October, 2001
Professional Risk Facilities
1. GENERAL DESCRIPTION
Professional Risk Facilities (PRF) offers miscellaneous professional liability (MPL) coverage for a multitude of various professions and occupations. The program is currently written on both an admitted and non-admitted basis through SAFECO. However, PRF has an agreement in principal to begin moving this business to the Northland Insurance Group as of January 28, 2002. The Northland policies will be identical to the SAFECO policies.
Another part of this same program with SAFECO is directors and officers (D&O) coverage. The SAFECO program is written on a non-admitted basis. In its press release announcing the agreement with Northland, PRF said: “This [new arrangement] will give PRF the flexibility to provide the same coverages for our insureds but also allow PRF to offer an admitted based D&O product if such is desired. . .PRF's partnership with Northland combines PRF's extensive knowledge and underwriting expertise of D&O and MPL Insurance products with Northland's financial strength and reputation for customer service.”
In its promotional material, PRF lists many ways in which its program is broader than others on the market. Those will be highlighted in this treatment.
2. CONTACT
Joseph Gravier Professional Risk Facilities, Inc. 300 Old Country Rd. Mineola NY 11501 Phone: 516-747-6060 (ext 138) FAX: 516-747-6074 mailto:[email protected]
3. UNDERWRITING GUIDELINES
While specific guidelines were not provided, PRF did provide the following list of the classes of business written in this program:
Accreditation/Credentailing Services
Actuaries/Actuarial Consultants
Advertising Agencies
Answering Services
Appraisers
Arbitrators/Mediators
Auctioneers/Auction Houses
Bookkeepers
Broadcasters
Business Brokers
Business/Personal Managers
Claims Adjusters/Administrators
Coin & Gem/Art Dealers
Collection Agencies
Computer/Software Developer Consultants
Consultants (miscellaneous)
Construction Managers
Contest Managers
Cost Containment Administrators
Court Reporters
Credit Bureaus
Credit Card Administrators
Dieticians/Nutritionists
Disaster Recovery Services
Document Destruction Services
Drug Testing Administrators
Employee Benefit Consultants
Escrow Agents
Executive Search Consultants
Financial Planners
Foreclosure Agents
Forensic Analysts
Franchisers
Freight Forwarders/Customs House Brokers
Human Resource Consultants
Insurance Agents/Brokers
Insurance Consultants
Insurance Inspectors (non-structural)
Interior Designers/Space Planners
Leasing Agents
Licensing Services
Management Consultants
Managed Care Organizations
Meeting Planners/Event Consultants
Mortgage Brokers/Bankers
Multimedia Services
Notary Publics
Pension Benefit Consultants
Photographic Studios
Premium Finance Companies
Printing Services
Private Investigators
Process Servers
Property Managers
Public Relations
Publishers Liability
Quality Assurance Consultants
Real Estate Agents/Brokers
Recording Studios
Referral Services
Risk Managers/Insurance Consultants
Safety Consultants
Security Guards/Alarm Monitoring Services
Social Service Agencies
Sports & Entertainment Managers
Storage/Archive Services
Structured Settlement Consultants
Tax Preparers (non-CPA)
Telecommunications Consultants
Temporary Placement Agencies
Testing Laboratories
Third Party Administrators
Title Agents/Abstractors
Trustees
Utilization Review Consultants
Wire Transfer Services
Other (Case by Case basis)
4. AVAILABILITY OF COVERAGE
All states.
5. LIMITS AVAILABLE/DEDUCTIBLE
While the insurer will consider any limits request, limits from $250,000 to $5 million are indicated on the application. That application offers deductibles ranging from $2,500 to $25,000.
6. INSURING AGREEMENT
This policy has a two-part insuring agreement. The first deals with payment of judgments; the second with defense costs.
The insurer promises to pay on behalf of the named insured any amount for which the insured becomes legally liable. The event for which the insured is legally liable must be a “covered claim” arising out of a “wrongful act.” The wrongful act must occur during the conduct of “Professional Services” or “E-Professional Services.” The claim must be made and reported to the insurer during the policy period. The policy also offers both an extended reporting period and a retroactive date.
The second insuring agreement is entitled “Judgments, Settlements, Claim Expenses, and Policy Territory .” The first paragraph details the insurer's right and duty to defend any covered claim, even if groundless. The PRF policy also covers defense costs for fee and commission disputes. The policy also allows the insured to appoint his own attorney, with the insurer's approval. The insurer must approval of any settlement.
If the insurer offers a settlement to the claimant, that settlement must also be approved by the insured. Once the policy limit is exhausted, the insurer's obligation to defend ends. The policy applies worldwide, as long as the suit is brought in the United States .
7. DEFINITIONS
The following terms are defined:
A. Application—the signed application and any other materials submitted with the application to the insurer. The application and such materials are part of the policy.
B. Affiliate—persons or entities related to the named insured. Such a relationship must be via “common ownership, control or management.” A subsidiary does not qualify as an affiliate.
C. Bodily Injury. The definition includes mental injury, anguish, stress, etc.
D. Breach of Confidentiality—is the unintentional disclosure, by the insured, of confidential information. If someone gains unauthorized access to the insured's computer network, any information disclosed is not such a breach.
E. Claim—a written demand for monetary or nonmonetary damages. Note that many policies do not cover nonmonetary damages.
F. Claim Expenses—include defense expense. The definition makes it clear that all such expenses are included inside the limit of liability.
G. Damages—include a monetary award or a settlement. The PRF policy includes pre and post-judgment interest. The insured may also choose to include punitive damages. The policy allows for punitives to be covered in the best venue: “The insurability of such damages shall be governed by the internal laws of any applicable jurisdiction which permits coverage of such damages.”
