درباره این اپیزود
Late-reported workers' compensation claims cost 45% more than those reported promptly – a startling statistic that reveals how critical timing can be when managing your company's experience modification factor. This hidden multiplier determines whether your business pays more or less for workers' comp insurance and, for contractors especially, can determine whether you qualify for jobs at all.
Jeremy Morrison, Director of Underwriting at Berkeley Industrial with 20 years in workers' compensation, breaks down the complex world of E-mods with refreshing clarity. He explains how the classification system uses three years of historical data to compare your company's performance against similar businesses in your industry. The resulting math produces a multiplier that can significantly impact your bottom line – particularly as your business grows.
We tackle common misconceptions about claims management, including why paying medical-only claims out-of-pocket often backfires financially. Jeremy explains how these claims are heavily discounted in the E-mod calculation and why prompt reporting nearly always saves money in the long run. We also explore why the system penalizes frequency more than severity, capping the impact of any single large claim on your rating.
Perhaps most valuable is our discussion about partnership. The strongest workers' comp programs emerge when claims adjusters, underwriters, risk management specialists, and business owners communicate openly about goals and challenges. When everyone understands how their role impacts the others, better outcomes naturally follow. For workers' compensation success, we truly believe that teamwork makes the dream work.
Think differently, care deeply, and discover how proper claims handling can transform your experience modification factor from a mysterious penalty into a competitive advantage. Subscribe, leave a review, and join us every two weeks for more insights that help you protect what matters.
Season 9 is brought to you by Berkley Industrial Comp. This episode is hosted by Greg Hamlin.
Visit the Berkley Industrial Comp blog for more!
Got questions? Send them to marketing@berkleyindustrial.com
For music inquiries, contact Cameron Runyan at camrunyan9@gmail.com
یادداشت ها را نشان دهید 🔗
رونوشت 🔗
00:00:11.233 --> 00:00:13.935
Hello everybody and welcome to Adjusted.
00:00:13.935 --> 00:00:26.213
I'm your host, greg Hamlin, coming at you from beautiful Birmingham, Alabama, and with me today is our special guest, jeremy Morrison, director of Underwriting.
00:00:26.213 --> 00:00:29.687
Jeremy, if you could introduce yourself to everyone.
00:00:29.908 --> 00:00:30.410
Yeah, hi.
00:00:30.410 --> 00:00:31.492
Good morning, thanks, greg.
00:00:31.492 --> 00:00:35.871
I am, as you said, jeremy Morrison, director of Underwriting at Berkeley Industrial.
00:00:35.871 --> 00:00:45.271
I've been with Berkeley Industrial going on six years in July and have been in the workers' compensation space for about 20 years, believe it or not.
00:00:46.021 --> 00:00:47.487
It's amazing how time flies right.
00:00:47.487 --> 00:00:49.765
Yes, it is.
00:00:49.765 --> 00:01:14.986
I was just telling my wife we went out last night for ice cream and I was telling her, like we were talking about AI, and I said people are never going to believe that when I started in claims 20 years ago, we still had paper files and we had walls of files that we pulled back and forth to like yeah, like that's just like mind blowing and I'd have to hand type notes to the file, otherwise we'd have to go pull the paper file.
00:01:14.986 --> 00:01:17.781
So the world's definitely changing Absolutely.
00:01:17.923 --> 00:01:19.328
Yeah, no, I'm right there with you.
00:01:19.620 --> 00:01:25.625
Well, one of the things I thought was interesting we're going to be talking today about experience modifications the myths, the facts and the solutions.
00:01:25.625 --> 00:01:45.966
But one things I thought was interesting we're going to be talking today about experience modifications the myths, the facts and the solutions, but one thing I thought was interesting as we go into this is that, as I was doing some research on this topic, that claims that are late reported in the fourth or fifth week following an injury are actually 45% more expensive than those reported in the first week.
00:01:45.966 --> 00:01:51.686
So I thought that was an interesting fact, and, as we go into this, I think we're going to get to the why behind some of that.
00:01:51.686 --> 00:01:59.611
So I thought first though, jeremy, I think we've had you on before, but I would still love to hear and remind our listeners about how you got into the industry.
00:01:59.611 --> 00:02:01.183
Yeah, yeah absolutely Well.
00:02:01.743 --> 00:02:15.110
I was fortunate enough to have a family connection that was involved in a small workers' compensation carrier when I was in high school and college and started doing some internship work for them in the claims department.
00:02:15.110 --> 00:02:22.320
When I graduated college I was able to join their team as an associate underwriter and have been in underwriting ever since.
00:02:22.320 --> 00:02:28.752
So it was really through the good fortune of a family connection that kind of got me started in the insurance space.
00:02:28.752 --> 00:02:41.473
I would not have thought of insurance really as a career when I was younger, but certainly glad for that good fortune and very, very grateful for the opportunity and it's been a very nice career.
