Data on California Private Self-Insureds’ 2022 Workers’ Comp Claim Experience

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California workers’ compensation private self-insured claim frequency rose 6% last year as both medical-only and indemnity claim volume increased, but a new report suggests that many of the claims may have been low-cost COVID-19 cases.

A California Workers’ Compensation Institute review of initial data from the state Office of Self-Insurance Plans shows private self-insureds’ average paid and incurred losses both declined, so their total paid losses at first report fell 1.2% to $311 million, while their incurred losses fell 3.3% to just under $812 million.

OSIP’s summary of private self-insured data offers a first glimpse at California private, self-insured claims experience for cases reported in 2022. It notes the total number of covered employees, medical-only and indemnity claim counts, and total paid and incurred losses on those claims through the end of the year, according to the CWCI.

The summary reports on the experience of private self-insured employers, which covered 2.49 million California workers last year and who reported 104,278 claims in 2022, 11.6% more than the 93,430 claims noted in the 2021 initial report, according to the CWCI.

Distribution by claim type was nearly evenly split, as private self-insured employers reported 52,300 medical-only claims in 2022, up 7.2% from 48,766 in 2021, while they reported 51,978 indemnity claims, up 16.4% from the 2021 first report level, the CWCI analysis shows.

This marked the third straight year that the private self-insured indemnity claim count has risen. The tally went from 34,307 claims in 2019 to 42,724 claims in 2020, then rose to 44,664 claims in 2021, before the addition of 7,314 more indemnity claims last year. The overall claim count for 2022 works out to 4.31 claims per 100 private self-insured employees, the highest rate in at least 16 years, according to the CWCI.

Despite increasing claim volume and claim frequency, first report total paid losses for 2022 fell 1.2% to $311 million, as total paid medical declined by $6.9 million to $149.2 million, more than offsetting the $3.2 million increase in paid indemnity, which rose 2.0% to $161.9 million. The average paid loss on a 2022 claim in the initial report was $2,983, down 11.5% compared with 2021 as average medical payments per claim fell 14.3% to $1,431, and average paid indemnity fell 8.7% to $1,552, the CWCI analysis shows.

CWCI members and subscribers may log on to the Communications section of the CWCI website to view a more details, analyses and graphics.