Uploading and Working with Loss Runs

Importing and Working with Loss Runs in Mod Advisor

This feature may not be available with your current subscription. Please contact sales@modadvisor.com for more information.

Loss runs provide detailed claim histories and are a vital tool for analyzing risk, preparing for mod calculations, and supporting client prospecting. Mod Advisor supports importing workers’ compensation loss runs to enhance claims analysis, generate actionable reports, and provide benchmarking insights.

Supported File Types

• Workers’ Compensation loss runs only
• Formats supported:
• PDF (scanned or digital files)
• Excel (e.g., carrier exports)

PART 1: Step-by-Step for Importing Loss Runs

1. Create an Account:
• Loss runs must be associated with an existing account in Mod Advisor.
2. Navigate to Claims Tab:
• Open the account, select the Claims tab, and click Import.
3. Upload Your File:
• Drag and drop or browse to upload the PDF or Excel loss run.
• The uploaded file and its evaluation date will display in the loss run view.
4. Processing & Notification:
1. Processing takes up to 48 hours, with human review for accuracy.
2. You will receive an email notification once the loss run is processed. Proceed to Part 2 once received.

PART 2: Claim Matching Logic

• Claims are automatically matched using:
1. Claim number (primary match)
2. State
3. Policy effective date
4. Policy number
• Match Status Types:

• Match: Full claim match.
• Partial Match: Missing fields (e.g., policy dates).
• No Match: No policy or claim match.

• Fallback Matching:

• If claim numbers or policy data are missing, Mod Advisor uses date of injury and state to assign claims to the correct policy period.

PART 3: Working with Matches

• Approve Matches:
• Select matches and approve to import claim details (medical, indemnity, descriptions).
• Handle No Matches:
• Review unmatched claims; add missing details or use date/state logic to map them.
• Group Claims (e.g., NCCI N-05):
• Claims grouped by NCCI may need manual mapping.

Loss Run Reports and Insights

Once processed, Mod Advisor provides:

• Claim breakdowns: Open vs. closed, medical vs. indemnity.
• State splits: Automatically separates claims by state
• Trend analysis:
• Claims by day of the week (e.g., most claims on Tuesdays)
• Monthly trends (e.g., highest incurred losses in August)
• Cause and body part analysis
• Benchmarking:
• Compare client claims to Bureau of Labor Statistics (BLS) injury data (Fall 2025).
• Identify outliers via enhanced dashboard graphics (Fall 2025).

Using Loss Runs Without Mod Worksheets

• You can upload loss runs before mod worksheets are available to prepare predictive models.
• This allows analysis of claim trends, payroll forecasting, and early insight ahead of renewal cycles.

Actuarial Method Reporting

• Actuarial reports allow unlimited years of loss run data (ideal for prospecting or non-mod-focused analysis).
• Provides rich claim reporting (by date, cause, injury, state) without requiring payroll values or mod impacts.

Manual Adjustments and Credits

• MCPAP Credits (Minnesota):
• Minnesota worksheets display MCPAP factors clearly.
• NCCI reports bury MCPAP credits in the remarks section, requiring manual input.
• Mod Advisor allows manual credit entry if extraction fails.
• Drug-Free and Safety Credits:
• Credits in other states (e.g., AL, FL) are detected via associated codes.

TIPS: Troubleshooting Import Issues

• OCR (Scanned PDFs):
• Poor scan quality may hinder claim parsing. Use clean, high-resolution scans.
• Garbled text when copied/pasted indicates OCR issues; Mod Advisor runs OCR automatically but complex cases are reviewed manually.
• Missing Claims:
• If claims do not import (e.g., grouped claims), notify support for review.
• Provide original loss run files for developer analysis and enhancements.

Best Practices

• Import mod worksheets for high-revenue accounts to leverage dashboards for open claim tracking and mod trend monitoring.
• Use loss run imports for prospecting: Analyze multi-year claims data to provide deeper insights (e.g., injury patterns, cost drivers).
• Validate claims mapping before approval to ensure data accuracy.

Future Enhancements

• OSHA Log Integration:
• Automatically populate OSHA logs from imported claims.
• Benchmarking Dashboards:
• Visual outlier detection for claims trends.
• AI-Powered Strategy Reports:
• Automated insights for client presentations.