Insurance Claims Management Statistics 2024 - Everything You Need to Know

Are you looking to add Insurance Claims Management to your arsenal of tools? Maybe for your business or personal use only, whatever it is – it’s always a good idea to know more about the most important Insurance Claims Management statistics of 2024.

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On this page, you’ll learn about the following:

Best Insurance Claims Management Statistics

Best Insurance Claims Management Statistics

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Insurance Claims Management Benefits Statistics

Insurers paid $3.7 in indemnity benefits (53% for temporary disability and 36% for permanent partial disability). ^[0]

Insurance Claims Management Usage Statistics

According to industry experts, retaliation and sexual harassment claims, gig worker classification, the gender pay gap and medical marijuana usage were among the top trending employment practices litigation cases in 2020. ^[1]

Insurance Claims Management Market Statistics

The NCCI argued for a rate reduction in 2019 of 16.8% in the voluntary market, thanks to a reduction in accidents and injuries. ^[0]

Insurance Claims Management Latest Statistics

Overall employment of claims adjusters, appraisers, examiners, and investigators is projected to decline 3 percent from 2020 to 2030. ^[2]
Technological advancements will likely stimulate industry revenue growth Insurance Claims Processing Software in the US industry trends. ^[3]
attach_money Market Size $16bn business Number of Businesses 878 poll Average Industry Profit Margin x.x% Purchase this report or a membership to unlock the average company profit margin for this industry. ^[3]
37,561 Biggest companies in the Insurance Claims Processing Software industry in the US pie_chart Accenture PLC Market Share x.x% Purchase this report or a membership to unlock our full summary for this industry. ^[3]
Providing automated billing solutions 00.5% increase 0. ^[3]
About 90 percent of all U.S. natural disasters involve flooding, according to the National Flood Insurance Program , administered by the Federal Emergency Management Agency. ^[4]
Between 2010 and 2018 the annual cost of flood damage in the United States was approximately $17 billion, according to FEMA , and was four times more than was recorded in the 1980s. ^[4]
On average, nationwide only 30 percent of homes in the highest risk areas have flood coverage, according to the Risk Management and Decision Processes Center of the Wharton School at the University of Pennsylvania. ^[4]
Latest data from the Triple I shows that nationwide, 27 percent of all American homeowners policyholders said they had flood insurance, a higher rate than estimates cited by the NFIP and other observers. ^[4]
results found that the rate was about 12 percent to 14 percent. ^[4]
A First Street study estimates economic damage due to flooding will grow over the next 30 years by 61 percent, to an average estimated annual loss of $7,563 per property for an estimated total loss of $32.3 billion. ^[4]
This total loss is almost double the cost of flood damage of about $17 billion annually between 2010 and 2018, according to FEMA’s data, cited above. ^[4]
According to Artemis, the 2021 cat bond raises FEMA’s NFIP flood reinsurance program funds to $2.925 billion of reinsurance protection, which will be reduced to $2.425 billion as the 2018 bond matures. ^[4]
According to FEMA more than 200,000 policies will have a significant increase in premiums while about 1.15 million policies will have a decrease. ^[4]
As of August 31, 2021, 88 percent of NFIP policies were held in the WYO program. ^[4]
As of August 31, 2021, 69 percent of policies covered single family homes; 21 percent covered condominiums and other residential properties; and 4 percent covered twoto four. ^[4]
In 2019 net premiums written for private flood insurance totaled $287.2 million, down 46.9 percent from $540.9 million in 2018, according to NAIC data compiled by S&P Global Market Intelligence. ^[4]
On the restated basis, net premiums written for 2019, at $287.2 million, were down at the much lower rate of 6.7 percent. ^[4]
Direct premiums written for private flood insurance totaled $522.6 million in 2019, up 45 percent from $360.1 million in 2018, excluding FM Global’s 2018 private flood premiums. ^[4]
