Send Us Email
Application
Long Term Care Workers compensation
In order to complete a quote we need the following information:
Don't Get Left Behind
Applications
In order for PMA Insurance Company to offer a competitive quote, the following data is necessary.
- Completed and signed Acord Application for the Worker Compensation exposure.
- Brief description of the operation.
- Complete addresses for all locations, not mail address.
- Recent financial statements, if applicable.
- Any pertinent loss control/ risk management reports for the operation
- Currently valued loss history for the past five (5) years, three (3) year minimum.
- A brief description for any loss greater than $25,000.
