Policy Administration Checklist

End-to-end policy administration workflow for an agency or MGA — new-business intake and underwriting through binding, claims handling, renewal, and compliance recordkeeping.

6 sections 25 steps Collects data
1

Submission Intake and Policy Setup

  1. Collect ACORD 125 and supplemental applications
    • Pull ACORD 125 (commercial app) plus line-specific supplementals — ACORD 130 for WC, ACORD 140 for property, ACORD 137 for auto, plus a current statement of values where applicable. AMS auto-population from prior renewals drifts over time; confirm class codes, payroll, and sales reflect current operations rather than what was on file two cycles ago.

    Collects file
  2. Verify producer NPN and state appointments
    • Confirm the producer of record is appointed by the carrier and licensed in the bind state via NIPR. CE lapses convert to license lapses; an unauthorized transaction is grounds for the carrier to rescind and creates E&O exposure.

  3. Run OFAC screening on the insured
    • Screen the named insured, additional insureds, and any disclosed beneficial owners against the OFAC SDN list before binding. Re-screening at claim payment is a separate control; do not assume issuance-time clearance covers later payouts.

  4. Open the submission in PolicyCenter
    • Create the submission record in Guidewire PolicyCenter (or Applied Epic / AMS360), attach the ACORD packet, and route to the assigned underwriter. Mark indications as non-binding — do not import an indication as a quote.

2

Underwriting and Risk Assessment

  1. Order five-year loss runs
    • Request loss runs from each prior carrier covering the past five policy years. For workers comp, also pull the experience mod worksheet from NCCI or the applicable independent bureau (NY, CA, NJ, PA, MI, MN, etc.).

  2. Classify the account against carrier appetite
    • Compare hazard grade, class codes, and exposure base against the carrier's published appetite guide and the producer's bind authority. Accounts outside delegated authority require senior underwriter referral before quoting.

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  3. Submit referral packet to senior underwriter
    • Package the submission, loss runs, and exposure analysis with a written rationale for going outside delegated authority. The referral underwriter signs off on terms, limits, and any required exclusions before the quote is issued.

  4. Rate the account and issue the quote
    • Run the rating engine (TurboRater, EZLynx, or carrier portal), apply schedule mods within filed bands, and confirm the form-filing posture in the rate state — prior approval states require pre-approval of any rate deviation. Issue the quote with named conditions and a stated expiration.

3

Binding and Payment

  1. Confirm bind authority for line and limits
    • Re-check the binding authority document for the appointed carrier — line of business, hazard grade, limits, and any state restrictions. Multi-carrier agencies often have different authority per carrier; binding outside scope is the most common cause of post-bind rescission.

  2. Issue the binder and declarations page
    • Generate the binder and dec page from PolicyCenter. Confirm effective date, named insured spelling, additional insureds, and endorsements match the bound terms. Send via DocuSign with the commission disclosure required under NY Reg 187, CA SB 250, or equivalent.

  3. Collect down payment or finance agreement
    • Record the down payment in the AMS or attach the executed premium finance agreement. For surplus-lines placements, flag the file for state-specific tax and stamping office filings, which run on tight 30–60 day post-bind windows.

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  4. Issue COIs to listed certificate holders
    • Generate ACORD 25 certificates for each holder on file. Distinguish certificate holder from additional insured — listing the management company as AI but not the property owner is the most common COI error in real-estate vendor onboarding.

4

Claims Administration

  1. Acknowledge FNOL within statutory window
    • Texas Insurance Code Chapter 542 requires acknowledgement of a first-party claim within 15 business days; other states track the NAIC Unfair Claim Settlement Practices model with similar windows. A missed acknowledgement triggers 18% statutory interest plus attorney's fees in TX.

  2. Set the initial case reserve in ClaimCenter
    • Place a stage-one reserve based on first-pass severity. Per the carrier reserve cadence, plan for 30/60/90-day re-evaluation; placeholder reserves left untouched contribute to IBNR drift and become market-conduct exam findings.

  3. Triage claim severity and coverage posture
    • Review the policy form, retro date, and ERP against the reported loss. Flag indicators of suspected fraud (staged loss, prior-claim patterns, late reporting with unusual documentation) for SIU. Borderline coverage matters trigger a reservation-of-rights letter, not a denial.

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  4. Refer the file to SIU and issue ROR
    • Open the SIU referral, place a litigation hold, and issue a reservation-of-rights letter that names each policy provision in question. For recorded statements, disclose recording at the start — failing to disclose makes the statement inadmissible and can support a bad-faith claim.

  5. Issue claim payment after signed release
    • Re-run OFAC against the claimant and any assignee before cutting payment. Note subrogation rights — most states require putting the at-fault party on notice within roughly six months, and missing the window waives recovery.

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5

Renewal Processing

  1. Pull the T-90 renewal expiration report
    • Run the renewal expiration report out of Applied Epic or AMS360 ninety days before policy expiration. State non-renewal windows govern the latest possible drop-decision date — NY runs 45–60 days, CA personal auto 45 days, FL 45–120 days depending on line.

  2. Compare current operations to in-force exposures
    • Walk the insured through payroll growth, new locations, fleet additions, and any class-code changes. Material exposure changes flip the renewal from same-terms to remarketing.

  3. Set the renewal strategy
    • Choose the path: renew at expiring terms, remarket to alternate carriers, or non-renew. Document the rationale in the AMS — remarketing decisions made late in the window force the insured into an unplanned coverage gap.

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  4. Send non-renewal notice within the state window
    • Use the state-required non-renewal form and statutory reason language. Send via certified mail or carrier-approved electronic delivery with proof of service. A late notice forces renewal at expiring terms regardless of the carrier's intent.

  5. Present the renewal package to the insured
    • Walk the insured through the renewal dec page, premium changes, loss-control recommendations from the carrier, and any new endorsements. Confirm certificate holders and AI lists are current before issuance.

6

Compliance and Recordkeeping

  1. File surplus-lines tax and stamping submissions
    • For E&S placements, remit state premium tax and file with the stamping office where required (FL, CA, TX, NY among others). Filing windows are typically 30–60 days post-bind; the producer of record carries ultimate compliance responsibility even when a wholesale broker handles mechanics.

  2. Confirm producer CE and license currency
    • Verify each producer of record on the book has current CE hours and active state licensing via NIPR. Lapses block bind authority for any account where they are listed; surface upcoming expirations 60 days before the renewal date.

  3. Archive the policy file per retention schedule
    • File the bound policy, application packet, signed disclosures, and commission record in ImageRight per the carrier's retention schedule — typically 5–7 years for P&C, longer for workers comp given lifetime medical exposure. Premature destruction creates discoverable spoliation risk.

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Sections 6
Steps 25
Category Insurance
Price Free to start
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