Hospitality and Liquor Liability Product

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1 Hospitality and Liqor Liability Prodct Depending on the laws in yor state, yo may be held liable for the actions of intoxicated or nderage persons yo serve The negligent service to an intoxicated or nderage person can prodce sbstantial verdicts or settlements Employers may be held liable for the actions of employees who sell or serve alcohol in violation of state laws Even if an establishment is not fond liable, it may cost hndreds of thosands of dollars to defend a claim Underage drinkers make p a significant portion of alcohol-related traffic crashes Why yo shold prchase the USLI Liqor Liability policy? The following are important coverages to have in yor policy. Check to make sre yo have all of these featres. Expense costs otside policy limits COVERAGE FEATURES USLI COMPETITORS Assalt or battery coverage available on most acconts p to fll limits Atomatic coverage for liqor license holder as additional insred Separate liqor liability limit from the general liability limit No dedctibles Aggregate per location endorsement offered for risks with mltiple locations Disconted online alcohol awareness training for employees of policyholders Schedled eqipment is atomatically registered in the National Eqipment Registry Theft database Established and stable liqor market for over 25 years Specialized claims team with over 25 years of experience in defending and mitigating liqor liability claims A.M. Best rated A ++ carrier A prod member of the Berkshire Hathaway Grop Policyholders have access to many services throgh or Bsiness Resorce Center that will assist in growing and protecting their bsinesses P *Basic Form prodct and adlt entertainment are not eligible in Iowa This docment does not amend, extend or alter the coverage afforded by the policy. For a complete nderstanding of any insrance yo prchase, yo mst first read yor policy, declaration page and any endorsements and discss them with yor agent. A sample policy is available from yor agent. Yor actal policy conditions may be amended by endorsement or affected by state laws. LL-POS-4/15

2 Retail Store Liqor Liability Prodct This prodct targets Retail Stores that sell, serve or distribte alcohol for off-premises consmption. Prodct Featres: Broad appetite for virtally all small to medim sized retail store classes Credits available for responsible establishments with a thirdparty server awareness training program Expense costs are otside the limit of liability No dedctible Assalt or Battery coverage available in most states Atomatic coverage for liqor license holder as an additional insred Limits p to $1,000,000 each common case/$2,000,000 aggregate Aggregate per Location Endorsement offered for risks with mltiple locations Landlord and Grantor of Franchise may be named as an additional insred for a nominal additional premim Additional Advantages: A.M. Best rated A++ carrier Established Liqor market for over twenty-five years Specialized Claims Unit with Expertise in Liqor Liability Qick qote trnarond Low minimm premims Policyholders have access to many services throgh or Bsiness Resorce Center that will assist in growing and protecting their bsinesses * In OH, ND, WA, WY Eligible Classes Inclde: Liqor stores, with and withot wine tastings on premises Convenience/Deli/Grocery stores Package stores Gas stations/mini Marts Retail and Wholesale Distribtors This docment does not amend, extend or alter the coverage afforded by the policy. For a complete nderstanding of any insrance yo prchase, yo mst first read yor policy, declaration page and any endorsements and discss them with yor agent. A sample policy is available from yor agent. Yor actal policy conditions may be amended by endorsement or affected by state laws. RS-NR 11/15

3 Retail Stores Liqor Liability Prodct Claim Examples A 16-year-old boy prchased beer from a local retail store where his ID was not checked. He took the beer to an nderage drinking party. Several hors later, his 20 year-old sister arrived to take him home, and she also consmed some beer. After they left, she lost control of her convertible which flipped over and killed her brother. The mother of the deceased filed sit against the retail store. Even thogh the person who cased the accident did not actally prchase the alcohol, the retail store was held liable de to the illegal sale to a minor. The claim settled for $580,000 in damages and expense costs totaled an additional $100,000. A 19-year-old was consming beer he prchased at a local gas station when he crashed his car into a tree. The passenger in his vehicle sstained significant brain damage, fractred legs and other internal injries. The passenger sed the gas station for selling alcohol to a minor. The claim settled for the fll policy limits of $1,000,000. A convenience store denied service to a patron who appeared intoxicated. The patron was later involved in an atomobile accident. Despite denying service, the convenience store was named in the sit. Ultimately, the convenience store was not fond liable, bt expense costs totaled $75,000.. An adlt woman prchased a bottle of alcohol at a local liqor store. Her hsband previosly instrcted all nearby stores not to sell alcohol to her becase she was an alcoholic. The day after prchasing the bottle of alcohol, it was discovered that the woman drowned after falling or jmping off a bridge. The deceased s family broght sit against the liqor store for selling alcohol to a known habital drnkard, and the case settled for $850,000. The Bsiness Resorce Center is available to all insreds with disconts on backgrond check services, tenant screenings, motor vehicle records and other great services! This docment does not amend, extend or alter the coverage afforded by the policy. For a complete nderstanding of any insrance yo prchase, yo mst first read yor policy, declaration page and any endorsements and discss them with yor agent. A sample policy is available from yor agent. Yor actal policy conditions may be amended by endorsement or affected by state laws. RS-CE 11/15

