Industry experts for workers compensation data collection and assigned risk placement in Michigan
Note: We will be upgrading the functionality and appearance of the special mod request application on October 30th. For any questions, please contact us at 734-462-9600.
Agents or Insureds (Letters of Authority) -- Click Here
An agent or insured can obtain experience modification data by submitting a Letter of Authority (LOA). LOA’s are submitted on the insured’s letterhead; the letter authorizes release of the mod data and is signed by the owner, a partner, or corporate officer. If an agent or insured requests a copy of the actual mod, the letter should state “actual mod will not be used for quoting purposes”. If the LOA does not specify actual mod then a payroll and loss data summary will be provided. The request can be submitted to email@example.com or faxed to 734-462-9721. The data requested will be returned by email. Remember to include your email address.