Despite these dangers, on average, in the United States only 30 percent of homes in the highest risk areas have flood coverage, according to the Risk Management and Decision Processes Center of the Wharton School at the University of Pennsylvania. ^[4]
Rank Group/company Direct premiums written Market share 1 Zurich Insurance Group $168,788 16.0% American International Group 156,871 14.9. ^[4]
The reconstruction cost is based on the 100 percent destruction of the residential structure, using a combined cost of construction materials, equipment and labor costs, calculated by geographic location. ^[4]
It’s a 10.7% decrease from 2019 when 5,333 workers died as a result of a workplace incident. ^[0]
According to the National Safety Council, construction has reported the most number of deaths since 2012. ^[0]
It identifies the “Fatal Four” construction accidents, which accounted for 58.6% of all construction worker deaths in 2018. ^[0]
According to OSHA, if workplaces could eliminate the fatal four, they would save 591 lives every year. ^[0]
And of those reported, 33.2% were related to diseases due to viruses not elsewhere classified, which includes COVID. ^[0]
The number of serious injuries has increased from 16% to 21% between 2001 and 2017. ^[0]
22% of serious claims were related to loading trucks and trailers. ^[0]
Arborists and tree related injuries made up 34% of the top 100 most expensive claims in this industry. ^[0]
Young workers made up 50% of serious injuries. ^[0]
Another 46% to 55% of injuries occurred in the first year on the job. ^[0]
The number of fatal injuries for this population increased from 20.4% in 2019 to 22.5% in 2020. ^[0]
Fatalities are up 21.9% since 2016 and have increased to more than 1,000 per year over the last two years. ^[0]
BLS data indicates that in 2019, Hispanic or Latino workers made up 18% of the US workforce. ^[0]
But, they accounted for 20% of workers who died on the job. ^[0]
In 2018, total losses were $13.3 billion or 77% of the calendar year premium. ^[0]
the most prolonged payouts of any state Data shows 56% of accident per year medical payments get paid more than three years after the beginning of the year of injury. ^[0]
However, the national average of claims paid after three years is 33%. ^[0]
The state takes 11 years to settle 95% of indemnity claims. ^[0]
The study found that 23% of workers said the claims process was negative or neutral with longer claims processing contributing to a poorer experience. ^[0]
The results found that engaging nurses early could knock as much as 50% off the medical bill. ^[0]
Other surprising news Lockton reviewed over 200,000 claims and found 67% of denied claims become paid claims within one year. ^[0]
And when those claims transition to paid, they cost an average of 55% more than the original claim might have. ^[0]
In the United States, the workers compensation insurance industry grew by 0.8% between 2015 and 2020. ^[0]
Between 2015 and 2018, the net premiums written grew by 2.1% despite lower premium prices during the same period. ^[0]
The average cost per $100 fell, as the WCIB predicted, to $1.77 in 2020. ^[0]
Written premium in 2020 dropped to an eight year low, down 23% from a peak of $18.1 billion in 2016. ^[0]
Between 2016 and 2018, the percentage of private sector employers paying workers comp premiums fell from 78% to 72%. ^[0]
Additionally, 67 72% of subscribers reported their premiums either fell or remained the same for the year 2018. ^[0]
The total recordable incidence rate decreased by 3.6% in 2020, despite the COVID. ^[0]
Sexual harassment claims represented roughly one third (31.7%). ^[1]
Just a 1 percent improvement in the loss ratio for a $1 billion insurer is worth more than $7 million on the bottom line. ^[5]
Awards to disabled workers accounted for 89 percent of awards to all disabled beneficiaries. ^[6]
Workers accounted for the largest share of disabled beneficiaries. ^[6]
The largest category of diagnoses was diseases of the musculoskeletal system and connective tissue. ^[6]
First, all data for those years are based on 100 percent data files. ^[6]
Scott’s assistant notifies him that his mobility insurance premium will increase by 4 to 8 percent based on the route he selects and the volume and distribution of other cars on the road. ^[7]
It also alerts him that his life insurance policy, which is now priced on a “payasyou live” basis, will increase by 2 percent for this quarter. ^[7]
