Specialty Non Profit Package

Transcription

1 UNITED STATES LIABILITY INSURANCE GROUP A BERKSHIRE HATHAWAY COMPANY USLI.COM Specialty Non Profit Package THE ALL-IN-ONE POLICY DESIGNED FOR NON-PROFITS INCLUDING: DIRECTORS & OFFICERS LIABILITY AND EMPLOYMENT PRACTICES LIABILITY, BUSINESSOWNERS POLICY FORM (BOP), SPECIAL EVENTS AND OPTIONAL LIQUOR LIABILITY, AND PROFESSIONAL LIABILITY & ABUSE AND MOLESTATION FOR COUNSELING/REFERRAL ACCOUNTS. WHY DO YOU NEED TO PURCHASE A SPECIALTY NON PROFIT PACKAGE POLICY? Non Profits are sed by their employees, committee members, volnteers, and clients Over 90% of claims against non-profit organizations are Employment Practices related Nearly 85% of non-profits have an annal bdget that is less than the average cost to defend a claim closed by litigation All organizations need General Liability coverage against Bodily Injry and Property Damage claims. Conseling/Referral Centers have the additional Professional and Abse and Molestation exposre Nearly all non-profits have either a bilding or a bsiness personal property exposre Many non-profit organizations host special events off-site Why shold yo choose the United States Liability Insrance Grop s Specialty Non Profit Package Prodct? Maximize efficiency: One Application, One Qote, One Underwriter, One Policy, One Renewal, One Carrier for all claims, with one concrrent effective date The following are important coverages to have in yor policy. Make certain yo have all of these coverage featres: COVERAGE FEATURES OUR GROUP COMPETITORS POLICY Separate limits of Liability for D&O, EPL and GL claims Defense Otside the Limit of Liability on all claims Third Party Sexal Harassment and Third Party Discrimination coverage Lifetime Occrence Reporting Provision Optional Special Events/Liqor Liability Coverage available Mental Angish and Emotional Distress inclded in the General Liability definition of Bodily Injry Atomatic coverage for volnteers Flexibility of prchasing the D&O and BOP separately WHY CHOOSE TO BE INSURED WITH UNITED STATES LIABILITY INSURANCE GROUP? One of only 20 A++ rated insrance grops in the United States by A.M. Best. A prod member of the Berkshire Hathaway Grop, recently voted the #1 most admired Property & Casalty Company in the world (Fortne Magazine). Insre yor financial well-being with a stable Company that will be there to pay yor claim. 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 Broker. A specimen policy is available from an Agent of the Company. Yor actal Policy Conditions may be amended by Endorsement or affected by State Laws. SNPP-POS 1-09

2 Specialty Non Profit Package Prodct From a Chamber of Commerce to Booster Clbs and Fondations, USLI is the carrier of choice for all yor fndraising, charitable, and bsiness associations. Comprehensive coverage is crcial for nonprofits, given their limited bdgets and contless exposres. We offer a variety of tailored coverages that can be packaged together to address the insred s operations, special events, and management liability all on one competitively priced policy. Backed with an A++ A.M. Best rating, sperior cstomer service, and competitive pricing, USLI offers a comprehensive policy to meet yor needs. Preferred Package Featres: Available, bt not limited to chambers of commerce, fondations, trade associations, bsiness associations, charitable associations, booster clbs and membership associations Minimm premim of $500 for general liability and property combined Bsiness meetings & seminar are atomatically inclded No general liability dedctible General liability coverage inclded for volnteers Hired & non-owned ato coverage available in most states Property is on special form with replacement cost coverage Bsiness personal property coverage of $5,000 inclded Cstomize yor policy by adding employee dishonesty, money and secrities and other coverage options Additional Advantages: A.M. Best rated A++ carrier Available on admitted basis in most states Qick qote and binder trnarond Policyholders have access to many services throgh or Bsiness Resorce Center that will assist in growing and protecting their bsinesses Directors & Officers/Employment Practices Featres: Separate limits of liability for directors and officers and employment practices liability claims Unlimited defense costs otside the limit Otside directorship liability coverage Coverage for both monetary and non-monetary claims Fll prior acts coverage Lifetime occrrence reporting provision for former directors and officers Free hman resorces hotline with nlimited nmber of calls and no time limits (when EPL is prchased) No intentional acts exclsion on EPL Atomatically incldes 3rd party discrimination and harassment Special Events Featres: Blanket special event endorsement is available for events p to 2,500 attendees with host liqor inclded The first three events with p to 250 attendees are inclded within the policy premim Ability to consider events with p to 5,000 attendees on a schedled basis. Fll Liqor coverage is available on schedled events in most states Available for organizations with revenes p to $3,000,000 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. SNPP-NR - 06/15

