Insurance Terms

1. Bonding & SuretyshipCompletion Bond Guarantees the lending party that funds borrowed will only be used for this work and free and clear of liensCourt Bonds -Appeal Bond-Attachment Bond-Cost Bond-Injunction Bond-Bail Bond-Replevin Bond-License & Permit BondFidelity Bond Guarantees that an employee will not commit certain acts-Loss sustained or Discovery Basis-Written to cover name employees or specific positionsFiduciary Bond A bond commonly used to bond persons appointed by a court to manage the property of others-guardians-administrators-trustees and executorsFinancial Institution Bond SF#24 Six Insuring Agreements1. Fidelity2. On Premises3. In Transit4. Counterfeit Currency5. Forgery (Optional)6. Securities (Optional)Financial Institution Bond SF#24 Riders -ATM-Computer Systems-Extortion -Fraudulent Mortgages-Insurers of registered checks of personal money orders-Pension Plans-ERISA-Servicing Contractors-Trading Loss-Voice Initiated Electronic Funds TransferJudicial Bonds -Fiduciary Bond-Court of Litigation BondsLabor & Material Bond Guarantees work has been completed without any outstanding liensParties Under a Contract Bond -Principal- Obtains the bond & pays the premium (fulfill service)-Obligee- Owner of project (request service)-Surety- Guarantor of the bond (will pay if service not fulfilled)SBA Surety Bond Guarantee Reimburses participating surety for losses (within limits) as a result of principal default on

a bid bondSurety Bond The obligation of one party is guaranteed by a 3rd party. Guarantee that someone will faithfully perform the acts they agreed to performTypes of Contract Bonds -Bid Bond-Performance Bond-Labor & Material Bond-Completion Bond-Supply Bond-Payment BondTypes of Surety Bonds -Public Official Bond-Judicial Bonds

2. Commercial Crime InsuranceClients Property The clients property is covered for theft by an identified employeeCommercial Coverage Forms -Loss Sustained Form-Discovery FormCustodian The insured, any partner or employee that has care and custody of insured propertyDiscovery Form Coverage up to 60 days after term expiration, if loss happened during policy periodDuties After Loss -Sworn proof loss within 120 days of lossEndorsements Client's PropertyExtortioninside the Premises Theft of Other PropertyInside the Premises Robbery or Burglary of Other PropertyInside the Premises Robbery or Safe Burglary of Money & SecuritiesEmployee Theft-Name or Position ScheduleLessees of Safe Deposit BoxesSecurities Deposited With OthersFunds Money & securities associated with an employee benefit planInsuring Agreements (Optional Coverages) Employee TheftForgery or AlterationInside the Premises Theft of Money & SecuritesInside the Premises Robbery or Safe Burglary of Other PropertyOutside the PremisesComputer FraudMoney Orders & Counterfeit MoneyFunds Transfer of FraudLoss Sustained Form -Coverage up to 1 year after term expiration, if loss happened during policy period-Loss sustained during prior insurance conditionPolicy will pay for loss occurring during a previous policy but discovered during current policy

Messenger Authorized person that has custody of property outside the premises for deliveryPremise Burglary Visible signs of forced entry or exit or forcing a watchman to unlock premiseRobbery Requires forced stealing, a threat of violence or injurySafe Burglary Taking property from a locked vault or safe, with visible signs of forced entry, or taking the safe itself.Valuation & Settlement Replacement Cost for loss other than money & securities

3. Commercial Lines-BOPAccounts Receivable Up to $10,000 if on premiseUp to $5,000 off premiseBiz Income-Extra Expense 72 hour wait period. Payroll expenses for 60 days after lossBiz Income from Dependent Properties up to $5,000Biz Personal Property Limit Seasonal Increase Limit auto increase by 25% for peak season coverage-100% value insured for previous 12 monthsBOP Additional Coverages Debris RemovalPreservation of PropertyFire Dept Service ChargeBusiness Income-Extra ExpensePollution Clean UpCivil AuthorityBusiness Personal Property Limit-Seasonal IncreaseLimited Coverage for Fungi, Wet/Dry Rot & BacteriaCollapseFire Extinguisher Systems Recharge ExpenseBusiness Income from Dependent PropertiesMoney Orders & Counterfeit CurrencyForgery or AlterationIncreased Cost of ConstructionBOP Coverage B -Property owned by insured and used in business-Property of others in the insureds care (different from CGL)-Tenant's bettermentsBOP Section I Property-Replacement Cost (ACV by endorsement)Cov A-BuildingCov B-Business Personal PropertyBOP Section II Liability-Includes $300,000/occurrence-Aggregate limits for Products/Completed Operations & BI/PD are 2x the per occurrence & medical payment limits

Business Owner Policy (BOP) Designed for small to med size companies, Includes-Replacement Cost Valuation (ACV available by endorsement)-Open Perils (Named by endorsement)

