Managing Workers' Comp.The workers' compensation workers' compensation, payment by employers for some part of the cost of injuries, or in some cases of occupational diseases, received by employees in the course of their work. managed-care industry is doing a better job of monitoring itself, but it needs to figure out what to do with the information. Claims executives and employers are challenging the role--indeed, the core rationale--for managed care in workers' compensation. Managed care costs a lot, but does it deliver? The bottom line is that the industry is doing better at reporting how managed care is doing. But there remains a big problem that has barely been addressed--using the reports to improve medical care. The challenge to managed care came down like a hammer in Verb 1. hammer in - teach by drills and repetition beat in, drill in, ram down drill - teach by repetition Florida Florida, state, United States Florida (flôr`ĭdə, flŏr`–), state in the extreme SE United States. A long, low peninsula between the Atlantic Ocean (E) and the Gulf of Mexico (W), Florida is bordered by Georgia and this year. During the 1990s, the state was a major market for managed-care services. This year, it is drawing back through a new law, which makes managed-care programs optional at the discretion of the employer. Several hundred corporate risk and workers' comp comp See comparison. managers met in Orlando Orlando, city, United States Orlando (ôrlăn`dō), city (1990 pop. 164,693), seat of Orange co., central Fla., in a lake region; inc. 1875. In a citrus fruit and farm area, it is one of the world's most visited vacation spots. in August with one question on their minds: Is managed care worth the cost? The Cambridge Cambridge, city, Canada Cambridge (kām`brĭj), city (1991 pop. 92,772), S Ont., Canada, on the Grand River, NW of Hamilton. It was formed in 1973 with the amalgamation of Galt, Hespeler, and Preston, all founded in the early 19th cent. , Mass-based Workers' Compensation Research Institute has computed the price tag. Costs in Florida are running more than $1,000 per claim. The cost is about $700 in other states, which the institute uses to represent the entire country. In Texas, regulators are about to prescribe pre·scribe v. To give directions, either orally or in writing, for the preparation and administration of a remedy to be used in the treatment of a disease. an added dose of best medical practice rules. The state Legislature A state legislature may refer to a legislative branch or body of a political subdivision in a federal system. The following legislatures exist in the following political subdivisions: verb 1. follow, keep, maintain, respect, observe, be true, fulfil, obey, heed, keep to, abide by, be loyal, mind, be constant, be faithful 2. return-to-work rules that include durations of disability. Change is also afoot in California California (kăl'ĭfôr`nyə), most populous state in the United States, located in the Far West; bordered by Oregon (N), Nevada and, across the Colorado River, Arizona (E), Mexico (S), and the Pacific Ocean (W). . Norm Grancell of the California Self-Insurance self-insurance, n the setting aside of funds by an individual or organization to meet anticipated dental care expenses or dental care claims, and accumulation of a fund to absorb fluctuations in the amount of expenses and claims. Association said "system costs are giant" and are being studied seriously. Nora Nora Ancient city, southwest of Cagliari, Sardinia. Ruins from the 7th century BC indicate that the site was first settled by Phoenicians. It was the capital of Sardinia after the Roman annexation in the 1st century AD. Blay n. 1. (Zool.) A fish. See Bleak, n. os> , a San Francisco-based consultant, predicts that treatment and duration guidelines guidelines, n.pl a set of standards, criteria, or specifications to be used or followed in the performance of certain tasks. will receive a lot more attention. These three states, which combined represent where one out of every four workers' comp dollars is spent, seem to be trying to beat an invisible deadline to contain any rise in claims costs before another workers' comp crisis breaks out. This is a good time to ask: Does managed care--in the form of provider networks, treatment and duration guidelines, utilization review u·til·i·za·tion review n. A process for monitoring the use, delivery, and cost-effectiveness of services, especially those provided by medical professionals. , bill review, case management--deliver? Any patient could ask, "How am I being cared for?" But suppose that question came from the longest duration workers' comp claimant CLAIMANT. In the courts of admiralty, when the suit is in rem, the cause is entitled in the Dame of the libellant against the thing libelled, as A B v. Ten cases of calico and it preserves that title through the whole progress of the suit. ever. In 1926, close to the very day of Queen Elizabeth Queen Elizabeth, or Elizabeth, may refer to: Living people
Bohemia Oregon, city (1990 pop. 18,334), Lucas co., NW Ohio, a suburb adjacent to Toledo, on Lake Erie; inc. 1958. It is a port with railroad-owned and -operated docks. The city has industries producing oil, chemicals, and metal products. sustained a head injury. After two weeks' convalescence convalescence /con·va·les·cence/ (kon?vah-les´ins) the stage of recovery from an illness, operation, or injury. con·va·les·cence n. 1. , the young man was back at work. Then in 1950, the insurer An individual or company who, through a contractual agreement, undertakes to compensate specified losses, liability, or damages incurred by another individual. An insurer is frequently an insurance company and is also known as an underwriter. awarded him a permanent disability due to seizures In counterdrug operations, includes drugs and conveyances seized by law enforcement authorities and drug-related assets (monetary instruments, etc.) confiscated based on evidence that they have been derived from or used in illegal narcotics activities. attributed to the original injury. He's he's 1. Contraction of he is: He's going to school today. 