Chubb Limited Group: Workers Compensation Forms
| Form | Title | Type | Edition | States |
|---|---|---|---|---|
| WC 99 0773 | Trade or Economic Sanctions Endorsement | Endorsement | 11 06 | 12 |
| WC 99 0310 | Waiver of Our Right to Recover From Others Endorsement – Controlled Insurance Program | Endorsement | 01 16 | 11 |
| WC 99 0312 | Designated Workplace Endorsement | Endorsement | 01 16 | 11 |
| WC 99 0660 | Additional Definitions | Endorsement | 01 16 | 11 |
| WC 99 0605 | Installment Endorsement | Endorsement | (Rev. 5-88) | 11 |
54 more forms
See more formsChubb Limited Group workers compensation filing activity
Nov 14, 2025 to Nov 13, 2026. These figures cover only Chubb Limited Group's workers compensation filings. The form inventory above covers the past five years.
- Filings
- 68
- 64 in the previous 365 days
- Change in filings
- +6.3%
- Compared with the previous 365 days
- States
- 40
- With filings in this period
- Companies filing
- 10
- Within this carrier group
- Avg. reported rate impact
- -4.3%
- 22 filings reporting a nonzero impact
flow
Tracked Filing Volume
where filings move
State Activity
rate impact
Reported Rate Impact
Filings
22
Companies
5
Avg Impact
-4.3%
Max Increase
+6.8%
Max Decrease
-9.7%
Reported rate impact by state
-9.7% to -8.3%-8.3% to -3.8%-3.8% to -3.2%-3.2% to +6.8%
Rate impact filingsShowing up to 22 filings
08/20/26Westchester Fire Insurance CompanyCAWorkers' CompensationRate/Rule+6.8%-
10/02/26Pacific Employers Insurance CompanyMIWorkers' CompensationRate/Rule+2.4%+13.9%
10/30/26Westchester Fire Insurance CompanyKYWorkers CompensationRate/Rule+0.3%+8.5%
10/09/26Westchester Fire Insurance CompanyILWorkers' CompensationRate/Rule-0.2%+4.4%
09/01/26Westchester Fire Insurance CompanyMOWorkers' CompensationRate/Rule-1.0%+6.5%
05/14/26Pacific Indemnity CompanyRIWorkers' CompensationRate/Rule-3.2%+5.8%
01/22/26Pacific Indemnity CompanyTNWorkers CompensationRate/Rule-3.2%-
09/16/26Westchester Fire Insurance CompanyNHWorkers CompensationRate/Rule-3.3%-
12/16/25Westchester Fire Insurance CompanyIAWorkers CompensationRate/Rule-3.6%-
02/02/26Westchester Fire Insurance CompanySCWorkers CompensationRate/Rule-3.7%-
02/12/26Westchester Fire Insurance CompanyPAWorkers' CompensationRate/Rule-3.8%+12.2%
11/25/25Westchester Fire Insurance CompanyAKWorkers' CompensationRate/Rule-4.1%-
04/16/26Westchester Fire Insurance CompanyTXWorkers CompensationRate/Rule-4.2%+15.0%
10/22/26Westchester Fire Insurance CompanyDEWorkers CompensationRate/Rule-4.9%-
11/25/25Westchester Fire Insurance CompanyHIWorkers' CompensationRate/Rule-5.6%+11.1%
04/17/26Penn Millers Insurance CompanyARWorkers CompensationRate/Rule-7.0%+0.8%
02/20/26Westchester Fire Insurance CompanyMTWorkers CompensationRate/Rule-8.3%+3.2%
01/28/26Vigilant Insurance CompanyNCWorkers CompensationRate/Rule-8.6%-
02/27/26Penn Millers Insurance CompanyMNWorkers CompensationRate/Rule-9.4%-2.7%
12/16/25Westchester Fire Insurance CompanyMSWorkers CompensationRate/Rule-9.5%-
04/23/26Westchester Fire Insurance CompanyARWorkers CompensationRate/Rule-9.7%-
01/14/26Westchester Fire Insurance CompanyGAWorkers' CompensationRate/Rule-9.7%0.0%
Reported impacts are filing-level figures, not an individual policyholder's premium change. The average is unweighted and excludes missing and zero values. Withdrawn and rejected filings are excluded. Each SERFF tracking number is counted once.
Workers Compensation product types
Product classifications reported in this period's filings.
| Product type | Filings | States |
|---|---|---|
| Standard WC | 57 | 40 |
| Alternative WC | 11 | 1 |
Companies filing in this period
Workers Compensation submissions by underwriting company.
| Company | Filings | States |
|---|---|---|
| Westchester Fire Insurance Company | 37 | 31 |
| Indemnity Insurance Company of North America | 11 | 1 |
| Penn Millers Insurance Company | 6 | 6 |
| Pacific Indemnity Company | 4 | 4 |
| Vigilant Insurance Company | 3 | 3 |
| Federal Insurance Company | 2 | 2 |
| Pacific Employers Insurance Company | 2 | 2 |
| ACE American Insurance Company | 1 | 1 |
| Bankers Standard Insurance Company | 1 | 1 |
| Great Northern Insurance Company | 1 | 1 |
Recent products and programs filed
The 10 most recently filed product/program names, as reported in filings. Names can include internal program codes and do not establish current product availability.
| Filed product/program | Filings | States | Latest filing |
|---|---|---|---|
| Workers Compensation | 20 | 17 | Oct 30, 2026 |
| Workers' Compensation | 47 | 31 | Oct 23, 2026 |
| Adoption Only | 1 | 1 | Mar 13, 2026 |
Companies filing
The Chubb Limited Group companies with the most workers compensation filings in the past five years.
- ACE American Insurance Company279 filings · 44 states
- Indemnity Insurance Company of North America277 filings · 44 states
- ACE Fire Underwriters Insurance Company276 filings · 44 states
- + 14 more companies
NCCI forms used
The NCCI forms in the most Chubb Limited Group filings.
| Form | Title | Chubb Limited Group filings |
|---|---|---|
| WC 00 01 06 | Longshore and Harbor Workers' Compensation Act Coverage Endorsement | 4 |
| WC 00 04 22 | Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement | 2 |
| WC 00 04 19 | Part Five, Premium Amendatory Endorsement | 1 |
| WC 00 04 21 | Catastrophe (Other Than Certified Acts of Terrorism) Premium Endorsement | 1 |
Related insurance research
Filing research
Workers Compensation forms
Form types
Related lines of business
Forms are active forms on Chubb Limited Group workers compensation filings submitted in the past five years, excluding withdrawn and rejected filings, grouped by form number.