Commercial Insurance:

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Whether it is insurance for your building, business property, equipment, inventory or company vehicles, we offer products and services and insurance packages that are tailored to protect different types of businesses.

For a detailed description of each coverage, click on the topics below:

Boiler & Machinery

This form of insurance provides mechanical breakdown coverage generally not available under any other insurance policy. A Boiler and Machinery policy can protect an insured against the effects of catastrophic property loss, such as steam boiler explosion or an expensive breakdown of machinery and equipment.

But it’s not just the physical damage caused by the explosion or breakdown that’s of concern. While repairs are being made, valuable time and profits are lost. Business Interruption coverage protects against this. Often Extra Expense coverage is required to keep the business in operation regardless of cost. Consequential Damage and Refrigeration Interruption insurance protect against spoilage as the result of a breakdown. Many times these business interruption, extra expense and spoilage losses can be much more extensive than the damage to the equipment itself.

Equally important is the very valuable inspection service that Boiler and Machinery insurance can provide. Not only does this service satisfy most jurisdictional inspection requirements, but it also can benefit the insured by providing sound loss control recommendations that can help assure efficient operation and longer equipment life.

Virtually every commercial business has some type of Boiler and Machinery insurance exposure. Keep in mind that mechanical breakdown coverage encompasses much more than just boilers and pressure vessels. It also can include refrigeration equipment, air conditioning equipment, various types of piping, turbines, engines, pumps, compressors, blowers, gearing, shafting, electric motors, generators, transformers and assorted other types of mechanical and electrical equipment. In fact, many policies are written for insureds who do not own or operate boilers or pressure vessels, but yet have sizable mechanical and electrical exposures.

Builders' Risk

Indemnifies for loss of or damage to a building under construction. Insurance is normally written for a specified amount on the building and applies only in the course of construction. Coverage customarily includes fire and extended coverage and vandalism and malicious mischief. Builders risk coverage can be extended to a “special” form as well. The builders risk policy also may include coverage for items in transit to the construction site (up to a certain percentage of value) and items stored at the site.

Business/Commercial General Liability Coverages

The Commercial General Liability Policy provides the insurance protection needed to pay damages for bodily injury or property damages for which the insured is legally responsible. The policy provides coverage for liability arising from personal injury and advertising injury. Coverage for medical expense is also provided. The policy also covers accidents occurring on the premises or away from the premises. Coverage is provided for injury or damages arising out of goods or products made or sold by the named insured. The insured is the named insured and the employees of the named insured. However, several individuals and organizations, other than the named insured, may be covered, depending upon certain circumstances specified in the policy. In addition to the limits, the policy provides supplemental payments for attorney fees, court costs and other expenses associated with a claim or the defense of a liability suit.

There are two commercial general liability coverage forms available, the occurrence form and the claims-made form. Both forms are somewhat identical in the coverages offered. The main difference is in the way claims are handled under the two forms. The occurrence form covers bodily injury or property damage claims that occur during the policy term, regardless of when the claim is reported. The claims-made policy form only covers claims made against the insured during the policy term. A claim made after the policy expires is not covered by a claims-made policy unless the claim is covered by an extended reporting period. The claims-made policy will only have the extended reporting period. The following terms reflect both forms.

Each Occurrence
Each occurrence is considered to be an accident, which could include continuous or repeated exposure to the same harmful conditions. An occurrence can also be a sudden event, or a result of a long term series of events.

General Aggregate
The General Aggregate Limit is the most money the insurer will pay under a certain coverage for all claims occurring during the policy term.

Premises/Operations
Coverage is provided for damages arising out of ownership or occupancy of the insured premises when not maintained in a reasonable manner. This also covers damages arising out of operations performed by the insured business.

Products/Completed Operations
Products coverage is provided for damages arising out of products manufactured, sold, handled or distributed by the insured. Completed Operations covers damages occurring after operations have been completed or abandoned, or after an item is installed or built and released for its intended purpose.

Medical Expense Limit
Medical payments coverage pays medical expenses resulting from bodily injury caused by an accident on premises owned or rented by the insured, or locations next to such property, or when caused by the insured’s operations. These payments are made without regard to the liability of the insured.

Fire Damage Limit
The fire damage limit provides coverage for fire damage caused by negligence on the part of the insured to premises rented to the named insured. If a fire occurs because of negligence of the insured and causes damage to property not rented to the insured, coverage would be provided under the occurrence limit.

