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WORKERS
COMPENSATION
VIRTUAL REFERENCE GUIDE

TABLE OF CONTENTS
2
Thank you for
choosing Chubb!
From policy issuance
to loss prevention
and premium audit,
this online tool kit
gives you one place
to access information
about your Chubb
Workers Compensation
insurance program.
Simply click on any
of the links in the
table of contents
to get started.
WORKERS COMPENSATION VIRTUAL REFERENCE GUIDE
1 POLICY INFORMATION AND LOSS REPORTS
View Policy Transactions»
» View Loss Reports for Your Policy
» Request Additional Posting Notices
2 CLAIMS REPORTING AND RESOURCES
» Report a Claim
Use Your Chubb Claims Kit»
» Do You Suspect Fraud?
3 MEDICAL AND DISABILITY RESOURCES
» Find Providers in Our Preferred Network
» Pharmacy Benefit Management Program Information
4 DEVELOPING A SAFETY PROGRAM
» Conducting a Safety Analysis
» Basic Safety Practices
» Monitoring and Measuring Your Program
5 PREMIUM AUDIT AND ACCOUNTING PROCESSES
» What is a Premium Audit?
» Premium Audit Timeline
» Preparing for a Premium Audit
» How to Request Audit Worksheets
» How to Dispute a Premium Audit

POLICY INFORMATION
AND LOSS REPORTS
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If an insured would like to know the status of a policy or see copies
of policy documents, agents can easily access this information and
order copies at:
On the @chubb home page, click BUSINESS POLICY
DETAIL on the Quick Links or under Account Management
and Inquiry.
Agents can view loss runs by policy number and share information
with insureds at:
On the @chubb home page, click BUSINESS LOSS RUNS on
the Quick Links or under Account Management and Inquiry.
Insureds may also have access to our Loss History Analyzer or
RMIS tools via the @chubb platform. If an insured does have
access to these tools, they can log in with their own credentials to
the @chubb homepage at:
VIEW POLICY TRANSACTIONS
1. POLICY INFORMATION AND LOSS REPORTS
VIEW LOSS REPORTS FOR YOUR POLICY
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Please contact your
network administrator for
an @chubb password if
you do not already have
one. If your organization
does not have an
administrator for Chubb’s
online systems, one can
be set up by contacting
our eBusiness Helpdesk
at 1.877.747.5266.
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REQUEST ADDITIONAL POSTING NOTICES
Issued policies will include one Posting Notice for each covered
state on the policy.
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CHUBB.COM/@CHUBB
CHUBB.COM/@CHUBB
CHUBB.COM/@CHUBB

Policies will not include Posting Notices for Monopolistic States
(North Dakota, Ohio, Washington, and Wyoming), as well as
Oregon and South Dakota because:
To request additional copies of Workers Compensation
Posting Notices, contact your agent or local Chubb
underwriter with the following information:
Policy Number and Insured Name
Policy Term (Effective and Expiration dates)
Name of the State, Form Number and # of copies needed for
each form. Please also include a total number requested.
Note: the state must be a covered state on the policy.
Specify the recipient of these forms — Insured, Producer,
Chubb Branch or Other.
If the forms should be sent to another party, please provide
the full name and address of the recipient.
1. POLICY INFORMATION AND LOSS REPORTS
5
Note: If you are aware of
the need for additional
posting notices prior to
policy issuance, it is best
to provide instructions in
your binding order.
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OREGON sends Posting Notices directly
from the Oregon Workers’ Compensation
Division when a policy is issued.
SOUTH DAKOTA does not require
Posting Notices.
EXCEPTIONS
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CLAIMS REPORTING
AND RESOURCES
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Choose whichever method is most convenient for you:
• Call 1-800-699-9916
• Fax 1-800-884-3946
If you choose to report a claim online, please review:
REPORT A CLAIM
2. CLAIMS REPORTING AND RESOURCES
Need to report a claim?
There are four ways to
report a claim to Chubb.
Only one Claims Kit is issued per policy, and we encourage you
to make copies of the forms provided in the kit for future use.
