Qumis

1. Basic Policy Details: 

• Named Insured, Policy Period, Locations: Verify accuracy. (Comparison: Note differences).

• Business Description: Accurate and complete?

2. Coverages & Forms: 

• Lines Included: Are expected lines of coverage present (GL, Prop, Auto, WC, Umb, Cyber, E&O, etc.)?

• Policy Forms: Identify primary forms (ISO vs. carrier-specific?). (Comparison: Same forms? Key language differences?). 

• Industry-Specific Coverages: Are standard coverages for this client's industry included (e.g., HNOA, EBLI, Bailee, Liquor)? Any critical gaps?

• Cyber (If Applicable): Key 1st/3rd party coverages included? Sublimits adequate?

3. Limits & Aggregates: 

• Primary Limits (GL, Prop, Auto, E&O, etc.): Identify key limits. Are they adequate for the client's exposure? 

• Property Valuation & Coinsurance: Correct valuation (RC/ACV)? Coinsurance met? 

• Key Sublimits: Any restrictive sublimits (perils, operations, property types, cyber)? Acceptable? 

• Aggregates: How do they apply (per location, shared)? Risk of exhaustion?

4. Deductibles / Retentions: 

• Primary Deductibles/SIRs: Identify amounts for key coverages. Financially manageable for the client? 

• Special Deductibles: Any unusual ones (Wind/Hail, Water, etc.)?

5. Exclusions & Endorsements: 

• Problematic Exclusions: Any unusual or operation-limiting exclusions present (specific work types, A&B, professional on GL, territory)? Extract all exclusions and provide real-world examples of what each would exclude.

• Necessary Endorsements: Are required endorsements attached (AI, WoS, P&NC, coverage grants)? (Comparison): Significant differences in exclusions or endorsement wording/forms?

6. Classification & Pricing: 

• Class Codes (GL/WC): Accurate reflection of operations? Optimal codes used?

• Rating Basis & Exposure: Correct basis (Payroll, Sales, SqFt)? Estimate accurate? 

• Premium Comparison: How does total premium compare? Main drivers for difference (rates, exposure, limits, coverage)?

7. Insurer Details: 

• Carrier & Status: Identify insurer. Admitted vs. Non-Admitted?

• Financial Strength: AM Best rating acceptable? (Comparison: How do ratings compare?) 

• Service Reputation: Agency experience (claims, service)?

8. Summary & Action Items: 

• Key Differences (Comparison): Summarize major variations.

• Gaps & Concerns: Note any coverage gaps, concerning terms, or inadequate limits. 

• Client Discussion Points: What needs clarification or discussion with the client? 

• Recommendation: Accept, quote, request changes, or seek alternatives?

9. Scripts: 

• Please give us talking points about notable exclusions and coverage enhancements on how it applies to this client. Give claims examples for each of these on how it would apply.

The carrier is denying the claim based on X. Based on the policy (upload the whole policy not just the declarations page) does that seem right and can we challenge this?

Is there any other area of the policy where coverage may apply?

Upload a copy of the FULL policy and the claim denial letter for review.

• COI Comparison Video

Does this policy have blanket additional insured?

Do we need to endorse the additional insured to the policy or does blanket additional insured apply?

Does this policy have primary and non contributory endorsement and do we need to specifically list the additional insured on the policy or does the blanket apply?

Does this policy have waiver of subrogation endorsement and do we need to specifically list the additional insured on the policy or does the blanket apply?

• Confirm the policy term the audit took place

• Make sure to have the declarations page for that correct policy term 

• Get a copy of the audit results

• Prompts-

• Use the compare feature to see the differences between the policy exposures, class codes, and payroll/sales

• Were any new class codes added?

• Was there any uninsured or insured subcontractors added?

• Any owners included or excluded that is different?

This protocol ensures that a business is not only covered for liability but that their physical assets and income streams are protected against total loss.

1. Data Requirements

• Policies: Property/BOP, GL, Auto, WC, Umbrella, Flood, Professional/Cyber, EPLI.

• Financials: 12-month projected Gross Profit (for Business Income check).

• Valuation: Most recent Statement of Values (SOV) or Building Appraisals.

• Loss History: 5-year Loss Runs (PDF or CSV).

