Innovative Risk Concepts, Inc.

New York State Workers' Compensation Safety Group Managers

 

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Workers' Compensation Safety Group Program Managers

Safety Group 568 - New York State Building Service Contractors' Trade Group

Safety Group 569 - New York State Medical Arts Trade Group

Safety Group 575 - New York State Veterinarians' Trade Group

Group 90 - General Pool

Workers' Compensation Underwriting Forms

In order to make a change to your current Workers' Compensation Policy managed by Innovative Risk Concepts, Inc. please complete the appropriate form below.

U-3 Form

Assignment of Interest Agreement

U-617-619 Form

Officer Exclusion Form

U-111 Form

Request for Inclusion of Additional Interest

U-626-627 Form

Officer Inclusion Form   

U-218 Form

Executive Officer Information Sheet

ERM-14 Form

Confidential Request for Ownership Information