Bona Fide Premium Disputes

Upon reviewing your audit statement, you may disagree with the premium we have calculated.  If this is the case, you should submit a Bona Fide Premium Dispute to us at:

Accident Fund Insurance Company of America
ATTN: Assigned Risk Solutions
PO Box 40767
Lansing, MI 48901

To qualify as a Bona Fide Premium Dispute, you must provide written notice that includes (1) all documentation relevant to the dispute, including written notice detailing the specific areas of dispute; (2) an estimate of the premium you believe to be correct, including explanation of the premium calculation; (3) payment of the undisputed portion of the premium – and if you have a Michigan policy, this undisputed portion must be paid by the due date of the billing statement.  All of these steps must be followed in order to suspend billing and collections activities on the disputed policy term and cancellation activity on any active term.  Failure to do so may result in cancellation of current coverage and could make you ineligible for future WCIP coverage.

If, after following the above steps, you cannot resolve this dispute with us, you may ask the Administrator for assistance.  To do so, you must submit all the documentation previously listed to:

For MI policies:

Michigan Workers’ Compensation Placement Facility
PO Box 3337
Livonia, MI 48151-3337

For all other policies:

NCCI
Dispute Resolution Services
901 Peninsula Corporate Circle
Boca Raton, FL 33487-1362
Email: [email protected]
Fax: 561-893-5043

In addition to the above, you must simultaneously send copies of all documents to all other parties to the dispute.