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Municipalentitiesacrossthecountryarelookingforwaystocutexpenseseachfiscalyear.Moneyisconstantlybeingre-allocatedto
variousprogramswhichresultsindecisionmakerstakingactiontofindnewsourcesofrevenue.Onesignificantlineiteminafiscal
budgetistheadministrationoftheentities’riskmanagementprogram.Municipalitiesarecontinuouslyre-evaluatingtheirrisk
managementprogramtodetermineiftherearebetteralternativesthatcouldsavemoneybutlimitexposure.
In2003,the*NewYorkTimespublishedanarticlethatdiscussedtherisingcostsofinsuranceinapost9/11era.Thearticle
concludedthconcludedthatmoreandmoretownsandcitieshavecometotherealizationthatself-insuringtheirexposuresisacosteffective
alternativetopurchasinganinsurancepolicy.Whenself-insuranceisnotaviableoption,manymunicipalitiesmakethedecisionto
carryalargeretentionforeachlineofbusiness(perhaps$100,000.00)andpurchaseaninsurancepolicytocoveranyincidentgreater
thantheretention.
Municipalitieswhoself-insureorcarrylargeretentionsarefacedwithuniquechallenges.Oftentimeswhentheyexperiencealossto
theirself-insutheirself-insuredpropertytheyfindthatthereisathirdpartywhosenegligencecausedtheloss.Thisputsthemunicipalityinaposition
wheretheyhavepaidtorepairorreplacedamagedproperty;howevertheywerenotresponsibleforthedamages.Whenthisoccurs,
themunicipalityhastherighttoplaceaclaimagainsttheat-faultpartytorecouptheirloss.Thisiscommonlyreferredtointhe
insuranceindustryastherightofrecoveryorsubrogation.
Insurancecompaniesrelyontherecoveryprocesstobringbackmoneypaidouttothebottomline.Thereisanintricateprocess
setuptoensusetuptoensurethatrecoveryeffortsaresuccessful.Priortoreceivingthesubrogationreferral,thereisateamoffrontlineadjusters
whohavegatheredallofthepertinentinformationandevidencethatwillbenecessarytosecurearecovery.Insurancecompanies
hireteamsofexperiencedlicensedadjusterstopursuetheirrecoveryinterests.Theseadjustersspendhoursonthephoneeveryday
negotiatingtheirdemandstobringbackthemostmoneyonbehalfoftheiremployer.Theircompensationisdirectlycorrelatedwith
howsuccessfultheyare.Intheeventthattherecoveryadjusterisunsuccessful,mostinsurancecompaniesaremembersofArbitration
FForums,whichallowsthemanalternativerecoursetoresolvethesubrogationclaim.
Unfortunatelypublicentitiesaresimplynotsetuptosecureasuccessfulrecovery.Therearethreeuniquechallengesthatmunicipalities
facewhenattemptingtorecovermoney.Thefirstchallengetoovercomeistheinvestigation.Therecoveryprocessatatypical
municipalentityisverydifferentfromtheprocessestablishedbytheinsurancecompanies.
*Goodenow,Evan.HighCostsForceTownstoSelf-Insure.TheNewYorkTimes,2003.
PublicEntitiesandSubrogationRecovery
Whenmunicipalpropertyisdamagedbyathirdparty,theresponseisnotfocusedonobtainingtheinformationthatwillhelp
recoveryefforts.Rathertheresponseisfocusedonsecuringtheareatoavoidfurtherdamageorinjury,followedbyrepairor
replacementofthedamagedproperty.Oncetherepairsarecompleted,themunicipalitymayormaynotcreateaninvoicethat
reflectsthecostsassociatedwithrepairingthedamagedproperty.Eveniftheinvoiceisgenerated,manypublicentitiesfailtoinclude
allchargeablelineitems.Asthepartypresentingtherecoverydemand,thepublicentityisfacedwiththeburdenofprovingtheir
claim.claim.Thismeansthatalldemandsneedtobebackedupwithproperdocumentation.
Asanexample,let’sassumethatyouareatownmanagerwhenacarlosescontrolandstrikesatrafficlight,renderingitinoperable.
Theaccidentgetsreportedtothepolicedepartmentwhoarrivesonscenetosecurethelocationanddirecttrafficwhilethelightisout.
Acontractoriscalledouttorepairthelight.Apublicworksemployeeisonscenesupervisingthejobfromstarttofinish.Partswere
ordered,laborwasinvestedanddayswentbyuntilthetrafficlightwasinoperatingorderagain.Atemporarystopsignwasputupto
assistwithtrafficflowwhilethelightwasinoperable.Nowit’stimetopresentyourclaimtotheinsurancecompanythatinsuredthe
at-faultvehicle.Youreceiveaonepageinvoicefromthepublicworksemployeethatlistsreplacementpartsneededtorepairthelight
.
Whatotherinformationshouldbeincludedontheinvoice?Whatcanyoubillfor?Whatdocumentationwillbeneededtoprovethe
claim?claim?
Inthisexample,theobviousbillableitemsarethepolicedetail,contractor’sinvoiceandreplacementpartsorderedtorepairthelight.
Someothercoststhatshouldbebilledbacktotheinsurancecompanyincludethesalarypaidtothepublicworksemployeewho
oversawthejob,thecostsassociatedwithinstallingatemporarystopsign,administrativefeestopreparethedemandandanyother
costsassociatedwiththeevent.Essentially,ifafeewasincurredbecausetheeventtookplace,thefeeisbillable.