3 USLI.COM Specialty Non Profit Package Claim Examples Non Profit Directors & Officers: The trstees of a trade association decided to expand their activities into areas that were not explicitly envisioned by the fonders. Their state s attorney general broght an action against them alleging misse of fnds and property for operating otside their charter, even thogh no third party had raised a complaint. A local chamber of commerce pblished a qarterly newsletter. The newsletter inclded a torism section, promoting places of interest, attractions, restarants, etc. A new restarant had recently approached the chamber with a reqest to advertise in the pcoming isse The chamber agreed and accepted a minimal advertising fee from the restarant. Upon release of the next isse, it was discovered that the Exective Director never expedited the restarant reqest and actally kept the money. The restarant in trn sed the chamber for breach of fidciary dty, breach of contract and interference with economic interests. A donor made a large contribtion to a fondation to aid stdents in need of tition. The board instead voted to expand their headqarters and commit a portion of the donation to the bilding fnd. The donor filed sit, alleging misappropriation of fnds. Damages inclded retrn of the fll contribtion pls interest. As some of the money was already spent, the fondation was financially nable to retrn the entire donation. The parents of a trobled teenager took their child to a conseling facility for help with depression. After talking at length with the teenager, the Conselor shrgged this off as typical teenage behavior. He sent the teenager home and schedled a follow-p visit. Unfortnately, the child committed sicide later that week. The parents filed a sit against the conselor alleging this wold not have happened had the conselor recognized the signs and referred their child to the proper facility. A drg addict revealed to his conselor that he was HIV positive. The conselor referred his client to a clinic to address his medical condition. The clinic reqested a copy of the client s file. The conseling facility released the information withot obtaining a signed release form. The client sed the facility for breach of the privacy act. Abse & Molestation: A 14-year-old girl went to a conseling agency and did not like her conselor. To avoid ftre visits, the girl stated the conselor improperly toched her The parents sed the facility. Special Events: A gest at a beer garden event sponsored by the chamber of commerce was strck on the head with a beer can thrown by a bartender. The gest filed a claim de to bodily injry. Employment Practices Liability: A chamber of commerce advertised an open position for a secretary. The organization received seven applications. Only one applicant was a male, who was 57. He was not interviewed. He alleged he was not interviewed becase of his age and filed sit against the organization for age discrimination. A tent at a designated fndraiser was not anchored properly. The tent blew over and damaged mltiple parked cars. The car owner sed for repairs. Professional Liability: The insred is a Family and Crisis Conseling operation. A family was directed by the cort to seek family conseling at this facility. There was an absive father in the family. The mother was trying to get a restraining order regarding child visitation rights for the father as a reslt of past mistreatment. The conselor at the facility was asked to made a recommendation. The conselor disagreed with the mother s opinion and recommended to the cort that the father be allowed to contine nspervised visitation. The father physically absed one of the children casing bodily injry. The mother sed the facility based on conselor s recommendation. 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 Broker. A specimen policy is available from an Agent of the Company. Yor actal Policy Conditions may be amended by Endorsement or affected by State Laws. SNPP-CLA (9/06)

4 USLI.COM Specialty Non Profit Package Package Policy designed for office based Non Profit organizations (inclding, bt not limited to Chamber of Commerce, Trade Associations, Bsiness Associations, Charitable Organizations, and Conseling and Referral Agencies). Type of coverage being reqested: Bsinessowners (General Liability and Property) Non Profit D&O Please fill ot the General Information section, along with the section(s) yo are reqesting coverage. SECTION I. General Information: 1. Name of Organization: 2. Mailing Address: Zip Code: 3. Location Address: Zip Code: 4. Description of Operation (inclding any activities, programs or services provided): 5. Prpose and Mission of the Organization: 6. Nmber of Years in Operation: 7. Does the organization have tax exempt stats as defined by the I.R.S.? Yes No 8. Website Address: 9. Address: 10. Inspection Contact: Phone: 11. Fnctioning Smoke Detectors in all common areas: Yes No 12. Annal Revenes: 13. Nmber of Members: SECTION II. Bsinessowners Liability: A. General Liability: 14. Limit of Coverage Selected: $300,000/$600,000 $500,000/$1,000,000 $1,000,000/$2,000,000 $1,000,000/$3,000, Check all that apply: Prodcts Sold - (Annal Sales) (Type of Prodct) Office owned or leased - (Sqare Footage) Membership Organization - (Nmber of members) Concession Sales - (Annal Sales) Hall Rental - (Sqare Footage) After school programs Overnight/Residential Retreat/Camp In Home Services Other 16. Details for above that are checked: 17. Have there been any general liability claims in the last 5 years? (If yes, please provide details separately.) Yes No 18. Additional Insred s to be inclded (List name, address and relationship to the applicant): B. Property (Complete this section for each location to be insred): 19. Bilding Address (if different than above): Zip Code: 20. Bilding Vale (at 80% Coinsrance/Replacement Cost): 21. Personal Property Limit (at 80% Coinsrance/Replacement Cost): 22. Total Sqare Footage of bilding: Area occpied by the Applicant-Sqare Footage: SNPP-4-08 page 1 of 4

