We are hired by employers, on a contingency-fee basis to perform a workers compensation review, and to find and recover premium errors and overcharges in current and past policies.
We do a workers compensation review of the experience modification and all the other premium calculation factors and credits that insurance companies use to figure out your Workers’ Compensation insurance premiums. In our experience, such errors and overcharges are occurring far more often than many in the insurance industry are going to admit — 90% of the time — and can cost you a tremendous amount of money. The complexities of keeping on top of the rules governing proper experience modification factors and all the other premium calculations and credits while adhering to the varying state and federal regulations and statutes mean that many employers are overcharged
without even knowing it.
Red Flags That APEX Looks For During Audits:
- High claim frequency.
- Incorrect information in your loss-run report.
- Data that would have lowered your experience mod but wasn’t used
- Multiple mod revision increases within one year.
- A “contingent” mod rating.
- A mod of 1.00 or lower does not mean your data is correct. Insured with such “credit” mods have received some of the largest refunds.
- Usage of incorrect factors and rates (Payroll, Classification, Premium Discount, Schedule Rating, Rate Differential, Second Injury Fund Surcharges, PPAP/ARAP, etc).
- Whether all of the applicable state and federal laws, regulations, and exceptions were followed.
- Information that could have been reported differently to benefit your company, but wasn’t.
- Whether your policy fits your business classification, or whether your policy pricing could have been lower.
- Change in business operations.
- Placement in the assigned risk pool.
- Ownership change.
- You have recently transitioned out of a PEO.
- Class code changes and payroll audit disputes.
- Insolvency of previous carriers.
- Multi-state policy (not all states have the same rules and regulations).
- High-risk industries such as construction, manufacturing, transportation, healthcare, and staffing essentially have a guaranteed chance of refunds merely due to the nature of their business!
- Refunds owed to your company from overpaid premiums.
With our workers compensation review, we identify and correct these errors and overcharges nationwide, producing reductions in your current premium and recovering refunds from your past policies, thereby also resulting in future years’ savings.
At the end of the day, when APEX has completed our audit on your Workers’ Comp premiums, we will restore the promise that the insurance company made to you when they first bound your coverage: the promise that as long as you are doing your job — paying your premiums — then they will do their job — abide by all state and federal regulations.
APEX makes sure the insurance companies make the corrections and send you back your money.
In over 20 years in the business, we have performed thousands of audits and have refunded over $48,000,000 dollars to employers. If you are paying an annual premium of around $100,000 or more for a guaranteed-cost or loss-sensitive insurance policy, we will conduct our compliance audit on a contingency-fee basis. We do not sell insurance, and we gain absolutely nothing by having you pay higher premiums. We get paid only if we reduce your payments. You will never pay us for good intentions, ONLY FOR RESULTS.
