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Operator
Welcome to the Pro Assurance First Quarter 2022 Earnings Conference Call. My name is Ruby and I will be your moderator for today's call. If you would like to ask a question during the presentation, please press start followed by one on your telephone keypad. I'll now hand over to our host, Jason Gingrich of VP of Investor Relations to begin.
Ruby
Thank you, Ruby. Good morning, everyone. Welcome to ProAssurance's conference call to discuss the company's first quarter 2022 results. These results were reported in a news release issued on May 9th, 2022, and in the company's quarterly report on Form 10-Q, which was also filed on May 9th, 2022. Included in those documents were cautionary statements about the significant risks, uncertainties, and other factors that are out of the company's control and could affect ProAssurance's businesses and alter expected results. Please review those statements. Management expects to make statements on this call dealing with projections, estimates, and expectations, and explicitly identifies these as forward-looking statements within the meaning of the U.S. federal securities laws and subject to applicable safe harbor protections. The content of this call is accurate only on May 10, 2022, and except as required by law or regulation, Pro Assurance will not undertake and expressly disclaims any obligation to update or alter information disclosed as part of these forward-looking statements. The management team of ProAssurance also expects to reference non-GAAP items during today's call. The company's recent news release provides a reconciliation of these non-GAAP numbers to their GAAP counterparts. I would like to remind you that the call is being recorded, and there will be a time for questions after the conclusion of prepared remarks. This morning, we will discuss selected aspects of our quarterly results on today's call and remind investors that they should review our filing on 410Q and the accompanying press release for full and complete information. On our call today, we have Ned Rand, President and CEO, Dana Hendricks, Chief Financial Officer, Mike Bogusky, President of our Specialty, Property, and Casualty Lines, and Kevin Shook, President of our Workers' Compensation Insurance Operations. Ned, will you start us off, please?
Ruby
Thank you, Jason. Last Thursday marked the one-year anniversary of the closing of the largest acquisition in our history. As we brought into the ProAssurance family the team members and policyholders of NorCal Group, While the closing of that transaction was the culmination of much hard work and due diligence, it also marked the beginning of the hard work of the integration process, which we'd spent over a year planning for. As I look back at the year that has passed, I am proud of how much the teams at ProAssurance and NorCal have accomplished to integrate the operations of these two great companies, while continuing to deal with the pandemic's impact on both our operations and the business of our insureds. I'm also pleased with the financial and operational benefits that the NorCal transaction has brought to ProAssurance, including a broader nationwide footprint, a wealth of talent and experience from the team members that joined our organization, greater scale and efficiency, and a history and reputation recognized by many physicians around the country. The additional assets in the portfolio also increased our investment leverage. providing an opportunity to benefit from more attractive core fixed income yields and increased investment income. The improvements we are making in our healthcare professional liability business are being seen in both the legacy pro assurance business and the acquired NorCal book. Dan and Mike will take you through those results in detail and provide insights into what actions are leading to the improved results. The workers' compensation insurance operations continue to provide diversification for the overall organization, as the team continues to navigate a competitive marketplace. Kevin will discuss the signs we are seeing in that business and the actions we are taking to respond appropriately to market conditions. We are also pleased to report that just last month, AMBEST affirmed the A, excellent financial strength rating of the members of the ProAssurance Group and upgraded the long-term issuer credit rating outlook to stable. We believe this is indicative of the strong capitalization and financial flexibility of our family of companies following the acquisition of NorCal. Finally, I'll note that we successfully implemented our return to office plan in March. As this establishes a more regular cadence to our office environment, we are eager to keep our full attention on what we do best, protecting others. Now I'll ask Dana to share results for the quarter. Dana?
