Submission Requirements



AMERISAFE works in high hazard industries many other providers avoid. Our firsthand experience in these industries allows us to make informed decisions, assessing each submission individually and considering all risks regardless of e-modifiers. The more information you include in a submission, the better we can serve our policyholders. Please include the following:

  • Completed ACORD 130 application
  • Expiring and 3-year current value, hard copy loss runs
  • Current Mod worksheet, or expiring and 3-year historical payrolls by class code
  • Narrative description of the account

AMERISAFE accepts submissions 120 days in advance of the current expiration date allowing our Field Safety Professionals ample time to survey accounts prior to Underwriting making a final decision. Our minimum rated premium is $10,000. 

For a complete guide to submitting business, download our Ready Reference Guide.

Additionally, the following is useful during the submission process:

Contact your AMERISAFE Underwriter for information.


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