-Income & Extra Expenses up to 12monthsCasual Dinning -Floor area less than 7,500 sq ft-Seat cap 150-Beer, Wine, Liquor sales < 50%-Catering < 10% of total sales-Must not be seasonal-Must install & maintain automatic extinguishing system for cooking equipment-Dancing not permitted-Live entertainment prohibited, except background music like piano playing-Happy Hour and similar promotions are prohibited-Bar operations cant be conducted when full table service is not availableContractors Ineligibility -Annual payroll > 300,000-Heavy construction (ie building bridges)-Manufacture or sale of products under contractors name-Annual sales > 6 million-Repairing or painting ships-Lawn chemical spraying-Work heights over 3 stories-Tree service or removal-Hazardous material or pollution removal-Annual sales unrelated to installation, service or repair > 25%-Subcontracted work > 10% of sales-Installing or dealing in hot tubs, pools or wood/coal stoves-Insulation work-Rent or lease equipment to others-Shop only carpentry or sheet metal work-Sales, service or install of auto open doors or garage doors-Use cranes-Waterproofing-General contracting-Demolition, high pressure boiler or gas work-Repair, install or service of boilers, alarm systems, auto fire extinguishing systems, elevators, escalators, or computersConvenience & Grocery Stores -Must have at least 3,000 sq ft of floor area if it also sales gas-Must not do auto service or repair work-Car wash not permitted-Must not fill propane or kerosene tanksDebris Removal If policy limit is exceeded, additional $10,000 if reported within 180 days after lossElectronic Data up to $10,000Eligibility Max 35,000 sq ftAnnual sales cant exceed 6 million

Eligible Buildings ApartmentsOfficeOther

Eligible Processing or Service Business Less than 25% of sales from off premise operationsie Funeral Homes, BakeriesEndorsements -Outdoor Signs-Money & Securities-Employee Dishonesty-Mechanical Breakdown-Hired & Non Owned Auto Liability-Earthquake-Utility Service Direct Damage Coverage-Protective Safeguards-Named PerilsExaminations of Books Anytime during policy term and up to 3 years afterFast Food Resturants Only grilling, enclosed broiling, deep frying, roasting or BBQ (excludes charcoal or hardwood)-Floor area less than 7,500 sq ft-Seat cap 150-Table service not permitted-Beer or Wine sales < 25% (hard liquor not permitted)-Catering < 10% of total sales-Cant be seasonalFD Service Charge up to $2,500Fine Dinning -Floor area less than 7,500 sq ft-Seat cap 150-Beer, Wine, Liquor sales < 75%-Catering < 15% of total sales-Must not be seasonal-Must install & maintain automatic extinguishing system for cooking equipment-Dancing not permitted-Live entertainment prohibited, except background music like piano playing-Happy Hour and similar promotions are prohibited-Bar operations for seated customers or those waiting to be seated only-Maitre'd supervises wait staff & controls customer turnover-Chief supervises food prep & other kitchen operationsFire Extinguisher Systems Recharge up to $5,000Forgery or Alteration up to $2,500Fungi, Wet/Dry Rot & Bacteria up to $15,000Increase Cost of Construction up to $10,000

Ineligible Risk for BOP -2 or more locations used for manufacturing-Banks etc.-Bars & night clubs-Buildings used only for manufacturing

-Places of amusement (theaters)Limited Cooking Resturants Doesnt require NFPA commercial exhaust system-Floor area less than 7,500 sq ft-Seating cap 75 people-Table service permitted-Beer or Wine sales < 25% (hard liquor not permitted)-Catering < 10% of total sales-Cant be seasonalMoney Orders & Counterfeit up to $1,000Motels 35,000 sq ft N/A Sales less than 6 million-Less than 3 stories -Cant be seasonal-Cant have a bar or cocktail loungeName Perils FireLightningVolcanic ActionSprinkler leakageSinkhole CollapseVMMEC Perils: WC SHAVVERTransportation:Covers damage while property in transitOutdoor Property Excludes signs attached to buildingUp to $2,500, max $1,000/tree, shrub, plantPersonal Effects Excludes theftUp to $1,000Personal Property Off Premise up to $10,000Pollution Clean Up Up to $10,000 if reported within 180 days after lossProperty Preservation up to 30 daysProtective Safeguards Requires insured to maintain protective devices or services as a conditions of the policy-P1-Auto Sprinkler System-P2 Auto Fire System-P3-Security Service with guard that makes hourly rounds-P4-Service Contract privately owned fire dept -P9-Any other protection system described in the endorsementStorage Facilities -Less than 2 stories -Doesnt permit cold storage or hazardous materialsValuable Papers & Records Up to $10,000 if on premiseUp to $5,000 off premiseWholesale Risk Eligibility Less than 25% of annual gross sales form retail operationsLess than 25% of total floor area open to public

4. Commercial Lines-CPPCommercial Package Policy Combines more than one monoline policy into one contract. Helps eliminate coverage gaps & overlapTo Qualify as a CPP Policy must contain:-Declarations form-Conditions-2 or more Coverage partsCoverage Parts -Commercial Property-Commercial Auto-Commercial Crime-Commercial Inland Marine-Farm-Equipment Breakdown-Commercial General Liability

