Target Loss Drivers. Claim/Loss Data Sources. No/Minimal Injuries? A. Know your history and trends

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1 Time Well Spent: Target Efforts to Reduce Workers Compensation Costs Angela DeLong Banerjee, CSP, ARM, ALCM Director Loss Control ACUITY, A Mutual Insurance Company The content of this presentation is general in nature and provided to you for informational purposes only. The information isderived from sources believed to be reliable and is offered as a resource to be used together with guidance from your professional insurance, legal, and safety advisors in maintaining a loss prevention program. ACUITY assumes no liability by reason of the information contained in this document. If you have a specific concern, you should contact your professional insurance, legal, or safety advisors. Time Well Spent.. 1. Target Loss Drivers 2. Reduce (WC) Costs (Injury/Insurance) 1

2 Target Loss Drivers A. Know your history and trends B. Reduce frequency & severity of loss drivers through - involving employees - incident investigation & analysis Claim/Loss Data Sources No/Minimal injuries Benchmark sources (BLS, OSHA, NSC) Have injury frequency Workers Comp Carrier (or agent) Your Records OSHA Log First Aid log Incident/close call reports WC First Report of Injury Tally sheets No/Minimal Injuries? Data for your industry (NAICS) NSC Injury Facts Data BLS Fatalities & Incidence rates OSHA violations (frequently cited) Insurance carrier benchmarking data What are your competitors experiencing? OSHA Establishment search=violations What is your state experiencing? High $ penalties by state 2

3 OSHA & BLS Data 3

4 What are your competitors experiencing? Inspection results What is your state experiencing? High $ enforcement cases: 4

5 Insurance Carrier Benchmarking Data When you have injuries Data Sources Workers Comp Carrier/agent OSHA Log First Aid log Incident/close call reports WC First Report of Injury Tally sheets Track number, costs, lost/restricted Compare those to Your own history BLS incidence rates Data Sources: Carrier Data PDF, list Graphs CSV/Excel 5

6 Your Records Tallying from history 6

7 Your Records - Tallying Losses From: 1/01/2013 To 12/31/2015 (as of 1/17/2016) TOTALS Incurred # Incurred # Incurred # Incurred Number (Paid & Reserves) Claims (Paid & Reserves) Claims (Paid & Reserves) of Claims (Paid & Reserves) of Claims $ # Object in Eye $4, $11, $3, $19, % 22% Strain $53, $25, $2, $81, % 18% Struck By $6, $53, $18, $78, % 16% Cut $26, $3, $2, $32, % 13% Caught in $32,319 6 $14,310 9 $3,379 7 $50, % 8% Fall or Slip $44,945 5 $168,948 8 $3,281 6 $217, % 7% Burn $1,119 2 $1, $0 5 $2, % 6% Strike Against $0 2 $4,061 5 $19,856 2 $23, % 3% Repetitive Motion $13,122 1 $23,916 4 $0 1 $37, % 2% Misc $9 1 $0 2 $9 2 $18 5 0% 2% Absorb/inject/ inhale 0 $57,716 1 $0 0 $57, % 0% TOTALS $182, $364, $53, $600, Your Records - Tallying Indemnity claims as Number Number Number of % of total Claim Costs Claims Active Indemnity Indemnity active (Pd & Rsvrs) reported claims 1 costs 2 claims claims 2013 $221, $41, % 2014 $142, $35, % 2015 $219, $9, % Totals $583, $86, % Claim Costs (Pd & Rsvrs) Number Claims reported Number Active claims 1 Indemnity costs 2 Indemnity claims as % Number of of total Indemnity active claims claims Dept A $221, $41, % Dept B $142, $35, % Dept C $219, $9, % Totals $583, $86, % Real-Time Tallying 7

8 Spreadsheets, Filters, Pivot Tables Ability to sort, filter, & graph by location, injury type, day of week, job titles, employee tenure, time of day, lag, etc. By Accident type 8

9 By Body Part Occupation # Months employed 9

10 months 14% >120 months 21% months 12% # Months employed unknown 1% 0-6 months 13% 7-24 months 39% # Months Employed % injuries % workforce > Day of the week By time of day 10

11 By time of day By month Average Cost by Type (or Dept) All other Caught In Motor Vehicle Slip/falls Cuts Strains $- $5,000 $10,000 $15,000 $20,000 $25,000 11