2. Contraction of he has: He's already been to the museum. still on workers' comp. Did he receive timely, correct health care at the outset? Was his condition monitored after his return to work? Was there enough attention given to his functional deterioration de·te·ri·o·ra·tion n. The process or condition of becoming worse. later in his working life? Was someone checking on how medical dollars were used? Did everyone cooperate during the initial acute episode and as seizures began? Were the claimant, the employer and the insurer satisfied with his care? This 75-year-old open claim sparks Sparks, city (1990 pop. 53,367), Washoe co., W Nev., just E of Reno; inc. 1905. The Southern Pacific RR was the major employer until the dieselization of railroad engines forced the closing (1957) of the railroad shops there. every important question about the value of managing medical care. Today, several torch lights train themselves upon measuring the performance of managed care in workers' comp. The Workers' Compensation Research Institute issues periodic reports from its multistate mul·ti·state adj. Of, relating to, or involving several states: a multistate environmental campaign. CompScope program. The Utilization Review and Accreditation accreditation, n a process of formal recognition of a school or institution attesting to the required ability and performance in an area of education, training, or practice. Commission has published a how-to-measure manual. The Journal of Workers' Compensation's annual survey on managed-care performance is now in its third year. And behind the scenes, a massive, soon-to-end Robert Wood Johnson Foundation Robert Wood Johnson Foundation, charitable organization devoted exclusively to health care issues. It was established in 1936 by Robert Wood Johnson (1893–1968), board chairman of the Johnson & Johnson medical products company. grant has enabled the assembling of data from dozens of funded projects. To measure the performance of managed care, one must measure resource use and cost, outcomes and management control. Medical Bill Review Medical bill review has been and remains a big topic. Maddy Bowling, a consultant from Chicago Chicago, city, United States Chicago (shĭkä`gō, shĭkô`gō), city (1990 pop. 2,783,726), seat of Cook co., NE Ill., on Lake Michigan; inc. 1837. , explained how to measure medical reimbursement Reimbursement Payment made to someone for out-of-pocket expenses has incurred. in four steps: "You start with the invoice An itemized statement or written account of goods sent to a purchaser or consignee by a vendor that indicates the quantity and price of each piece of merchandise shipped. A consular invoice is one used in foreign trade. as submitted by the medical provider, say $400. You first want to know how it declines by being cut to the formal state fee schedule, if there is one, or to a usual and customary rate, if there isn't is·n't Contraction of is not. isn't is not isn't be . The reduction is usually, say, 15%. Then, you check for a further provider network reduction below the fee schedule. Roughly, across the nation, this is another 15% of gross amount. "Next, you see if the bill is subject to further, more manual scrutiny Scrutiny (Fr. scrutin, Late Lat. scrutinium, from scrutari, to search or examine thoroughly) is a careful examination or inquiry (as though there was a mistake). , such as is applied to large inpatient inpatient /in·pa·tient/ (in´pa-shent) a patient who comes to a hospital or other health care facility for diagnosis or treatment that requires an overnight stay. in·pa·tient n. bills. Related to injury? Medically necessary medically necessary Managed care adjective Referring to a covered service or treatment that is absolutely necessary to protect and enhance the health status of a Pt, and could adversely affect the Pt's condition if omitted, in accordance with accepted ? Approved by case management? These final audits wring wring v. wrung , wring·ing, wrings v.tr. 1. To twist, squeeze, or compress, especially so as to extract liquid. Often used with out. 2. out about 5% to 10%. In the end, you have reductions from the original amount that total about 35% to 40%. You need to count how much the whole bill-review process costs--usually about 5% to 10% of the bill. Thus, your net savings are about 30%." Bill review, according to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. Bowling and others, has contained workers' comp costs but has increased administrative costs administrative costs, n.pl the overhead expenses incurred in the operation of a dental benefits program, excluding costs of dental services provided. and indirectly compromised the quality of care. Tom Callahan Tom Callahan (born June 2, 1921) is a retired American basketball player. He played collegiately for the Rockhurst University. He played for the Providence Steamrollers (1946-47) in the BAA for 13 games. of Sunapee Sunapee may refer to:
adj. 1. Having distinct limits: definite restrictions on the sale of alcohol. 2. Indisputable; certain: a definite victory. 3. see how the individual bills are reduced. But it does nothing to contain the total number of bills. Worse, a focus on bill reduction has induced induced /in·duced/ (in-dldbomacst´) 1. produced artificially. 2. produced by induction. induced, adj artificially caused to occur. induced induction. many provider networks to expand solely for the purpose of running more bills through their reduction apparatus apparatus /ap·pa·ra·tus/ (ap?ah-ra´tus) pl. appara´tus, apparatuses a number of parts acting together to perform a special function. branchial apparatus pharyngeal a. ," Callahan Callahan, an Irish surname, can refer to: People In sports
Publicly accessible computer network connecting many smaller networks from around the world. It grew out of a U.S. Defense Department program called ARPANET (Advanced Research Projects Agency Network), established in 1969 with connections between computers at the services that were free, the business model is simply wrong-headed wrong-head·ed adj. Stubbornly defiant of what is right or reasonable; obstinately perverse in judgment or opinion. wrong for the long term." Managing the use of tests and treatment is a much more direct way to control the use of medical resources. The introduction of treatment guidelines into workers' comp was a giant step in the 1990s. These guidelines can set a floor for acceptable medical practice. Research into medical care consistently picks treatment guidelines as stepping stones
The Stepping Stones are three prominent rocks lying 0.5 miles north of Limitrophe Island, off the southwest coast of Anvers Island. to better care. The industry is now beginning to see reports on how often a procedure or test is used. The Workers' Compensation Research Institute and other research teams are publishing reports on the frequency of surgeries and diagnostic tests. A few years ago, this information was simply unavailable. But information is not available on compliance rates for treatment guidelines and other useful facts about medical care. Few, if any, firms in the field are reporting referral patterns--how a patient goes from doctor to test to another doctor, along the continuum Continuum (pl. -tinua or -tinuums) can refer to:
intake, n the substance or quantities thereof taken in and used by the body. and assessment of a fresh injury. One exception is American American, river, 30 mi (48 km) long, rising in N central Calif. in the Sierra Nevada and flowing SW into the Sacramento River at Sacramento. The discovery of gold at Sutter's Mill (see Sutter, John Augustus) along the river in 1848 led to the California gold rush of Re, which is closely monitoring the time-critical process of bringing patients with head injuries from the moment of injury into specialty A contract under seal. A specialty is a written document that has been sealed and delivered and is given as security for the payment of a specifically indicated debt. care. Lost Days Employers and insurers have made it clear that managed care must be measured by the success of keeping people at work or returning them to work as soon as possible. Their focus is on the injury at hand. Downstream From the provider to the customer. Downloading files and Web pages from the Internet is the downstream side. The upstream is from the customer to the provider (requesting a Web page, sending e-mail, etc.). problems are typically glossed over, because data from the out years are notoriously no·to·ri·ous adj. Known widely and usually unfavorably; infamous: a notorious gangster; a district notorious for vice. hard to collect. The entire workers' comp field is fixated fix·ate v. fix·at·ed, fix·at·ing, fix·ates v.tr. 1. To make fixed, stable, or stationary. 2. To focus one's eyes or attention on: fixate a faint object. on how many lost clays an injured in·jure tr.v. in·jured, in·jur·ing, in·jures 1. To cause physical harm to; hurt. 2. To cause damage to; impair. 3. worker incurs for a single injury or how many days are lost for a whole work force for all injuries. And for good reason: Lost work days are fairly easy to measure, understand and use for performance targets. There is virtually total agreement that managed care is supposed to reduce lost days. It is one thing to report the number of lost days. It is a better thing to compare the reported number with a benchmark A performance test of hardware and/or software. There are various programs that very accurately test the raw power of a single machine, the interaction in a single client/server system (one server/multiple clients) and the transactions per second in a transaction processing system. or guidelines. Duration guidelines come in two flavors Flavors - Lisp with object-oriented features by D. Weinreb and D.A. Moon <moon@cambridge.apple.com>, 1980. ["Object-Oriented Programming with Flavors", D.A. Moon, SIGPLAN Notices 21(11):1-8 (OOPSLA '86) (Nov 1986)]. : prescriptive pre·scrip·tive adj. 1. Sanctioned or authorized by long-standing custom or usage. 2. Making or giving injunctions, directions, laws, or rules. 3. Law Acquired by or based on uninterrupted possession. (should have been) and actual (what was). Several vendors sell these guidelines, the leading vendors being well known in the field. In the next few years, the Years, The the seven decades of Eleanor Pargiter’s life. [Br. Lit.: Benét, 1109] See : Time industry can expect a major expansion of duration guidelines, with large employers and insurers and perhaps state databases releasing data on actual durations. Industry observers predict that by 2003 the workers' comp field will have routine access to regularly updated, actual duration data derived de·rive v. de·rived, de·riv·ing, de·rives v.tr. 1. To obtain or receive from a source. 2. from work forces in the millions. This huge scale will be matched by an unprecedented amount of data about jobs, households and medical conditions See carpal tunnel syndrome, computer vision syndrome, dry eyes and deep vein thrombosis. . Gerry Ger·ry , Elbridge 1744-1814. American politician. A signer of the Declaration of Independence (1776) and a delegate to the Continental Congress (1787), he served as governor of Massachusetts (1810-1811) and as Vice President of the United States Hendershot, Ph.D., works out of University Park, Md., with large databases that contain information about injured workers. "We can profile, say, work-injured Hispanic Hispanic Multiculture A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race Social medicine Any of 17 major Latino subcultures, concentrated in California, Texas, Chicago, Miam, NY, and elsewhere workers with regard to lost days and the prevalence prevalence /prev·a·lence/ (prev´ah-lins) the number of cases of a specific disease present in a given population at a certain time. prev·a·lence n. of comorbidities and household data and compare them with whites and blacks with work injuries," he said. "We can also compare work-related and nonwork-related injuries." Moreover, there will almost certainly be an increasing demand for guidelines of this type, based on actual experience. "Federal and state courts are increasingly expecting expert testimony Testimony about a scientific, technical, or professional issue given by a person qualified to testify because of familiarity with the subject or special training in the field. to be backed up by evidence based on facts, not just expert judgment," said Castro Valley Castro Valley, uninc. city (1990 pop. 48,619), Alameda co., W Calif., near San Francisco Bay. Chiefly residential, it also has light industries. , Calif.-based consultant Linda A set of parallel processing functions added to languages, such as C and C++, that allows data to be created and transferred between processes. It was developed by Yale professor David Gelernter, when he was a 23-year old graduate student. Stutzman of Disability Management Insights, who specializes in evidence-based disability-management issues in litigation An action brought in court to enforce a particular right. The act or process of bringing a lawsuit in and of itself; a judicial contest; any dispute. When a person begins a civil lawsuit, the person enters into a process called litigation. . Management Controls A third way of measuring performance is to monitor the workflow The automatic routing of documents to the users responsible for working on them. Workflow is concerned with providing the information required to support each step of the business cycle. of a managed-care operation. Do employers and doctors report on time? Do case managers triage triage Division of patients for priority of care, usually into three categories: those who will not survive even with treatment; those who will survive without treatment; and those whose survival depends on treatment. cases correctly? The industry should be able to ask these questions and get answers. Workflow-management software figures very much into the equation. With this software, linked to report-generating tools, these reports are deliverable on a real-time 1. real-time - Describes an application which requires a program to respond to stimuli within some small upper limit of response time (typically milli- or microseconds). Process control at a chemical plant is the classic example. , as-needed basis and by e-mail, without having to ask. And they are compliant
