but there are new market entrants and I think everybody's just trying to get their hands around what the claims are going to look like coming out of COVID and what this new competition is going to do to the terms and the pricing as we go forward into 2024.
Rebecca Adelman:Yeah, this is Rebecca. Thanks again for having me. For my perspective as a lawyer and a claims manager, my sort of one sentence on what the marketplace is like now. The general marketplace, is it some risky litigation business? I think it's a little risky in the litigation world, which then lends itself to some proactive claims management.
Amanda Knight:Well, you're talking about claims and the fact that the marketplace is, you know, a little volatile, for lack of a better word. We know that senior living facilities are under pressure, right, they've got rising costs, they've got staff shortages and, in an effort to reduce expenses, some facilities may be looking for an alternative liability option. New entrants to the market may offer some lower prices than an incumbent carrier. However, is a new carrier always the right long term solution? What do agents and insurers need to consider before making a change like that in an effort to garner some short term savings?
Truitt Taylor:So I think I can take that one to start. I mean, the first thing is prices, just one of the metrics that you want to consider when you're considering insurance for your senior living facility. The next one is the terms and conditions of the policy, because they all differ. Everybody's policy is totally different. It's written individually for each individual carrier and there's a lot of restrictions that are being put on there. So just because it's the cheapest doesn't always make it the best. And then the third is really the longevity and the claim handling ability of the carriers. How long have they been in the market? What's their experience been in handling claims and what's their experience going to be? What's your experience going to be with them handling your claim? Because it's all good to save a few dollars on the front end, but if it costs you a lot in the long term, that's really not the best option for you.
Lee McClure:Yeah, I think Truitt nailed it there.
Lee McClure:To me there's a lot of value in understanding who your claims adjuster is the process of claims reporting you can't really put a price on that, and when you have to reinvent that on your account executive level, a lot of things can get missed. The other thing I would add too and I think Rebecca could comment on this would be Anytime you go with a new entry or a new market, they've never had a defense verdict, so they don't know how to attack a senior housing claim or even what the process could look like, until you're there and now you're spending more money defending something that may have been settled with your previous carrier because there was rapport and there was. You know a rhythm to. You know being with someone for an extended amount of time. And then, like you had mentioned, you know certain mechanics of the policy. You know anytime you change carriers, you may assume that you have certain functions, but don't. And that's where you can realize that the cost of save money up front ends up costing more because you didn't have certain luxuries.
Rebecca Adelman:Yeah, for me this falls into this.
Rebecca Adelman:Is Rebecca, this falls into Pennywise pound foolish?
Rebecca Adelman:I think what I have seen with our risk retention group is that it really is about subject matter expertise and being able to align the mission and the vision of your senior living you know portfolio with your claims group to really get to know who you are.
Rebecca Adelman:It's a very complex ecosystem senior living is, and so really to sort of a short range look at, you know, saving a few dollars on the bottom line versus the long range view of how do we proactively mitigate risk, how do we work on our claims and try and use the claim, you know, the claim expertise that we have in senior living, for example, both from a legal standpoint, from a risk management standpoint, to, you know, help manage all of those resources with a long view. I don't think this can be a short view. Senior living isn't a short view. It never has been. So I think that's making sure that you know there's proactive risk mitigation strategies in place that are tried, that are true, and that you've got subject matter expertise, you know, in the, you know with the carrier on the claim side. That's, that's those would be my key factors that I think should be considered.
Scott Gordon:Well, and this will be a good jumping off from that and maybe a little redundancy here but in the last few years, especially the senior living sector has evolved a bit, especially post pandemic. So what trends are emerging around the data? Underwriters want to see submission requirements, exclusions or other areas that agents need to be aware of.
