
By William Nibbelin, Head of Industry Data and Actuarial Science, Triple-I
Factors driving stability in the workers’ compensation line were a central focus at the NCCI Annual Insights Symposium (AIS) 2026 – a key event for the workers’ comp industry. In aggregate, workers’ comp welcomed its 11th consecutive year of net underwriting profitability in 2025, continuing to outpace the broader property/casualty industry.
Alongside this success, industry leaders and actuaries provided insights into the underlying trends and emerging risks to watch going forward for the line.
Key Findings
- Premium: Workers’ comp net written premium decreased by 1.5 points in 2025, to $45.6 billion. For private carriers, this decrease was 0.2 points, to $41.6 billion.
- Changes in premium include a 6-point decline in 2025 bureau loss costs and payroll growth of 4.8 points, comprising 0.5 points in employment and 4.3 points in wage rate.
- Despite an overall decrease in premium, the residual market share declined to just 5 percent in 2025.
- Profitability: The 2025 calendar year net combined ratio of 92.8 was an increase of 4.0 points over 2024 at 88.8. For private carriers, the net combined ratio of 91 was an increase of nearly 5 points over 2024 at 86, marking 12 consecutive years of underwriting gains. The accident year combined ratio of 102 is projected to develop downward by 5 to 6 points based on historical reserve experience.
- Reserves: NCCI estimates a net redundant industry reserve position of $14 billion for private carriers.
- Severity Trends: Both medical and indemnity severity increased by 4 points in 2025.
- Frequency Trends: Lost-time claim frequency decreased by 2 points in 2025, compared to a decrease of 5.9 points in 2024. This represents a more moderate decrease in frequency compared to the long-term average annual decline of 3.8 points.
Economic Uncertainty
NCCI filed a 5 percent decrease in loss costs effective in 2026, marking the 13th consecutive year of declines. These results are a product of rising payroll and long-term frequency improvements, coupled with favorable reserve development expectations, which together have outpaced severity increases.
However, underwriting margins face clear headwinds from economic uncertainty, including the significant rise in energy prices and the potential for stagflation. In a stagnant economy, businesses stop growing, unemployment rises, and prices increase.
Yet, as NCCI Practice Leader and Senior Economist Stephen Cooper noted, the economy has remained resilient in 2026, despite these risks.
“Employment growth on a month-to-month basis has been volatile over the past year, with most growth concentrated in one sector,” Cooper explained. “Overall, however, the labor market remains in balance, as both supply and demand have evened out and there have been early signs of the labor market potentially strengthening in 2026.”
Evolving Risks
The symposium highlighted several structural and technological changes altering the nature of workers’ comp risk:
Pain Management: Pain management protocols have increasingly shifted toward holistic treatment methods, including extended physical therapy and topical solutions. Major surgery utilization has dropped by 8 points since 2016, whereas physical therapy utilization has expanded considerably, driven by a greater intensity of procedures per session, rather than an increase in session frequency.
Delivery of Care: Medical benefits are heavily impacted by the broader U.S. healthcare delivery system. Over the past decade, private equity firms have invested more than $1 trillion into independent ambulatory surgery centers, specialty practices, and outpatient clinics. Simultaneously, massive hospital networks are consolidating or restricting health care access in rural communities. These changes contributed to a 5-point drop in the share of workers visiting emergency departments on the day of their injury.
Remote Work: Work-from-home options are increasingly used as “reasonable accommodations” for injured employees in some industry sectors. By eliminating commuting constraints, remote work structures allow injured employees to perform tasks virtually, mitigating lost-time indemnity claims.
AI: Beyond general system performance optimization, AI tools are being deployed for early-stage claim triage, automated medical bill auditing, and identification of potential litigation vulnerability. NCCI has also instituted formal governance structures for digital assets and initiated programs that leverage machine learning models to streamline the risk classification code assignment process.
Aging Workforce: Employees aged 55 and older now account for nearly one-quarter of the total labor force, a segment that will expand over the next decade. While the experience of older workers minimizes injury frequency, their physiological responses are more complex, yielding higher average medical costs and prolonged recovery periods.
“Demographic forces help to shape the workers’ compensation claim environment,” said Paul Hendrick, NCCI Practice Leader and Senior Actuary. “Factors such as employee tenure or the aging workforce are not abstract economic concepts; they have a real, tangible impact on the nature and frequency of claims that occur every day in the workers’ comp system.”
Learn More:
Steady Workers Comp Performance Masks Uneven Industry Realities
Triple-I State of the Line Issues Brief: Workers’ Comp (members only)








