Workers’ Compensation Insurance Rating Bureau of California®
Report on 2012 California Workers’ Compensation
Losses and Expenses
Released: June 26, 2013
Notice
The 2012 California Workers’ Compensation Losses and Expenses (Report) was developed by the Workers’
Compensation Insurance Rating Bureau of California (WCIRB) for the convenience of its users. The WCIRB has
made reasonable efforts to ensure the accuracy of this Report. You must make an independent assessment
regarding the use of this Report based upon your particular facts and circumstances.
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Report on 2012 California Workers’ Compensation Losses and Expenses
Released: June 26, 2013
2012 California Workers’ Compensation Losses and Expenses
Pursuant to Section 11759.1 of the California Insurance Code, the Workers’ Compensation Insurance
Rating Bureau of California (WCIRB) has prepared this report containing estimated California workers’
compensation costs for 2012 based on insured employer experience. The report also reflects payments
made by the California Insurance Guarantee Association (CIGA) in the statewide loss payments for
1
calendar years 2000 through 2012.
Hospital, Physician and Medical-Legal Costs
In 2012, $4.8 billion, or 60% of total loss payments, were for medical services. This figure includes an
estimated proportion of loss payments made by CIGA for medical benefits during calendar year 2012. (In
2011, $4.4 billion, or 60% of total loss payments, were for analogous medical services.)
Exhibits 1.1 through 1.4 contain summaries of amounts paid for medical services in 2012. These exhibits
are based on the WCIRB’s Aggregate Indemnity and Medical Costs Call and Call for California Workers’
Compensation Calendar Year Experience. These medical payments are segregated into category based
on the type of medical provider receiving payment and not necessarily the medical procedures performed;
therefore, the resulting distribution of medical payments to these categories may differ from one that
would be based on the type of medical services provided. (For example, a payment made to a hospital is
categorized as a hospital payment – even if the payment was made for physical therapy or
pharmaceutical services.) Also, note that the amounts shown for the cost of medical cost containment
programs only reflect the amount of such costs included in medical loss and does not include the amount
of medical cost containment program costs reported as allocated loss adjustment expense.
Table 1 summarizes the estimated total medical losses paid by category of recipient in calendar years
2011 and 2012:
Table 1: Summary of Medical Losses Paid by Recipient/Payee
Recipient/Payee
CY 2011
CY 2012
Physicians
Injured Workers
Hospitals
Pharmacies
Medical Cost Containment Programs (medical loss only)
Medical-Legal Evaluations
Payments Related to Medicare Set-Aside Accounts2
Reimbursements to Medicare
Other
$1.6 billion
$1.1 billion
$877 million
$391 million
$309 million
$182 million
----$17 million
$1.7 billion
$1.3 billion
$878 million
$418 million
$245 million
$192 million
$92 million
$3 million
$5 million
Total Medical Losses Paid
$4.4 billion
$4.8 billion
1
For calendar years 2000 through 2009, the total workers’ compensation benefit payments made by CIGA have been apportioned
to benefit categories by assuming that CIGA calendar year benefit payments were distributed in a manner identical to the average
insurer distribution for that year. Since calendar year 2010, the workers’ compensation benefit payment information from CIGA has
been provided separately for its indemnity and medical components.
2
Medical Payments Related to Medicare Set-Aside Accounts and Reimbursements to Medicare were first reported on the calendar
year 2012 call. The estimated statewide costs shown for these components were estimated based on the information reported by
insurers who were able to segregate these costs from other medical cost components.
1
WCIRB California®
Report on 2012 California Workers’ Compensation Losses and Expenses
Released: June 26, 2013
Beginning with claims incurred on policies incepting on or after July 1, 2010, the cost of medical cost
containment programs is required to be reported to the WCIRB as allocated loss adjustment expense
rather than as medical loss. The medical cost containment program costs shown in Table 1 only reflect
those costs reported as medical loss. The total cost of medical cost containment programs, including that
reported as allocated loss adjustment expense, is shown in Table 2.
