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

• Over 50 years experience serving niche industries
• 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. Is there a minimum premium?

Yes, $10,000.

5. Can Workers' Compensation be written monoline?

Yes.

6. What is the carrier rating?

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

7. 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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