Volume 4, Number 2

You've Found a Mod Error - Now What?

Steps to Get a Mod Corrected

How Do I Know If There's Really a Mod Error?

ModMaster FAQ Highlight: When I try to calculate a mod, I am getting the message that a certain payroll code is not in the database. What do I do?

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You've Found A Mod Error -  Now What? 

In this issue of NewSolutions, Frank Pennachio of the Institute of WorkComp Advisors shares his list of eleven steps to obtain a corrected mod for your client. This is a process which can take a lot of communication and reminders to several people. Frank advises that you be diligent and keep in contact with the insured throughout the process. Your result should be a satisfied client!

Steps to Get a Mod Corrected
by Frank Pennachio
Institute of WorkComp Advisors

1.   Contact the insurance carrier and find out who is responsible for filing the Unit Statistical Reports to the rating bureau. This person usually works in the audit department.

2.   Call and discuss the error and the anticipated time of resolution with the insurance carrier’s contact person.

3.   Follow up with a letter to the insurance carrier. Include the insured’s name, policy number, policy period(s) with error(s), the risk ID#, and a brief discussion of the problem.

4.   Put a time in your date book or tickler file to call the insurance carrier on or near the time of anticipated resolution.

5.   Continue contact with carrier until corrected data has been submitted to the rating bureau.

6.   Contact the rating bureau one week after the carrier has submitted the corrected data to make certain the bureau received it. Ask for an anticipated time when the corrected mod will be published.

7.   Continue contact with the rating bureau until the corrected mod has been published.

8.   Get a copy of the corrected mod.

9.   Forward a copy of the corrected mod to the insurance carrier.

10. Put a time in your date book or tickler file to track the endorsement to the policy and credit billing statement.

11. Communicate with the insured when the policy is endorsed and the premium credit is processed. "Toot your horn!”  If you don’t do it, who will?

Don’t forget that the Insurance Carrier must adjust the premiums back to the inception of the policy or policies. You can correct the current mod and the mods for the two previous policies.  (If subrogation is involved, you can correct four previous policies.) Remember, the job is not done until the revised mod is endorsed on the policy and the credit has been issued.

How Do I Know If There's Really a Mod Error?

Your first indication of an error is when the mod you calculate in ModMaster does not agree with the mod promulgated by the bureau. However, this is a first indication only, and you must check your data input along with ModMaster rating values before you can determine that an error truly exists. 

To check these values:

1. Verify that you have marked all IJ code 6 (medical only) losses in ModMaster. On both the small loss screen and the large loss screen, you will see an IJ code field. If a claim is medical only, put a 6 in this field.

2. Verify that the effective date of the mod you computed with ModMaster matches the effective date shown on the bureau worksheet. The effective date of the mod is shown in the upper right hand corner of the worksheet.

3. Verify that your loss and payroll data has been entered identically to what is shown on the bureau loss sheet.

4. Compare the expected loss rates (ELRs) on the bureau sheet to those shown on the ModMaster sheet.  If the values differ, verify that you are on the latest ModMaster update. 

For further details about checking your update level and more ideas for how to look for discrepancies, see the FAQ  What if the mod calculated by ModMaster doesn't match the bureau's value?

Once you've verified your data input, remember that ModMaster support will be glad to assist you with your evaluation.

ModMaster FAQ Highlight

Remember, the more you use our FAQ database, the better we'll be able to make it! Here's a common question:

When I try to calculate a mod, I am getting the message that a certain payroll code is not in the database. What do I do?

We also encourage you to check out our ModMaster WebHelp tutorials and videos, another method we're using to bring even more value and understanding to our products.

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Sincerely,
Tim Coomer
President, Specific Software Solutions, LLC

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