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Workers Comp Audit Materials Needed For Full Review

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Workers Comp Audit Materials Needed

The materials needed for Workers Comp Audit are communications, data, information and contracts. We receive this question quite often when customers or potential clients inquire about our services.  

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We usually do not disclose this information until a contract is signed as we use a copyrighted info grid that I constructed from working with clients over the years.

I decided to shed some light on the subject as this is where we often have a breakdown in communications as the amount of data required can sometimes be very large.   The amount of data needed also depends on the states of operation for a certain business.

California insureds usually only require three years at a maximum due to the premium audit laws in CA. However, this is for states that operate only in California.   We actually request the two prior years and the current years’ information.

In California, we can only examine the current year and the prior years’ WC data.  This is due to the rules established by the Insurance Commissioner and the rating bureau – the WCIRB.

Materials For Workers Comp Audit Vector
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Almost all other states have a three year look-back period which means that the Insurance Commissioner  State Rating Bureau, and/or NCCI allow the current policy and three years’ prior policies to be examined overall.   There are some very rare exceptions to this rule.  I will not cover those examples.

If your company operates in multiple states, the NCCI will usually have jurisdiction over your rating better known as a multi-state rating.  This can cause some confusion as some of the independent bureaus such as California or Ohio wish to have the part of the ratings as a separate policy for just their state.

I would just list all the workers comp audit items that we usually request.  However, there are many documents that are requested due to a specific company such as drivers’ expense records for a trucking company.  The main thing to start now is a Workers Comp file, whether scanned or paper, that has EVERY piece of info you have received or sent including emails over the last five years – three for California employers.

We actually found a mistake made on a policy resulting from a sticky note that saved an employer over $25,000 over a three year period.  I also recommend not letting your agent or broker have the only copy of your WC info including policies, amendments, payroll audits, etc.  You should have a local copy of everything at your disposal.

NCCI, or your State Rating Bureau will usually provide a free copy of your E-Mod rating if your  company requests it on your company letterhead.

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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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