00:02:41.979 --> 00:02:42.681
That's awesome.
00:02:42.681 --> 00:02:51.050
So, if you don't mind me asking, jeremy, when you went to school, what were your thoughts at the time you were in college, of where you were going to go with your career?
00:02:51.199 --> 00:02:52.406
Yeah, I wasn't sure, man.
00:02:52.406 --> 00:02:54.187
I just really wanted to land a job.
00:02:54.187 --> 00:03:07.681
I was thinking about perhaps going back to graduate school, but I just felt like I needed to get a job and start paying off student loans and just really wanted to just get hired somewhere, anywhere, and that was my focus.
00:03:07.681 --> 00:03:19.881
I was just looking for an opportunity to go anywhere and I was living in North Carolina at the time, going to school there, and drove back to Pennsylvania for the job interview.
00:03:19.881 --> 00:03:24.569
It started the next day and I was just really grateful to have a job.
00:03:24.569 --> 00:03:29.247
But yeah, I wouldn't have thought of insurance as a career Wasn't on the foremost of my mind.
00:03:29.247 --> 00:03:32.008
I just really wanted to get a job and start working.
00:03:32.269 --> 00:03:33.131
Totally can relate.
00:03:33.131 --> 00:03:39.739
I actually very similar path in that I was a criminal justice major and was planning to go to law school.
00:03:39.739 --> 00:03:42.489
That was the thought process at the time.
00:03:42.489 --> 00:03:45.689
And then, while I was doing my undergrad work, I met my wife.
00:03:45.689 --> 00:03:51.508
We got married, had a baby while I was still finishing up school, so then it was time to get a job.
00:03:51.508 --> 00:03:52.262
I was like man.
00:03:52.282 --> 00:03:58.627
I got a daughter to feed and my wife wants more and so I need to go figure this out.
00:03:58.627 --> 00:04:04.343
And knew nothing about insurance, but it's been a great career over the last 20 years, so definitely for our listeners.
00:04:04.343 --> 00:04:14.612
Just would encourage you like this is one of those industries that does need more talent and I think we don't always do a good job of just getting people into the field, so I recommend a friend.
00:04:14.793 --> 00:04:15.653
Absolutely yeah.
00:04:15.653 --> 00:04:17.795
There's a desperate need of talent in all disciplines.
00:04:17.795 --> 00:04:18.497
I believe yeah.
00:04:22.699 --> 00:04:32.452
So, jeremy, when I used to do career fairs it's been a while since I've been to one, but we would often recruit for both claims and underwriting and I remember having people who are English majors coming up to me saying, oh, I'm such a great writer, this sounds great.
00:04:32.452 --> 00:04:35.389
And they didn't really understand what underwriting is.
00:04:35.389 --> 00:04:37.226
Not that they couldn't have done well at it.
00:04:37.226 --> 00:04:48.913
Yeah, for those who might not know what underwriting is, maybe they're on the claim side or they have limited insurance experience Can you talk a little bit about what underwriting is and why it's even called that?
00:04:48.954 --> 00:04:55.137
Yeah, Well, I think I have to go back to the early days in London, the first insurance policies that were created.
00:04:55.137 --> 00:04:58.286
But we're not going to get into the history of underwriting, I don't think.
00:04:58.286 --> 00:05:03.127
But the name underwriting kind of derives from that origin a long, long time ago from what I recall.
00:05:03.127 --> 00:05:12.682
But the underwriter's role is really to price the risk, it's to assess the risk and determine an acceptable premium for the risk that we're assuming.
00:05:12.682 --> 00:05:15.228
And we're in the workers' comp space.
00:05:15.228 --> 00:05:20.642
But underwriters are needed in all financial fields where there's some risk that's being assumed.
00:05:20.642 --> 00:05:24.225
And for us specifically, we have to assumed.
00:05:24.225 --> 00:05:52.788
And for us specifically, we have to evaluate a business and their management, their culture, their employees, their loss experience, the jurisdictions they work, the characteristics of what they're doing, whether they're ground level, in vehicles, at heights, underground, in ditches or trenches, if they climb, if they have exposure to chemicals or dust or other things that may cause loss.
00:05:52.788 --> 00:06:04.562
But it's really assessing all aspects and facets of the risk and then trying to use that information to come up with a premium that will support losses profitably over time.
00:06:04.562 --> 00:06:08.586
We won't stay in business if we don't make the underwriting decisions.
00:06:08.586 --> 00:06:15.072
We have to be able to cover our liabilities and our expenses and that's very, very important.
00:06:15.112 --> 00:06:21.865
So I think underwriting is a little bit more art than science, but it's interesting to talk about a misconception about.
00:06:21.865 --> 00:06:24.172
You know, I'm an English major and I like to write.
00:06:24.172 --> 00:06:30.290
You know we don't write creative stories in underwriting and we're not writing essays or papers or anything like that.
