Occupational accident insurance application 2026

1. Click ‘Get Form’ to open the Occupational Accident Insurance Application in the editor.
2. Begin by filling out the Motor Carrier Information section. Provide details such as the motor carrier name, address, and contact information. Ensure all fields marked with an asterisk are completed.
3. Proceed to Section I, where you will answer questions regarding your business operations, including years in business and number of independent contractors. Be specific about hazardous materials and loading/unloading practices.
4. In Section II, provide driver information. Include minimum and maximum age requirements for independent contractors and any training provided.
5. Move to Section III to specify your desired insurance plan and coverage options. Indicate target rates and whether you wish to add optional coverages.
6. Complete Sections IV through VI by providing contingent liability information, loss control details, and producer information. Don’t forget to sign the questionnaire at the end.

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