Workers’ Comp Stays Profitable in 2024 Despite Lower Premiums and Rising Claim Severity

The workers' compensation insurance industry posted an 86% combined ratio in 2024—marking its 11th straight year of underwriting gains, according to NCCI's State of the Line report.
By: | May 19, 2025

The workers’ compensation insurance industry maintained profitability in 2024 with an 86% combined ratio, despite a 3% decrease in net written premium to $41.6 billion, according to NCCI’s annual State of the Line report.

Workers’ comp continues to be a consistently profitable line of business in the property and casualty insurance industry, though its overall market share has diminished significantly. The sector now accounts for only 10% of total commercial lines premium, down from 17% in 2004, as premiums in other commercial lines have outpaced growth in workers’ comp, according to the report.

The 2024 calendar year combined ratio of 86% represents a 14-point underwriting gain, reflecting significant profitability for carriers in this line. This marks the 11th consecutive year of underwriting gains for the industry.

Premium volume has experienced downward pressure, with private carriers recording $41.6 billion in net written premium, a decrease of about 3% from 2023, NCCI reported. When including state funds, the total market premium reached $46.3 billion.

The premium decrease was widespread geographically, with 31 states experiencing decreases in direct written premium. Overall, NCCI and independent bureau private carrier direct written premium decreased by 1.3% between 2023 and 2024, though most state-level changes were described as moderate.

Key Loss Drivers and Severity Trends

Claim severity has shown a consistent upward trajectory, with total claim severity (combining indemnity and medical components) increasing approximately 2% per year on average since 2004, according to the report.

For 2024, NCCI estimates that average total lost-time claim severity will be approximately 6% higher than in 2023. This increase applies to both the indemnity and medical components of claims.

The indemnity severity trend is noteworthy, as accident years 2022–2024 each experienced larger-than-average increases. This acceleration is primarily driven by significant wage growth in recent years, as indemnity claim severity has historically tracked closely with changes in average wages, the report stated.

Medical costs continue to represent a disproportionate share of high-value claims. For claims with total incurred losses of $5 million or more, medical expenses constitute approximately 90% of total costs, NCCI found.

This percentage decreases gradually with claim size, accounting for about 80% of costs for claims between $4-5 million, 70% for claims between $3-4 million, and 60% for claims between $2-3 million.

While severity continues to rise, claim frequency shows a persistent downward trend. NCCI estimates that lost-time claim frequency for accident year 2024 will be 5% lower than in 2023, representing the third consecutive year of frequency decreases greater than the long-term average annual decline of 3.6%. This follows a pandemic-related increase in frequency observed in 2021.

Financial Results and Future Outlook

The workers’ comp line’s financial performance remains strong despite the premium decreases. The 2024 loss ratio stayed under 50% for the eighth consecutive year, while dividends, underwriting expenses and loss adjustment expenses remained relatively consistent with 2023 levels, according to the report.

The 2024 accident year combined ratio is estimated at 99%, with prior years continuing to experience downward reserve development. This favorable reserve development has been a consistent pattern, contributing to the line’s overall profitability.

Additionally, the volume of medical losses in 2024 is approximately 2% higher than in 2023, but this is offset by an estimated 4% decrease in lost-time claim volume.

Looking ahead, NCCI expects the long-term downward trend in claim frequency to continue for at least the near future. This persistent decline in frequency has been a significant factor in maintaining profitability despite increases in claim severity and could help sustain favorable results even as wage inflation puts upward pressure on indemnity costs.

Access the full report and findings from NCCI here. &

The R&I Editorial Team can be reached at [email protected].

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