A Seven-Year Longitudinal Claim Analysis to Assess the Factors Contributing to the Increased Severity of Work-Related Injuries

Nimisha Kalia, Robert A. Lavin, Larry Yuspeh, Edward J. Bernacki, Xu Guang Tao

Research output: Contribution to journalArticle

Abstract

Background: In recent decades, the frequency of Medical Only (MO) and Lost Time (LT) workers' compensation claims has decreased, while average severity (medical and indemnity costs) has increased. Objective: The aim of this study was to compare claim frequency, mix, and severity (cost) over two periods using a claim cohort follow-up method. Methods: Sixty-two thousand five hundred thirty-three claims during two periods (1999 to 2002 and 2003 to 2006) were followed seven years postinjury. Descriptive analysis and significant testing methods were used to compare claim frequency and costs. Results: The number of claims per $1M of premium decreased 50.4% for MO claims and 35.6% for LT claims, consequently increasing the LT claim proportion. The average cost of LT claims did not increase. Conclusion: The severity increase is attributable to the proportional change in LT and MO claims. While the number of LT claims decreased, the inflation-adjusted average cost of LT claims did not increase.

Original languageEnglish (US)
Pages (from-to)e320-e324
JournalJournal of Occupational and Environmental Medicine
Volume58
Issue number9
DOIs
StatePublished - Oct 19 2016

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Insurance Claim Review
Wounds and Injuries
Costs and Cost Analysis
Workers' Compensation
Economic Inflation
Insurance

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

@article{7152c8741d454afab15c0d7d57d133ec,
title = "A Seven-Year Longitudinal Claim Analysis to Assess the Factors Contributing to the Increased Severity of Work-Related Injuries",
abstract = "Background: In recent decades, the frequency of Medical Only (MO) and Lost Time (LT) workers' compensation claims has decreased, while average severity (medical and indemnity costs) has increased. Objective: The aim of this study was to compare claim frequency, mix, and severity (cost) over two periods using a claim cohort follow-up method. Methods: Sixty-two thousand five hundred thirty-three claims during two periods (1999 to 2002 and 2003 to 2006) were followed seven years postinjury. Descriptive analysis and significant testing methods were used to compare claim frequency and costs. Results: The number of claims per $1M of premium decreased 50.4{\%} for MO claims and 35.6{\%} for LT claims, consequently increasing the LT claim proportion. The average cost of LT claims did not increase. Conclusion: The severity increase is attributable to the proportional change in LT and MO claims. While the number of LT claims decreased, the inflation-adjusted average cost of LT claims did not increase.",
author = "Nimisha Kalia and Lavin, {Robert A.} and Larry Yuspeh and Bernacki, {Edward J.} and Tao, {Xu Guang}",
year = "2016",
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T1 - A Seven-Year Longitudinal Claim Analysis to Assess the Factors Contributing to the Increased Severity of Work-Related Injuries

AU - Kalia, Nimisha

AU - Lavin, Robert A.

AU - Yuspeh, Larry

AU - Bernacki, Edward J.

AU - Tao, Xu Guang

PY - 2016/10/19

Y1 - 2016/10/19

N2 - Background: In recent decades, the frequency of Medical Only (MO) and Lost Time (LT) workers' compensation claims has decreased, while average severity (medical and indemnity costs) has increased. Objective: The aim of this study was to compare claim frequency, mix, and severity (cost) over two periods using a claim cohort follow-up method. Methods: Sixty-two thousand five hundred thirty-three claims during two periods (1999 to 2002 and 2003 to 2006) were followed seven years postinjury. Descriptive analysis and significant testing methods were used to compare claim frequency and costs. Results: The number of claims per $1M of premium decreased 50.4% for MO claims and 35.6% for LT claims, consequently increasing the LT claim proportion. The average cost of LT claims did not increase. Conclusion: The severity increase is attributable to the proportional change in LT and MO claims. While the number of LT claims decreased, the inflation-adjusted average cost of LT claims did not increase.

AB - Background: In recent decades, the frequency of Medical Only (MO) and Lost Time (LT) workers' compensation claims has decreased, while average severity (medical and indemnity costs) has increased. Objective: The aim of this study was to compare claim frequency, mix, and severity (cost) over two periods using a claim cohort follow-up method. Methods: Sixty-two thousand five hundred thirty-three claims during two periods (1999 to 2002 and 2003 to 2006) were followed seven years postinjury. Descriptive analysis and significant testing methods were used to compare claim frequency and costs. Results: The number of claims per $1M of premium decreased 50.4% for MO claims and 35.6% for LT claims, consequently increasing the LT claim proportion. The average cost of LT claims did not increase. Conclusion: The severity increase is attributable to the proportional change in LT and MO claims. While the number of LT claims decreased, the inflation-adjusted average cost of LT claims did not increase.

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