Ryan Smith is the Senior Solutions Advisor for True Insurtech Solutions
Two of the most useful sessions at AIS 2026 sat back-to-back on the agenda for a reason. Patrick Coate laid out the demographic forces reshaping the American workforce. Paul Hendrick translated those forces into the claims data we already have. Together, they made a quiet but unmistakable case: the workers’ compensation book of 2030 will look meaningfully different from the one you are managing today, and the early signs are already sitting in your claim files.
I sat through both sessions back to back, and the value was in the handoff. Coate’s macro view set up Hendrick’s claims-level analysis, and the implications for underwriting, claims, and reserving emerged in the connections between the two. Our pre-conference take on these themes lives on our AIS 2026 Resource Hub. Here is the picture as I read it after Orlando.
The Population Story Behind the Premium Story
Before Coate got into workforce specifics, he spent time on the broader population context. The demographic engine that drives the U.S. labor force has been slowing for years, and the composition of that growth has fundamentally changed.
U.S. population growth has averaged less than 1% annually for the past two decades. Immigration is now an increasing share of total growth because natural change (births minus deaths) is approaching zero. The Congressional Budget Office projects natural change to turn negative within roughly five years. That is a meaningful inflection. The country has historically grown its workforce through a combination of births and immigration, and one of those two pillars is on track to flip.
Where that growth is happening matters as much as how much of it is happening. Between 2015 and 2025, the South added roughly 12 million people. The West added 4.1 million, the Midwest 1.2 million, and the Northeast just 0.4 million. Domestic migration drove most of the South’s gains. Immigration was a net positive in every region, but in some states and metros it was offset by out-migration.
For carriers with multi-state books, this is the macro layer underneath the premium story. The workforce composition in any given state is being reshaped by migration and immigration patterns that do not move in sync with national averages. The workers carrying that state’s exposure ten years from now will be a different population than today, and the rate environment, claim mix, and operational footprint should reflect that.
Mid-Career Workers Have Been Carrying the Frequency Decline
One of the more striking findings Coate presented was on the age distribution of frequency improvement. The headline frequency decline that the workers’ comp system has been celebrating for two decades has not actually been broad-based. It has been concentrated.
Looking at BLS Survey of Occupational Injuries and Illnesses data from 2014 to 2024, frequency per 10,000 full-time equivalent workers fell 22.9% for ages 25 to 54. It fell 12.3% for workers 55 and over. And for workers 16 to 24, it actually rose 2.9% over the decade. The mid-career cohort has been doing nearly all the work, and the youngest and oldest cohorts are now the highest-incidence groups in the workforce.
Coate’s own framing of the takeaway was direct. Future labor force growth will come primarily from workers ages 45 to 54 and 65 and over. The number of young workers will decline. That has clear consequences for the frequency story going forward. The cohorts that have been carrying the decline are aging out, and the cohorts replacing them are the higher-incidence ones.
The 55+ Risk Profile That Doesn’t Show Up Until the Claim Lands
Hendrick picked up the thread with NCCI’s own claims data. The picture he laid out is one where older workers are growing as a share of claims faster than they are growing as a share of the labor force, and the claims they generate are systematically harder to resolve.
The headline numbers are striking. Workers 55 and over represent 24% of the U.S. labor force but account for 28% of lost-time claims and 34% of lost-time losses. On average, they have 23% higher claim frequency and 32% higher severity than other workers. That gap shows up consistently year over year, and the cohort is also growing as a share of claims. The 55 to 64 share of lost-time claims rose from 18% in 2015 to about 22% in 2025. The 65 and over share doubled, from 4% to 8% over the same period.
NCCI expects the trend to continue. Improvements in medicine and lifespan, retirement savings gaps, and a meaningful preference among older workers for the human connection of staying in the workforce are all pushing labor force participation higher in the older age bands. None of those drivers are turning around in the near term.
What makes these claims operationally different is what happens after the injury. Workers age 65 and over are 10% more likely than the average worker to have a comorbidity, and 5% more likely to have surgery. The injury mix shifts too. Falls and slips account for a larger share of 65+ losses, and more than half of those falls occur on level surfaces. The clearest visible difference is in claim duration. Only 53% of claims for workers 65 and over close at first report, compared with 77% for workers 16 to 24.
That duration gap matters for reserving, for claims staffing, and for the financial assumptions baked into long-tail forecasts. The 55+ cohort is not just a frequency story. It is a duration and severity story that builds in over years, and it connects directly to the medical severity dynamics we covered earlier in this series.
The New-Hire Drag Got Smaller, But Not for Everyone
The other side of the demographic conversation is tenure. New hires generate disproportionately more claims than their share of the workforce would suggest, and the size of that drag fluctuates with the labor market.
Workers with less than one year of experience are roughly 20% of the labor force but generate about 40% of lost-time claims. Their claim frequency runs roughly double that of all workers. Hendrick showed that the share of new-hire claims has been declining since 2022, tracking almost perfectly with the JOLTS hires rate. The low-hire, low-fire labor market of 2024 and 2025 produced fewer short-tenured workers, and fewer short-tenured workers produced fewer of the elevated-risk claims that cohort generates.