00:06:30.290 --> 00:06:47.826
But there is an element to being able to communicate and articulate that is really really important and I think that communication is a critical, critical skill and can make an underwriter very effective if they're a good communicator, and that's both verbally and written.
00:06:47.826 --> 00:06:56.482
A lot of our work is done through the phone, some via email, you know, in text, but you got to be able to listen and you got to be able to communicate.
00:06:56.482 --> 00:07:01.641
So there is an element to communication and writing that is inherent to underwriting, I think.
00:07:01.800 --> 00:07:14.550
I couldn't agree more and I actually think, as we move forward over the next decade, communication skills are going to be one of the most valuable tools for young, talented people looking to enter any industry.
00:07:14.550 --> 00:07:21.069
Really, as we look at how much AI is going to automate so many things that were process-oriented.
00:07:21.069 --> 00:07:34.987
So from there, one of the things that we hear a lot or I do, at least on the claim side, and I think even if you turned your TV on and you saw insurance ads for personal lines like house and auto, people are always concerned about price.
00:07:34.987 --> 00:07:39.509
They're always concerned about what their rates are going to be and nobody wants their rates to go up.
00:07:39.509 --> 00:07:44.447
And I know in the world we're in that in workers comp that's their experience mod or their ear E mod.
00:07:44.447 --> 00:07:47.800
And I know in the world we're in that in workers' comp that's related to their experience mod or their e-mod.
00:07:47.800 --> 00:07:58.762
And I wanted you if you could just talk a little bit about what that is and how that impacts an insured's rates For sure.
00:07:58.942 --> 00:07:59.403
For sure.
00:07:59.403 --> 00:08:04.033
The experience modification factor is a component of the pricing.
00:08:04.033 --> 00:08:07.319
Experience modification factor is a component of the pricing.
00:08:07.319 --> 00:08:14.608
It's usually thought to be something that the insured can control to an extent to influence their pricing up or down.
00:08:14.608 --> 00:08:25.918
There's a number of states that have independent bureaus that publish experience mods for businesses and then the NCCI is a group of many states that also publishes experience mod factors for businesses.
00:08:25.918 --> 00:08:27.321
So larger risks.
00:08:27.321 --> 00:08:59.519
Generally speaking, if you're deriving $10,000 or $15,000 of premium on your policy, you're going to be considered large enough to be experience rated and the rating bureaus or NCCI will take your experience from three years, not including the most recent year your lost data, the losses that you've had and also your payroll data, and run it through a formula and come up with a modification factor that's applied to the policy.
00:08:59.519 --> 00:09:10.491
Of course, if it's over 1.0, that's a debit to the policy and it will add more premium, and if it's under 1.0, it's a credit and will subtract premium from your policy.
00:09:10.491 --> 00:09:14.792
So it is a factor of the pricing, but it's not the only thing that matters.
00:09:15.340 --> 00:09:23.951
Carriers have a lot of tools at their disposal to assess and price a risk and the rates and the lost costs are part of that pricing.
00:09:23.951 --> 00:09:26.442
The experience mod is part of that pricing.
00:09:26.442 --> 00:09:29.904
Underwriters typically have schedule rating right.
00:09:29.904 --> 00:09:59.289
If you'd use 1.0 as a baseline, that's kind of the big part of the bell curve and risks that are above a one are considered to have performed maybe a little less satisfactory than risks that have performed with a mod under 1.0.
00:09:59.289 --> 00:10:09.734
So you kind of get compared to risks that are in your class of business and the data sets for insurance you're being compared with other risks that are in your class of business and the data sets for insureds you're being compared with other risks that are similar to you.
00:10:09.734 --> 00:10:13.465
But that's kind of the experience mod component to the rating.
00:10:13.465 --> 00:10:27.844
And they often do get a lot of attention from insureds because larger insureds can be significantly impacted by their modification factor going up or going down depending on how their historical losses have been.
00:10:28.184 --> 00:10:42.450
So if I'm following you, say I'm a roofer or I have a roofing company and I've got, you know, several hundred employees, I'm big enough that I have one of these experience mods how far back, first of all, does that go?
00:10:42.450 --> 00:10:46.450
You might have mentioned this how many years back are they looking at my loss history?
00:10:46.450 --> 00:10:59.210
And the other question that I have is let's say that I'm completely average, I'm at a 1.0 as far as that history goes, and maybe I'm paying 20,000 in premium.
00:10:59.210 --> 00:11:03.626
If I'm completely average, if I'm paying 20,000 in premium, how far back does that go?
00:11:03.626 --> 00:11:12.327
And then kind of talk about if I'm worse than average or better than average, how that could change that number with the EMOD Sure.
00:11:13.070 --> 00:11:20.528
Okay, well, in your scenario as the roofing contractor, the rating bureaus are going to go back three years, not including the most recent year.