Lee McClure:I mean, I think the biggest thing we're seeing right now from a submission standpoint is there's a lot of emphasis on staffing levels. I mean, obviously we've talked about that really since COVID that you know a lot of undriders are really focused on the staffing levels. You know people that are overworked and there's a large, you know, patient to staff ratio. Then the assumption is at some point something's going to be missed, which could obviously, you know, turn into an adverse event. I think financials are becoming a larger requirement now, especially if an insurer is looking to take on a larger deductible to make sure the facility is solvent. And then, unfortunately, you know the 10 plus years of lost data, which is really challenging if they've changed hands multiple times. From an exclusion standpoint, we're seeing markets put up class action exclusions. I think all of that stem from COVID, potentially. But you've got markets that you know there is no wiggle room there and then, depending on the market, you have people that may sublimit certain adverse events, whether it's a slip and fall, bed sores, pressure ulcers, certain scenarios like that.
Amanda Knight:In addition to the kinds of trends we're seeing around, what kind of data underwriters want to see? Are we seeing trends when it comes to litigation or claims Like are we seeing claims based on lack of staff or other issues needed to that?
Rebecca Adelman:You know, I think we're seeing more and more. If we look at it from the 10,000 foot view, the trend is really about corporate liability. So we're moving from the direct operator care provider and zooming out to corporate exposure. And then baked into corporate exposure is corporate management, is private equity, is staffing budgets. So you've sort of got this sort of large. You get this focus on how corporate management, corporate compliance and corporate liability is what their operations look like. I think we're seeing more and more of that. And management also, and I think that goes to sort of underwriting making sure we're underwriting to good management. And I'm seeing trends in assisted living. I'm seeing more and more assisted living cases. The population in assisted living has changed a lot and we're seeing more and more on the assisted living and memory care side.
Rebecca Adelman:Post pandemic, of course, we all know we're seeing much higher verdict. So I think post pandemic, you know our, our juries, the people who are making the decisions around these cases are seem to be much angrier. And you know senior living has been the focus of sort of poor reputational issues anyway. But I think post pandemic it's really escalated. So I think we're trying to overcome these massive hurdles when it comes to reputational issues and senior living. So those are some of the trends much more medication error stuff, a lot more defendants in cases where it used to just be the senior living operator. We're seeing physicians, we're seeing you know pharmacy, we're seeing you know rehab, we're seeing hospice, so we're seeing sort of the whole ecosystem as a set of defendants. So got sort of some new, new, new game plans, new playbooks since the since the pandemic, I think.
Truitt Taylor:I mean, I would add to that she hit on it some of the private equity stuff, but there's been an abnormal amount of merger and acquisition activity after the pandemic. There's just been a lot of like like a lot of industries. There's been a lot of consolidation in the senior living space, and so, from a placement perspective, we are getting a significant amount more questions from our insurance carrier underwriters trying to determine exactly who owns the facility, what experience they have, where they came from, what other facilities they've managed or owned. We're getting we're getting a lot more questions related to all right, not just what is the name of the facility, but who is the person or persons that I'm ensuring, who, who are the people running this facility?
Amanda Knight:Well, with those trends in mind you know sort of those, like you said, the 10,000 foot view, these big macro trends with more defendants, you know hitting claims, that sort of a wider claims going to have a wider ripple effect than maybe ever before. With that in mind, how can senior living facilities navigate that claims process effectively to try to ensure a timely resolution and minimize, you know, disruptions to the way they operate?
Rebecca Adelman:Yeah, I think it all starts with, I think, from from our perspective as the claims management group for future care, our goal is to stay as proactive as possible and to know as much about the internal enterprise risk management of our clients, understand their you know their management's internal policies, procedures and protocols and so that we can really help them proactively on the risk side. Number one in terms of claims management is to, again, you got to make sure that the folks who are handling your claims have subject matter expertise. It's so critically important. It's a very, very complex claim. Senior living is and and continues to become more complex. So and and so I think that's kind of some of the keys and just make sure you've got great communication with your claims managers. Make sure you involve everyone. Break down the silos in your own organization, in your own senior living organization. Break down those silos so you are getting internally feedback and involvement in the claims process from everyone who appreciates and understands that risk belongs to everyone.
