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Analyzing Workers' Compensation Claims and Payments Made Using Data from a Large Insurance Provider
Navneet Kaur Baidwan1, Nathan W Carroll1, Bunyamin Ozaydin1
1Department of Health Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
Summary
Workers' Compensation (WC) payments vary significantly by claim severity and injury type. Workplace interventions should focus on both claim costs and injury frequency to reduce the overall financial burden.
Area of Science:
- Occupational health and safety
- Insurance analytics
- Economic impact of workplace injuries
Background:
- Workers' Compensation (WC) systems are established in all US states to address occupational safety and health.
- This study analyzes WC payment data from a major insurance provider spanning 2011-2018.
- Estimates of WC payments are stratified by claim severity, including medical-only and indemnity claims.
Purpose of the Study:
- To estimate Workers' Compensation (WC) payments.
- To analyze the association between injury characteristics and total WC payments.
- To determine the overall cost burden of workplace injuries.
Main Methods:
- Utilized data from a large insurance provider (2011-2018).
- Employed generalized estimating equations for statistical analysis.
- Analyzed key injury characteristics: nature, source, and body part injured.
Main Results:
- Out of 151,959 closed claims, 83% were medical-only.
- Mean WC payment was $1477 (SD: $7221) per claim with a payment.
- Amputations had the highest mean payment in medical-only claims; ruptures in disability/death claims. Strains represented the highest overall cost burden when frequency was considered.
Conclusions:
- Workplace interventions should target both average claim costs and injury frequency.
- Prioritizing interventions based on both cost and frequency can mitigate financial burdens.
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