Category Archives: Frequency

Trends in Workers’ Compensation Claims: Some Things to Think About for Medical Travel

It is rare that I post articles from the National Council on Compensation Insurance (NCCI) on this blog, and it has been some time since I discussed workers’ comp and medical travel in the same post, so I thought that this would be a good time to do so.

NCCI is the premier source for data collection in the workers’ compensation industry. Their focus is more involved with the factors that drive the cost of workers’ comp insurance, rather than specific issues in workers’ comp that one might find from reading the reports of the Workers’ Compensation Research Institute (WCRI).

As the article will note, there has been a decrease in frequency of claims, but an increase in severity. Claim frequency is defined by NCCI as the number of claims involving lost wage benefits paid, divided by earned premium. For those of you in the health care and medical travel worlds, just know that it means there are more claims reported to insurance carriers.

Claim severity, on the other hand, is defined as losses incurred, divided by the number of claims, for lost wage benefits paid. This will be of importance to the medical travel industry, as they have found a +16% increase in medical severity from 2011 to 2016.

I will let you read the rest of the article here.

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Opt-Out A Boon to Employers, Not So Injured Workers

Employers opting out of workers’ comp in Texas are reducing costs, but more study is needed on how non-subscription affects injured workers, according to Stephanie Goldberg of Business Insurance.

Ms. Goldberg reports that a study released last week by Alison D. Morantz of Stanford Law School, found that the overall cost per claim is about 49% lower in the non-subscription environment, which is largely due to declines in medical and wage replacement costs.

The study also found, she writes, that despite no significant decline in frequency of claims, that more serious claims involving replacement of lost wages are about 33% less common among non-subscribing employers.

For the study, Ms. Goldberg adds, Ms. Morantz recruited 15 large multistate companies that operate homogenous facilities nationwide, and compared outcomes in traditional workers’ comp versus opt-out for each company from 1998 to 2010.

The study found also that the frequency of nontraumatic injuries declined about 47% with opt-out coverage.

It could be that nonsubscribers are better at screening out nontraumatic claims under one of the many exclusions that private plans typically contain,” said Ms. Morantz.

Meanwhile, Ms. Goldberg wrote, a nontraumatic injury that is covered may be denied if it is not reported by the end of the employee’s shift, or within 24 hours.

Thirteen of the fifteen employers in the study have “good cause” provisions that allow a claims administrator to determine if there was a good reason the claim was made late.

Finally, Ms. Morantz said that, “the biggest unanswered question is how these plans affect the welfare of workers.

As I reported yesterday in two posts, “Texas State House Seeks to Change Rules for Workers’ Comp” and “Workers’ Comp Opt-Out Goes Under US Microscope“, there are a lot of unanswered questions surrounding the effect opt-out will have on the injured worker.

Those who support opt-out expansion really don’t care about injured workers; they care about saving money for employers (i.e., profits that go back to the investors or to the top executives). They are also diametrically opposed to giving workers any benefits, and would prefer that workers’ comp had never existed, along with unemployment insurance and health insurance.

Those who see through the smoke and mirrors of opt-out know what the world was like before workers’ comp laws, and they don’t want to go back to those days, and whether or not they really are concerned with the welfare of workers, or just say they do, I am afraid that they may not be able to stop this move on the part of opt-out proponents.

But federal oversight would be welcomed to prevent going back to the bad old days before Triangle, which happened 105 years ago tomorrow. Marty McFly went back to the future, these guys in opt-out want to go back to the past.

 

 

Trouble Ahead for Workers’ Comp

The Denver Business Journal today published an article by Steve Doss, VP of Commercial Lines at CCIG.

Here are the key takeaways from Conning, a Connecticut-based investment management company for the insurance industry:

  • Accident frequency has increased. A stronger U.S. economy has meant more inexperienced workers have joined the workforce, so high-hazard occupations like transportation and construction have seen increases in work-related injuries since 2012. For example, non-fatal work-related construction injuries jumped 9.5 percent from 2012 to 2013. Also, as older employees work longer, the number of accidents among those 65 and older rose 18.5 percent from 2012 to 2013.
  • Accident severity is rising. The Bureau of Labor Statistics reports that construction fatalities rose 5.6 percent from 2013 to 2015, and manufacturing fatalities rose 9.3 percent from 2013 to 2014. In addition, hospital and drug costs – the biggest expenses associated with workers’ compensation claims – are rising faster than inflation.
  • Evidence of cost-shifting. The Affordable Care Act may be driving physicians and hospitals to “leak” group health cases into the workers’ compensation system, where they can charge more for the same services than under a group health contract, according to Conning.

For those of you not familiar with workers’ compensation, and those of you who are, what each of the bullet points mean, in simple terms is this:

  • More accidents,
  • Degree of accident injury increasing and,
  • Cost-shifting is occurring.

Isn’t time to stop and realize that whatever programs are implemented, whatever analytical or predictive modeling techniques are utilized, whatever the so-called “experts” say is the cause of this or that problem, whatever so-called “reform” or work comp alternative is attempted, wouldn’t it be prudent to think outside the box, and outside the borders of your limited minds?

Schopenhauer said the following:

“Every man takes the limits of his field of vision for the limits of the world”

Those of you who will not listen to other ideas, no matter how far-fetched they may be, have limited your field of vision and taken them as the limit of the world. The world is globalizing, health care included.

Aerospace technology will very soon allow us to travel to any part of the world in under four hours. Don’t believe me? Ask Boeing why they are running commercials that tout that very same possibility.

Those who cite judges as saying no to medical travel must ask yourselves this question: Do doctors sentence people to death? (By that I mean execution, not natural death from disease or incompetence)

Those who say the laws won’t allow it, should know that laws can be changed, and laws written in the era of the horse and buggy should not dictate to the post-modern, jet-age, and soon-to-be sub-orbital space plane age. Would you like to live under the laws of Caesar or Charlemagne?

And finally, those who say the injured workers won’t go abroad to get better medical care, have you ever asked them, or are you just putting your words in their mouths?

Methinks you all doth protest a bit too much for the sake of injured workers and myself. Look in the mirror and ask yourselves why workers’ comp is failing. The answer is staring right back at you.