Personal Injury
Personal Injury means injury other than bodily injury. Coverage is provided for injury resulting from offenses such as false arrest, malicious prosecution, detention or imprisonment, the wrongful entry into, wrongful eviction from and other acts of invasion, or rights of private occupancy of a room. Coverage for libel and slander is also provided in the policy.

Advertising Injury
This coverage pays for damages done in the course of oral or written advertisement that disparages, libels or slanders a person’s or organization’s goods, products or services. Coverage for these offenses is provided under advertising injury coverage only if they occur during the course of advertising the named insured’s own goods, products or services.

“Claims Made” Basic Extended Reporting Period (Basic Tail)
This coverage is provided automatically without an additional premium charge if coverage is canceled, not renewed, or the insurer renews with a later retroactive date. The basic extended reporting period starts at the end of the policy period and lasts for five years for claims made against the insured within the five year period and reported to the insurer within 60 days after the end of the policy period.

“Claims Made” Supplemental Extended Reporting Period (Supplemental Tail)
The supplemental extended reporting period is available under the same circumstances as the basic one. However, it becomes effective only if the named insured makes a written request within 60 days after termination of the policy period and the additional premium is paid. The supplemental extended reporting begins when the basic one ends, and it continues forever. It cannot be canceled by the insured or insurer. The supplemental tail endorsement would provide coverage for claims reported to the insurer within sixty days after the end of the policy period but did not result in a claim being made against the insured until after the end of the five year policy period.

Other types of occurrence or offenses that are unknown by the insured and therefore not reported within the sixty days after the end of the policy period could also be covered by the supplemental tail. When the tail is purchased the policy’s general aggregate limit and the products/completed operations aggregate limit is reinstated.

Commercial Automobile Coverages

Liability Coverage
The liability coverage of the commercial auto policy provides protection against legal liability arising out of the ownership, maintenance, or use of any insured automobile. The insuring agreement agrees to pay damages for bodily injury or property damage for which the insured is legally responsible because of an automobile accident resulting from the ownership, maintenance, or use of a covered auto. The insuring agreement also states that in addition to the payment of damages for which the insured is legally liable for, the insurer also agrees to defend the insured for all legal defense cost. The defense cost is in addition to the policy limits.

Medical Payments Coverage
The insuring agreement states that the insurer will pay all reasonable and necessary medical and funeral expenses incurred by an insured because of bodily injury caused by an accident. The insured is the named insured, the insured’s employees and guests, and any other person occupying a covered auto. These payments are made without regard to fault.

Uninsured Motorist
This insuring agreement pays for bodily injury to an insured who is injured by an uninsured motorist, a hit-and-run driver, or a driver whose insurer becomes insolvent. These benefits are paid under the named insured’s policy.

Underinsured Motorist
This coverage is added to supplement the Uninsured Motorist Coverage, the coverage applies only when the other driver has liability limits at the time of an accident, but the liability limits carried may be insufficient to pay for damages for which the driver is responsible. This is when the insured’s underinsured motorists coverage would apply and payment for the difference could be made. The two coverages are mutually exclusive and do not overlap or duplicate each other.

Hired and Non-Owned Autos
Coverage is provided only for autos not owned, leased, hired, or borrowed by the named insured. Coverage includes autos owned by the insured’s employees or members of their households, but only while used in the named insured’s business or personal affairs.

Collision Coverage
This coverage provides protection against loss or damage to a covered auto or a non-owned auto resulting from the impact with another vehicle or object. Collision losses are paid regardless of fault.

Comprehensive Coverage
Comprehensive coverage provides protection against loss or damage to a covered auto resulting from loss other than a collision or upset. This coverage also provides for supplemental payments for transportation expenses in the event of total theft of a covered auto or a non-owned auto. Coverage begins forty-eight hours after the theft.

Commercial Crime Coverages

 

Commercial Crime Coverages
Employee dishonesty is considered to be a criminal act committed by an employee acting alone or in collusion with others. There must be intent by the employee to cause the employer a loss and to obtain a financial benefit for the employee or someone else.

