Future Medical Whitepaper

Future medical claims are on the rise. It’s a phenomenon employers can’t afford to ignore. Athens Administrators research has found that future medical claims have proportionately increased relative to all workers’ compensation open indemnity claims, in both number of total open claims and total reserve dollars.

Those facts alone make it surprising that future medical claims don’t attract more attention. On a per claim average, they can be open for as many as 8, 10, or more years; have $40,000 or more in reserves; and can represent 35% of a total open indemnity inventory. The math is shocking: with 20 to 30 future medical claims in an inventory of 100, that means $800,000 to $1,400,000 could be tied up in reserves alone.

To control continued future medical inventory growth, it is critical to analyze and understand this swelling body of claims. This Athens Administrators report offers employers and organizations the information they need to do just that. This explains the history behind future medical claims, examines why they are increasingly common, and explores the implications of growing inventory and escalating medical costs for California’s workers’ compensation marketplace. It also clarifies for employers how future medical claims impact their programs, and the negative consequences they may hold for an organization.

Medicare settlement arrangements, medical costs that are increasing relative to wages, changing workforce demographics, and a decline in the frequency of new claim submissions, all have affected the demand for settlements with open medical awards. This Athens Administrators report helps employers understand the driving forces behind these influencing factors and other related trends, and offers effective management practices for impacting them. Future medical claims can be open for life. The deeper an employer’s knowledge of future claims is, the better the odds are for successful claim resolution.

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