SATURDAY, OCTOBER 21, 2017
 
Workers Compensation Shop.com

Workers' Comp Forms

Hz Spacer for Workers Compensation Shop

Forms, Guides, Applications
Contact a Workers Compensation Specialist

Workers' Compensation Forms

Free access to the most current and helpful workers compensation forms available online.

Workers' Compensation Form

Get access to free workers compensation forms, state guides, and applications.

Workers Compensation Shop.com provides free access to our collection of insurance forms with no guarantees or warranties.  We make reasonable efforts to keep our forms library up-to-date and current with the most current insurance forms and documents available.  Visit our state work comp form pages listed below for specific state workers comp forms.


Get Workers Compensation Insurance Quote
Obtain the best deal on workmans' compenation

Online Workers' Compensation Quote  Secure • Fast • Easy


Have an Agent Contact Me:

Your Name:

*

Company:

Phone Number:

*

Email:

*

# Employees:

Zip Code:

  * Required

Need Work Comp? Call 888-611-7467 for a Workers Compensation Shop Specialist

Hz Spacer for Workers Compensation Shop

Insurance Forms for Workers Compensation Workers Compensation Shop.com Icon.

General Workers Compensation Forms
Acord 130 Workers Compensation Application Form
The standard workers compensation insurance application for work comp and employers liability coverage. 
*Form not applicable for Florida quotes.
Acord 4 First Report of Injury Form
This form should be completed anytime an employee is inured on the job, or claims to be injured.  Employers are required to report all injury claims to the insurance company within 7 business days from the 5th day of disability.
Workers Compensation Loss Affidavit
A workers comp loss affidavit should be completed by prospects seeking coverage when they are unable to obtain official loss runs from their insurance company or current agent of record.
Workers Compensation Loss Runs Request Form
This form may be used to request loss runs from your current agent of record or insurance company.
Agent of Record Change Request Form
Complete this form if you would like to change the agent of record from your current agent or agency to Workers Compensation Shop/The Insurance Shop as the agent on file with the carrier.  This will enable us to service your policy and work with the insurance company and NCCI on your behalf.
Experience Mod Release Authorization Form
Complete this form in order to authorize NCCI to release your experience modification worksheets to our agency.
Acord 35 Cancellation Request - Policy Release
Complete this form in order to officially cancel an active or renewal policy with an existing insurance company.  Most insurance carriers will continue to charge premium until this form is returned to them.
ERM 14 Form
ERM 14 Instructions
Complete this form if there has been any change in ownership for any existing workers comp policy.  The form may be submitted to the rating organization by the insured, agent, or insurance company.

Workers Comp Exemption Forms

Business owner and officer policy inclusion and exclusion rules are determined by each state based on the laws and regulation of the state. Current workers compensation Exemption Forms can be found by choosing your State Form Link to the right.


Injury Reports and Claim Forms

See Acord First Report of Injury Form above. Many states and insurance companies also utilize the their own versions of Incident Report Forms. It is imperative that employers report injuries directly to their insurance company or agent as close to the accident as possible.


Workers Compensation Waivers

Waivers are not the same thing as Exemption Forms. Exemptions and Exclusions are for businesses who have a policy in place for employees but need to elect or reject work comp coverage for the owners and officers. Waivers are for business owners who do not have employees and do not want to purchase coverage.

State rules will vary considerably regarding waivers. While a few states still allow waivers, most states are requiring coverage for all businesses. Most notably, contractors are now required to carry coverage regardless of not having employees.

Contact one of our Licensed Specialists at 888-611-7467 for the most current rules and laws in your state.

Hz Spacer for Workers Compnesation Shop

Need Help
With a Form?

888-611-7467

Give us a call for a quote or a form.

Hz Spacer for Workers Compnesation Shop


Workers Compensation Forms by State

Alabama Forms Montana Forms
Alaska Forms Nebraska Forms
Arizona Forms  Nevada Forms
Arkansas Forms New Hampshire Forms
California Forms New Jersey Forms
Colorado Forms New Mexico Forms
Connecticut Forms New York Forms
Delaware Forms North Carolina Forms
Florida Forms North Dakota Forms
Georgia Forms Ohio Forms
Hawaii Forms Oklahoma Forms
Idaho Forms Oregon Forms
Illinois Forms Pennsylvania Forms
Indiana Forms Rhode Island Forms
Iowa Forms South Carolina Forms
Kansas Forms South Dakota Forms
Kentucky Forms Tennessee Forms
Louisiana Forms Texas Forms
Maine Forms Utah Forms
Maryland Forms Vermont Forms
Massachusetts Forms Virginia Forms
Michigan Forms Washington Forms
Minnesota Forms Washington DC Forms
Mississippi Forms West Virginia Forms
Missouri Forms Wisconsin Forms
Wyoming Forms- no forms


Help With Workers' Compensation Insurance


What is Workers Compensation?

The Basics of Workers Comp

Workers Compensation Q and A?

Insurance Laws for Work Comp

Managing Policy Claims

Getting Work Comp Benefits

NCCI Classification Codes

Experience Modifiers and Ratings

State Fund Coverage

Workers Compensation Forms

Handling Workers Comp Audits

Understanding an Employer Liability Policy

Excluding Owners and Officers

Insurance Commission


Get a Pay As You Go Workers' Compensation Insurance Quote.

Workers Compensation Experts Federal Forms. State Forms. Fast Quotes.

Workers Compensation Shop.com is a national leader in workers' comp insurance. Whether you're just looking for a form or you're interested in comparing our rates to your current price, we're here to help.

Give one of our Workers Compensation Specialists a call at 888-611-7467 if you need help find or completing a workers comp form. Or contact us online for a free, no-obligation quote.

National Agency Number: 8847381
National Producer Number: 5064979

Contact a Work Comp Specialist