Coverage is provided for dishonest acts of employees of the named insured only. Coverage insures against loss of money, securities, and property other than money and securities. The blanket form provides coverage for dishonest acts of all employees. The limit for blanket coverage applies per loss, regardless of how many employees are involved. The scheduled form provides coverage only for the dishonest acts of employees specifically listed in the policy. On the scheduled form, a separate limit applies to each employee listed on the schedule.

Forgery or Alteration
Forgery is generating a document or signature that is not genuine.

Alteration is changing a document in a manner that is neither authorized nor intended.

This form insures against loss caused by the forgery or alteration of a covered item drawn against the insured’s accounts. A covered item might be a check, draft, promissory note, bill of exchange or similar instrument.

Theft, Disappearance and Destruction
Theft means any act of stealing.

Disappearance is unknown causes of loss. Disappearance lacks the elements of knowing if the crime was a theft, burglary or robbery.

Destruction is the loss of certain property, it is usually the result of another cause of loss.

Section (1) of the form covers money and securities against loss by theft, disappearance, or destruction inside the premises. Section (2) covers money and securities outside the premises in the care and custody of a messenger.

Robbery and Safe Burglary
Robbery is the taking of property from a person by the threat of personal injury to that person.

Safe Burglary is a specific kind of burglary that means the taking of property from a safe or vault which shows visible signs of forcible entry.

This form covers property other than money and securities inside and outside the premises. Property other than money and securities is covered while outside the premises and only in the care and custody of a messenger. Coverage inside the premises is for loss or damage resulting from robbery of a custodian or from safe burglary. A custodian is the named insured or a partner or employee of the insured.

Premises Burglary
Covers property other than money and securities inside the premises. It also covers damage to the insured’s premises resulting from a coverd cause of loss.

Computer Fraud
Computer fraud is a specialized kind of theft where a computer is used to steal property from its rightful owner. This form may be added to any commercial property policy.

Extortion
Extortion is the surrender of property away from the premises as a result of a threat of bodily harm to someone who is, or allegedly is, being held captive.

Premises Theft & Robbery Outside
Section (1) covers property other than money and securities inside the premises for a loss caused by actual or attempted theft. Section (2) Robbery Outside the premises covers property other than money and securities while it is in the care and custody of a messenger.

Commercial Property Coverages

 

Property Insurance is any type of insurance that indemnifies an insured party who suffers a financial loss because property has been damaged or destroyed. Property is considered to be any item that has a value. Property can be classified as real property or personal property. Real property is land and the attachments to the land, such as buildings. Personal Property is all property that is not real property. The Building and Personal Property coverage form is the form used to insure almost all types of commercial property. The insuring agreement in the Building and Personal Property coverage form promises to pay for direct physical loss or damage to covered property at the premises described in the policy when caused by or resulting from a covered cause of loss. The following is a brief outline of coverages and how they are used within the Commercial Building And Personal Property coverage form.

Buildings and Business Personal Property
Coverage for the building includes the building and structures, completed additions to covered buildings, outdoor fixtures, permanently installed fixtures, machinery and equipment. The building material used to maintain and service the insured’s premises is also insured. Business Personal Property owned by the insured and used in the insured’s business is covered for direct loss or damage. The coverage includes furniture and fixtures, stock, and several other similar business property items when not specifically excluded from coverage. The policy is also designed to protect the insured against loss or damage to the personal property of others while in the insured’s care, custody or control.

Replacement Cost vs. Actual Cash Value
Property can be valued in several different ways. Insurance companies commonly use two approaches to determine value, which also determines how a loss will be paid; the replacement cost method and the actual cash value method. Insurers consider replacement cost of a property item to be the cost to replace it with new property of like kind. Actual cash value is replacement cost, minus the accumulated depreciation for age and condition.

Coinsurance
Most building and business personal property policies have a coinsurance clause which requires the insured to carry insurance equal to at least a specified percentage of the actual cash value of the property. If a loss occurs, and it is determined that the amount of insurance carried is less than the amount required, a penalty could be placed on the insured.

Agreed Value
When the agreed value option is used the coinsurance requirement is removed and the insurer agrees to cover losses for its agreed value. As an example, the insured has property insured for $100,000 and the agreed value is also $100,000, if a loss occurs, any loss up to $100,000 is covered at 100%.  When this option is used the insured and the insurance company agree on the value of the property before the policy is issued. This option is usually assigned to one-of-a-kind property.

