Benchmark study shows Montana with highest workers’ comp rates; some providers stung by unemployment

This might seem an odd way to rank something. Normally, when we say something is Number One, that’s a good thing.

Not in this case.

As ranked in a biennial study by an Oregon state consumer agency, Alaska and Montana swapped places since 2008 in rankings of states with the highest premiums for workers’ compensation insurance.

Thus, Montana has moved from second-place to first, as the state with highest 2010 worker’s compensation premiums. Alaska was the worst in the 2008 study but dropped to second-worst in the rankings released Oct. 20.

51 rankings: all states and D.C., too

According to a Department of Consumer and Business Services’ press release, “The study ranks all 50 states and the District of Columbia according to their workers’ compensation premium rates. The median index rate, a benchmark for rates nationally, dropped to $2.04 for 2010, 10 percent below the 2008 median value. Oregon’s index rate, at $1.69, was 17 percent below the 2010 median.”

An Oct. 21 article at Bloomberg Businessweek.com says, “The study undertaken every two years by the . . . [department] found Montana’s premium rates this year are $3.33 for every $100 of payroll.” That’s 163 per cent of the national median, which Businessweek says is “$2.04 per $100 of payroll.”

Montana is one only three states that “topped the $3 mark.” The other two are Alaska, with an index rate of $3.10, and Number 3 Illinois, at $3.05, which puts them, respectively, at 152 per cent and 149 per cent of the median.

Business Insurance notes that “North Dakota had the lowest rates at $1.02 per $100 of payroll, or 50% of the national median.”

National median dropped 10 per cent

According to the study, a summary of which is here, including an easily read table, the median dropped 10 per cent from 2008 levels.

California’s re-ranking exemplifies significant change over the two-year period, moving from 13th most expensive in 2008 to eighth, with a 2010 cost of $268 per $100 of payroll.

Wisconsin also saw a significant change in its ranking, moving from No. 34 in 2008 to No. 19 this year, with its average rates at $2.21 per $100 of payroll, or 108% of the national median.

Delaware, with a rate of $1.84, improved to 34 on the list from its 2008 ranking of 7. The District of Columbia also made a big move, falling to 48 from 29. Indiana and North Dakota remain unchanged; they were 50 and 51 in 2008  maintain those spots, with respective rates of $1.16 and $1.02.

A ‘black eye’ for Montana

According to the Businessweek story, Montana is not happy about having the highest rates in the nation. “Montana Chamber of Commerce president and CEO Webb Brown said in a statement Thursday the ranking is a black eye for the state. His organization called on the Legislature to change workers compensation laws when it meets in January.

“The business association says high premiums hurt wage levels and Montana’s image as a business-friendly state.”

Unemployment pinches workers comp providers

The economy is putting pressure on the workers’ comp industry, in general.

According to a Reuters analysis piece posted Oct. 22, “Persistently high unemployment translates to fewer workers to cover, which cuts into revenue. And insurers known as ‘workers comp’ providers face higher payouts because claiming workers are staying on benefits longer for lack of other jobs.

“Companies such as Travelers Companies Inc, Employers Holdings Inc, SeaBright Holdings Inc and Amerisafe Inc are already seeing the effects of weak employment. Even if the jobs market is showing marginal improvements, these companies are still likely to suffer.”

Seabright reported $15.5 million loss

This MarketWatch piece from July addresses  Seabright’s troubles:

SeaBright . . . reported a second-quarter net loss $15.5 million, or 74 cents a share, versus net income of $4.3 million, or 20 cents a share, a year earlier.

The loss came as the insurer had to set aside more money to cover higher-than-expected claims from policies sold in previous years. Most of this was driven by SeaBright’s book of workers’ compensation insurance it sold in California.

“During the second quarter we undertook prudent measures to strengthen our loss reserves to reflect recent adverse claim development we have experienced, primarily in our California book of business,” John Pasqualetto, SeaBright’s chief executive, said in a statement.

“In California, we encountered increasing medical cost trends and longer average claim durations, made worse by protracted high unemployment levels,” he added.

The Reuters piece quotes an investment manager and points out potential problems for the industry: ” ‘SeaBright is a very clear warning sign to investors that there could be some negative surprises in this space,’ said James Ellman, president of San Francisco-based investment manager Seacliff Capital.

” ‘It is an industry where losses are going up and this, unfortunately, happens when you get a recession.’

Some companies too specialized

“The companies that could be hit hardest are the ones that focus exclusively on workers compensation. SeaBright’s share valuation is among the lowest in the industry, trading at just under half its book value, or the net accounting value of its assets.

“If the job market remains soft, the company could be hurt even further, Ellman said.”