Jason
Thanks, Ned, and good morning, everyone. For the first quarter, we reported a net loss of $3.6 million, or 7 cents per share, and operating income of $7.7 million, or 14 cents per share. The main difference between the net loss and operating income in the quarter was, of course, the impact of the current investment environment, which I'll discuss further after touching on our core operating results. Our operating income in the quarter reflected improvement in underwriting results, the benefit of expense synergies from the NorCal acquisition, and growth in net investment income. From a production standpoint, gross premiums written increased almost 50% due to the addition of the NorCal premium base. Excluding NorCal, our top line declined, reflecting our dedication to disciplined underwriting in our specialty PNC segment and the impact of our lower participation in Lloyd's Syndicate 1729, beginning with the 2021 underwriting year. From an underwriting results perspective, our consolidated combined ratio, excluding transaction-related costs, improved just over four points from the prior year quarter, driven by an almost five-point improvement in the combined ratio in our specialty P&C segment. However, all of our operating segments, excluding workers' compensation insurance, contributed to that result. Before discussing the components of the combined ratio, I'll briefly touch on the change in our estimate of unallocated loss adjustment expenses, or ULAE, in our specialty PNC segment in the quarter. We decreased our estimate of ULAE to incorporate changes to the segment's expense model after substantially integrating NorCal into our operations. That change resulted in a decrease in our consolidated net loss ratio of 2.7 points with an equal and offsetting increase to our consolidated expense ratio. Note, the change had no impact to our total expenses, combined ratio, or operating results. Excluding the change in ULAE, our consolidated current accident year net loss ratio was about one point higher, as the impact of lower loss ratios in our standard physician book were muted by the addition of the NorCal book, which carries a higher average loss ratio The consolidated current accident year net loss ratio also reflected a higher ratio in our workers' compensation insurance segment, driven by the continuation of intense marketplace competition and resulting renewal rate decreases, partially offset by the impact of favorable claims trends on our current year loss estimate. As it relates to prior accident years, we recognize just over $5 million of favorable development in the quarter the majority of which came from our specialty P&C and workers' compensation insurance segments. Excluding the change in ULAE, our consolidated expense ratio improved almost six points, reflecting both improved leverage on our operating expense base and synergies realized from the NorCal acquisition, as well as the benefit from prior organizational restructuring. From an investment results perspective, net investment income grew with the addition of NorCal's investment portfolio. Our equity and earnings from our LP and LLC portfolio produced $10 million in the quarter, a very strong result. However, we anticipate the impact of current market volatility to be reflected in next quarter's results as our LP and LLC investments are reported on a one-quarter lag. As I previously mentioned, the investment environment was a challenge this quarter as interest rate increases weighed on bond prices. These interest rate increases led to net investment losses of $14 million recognized through earnings, leading to the net loss in the quarter. Net investment losses were primarily related to changes in the fair value of our bond funds, which are classified as equity. The current interest rate environment also led to $141 million of after tax unrealized holding losses on our fixed income portfolio. These unrealized losses flow through our other comprehensive loss directly to equity, accounting for most of the decline in book value. I'd like to stress that we have a history of strong operating cash flows and an investment approach that holds most securities until maturity. We're happy to trade temporary fixed income price declines with the opportunity to reinvest at higher yields. In fact, current bond reinvestment rates are approximately 100 to 150 basis points higher than our reported average book yield for the quarter. Overall, we're pleased with our quarterly operating results as we continue to show improvement in underwriting results and see the benefit of the operational leverage of the NorCal transaction. With that, I'll turn it back over to Jason.
Ruby
Thanks, Dana. Now we're going to pivot to Mike Bogusky for commentary on the specialty, property, and casualty segments. Mike.