Coverage Extensions and Additional Coverages
In addition to the limits stated in the Building and Personal Property coverage form, the policy has a coverage extensions section and an additional coverages section. The coverage extensions section provides limited coverage for newly acquired or constructed property, property of others, certain outdoor property, and the cost to research and reconstruct information on destroyed records. When coverage is placed on the all risk form, two additional extensions are added for property in transit and coverage for certain repair costs related to damage caused by water. The two additional extensions are covered by certain perils only. The additional coverage section provides coverage for indirect losses that result from a direct loss. The coverage applies to removal of debris, preservation of property, fire department service charges and pollutant cleanup and removal. The coverage extensions and the additional coverages have limitations and are subject to certain conditions.

Earthquake Coverage
This endorsement, when added to your commercial policy, extends your cause of loss to include damage that results directly from an earthquake. Coverage is provided for replacement of buildings only. All earthquake shocks that occur within a 168 hour period (one week) are considered to be a single occurrence. A separate deductible applies and is determined by the value of the insured property.

Cyber Liability

 

Cyber Liability provides coverage for any organization that uses technology to do business. This includes companies that collect credit card information for online sales and maintain a large data base of personal information for lead generation, or small businesses that may only maintain sensitive digital information for in-house employees. The amount of coverage an organization needs depends on the level of risk.

There are two major types of Cyber Liability Insurance:
First-Party Coverage and Third-Party Defense and Liability Coverage.

First-Party Coverage
First-party coverage offers financial compensation that helps to address immediate customer and business needs, such as those resulting from an in-house IT network going down.

Third-Party Coverage
Third-party coverage protects a company’s assets in the event of a lawsuit brought by a customer or partner for a data breach that the business’s actions or negligence allowed.

Depending on a company’s specific needs and level of risk, they may choose either or both types of coverage.

Typically, a general liability policy does not cover losses incurred because of the Internet. A cyber liability policy can close the gap when damage or theft of digital property or litigation arising from a cyber-event occurs.

Directors & Officers Liability

 

Directors and Officers Liability Insurance (often called D&O) is liability insurance payable to the directors and officers of a company, or to the organization(s) itself, to cover damages or defense costs in the event they suffer such losses as a result of a lawsuit for alleged wrongful acts while acting in their capacity as directors and officers for the organization. Such coverage can extend to defense costs arising out of criminal and regulatory investigations/trials as well; in fact, often civil and criminal actions are brought against directors/officers simultaneously. It has become closely associated with broader management liability insurance, which covers liabilities of the corporation as well as the personal liabilities for the directors and officers of the corporation.

D&O insurance is usually purchased by the company itself, even when it is for the sole benefit of directors and officers. Reasons for doing so are many, but commonly would assist a company in attracting and retaining directors. Where a country’s legislation prevents the company from purchasing the insurance, a premium split between the directors and the company is often done, so as to demonstrate that the directors have paid a portion of the premium. Problems related to income tax liability may come into play when a corporation avoids country specific liability law in order to protect its individual directors and officers through insurance.

A common misperception of D&O insurance is that it makes directors or officers able to engage in acts they know to be wrong; this is not the case. Intentional illegal acts or any illegal gains/profits obtained by directors/officers are not covered under most D&O insurance policies; coverage would only extend to “wrongful acts” as defined under the policy, which may include certain acts, omissions, misstatements while acting as a director/officer of the organization. Exclusionary language, however, would not provide coverage for fraud, illegal profits/gains, or intentional/wanton illegal conduct by such director/officer (as examples).

Employment Practices

Employment Practices Liability is an area of United States law that deals with wrongful termination, sexual harassment, discrimination, invasion of privacy, false imprisonment, breach of contract, emotional distress, and wage and hour law violations.

Most commonly, employment practices liability deals with laws and protections brought under Title VII of the Civil Rights Act of 1964, the ADA (Americans with Disabilities Act) of 1990, the Civil Rights Act of 1991, ADEA (Age Discrimination in Employment Act) of 1967, and Family and Medical Leave Act (FMLA). The Equal Opportunity Employment Commission (EEOC) interprets and enforces these laws.

A growing product on the insurance markets is employment practices liability insurance (EPL), a type of policy that business owners can buy to protect their organizations against employee suits for rights protected under acts above. More recently, with the expansion of privacy law(s), employee privacy concerns have come to the fore as private employee data is stored electronically. This is not always covered under an EPL policy, but the insurance industry has responded by offering cyber liability and network security policies, which are also available through a carrier of choice with Spain Agency.