Even though an economy with fewer workers is also an economy with fewer injured workers, fewer premium fees coming in adds pressure on insurers already facing rising costs, longer recoveries, and reduced opportunities for alternate work that might be available to ease a recovering worker back into full time employment.

“Analysts say performance in the industry is very much a company-by-company story,” says Reuters, “depending on what industries and regions a company participates in and how well it does at managing its book.”



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Among several concerns in review, North Dakota’s aggravated-injury provision draws particular attention

Whew–the workers comp picture in North Dakota resembles a bowl of spaghetti.

The issues sort of splay all over the place, with some overlapping others, then disappearing into the pile and re-emerging on the other side.

Unusual provision

An Aug. 16 post at Insurance Journal says, “An unusual North Dakota workers’ compensation law provides reduced benefits when a job injury worsens a medical problem the employee already has, and a consultant told state lawmakers on Friday they should repeal it.”

The Aug. 12 Bismark Tribune reports, “The latest performance evaluation of the Workforce Safety and Insurance department shows denials of claims have nearly doubled since 2005.

Claims denials

“The report, prepared by Sedgwick Claims Management Services for today’s Interim Worker’s Compensation Committee, finds that while North Dakota’s initial claims denials are lower than the national average, they are high compared with other states.

“The report recommends looking further into whether the denials are ‘appropriate based upon state law, administrative code and WSI internal claims practices.’ ”

On Aug. 16, claimsjournal.com had this to say: “A review of North Dakota’s workers compensation agency says its number of denied benefit claims has risen steadily since 2005.

Data skewed by over-reporting?

“Workforce Safety and Insurance director Bryan Klipfel says the numbers are inflated because they include incidents when a worker didn’t lose job time or need medical treatment. Klipfel says some denials were reversed later when new information became known.”

An AP post, also Aug. 16, at Bloomberg BusinessWeek has yet another angle: “North Dakota’s workers compensation director says outside reviews of his agency are too frequent and expensive.

WSI director cites too-frequent reviews

“North Dakota law says the performance reviews of Workforce Safety and Insurance must be done every two years. Auditors concentrate on specific issues and write reports for state legislators to review.

“WSI director Bryan Klipfel says it would be better to have reviews every three or four years. He says sometimes the agency barely has time to digest one set of recommendations when it has to start preparing for another.”

Gosh, no kidding, Mr. Klipfel–where do you start?

The ‘aggravation’ provision

Well, let’s start with the “unusual North Dakota law.” It’s called the aggravation provision, as in aggravating a previous injury.

Here’s how KXMC TV describes it, our emphasis added: “Under the current ‘aggravation’ law, a worker may get a reduced benefit if his job injury worsens a medical problem the worker already has. The consultants’ report says it should be repealed, and workers should get full benefits in those cases. WSI estimates the agency would have to raise insurance rates by about 2.7 percent to cover the extra $4.8 million cost.”

In other words, let’s say Mary gets in a car wreck and hurts her shoulder. Time passes and she’s back on the job; an accident occurs, and the injury aggravates the previous shoulder injury.

Most people would think well, she got hurt on the job, so what? Just take care of her. Right?

Not in North Dakota.

Back to the Insurance Journal:

“I don’t think there’s another jurisdiction in the country” that has a similar law, Malcolm Dodge, a Sedgwick assistant vice president, said in an interview.

“The provision, often called the “aggravation” law, says a worker’s benefits could be reduced by half after 60 days if he or she suffers a work injury that makes an employee’s existing medical problem worse.

“Dodge said the law would come into play if an employee injured his or her back in a car accident away from work, and then suffered a similar back injury on the job. The law says the work injury must substantially accelerate or worsen the existing injury for the employee to be eligible for full benefits.”

To his credit, Klipfel has said WSI will draft legislation that will change the provision–but it does incite wonder that such a provision would be on the books in the first place.

Denials explained

Concerning the number of denied claims, the ClaimsJournal report that ” . . . Klipfel says the numbers are inflated because they include incidents when a worker didn’t lose job time or need medical treatment. Klipfel says some denials were reversed later when new information became known.”

The Insurance Journal piece indicates that despite several concerns noted in Sedgwick’s report, Assistant VP Dodge gives the agency a passing grade on its denial rate, and Klipfel seems confident about continued progress at an agency that has seen its share of trouble in recent years:

“Dodge said the national average was about 94 percent. The consultants’ review, he said, showed WSI was applying state law correctly to claims decisions.

“Klipfel said he thought the report’s conclusions favored WSI. The agency has been in turmoil in recent years; its former director was forced out of his job and later prosecuted for misspending public funds.

” ‘Things are going good at this agency,” Klipfel said. ‘There’s a lot of positive things that we have going on … We confirmed that our claims practices are sound.’ “

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Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Injury on the job

Filing a claim



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