April 29, 2025 • 29 mins
The healthcare insurance landscape is rapidly evolving beyond traditional pain points, creating new challenges for retail agents seeking coverage for specialized risks. From ketamine clinics to advanced med spas, these emerging sectors require specialist navigation to secure appropriate protection. Healthcare has always presented unique insurance complexities, but today's market features several particularly difficult placement categories. While correctional healthcare and locum tenens staffing remain challenging, CRC Healthcare Broker Scott Scheiblin highlights several additional sectors creating headaches for agents and insureds alike. Ready to navigate the complexities of today's toughest healthcare risks? Reach out to your local CRC Group producer for guidance and market access that can provide successful solutions when you hit placement challenges
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Scott Gordon (00:00):
Welcome to another episode of Placing you First,
the podcast where we explore thelatest challenges and
opportunities in the wholesaleinsurance space.
I'm Scott Gord, joined by myco-host, Amanda Knight.
Amanda Knight (00:12):
Thanks, scott.
Today we're diving into thecomplexities of insuring health
care risks, especially thosethat have been growing in
difficulty for retail agents.
We're joined by CRC HealthcareBroker Scott Scheiblin to talk
about what's happening in themarket and how wholesale brokers
can help navigate these uniquechallenges.
(00:32):
This is the Placing you Firstpodcast from CRC Group.
Scott Gordon (00:36):
This podcast features news and insights from
a vast knowledge base of over5,100 associates who write more
than $35 billion in premiumannually.
Amanda Knight (00:46):
Plus, we give you the latest information on
what's happening at CRC thisthis.
Scott Gordon (00:50):
This is the Placing you First podcast and
now the hosts of the podcastAmanda.
Knight and.
Amanda Knight (00:56):
Scott Gordon.
Scott, great to have you back.
Scott Gordon (00:59):
Yeah, thanks for having me.
Well, let's start by talkingabout the overall landscape.
In the past, I know we'vetalked about correctional health
care and locum tenens staffing,as well as known pain points,
but beyond that, there areseveral classes of health care
risks that are becomingincreasingly difficult to place.
So what are you seeing, scott,in terms of the most pressing
(01:22):
challenges these days?
Scott Scheiblin (01:31):
Yeah, I think you hit it on the head.
What you notice is a lot of thepain point marketing material
you'll see from many places dodeal with locum and correctional
and those are very, verychallenging, but what has
emerged is specifically the useof ketamine for drug-resistant
depression, the expansion of medspas that have really become
more of anti-aging clinics withhuge expansions to their kinds
(01:54):
of things.
One pain point I would say hasbeen pretty consistent but is
not going away and maybe isn'ttalked about as much, is nursing
homes and having doctors gointo nursing homes.
Then there's also multi-stateexposures.
A lot of these companies arevery entrepreneurial and they're
trying to move into new placesand with moving into new places,
(02:16):
they can be confronted bythings like PCF funds that,
frankly, if you're not in it allthe time, are the types of
things that can be incrediblymind-blowingly challenging and
bureaucratic.
So there's quite a fewdifferent spaces where I think
it would be helpful to talkabout how we can help our retail
(02:37):
agents, help insureds, make theprocess easier, make their life
easier for some of these risksthat aren't talked about as much
but do present very unique andsometimes pretty cumbersome
challenges.
Amanda Knight (02:49):
Okay, well, let's just sort of jump in and see if
we can go one by one aroundsome of these challenges and go
a little deeper for the benefitof our retail agent listeners.
Let's start with physiciansworking in, specifically working
in nursing homes.
What would be some of thechallenges around ensuring those
(03:11):
risks?
Scott Scheiblin (03:12):
Some of the exposures and some of the
classes that we'll talk aboutare newer.
They're emerging.
Physicians working in nursinghomes is a consistent challenge.
It is not one that is new, butit's also not one that's going
away anytime soon in terms ofthe challenges it presents and
you know, for a multitude ofreasons the need to use outside
(03:33):
staffing for services, etc.
So the reason that those wouldbe challenging from an
underwriting perspective is aphysician working in a nursing
home is inexorably tied to theactual setting.
So when a underwriter isreviewing that individual
physician, what we're concerningourselves with the insured that
(03:56):
we've been asked to findcoverage for, the underwriter
does have to review the nursinghome itself.
This is one of those exposureswhere you're reviewing the
insured and you're reviewingwhere the insured works and
because of that it means thatyou're thinking about nursing
homes and thinking about thechallenges that nursing homes
(04:17):
present.
So, while it may only be thephysician that you're requesting
coverage for the multitude ofother uh challenges that nursing
homes themselves presentfactors into the equation.
Those would be things rangingfrom the fact that the general
public has a pretty low opinionof nursing homes 40%, or so you
(04:40):
know, would qualify them as a Dor an F on a scale of uh, you
know, would qualify them as a Dor an F on a scale of a grading
system without having anyknowledge of it, just a public
perception.
Wise they would.
So that means that juries areless sympathetic to women,
already have certain predisposedideas of the type of care
that's appearing in nursinghomes, of the type of care
(05:01):
that's appearing in nursinghomes.
That also it factors into whatactually does happen in nursing
homes and the various stages.
Nursing homes can be used asshorthand for, I think sometimes
, or does get used as shorthandfor various settings, various
levels of care.
You know, from assisted torehab to et cetera, care.
(05:28):
You know from assisted to rehabto et cetera, um, but at its
core this is generally peoplewho are older or who are health
compromised.
So the potential for severeseverity or the potential for
claims themselves exist becausethese people um need care and
maybe have comorbidities, havesome age-related degeneration,
(05:48):
things like that, and withoutbeing insensitive to it, it's
also a place where people passaway.
So the potential exists forthat to just be the reality of
the patient base, or I shouldn'tsay the potential, it is the
reality of the patient base.
And then nursing home claimswhen you were, if you were to
(06:13):
look at them not strictly from aphysician standpoint, but if
you looked at them as a moremacro thought, and that does
encompass GL and other parts.