Dana
Thank you, Jason. The positive operating momentum in the segment continued in the first quarter of 2022. The five-point improvement year-over-year in the combined ratio reflected the benefits of prior re-underwriting and reorganizational efforts, as well as the early success of the NORCOW integration. This included $129 million of gross written premium from NorCal in the quarter, a significant contribution to the top-line growth in the segment. Importantly, this reflected strong premium retention of 90 percent and average price increases of 11 percent in the NorCal standard physician book. Overall, gross premiums written in the quarter were $258 million, a year-over-year increase of 86 percent. Premium retention of 83% and pricing increases of 9% were both year-over-year improvements in our underwriting performance. Specialty healthcare retention was 61% in the quarter due to the loss of three large accounts representing $12 million of premium writings. We remain focused on bottom line results in the large account space. $8 million of new business was written across the segment a decrease of $4 million to the comparable quarter as we continue to be disciplined in a competitive marketplace. Excluding the ULE changes outlined previously by Dana, we experienced a three-point reduction in the legacy pro-assurance current action-at-year loss ratio as a result of the execution of our underwriting strategies. This was offset by a higher average loss ratio on the NorCal Book of Business resulting in a relatively flat year-over-year loss ratio. We continue to be pleased with our underwriting efforts on the NorCal book as we focus on bringing the loss ratios in line with the Legacy Pro Assurance book. We were encouraged by lower than historical frequency reductions in our healthcare professional liability business, which we attribute to disruption in the court systems and the benefit of continued underwriting efforts. Due to the uncertainty of COVID-19 disruptions and the long-tailed nature of our lines of business, we remain cautious in recognizing these favorable frequency trends in our current accident year loss ratio. Exclusive of the ULE changes, the segment expense ratio declined by five percentage points year over year. This included $1.6 million of non-recurring expenses incurred during the current period related to the transaction and restructuring efforts. The largest drivers of improvement are the prior organizational restructuring, proactive expense management strategies, and of course, the expense synergies recognized from the NorCal acquisition. We established an initial plan to achieve $18 million in expense synergies from the transaction. And through our efforts to date, we have achieved $22.5 million in annual savings. We continue to be pleased with the NorCal integration and ongoing improvements in our operating performance. We would describe the NorCal integration as exceeding our expectation and is ahead of schedule from numerous perspectives, including re-underwriting efforts, operations, top-line growth, and expense synergies. Overall, the combination of the companies has improved our future competitive position. Jason?
Ruby
Thanks, Mike. Kevin? Will you bring us up to date on the workers' compensation insurance and the segregated portfolio sell reinsurance segments?
Mike
I will, Jason. Thank you. The workers' compensation insurance segment produced income of $1 million and a combined ratio of 99% for the quarter ended March 31, 2022. The combined ratio excluding intangible asset amortization and the corporate management fee was 96%, an indicator of the results of our ongoing business performance. During the first quarter, the segment booked $72 million of gross premiums written, essentially flat compared to the first quarter of 2021. We continue to exercise prudence in underwriting, focusing on adequate rate for exposure, particularly in this highly competitive pricing environment in workers' compensation. Renewal price decreases in our traditional book of business, were 4% in 2022 compared to 2% in 2021, and premium renewal retention was 85% for the first quarter of 2022 versus 89% in 2021. New business writings for 2022 were $4 million compared to $6 million in 2021. Audit premium in our traditional book of business increased about $1 million quarter over quarter, indicative of the paywall rebound after the lifting of pandemic restrictions in our underwriting territories. We made no adjustment to our earned but unbilled audit premium, otherwise known as EBUB in the first quarter. We will continue to monitor process audit activity and the impact of higher wages on the EBUB asset in future quarters, but remain conservative in our view of increasing this asset currently. The calendar year loss ratio increased slightly to 67% in 2022, reflecting a higher current accident year loss ratio. While the current accident year loss ratio increased one point to 72% compared to the first quarter a year ago, the ratio improved compared to our full year 2021 ratio of 74%. Favorable development was $2 million in both 2021 and 2022. Early in and throughout 2021, we discussed the increase in loss activity we experienced and recognized related to return to employment and the labor shortage. The short-tailed nature of our business model enabled us to recognize these trends real time. The decrease in the first quarter of 2022 accident year loss ratio compared to the 2021 full year reflects the impact of favorable claim trends partially offset by renewal rate decreases driven by the competitive marketplace. The claims operation closed 19% of 2021 and prior claims during the first quarter of 2022, indicative of the short-tailed nature of our workers' compensation business model. Turning to expenses, The underwriting expense ratio increased in the first quarter from 31% in 2021 to 32% in 2022, largely due to higher general expenses from team member compensation, business-related travel, and the early termination of a real estate lease. Wrapping up with the segregated portfolio sell reinsurance segment, we reported a segment loss of $153,000 for the quarter which included underwriting income of $476,000 that was more than offset by investment losses. We renewed all of the alternative market programs that were available for renewal during the quarter. Jason?