4 CARRIER: Liqor Liability Warranty Application Retail Stores, Liqor Stores and Wholesale Operations All States Exclding Texas YOU CAN OBTAIN A QUOTE BY PROVIDING THE INFORMATION IN SECTION I - INSTANT QUOTE BELOW, SUBJECT TO THE REMAINDER PROVIDED PRIOR TO BINDING. I. INSTANT QUOTE INFORMATION Instant Qote is only available for acconts with no losses or violations in the past five years. Applicant s name: Location address: q Same as mailing address. City: State: Zip code: Nmber of locations to be insred: (complete one application per location) Description of Operations: What year did the applicant start bsiness at this location? Liqor Liability Section Each common case limit: $ Aggregate limit: $ Exposre basis: Retail alcohol receipts: $ Wholesale alcohol receipts: $ Does applicant offer on-premises tasting or sampling of alcoholic beverages? q Yes q No If Yes, complete the following: a. Are more than eight onces of samples permitted for any one patron per day? q Yes q No b. If persons other than the applicant s employees are serving the samples, are they reqired to carry their own liqor liability insrance at limits eqal to or greater than the applicant s? q Yes q No Does applicant deliver alcoholic beverages to their cstomers? q Yes q No If Yes, complete the following: a. Is alcohol only delivered to individals age 21 or over with proper identification and signatre reqired? q Yes q No b. Does applicant deliver to any of the following states: AK, AL, IA, IL, LA, MS, OR, RI and WV? q Yes q No Does the establishment attract a predominantly yothfl crowd ranging from years of age? q Yes q No What time does the sale of alcohol cease? q a.m. q p.m. q 24 hors Are all alcohol-serving employees certified in a formal alcohol awareness training corse not mandated by the state? q Yes q No If Yes, provide the name of the corse: To be eligible for a credit on yor qote, company reqires copies of the certificates within 21 days of binding Does the establishment have and tilize an identification scanner device to verify age of patrons? q Yes q No Additional Interests Name Relationship/Interest Address City, State, Zip II. ELIGIBILITY CRITERIA 1. Applicant has no knowledge of any liqor liability and/or assalt and battery claims or the notification of potential liqor liability and/or assalt and battery claims at this location within the past five years. q Tre q False If False, provide the following information on each claim: Date(s): Description(s): Total incrred losses (reserves and payments): Stats(open or closed): Measres in place to prevent ftre violations: 2. Applicant has no knowledge of any fines or citations for violation of law or ordinance related to illegal activities or the sale of alcohol at this location within the past five years. q Tre q False If False, provide the following information on each fine or citation: Date(s): Description(s): Measres in place to prevent ftre violations: LLA RET 7/14 USLI page 1 of 3

