296-17B-540 - Determining loss incurred for each claim

296-17B-540. Determining loss incurred for each claim

(1) Calculating the initial loss incurred:

For each of your claims, we will multiply the case incurred loss by the appropriate discounted loss development factors to determine the initial loss incurred.

If you have a fatality, we will use four hundred forty-seven thousand two hundred dollars ($447,200) as the claim's initial incurred loss for the claim, with four hundred seventeen thousand one hundred dollars ($417,100) for accident fund incurred loss and thirty thousand one hundred dollars ($30,100) for the medical aid incurred loss, regardless of the case incurred loss, and before recovery factors if applicable.

(2) Applying the single loss occurrence limit:

The initial loss incurred for a claim will be the amount we use as the loss incurred unless the single loss occurrence limit applies.

The single loss occurrence limit applies when the sum of all initial losses incurred for your claims arising out of a single event is greater than your selected single loss occurrence limit. In that case, each claim's initial loss incurred will be its proportionate share of your single loss occurrence limit.

(3) Applying the expected loss ratio factors:

The preliminary loss incurred for a claim will be the amount of the initial loss incurred, after application of the single loss limit, multiplied by the appropriate expected loss ratio factor. The accident fund and medical aid fund portions of each claim will have separate expected loss ratio factors applied.

(Amended by WSR 13-24-073, filed 11/30/13, effective 1/1/14 Amended by WSR 14-24-084, Filed 12/1/2014, effective 1/1/2015 Amended by WSR 15-24-103, Filed 12/1/2015, effective 1/1/2016 Amended by WSR 16-24-014, Filed 11/29/2016, effective 1/1/2017 Amended by WSR 17-24-041, Filed 11/30/2017, effective 1/1/2018 Amended by WSR 18-24-073, Filed 11/30/2018, effective 1/1/2019 Amended by WSR 19-24-029, Filed 11/25/2019, effective 1/1/2020 Amended by WSR 20-24-094, Filed 11/30/2020, effective 1/1/2021)

Statutory Authority: RCW 51.16.035, 51.32.073, 51.08.010, and 51.04.020(1). 12-24-048, § 296-17B-540, filed 11/30/12, effective 1/1/13; 11-24-026, § 296-17B-540, filed 12/1/11, effective 1/1/12. Statutory Authority: RCW 51.16.035, 51.16.100, 51.04.020(1), and 51.18.010. 10-21-086, § 296-17B-540, filed 10/19/10, effective 11/19/10.

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