But the average severity ofnursing home claims by some
estimates is like a million.
So an underwriter reviewing aphysician to work in a nursing
(06:35):
home has to think about the factthat they are working in a
nursing home and what challengesthe nursing home itself
presents.
They have to review them as notonly the individual but as the
individual and the setting.
And that means that whereaswhen you insure a nursing home
(06:56):
itself, you might get X premiumfor it and you're preparing for
the GLPL claims that areassociated with, but you're
getting a premium that you feelis adequate for it, when you're
insuring the individualphysician, you're insuring an
individual physician in asetting that you think has the
potential for severity or atleast claims, but you are not
(07:18):
getting that kind of premium forit.
That individual physician isnot going to generate six
figures for their premium.
So they want to be prettystringent and pretty strategic
in where they will write thesephysicians, because if the
pricing is going to be, forexample, $7,500 for someone that
(07:41):
may be doing bed sores andother care within.
They can't afford to writevolume.
That could lead to more claims.
That could lead to severeclaims without having done the
due diligence.
So, long story short, it canlead to a lot of questions, can
(08:05):
lead to the need to reallypresent the insured in the most
positive light.
There are challenges that youmay just not be able to overcome
in terms of what facilitiesthey happen to work at.
I think where the usage of aknowledgeable broker is
especially helpful is that thequestions that underwriters are
(08:29):
going to want to have are notcaptured necessarily in
applications for physicians.
They are the extra questions wecan provide.
Those extra questions provide abit of a roadmap of how to
present the insured and what theunderwriters are going to want
to know to be comfortable theinsured and what the
(08:51):
underwriters are going to wantto know to be comfortable.
So ultimately it's not thephrase, I guess, death by a
thousand paper cuts of gettingthese.
You know, one round ofquestions comes in, you get
another round of questions.
We try to preempt and get aheadof that and we also are
targeted in who we go after.
You could easily go and send itto a multitude of markets that
(09:14):
just literally will not writethe risk and that will only
delay the inevitable, which isgetting it to the appropriate
markets and getting the pricingreflective and the terms
reflective from the markets thatactually will write it.
So that's where the challengespresent and where CRC is helpful
(09:39):
and can be helpful in makingthis an easier process for an
exposure that is consistentlydifficult and has no reason to
think it's not going to continuebeing consistently difficult.
Scott Gordon (09:52):
So another emerging challenge is the rise
of ketamine clinics and themarket's growing fast, you know.
But there are a lot of concernsaround treatment protocols and
liability.
We've heard a lot of storiesabout some high profile abuse of
ketamine lately, you know,administered wrong.
No one monitoring all thatstuff.
So what should agents knowabout placing coverage for these
(10:14):
types of clinics?
Scott Scheiblin (10:15):
Yeah, I mean, obviously the recent news you
know puts more of a focus on it.
But really, ketamine at thispoint it is utilized for drug
resistant depression.
However, there's only one FDAapproved actual delivery method
for it, spurbato and anintranasal one.
The others are all off-labeluse so they're allowed but they
(10:38):
are not FDA approved quoteunquote for that.
So when underwriters arelooking at a risk and they're
looking at, they want to knowhow's it being delivered.
They want to know the protocolsbehind the patient selection.
You know, are you just lettingsomebody off the street say, hey
, I don't feel good and getketamine Like, or or is this
(11:01):
coming from a primary careprovider?
A psychiatrist referral?
That's the requirement to haveit.
What are your protocols aroundmonitoring?
You know you give the dosage,whether it be intramuscular or
through iv.
How long are you with them?
Is this part of a guidedtherapy?
If so, who?
You know?
Is this through a psychiatrist?
(11:22):
There are also questions oflike.
While it's deemed I would say II want to choose the words
carefully it's been used as anaesthetic safely, so it's not
deemed as necessarily dangerous.
However, with that awareness,use an aesthetic, you have
(11:43):
safety protocols around using anaesthetic.
You have resuscitation, youhave monitoring, you have, you
know, have checking bloodpressure before after all of
those things?
Are those present in yourclinic?
Are you utilizing those?
So underwriters are not.
There's limited markets, butmarkets that are open to many
(12:05):
different forms of this.
But they want to know all ofthese various factors up front
in order to evaluate how muchthey like the risk, how safe
they feel the risk is.
And then, every once in a while, you'll get an absolute curve
ball of well, we'd like to startsending this out to people and
we'll watch them on a Zoom cam.
(12:26):
So there's all kinds ofpermeations that have occurred
under this.
But it is again another placewhere I think insureds and
agents can get quite upset witha litany of questions coming at
them after the submissionprocess.
I personally find it easier togive a lot of these questions up
(12:49):
front, having worked multiplesof these accounts and an
awareness of what markets willand will not do.
We can give that to you.
So, again, you can qualify itup front, you can get the
necessary information, you canmake an insured aware like, hey,
you don't have X, y and Z.
This is going to be a realtough slog to find something,
(13:09):
but it is part of an emergingside of mental health.
That is not slog to findsomething, but it's.
You know it is part of anemerging side of mental health
that is not going to go away.
You know, holistic, alternativetherapies are only going to
likely become more and morecommonplace and carriers are
figuring out the right way toevaluate those risks right now.
Amanda Knight (13:31):
And I feel like I've actually seen as a person
in the public, I guess I'll sayI've seen, you know, a ketamine
clinic.
Pop up down the street and bethere a few months and then it's
gone, right, it disappears, butthen, I've had, you know,
friends be treated with for thatdrug resistant major depression
via ketamine in a very wellknow, well-respected setting and
(13:53):
have phenomenal results fromthat.
So I'm sure that there is awide spectrum of just like with
any risk, right, You've got awide spectrum when it comes to
ketamine, clinics of you knowquality, what they're doing, how
they're doing it.
So working with a qualifiedwholesaler makes a difference,
(14:14):
you know, depending especiallyon the risk.
