The Difference Between Workers Comp File Reviews, Premiums Reviews, and Reserve Reviews - yes, they are all different.

I have posted on this issue more than a few times. This is most of what we do for a business. I felt the need to re-post on the subject as we receive questions daily on file, or premium, or reserve reviews. Employers, agents, and others are sometimes confused by the terms.

• File Reviews - also called Performance Reviews. File reviews are usually reviewing all aspects of the way that a Workers Comp Claims Adjuster handled a specific file or group of files. The performance on the set of files is scored against a group of weighted criteria. Any trends are noted. We do not and will not pick out a few things that an adjuster erred on in the handling of the Workers Compensation claims. We look for trends such as over-reserving of files, late three-point contact, etc. Most adjusters do very well in our audits.


• Reserve Review - we should call this the Total Incurred Review, but most people outside the Insurance Industry refer to the Total Incurred as the reserves. We review the Workers Comp loss runs to make sure that the reserves are in line with the accident and the claims status provided by the adjuster. This can be part of the File Review.


• Premium Review - this is where we actually confirm all the premium calculations and the structure of the calculations. We examine areas such as classification codes, E-mods, original Workers Comp policies, year-end audits, etc.

Quite a few of our clients are now requesting E-Mod reviews. This is where we assist in lowering the E-mod or getting a company out of the Assigned Risk Pool. There are many areas where a company's Workers Compensation premium payments may be reduced. We see so many companies just writing a Workers Comp premium check without questioning how the payment was calculated. Questioning the $ you pay out is the best place to start a Workers Comp premium reduction program.

Our main website is www.cutcompcosts.com