5. Commercial Lines-Equipment Break DownAutomatic Coverage Up to 90 days for equipment in use or connected & ready for use at newly acquired or existing locations-If insured notified within 90 days of purchase-Must be ready for use and a type of equipment included on the DeclarationsData or Media Limit Actual data or media equipment not covered, up to $25,000 for cost to research and restore lost dataExclusions Similar to other policy exclusions including:-Water or other means used to extinguish a fire;- An accident to any object while being tested;- Lack of power, light, heat, steam or refrigeration;Hazard Removal Limit Up to $25,000 for clean up, replacement or disposal of equipment determined to be hazards by government agencyOptional Coverages -Business Income & Extra Expense-Business Income- Report of Values-Refrigeration Interruption -Turbine Units Explosion-Pressure or Vacuum Equipment-Actual Cash ValuePercentage of Loss Deductable Insurer will deduct a % of gross lossReduction In Value of Stock Limit Up to $25,000 for stock thats unable to be soldSpoilage Limit Up to $25,000Supplementary Payments Similar to other Liability policies-$ Up to $100/day loss of incomeWater Damage Up to $25,000 unless caused by sprinkler system leak

6. Commercial Lines-PropertyAdditional Biz Income Coverage's Extended Biz IncomeOrder of Civil AuthorityAlterations & New BuildingsAdditional Coverage's -Debris Removal-Preservation of Property-Fire Department Service Charge-Pollutant Clean Up & Removal-Increased Cost of Construction-Electronic Data-MoldAgreed Value Income Coverage After submitting financial data, the insurer may agree to valued coverage based on an optional coinsurance percentageAlterations & New Buildings Covers building supplies w/in 100ft of premise if they are being used in construction.Period of restoration starts on the day operations were suppose to begin before the lossBasic Cause of Loss Form WC SHAVVER+VandalismSprinkler Leakage (Accidental leakage)Sinkhole CollapseBiz Income Coverage Options Four Optional Coverage's1. Coinsurance2. Max Period of Indemnity3. Monthly Limit of Indemnity4. Agreed ValueBroad Cause of Loss Form Basic Cause of Loss Form Perils+W-Weight of IceC-CollapseF-Falling ObjectsA-Accidental Water DischargeB-Broken GlassBuilder's Risk Insured at %100 coinsurance of completed valueProperty insurance for the building while it's under construction. Covers losses result from fire, smoke, water, explosions, vandalism, and theft.Building & Personal Property Form Describes property insured from direct lossCov A-BuildingCov B- Business Personal PropertyCov C- Personal Property of OthersBusiness Income Net income + continuing operating cost (e.g.utilities, payroll, rent)Cause of Loss Form States the perils insured againstBasic

BroadSpecialCoinsurance Indemnity Allows insured to choose coinsurance percent of gross income minus expenses that would discontinueCommercial Line Coverage A Building Coverage • Permanently installed fixtures (e.g. PA systems);• Machinery and equipment (eg refrigerated lockers);• Outdoor fixtures (eg: light and flag poles);• Personal property used to maintain or service the premises (eg: fire extinguishers, ladders);• Outdoor furniture, floor coverings, certain appliances (eg cooking, dishwashing);• Additions, alterations, repairs in progress, including materials, supplies and temporary structures on or within 100 feet of the described premises.Commercial Line Coverage B Business Personal Property covered while located in the building, in the open or in a vehicle within 100 feet of the premises. • Furniture, Fixtures, Machinery, equipment;• Stock, • Labor, materials or services furnished or arranged on personal property of others. • Tenant's use interest in improvements and betterments. • Leased personal property when there is a contractual responsibility to insure, unless it is covered under Personal Property of Others.Commercial Line Coverage C Personal Property of Othersup to $2500 included in Extensions of Coverage, limit needed for more coverageCommercial Property Declarations Page Who, What, When, Where-Name & address of insured-Location of property-Specific forms-Inception & Expiration Date-LimitsContingent Business Interruption Covers indirect loss caused by damage to others.(Optional)Written for company operations dependent on:-biz at other locations providing supplies-biz at other locations to receive companies products-biz at other locations that attract biz to companies locationCoverage Extensions Coinsurance of 80% or more or a value reporting the coverage may be extended as follows:-Newly Acquired or Constructed Property-Newly Acquired Personal Property - Personal Effects and Personal Property of Others -Valuable Papers and Records -Property Off Premises -Outdoor Property -Non-owned Detached TrailersDebris Removal up to 10,000 in addition to limitsDeductible Increased from $250 to $500 on new forms

Difference in Conditions Insurance Covers perils that would be excluded by insurance forms or package policyEarthquake & Volcanic Eruption Endorsement -shocks/eruptions in 168 hour period=1 occurrence-Tsunami damage caused by shocks/eruptions not covered-Law & ordinance not covered-Masonry Veneer not covered, unless less than 10%of outside wallExpense Coverage Covers additional expenses to keep biz in operation. Limits are applied to recovery depending on the period of restoration.