00:11:20.528 --> 00:11:27.371
So for 2025, payroll data is going to be used for 2023, 2022, and 2021.
00:11:27.371 --> 00:11:48.394
Your audit's not going to have been completed for 2024, most likely and the losses that are incurred for 2024 are going to be considered too new or too green to be evaluated fully and, frankly, the experience mod for 2025 is published several months in advance of your effective date, so that's another reason why the most current year's data is not used.
00:11:48.394 --> 00:11:57.129
So 23, 22, and 21, right, the last three years, not including the most recent year, will be utilized payroll data and loss data.
00:11:57.919 --> 00:12:08.792
And in the scenario you described, the premium is $20,000 and you have a 1.0 experience not going to impact that pricing for that premium really at all.
00:12:08.792 --> 00:12:27.450
But if you've had some losses in the rating period that you're being evaluated for and your experience mod goes up to a 1.10, like a 10% surcharge or a 10% debit so that premium that was $20,000 would now be 10% higher.
00:12:27.450 --> 00:12:39.505
On the other side of it, if your losses have been better than average and your experience mod is published at a 0.9, you'll have a 10% discount applied to your rating.
00:12:39.505 --> 00:12:47.163
So that $20,000 premium you may not think well, that's not a ton of premium to go up 10% or down 10%.
00:12:47.163 --> 00:12:58.796
But the larger the risk gets and the more premium that is involved in the rating, obviously the more of an impact and the more significant a debit or credit mod is to the insurer.
00:12:59.417 --> 00:13:02.928
Absolutely Well, and if I'm a small business owner, a couple thousand dollars is a big deal to me.
00:13:02.969 --> 00:13:06.730
Correct, yes, I think all small businesses would agree with that for sure.
00:13:07.139 --> 00:13:08.563
So I could definitely see that.
00:13:08.563 --> 00:13:11.730
So talk to me a little bit about I mean.
00:13:11.730 --> 00:13:14.846
Obviously there's different types of claims that go into those losses.
00:13:14.846 --> 00:13:30.413
There's med only claims and then there's lost time claims, or we call them indemnity claims, where the injured worker is actually off work receiving wage loss, and the other instance, when it's a med only file, maybe they go to the doctor but they're back to work and it's more of a treat-and-release situation.
00:13:30.413 --> 00:13:34.009
How do those impact the experience month differently?
00:13:34.551 --> 00:13:44.913
Yeah, the med-only claims that are smaller and don't have lost time associated when they are reported to NCCI or other state rating bureaus.
00:13:44.913 --> 00:13:48.660
I'm going to be very general and broad here because there's a lot of nuance.
00:13:48.660 --> 00:13:55.964
So in general, medical-only claims are discounted by the rating bureaus by various percentages.
00:13:55.964 --> 00:13:57.809
It just kind of depends on what state you're in.
00:13:57.809 --> 00:14:04.173
But the cost of the medical-only claim if you had a $1,000 claim, it's going to be discounted.
00:14:04.173 --> 00:14:08.494
If there was no lost time and it hits your experience model worksheet, it's going to be discounted.
00:14:08.494 --> 00:14:15.826
If there was no lost time and it hits your experience model worksheet, it's going to reflect a value that is not the same value on your loss run.
00:14:15.826 --> 00:14:16.528
It's going to be discounted.
00:14:16.528 --> 00:14:23.087
And that's something that I think NQCI utilizes as a way to keep mods from inflating too much in the face of medical cost inflation.
00:14:23.708 --> 00:15:05.073
Lost time claims are generally a little bit more expensive and are probably going to have a higher claim dollar because not only do you have to provide medical treatment for the employee and make them whole, but there may be some time off of work, right, they may be out of work for a couple of days or a couple of weeks or months, depending on the nature of the injury and while the medical costs and things of that nature will be discounted, it's still going to be a sizable claim and so most state bureaus and NCCI will cap the maximum value of a loss on the experience mod worksheet and every year that changes.
00:15:05.620 --> 00:15:09.044
That changes a little bit year to year based on what the actuaries do.
00:15:09.044 --> 00:15:26.668
But for instance, if you have a $50,000 claim that was a lost time claim for one of your employees, that value is going to be capped on the mod worksheet and it's, I think, right now again depending on the state, maybe $18,500 or $19,000,.
00:15:26.668 --> 00:15:31.655
There's a claim cap, again based on different states.
00:15:31.655 --> 00:15:37.591
People that are interested can look that up on MCCI or the various state bureaus.
00:15:37.591 --> 00:15:45.785
But the capping of losses again is designed to help keep the mods from swinging too significantly just because of one claim.
00:15:46.768 --> 00:15:54.452
Those are really important points because I think this is one of the pitfalls we sometimes see on the claim side is there's a thought process.
00:15:54.452 --> 00:15:59.571
And so I'll go back in time to 16-year-old Greg, who I wouldn't trust with anything.
