The Blog

INSURED - The insured is a residential plumbing contractor with 265 employees. SITUATION - The company was in a transitional stage causing a higher-than-average claims activity. The result was a large number of open claims that included indemnity and an Experience Mod of .98 and rising. ASSESSMENT - CWCAs reviewed the situation and realized that the Experience Mod was being driven up not only by the number of claims, but also by the number of malingering claims that were not successfully closed. In fact, because there was no injury management process in place, 80% of the lingering claims included indemnity.…

INSURED - The insured is a large oil company making deliveries to area businesses, including five convenient stores/service stations that it owns. The company has 40 employees and estimated annual revenues in excess of $50 million. SITUATION - Following an audit, the insurance company attempted to charge the company for higher job classifications even though the number of employees nor the type of work had not changed. ASSESSMENT - CWCAs reviewed all audit worksheets. After a careful review and discussion of the situation with the head of the company, it was determined that there were two employees who had been…

INSURED - A conglomerate of associated companies with several locations within one state. SITUATION - Over the course of five years, the company purchased multiple related companies. Numerous errors were made when combining the loss experience. Some were never combined with the parent and were issued their own rating, while others had multiple payroll and claims history reporting errors. This resulted in multiple Experience Modification errors, totaling $329,000. It was determined that the insurance broker was in over his head and it was necessary to hire an outside consultant to untangle the mess. The decentralization of management and operational practices…

INSURED - A metal fabricator with 26 employees that manufactures metal sign-holders for various retailers. SITUATION - With no history of carpel tunnel issues, the insured experienced a rash of carpel tunnel injuries unexpectedly, with two in excess of $80,000. This drove the company’s Experience Mod up to 1.72 and resulted in the policy being canceled by their Workers’ Comp carrier. ASSESSMENT - The first claim was a legitimate case and the employee required medical attention and physical rehabilitation. The following claims occurred so rapidly that they were deemed questionable. There was also no clear language in place in the…

INSURED - A midsize masonry contractor. SITUATION - The masonry contractor was using a PEO (Professional Employer Organization) and was concerned what it was paying for Workers’ Comp was higher than that of its competitors. It was difficult for them to determine their rate because the payroll taxes, Workers’ Comp and additional fees were combined. ASSESSMENT - CWCAs analyzed the PEO invoice and broke out the payroll taxes, fees and Workers’ Comp costs. It turned out that Workers’ Comp came to $59,000 a year. Payroll data and loss information was requested and the Experience Mod was calculated at .95. SOLUTION…

INSURED - This major landscape contractor servicing commercial properties employs 120 people and does $1.9 million in annual revenues. SITUATION - A year after purchasing the company, the insured was concerned why, as a relatively new business, its Experience Mod was extremely high at 1.39, with annual premiums in excess of $400,000. ASSESSMENT - Certified WorkComp Advisors conducted a complete needs analysis on the company, running the gamut from human resources to claims filing. The insured was unaware of how the system worked in regards to ownership changes and it was discovered that the insured had actually inherited the previous…

INSURED - The insured is an HVAC service company with approximately 23 employees and estimated sales of $4 million. SITUATION - The company was in serious danger of losing one of its biggest accounts, a leading national paper manufacturer. The paper manufacturer was highly interested in promoting on-site job safety and had an established policy that it would not do business with any vendor whose Experience Mod was greater than 1.0. The insured was unable to meet that guideline. ASSESSMENT - The CWCA determined that the way to handle the situation was to break apart the company’s Service Department, to…

INSURED - This grading contractor employs 42 people with annual revenues of approximately $3 million. SITUATION - The company had been with the same broker for 21 years. The broker had never audited or verified the insured’s Experience Modification Factor and routinely accepted the Mod Worksheet provided by NCCI as accurate and correct. The company’s Mod was 1.40. ASSESSMENT - Recognizing that mistakes are common in Experience Mods, Certified WorkComp Advisors performed an audit of the current Mod and found a number of unnecessary errors that were adversely affecting the Mod. Several high-severity claims were still listed on the Experience…

INSURED - The insured is a contract hauler that services major building supply companies and contractor equipment dealers in 11 states. Annual gross revenues are in excess of $6,000,000. SITUATION - The company’s Workers’ Compensation premium was $140,000 and the Experience Mod was .96, predominantly a result of claims in two states. ASSESSMENT - CWCAs reviewed the company’s operations for state and federal filings and to make sure the coverage was proper. Then they reviewed the Experience Mod worksheet. Careful analysis revealed a number of claims still open, dating back six years with no activity. SOLUTION - With help from…

INSURED - This free-cast prestressed concrete manufacturer and contractor has annual revenues of nearly $15 million and employs 60 people. SITUATION - The company, which traditionally had an Experience Modification Factor in the .89 to .90 range, saw a rise to 1.2. This resulted in the company going from a credit experience modification factor (under 1.0) to a debit or penalty experience modification rate (over 1.0). To further illustrate how the increased rate impacted standard annual premium: Previous: $40,000 annual premium times the experience modification factor of .90 = $36,000 New: $40,000 annual premium times the experience modification factor of…