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Tina
Tina, Attorney
Category: California Employment Law
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Experience:  JD, 17 years experience & recognized by ABA for excellence in employment law.
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our workers comp insurance carrier performed an audit and

Resolved Question:

our worker's comp insurance carrier performed an audit and tried to bill us for two office employees who they claimed should be put in the warehouse category. These two employees are 100% office clerks. what should we do?
Submitted: 3 years ago.
Category: California Employment Law
Expert:  Tina replied 3 years ago.
Hello and welcome,

If they cannot justify the classification and will not reconsider their recommendation, I would look for another insurance carrier since there would typically be no basis for paying the higher premium of a warehourse worker if the employees are plainly office workers.

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Customer: replied 3 years ago.

Our Workers' Comp policy was insured by them in 2010 and they did the audit in March 2011. They have been attempting to bill us by sending us invoices and stated on the invoice that the amount will be sent for collections. Should we just ignore the invoices? we did switch to a different insurance company in 2011 for the workers' comp policy and are no longer doing business with them.

Expert:  Tina replied 3 years ago.
I see.

I would send a written dispute letter to them and mail it return receipt requested so they know the amount is disputed and why and cannot later claim in court, if a suit is filed, that you never raised the issues you now raise in court.

Customer: replied 3 years ago.

can we hold our insurance agent/broker responsible for resolving the dispute with the insurance carrier? We had no knowledge about this insurance company and had never heard of them, we switched our policy to them in 2010 based on our agent's recommendation, their annual premium was the most competitive among all the quotes that we received from the agent.

Expert:  Tina replied 3 years ago.
The broker/agent would not normally be liable for this dispute unless they contractually agreed to be held liable or engaged in fraud to your detriment, which is usually not the case.

Tina, Attorney
Satisfied Customers: 32720
Experience: JD, 17 years experience & recognized by ABA for excellence in employment law.
Tina and other California Employment Law Specialists are ready to help you
Customer: replied 3 years ago.

Thank you for advising us to send them a written dispute letter. It's important to have everything written and documented for the dispute. We will send in the letter to the carrier right away with a return receipt requested. From your past exerience in dealing with a case of this nature, do you think the insurance company have any basis to win the case? During the audit, their auditor did not ask any question, did not tour our oiffce and warehouse facility and did not raise a single question about any employee on the Payroll report. In addition, the auditor was late for his appointment by more than one hour. We strongly questioned the fairness and credibility of the audit. Is there anything that you would paritcularly recommend us to put in the dispute letter?

Expert:  Tina replied 3 years ago.
I would refer to the definition of clerical worker and indicate in your dispute letter how the worker's job duties fit the definition precisely. I doubt the insurer will file suit against you, but they may continue to send invoices, which I would ignore once you have documented the dispute with them.

All the best!


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Customer: replied 3 years ago.
Thank you so much! That was very helpful and we appreciate it!
Expert:  Tina replied 3 years ago.
You are very welcome and good luck to you!



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