Importance

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Abstract

A system funds future losses incurred by an insurance carrier on active workers' compensation insurance claims. Statistical models are used to predict future costs and durations of claims. The statistical models are generated by applying statistical analysis techniques to representative historical insurance claim data with the aid of a professional statistician. Forecasting accuracy is improved by generating several models wherein each model represents a predefined type of insurance claim. Each model is applied to active claims of the corresponding type to obtain cost and duration predictions for those claims. A total cost prediction for a claim is proportioned among various cost categories to more accurately reflect actual and predicted claim costs. For each claim, a reserve amount is calculated which is the predicted cost minus the amount of money paid to date on the claim. Balancing of the respective reserve amounts computed for active claims is achieved by use of a hypothetical fund which transfers reserve money from overpredicted claims to the reserves of underpredicted claims. A total reserve amount is calculated for each claim, and an aggregate reserve amount is calculated for all the carrier's active claims. The aggregate reserve amount is used to set a loss reserve account maintained by the carrier to fund future losses incurred on those claims. A system computer and program generate the statistical models. A carrier-accessible computer houses the models for application to active claims. A carrier host computer stores and updates the active claims of the insurance carrier.

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First Claim