Dennis R. Lundgren began his insurance brokerage career in 1989 and after various roles was promoted to president of HRH Northern New England in May 2002 following the acquisition of The Dunlap Agency. Lundgren held this position for 11 years until his subsequent employment at Cross Insurance in January 2014. Lundgren’s client base includes some of the agency’s largest accounts, including a large Maine hospital system, a related health care captive domiciled in Grand Cayman, BWI, and a substantial real estate development and construction firm in Massachusetts. Cross has formed a health care practice, which will be led by Lundgren and Vice President William B. McKechnie to focus on the needs of the health care industry, while expanding the agency’s health care risk management footprint in New England.
PBN: What are some of the ways that health care providers are managing risk on their own and how do the efforts of a company like Cross complement those efforts?
LUNDGREN: Physicians, nurses and hospital administrators are working more closely together to mitigate their collective exposure to medical malpractice claims. Also, the utilization and evolution of electronic medical records have improved information flow and care. In addition to the day-to-day servicing and placement and structuring of the insurance program, Cross can act as a second set of eyes with respect to tracking and analyzing claim trends, advocating for our client regarding large claims, consult on the structure and staffing of the internal risk management department and coordinate clinical risk management assistance with insurance carriers.
PBN: When Cross pitches its services to a health care provider, is it able to show financial evidence that demonstrates why taking the company on is in the provider’s best interest?
LUNDGREN: Three years ago, we instituted a “slot” program for the employed physicians of a hospital system which resulted in a $600,000 savings over a two-year period due to the fact the “slot” program obviated the need for “tail” coverage for any physicians leaving the system. Coverage was tied to the “slot” that stayed in the program, not the physician that left. In addition, there were other benefits to the client from a cash flow and budgeting perspective.
PBN: What kind of savings do hospitals, for instance, whose risk you manage typically see?
LUNDGREN: There are too many factors to answer this in general with a specific dollar amount or percentage. However, building the optimal insurance program when considering retention, limits and premium is critical to minimizing the client’s exposure in the most cost-effective manner. I will add, in the alternative risk programs we are involved in, expense ratios run in the 5 percent to 10 percent range versus 25 percent to 35 percent in the carrier world, and the investment income can “stay at home.”
PBN: How long has the trend toward risk management been visible to you; was there a clear starting point, or did it emerge more slowly than that?
LUNDGREN: Circumstances brought risk management more to the forefront internally for health care providers in the early 1980s, when it was very difficult to find insurance carriers to write medical malpractice coverage. This happened again from 1999 to 2002 when various carriers, including St. Paul Insurance Company, the largest writer of medical malpractice at the time, suddenly pulled out of the medical malpractice market. Mutual insurance companies, such as Medical Mutual Insurance Company of Maine, and others around the country, sprang up – predominantly led by physicians.
PBN: In your line of work, what are “captives?”
LUNDGREN: A captive is an alternative risk insurance vehicle organized primarily to cover the insurable interests of the parent organization. If managed properly, it can have various benefits. A captive gives the organization greater control and flexibility. As previously mentioned, one can capture investment income versus going to a third party, and reduce administrative costs. The captive has a dedicated board of directors so there is oversight with respect to risk management and the financial aspects of the captive. The captive also has the ability to access reinsurance markets directly.
PBN: Cross has an office in East Providence. How much business do you do in the Ocean State, and what are your plans in terms of maintaining or growing the size of your business here?
LUNDGREN: Cross Insurance is now one of the top five independent insurance agents in Rhode Island. This footprint offers a great foundation to build upon working with our colleagues in Rhode Island. We see a bright future for the health care practice in New England. We will work hand in hand with the insurance professionals at Cross Insurance – Rhode Island to maintain existing business and create opportunities for growth.
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