Table 2: Total Paid Cost of Medical Cost Containment Programs (in $Millions)
Reported as Medical
Loss Paid
Reported as Allocated
Loss Adjustment
Expense Paid
Total Medical Cost
Containment
Program Costs Paid
CY2006
CY2007
CY2008
CY2009
CY2010
CY2011
CY2012
226
245
356
339
352
309
245
N/A
N/A
N/A
N/A
4
73
167
226
245
356
339
356
382
412
Exhibits 1.1 through 1.4 also show distributions of medical payments to physicians by physician
specialty.3 The estimate of the statewide distribution of payments by physician specialty was based on
reports of insurers who were able to provide a comprehensive breakdown of medical payments by each
of the physician specialty categories requested. Table 3 summarizes the estimated distribution of medical
payments by physician specialty in calendar years 2011 and 2012:
Table 3: Distribution of Medical Losses Paid by Physician Specialty
Physician Specialty
General and Family Practice
Clinics
Orthopedics
Physical Therapists
Physical Medicine – MDs
Radiology
Chiropractors
All Others
Total Payments to Physicians
CY 2011
CY 2012
22.8%
12.9%
11.8%
10.7%
5.7%
6.3%
5.5%
24.3%
20.9%
13.6%
11.1%
10.5%
7.1%
7.0%
4.6%
25.2%
100.0%
100.0%
3
In accordance with Insurance Code Section 11759.1, the information provided in this report pertaining to payments by physician
specialty represents the specialties of the physician to which these payments were made, and may not fully represent payments for
all services that were provided under that same specialty.
2
WCIRB California®
Report on 2012 California Workers’ Compensation Losses and Expenses
Released: June 26, 2013
Exhibits 2.1 through 2.3 contain summaries of medical-legal costs for 2012 based on the WCIRB’s
Permanent Disability Claim Surveys. The exhibits show that orthopedic evaluations accounted for about
54% of the cost of all medical-legal evaluations. The exhibits also show that the average cost of a
medical-legal evaluation was $1,970. Psychiatric evaluations were the most expensive, averaging $3,774.
Indemnity Benefits
In 2012, $3.2 billion, or 40% of total loss payments, were for indemnity benefits (including vocational
rehabilitation benefits). This figure includes an estimated proportion of loss payments made by CIGA for
indemnity benefits during calendar year 2012. (In 2011, payment for analogous indemnity benefits totaled
$3.0 billion, or 40% of total loss payments.)
Exhibits 3.1 and 3.2 contain summaries of paid indemnity benefits by type of benefit for calendar year
2012. The data in Exhibit 3 is derived from the WCIRB’s Aggregate Indemnity and Medical Costs Call,
current unit statistical report data, and the WCIRB’s Call for Calendar Year Experience. The exhibit shows
that for 2012, temporary disability benefits (48%) and permanent partial disability benefits (41%)
accounted for the vast majority of the indemnity payments.
Exhibits 4 through 15 contain summaries of indemnity and medical benefits by permanent disability rating
interval for various types of injuries resulting in permanent disability. The exhibits are based on 2010
policy experience – the most current available data on permanent disability claims. (Note that these
average claim values are based on claims evaluated as of 18 months from inception of each 2010 policy,
and have not been adjusted to an ultimate value basis.) Exhibits 4 and 5 show a segregation of indemnity
and medical benefits for back injury claims. Exhibits 6 and 7 show indemnity and medical benefits for slip
and fall injuries. Exhibits 8 and 9 segregate indemnity and medical costs for psychiatric and mental stress
injuries. Exhibits 10 and 11 show the indemnity and medical costs of carpal tunnel and repetitive motion
injuries. Exhibits 12 and 13 show indemnity and medical costs for other cumulative injuries. Finally,
Exhibits 14 and 15 show indemnity and medical costs for all injuries.
