Named Insured:

D/B/A:

Address:

City, State:

Phone:

Fax:

e-Mail:

Website:

Named Insured is a(n):____Individual____Partnership____Corporation

____Limited Liability Co.____Joint Venture

____Other

General business operations:

States/territories in which insured has operations:

Loss control contact name/phone:

 Liability Coverage

 ___1.Are all owned autos (and those under long term lease) described in the policy? (This is especially important when coverage is arranged for "specifically described autos only".) Note that owned autos needs to include trailers with less than 2,000 load capacity that will be used on roadways.)

___2.If insured does not have "any auto" symbol liability coverage, is insurance company willing to provide this type of coverage? Does insured understand the arrangement, contrasting symbol 1 any auto coverage with other coverage options? 

___3.Is a deductible advantageous for the insured?

___4.Any leased autos? If so, does lease stipulate any insurance requirements not provided by existing insurance?

___5.Any possibility of short term rental or borrowed autos? Even if this seems unlikely, hired autos coverage on an "if any" basis should be urged if symbol 1 is not on the policy.

___6.Do employees, partners, or other agents use their own autos on company business? Even the possibility calls for nonownership liability coverage.

___7.Do any leased employees or temporary workers use their own autos on company business?

___8.Are driving records and driving history for all drivers checked?

___9.Is named insured an individual? If so, are spouse and family members to be considered as insureds?

___10.If named insured is a partnership, are any individually owned cars used in business?

___11.Do insured's employees drive customers' cars or provide valet parking? If so, garagekeepers insurance is appropriate, even if the insured is not a garage risk.

___12.If garagekeepers insurance is indicated, what basis is preferable: legal liability, direct primary, or direct excess?

___13.Has insured assumed any automobile exposures of others, via hold harmless agreements, that are not covered by insured's automobile liability insurance? Separate contractual liability insurance may be needed.

___14.Have any rating bases changed? Especially vehicle size, radius, and use classes, and, in case of nonownership liability coverage, number of employees.

___15.Compare definition of mobile equipment in insured's auto policy with that in the insured's general liability policy. Make sure there are no resulting coverage gaps with respect to any equipment owned or used by the insured, particularly equipment mounted on an auto or truck to afford mobility.

___16.Stress the advantages of having automobile and general liability insurance through the same insurer.

___17.If insured is a dealer garage risk, check desirability of expanded liability coverage for customers and liability coverage for repossessed autos.

___18.If insured is a trucker risk (i.e., transports materials or commodities for others): a) are proper policy provisions being used (e.g., truckers/motor carriers policy)?  b) is trailer interchange insurance needed?  c) is coverage for "bobtail" or "deadhead" operations needed?  d) do policy limits meet current state and federal insurance requirements, if applicable?

___19.Does insured have pollution liability exposures that would be excluded by basic policy provisions? If so, obtain appropriate coverage through either limited coverage buyback endorsement or broader pollution liability policy.

___20.Is insured a funeral director; law enforcement agency; ambulance service; fire department; leasing or rental concern; driver training program or school; automobile body manufacturer or installer; or driveaway contractor? If so, special rules, rates, and forms may apply. See "special types" section in automobile rules of commercial lines manual.

 Medical Payments Coverage

 ___21.Is named insured an individual without separate personal auto medical payments coverage? If so, business auto medical payments endorsement may be desirable way of providing this coverage to named insured, spouse, and family members.

___22.If named insured is a partnership or a corporation, medical payments coverage has no applicability to "named insured and family members." Need must be based on presence of other possible insureds. Points to consider: a) are employees covered by workers compensation law? If so, medical payments will not apply to them if injured on the job; b) do customers (or anyone else besides employees) ever occupy company autos? If so, medical payments would be applicable to these persons.

 Uninsured Motorists Coverage

 ___23.Is uninsured motorists coverage compulsory (i.e., cannot be rejected by insured) in insured's state? If so, is declarations page properly marked?

___24.If uninsured motorists is not compulsory, does insured want the coverage? Points to consider: a) is named insured an individual, partnership, or corporation? Unless an individual, coverage for "named insured and family members" will have no application, subject to state court rulings; b) are employees covered by workers compensation law? If so, coverage for "anyone else" will be reduced by amounts required by law; c) do customers or other nonemployees occupy company cars? If so, coverage will apply to them.

___25.Are increased uninsured motorists limits and underinsured motorists coverage desired?

 No-Fault Coverage

 ___26.Is no-fault coverage compulsory in insured's state? If so, is declarations page properly marked?

___27.If no-fault is not compulsory, are voluntary benefits desirable?

___28.If no-fault is purchased, is additional personal injury protection desirable?

 Physical Damage Coverage

 ___29.As in the case of liability and other coverages, check for automatic vs. specified auto basis of coverage.

___30.Can the insured use higher deductibles on collision, comprehensive, or specified perils coverages?

___31.If the insured has specified perils coverage, is upgrade to comprehensive coverage desirable? On the other hand, would a switch from comprehensive to specified perils coverage be justified by the resulting savings?

___32.Does the insured lease any autos? If so, ascertain that all requirements of lease are met; e.g., primary insurance, lessor as additional insured, etc.

___33.Are there any parties that should be named as loss payees?

___34.Are any supplemental endorsed coverages desired, such as towing and labor costs, sound receiving and transmitting equipment, higher transportation expenses, employees as insureds, auto hacking expense coverage?

___35.If a dealer garage risk, check need for and desirability of driveaway collision coverage; trick and device coverage; financed automobiles and single interest coverages; repossessed autos coverage; reporting vs. nonreporting rating basis on merchandise.

___36.Is there any hired auto physical damage exposure?

 Special Exposure Considerations

 ___37.Any travel to Mexico?

___38.Does insured service their own vehicles? Obtain details.

___39.Any golf carts, ATVs, farm tractors, buses or other?

___40. Any amphibious vehicles?

___41. Any concessions or food trucks? Delivery vehicles?

___42. Any public transport, livery service, or transport of seasonal/migrant workers?

___43. Any transport of explosives, such as fireworks?

___44. Any refrigerated or special equipped vehicles? Older or antique vehicles?

___45. Any mobile homes to be covered? Mobile home contents?

___46. Any non-dealer sales of vehicles, such as when replacing fleet vehicles?

 Other Special Considerations

 ___47. What risk management practices in place – replace older vehicles with new, what is done with problem drivers, vehicle storage in good condition/protected, etc.? Insurer may have mandatory or favorable risk characteristics.

 ___48.Are limits of liability adequate?

___49.Does insured have other insurance, collectible or not?

___50.Has insured ever filed for bankruptcy?

___51.What is the insured's loss history? Will a change or addition of deductible help offset frequency claims?

___52.Has insured ever been cancelled or non-renewed? Obtain details.

___53.Does insured have an active and effective loss control program?

___54.Any trailers used? Owned and nonowned. Do they meet coverage requirements?

___55.Does insured understand diminution in value exclusion?

___56.Does insured understand duties in event of loss or claim?

___57. Is insurer filed/approved to provide coverage for vehicles in all states with vehicle exposures?