Ruby
Thank you, Kevin. Now we'll turn back to Ned for a review of the results from Lloyd's. Ned?
Ruby
Thanks, Jason. The Lloyd's segment reported a profit in the first quarter and a significantly improved combined ratio compared to the first quarter of 2021. For the 2022 underwriting year, we are continuing participation at 5% in Syndicate 1729. Also for the 2022 underwriting year, Syndicate 6131 ceased underwriting on a quota share basis with Syndicate 1729, and its applicable business will be retained within Syndicate 1729. That wraps up our review of the consolidated and by segment results for the quarter. Before turning the call back over, I'd like to offer my heartfelt gratitude to our longtime CEO and executive chairman, Stan Starnes, who will be retiring as executive chairman of the Pro Assurance Board of Directors on May 24th. Stan, thank you for your support of me personally and for all that you have done over the past 15 years for our team members, insureds, and partners. You have left a lasting influence on ProAssurance, and we wish you the very best in all that you continue to do for the community around you. Now our team would be happy to answer what questions you have about our results or other aspects of our business.
Ruby
Thank you, Ned. Ruby, that concludes our prepared remarks. We are ready for questions.
Operator
Thank you. If you would like to ask a question, please press star followed by one on your telephone keypad now. When preparing to ask your question, please ensure you are unmuted locally. If you change your mind, please press start followed by two. Our first question is from Greg Peters of Raymond James. Your line is now open. Please go ahead.
Greg Peters
Yeah, good morning everyone. So for my first question I'm going to focus on just the top line in specialty PC and I know you provided us color and about what was going on there. And I guess what I'm looking is for more information on the results excluding the benefit from NorCal. It looks like there was a slight decline in premium. Also, if you could give us some more color around the 61% retention in specialty health care, that would be helpful.
Dana
Good morning, Greg. It's Mike. Just to comment on the premium ratings exclusive of NorCal, that really was driven by specialty. We had three large accounts in the quarter representing $12 million of premium that we lost, which drove the 61% premium retention rate and the decline in premium exclusive of NorCal. That is really very much a design strategy to be disciplined in the large account space. A number of large accounts, even over the last two quarters, roughly about $30 million have not met our profit expectations. So we've been really disciplined on that side of it and made those decisions.
Greg Peters
Well, that makes sense. And I guess going forward, do you think the book is settling out at this point, or do you anticipate some further disruptions based on your underwriting actions?
Dana
The really great news on that front, Greg, is once we get to the third quarter of 2022, we will have been through re-underwriting efforts at Pro Assurance Legacy, and we will be through all the NorCal re-underwriting efforts. The large account activity, just going back to that for a minute, has taken a lot of premium and loss volatility out of our organization. And what I'll outline there is we now, Greg, as you look at that large account space, our largest account is $5 million or lower. So we no longer have accounts on the books in that kind of $7 to $10 million range. So that should be helpful from a retention perspective and a loss volatility perspective as we go forward.
Greg Peters
Got it. Makes sense. Okay. And then my second question is pivoting to investment income. I understand there's some issues with investment gains and losses and equity earnings and unconsolidated, but your investment income still was up 36%. And Dana, I was wondering if you could just provide us a little bit more color behind the moving pieces because With the bump up in rates, I'm sure at some point that's going to be a benefit to your fixed income portfolio.
Jason
Sure, sure. Happy to do that. So as I think about it, you know, average yield for our fixed income maturity portfolio in the quarter was our average yield was about 2.3 points, slightly lower than the first quarter of the prior year. That said, you know, with the rise in the interest rates, our current reinvestment rate is about 100 to 150 basis points higher than that average yield. So, while our fixed income portfolio, you know, it's primarily composed of like high quality fixed income securities with more than 90% being investment grade, And our weighted average effective duration is around 3.8 years. So we'd expect the portfolio to completely reprice between years three and four. So, you know, looking forward to that aspect of the rising interest rate environment.