Example Stated in Declarations as 40%/80%/100% meansless than 30 days-40% of full limit31-60 days 80% of full limitover 60 days 100% of full limitExtended Biz Income Pays for loss of income after operations have resumed for up to 30 daysFire Department Service Charge up to $1,000Glass Valuation RRCIncreased Cost of Construction Only available to property insured for replacement cost-Max, lower of%5 of Coverage A OR$10,000Higher limits available by endorsementMax Period of Indemnity Limits the period of indemnity to 120 daysMethods For Providing Coverage Specific Basis Blanket CoverageValue Reporting FormAgreed ValueMisc Property Forms & Endorsements -Difference in Conditions Insurance-Earthquake & Volcanic Eruption-Peak Season Endorsement-Radio Active Contamination Coverage-Protective Safeguards Endorsement-Leasehold Interest-Flood Coverage Endorsement-Ordinance or Law EndorsementMold $15,000 part of limitMonthly Limit of Indemnity Limits the amount of recovery to a fraction (1/3, 1/4, or 1/6) of policy limits recoverable every 30 days during the period of restorationNewly Acquired or Constructed Property $250,000 for 30 days

Newly Acquired Personal Property $100,000 for 30 daysNon-owned Detached Trailer $5,000Order of Civil Authority Pays biz income & extra expenses when civil authority stops access because of damage to neighboring area.-Up to 3 weeksOutdoor Property landscaping, signs(not attached)$1,000/$250 max per plantPeak Season Endorsement Increase content coverage for specified periods of timePeriod of Restoration Period of Coverage for Biz Income CoverageBeginsBiz Income-72 hours after direct damageExtra Expense- immediatelyEndsDate property should be repaired or biz resumes at new locationPersonal Property of Others $2,500, excludes theftPollutant Clean Up and Removal Covered if reported within 180 days of loss, will remove from water or landPreservation of Property 30 daysProperty NOT Covered a. Accounts, bills, currency, deeds, evidences of debt, money, notes or securities; b. Animals, unless owned by others and boarded by you, or if owned by you, only as "stock" while inside of buildings; c. Automobiles held for sale;d. Paved surfaces;e. Contrabandf. The cost of excavations, grading, backfilling or filling; g. Foundations of buildings, structures, machinery or boilers if their foundationsare below: (1) Lowest basement floor; or(2) Surface of the ground, if there is no basement; h. Land, growing crops. or lawns; i. Personal property while airborne or waterborne; j. Pilings, piers, wharves or docks;k. Property that is covered under another coverage form l. Retaining walls that are not part of the building m. Underground pipes, flues or drains;n. The cost to research, replace or restore the information on valuable papers and records, including those which exist on electronic or magnetic media, except as provided in the Coverage Extensions; o. Vehicles or self-propelled machines (including aircraft or watercraft) that:

(1) Are licensed for use on public roads;(2) Are operated principally away from the described premises; or(3) You do not manufacture, process, warehouse or hold for sale. does not apply to rowboats or canoes out of the water at the described premises; p. The following property while outside of buildings:

(1) Grain, hay, straw or other crops;

(2) Fences, radio or television antennas, signs (other than signs attached to buildings), trees,shrubs or plants, all except as provided in the Coverage Extensions.Property Off Premise Up to $10,000 if:a. Temporarily at a location the insured does not own, lease or operate;b. In storage at a non-owned locationc. At any fair, trade show or exhibitionProtective Safeguards Endorsement Attached to policy when the following have been installed-Auto Sprinkler System-Auto Fire Alarm-Security Service-Service ContractIf insured cannot restore a broken Auto Sprinkler System in 48hrs, insured must be notified else fire coverage can be voidedSpecial Cause of Loss Form Open Perils

Exclusions:Loss of Market Agricultural smudgingSmog Wear and tearPollutants Mechanical breakdown*Settling, cracking, shrinking *Rust, corrosion, fungus, decay, deterioration, hidden or latent defects.*Damage caused by insects or animals* Explosion of steam boilers, pipes and engines* Dishonest or criminal acts of insured employees * Voluntary parting with property by fraud or trick * Rain damage to Personal Property not in a building* Loss resulting from acts or decisions, * Collapse (except under additional coverage)* Faulty workmanship or repair* Artificially generated electric current * The enforcement of any law or ordinanceSpoilage Endorsement Covers perishable goods due to power outage, mechanical break down, or contaminationStock Valuation if already sold, valued at net selling priceTenants Improvements Valuation -If repaired promptly- ACVelse proportion of original costTime Element-Business Income Coverage Provides protection for Indirect Loss that occurs when, operations cant resume until repairs are competed and extra expenses in attempt to keep operations running3 Forms1. Biz Income w/ Extra Expense2. Biz Income w/o Extra Expense3. Extra Expense OnlyVacancy Condition If vacant for more than 60 days before the loss (or less than 31% of building occupied), the insurer will not pay for loss due to vandalism, water damage,

theft or attempted theft, building glass breakage, or sprinkler leakage (unless protected against freezing). In addition, a covered loss will be reduced by 15%Valuable Papers and Records $2,500Valuation -Most Losses- ACV-If coinsurance 80% & loss less than $2500-RRCValue Reporting Form Bases the insured's premium for business personal property on the values that the insured reports periodically during the policy period.

