| Admitted "A" Excellent (XII) rated carrier by A.M. Best Company. |
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| States |
| CA |
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Targeted Classes of Business |
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* Auto or Truck Dealers |
* Concrete or Cement Work |
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* Country or Golf Clubs |
* Electrical Wiring |
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* Hotels |
* Janitorial Services |
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* Landscaping |
* Light Manufacturing |
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* Machine Shops |
* Plastic |
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* Plumbing Contractors |
* Restaurants |
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* Retail / Wholesale Stores |
* Sheet Metal Work |
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| Endorsement |
| Please email all endorsement requests to endorsementreq@singlepointins.com. |
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| Loss Run Report |
| Please email all loss run requests to lossrunreq@singlepointins.com. |
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| Audit Information |
| To file a dispute on a final audit, the insured must submit a formal letter of dispute within 30 days of the final audit billing. We can help you faster if you: |
- Please indicate specifically what is being disputed.
- Write the letter on company letterhead.
- Letter must be signed by a company officer.
- Provide supporting payroll records.
- Please submit the formal letter of dispute by fax or mail.
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| Waiver of Subrogation |
| Specific Waivers of Subrogation require underwriting approval and a charge of 5% of payroll per entity/job, subject to a $50 minimum charge per entity/job. Requires certificate of insurance and completed job worksheet. |
| A specific waiver request must be accompanied by a job worksheet and certificates of insurance. A blank copy of a job worksheet can be found here. |
| Blanket Waivers of Subrogration require underwriting approval and a charge of 3% of the total policy premium. No minimum charge is applicable. |
| Requests for blanket waivers should be made at the time the bind order is submitted. Blanket waiver requests received after inception will be processed mid-term. In order to consider a blanket waiver, the follwoing information is required: |
- A list of jobs from the past six months and any prospective jobs. (Please include a brief description of the duties that the employees are performing.)
- A description of the safety procedures for employees at the worksite or construction site.
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| MPN |
| Medex Healthcare, Inc. |
| www.icwgroup.com/mpn |
| Tel: 562.498.6767 |
| MPN Coordinator: Deidre Doughty, 800.877.1111 |
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| Claim Services |
| First Notice of Loss |
To Request Claim Forms: |
| P.O. Box 8556 |
ICW Group |
| San Diego, CA 92186-5563 |
Attn: Workers' Compensation Underwriting |
| Tel: 877.442.9669 |
P.O. Box 85563 |
| Fax: 858.436.8916 |
San Diego, CA 92186-5563 |
| Email: firstnotice@icwgroup.com |
Email: WCClaimsForms@icwgroup.com |
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| Customer Service and Billing Information |
| Michielle Givens |
| ICW Premium Accounting |
| mgivens@icwgroup.com |
| Tel: 858.350.2994 |
| Fax: 858.350.2802 |
| All payments, except for deposits, should be paid and mailed to Singlepoint Insurance Services, Inc. |
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