Claim emergence patterns can change over time, and the assumptions applied in estimating ultimate large claim shares can impact results. While overall large claim emergence has decreased compared to historical patterns, fast-emerging large claims are making up a greater share of large claims. If this trend continues, it could mean that fewer “lurking” large claims will emerge for the industry.
This article examines how the shares of fast-emerging, slow-emerging, and total large claims have changed over time.
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Defining Fast- and Slow-Emerging Large Claims*
For the purposes of this article, fast-emerging large claims are claims that reach $1 million of incurred losses (or the applicable threshold) within approximately 24 months of the accident date. Historical NCCI research indicates that the top causes of fast-emerging large claims include motor vehicle accidents and slips and falls from elevation, which can inflict severe trauma with catastrophic results. These types of severe injuries sometimes necessitate higher utilization of in-home care—a factor that is known to increase costs.
Conversely, slow-emerging large claims are those that reach $1 million at a later point. Historical NCCI research identifies strains or injury by lifting as leading causes. These types of injuries are often fundamentally different than the injuries that tend to result in fast-emerging large claims. For example, in contrast to the in-home-care costs that can contribute to fast-emerging large claims, prescription drugs are often a more significant cost driver for slow-emerging large claims.
While NCCI’s analysis of fast- and slow-emerging large claims is limited to states where NCCI operates and is focused on thresholds of $500,000, $1 million, and $2 million, previous
multi-bureau collaborations have taken a deeper dive into insights and trends in countrywide mega claims, including large claim thresholds as high as $10 million.
While the focus here is on the share of fast- and slow-emerging large claims relative to all lost-time claims, keep in mind that over the past couple of decades,
overall lost-time claim frequency has exhibited a long-term pattern of decline that is not apparent when focusing solely on the share of large claims.
In the past two decades, the share of slow-emerging large claims has decreased significantly, while the share of fast-emerging large claims has increased slightly. As a result, fast-emerging large claims have become a bigger portion of large claims. Take the $1 million large-claim threshold as an example: In 2003, approximately 25% of large claims were fast‑emerging, whereas by 2023, this had risen to almost 60%.
Large Claim Shares at $1 Million Threshold
| Accident Year | Large Claims | Fast-Emerging | Slow-Emerging | Fast vs. Slow Split Among Large Claims |
| 2003 | 0.52% | 0.14% | 0.38% | 27% vs. 73% |
| 2008 | 0.60% | 0.19% | 0.41% | 32% vs. 68% |
| 2023 | 0.34% | 0.20% | 0.14% | 59% vs. 41% |
Claim Emergence Patterns Over Time
On an inflation-adjusted basis, the overall share of large claims, as measured by $500,000 and $1 million thresholds, decreased notably from 2008 to 2015, with the share remaining flatter in more recent years. At the $2 million threshold, the overall large claim share has remained relatively flat over time.
Across all three thresholds, slow-emerging large claims have become a much smaller share relative to both lost-time claims and overall large claims, indicating a shift in claim emergence patterns among large claims.
Earlier identification of specific claim characteristics can help injured workers receive appropriate treatment sooner, which may ultimately support faster healing and return-to-work outcomes. These types of interventions may also be contributing to the observed decline in the share of slow-emerging large claims, and large claims overall, by reducing delays in care and mitigating claim deterioration.
Other potential factors that may have contributed to the reduction in slow-emerging large claims over this period include reduced opioid utilization and more sophisticated claims management practices that allow carriers to establish more precise case reserves earlier in the life of severe claims.
Fast- vs. Slow-Emerging Large Claims Tool
NCCI has developed a
Fast- vs. Slow-Emerging Large Claims Tool, which is available to affiliates and regulators. Users can view large claim statistics using thresholds of $500,000, $1 million, or $2 million, and results can also be examined by Hazard Group. This resource also provides additional information on the methodology and assumptions applied.
Please reach out to
our team with questions or for additional insights.
*Large claims are identified based on total incurred losses that are adjusted for inflation to 2024. Development factors are applied to estimate the ultimate share of fast-emerging and slow-emerging large claims. Additional methodology details can be found in the
Fast- vs. Slow-Emerging Large Claims Tool.
This article is provided solely as a reference tool to be used for informational purposes only. The information in this article shall not be construed or interpreted as providing legal or any other advice. Use of this article for any purpose other than as set forth herein is strictly prohibited.