7. GA Auto-PersonalEligibility Requirements 1. Four wheel vehicle owned or leased (for at least 6 months)2. Not over 10,000 GVW 3. Not used for business purposeExtended Non-Owned Liability Endorsement Broader coverage for driving non-owned autoMisc Vehicles Endorsement Motor homes, motorcycles, mopedsNamed Non-Owner Endorsement Used for persons that don't own a vehicle, but would like there own coverage when driver non owned vehiclesNo Fault Insurance Endorsement Pays insured, up to a specified limit, for certain expenses. After exhausted will need to seek legal action against the person at fault for the rest of recoveryOccupying -in a vehicle; -upon a vehicle; -getting into, onto, out of, or off of a vehiclePAP 3rd Party Policy Coverage some 1st Party Coverage by Endorsement-CoveragePart A-LiabilityPart B-Medical PaymentPart C-Uninsured MotoristPart D-Physical Damage-ConditionsPart E- Duties After an AccidentPart F- General ProvisionsPart A Coverage -Liability coverage may be written alone or with any of the other parts-Written as a split or single limit

GA min 25/50/25Part A Exclusions -Damage to property owned or being transported-Damage to property rented, used, or in the care of insured except for non owned residence & garages-BI to an employee, except domestic worker that doesnt qualify for Workmans Comp-Vehicle used to transport people or property for a fee-While engaged with a business that is selling, repairing, servicing or parking vehicle

-Person doesnt have permission to use vehicle-Motorized vehicle with less than 4 wheels EXCEPT*Being used in medical emergency*Owned or non-owned trailers*Non-owned golf cartsPart B Coverage Medical PaymentsCovers expenses for insured, any family member, and any other person while they are occupying a covered auto for any auto related (including being hit while a pedestrian) incident-Medical Expenses incurred within 3 years of accident-Funeral expensesPart B Exclusions Excludes BI caused-While operating vehicle w/less than 4 wheels-While carrying people or property for a fee-While occupying a vehicle used as a residence-To employees if workers comp benefits are requiredPart C Coverage Uninsured Motorist-Pays the insured & occupant for BI claims they are legally able to recover, but cant, from an uninsured or under insured motoristIn GA-Must be carried unless rejected in writing by insured-Must include loss of use coverage-Physical contact required, unless eye witness can corroborate-No distinction between uninsured & underinsuredPart C Exclusions Doesn't cover vehicles:-Owned or available for regular use by insured or any family member-Owned or operated by a self insured-Designed for off road use-Used as residencePart D Coverage Physical Damage Coverage-Collision-ComprehensiveCoverage for non owned vehicles will be on an excess basisPart D Limits Limit of liability lesser of:1. ACV2. Repair/Replacement cost-$1,500 Non owned trailer-$1,000 after market permanetly installed sound systemPart E Duties After an Accident or Loss-Immediatly notify police in the event of Hit & Run, TheftPart F General Provisions Cancellation-10 day noticeNon paymentWithin 60 days of initial policy

-20 days notice for all other *If policy in effect for longer than 60 days can only be cancelled for1. Misrepresentation in obtaining policy2. License suspended or revoked3. Non-payment of premium

Non Renewal-30 days noticeTowing & Labor Endorsement Coverage at break down location for towing & labor up to $25,50,75,100Transportation Expense Supplemental Coverage-$20/day max $600 Physical Damage-24 hr wait periodTheft-48 hr wait periodWho is an insured Any relative or member of the insureds householdAny person given authority to use the vehicle

8. GA Workers CompensationBenefits MedicalIncomeRehabilitationDeath & BurialCatastrophic Injury Benefits -2/3 weekly pay up to max allowed by law, until employee is able to returnCivil Penalties Violation of Rules-$100-$1000 per violationFalse Statements-$1,000 - $10,000 per violationNot Providing Coverage- $500 - $5,000Common Law Duties of Employers 5 duties employers have to provide "reasonable care"1. Provide a safe place to work2. Provide an adequate number of competent workers3. Provide safe tools & equipment4. Warn of dangers5. Make & enforce safety rulesConformed Panel of Physicians -Min of 10 physicians or professional associations-Same requirements of Traditional PLUS*Chiropractor*General SurgeonCriminal Provision Refusing or willfully neglecting to provide coverage is a misdemeanor, punishable by -Fine $1,000 - $10,000 - Up to 1yr imprisonment-Or bothFailing to Provide Coverage Still held responsible for compensable injuries

-Board may assess attorney fees, civil penalties, and 10% increase in compensation to employeeFederal Employees Compensation Act Non military federal employees are given no-fault workers compensation benefitsFederal Employers Liability Act Railroad employeesFour Classifications of Disability 1. Permanent Total-can no longer work2. Permanent Partial- permanent impairment 3. Temp Total- can do no work, but expected to recover4. Temp Partial-cant return to same work, but can do "light duty"General Section Five General Provisions1. Policy2. Who's insured3. Workers Compensation Law in the state insured4. State insured in5. LocationsIncome Benefits Entitled to weekly income benefit if they have more than 7 days of loss time. -Check must be mailed within 21 days after injury-Payment for the 1st 7 days payable after 21 consective days of disability-Employee that receives regular wages during disability are not entitled to weekly benefits for the same periodInformation Page Declarations PageThe Jones Act Allows crew members of a vessel to sue employers for negligence that results in injury or death.Medical Benefits No dollar or time limit.Medical Care for Injured Employees One of 3 Options1. Traditional Panel of Physicians2. Conformed Panel of Physicians3. Workers Compensation Managed Care Organization-Employer must post in prominent place type of panel chosen-Employee may select any physician on panel and make one change to any other physician on the panel w/o approval from employer.-Employers must fully explain the purpose of the panel to all employees and assist in obtaining medical careNon Catastrophic -2/3 weekly pay for up to 400 weeksNotice of Cancellation by Insurer 75 daysPart 1 Workers Compensation Insurance-Covers the benefits required to be paid by the employer by the workers compensations laws of the statePart 2 Employers Liability InsuranceCovers employer's legal liability for bodily injury that occurs1. During policy period2. Outside the scope of state & federal workers comp laws3. Was not caused intentionally by the employer4. Is not excluded by other conditions in the policy