According to the Centers for Medicare and Medicaid Services (CMS) website, Title I of HIPAA protects health insurance coverage for workers and their families when of 1996. Patty Walker, who works for the insurance software firm Delphi Technology, said automated au·to·mate v. au·to·mat·ed, au·to·mat·ing, au·to·mates v.tr. 1. To convert to automatic operation: automate a factory. 2. workflow links between claims and managed-care staffs are key features in this year's claims software market. The big problem is that the more the industry knows how managed care is doing, the more it becomes painfully clear it really has to figure out what to do with the information. Making improvements in medical care for injured workers requires working with the physician community. Over in the field of health plans, researchers have been doing a good number of studies of what works to improve medical practice. Sometimes these are called studies of "translating" advances in medical practice into the physician community. The good news is that researchers appear to agree that several methods are effective. The bad news is that precertification precertification, n confirmation by a third-party payer of a patient's eligibility for coverage under a dental benefits program. See also preauthorization and predetermination. , a soldered-in component of most workers' comp managed-care programs, is not one of them. There are three drivers of change: treatment guidelines that are respected by the practitioners they affect; one-on-one one-on-one adj. 1. Consisting of or being direct communication or exchange between two people: one-on-one instruction. 2. Sports Playing directly or exclusively against a single opponent. consultation, peer to peer; and reminders and prompts. Managed care will come under intense scrutiny in a dozen states in the next year. This painful but healthy process will cause the workers' comp community to pay more attention to the paramount Paramount (pâr`əmount'), city (1990 pop. 47,669), Los Angeles co., S Calif.; inc. 1957. Originally a dairy region, it has become highly industrialized since the 1950s. , systemwide performance goal: containing the amount of disability days. This is the common basis of measurement of all parties in the game. Regulators will more actively endorse To sign a paper or document, thereby making it possible for the rights represented therein to pass to another individual. Also spelled indorse. endorse (indorse) v. the use of return-to-work guidelines. Employers will be more insistent in·sis·tent adj. 1. Firm in asserting a demand or an opinion; unyielding. 2. Demanding attention or a response: insistent hunger. 3. on applying duration-of-disability targets. And more attention will be paid to evidence-based clinical practice and duration guidelines, based on actual experience and solid research. Peter Rousmaniere, a Little Rock, Ark.-based consultant, has worked in the disability-management field for 15 years. Dale Dale , Sir Henry Hallett 1875-1968. British physiologist. He shared a 1936 Nobel Prize for work on the chemical transmission of nerve impulses, particularly for the isolation and study of acetylcholine (1914). Chadwick Chad·wick , Henry 1824-1908. British-born American sportswriter who helped organize professional baseball. In 1869 he began an annual baseball handbook, which later became Spalding's Official Baseball Guide. specializes in managed care for high-risk high-risk adjective Referring to an ↑ risk of suffering from a particular condition Infectious disease Referring to an ↑ risk for exposure to blood-borne pathogens, which occurs with blood bank technicians, dental professionals, dialysis unit conditions, including substance abuse and mental health, for the Veterans Administration.
Workers' Compensation, Top U.S. Reinsurers--2000
Workers'
Comp Total Lines
Company Assumed Assumed
Employers Reinsurance Corp $286,498,902 $2,347,010,792
Zurich Reinsurance (NA) Inc 155,682,185 1,219,313,211
Swiss Reinsurance America Corp 89,475,487 1,740,387,468
American Re-Insurance Co 88,823,582 3,224,860,119
General Reinsurance Corp 83,338,858 3,379,611,808
Everest Reinsurance Co 60,323,269 1,175,972,329
Commercial Risk Re-Insurance 56,332,499 87,438,305
GE Reinsurance Corp 53,864,224 1,370,242,708
Berkley Insurance Co 39,085,101 363,994,410
Gerling Global Re Corp of America 31,282,244 970,192,333
Scor Reinsurance Co 30,206,255 422,561,961
Underwriters Reinsurance Co 24,314,633 337,683,860
Chartwell Insurance Co 20,181,576 128,889,097
Transatlantic Reinsurance Co 19,796,552 1,541,998,030
Sorema North America Reins Co 18,433,125 191,106,323
Insurance Corp of Hannover 16,598,810 226,605,506
Odyssey America Reins Corp 12,578,361 599,702,580
PMA Capital Insurance Co 12,126,080 392,638,744
XL Reinsurance America Inc 11,538,068 572,084,826
Trenwick America Reins Corp 10,547,456 213,857,795
Odyssey Reinsurance Corp 4,043,707 109,210,341
Axa Corporate Solutions Re Co 3,774,529 296,532,431
Dorinco Reinsurance Co 3,685,843 178,825,163
Partner Reinsurance Co of US 1,356,412 348,142,557
American Fuji Fire & Marine 643,757 3,888,121
Total U.S. P/C Industry $2,167,920,853 $43,151,669,490
% WC
Assumed
To All
Company Lines
Employers Reinsurance Corp 12.2
Zurich Reinsurance (NA) Inc 12.8
Swiss Reinsurance America Corp 5.1
American Re-Insurance Co 2.8
General Reinsurance Corp 2.5
Everest Reinsurance Co 5.1
Commercial Risk Re-Insurance 64.4
GE Reinsurance Corp 3.9
Berkley Insurance Co 10.7
Gerling Global Re Corp of America 3.2
Scor Reinsurance Co 7.2
Underwriters Reinsurance Co 7.2
Chartwell Insurance Co 15.7
Transatlantic Reinsurance Co 1.3
Sorema North America Reins Co 9.7
Insurance Corp of Hannover 7.3
Odyssey America Reins Corp 2.1
PMA Capital Insurance Co 3.1
XL Reinsurance America Inc 2.0
Trenwick America Reins Corp 4.9
Odyssey Reinsurance Corp 3.7
Axa Corporate Solutions Re Co 1.3
Dorinco Reinsurance Co 2.1
Partner Reinsurance Co of US 0.4
American Fuji Fire & Marine 16.6
Total U.S. P/C Industry 5.0
Source: A.M: Best Statement and Competitive Analysis Report Products
Workers' Compensation Reinsurance, Top Users--2000
Rank is based on workers' comp ceded to nonaffiliates.