Lee McClure:Yeah, Rebecca nails it there. This is Lee, and I mean the biggest thing that we tell our brokers is it's okay to report anything you thought could give rise to a claim. Because what we see insurers getting trouble is it's a locally owned property, they know all the residents, they assume nothing's ever going to come of a potential situation. And then it does, and then they've either failed to report in a timely manner and then everybody's kind of backpedaling to honor the filed claim. So if anything happens we always say report. If nothing happens it doesn't negatively affect you, it doesn't even go on the law throne until there's either defense filed or there's indemnity that may be triggered. But to me it's always a good steward to your insurance, to your claims team, to always report. That way you're not missing anything.
Truitt Taylor:You know we're talking about handling the claims and making sure that the claims process runs smoothly, and we talked about the new insurance and some of the new insurance into the market, some of the evolution of the market. I think it's always important to have a broker or an agent that understands the market and isn't going to, you know, we'll go back to what Rebecca said a pennywise pound full. Place you with a carrier that doesn't have a claims apparatus with an experience to handle a complex senior living claim.
Scott Gordon:Right.
Rebecca Adelman:And to add to that too, scott, you've got to make sure that your attorneys that are being assigned to defend these cases really understand how to defend senior living. These are not medical malpractice cases, they're not general liability cases. You know they are very unique and have these qualities that are very, very unique. So again, you know, understanding leverage points all of that is very, is very critically important on the claims side, I think.
Scott Gordon:You know whether it's placing business or working through a claim. At CRC group, we pride ourselves on being, you know, specialists that can get the job done for our retail partners. So how can partnering with the CRC group producer help agents with health care or senior living industry insurers?
Truitt Taylor:So I think, first it's the expertise right. So for most of us this is predominantly all we do all day, every day, is handle placements for senior living operators. So with that comes you know what I'm going to call unparalleled market access and products that they're going to get from us that they can't get anywhere else. They get the expertise, and so what they get it really is the guidance and the specialty to know that when they bring a risk to us it's going to be placed with the proper carrier, at the proper price, with the proper terms and conditions.
Lee McClure:in a nutshell, yeah, I would agree with that. Truett, I think you know, obviously, working with a large wholesaler like CRC, you know we do have a lot of leverage in the marketplace. So I do think anytime you can partner with a specialist in addition to a retail broker who also specializes in the senior housing vertical, I think it presents well to the marketplace and I think you know certain underwriters see that as a favorable combination and I think we're able to utilize both sides of the fence like hey, this is coming from this retailer, this wholesaler, and then, you know, we also get the privilege of utilizing the best of the best underwriters, those who are very broker-minded, who want to write business just as much as we do. I think once you, you know, have that partnership and that expertise, it shows. It shows in a way that you know CRC's healthcare practice group writes $700 million in gross profit and premium, with 45% of that being senior housing driven. I don't think anybody in the country can uh, say that those are some great numbers.
Amanda Knight:Now, rebecca, I know this wasn't on the outline, but you know these guys that we've got on the podcast today. Do you vouch for?
Rebecca Adelman:them. So I've known the guys at c r c. I go way back with rusty and uh have been. You know, I've been in the senior living industry for 35 years, so this is, you know, this is where I've spent really all my time, uh, as a defense lawyer, as a claims manager, uh, as a risk eliminator.
Rebecca Adelman:I like to say so, yeah, I've known c r c for for decades and um, you know, the reason that future care has aligned itself with c r c is because of, you know, their expertise and their, you know connectivity in the um, in the marketplace and how they really do deliver and and how it intersects with our mission vision of how they really deliver um, the finest, really the finest product and and services. So I think, uh, you know that's, there was just a total alignment of our um, of our value sets in senior living, in in choosing the you know our broker partner, so, um, but yeah, I've known them, I think, true, and I've known to use a baby. These are like little kids, true, and we are children compared to. So, anyway, thank you for asking, amanda. These relationships are, they are the most important drivers of, of quality really yeah, and all reality.