Four types of damages insurer will pay1. 3rd Party over actions2. Care & loss-including from family members of employee3. Consequential bodily injury-to a immediate family member4. Dual capacity- including claims where employer was acting in a capacity other than employerPart 3 Other State Insurance-If a state in in the Other State field on information page the policy will automatically cover claims in that statePart 4 Duties if Injury Occurs-Must provide medical services required by injured party, report injury to insured and cooperate with the investigation and settlement of claimPart 5 Premium-Describes how the policy's premium is determined-Insurer has right to audit records for 3 years after policy has expired and adjust final premiums accordinglyPart 6 Conditions-General conditions-Insured has right to inspect workplace conditions at any timeParts of the Standard WCP Form NCCI -Information Page-General Section-Part 1-6Premium Determination in the Standard Policy Form Work Classification Rates-Rate per $100 of payrollExperiance Modification Factor-Discount of premiums if yearly loss is lowReporting Immediately, upon knowledge, to insurer Within 21 days to the Board for injuries longer than 7 daysSelf Insurance Must be approved by the Board & Trust Fund-3 years financial statement-$500 application fee If approved-Surety bond or letter of credit based off financial statementsSurvivor Benefits -2/3 average weekly wagesDependent Children-18 years old or enrolled in Higher Ed til 24 yearsSpouse-Until RemarriedTraditional Panel of Physicians At least 6 non associated physicians-1 Orthopedic-No more than 2 physicians from industrial clinics-Must include a minority physician if possibleWorkers Compensation Workers injured at work lose their common law right to sue their employers for negligence in exchange for certain benefits without having to prove fault-Required in GA for any business employing 3 or more people

Workers Comp Managed Care Organization Plan certified by the Board the provides the delivery and management of treatment under the GA Workers Compensation Act-Must include a minority providersWorkers Under Federal Jurisdiction 1. US Longshoremen's & Harbor Workers2. Federal Black Lung (miners)

9. Inland MarineAccounts Receivable Form Covers sums due to the insured from customers that are not recoverable due to loss of accounts receivable recordsAnnual Transit Policy Protects shipper or receiver of goods against loss to goods in transit. Covers all of the insured's incoming or outgoing shipments during the yearCoverage is available on as a named or open peril basisBailee Forms Covers losses to customers' property in the care, custody, or control of the insuredBusiness Floaters Accounts Receivable-controlledValuable Papers & Records-controlledInstallation Coverage-controlledSign Coverage-controlledElectronic Data Processing (EDP)Commercial Articles Form Coverage for commercial cameras, musical instruments, related equipment, and similar property of others while in insured's careCommercial Property Floaters Equipment FloatersBusiness FloatersBailee Forms & Dealer's PoliciesContractors Equipment Form Largest class of inland marineNamed or open peril basis at the insurer's choiceBlanket coverage (Large contractors, small items) Scheduled (small contractor, large items)Domestic Shipment Forms Uncontrolled forms-Annual Transit Policy-Trip Transit Policy-Motor Truck Cargo PolicyElectronic Data Processing (EDP) Form Usually provided on Open Peril basisCovers both hardware & software damage to computer systemsEquipment Floaters Contractors Equipment-uncontrolledCommercial Articles-uncontrolledPhysicians & SurgeonsInstallation Coverage Form Named or Open Peril coverageCovers property sold by the insured that must be transported to another location and installed

Instrumentalities of Transportation & Communication UncontrolledCoverage for damage to bridges, tunnels, dams, pipelines, piers, docks, radio & TV towersJewelers Block Form Form that covers the merchandise of retail jewelers, including similar property of others in the insured's care, custody, or control.Two Optional Coverage's-Show Windows Coverage- theft from show window that has been cut or smashed-Money Coverage- theft of money from locked safes or vaults insured's premisesMotor Truck Cargo Policy Protects carrier from liability for loss to domestic shipments in transitNationwide Definitions Six categories of eligible marine risks:1. Imports (Ocean Marine)2. Exports (Ocean Marine)3. Domestics shipments4. Instrumentalities of transportation or communication5. Personal property floater risks6. Commercial property floater risks

Usually what makes property eligible is its portability. As a general rule, inland marine insurance does not cover stationary property.Personal Articles Floater -All risk-Scheduled basis -Usually requires an appraisal for accurate description and proper valueCovers 9 categories1. Jewelry2. Furs3. Cameras4. Musical Instruments5. Silverware6. Golf equipment7. Fine Arts8. Stamps9. CoinsPersonal Effects Floater Coverage while traveling or vacationing for items usually carried or wornPersonal Property Floater All risk, unscheduled basis for 13 basic categories of personal property with a separate limit of insurance for each categoryPersonal Property Floaters Coverage for movable property wherever it may be located.Three Floaters1) Personal Articles2) Personal Property3) Personal EffectsPhysicians & Surgeons Equipment Form Open peril coverage for owned equipment both on and off premisesSign Coverage Form Covers signs of the insured and similar property in the care of the name insuredTrip Transit Policy Protects single shipments of specifically described property while in transit from departure to destination and temporary storage along the way.

