Worker’s Comp Quote – LRA Insurance

To receive a quote for workers comp insurance, fill out the information below and we'll get back to you right away with a competitive quote.

Business Information
Business name*
Business type
- Corporation
- LLC
- Partnership
- Sole proprietorship
Contact Information
Contact name*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Fax
Website
Additional Information
Years in business
Do you have employees or uninsured subcontractors?
- Yes
- No
Annual payroll for all employees and subcontractors ($)
Would you like the quote to include coverage for the owner/officer?
- Yes
- No
Effective Date of coverage (the date you would like it to begin)
Date Format: MM slash DD slash YYYY
Comments

Business Information