CHUBB CLAIMS KIT
Chubb Claims Kit
contains the materials
you need to expedite the
reporting of a Workers
Compensation claim.
If you suspect fraud or an exaggerated claim, contact
Chubb’s Special Investigation Unit (SIU) by notifying your
adjuster or call 1-800-35-Chubb (2-4822). Our SIU includes
a special team dedicated to investigating potentially
fraudulent workers compensation claims.
DO YOU SUSPECT FRAUD?
7WORKERS COMPENSATION VIRTUAL REFERENCE GUIDE
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CHUBB.COM
ONLINE CLAIM REPORTING APPLICATION
ONLINE CLAIM REPORTING INSTRUCTIONS
ONLINE KIT

MEDICAL AND
DISABILITY RESOURCES
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CorVel (All States)
• Dial 1-800-318-6668 or go to
• Click “Find a Provider”
• Select Workers Compensation
• Fill in the distance and the city and state
• Enter your zip code and click “Find providers that meet search criteria”
CorVel (Texas)
• To access the HCN in Texas log on to
• Select Texas CorCare Certified Network
CorVel (California MPN)
• To access the MPN in California log on to
• Select California MPN Network
FIND MEDICAL PROVIDERS IN OUR PREFERRED NETWORK
PHARMACY BENEFIT MANAGEMENT PROGRAM INFORMATION
3. MEDICAL AND DISABILITY RESOURCES
Chubb gives you and your
employees access to a
network of providers that
provide quality medical at
reasonable rates, which is
why we encourage you to
use the providers affiliated
with these networks.
The Pharmacy Benefit Management Program (PBM) for Workers
Compensation is administered by Express Scripts (ESI), except in
Texas where Chubb uses Corvel’s CorCareRX.
Contact Your PBM
• Call Express Scripts at 866-672-2482
• Call CorCareRX (TX) at (800) 563-8438
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CORVEL.COM
CORVEL.COM
CORVEL.COM
VISIT EXPRESS SCRIPTS EXPRESS SCRIPTS TEMPORARY ID CARDS

DEVELOPING A
SAFETY PROGRAM
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Direct expenses—including lost wages, medical expenses and
increased workers compensation premiums—cost companies
billions of dollars. In addition, accidents may cause low
employee morale, poor work attitudes, low productivity and
reduced quality.
A comprehensive safety program reduces the potential risk of
injury or illness to your employees, allowing them to work safely
and productively, thereby positively impacting your bottom line.
4. DEVELOPING A SAFETY PROGRAM
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A safety program establishes a focused, company-wide
approach to safety that communicates with employees,
identifies and controls hazards, and defines a policy of
involvement and accountability throughout the organization.
Every activity that relates to safety becomes part of the unified
safety program. To help eliminate accidents and reduce the
potential effects of exposure to harmful substances, injuries
due to repetitive tasks, and other workplace occurrences, safety
must be managed, measured and rewarded.
A successful safety program has elements in common
with other management programs:
Well-defined and measurable goals
Clearly assigned responsibilities
Frequent communication between management and
employees
Comprehensive training
Methods to guide, evaluate and monitor progress
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The goals and structure
of your safety program
must be based on a
clear understanding
of the hazards your
employees face.
ELEMENTS OF AN EFFECTIVE PROGRAM
Each year, millions of
disabling injuries and
thousands of deaths
occur on the job.
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Reference Chubb’s loss control resources included
in this virtual guide to start your program:
You can also use the following third-party sources
to help develop your program:
Slip and fall guidelines:
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TOOLS TO HELP BUILD YOUR PROGRAM
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CONDUCTING A SAFETY ANALYSIS
BASIC SAFETY PRACTICES
MONITORING & MEASURING YOUR PROGRAM
OSHA LAWS & REGULATIONS
OSHA SAMPLE SAFETY & HEALTH MANAGEMENT SYSTEM ETOOL
OSHA INJURY & ILLNESS RECORDKEEPING & REPORTING REQUIREMENTS
USA CANADA

CONDUCTING A
SAFETY ANALYSIS
A safety analysis is a means of studying data on a
scheduled basis to determine trends and identify
problem areas. This analysis allows you to concentrate
on areas of your business that pose the greatest
threat to the health and safety of your employees.
