The Mental Health Risk Retention Group values the opportunity to review your new business submission. Our experienced underwriting staff is here to evaluate your submission and design a comprehensive solution for your insured’s needs.
Below are items required for underwriting.
General & Professional Liability
- Completed Negley GL/PL application or incumbent’s renewal application (including supplemental applications)
- Most current audited financial statement, tax form, or Profit & Loss Statement (including Balance Sheet)
- Brochure or website address
- 5 years of currently valued loss runs
- 5 years of premium and carrier history
Directors & Officers Liability
including Employment Practices
- Completed Negley application or incumbent’s renewal application
- Current list of the Board of Directors
- Copy of By-Laws
- 5 years of currently valued loss runs
- 5 years of premium and carrier history
Other Coverages available through Negley Associates
Excess Liability and Umbrella
- $4,000,000 additional limits of coverage is available separately
Property
- Completed ACORD 140 application
- 5 years of currently valued loss runs
- 5 years of premium and carrier history
Workers Compensation
- Completed ACORD 130 application
- Current experience rating worksheet
- 5 years of currently valued loss runs
- 5 years of premium and carrier history
Submissions may be sent electronically via e-mail to submissions@jjnegley.com or via fax to 973-830-8585.Contact our Underwriting Department today with any questions! (973-830-8500)