CLICK THE BUTTON ABOVE TO DOWNLOAD WORKERS' COMPENSATION APPLICATIONS

Click here for Workers' Compensation FAQs....

The Brownyard Group offers custom-tailored Workers' Compensation Coverage to the industry.

The Brownyard Advantage Program Highlights….

• Highly rated insurance carriers
• Available in most states
• Convenient, interest-free payment options
• Competitive pricing

You can obtain a quote by providing the following information to us…

• Completed Brownyard program application (click on link to Applications);
• Completed ACORD WC application;
• Four-year loss history with appropriate details (must be currently dated);
• Copy of written safety program;
• Most current experience modification worksheet;
• Copy of Broker's License and proof of Errors & Omissions Insurance.

The Brownyard Advantage Program

• Highly skilled and responsive staff to service your account
• Insurance companies highly rated by A.M. Best

GAMBLE CUCE, Program Manager, Workers' Compensation/Crime, extension 115

THERESA PRICE, Account Manager, Workers' Compensation, extension 116

Workers' Compensation - Frequently Asked Questions

1. How do I apply for coverage?

The process is simple. Just mail, fax or email the required information (see question 2, below) for review and approval in approximately 5 business days from the date of submission.

2. What information is required to obtain a quote?

• Complete a Brownyard Workers' Compensation application.
• Complete an ACORD Workers' Compensation application.
• Provide detailed currently-dated 4-year loss history.
• Most current experience modification worksheet.
• Copy of Broker's License and proof of Errors & Omissions Insurance.

3. In what states is the program available?

Our program is available in most states. Check with us for the latest availability.

4. Can Workers' Compensation be written monoline?

Yes.

5. What is the carrier rating?

Our program is written through a carrier highly rated by A. M. Best Company.

6. How competitive is your pricing?

As a leading writer of Workers' Compensation for nationwide, we are highly competitive in the marketplace.

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Workers' Compensation Applications

Click on the application link to download interactive PDFs. (Acrobat Reader is required.)

Instructions:

Using our interactive PDFs, applicants who choose to do so may fill out applications on-screen and print them when completed to mail or fax.

PDF Tips:

• Each field to enter data has a limited number of characters.
• Please use abbreviations when possible (Ex: Ave. not Avenue)
• To move from field to field, use the "Tab" key on your keyboard.
• To enter a "check" mark, simply mouse click within the desired box.

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