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There are 3 types of
analysis you can use:
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TREND ANALYSIS
JOB SAFETY ANALYSIS
RISK ASSESSMENT

TREND
ANALYSIS
By keeping track of accident and injury data, you can identify
particular types of injuries and the causes of those injuries.
For example, back injuries caused by or correlated to lifting
operations. Analyzing this data can help uncover which injuries
tend to reoccur and potential causes. The trend analysis may
indicate the need for additional training, new procedures,
or engineering controls to help eliminate the problems.
To conduct a trend analysis, you should:
»» Determine what data will be analyzed and compile that data
(example: accident injury data, records of hazards identified
during inspections, etc.). Contact your agent or broker for a
three-year history of losses as well.
»» Determine how often the analysis will be conducted, and
what time period your results will cover (monthly, quarterly,
semiannually).
»» Identify similarities in data (for example, you may find that
three out of four accidents involved a back injury, all injuries
were from the same work area, three out of four involved the
same work activities, and the same hazards were identified
during inspections).
»» Develop corrective measures to help stop the unfavorable
trends.
A trend analysis requires a formal, consistent analysis procedure.
Your procedure should establish, in writing, who is responsible for
the analysis (by position) as well as the data to be analyzed and
frequency of analysis.
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A JSA is a way to identify hazards associated with a certain task
and apply measures to help protect the employee, or eliminate
or control the hazard. A simple system of job analysis can also
help you obtain maximum efficiency and safety.
The term “job” refers to the steps or activities involved in
a person’s occupation, and a JSA applies a technique that
analyzes the relationship between your employee, the tasks
they perform, the tools they use, and the environment they work
in. When conducting a JSA, all factors, such as quality control,
production and safety, must be included in the analysis because
all of them contribute to a more efficient operation.
For more on how to conduct a JSA, refer to:
Solutions that result from a JSA can take the form of physical
changes that minimize or control job hazards (for example, using
machine guards). Other solutions might include a change in job
procedures that eliminate or minimize hazards (for example,
piling materials more safely).
JOB SAFETY
ANALYSIS
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OSHA’S JOB HAZARD ANALYSIS RESOURCE

Using the information you uncovered in your trend analysis and
JSA, you can now determine which hazards may pose the greatest
threat to the safety and health of your employees. In the risk
assessment phase, use a risk classification matrix, applying the
likelihood and consequences of a loss, to categorize the exposure
as low, medium, serious, or high.
This initial assessment will help you determine the risk of injury
or illness based on the current level of control (or lack thereof).
Subsequent assessments of the same exposure as you improve
your level of control will help you determine what prevention
methods have proven effective so you can appropriately direct
your resources.
The reduction of risk is achieved by applying the
following hierarchy of controls (in the order of
effectiveness):
Elimination
Substitution of less hazardous materials, processes,
or operations
Engineering controls (ventilation or isolation)
Warnings (visual or audible)
Administrative controls (rest periods or job rotation)
Personal protective equipment
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RISK
ASSESSMENT
A
B
C
D
E
F
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BASIC SAFETY
PRACTICES
A comprehensive safety program reduces the
potential risk of injury or illness to your employees,
allowing them to work safely and productively,
thereby positively impacting your bottom line.
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Experience has shown that sincere commitment and participation
by management is necessary for a safety program to achieve
its goals. When management demonstrates genuine interest
in preventing workplace injuries and illnesses, supervisors and
employees are more likely to do the same.
Management should demonstrate active participation
by translating ideas into specific safety actions such as:
Issuing a written statement of a safety policy.
Providing realistic allocations of time and money for
safety items.
Assigning responsibility and authority for implementing
and enforcing your loss prevention program.
Reacting promptly to recommendations, suggestions,
and complaints developed as a result of the loss
prevention program.
Attending safety talks and meetings.
Demonstrating safe behavior and concern for the safety
of others.
