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Policy Dispute Time Limit – 36 Months Maximum


Why The Number 36 Is A Crucial Policy Dispute Time Limit

We are contacted at least twice a month where the policy dispute time limit comes into play.

sign 36 month policy dispute time limit
Commons 2.0 License – Marcin Wichary

For example, recently J&L was able to find multiple major coding errors on various claim files that stretched back at least two decades.  The employer contact became furious that we could not go back to the early 2000s with the errors and recover from over 20 policies.

I tried to explain that 36 months after the policy expiry was the policy dispute time limit.  Most worker comp policies contain language that directly addresses this policy dispute time limit.   One needs only to look at Section G in most standardized workers comp policies in NCCI states.

The unfortunately unhappy employer did receive back a premium refund for the prior three years and the current policy was corrected.

That Also Works For the Insurance Carrier

The workers’ comp policy dispute limit also applies to insurance carriers.   What if the tables were turned and the insurance carriers were allowed to perform premium audits 20 years into the past?  I have only seen one carrier attempt auditing 10 years into the past.  One letter to the carrier pointing out the time limits (in the policies) was all that it took to stop the audits.

The 10-year audit was produced by a rogue independent company auditor.

Reason For Using 36 Months And Not Three Years

Yes, I and many people reading this article say that 3 years is the limit.  I agree, but whenever I use 36 months, insureds tend to pay more attention to the dispute time limits.  For example – in three years, we have plenty of time to raise a dispute.  Thirty-six months makes the time look shorter.   You are in the 34th month out of 36 vs. the 2nd of 3 years.

California allows a shorter timeframe.  Check out the link for a 2010 article on the subject.  As I try to write articles that cover all states, many exceptions exist to the 36-month time limit.


Repeating Workers Comp Premium Audits – #1 Question Received


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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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