** 75% of patients are looking up the cost of medical procedures online. ^[8]
62% of patients said knowing their outof pocket expenses in advance of service impacts the likelihood of pursuing care. ^[8]
49% of patients said having clear information on expected outof pocket costs before receiving treatment impacts their decision to use a healthcare provider. ^[8]
A new TransUnion Healthcare analysis revealed that patients experienced an 11% increase in average outof pocket costs during 2017, rising from $1,630 in Q4 2016 to $1,813 in Q4 2017. ^[8]
The analysis also revealed that in 2017, on average, 49% of patient outofpocket costs per healthcare visit were below $500; 39% were $501 $1,000; and 12% were more than $1,000. ^[8]
Total hospital revenue attributable to patient financial responsibility after insurance increased 88 percent between 2012 and 2017 Source. ^[8]
69% have a budget process that takes more than three months from initial rollout to board presentation (the process takes more than six months for 9% of these organizations). ^[8]
41% use rolling forecasts to complement or to replace an annual budgeting process (31% have to plans to implement rolling forecasts). ^[8]
The administrative costs associated with billing and insurance related activities as estimated to be up to 25.2% for emergency department visits. ^[8]
Associated With Physician Billing and InsuranceRelated Activities at an Academic Health Care System Patient healthcare costs – including both deductibles and outof pocket maximum payments – have increased by almost 30% percent since 2015. ^[8]
83% of Physician Practices under five practitioners said the slow payment of high deductible plan patients are their top collection challenge, followed by the difficulties that practice staff have at communicating patient payment accountability (81%). ^[8]
16% have a deductible under $500 19% have a deductible between $500 and $999. ^[8]
46% have a deductible between $1,000 and $2,999 6% have a deductible between $3,000 and $3,999 6% have a deductible that is $4,000 or higher. ^[8]
3% have a deductible under $500. ^[8]
11% have a deductible between $500 and $999. ^[8]
29% have a deductible between $1,000 and $2,999. ^[8]
26% have a deductible between $3,000 and $4,999. ^[8]
23% have a deductible of $5,000 or higher. ^[8]
68% of patients failed to fully pay off medical bill balances in 2016, up from 53 percent in 2015, and 49 percent in 2014. ^[8]
This number is expected to climb to 95% by 2020. ^[8]
67% of Americans are either very worried or somewhat worried about unexpected medical bills (compared to 41% who are very or somewhat worried about paying their rent or mortgage). ^[8]
Consumers are demanding more from healthcare92% of consumers want to know payment responsibility prior to a provider visit74% of consumers are confused by Explanation of Benefits and. ^[8]
medical bills73% of providers report that it takes one month or longer to collect from patients. ^[8]
The Rise of Self Pay Accounts , The Association of Credit and Collection Professionals, Collector Magazine , February 2015 30% of the average healthcare bill now comes from the patient’s pocket. ^[8]
74 percent of healthcare providers reported an increase in patient financial responsibility in 2015 90% of patients felt it was important to know their payment responsibility upfront. ^[8]
2015 U.S. health care spending increased 4.6 percent to reach $3.6 trillion, or $11,172 per person in 2018. ^[8]
The growth in 2018 was faster than in 2017 when health care spending increased 4.2 percent. ^[8]
The faster growth in 2018 was associated with faster growth in the net cost of health insurance, which increased 13.2 percent following growth of 4.3 percent in 2017, due primarily to the reinstatement of the health insurance tax in 2018. ^[8]
The overall share of gross domestic product related to health care spending was 17.7 percent in 2018, down from 17.9 percent in 2017. ^[8]
The insured share of the population was 90.6 percent in 2018 and 90.8 percent in 2017, as the number of uninsured increased by 1 million to 30.7 million in 2018. ^[8]
75% of patients say that understanding their outof pocket costs improves their ability to pay for healthcare. ^[8]
62% reported being either sometimes or always surprised by outof. ^[8]