Fiduciary Liability

Fiduciary liability, also known as pension trust liability, provides coverage for loss that the insured becomes legally liable to pay because of a claim made against the insured for any alleged wrongful act by such insured or by any other person for whom the insured is legally responsible. It also covers the defense costs in connection with a covered claim. The policy is written on a claims made form.

A wrongful act includes any violation of the responsibilities, obligations, or duties imposed on fiduciaries by the Employee Retirement Income Security Act (ERISA), as well as acts, errors, or omissions in the performance of the duties of the plan administrator.

The ERISA definition of a fiduciary is very broad. It is any person so named in the plan or any person who exercises any discretionary authority or control with respect to the management or administration of the plan or its assets.

The rules and regulations of ERISA include strict guidelines for fiduciaries. Failure to comply can result in lawsuits from employees, former employees, and beneficiaries, as well as the Secretary of Labor, Treasury Department, and Pension Benefit Guarantee Corp. The sponsor corporation as well as the individual fiduciaries are at risk.

ERISA also has a broad definition of what is considered an employee benefit plan. It includes any plan, fund, or program established or maintained for the purpose of providing employee benefits to its participants or beneficiaries. Under a fiduciary liability policy, the insured includes the following:

  • The sponsor organization
  • The plan(s)
  • Any natural person in his/her capacity as fiduciary or administrator of the plan(s)

Most fiduciaries are unaware of their personal financial risk or that of the sponsor organization. Fiduciary liability coverage provides one way of reducing the risk and providing protection for the sponsor organization and individual fiduciaries.

Garage Liability

Garage Liability provides coverage to owners of storage garages, parking lots, etc. for liability as bailees with respect to damage to automobiles left in their custody.

Coverage is contingent upon establishing liability on the part of the insured.

Inland Marine Coverages

Inland Marine Insurance provides coverage for goods in domestic transit, goods of bailees’ customers, moveable equipment, and unusual property. Property of certain dealers and instrumentalities of communication and transportation are also covered. In short, inland marine insurance provides coverage for loss exposures that cannot be conveniently or reasonably confined to a fixed location. A bailee is any person or business that accepts the property of others for a specific purpose. Instrumentalities of communication and transportation are properties essential to communication or transportation. Properties that may come under this class are radio and television equipment, bridges, roads, tunnels, pipelines and piers.

There are many kinds of inland marine policies that cover several kinds of loss exposures. The insurance industry has recognized this diversity by dividing inland marine into two categories; filed and non filed. Filed policies are those for which the policy forms and rates are filed with the state insurance department. These policies are characterized by the number of potential insureds with the same kinds or similar loss exposures. Most filed forms cover risks of direct physical loss to the covered property. The following are some examples of inland marine filed policy forms: commercial articles coverage form, equipment dealers coverage form, signs coverage form, mail coverage form, accounts receivable coverage form, and the valuable papers/records coverage form.

Non-filed inland marine policies are those for which neither the policy forms or the rates are filed with the state insurance department. The majority of inland marine policies are non-filed. Non-filed policies are characterized by a relatively small number of potential insureds with different loss exposures. A non-filed policy may be substantially different among insurers. Many non-filed policies provide coverage against risk of direct physical loss or damage to covered property. Other policies may insure against only specified causes of loss. The type of property that can be insured under a non-filed inland marine policy is almost limitless. The following are some examples of non-filed inland marine policies: electronic data processing equipment policy, contractors equipment policy, and builders risk/installation policy. Bailees’ policies and instrumentalities of transportation and communication would also come under the non filed policy category.

Limit of Insurance
The limit of insurance in an inland marine policy will always vary depending on the type of inland marine policy. For example, transportation policies can have two limits of insurance. One limit could be per unit or per conveyance, which would be a limit per truck, per railroad car, per vessel, or per airplane. A catastrophe limit could also be included, which would apply to losses involving more than one unit or conveyance. It is also possible for a transportation policy to be written with a single per occurrence limit.

