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Frequently Asked Questions

Here is a list of commonly asked questions within the high-risk insurance industry. Feel free to click a question to the right to be taken to that question’s answers.


What is the Difference Between “Admitted” & “Non-Admitted”?

An Admitted carrier is “backed” by the California Insurance Guarantee Association (CIGA) Fund. The Fund would cover the claim up to you policy limit or $500,000 in liability; whichever amount is lower, in the case that the carrier becomes insolvent.

A ‘Non-Admitted” carrier has been approved by the California Department of Insurance to operate on a “Non-Admitted” basis but is not “backed” by the CIGA Fund. Financial stability of the carrier becomes very important when they are transacting business on a “Non-Admitted” basis. This can be investigated by using companies such as A.M. Best who are in business for the sole purpose of researching insurance carriers and compiling statistical information.

One point that should be mentioned is that financial strength is not always related to the carriers Admitted or Non-Admitted status. Furthermore, there are more regulatory restrictions placed on the Admitted carrier. Some of the largest insurance companies in the world choose to transact business in California, and in all states, on a Non-Admitted basis.


What is an “Additional Insured” & Why do I Need One?

This is an endorsement which names others as an insured to your policy. It is a requirement by almost all carriers that if you hire a Sub-Contractor – you must have your Company named as “Additional Insured” on their policy. Failure to comply with this requirement can get you Cancelled or could affect any claim should one arise. A few more examples of additional insured requests are:

*If you are a contractor and plan to do work for a homeowner, they may ask to be named as additional insured to your insurance policy. This is the homeowners way of protecting themselves from any liability arisng out of your work on their property.

*If you rent an office for your business, the property owner may require that you name him/her to your insurance policy as additional insured. This is the property owners way of protecting him/herself against claims that may arise from your business operations in the rented office space.

*If you plan to rent a private or public facility to hold an event, the private owner or public entity, may require additional insured status before the facility can be used.

In most cases (but not all), there is an additional premium charged by the insurance carrier for this endorsement. Your insurance broker/agent does not have control over the amount charged. Some insurance carriers offer “Blanket” additional insured. This option could prove to be less costly in the long run, if you require many additional insured endorsement throughout the policy year.


How Can I Obtain a Quote?

We try to obtain as much information as we can from you during your first conversation. with us. However, the insurance company underwriter may have additional questions.

With this information, we will be able to determine what carrier(s) will best fit your needs and provide you with the best price. In some cases; it will take a few phone calls and completing several applications to get you the best quote. The questions vary, depending on the type of insurance you need. For instance, we will not ask you to provide information about your companies vehicles, if you need a quote for Workers Compensation.

Here are some examples of questions we may ask:

  1. Annual gross receipts (all coverage types)
  2. Annual Employee Payroll (commercial liability, workers’ compensation, E&O)
  3. Description of business operations (all coverage types)
  4. Sub-contractor costs (commercial liability, E&O)
  5. Vehicle make, year, model (commercial auto, truckers)
  6. Miles driven annually (commercial auto, truckers)
  7. Federal Employee I.D. Number (F.E.I.N.) (workers’ compensation, liability)
  8. Social Security number (for bonds & occasionally commercial auto)
  9. Square footage of building (commercial property, BOP)
  10. Year of construction (commercial property, BOP)
  11. Building improvement information (commercial property, BOP)
  12. Loss history (all coverage types)
  13. Past, current and projected gross receipts (commercial liability, professional liability)

What Are the Different Parts of a General Liability Policy?

  • General Aggregate – This is the limit the insurance company will pay on your behalf for any number of claims during the policy period. The most they will pay on one loss cannot exceed the Occurrence Limit.
  • Products and Completed Operations – The limit of this coverage is the amount the Insurance Company is obligated to pay on your behalf based on policy coverage. This coverage extends protection to you during manufacturing or contracting operations. An example would be if you installed something incorrectly and caused damage or if you sold a defective product.
  • Personal and Advertising Injury – This coverage affords protection against claims such libel, slander, defamation of character or invasion of privacy (personal Injury) and claims alleging written or publicized offenses of the above examples.
  • Each Occurrence – The total amount shown as a limit of this coverage establishes how much the Insurance Company is obligated to pay on your behalf for each incident which leads to a claim made to the Company under the terms of your policy.
  • Fire Damage Liability – The maximum amount the company will pay on your behalf, if you negligently cause a fire which damages a building you lease or rent for your business.
  • Medical Expense – The limit the company will pay for medical bills incurred by a person injured on your premises, regardless of whether or not your organization was at fault for causing the injury. If your business is deemed to be negligent, the responsibility falls within the limit of bodily injury portion of coverage.
  • Bodily Injury & Property Damage – This section of a policy defines certain covered losses and excludes certain losses. An example of a covered loss under Bodily Injury could be “trip and fall” accidents. Property damage claims relate to damage to physical objects (an example is a building).