Oncethetrafficlightisrepairedandtheinvoiceisgenerated,municipalitiestypicallyrelyonanemployeefromfinanceor
administrationtomanagetherecovery.Personnelissuespresenttheseconduniquechallengethatpublicentitiesfacewhenattempting
torecovermoniesowedtothemafteraloss.Aspreviouslystated,insurancecompanieshirelicensedadjusterswithyearsof
negotiationexperiencetoadministertheirsubrogationrecoveryprogram.Apublicentitydoesnothavethesameresourcesavailable
tothem.Theassignedpointpersonischargedwiththetaskofidentifyingtheat-faultparty,reportingtheclaimtotheappropriate
insurancecompainsurancecompanyandfollowingupwiththeadjusteruntilthemoneyisrecovered.Inaperfectworld,thisprocesstakes
approximately30-60days.Thepointpersonhowever,hasafull-timejob.Becausehisorherprimaryresponsibilityisnotrecovery,
thetaskfallstothebackburner.Thedemandmayormaynotgetsentouttimely.
Thepointpersonmaynothavethetimetofollowupwiththeinsurancecompanyonaweeklybasis.Whatifthedemandgetslostby
theinsurancecompanyandneedstobere-submitted?Nowafewmoremonthsgobyandthepointpersonhasheardnothing.The
processprovestobecomplexandcumbersome.
Afewmonthsgobyandyouremployeehasmadeafewcalls.Suddenly,heorshereceivesacallfromtheinsurancecompanywhois
inreceiptofyourdemand.Thisbringsustothethirduniquechallengethatpublicentitiesarefacedwith.Theadjusterwouldliketo
negotiate.Theadjusterontheotherendofthephonereceiveshundredsofdemandlikeyourseverymonth.Theadjusteris
eexperiencedandknowledgeablebutworsethanthat,theadjusterhasleverage.Sheisbreakingdowneverylineiteminyourdemand.
Shewantstoseetheinvoicefromthecontractor,thetimecardsforthepoliceofficerandthepublicworksemployee,thereceiptfor
thepartsorderedtorepairthetrafficpole,thereceiptforthestopsign,thetimecardsfortheemployeeswhoinstalledthestopsign,
andwhyonearthareyoucharginganadministrationfee?Weeksgobyasyouremployeegathersandsubmitsthedocumentation.
Shecallsbackandoffersyou70%ofyourdemand.Youremployeerefuses,askingherforjustification.Sherespondsthatshehashad
thedemandthedemandreviewedbya3rdpartyvendorwhohastakendepreciation.Theyalsodeterminedthatthelaborratewasexcessivein
comparisontosimilardemandsreceived.Theadjusterconcludesbyoffering75%ofyourdemandandadvisesthatthisisherfinal
offer.Takeitorleaveit.Whatisyourrecourse?
Unfortunately,municipalentitiesareatadisadvantagewhennegotiatingwithaninsurancecompany.Manyinsurancecarriersare
membersofArbitrationForums.Whentwoinsurancecompaniescannotresolveaclaimontheirown,arbitrationoffersan
inexpensivealternativetolitigation.Althoughself-insuredentitiesarewelcometojoinArbitrationForums,mostarenotmembers.
MunicipalitiesMunicipalitiesmustrelysolelyonthenegotiationskillsoftheemployeehandlingtherecovery.Typicallythisemployee’sbackground
isinfinanceoradministration,notnegotiation.Suitisalwaysaviablerecourseiftheinsurancecompanyrefusestomakeareasonable
offerhoweverthecostofretaininganattorneyandfilingsuitisn’tusuallyjustifieddependingonthesizeofthedemandandtheoffer
presentedbytheinsurancecompany.
Whenfacedwiththeburdenofrecoveringmoneyfromaninsurancecompany,publicentitiesareoftenacceptinglessmoneythan
wwhatisowedtothemsimplybecausetheylacktheresourcestoeffectivelyrecoverwhatisrightfullyowed.Whetherit’sadisorganized
investigation,lackofdedicatedpersonnelorineffectivenegotiation,municipalitiesaregettingtheshortendofthesticktimeaftertime.
Whileacceptingthatthesechallengesareinevitableisonepotentialresponse,thereareproactivestepsthatmunicipalitiescantake
toaddresstheseissues.
Engagingaconsultanttoreviewyourinternalproceduresandmakerecommendationsonhowtomoreeffectivelyrecover
outstandingfundsisonesolution.Alternatively,hiringathirdpartyfirmtoadministertherecoveryprogramoffersa
comprehensivesolutiontotheproblem.Whileathirdpartyfirmwillchargeafee,thefeeistypicallyapercentageoftherecovery.
Thissolutionnotonlybecomescosteffective,buteliminatestheneedforadedicatedpersonnelresourcewithinthepublicentity.
Whicheversolutionyoupursue,wehopethatthisarticlehasencouragedyoutore-evaluateyourcurrentrecoveryprogramand
inspiinspiredyoutotakeactiontoguaranteesuccessfulrecoveries.
ArticleCredit:
NicholeMagnifico,CPCU
SeniorClaimsConsultant
401-435-3600x1152
nmagnifico@starshep.com

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