DEFINING YOUR SAFETY GOALS
RESPONSIBILITY FOR SAFETY STARTS AT THE TOP
A loss prevention program is more likely to accomplish the desired
results when safety goals have been established. Goals should
be easy to understand, realistic, and measurable. For example,
if your operation has a high accident experience, a realistic and
quantifiable goal may be to reduce accident frequency by 25%
during the next year. Safety goals should be established for every
organization, regardless of size.
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COMPREHENSIVE TRAINING FOR YOUR EMPLOYEES
As an owner or manager, you must ensure that all employees are
educated about the materials and equipment they handle, known
hazards involved in their jobs, and how to control those hazards.
Foundationally, each employee needs to know that your
organization supports and expects them to comply with
the following guidelines:
No employee is expected to undertake a job until he or she
has received job instructions on how to do it properly and
has been authorized to perform that job.
No employee should undertake a job that appears unsafe.
You may be able to combine safety and health training with other
job-specific training that you do, depending on your company’s
hazards and current training practices. New employee orientation,
for example, should include safety information. The goal of your
training in any situation should be that every employee knows
what they need to do to keep themselves and their fellow workers
safe and healthy.
Here are a few tips to help make your training
program effective:
Don’t just explain hazards and prevention—verify that
employees really understand what you have taught them.
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Train your supervisors to know all the hazards that face the
people they supervise and how to reinforce safety training
with quick reminders and refreshers, and with disciplinary
action if necessary. Verify that they understand what is
expected of them.
You and all of your top management staff should understand
all of your safety responsibilities and how to hold subordinate
supervisory employees accountable for theirs.
Additionally, to prevent injuries, encourage your
management staff and supervisors to:
Pay special attention to new employees and employees
who are moving to new jobs. Because they are learning new
operations, they are more likely to get hurt.
Encourage employees to be particularly cautious while
performing tasks that are non-routine, such as emergency
repairs or rarely occurring maintenance. This is when many
fatalities and severe injuries occur.
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COMPREHENSIVE TRAINING FOR YOUR EMPLOYEES
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All accidents and near-miss incidents in your company should
be investigated, no matter how minor the injuries or damage.
Conditions or acts that cause minor injuries or damage once could
just as easily cause a catastrophe under different circumstances.
For more on how to conduct an accident investigation,
please review Chubb Loss Control Service’s:
An interactive software program that helps identify
and understand common safety and health hazards
in your workplace.
Resource providing guidance for hazard and
control programs.
Booklet providing information related to planning
for emergency events.
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ACCIDENT INVESTIGATION
Investigating accidents is
an important part of any
loss prevention program.
RESOURCES TO HELP BUILD YOUR PROGRAM
Occupational Safety and
Health Administration
(OSHA) offers tools and
information to help
companies build safety
programs.
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ACCIDENT INVESTIGATION GUIDE
HAZARD AWARENESS ADVISOR
HAZARD CONTROL
HOW TO PLAN FOR WORKPLACE EMERGENCIES AND EVACUATIONS

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MONITORING
AND MEASURING
YOUR PROGRAM
It is important to monitor the implementation
of your loss prevention program and establish
metrics that indicate the program is meeting or
exceeding your company’s safety goals and the
expectations of management. On a scheduled
basis, the company should review their loss
prevention metrics and consider alternative
methods if the results are not acceptable.
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MONITORING THROUGH SELF-INSPECTIONS
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Regularly scheduled and recorded self-inspections can help you
verify that controls are in place per your loss prevention program
and that they are being maintained. A well-planned safety
inspection program helps you detect uncontrolled or under-
maintained hazards before an injury or illness occurs. They can
also identify new hazards that have not been assessed.
To implement a self-inspection, first decide:
Who will perform the inspection?
How often will inspections occur?
How will the inspection be recorded?
Who is responsible for reviewing the reports and
recommending or approving corrective actions?
Check your injury and illness records for the location and causes
of accidents so the prescribed controls can be verified by the
inspection. Use an inspection checklist to assist you and add
additional items if necessary.
In addition to routine inspections, consider conducting a self-
inspection following a key company change—whether your
company has increased production, changed operations or
job tasks, installed new equipment, or hired untrained new
employees. These events often pose new hazards.
