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1. Are you responsible for the Building you are in?

       Own the Building

       Rent the Building

___ Condo ownership

___ Office in residence

 

2. Are you responsible for the Permanent Attachments to the building, Fixtures, and

Equipment for servicing the premises:

 

       Not responsible rent

___ Responsible for common areas and rent

___ Responsible for improvements in condo ownership or renter

       I am responsible for all property

 

3. Business Personal Property and Property of Others:

 

       The owner of the equipment in my office

       Care, custody, control of the property of others ie do you lease equipment like a copier?

___ Have mobile equipment provided to employees such as computers and cell phones

 

4. Income Protection if there was a disaster:

       Lose money if I could not operate my practice.

       Would not be able to pay my employees If could not operate

       Could not pay my expenses if I could not operate

        Would have extra cost to continue my business after a disaster at this location or

at another location

___ Do you have another space to relocate to if need be for a period of time

 

5. Practice has employees or contract employees?

___ Workers Compensation Insurance

___ Employment Practices Liability Coverage

 

6. Have Trust/IOTA Accounts

___ Crime Insurance

___ Clients required to be names on crime coverage

       Money and Securities

 

7. Have Data Breach/Cyber Liability Exposures, store sensitive information about clients on computers, servers or paper files

___ Data Breach/Cyber Insurance

___ Clients that require Data Breach/Cyber Insurance

 

8. Does firm use autos for business?

___ Employees Occasionally use Personal autos

___ Employees Frequently use Personal autos

___ Firm Leases autos for employees

___ Firm owns autos used by employees

 

9.  Other Insurance needs?

___ Directors & Officers/Management Liability Insurance

___ ERISA Bonds

___ Employee Benefits Errors & Omissions coverage

___ Excess Insurance – Professional Liability Insurance

       Flood Insurance

___ Earthquake Coverage

___ Surety Bonds

___ Umbrella Insurance

 

 

10. Do you need coverage for any of the following: Check all that apply

     _ Valuable Papers & Records

___ Law Library

___ Art Work

       Newly Acquired or Constructed Property

        Accounts Receivable

        Exterior Signs, Lights and Clocks

        Glass

        Fire Department Service Charge

        Fire Extinguisher Recharge

        Electronic Data Processing Equipment Coverage-Property

        Other, Describe unusual property you my own:

 

11.  Specific Insurance Coverage questions:

___ Number of years Owned Business( ____)

___ Have current insurance coverage

        ___ If no have had coverage in past let lapse

        ___ Will provide copy of expiring coverage(s)

__ The legal status of entity is:

        ___ Corporation

        ___ Partnership

        ___ LLC/PA/PLLC etc

___ More than one location

___ Had nonprofessional liability insurance claims?

 

 

The above information is not an insurance policy. It is only intended to provide a general

guide to possible exposures for Small Firm/In-Home Firm. Actual insurance policies contain specific details of the coverages, conditions and exclusions.

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