November 2008, Volume 23
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Category: Service Businesses Risk: Law Offices

Checklist Instructions:

Agent: The coverages listed below are suggested for consideration for service operations. After evaluating each of the listed coverages, check the recommended blank by those that apply specifically to this client. Make sure both the exposure and the coverage are explained to the client. Each coverage and option is explained in the Definitions section of this program.

Client: For each of the coverages that the agent has recommended, initial whether you have chosen to accept or reject that coverage in the blanks provided.

COVERAGE CHECKLIST

       

PROPERTY COVERAGES

     

Recommend

Accept

Reject

Building and Personal Property Coverage Form

     

Building

______

______

______

Business Personal Property

______

______

______

Personal Property of Others

______

______

______

Improvements and Betterments

______

______

______

Condominium Coverage Form

     

Condo-Unit Owners Coverage

______

______

______

Commercial Output Policy

______

______

______

       

Building and Personal Property Coinsurance

______

______

______

Percentages    None 80% 90% 100%

______

______

______

Bldg               ____ ____ ____ ____

______

______

______

BPP               ____ ____ ____ ____

______

______

______

PPO               ____ ____ ____ ____

______

______

______

I & B               ____ ____ ____ ____

______

______

______

       

Alternatives to Coinsurance

Agreed Value

______

______

______

Functional Replacement Cost

______

______

______

Peak Season

______

______

______

Reporting Form

______

______

______

Other ________________________

______

______

______

       

Optional Property Coverages

Boiler and Machinery

______

______

______

Legal Liability

______

______

______

       

Optional Property Endorsements

     

Additional Debris Removal

______

______

______

Ordinance or Law

______

______

______

Outdoor Trees, Shrubs and Plants Enhancement

______

______

______

Replacement Cost Valuation

______

______

______

Spoilage

______

______

______

Utility Services-Direct Damage

______

______

______

       

 

 

     

Other Property Options

     

______________________________________

______

______

______

______________________________________

______

______

______

______________________________________

______

______

______

       

TIME ELEMENT COVERAGES

     

Recommend

Accept

Reject

Business Income With Extra Expense Coinsurance Percentage ___

______

______

______

Business Income Without Extra Expense Coinsurance Percentage ___

______

______

______

Extra Expense

______

______

______

Leasehold Interest

______

______

______

       

Alternatives to Coinsurance

______

______

______

Agreed Value

______

______

______

Maximum Period of Indemnity

______

______

______

Monthly Limit of Indemnity

______

______

______

Premium Adjustment

______

______

______

       

Optional Time Element Endorsements

     

Business Income from Dependent Properties

______

______

______

Ordinance or Law Increased Period of Restoration

______

______

______

Utility Services

______

______

______

       

Other Time Element Coverages

     

______________________________________

______

______

______

______________________________________

______

______

______

______________________________________

______

______

______

       

PROPERTY AND TIME ELEMENT CAUSES OF LOSS

     
 

Recommend

Accept

Reject

                    Bldg BPP PPO BI   EE

     

Basic          ____ ____ ____ ___ ____

______

______

______

Broad          ____ ____ ____ ___ ____

______

______

______

Special       ____ ____ ____ ___ ____

______

______

______

Earthquake ____ ____ ____ ___ ____

______

______

______

Flood          ____ ____ ____ ___ ____

______

______

______

       

Other Cause of Loss Endorsements

     

______________________________________

______

______

______

______________________________________

______

______

______

______________________________________

______

______

______

       
       

INLAND MARINE COVERAGES

     
 

Recommend

Accept

Reject

Accounts Receivable

______

______

______

Bailees Customer

______

______

______

Commercial Articles

______

______

______

Contractors Equipment

______

______

______

Difference In Conditions – DIC

______

______

______

Electronic Data Processing

______

______

______

Fine Arts

______

______

______

Goods in Transit

______

______

______

Miscellaneous

______

______

______

Signs (Neon and Electric)

______

______

______

Valuable Papers and Records

______

______

______

       

Other Inland Marine Coverages

     

