For over three decades, the industry has depended on our flagship Workers Compensation Audit and Recovery Services. Our highly specialized audit team uncovers inadvertent errors and mistakes by the carrier and certifies accurate workers’ compensation audit premium. During our workers’ compensation audit analysis, SMP Consulting Group‘s Audit Team focuses on incorrect employee classifications and/or inappropriate experience modification rates. Misclassifications and Incorrect MOD Rates may lead to higher premiums and overall costs. SMP Consulting Group‘s workers’ compensation audit streamlines the process to secure client refunds.
WORKERS’ COMPENSATON AUDIT PROGRAM
Through our trained licensed specialists SMP Consulting Group specializes in analyzing workers’ compensation premium overpayments. We have found that many times human error leads to incorrect classifications, erroneous modification factors, payroll audits, and other rating factors. Our consultants know where to focus and make the adjustments that result in lower premiums. SMP Consulting Group has had successful results in many industries including schools, non-profits, healthcare, manufacturing, construction, wholesale/distribution, and trucking with annual premiums in excess of $35,000. The annual premium reductions extend to many subsequent years.
“PEO” AUDIT PROGRAM
Is your PEO accurately pricing your benefits? SMP Consulting Group will know. Our audits focus on errors or misstatements that lead to higher and erroneous billing. Our trained specialists find and correct these mistakes so your costs and expenses are reduced. These lower costs extend to future year savings.
SUBROGATION AUDIT PROGRAM
Medical expenses are paid regardless of how an accident or injury occurs. Subrogation recovery focuses on health care payments reimbursements when a third party is at fault or a workers’ compensation carrier should be paying the bills. If you have paid medical benefits that were the result of an injury caused by a third party, you may have the right to recover those expenses from the third party, their insurance company, or any other responsible party. SMP Consulting Group provides highly-trained recovery consultants to evaluate each claim and file for reimbursement.
Hidden overcharges in Workers Comp insurance are far more common than the insurance industry likes to admit, and often get repeated year after year after year, in spite of competitive bidding by different insurers or agents.
Errors in Experience Modification Factors are often overlooked because underwriters, auditors, and agents lack training in the rules that govern experience mod calculation. And the rating bureaus that calculate mods tend to accept at face value data reported by member insurance companies without checking it for accuracy.
HAVE YOU HAD ANY WORKERS COMP CLAIMS?
You may be surprised to learn that those claims may be unnecessarily inflating your EMOD through a common carrier practice known as Subrogation.
When the carrier pays for the injury of an employee, oftentimes they are recouped for that cost through Subrogation. This is when the carrier identifies a third party who had some potential liability in that particular claim. They will then file a lawsuit against that third party and recoup some or all of the cost of that claim. It is then the carrier’s responsibility to notify the NCCI and Rating Bureau that they’ve recouped that cost so that claim isn’t having the same impact on your MOD. Well, many times – THEY DO NOT! The SMP Consulting Group team will analyze and review each and every claim on your behalf!
Another common practice relates to Claim “Reserves”. When your employee has an injury, the carrier is responsible to set aside “reserve”. Many times they “Over-reserve” or even leave reserves open after the claim is settled. This common carrier practice inflates your EMOD!
If you take a back injury, for example, your carrier may set aside 25,000. 6 months later that claim is settled for 5,000. The remaining 20,000 should be closed out of the system immediately. But when we take a good hard look at the loss runs – IT’S NOT! It can remain open FOR YEARS having a negative impact on your MOD – YEAR AFTER YEAR! SMP Consulting Group team will analyze and review each and every reserve for accuracy!
Errors in classification, for example, tend to get repeated year after year because insurers and agents rely on past policies and audits for determining classifications, instead of taking a fresh look to determine what the true proper classification is for your business.
Errors in payroll audits are rarely caught because specialized training is required to identify them and specialized experience is needed to get insurance companies to retroactively correct them.
We have that training and experience.
Insurance company folks, and some insurance agents and brokers, often downplay the severity and the frequency of these hidden overcharges. Denial is more than a river in Egypt, as they say. But consider this recent case of ours, which puts the lie to such denials. This client is a small manufacturer of precision machined parts for other companies. We’ve just finished arranging a refund of $55,000 from four past policies from a major insurance company. This is in addition to the more than $100,000 in refunds we’ve already produced for them, from a bunch of past policies. These refunds came from four different past insurance companies, sold by multiple different insurance agents. We’ve been working with this client for a couple of years now, obtaining refunds back from one insurance company after another, on their behalf.
This wasn’t for some big company, either, with huge insurance premiums. Most years, these folks had around 30 employees. Annual Workers Comp premiums for them were in the range of $45,000. None of these insurance agents, underwriters, or auditors figured out that they were using the wrong classification (and thus the wrong manual rate) for this company. So the overcharges went on, year after year after year after year. Until we came along and convinced them to let us check things over. That’s what Premium Recovery is all about.
And don’t let any insurance agent or underwriter tell you it couldn’t have happened to you, that competitive bidding or insurance regulation would prevent it. We’ve found and recovered hidden overcharges for almost every kind of business imaginable, all across the U.S.
These overcharges are not uncommon, because the rules governing Workers Compensation insurance premiums are complicated, arcane, and the insurance industry often lacks the motivation to catch and correct such technical errors.