Loading, unloading wheelchair clients poses the biggest exposure to transportation companies
Today, paratransit operators are having difficulty with their financial bottom line. Increases in fuels costs and insurance premiums are high on the list of causes. Reductions in rates paid by transportation management companies are contributing to dwindling or disappearing profit margins. How can this industry survive? Answers to that question cannot be answered in this article. However, reducing losses can reduce insurance premiums. An area that can be overlooked is loading and unloading of wheelchair clients. We’ll take a look at some of the issues and possible solutions.
Wheelchair loading and unloading losses, like all automobile losses, can cause significant hardships on paratransit operators. The bottom line is that these misfortunes cause financial loss. The operator needs to know what these costs are and how proper driver training in securement techniques can reduce them.
The first pinch in the pocketbook can be felt in higher insurance premiums. Remember, the client being transported may already have health issues. A small fender bender involving a healthy person will produce lower medical, lost time and pain and suffering losses, than one involving a wheelchair bound passenger. Since a large portion of an insured’s insurance premiums is based on loss history, the paratransit operator who has had securement losses is starting off at a disadvantage.
In addition to the direct cost of higher insurance costs, there are some hidden costs as well. Depending upon the severity of the loss, claims investigation can cause a unit to be taken out of service. Investigators may want to examine securement hardware to see if its malfunction could have caused the loss. Revenue will be lost in this situation.
There is also the driver situation. If the company has a policy of dismissing at-fault drivers, a new driver needs to be hired. Costs are incurred to hire and train that new person. Not being familiar with routes, clients and vehicles will make the drive less productive than his counterparts.
Loss of public trust will produce harmful results as well. If an operator has a significant number of securement losses, clients will be reluctant to continue their services and may look to a competitor. Negative publicity will cause a decrease in riders and loss of revenue. It could also result in the loss of a lucrative contract.
Most of these situations can be reduced significantly with the implementation of a good securement-training program for all drivers who handle wheelchair bound clients. There are many programs available on the market to accomplish this. A search of the web will show companies that provide driver training programs that include securement techniques. Insurance companies who write paratransit business have loss control departments who can help in this endeavor as well. State and national transportation associations may have staff available to provide instruction. These programs can be very basic or provide instruction on how to handle oversized wheelchairs, infant seats and scooters. The amount and type of clients transported determine the intensity of the training required.
The unfamiliar and inspections
The operator should familiarize him/herself with the rules or laws of the jurisdiction in which he/she operates, especially when dealing with oversized wheelchairs and scooters. In addition there may be contract specifications that apply to this area as well. In this context, thought should be given on how to safely handle situations outside the norm. If the situation can be anticipated and a solution found, it alleviates unsafe transportation of clients.
However, training is just the beginning. Too often, losses can be traced to a driver error. Tight scheduling may cause the driver to hurry to get to his/her next stop. He/she does not make sure that the tie-down straps are taught or if the wheelchair is aligned correctly. A minor bump or sudden stop is all it takes to have the wheelchair roll or tip, causing injury to the occupant.
In addition to the proper securement of the wheelchair to the vehicle, the occupant must be properly secured to the wheelchair. If there are no lap or shoulder belts to hold the occupant to the chair, he/she can slide out if there is a sudden stop. The resultant injury could be serious.
In order to prevent these types of occurrences, it is up to the owner or risk manager, to reinforce the importance of using these techniques on a daily basis. There should be a no-tolerance attitude toward these situations. The driver should understand the responsibility that is being placed on him/her to transport the client safely to their destination. The subject should be covered at every opportunity, whether it is a formal safety meeting or brief chat with the driver before he/she leaves on their route.
Along with driver training and reinforcement of securement techniques, inspection of securement equipment should be a regular part of pre/post vehicle inspection. Frayed straps should be replaced. All tracks and floor anchors should be checked that they are in good working condition. There should be a program for scheduled replacement of securement equipment. Manufacturers will generally provide assistance in this undertaking.
Maintenance and common sense
Once the vehicle exposures are reviewed and a program implemented to reduce these types of losses, thought should be given to the loading and unloading of passengers. Again, proper maintenance of any vehicle’s ramps and lifts is essential. Pre/post trip inspections should include these items and repairs made immediately if deficiencies are found.
The second issue that relates to loading and unloading is mainly common sense. Losses have occurred with drivers pushing wheelchairs down front porch steps; deviating from sidewalks over rough ground to get to the vehicle quicker; and pushing clients with no lap belts. These situations have resulted in serious injuries. Thinking about the consequences of such actions might have prevented these losses.
Finally, when thinking about loading and unloading, it is a good idea to find out how the carrier handles these losses. Is it a general liability or automobile loss? If it is considered general liability, it may be worthwhile to consider general liability limits equal to auto limits. In some instances, paratransit operators have felt that there is no need for general liability insurance, as most exposures presented are automobile related. Careful thought should be given to this decision based on the policy interpretation of the claims department of the company insuring the automobile.
While these steps to reduce losses from loading and unloading may be considered very rational, in everyday practice they are overlooked. As the saying goes “an ounce of prevention is worth a pound of cure.” It makes good business sense to spend a few extra bucks in training and follow-up on securement issues. Insurance costs can go down, thereby improving the bottom line.
Bruce Coulson is general manager of the Mechanicsburg, Penn., office of National Interstate Insurance Company. His office underwrites the company’s non-emergency medical transportation business. Formerly, he was an underwriting manager at a managing general agency that underwrote non-emergency medical transportation risks. His e-mail is: email@example.com.