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MEASURING YOUR PROGRAM
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There are many ways to measure the success of your program. If
your company is required to report injury and illness data OSHA,
you can determine your rate of OSHA recordable injuries and
illnesses per 200,000 hours of work:
Using Bureau of Labor Statistics (BLS) data, you can compare your
OSHA injury and illness rates to other companies in the same
industry and within your state. To determine and compare your
data access the:
Using workers compensation data, your company may measure
and compare the number of claims submitted in a specified time
period, or the cost of those claims. If your company has a workers
compensation experience modifier, it can also be used to compare
your workers compensation performance to others in your state
and industry on an annual basis. Your insurance agent or broker can
assist you with your experience modifier.
Some companies may use activity metrics to measure the success
of their program. Examples would include the number of safety
inspections completed in a month or quarter, the number of job
safety analyses completed, or the number of safety meetings held.
Another effective metric is quantifying the number of risk
assessments completed and using historical data to demonstrate
the level of risk reduction achieved through the application of more
effective controls.
On a routine basis, your
company should review
their loss prevention
metrics and consider
alternative methods if the
results are not acceptable.
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OSHA RECORDABLE INJURIES AND ILLNESSES
BLS INCIDENCE RATE CALCULATOR & COMPARISON TOOL
$$$

REVIEWING YOUR PROGRAM
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A regular review of your loss prevention practices will keep your
program effective and current. It is an opportunity to fine-tune
your program and make meaningful adjustments.
Conduct a thorough review of each practice. Make sure
that any new equipment, procedures, or operations are
incorporated into the appropriate components of your plan.
Check your existing procedures against your metrics to ensure
that they are meeting your safety needs. Make changes and
adjustments in your plan where necessary, and don’t forget to
notify your workers of the changes.
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PREMIUM AUDIT AND
ACCOUNTING PROCESSES
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WHAT IS A PREMIUM AUDIT?
CHUBB PREMIUM AUDIT TIMELINE
5. PREMIUM AUDIT AND ACCOUNTING PROCESSES
A premium audit is a review of a policyholder’s records and
operations to ensure that the exposure information is accurate.
When Chubb writes your policy, we base premium on estimated
payroll. After the policy expires, we perform an audit to
gather your gross payroll. The gross figures, less any allowable
deductions, are then used to correctly adjust the premium.
The following timeline explains what to typically expect during
a premium audit, and shows who is responsible for what tasks:
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CHUBB PREMIUM AUDIT TIMELINE
ESTIMATED TIMELINE
POLICYEXPIRES
30 DAYS 60 DAYS 30 DAYS
CLIENT CONTACT
& PREPARATION
FIELD AUDIT
ANALYSIS
PREMIUM AUDIT
CENTER PROCESSING COMMUNICATION
Documents
completed and
information
submitted by
Client
Schedule audit
appointment
Audit
appointment
completed
All client info
received
Complete audit
submitted to
Premium Audit
Audit center
review,
processing,
and billing
Communication
between Audit
center, auditor,
underwriter
Client contact
Chubb auditor
Chubb auditor
Chubb Audit
Center
Chubb auditor
Chubb
underwriter
TASKS
RESPONSIBILITY
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ONGOING
THROUGHOUT
PROCESS90 DAYS 120 DAYS30 DAYS
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PREPARING FOR A PREMIUM AUDIT
To help anticipate what information your company
will need to share with Chubb, use our:
Prior to the premium audit process, you will be
required to complete the:
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AUDIT PAYROLL SPREADSHEET
It is important that you
cooperate in a timely
manner to ensure the
completion of the
premium audit within
the indicated timeline.
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GUIDE TO PREPARING FOR A PREMIUM AUDIT

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PREPARING FOR
A PREMIUM AUDIT
A premium audit is a review of a policyholder’s
records and operations to ensure that the exposure
information is accurate.
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PREMIUM AUDIT
Generally conducted on
site or at an appropriate
secondary location (e.g.
accountant’s office). This
audit may be performed
by a Chubb auditor or
by an independent audit
company hired by Chubb.
A Chubb telephone
auditor or an independent
audit company hired by
Chubb will contact the
insured over the phone to
complete the audit.
The premium audit format is based on jurisdictional
requirements, as well as the size of the policy and/or the
nature of the operations.
