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Secure Member Access Request to “THE POOL”

The Pool provides a “Secured Member Login” from our website to facilitate convenient, 24 hour access to Member specific information and enhanced communication with The Pool. We take very seriously the security of our Members information as it is confidential and may be part of an ongoing claim and or legal action. This secured member login must not be shared. The Pool reserves the right to disable any login, for any reason, at any time.

We will be adding capabilities to these online services in phases so, as you decide who will be granted access, please consider all information that is shared between our organizations not just what is available in the current phase. If there is any claim, litigation, policy, budget, or other information that you do not want a person to see then the best solution is to not provide that person access. Instead, designate someone who can see everything and have that person provide specific information to others as needed and deemed appropriate.

Please acknowledge your understanding of the above information by completing the items below.

I understand that by submitting this form I represent I have the authority to make the following designation for my entity. It is the responsibility of the Member's Primary User to notify The Pool immediately of any changes to access through The Pool Secure Portal.

If you are an AGENT please contact Members Services at The Pool.


Entity (Member Name) as listed on Policy: * REQUIRED IN ALL INSTANCES OF USING THIS FORM
First Name:  Last Name: 
Title: 
Email: 
Phone:  -   -     Ext:


Primary Account Holder Is:  The person that will have access to ALL your information and will have the authority to request additional user access (up to four). They will also be responsible for notifying The Pool when to remove access that has previously been granted (i.e. change of responsibilities, termination, etc.).


First Name:  Last Name: 
Title: 
Email: 
Primary Account Holder Phone:  -   -     Ext:
Is this an "EMPLOYER" provided email address:  YES NO
Is this Account Holder an "INSURANCE AGENT" YES NO
Claims Metrics :  Liability Property Workers Comp
*Claims Metrics Access is a dashboard view of claims data that allows the user to drill-down and obtain claim specific information.


Additional Account Holder(s); if any

First Name:  Last Name: 
Title: 
Email: 
Is this an "EMPLOYER" provided email address:  YES NO
Is this Account Holder an "INSURANCE AGENT" YES NO
Claims Metrics Access:  Liability Property Workers Comp
Online Claims Filing Access Only YES


First Name:  Last Name: 
Title: 
Email: 
Is this an "EMPLOYER" provided email address:  YES NO
Is this Account Holder an "INSURANCE AGENT" YES NO
Claims Metrics Access:  Liability Property Workers Comp
Online Claims Filing Access Only YES


First Name:  Last Name: 
Title: 
Email: 
Is this an "EMPLOYER" provided email address:  YES NO
Is this Account Holder an "INSURANCE AGENT" YES NO
Claims Metrics Access:  Liability Property Workers Comp
Online Claims Filing Access Only YES


First Name:  Last Name: 
Title: 
Email: 
Is this an "EMPLOYER" provided email address:  YES NO
Is this Account Holder an "INSURANCE AGENT" YES NO
Claims Metrics Access:  Liability Property Workers Comp
Online Claims Filing Access Only YES




We recommend you print a copy for your records  
Click the EMAIL button to forward your request