Valuable Papers & Records Form Coverage for documents, manuscripts, or records of the insured or the property of others in the insured's custody

10. Misc Policies-AviationAdmitted Aircraft Liability (Optional) N/A for passengers carried for hireProvides principle sum payments for death or dismemberment if:1) Insured request for payment to be made2) The company will be released from further liabilityAircraft Hull Policies Not StandardizedGenerally 2 options1) All risk while not in motion Named risk while in motion2) All risk whether in motion or notAircraft Liability Similar to auto liability except:Liability to passengers is a separate exposureAir Meet Liablity Provides coverage for air meets and showsAirport Liability Protect owners and operators of private, municipal, and commercial airportsDeductible % value of aircraft-Doesn't apply to loss form fire, lightning, explosion, transportation, theft, robbery, or pilferage-Does apply to in motion coverage for fire or explosion resulting from collisionHangarkeeper Liability Open Peril coverageProtects insured against injury or destruction to aircrafts of others in the custody of insured for storage, repairMedical Payments Provides medical expenses for BI by accident without regard to legal liabilityMedical payment for crew can be added for an additional premiumPilot Warranty States who may fly the aircraft and be covered. Two forms of coverage -Named Pilot-specifically lists name of covered pilots-Open Pilot- list min. pilot qualificationsProduct and Cargo Liability Protects against legal liability for loss or damage to cargo or baggageUnderwriting Considerations -Pilots-Size-Type-Age & condition

11. Ocean MarineCargo Insurance Covers loss or damage to the ships cargo while in transit over water-Break Bulk-Loose cargo (ie cartons stowed in the ships hold)-Containerization-Containers interchanged between trucks without having to rehandle contents-Bulk Shipments-loaded directly onto ship (ie coal)-Demurrage-compensation for delaying a ship carrying freightWarehouse to warehouse-Covers land transport from pick up to drop off pointsFreight Insurance Indirect Loss

Reimbursement or payment for shipping charges when ship and/or cargo is lost or damagedGeneral Average Loss is shared by all parties (owners of ship, cargo, & freight) in proportion to their interest, from a partial loss which resulted from a voluntary sacrifice made to benefit all concerned (ie jettison)Hull Insurance Covers loss or damage to the ship by a covered perilInchmaree Clause Adds coverage to an ocean marine cargo policy for loss resulting from bursting of boilers, breakage of shafts, latent defects in the vessel, or faults or errors in the navaigation or management of the vesselOcean Marine Four Coverage's-Hull -Cargo-Freight -Protection & Indemnity (P&I)Ocean Marine Implied Warranties 1. voyage must be legal2. vessel must be sea worthy3. cargo must be properly packed4. there must be no deviation in the planned route of the voyage***Ocean Marine Named Peril Coverage Perils OF the sea-wind, wave action, collision, stranding, sinking, or capsizingPerils ON the sea-fire, lightning, earthquake, pirates, jettison, barratry

Jettison-throwing cargo overboard to save ship Barratry-wrongful acts committed by the crew without the ship owner's knowledgeParticular Average Only party having an interest in the lost or damaged property will cover the lossProtection & Indemnity Coverage Provides marine legal liability arising out of the operation of the ship• Loss of life and bodily injury or illness;• To seamen for injuries resulting from unseaworthiness of the vessel, for other job injuries or sickness, and general damages under the Jones Act for injuries caused by negligence; • To stevedores, longshoremen, and harbor workers;• For cargo, if lost or damaged through negligence;• For damage to other property, including fixed objects. Excluding, damage to another vessel or any property aboard it caused by collision with the vesselSalvage Marine Law for life saving, no salvage rewardSalvage Reward for property, requirement for reward-Property must be in peril from some hazard-Salvage service must be voluntary-Must be successfulTotal Loss -Total Destruction- Physical destruction-Loss of Specie-Property so damaged its not recognizable as the item shipped (ie cement wet by water and hardening)-Irretrievable Deprivement-The owner has been deprived of the use of the property even though its not damaged (gold coins lost overboard)-Vessel Lost-The ship is posted as missing at Lloyds of London

12. P&C Policy Contract ProvisionsAleatory Contract Execution of contract depends on an uncertain, random event which sums paid by parties are unequal value. Insured pays small premium, but receives large coverage pay out.Apparent Authority Authority that a normal prudent person would think or be lead to believe the agent has.Appraisal Clause Used when the insured and insurer agree that the loss is covered, but the amount of loss is in dispute.Each party selects an appraiser to determine value of loss. If value of loss cant be agreed upon, the appraisers choose an umpire to decide value.Arbitration Clause In the event of a dispute, the parties will submit the dispute to arbitration rather than litigate the dispute in court.Assignment Policy can't be assigned to another party without the consent of the insurance companyCharacteristics of an Insurable Risk Risk must beC-Calculable (calculate chance of loss)A-Affordable N-Non catastrophic (earthquakes)H-Homogeneous exposuresA-AccidentalM-Measurable (cause economic hardship)Claim Settlement Options PROPERTY-Repair-Replace with like kind & quality-Replace with new-Fair value for damaged property▬Insured should be indemnified but not profit from a loss

