Main Errors – Auditing Workers Compensation Policies
Auditing workers compensation policies involves many steps.
We have examined a large number of Workers Compensation policies in our existence. We find errors auditing at least 50% of the time.
The most common errors that we have seen are (in order from most common to least):
- Over-reserving or not closing files timely (see the previous post on Total Incurred)
- Employees misclassified into the wrong classification code
- Governing classification code wrong – very expensive
- Subcontractors classified as employees
- Wrong payroll items counted as Workers Comp remuneration
- Two or more distinct businesses classified as one business
When you are auditing your Workers Comp insurance policies and loss runs, please remember that 130 variables go into a claim, and there are 34 steps to taking the Total Incurred and converting them into your E-Mod or X-Mod.
Then, there are approximately 1o more steps once you have your Experience Mod to calculate your premium. As each of the variables feeds into each other, you can multiply them to see what the chance of error would be for a given Work Comp policy.
130 * 34 * 10 = 44,200
Hold on, though as that is for one claim figuring into your premium. If you have 20 open claims, then you would multiply 44,200 * 20 = 884,000
So, there are 884,000 calculations or variables that must all be correct for you to pay your correct premium. Are you still willing to just write a check to the Workers Compensation insurance carrier?
I wrote about the Self-Insured Phenomenon yesterday. At this point, if you are self-insured, are you thinking that you’re OUT of this type of system? The actuary that sets your LDFs or Loss Development Factors has as many variables and combos to examine. If you are self-insured, then the number of open claims may be even higher.
I will talk about each of the above errors in auditing workers compensation policies over the next few days. Notice how many times the word Classification is in the above list.