Direct Premiums
Company/Group AMB# Written
Liberty Mutual Insurance Co 02283 $343,833,319
Legion Insurance Co 02352 632,525,994
Travelers Indemnity Co 02520 141,664,659
Lumbermens Mutual Casualty Co 02279 483,342,874
Security Insurance Company of Hartford 02457 122,068,163
Clarendon National Insurance Co 01975 250,044,466
Fireman's Fund Insurance Co 02179 209,699,217
Virginia Surety Co 02314 242,599,169
Continental Casualty Co 02128 291,531,031
Zurich American Insurance Co 02563 457,708,200
American Interstate Insurance Co 03585 337,980,472
Ace Property & Casualty Insurance Co 01996 5,490,311
Great American Insurance Co 02213 48,373,091
Discover Reinsurance Co 11220 0
National Union Fire Ins Co of Pittsburgh, Pa. 02351 388,515,822
American Home Assurance Co 02034 550,280,970
Associated Industries Insurance Co 11693 136,447,684
American Zurich Insurance Co 02743 162,896,423
Hartford Fire Insurance Co 02231 153,774,619
Total U.S. P/C Industry $32,546,685,713
Total Workers' Comp
Ceded to
Company/Group Nonaffiliates
Liberty Mutual Insurance Co $460,786,677
Legion Insurance Co 413,443,663
Travelers Indemnity Co 392,019,530
Lumbermens Mutual Casualty Co 294,914,406
Security Insurance Company of Hartford 259,201,154
Clarendon National Insurance Co 258,373,766
Fireman's Fund Insurance Co 240,501,718
Virginia Surety Co 238,568,672
Continental Casualty Co 185,672,173
Zurich American Insurance Co 168,942,467
American Interstate Insurance Co 102,938,228
Ace Property & Casualty Insurance Co 99,655,158
Great American Insurance Co 96,730,875
Discover Reinsurance Co 94,040,753
National Union Fire Ins Co of Pittsburgh, Pa. 78,169,571
American Home Assurance Co 74,239,554
Associated Industries Insurance Co 73,222,376
American Zurich Insurance Co 72,933,824
Hartford Fire Insurance Co 70,268,188
Total U.S. P/C Industry $6,184,503,600
Total All Lines
Ceded to
Company/Group Nonaffiliates
Liberty Mutual Insurance Co $1,182,869,902
Legion Insurance Co 747,999,630
Travelers Indemnity Co 892,390,156
Lumbermens Mutual Casualty Co 1,189,306,559
Security Insurance Company of Hartford 478,829,109
Clarendon National Insurance Co 1,158,435,376
Fireman's Fund Insurance Co 1,133,345,231
Virginia Surety Co 413,926,700
Continental Casualty Co 1,848,480,808
Zurich American Insurance Co 916,179,000
American Interstate Insurance Co 103,553,145
Ace Property & Casualty Insurance Co 1,381,771,573
Great American Insurance Co 728,891,516
Discover Reinsurance Co 320,672,569
National Union Fire Ins Co of Pittsburgh, Pa. 1,677,913,497
American Home Assurance Co 1,594,783,008
Associated Industries Insurance Co 73,222,376
American Zurich Insurance Co 189,247,254
Hartford Fire Insurance Co 838,264,556
Total U.S. P/C Industry $55,963,825,211
Total Workers' Comp
Ceded to All
Company/Group Lines Ceded (%)
Liberty Mutual Insurance Co 39.0
Legion Insurance Co 55.3
Travelers Indemnity Co 43.9
Lumbermens Mutual Casualty Co 24.8
Security Insurance Company of Hartford 54.1
Clarendon National Insurance Co 22.3
Fireman's Fund Insurance Co 21.2
Virginia Surety Co 57.6
Continental Casualty Co 10.0
Zurich American Insurance Co 18.4
American Interstate Insurance Co 99.4
Ace Property & Casualty Insurance Co 7.2
Great American Insurance Co 13.3
Discover Reinsurance Co 29.3
National Union Fire Ins Co of Pittsburgh, Pa. 4.7
American Home Assurance Co 4.7
Associated Industries Insurance Co 100.0
American Zurich Insurance Co 38.5
Hartford Fire Insurance Co 8.4
Total U.S. P/C Industry 11.1
Workers' Compensation, Top Writers--2000
Workers' comp covers an employer's responsibility to compensate
injuries, illness, disability or death of employees. It is prescribed by
state workers' compensation laws.