The inland marine valuable papers policy form is another example of varying limits. The limit of insurance on the declarations page states per occurrence; however, the policy is structured to indicate the insured has one limit for specifically described valuable papers on the insured’s premises, and another limit for all other valuable papers and records on the insured’s premises. The policy also states another limit for valuable papers and records temporarily away from the insured’s premises, but this limit is shown as an additional coverage and not as a sublimit of the policy.

Deductibles
The deductibles in inland marine policies vary just as the limits do. An example would be the transportation policy. Since there are no standard policies, there are no standard deductibles. However, most policies are written with a per occurrence deductible. Even though most deductibles are written on a per loss basis, the wording in a deductible clause can put restrictions on the policy limit. As an example, some insurers state they will subtract the deductible amount from the amount they are obligated to pay. This type of clause prevents the insured from ever collecting the full policy limit of insurance. Other insurers might have a deductible clause similar to the one found in the valuable papers and records coverage form which states; the insurer will pay the amount of the loss less the deductible, up to the policy limit of insurance. This deductible clause would allow the insured to collect up to the policy limit.

Valuation Clause
Inland marine policies can also differ with valuation clauses. An example would be the inland marine transportation insurance policy which has a valuation clause at invoice cost. However, if there is no invoice, valuation can be the actual cash value of the property. Some insurers state if there is no invoice, valuation will be the market value of the property once it reaches its destination. Another example of a valuation clause would be the valuable papers and records policy form. This form states the agreed valuation on specifically declared items will be the limit of insurance stated in the policy. Valuation for all other valuable papers and records will be determined by the lesser of its cash value, cost of restoring the property to its original condition prior to the loss, or the cost of replacing the property with similar or identical property. This last method is usually the valuation method used on this form.

Liquor Liability

 

Liquor liability insurance provides coverage for bodily injury or property damage for which an insured may be held liable by reason of the following:

  • Causing or contributing to the intoxication of any person.
  • Furnishing alcoholic beverages to a person under the legal drinking age or under the influence of alcohol .
  • Violating any statute, ordinance, or regulation relating to the sale, gift, distribution, or use of alcoholic beverages.

This coverage applies only if the insured is involved in the following activities:

  • Manufacturing, selling, or distributing alcoholic beverages.
  • Serving or furnishing alcoholic beverages for a charge, whether or not such activity requires a license or is for the purpose of financial gain or livelihood.
  • Serving or furnishing alcoholic beverages without a charge, if a license is required for such activity.
Professional Liability

Professional liability insurance (PLI), also called professional indemnity insurance (PII) but more commonly known as errors & omissions (E&O) in the US, is a form of liability insurance that helps protect professional advice- and service-providing individuals and companies from bearing the full cost of defending against a negligence claim made by a client, and damages awarded in such a civil lawsuit. The coverage focuses on alleged failure to perform on the part of, financial loss caused by, and error or omission in the service or product sold by the policyholder. These are potential causes for legal action that would not be covered by a more general liability insurance policy which addresses more direct forms of harm. Professional liability coverage sometimes also provides for the defense costs, including when legal action turns out to be groundless. Coverage does not include criminal prosecution, nor a wide range of potential liabilities under civil law that are not enumerated in the policy, but which may be subject to other forms of insurance. Professional liability insurance is required by law in some areas for certain kinds of professional practice (especially medical and legal), and is also sometimes required under contract by other businesses that are the beneficiaries of the advice or service.

Professional liability insurance may take on different forms and names depending on the profession. For example, in reference to medical professions it is called malpractice insurance, while errors and omissions (E&O) insurance is used by consultants, brokers and lawyers. Other professions that commonly purchase professional liability insurance include accounting and financial services, construction and maintenance (general contractors, plumbers, etc., many of whom are also surety bonded), and transport. Some charities and other nonprofits/NGOs are also professional-liability insured.

Umbrella Liability Coverages

Umbrella liability insurance provides excess liability coverage over several of the insured’s primary liability policies. Most umbrella liability policies provide coverage that is broader than the insured’s primary policies. An excess liability policy may be what is called a following form policy, which means it is subject to the same terms as the underlying policies; it may be a self-contained policy, which means it is subject to its own terms only; or it may be a combination of these two types of excess policies. Umbrella policies have three functions: (1) To provide additional limits above the each occurrence limit of the insured’s primary policies; (2) To take the place of primary insurance when primary aggregate limits are reduced or exhausted; and (3) To provide broader coverage for some claims that would not be covered by the insured’s primary insurance policies, which would be subject to the policy retention. Most umbrella liability policies contain one comprehensive insuring agreement. The agreement usually states it will pay the ultimate net loss, which is the total amount in excess of the primary limit for which the insured becomes legally obligated to pay for damages of bodily injury, property damage, personal injury, and advertising injury.

