Applied Risk: Featured News

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The Industrial Code Rule 60 Workplace Safety and Loss Preventive Incentive Program was established on September 2, 2009 as part of New York State’s efforts to reduce the number of and the cost associated with occupational injuries and illnesses in the workplace. The regulation encourages and rewards employers who implement a quality, cost effective safety, return to work or drug & alcohol prevention program.

For all practical purposes, the program only began to offer credits for approved plans in the Spring of 2010. Applied Risk conducted the review and assisted a client in receiving the first credit issued in the State of New York on 7/1/10. Credits for Workers Compensation policies are available for self insured's and fully insured businesses that have one, two or all three of the incentive programs underlined above.

For additional information, please do not hesitate to contact Harry P. Mirijanian, president.

US Labor Department's OSHA publishes proposed rulemaking to prevent injuries from slips, trips and falls on walking-working surfaces

WASHINGTON — The U.S. Department of Labor's Occupational Safety and Health Administration has announced in a notice of proposed rulemaking published in today's Federal Register its plans to require improved worker protection from tripping, slipping and falling hazards on walking and working surfaces. A public hearing on the revised changes will be held after the public comment period for the NPRM.

"This proposal addresses workplace hazards that are a leading cause of work related injuries and deaths," said Assistant Secretary of Labor for OSHA Dr. David Michaels.

The NPRM describes revisions to the Walking-Working Surfaces and Personal Protective Equipment standards to help prevent an estimated annual 20 workplace fatalities and more than 3,500 injuries serious enough to cause people to miss work. For example, in July 2009, a worker at a chocolate processing plant was killed after falling from an unguarded work platform.

"This is a clear and grave example of the human cost incurred when fall protection safeguards are absent, ignored or inadequate," said Michaels. "The loss of a worker's life might have been prevented if the protective measures in these revised standards had been in place and in use."

The current walking-working surfaces regulations allow employers to provide outdated and dangerous fall protection equipment such as lanyards and body belts that can result in workers suffering greater injury from falls. Construction and maritime workers already receive safer, more effective fall protection devices such as self-retracting lanyards and ladder safety and rope descent systems, which these proposed revisions would also require for general industry workers.

The current walking-working surfaces standards also do not allow OSHA to fine employers who let workers climb certain ladders without fall protection. Under the revised standards, this restriction would be lifted in virtually all industries, allowing OSHA inspectors to fine employers who jeopardize their workers' safety and lives by climbing these ladders without proper fall protection

COLUMBUS — Ohio Department of Insurance Director Mary Jo Hudson has announced that the Department has revoked the license of Atlantic Mutual Insurance Company (AMIC) of New York, New York for violations of Ohio insurance law.

AMIC reported a negative capital and surplus of $25,106,505 as of December 31, 2009 in its annual financial statement. Ohio insurance law requires insurance companies that have authority to write commercial lines of business, like AMIC, to maintain a minimum capital and surplus of $5 million to do business in the state of Ohio and allows the Director to revoke a company’s license for failing to do so.

AMIC has not written any new business in Ohio since November 2007 and there are no current policyholders in Ohio. However, Ohio policyholders that have a claim under a policy with AMIC can still file claims with the Company.

The Director suspended AMIC’s license on March 15, 2010 and revoked its license effective May 3, 2010.

2007 MURDER LEADS TO ARREST OF NORWICH APARTMENT OWNER FOR WORKERS' COMPENSATION FRAUD AND PERJURY

The owner of a Norwich apartment complex was arrested for fraud Thursday in connection with his failure to provide workers' compensation insurance for an employee who was raped and murdered in 2007.

Douglas Kelly, 50, of Hill View Drive, Norwich, was arrested following a joint investigation by the New York State Insurance Department's Frauds Bureau and the Workers' Compensation Board Office of the Inspector General.

Kelly is accused of failing to insure Tammy Periard, who was employed by Kelly as a property manger when she was killed. He is also accused of lying by testifying at a Board hearing that Periard did not work for him.

Binghamton police arrested Kelly on charges of perjury and workers' compensation fraud. He was released on his own recognizance pending a hearing to be scheduled in Broome County Court where the case will be prosecuted by Assistant District Attorney Michael Garzo. Kelly could be sentenced to up to seven years in prison if he is convicted.

Authorities learned that Kelly failed to carry insurance when Periard's estate filed a death benefit claim with the Workers' Compensation Board. The Board paid the woman's estate $50,000, an amount Kelly reimbursed to the Board earlier this year. The money was paid from the Board's Uninsured Employers' Fund, which pays claims for people whose employers neglect to carry workers' compensation insurance.

In addition, Kelly also paid $5,000 for Periard's funeral and another $6,000 in penalties to the Board for failing to carry insurance. Kelly also has an outstanding $30,000 penalty for operating without insurance this year. He is disputing the penalty, saying he doesn't have any employees.

Periard, 45, worked for Kelly Management. She managed several apartment buildings owned by Kelly in the Norwich area. Her body was found inside a first floor apartment at a Henry Street apartment complex in March 2007. The tenant of the apartment, Daniel L. Brown Sr., was arrested for her murder. He was sentenced to life in prison in December 2007.

TALLAHASSEE, Fla. – Florida Insurance Commissioner Kevin McCarty today announced the Office has ordered 16 workers' compensation insurance companies or groups to return a total of over $9.4 million in excessive profits to their policyholders.

Workers' compensation insurers are required to return excess profits pursuant to Section 627.215, Florida Statutes. The Office recently performed an evaluation of submitted data that included earned premium and incurred losses. The Office determined that 16 different workers' compensation insurance companies or groups realized excess profit as defined by statute for the 2005, 2006 and 2007 calendar/accident years.

