Challenges

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Incorrect business and employee classifications

Incorrect classification leads to incorrect assessment of exposure and premium, leading to under or overvalued premium

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Lengthy process for premium audit for commercial P&C businesses

Audit is still a very manual and tedious process with lots of information collection and verification

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Compliance with states’ guidelines & regulations

Each state can have different regulations and guidelines making compliance tough. Documenting audit decision accurately for different states becomes a challenging task.


Solution & Benefit

Insured Communication

Solutions

Automate information requests with insureds to drive timely completion of audits.

- Easily request collection of missing information with AI-driven messages on behalf of auditors.

- Collect the right information needed based on industry and class code with support from dynamic data collection methods.

Benefits

Timely communication schedules ensure compliance with communication regulations.

- Dynamic questions ensure the right information is collected.

AI-driven missing information and document requests reduce auditor communication time and further shorten audit cycles
 rates.

Insured communication

Ingestion

Solutions

- Automate the ingestion of all audit-related documents including audit requests/orders, payroll documents, payroll tax returns, insured filled forms, and other essential documents.

- Leverage expert-developed line of business, audit, industry, and regulatory knowledge graphs to accurately capture information in the correct insurance and business context.

- Manage quality by identifying missing documents and incorrect documents and generate insured requests to rectify.

Benefits

- Significant reduction of audit cycle time frees up auditors to focus on critical audit decisions.

- Knowledge graphs ensure accurate information capture regardless of document structure or format, and then ensure the correct information is corrected.

- Automated requests for missing documents and corrections help ensure that audits can start promptly.

Ingestion

Business Profiling

Solutions

- Access internal and external data sources (public and commercial) to enrich the understanding of insured operations.

- Evaluate insured websites and social media to validate descriptions of operations provided in original applications.

- Capture and validate corporate structure information from state government data sources.

Benefits

- Accurate descriptions of operations help correctly classify the insured.

- Additional sources of information help justify and defend any classification corrections.

- Correct corporate structure is needed for a variety of state regulations, including the treatment of officers' remuneration.

Business Profiling

Business Classification

Solutions

- Accurately classify insured governing class codes, companion class codes, and permitted exception class codes per state guidelines.

- Identify alternate class codes based on description of operations.

- Auditor reviews (human in the loop) submitted and recommended class code changes with references to appropriate regulatory rules and decision rationale.

Benefits

- Correct and fully validated class codes for the audit and future renewals.

- Full documentation of validation or changes to support broker and regulatory communications.

- Easy-to-use interface for auditors to review options and supporting regulations.

Business Classification

Payroll & Wage Analysis

Solutions

- Leverage knowledge graphs to ingest and extract payroll information (payess, wage types and remuneration).

- Knowledge graphs help audit departments concentrate on collecting necessary information rather than learning document structure.

- Collect information across all documents with awareness of individual state requirements.

- Ensure time period alignment of payroll reports and validating documents (usually tax returns).

Benefits

- Rapid and complete collection of audit information with full lineage of source information to support accurate exposure analysis.

- Ability for audit departments (business users) to fine-tune information collection without technical programming.

- Substantially reduce audit cycle times with automated payroll extraction and comparison of payroll and validating document time periods.

Payroll and wage analysis

Employee Census

Solutions

- Create and identify a census of all employees and contractors considered part of the payroll exposure.

- Validate employee information, roles, and descriptions across multiple documents and information sources. Associate titles/ roles, departments, and job descriptions with each employee.

- Document and resolve identity conflicts automatically with generative AI.

Benefits

- Accurate employee census is the foundation for calculating permissible employee remuneration and exposure.

- Fully documented validation of employee job function helps make accurate class code assignment.

- Resolving identity conflicts enhances audit credibility, trust and accuracy.

Employee Census

Calculate Remuneration

Solutions

- Accurately evaluate state guidelines and identify permissible wages, with reference to appropriate guidelines.

- Address officer min/max and wage cap requirements as specified for each state.

- Calculate remuneration for all employees and subtotal remuneration by class code

Benefits

- More accurate audit analysis with documented, trustworthy results.

- Application of one or more state guidelines and rules affecting remuneration with full documentation.

Calculate Remuneration

Additional Premium

Solutions

- Calculate changes in premiums in compliance with state guidelines.

- Provide full justification to support auditor, underwriter, insured, and broker communications.

- Plain English explanations and clear accounting tables explain changes in class code exposure and premium

Benefits

- Accelerate the collection of additional premiums when and as permitted by state guidelines.

- Support auditor communications with underwriters, insurers, and brokers to document and clearly explain any changes in class codes, exposure, and premium.

- Provide fast, clearly documented, and accurate premium and exposure adjustments to create transparency and trust.

Additional Premium (AP)

Audit Report

Solutions

- Detailed final audit report documents the full audit experience and meets carrier and regulatory audit requirements.

- Provides a full description of the insured’s operations, validated class codes, confirmation of payroll report accuracy, and any recommended changes.

- All recommendations are fully documented with links to source data and documents, and relevant state regulations

Benefits

- Clearly documented final report that explains all recommendations.

- Links to support documentation and regulations build trust.

Audit report

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