Scott Scheiblin (14:16):
It makes a big difference, I think, to be able
to articulate the ways in whichthe risks are looked differently
by different carriers, and Ithink having some working with a
wholesaler that doesn know orat least has seen many of the
risks can be incrediblybeneficial.
Even if it can be tedious tothe insured, it can be
(14:37):
incredibly beneficial long term.
Amanda Knight (14:39):
Well, I mean, I feel like our team is really
good at in all things.
We may not be able to tell youexactly what your insured wants
to hear, but we will tell youthe truth and we will tell you
what they need to hear for thebest outcome in the long run,
right, which is ultimately thebest thing for everyone.
I think that applies to thesectors we've talked about so
far, and then this next one thatwe're going to talk about,
(15:00):
which is med spas and anti-agingtreatments.
I think every third ad I see onsocial media or television or
you know any sort of media, isthis new sort of anti-aging or
med spa or some amalgamation ofall the things.
I know that's exploding inpopularity, but that also has to
(15:22):
bring some new risks to light.
So what are some of the biggestconcerns when we're approaching
, you know, med spas oranti-aging clinics from an
insurance standpoint?
Scott Scheiblin (15:32):
Yeah, well, you nailed it.
Med spas, let's say 10 yearsago, just to use a number, it
was Botox, it was like Juvederm,it was some laser hair removal.
You know it was pretty standardstuff that you would expect out
of a med spa and they werepretty consistent, like every
(15:54):
med spa kind of did it.
The most challenging, pressingthing back then was the Botox
parties, where they wanted to doit at a house and serve some
champagne.
That was the hardest thing.
What med spas have figured outis is pivoting or or or bringing
in more of what what I wouldterm anti-aging.
(16:15):
Um, these are processes thatare still aesthetic a lot of
times in in in their compositionor in their goal, but these are
not traditional med spaprocedures.
So you have things like theusage of exosomes and stem cells
, both in an IV treatment oreven on a facial kind of thing.
You have, well, obviouslythere's the GLPs, the weight
(16:38):
loss medications, all of thosesorts of things.
Um, you have more laser basedstuff, that that are more higher
level cosmetic like IVtreatments and stuff too right.
Yeah, higher level cosmetic,Like IV treatments and stuff too
, right, yeah, IV vitamins,peptides, all kinds of things
aimed at not just, you know,reducing a wrinkle, but this
(16:59):
idea of feeling being younger,all of that.
There's a lot of questionswithin that about where are you
getting this stuff?
You know stem cells can beharvested from you or they can
be brought by a third party.
Uh, exosomes are, are sort of aderivative of stem cells, the
(17:20):
the kind of the bubbles thatcome up, Um, and and how are you
utilizing them?
Uh, what's your training?
What promises are you makingwith this kind of thing?
You know they have thepotential, I'm sure, for good
and they also have the potentialfor some negative, bad results.
So, and there's the expansion ofmore and more of even just the
(17:41):
aesthetic ones, like vampirefacials, for instance, or things
like that, which use PRP andyou know, or I mean it's kind of
self-explanatory they they'repuncturing and with the needle.
Uh, you know, I think the most,uh, probably well-known,
hellacious med spot claim is issomebody doing something like
(18:03):
that didn't clean the needles,and I believe it was somewhere
in the neighborhood of sixpeople contracted hiv out in, I
think I believe it was newmexico.
So it's a combo of a lot ofdifferent stuff.
It's more emerging procedures,more catered towards anti-aging,
that are bringing in differentthings, as you said, like IV
(18:24):
hydrations, peptides, GLPs, stemcells, all those types of
things, and then also aestheticsthat have gotten even further
along the line than just Botox.
Now you're talking about morelaser-based cold lipo, all kinds
of different things.
So when the markets are lookingat that, they want to have an
(18:47):
understanding of the trainingfor the various people that are
there.
What's the level of servicesthere is going to be provided,
things like where are the stemcells harvested from?
What are the specific promises,uses and reasons for it?
You know, I think, thatsometimes you just have insureds
(19:09):
say, well, we're going to usestem cells, but for what?
Right, Like you would put it oncereal, Like what are you going
to?
Amanda Knight (19:17):
There's some things happening.
Be specific, yeah.
Scott Scheiblin (19:21):
What's it going to be?
So I mean, that's anentrepreneurial spirit that the
med spas have expanded.
It's very good for them becauseit is cash-based, or I should
say at least it's not insurancereimbursable, and so they're
expanding it out further andfurther.
You are moving away from sortof very predictable aesthetic
(19:47):
claims.
You knew what a laser hairremoval was going to be, you
knew what it was going to do,you knew how much you were going
to pay, you knew what anuisance claim was going to be
all that kind of stuff to claimsthat have a higher chance for
severity.
So you have to amend how you'regoing to underwrite it, what
you're going to price it for andhow focused you're going to be
(20:12):
on various things to see whetheror not the risk is possibly
doing what it can to mitigatethe liabilities, mitigate the
liabilities, and so it's a realexpansion of that whole side of
the business.
Amanda Knight (20:28):
And I don't see that slowing down.
I think it's only going to keepgoing.
Scott Scheiblin (20:33):
No, not at all.
If there's one truth that isuniversal, it's that everybody
wants to look younger and thatindustry is part of the beauty
industry.
And I, what is that?
How many billions?
At this point, I mean, yeah, so, and and I think, uh, you know,
once glp's really hit it,expanded it out even further.
(20:56):
Oh, sure for sure because thosearen't everywhere yeah, well,
it's going to be interesting.
The glp ones are very, veryinteresting.
I think it's one of thosepieces where, over the next
couple months, it's going toactually be incredibly
beneficial for people to utilizetheir wholesaler for glp risks,
because I think we'reapproximately two months away
(21:18):
from the idea of thosecompounding ones using smaglutut
and terazapatide not the FDAsaying that the shortage is over
and it can be met and thereforethe compounding is not going to
be needed any longer or allowed.