______________________________________

______

______

______

______________________________________

______

______

______

______________________________________

______

______

______

       

CRIME COVERAGES

     
 

Recommend

Accept

Reject

Money, Securities and Other Property

     

Employee Dishonesty Coverage

______

______

______

   Including Customer’s Goods

______

______

______

Computer Fraud Coverage

______

______

______

Extortion Coverage

______

______

______

Forgery or Alterations Coverage

______

______

______

Lessees of Safe Deposit Boxes Coverage
(Securities and Other Property only)

______

______

______

       

Money and/or Securities Only

     

Theft, Disappearance and Destruction

______

______

______

Robbery and Safe Burglary

______

______

______

Securities Deposited With Others Coverage

______

______

______

       

Property other than Money and Securities

     

Premises Burglary

______

______

______

Premises Theft

______

______

______

Robbery and Safe Burglary

______

______

______

       

Other Crime Coverages

     

______________________________________

______

______

______

______________________________________

______

______

______

______________________________________

______

______

______

       

LIABILITY COVERAGES

     
 

Recommend

Accept

Reject

Commercial General Liability

     

   Occurrence Basis

______

______

______

   Claims- Made Basis

______

______

______

       

Optional Liability Coverages

     

Directors and Officers

______

______

______

Employee Benefits

______

______

______

Employment- Related Practices

______

______

______

Liquor

______

______

______

Owners and Contractors Protective

______

______

______

Professional/E&O Liability

______

______

______

Railroad Protective

______

______

______

Special Events

______

______

______

       

Other Liability Coverages

     

______________________________________

______

______

______

______________________________________

______

______

______

______________________________________

______

______

______

       

COMMERCIAL AUTO COVERAGES

     
 

Recommend

Accept

Reject

Liability

______

______

______

Physical Damage

______

______

______

Uninsured Motorists

______

______

______

Underinsured Motorist

______

______

______

Hired Cars

______

______

______

Non-Ownership Auto

______

______

______

P.I.P./No-Fault

______

______

______

Garagekeepers

______

______

______

       

Other Auto Coverages

     

______________________________________

______

______

______

______________________________________

______

______

______

______________________________________

______

______

______

       

WORKERS COMPENSATION COVERAGES

     
 

Recommend

Accept

Reject

Workers Compensation and Employers Liability

______

______

______

Stop Gap or Employers Liability Coverage

______

______

______

Federal Employers Liability Act

______

______

______

Longshore and Harbor Workers Coverage

______

______

______

Voluntary Compensation

______

______

______

       

Other Workers Compensation Endorsements

     

______________________________________

______

______

______

______________________________________

______

______

______

______________________________________

______

______

______

EXCESS LIABILITY COVERAGES

     
 

Recommend

Accept

Reject

Umbrella Policy

______

______

______

Excess Liability Policy

______

______

______

       

AVIATION COVERAGES

     

Aircraft Policy

______

______

______

Passenger Liability

______

______

______

       

SPECIALTY COVERAGES

     

Environmental Impairment Liability Policy

______

______

______

Fiduciary Liability Insurance

______

______

______

International/Foreign Operations Insurance

______

______

______

Rain or Weather Insurance

______

______

______

Terrorism Insurance

______

______

______

Underground Storage Tank Liability – UST

______

______

______

Other ____________________________________

______

______

______

       

BONDS

     

Bid Bond

______

______

______

Contract Bond

______

______

______

License Bond

______

______

______

Other _________________________________

______

______

______

       

Other Options

     

______________________________________

______

______

______

______________________________________

______

______

______

______________________________________

______

______

______

Comments

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

I certify that I have reviewed my coverage needs in accordance with this checklist with my agent and I have accepted or rejected the recommended coverages as indicated by my initials in the spaces above.

___________________________________ Signature of Client ______________________ Date

_____________________________________________ Title

I certify that I have reviewed the coverages outlined in this checklist with my client and that the initials of the client indicate the acceptance or rejection of the coverages recommended.


___________________________________ Signature of Agent _______________________ Date