insurance companies

Workers Comp Premium Appeal Support for Insurance Companies

How We Can Help Insurers.  From time to time, insureds may challenge an insurer’s premium determination because they conclude they are paying “too much” for insurance. When this happens, the insurer must be prepared (i) to assert the accuracy of the premium and (ii) to respond to the policyholder’s appeal to outside parties like State Rating Bureaus,  state  departments of insurance, and sometimes, the courts.

We have worked inside the State Rating Bureaus and inside State Departments of Insurance. We know their orientation. In this regard, when challenged, insurers must be able to show that the premium at issue has been determined in accordance with the insurance regulator’s rules and regulations.

We can be of help at every phase of that effort. 

Why You Should Consider Us: Because We Literally Wrote the Book on These Issues.   Yes, you could say we wrote the book:

  • On the experience mod system (or the e-mod; or the experience modification factor);
  • On the classification system (class code);
  • On the retro rating system (retrospective rating);
  • On large deductibles (high deductibles);
  • On proper corporate combinations for e-mod calculations;
  • On payroll determinations;
  • All of which drive how the workers compensation premium is calculated;

Why You Should Consider Us:  We Know This Stuff.  After all, during our years at the National Council on Compensation Insurance (NCCI), that was precisely our job.  NCCI set the rules of the road for the calculation of e-mods; NCCI wrote the book – the Scopes Manual - setting out the entire classification system; and NCCI is charged with assuring premiums are fair and accurate.  Together with our staff:

  • We oversaw the U.S. e-mod system;
  • We wrote the descriptions for the 600+ classifications that appear in the Scopes Manual;
  • We secured approvals for the complex formulas for retros and high deductible workers' compensation insurance rates;
  • We wrote the rules on corporate combinations for e-mod purposes;
  • We wrote the definitions of “payroll” for workers’ compensation premium purposes;
  • We authored and filed some 500 statewide rate filings used throughout much of the U.S, setting the premium levels on about $15 billion of workers compensation premium – every year. 
  • And all of which find their way into most audits of workers compensation policies. 

As Commissioner of Insurance, we passed regulatory judgment and approved each of these matters as submitted to Departments of Insurance. 

We are Familiar with the Process. Over the years we have worked with hundreds of premium calculation cases – as State Department of Insurance officials, as State Rating Bureau executives, as insurers, and as consultants. We will use our familiarity with the process and expertise with the rules to most effectively assert your case. With our professional firepower, we believe you will significantly increase your chances of having your calculations upheld.

We are an Independent Third Party.  Our support of your position can add to your credibility. We offer a respected, fair, independent opinions on the issues in your case and can present these opinions in whatever forum required. We know what is behind all premium determination issues including e-mods, class codes, retros, large deductibles, corporate combinations, premium calculations, audits and payroll, to name just a few.  We know the issues.  We know because we have been there. We have worked inside state rating bureaus, inside insurance departments, and with insurance policyholders.   Please contact Bill Hager at 561-306-5072 or bhager@expertinsurancewitness.com for more information.


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