00:15:59.571 --> 00:16:03.946
But my first car was a minivan with wood paneling.
00:16:03.946 --> 00:16:06.630
It was really cool, a hand-me-down from my parents.
00:16:06.630 --> 00:16:09.917
Minivan with wood paneling it was really cool, a hand-me-down from my parents.
00:16:10.057 --> 00:16:32.388
And one night I went to watch a movie with a friend who lived in an apartment and I was a new driver and I backed out of this carport and I don't know how I did this, but I somehow, backing out, took out the driver's side door with a pillar on this carport and so, of course, you know, cracks the window, breaks up the door, and I'm telling my mom about this and she's like not believing me.
00:16:32.388 --> 00:16:34.187
But that's exactly what happened.
00:16:34.187 --> 00:16:42.369
And we drove there the next day and of course there's nothing like the carport's fine, you can't even tell anything happened and my car is like messed up.
00:16:42.369 --> 00:16:51.682
So I told my mom about it and she's like well, we're going to go to a junkyard and get a door because I don't want to report this to the insurance carrier that's going to make our insurance go up.
00:16:51.682 --> 00:17:00.168
So for the rest of my high school career I had this door that was a different color than the rest of the van as a reminder of being a dumb six-year-old driver.
00:17:00.690 --> 00:17:35.134
But I think sometimes, when we talk to our insureds, there's a misconception that if I pay for that med only claim myself and I don't report it to the carrier, that's going to keep my insurance rates down, and what we see on the claim side is that often is a pretty big misconception, because if they were to go to the ER and that bill's $2,500 for I don't know, a laceration where they get some stitches, by the time we would pay the PPO fee and everything else associated with our discounts and the fee schedule, that bill might be $800.
00:17:35.701 --> 00:17:44.028
And then, if you take into account NCCI's rating right and how they're discounting, it may impact them half of that by the time.
00:17:44.028 --> 00:17:52.470
It's all done for a med only file, and so what ends up happening, though, is, in those claims where it's more significant and we don't know about it.
00:17:52.470 --> 00:17:57.250
Going back to that initial fact, what happens when a claim's late reported in the fourth or fifth week?
00:17:57.250 --> 00:18:18.710
Sometimes we see those claims get off the rails, and so I think that's a really important thing to educate those who are listening about is there really is value in just getting those met-onlys reported to us, because it's not going to really make that huge of a difference on your e-mod in the grand scheme of things and it's going to actually save you money probably in the long run.
00:18:20.560 --> 00:18:22.001
Would you agree, jeremy?
00:18:22.001 --> 00:18:42.038
And contractors in particular are in a tough spot because a lot of times to get on job sites or to be used as a subcontractor or a prime contractor, you've got to show that your experience mod is under a 1.0 because that's considered safer and better than average.
00:18:42.038 --> 00:18:51.128
So contractors are in a tough spot and a lot of times this question comes up with contractors in particular and we insure a lot of contractors.
00:18:51.128 --> 00:18:54.067
But I think the points you're making are very, very good points.
00:18:54.067 --> 00:19:07.755
You started this call with kind of that fact about Claims that are reported late generally are significantly more expensive than claims that are reported timely within the first day or the first couple days.
00:19:08.200 --> 00:19:18.115
I certainly am empathetic to contractors that really have to manage that experience mod and keep it under a 1.0 to keep their jobs and their livelihoods lined up.
00:19:18.115 --> 00:19:19.184
I totally get that.
00:19:19.184 --> 00:19:26.054
However, I also do agree that reporting claims reporting all claims timely is a best practice.
00:19:26.054 --> 00:19:26.779
You know.
00:19:26.779 --> 00:19:42.175
I just think that's the best way to make sure that things don't become that a small you know, a small issue does not become a larger significant issue for the insured down the road and again everybody's got to manage their business differently.
00:19:42.175 --> 00:19:42.896
But I agree.
00:19:42.896 --> 00:19:47.403
If you're reporting claims based on fee schedules, there's going to be discounting of a claim.
00:19:47.403 --> 00:19:57.761
Ncci is going to discount the claim even further in all likelihood, and what might have been a few thousand dollars will show up on the mod worksheet typically as significantly less.
00:19:57.761 --> 00:20:12.884
Ncci, the actuaries, penalize frequency and so if you have a lot of claims, even if they're a lot of small claims, the mod formula is harsher for claim frequency than it is for one large claim because of the capping.
00:20:13.385 --> 00:20:22.298
The belief there is that risk with many claims is unsafer than a risk with one claim that happened to be a large claim of significance.
00:20:22.298 --> 00:20:28.880
And you know we could debate those points and talk about you know if in fact that is or is not valid.
00:20:28.880 --> 00:20:30.386
But that's what the actuaries do.
00:20:30.386 --> 00:20:32.174
That's the rationale behind it.
