3/28/2016

Inside Risk: Denise Pinto, Fulton County

Fulton County’s Assistant Manager for Risk Management, Finance Division dishes on how to keep hundreds of claims under control.

By Eric Gilkey

Denise Pinto, Assistant Manager for Risk Management, Fulton County’s Finance Division

With 5,000 employees and over 1,500 government vehicles, Georgia’s Fulton County requires innovative thinking and planning from its leaders, especially when it comes to managing risk. Find out how CLM Fellow Denise Pinto keeps the hundreds of claims she faces every year under control, with only three percent developing into litigation. 

Q. Did you find risk management, or did it find you?

A. I found my calling in insurance/risk management early. While contemplating college offerings, I received a brochure from Howard University announcing the launch of a new public/private partnership that created a major for insurance. Two diverse visionaries (Maurice Williams, formerly a Metropolitan executive, and James Chastain, celebrated author and advisor) had crossed paths and recognized a diversity gap in middle and corporate management positions in the insurance industry. They tapped their contacts and leveraged their acumen to formulate the insurance major, which offered in-depth interaction with giants in the industry, internships, and a pathway to employment. I was one of the first 100 recruited.  When I saw the opportunities, the multifaceted paths that appealed to my interests in law and business, and the financial rewards available in a city that I aspired to visit (Washington, D.C.),  I was hooked.

Q. Did you ever work claims?

A. I discovered the claims field at GEICO after working on the other side of the floor in corporate marketing. Claims is dynamic, and it requires creative and analytical processes. It’s important to stay on trend with things like regulations and coverage interpretations. Claims professionals are a natural fit for risk management and law careers, and many of my peers are both. I chose risk management because it provides wide autonomy to develop customized solutions, drive impact, and appease my type-A personality!

Q. How did this experience help you in your current role?

A. Drawing from my claims background, I created claims protocols, policies, and procedures governing proof and settlement (or declination), along with job descriptions. We ditched the third party administrator and hired inside claims professionals. Also, we created an internal subrogation/recovery program to maximize recoveries without the expense of an outside vendor, which I still directly administer (claims tendencies die hard!). I also directly administer the public official bonds procurement program, which draws on my former work at Fireman’s Fund handling fidelity and surety bond claims.

Q. What unique challenges exist in the public sector and at Fulton County?

A. My division manager, who also is a former private sector person oriented toward risk financing, and I put into place something uncommon at public entities: a real self-insurance plan. We have a $2 million self-insurance retention (liability) and purchase excess liability and excess compensation as well as property and some specialty pieces for some of the human services and other programming offerings, like our police helicopter and our $2 billion in facilities/treatment plants and special purpose buildings.

Our biggest challenge in cost sectors at Fulton, though, has been litigation. The mechanics of historical approaches to litigation and settlement philosophies as well as the pas de deux between department heads, claims professionals, and attorneys is an existing condition and unstinting dance. We are a target and, sometimes, press fodder. Constitutional officers autonomy is something not necessarily encountered in the private sector; our faults and failings happen in the public eye.

Q. Have you ever taken a risk and turned it into an opportunity?

A. My first week at Fulton County, I received a call from a claimant’s wife at a hospital. Her husband was in a coma and had been for days. The user agency from where the claim originated had been handling the matter internally, as per status quo. I went into claims preservation mode with the claimant and defied all internal job chains, marched on the director, and demanded to know how they were managing the claim. It was a huge exposure involving an employee driver, and showcased the outdated claims resolution process we had in place. The seriousness of the matter and subsequent litigation was a platform used to bring change to our automobile claims resolution process, which I helped draft and resulted in giving our risk department more authority and influence. Years later, the state waiver of sovereign immunity on auto accidents involving public entities occurred. We were locked in at the table.

Bad things happen, so it’s important to turn them into learning opportunities and create influence in a way that is impactful and mitigates the drain on financial resources. It also hinges on bettering people, improving processes, elevating systems, and preserving sustainability. That’s the purpose I serve.   



Eric Gilkey is executive editor of CLM Magazine, a publication of the Claims and Litigation Management (CLM) Alliance. He may be reached at 513-273-8025, eric.gilkey@TheCLM.org.

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