Falls, Pressure Ulcers Continue to Be Most Frequent Claims; Cyberliability Emerging as Costly

November 18, 2016 | Aging Services Risk, Quality, & Safety Guidance

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​Falls continue to be the most frequent allegation in claims against aging services organizations, and claims for cyberliability are emerging as a high-cost area of exposure, according to Using Evidence to Achieve Excellence: Engage, Lead, Succeed, the 2016 closed claims report from the insurer CNA. The report, based on 2,617 claims that closed between January 1, 2011, and December 31, 2015, found an overall average payment of $211,709, an increase over the $200,837 reported in 2014 (see the November 7, 2014, Issues in Continuing Care Risk Management). Falls remained the most frequent allegation, representing 43% of all closed claims, followed by pressure ulcers (19%), improper care excluding falls (15%), and failure to monitor (6%). Other claim types were more costly, however, led by elopement, with an average payment of $325,561, followed by failure to follow a physician order ($323,325), delay in seeking medical treatment ($245,783), and pressure ulcers ($232,398). Because of their high frequency and severity, CNA includes additional review of claims related to falls and pressure ulcers.

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