Work Comp Loss History Survey

Previous Work Comp Info

Previous Work Comp Info

Our insurance company has asked us to gather information about previous WC claims from all schools who currently have coverage and are moving to the master policy. We regret the inconvenience.

You should be able to get your loss history as a report from your work comp insurance agent. Please upload that report below, even if it's an empty report. 

If you haven't had coverage, please answer "No" to that question below, and we won't require any additional information.

Did your school have Work Comp for 2022-2023 school year?

Information Requested

If your previous insurance company provides a loss run document, you can chose the first option and upload the file below.


If they inform you by email that you have had no losses to date, you can chose the second option, then just forward that email to

Please include the school name in any email. Thanks!


Maximum file size: 130MB