AI Workers Compensation Loss Development Analysis Playbook

An actuarial analyst is reviewing a mid-size employer's workers compensation loss history for renewal pricing. The insured has 5 years of loss data. The current year has higher open reserves on 3 claims than the prior actuary expected. The renewal premium is being contested by the broker.

When to use this playbook

• Use this playbook when the decision looks like the situation above: An actuarial analyst is reviewing a mid-size employer's workers compensation loss history for renewal pricing.
• It is a fit when you have source files in hand and need a structured, reviewable analysis — not a generic chat answer about "Workers Compensation Loss Development Analysis".
• Do not use it as a substitute for licensed, legal, clinical, or authorized official judgment in the domain.

What you'll need

• 5-year loss development triangle (paid losses, incurred losses, open claim count)
• Large loss detail for all claims >$100,000
• Prior actuary's reserve analysis
• Industry development factors for the insured's SIC code
• Current open claim status reports for the 3 high-reserve claims

Attachments: Documents (Documents)

You are an actuarial analyst reviewing workers compensation loss development for renewal pricing. I am attaching:

Work only from the attached source files. If a conclusion is not supported, say so.

Produce:
1. Calculate the ultimate loss projection using chain-ladder development factors and compare to the prior actuary's projection—quantify any divergence.
2. Assess whether the 3 high-reserve claims are adequately or inadequately reserved based on claim status and development patterns.
3. Calculate the experience modification factor (EMF) and renewal premium at current projections vs. the prior actuary's projections.
4. Identify whether the insured's loss development pattern is consistent with industry development factors or shows anomalies requiring explanation.
5. Tell me the renewal premium range, the defensible position for the broker negotiation, and what additional claim information I need before I can finalize the analysis.

Call out where independent models are likely to disagree, and list follow-up documents a reviewer should request.

What to expect

• Ultimate loss projection with chain-ladder analysis
• Reserve adequacy assessment for large claims
• Experience modification and renewal premium range
• Development pattern anomaly analysis
• Broker negotiation position and outstanding information requests

Review before you act

• Validate this output against source files before relying on it: Calculate the ultimate loss projection using chain-ladder development factors and compare to the prior actuary's projection—quantify any divergence.
• Validate this output against source files before relying on it: Assess whether the 3 high-reserve claims are adequately or inadequately reserved based on claim status and development patterns.
• Validate this output against source files before relying on it: Calculate the experience modification factor (EMF) and renewal premium at current projections vs. the prior actuary's projections.
• Validate this output against source files before relying on it: Identify whether the insured's loss development pattern is consistent with industry development factors or shows anomalies requiring explanation.
• Confirm every cited figure, date, counterparty, or requirement against the attached originals — models compress and can drop a qualifier.
• Treat disagreement between models as a review item, especially on classification, materiality, and recommended next action.
• Do not authorize an operational, clinical, legal, credit, or enforcement action solely because the models agree.