Binding Procedure
Only FUBA Workers' Comp has binding authority. DO NOT REQUEST PAYMENT FROM YOUR CLIENT unless a quote has been issued. Coverage will not be bound until we receive all required documents. We will confirm the binding date and policy number via fax. Additional information may be requested.
To bind coverage, the Underwriter must receive:
- A copy of the Acord Form 130-FL (revised 2002/07) signed and notarized
- A copy of the FCBI Supplemental Application signed and notarized
- A copy of the down payment check made payable to FCBI. Down payments must be made by certified check/money order or issued from the agency's business account. Please note: we are not responsible for insured's NSF checks written to your agency.
- A copy of the application for membership in Florida United Businesses Association and a copy of the $85.00 check for membership dues made payable to FUBA. (Insureds checks are acceptable for payment of membership fees.)
- Evidence of currently held officer exemption or revocation forms (if applicable)
- Complete application and copy of the formalized program for Drug-Free and Safety Program Premium Credits
- Resume from owners/officers reflecting experience in current operations
- Statement of no loss from owners/officers if loss runs are not provided
The Policy will be issued upon receipt of:
- Original signed and notarized Acord Form 130-FL (revised 2002/07)
- Original signed and notarized FCBI Supplemental Application. This is a double-sided form that must have blue text on the front side. If you need this form, please call us prior to binding. Use only originals - copies, print-outs, and other facsimiles are not acceptable.
- Required deposit or premium payment
- Application for membership in Florida United Businesses Association and a separate $85.00 check to FUBA for yearly dues
- Copies of any Drug-Free and Safety Programs if requesting premium credits
This must be received within 7 working days from the effective date of coverage. If the Acord and FCBI Supplemental Application are not both signed and notarized, the policy will be subject to cancellation.
New Member Packets including policies, estimated billing, coverage agreement and claims reporting information will be mailed directly to members. A copy of the original policy will be forwarded to the agent.
Please email the Underwriting Department with any additional questions.
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