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Analyzing Workers’ Compensation Claims and Payments Made Using Data from a Large Insurance Provider

Author

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  • Navneet Kaur Baidwan

    (Department of Health Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL 35294, USA)

  • Nathan W. Carroll

    (Department of Health Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL 35294, USA)

  • Bunyamin Ozaydin

    (Department of Health Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL 35294, USA)

  • Neeraj Puro

    (Health Administration Programs, School of Business, Florida Atlantic University, Boca Raton, FL 33431, USA)

Abstract

Background: All states in the USA have established Workers’ Compensation (WC) insurance systems/programs. WC systems address key occupational safety and health concerns. This effort uses data from a large insurance provider for the years 2011–2018 to provide estimates for WC payments, stratified by the claim severity, i.e., medical only, and indemnity. Methods: Besides providing descriptive statistics, we used generalized estimating equations to analyze the association between the key injury characteristics (nature, source, and body part injured) and total WC payments made. We also provide the overall cost burden for the former. Results: Out of the total 151,959 closed claims, 83% were medical only. The mean overall WC payment per claim for the claims that resulted in a payment was $1477 (SD: $7221). Adjusted models showed that mean payments vary by claim severity. For example, among medical only claims, the mean payment was the highest for amputations ($3849; CI: $1396, $10,608), and among disability and death related claims, ruptures cost the most ($14,285; $7772, $26,255). With frequencies taken into account, the overall cost burden was however the highest for strains. Conclusions: Workplace interventions should prioritize both the costs of claims on average and the frequency.

Suggested Citation

  • Navneet Kaur Baidwan & Nathan W. Carroll & Bunyamin Ozaydin & Neeraj Puro, 2020. "Analyzing Workers’ Compensation Claims and Payments Made Using Data from a Large Insurance Provider," IJERPH, MDPI, vol. 17(19), pages 1-12, September.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:19:p:7157-:d:421809
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    References listed on IDEAS

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    1. Azaroff, L.S. & Levenstein, C. & Wegman, D.H., 2002. "Occupational injury and illness surveillance: Conceptual filters explain underreporting," American Journal of Public Health, American Public Health Association, vol. 92(9), pages 1421-1429.
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    1. Brenda S. Shewiyo & Hussein H. Mwanga & Ezra J. Mrema & Simon H. Mamuya, 2021. "Work-Related Injuries Reported toWorkers Compensation Fund in Tanzania from 2016 to 2019," IJERPH, MDPI, vol. 18(17), pages 1-10, August.
    2. Xiuming Dong & Johanna Catherine Maclean & David Powell, 2024. "Social Insurance Spillovers: Evidence From Paid Sick Leave Mandates and Workers' Compensation," NBER Working Papers 32751, National Bureau of Economic Research, Inc.
    3. Rahi Abouk & Keshar M. Ghimire & Johanna Catherine Maclean & David Powell, 2023. "Pain Management and Work Capacity: Evidence From Workers’ Compensation and Marijuana Legalization," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(3), pages 737-770, June.

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