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Preliminary Indication
Same numbers your underwriter sees · Subject to final confirmation
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Submit a Workers' Comp Opportunity
Upload your client's ACORD 130 and loss runs. Our AI underwriting system analyzes the submission and provides a conditional indication within minutes. A formal quote follows within 24–48 hours.
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Your Information
So we know who to send the formal quote to.
Client Information
Basic info about the account you're submitting. This helps our underwriting team process faster.
Upload Documents
Upload the ACORD 130 (required) and loss runs (strongly recommended). We accept PDF, Excel, Word, and image files.
ACORD 130 — Workers' Comp Application *
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Drop ACORD 130 here or click to browse
PDF, Excel, or image files
Loss Runs — 3 to 5 Years (recommended)
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Drop loss runs here or click to browse
PDF, Excel, or image files
Analyzing Submission
Review Extracted Information
Please verify the information our AI extracted from your documents. We pull data directly from the ACORD and loss runs, but OCR can miss fields or misread handwriting. A quick review before final submission prevents delays in underwriting.
Employer Information
Class Codes & Payroll
State
Code
Description
Gross Wages
Employees
Loss History
Year
Total Claims
Incurred $
Paid $
Open Claims
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