Commercial Insurance Protection Renewal Checklist

Name:
Company Name:
Email Address:
Website:

GENERAL:

1. Have you formed any new business entities such as a corporation, partnership, joint venture, LLC or profit sharing plan?
Yes No

2. Do you enter into any types of contracts (ex. premises lease, employee lease, construction contracts, etc.) that require you to carry certain insurance limits or policies? If so, please list the types of contracts and forward a copy for our review.
Yes No

PROPERTY:

1. Are the insurance values listed for each coverage sufficient to cover full replacement cost should your property be destroyed?
Yes No

2. Have you expanded, renovated, or upgraded your building?
Yes No

3. Have you done any updates to the following?

Heating or Air Conditioning Yes No
Plumbing Yes No
Electrical Yes No
Roof Yes No

4. Have you purchased new equipment or increased your personal property / contents?
Yes No

5. Do you have a central station fire alarm?
Yes No

6. Do you have a central station burglar alarm?
Yes No

7. Would you consider increasing your deductible to lower your premium?
Yes No

8. If your building suffered a loss and you had to build differently to satisfy new building codes, would you want your insurance company to pay for increased costs?
Yes No
a. If so, would you want a quote on this type of insurance?
Yes No

9. Do you need special coverage for the Directors and Officers of your company?
Yes No

10. Your policy has sub-limits that limit the amount of coverage for certain items. Do you have a need for increased coverages for any of the following? (Check all that apply)
Computer Hardware
Computer Software
Your personal property away from the premises
Personal property of others in your possession
Cost to reproduce valuable papers (blueprints, customer files)
Money, Notes, Securities at your office/business
Fine Arts
Patterns, Molds, Dyes
Glass Coverage
Sign Coverage
Personal articles of employees

11. Coverage for these perils is not included in your policy. Please check any coverage that you would like to receive a quote on.
Flood
Earthquake
Boiler Explosion
Loss of Power
Power Surges


GENERAL LIABILITY:

1. What are your estimated gross sales revenues for the next 12 months?

2. What is your estimated payroll for the next 12 months?

3. Do you use subcontractors?
Yes No

4. If yes, do they provide you with a certificate of insurance indicating that they carry their own general liability and workers' compensation with an occurrence limit the same as yours?
Yes No

5. Do your employees ever use their own vehicles to conduct business or run errands on your behalf?
Yes No

BUSINESS AUTO:

1. How many people drive vehicles for your company? (Please include every person that drives company owned cars, any person that drives his/her own car for company business, and any person that may rent or lease a vehicle for company use.)

2. Please review your list of vehicles. Are there any changes?
Yes No

3. Have any of the vehicles been paid off or have any of the lien holders changed?
Yes No

4. Do you or any of your employees who use company vehicles not have a personal auto policy covering a vehicle that is owned by you?
Yes No

5. Do any vehicles have customized equipment (ex. truck caps, racks, etc.) that was not installed by the original manufacturer?
Yes No
a. If so, do you want it covered?
Yes No

WORKERS COMPENSATION:

(Massachusetts's law requires every business (sole propietors, partnership, corporate, etc.) to carry workers compensation insurance.

WARNING! If you do not currently hold certificates of insurance for your subcontractors, YOU could be charged for their workers compensation.
Do you have their certificates on file?
Yes No

1. Do you plan on using any subcontractors over the next 12 months?
Yes No

2. If yes, what type of services will they perform?

3. If yes, what is the annual cost of the subcontractors?

4. Do you have operations in any other States?
Yes No

5. Do you hire employees in other States?
Yes No

GENERAL QUESTIONS:

1. If a loss to your property caused your business to shut down for an extended period, would you need cash to continue salaries or other expenses?
Yes No

2. Are you dependent on your website for a significant portion of your revenues? Would you like coverage in the event that your website is shut down by hackers or malicious virus/worm?
Yes No

3. If you were sued for $797,000.00 more than your general liability policy limit, would you want your insurance coverage to pay for it?
Yes No

4. If a disgruntled employee were to sue you for $250,000.00 for alleged discrimination, sexual harassment, or wrongful termination, would you want an insurance policy to cover this?
Yes No

5. If you are involved in an auto accident where you are sued for $457,000.00 more than your auto liability limits, would you want your insurance coverage to pay for it?
Yes No

6. If you provide employee benefits to your employees such as group health insurance, would you want coverage if you were sued for making an administrative error such as failing to add a new employee to the plan, and if such employee incurred $139,000 in uncovered medical bills as a result?
Yes No

7. If a key person in your business were to die, would you like for insurance to pay your business for loss of the employee’s unique services?
Yes No

8. If an employee stole money from your business, would you want it paid back?
Yes No

9. Would you like a quote for health, disability income, or life insurance for yourself, key employees, or for all your employees?
Yes No

10. What is your e-mail address?