With premiums soaring past $64 billion yet premium rates paradoxically softening, the U.S. workers' compensation landscape is a complex tapestry of massive financial flows, evolving risks, and human stories.
Key Takeaways
- In 2022, the U.S. workers' compensation direct premiums written reached $64.1 billion, marking a 7.8% increase from 2021.
- The workers' compensation industry's combined ratio improved to 96.8% in 2022 from 98.5% in 2021.
- Total workers' comp market size projected to grow at 5.2% CAGR from 2023-2030.
- The national average workers' compensation premium rate index decreased by 1.2% in 2023, reflecting ongoing softening in the market.
- California had the highest workers' comp premiums at $12.4 billion in 2022, representing 19.3% of the national total.
- Nationwide advisory premium rate decreased by 3.9% for voluntary market in 2024.
- Workers' compensation medical losses in 2022 totaled $32.4 billion, accounting for 50.6% of total incurred losses.
- Indemnity benefits paid out $17.8 billion in 2022, comprising 27.8% of total benefits.
- The average cost per workers' comp claim rose 4.1% in 2022 to $41,857.
- Approximately 2.7 million nonfatal workplace injuries and illnesses were reported in private industry in 2022, with workers' comp covering most claims.
- Private industry employment covered by workers' comp reached 142 million workers in 2022.
- 4,795 fatal work injuries occurred in 2022, with average workers' comp benefit of $1.2 million per fatality.
- Workers' comp fraud costs the industry an estimated $5 billion annually.
- States with monopolistic funds wrote $3.6 billion in premiums in 2022.
- Telemedicine utilization in workers' comp claims rose 25% in 2022.
Despite rising costs, the U.S. workers' compensation market remains profitable and competitive.
Claims and Losses
- Workers' compensation medical losses in 2022 totaled $32.4 billion, accounting for 50.6% of total incurred losses.
- Indemnity benefits paid out $17.8 billion in 2022, comprising 27.8% of total benefits.
- The average cost per workers' comp claim rose 4.1% in 2022 to $41,857.
- Medical loss ratio for workers' comp was 52% in 2022.
- Lost-time claims frequency decreased 2.5% in 2022.
- Average weekly wage replacement benefit is 66.7% of pre-injury wage nationally.
- Indemnity claim frequency down 5.8% from 2018-2022.
- COVID-19 claims accounted for 1.2% of total claims in 2022.
- 1.4 million workers' comp claims filed in 2022.
- Average medical claim cost $38,250 in 2022.
- Musculoskeletal disorders represent 32% of all claims.
- Fatality claims costs averaged $1,370,000 in 2022.
- Slips, trips, falls: 27% of nonfatal injuries.
- Total incurred losses $64.0 billion in 2022.
- Overexertion claims 22% of total.
- Average PPD benefit duration 112 weeks.
- Contact with objects 18% of injuries.
- Medical payments per lost-time claim $29,800.
- Sprains/strains 30% of claims.
- Total benefits paid $30.2 billion in 2022.
- Fatalities in transportation 1,500 in 2022.
- Indemnity loss costs declined 1.4%.
- Average claim severity up 3.7%.
- Lost wage benefits $12.5 billion.
- Needlestick injuries down 20%.
- Medical-only claims 62% of total.
- Hearing loss claims 4% of total.
- Permanent total disability rare at 0.5%.
- Violence assaults 12% injuries.
- Attorney involvement 25% of claims.
- Carpal tunnel 5% of claims.
- Temporary total benefits dominant 55%.
- Burns 2% of claims.
- Settlement rates 85% of litigated claims.
- Fractures 8% of injuries.
- Max TTD duration avg 104 weeks.
- Amputations avg cost $150,000.
- PPD settlements median $45,000.
- Concussions rising 12% yearly.
Claims and Losses Interpretation
While we're getting slightly better at not getting hurt at work, the remaining injuries are becoming a more expensive and complex tapestry of papercuts and concussions, where the cost of care now eclipses the cost of wages, proving that the real heavy lifting is in the paperwork and payouts.
Coverage and Employment
- Approximately 2.7 million nonfatal workplace injuries and illnesses were reported in private industry in 2022, with workers' comp covering most claims.
- Private industry employment covered by workers' comp reached 142 million workers in 2022.
- 4,795 fatal work injuries occurred in 2022, with average workers' comp benefit of $1.2 million per fatality.
- 88% of U.S. workers are covered by state-mandated workers' comp laws.
- Texas non-subscriber employers cover 27% of workforce without workers' comp.
- Return-to-work rate within 6 months reached 70% in 2022.
- Manufacturing sector had highest claim costs at $1.2 billion per 100 full-time workers.
- 65% of employers offer safety programs reducing premiums by 10-20%.
- Government workers covered: 12 million in 2022.
- Construction injury rate 2.8 per 100 workers.
- Agriculture workers comp coverage 85%.
- Healthcare workers injury rate 5.5 per 100.
- Self-insured market 15% of premiums.
- Retail trade claims frequency 1.8 per 100.
- Independent contractors coverage gap 25%.
