Written by Hilary Millspaugh
Workers’ compensation claim costs are rising again. A recent study from the Workers Compensation Research Institute (WCRI) shows that claim costs increased an average of 6 percent annually from 2022 through 2025 across the 18 states studied. After several years of relative stability, this shift signals a more challenging cost environment for self‑insured employers and risk managers.
These increases are not limited to isolated claims or late‑developing losses. They are appearing early in the life of a claim and across multiple cost components. As a result, employers may need to reassess how their programs are structured, monitored and supported.
Understanding the Cost Drivers
According to the WCRI analysis, upward pressure is affecting nearly every major component of a lost‑time claim:
- Rising medical payments per claim: This increase is largely driven by higher prices for medical services rather than greater utilization. In several states, growth is further influenced by an increase in higher‑severity claims.
- Increasing indemnity costs per claim: Longer temporary disability durations and higher injured worker wages are contributing to this trend, even as wage growth begins to moderate in some sectors.
- Added overall costs due to benefit delivery expenses: Medical cost containment services and litigation‑related expenses are placing additional pressure on total claim spend.
These trends are becoming evident at just 12 months of claim maturity, suggesting that the increases are structural rather than the result of aging or unusually complex claims.
Why Claims Administration Matters More Than Ever
Claims administration is a critical driver of overall program performance, especially when cost pressures rise across the board. Early engagement, coordination and informed decision‑making can significantly influence outcomes. A focused and proactive third‑party administrator can make a measurable difference in several key areas:
- Early intervention and return‑to‑work coordination: Lengthening disability durations are a primary contributor to rising indemnity costs. Early coordination among the adjuster, treating provider and employer helps ensure injured employees receive appropriate care and return to work as soon as medically appropriate.
- Medical management beyond bill review: As medical pricing outpaces utilization, cost containment requires more than fee schedule compliance. Network steerage, utilization review and pharmacy benefit management, particularly around opioid and habit‑forming medications, play an important role in managing both cost and quality of care.
- Litigation management: Benefit delivery expenses are increasing in part due to greater litigation activity. Adjusters who can identify litigated claims early and manage attorney involvement strategically help limit escalation and resolve disputes more efficiently.
- Data and analytics: Timely, accurate reporting allows risk managers to identify trends before they become established. Loss development monitoring, benchmarking and actionable data support more informed decisions around reserves, program design and loss prevention investments.
Looking Ahead
For self‑insured programs, rising claim costs have a direct impact on the balance sheet, making proactive oversight more important than ever. Our Claims and Third‑Party Administration team closely monitors market developments and works alongside employers to address emerging cost drivers early. Through integrated claims, risk and data consulting services, we help employers manage immediate challenges while strengthening long‑term program performance by combining hands‑on claims experience with analytics and technology.