"These results confirm the importance of the workers' compensation insurance reforms enacted by the Florida Legislature in 2003, which continue to yield positive results," stated Commissioner McCarty. "These premium refunds contribute to lowering costs for Florida businesses and in contributing to our state’s future economic growth."

US Labor Department's OSHA cites Linden, NJ, manufacturer for exposing employees to chemical hazards

LINDEN, N.J. - The U.S. Department of Labor's Occupational Safety and Health Administration has cited Infineum USA L.P. for 22 workplace safety violations, including exposing employees to chemical hazards, at the company's Linden facility. Proposed penalties total $88,500.

OSHA initiated its inspection on Nov. 24, 2009, in response to a complaint related to a chlorine release at the facility. As a result of the inspection, the company has received citations for violations related to a deficient process safety management system. Among the hazards observed by OSHA inspectors was the company's failure to establish and implement written procedures required to manage any changes to technology, facilities, equipment and procedures that can potentially impact a chemical process.

"Chlorine is a highly hazardous chemical that can have a severe impact on employees' safety and health," said Patricia Jones, director of OSHA's Avenel Area Office. "All aspects of the OSHA process safety management standard must be followed by employers in order to ensure that workers go home safe at the end of the day."

The PSM is intended to prevent or minimize the consequences of a catastrophic release of toxic, reactive, flammable or explosive chemicals from a process. A process is any activity or combination of activities including any use, storage, manufacturing, handling or the on-site movement of highly hazardous chemicals.

Infineum USA L.P. is a manufacturer of petroleum additives with 262 employees at this site.

Commissioner Poizner Announces Manhattan Beach Woman Arrested On $500,000 Bail For Alleged Disability Insurance Fraud

Insurance Commissioner Poizner today announced the arrest of a San Diego woman for allegedly filing fraudulent disability insurance claims. Wanda Podgurski (aka Wanda Lee Ann Plager), 57, of Manhattan Beach, was arrested at her home and booked in the Los Angeles County Jail on $500,000 bail. Podgurski was charged with 38 felony counts by the San Diego District Attorney's Office on May 26, 2010.

"If you file fraudulent disability insurance claims, you will face serious consequences," said Commissioner Poizner. "CDI enforcement officials in San Diego and throughout the state will continue to make sure that insurance fraud perpetrators are brought to justice."

From 2004 through 2006, Podgurski purchased long term care insurance policies from Prudential Group Insurance, Kanawha Insurance Company, Unum Life Insurance Company and Metropolitan Insurance Company. She had disability income policies with Balboa Insurance Group and Reassure America Life Insurance Company. Beginning on August 30, 2006, Podgurski filed claims with all six insurance companies for benefits. She also filed a disability claim with her employer, Amtrak.

Podgurski allegedly claimed she had fallen down the stairs at her home and had injured her back, hip and leg and was unable to work and care for herself. She claimed she needed daily care and hired various caregivers to care for her in her home. An investigation revealed that Podgurski was allegedly not incapacitated and could perform activities of daily living without the aid of a caregiver.

Wanda Podgurski allegedly filed fraudulent claims for disability insurance benefits from Balboa Insurance Group, Reassure America Life Insurance Company, Prudential Group Insurance, Kanawha Insurance Company, Unum Insurance Company, Metropolitan Life (MetLife) Insurance Company and Sickness Benefits for Railroad Employees, United States Railroad Retirement Board, when she reported she was unable to work and care for herself. Podgurski received $626,395.15 in disability and long term care benefits from 2006 through 2009.

The San Diego County District Attorney's Office is prosecuting this case. Podgurski's arraignment is pending.

A 60-year-old Red Hook man got workers’ compensation payments after he swore he could hardly get out of the house and could not even walk after a work-related injury. But former Poughkeepsie Housing Authority employee Philip Silvernail of 5 Hewlett Road, still managed to both carry and paint on a ladder, replace window shutters and an outside deck, install awnings and stair rails, and operate a backhoe, according to a New York State Insurance Department investigation.

Silvernail had been awarded total disability payments by the New York State Insurance Fund after reporting a back injury on his job at the Housing Authority in January 1992. This alleged misrepresentation of his work status resulted in an overpayment from the State Insurance Fund in the amount of $20,546.20. Now Silvernail faces up to seven years in state prison after being charged with insurance fraud in the third degree.

Silvernail was arrested on June 7, processed at the Dutchess County Sheriff’s office and transported to the Village of Red Hook Town Justice Court where he was arraigned before Town Justice Jonah Triebwasser and released on his own recognizance to reappear on June 24.

Senior Investigator J. W. Kochetta, Jr., conducted the investigation for the Insurance Department, assisted by Investigator John Cozzolino of the New York State Insurance Fund. Detective Vincent Stelmach of the Dutchess County Sheriff’s Office assisted in the arrest. The case is being handled by Dutchess County Assistant District Attorney Anthony Parisi.

An Oneida County auto mechanic who fraudulently collected $24,570 in workers' compensation benefits was sentenced to make full restitution after pleading guilty to lying about injuries he claimed left him unable to work, the New York State Insurance Department reported.

Ronald J. Snyder, 41, of State Route 49, North Bay, was sentenced in Oneida County Court. In addition to paying restitution for the wage replacement benefits he accepted, he was ordered to serve five years' probation.

Snyder admitted violating the Workers' Compensation Law. He was accused of filing false documents with the New York State Insurance Fund claiming that job-related injuries he suffered in 2003 and 2004 left him unable to work while he was actually employed as a mechanic.

A joint investigation by the Insurance Department's Frauds Bureau, the Insurance Fund and the New York State Workers' Compensation Board Office of Fraud Inspector General led to Snyder's arrest in August 2009.

"I’d rather be a failure at something I enjoy than a success at something I hate."
- George Burns