Medicaid DSH Payments Cover 51% of Uncompensated Care Costs, RevCycle Intelligence, August 6, 2019. ^[8]
The average single premium increased 4% and the average family premium increased 5% over the past year. ^[8]
Workers’ wages increased 3.4% and inflation increased 2%. ^[8]
U.S. hospitals provided $45.9 billion in uncompensated care in 2012, representing 6.1 percent of annual hospital expenses. ^[8]
In 2018, 30.4 million persons of all ages (9.4%). ^[8]
National Health Interview Survey Early Release Program, CDC PPOs continue to be the most common plan type, enrolling 44% of covered workers in 2019. ^[8]
Thirty percent of covered workers are enrolled in a high deductible plan with a savings option , 19% in an HMO, 7% in a POS plan, and 1% in a conventional plan. ^[8]
2019 Employer Health Benefits Survey, Kaiser Family Foundation, September 25, 2019 28% of uninsured adults either delayed or did not receive care because of cost Source. ^[8]
Patients’ outof pocket costs averaged $1,109 for an outpatient visit in 2018, up 12% compared with $990 in 2017. ^[8]
68% of Consumers Did Not Pay Patient Financial Responsibility, RevCycle Intelligence, June 27, 2017. ^[8]
80 percent of patients say they would prefer to pay for their care online. ^[8]
The percentage of persons under age 65 with private health insurance enrolled in a high deductible health plan increased from 43.7% in 2017 to 45.8% in 2018. ^[8]
National Health Interview Survey Early Release Program, CDC 68% of hospital bills under $500 were not paid in full Source. ^[8]
In 2020, 32% of American workers had medical debt Source. ^[8]
32% of American workers have medical debt—and over half have defaulted on it. ^[8]
A 2013 study found that 26% of bankruptcies were due to medical debt Source. ^[8]
11% of people surveyed with medical debt in 2017 were 27 years old Source. ^[8]
An estimated 48 million people were paying off medical debt in 2012, up from 44 million in 2010 and 37 million in 2006. ^[8]
In 2012, 41 percent of adults reported that they had medical debt or trouble paying medical bills. ^[8]
Of those who reported difficulties paying medical bills or paying off medical debt, 42 percent said they received a lower credit rating as result of unpaid medical bills. ^[8]
In 2012, 43 percent of adults, or 80 million people, said they had skipped or delayed getting needed health care or filling prescriptions because of the cost. ^[8]
More than a quarter of adults with a chronic health condition said they had skipped doses or not filled a prescription for their health condition because of the cost. ^[8]
62% of ablebodied adults enrolled in Medicaid are either working parttime or full. ^[8]
Understanding the Intersection of Medicaid, Work, and COVID 19 Medicaid spending grew 2.9% to $613.5 billion in 2019. ^[8]
Like your typical consumer of goods, over 92% of patients want to know outof. ^[8]
In fact, 74% of patients are confused by their medical bills. ^[8]
According to studies, patients prefer this 62% of patients said knowing their outof pocket expenses in advance of service impacts the likelihood of pursuing […]. ^[8]
According to 2018 data compiled by MedData, 83 percent of physician practices reported that their top collection challenge was slow payment along with […]. ^[8]
One US insurer, for example, implemented a digital case tracking tool and reduced the number of status request calls by more than 50 percent. ^[9]
A European insurance carrier, for example, significantly improved its fraud detection accuracy implementing an AI based fraud detection system resulting in an 18 percent increase in fraud prevention as well as productivity gains in fraud investigation. ^[9]
The total cost of insurance fraud is estimated to be more than $40 billion per year. ^[10]
Of the $80 billion in government funding appropriated for reconstruction, it is estimated that Insurance Fraud may have accounted for as much as $6 billion. ^[10]
VA released Percent Change in Veteran Population by State from 2000 to 2020The Department of Veterans Affairs provides official estimates and projections of the Veteran population using the Veteran Population Projection Model. ^[11]
The “Percent Change in Veteran Population” data table shows the change in the Veteran population from 2000 to 2020 by state. ^[11]
During this period, the average decrease in the Veteran population is 25% at the state level. ^[11]

