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Workers Comp Claim Development – Long Six+ Month Wait

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Workers Comp Claim Development – Why The Six Month Delay?

The Workers Comp claim development process has frustrated more than a few insureds or agents.

Every time that I publish an article on how claims are reported and tabulated by the rating bureaus (NCCI, WCIRB, and others), the same question eventually pops up in the discussion.

picture of clock face with six numerals workers comp claim development
Wikimedia Use License – Maristela Possamai

Why do I have to wait an additional six months to receive my Experience Mod each year?   The rating bureaus refer to the six-month delay as workers comp claim development.

How Workers Comp Claim Development Works

There are two steadfast rules in Workers Comp ratings.  They are:

  • Your policy does not show up in your Experience Mod until the following year.  Yes, the claim totals are delayed for one year.   For example – your 01/01/2019 – 01/01/2020 policy will not affect your company’s Mod until 1/1/2021 – 1/1/2022.
  • The very important UNIT STAT Date is 07/01/2020 – when the claim values peg to the NEXT year’s Mod.  The reason for the six-month delay is called Workers Comp claim development.

NCCI and Other Rating Bureaus Faster Now On Mod Publishing

I often receive this question.  Why do we have to wait four more months after the UNIT STAT date to receive our Mod?  We would like to have it as soon as possible.

On the example above, the insured has to wait until 10/01/2020 to receive their Modification factor.  Those were the old days as the rating bureaus publish Mods much faster now than in previous years.

Over the last two years, a positive trend has occurred with insureds and their agents receiving the Mods within 30 days after the UNIT STAT date.

In our example, the insured would likely receive the Experience Mod Sheets by 08/01/2020 or sooner.

The Reasons For Delays

Many times we receive emails or calls on Mods being delayed – why do delays occur?

  • One of the states that report to the rating bureau may not have published their final state rating data
  • A carrier may have not reported all the data required to finalize the Mod
  • Your company may not qualify for a Mod due to premium level
  • The UNIT STAT data is due 60 days after the UNIT STAT date.  Most carriers presently report the data almost instantaneously – within the first week after the UNIT STAT date.

The fix – call the rating bureau or contact me to see if J&L can assist you.   We also can estimate your company’s Mod from your loss runs including the Workers Comp claim development.

 

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James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt 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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