Greg Peters
Thanks for the color. I guess I'd be remiss if I just didn't ask a reserving question. You know, the courts were seemingly closed or maybe there was a growing backlog of claims because of COVID. Just curious where you are in that process. That's my last question.
Ruby
Yeah, it's a good question, Greg. And I think it's really kind of state specific as to where the court systems are. While court systems have opened up largely, You're right in stating that there are pretty big backlogs that the court systems are having to work their way through. So we're not up to, I would say, the kind of the activity that we would historically have seen. It certainly is picking up. I think from a reserving standpoint, it's the uncertainties around what all that means that it causes us to be very cautious. Mike mentioned in his remarks We saw yet again a decline in claim frequency, but we're reluctant to really respond to that because we don't know what's over the horizon. One thing we know as regards COVID and potential claims that might arise from COVID is that we're beginning to approach the time where the statute of limitations will begin to run. And what we're uncertain about is whether or not we'll see a flood of claims for the industry as that statute approaches. Certainly don't anticipate that, but we also don't want to be overly enthusiastic in buying into the claim frequency reductions both in our reserving end and how we price going forward.
Greg Peters
Makes sense. Thank you for the answers.
Ruby
Thanks, Greg.
Operator
Our next question is from Mark Hughes of Truist. Your line is now open. Please go ahead.
Mark Hughes
Yeah, thanks. Good morning. Ned or Mike, when you think about the decline in the frequency once again, but then you're pushing your physician pricing, and it's great to see up 10%, how do you make those judgments about whether you need the pricing if claims are still falling?
Dana
Hey, Mark. Good morning. It's Mike. Yeah, just a little color on the frequency trends. Those trends remain at similar levels to 2021 in our healthcare professional liability book, which was significantly lower than pre-pandemic levels. So, you know, that's kind of the good news. I think it really relates back to what Ned just outlined. We need to make sure that our pricing is adequate and if the pinch in the pipe from the court systems come back later in the year or in future years, we want to make sure that we're pricing for that exposure. There's just uncertainty. I do think that we're very encouraged by the pricing level increases, particularly with the NorCal book to start the year. Part of the reason we were able to book $129 million which was half of our segment's premium in the quarters, they had a great retention on that at 90% in the standard position business plus 11% increase. So we're pleased with that result.
Ruby
I think that covers it well, Mike.
Mark Hughes
Thanks. The $129 million from NorCal, what was their written premium in this quarter last year?
Ruby
I don't think we've got that right in front of us. We had about a 90% retention of the business that renewed in the first quarter for NorCal.
Mark Hughes
Yeah, yeah. Is there, at this point, in pushing for the rate increases, is there a combined ratio target? A lot of moving parts, and I understand your conservatism around the booking losses? If we think, you know, kind of a year or two years out on a normalized basis, what should the combined ratio be in the healthcare business?
Ruby
You know, Mark, we continue to target 700 basis points over a 10-year treasury for the kind of overall return for the organization. And when we look at the individual lines of business, and it varies but we need to write in that high mid-90s combined ratio in order to achieve those objectives.
Mark Hughes
And that's for the organization as a whole?
Ruby
Yeah, it's going to vary a point or two by line depending kind of on the duration of the liabilities and the leverage that you feel you need for that particular line of business. So because the duration of the liabilities and the volatility of our work comp business is lower than the healthcare business we think we can write that on a slightly more levered basis than we do the healthcare and specialty pnc business but it you know it's a one or two point swing in the in the loss ratio from that but it's for all of them it's going to be that you know high mid 90s to call it 96 97 98 combined ratio that we need to hit in order to achieve those targets then one quick uh final question um dana the 10 million equity and earnings
Mark Hughes
you point out that that's reported on a lag and presumably this equity market weakness in the Q1 will impact that. How correlated is that with the broader equity markets? Are there other sensitivities that drive that result? If you could just refresh me on that.