Ooh, I can only guess theamount of twists and turns we're
(21:39):
going to have over the nextcouple of months because you
know, keeping abreast of bothwhat's happening from the
regulatory side and then howcarriers are going to respond to
it, this is going to be a timewhere I think it's going to be
incredibly beneficial to beutilizing a broker who has the
relationships and awareness inthat realm, because I think some
(22:03):
stuff could turn on a dime veryquickly.
Amanda Knight (22:05):
Absolutely.
Scott Gordon (22:06):
Yeah, we talked about that before.
Anything that comes out of thegate this hot, everything else,
including insurance, has to kindof catch up with it.
Yeah, 100%, it's catching up.
Multi-state operations are yetanother layer of complexity
that's been added to this,especially when it comes to PCFs
or patient compensation funds.
So what do agents need to knowabout this Patient?
Scott Scheiblin (22:29):
compensation funds.
I think they can affect in anyrealm of business.
They are I'm trying to say itpolitely the bane of many
people's existence.
Amanda Knight (22:46):
Fair.
Scott Scheiblin (22:47):
Yeah, I mean, it's like it's like trying to
read how to do your taxes, youknow, or put together your
stereo.
It's in English but it's aspecific way of writing that
English Right, but in allseriousness, they are.
There are mandatory and thereare voluntary ones.
There are places where, asbusinesses expand and you see
(23:13):
more and more expansion, bothfrom a tele perspective and from
just a geographical perspective, as insurers want to do that,
from just a geographicalperspective, as insurers want to
do that when you move intocertain of these states,
especially the mandatory, youare faced with the proposition
of having to be in some of thesepcfs or, for a portion of your
risk, having to.
Um, it is always going to bethe responsibility of the
(23:35):
insured and and the specificdoctor generally to make sure
they're compliant with the fund.
But the bottom line is, if youget into those states, you have
to be aware of it and you wantto be working with a wholesaler
who also knows how to find theright carrier partner, because
in some cases the carrier has todo this, and so you could take
(23:59):
it out to 20 markets, butthere's only three that are the
right ones.
I've had quite a few insuredsdecide this isn't necessary at
this juncture of my business toexpand into this venue.
That's going to create thisproblem and this extra cost.
I'd rather focus in on otherstates and and they save
(24:20):
themselves a lot of hassle andthey save themselves a lot of
frustration by knowing upfrontwhere was going to be difficult
and where wasn't going to bedifficult.
So I that's another way that Ithink a wholesaler may, may you
know they're not going todictate your business, they're
not going to say anythingabsolutely particular, but can
(24:42):
at least help you haveconversations with your insureds
Because, again, the goal isalways to make it as easy as
possible for everyone, um andand try to present the knowledge
so that you, you can have thatbe as easy as possible.
Scott Gordon (24:57):
We've got the roadmap.
Scott Scheiblin (24:58):
Yeah.
Scott Gordon (24:59):
Yeah, or we've got the.
We've got the map legend yeah.
Whether or not you go down it,crc can tell you which states
are hot and which states are not.
Scott Scheiblin (25:08):
If you want to go, you go, but at least you
know up front.
Amanda Knight (25:11):
Right, that's another one of those.
We may not be able to tell youwhat you want, but we can tell
you what you need, kind of thing.
Yeah, exactly.
Well, before we wrap up, Scott,it's time for everyone's
favorite segment.
Let's be honest Rapid fire.
It's here, scott Gordon, takeit away.
Scott Gordon (25:27):
Yeah, this is whatever comes off the top of
your head, you know the rulesOkay.
So question number one if youhad to swap jobs with any famous
person for a week, who would itbe, and what's the first thing
you'd do?
Scott Scheiblin (25:42):
this is one of those questions that that feels
like it should I have to havelike 8 000 follow-ups.
But um, I mean, the obviousanswer is jeff bezos and I and I
would have him cut a check toscott schaiblin for about six
billion dollars.
I mean that, that's, that's theobvious.
Uh, yeah, if I stay away fromany of the third rails of
(26:04):
politics and all the rest, whatI would say?
I've never dunked a basketball,so, being LeBron, that could be
fun.
Yeah, the first thing I woulddo is dunk a basketball.
I'd be dunking basketballs oneverybody.
Amanda Knight (26:19):
For the whole week.
Scott Scheiblin (26:20):
I'd just be dunking yeah, I'd be dunking on
the concierge at the hotel.
All the rest, either eitherthat or uh I don't know any
names, but it would be prettycool to be like a very uh
skilled and famous chef, becauseI would love to know what it
feels like to uh cook well andactually enjoy cooking.
Scott Gordon (26:42):
there you go, yeah and know what things are.
That's the thing.
Yeah, like, what is this?
Um, that's awesome.
Um, yeah, you need to go findone of those, uh, little lowered
basketball goals I've donethose all the time.
My pride keeps me from it.
Go up, show those kids who'sboss or who's you know older.
Um, all right, our secondquestion what's one completely
(27:06):
useless talent or skill that youhave that you're oddly proud of
?
Scott Scheiblin (27:10):
oh, guys I have so many niche hobbies, so many
hobbies I mean there.
There's a thousand things Icould list.
I would, if not for the factthat it would be inappropriate,
plug my literal an aquarium andI hard scaped it with like
(27:31):
expanding foam and rocks andmoss and all kinds of stuff, and
then I layered the tubingthrough it and created an actual
(27:52):
fountain.
I don't think anyone I don'tthink anyone is ever going to be
on a plane saying like quick,is there a man who can create a
fountain?
Maybe?
If so, I'm there.
I got quite a few.
There's at least anotherpodcast worth of things that I
(28:13):
could say for this.
Amanda Knight (28:15):
We'll have to ask this question again and require
a different answer every time.
Scott Scheiblin (28:19):
I'll have at least 100.
Amanda Knight (28:21):
Well, thank you, scott, for joining us today and
sharing your insights and beinga good sport.
