Factors influencing mode of claims settlement in workers' compensation cases. 1995

D L Morrison, and G A Wood, and S MacDonald
Department of Psychology, University of Western Australia, Nedlands, Perth.

This paper examines the variables that influence the means by which 10,192 injured workers settled their compensation claims during 1990. The data on which this study is based come from a state in Australia where there are three means by which workers' compensation claims can be settled by lump sum payment: settlement following a specific injury payment, early settlement payment and settlement following a common law payment. This paper is specifically concerned with identifying the variables that determine whether the claim will be settled by a lump sum payment and whether different modes of claims settlement by lump sum are unique and predictable from a range of variables that include injury characteristics and demographics. The results of logistic regression modelling revealed that those who received a lump sum settlement could be reliably distinguished from those who did not receive such a payment. Each mode of settlement varied in the extent to which it could be predicted. Contrary to expectations, the most difficult form of settlement mode to predict was that of specific injury payments (4% accurate) with the most predictive being early settlement payments (81% accurate). Common law payments were also highly predictable (48% accurate). The form of lump sum payment received by injured workers was found to depend on a range of injury characteristics, indices of severity and for common law payments, gender and potential income loss. It is argued that although injury characteristics play a part in the process of claims settlement, personal circumstances and insurance company policies are influential in dictating the form by which workers compensation cases are finalized.

UI MeSH Term Description Entries
D007343 Insurance Carriers Organizations which assume the financial responsibility for the risks of policyholders. Insurance Providers,Insurers,Carrier, Insurance,Carriers, Insurance,Insurance Carrier,Insurance Provider,Insurer,Provider, Insurance,Providers, Insurance
D007345 Insurance Claim Review Review of claims by insurance companies to determine liability and amount of payment for various services. The review may also include determination of eligibility of the claimant or beneficiary or of the provider of the benefit; determination that the benefit is covered or not payable under another policy; or determination that the service was necessary and of reasonable cost and quality. Claims Review,Insurance Audit,Insurance Claims Processing,Analysis, Claims,Claim Review, Insurance,Claims Analysis,Insurance Claims Analysis,Review, Claims,Review, Insurance Claim,Analyses, Claims,Analyses, Insurance Claims,Analysis, Insurance Claims,Audit, Insurance,Audits, Insurance,Claim Reviews, Insurance,Claims Analyses,Claims Analyses, Insurance,Claims Analysis, Insurance,Claims Processing, Insurance,Claims Reviews,Insurance Audits,Insurance Claim Reviews,Insurance Claims Analyses,Processing, Insurance Claims,Reviews, Claims,Reviews, Insurance Claim
D008297 Male Males
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000367 Age Factors Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time. Age Reporting,Age Factor,Factor, Age,Factors, Age
D012737 Sex Factors Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances. Factor, Sex,Factors, Sex,Sex Factor
D014904 Western Australia A state in western Australia. Its capital is Perth. It was first visited by the Dutch in 1616 but the English took possession in 1791 and permanent colonization began in 1829. It was a penal settlement 1850-1888, became part of the colonial government in 1886, and was granted self government in 1890. (From Webster's New Geographical Dictionary, 1988, p1329)
D014942 Workers' Compensation Insurance coverage providing compensation and medical benefits to individuals because of work-connected injuries or disease. Workmen's Compensation,Worker's Compensation,Workman's Compensation,Compensation, Worker's,Compensation, Workers',Compensation, Workman's,Compensation, Workmen's,Compensations, Worker's,Compensations, Workers',Compensations, Workman's,Compensations, Workmen's,Worker Compensation,Worker's Compensations,Workers Compensation,Workers' Compensations,Workman Compensation,Workman's Compensations,Workmans Compensation,Workmen Compensation,Workmen's Compensations,Workmens Compensation
D016009 Chi-Square Distribution A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another. Chi-Square Test,Chi Square Distribution,Chi Square Test,Chi-Square Distributions,Chi-Square Tests,Distribution, Chi-Square,Distributions, Chi-Square,Test, Chi-Square,Tests, Chi-Square

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