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Workers Compensation Premium Auditors – Not Licensed Like Claim Adjusters?


Workers Compensation Premium Auditors Licensed Like Claim Adjusters?

The Workers Compensation premium auditors should likely have licenses like claim adjusters.

Picture of Hand Presenting Licensed Like Claim Adjusters Premium Auditors Concept

Workers Compensation premium auditors have never been licensed or actually regulated in most states. I have spoken often to the other premium audit companies for employers about starting an organization that would oversee the employers’ Workers Comp premium audit sector of the insurance industry. After the Workers Compensation consultant debacle in South Carolina, I would say that states need to consider licensing ALL premium or other types of auditors.

The premium auditors are very similar to adjusters in many ways. Adjusters and premium auditors do have fiduciary responsibilities to their customers.

The amount of premiums that an employer pays will always center on the work of adjusters and premium auditors. The adjusters indirectly charge premiums by setting reserves which affect the E-Mod.

The auditors can directly change the premiums by auditing the payroll and company overall.

Hand Presenting Premium Auditors Strategy

For some reason, as the insurance industry has evolved, licensing auditors of premiums has never even shown as a blip on the radar screen of regulators. Licensing auditors would be a quick income source for the Departments of Insurance. One has to wonder why a state department allows this untapped quick source of funds to escape their licensing fees.   Most workers comp adjusting licenses cost $100 – $200 per year.  Out of state adjuster licenses can be very expensive.

Licensing any type of insurance personnel allows the states to control their actions by fining or license revocation.  Every state insurance department issues a list of fines or license revocations at least quarterly.

I think we will at least see a large association started of employer premium auditors. That is a great idea, but should the regulation be self-imposed? I have seen little or no attention from any governing body on the subject. What about insurance company based or independent premium audit companies? Should these premium auditors also be regulated?

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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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