2000 Direct
Premiums % Change
Company/Group ($ Thousands) in Premium
Liberty Mutual Insurance Cos $2,976,116 4.0
State Comp Fund of California 1,798,962 44.6
American International Group 1,627,342 42.7
CNA Insurance Cos 1,571,501 -9.2
Zurich/Farmers Group 1,543,423 30.3
Kemper Insurance Cos 1,334,684 22.0
Travelers/Citigroup Co 1,282,232 0.7
Royal & SunAlliance 1,083,734 12.5
Fremont General Group 1,077,017 -5.2
Hartford Insurance Group 1,055,221 -1.4
Legion Insurance Group 726,088 36.0
St Paul Cos 635,089 49.6
Allianz of America 609,795 -19.8
Fairfax Financial (US) Group 602,746 14.1
CGU Group 545,586 14.8
Chubb Group of Insurance Cos 401,312 12.4
Great American P&C Group 387,134 -4.2
Safeco Insurance Cos 385,838 5.3
FCCI Group 352,421 30.7
Amerisafe Insurance Group 341,880 54.5
Top 20 U.S. Companies $20,338,122 12.8
Total U.S. Companies $32,805,376 8.4
Market Share (%)
Company/Group 2000 1999 1998
Liberty Mutual Insurance Cos 9.1 9.5 10.2
State Comp Fund of California 5.5 4.1 4.1
American International Group 5.0 3.8 4.8
CNA Insurance Cos 4.8 5.7 6.0
Zurich/Farmers Group 4.7 3.9 3.5
Kemper Insurance Cos 4.1 3.6 4.4
Travelers/Citigroup Co 3.9 4.2 4.6
Royal & SunAlliance 3.3 3.2 2.7
Fremont General Group 3.3 3.8 2.8
Hartford Insurance Group 3.2 3.5 3.7
Legion Insurance Group 2.2 1.8 1.2
St Paul Cos 1.9 1.4 1.5
Allianz of America 1.9 2.5 2.6
Fairfax Financial (US) Group 1.8 1.7 1.6
CGU Group 1.7 1.6 1.6
Chubb Group of Insurance Cos 1.2 1.2 1.3
Great American P&C Group 1.2 1.3 1.5
Safeco Insurance Cos 1.2 1.2 1.1
FCCI Group 1.1 0.9 1.0
Amerisafe Insurance Group 1.0 0.7 0.5
Top 20 U.S. Companies 62.0 59.6 60.5
Total U.S. Companies 100.0 100.0 100.0
Adjusted Loss Ratio[1]
Company/Group 2000 1999 1998
Liberty Mutual Insurance Cos 85.1 82.3 71.9
State Comp Fund of California 96.3 100.0 100.8
American International Group 94.4 46.3 83.2
CNA Insurance Cos 93.2 77.3 54.0
Zurich/Farmers Group 88.2 74.2 67.9
Kemper Insurance Cos 83.2 100.4 48.8
Travelers/Citigroup Co 74.6 83.2 66.0
Royal & SunAlliance 84.5 84.8 63.3
Fremont General Group 111.5 88.5 78.5
Hartford Insurance Group 65.6 70.1 52.8
Legion Insurance Group 71.5 111.1 92.4
St Paul Cos -18.6 50.7 94.7
Allianz of America 114.2 104.7 79.5
Fairfax Financial (US) Group 67.7 124.5 71.2
CGU Group 110.7 47.0 68.6
Chubb Group of Insurance Cos 54.1 56.3 57.8
Great American P&C Group 91.3 95.7 90.5
Safeco Insurance Cos 86.6 89.5 70.9
FCCI Group 81.1 59.3 79.7
Amerisafe Insurance Group 112.6 127.3 52.8
Top 20 U.S. Companies 85.2 82.1 71.1
Total U.S. Companies 84.2 81.1 72.2
% of
Company's
Company/Group Premiums
Liberty Mutual Insurance Cos 32.2
State Comp Fund of California 100.0
American International Group 12.5
CNA Insurance Cos 15.4
Zurich/Farmers Group 8.4
Kemper Insurance Cos 36.8
Travelers/Citigroup Co 11.8
Royal & SunAlliance 25.9
Fremont General Group 99.6
Hartford Insurance Group 15.5
Legion Insurance Group 53.1
St Paul Cos 11.6
Allianz of America 12.7
Fairfax Financial (US) Group 27.1
CGU Group 11.7
Chubb Group of Insurance Cos 7.3
Great American P&C Group 11.6
Safeco Insurance Cos 8.2
FCCI Group 74.5
Amerisafe Insurance Group 99.3
Top 20 U.S. Companies 18.1
Total U.S. Companies 10.4
(1)Adjusted loss ratio is direct losses incurred divided by the
difference between direct premiums earned and dividends paid to
policyholders.
Source: A.M. Best Statement and Competitive Analysis Report Products
Workers' Compensation, Top Writers by State--2000
Rank based on direct premiums written.
($ Thousands)
% of %
No. of Direct U.S. Prem.
State Rank Cos. Premiums Total Chg.
