|
Performance Measure |
Definition |
|
Time to notice of injury and first indemnity payment
|
|
Date of injury to payor notice of injury |
Cumulative percentage of lost-time claims by period
based on the number of days from the date of injury to
the date of payor notification of injury
|
|
Date of employer notice to payor notice of injury |
Cumulative percentage of lost-time claims by period
based on the number of days from the date of employer
notification to the date of payor notification of injury
|
|
Date of injury to first indemnity payment |
Cumulative percentage of lost-time claims by period
based on the number of days from the date of injury to
the date of the first indemnity payment
|
Date of payor notice of injury to
first indemnity payment |
Cumulative percentage of lost-time claims by period
based on the number of days from the date of payor
notification of injury to the date of the first
indemnity payment |
|
Average benefit payments and claim costs
|
All paid claims
|
Total cost (medical and
indemnity benefits and benefit delivery expenses and
vocational rehabilitation provider expenses) per claim
|
The sum of the average medical and indemnity payments
per claim and benefit delivery
expenses and vocational rehabilitation provider expenses
per claim for all paid claims |
|
Benefit payment (medical and indemnity benefits) per
claim |
The sum of medical and indemnity payments for
all paid claims, divided by the
total number of all paid claims |
|
Medical payment per claim |
The sum of medical payments for all
paid claims, divided by the total number of all paid
claims |
|
Indemnity payment per claim |
The sum of indemnity payments for
all paid claims, divided by the total number of all paid
claims |
Benefit delivery expense per
claim |
The sum of benefit delivery expenses for
all paid claims, divided by the
total number of all paid claims |
|
Total incurred cost (medical and indemnity benefits and
other) per claim |
The sum of incurred medical and indemnity benefits and
other for all claims, divided by the total number of all
claims |
Incurred medical benefit per
claim |
The sum of incurred medical benefits for all claims,
divided by the total number of all claims |
|
Incurred indemnity benefit per claim |
The sum of incurred indemnity benefits for
all claims, divided by the total
number of all claims |
Claims with more than 7 days of lost time
|
Total cost (medical and
indemnity benefits and benefit delivery expenses and
vocational rehabilitation provider expenses) per claim
|
The sum of the average medical and indemnity payments
per claim and benefit delivery
expenses and vocational rehabilitation provider expenses
per claim for lost-time claims |
|
Benefit payment (medical and indemnity benefits) per
claim |
The sum of medical and indemnity payments for lost-time
claims, divided by the total number of lost-time claims |
|
Medical payment per claim |
The sum of medical payments for lost-time claims,
divided by the total number of lost-time claims |
|
Indemnity payment per claim |
The sum of indemnity payments for lost-time claims,
divided by the total number of lost-time claims |
Percentage of claims with vocational rehabilitation
maintenance benefits as a percentage of lost-time claims
|
The number of claims with vocational rehabilitation
maintenance benefits, divided by the total number of
lost-time claims |
Vocational rehabilitation maintenance benefit per claim
with vocational rehabilitation maintenance benefits
|
The sum of vocational rehabilitation maintenance
benefits for lost-time claims, divided by the total
number of claims with vocational rehabilitation
maintenance benefits |
Benefit delivery expense per
claim |
The sum of benefit delivery expenses for lost-time
claims, divided by the total number of lost-time claims |
|
Total incurred cost (medical and indemnity benefits and
other) per claim |
The sum of incurred medical and indemnity benefits and
other for lost-time claims, divided by the total number
of lost-time claims
|
Incurred medical benefit per
claim |
The sum of incurred medical benefits for lost-time
claims, divided by the total number of lost-time claims |
|
Incurred indemnity benefit per claim |
The sum of incurred indemnity benefits for lost-time
claims, divided by the total number of lost-time claims |
|
Average benefit payments and claim costs
|
Temporary disability claims
|
|
Temporary disability claims as a percentage of all
lost-time claims |
The number of temporary disability claims, divided by
the total number of lost-time claims |
Total cost (medical and
indemnity benefits and benefit delivery expenses and
vocational rehabilitation provider expenses) per claim
|
The sum of the average medical and indemnity payments
per claim and benefit delivery
expenses and vocational rehabilitation provider expenses
per claim for claims classified as temporary disability
claims |
|
Benefit payment (medical and indemnity benefits) per
claim |
The sum of medical and indemnity payments for claims
classified as temporary disability claims, divided by
the total number of temporary disability claims
|
|
Medical payment per claim |
The sum of medical payments for claims classified as