00:20:32.174 --> 00:20:36.788
But there is mechanisms in place to keep those costs very low on the bottom work sheet.
00:20:37.148 --> 00:20:41.306
And I think, going back to everything you just said, that's where teamwork makes the dream work.
00:20:41.306 --> 00:20:58.207
If dream work, you really want to have a partnership with your carrier and you want to make sure that, if you're a contractor and you have certain goals that you're trying to achieve, that you're working lockstep with your carrier, with your claims team, with your underwriter, with their safety department, because that's when the really good results happen.
00:20:58.207 --> 00:21:10.347
And I can tell you from my experience, when things do get off the rails, it's often because there's not good communication with all those parties on what the goals are and how we can work together to achieve them.
00:21:10.347 --> 00:21:12.858
So I think you hit on some important things.
00:21:12.858 --> 00:21:23.509
There's a lot pulling at an insured to try to manage their risk and I think this whole EMOD process is very confusing If this isn't what you do all day long.
00:21:23.509 --> 00:21:27.518
Trying to understand this while you're running a small business is hard From your end.
00:21:27.759 --> 00:21:30.105
I'm going to switch gears a little bit and talk about reserving.
00:21:30.105 --> 00:21:31.671
This is more of a claims thing.
00:21:31.671 --> 00:21:40.184
How does accurate reserving impact an underwriter and how does not getting reserves up timely impact what your team's trying to do?
00:21:40.465 --> 00:21:46.086
Well, the reserves when we're looking at a risk, whether it's a piece of new business or whether it's a renewal.
00:21:46.086 --> 00:22:01.012
If there's open claims that have a reserve posted, that reflects what the claim professional and their management team believes is going to be the ultimate value of that claim or the ultimate cost of that claim.
00:22:01.012 --> 00:22:14.056
Again, I think that reserving claims is a really difficult science or a difficult art to really master, but the claim reps have a lot of experience in how much certain treatments or procedures are going to cost.
00:22:14.056 --> 00:22:19.352
They're experts in this is how long they're going to be out of work until they're able to go back to work.
00:22:19.352 --> 00:22:28.163
So we need to allocate this much for their payment or their paychecks in lieu of working, and it reflects what the final cost of a claim is likely to be.
00:22:28.163 --> 00:22:42.088
It helps us price the risk because we're trying to determine what the premium for this year is going to be, and one element of that is what have the losses been in the past five or seven years?
00:22:42.088 --> 00:22:55.930
So, if the reserve is accurate or close to accurate, that kind of helps us get into an area where we can see, based on the last couple of years, the last 60 months or 72 months.
00:22:55.930 --> 00:23:06.169
This is what we think we're going to need for the next 12 months If the reserves are not adequate, if the claim isn't reserved correctly or doesn't have any reserves.
00:23:06.529 --> 00:23:30.990
That can be a little bit tricky If you're working on an account that you wrote coverage on and you look at their loss experience on the mod worksheet in 2025 and you see a claim from 2022 developed and, and last year when you evaluated the risk it was a $2,000 claim on the last run in the mod sheet and then this year at renewal it's a $100,000 claim.
00:23:33.027 --> 00:23:40.612
Boy, that's a tough thing to kind of evaluate because somebody thought it was a not only claim and actually is much, much more significant.
00:23:40.612 --> 00:23:49.147
So maybe that was the claim that would have been kind of a late report, or maybe the company didn't have good information or who knows what the circumstances could be.
00:23:49.147 --> 00:23:58.006
But we do see that actually more than you'd believe in underwriting and it does make the pricing a little bit tricky because we have to say well, what happened on this claim.
00:23:58.006 --> 00:24:04.733
On the last run it says it was a minor issue and on the mod sheet this year it's reserved at $100,000.
00:24:04.733 --> 00:24:06.037
Something must have happened.
00:24:06.037 --> 00:24:08.464
Do we have our hands around what the exposures are?
00:24:08.464 --> 00:24:13.163
So it does lead to some questions and it kind of leads to some pricing steps for the carrier.
00:24:13.163 --> 00:24:19.924
But yeah, reserving practices are critical and really do impact kind of how the pricing is going to be for an underwriter.
00:24:20.286 --> 00:24:24.233
So, jeremy, I've had that exact circumstance happen in a prior life.
00:24:24.233 --> 00:24:25.705
I've been in claims for a while.
00:24:25.705 --> 00:24:44.112
This isn't a recent example, but we had a injured worker I think it might have been something minor like came in as like a shoulder sprain or something like that and eventually that injured worker needed to have surgery and the employer was one of these amazing employers that had modified duty.
00:24:44.112 --> 00:24:45.201
The guy was family.
00:24:45.201 --> 00:24:49.972
They got him in to work right away, so there really wasn't any lost time on that claim.
