Above: Indexed Estimated Frequency of Mega-Claims per 100,000 
Indemnity Claims by Threshold (Three-Year Moving Average); Source: NCCI

Mega-claims: Few, but Costly, Finds NCCI

• Mega-claims represent less than 0.1% of all workers’ compensation claims but account for more than 2% of total loss dollars, topping $1 billion annually, according to NCCI.
• About 53% fall within the $2 million-$3 million range, 27% between $3 million-$5 million, 15% between $5 million-$10 million, and 4% at more than $10 million.
• The study analyzed a total of 11,330 mega claims from accident years 2001 through 2021, and were reported as of Dec. 31, 2022, with incurred loss in excess of $2 million at 2022 cost levels, which is approximately one out of every 1,295 reported indemnity claims.
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NJ Supreme Court Limits Employer Insurance Coverage for Worker Injuries

• The New Jersey Supreme Court last Thursday clarified the scope of insurance coverage for employers facing lawsuits from injured workers. 
• In Dionicio Rodriguez v. Shelbourne Spring LLA,the court clarified that employer’s liability insurance policies generally do not cover so-called Laidlow claims.
• Employers should be aware of this limitation and may need to consider additional insurance coverage or risk management strategies to protect themselves from such claims, noted attorney Jon Gelman, in a Dec. 13 blog post.
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Ohio High Court Ruling Limiting TTD Benefits Raises Concerns

• The Ohio Supreme Court’s recent ruling in State ex rel. AutoZone Stores, Inc. v. Indus. Comm. has sparked concern among workers’ rights advocates and legal experts. The Nov. 26 decision upholds AutoZone’s argument, effectively limiting access to temporary total disability benefits for workers who have been terminated from their jobs, even when medical conditions related to their workplace injuries prevent them from working.
• The decision also emphasizes Ohio Revised Code 4123.56(F), which requires a ‘direct result’ relationship between the injury and wage loss to qualify for benefits.
• The case originated from an AutoZone employee who was terminated while on light duty and later sought temporary total disability benefits following surgery related to their workplace injury.
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