Ombudsman as Intermediary
If you have a dispute, the Policyholder Ombudsman can act as an intermediary between you and your insurance company and/or the WCIRB by clarifying the issues and putting you in contact with the appropriate individuals to resolve your dispute.
The objective is to facilitate a resolution of the issues by ensuring that all parties are fully informed and understand each others' positions. The Policyholder Ombudsman is not permitted to be an advocate for any of the parties involved nor does the Policyholder Ombudsman have direct authority to implement changes.
To contact the Policyholder Ombudsman about a dispute, fill out the following form:
Speaking Opportunities
The Policyholder Ombudsman is available to speak to employers and employer associations to help improve understanding of the workers’ compensation insurance system, prevent issues from arising and provide information to facilitate dispute resolution.
If you would like the Policyholder Ombudsman to speak at your organization, fill out the following form:
Contact the Ombudsman:
Workers Compensation Insurance Rating Bureau
1901 Harrison St., 17th Floor
Oakland CA 94612
Attn: Policyholder Ombudsman
Phone: 415.778.7159
Fax: 415.371.5288
Email: [email protected]
Learn how the Ombudsman can help you:
Policyholder Ombudsman Position
California state law defines the Policyholder Ombudsman's position as an employee of the WCIRB working in an independent associate capacity. The position receives guidance from an oversight committee comprised of an insurer, an employer representative and a representative of the California Department of Insurance, who chairs the committee.
California law established the Office of the Policyholder Ombudsman in Section 11752.6(g) of the Insurance Code.
The Policyholder Ombudsman may facilitate matters for you with the WCIRB or your insurer, but cannot make decisions on behalf of the WCIRB or your insurer. Your contact with the Policyholder Ombudsman does not constitute initiation of any dispute resolution process with the WCIRB or with your insurer. The procedures for resolving disputes with the WCIRB may be found in the California Workers' Compensation Experience Rating Plan—1995, California Workers' Compensation Uniform Statistical Reporting Plan—1995, Miscellaneous Regulations for the Recording and Reporting of Data—1995 and Title 10 of the California Code of Regulations at Sections 2509.40 et seq.
Time Card Recordkeeping Requirements
Learn how to apply rules in the California Workers’ Compensation Uniform Statistical Reporting Plan—1995 (USRP) for recordkeeping, division of payroll and dual wage classifications.
Dispute Process
If you have tried to resolve an issue regarding an action or failure to act on an informal basis and would like to pursue the issue as a formal dispute, the avenue for doing so is either through your insurer's internal dispute process or the WCIRB's internal dispute process. Visit the Dispute Process page to learn the steps.
Classification Inspection Site Visits and Test Audits
Have you received a letter stating you've been selected for an inspection or a test audit? Visit the Classification Inspection Site Visits and Test Audits page for information.
Video Resources for Employers
The Standard Classification System: Time Card/Recordkeeping Requirements
Learn about the importance of recordkeeping for the division of payroll and dual wage classifications.
Video Runtime: 13 minutes
The Standard Classification System: Standard Exception Classifications
Learn about the classification requirements for Clerical Office Employees, Outside Salespersons and Clerical Telecommuter Employees, as well as the application of the standard exception classifications.
Video Runtime: 14 minutes
California's Experience Rating System: Payroll Records – Not Available
Learn why it's important for the insurance company to conduct an audit, the impact of unaudited payroll on the experience modification and about working with the insurance company to complete the audit.
Video Runtime: 10 minutes
Understanding the Workers' Compensation Dispute Process
Gain a better understanding of the WCIRB dispute process, the insurer dispute process and the appeal process. We’ll also discuss some resources to help you navigate the dispute process.
Video Runtime: 12 minutes