Excess Loss Is Very Important on Experience Mod Sheets

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Term Of The Day – Excess Loss

The Workers Comp term of the day is excess loss.  It is the amount of a Workers Compensation claim that exceeds the Primary Loss – usually $5,000.

Graphic Of Sack Of Money Excess Loss Color Green
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The Excess Loss does not affect the EMR/E-Mod/X-Mod as much as the Primary Loss on a dollar-per-dollar basis.  It is still an important factor in determining the premium amount.

The split point level was increased by most of the rating bureaus including NCCI in 2012.  The level was increased from 5,000 to 15,000 over a span of three years.  J&L Risk Management Consultants wrote numerous articles on the very critical increases.

NCCI had expressed in various articles that the increased minimum Excess Loss was premium neutral.  This may not have been the case for many safe employers.   Many saw increases in their E-Mods with no adverse claims data.

As with the Primary Loss part of the Workers Comp claim, the amounts are based on the Total Incurred associated with the claim.

The rating bureaus provide a factor that reduces the effect on the Experience Mod.   The factor appears on the Experience Rating sheets.

Update – The Split point now begins at $15,000 for most NCCI-rated states.  California has a floating split point that relies on company size.

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James J Moore - Workers Comp Expert

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Management Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

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  • WorkCompCentral.com
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  • Risk & Insurance Magazine
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