Ala 28 339 $284,449 0.9 1.8
Alaska 4l 223 141,044 0.4 11.8
Ariz. 23 303 428,989 1.3 -10.2
Ark. 34 324 206,080 0.6 12.6
Calif. 1 351 6,322,669 19.3 9.1
Colo. 13 311 733,923 2.2 9.4
Conn. 22 288 447,862 1.4 2.5
Del. 43 287 107,462 0.3 3.4
D.C. 45 281 87,240 0.3 -6.0
Fla. 2 355 2,650,085 8.1 8.1
Ga. 12 389 756,755 2.3 5.5
Hawaii 38 196 172,539 0.5 9.1
Idaho 35 280 204,350 0.6 12.1
III. 5 418 1,646,608 5.0 3.0
Ind. 14 384 591,935 1.8 10.3
Iowa 26 355 329,952 1.0 1.7
Kan. 29 329 282,390 0.9 10.6
Ky. 24 374 346,123 1.1 10.7
La. 21 308 480,245 1.5 4.1
Maine 37 211 173,758 0.5 24.3
Md. 18 354 543,644 1 7 45.5
Mass. 10 294 855,601 2.6 1.3
Mich. 9 360 1,077,212 3.3 16.4
Minn. 16 331 570,797 1.7 7.6
Miss. 31 331 217,714 0.7 -5.3
Mo. 19 349 513,173 1.6 5.6
Mont. 39 260 149,349 0.5 10.2
Neb. 32 331 209,024 0.6 14.5
Nev. 30 236 223,073 0.7 135.2
N.H. 36 255 194,907 0.6 23.4
N.J. 8 346 1,157,000 3.5 4.1
N.M. 42 285 118,046 0.4 -14.8
N.Y. 3 369 2,053,434 6.3 12.4
N.C. 11 343 789,304 2.4 4.8
N.D. 51 171 1,698 0.0 -32.6
Ohio 48 239 29,960 0.1 -27.0
Okla. 27 306 318,333 1.0 5.7
Ore. 20 286 511,979 1.6 3.8
Pa. 6 404 1,615,506 4.9 6.1
R.I. 40 262 148,077 0.5 12.8
S.C. 25 324 337,140 1.0 3.0
S.D. 46 290 86,649 0.3 8.4
Tenn. 17 378 563,686 1.7 2.0
Texas 4 392 2,024,663 6.2 16.2
Utah 33 277 207,137 0.6 14.4
Vt. 44 233 95,673 0.3 19.4
Va. 15 355 591,483 1.8 6.7
Wash. 47 201 33,573 0.1 14.7
W.Va. 49 163 2,723 0.0 29.7
Wis. 7 354 1,167,977 3.6 3.3
Wyo. 50 162 2,385 0.0 -34.8
U.S. Total 1006 32,805,376 100.0 8.4
Market Share
Agency Direct
State ALR [1] DOCCE [2] Writer [3] Writer [4]
Ala 61.9 6.8 69.6 30.4
Alaska 110.7 9.6 83.0 17.0
Ariz. 127.4 5.l 49.4 50.6
Ark. 52.1 3.8 71.1 28.9
Calif. 111.9 8.9 54.2 45.8
Colo. 72.2 4.6 37.5 62.5
Conn. 80.0 3.8 78.0 22.0
Del. 71.9 6.5 74.7 25.3
D.C. 61.6 4.2 82.9 17.1
Fla. 68.1 7.5 75.0 25.0
Ga. 70.7 6.7 78.6 21.4
Hawaii 74.4 4.5 87.7 12.3
Idaho 93.0 6.1 20.8 79.2
III. 94.2 7.3 76.7 23.3
Ind. 63.4 3.4 73.6 26.4
Iowa 86.4 3.4 77.0 23.0
Kan. 63.4 5.7 73.3 26.7
Ky. 77.2 6.2 76.0 24.0
La. 87.3 6.6 76.1 23.9
Maine 86.0 3.3 85.5 14.5
Md. 95.6 4.2 84.1 15.9
Mass. 61.9 6.3 76.1 23.9
Mich. 59.1 5.0 84.9 15.1
Minn. 87.6 7.5 71.6 28.4
Miss. 35.8 5.9 65.1 34.9
Mo. 85.1 6.6 73.1 26.9
Mont. 96.8 11.8 30.6 69.4
Neb. 75.6 3.2 72.4 27.6
Nev. 57.9 5.3 75.2 24.8
N.H. 58.9 2.4 68.6 31.4
N.J. 79.1 7.5 68.6 31.4
N.M. 34.9 0.8 78.3 21.7
N.Y. 62.5 4.7 82.5 17.5
N.C. 74.0 5.0 79.6 20.4
N.D. 20.8 0.1 79.0 21.0
Ohio 22.7 2.3 66.6 33.4
Okla. 69.7 4.5 75.1 24.9
0re. 174.2 11.3 31.0 69.0
Pa. 85.3 5.3 80.1 19.9
R.I. 74.0 4.5 92.3 7.7
S.C. 74.5 7.6 78.0 22.0
S.D. 69.1 3.7 67.6 32.4
Tenn. 71.7 5.8 78.1 21.9
Texas 81.4 4.3 61.6 38.4
Utah 76.1 7.2 32.9 67.1
Vt. 80.0 6.5 74.6 25.4
Va. 79.1 3.6 73.1 26.9
Wash. 90.6 10.2 78.5 21.5
W.Va. -99.9 12.1 73.7 26.3
Wis. 86.5 4.4 72.1 27.9
Wyo. 1.1 1.4 66.4 33.6
U.S. Total 84.2 6.3 68.7 31.3
%
Market
State Leading Writer Share
Ala Liberty Mutual Ins Cos 8.7
Alaska Alaska National Ins Co 28.6
Ariz. Arizona State Comp Fund 38.3
Ark. CNA Insurance Cos 8.0
Calif. State Comp Fund Calif 28.5
Colo. Pinnacol Assurance Co 43.2
Conn. Liberty Mutual Ins Cos 11.7
Del. Liberty Mutual Ins Cos 12.2
D.C. Hartford Insurance Group 19.0
Fla. Liberty Mutual Ins Cos 13.0
Ga. CNA Ins Cos 6.9
Hawaii CNA Ins Cos 17.0
Idaho Idaho State Ins Fund 53.0
III. Liberty Mutual Ins Cos 10.5
Ind. Liberty Mutual Ins Cos 14.5
Iowa EMC Insurance Cos 11.5