Having you on is always a lotof fun and also very informative
.
So thanks for joining us and toour listeners.
If you need help placing thesechallenging risks, reach out to
your local CRC Group producer.
Thanks for tuning in Once againto your local CRC Group
(28:42):
producer.
Thanks for tuning in.
Once again Scott thanks forjoining us, thanks for having me
, and we'll see you all nexttime.
On Placing you First,
Welcome to another episode of Placing you First,
the podcast where we explore thelatest challenges and
opportunities in the wholesaleinsurance space.
I'm Scott Gord, joined by myco-host, Amanda Knight.
Amanda Knight (00:12):
Thanks, scott.
Today we're diving into thecomplexities of insuring health
care risks, especially thosethat have been growing in
difficulty for retail agents.
We're joined by CRC HealthcareBroker Scott Scheiblin to talk
about what's happening in themarket and how wholesale brokers
can help navigate these uniquechallenges.
(00:32):
This is the Placing you Firstpodcast from CRC Group.
Scott Gordon (00:36):
This podcast features news and insights from
a vast knowledge base of over5,100 associates who write more
than $35 billion in premiumannually.
Amanda Knight (00:46):
Plus, we give you the latest information on
what's happening at CRC thisthis.
Scott Gordon (00:50):
This is the Placing you First podcast and
now the hosts of the podcastAmanda.
Knight and.
Amanda Knight (00:56):
Scott Gordon.
Scott, great to have you back.
Scott Gordon (00:59):
Yeah, thanks for having me.
Well, let's start by talkingabout the overall landscape.
In the past, I know we'vetalked about correctional health
care and locum tenens staffing,as well as known pain points,
but beyond that, there areseveral classes of health care
risks that are becomingincreasingly difficult to place.
So what are you seeing, scott,in terms of the most pressing
(01:22):
challenges these days?
Scott Scheiblin (01:31):
Yeah, I think you hit it on the head.
What you notice is a lot of thepain point marketing material
you'll see from many places dodeal with locum and correctional
and those are very, verychallenging, but what has
emerged is specifically the useof ketamine for drug-resistant
depression, the expansion of medspas that have really become
more of anti-aging clinics withhuge expansions to their kinds
(01:54):
of things.
One pain point I would say hasbeen pretty consistent but is
not going away and maybe isn'ttalked about as much, is nursing
homes and having doctors gointo nursing homes.
Then there's also multi-stateexposures.
A lot of these companies arevery entrepreneurial and they're
trying to move into new placesand with moving into new places,
(02:16):
they can be confronted bythings like PCF funds that,
frankly, if you're not in it allthe time, are the types of
things that can be incrediblymind-blowingly challenging and
bureaucratic.
So there's quite a fewdifferent spaces where I think
it would be helpful to talkabout how we can help our retail
(02:37):
agents, help insureds, make theprocess easier, make their life
easier for some of these risksthat aren't talked about as much
but do present very unique andsometimes pretty cumbersome
challenges.
Amanda Knight (02:49):
Okay, well, let's just sort of jump in and see if
we can go one by one aroundsome of these challenges and go
a little deeper for the benefitof our retail agent listeners.
Let's start with physiciansworking in, specifically working
in nursing homes.
What would be some of thechallenges around ensuring those
(03:11):
risks?
Scott Scheiblin (03:12):
Some of the exposures and some of the
classes that we'll talk aboutare newer.
They're emerging.
Physicians working in nursinghomes is a consistent challenge.
It is not one that is new, butit's also not one that's going
away anytime soon in terms ofthe challenges it presents and
you know, for a multitude ofreasons the need to use outside
(03:33):
staffing for services, etc.
So the reason that those wouldbe challenging from an
underwriting perspective is aphysician working in a nursing
home is inexorably tied to theactual setting.
So when a underwriter isreviewing that individual
physician, what we're concerningourselves with the insured that
(03:56):
we've been asked to findcoverage for, the underwriter
does have to review the nursinghome itself.
This is one of those exposureswhere you're reviewing the
insured and you're reviewingwhere the insured works and
because of that it means thatyou're thinking about nursing
homes and thinking about thechallenges that nursing homes
(04:17):
present.
So, while it may only be thephysician that you're requesting
coverage for the multitude ofother uh challenges that nursing
homes themselves presentfactors into the equation.
Those would be things rangingfrom the fact that the general
public has a pretty low opinionof nursing homes 40%, or so you
(04:40):
know, would qualify them as a Dor an F on a scale of uh, you
know, would qualify them as a Dor an F on a scale of a grading
system without having anyknowledge of it, just a public
perception.
Wise they would.
So that means that juries areless sympathetic to women,
already have certain predisposedideas of the type of care
that's appearing in nursinghomes, of the type of care
(05:01):
that's appearing in nursinghomes.
That also it factors into whatactually does happen in nursing
homes and the various stages.
Nursing homes can be used asshorthand for, I think sometimes
, or does get used as shorthandfor various settings, various
levels of care.
You know, from assisted torehab to et cetera, care.
(05:28):
You know from assisted to rehabto et cetera, um, but at its
core this is generally peoplewho are older or who are health
compromised.
So the potential for severeseverity or the potential for
claims themselves exist becausethese people um need care and
maybe have comorbidities, havesome age-related degeneration,
(05:48):
things like that, and withoutbeing insensitive to it, it's
also a place where people passaway.
So the potential exists forthat to just be the reality of
the patient base, or I shouldn'tsay the potential, it is the
reality of the patient base.
And then nursing home claimswhen you were, if you were to
(06:13):
look at them not strictly from aphysician standpoint, but if
you looked at them as a moremacro thought, and that does
encompass GL and other parts.
But the average severity ofnursing home claims by some
estimates is like a million.
So an underwriter reviewing aphysician to work in a nursing
(06:35):
home has to think about the factthat they are working in a
nursing home and what challengesthe nursing home itself
presents.
They have to review them as notonly the individual but as the
individual and the setting.
And that means that whereaswhen you insure a nursing home
(06:56):
itself, you might get X premiumfor it and you're preparing for
the GLPL claims that areassociated with, but you're
getting a premium that you feelis adequate for it, when you're
insuring the individualphysician, you're insuring an
individual physician in asetting that you think has the
potential for severity or atleast claims, but you are not
(07:18):
getting that kind of premium forit.
That individual physician isnot going to generate six
figures for their premium.
So they want to be prettystringent and pretty strategic
in where they will write thesephysicians, because if the
pricing is going to be, forexample, $7,500 for someone that
(07:41):
may be doing bed sores andother care within.
They can't afford to writevolume.
That could lead to more claims.
That could lead to severeclaims without having done the
due diligence.
So, long story short, it canlead to a lot of questions, can
(08:05):
lead to the need to reallypresent the insured in the most
positive light.
There are challenges that youmay just not be able to overcome
in terms of what facilitiesthey happen to work at.
I think where the usage of aknowledgeable broker is
especially helpful is that thequestions that underwriters are
(08:29):
going to want to have are notcaptured necessarily in
applications for physicians.
They are the extra questions wecan provide.
Those extra questions provide abit of a roadmap of how to
present the insured and what theunderwriters are going to want
to know to be comfortable theinsured and what the
(08:51):
underwriters are going to wantto know to be comfortable.
So ultimately it's not thephrase, I guess, death by a
thousand paper cuts of gettingthese.
You know, one round ofquestions comes in, you get
another round of questions.
We try to preempt and get aheadof that and we also are
targeted in who we go after.
You could easily go and send itto a multitude of markets that
(09:14):
just literally will not writethe risk and that will only
delay the inevitable, which isgetting it to the appropriate
markets and getting the pricingreflective and the terms
reflective from the markets thatactually will write it.
So that's where the challengespresent and where CRC is helpful
(09:39):
and can be helpful in makingthis an easier process for an
exposure that is consistentlydifficult and has no reason to
think it's not going to continuebeing consistently difficult.
Scott Gordon (09:52):
So another emerging challenge is the rise
of ketamine clinics and themarket's growing fast, you know.
But there are a lot of concernsaround treatment protocols and
liability.
We've heard a lot of storiesabout some high profile abuse of
ketamine lately, you know,administered wrong.
No one monitoring all thatstuff.
So what should agents knowabout placing coverage for these
(10:14):
types of clinics?
Scott Scheiblin (10:15):
Yeah, I mean, obviously the recent news you
know puts more of a focus on it.
But really, ketamine at thispoint it is utilized for drug
resistant depression.
However, there's only one FDAapproved actual delivery method
for it, spurbato and anintranasal one.
The others are all off-labeluse so they're allowed but they
(10:38):
are not FDA approved quoteunquote for that.
So when underwriters arelooking at a risk and they're
looking at, they want to knowhow's it being delivered.
They want to know the protocolsbehind the patient selection.
You know, are you just lettingsomebody off the street say, hey
, I don't feel good and getketamine Like, or or is this
(11:01):
coming from a primary careprovider?
A psychiatrist referral?
That's the requirement to haveit.
What are your protocols aroundmonitoring?
You know you give the dosage,whether it be intramuscular or
through iv.
How long are you with them?
Is this part of a guidedtherapy?
If so, who?
You know?
Is this through a psychiatrist?
(11:22):
There are also questions oflike.
While it's deemed I would say II want to choose the words
carefully it's been used as anaesthetic safely, so it's not
deemed as necessarily dangerous.
However, with that awareness,use an aesthetic, you have
(11:43):
safety protocols around using anaesthetic.
You have resuscitation, youhave monitoring, you have, you
know, have checking bloodpressure before after all of
those things?
Are those present in yourclinic?
Are you utilizing those?
So underwriters are not.
There's limited markets, butmarkets that are open to many
(12:05):
different forms of this.
But they want to know all ofthese various factors up front
in order to evaluate how muchthey like the risk, how safe
they feel the risk is.
And then, every once in a while, you'll get an absolute curve
ball of well, we'd like to startsending this out to people and
we'll watch them on a Zoom cam.
(12:26):
So there's all kinds ofpermeations that have occurred
under this.
But it is again another placewhere I think insureds and
agents can get quite upset witha litany of questions coming at
them after the submissionprocess.
I personally find it easier togive a lot of these questions up
(12:49):
front, having worked multiplesof these accounts and an
awareness of what markets willand will not do.
We can give that to you.
So, again, you can qualify itup front, you can get the
necessary information, you canmake an insured aware like, hey,
you don't have X, y and Z.
This is going to be a realtough slog to find something,
(13:09):
but it is part of an emergingside of mental health.
That is not slog to findsomething, but it's.
You know it is part of anemerging side of mental health
that is not going to go away.
You know, holistic, alternativetherapies are only going to
likely become more and morecommonplace and carriers are
figuring out the right way toevaluate those risks right now.
Amanda Knight (13:31):
And I feel like I've actually seen as a person
in the public, I guess I'll sayI've seen, you know, a ketamine
clinic.
Pop up down the street and bethere a few months and then it's
gone, right, it disappears, butthen, I've had, you know,
friends be treated with for thatdrug resistant major depression
via ketamine in a very wellknow, well-respected setting and
(13:53):
have phenomenal results fromthat.
So I'm sure that there is awide spectrum of just like with
any risk, right, You've got awide spectrum when it comes to
ketamine, clinics of you knowquality, what they're doing, how
they're doing it.
So working with a qualifiedwholesaler makes a difference,
(14:14):
you know, depending especiallyon the risk.
Scott Scheiblin (14:16):
It makes a big difference, I think, to be able
to articulate the ways in whichthe risks are looked differently
by different carriers, and Ithink having some working with a
wholesaler that doesn know orat least has seen many of the
risks can be incrediblybeneficial.
Even if it can be tedious tothe insured, it can be
(14:37):
incredibly beneficial long term.