Exhibit 16.1 graphically shows the proportion of total loss dollars reported on permanent disability claims
attributable to various types of injuries. Exhibit 16.2 shows the average cost per claim for these injuries. As
shown on Exhibit 16.2, slip and fall injuries are the most costly of the injury categories summarized.
Vocational Rehabilitation Benefits
Exhibit 17 summarizes the amounts estimated to be paid for vocational rehabilitation maintenance
allowance, evaluation, education and training, vocational rehabilitation settlement, nontransferable
education vouchers, as well as other vocational rehabilitation benefits (primarily voluntary vocational
rehabilitation benefits).4 The exhibit is based on data derived from the WCIRB’s Aggregate Indemnity and
Medical Costs Call, WCIRB Permanent Disability Claim Surveys, the WCIRB’s 2008 study on the impact
of the 2002 through 2004 reforms on loss development patterns,5 as well as the WCIRB’s Call for
Calendar Year Experience. In total, insurers paid about $37 million in vocational rehabilitation-related
benefits in calendar year 2012. This was 1.1% of all indemnity payments or 0.5% of all benefit payments
in 2012, of which 95% was for non-transferable education vouchers. (For comparison purposes, in 2011,
vocational rehabilitation benefits paid was $32 million or 1.1% of all indemnity payments, of which 94%
was for non-transferable education vouchers.)
4
Vocational rehabilitation settlements were allowed on injuries occurring on or after January 1, 2003 pursuant to Assembly Bill No.
749. Effective on injuries occurring on or after January 1, 2004, mandatory vocational rehabilitation was repealed and a system of nontransferable education vouchers created with the passage of Assembly Bill No. 227 and Senate Bill No. 228.
5
Impact of Recent Reform Legislation on Loss Development Patterns—2008 Update, WCIRB Bulletin No. 2008-04, released April 2,
2008.
3
WCIRB California®
Report on 2012 California Workers’ Compensation Losses and Expenses
Released: June 26, 2013
Insurer Losses, Expenses and Profits
Exhibits 18.1 and 18.2 summarize California workers’ compensation underwriting experience for calendar
year 2012.6 Calendar year 2012 earned premium totaled $12.1 billion (as compared to the $10.4 billion of
premium earned in 2011). Note that the premiums shown on this exhibit are on a direct basis (i.e., prior to
reinsurance assumed or ceded), are prior to the application of deductible credits and retrospective rating
plan adjustments, and do not reflect any non-standard California workers’ compensation business, such
as excess or USL&H insurance. In total, paid losses in 2012, including benefit payments made by CIGA,
were $8.0 billion, or 67% of insurer calendar year earned premium.
Total insurer paid losses (i.e., excluding payments made by CIGA) in 2012 were $7.9 billion, or 65% of
calendar year earned premium. Combining insurer paid losses with a $1.3 billion increase in total insurer
loss reserves resulted in total insurer incurred losses, excluding payments made by CIGA, of $9.2 billion,
or 76% of the premium earned in 2012. (For comparison purposes, in 2011, total insurer paid losses –
excluding those made by CIGA – were 70% of earned premium and, with an increase in insurer loss
reserves totaling 4% of earned premium, total insurer incurred losses, excluding payments made by
CIGA, were 74% of total insurer earned premium.) 7
The 76% of earned premium stated above pertains to total insurer losses incurred during the “calendar
year” 2012. This includes all insurer losses paid and insurer loss reserve changes that occurred during
2012, regardless of when the accidents occurred or to which policies these losses belonged.
Incurred loss adjustment expenses (allocated and unallocated) in 2012 were $2.2 billion, or 18% of
earned premium. (This includes the full cost to insurers of administering, adjudicating and settling claims.)
This was a large decrease from 2011 in part due to a substantial takedown of unallocated loss adjustment
expense reserves in 2012 by one insurer. Incurred loss adjustment expenses include $773 million in
defense attorney expenses incurred in 2012.
