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Massachusetts Insurance Inquiry Form for Workers' Compensation

State:
Massachusetts
Control #:
MA-174-WC
Format:
PDF
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Description

This is one of the official Workers' Compensation forms for the state of Massachusetts.

How to fill out Massachusetts Insurance Inquiry Form For Workers' Compensation?

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FAQ

A workers' compensation certificate of insurance is proof that a business carries workers' comp coverage. It can sometimes be referred to by other names, including COI, insurance certificate, certificate of insurance form, subcontractor certificate of insurance, or proof of insurance.

If your employer has regular workers compensation insurance, his/her insurance information will be available on the Workers Compensation Insurance Rating Bureau (WCIRB) website. Use your employer's correct name when doing the search about your employer's insurance company.

All employers operating in Massachusetts are required to carry workers' compensation insurance for their employees and themselves if they are an employee of their company.The only exception is for domestic employees who must work at least 16 hours a week to be covered under a workers' compensation policy.

#1: Medical-Only Coverage. #2: Temporary Disability. #3: Permanent Disability.

The amount of weekly benefits for total disability is usually 60% or 2/3 (66 2/3%) of the employee's pre-injury average weekly wage (AWW). AWW is the employee's actual earnings, including overtime, for a certain number of weeks before the injury (up to 52), divided by that number of weeks.

Workers' comp insurance premiums are calculated according to how employees are classified (with regards to the specific type of work they perform) and the rate assigned to each employee classification. The premium rate itself is expressed as dollars and cents per $100 dollars of payroll for each class code.

Public information regarding workers' compensation cases in California, is accessible online through the Electronic Adjudication Management System (EAMS) website, maintained by the California Division of Workers' Compensation (DWC).

A Workers Compensation or WC certificate is proof and limits of IT AMG's Workers Compensation coverage. The WC certificate provides coverage details, insurer information, covered entities and period of effect.

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Massachusetts Insurance Inquiry Form for Workers' Compensation