5 3. Applicant or any principal with a controlling interest in the applicant has not filed for bankrptcy in the last 12 months. q Tre q False 4. Applicant is not reqesting liqor liability limits greater than the general liability limits carried. q Tre q False As a condition of coverage, general liability limits mst be maintained at limits eqal to or greater than liqor liability limits. 5. Applicant has and will maintain a valid liqor license, if reqired by ordinance or law, prior to the applicant selling serving or distribting alcohol. q Not Reqired q Tre q False 6. Employees or other persons selling or serving alcohol are not permitted to consme alcohol dring their hors of employment or service. q Tre q False 7. Applicant does not sell or serve alcohol away from the premises. q Tre q False If Off-premises coverage is desired, attach a completed Catering Pls Spplemental Liqor Liability Application, form CP-APP, to this sbmission. 8. Within the past five years, applicant s liqor liability coverage has not been cancelled or non-renewed. (not applicable in Missori) q Tre q False If False, explain: III. ADDITIONAL APPLICANT INFORMATION Form of Bsiness: q Individal q Corporation q Partnership q LLC q Other Applicant s mailing address: (if different than the location address above) City: State: Zip code: address of primary contact: Phone: Inspection contact name: Telephone/ address: Adit contact name: Telephone/ address: FRAUD STATEMENTS Alabama, Arkansas, District of Colmbia, New Mexico, Rhode Island and West Virginia: Any person who knowingly presents a false or fradlent claim for payment of a loss or benefit or knowingly presents false information in an application for insrance is gilty of a crime and may be sbject to fines and confinement in prison. Colorado Frad Statement: It is nlawfl to knowingly provide false, incomplete, or misleading facts or information to an insrance company for the prpose of defrading or attempting to defrad the company. Penalties may inclde imprisonment, fines, denial of insrance and civil damages. Any insrance company or agent of an insrance company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or claimant for the prpose of defrading or attempting to defrad the policyholder or claimant with regard to a settlement or award payable from insrance proceeds shall be reported to the Colorado division of insrance within the department of reglatory agencies. Florida Frad Statement: Any person who knowingly and with intent to injre, defrad, or deceive any insrer files a statement of claim or an application containing any false, incomplete, or misleading information is gilty of a felony of the third degree. Kansas Frad Statement: Any person who, knowingly and with intent to defrad, presents, cases to be presented or prepares with knowledge or belief that it will be presented to or by an insrer, prported insrer, broker or any agent thereof, any written statement as part of, or in spport of, an application for the issance of, or the rating of an insrance policy for personal or commercial insrance, or a claim for payment or other benefit prsant to an insrance policy for commercial or personal insrance which sch person knows to contain materially false information concerning any fact material thereto; or conceals, for the prpose of misleading, information concerning any fact material thereto commits a fradlent insrance act. Maine Frad Statement: It is a crime to knowingly provide false, incomplete or misleading information to an insrance company for the prpose of defrading the company. Penalties may inclde imprisonment, fines or a denial of insrance benefits Maryland Frad Statement: Any person who knowingly or willflly presents a false or fradlent claim for payment of a loss or benefit or who knowingly or willflly presents false information in an application for insrance is gilty of a crime and may be sbject to fines and confinement in prison. New Jersey Frad Statement: Any person who incldes any false or misleading information on an application for an insrance policy is sbject to criminal and civil penalties. New York Frad Statement: Any person who knowingly and with intent to defrad any insrance company or other person files an application for insrance or statement of claim containing any materially false information, or conceals for the prpose of misleading, information concerning any fact material thereto, commits a fradlent insrance act, which is a crime and shall also be sbject to a civil penalty not to exceed five thosand dollars and the stated vale of the claim for each sch violation. Oklahoma Frad Statement: WARNING: Any person who knowingly, and with intent to injre, defrad or deceive any insrer, makes any claim for the proceeds of an insrance policy containing any false, incomplete or misleading information is gilty of a felony. Oregon Frad Statement: Notice to Oregon applicants: Any person who, with intent to defrad or knowing that he is facilitation a frad against an insrer, sbmits an application or files a claim containing a false or deceptive statement may be gilty of insrance frad. Kentcky, Pennsylvania AND Ohio Frad Statement: Any person who knowingly and with intent to defrad any insrance company or other person files an application for insrance or statement of claim containing any materially false information or conceals for the prpose of misleading, information concerning any fact material thereto commits a fradlent insrance act, which is a crime and sbjects sch person to criminal and civil penalties. Tennessee, Virginia and Washington Frad Statement: It is a crime to knowingly provide false, incomplete or misleading information to an insrance company for the prpose of defrading the company. Penalties inclde imprisonment, fines and denial of insrance benefits. Frad Statement (All Other States): Any person who knowingly presents a false or fradlent claim for payment of a loss or benefit or knowingly presents false information in an application for insrance is gilty of a crime and may be sbject to fines and confinement in prison. STATE NOTICES Arizona Notice: Misrepresentations, omissions, concealment of facts and incorrect statements shall prevent recovery nder the policy only if the misrepresentations, omissions, concealment of facts or incorrect statements are; fradlent or material either to the acceptance of the risk, or to the hazard assmed by the insrer or the insrer in good faith wold either not have issed the policy, or wold not have issed a policy in as large an amont, or wold not have provided coverage with respect to the hazard reslting in the loss, if the tre facts had been made known to the insrer as reqired either by the application for the policy or otherwise. LLA RET 7/14 USLI page 2 of 3

