Not All Claims Should Have NCCI Catastrophe Code 12 – But Some Should
The COVID 19 Code Will Save You Premiums
I was reviewing how NCCI was handling the catastrophe code that COVID 19 claims would be coded under to not have the claims count against an employer’s Mod. <<<extremely important
The NCCI Catastrophe Code is an ELE Code Stupid
What is an ELE Code? It is not a Class Code. According to NCCI – (See further down for NCCI Catastrophe Code 12)
An Extraordinary Loss Event (ELE) catastrophe is a significant loss event from a workers compensation perspective, which is determined by NCCI or the affected independent worker’s compensation bureau on a case-by-case basis.
When an ELE has been established, the catastrophe number identified with this event is communicated by NCCI through a circular. The catastrophe numbers reserved for identifying ELEs are 11 through 99.
An overview of the reporting requirements for ELE claims are as follows:
- Unit Statistical—Claims involving an ELE are coded using the established catastrophe code, which is reported in the catastrophe number field on the Loss Record. The rules for catastrophe code reporting are provided in the Statistical Plan, and additional information including a reporting example is provided in the Unit Statistical Reporting Guidebook.
- Financial Calls—ELE claims are reported in the aggregate Call loss experience, and they are identified individually in Large Loss and Catastrophe Call (#31) and other Financial Calls in accordance with the rules in the Financial Call Reporting Guidebook.
- Detailed Claim Information (DCI )—Reporting ELE claims is unique in DCI because the Extraordinary Loss Event Claim Indicator is used. Claims involved in an ELE are reported with an ELE Indicator of Y. For additional reporting rules, refer to the Detailed Claim Information Reporting Guidebook.
It is an ELE Code, not a Class Code Stupid
The stupid would be me. I said that the code would be a Classification Code, not some other type of code. Check out the link in the first sentence of the article you are reading to see the actual pages – save yourself the search and time as I have provided the description below:
Extraordinary Loss Event (ELE) Codes and Descriptions ELE Code Description 2019
Code 12
Identifies claims attributable to COVID-19 Coronavirus with Accident Dates of 12/1/2019 and subsequent. At this time, the ending accident date has not yet been established. Once the ending accident date has been established, this document
will be updated.
The NCCI Catastrophe Code should make the COVD 19 claims on your loss run not show up in your Experience Mod Factors.
Self Insureds Would Not Receive NCCI Catastrophe Code Credit
I think the above heading goes without saying. Many times I hear from self-insured Workers Comp programs that I often ignore what amounts to approximately 12% of the workers’ comp market.
Yes, you will not receive any credits as your Experience Mod is actually your Loss Development Factor (LDF). You should talk to your Actuary or whoever calculates your LDF on receiving some type of credit for the claims. You may have a tough time convincing them to adjust your LDF for COVID 19 claims.
You Still Have To File Your Claims With Your Carrier
Next week, I will cover how California is handling the COVID 19 claims. File your claims even if they involve COVID 19 with your carrier. Then, make sure that the NCCI Catastrophe Code 12 takes them off your Experience Mod Sheets.
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