H. E-Professional Services—the services specified in the declarations that the insured performs via the Internet or a network of two or more computers.
I. Extended Reporting Period—as described on the declarations.
J. Individual Insured(s)—includes past, present, and future: partners, directors, officers, stockholders, members, management committee members, or employees. The policy also extends individual insured status to independent contractors for “Professional Services” they perform on behalf of and at the direction of the named insured.
K. Insured(s)—includes the individual insureds (above) and the insured company, which is defined as: the named insured; any subsidiary of the named insured; or a joint venture. The policy goes on to define joint venture as a business endeavor between the insured and at least one other party for whom the insured is performing professional services.
L. Named Insured—includes all different types of organizational structures such as an individual, corporation, partnership, limited liability company, limited partnership, or any other entity named;
M. Personal Injury. This is a broad definition that includes almost any injury other than bodily injury. It covers the following offenses:
1. False arrest, detention, or imprisonment.
2. Malicious prosecution.
3. Wrongful eviction.
4. Slander.
5. Violation of a person's right of privacy
N. Policy Period.
O. Pollutants—includes those items listed by the U.S. Environmental Protection Agency (EPA).
P. Professional Services—are described in the declarations.
Q. Property Damage.
R. Subsidiary—is identified on the declarations; the named insured must own at least 50% of its stock.
S. Retroactive Date—is shown on the declarations.
T. Wrongful Act—is what the policy covers. It includes: any “actual or alleged breach of duty, neglect, error, omission, Personal Injury or Breach of Confidentiality” that the insured commits in the conduct of the Professional Services or E-Professional Services, described on the declarations.
8. EXTENSIONS OF COVERAGE
In addition to covering the liability for wrongful acts, the PRF policy extends coverage to:
A. Estates, Heirs, and Legal Representatives. If an individual insured dies or becomes incapacitated, the policy extends coverage to his estate, etc. In the case of bankruptcy of any insured, the policy will likewise extend.
B. Marital Spousal Liability. Claims may sometimes be made against the spouse of an individual insured, simply due to his/her status as a spouse. In that case, the policy considers such a claim to be made against the individual insured.
C. Supplemental Payments. The policy provides, outside of the limit of liability, coverage for certain expenses incurred by the insured at the request of the insurer. Payments include up to $250 per day for lost wages. This coverage is capped at $5,000 per claim.
9. LIMITS OF LIABILITY & DEDUCTIBLE
The amount shown in the Declarations is the most the insurer will pay for any one wrongful act, during the policy period and any extended reporting period.
All claim expenses are included within the limit of liability.
The declarations shows an “Each Policy Period Aggregate,” which represents the insurer's maximum liability for damages and claim expenses.
Claims that arise out of interrelated Wrongful Acts are treated as one claim.
10. EXTENDED REPORTING PERIOD
If either the insured or the insurer cancels or nonrenews the policy, the insured may purchase an extended reporting period. The coverage during the extended reporting period applies only to wrongful acts committed during the policy period.
Note that this is a bi-lateral extended reporting period. Even if the insured requests that his own policy be cancelled, the insured may still purchase an extended reporting period.
The following extended reporting periods are available:
1. One year at 75% of the annual premium.
2. Two years at 125% of the annual premium.
3. Three years three years at 150% of the annual premium;
11. EXCLUSIONS
The policy does not provide coverage for the following claims:
A. Fraud, dishonesty, or criminal acts committed by the insured. The policy does, however, cover claim expenses until the insured has been adjudicated as guilty. It also makes an exception for any insured not involved in the criminal behavior.
B. Bodily injury or property damage.
C. Those alleging illegal profit or gain.
D. Those claiming discrimination. However, expenses are paid until a final adjudication is reached. The exclusion does not apply to any insured who had no knowledge of the wrongful act.
E. Wrongful acts committed prior to the retroactive date.
F. Those brought by one insured against another insured. However, the policy does make these two exceptions:
1. Claims brought by Affiliates are not excluded if they are brought independently of the Insured; and
2. Cross claims/third party claims for contribution or indemnity do not trigger the Insured vs. Insured exclusion.
G. From current or former employees or job applicants.
H. ERISA claims
I. Securities Acts claims.
J. Contractual liability. However, this exclusion does not apply if liability would have attached to the Insured even in the absence of such contract.
K. Nuclear.
L. Pollution.
M. Infringement of copyright, trademark, patent, etc.
N. Against a subsidiary for acts when it was not a subsidiary of the named insured.
O. Breach of warranty.
12. GENERAL CONDITIONS
The following conditions apply:
A. Claim Reporting—claims must be reported no later than 60 days after the end of the policy. The insured may enter into arbitration only with the consent of the insurer. The insured must cooperate with the insurer and do everything to protect the insurer's rights under the policy.
B. Notice of Potential Claims—if the insured becomes aware of a possible claim, the insurer must be notified of the circumstances.
C. Acquisition or Creation of Another Entity—the policy applies to newly acquired or created entities. If the new entity's revenues exceed 10% of the insured company's annual revenues, then the new entity must be reported to the insurer within 90 days.
D. Action Against the Insurer.
E. Other Insurance—this policy is excess over any other valid and collectible insurance
F. Subrogation.
G. Notice of Cancellation—the insurer must give 60 days notice; 10 days for nonpayment cancellation.
H. Alteration and Assignment—must be first approved by the insurer.
I. Representations.
J. Bankruptcy or Insolvency—of the insured does not alter the insurer's responsibilities under the policy.
K. Titles of Paragraphs—this condition emphasizes that the titles are inserted only for convenience and do not affect any provisions of the policy.
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