The audit may be completed in one of two ways:
Premium auditors gather information from books of original entry
and verification from tax documents. The records required for an
audit depend on the type of coverage on the policy. In order to
take advantage of possible premium reducing credits, records
need to be clear and concise.
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PHYSICAL AUDIT
OR
TELEPHONE AUDIT
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PAYROLL AUDIT
A payroll audit is
conducted for workers
compensation policies.
The auditor will look for records that reflect:
Employees by name with job duties and working state
Documents maintained to show payroll categories
separately such as:
• Gross Payroll / Remuneration
• Payments for Active Military Duty
• Overtime / Double Time
• Group Term Life
• Severance Pay
• Tips
Non Qualified Stock Options - exercised
Third-Party Sick Pay
Executive officers, partners, and members of an LLC may
be subject to payroll limitations. Records must reflect
these individuals separately. Corporate by-laws may be
used to verify executive officers.
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INCLUDED REMUNERATION
Wages or salaries, including those that are retroactive
Total cash received by employees for commissions and draws
against commissions
Bonuses, including stock bonus plans
Pay for overtime work except for the premium portion of
overtime pay
Payment by an employer of amounts that would have been
withheld from employees to meet statutory obligations for
insurance or pension plans such as the Federal Social Security
Act or Medicare
Pay for holidays, vacations, or periods of sickness
Payments to employees on any basis other than time worked,
such as piecework, profit sharing, or incentive plans
Payments or allowances for hand tools or handheld power
tools used by employees in their work or operations
The rental value of an apartment or house provided to an
employee based on comparable accommodations
The rental value of lodging, other than an apartment or house
received by employees as part of their pay to the extent
shown in the insured’s records
The value of meals received by employees as part of their pay
to the extent shown in the insured’s records
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The information in connection with
remuneration is based primarily on
the NCCI Workers Compensation
And Employers Liability manual.
This information is being provided
to you for discussion and
informational purposes only. The
definition of remuneration may vary
from state to state and is subject to
the actual Workers Compensation
And Employers Liability manual
applicable in a given state.
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INCLUDED REMUNERATION
Value of store certificates, merchandise, credits or any
other substitute for money received by employees as part
of their pay
Payments for salary reduction, savings plans, retirement or
cafeteria plans made through employee-authorized salary
reduction from the employee’s gross pay
Davis-Bacon wages or wages from a similar prevailing
wage law
Annuity plans
Expense reimbursement to employees to the extent that
an employer’s records do not confirm that the expense
was incurred as a valid business expense
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And Employers Liability manual.
This information is being provided
to you for discussion and
informational purposes only. The
definition of remuneration may vary
from state to state and is subject to
the actual Workers Compensation
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EXCLUDED REMUNERATION
Tips or other gratuities received by employees
Payments by an employer to group insurance or group
pension plans
Payments by an employer into third-party trusts for the
Davis-Bacon Act or a similar prevailing wage law provided
the pension trust is qualified under IRC Sections 401(a)
and 501(a)
The value of special rewards for individual invention or
discovery
Dismissal or severance of payments except for time worked or
vacation accrued
Payments for active military duty
Employee discounts or goods purchased from the employer
Expense reimbursements to employees to the extent that an
employer’s records confirm that the expense was incurred as
a valid business expense
The premium portion of the overtime wages can be excluded
as long as overtime is paid at 1.5 or 2x the regular wage rate.
Records must be kept to reflect these payments
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And Employers Liability manual. This
information is being provided to
you for discussion and informational
purposes only. The definition
of remuneration may vary from
state to state and is subject to the
actual Workers Compensation
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STATUS OF INDEPENDENT CONTRACTORS
After reviewing the 1099s, the auditor will determine whether
the designation of independent contractors is acceptable
for insurance purposes and review documents illustrating
the relationship between the insured and its independent
contractors and/or subcontractors, including:
Proof of insurance (Certificates of Insurance and insurance
policies)
Exemptions from workers compensation insurance filed
with the state
Contracts between the insured and the independent
contractor or subcontractor
Payments to contract labor and/or subcontractors may
be included in the absence of a Certificate of Insurance
showing the appropriate coverages for the policy period
Decide who should be the primary contact. This should
be a person who is familiar with the work done by all
departments and employees.
