OFFICE CLOSING - The FWCJUA Office will be closed for the Holidays November 27th and 28th.

Duties & Responsibilities

  1. To comply with all provisions of the FWCJUA, including accurately and fully completing the required FWCJUA Application for Coverage and any supporting documents which may be required, as requested by the FWCJUA.

  2. To ensure that all necessary election and/or exemption of coverage forms are timely filed with the Bureau of Compliance.

  3. To keep your selected Agency or Designated Producer and our Service Provider, Travelers, fully advised of changes in name or ownership, operations, locations or exposures which may affect coverage, classifications, rates, premium estimates or other aspects of the coverage being provided by the FWCJUA.
  4. To cooperate fully with our Service Provider in the verification of any prior workers compensation insurance coverage, including loss history and corresponding policy premium by promptly submitting loss runs with corresponding policy premium generated by prior Insurer(s) or other such verifiable loss history and corresponding policy premium information that may be requested by the Service Provider to confirm or determine tier eligibility.

  5. To cooperate fully with our Service Provider in the verification of the number of and names of employees by promptly submitting a Monthly Change Sheet (ACORD 175) or other such form that may be requested by the Service Provider.

  6. To cooperate fully with our Service Provider in the verification of policy premium by promptly submitting completed Quarterly Payroll Reporting Forms as well as RT-6 payroll information or other such verifiable payroll information that may be requested by the Service Provider.

  7. To submit all premium, assessments, penalties, fees or surcharges in a timely manner to avoid cancellations and lapses in coverage.

  8. To comply with the FWCJUA safety program and to cooperate fully with our Service Provider in implementing all reasonable safety recommendations.

  9. To promptly report all claims through the toll-free telephone reporting mechanism and cooperate with our Service Provider in the investigation and settlement of claims.

  10. To comply with the FWCJUA Managed Care Arrangement including directing all injured workers to a Managed Care Arrangement (MCA) physician in the general geographic area when same is available.

  11. To allow our Service Provider reasonable access for audit or inspection.

  12. To comply strictly with all terms and conditions of the policy.

Questions?
Contact us at 1-941-378-7400 or underwriting@fwcjua.com