Workers comp premium audit files, assembled for your account manager before the auditor calls.

Today an account manager collects the quarterly payroll reports, the ledger export and a folder of certificates, then sets them against the information page, where each class code sits with its estimated remuneration. Someone totals payroll by class, hunts for subcontractors paid with no proof of coverage, and notes whatever the auditor is likely to raise.

In the proof of concept, AI takes that first pass on copies. It drafts the prep file: payroll by class against the estimate, subcontractors with no certificate on file, overtime and officer items to look at, and the mismatches for your account manager to review. It speaks to nobody. Your reviewer compares each draft with the file your team actually assembled.

The record list comes from the policy. Part Five lets the insurer examine ledgers, journals, vouchers, contracts, tax reports, payroll and disbursement records. Alaska's Division of Insurance spelled out in Bulletin B 15-08 what that can mean: IRS Form 941, Forms 1099 and 1096, W-2 or W-3, the state's quarterly unemployment contribution report, the payroll ledger, certified payroll reports, the latest general liability audit, and a list of vendors and subcontractors with amounts paid and their certificates. Bank statements, Schedule C and Form 1120 come up only in unique circumstances. The draft ties each quarter's report to the ledger and names any record it never saw.

Overtime and split duties live or die on the records. North Carolina's Basic Manual excludes the extra pay for overtime where the books show it separately by employee and in summary by class; overtime booked as one combined figure at time and a half loses one third of that figure instead. A night shift premium stays in, and hours past 40 at straight time have no extra pay to exclude. The same manual divides one person's payroll across codes only when records show actual time in each, says estimates and percentages don't count, and sends the whole payroll to the highest rated class otherwise. Oregon's rule 836-042-0060 wants a time basis, a description of duties and original entries such as time cards or daily logs. Clerical 8810 and outside sales 8742 can't be split at all. Rules vary by state, so the draft marks each item and leaves the treatment to your account manager.

A sub with no proof changes your client's payroll. Rule 2-H of that manual charges additional premium for each subcontractor without evidence of coverage, figured from the sub's own payroll records when they are complete and otherwise from the subcontracted price, with minimum shares that differ for equipment with operators, labor and material, labor only, and piecework. The code is the one those workers would carry as your client's own employees, and the client's mod applies. What counts as proof varies too. New York's Department of Labor, on its handout SH 439 (May 2024), accepts only forms C-105.2, U-26.3, SI-12, GSI-12, GSI-105.2 and CE-200, and says it does not take ACORD forms. So the draft names each sub's form and sets its dates against the dates paid.

Officers have their own arithmetic. Under the same manual an executive officer's payroll sits between a minimum and a maximum in the state's values, prorated by weeks for someone who held office part of the term, and an officer with no salary drawn or credited is carried at the minimum. Officers who regularly do a foreperson's work go to the governing class. In North Carolina an officer opts out through endorsement WC 00 03 08, while Pennsylvania has its own executive officer exception, forms LIBC-509 and LIBC-513. The draft reports what the policy shows and lists each officer item without a name unless your reviewer agrees otherwise.

What your reviewer will watch for. A quarter that doesn't tie to the ledger. A certificate that lapsed before the last payment. A contract labor account in the ledger with no matching sub on the list. Davis-Bacon wages kept apart from payments into a qualified third-party trust, since the manual counts the first as payroll and leaves the second out. These are examples, not legal or coverage advice, and the draft never picks which rule applies.

Once your reviewer signs off, accounts coming up for audit run through the same job for about 30 days.

An account manager approves every file before it reaches a client or an auditor, and handles every conversation with the insurer. The AI stays off live policies and writes nothing into your systems.

Your reviewer keeps scoring the live files against the written criteria from the test.