Skip to content
Senior Living Liability

Question

How do we read our loss runs before renewal?

Short answer

Read it the way an underwriter will: total incurred rather than paid, open claims and their reserves rather than closed ones, the development pattern from one valuation to the next, and the claim count per occupied bed, because those four things decide the rate far more than the total dollar figure does.

The columns that matter

Paid is money already out the door. Reserve is the carrier estimate of what remains. Incurred is the sum of both and it is the number that prices you. An operator looking at paid and concluding the year was quiet is reading the wrong column.

Status matters as much. A closed claim is a known quantity. An open claim with a large reserve is an underwriter forecasting future loss, and open claims are where a renewal is won or lost.

Then look at the valuation date. A loss run valued three months ago on a class with long development is stale, and an underwriter will either ask for a current one or assume the worst.

Development is the real signal

Ask for the same policy years valued at several points in time. If year over year the incurred total for a closed period keeps rising, your claims are developing adversely, which tells an underwriter that today reserves are also understated and that the pricing should include a load for it.

Favorable development does the opposite and is worth real money. It is also the thing an operator can influence, through early reporting, early investigation, and pushing the carrier to close claims that are effectively resolved rather than leaving them open with a reserve attached.

What to fix before you send it

Facility attribution. Claims assigned to the wrong building distort the per-bed figures and cause an underwriter to price a building for losses it did not have. This error is common in portfolios and it is worth checking every line.

Duplicates, which appear when a claim is reported twice or when a carrier system splits indemnity and expense into separate records.

Claims that should be closed. Ask the carrier to review any claim with no activity in twelve months. A closed claim at a small paid figure reads entirely differently from an open claim at the same figure with a reserve behind it.

And divested or sold locations, which should be identified so the underwriter is pricing the portfolio you actually operate.

The narrative that goes with it

Every large claim on the run should have a one-paragraph explanation: what happened, what changed afterward, and where it stands. An underwriter reading a large loss with no explanation assumes the worst version of it.

The most valuable version of that paragraph names a specific operational change with a date. A fall claim followed by a documented change to the post-fall assessment protocol six weeks later is a different risk from an identical fall claim followed by nothing.

Primary sources

Sources and references

This answer draws on the following regulatory, statutory, and standards-body sources. Coverage availability and program structure also depend on market appetite and underwriter discretion not captured by these sources.

Related practice areas

Insurance clauses in this area

Related questions

Have a more specific question?

A specialist will reach out by the end of the day.

Request a free coverage review

Last updated

Free coverage review

A specialist will reach out by the end of the day.

No marketing sequences, no list rental.