In total, California insurers have incurred about $4.6 billion in expenses in 2012, or 38% of 2012 earned
premium. (For comparison purposes, in 2011, incurred loss adjustment expenses were 25% of earned
premium, including $712 million in defense expenses, resulting in total expenses incurred of 48% of
earned premium.)
In total, incurred losses and expenses in calendar year 2012 were $13.9 billion, or 115% of earned
premium. Based on insurer statutory Annual Statement information, the WCIRB estimates policyholder
dividends incurred in 2012 to be 0.9% of 2012 earned premium, resulting in an underwriting loss of $1.9
billion, or 15.6% of premium. Note that the underwriting profits or losses shown on this exhibit represent
only California workers’ compensation insured policies and is prior to reinsurance assumed or ceded, the
application of deductible credits or retrospective rating plan adjustments. Similarly, this summary reflects
underwriting results only and not overall profitability as figures shown do not contemplate any measure of
investment income or federal income taxes.8 (For 2011, the underwriting loss was about 22% of earned
premium, or $2.3 billion.)
6
Total statewide calendar year 2012 premiums, losses and expenses were estimated based on the experience of insurers that
reported premium, loss and expense information to the WCIRB.
7
Benefit payments made by CIGA during calendar years 2000 to 2012 are also shown as paid loss percentages to insurer earned
premium for those calendar years.
8
See the National Association of Insurance Commissioners’ Report on Profitability By Line By State, which is published annually,
for an estimate of the overall profitability of California workers’ compensation.
4
WCIRB California®
Report on 2012 California Workers’ Compensation Losses and Expenses
Released: June 26, 2013
Fees Paid to Applicant Attorneys
Although generally part of incurred indemnity losses rather than expenses, the amount paid in 2012 to
applicant attorneys was derived from the WCIRB’s Annual Expense Call. In 2012, applicant attorneys
were paid $450 million. (In 2011, applicant attorneys were paid $386 million.)
Workers’ Compensation Costs by Type of Injury
Exhibits 19 through 21 summarize loss experience by type of injury for the most current policy year
available. Exhibit 19 shows the number and proportion of claims and incurred losses by cause of injury
(e.g., fall, repetitive motion, etc.). Exhibit 20 shows the number and proportion of claims and incurred
losses by the nature of the injury sustained (e.g., strain, fracture, etc.). Exhibit 21 shows the number and
proportion of claims and incurred losses by the part of body injured. The information in Exhibits 19
through 21 is based on unit statistical reports submitted on policy year 2010 claims at first report level.
Conditions and Limitations
1.
The information contained in this report is a summary of historical data provided to the WCIRB by
over 130 insurer groups. While numerous detailed data quality checks are performed, the WCIRB
can make no warranty with respect to the information provided by third parties.
2.
This report is based on data reported to the WCIRB through June 17, 2013. Subsequent revisions to
the data could impact the analysis reflected in this report.
3.
Some of the cost distributions have been estimated based on less than 100% of the total market.
4.
Premium information is prior to reinsurance assumed or ceded or credits for deductibles, and does
not reflect retrospective rating plan adjustments or any premiums resulting from non-standard
California workers’ compensation coverage such as excess or USL&H insurance. Similarly, losses
and expenses shown are prior to reinsurance and do not reflect any deductible recoveries or any
losses from non-standard coverages.
5.
The report has been based on the reported experience of insured employers. No self-insured data
has been included.
6.
The information contained in this report has been based on data submitted to date by insurers to the
WCIRB. To the extent that insurers who are in rehabilitation or liquidation are no longer reporting
data to the WCIRB, the information contained in this report will not reflect the experience of the
entire California workers’ compensation insurance market. However, loss payments made by CIGA
during calendar years 2000 through 2012 have been included in this report.
5
WCIRB California®
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7
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