LEAD REFERRAL FORM

Imagine making more money without doing more work-test

Let The Hartford's Inside Sales Team do the work to turn those small business leads into revenue for YOU.

Complete the form below with the lead's information and The Hartford's Inside Sales Team will take it from there. They will contact the business owner within 24 hours to provide them a quote over the phone.

Not sure if your lead is in The Hartford's appetite? - Review our Top 10 Industries to get a better idea!

Or if you'd rather warm transfer the lead over the phone, please call us at 855-852-9058 (Monday through Friday, 8 AM to 7 PM Eastern time).

When warm transferring to The Hartford, please provide the below information to ensure a successful handoff:

Provide your name and email
Customer name and industry
Advise BOP checklist to be sent to email if issued

What is the business owner's first and last name?

What is the name of the business?

What industry is the business in?

What is the business owner's phone number, including area code?

What state is the business in?

What is the business owner's email address?

What is the ADP producer name?

What is the ADP producer email address?

What is the ADP office location?

What is The Hartford's workers' comp policy number?
No spaces or dashes.
Example: 76WEGAA9BBB

What is the product type?

What is the spectrum class code?

Is there any other information you can provide about this business?

characters remaining

The coverages and services described herein are summaries only. All policies should be read carefully to determine exclusions, limitations and other terms and conditions. In the event of a conflict, the terms and conditions of the policy will govern. All coverages and services may not be available for all businesses or in all states. This program is not available in AK, or HI. Please contact your agent or broker for details.

Coverage is underwritten by Hartford Fire Insurance Co. and its property and casualty insurance affiliates (CA lic #8701). In TX, this insurance is written by Sentinel Insurance Company, Ltd., Hartford Casualty Insurance Company, Hartford Lloyd’s Insurance Company, Hartford Underwriters Insurance Company, Twin City Fire Insurance Company, Hartford Accident and Indemnity Company and Hartford Fire Insurance Company. In WA, this insurance is written by Hartford Fire Insurance Company, Hartford Casualty Insurance Company, Hartford Accident and Indemnity Company, Hartford Underwriters Insurance Company, Twin City Fire Insurance Company, Sentinel Insurance Company, Ltd. and Hartford Insurance Company of the Midwest.