The Basics On Workers’ Compensation

The Basics

When it comes to purchasing worker’s compensation insurance, your options are limited by the state in which you live and the national rates that affect your premiums. Unless you own a business in Texas (the only state where worker’s comp is not required), you are subject to state laws that govern this particular kind of insurance.

To begin with, each state sets its own rules regarding how much medical coverage you must provide your employee in the event of a work-related injury. If the injury causes missed work, it dictates the percentage of the employee’s salary you must pay and how long you are required to pay it. Some states require coverage for funeral expenses and financial support to dependents in the event of death, as well as liability coverage for damages stemming from an employee claim. The state also decides who gets to select a physician to care for the injury — the employer, the employee, the state agency or a combination of these. Most states allow either the employer or employee their choice of physician. You may have the option of using an insurance plan that uses managed medical care to treat injured workers. If so, this can reduce your medical costs and may facilitate an earlier return to work. More than half the states now allow HMOs, PPOs and other managed-care providers to handle worker’s comp claims.

State-Managed Funds?

As a business owner, your first concern is whether your state operates a fund from which you are required to purchase worker’s comp insurance, or whether it allows private insurance companies to sell the insurance. A little less than half of the states have no state-managed fund. This means you buy your policy from private companies. The other half offer you a choice between buying from a state-managed fund or a private company. Only a handful of states require you to contact them directly as your only source of worker’s comp coverage.

Even in states that offer competition from private companies, worker’s comp packages are fairly standardized. Because requirements are clearly defined by each state, there is little variation among the basic policies of different companies.

Premiums

Your premiums are based on a rate classification from either a national rating bureau called the National Council on Compensation Insurance (NCCI), or by a state rating bureau. These bureaus calculate risks based on business classifications. In other words, the riskier the business, the higher your base rate will be. Although the state controls the rate, it doesn’t actually set your premium. Insurers use many variables to determine your risk level and how much you should pay. Therefore, premiums can vary from provider to provider. More and more states are allowing competitive pricing for worker’s comp. In addition, these insurers may discount premiums by loosely defined credits. Credits are often given to companies that maintain a safe workplace or conform to other safety standards. If your state allows this kind of competition, it is definitely worth your while to shop around.

You do have several options when it comes to lowering your premiums: making sure you are classified correctly, offering better working conditions, scrutinizing payroll records and maintaining a good claims record. It’s a good idea to get to know these options in order to reduce your costs. (Click here for more on Lowering Costs.)

Are You Required to Buy It?

Most states require you to purchase worker’s compensation insurance as soon as you have employees. In these states, you are considered to have employees from the moment your corporation is formed. In other states, small employers with few than four or five employees aren’t required to carry any worker’s comp insurance. In addition, some states don’t require coverage for all employees. Your state agency or agent can provide you with this information.

Insurance Pools and Self-Insurance

If you live in a state that allows competition, you may be able to self-insure or join a self-insurance pool.

The benefit of self-insurance is that you don’t have to pay premiums. Instead, your business must pay for all of the associated costs of a worker’s comp claim when it occurs. Self-insurance is usually reserved for large employers who meet minimum payroll or employment levels. However, in more than half of the states, smaller companies may join a pool of small employers where the combined assets of the members allow them to self-insure.

Not to be confused with self-insurance pools, state insurance pools are maintained for those companies that are unable to buy worker’s comp through normal means because they are considered too risky. These pools are quite costly with high premiums and oftentimes poor service. An agent can help determine why your business is in this category and help you to find a way to get out. It may take several years to demonstrate a reduction of claims before you can purchase insurance from somewhere other than the state insurance pool. In the meantime, you may also be able to join a self-insurance pool.

Penalties

If you fail to purchase worker’s compensation insurance, you will be penalized by the state. If an employee is injured, you will be held personally liable. In addition, the Worker’s Compensation Division has the authority to close you down until proper coverage is obtained.

With all the laws surrounding it, purchasing worker’s compensation insurance can seem like a no-win situation. However, knowing your state’s laws and working to lower premiums are ways that you can even the playing field to gain flexibility and perhaps lower your costs.