1. Risk Appetite Overview
OpenInsure writes commercial lines for small-to-mid-market risks through its appointed producer network. Our appetite is defined by class code eligibility, premium thresholds, and qualitative risk factors.1.1 Core Target Segments
General Liability
Artisan contractors, retail/wholesale trade, light manufacturing, janitorial and landscaping, staffing agencies, professional services (select classes), hospitality (limited)Workers’ Compensation
Service industries, light manufacturing, retail, office/clerical, healthcare (select), construction (non-high-hazard)Commercial Auto
Private passenger-type commercial, light trucks (≤ 1 ton GVW), contractor fleets (≤ 25 units), service vehicles1.2 Absolutely Unacceptable Risks
The following classes will be declined without exception at any underwriter level:- Fireworks, explosives, or ammunition manufacturing or distribution
- Cannabis operations (cultivation, processing, distribution, dispensary) or businesses deriving >5% of revenue from cannabis adjacency
- Adult entertainment or escort services
- Asbestos, lead, or environmental remediation as primary operations
- Residential construction as primary work
- Long-haul trucking (radius > 500 miles or interstate common carrier)
- Livery, transportation network companies (TNC), or ride-share operations
- Businesses with principals on OFAC sanctions lists
- Accounts with open or unresolved criminal fraud charges involving insurance
2. Application Requirements and Completeness Standards
2.1 Required Forms by Line
| Line | Primary Form | Supplements |
|---|---|---|
| General Liability | ACORD 125 | ACORD 140 (contractors), per-class supplement |
| Workers’ Compensation | ACORD 130 | Payroll schedule, EMR worksheet |
| Commercial Auto | ACORD 137 | Vehicle/driver schedule, MVRs |
| Package (GL + other) | ACORD 125 + 140 | All applicable supplements |
2.2 Completeness Checklist
Before assigning a submission for review, verify all of the following:- Named insured matches the legal entity name registered with the state and the FEIN provided
- Effective date is at least 5 business days in the future (rush processing triggers a fee)
- All ACORD forms are signed and dated by the insured (no producer-signed applications) 4. Loss runs are currently valued (within 90 days), cover 5 years, and are on prior carrier letterhead 5. Supplemental applications attached where required by class code 6. Supporting documents (financial statements, payroll schedules, MVRs) complete per requirements 7. Premium estimate has been provided by producer (confirms reasonable expectations)
3. Risk Appetite Matrix
3.1 General Liability Appetite
| Factor | Preferred | Acceptable | Refer | Decline |
|---|---|---|---|---|
| Annual premium | 50K | 100K | 250K | > $250K |
| Years in business | ≥ 5 | 2–5 | < 2 (new venture) | — |
| 5-yr loss ratio (GL) | < 40% | 40–65% | 65–80% | > 80% |
| Products exposure | None | < 25% revenue | 25–50% revenue | > 50% revenue |
| Completed operations | Standard | Moderate | High-hazard | Residential roofing |
| State | Southeast US | Most states | FL, LA, NY | CA |
3.2 Workers’ Compensation Appetite
| Factor | Preferred | Acceptable | Refer | Decline |
|---|---|---|---|---|
| Annual premium | 50K | 100K | 250K | > $250K |
| Experience mod | < 0.95 | 0.95–1.15 | 1.15–1.30 | > 1.30 |
| 5-yr loss ratio (WC) | < 45% | 45–70% | 70–85% | > 85% |
| Annual payroll | < $2M | 10M | 15M | > $15M |
| High-hazard class codes | None | < 20% payroll | 20–40% payroll | > 40% payroll |
3.3 Geographic Risk Factors
| State | Modifier | Notes |
|---|---|---|
| Georgia | None | Core territory |
| South Carolina | None | Core territory |
| North Carolina | None | Core territory |
| Tennessee | None | Core territory |
| Virginia | +5% | Competitive market; price carefully |
| Florida | +15% GL | Hurricane/litigation environment; WC not available |
| Louisiana | +20% | Refer all; high tort environment |
| New York | +10% | Labor law exposure; WC refer |
| Texas | None (WC) | Non-subscriber ineligible; traditional WC OK |
4. Rating Methodology
4.1 General Liability Rating
GL pricing uses a class-modified manual rate approach:- Base rate — from actuarially determined class code rate table in
packages/rating - Exposure base — payroll, receipts, or area depending on class code
- Manual premium — base rate × exposure
- Schedule modification — debit/credit applied for risk-specific factors (see §4.3)
- Experience modification — applied if prior losses justify (optional for GL; standard for WC)
