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How to Dispute Your Workers Compensation Audit

On this page we'll show you how and when to dispute your workers compensation audit...

Here are a few items you need to know about the audit dispute process. Keep in mind these are only provided to you as a guide. The exact process may differ depending on your insurance carrier or workers compensation providers specific audit dispute requirements.

How can you tell if you need to file a workers compensation audit dispute. Here's a few things to look for;
  • Your audit clearly includes mistakes made by the auditor or insurance company?
  • The payroll numbers used on your audit do not match those you provided the auditor for the policy period being audited.
  • You received a significant audit bill but any increase in payroll does not seem to justify such a large additional premium bill.
  • Your workers compensation job classifications were changed by the auditor or insurance company.
  • Your experience modification factor is different than the one used on your policy.
  • The auditor has improperly classified you and your employees.
  • You are a contractor who performs different types of work or has crews who fall into different job classifications and the auditor did not allow you to use payroll separation.
  • You have been charged for uninsured subcontractors when you have certificates that show they had coverage.
  • Your insurance company removed or changed policy credits on your audit billing statement.
  • You did not receive copies of the auditors worksheets.
  • The auditor did not complete your audit while on site.

What you need to do to file a work comp audit dispute with your workers compensation provider;

  • Filing a formal work comp audit dispute will accomplish this;
    • It will put on hold any collection procedures for the premium in dispute.
    • It will put on hold any endorsements or changes to your current years policy until the dispute is settled.
  • How to file a formal workers compensation audit dispute;
    • You must provide to your insurance carrier a WRITTEN detailed explanation of why you believe your bill is incorrect.
    • You must provide to your insurance carrier a WRITTEN detailed estimate of what the correct premium should be.
    • You will be asked to pay any undisputed portions of the premium you owe by the due date on the original audit bill.

The formal workers compensation audit dispute request must be submitted to the insurance carrier in writing along with all paperwork supporting your belief. If this process is not followed the insurance carrier may continue all collection procedures against you which may include turning your account over to a collection agency. Do they really do that? You bet they do!

Here's a few things to keep in mind if you feel your audit is incorrect;

  • Do not wait until the last minute to respond to the audit.
    • The worse thing you can do is procrastinate. Don't wait until your account has been turned over to a collection agency! It just makes negotiating with your insurance carrier impossible.

  • Be proactive at correcting your audit.
    • Remember, mistakes occur in a high percentage of audits. Insurance carriers know that. Be proactive at correcting those errors!

  • Follow the rules established by your insurance carrier for filing a workers compensation audit dispute.
    • Taking short cuts will not work if you are trying to correct a work comp audit. Mistakes made in following the work comp audit dispute procedure will only delay the correction and in some instances cause your account to be turned over to collection. Not a very friendly outcome.

If you are having trouble filing a workers compensation audit dispute, have filed a dispute and it's not going in a favorable direction or would like assistance with your work comp audit dispute, you should contact Workers Compensation Consultants at [email protected] for assistance. We should be your FIRST RESOURCE for help with a workers compensation audit dispute.

Here's how we fix work comp premium errors.

Make no mistake; we do not sell insurance and we will not replace your current insurance agent, insurance broker, or insurance company. Our services will only enhance your efforts to control your workers compensation cost.

That's where we come in. We represent you and your business!

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