Background
A 12-person residential and commercial roofing operation in the Inland Empire, classified primarily under WCIRB Class Code 9554 (Roofing) with $1.3 million in annual payroll. Three prior policy years had produced seven total claims, four of which involved fall-related injuries requiring surgery. Two claims were still open at the time of our engagement, with combined reserves of $138,000 showing on the Unit Statistical Report.
The employer had been with State Fund for six consecutive years. Their prior broker had never conducted a claim review meeting, never pulled the Unit Stat, and renewed the policy each year without a competitive market submission. The result: a 1.35 experience modification and an annual premium of $187,000 — a figure that would have continued climbing without active intervention.
The Problem — Three Compounding Issues
- Open claims inflating the Unit Stat reserve values. Two claims with $138,000 in combined reserves were still active, overstating the employer’s projected losses in the mod calculation by tens of thousands of dollars above what would ultimately be paid.
- No written IIPP or fall protection documentation. Without a documented Injury and Illness Prevention Program specific to roofing operations, voluntary market carriers were declining to quote. The employer was effectively locked into State Fund pricing.
- Prior broker had only ever quoted State Fund. No voluntary market access had been explored. The employer had never seen a competitive premium comparison in six years of coverage.
The Intervention — Month 1
Step 1 — Unit Stat Review
Pulled the WCIRB Unit Statistical Report and identified two reserve discrepancies. One claim reserved at $48,000 had been paid out at $21,000 and was effectively settled but had not been closed in the carrier system — the reserve had not been updated to reflect actual paid amounts.
Step 2 — SIU Referral
Broker engaged the carrier’s Special Investigations Unit on a third claim with an inconsistent injury description and conflicting medical documentation — a claim that had been open for 14 months with a $62,000 reserve and no clear path to resolution.
Step 3 — IIPP Implementation
Drafted a comprehensive written IIPP and fall protection plan specific to roofing operations — covering OSHA-compliant fall arrest systems, ladder safety, leading edge work, and emergency response protocols. Implemented with documented foreman training and crew sign-offs.
Claim Resolution — Months 2–8
Step 1 — Reserve Correction
Advocated directly with the claim examiner on the $48,000 reserve. Confirmed that the claim had been fully paid at $21,500, treatment was complete, and the claimant had returned to work elsewhere. Claim closed at $21,500 actual paid — a reserve reduction of $26,500.
Step 2 — SIU Outcome
The SIU referral led to a Compromise and Release settlement on the suspicious claim at $14,000 versus the $62,000 reserve — a reduction of $48,000 in the Unit Stat exposure that had been inflating the mod calculation.
Step 3 — RTW Program
A formal return-to-work offer letter was drafted and presented to the injured worker on one remaining open claim. The employee accepted modified duty assignment and returned to light-duty work within 30 days, converting from total temporary disability to modified duty status.
Step 4 — Safety Culture
The employer implemented documented weekly safety tailgate meetings for all crew members, with signed attendance sheets maintained in a binder on-site. This documentation became a key underwriting differentiator in the voluntary market submission at renewal.
Market Access — Month 9 (Renewal)
With the mod projected at 1.22 for the upcoming year (down from 1.35 based on corrected Unit Stat values), the risk was now marketable to voluntary carriers. Three admitted carriers were approached simultaneously, with the IIPP documentation package included in the submission.
ICW Group came in at a Loss Cost Multiplier of 0.91 versus State Fund’s LCM of 1.00 — an additional 9% difference in pricing on top of the mod improvement. The policy was bound with ICW Group. State Fund released without penalty. The first-year premium under the new carrier: $158,000 — a $29,000 reduction from the prior year even before the mod had fully recovered.
Years 2 and 3
Year 2 produced zero claims. The IIPP and fall protection program were doing their job — no lost-time injuries in a full policy year for a 12-person roofing crew is meaningful evidence of a genuine safety culture change. The mod moved from 1.22 to 1.08 at the second renewal.
Year 3 saw one minor claim — a laceration requiring four stitches. The employer handled it through their RTW process: the employee returned to modified duty in six days, and the claim closed within eight weeks at $4,200. The mod reached 0.94 at the Year 3 renewal — a credit modification for the first time in the company’s history.
The Numbers
Total premium savings over three years versus continuing on the State Fund trajectory with a worsening mod: approximately $184,000. Cost of broker intervention: $0 (commission-based brokerage). IIPP and foreman training implementation cost: approximately $3,200 (one-time). Return on investment from the safety program alone: effectively unlimited — zero-claim years generate compounding mod improvement for three subsequent renewals.
“We didn’t know our unit stat had errors. Nobody had ever asked us to look at it. The first thing Aaron did was pull it and start making calls.”
— Business owner, name withheld