- Minimum premium — applied if calculated premium falls below threshold
4.2 Workers’ Compensation Rating
WC uses the NCCI rating methodology:- Classification rates — from current NCCI or independent bureau rates for applicable state
- Payroll — per $100 payroll by class code
- Manual premium — sum of all class code premiums
- Experience modification — applied from NCCI e-mod worksheet (required for accounts over $10K manual premium)
- Schedule credit/debit — underwriter-applied (requires documentation; limited to ±25% without referral)
- Minimum premium — applied per state and class code
4.3 Schedule Rating Guidelines
Schedule rating allows manual adjustment based on documented risk-specific factors. All schedule modifications must be documented in the underwriting file.| Factor | Maximum Credit | Maximum Debit |
|---|---|---|
| Management / safety culture | 10% | 10% |
| Premises / equipment condition | 10% | 10% |
| Claims experience (beyond EMR) | 10% | 10% |
| Classification characteristics | 5% | 5% |
| Medical facilities access (WC) | 5% | 5% |
- ≤ ±15% total schedule modification: any licensed underwriter
- ±16–25%: Senior Underwriter approval required
-
±25%: Not permitted without Director of Underwriting approval
4.4 Rating Documentation
Every quote file must include:- Completed rating worksheet showing all factors
- Documentation for every schedule debit or credit applied
- Comparison to prior carrier premium if available
- Pricing memo for any account with schedule modification > ±15%
5. Referral Triggers and Authority Matrix
5.1 Automatic Referral Triggers
The following conditions automatically route a submission to the Senior Underwriting queue: Premium thresholds:- GL: written premium > $100,000
- WC: written premium > $75,000
- Any single policy with total insured value > $5,000,000
- Experience mod > 1.15
- 5-year loss ratio > 65% (GL) or 70% (WC)
- New venture (< 2 years in business) with premium > $15,000
- Any account in Louisiana, or FL premium > $25,000
- Named insured or principal with a prior felony conviction (non-insurance fraud)
- Any account requiring surplus lines placement in states requiring individual filing
- Pollution exclusion buyback requested
- Umbrella/excess with primary GL > 2M limits
- Professional liability exposure > 25% of operations
- Subcontractor operations > 50% of GL receipts without blanket AI + waiver of subrogation requirements
5.2 Delegated Authority Matrix
| Role | GL Bind Authority | WC Bind Authority | Schedule Mod |
|---|---|---|---|
| Junior Underwriter | Up to $25K | Up to $20K | ±10% |
| Underwriter | Up to $100K | Up to $75K | ±15% |
| Senior Underwriter | Up to $250K | Up to $200K | ±25% |
| Director of Underwriting | Unlimited (within program) | Unlimited | Unlimited |
| Carrier approval required | > $500K | > $400K | N/A |
5.3 Referral Process
- Click Refer on the submission detail page 2. Select the referral reason from the dropdown (required) 3. Prepare a referral memo in the Notes section: risk summary, your recommended action, and questions for the reviewing senior UW 4. Assign to the Senior Underwriting queue 5. Senior UW must respond within 2 business days 6. If the senior UW disagrees with your recommended action, schedule a brief review call before deciding
6. Declination Procedures
6.1 When to Decline Without Referral
Decline immediately (no referral required) for:- Risks in the absolutely unacceptable list (§1.2)
- OFAC sanctions match on named insured or any principal
- Submitted loss ratio > 85% with no extenuating circumstances
- Prior conviction for insurance fraud on the application
- Submission for a policy that was previously cancelled for fraud by this MGA
6.2 Declination Documentation
Every declination must be documented in the underwriting file with:- Specific underwriting reasons (fact-based, not discriminatory)
- Whether the producer was consulted before declining
- Date and method of declination notification
6.3 Adverse Action Notices
Certain states require formal adverse action notices when declining or non-renewing. The system automatically generates the required notice when you click Decline. Review the generated notice before sending — it is delivered to the producer and optionally to the named insured.Caution: Declination notices must be factually accurate and may not reference protected characteristics. If you are uncertain whether a declination reason is legally permissible, consult the compliance team before declining.