I know you want to use Insurance Claims Management Software, thus we made this list of best Insurance Claims Management Software. We also wrote about how to learn Insurance Claims Management Software and how to install Insurance Claims Management Software. Recently we wrote how to uninstall Insurance Claims Management Software for newbie users. Don’t forgot to check latest Insurance Claims Management statistics of 2024.

Reference

getforesight – https://getforesight.com/workers-compensation-statistics/.
amtrustfinancial – https://amtrustfinancial.com/blog/insurance-products/top-trends-employment-practices-liability-claims.
bls – https://www.bls.gov/ooh/business-and-financial/claims-adjusters-appraisers-examiners-and-investigators.htm.
ibisworld – https://www.ibisworld.com/united-states/market-research-reports/insurance-claims-processing-software-industry/.
iii – https://www.iii.org/fact-statistic/facts-statistics-flood-insurance.
sas – https://www.sas.com/en_us/insights/articles/risk-fraud/big-data-analytics-improves-claims-processing.html.
ssa – https://www.ssa.gov/policy/docs/statcomps/di_asr/index.html.
mckinsey – https://www.mckinsey.com/industries/financial-services/our-insights/insurance-2030-the-impact-of-ai-on-the-future-of-insurance.
meddata – https://www.meddata.com/blog/2017/10/26/medical-billing-statistics/.
mckinsey – https://www.mckinsey.com/industries/financial-services/our-insights/claims-in-the-digital-age.
fbi – https://www.fbi.gov/stats-services/publications/insurance-fraud.
va – https://www.va.gov/vetdata/.

How Useful is Insurance Claims Management

One of the primary benefits of insurance claims management is its ability to streamline the claims process for policyholders. By working with a designated claims manager, policyholders can directly communicate their needs and concerns, ensuring that their claims are handled promptly and efficiently. This streamlined process not only saves time for policyholders but also reduces the potential for errors or issues to arise during the claims process.

Additionally, insurance claims management plays a significant role in ensuring that policyholders receive fair and equitable compensation for their covered losses. Claims managers are trained to assess the value of a claim, taking into account various factors such as the extent of damage, estimated repair costs, and policy limits. This expertise allows claims managers to advocate for policyholders and negotiate on their behalf to secure a fair settlement.

Furthermore, insurance claims management can provide peace of mind for policyholders during what can be a stressful and overwhelming experience. Dealing with the aftermath of a loss, whether it be a car accident, natural disaster, or other unforeseen event, can be emotional and chaotic. Having a claims manager to guide policyholders through the process, answer questions, and provide updates can offer reassurance and support during a challenging time.

Another crucial aspect of insurance claims management is its role in fraud prevention and detection. Claims managers are trained to identify red flags and inconsistencies in claims, helping to mitigate the risk of fraudulent activity. By carefully scrutinizing claims and conducting thorough investigations when necessary, claims managers can protect both policyholders and insurance companies from falling victim to fraudulent schemes.

Moreover, insurance claims management can enhance the overall customer experience for policyholders. Clear communication, transparency, and timeliness are key components of effective claims management. When policyholders feel supported and informed throughout the claims process, they are more likely to have a positive view of their insurance company and continued loyalty.

In conclusion, the utility of insurance claims management cannot be overstated. From streamlining the claims process to ensuring fair compensation, providing peace of mind to preventing fraud, claims management is a crucial service that benefits both policyholders and insurance companies alike. Policyholders should take the time to understand and appreciate the role of insurance claims management in their coverage and feel confident that they are in good hands when faced with a loss.

In Conclusion

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Insurance Claims Management Statistics 2024 – Everything You Need to Know