Case Study:

Experience Modification Factor Analysis

Quick Facts

Community Type: Nursing Homes

Number of Locations: 6

Resource: Workers Compensation Experience Modification Factor Analysis

Valued Client Since: 2020

Challenge

A large percentage of workers compensation experience modification factors are promulgated inaccurately. This can be caused by data entry errors, claims coded incorrectly or aggravated inequities.

On a client’s 8/28/2019 experience mod worksheet, there was a claim from the 2017 policy period that contained an open indemnity reserve of $13,014.

Solution

While verifying the client's current workers' compensation experience modification factor, the AssuredPartners Workers Compensation Data Analytics Coordinator noticed a potential error that could be favorable for the client. The carrier loss run from the same policy period showed this claim was closed on 6/9/2019 for $1,500 in medical expenses only, with no indemnity payments. The AssuredPartners Workers Compensation Data Analytics Coordinator approached the prior carrier from 2017 with this data and was able to confirm the claim had in fact closed as shown on the loss run. Based on the information provided, the carrier revised the 8/28/2019 experience mod worksheet.

Value

On 3/27/2020, NCCI revised the experience mod which led to a mod reduction from a .97 to a .90. This adjustment resulted in approximately a $19,000 premium savings on the current policy.In addition to the current mod reduction, this adjustment will also have a positive impact on the 2020 and 2021 experience modification factors.AssuredPartners contacted the carrier and requested that they retro this adjustment back to the 8/28/2019 effective date.