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SFMT FMTA Munic icip ipal l Transpo porta tati tion Agency - PowerPoint PPT Presentation

SFMT FMTA Munic icip ipal l Transpo porta tati tion Agency Workers Compensation Loss Summary September 9, 2019 Claim aim V Volum umes NEW CLAIMS BY TYPE CLAIM TYPE FY 19-20 July August September October November December


  1. SFMT FMTA Munic icip ipal l Transpo porta tati tion Agency Worker’s Compensation Loss Summary September 9, 2019

  2. Claim aim V Volum umes NEW CLAIMS BY TYPE CLAIM TYPE FY 19-20 July August September October November December January February March April May June FY Total Monthly Average INDEMNITY # 54 54 54 MEDICAL ONLY # 12 12 12 OTHER # 0 0 0 INDEMNITY % 81.81% 81.81% 81.81% MEDICAL ONLY % 18.18% 18.18% 18.18% OTHER % 0.01% 0.01% 0.01% CLAIM TYPE FY 18-19 July August September October November December January February March April May June FY Total Monthly Average INDEMNITY # 39 38 46 62 44 54 50 39 42 40 45 49 548 46 MEDICAL ONLY # 4 7 6 9 4 4 1 6 13 15 9 6 84 7 OTHER # 1 4 2 8 11 2 5 2 5 10 3 1 54 5 INDEMNITY % 88.64% 77.55% 85.19% 78.48% 74.58% 90.00% 89.29% 82.98% 70.00% 61.54% 78.95% 87.50% 79.88% 80.70% MEDICAL ONLY % 9.09% 14.29% 11.11% 11.39% 6.78% 6.67% 1.79% 12.77% 21.67% 23.08% 15.79% 10.71% 12.24% 12.28% OTHER % 2.27% 8.16% 3.70% 10.13% 18.64% 3.33% 8.93% 4.26% 8.33% 15.39% 5.26% 1.79% 7.87% 7.02% CLAIM TYPE FY 17-18 July August September October November December January February March April May June FY Total Monthly Average INDEMNITY # 51 54 40 45 57 32 44 52 40 44 45 41 545 45 MEDICAL ONLY # 3 6 5 11 13 7 12 10 6 13 9 2 97 8 OTHER # 2 1 3 3 3 3 2 1 5 3 7 2 35 3 INDEMNITY % 91.07% 88.52% 83.33% 76.27% 78.08% 76.19% 75.86% 82.53% 78.43% 73.33% 73.77% 91.11% 79.75% 80.70% MEDICAL ONLY % 5.35% 9.83% 10.41% 18.64% 17.80% 16.66% 20.68% 15.87% 11.76% 21.66% 14.75% 4.44% 15.03% 15.79% OTHER % 3.58% 1.65% 6.26% 5.09% 4.12% 7.15% 3.46% 1.60% 9.81% 5.01% 11.48% 4.45% 5.22% 3.51% CLAIM TYPE FY 16-17 July August September October November December January February March April May June FY Total Monthly Average INDEMNITY # 46 41 38 46 36 41 40 36 47 53 60 63 547 46 MEDICAL ONLY # 6 9 8 4 5 4 4 8 13 9 5 6 81 7 OTHER # 0 5 5 1 1 0 0 1 0 1 5 3 22 2 INDEMNITY % 88.46% 74.54% 74.50% 90.19% 85.71% 91.11% 90.90% 80% 78% 84% 86% 87% 83% 85% MEDICAL ONLY % 11.54% 16.36% 15.68% 7.84% 11.90% 8.89% 9.10% 17.77% 22% 14% 7% 8% 14% 13% OTHER % 0.00% 9.10% 9.82% 1.97% 2.39% 0.00% 0.00% 2.33% 0% 2% 7% 5% 3% 2% CLAIM TYPE FY 15-16 July August September October November December January February March April May June FY Total Monthly Average INDEMNITY # 40 51 44 56 32 58 45 52 59 50 39 39 565 47 MEDICAL ONLY # 6 9 3 7 8 7 2 12 6 9 7 8 84 7 OTHER # 3 0 0 2 0 1 2 1 2 1 2 3 17 1 INDEMNITY % 81.63% 85.00% 93.62% 86.15% 80% 87.87% 91.84% 80% 88% 83% 81% 78% 85% 84% MEDICAL ONLY % 12.24% 15.00% 6.38% 10.77% 20% 10.60% 4.08% 18.46% 9% 15% 15% 16% 13% 12% OTHER % 6.12% 0.00% 0.00% 3.08% 0.00% 1.53% 4.08% 1.54% 3% 2% 4% 6% 2% 4% Data prior to March 2013 is drawn from Sedgwick data as reported in HR Monthly Reports Other # = First Aid, Future Medical, Reported Workers' Compensation Council Meeting September 9, 2019 2

