Questions & Answers
The following is the most common questions that are asked about our service and the value we bring.
1. My Agent does this.......
Insurance agents are valuable partners in securing coverage for your business, they have different skillsets and focuses compared to forensic auditors specializing in worker's comp. Here are some points to consider:
Different Expertise:
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Insurance agents: Broad knowledge of various insurance products and risk assessment. They focus on finding suitable coverage at the best price.
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Forensic auditors: Deep expertise in worker's comp regulations, reporting, and compliance. We meticulously review your policies and records to identify errors and discrepancies, potentially leading to cost savings.
Data Usage:
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Insurance agents: Use available data from your business and industry to estimate risks and recommend coverage options and cost. This data can be incomplete or inaccurate.
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Forensic auditors: Analyzes the data your agent is using for hidden errors and non-compliance, thus giving the agent accurate information to obtain they best coverage at the lowest cost.
While insurance agents are invaluable for finding general coverage, they don't specialize in the complexities of worker's comp like a forensic auditor.
2. Isn't the insurance industry regulated?
While insurance regulations exist, they don't always guarantee a level playing field. When systems falter or human errors occur, it's often up to the policyholder to identify and rectify issues—a daunting task for those who lack the knowledge or resources to challenge industry giants.
Even when errors favor the insured, insurance companies aren't proactive in returning overpayments. They often quietly pocket the extra profit unless a formal request is made. This highlights a fundamental truth: insurance companies are businesses designed to maximize profits, not hand back money willingly.
3. What happens to overpaid premiums on expired policies?
Unfortunately, without active intervention, they often remain unclaimed, silently boosting insurance company coffers.
4. I receive a refund every year....
You're absolutely right! While receiving a refund from the insurance company can feel like a win, it's important to remember that it often represents overpayment due to overestimated payrolls rather than active cost reduction.
Your business essentially lends your money to the insurance company for the entire policy period, only to get it back later, potentially missing out on investment opportunities or hindering cash flow.
5. Is my agent at fault if CIV find errors and recover funds?
It's not necessarily that your agent is specifically at fault if CIV Inc. finds errors and recovers funds in your worker's comp policy. Here's how to break it down:
Your agent's role:
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Insurance agents typically specialize in finding the right coverage for your business's needs based on the information you provide.
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They may not have the specialized expertise in worker's comp complexities and regulations that forensic auditors like CIV Inc. do.
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Agents might also be limited by the data you, the insurance companies and the rating bureaus provide, which may not be complete or accurate.
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Agents present you policies written by your insurance company. The agent should not be held liable if the insurance company has written a policy that is not in compliance with your states regulations.
6. Is it my controllers fault if CIV find errors and recover funds?
No, it's not your controller's fault if CIV finds errors and recovers funds in your worker's comp policies.
While controllers play a crucial role in managing financial data, worker's comp is a highly specialized area where errors often originate beyond their control. Here's why:
Insurance Industry's Data Control:
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Your data, their hands: Insurance companies and rating bureaus hold the primary responsibility for maintaining your worker's comp data accurately.
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Limited visibility: You often lack direct access to verify this data, making it challenging to spot errors independently.
Complex Systems and Human Factors:
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Multiple touchpoints: Your data passes through numerous hands, from underwriters to claim adjuster to policy administrators, increasing the likelihood of errors.
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Simple mistakes, costly consequences: Even a single typo, misunderstanding of a rule, or misclassification can lead to significant overpayments— we have seen multiple cases, the largest being a $90,000 typo.
Beyond Your Team's Control:
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Best efforts, unseen risks: Your team—agents, risk managers, safety experts—may do everything right, but undetected errors within the insurance system can still silently inflate premiums.
7. What will my insurance company think if I have a review done?
Most insurance companies understand the importance of reviewing policies and data for accuracy. They actually welcome the opportunity to ensure compliance and avoid potential issues.
8. How much of my time is needed?
Our service is performed offsite - Typically 30-45 mins over a 8-12 week period. This allows time for the occasional phone call or an email update.
9. What is my probability of recovery?
CIV Inc. has over a 91% success rate. Our average recovery of companies paying over $100,000 per year - $42,000.00
10. How much will the Forensic Review cost me?
We work on a contingency fee basis - No Recovery - No Fee - No Risk