Jason
Sure. It's sort of directionally related. The LPs and LLCs are going to track directionally. They're not going to be a literal tie to what's going on in the broader equity market. So just more generally. So we certainly, if we saw $10 million in income from those LPs and LLCs in the first quarter based on sort of market movement of the fourth quarter, we look to see something significantly less than that in the second quarter.
Gary Ransom
Thank you.
Operator
Thank you. Our next question is from Matt Carletti of JMP Securities. Your line is now open. Please go ahead.
Matt Carletti
Hey, thanks. Good morning.
Ruby
Good morning, Matt.
Matt Carletti
Dana, this is a quick one. Just on the commentary around the ULA and the good guy on the loss ratio, or I guess up on the loss ratio, down on the expense ratio, is that a one-time, or is there any kind of ongoing persistency to that kind of trading-off movement?
Jason
Yeah. So, Matt, it's the reverse of what you said. It resulted in a lower... current accident-year-loss ratio and a higher expense ratio. Got it. That's direct. And then it will persist. It is not a one-time event. It will persist.
Matt Carletti
Okay. Just kind of reset the bar going forward. Okay. That's correct. And then, I don't know if it's for Ned or Mike, just the commentary around, you know, the three-point, kind of improvement in the, the legacy pro assurance portfolio, um, and kind of the offsetting NorCal. Can you just dig in a little deeper on, you know, why it is that NorCal runs a little higher? Is it anything to do with just geography and markets are in, or is it just a difference in kind of, you know, pro assurances, corporate targets versus where, where NorCal's targets have been historically?
Dana
Yeah. Good morning. Good morning, Matt. Um, just a, just a couple comments on that. Um, It's really, I think, about starting point. We started at a higher average loss ratio at NorCal. And just keep in mind that the two years prior to having NorCal on board, we had done some really good work on our re-underwriting efforts with our legacy business. It really brought those loss ratios in line, and they continue to improve on an accident year basis. The really good news is NorCal did a nice job. The underwriters did a nice job of getting off to a good start in 2020, which helped us on that book of business as we moved into 21 and 22. We accelerated the re-underwriting efforts, double-digit price increase, a lot of work, a good point on state strategy. We really worked to increase our writings in core states and maybe de-emphasize them in non-state non-core states which which also improves profitability as we go forward so it's just a process of of working through that over the next 18 to 24 months earning out the premium from from those those rate increases and just bringing it in line the other thing are two two things i would add to that man i agree with everything mike just said so we still have in this quarter unearned premium
Ruby
that was in place at the time of the acquisition. So business we didn't underwrite as a part of Pro Assurance, earning in. So I think that's one aspect of it. The other, I think, just has to do with familiarity with the book. We are still learning the NorCal Book of Business. We're pleased with all that we learn about it. But that lack of familiarity, I think, causes us to be cautious as we set initial reserves on that as well. OK.
Matt Carletti
Makes sense. Thanks very much for the color.
Dana
Yeah. Thanks, Matt. Thank you, Matt.
Operator
Our next question is from Gary Ransom of Dowling and Partners. Your line is now open. Please go ahead.
Gary Ransom
Good morning. I got a follow up on the ULAE question too. If it persists, it sounds like there was just an allocation issue that somehow NorCal was allocating. ULAE and expense differently from you? Am I reading that correctly or was there something else?
Ruby
No, Gary, I guess essentially so ULAE is an allocation of general operating expenses to losses to reflect the fact that there are various aspects of your operations, your claims professionals, your accounting folks, and kind of different aspects of the organization that spend time on the claims process and the adjudication of claims. And so we allocate a portion of our expenses to losses. Bringing NorCal in, all the reorganizational efforts that we've done over the last couple of years kind of led to a reevaluation of what percent of those expenses should we be allocating to losses. And we reduced that allocation in the quarter. So you get a smaller allocation of those general operating expenses into losses and consequentially more expenses that are kind of retained within that general operating expense number. So it's just an allocation and a change in that allocation reflective of some of the changes we've made in the organization.
Gary Ransom
And so would that mean that this quarter it was a little bit bigger because there was a ULAE reserve that was also getting reallocated?