5 23. Bilding Interest: (please check one): Owner Tenant 24. Bilding Age: Roof Age: 25. Bilding Constrction (please check one): Frame Joisted Masonry Non-Combstible Masonry Non-Combstible Fire Resistive 26. Protection Class (1-10): 27. Type of roof? Flat Wood Shake Shingle Metal Tile Slate Other 28. When were the following last pdated? Electrical Heating Plmbing 29. Is all electrical wiring on fnctional and operational circit breakers? Yes No 30. Is there any Alminm Wiring or Knob and Tbe Wiring? Yes No 31. Central Station Brglar Alarm: Yes No 32. Type of plmbing? PVC/Plastic Copper Iron Lead Galvanized Other 33. Loss Payee: 34. Mortgagee Clase (if applicable): 35. Have there been any property claims in the last 5 years? (If yes, please provide details separately.) Yes No C. Optional Coverage (Check if coverage is desired): 36. Conseling and Referral Services (Professional/Abse & Molestation) Please complete or Conseling and Referral Addendm, NPP ADD CRS. SECTION III. Optional Coverage (Check if coverage is desired): 37. Hired and Non Owned Ato a. Does organization have an atomobile policy in place? Yes No b Does organization own any atos or lease any atos on a long term basis? Yes No c. Does organization reqire its employees or volnteers to se their personal atomobile to condct the applicant s bsiness on a reglar basis? Yes No d. Does organization reglarly deliver goods or prodcts or reqire its employees or volnteers to transport clients? Yes No 38. Employee Benefits a. Nmber of Employees: 39. Employee Dishonesty a. Limit: $. b. Nmber of Employees: c. Is an annal adit performed by a CPA or a Pblic Accontant? Yes No d. Bank acconts reconciled by someone not athorized to deposit or withdraw? Yes No e. Contersignatre of checks reqired? Yes No 40. Money and Secrities a. Limit Inside: $ Limit Otside: $ 41. Otdoor Signs a. Limit: $ 42. Acconts Receivable a. Limit:$ 43. Valable Papers a. Limit: $ 44. Personal Property of Others a. Limit: $ 45. Fire Legal Liability ($100,000 inclded, please check increased limit if desired): $250,000 $300,000 $500,000 $1,000, Special Event Do yo host any Special Events involving those other than yor employees/volnteers? Yes No If YES, please complete or Non Profit Package Special Events/Liqor Liability Addendm for each event (NPP ADD SPE). page 2 of 4

