California Changes Landscape On Premium Audits And Other Disputes

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California Changes Disputes With Bill Signed By Governor Brown

The State of California changes landscape of premium audits and others disputes.   Last night, I was reading over a short article that covered a new area for insureds in California Workers Comp disputes. I will actually cover more on CA over the next few weeks. The state has been very active lately on Workers Compensation law changes.

Image Of Governor Brown California Changes In Portrait
Wikipedia – State of California

One caveat is the bill signed by Governor Brown does not say that you can actually negotiate contract provisions AFTER the policy have been signed off on by all parties. Your company must act BEFORE the policy goes into effect. This is Risk Management at its best. Insureds being able to possibly change their insurance policies provisions BEFORE the policy may be of benefit.

We usually receive calls and emails after a policy dispute has begun with a carrier. One thing that we write in all of our reports to clients is that we must follow what is in the policy. Workers Comp policies are usually created cookie-cutter style when it comes to the policy provisions. By the way, when is the last time that you or one of your staff read your WHOLE Workers Comp insurance policy?

Landscape With Sun Set California Changes Graphic
StockUnlimited

There are certain sections of the policy that define when and how your company has to proceed with any type of dispute. There are also provisions on coverages such as states in which your company has insurance. We have seen companies having to pay out-of-pocket in CA as their employee was injured in another state and filed a claim that was accepted in another state. This happens very often with trucking/transportation companies. Do you know which states your Workers Comp policy provides coverage?

We find those provisions in the back pages of the policy. I also recommend that you read your Workers Comp policy like you are studying for a test with highlighter in hand. If you find clauses in your policy that you do not understand or question, please forward those to your agent or you can always send me an email.

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James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt 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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