Limits of Insurance
All umbrella liability policies contain an each occurrence limit of insurance. Some umbrella liability policies may have a separate limit that applies to all personal and advertising injury for one person or for the organization. Also, some policies are written with aggregate limits for only one type of loss. Other policies may have one or more aggregates for all losses. Umbrella policies can be written with several different variations of the aggregate limits. There are no standard umbrella policies.

Pay on Behalf
This is an insuring agreement used in some umbrella policies. The agreement promises to make direct payment on behalf of the insured for those sums of money the insured becomes legally obligated to pay because of liability imposed upon the insured by law, or assumed under contract.

Indemnity
This is the insuring agreement clause found in most umbrella policies as opposed to the pay on behalf agreement. When the indemnity insuring clause is used, the insurer will indemnify or reimburse the insured for those sums of money the insured becomes obligated to pay by reason of liability imposed upon the insured by law, or assumed under contract.

Self Insured Retention
The self insured retention is the amount of the loss an insured must pay before the umbrella policy would be required to respond. The self insured retention would only apply when a loss is excluded from coverage under the primary policy, but not excluded under the umbrella policy.

Required Underlying Limits
Required Underlying Limits is a requirement of the insurer. It requires the insured to have certain types and amounts of primary insurance before the umbrella policy can be written.

Workers’ Compensation

What is workers’ compensation?
Workers’ compensation laws allow workers who are injured in the course of their employment to be compensated for their injuries without having to resort to a traditional lawsuit, or court proceedings. An injured worker does not have to prove that his or her employer was negligent, or at fault for the injury, only that the injury happened in the course of the worker’s employment. Workers’ compensation is your sole remedy for your injuries unless someone other than your employer was liable for your injuries.

What kinds of injuries are covered?
Almost any kind of physical injury or disease is covered by workers’ compensation. An injury or condition you already had will not qualify, unless it was aggravated or made worse while on the job.

What do I receive for my injuries?
The workers’ compensation law provides for specific amounts that are awarded for different injuries. In addition, the law authorizes payment of the medical bills that relate to your injury, as well as payments to make up, at least in part, for the wages you lose because of your injury. In some cases, you may be able to receive money to help you train for a new job.

Who pays workers’ compensation benefits?
Your employer is required either to carry worker’s compensation insurance, or to be self-insured. Your employer’s insurer is the one responsible for making payments to you.

What do I do if have been injured on the job?
Your first step should be to report your injury to your employer as soon as possible after your injury. You should be told who receives your report: your supervisor, your foreperson, or your employer’s human resource office. Usually, a verbal report is all you need to make, and the report does not have to be followed up in writing (but you should check with your employer to be sure).

If you are in need of medical care or treatment, you should inform your employer of this need as soon as you decide you need to see a doctor.

Who chooses the doctor that I see?
Usually, your employer, or your employer’s workers’ compensation insurer, selects the doctor you will see. If you are unhappy with the doctor or other health care professionals selected, you may have the right to request treatment from someone else.

Are workers’ compensation benefits taxed?
Most states do not tax worker’s compensation benefits. The U.S. government does not tax workers’ compensation benefits.

My employer and I disagree about my workers’ compensation benefits. What can I do?
The workers’ compensation laws provide an opportunity for a hearing if you and your employer, or your employer’s insurer, can’t resolve a dispute. While it is not required, it is a good idea to be represented by an attorney at this hearing.

I was injured on the job, but the injury was caused by someone with no connection to my employer. What are my rights?
You still have the right to receive workers’ compensation benefits. In addition, you may be able to bring a separate lawsuit against the party who caused your injuries. It is important to consult with an attorney with experience in this area of the law, to learn exactly what your rights are in this situation.

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For more information, call us at: (800) 247-5521

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Brown & Brown of New York, Inc. dba Spain Agency

625 Route 6, Mahopac, NY 10541

Ph: (845) 628-4500     |     Toll-Free: (800) 247-5521     |     Fax: (845) 628-1804     |     Email: Spainagency@spainins.com