12 Auto by Type of Incident Intersection 15% Hit while parked 7% All other 11% Backing 27% Rearending 22% Hitting stationary object 18% Auto by month Is this your busiest month? Auto by time 12

13 Avoid Garbage in/garbage Out Determine finite job titles/occupations Be precise with accident cause, injury type Report TIME of incident Target Loss Drivers Know your history and trends B. Reduce frequency & severity of loss drivers by involving employees in Target Loss Drivers Know your history and trends B. Reduce frequency & severity of loss drivers through - involving employees - incident investigation & analysis 13

14 Involve Employees Understanding why in the data Digging into the loss leaders Task review/jsa Observations Go-Forward activities Incident investigation & analysis Corrective actions Close call reporting Time Well Spent.. Target Loss Drivers 2. Reduce (WC) Costs EMod reduction through reduced (Injury severity) Medical costs Indemnity/lost wages Insurance costs Experience Modification Rate EMR Experience Mod EMod 14

15 Insurance is a large expense EMod DIRECTLY affects your premium Contractors: Emod >1: can't bid some jobs EMod & Lost-time claims FACTS: Eliminating lost time has a notable affect on EMod & insurance cost Lost-time for WC and OSHA recordables differs RTW & Injury management must be pre-planned to improve EMod EMod of 1 = Average Established & calculated by WC Bureau NCCI is national rating bureau Some state-specific bureaus/rates NOT in NCCI Multi-state operation 15

16 Where & how it s used: WC Premium Calculation Rate* X Payroll X EMod $100 CLASS CODE DESCRIPTION RATE* 8810 Clerical Office Employees $ Steel Erection $43.68 Medical-Only Vs. Indemnity All claims have medical costs Becomes indemnity if. Lost time or restricted duty Needs investigation or contact w/claimant 16

17 For EMod calculation, Medical-Only losses are reduced by 70% WC Loss -Company A- Med-Only Losses -Company B- Indemnity Losses $ 500 $ 150 $ 500 $1,000 $ 300 $1,000 $4,000 $1,200 $4,000 Loss Amount included in EMod Calculation $1,650 $5,500 Applies added weight to a company s loss frequency Places a cap on claim severity such that one large loss does not skew the E-Mod Injury Management/RTW Policy statement Responsibilities assigned (Mgt) training & orientation Triage/in-house care Procedures Medical providers Task list In-network Meeting, planning, visit your facility Kit for employees & doctors Explanation of RTW policy/program Light duty task list Restriction checklist 17

18 Injury Management/RTW Policy statement/program Intent Responsibilities assigned Point person must keep contact with employee (Mgt) training & orientation Why, impact Require written release/restrictions after injury Don t allow work beyond restrictions Don t send employee home if they can t Triage/in-house care Nurse, nurse hotline Injury Management/RTW Medical providers In-network AND commonly used doctors Meeting, planning, visit your facility Procedures Transport to doctor Who accompanies employee? When would employee go home vs. back to work? What documents and information are required? Medical follow-up visit requirements Injury Management/RTW Transitional duty task list Modified and Alternate Kit for employees & doctors (letter) Explanation of RTW policy/program Restriction/release checklist or form Modified and Alternate duty task list RTW Agreement Progress and communication chart 18

19 Modified/Alternate Duty Task List Understanding RTW Employee choice vs. Employer choice (Differs by state) Doctors Orders Dictate Helps to have physical demands for jobs/tasks Employee must follow treatment protocols Restrictions/time off HR/ADA/EEOC considerations State Differences EmployEE vs. EmployER choice Waiting periods Litigation climate 19

20 EmployEE Choice States Illinois Wisconsin Minnesota South Dakota Nebraska Kentucky Utah Arizona Montana Nevada Direct Care States (EmployER choice) Indiana Missouri Michigan Iowa Kansas - First 28 days then employee choice New Mexico - First 60 days then employee choice Maine - First 10 days then employee choice Treatment Panel States Colorado two unaffiliated panel doctors within 7 days Pennsylvania panel has to be in place prior to injury Tennessee panel of 3-4 doctors 20

21 How is EMod Calculated? Rolling 3 year window Excludes most recent policy year ( green losses) Which 3 years? Policy Year 2015 Policy Year How is EMod Calculated? Rolling 3 year window Excludes most recent policy year ( green losses) Claim count and costs Caps large losses (Split Point) 70% Cost reduction for Med-only Encourages RTW 21

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