Insurance Proposal Template

Business Insurance Proposal

For ::ClientCompany::

Presented By

::SenderName::

::SenderCompany::

::SenderCompanyAddress::

::SenderCompanyPhone::

IMPORTANT: This proposal is a general outline of the terms and conditions of the insurance proposed by the insurers, based on the information provided by your company.  It does not include all of the terms, coverages, exclusions, limitations, and conditions of the actual policy contract language.  The insurance policies themselves must be read for those details.  Policy forms for your reference will be made available upon request.

Payment

This area will be replaced with PayPal button.

PayPal email: [object HTMLCollection]

Amount: [object HTMLUListElement] [object HTMLUListElement]

Named Insured Schedule

[List additional Named Insureds]

Any entity, partnership, joint venture or Limited Liability Company not named as an insured is not covered under these proposed coverages.

Locations Schedule

[List Locations & Addresses]

Vehicles Schedule

[List vehicles – Year/Make/Model/Vin #]

Business Property Coverage

Insurance Company:         [Insurance Carrier Name]

A.M. Best Rating:               [Carrier Rating]

Admitted/Non-Admitted:    [State Admitted or Non-Admitted]

Proposed Policy Term:       [Effective Date] to [Expiration Date]

Limits:

• Buildings
• Business Personal Property
• Business Income
• EDP Equipment
• Building Ordinance
• Equipment Breakdown
• Earthquake Sprinkler Leakage
• Mobile Equipment
• [Insert additional coverages]

Deductibles:

• Per Occurence for Direct Damage, Except
• Earthquake Sprinkler Leakage
• Mobile Equipment
• [#] Hours Business Income Waiting Period

Coverage Highlights:

• Special Causes of Loss
• Replacement Cost, except
• Actual Cash Value for Mobile Equipment
• Business Income based on Actual Loss Sustained basis
• [Insert additional coverage extensions]

Coverage Limitations: 

Exclusions included, but not limited to

• Earthquake
• Flood
• Terrorism (if coverage rejected)
• Computer Virus and Computer Vandalism
• Pollution
• Mold, Fungi, Mildew, Microbe
• Governmental Action
• Employee Dishonesty
• Delay and/or Loss of Market
• Nuclear
• Biological and chemical contamination
• [Insert additional exclusions]

Subjectivities:

• [If applicable, list any carrier conditions to bind coverage]

General Liability Coverage

Insurance Company:         [Insurance Carrier Name]

A.M. Best Rating:               [Carrier Rating]

Admitted/Non-Admitted:    [State Admitted or Non-Admitted]

Proposed Policy Term:       [Effective Date] to [Expiration Date]

Limits:

1. Bodily Injury and Property Damage, Each Occurrence
2. General Aggregate
3. Products & Completed Operations Aggregate
4. Personal & Advertising Injury
5. Fire Damage Liability
6. Medical Expense

Employee Benefits Liability – Claims Made Form:

• Per Claim
• Annual Aggregate
• [Date] Retroactive Date
• Deductible

Exposure Basis:

[List Class/Description/Basis/Exposure]

Coverage Highlights:

• Additional Insured – Vendors
• Additional Insured – Lessors of Equipment & Premises
• Additional Insured – Mortgagee, Assignee or Receiver
• [Insert additional coverage extensions]

Coverage Limitations: Exclusions included, but not limited to

• Intentional Acts
• Workers Compensation
• Employers Liability
• Pollution (with Hostile Fire exception)
• Nuclear Energy
• Employment Practice Liability
• Intellectual Property Rights, including Trade/Patent Infringement
• Professional Liability
• Owned Aircraft Liability
• Watercraft (except for non-owned under 55 feet in length)
• Damage to property
• Damage to your work
• Damage to your product
• Asbestos
• Lead
• Terrorism (if coverage rejected)
• Professional Liability
• Aircraft products
• Discrimination
• [Insert additional exclusions]

Subjectivities:

• [If applicable, list any carrier conditions to bind coverage]

Business Auto Coverage

Insurance Company:         [Insurance Carrier Name]

A.M. Best Rating:               [Carrier Rating]

Admitted/Non-Admitted:    [State Admitted or Non-Admitted]

Proposed Policy Term:       [Effective Date] to [Expiration Date]

Limits:

• Bodily Injury/Property Damage (Combined Single Limit)
• Medical Payments
• Uninsured Motorists
• Underinsured Motorists
• Hired Auto Physical Damage

Deductibles:

• Comprehensive
• Collision

Coverage Highlights:

• Employees as Insureds
• Additional Insured – Lessor
• [Insert additional coverage extensions]

Coverage Limitations: Exclusions included, but not limited to (cont.)

