Quoting Procedure
To present a submission for possible quote, either email (fubawc@fubaworkerscomp.com) or fax (888-871-7474) the following to our office. Incomplete submissions will not be given to an Underwriter and will delay response time.
- Completed ACORD form 130-FL (2002/07)
- Loss runs for past 3 years
- Federal ID number
- Years experience in current operations
- Number of employees
- Full names of owners/officers/employees
- Social security numbers for owners/officers/employees
- Payroll for owners/officers/employees
- Percentage of work subcontracted
- Detailed description of operations
- Copy of exemption or revocation of exemption
- UCT-6 report for the last two quarters if applicable
Please include any instructions on applicable credits such as Drug-Free Workplace, Safety, FCCPAP, etc. Pre-inspection may be required for the following conditions: nature of operations, excessive loss ratio, or prior policy cancelled for cause.
If we request more information regarding a submission and do not hear back from the agent, the submission will be considered closed 30 days from the date of the request. No further action will be taken. If we issue a quote and do not receive a written request to bind within 30 days, the quote will expire and a new application must be submitted in order to be considered by FCBI.
To make changes to a quote, fax a written request to Underwriting prior to binding. Agents cannot adjust a quote once it has been issued.
Incomplete applications will result in delay of underwriting.
Please email the Underwriting Department with any additional questions.
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