Analysis of commercial lines insurance claims in the nursing home industry

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Schaufenbuel, Jason
Major Professor
Steven Freeman
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Agricultural and Biosystems Engineering

These studies provide information to the owners and operators of nursing homes, so they can better understand the causes of commercial insurance (property, auto, general liability, and workers’ compensation) claims in their industry. Insurance claim loss data are provided from a sample of nursing homes in the midwestern United States. The first article analyzes the commercial property, auto, and general liability claims from nursing homes from January 2007 and March 2017. Claim frequency is calculated based upon the number of bed years, with commercial property insurance having the greatest frequency of claims. Median incurred cost data are provided, permitting comparisons between lines of insurance coverage. Control measures are suggested to help nursing home operators reduce the potential for the most frequently occurring losses in their industry. The second article utilizes text mining to evaluate over 3,000 nursing home employee workers’ compensation claim descriptions to identify the frequent activities that lead to injury. Incurred loss information allows a review of the relationships between injury categories, word terms, and claim cost. The median claim cost per claim category is provided. The simple analysis process identifies specific activities which lead to injury, allowing the industry to better focus their injury reduction efforts than permitted through traditional classification systems. The final study evaluates 1,922 workers’ compensation claims related to resident handling. Definitions are established for the identified activities, with claim frequency and median cost data. The data indicate that all categories of resident handling claims have similar claim costs. Employers wanting to make the largest impact on their resident handling claim loss experience should simply focus interventions on those activities leading to the most injuries in their organization, or resident transfers, as they are the most frequent source of resident handling related injury in the industry. The provided data and analysis identify the most frequent sources of claims and relationships between claims and their respective costs. Suggested control measures are provided. The combination of data and controls allow organizations to compare their commercial insurance loss performance and take steps to reduce losses to enhance their profitability and improve resident and employee safety.

Sun Jan 01 00:00:00 UTC 2017