6 SECTION V. Non Profit Directors & Officers and Employment Practices Liability: 47. Is the Organization involved in prodct research, development, testing and/or certification? Yes No 48. Does the Organization engage in any disciplinary actions as a reslt of peer review activities? Yes No 49. Does the Organization administer or sponsor any insrance programs? Yes No 50. Is the Organization involved in any accreditation or standard setting activities? Yes No 51. Is the Organization involved in any labor/nion negotiations or collective bargaining activities? Yes No 52. Total nmber of Employees: Fll Time Part Time Volnteers Seasonal 53. Nmber of chapters: If there are chapters, is coverage reqested for them nder this Policy? Yes No 54. Does the Applicant have any Sbsidiaries reqiring coverage? Yes No If yes, please complete the Non Profit Sbsidiary Addendm (NPSADD). 55. Name and title of individal designated to receive all notices on behalf of the Insred: Title: Phone Nmber: 56. Directors and Officers Liability Insrance carried: Insrer Limits of Liability Premim Retention Policy Period 57. Does the organization crrently carry General Liability Insrance? Yes No 58. Please provide the following financial information for the last three (3) years. (If organization in existence less than 3 years please provide Bdgeted Revene/Expense statement for next 3 years.) Year Total Revenes Net Income (Loss) Crrent Fnd Balance* $ $ $ $ $ $ $ $ $ * Fnd balance = Total Assets - Total Liabilities 59. Within the last 5 years, has any inqiry, complaint, notice of hearing, claim or sit been made (inclding, bt not limited to, Eqal Employment Opportnity Commission, State Hman Rights Boards, Mnicipal, State or Federal Reglatory Athorities), against the Organization, or any person proposed for Insrance in the capacity of Director, Officer, Trstee, Employee or Volnteer of the Organization? Yes No (If yes, please forward a completed USLI spplemental claims application.) 60. Is any person proposed for this insrance aware of any fact, circmstance or sitation, which may reslt in a claim against the Organization or any of its Directors, Trstees, Officers, Employees or Volnteers? Yes No (If yes, please forward a completed USLI spplemental claims application.) SECTION VI. Fidciary Liability (Available for 100 employees or less): 61. Does each Pension Plan se an otside Investment Manager? Yes No (If No, Fidciary will not be offered.) 62. Does each Plan sbject to ERISA comply with all applicable reqirements of ERISA and the Internal Revene Code of 1982, as amended (the "Code") inclding eligibility, participation, vesting, fidciary responsibility and fnding standards? Yes No If no, please attach details. 63. In the past two (2) years has there been or is there now nder consideration any material changes to a Plan or termination / consolidation of a Plan? Yes No If yes, please attach details. 64. Has there been or is there now pending any claims(s) against any proposed Insred arising ot of any Plan? Yes No If yes, please attach details. 65. Does any proposed Insred have knowledge or information of any act, error or omission which might give rise to a claim nder the proposed Fidciary Liability Coverage? Yes No If yes, please attach details. New York Disclosre Notice: This policy is written on a claims made basis and shall provide no coverage for claims arising ot of incidents, page 3 of 4

7 occrrences or alleged wrongfl acts that took place prior to the retroactive date, if any, stated on the declarations. This policy shall cover only those claims made against an insred while the policy remains in effect and all coverage nder the policy ceases pon termination of the policy except for the atomatic extended reporting period coverage nless the insred prchases additional extend reporting period coverage. The policy incldes an atomatic 60 day extended claims reporting period following the termination of this policy. The Insred may prchase for an additional premim an additional extended reporting period of 12 months, 24 months or 36 months following the termination of this policy. Potential coverage gaps may arise pon the expiration for this extended reporting period. Dring the first several years of a claims-made relationship, claims-made rates are comparatively lower than occrrence rates. The insred can expect sbstantial annal premim increases independent overall rate increases ntil the claims-made relationship has matred. Virginia Notice: Yo have an option to prchase a separate Limit of Liability for the extension period, policy common conditions I. If yo do not elect this option, the Limit of Liability for the extension period shall be part of and not in addition to the limit specified in the declarations. Statements in the application shall be deemed the insred s representations. A statement made in the application or in any affidavit made before or after a loss nder the policy will not be deemed material or invalidate coverage nless it is clearly proven that sch statement was material to the risk when assmed and was ntre. Minnesota Notice: The clase and/or athorization or agreement to bind the insrance. is replaced with Athorization or agreement to bind the insrance may be withdrawn or modified 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. 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. District of Colmbia Frad Statement: WARNING: It is a crime to provide false or misleading information to an insrer for the prpose of defrading the insrer or any other person. Penalties inclde imprisonment and/or fines. In addition, an insrer may deny insrance benefits if false information materially related to a claim was provided by the applicant. 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. Kentcky Frad Statement: Any person who knowingly and with intent to defrad any insrance company or other person files an application for insrance 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. Maine 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 may inclde imprisonment, fines or a denial of insrance benefits. 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. Ohio Frad Statement: Any person who, with intent to defrad or knowing that he is facilitating a frad against an insrer, sbmits an application or files a claim containing a false or deceptive statement is gilty of insrance frad. 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. Pennsylvania 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 and Virginia 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. Applicant s Signatre Title Date (President, Chairperson or Exective Director) If the primary address of the location listed in item #1 is in the state of New York, Iowa, or Florida, the states of New York, Iowa and Florida reqire that we have the name and address of yor (insred s) athorized Agent or Broker. Name of athorized Agent or Broker Address: Agent or Broker License nmber Mail complete application throgh local Agent or Broker to: page 4 of 4