The California Workers’ Compensation Institute reported that an increase in the volume of medical-only claims and compensation claims in 2021 pushed the rate of private self-insured employers to the highest level since 2007.
“Initial data on California workers’ comp private self-insurer claims experiences from calendar year 2021 show that the overall claim rate increased nearly 6% last year, largely driven by a 9.6% increase in the incidence of medical-only claims, while average claims paid and incurred Losses also increased, pushing up private self-insured first report total paid losses by $46.4 million, while first report total incurred losses increased by $97.4 million, according to a CWCI review of new state data,” the institute said in a bulletin is published on Friday.
Private self-insured employers reported a total of 93,430 claims in 2021
compared to 86,503 in 2020. With approximately 2.4 million workers covered by private self-insured employers, that translated to an overall claim rate of 3.92 per 100 workers, up from 20207 in 2020. .The proportion of medical claims increased to 2.05 per 100 employees from 1.97 in 2020.
However, the CWCI said medical-only claims fell to 43,779 when the pandemic hit in 2020, from 51,545 in 2019, so the recovery to 48,766 claims in 2021 is still below the pre-pandemic level.
The CWCI reported that its review of First Report claims volume over the past three years shows that since the pandemic declaration in 2020, a large portion of the increase in private self-insured claims has been on indemnity claims: from 34,207 in 2019 to 44,664 in 2021.
“It has led to a shift in the distribution of private self-insured medical-only and indemnity claims since the start of the pandemic, as the number of indemnity claims per 100 employees increased from 1.47 in 2019 to 1.83 in 2020, then increasing to 1, 87 in 2021, while the number of medical claims per 100 employees fell from 2.21 in 2019 to 1.87 in 2020 before recovering to 2.05 last year,” the CWCI said.
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