  3. Clai aim V m Volume umes CLAIMS REOPENED Monthly FISCAL YEAR July August September October November December January February March April May June FY Total Average FY 2019-2020 9 9 9 FY 2018-2019 2 12 6 11 6 3 5 3 6 4 10 10 78 7 FY 2017-2018 3 3 8 7 11 4 9 6 13 3 7 6 80 7 FY 2016-2017 11 12 8 3 6 7 2 8 4 9 13 9 92 8 FY 2015-2016 8 7 4 7 4 6 6 6 18 8 7 11 92 8 CLAIMS CLOSED Monthly FISCAL YEAR July August September October November December January February March April May June FY Total Average FY 2019-2020 57 57 57 FY 2018-2019 45 60 56 71 34 68 74 50 67 58 78 91 752 63 FY 2017-2018 52 69 51 53 50 98 58 70 70 69 42 73 755 63 FY 2016-2017 48 67 59 61 68 75 47 60 67 70 62 73 757 63 FY 2015-2016 46 53 45 82 41 99 35 62 72 82 75 69 761 63 CLOSING RATIO Monthly FISCAL YEAR July August September October November December January February March April May June FY Total Average FY 2019-2020 76% 78% 76% FY 2018-2019 98% 98% 93% 79% 52% 108% 121% 100% 102% 84% 116% 138% 170% 99% FY 2017-2018 88% 108% 91% 80% 60% 213% 87% 101% 109% 110% 62% 140% 166% 101% FY 2016-2017 76% 100% 100% 113% 136% 144% 102% 113% 105% 97% 75% 90% 102% 104% FY 2015-2016 80.70% 79.10% 88.24% 113.89% 93.18% 137.50% 63.63% 87.32% 84.70% 120.58% 136.36% 113.11% 100% 100% CLAIMS PENDING EOM Monthly FISCAL YEAR July August September October November December January February March April May June FY Total Average FY 2019-2020 1,645 1,645 1,645 FY 2018-2019 1,616 1,617 1,621 1,640 1,671 1,666 1,653 1,653 1,652 1,663 1,652 1,627 1,627 1,644 FY 2017-2018 1,620 1,615 1,620 1,633 1,667 1,615 1,624 1,623 1,617 1,611 1,637 1,615 1,615 1,625 FY 2016-2017 1,643 1,643 1,643 1,636 1,616 1,593 1,592 1,585 1,582 1,584 1,605 1,613 1,613 1,611 FY 2015-2016 1,642 1,656 1,662 1,652 1,655 1,628 1,648 1,657 1,670 1,656 1,636 1,628 n/a 1,649 Data prior to March 2013 is drawn from Sedgwick data as reported in HR Monthly Reports Other # = First Aid, Future Medical, Reported Workers' Compensation Council Meeting September 9, 2019 3

  4. Fina nanc ncials FY 2018/2019 FY 2019/2020 One Month One Month Expenditures Expenditures Increase/Decrease % of Change INDEMNITY Temporary Disability $777,822 $976,257 $198,435 25.51% Permanent Disability $565,758 $559,315 ($6,442) -1.14% Total Indemnity $1,343,579 $1,535,572 $191,993 14.29% Vocational Rehabilitation $0 Total Vocational Rehabilitation $10,468 ($10,468) -100.00% MEDICAL Total Medical $769,251 $106,003 ($663,248) -86.22% EXPENSE $53,614 Total Expense $205,577 ($151,962) -73.92% RECOVERY Total Recovery Processed $0 ($1,152) ($1,152) 0% GRAND TOTAL $2,328,875 $1,694,038 ($634,837) -27.26% Workers' Compensation Council Meeting September 9, 2019 4

