Claims investigation brings client’s Mod to an all-time low

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 a private investigator, it was learned that two of the claims were fraudulent and quickly closed without payment. Two previous claims, which had excessively high reserves, were amended to less than a quarter of the original. And one remaining claim is pending in litigation, though it is expected to settle for a fraction of the original estimate.

RESULT

By managing the claims properly, the CWC was able to reduce the company’s expiring annual premium from $140,000 to $90,000, and the Experience Modification Factor from .96 to an all-time low of .67.