Risk services help those who buy insurance or carriers who sell it. Premium audits are a process in which the calculation of the price an insurance policy is reviewed. Most workers compensation, general liability, and other policies are based on a fluctuating factor such as payroll, sales, or some other unit of measure. The policy is issued based on an estimate and then an audit is done to compare actual to the estimate. Premium audits are generally required by law to make sure that employers are providing workers compensation coverage. Employers can also be proactive in lowering their costs by having their employee classifications reviewed.
Insurance claims also present the need for a wide variety of field services. Adjusting is the process of an investigating a claim, determining what is covered by a policy, signing a release, and making a payment. Many disputes arise when adjusting insurance claims. Those need to be either settled through ADR or a formal legal proceeding. Sometimes additional calculations need to be made to determine the amount of a loss. For example, if household goods or business inventory are damaged, that will all need to be documented and a value assigned. Likewise, if there has been an interruption to a business, they may have coverage to reimburse them for lost profits or expenses.
Finally, insurance carriers, governments, and a variety of other interest groups need to analyze copious amounts of data to gain insights into premiums, claims, financial performance, regulatory requirements, and expenses. The internal audit and data analysis techniques can aid anyone needing this information.