But the industry-level picture is not uniform. Health Care has not seen the hiring slowdown that most other industries experienced. Its new-hire claim share remains elevated relative to all industries, in a sector that also overrepresents 55+ workers in its claim mix. Construction is largely insulated from the tenure story and underrepresented in 55+ claim share. Leisure and Hospitality follows the all-industry trend on new hires but is experiencing significant wage growth in injured-worker wages, with an average annual increase of 7.9% compared with 4.7% across all industries.
Hendrick’s takeaway is worth sitting with. A continuing decline in new-hire claims could mean lower frequency but higher average severity, plus a different claim mix carriers and administrators need to consider. The math works because newer hires tend to have lower-severity injuries (more contusions and lacerations) while experienced workers carry more of the high-severity load. Fewer of one, more of the other, and the average severity number drifts upward even if total losses stay flat.
The Gender Shift That’s Showing Up Quietly
One of the data points worth pulling out of Hendrick’s session is the gender shift in claims, which has been moving steadily in the background while attention focused elsewhere.
Between 2012 and 2025, women’s share of lost-time claims rose by 7 percentage points, and women’s share of loss dollars rose by 8 points. Men still represent 63% of claim counts and 73% of losses, but the trajectory has moved meaningfully. The industry mix explains a lot of it. Men make up 95% of Construction claims, but only 49% in Leisure and Hospitality and 18% in Health Care.
Health Care’s continued absorption of net employment growth is gradually rebalancing the overall claim mix in ways that may affect reserving assumptions, return-to-work program design, and class-level pricing over time. None of these shifts are dramatic on a single-year basis. They compound.
What’s on the Horizon: Obesity Decline and Insurance Access
Hendrick closed his session with two emerging trends NCCI is watching closely. Both have the potential to reshape claim composition in the next several years.
The first is obesity. The U.S. obesity rate peaked at 40% in 2022 and has declined to 37% in 2025. GLP-1 medications are part of the story. NCCI’s data shows 16% of workers ages 40 to 49 and 17% of workers ages 50 to 64 reported taking a GLP-1 for weight loss in 2025. That matters for workers’ comp because those age bands are exactly where strain losses are concentrated, accounting for 25% and 41% of strain losses respectively. Obesity contributes indirectly to both higher injury likelihood and slower recovery, so even modest changes in obesity prevalence in those middle-age cohorts could move the strain-injury picture in measurable ways over the next several years.
The second trend is health insurance access, and it moves in the opposite direction. Medicaid enrollment has declined steadily since the pandemic-era expansion ended. The uninsured population is concentrated in lower-income workers, Southern states, small employers, and Construction and Leisure and Hospitality industries. For workers’ comp, the implications run two ways: cost shifting (workers using comp for conditions that would otherwise be addressed in general health) and worker health (less healthy workers entering the comp system with more comorbidities and longer recoveries).
What This Changes About Your Book
Three operational implications from the Coate and Hendrick sessions are worth weighing into 2026 planning.
First, model age and tenure exposure explicitly. The aggregate frequency number for your book is increasingly the average of two diverging populations: low-frequency mid-career workers and higher-frequency workers at both ends of the age distribution. Without segmenting your book by age band and tenure, the trend in your topline frequency line will hide the structural shifts that affect reserves and claims operations.
Second, treat new-hire trends as a leading indicator. The decline in new-hire claim share is partially explained by labor market conditions that can shift quickly. When hiring picks up, especially in industries with high physical demands or in Health Care, new-hire claim share will rise first, and frequency will follow with a short lag. Claims operations that can identify that signal in their own data have time to staff and reserve appropriately. Claims operations that wait for the aggregate frequency number to shift will be behind.
Third, segment your data by demographic dimensions, not just class. The combination of an aging workforce, shifting gender mix, comorbidity prevalence, and tenure distribution means that two books with similar class-mix profiles can have very different cost and duration realities. Modern claims administration platforms like TrueClaims™ are designed to make demographic and tenure dimensions part of standard claims analytics rather than a research project. The carriers and administrators that can see those patterns in their own data will be better positioned to act on them.
Why This Matters for Your Organization
Demographic change is the slowest fastball in the industry. The aging workforce, the migration story, the tenure dynamic, and the health-insurance access question all move on multi-year timeframes. You can see them coming. The question is whether your data is structured to recognize what is already showing up in your book and whether your reserving, underwriting, and claims operations are positioned to act on what you see.
The carriers I see managing demographics well are the ones treating it as a current operational discipline rather than a strategic discussion. The ones treating it as a 2030 problem are running books that already look more like 2030 than they realize.
Let’s Talk
If you are thinking about how demographic shifts are affecting your book composition, your severity expectations, or your claims operations, I would welcome the conversation. Book a discovery call with me.
Additional Resources from NCCI
For readers who want to go directly to the NCCI source materials referenced in this post:
