Business Insurance recently named the five highest-paid executives in the country for 2024. These executives’ compensation packages are, as expected, massive—and employers are footing the bill.

So, what are employer dollars purchasing?

Insurers deploy staggering resources to deny treatment and slash physician reimbursement, effectively siphoning employer dollars meant for patients' care and redirecting them to the C-suite.

Below is a snapshot of where the money goes when employers cut checks for insurance premiums.

Insurance Industry’s 5 Highest-Paid Execs

According to the National Council on Compensation Insurance (NCCI), workers’ compensation is a profit geyser for insurers. No surprise there—when you can limit care through Utilization Review and gut reimbursements via network discounts, workers’ comp becomes what every executive dreams of: “money for (almost) nothing.”

Below are the five highest-paid insurance executives in the industry, who are reaping the benefits as injured workers fight to obtain care and doctors struggle daily to get paid.

5 Highest-Paid Insurance Executives (2024)

Congrats to Chubb’s Evan Greenberg, who enjoyed a 9% raise–even while his company pays providers roughly 78% of the fee schedule rates for treating injured workers.

Employers: Are You Paying for Care — or Caviar?

How can these insurers afford to keep their executives in the latest caviar-powered superyachts? Part of the answer is the real-world reimbursement rates they pay for doctors who treat injured workers.

For example, as the Explanation of Review below shows, Berkshire Hathaway paid an orthopedist just $64.16 for an injured worker’s Evaluation and Management.

With employer dollars, Berkshire paid this doctor less than half the state fee schedule rate, and about 2/3 of the Medicare rate for treating an injured worker (while paying Vice Chairman of Insurance Operations Ajit Jain north of $21M).

This EOR is not an isolated incident or a fluke.

daisyData drawn from millions of bills and payments confirms that this kind of underpayment is routine, especially for orthopedists. Insurers consistently pay rates that are significantly lower than those set by the state.

Multiply that across all injured worker care nationwide, and it’s easy to see how insurers can afford to shower executives with millions while stiffing the people who deliver the treatment.

The Workers’ Comp Model: Collect High, Pay Low

Insurers follow a well-worn playbook: collect as much as possible, pay out as little as possible, and demand increased employer premiums annually—justified by “data” promulgated by industry-funded organizations.  

In workers’ comp, this model is supercharged by:

• Burdensome regulations (for providers)
• Non-existent regulatory enforcement
• Aggressive discount contracting
• Skewed industry “data”

These systemic hurdles create a hostile environment for medical providers. And while insurers and policymakers often blame the administrative burden for why so few physicians are willing to treat injured workers, they ignore the more profound truth: it’s not just the paperwork—it’s the pathetically low reimbursement for enduring it.

Mountains of paperwork and endless compliance hoops would be easier to endure if the pay even came close to justifying the effort. But when insurers too often pay below Medicare and far below state fee schedule rates, providers are left with all the hassle and none of the compensation.

This dynamic raises a critical question:

When an employer pays their workers’ comp premiums, how much of that money actually goes to treating injured employees—and how much goes to bloated executive compensation packages?

You know what insurance execs are paid. daisyWizard’s Fee Schedule Calculator lets you know what your practice is supposed to get paid. Click below to try it for free.

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