temporary disability claims, divided by the total number
of temporary disability claims
|
|
Indemnity payment per claim |
The sum of indemnity payments for claims classified as
temporary disability claims, divided by the total number
of temporary disability claims
|
Temporary disability payment
per temporary disability claim |
The sum of temporary disability payments, divided by the
total number of lost-time claims classified as temporary
disability claims
|
Permanent disability claims
|
|
Permanent disability claims as a percentage of all
lost-time claims |
The number of permanent disability claims, divided by
the total number of lost-time claims |
Total cost (medical and
indemnity benefits and benefit delivery expenses and
vocational rehabilitation provider expenses) per claim |
The sum of the average medical and indemnity payments
per claim and benefit delivery
expenses and vocational rehabilitation provider expenses
per claim for claims classified as permanent disability
claims
|
|
Benefit payment (medical and indemnity benefits) per
claim |
The sum of medical and indemnity payments for claims
classified as permanent disability claims, divided by
the total number of permanent disability claims
|
|
Medical payment per claim |
The sum of medical payments for claims classified as
permanent disability claims, divided by the total number
of permanent disability claims
|
|
Indemnity payment per claim |
The sum of indemnity payments for claims classified as
permanent disability claims, divided by the total number
of permanent disability claims
|
Permanent disability payment
per permanent disability claim |
The sum of permanent disability payments, divided by the
total number of lost-time claims classified as permanent
disability claims
|
Permanent partial disability (PPD) claims (and lump
sums)
|
|
PPD/lump-sum claims as a percentage of all lost-time
claims |
The number of PPD or lump-sum claims, divided by the
total number of lost-time claims
|
Total cost (medical and
indemnity benefits and benefit delivery expenses and
vocational rehabilitation provider expenses) per claim
|
The sum of the average medical and indemnity payments
per claim and benefit delivery expenses and vocational
rehabilitation provider expenses per claim for claims
classified as PPD or lump-sum claims |
|
Benefit payment (medical and indemnity benefits) per
claim |
The sum of medical and indemnity payments for claims
classified as PPD or lump-sum claims, divided by the
total number of PPD or lump-sum claims
|
|
Medical payment per claim |
The sum of medical payments for claims classified as PPD
or lump-sum claims, divided by the total number of PPD
or lump-sum claims
|
|
Indemnity payment per claim |
The sum of indemnity payments for claims classified as
PPD or lump-sum claims, divided by the total number of
PPD or lump-sum claims
|
|
PPD/lump-sum payment per PPD/lump-sum claim |
The sum of PPD payments and lump-sum settlements,
divided by the total number of lost-time claims
classified as PPD or lump-sum claims
|
Temporary disability payment
per PPD/lump-sum claim |
The sum of temporary total disability and temporary
partial disability payments, divided by the total number
of lost-time claims classified as PPD or lump-sum claims
|
|
Claims with lump-sum settlements as a percentage of
lost-time claims |
The number of claims with lump-sum settlements, divided
by the total number of lost-time claims |
Lump-sum settlement payment per claim with lump-sum
settlements
|
The sum of lump-sum settlement payments, divided by the
total number of claims with lump-sum settlements |
|
Average benefit payments and claim costs
|
Three categories of PPD/lump-sum claims
|
Claims with lump-sum settlements but no periodic PPD
payments as a percentage of
lost-time claims
|
The number of claims with lump-sum settlements but no
periodic PPD payments, divided by the total number of
lost-time claims |
Lump-sum settlement payment per claim with lump-sum
settlement but no periodic PPD payments
|
The sum of lump-sum settlement payments, divided by the
total number of claims with lump-sum settlements but no
periodic PPD payments |
Claims with periodic PPD payments but no lump-sum
settlement as a percentage of lost-time claims
|
The number of claims with periodic PPD payments but no
lump-sum settlement, divided by the total number of
lost-time claims |
PPD payment per claim with periodic PPD payments but no
lump-sum settlement
|
The sum of PPD payments, divided by the total number of
claims with periodic PPD payments but no lump-sum
settlement |
Claims with both lump-sum settlements and periodic PPD
payments as a percentage of
lost-time claims
|
The number of claims with both lump-sum settlements and
periodic PPD payments, divided by the total number of
lost-time claims |
PPD/lump-sum payment per
claim with both lump-sum settlement and periodic PPD
payments
|
The sum of lump-sum settlements and PPD payments,
divided by the total number of claims with both lump-sum
settlement and periodic PPD payments |
Permanent total disability claims
|
Permanent total disability claims as a percentage of all
lost-time claims
|
The number of permanent total disability claims, divided
by the total number of lost-time claims |
Total cost (medical and
indemnity benefits and benefit delivery expenses and
vocational rehabilitation provider expenses) per claim
|
The sum of the average medical and indemnity payments
per claim and benefit delivery
expenses and vocational rehabilitation provider expenses
per claim for claims classified as permanent total
disability claims |
|
Benefit payment (medical and indemnity benefits) per
claim |
The sum of medical and indemnity payments for claims
classified as permanent total disability claims, divided
by the total number of permanent total disability claims |
|
Medical payment per claim |
The sum of medical payments for claims classified as
permanent total disability claims, divided by the total
number of permanent total disability claims
|
|
Indemnity payment per claim |
The sum of indemnity payments for claims classified as
permanent total disability claims, divided by the total
number of permanent total disability claims
|
Permanent total disability
payment per permanent total disability claim |
The sum of permanent total disability payments, divided
by the total number of lost-time claims classified as
permanent total disability claims
|
Fatality claims
|
Fatality claims as a percentage
of all lost-time claims |
The number of fatality claims, divided by the total
number of lost-time claims |
Total cost (medical and
indemnity benefits and benefit delivery expenses and
vocational rehabilitation provider expenses) per claim
|
The sum of the average medical and indemnity payments
per claim and benefit delivery
expenses and vocational rehabilitation provider expenses
per claim for claims classified as fatality claims |
|
Benefit payment (medical and indemnity benefits) per
claim |
The sum of medical and indemnity payments for claims
classified as fatality claims, divided by the total
number of fatality claims
|
|
Medical payment per claim |
The sum of medical payments for claims classified as
fatality claims, divided by the total number of fatality
claims |
|
Indemnity payment per claim |
The sum of indemnity payments for claims classified as
fatality claims, divided by the total number of fatality
claims |
|
Fatality payment per fatality claim |
The sum of fatality payments, divided by the total
number of lost-time claims classified as fatality claims |
|
Vocational rehabilitation costs and frequency
|
Percentage of lost-time claims with vocational
rehabilitation maintenance benefits
|
The number of lost-time claims with vocational
rehabilitation maintenance benefits, divided by the
total number of lost-time claims |
Percentage of lost-time claims with vocational
rehabilitation expenses
|
The number of lost-time claims with vocational
rehabilitation expenses, divided by the total number of
lost-time claims |
Average vocational rehabilitation expense per lost-time
claim with vocational rehabilitation
expenses
|
The sum of payments for vocational rehabilitation
expenses, divided by the total number of lost-time
claims with vocational rehabilitation expenses
|
|
Attorney involvement and benefit delivery expenses
|
|
Percentage of lost-time claims with defense attorney
payments |
The number of lost-time claims with defense attorney
payments greater than $500, divided by the total number
of lost-time claims
|
Average defense attorney
payment per lost-time claim with defense attorney
payments |
The sum of payments to defense attorneys, divided by the
total number of lost-time claims for claims with defense
attorney payments greater than $500
|
Percentage of lost-time claims with medical cost
containment expenses
|
The number of lost-time claims with medical cost
containment expenses, divided by the total number of
lost-time claims |
Average medical cost
containment expense per lost-time claim with medical
cost containment expenses
|
The sum of payments for medical cost containment,
divided by the total number of lost-time claims with
medical cost containment expenses |
|
Percentage of lost-time claims with medical-legal
expenses |
The number of lost-time claims with medical-legal
expenses, divided by the total number of lost-time
claims |
|
Average medical-legal expense per lost-time claim with
medical-legal expenses |
The sum of payments for medical-legal expenses, divided
by the total number of lost-time claims with
medical-legal expenses
|
|
Duration and claim closure patterns
|
|
Lost-time claims by duration |
The cumulative percentage of lost-time claims with
equivalent weeks of temporary disability payments
(temporary total disability plus temporary partial
disability) within each specified period
|
|
Lost-time claims by duration, incurred benefits as
numerator |
The cumulative percentage of lost-time claims with
equivalent weeks of incurred indemnity benefits within
each specified period
|
|
Lost-time claims closed |
The percentage of lost-time claims closed as of 6 months
after the end of the accident year |
|
Date of injury to date of claim closure |
The cumulative percentage of closed lost-time claims in
which the lag between the injury date and the claim
closure date falls within each specified period |
