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Large Deductible Programs Can Be Reviewed for Premiuim Overcharges


Large Deductible Programs Reviewable For Premium Recoveries

Most Large Deductible Programs were ignored by auditors in the employer premium recovery industry for many years.

Vector Graphic of Businessman Standing Large Deductible Programs Infographic

We often hear from very large companies that they are in a large deductible program and that examining the Workers Comp Audit (by the insurance carrier) is an exercise in futility as there are no premiums that can be recovered.

This is simply not the case.  Without going into the intricacies of certain Workers Comp agreements, there are other areas of the Workers Comp policy and audits that can be examined for mistakes and overcharges.  As long as an Experience Modification Factor (E-Mod/X-Mod) is promulgated (calculated) and a premium is charged by a carrier, the policy and workers comp audits of large deductible programs can still be analyzed for overcharges.

Many times we have heard employers with large deductible programs say that they “are  outside of the Workers Comp rating system.”  That is not the case.

The % of recovery may not be as large as on a regular Workers Compensation agreement.  The larger premium amounts will usually balance out the smaller %’s of recovery.  The bottom line is that unless a company is fully self-insured, there is always a possibility of premium recovery.

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James J Moore - Workers Comp Expert

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Management Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications


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