Kan. Liberty Mutual Ins Cos 8.9
Ky. Kentucky Employers' Mutual 13.5
La. Louisiana Workers' Comp Co 34.6
Maine Maine Employ Mutual Group 51.0
Md. Injured Workers Ins Fund 18.9
Mass. Liberty Mutual Ins Cos 13.3
Mich. Accident Fund Co 19.5
Minn. State Fund Mutual (MN) 10.4
Miss. Amerisafe Ins Group 11.7
Mo. Liberty Mutual Ins Cos 9.6
Mont. Montana State Fund 47.8
Neb. Liberty Mutual Ins Cos 9.3
Nev. American International Group 8.5
N.H. Liberty Mutual Ins Cos 23.3
N.J. NJ Manufacturers Group 16.1
N.M. NM Mutual Casualty Group 26.4
N.Y. American Intemational Group 13.6
N.C. Liberty Mutual Ins Cos 8.6
N.D. Alianz of America 23.5
Ohio American International Group 23.0
Okla. National American Ins Co (OK) 11.1
0re. Saif Corp 43.0
Pa. PMA Capital Cop 7.4
R.I. Beacon Mutual Ins Co 64.4
S.C. American Intemational Group 7.5
S.D. Medical Assurance Group 8.4
Tenn. Liberty Mutual Ins Cos 9.3
Texas Texas Workers' Comp Ins Fund 15.0
Utah Workers Comp Fund Group 51.6
Vt. Liberty Mutual Ins Cos 16.8
Va. Liberty Mutual Ins Cos 10.1
Wash. Kemper Insurance Cos 28.9
W.Va. American International Group 33.3
Wis. Liberty Mutual Ins Cos 14.0
Wyo. Liberty Mutual Ins Cos 19.9
U.S. Total Liberty Mutual Ins Cos. 9.1
%
Market
State Second Leader Share
Ala Allianz of America 6.4
Alaska Fremont General Group 25.7
Ariz. Fremont General Group 10.8
Ark. Liberty Mutual Ins Cos 7.7
Calif. Fremont General Group 7.2
Colo. Zurich/Farmers Group 8.4
Conn. Travelers/Citigroup Co 11.7
Del. PMA Capaital Corp 7.1
D.C. Travelers/Citigroup Co 15.2
Fla. FCCI Group 11.6
Ga. Legion Insurance Group 6.7
Hawaii Hawaii Employers Mutual 14.2
Idaho Liberty Mutual Ins Cos 13.0
III. Fremont General Group 7.4
Ind. Royal & SunAlliance 4.0
Iowa Aon Corp Group 5.8
Kan. CGU Group 8.9
Ky. Liberty Mutual Ins Cos 10.2
La. CNA Insurance Cos 8.3
Maine Liberty Mutual Ins Cos 9.4
Md. Kemper Insurance Cos 8.6
Mass. Travelers/Citigroup Co 10.9
Mich. Allmerica P & C Cos 7.2
Minn. Liberty Mutual Ins Cos 8.7
Miss. Liberty Mutual Ins Cos 8.6
Mo. Travelers/Citigroup Co 7.8
Mont. Liberty Mutual Ins Cos 14.5
Neb. EMC Insurance Cos 8.1
Nev. Zurich/Farmers Group 8.5
N.H. Royal & SunAlliance 9.5
N.J. Kemper Insurance Cos 5.9
N.M. Mountain States Group 8.8
N.Y. Liberty Mutual Ins Cos 9.8
N.C. Builders Mutual Ins Co 7.0
N.D. American International Group 22.3
Ohio GE Capital Insurance Group 12.2
Okla. Liberty Mutual Ins Cos 9.0
0re. Liberty Mutual Ins Cos 20.6
Pa. Liberty Mutual Ins Cos 6.0
R.I. Liberty Mutual Ins Cos 5.9
S.C. Liberty Mutual Ins Cos 7.4
S.D. W R Berkley Group 7.8
Tenn. Travelers/Citigroup Co 9.1
Texas Liberty Mutual Ins Cos 8.6
Utah Liberty Mutual Ins Cos 10.0
Vt. Fairfax Fin (US) Group 11.5
Va. Travelers/Citigroup Co 7.6
Wash. Fremont General Group 28.4
W.Va. Westfield Group 12.9
Wis. CNA Insurance Cos 7.8
Wyo. Hartford Insurance Group 18.3
U.S. Total State Comp Fund California 5.5
(1)ALR: Adjusted loss ratio is direct losses incurred divided by the
differene between direct premiums earned and dividends paid to
policyholders.
(2)DDCCE: Direct defense and cost- containment expense ratio is the
former allocated loss adjustment expense (ALAE) ratio.
(3)Insurers that distribute primarily through independent agents.
(4)Insurers that distribute primarily exclusive agency system.
Source: A.M. Best Statement and Competitive Analysis Report Products.
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