Apply

Assigned Risk Coverage can be applied for through our Online Assigned Risk (OAR) system.

MWCPF Information & Procedures Handbook

Our procedures handbook, found here, was created specifically for licensed Michigan insurance agents to help them understand the Facility and provide better service to their assigned risk policyholders.

Forms

• Application for Assigned Risk Coverage
• Specific Person Exclusion/Certified Resolution/Consent Form
• ERM-14 Confidential Request for Information
• Sole Proprietor Independent Contractor Worksheet
• Sole Proprietor Independent Contractor Supplemental Worksheet – Truckers

requirements for insureds that use contractors

• Guidelines for Insureds that use Contractors

Classification

• Class Code Manual
• Class Code Lookup

Increased Limits

Employers Liability Coverage - Part Two is restricted to the standard limit of liability of $100,000 unless the insured requests higher limits of $500,000 or the maximum limit of $1,000,000.

Note: Additional charge is based on the total premium and added before the experience modification.

Servicing Carriers

L M Insurance

• P.O. Box 8090
• Wausau, WI 54402-8090
• Phone: 800-653-7893
• Fax: 603-427-1885
• ims@libertymutual.com

The Travelers

• Document Management – RMD
• 300 Windsor Street
• Hartford CT 06120
• Phone: 800-443-4404
• Fax: 877-634-3710
• arwc@travelers.com

Accident Fund Ins Co of America (Effective 1-1-17)

• P.O. Box 40767
• Lansing, MI 48901-7967
• Phone: 866-221-9640
• Fax: 844-778-1070
• Policy@AssignedRiskSolutions.com

Certificate of Insurance 

Certificates of insurance are to be issued by the Servicing Carrier within 5 working days of receipt of the request.
Often, more immediate issuance is required. If so, the Servicing Carrier should be contacted to see what arrangements can be agreed upon.

Common Reasons an App is Rejected

In order to ensure your application is completed in a timely manner, please view these common reasons an application is returned or delayed.

Assigned Risk FAQs

The answers to most frequently asked questions for the assigned risk process can be found here, or under the resource(s) links to the right.

Assigned Risk Depopulation Report

The Depopulation Report contains all Facility policies expiring in the next quarter year. This report includes Employer Name, City, State, Risk I.D. Number, Premium, Expiration Date, Classification Code, Experience Modification and Pool Surcharge.

The data is formatted in an ASCII file capable of being opened in a spreadsheet program. Facility member carriers may distribute this information to their agents. Member carriers may also display this depopulation information on their web site and/or establish links to CAOM’s web site.

A printable PDF version, and a downloadable comma separated value text file (right click -> save link as) for spreadsheet use are available below.  Once downloaded, the file can be opened in Excel, or notepad.