Ruby
Yeah, so this does not impact the ULAE reserve. We do carry a ULAE reserve, and that ULAE reserve tries to estimate the operating expenses of running off the book of claims. This solely has to do with ULAE or operating expenses in the current quarter.
Gary Ransom
Okay, thank you. I think I understand that now. Just on another procedural issue, can you remind us how you review the reserves over the course of the year? Do you completely review them every quarter, or is there some schedule that you follow?
Ruby
Yeah, it's a good question. So we do review them every quarter, but recognizing, especially for the long-tailed nature of the businesses we write, that not a lot happens in any given quarter. We do deeper dives on the actuarial analysis in the second quarter and fourth quarter. But there is a comprehensive review. There is a comprehensive review that's done every quarter. We just go a little deeper on those two other quarters.
Gary Ransom
All right. I was sort of asking because in the recent quarters, there was almost a little bit of a up and down pattern to the quarterly reserve for leases where big, big, more complete reserve.
Ruby
Yeah, Gary, it's a good observation. And I think that is reflective of the more in-depth analysis and, and just the, the fact that you've got, you know, when we get to that second quarter, we've got six months of additional data as opposed to just a quarter. We, again, again, given the nature of our business, we really hesitate to make any kind of big moves and big decisions based on 90 days of data.
Gary Ransom
Very different than an auto carrier. Thank you very much on that. Right, absolutely. And then another question on metrics. As you were talking about the the frequency declining and how you are trying to recognize that. Do you see, have any insight into what the doctors themselves are seeing in terms of the flow of patients? Presumably that kind of went down at least for non COVID patients and during 20 and that maybe that's building up. Does that, do you get, can you see those metrics? And if so, does that inform you at all about how to be cautious or, or what to watch for?
Ruby
So you're absolutely right. Especially during the kind of summer of 20, you saw the provision of services outside of kind of emergency room and COVID related things reduced dramatically. And so one expectation would be that at some point that reduction in the provision of services by the physician community would result in a reduction in claim frequency. um and and historically i'd say there's a anywhere from six to 24 month lag and in that kind of reporting time horizon um and we write in writing a claims made book of business is when that report comes through that kind of matters to us so we don't know as we sit here today if that is part of the reason for the decline in frequency it certainly could be i i think by and large um again with with exceptions as there are kind of um increases through the Omnicron variant that came through. You know, when you get to those peaks, I think the provision of more elective procedures and things slows down again, but nothing like we saw in 2020. And I think by and large, physicians' options are back to full capacity. Now, full capacity may be different today than it was pre-pandemic. And it might be in a lot of instances lower, more provision of services through telehealth as an example. So maybe not as many people coming into the doctor's offices can, you know, kind of the flow of business being a bit different. But we're closer today to kind of pre-COVID rates, if not all the way back. Right. Okay. Okay. That's helpful.
Gary Ransom
And maybe one last question on workers' comp rates. I noticed they were down more in this quarter versus where they had been most of last year. Is there anything to read into that?
Mike
You know, there's not. It's just a very, very competitive marketplace. We're very focused on keeping our good risks that have made us profitable for so long. So if we're, if we have to get back a few points of rate, uh, we're, we're, we're okay with it, but there's, there's really nothing more than that, uh, to read into that.
Gary Ransom
And as far as you can see the workers comp loss trends still are relatively favorable.
Mike
Yeah, they certainly, you know, at least for the first quarter of 2022, you know, last year we talked a lot about the labor shortage and return to employment. kind of byproducts of the pandemic. And at least for the first three months of this year, we're seeing that on the decline. So it does remain relatively favorable, yes.
Gary Ransom
Great. Thank you very much for all those answers.
Ruby
Thanks, Gary.
Operator
We have no further questions, so I'll hand back to our host, Jason.
Ruby
Thanks Ruby, and thanks to everyone that joined us today. We look forward to speaking with you again in 2022. Have a good day.
Operator
This concludes today's call. Thank you for joining. You may now disconnect your line.
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