Assessment Audit Program

Most Connecticut companies pay SIF assessments in accordance with state law. However, the companies that underpay or fail to pay unfairly burden other businesses with the cost of funding the Second Injury Fund.

The Audit Program - How It Works
Selection Criteria - Insurance Companies (one of the following applies):

• Systematic selection of insurance companies doing business in Connecticut
• Failed to report and pay written premium assessment to the Fund
• Notice of bankruptcy
• Incorrect completion of the quarterly Remittance Detail Template.

Selection Criteria - Self Insured Companies (one of the following applies)

• Systematic selection of all self-insured employers
• Failed to report paid losses for the calendar year to the Fund
• Notice of Bankruptcy
• Workers' Compensation Commission notifies the Fund of employer's status change to self-insured
• Incorrect completion of the Paid Loss Detail Template.

The Fund selects a company for audit and a letter is sent notifying the insurance company or self-insured company that their business has been selected for audit. A conference call is scheduled with the appropriate representative to discuss documents and data necessary to begin the audit. A submission deadline is also set which allows the company sufficient time to comply with the Fund's request.

Look-back Period - (effective July 1, 2006) the period of audit review will be three years retrospectively. When the requested information is received, the audit team tests the data. If the data matches the Fund's original test selections, the assessment due the Fund is verified. If data doesn't match, the company must rerun detail until the employer reports them correctly.

A few policies are selected from the original list for the audit, with the checklist for instruction on what sections of the policy the Fund will need. When the requested information is received, the audit on the policies selected will begin. If the recalculated premium from the policies matches the Fund’s original test selections, then the auditor will verify the assessment due. If the recalculated premium does not match, then the company is informed of the problem, and they are told to rerun detail policy lists until the policy detail matches the paper policy received.

When the audit is complete, the company is presented with the findings and is formally notified if it will be required to pay any additional assessment and interest.