Loss control inspections: the insurer's visit to your office and vans
Overview
A loss control inspection is an insurer's review of how your company actually operates, done by its own loss control staff, a contracted firm, or a digital risk review you fill in. It checks whether the risk matches your application and where claims could be prevented, and it ends in recommendations. Some NEMT programs require one before binding and look for owners who carry out the recommendations.
On this page
Who sends the inspector
The insurer does, through its own loss prevention staff or a contracted service, and California’s regulator says the service usually comes bundled with higher-risk, higher-premium accounts. On mid-size and large accounts the insurer often orders a loss control report, and the specialist usually visits to see the operation in person. The help that can come with it, from driver training to telematics discounts, is covered in NEMT fleet insurance.
Not every review is a visit. RLI’s NEMT and paratransit program accepts either an on-site inspection or a digital risk review filled in by the insured, and its own loss control team checks both. What a written fleet safety program should contain, and what to have ready, is covered in that guide.
What the inspection is checking
The inspection tests your application against your operation. RT Specialty’s NEMT workers’ comp application ends by stating that every answer is subject to verification through an underwriting survey or inspection, and that coverage can be cancelled for misrepresentation. CRC Group’s NEMT form says incorrect answers could void coverage. RT’s form also asks about pulling driving records when a driver is hired and every six months after, and about keeping copies in personnel files, so those files are what an inspector can ask to see. The full list of those questions is in getting NEMT insurance.
Recommendations and your renewal
An inspection ends with recommendations, and some arrive as requirements. California’s guide describes the agent, underwriter, claims representative, and loss control representative building a prevention program together, with premiums falling as your loss experience improves. One specialty program spells out its expectations: RLI looks for owners willing to work with its underwriter and loss control team to carry out requirements and recommendations, and it turns away risks with a clear history of egregious behavior around loss control, safety, and compliance.
Treat each recommendation as a dated task, keep proof that it was done, and send that proof before renewal. The state rules on cancelling a policy midterm, including grounds tied to loss control requirements, are in the guide to cancelled or non-renewed NEMT insurance.
Texas workers’ comp: the state checks the insurer
In Texas, workers’ comp insurers must maintain or offer accident prevention services suited to their policyholders’ operations, under Labor Code Chapter 411 and 28 TAC Chapter 166. Each insurer sends the state an annual accident prevention report, due April 1. During its inspections of insurers, the state’s Division of Workers’ Compensation holds remote visits with policyholders to confirm the services fit the policyholder’s needs, so a Texas NEMT company can hear from the state as well as its carrier.
Inspection records in HealthRide
Inspectors look for proof that vans are checked and credentials are current. In HealthRide, every shift starts with a vehicle inspection checklist the driver completes in the app, and dispatch sees a failed one right away. The fleet and credentials registry flags anything expired during assignment and sends reminders ahead of each license, insurance, and certification date.
Frequently asked questions
- Loss runs or a loss control inspection, what separates them?
- Loss runs are your claims history from past insurers. The inspection looks at how you operate today. Underwriters use both: RLI's NEMT program, for example, wants four years of loss runs with values dated inside 90 days of the start date, and an on-site or digital review as well.
- Can I refuse the inspection?
- You can, but expect no offer from a program that lists it as a requirement. One NEMT program for hard-to-place fleets lists an acceptable on-site inspection or digital risk review among its requirements before it will write the account. If a site visit is a problem, ask whether a remote or digital review is accepted instead.
- What if I disagree with a recommendation?
- Reply in writing within the time the insurer gives you. Explain what you already do, attach the record that shows it, and propose an alternative if the recommendation does not fit your operation.
