Step One: What Are the Issues.  When we are contacted by you, we first work to gain an understanding of your particular issues and concerns.  We will ask questions that zero in on the key drivers of workers’ compensation costs.  Through this process, we work together to understand the issues that will need to be tackled.

Step Two: Information to be Provided to us by You.  Our next step is a detailed data request to you. Each data request is different due to the unique circumstances of each individual case; however almost all data requests include a three year claim history, three policy declaration pages from the prior three years, and experience modification factor worksheets for the past five years. Sometimes not all data requested is available, or sometimes the available data is not well organized. This should not be a concern to you; we can work with whatever data you have in whatever format you have it. All data provided to us will be treated in the strictest of confidence.

Step Three:  Initial Analysis Report.  We then get straight to work analyzing the data provided. It is at this stage that we begin to identify an action plan to further explore specific aspects of the workers’ compensation costs. We also attempt to quantify the amount of premium adjustments based on likely outcomes of our work.  We will submit an “Initial Analysis Report” to you containing the results of this work.

One of our principals will then contact you to discuss the Initial Analysis Report and recommend a course of action. During that discussion, we also may ask for additional documentation supporting our proposed course of action.

Step Four:  Recommended Course of Action. Once we receive your approval for our recommended course of action, we will begin executing the plan. We are prepared to do the following:

  • Classification.  If you have a grievance with your (i) insurance company or (ii) your state’s Rating Bureau about your classification or e-mod or payroll determination, we will appeal your case to them;
  • Audit.  If your insurance company has audited your policy and has entered an audit conclusion adverse to you and you have been wronged by the audit conclusions, we will appeal your audit directly to the insurance company and further if need be.  We believe if we are retained early after the audit has been completed that we will be most effective. 
  • Appeals.  If an appeal from the Rating Bureau is required to be taken to the State Department of Insurance, we will take your appeal directly to your State Department of Insurance;
  • State Department of Insurance.  If you have a matter that should be addressed by your State Department of Insurance, we will take the matter straight to the regulators. 
  • Insurers.  If you are an insurer and in the event your policyholder has filed an appeal with your State Rating Bureau, we will handle your case directly with the State Rating Bureau (or Department of Insurance, as the case may be); 
  • Litigation.  If formal litigation ensues, we are prepared as appropriate, to serve as expert witnesses on your behalf.  We will not however represent you as your lawyers.  As consultants, we do not practice law. 

We Will Turn Over Every Stone.  We will not consider our assignment complete until we have explored every aspect of your workers’ compensation costs, and our course of action has reached a final outcome.

 Please contact Bill Hager at 561-306-5072 or bhager@expertinsurancewitness.com for more information.