What are carrier premium audits?

Edited

Overview

Carrier Audit Process

Carrier Contacts

FAQs

Related Articles


Overview

Insurance carrier premium audits are reviews conducted by insurance carriers at the end of a policy period to verify that premiums accurately reflect the actual exposure during the coverage period. The purpose of these audits include:

  • Ensure premiums match actual business exposure

  • Adjust final premiums based on actual, not estimated, figures

  • Establish accurate data for future premium calculations

Important: Insurance carriers have varying criteria and processes for selecting policies to audit. Pathpoint does not participate in this selection. Any disputes regarding audit findings should be directed to the carrier.


Carrier Audit Process

Insurance carriers have varying criteria. Below is the general process:

  1. Notification: The insurance carrier informs the insured about the upcoming audit and requests specific business documentation, such as payroll records, tax forms, or financial statements

  2. Review: The carrier's auditor evaluates the provided documents, comparing actual business exposure against initial estimates used at policy inception.

  3. Premium Adjustment: Based on the audit, the carrier determines if premium adjustments are necessary.

  4. Reporting: Audit results are sent to Pathpoint, which then forwards the findings to you, the insurance agent. You can expect these potential outcomes:

    • Higher Actual Exposure: If actual exposure exceeds estimates, the insured will receive a bill for additional premium. *

    • Lower Actual Exposure: If exposure is lower than estimated, no refund is provided as premiums are 100% minimum and a deposit (carrier-specific rule).

    • Matched Exposure: If exposure matches initial estimates, the insured receives a closed-even audit, requiring no further action.

    • *Note: If the insured seeks a payment plan for additional premiums, please contact Pathpoint’s Operations team after receiving the invoice. We will request a payment plan from the carrier; however, approval of installment plans is uncommon and at the carrier's discretion.


Carrier Audit Contacts

Some carriers permit direct contact by the insured, while others require communication through the wholesaler. See the list below.

Carrier

Contact Information

Crum & Forster

Submit disputes within 45 days to SS.PremiumAudits@cfins.com.

Provide documentation such as payroll records, federal payroll filings, and sales records.

Markel

Questions or disputes can be sent to markelaudits@markel.com.

Nautilus

Call 800-842-8972 or email nicaudit@nautilus-ins.com.

All other carriers

Contact Pathpoint Operations at ops@pathpoint.com.


FAQs

Why would a policy be audited?

  • Audits ensure the premium accurately reflects the actual business exposure during the coverage period.

What documents are required for the audit?

  • Common documents include payroll records, tax forms, and financial statements.

Will a refund be issued if the exposure was lower than estimated?

  • No. Premiums are 100% minimum and deposit, so refunds are not issued

What actions should be taken if there is a disagreement with the audit findings?

  • Depending on the carrier, disputes must be addressed directly with the carrier using the contact information provided or with Pathpoint's Operations team.

Can a payment plan be requested for additional premiums due?

  • Yes. Contact Pathpoint’s Operations team after receiving the invoice. Approval of installment plans is at the carrier's discretion.


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