Mega Claims in Workers Compensation

Posted Date: August 29, 2018
    

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There are claims, and then there are mega claims. These extraordinary occurrences exceed $10M and can have a significant impact on the workers compensation industry. What’s surprising is that the number of mega claims jumped in 2016. Whether this is a one-time blip, or a new trend, remains to be seen but will be key for the industry.

In a new Research Brief, NCCI researchers examine this category of workers compensation claims through Financial, Unit Statistical, and Medical Call data to further explore the impact and characteristics of mega claims.

Key findings from the report include:

  • Increase in 2016—Recent data shows an uptick in the number of mega claims. For accidents occurring in 2016, ten claims of at least $10M have been observed (more than for any of the previous 15 accident years).
  • By Cause—Motor vehicle accidents and falls from elevation are the leading causes—nearly 70%—of mega claims. Many result in injuries to the head, neck, or spine.
  • Where Are the Dollars Going?—Hospital inpatient and home health care services account for more than half of mega claim medical costs. This is in stark contrast to all lost-time claims where most of the medical costs are for physician and hospital outpatient services.

NCCI will continue to monitor these high-cost claims through future research.

To learn more about mega claims, read the full NCCI Research Brief. Look for new research on this and other topics at ncci.com.