5/18/2018

Comp Claims

What’s driving workers compensation claims activity?

By Phil Gusman

“Communication. Demands to move claims quickly may lead to decision-making without communication between the players. Poor communication will drive workers compensation activity. A claimant is more likely to successfully return to work when treated with care. Communication impacts the amount of activity required to move claims toward resolution.”

Teri Zarrillo,
Partner, Goodman McGuffey LLP. CLM Member since 2012.

“In my 38 years of workers compensation insurance defense, I have seen a sea change in dollar spend. The majority of our dollar used to be spent on indemnity. Now it’s all about medical expenses. Claims involving chronic pain with costly dangerous and ineffective prescription medications like opioids are especially costly.”

Edward M. Moriarty, Jr.,
Senior Partner, Moriarty & Associates, P.C. CLM Member since 2011.

“Risk management decisions, driven by individualized risk appetites. However, identification of risks prior to inception, and over the lifetime of a claim, coupled with established best practices, can minimize, and result in the avoidance of costs. Risk can even be present after settlement of a claim, and must be effectively considered.”

Jean S. Goldstein,
Legal & Corporate Affairs Manager, MEDVAL. CLM Fellow since 2017.

“Ineffective communication, which results in adverse claims activity. My approach to claims resolution includes effective communication and relationship-building from the outset. The goal is to build the relationship with an injured worker to understand the unique needs of that individual to drive the claim to a superior resolution.”

Dorothy Stolle,
Assistant Branch Manager, Gallagher Bassett. CLM Fellow since 2015.


5,190

Number of fatal work injuries in 2016, the highest since 2008.

Source: Survey of Occupational Injuries and Illnesses

50%

Percent share of total workers compensation benefits that were medical benefits in 2015. (In 1980, it was 29%).

Source: National Academy of Social Insurance

98

The estimated accident year combined ratio for workers compensation in 2016, up two points from 2015.

Source: I.I.I., NCCI

65+

The age group with the fastest growing labor force participation rate expected through 2024.

Source: Bureau of Labor Statistics

61%

Percent of businesses that said in a 2017 survey that they worry “a great deal/some” about medical cost inflation.

Source: Travelers

 



Phil Gusman is managing editor of CLM magazine, a publication of the CLM. He can be reached at phil.gusman@theclm.org.

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