Truitt Taylor:Rebecca and I probably did meet on this 20 years ago, so I don't know I don't know who that's telling on more she or I, but it's been at least 20 years of relationships, so it has it has.
Amanda Knight:I think that says great things about both future care rg and about c rc group. When we say we have long lasting, thriving marketplace relationships, we back that up, and you guys just did that. You know you've, you've known each other for 20 years, so that says something to me, and I think it says something to our listeners too we've got.
Scott Gordon:C rc has a deep bench, no doubt, yeah, we've got. We've got a lot, a lot of knowledge here all right, scott, take us home um, well, uh, if anyone has anything else to add, otherwise we can get to the fun stuff. Do you guys want to answer some, uh, rapid fire questions? What are those? Okay, well, this is just a little quick thing we do. We just have a rapid fire where you just answer the first thing that comes into your mind. There's no right or wrong answers no, no right or wrong we'll go.
Scott Gordon:Uh, we'll go alphabetical, by last name. Yeah, we'll go. Rebecca lee, and true, it first one. This is pitched to rebecca first. If you had to eat one meal for the rest of your life, just one meal what would it be?
Lee McClure:um um vegetarian omelet healthy, healthy, good choice lee uh, mom, to be steak for sure we got the vegetarian and the carnivore.
Amanda Knight:All right, true it.
Truitt Taylor:You're up, I'm gonna, I'm gonna fall in the middle and say spaghetti oh nice, that's some good answers number two what's your biggest irrational phobia and why?
Rebecca Adelman:what's yours?
Amanda Knight:amanda and get us rolling.
Rebecca Adelman:All my teeth falling out at one time, oh my gosh I have nightmares amanda, amanda, that is the craziest thing I know, that is mine I have dreams about that me too, they coming out uh-huh.
Amanda Knight:They say it's a stress dream, but I have nightmares where they do they do.
Rebecca Adelman:Well, if that's the case, then then you're, we're in the same boat, all my and my hair and my hair I know what about you guys.
Amanda Knight:Do you guys have any weird stress, dream slash phobia?
Lee McClure:mine's probably missing a flight, oversleeping for an early oh, whatever reason. Anytime I travel, I don't sleep, but I'm constantly waking up. Same, so it's just more of those like oh, I'm sleeping longer than I need to be, but yet you know, it's still early in the morning yep, true.
Amanda Knight:Are you fearless?
Truitt Taylor:I don't know about fearless, I will say you know, one of my phobias is probably heights. So you can't, you can't tell this from the podcast, but I'm I'm not very tall, so I don't like being far off the ground, me neither me neither.
Scott Gordon:True it wow, okay, now this last one. Yeah, this, I'm gonna expand a little bit on this one. If you could time travel, travel, when would you go and where would you go?
Rebecca Adelman:oh goodness, gracious everybody, I go back to 1976 and I would go to cedar point in sandalsky, ohio, in this big amusement park where I would spend days with my dad, who has since passed. So that is what I would do. I would go back and spend time with him. That's what I would do.
Amanda Knight:That's sweet anybody else want to try and travel well, yeah, I don't know.
Lee McClure:I mean, mom would probably go back in in a period of time that you know. You just read about whether that you know. I mean, I don't know, I really hadn't really thought about time travel, uh, probably just to see what life was like, but, um, there's not a certain time period that I've thought about, but I can tell you where I don't want to go.
Amanda Knight:I don't know where I want to go in the past, but you know I have zero interest in like time traveling too far into the future.
Scott Gordon:I feel like maybe I don't want to know I was gonna say nobody wants to go to the future anymore right, just surprise me
Truitt Taylor:I mean I, I was gonna say I, I. You know I had trouble getting logged into the podcast so I probably didn't know how to do future well.
Amanda Knight:Thank you all for being here, even when you had a little technical difficulty. We appreciate your patience, rebecca, we also really enjoyed having you as a special guest with us today. Thanks for having me, you guys. If you're a listener, we appreciate you too. Providing current insights into the marketplace is just one more way crc group is placing you first. Don't forget to subscribe and share.
