Insured
Insured Name:
Rating Effective Date:			*

Selected 4-Digit Years, Class Codes and Payrolls

Listed below are the 4-digit years, class codes and payrolls that you have selected for this calculation. To edit, click the edit hyperlink in the row you wish to modify.

Add Payroll Record

Enter the information below, and then click Add.

4 Digit Year: * Class Code: * Payroll: *

4 Digit Year Class Code Payroll ELR D Ratio Actual Expected Losses Primary Expected Losses Edit Delete

Add Losses Information

Enter the information below and then click Add.

4 Digit Year: * Losses: * Accident Date: * Catastrophe: No Yes * Type of Claim: *

Losses

Listed below are the losses that you have selected for this application. To edit, click the edit hyperlink in the row you wish to modify.

4 Digit Year Losses Accident Date Catastrophe Type Of Claim Calculated Actual Incurred Losses Calculated Primary Actual Losses Edit Delete