LIABILITY-Special Damages-General DamagesClaim Settlement Release Options -Full Release Settlement-Scheduled/Open Ended Payment Release -Payment of BI/PD Pending-No Release -Advance Payment-Structured Settlement-Rehabilitation-Draft Authority-Subrogation ProceduresComprehensive Personal Liability Non-business liability exposure of individuals who are insured under policy. The most common personal liability exposures arise out of the residence premises and activities of individuals and family members. Comprehensive personal liability coverage first became available as a separate policy. Eventually it was incorporated into Homeowners policies.Concealment Failure to reveal relevant facts known to the insuredConditional Contract The contract may be voided if all policy conditions are not met

Conditions Sets provisions, rules of conduct, duties, and obligations for the partiesContract of Adhesion The contract must be accepted by insured exactly as written by insurerContribution by Equal Shares Other insurance clauseAll insurers to contribute equally up to the limit of the policy,until the loss is paid in full or until all policy limits are exhausted.Declarations Contains 6P's 1. Person Name & Address2. Property Description or Schdule of Coverage Parts3. Policy Number4. Policy term5. Policy limit6. Premiumand a list of any EndorsementDuties of Insured After A Loss -Prompt notification of loss-Protect damaged property from further loss-Separate damaged from undamaged property -Provide written proof of loss -Provide inventory of damaged property -Cooperate with the insurerElements of a Contract C-Competent partiesL- Legal objectiveA- Agreement: C- Consideration: exchange of values (money for service)Endorsements Amendments attached to the policy to broaden or restrict coverage, or to further define certain policy provisions.Endorsements Used to add, delete, or change any of the policy partsExclusions Whats not coveredExpress Authority Authority specifically given to the agent either in writing or orally.Implied Authority Authority to do things not specifically authorized in order to carry out express authorityInsuring Agreement Describes how coverage is provided by insurer & perils coveredLoss Payable Lienholder of personal property will be compensated first, then all access will be paid to insured (ie car loss)Misrepresentations Untrue statement made by insured.Mortgagee Rights It provides for payment to to mortgagee as well as the insured, based on their interest in the property. Also grants payment if loss intentionally caused by insured. Must be notified if policy cancelled or not renewedNotice of Claim Notice to the insurer that payment is requested for a covered loss, subject to all of the conditions and exclusions of the policy.

Other Insurance if insured has other sources of recovery for a covered claim, in order to avoid over indemnification:-Primary: primary policy pays first up to the lesser of its limit or amount of loss -Excess: excess policy pays after primary limits are exhausted -Pro rata liability: amount paid for a loss is proportionate to the total loss as the amount of coverage bears to the total coveragePersonal Contract Insures the person who own the property, not the property itselfPolicy Structure D - Declarations page I - Insuring agreementC - ConditionsE-ExclusionsE-Endorsements (Riders)Proof of Loss A written, signed, and sworn-to statement by the insured listing property damaged or lost due to covered claim.Representations Statements made that are believed to be true, but are not guaranteed to be true. Not a consideration of a contract so policy cant be voidedSpecial Features of Insurance Contracts -Unilateral Contract-Aleatory contract-Contract of adhesion-Conditional Contract-Personal ContractSubrogation After payment of a covered claim that was caused by another party, the insurance company is entitled to seek recovery from the negligent partyTypes of Adjuster Reports Initial/Field-Results of initial investigationInterim-Interval reports on the status of the claimFull-Final RepotUnilateral Contract Only enforced by one party. Only insurer is legally bound to perform.Warranty Statement that is considered to be a guarantee 100% of the time

13. Professional Liability InsuranceConsent to Settle Clause Insurer must obtain insured's consent before settling any claimDirectors & Officers Liability Covers individual directors & officers of a corporation for wrongful acts while acting in official capacity. Also covers the corporation for amount stated in by-laws to reimburse directors & officers for defense & damages caused by legal proceedingsEnvironmental Liability Coverage for unintentional bodily injury and property damage that arises out of the discharge, release, dispersal or escape of smoke, vapors, soot fumes, acid, toxic chemicals or irritants. Also provides coverage for the accidental discharge of pollutants or contaminants in or upon land , atmosphere, or any body of water.Fiduciary Legal Liability Coverage 1. Employee Retirement Income Security ACT (ERISA)Covers employer's honest error & omissions for qualified retirement plans2. Employee Benefits & Counseling Errors & Omissions

Covers employers honest error & omissions in explaining employee benefitsProfessional Liability Protections against legal liability from failing to render professional services-Medical Professional Liability (Malpractice)-Errors & Omissions (Non Medical)

14. Umbrella/Excess liabilityLiability Coverage -Higher limits-Covers exposures that are limited or excluded by other underlying coveragesSettlement Pays after underlying insurance limits have been exhausted and deductible has been paidUmbrella Policy Offers Broader Coverage-World Wide Coverage-Blanket Contractual Liability-All property in care, custody, or control of insured-Owned & Non-owned auto, aircrafts, and boats-Personal Injury