00:24:49.972 --> 00:25:01.924
But in that particular state there was still an impairment rating that was due, which falls under the indemnity category along with lost time, which makes it considered a lost time claim, even though he hadn't missed any days from work.
00:25:01.924 --> 00:25:18.007
Really, the adjuster just didn't think about that and two years later they put this large reserve up for his settlement for his impairment rating and that really frustrated the underwriter because they had already quoted the account without that information.
00:25:18.508 --> 00:25:29.121
So I just put that story out there as a cautionary tale for adjusters that what they do when they're reserving a file really does impact what the underwriters are trying to do on your side.
00:25:29.121 --> 00:25:36.448
So I appreciate you spending some time on that to explain that and I want to take that a step further than you know.
00:25:36.448 --> 00:25:42.767
I know some companies are really large and claims and underwriting maybe don't talk as much as they should, but why do you feel like that?
00:25:42.767 --> 00:25:45.393
Partnership between claims and underwriting is important?
00:25:45.393 --> 00:25:46.303
That's critical.
00:25:46.303 --> 00:25:47.026
It's critical.
00:25:48.140 --> 00:25:53.823
Underwriting companies' profitability is not just on the underwriting team, right, it's on everybody.
00:25:53.823 --> 00:25:57.637
It's everybody working together and claims is a big part of that.
00:25:57.637 --> 00:25:59.101
Many, many times.
00:25:59.101 --> 00:26:04.403
The claims team and the risk management team are really the eyes and ears for us.
00:26:04.403 --> 00:26:07.465
We don't often see a lot of our insureds.
00:26:07.465 --> 00:26:14.671
We don't talk to our insureds, we're not really engaging with our insureds and we rely on our risk management team.
00:26:14.711 --> 00:26:29.912
Have a client or an insured that maybe isn't as cooperative as we'd like, we feel like they're hiding something or just not being forthright.
00:26:29.912 --> 00:26:31.923
That's good information for us to know.
00:26:31.923 --> 00:26:40.068
It's probably not a great partnership then for our company and that insured and thankfully that hardly ever happens.
00:26:40.068 --> 00:27:02.771
But being able to communicate with our claims team on a regular basis before our recording today I got a note from one of our adjusters on that very thing, on something that one of our insured needed, and I just don't think that happens at a lot of places where claims and underwriting are separate silos and there's really not a unified togetherness about servicing a policy.
00:27:02.771 --> 00:27:15.691
So, yeah, communication on what's happening with accounts and if there's any challenges that claims is experiencing and needs, those things are critical to help keep the policy going smoothly.
00:27:15.691 --> 00:27:17.682
So I can't stress that enough.
00:27:17.682 --> 00:27:20.448
Communication is critical between disciplines.
00:27:21.108 --> 00:27:22.952
And then let's take it a step further.
00:27:22.952 --> 00:27:35.011
Jeremy, I know you and I work in a specialty niche in workers' comp where we ensure some pretty difficult risks, so we're probably built a little different than some of our competition out there.
00:27:35.011 --> 00:27:41.790
What are some of the solutions that we offer to the marketplace that maybe others don't?
00:27:41.790 --> 00:27:50.034
Tools that we can help them as far as their e-mod goes, things that we can do to really help them with their business.
00:27:50.440 --> 00:27:50.621
Yeah.
00:27:51.061 --> 00:27:58.403
Well, I think every carrier is similar in a lot of ways and there's a lot of good people that work at a lot of great underwriting companies.
00:27:58.403 --> 00:27:59.625
There's no doubt about that.
00:27:59.625 --> 00:28:13.528
I think one of the things that makes Berkeley Industrial special and a great solution for insureds and the agents and brokers that represent us is that we are very agile and very nimble.
00:28:13.528 --> 00:28:17.523
Right, we have a very responsive team that is here to help.
00:28:17.523 --> 00:28:21.292
I think our risk managers are some of the finest that you can find anywhere.
00:28:21.292 --> 00:28:24.926
There's a lot of good risk management professionals and workers' compensation.
00:28:24.926 --> 00:28:26.871
Our guys are right up there.
00:28:26.871 --> 00:28:29.423
They're all experienced in the field.
00:28:29.423 --> 00:28:46.300
They have industry experience before they've come to us on the carrier side and they really try to work collaboratively with our insurers to help make their programs better and safer in a realistic fashion.
00:28:46.300 --> 00:28:55.141
Right, in a fashion that is not micro ticky-tack, inspector-type, checklist-type of consulting.
00:28:55.141 --> 00:28:57.846
It's a very partnership-heavy.
00:28:57.846 --> 00:29:03.768
How can we collaborate to help with the realities of what you guys are insured, what they do?
00:29:04.400 --> 00:29:16.785
Likewise, I think our claims team is really special, because the claims team that you built, greg, are really experienced professionals who do a fantastic job.
