YMCA Management Webinar Series: Claims

YMCAs experience a wide range of claims that vary in both frequency and impact. Claim impact is not only financial. How an incident is handled can influence community trust, internal morale and reputation long after closure.

Common claim categories discussed include:

• Aquatics incidents and slip, trip and fall activity around pool environments.
• Slip, trip and fall claims across facilities and entryways.
• Childcare-related injuries including playground falls and unmonitored transitions.
• Employment practices claims tied to the employer-employee relationship.
• Workers’ compensation frequency.
• Property losses shaped by geographic exposures such as hurricanes, convective storm, hail, vandalism and fire.

Every claim follows a similar path regardless of severity.

Incident and frontline response: Immediate priorities include checking on the injured party, identifying conditions and documenting facts such as time, location and sequence.

Internal reporting and escalation: Consistency is critical. Supervisors, HR, risk and leadership should clearly understand escalation triggers and ownership.

Filing the claim and investigation: Claims should be placed on notice promptly, with brokers actively involved. Adjusters may request documentation, video, photos and witness information.

Resolution and closure: Depending on the claim, resolution may include medical or legal review, negotiation, settlement or closure. Internal review should follow every claim to identify improvements.

Claims Reporting Philosophy

Do not bury claims or pay them out-of-pocket to avoid reporting, particularly when there is potential for escalation.

Key points discussed:

• Claim dollars and loss ratio often matter more than claim count.
• Late reporting can jeopardize coverage.
• Certain claim types carry legal reporting obligations.

Carriers generally expect notice within 24 to 72 hours of an incident.

“Facts Only” Documentation

• Document facts only, not opinions.
• Avoid conclusions about fault.
• Preserve evidence immediately.

Evidence Preservation

Video retention periods vary. If claims are reported late, footage may already be lost. Saving video and photos immediately is a simple but critical habit.

Member Communication

Checking on a member is appropriate but must be handled carefully. Outreach should never imply fault but can help identify whether a claim may develop.

Clear role definition improves consistency:

• Frontline staff: response and fact gathering
• Supervisors: validation and escalation
• Risk or claim lead: filing and coordination
• Broker: advocacy and strategy
• Carrier: investigation and resolution

Training across all levels ensures consistent response.

Claims should be viewed as feedback, not one-off events.

Recommended practices include:

• Reviewing claims through cross-functional safety committees.
• Identifying trends by location, program and timing.
• Prioritizing high-frequency or high-severity areas.
• Conducting annual or biannual claims reviews.

Claims reviews support reserve management, return-to-work efforts and operational improvements.

Waivers and accident policies

Waivers and accident policies can reduce claims activity, though enforceability varies by state. Accident policies can be especially useful in camp settings.

Claims dashboards

Dashboards improve visibility into open claims, reserves, trends and closure speed and may be provided by brokers, carriers or internal systems.