• Expected or Intended Injury
• Liability Assumed Under Contract
• Pollution
• Employers Liability
• Workers Compensation
• Racing
• War
• Movement of Property by Mechanical Device
• Bodily Injury or Property Damage Arising Out of Use of Mobile Equipment
• Economic and Trade Sanctions Condition
• Nuclear Energy Liability
• [Insert additional exclusions]

Subjectivities:

• [If applicable, list any carrier conditions to bind coverage]

Workers Compensation and Employers Liability

Insurance Company:         [Insurance Carrier Name]

A.M. Best Rating:               [Carrier Rating]

Admitted/Non-Admitted:    [State Admitted or Non-Admitted]

Proposed Policy Term:       [Effective Date] to [Expiration Date]

Limits:

A.   Workers Compensation

• [Insert “Statutory” or $]  – [Insert State(s) covered]

B.  Employers Liability:

• Bodily Injury by Accident, Per Person
• Bodily Injury by Disease, Policy Limit
• Bodily Injury by Disease, Per Person

Schedule of Exposures:

• [List Class/Description/Payroll]

Officer-Owners Excluded:

• [List Name/Title]

Coverage Highlights:

• Terrorism Risk Insurance Act Coverage
• [Insert additional coverage extensions]

Coverage Limitations: Exclusions included, but not limited to (cont.)

• Loss arising out of operations for which Insured has rejected any workers compensation law
• Liability assumed under a contract
• Bodily injury intentionally caused or aggravated by the Insured
• Fines or penalties imposed for violation of federal or state law
• Damages arising out of coercion, criticism, demotion, evaluation, reassignment, discipline, defamation, harassment, humiliation, discrimination against or termination of any employee, termination of employment, or any personnel practices, policies, acts, or omissions

Experience Modification:  [#] %

Subjectivities:

• [If applicable, list any carrier conditions to bind coverage]

Umbrella Liabilty Coverage

Insurance Company:         [Insurance Carrier Name]

A.M. Best Rating:               [Carrier Rating]

Admitted/Non-Admitted:    [State Admitted or Non-Admitted]

Proposed Policy Term:       [Effective Date] to [Expiration Date]

Limits:

• Per Occurrence
• Annual Aggregate

Self-Insured Retention:

• Per Occurrence

Underlying Insurance Informatino:

• [List Coverage/Insurer/Limit/Policy Term]

Coverage Highlights:

• Defense costs are in addition to limit
• Non-auditable
• [Insert additional coverage extensions]

Coverage Limitations: Exclusions included, but not limited to

• Absolute Pollution
• Temporary Worker and Leased Worker Injury
• War liability
• Nuclear Energy
• Property in Your Care, Custody or Control
• Lead
• Fungi or Bacteria
• Terrorism (if coverage rejected)
• Violation of Information Distribution Laws
• Expected or intended injury
• Contractual Liability
• Asbestos
• Lead
• Professional Liability
• Aircraft products
• Discrimination
• [Insert additional exclusions]

Subjectivities:

• [If applicable, list any carrier conditions to bind coverage]

Premium by Coverage

1. Commercial Property

2.  General Liability

3. Business Auto

4. Workers Compensation

5. Umbrella Liability

Insurance Program Premium

Disclaimers

We are willing to discuss any of the items relating to the processing of your business at any time. We encourage full disclosure of our practices to assure you that we always act in your best interest.

[List any agency disclaimers here. Suggestions listed below – remove or reword]

Broker Disclosure

::SenderCompany:: may receive compensation from an insurer or other intermediary as a result of the sale of insurance to you.

The compensation received by ::SenderCompany:: may differ depending on the product, insurer, and/or other intermediary.

::SenderCompany:: may receive additional compensation from the insurer and/or other intermediary based upon other factors, such as premium volume placed with a particular insurer or through a particular intermediary and loss or claims experience.

Communication

Any requests that you make to confirm, bind, or alter your insurance program through e-mail, voice mail, or other automated systems will not take effect until you receive confirming communication from your ::SenderCompany:: representative.

Claim Reporting Requirements

Changing market conditions have had an adverse effect on many carriers’ claim reporting terms and conditions.  Many policy forms now include verbiage that severely restricts or negates coverage should a carrier not be immediately notified of a claim or potential claim.  Refer to your policies for a more complete explanation of your carrier’s reporting requirements.