Insurer Access Request

Fill out the form as completely and accurately as possible and click 'Submit Request' to forward the request to the FWCJUA. We will review the request to ensure all required information is present and accurate. Once the verification is complete, you will be notified via the email submitted.

 If you have any questions in regard to what type of information a particular field is looking for, hover over the field with your mouse for additional information.

  FL Comp Code / NAIC Code

To continue with the request, we need either a FL Comp Code or NAIC Code for a carrier authorized to sell Workers Compensation Insurance in the state of Florida. The code will be verified when the Next  button is clicked.