6.4 Producer Communication
Notify the producer immediately upon declination by:- Sending the declination notice through the portal (automatic)
- Calling the producer within 24 hours to explain the reasoning and discuss alternatives
- Documenting the call in the Notes section of the submission
7. Quote Expiration and Re-Rate Conditions
7.1 Standard Quote Validity
All quotes are valid for 30 calendar days from the quote date unless stated otherwise.7.2 Re-Rate Conditions
A re-rate is required (not just an extension) when:| Condition | Action Required |
|---|---|
| Risk information materially changes | Full re-underwrite |
| New loss occurs after quote date | Full re-underwrite; reassess eligibility |
| Quote expired > 30 days | Full re-rate at current rates |
| Effective date shifts > 30 days from original | Full re-rate |
| Carrier files new rates in effective state | Re-rate if rate change > 5% |
7.3 Backdating Prohibition
No quote or policy may be backdated to cover a loss that has already occurred. If a producer requests a backdated effective date and there is any possibility of a known loss, consult the compliance team before proceeding.8. Endorsement Underwriting
8.1 Auto-Approve Endorsements (No Review Required)
| Endorsement | Conditions |
|---|---|
| Blanket additional insured | Per policy form — auto-issue |
| Waiver of subrogation | Per policy form — auto-issue |
| Certificate holder change | Administrative only — auto-issue |
| Named driver addition (auto) | MVR clean (no at-fault accidents in 3 years) |
| Vehicle addition (auto) | Same class as existing fleet; value within schedule |
| Location addition (GL) | Same state; same class; increase < 15% of premium |
8.2 Endorsements Requiring Underwriting Review
| Endorsement | Required Documentation | Authority |
|---|---|---|
| Limit increase | Re-rate, updated application | Per authority matrix |
| Coverage extension (pollution, professional) | Detailed exposure description | Senior UW |
| Named insured change (ownership change) | Explain change; re-underwrite if ownership > 50% | Senior UW |
| Location deletion | Confirm no active claims at location | Any UW |
| Driver addition with violations | MVR, explanation letter | Any UW |
| Retroactive date change (E&O/PL) | Carrier approval | Director |
8.3 Out-of-Sequence Endorsements
An out-of-sequence (OOS) endorsement has an effective date earlier than the most recent processed endorsement. The system detects this automatically and flags it with an OOS badge. Before issuing:- Review all endorsements in sequence order — the endorsement detail shows the
sequenceNumberandisOutOfSequenceflag 2. Review the cascade impact — the system calculates how the OOS insertion affects downstream endorsements’ premium, shown aspastPeriodAdjandfuturePeriodAdj - Confirm no coverage gaps result from reordering 4. Issue in the correct chronological sequence — the system enforces this by blocking issuance if an earlier-dated pending endorsement exists 5. Flag if producer disputes the sequence — escalate to Senior UW
9. Renewal Underwriting
9.1 Renewal Timeline
| Days Before Expiry | Action |
|---|---|
| 90 | Renewal appears in queue; review prior year experience |
| 75 | Contact producer if updated loss runs not received |
| 60 | Complete renewal underwriting decision |
| 45 | Issue renewal quote (or non-renewal notice) |
| 30 | Statutory minimum for non-renewal notice (most states) |
| 0 | Policy expires if not renewed |
9.2 Loss Ratio Triggers
| Renewal Loss Ratio (GL) | Action |
|---|---|
| < 50% | Standard renewal at current rates |
| 50–65% | Renewal with rate review; consider 5–10% increase |
| 65–80% | Renewal with mandatory rate increase; referral required |
| > 80% | Non-renewal strongly indicated; Director approval to renew |
| Renewal Loss Ratio (WC) | Action |
|---|---|
| < 55% | Standard renewal at current rates |
| 55–70% | Renewal with rate review |
| 70–85% | Renewal with rate increase + referral |
| > 85% | Non-renewal strongly indicated; Director approval to renew |
9.3 Non-Renewal Procedures
- Document the non-renewal reason in the underwriting file 2. Obtain Director of Underwriting approval for non-renewals 3. Issue the non-renewal notice through the portal — the system generates the state-required form 4. Confirm statutory notice period is satisfied (system checks this automatically) 5. Notify the producer immediately by phone; document the call 6. Do not reverse a non-renewal decision within 14 days of expiry without carrier approval
10. Underwriting File Standards
Every bound policy must have a complete underwriting file in the workbench containing:- Original ACORD application(s) — signed and dated
- All supplemental applications
- Loss runs (5-year, currently valued)
- Rating worksheet with all factors documented
- Schedule modification documentation (if applied)
- Underwriting notes summarizing the risk assessment
- Any referral memos and approval documentation
- Subjectivities checklist with satisfaction dates
- Adverse action notice (if declination or non-renewal)
These guidelines are effective January 1, 2026. Underwriting appetite is subject to change based on loss experience and carrier directives. Material changes will be communicated by the Director of Underwriting with at least 10 business days notice.