Resources
Microsoft Word documents can be downloaded, saved, and filled out on your computer.
1. Click on the link, download the document and save it on your computer.
2. To complete an application, bring the document up in Word and tab through the fields. If you need to skip a field, just tab through it. To move back a field, hold down the shift key and tab. You can also "click" into any field using your mouse.
3. If you are submitting an application for Excess Workers' Compensation or Large Deductible Excess Workers' Compensation on a form other than the Safety National Application, please complete our Fraud Warning Statement (available from the list below) and submit it with your other documentation.
If you have any questions, problems or suggestions please contact:
Karla Antrobus
Assistant Vice President, Business Development Operations
888-995-5300
|
DOC
|
|
PDF
|
|
XLS
|
|
TXT
|
|
| Aircraft |
|
|
|
|
|
|
|
|
| Contractor's Supplemental Questionnaire |
|
|
|
|
|
|
|
|
| Credit Risk |
|
|
|
|
|
|
|
|
| Electrical Supplemental |
|
|
|
|
|
|
|
|
| Employee Concentration Sup. Info |
|
|
|
|
|
|
|
|
| Excess Unemployment Compensation |
|
|
|
|
|
|
|
|
| Excess Workers' Compensation (revision coming soon) |
|
|
|
|
|
|
|
|
| Hospital Supplemental |
|
|
|
|
|
|
|
|
| Large Deductible Workers' Compensation |
|
|
|
|
|
|
|
|
| Loss Portfolio Transfer |
|
|
|
|
|
|
|
|
| MAP Registration |
|
|
|
|
|
|
|
|
| Surety Bond |
|
|
|
|
|
|
|
|
| TEXcess Application |
|
|
|
|
|
|
|
|
| Third Party Administrator |
|
|
|
|
|
|
|
|
| Vehicle Supplemental |
|
|
|
|
|
|
|
|
| Voluntary Payroll Declaration |
|
|
|
|
|
|
|
|
| Watercraft Supplemental |
|
|
|
|
|
|
|
|
| |
|
DOC
|
|
PDF
|
|
XLS
|
|
TXT
|
|
| About Safety National |
|
|
|
|
|
|
|
|
| Ask Best Doctors Program |
|
|
|
|
|
|
|
|
| Best Doctors CatCare Program |
|
|
|
|
|
|
|
|
| Best Doctors Results |
|
|
|
|
|
|
|
|
| Construction |
|
|
|
|
|
|
|
|
| Excess Workers' Compensation |
|
|
|
|
|
|
|
|
| Excess WC vs Large Deductible Comparison |
|
|
|
|
|
|
|
|
| Large Casualty Program |
|
|
|
|
|
|
|
|
| Large Casualty Collateral Options |
|
|
|
|
|
|
|
|
| Loss Portfolio Transfer |
|
|
|
|
|
|
|
|
| MAP Client Services |
|
|
|
|
|
|
|
|
| Public Entity Multi-Line Program |
|
|
|
|
|
|
|
|
| RISE Brochure |
|
|
|
|
|
|
|
|
| TEXcess Brochure |
|
|
|
|
|
|
|
|
| Treaty Reinsurance |
|
|
|
|
|
|
|
|
| |
|
DOC
|
|
PDF
|
|
XLS
|
|
TXT
|
|
| Auto/GL- First or Supplemental report |
|
|
|
|
|
|
|
|
| First Report |
|
|
|
|
|
|
|
|
| Supplemental Report |
|
|
|
|
|
|
|
|
| |
Request for Reimbursement |
DOC
|
|
PDF
|
|
XLS
|
|
TXT
|
|
| Aggregate Claim |
|
|
|
|
|
|
|
|
| Specific Claim |
|
|
|
|
|
|
|
|
| Specific Claim (pro-rated claim expense) |
|
|
|
|
|
|
|
|
| |
|
DOC
|
|
PDF
|
|
XLS
|
|
TXT
|
|
| Best Practices for SIGs |
|
|
|
|
|
|
|
|
| |
Wisconsin Large Risk Alternative Rating Option Questionnaires |
DOC
|
|
PDF
|
|
XLS
|
|
TXT
|
|
| Aircraft Supplemental |
|
|
|
|
|
|
|
|
| Approved Service Organization |
|
|
|
|
|
|
|
|
| Credit Risk |
|
|
|
|
|
|
|
|
| Electrical Exposure Supplemental |
|
|
|
|
|
|
|
|
| Employee Concentration Info |
|
|
|
|
|
|
|
|
| Hospital Health Care Supplemental |
|
|
|
|
|
|
|
|
| Surety Bond |
|
|
|
|
|
|
|
|
| Unemployment Compensation |
|
|
|
|
|
|
|
|
| Vehicle Supplemental |
|
|
|
|
|
|
|
|
| Workers' Comp Questionnaire |
|
|
|
|
|
|
|
|
| |
|
|
|
FLASH
|
|
| Maximize Your Resources to Manage High Exposure Claims |
|
|
|
|
