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ACORD 130 auto-fill
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General questions
Account name
States, class codes, employees & payroll
Loc #
State
Class code
Description
FT EE's
PT EE's
Total
Payroll (USD)
Total employees0
Total payroll$0
Risk description
Experience mod & estimated premium
$
Yes / no questions
Please complete the Yes and No questions to complete the UW Review
Loss history
Please provide the NLHA
Loss run — policy periods
Add each policy period, confirm if on file, and enter claim count.
Auto-fill policy periods
Ends at the effective date (or the date below) and works backward in 1-year periods
# Period fromPeriod to Historial premium Incurred On file? Claims
Enter the valuation date for each policy period. Dates older than 45 days will trigger an alert.
Auto-fill all periods
Set one valuation date and apply it to every period at once
No loss run periods added yet — add periods in the section below.
Additional named insured
Voice control “start” · “premium 185 thousand” · “loss runs yes” · “analyze”
Speech is recognised by the browser’s service, not on this machine — the audio leaves it. Fine for yes, no and commands; dictating a description sends a real account’s words away, so that one asks you to confirm before it is typed. Speaking back is entirely local.
Run market fit analysis

Based on states, premium, mod, exposures and risk description — each market will be checked and restrictions flagged.

Action required — submission notes
No alerts — all reviewed items look complete.
Market fit results
0 markets