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Top Four Self Insured Workers Compensation Success Measurements


Top Four Workers Compensation Success Measurements Easily Acquired

The Top Four Workers Compensation success measurements for self-insureds are easy to find in your Workers Comp materials.

In my last two posts, I covered how to measure the success (or failure) of a Worker’s Compensation program. I want to be fair to self-insureds as I am often reminded to include the self-insurance angle on my posts.

The measurements for self-insureds are:

Graphic of Green Apple With Tape Measure Success Measurements Concept
  1. Loss Development Factors (LDFs)
  2. Current reserve levels (including all claims)
  3. TPA Statistics
  4. Bottom line – payments made over the life of the claim


Loss Development Factor (LDF)

The LDF, in my opinion, is one of the least understood of all variables in the Worker’s Compensation process. The LDF is analogous to the E-Mod. The LDF will usually cover a 10-year time frame. Many software packages will calculate LDFs.

An LDF remains one of the best success measurements – similar to your personal credit score.  The LDF will let you see your company’s workers comp roadmap starting point.

One inherent risk with LDF software is knowing which variables need to be adjusted before inputting the loss data. I have seen LDFs vary greatly even though the same software was used for the calculations. Incurred But Not Reported (IBNR) is one of the main parts of the LDF statistic. IBNR is an estimation of any claims that have occurred but have not been reported.

Current Reserve Levels (For All Current Claims)

The current reserve levels for a self-insured employer is just as important for one that pays a premium for their Worker’s Compensation coverage. If the reserve levels are inadequate, the LDF will be inaccurate and the self-insured will not set aside a large enough budget to pay future Workers’ Compensation claims and payments. If the reserves are too high, there may be too large of an amount of funds appropriated for Worker’s Compensation payments that could have been used elsewhere in the organization’s budget.

Stethoscope Success Measurements on the table
Wikimedia Commons – Pkd2016

Statistics Provided By The TPA

I had already mentioned this subject in my last note. I did want to again bring up the fact that the person or persons that are setting your reserves – the adjusters – have many ranking statistics for how their clients are performing in such areas as delayed first reports of injury, return to work, etc. Most TPAs will provide you with the information if you request it free of charge.

Bottom Line payments made over the life of the claim

The huge difference between a Worker’s Compensation program with an insurance carrier and a TPA is that certain claims are not counted in the E-Mod system. Open claims are ALL counted when calculating an LDF. All payments made on any claim at any time are counted into your Workers Comp budget.

Money And Calculator Success Measurements Budget Concept

A different tact has to be used when reviewing TPA loss runs versus an insurance carrier’s loss run. One thing to watch is an old claim that is reopened for payment and then closed again. I have seen many of our clients concentrate on only the open claims or getting the claims closed. One piece of advice that we give is that payments made are just as important as the reserves.

The TPA and the self-insured have a direct fiduciary relationship. I always tell our self-insured clients the TPA is spending directly out of your company’s budgeted account. Loss reduction strategies can make or break a self-insured program. There are hundreds of posts in this blog on loss reduction strategies.

As I have posted often, self-insureds have told me that they are out of the Workers’ Compensation system. Self-insureds are more in the system than insured paying premiums to an insurance carrier. Self-insureds have no buffer for a huge claim or a large number of claims.

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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:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications


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