We welcome your small to mid-sized Workers' Compensation submissions for risks in the states where we are currently writing business. Our responsive underwriting staff, broad eligibility and processing support will provide ease of doing business. We offer competitive rating tiers and are committed to providing a quick turnaround on a comprehensive Guaranteed Cost Proposal.
The list below represents the Submission Data required for all Workers' Compensation risks:
- Acord 130 Workers' Compensation Application
- Signed by the applicant and producer within 5 days of binding
- Application to include the current exposures /payroll and number of employees per class code by location
- Description of Operations
- FEIN – Federal Employer Identification Number
- Minimum 2 years and currently valued loss runs (within the last 90 days)
- Waived if premium is $25,000 or less and no losses in last three years
- Detailed explanation is required on incurred losses of $25,000 or more
- Experience modification and effective date – current and prior two years (if available)
- Supplemental application (as required)