Amanda Knight (14:39):
Well, I mean, I feel like our team is really
good at in all things.
We may not be able to tell youexactly what your insured wants
to hear, but we will tell youthe truth and we will tell you
what they need to hear for thebest outcome in the long run,
right, which is ultimately thebest thing for everyone.
I think that applies to thesectors we've talked about so
far, and then this next one thatwe're going to talk about,
(15:00):
which is med spas and anti-agingtreatments.
I think every third ad I see onsocial media or television or
you know any sort of media, isthis new sort of anti-aging or
med spa or some amalgamation ofall the things.
I know that's exploding inpopularity, but that also has to
(15:22):
bring some new risks to light.
So what are some of the biggestconcerns when we're approaching
, you know, med spas oranti-aging clinics from an
insurance standpoint?
Scott Scheiblin (15:32):
Yeah, well, you nailed it.
Med spas, let's say 10 yearsago, just to use a number, it
was Botox, it was like Juvederm,it was some laser hair removal.
You know it was pretty standardstuff that you would expect out
of a med spa and they werepretty consistent, like every
(15:54):
med spa kind of did it.
The most challenging, pressingthing back then was the Botox
parties, where they wanted to doit at a house and serve some
champagne.
That was the hardest thing.
What med spas have figured outis is pivoting or or or bringing
in more of what what I wouldterm anti-aging.
(16:15):
Um, these are processes thatare still aesthetic a lot of
times in in in their compositionor in their goal, but these are
not traditional med spaprocedures.
So you have things like theusage of exosomes and stem cells
, both in an IV treatment oreven on a facial kind of thing.
You have, well, obviouslythere's the GLPs, the weight
(16:38):
loss medications, all of thosesorts of things.
Um, you have more laser basedstuff, that that are more higher
level cosmetic like IVtreatments and stuff too right.
Yeah, higher level cosmetic,Like IV treatments and stuff too
, right, yeah, IV vitamins,peptides, all kinds of things
aimed at not just, you know,reducing a wrinkle, but this
(16:59):
idea of feeling being younger,all of that.
There's a lot of questionswithin that about where are you
getting this stuff?
You know stem cells can beharvested from you or they can
be brought by a third party.
Uh, exosomes are, are sort of aderivative of stem cells, the
(17:20):
the kind of the bubbles thatcome up, Um, and and how are you
utilizing them?
Uh, what's your training?
What promises are you makingwith this kind of thing?
You know they have thepotential, I'm sure, for good
and they also have the potentialfor some negative, bad results.
So, and there's the expansion ofmore and more of even just the
(17:41):
aesthetic ones, like vampirefacials, for instance, or things
like that, which use PRP andyou know, or I mean it's kind of
self-explanatory they they'repuncturing and with the needle.
Uh, you know, I think the most,uh, probably well-known,
hellacious med spot claim is issomebody doing something like
(18:03):
that didn't clean the needles,and I believe it was somewhere
in the neighborhood of sixpeople contracted hiv out in, I
think I believe it was newmexico.
So it's a combo of a lot ofdifferent stuff.
It's more emerging procedures,more catered towards anti-aging,
that are bringing in differentthings, as you said, like IV
(18:24):
hydrations, peptides, GLPs, stemcells, all those types of
things, and then also aestheticsthat have gotten even further
along the line than just Botox.
Now you're talking about morelaser-based cold lipo, all kinds
of different things.
So when the markets are lookingat that, they want to have an
(18:47):
understanding of the trainingfor the various people that are
there.
What's the level of servicesthere is going to be provided,
things like where are the stemcells harvested from?
What are the specific promises,uses and reasons for it?
You know, I think, thatsometimes you just have insureds
(19:09):
say, well, we're going to usestem cells, but for what?
Right, Like you would put it oncereal, Like what are you going
to?
Amanda Knight (19:17):
There's some things happening.
Be specific, yeah.
Scott Scheiblin (19:21):
What's it going to be?
So I mean, that's anentrepreneurial spirit that the
med spas have expanded.
It's very good for them becauseit is cash-based, or I should
say at least it's not insurancereimbursable, and so they're
expanding it out further andfurther.
You are moving away from sortof very predictable aesthetic
(19:47):
claims.
You knew what a laser hairremoval was going to be, you
knew what it was going to do,you knew how much you were going
to pay, you knew what anuisance claim was going to be
all that kind of stuff to claimsthat have a higher chance for
severity.
So you have to amend how you'regoing to underwrite it, what
you're going to price it for andhow focused you're going to be
(20:12):
on various things to see whetheror not the risk is possibly
doing what it can to mitigatethe liabilities, mitigate the
liabilities, and so it's a realexpansion of that whole side of
the business.
Amanda Knight (20:28):
And I don't see that slowing down.
I think it's only going to keepgoing.
Scott Scheiblin (20:33):
No, not at all.
If there's one truth that isuniversal, it's that everybody
wants to look younger and thatindustry is part of the beauty
industry.
And I, what is that?
How many billions?
At this point, I mean, yeah, so, and and I think, uh, you know,
once glp's really hit it,expanded it out even further.
(20:56):
Oh, sure for sure because thosearen't everywhere yeah, well,
it's going to be interesting.
The glp ones are very, veryinteresting.
I think it's one of thosepieces where, over the next
couple months, it's going toactually be incredibly
beneficial for people to utilizetheir wholesaler for glp risks,
because I think we'reapproximately two months away
(21:18):
from the idea of thosecompounding ones using smaglutut
and terazapatide not the FDAsaying that the shortage is over
and it can be met and thereforethe compounding is not going to
be needed any longer or allowed.
Ooh, I can only guess theamount of twists and turns we're
(21:39):
going to have over the nextcouple of months because you
know, keeping abreast of bothwhat's happening from the
regulatory side and then howcarriers are going to respond to
it, this is going to be a timewhere I think it's going to be
incredibly beneficial to beutilizing a broker who has the
relationships and awareness inthat realm, because I think some
(22:03):
stuff could turn on a dime veryquickly.