00:29:17.349 --> 00:29:41.912
You have built the department to have folks that have, I would call, industry lows in terms of what their desk claim count is is, and that's on purpose because, as we mentioned earlier, we don't necessarily write a lot of companies that have a lot of claims in terms of the frequency with which they have claims Our customers.
00:29:41.912 --> 00:29:50.636
When they have claims, they're typically lost time and sometimes they're a little bit difficult or challenging because of the nature of what we insure.
00:29:50.636 --> 00:30:09.223
So our claims team, which you built strategically, are able to respond and provide a better customer service experience because they're not trying to manage hundreds of claims at the same time and bouncing from file to file.
00:30:09.223 --> 00:30:17.922
They can really work with our insureds, I think, in a little more collaborative fashion, and those factors are significant with the space that we're in.
00:30:17.922 --> 00:30:22.680
So again, I don't want to knock any other company or carrier.
00:30:22.680 --> 00:30:28.882
There's a lot of wonderful workers' comp carriers that do a great job, but I think our folks are top notch as well.
00:30:29.569 --> 00:30:29.971
I agree.
00:30:29.971 --> 00:30:31.292
I agree with everything you said there.
00:30:31.292 --> 00:30:33.557
I think we do a lot of things that are pretty special.
00:30:33.557 --> 00:30:59.116
I've worked a number of places and in good places, but the underwriting team, the claims team and the risk management team really are in lockstep and I had our attorney in the office last month, does a lot of work for us and one of the things he had told me he's like I have my associates handle some of my other accounts, but I always handle yours because your people are fantastic to work with and I don't have to pull them through the claim.
00:30:59.116 --> 00:31:16.884
They're working lockstep with me and I think, if you went around and looked at whether it's our risk management team or underwriting team, that engagement is where we stand out and that personal touch and the ability to really answer the phone and solve problems sets us apart a little bit from others that are out there.
00:31:17.425 --> 00:31:19.854
Jeremy, I really appreciate having you on this episode.
00:31:19.854 --> 00:31:23.592
I think this is always helpful just to revisit every so often, because it is confusing.
00:31:23.592 --> 00:31:30.133
One thing I've really been trying to focus on in my own life, and even with the podcast over the last couple of years, is gratitude.
00:31:30.133 --> 00:31:46.152
I felt like we live in a world where there is a lot of noise, and I think there could be a lot more happiness if we focus on the things that are most important and the things that we're really grateful for, and it's something that I've been working towards.
00:31:46.152 --> 00:31:53.174
So I would love it today if you could, jeremy, and it doesn't have to be work-related or it can be, but what's something you're grateful for.
00:31:53.435 --> 00:32:04.583
Well that's wonderful to ask and I appreciate it, but I'm going to stay right where we're at and I'm extremely grateful for the work I do.
00:32:04.583 --> 00:32:09.058
I'm grateful to work for WR Berkeley and Berkeley Industrial.
00:32:09.058 --> 00:32:19.212
We've got a fantastic team and I'm probably one of the you know maybe not a lot of people that wake up every day and love their job, love going to work, but I absolutely do.
00:32:19.212 --> 00:32:20.977
We have fantastic co-workers.
00:32:20.977 --> 00:32:23.143
As you know, we work with a lot of great people.
00:32:23.143 --> 00:32:27.398
Yeah, very, very grateful to have the opportunity to work here.
00:32:27.398 --> 00:32:28.622
It's awesome.
00:32:40.217 --> 00:32:43.578
Well, I'm going to hop on that same bandwagon, Jeremy.
00:32:43.578 --> 00:32:46.840
This last week I went through some challenging stuff where I had to.
00:32:46.840 --> 00:32:56.946
It's awesome thing that normally I would be worried about was taken care of, and we even had some really challenging losses that came in that everything was covered and I felt supported.
00:32:56.946 --> 00:33:10.857
I felt appreciated and grateful that I get to work with people who really not only do I call them my colleagues, but they're my friends, and that means a lot to me.
00:33:10.857 --> 00:33:20.373
So I'm going to stay in that same lane with you and certainly encourage our listeners to do right, think differently and don't forget to care.
00:33:20.373 --> 00:33:23.259
And like to also encourage you.
00:33:23.319 --> 00:33:29.565
If you haven't, please go on iTunes or Apple or wherever your streaming platform is.
00:33:29.565 --> 00:33:34.134
Give us a five-star rating, Leave us some comments so we can help some other people find the podcast.
00:33:34.134 --> 00:33:37.371
We feel like we're doing some good things and putting some good vibes out in the universe.
00:33:37.371 --> 00:33:38.976
We'd love this to reach some others.
00:33:38.976 --> 00:33:41.000
So if you can, please do that.
00:33:41.000 --> 00:33:47.569
And then we encourage you to follow us and look for our episodes to release every two weeks, as they do on Monday.
00:33:47.569 --> 00:33:49.050
Take care everybody.