Review your payroll documents to assure that the
auditor can break out the categories of payments and
separate the employees by the job duties and the state of
employment.
Review the audit findings with the auditor and request a
copy of the audit worksheets.
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KEYS TO A SMOOTH AUDIT
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HOW TO REQUEST AUDIT WORKSHEETS
Note: An authorization is
only good for that audit
term. Each audit will require
a new insured authorization
and documentation.
To request copies of the Audit Worksheets, please send a request
to Chubb’s Premium Audit Center mailbox:
In your subject line, please follow this format:
Worksheet Request - Insured Name, Policy Number,
mm/dd/yy–mm/dd/yy.
Please note that these Audit Worksheets contain confidential
payroll information and may not be released to anyone outside of
Chubb (including agents) without the approval of the insured. All
requests for copies of the Audit Worksheets must be accompanied
by authorization from the insured, either from an email address
with the insured company domain or an attached document using
company stationary.
The authorization must specify:
Policy number
Effective date of audit
Name and title of requestor
Name and address of recipient, if different than requestor
AUDITDISPUTES@CHUBB.COM
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HOW TO DISPUTE A PREMIUM AUDIT
Our auditors’ goal is to minimize potential disputes during the
audit process through clear communication with you. However, if
you would like to file a formal dispute of a premium audit, we ask
that you follow the process below:
We ask that the agent and insured review and verify the
audit billing statements together.
If an agent or insured disputes the audit because of
incorrect exposures or classification issues, please provide
a detailed explanation and any supporting documentation
(e.g. payroll reports, job titles and descriptions, tax return,
corporate bylaws).
Send the dispute to:
Once the dispute is received, the Premium Audit Center will
acknowledge receipt of the dispute, and our audit analysts
will review and send an initial response to the insured
typically within 5 business days.
Often, additional information is needed to respond to the dispute.
We ask that all required information be returned within 10 business
days. If the required information is not received, a final notice will
be sent allowing 5 more business days. If there is no response
within 5 days after the final notice, the dispute is closed and the
audit premium is expected to be paid. Our goal is to resolve all
disputes within 30 days.
AUDITDISPUTES@CHUBB.COM
38
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PREMIUM AUDIT COLLECTION & UNPAID AUDITS
When a workers compensation audit is issued, the payment due
date is typically determined by the issue date and the agent’s
payment terms with Chubb. For example, if an audit was issued
by Chubb in January, an agent with 45-day payment terms is
expected to pay that audit in March.
When a workers compensation audit is not paid by the due
date, Chubb’s Premium Accounting Service Center (PASC)
will investigate to determine if there is a potential dispute or
revision. Agents, if you know an audit is being disputed, please
inform PASC to ensure the collection is put on hold until the
dispute is resolved.
If research indicates that the audit stands as issued, PASC may
issue a notice of cancellation for non-payment of premium on
the current term in compliance with any applicable cancellation
laws or regulations.
If the audit remains unpaid and it stands as issued, Chubb
may pursue any available remedies under any applicable law
or regulation, including but not limited to, proceeding with a
collections action.
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40
We are committed to helping you find ways to create a safer
workplace, addressing claims promptly and fairly, assisting you
in managing costs, and providing support to get your employees
back on the job as soon as possible.
We hope this resource helps you manage your workers
compensation program more efficiently, and look forward to
continuing to support your needs.
Thank you for
trusting Chubb
with your Workers
Compensation
insurance.
THANK YOU
This document is advisory in nature. It is offered as a resource to be used together with your professional insurance advisors. Evaluations,
reports, and recommendations are made solely to assist the insurer in underwriting and loss control. Evaluation for any hazard or
condition does not imply that it is covered under any policy. Actual coverage is subject to the language of the policies as issued.
No liability is assumed by the information contained in this document. Chubb refers to the member insurers of the Chubb Group of
Insurance Companies. Not all insurers do business in all jurisdictions. Chubb, Box 1615, Warren, NJ 07061-1615.
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