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Why Do Loss Run Numbers Never Match Experience Mod Sheets?

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Recent Reader Question  – Loss Run Numbers and Experience Mod Sheets Confusion

One of the most frequent questions that we have received over the years is why the workers’ comp loss run numbers never match the info on the Experience Mod Sheets.   Let us look at three reasons why this happens during a loss run review.

I was performing a loss run review for an agent-client that caused me to write this article.  Matching up the loss run to the Mod Sheets was quite a task as all three of the below instances occurred with the review.

pic man confused loss run numbers
WikiPublicUse License – Ion Chibzii

Loss Run Numbers Are Current – Rating Bureau Mod Sheets Are Not

If you have online access to your claims or can download the loss run numbers on demand, the information that you have is very current.

If you do not have online access to your claims, ask your carrier or agent for a username and password for access.   Many articles covering online access advantages are covered on this website such as this article.

Experience Mod Sheets are dependent upon the insurance carriers’ data reporting departments supplying timely information to the Rate Bureau (NCCI, WCIRB, and others).

The Experience Rating period delays the reporting of the loss run numbers an extra six months.   This allows claims development for an extra six months.

Allocated Expenses Do Not Count on Mod Sheets

Allocated Expenses (ALAE) are the third set of numbers that you will see in the loss run numbers.  ALAE means the carrier’s cost of handling the claim such as defense attorney or medical bill processing fees.  The rating bureaus decided long ago that ALAE should not figure into the Experience Mod.

On some losses, ALAE can be as large as the indemnity or medical columns on the loss runs.  I reviewed one over the weekend that had over $30,000 in ALAE.  The indemnity and medical totaled $28,000.  This occurs more now than in the past due to the severity of claims increasing every year.

Carriers May Use Partial or Different Claim Numbers

Some claim numbers may be a little different when comparing the worker’s comp loss run numbers.   Claim numbers can be up to 40 characters long.  Rate bureaus vary on the length allowed for claim numbers.  From what I have seen, the claim numbers are truncated at 20 – 25 characters.

Loss run reviews can take time to accomplish if you decide to compare them to the Experience Mod sheets.  Do not rush the comparison.

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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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