6 Florida Srpls Lines Notice: (Applies only if policy is non-admitted) Yo are agreeing to place coverage in the srpls lines market. Sperior coverage may be available in the admitted market and at a lesser cost. Persons insred by srpls lines carriers are not protected nder the Florida Insrance Garanty Act with respect to any right of recovery for the obligation of an insolvent nlicensed insrer. Florida and Illinois Pnitive Damage Notice: I nderstand that there is no coverage for pnitive damages assessed directly against an insred nder Florida and Illinois law. However, I also nderstand that pnitive damages that are not assessed directly against an insred, also known as vicariosly assessed pnitive damages, are insrable nder Florida and Illinois law. Therefore, if any Policy is issed to the Applicant as a reslt of this Application and sch Policy provides coverage for pnitive damages, I nderstand and acknowledge that the coverage for Claims broght in the State of Florida and Illinois is limited to vicariosly assessed pnitive damages and that there is no coverage for directly assessed pnitive damages. Maine Notice: The insrer is not permitted to withdraw any binder once issed, bt a prospective notice of cancellation may be sent and coverage denied for frad or material misrepresentation in obtaining coverage. A policy may not be nilaterally rescinded or voided. Minnesota Notice: Athorization or agreement to bind the insrance may be withdrawn or modified only based on changes to the information contained in this application prior to the effective date of the insrance applied for that may render inaccrate, ntre or incomplete any statement made with a minimm of 10 days notice given to the insred prior to the effective date of cancellation when the contract has been in effect for less than 90 days or is being canceled for nonpayment of premim. Ohio Representation Statement: By acceptance of this policy, the Insred agrees the statements in the application (new or renewal) sbmitted to the company are tre and correct. It is nderstood and agreed that, to the extent permitted by law, the Company reserves the right to rescind this policy, or any coverage provided herein, for material misrepresentations made by the Insred. It is nderstood and agreed that the statements made in the insrance applications are incorporated into, and shall form part of, this policy. THE INSURED UNDERSTANDS AND AGREES THAT ANY MATERIAL MISREPRESENTATION OR OMISSION ON THIS APPLICATION WILL ACT TO RENDER ANY CONTRACT OF INSURANCE NULL AND WITHOUT EFFECT OR PROVIDE THE COMPANY THE RIGHT TO RESCIND IT. Utah Pnitive Damages Notice: I nderstand that Pnitive Damages are not insrable in the state of Utah. There will be no coverage afforded for Pnitive Damages for any Claim broght in the State of Utah. Any coverage for Pnitive Damages will only apply if a Claim is filed in a state which allows pnitive or exemplary damages to be insrable. This may apply if a Claim is broght in another state by a sbsidiary or additional location(s) of the Named Insred, otside the state of Utah, for which coverage is soght nder the same policy. If yor state reqires that we have information regarding yor Athorized Retail Agent or Broker, please provide below. Retail agency name: License #: Agent s signatre: Main agency phone nmber: (Reqired in New Hampshire) Agency mailing address: City: State: Zip: The signer of this application acknowledges and nderstands that the information provided in this Application is material to the Insrer s decision to provide the reqested insrance and is relied on by the Insrer in providing sch insrance. The signer of this application represents that the information provided in this Application is tre and correct in all matters. The signer of this Application frther represents that any changes in matters inqired abot in this Application occrring prior to the effective date of coverage, which render the information provided herein ntre, incorrect or inaccrate in any way will be reported to the Insrer immediately in writing. The Insrer reserves the right to modify or withdraw any qote or binder issed if sch changes are material to the insrability or premim charged, based on the Insrer s nderwriting gides. The Insrer is hereby athorized, bt not reqired, to make any investigation and inqiry in connection with the information, statements and disclosres provided in this Application. The decision of the Insrer not to make or to limit any investigation or inqiry shall not be deemed a waiver of any rights by the Insrer and shall not estop the Insrer from relying on any statement in this Application in the event the Policy is issed. It is agreed that this Application shall be the basis of the contract shold a policy be issed and it will be attached and become a part of the Policy. Applicant s signatre: Title: President, Chairperson of the Board, Managing Member, or Exective Director Date: LLA RET 7/14 USLI page 3 of 3

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