Checking a workers compensation audit before the insured pays it
Every disputable item on a workers compensation audit sits on the worksheet rather than on the invoice, which is why the worksheet is the thing to ask for. The comparison runs against the exposure the policy was rated on and against what the insured reported: payroll split across codes where duties are genuinely split, or a subcontractor picked up as payroll because a certificate was never collected. Neither agency nor insured can change the number, so the output is a written challenge citing worksheet lines.
A certificate request arrives as a sentence in an email, and answering it correctly requires deciding which endorsements the policy actually grants.
The agency management system is the record, and a standardised download feed keeps parts of it current. The feed is positional flat file in origin, its coverage varies by carrier and by line of business, and a policy that arrives without matching an existing record lands in a queue somebody clears by hand.
- Applied Epic
- Excel
- Outlook
When this is the wrong thing to build
Pick something else if your carriers send audits as scanned worksheets with handwriting on them, which several still do. A printed audit statement is workable. A fax of a spreadsheet annotated by hand is a different problem, and the accuracy you could promise on it is not the same.
The constraint that shapes it
Producing a quote or binding coverage happens under a licence that is issued per state and per line, and separately under a carrier appointment, so a person can be licensed without being appointed. More on how this sector works.
Two sources of truth. One queue of the rows that do not line up. Read what this shape is, or start from one of these.
- Rebuilding an annual operating expense reconciliation from the lease
- Reconciling a broker trust account three ways every month
- Matching a closed transaction back to the lead that produced it
- Collapsing two overlapping MLS feeds into one property list
- Widening a conflicts search past exact spelling
- Rebuilding a billable day from the trail the systems already keep
- How do I check a workers comp premium audit for wrong class codes?
- What is on the audit worksheet that is not on the audit invoice?
- Can payroll be split between two workers compensation class codes?
- How do I dispute a workers compensation audit with the carrier?
- Why did uninsured subcontractors get charged as payroll on the audit?
Back to insurance agencies, or see how this is priced and scoped.