- Transportation warehousing rate 3.2/100.
- Gig economy claims projected 20% rise.
- Mining injury rate highest 3.5/100.
- Federal employees covered by FECA: 2.9 million.
- Utilities low rate 1.2/100.
- Finance sector rate 0.8/100.
- Maritime coverage special 95%.
Coverage and Employment Interpretation
The grim reality of workplace safety is that nearly 3 million nonfatal injuries were reported last year, reminding us that while a 70% return-to-work rate is commendable progress, we must still fiercely address the sectors with staggering injury rates and the millions, like independent contractors and Texas non-subscribers, who remain perilously exposed.
Market Size and Growth
- In 2022, the U.S. workers' compensation direct premiums written reached $64.1 billion, marking a 7.8% increase from 2021.
- The workers' compensation industry's combined ratio improved to 96.8% in 2022 from 98.5% in 2021.
- Total workers' comp market size projected to grow at 5.2% CAGR from 2023-2030.
- U.S. workers' comp earned premiums hit $59.2 billion in 2022.
- Global workers' comp market valued at $232 billion in 2022.
- Carrier surplus in workers' comp grew 8.4% to $45 billion in 2022.
- Projected 4.5% premium growth in 2024.
- Industry policy count increased 1.8% to 3.2 million in 2022.
- Net premiums written up 6.5% to $55.3 billion.
- P&C insurers hold 65% market share in workers' comp.
- Dividend payments to policyholders $2.1 billion in 2022.
- Mutual companies wrote 42% of premiums.
- Pre-tax operating gain $6.8 billion.
- Top 25 groups hold 56% market share.
- Underwriting profit margin 4.5%.
- Investment yield 3.2% average.
- Reinsurance recovery $1.5 billion.
- Expense ratio 28.4%.
- Loss reserve development favorable $2.3B.
- Leverage ratio 1.8:1.
- Stock companies 55% premiums.
Market Size and Growth Interpretation
Despite soaring premiums and cozy profits, the industry's improving health suggests employers are paying a steeper price for a safety net that, thankfully, seems to be holding strong.
Premiums and Rates
- The national average workers' compensation premium rate index decreased by 1.2% in 2023, reflecting ongoing softening in the market.
- California had the highest workers' comp premiums at $12.4 billion in 2022, representing 19.3% of the national total.
- Nationwide advisory premium rate decreased by 3.9% for voluntary market in 2024.
- Florida's workers' comp rates declined by 10.2% in 2023.
- Workers' comp insurance penetration rate is 92% in construction industry.
- New York workers' comp premiums totaled $5.8 billion in 2022.
- Illinois approved 12.1% rate decrease for 2023.
- Pennsylvania premiums $3.9 billion, up 6.2% in 2022.
- Michigan rate index down 8.7% for 2023.
- Texas premiums $4.1 billion despite opt-out provision.
- Georgia approved 9.4% rate reduction in 2023.
- Indiana premiums grew 5.3% to $1.2 billion.
- Kentucky rate decrease 11.5% in 2023.
- Louisiana premiums $1.1 billion.
- Missouri rate index -7.2%.
- North Carolina premiums $2.0 billion.
- Ohio BWC premiums $4.2 billion.
- Oklahoma rate decrease 6.8%.
- Oregon monopolistic fund $1.0 billion premiums.
- South Carolina rate -5.9%.
- Washington state fund $1.4 billion.
- Alabama premiums up 4.2%.
Premiums and Rates Interpretation
Despite California stubbornly clinging to its title as the nation's most expensive place to get sued for a stubbed toe, employers everywhere else are quietly enjoying a widespread discount party, with rates falling faster than morale on a Monday morning.
Trends and Regulations
- Workers' comp fraud costs the industry an estimated $5 billion annually.
- States with monopolistic funds wrote $3.6 billion in premiums in 2022.
- Telemedicine utilization in workers' comp claims rose 25% in 2022.
- Opioid prescriptions in workers' comp fell 45% from 2017 to 2022.
- ESG factors influencing 15% of workers' comp investment decisions in 2023.
- AI utilization in claims processing up 30% in 2023.
- Pharmacy costs down 3.2% per claim in 2022.
- Benefit adequacy improved in 42 states per 2023 study.
- Mental health claims up 15% post-COVID.
- Captive insurance growing at 7% annually.
- Climate risk impacting claims up 8%.
- PBMs managing 90% of pharmacy benefits.
- Cybersecurity incidents cost $300M yearly.
- Wellness programs reduce claims 18%.
- Blockchain in claims piloted by 10% carriers.
- Functional restoration success 75%.
- Drones reducing inspections 40%.
- VR training cuts accidents 30%.
- Predictive analytics accuracy 85%.
- IoT sensors prevent 22% incidents.
Trends and Regulations Interpretation
While the industry is impressively slashing opioid use and boosting benefit adequacy, it must also outrun a $5 billion fraud problem and rising cyber costs, all while cautiously embracing AI, blockchain, and drones that promise a more efficient, if not slightly sci-fi, future.
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