How to Fill out a Worker's Compensation Insurance Application

by Contributor; Updated September 26, 2017

How to Fill out a Worker's Compensation Insurance Application. The application process to obtain a worker's compensation insurance policy is quite easy. Many large insurance companies allow their potential customers to download and fill out application forms online. You will need to have payroll and other information about your business handy when you fill out the insurance application.

Items you will need

  • Payroll reports
  • Social Security numbers
  • Application packet
  • Reports of previous on-the-job accidents
  • Contact information for previous insurance carrier
  • Business license numbers

Prepare for and Complete a Worker's Compensation Insurance Application

Step 1

Gather all the materials you will need to fill out the worker's compensation insurance application in its entirety. Usually, you will need to input information about company revenue, how much is paid out to employees and what company (if any) has provided you with insurance in the past.

Step 2

Pull from your files information about how many worker's compensation claims your employees have made in the past 3 to 5 years.

Step 3

Download the application forms from the insurance company's website, if applicable, or have them send you a packet through the mail. If you can apply for the insurance online, make sure you have a secure Internet connection that will not be interrupted during the application process.

Step 4

Read the application forms fully before you start to fill them out. There may be sections labeled "for office use only" that are not meant for you to complete.

Step 5

Fill out your personal information, as well as that of any co-owners of your business. This includes your full name, address, Social Security number and birthdate.

Step 6

Be able to accurately describe the nature of your business. Worker's compensation insurance is based on how much risk your industry is perceived to have. You will probably be asked to answer questions about the type of machinery used and the locations where your employees work.

Step 7

Include any business or contractor license numbers you may have, if asked for them.

Step 8

Proofread the application carefully after you have finished filling it out. Correct any mistakes you have made. If you are applying online, be sure to save the document to your computer before you hit the "Send" button.

Step 9

Make a copy or print out your completed worker's comp insurance application and keep it handy until you hear that your application has been accepted. Once you've been accepted, file the copy of your application in a safe place. You never know when you might need it.


  • If you are applying for worker's compensation insurance online and do not understand a portion of the application, find a customer service number to call for help. Use a new window on your computer to search for contact information so you do not lose the partially completed application.

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