  5. Fina nanc ncials Open Claims Stratification: Open Claims Stratification by Severity $100K+ Total Incurred = All Policy Years $100K+ Incurred Claims 656 250 212 200 150 134 121 100 51 50 36 17 16 16 12 8 8 5 4 4 4 3 3 1 1 0 100k- 150k- 200k- 250k- 300K- 350K- 400k- 450k- 500k- 550k- 600k- 650k- 700k- 750k- 800k- 850k- 900k- 950K- 1M+ 150K 200K 250K 300K 350K 400K 450K 500K 550K 600K 650K 700K 750K 800K 850K 900K 950K 1M Total 212 134 121 51 36 17 16 12 8 3 1 5 8 4 4 1 4 3 16 Workers' Compensation Council Meeting September 9, 2019 5

  6. Lit itig igation S Statis istics LITIGATION RATIO FISCAL YEAR 2019-2020 July August September October November December January February March April May June Open Litigated Claims* 430 Open Indemnity Claims* 1,114 Litigated Ratio 38.60% FISCAL YEAR 2018-2019 July August September October November December January February March April May June Open Litigated Claims* 412 418 411 410 417 415 421 421 412 423 427 431 Open Indemnity Claims* 1,075 1,076 1,076 1,098 1,120 1,119 1,128 1,138 1,115 1,106 1,111 1,103 Litigated Ratio 38.33% 38.85% 38.20% 37.34% 37.23% 37.09% 37.32% 36.99% 36.95% 38.25% 38.43% 39.08% FISCAL YEAR 2017-2018 July August September October November December January February March April May June Open Litigated Claims* 399 409 429 429 428 418 423 423 429 428 433 417 Open Indemnity Claims* 1,077 1,085 1,081 1,094 1,117 1,082 1,079 1,084 1,073 1,079 1,098 1,075 Litigated Ratio 37.05% 37.70% 39.69% 39.21% 38.32% 38.63% 39.20% 39.02% 39.98% 39.67% 39.44% 38.79% FISCAL YEAR 2016-2017 July August September October November December January February March April May June Open Litigated Claims* 358 393 383 387 388 386 385 389 391 377 389 391 Open Indemnity Claims* 1080 1129 1106 1096 1076 1058 1045 1042 1037 1038 1,052 1,065 Litigated Ratio 33.15% 34.81% 34.63% 35.31% 36.06% 36.48% 36.84% 37.33% 37.70% 36.32% 36.98% 36.71% FISCAL YEAR 2015-2016 July August September October November December January February March April May June Open Litigated Claims* 412 406 403 397 384 385 384 378 371 366 377 364 Open Indemnity Claims* 1113 1121 1128 1129 1046 1098 1127 1130 1135 1114 1105 1076 Litigated Ratio 37.02% 36.22% 35.73% 35.16% 36.71% 35.06% 34.07% 33.45% 32.69% 32.85% 34.12% 33.83% *Does not include Future Medical Claims Data prior to March 2013 is unreliable and is excluded Workers' Compensation Council Meeting September 9, 2019 6

  7. Cause use A Ana nalysi ysis CLAIM CAUSE ANALYSIS Top 10 Claim Causes by Frequency BY FREQUENCY Rolling 12 Reporting Months 90 90 80 70 56 60 50 48 50 35 40 32 30 24 21 18 16 20 10 0 Repeated Assault/ Vehicle Twisting/ Collision Pulling/ Fall Same Stress- Continuou Struck By Motion Physical Accident Turning Pushing Level (NEC) MTA s Trauma Moving Object Total 56 90 50 32 16 48 18 24 35 21 Workers' Compensation Council Meeting September 9, 2019 7

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