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Insurance Policy = Contract Between Your Company and Carrier

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Read Your Insurance Policy On Receipt To Save Headaches

Your insurance policy equals a contract between you/your company and your insurance carrier.   This applies to Workers Comp policies even though they are usually more state-regulated than liability policies.

Three questions asked over the last two weeks that applied to an insurance policy made me decide to step outside of Workers Comp a little.

Using a highlighter, whether electronic or the one in your desk drawer, go over any policy line by line, word by word.  I did this with an auto policy last weekend.  Watching grass grow seemed more exciting.   However, I did find a mistake in one of the policies, so I felt vindicated in reviewing the policy.

picture barn raising insurance policy rural
Wikimedia Commons – Ron Shawley

Our Workers Comp consultant interns initial training requires the college student to read all of our policies along with the various endorsements. Yes, I do not read the one for the businesses, the interns read them over.   They learn bucket-loads of knowledge. Many compile a list of questions to ask me.   So, if our interns can read them, someone can read them in your offices or at home for personal policies.

For instance, the Proof of Loss policy requirements generate so many misunderstandings. Yes, a claim must be filed immediately.   However, almost all carriers in all states require a Proof of Loss in 60 days.    FEMA provides a great explanation for Proof of Loss here.

A summary  is:

Proof of Loss is a policyholder’s statement of the amount of money being requested, signed to and sworn to by the policyholder with documentation to support the amount requested. It is important to understand the Proof of Loss is not the claim.

Magnifying Glass Insurance Policy With Proof Foot Print
StockUnlimited

On a side note, I decided to become FEMA flood certified this year to handle FEMA NFIP claims.

Your Workers Comp insurance policy requires no Proof of Loss.   However, you should read the policy front to back or as recommended in this blog back to front.   The Declarations Page counts as a few pages.  The Dec Pages do not count as the whole policy.  Also, read the Endorsements on your Work Comp insurance policy as you receive them throughout the policy year.

Always call or email (my recommendation) with questions on your insurance policy.

Related:

What Is A Group Insurance Plan ?

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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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