Amanda Knight (22:05):
Absolutely.
Scott Gordon (22:06):
Yeah, we talked about that before.
Anything that comes out of thegate this hot, everything else,
including insurance, has to kindof catch up with it.
Yeah, 100%, it's catching up.
Multi-state operations are yetanother layer of complexity
that's been added to this,especially when it comes to PCFs
or patient compensation funds.
So what do agents need to knowabout this Patient?
Scott Scheiblin (22:29):
compensation funds.
I think they can affect in anyrealm of business.
They are I'm trying to say itpolitely the bane of many
people's existence.
Amanda Knight (22:46):
Fair.
Scott Scheiblin (22:47):
Yeah, I mean, it's like it's like trying to
read how to do your taxes, youknow, or put together your
stereo.
It's in English but it's aspecific way of writing that
English Right, but in allseriousness, they are.
There are mandatory and thereare voluntary ones.
There are places where, asbusinesses expand and you see
(23:13):
more and more expansion, bothfrom a tele perspective and from
just a geographical perspective, as insurers want to do that,
from just a geographicalperspective, as insurers want to
do that when you move intocertain of these states,
especially the mandatory, youare faced with the proposition
of having to be in some of thesepcfs or, for a portion of your
risk, having to.
Um, it is always going to bethe responsibility of the
(23:35):
insured and and the specificdoctor generally to make sure
they're compliant with the fund.
But the bottom line is, if youget into those states, you have
to be aware of it and you wantto be working with a wholesaler
who also knows how to find theright carrier partner, because
in some cases the carrier has todo this, and so you could take
(23:59):
it out to 20 markets, butthere's only three that are the
right ones.
I've had quite a few insuredsdecide this isn't necessary at
this juncture of my business toexpand into this venue.
That's going to create thisproblem and this extra cost.
I'd rather focus in on otherstates and and they save
(24:20):
themselves a lot of hassle andthey save themselves a lot of
frustration by knowing upfrontwhere was going to be difficult
and where wasn't going to bedifficult.
So I that's another way that Ithink a wholesaler may, may you
know they're not going todictate your business, they're
not going to say anythingabsolutely particular, but can
(24:42):
at least help you haveconversations with your insureds
Because, again, the goal isalways to make it as easy as
possible for everyone, um andand try to present the knowledge
so that you, you can have thatbe as easy as possible.
Scott Gordon (24:57):
We've got the roadmap.
Scott Scheiblin (24:58):
Yeah.
Scott Gordon (24:59):
Yeah, or we've got the.
We've got the map legend yeah.
Whether or not you go down it,crc can tell you which states
are hot and which states are not.
Scott Scheiblin (25:08):
If you want to go, you go, but at least you
know up front.
Amanda Knight (25:11):
Right, that's another one of those.
We may not be able to tell youwhat you want, but we can tell
you what you need, kind of thing.
Yeah, exactly.
Well, before we wrap up, Scott,it's time for everyone's
favorite segment.
Let's be honest Rapid fire.
It's here, scott Gordon, takeit away.
Scott Gordon (25:27):
Yeah, this is whatever comes off the top of
your head, you know the rulesOkay.
So question number one if youhad to swap jobs with any famous
person for a week, who would itbe, and what's the first thing
you'd do?
Scott Scheiblin (25:42):
this is one of those questions that that feels
like it should I have to havelike 8 000 follow-ups.
But um, I mean, the obviousanswer is jeff bezos and I and I
would have him cut a check toscott schaiblin for about six
billion dollars.
I mean that, that's, that's theobvious.
Uh, yeah, if I stay away fromany of the third rails of
(26:04):
politics and all the rest, whatI would say?
I've never dunked a basketball,so, being LeBron, that could be
fun.
Yeah, the first thing I woulddo is dunk a basketball.
I'd be dunking basketballs oneverybody.
Amanda Knight (26:19):
For the whole week.
Scott Scheiblin (26:20):
I'd just be dunking yeah, I'd be dunking on
the concierge at the hotel.
All the rest, either eitherthat or uh I don't know any
names, but it would be prettycool to be like a very uh
skilled and famous chef, becauseI would love to know what it
feels like to uh cook well andactually enjoy cooking.
Scott Gordon (26:42):
there you go, yeah and know what things are.
That's the thing.
Yeah, like, what is this?
Um, that's awesome.
Um, yeah, you need to go findone of those, uh, little lowered
basketball goals I've donethose all the time.
My pride keeps me from it.
Go up, show those kids who'sboss or who's you know older.
Um, all right, our secondquestion what's one completely
(27:06):
useless talent or skill that youhave that you're oddly proud of
?
Scott Scheiblin (27:10):
oh, guys I have so many niche hobbies, so many
hobbies I mean there.
There's a thousand things Icould list.
I would, if not for the factthat it would be inappropriate,
plug my literal an aquarium andI hard scaped it with like
(27:31):
expanding foam and rocks andmoss and all kinds of stuff, and
then I layered the tubingthrough it and created an actual
(27:52):
fountain.
I don't think anyone I don'tthink anyone is ever going to be
on a plane saying like quick,is there a man who can create a
fountain?
Maybe?
If so, I'm there.
I got quite a few.
There's at least anotherpodcast worth of things that I
(28:13):
could say for this.
Amanda Knight (28:15):
We'll have to ask this question again and require
a different answer every time.
Scott Scheiblin (28:19):
I'll have at least 100.
Amanda Knight (28:21):
Well, thank you, scott, for joining us today and
sharing your insights and beinga good sport.
Having you on is always a lotof fun and also very informative
.
So thanks for joining us and toour listeners.
If you need help placing thesechallenging risks, reach out to
your local CRC Group producer.
Thanks for tuning in Once againto your local CRC Group
(28:42):
producer.
Thanks for tuning in.
Once again Scott thanks forjoining us, thanks for having me
, and we'll see you all nexttime.
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