• Niche Stats: Industry-specific data (Daycare kids, Tree height, Roofer open-roof status).

2. The Commercial "Super Prompt"

[START OF PROMPT]

Role: You are a Senior Commercial Underwriter and Forensic Risk Manager.

Objective: Conduct a "Total Asset Audit" for the following business. Identify liability gaps, niche exclusions, and specifically audit the Property/Income values and Claims History to ensure the business is "Best in Class."

Docs to be added- Loss runs, supplementals, applications to look for inconsistencies 

Client Profile:

• Industry/Niche: WE NEED TO ENTER FROM EZLYNX 

• Add website: WE NEED TO ENTER FROM EZLYNX 

• Revenue/Gross Profit: WE NEED TO ENTER OR GET DATA FROM INSURED OR CHECK DECLARATIONS 

• Operations: WE NEED TO ENTER FROM EZLYNX 

• Property Value (Limit): extract from declarations page 

• Business Income Limit: [Insert current limit]

• Claims History: check loss runs 

• States insured works in WE NEED TO ENTER FROM EZLYNX  OR LOOK ON SUPPLEMENTAL (AI SHOULD DO THE LOOKING)

Required Analysis Modules:

1. Property & Business Income (BI) Audit:

• BI Adequacy: Based on the revenue of [Insert Revenue], evaluate the Business Income limit.

• Recommendation: Compare current limits to a "12-month Total Shutdown" scenario. Flag if they are underinsured for fixed costs and payroll.

• Replacement Cost Estimator (RCE): Analyze the building limit vs. construction costs (approx. $250-$400/sq ft). Flag the specific "Co-Insurance Penalty" risk.

• Flood & Excess: Recommend Primary or Excess Flood regardless of Zone if the business relies on a single location.

• Property theft/installation. floater is it enough?

2. Claims Intelligence (Loss Run Audit):

• Frequency vs. Severity: Identify if the client has a "culture" of small claims or a single large event.

• Trend Detection: Identify patterns in types of injuries or accidents (e.g., "Back strains on Fridays" or "Rear-end collisions").

• Premium Impact: Explain how these losses will impact the renewal pricing and what "Safety Steps" could mitigate this.

3. Liability & Niche Gaps:

• Niche "Silent Killers": Audit for Open Roof (Roofers), Abuse/Molestation (Care), Height/Crane (Tree), or Pollution (Landscapers).

• Management Liability: Search for EPLI (Employment Practices) and D&O. If missing, flag the risk of employee lawsuits or board-related litigation.

• Hired & Non-Owned Auto: If the client has no Auto policy but has employees running errands, flag the massive gap for Hired/Non-Owned liability.

• Installation floater exposure?

• Are there any states exclusion?

• Retro dates bring this up

• Named insured does it match across all policies 

4. Benchmarking & Compliance:

• Umbrella Tiering: Suggest limits based on Revenue ($1M-$5M revenue = $5M Umbrella; $10M+ revenue = $10M+ Umbrella).

• Certificate Audit: Cross-reference the Certificate Holder export for any contractual breaches in limits or endorsements.

5. Think of any other items to protect the agency from E&O exposure

• Create a checklist for items to address and sign

• Retro dates named insured consistency 

Output Format:

• CRITICAL RISK ALERTS (Action Over, Exclusions, Under-Insurance)

• PROPERTY & INCOME PROTECTION REPORT (RCE and BI Analysis)

• LOSS HISTORY INSIGHTS (Pattern detection & Safety recommendations)

• THE COMPLIANCE SCORECARD (Certificate Mismatches)

• THE BROKER'S "CONSULTATIVE" PITCH: A summary to convince the client why these changes are vital.

[END OF PROMPT]

3. Action Steps for the Team

• The "BI" Conversation: Use the Qumis analysis to show the client: "If you have a fire, your building is covered, but how do you pay your key employees for the 12 months it takes to rebuild? Your current Business Income limit is $50k—it needs to be $500k."

• The "Social Engineering" Warning: Specifically ask about wire transfers. Most standard policies exclude "Voluntary Parting" (sending money to a scammer).

• RCE Check: If the RCE shows they are insured for $100/sq ft but local costs are $300, warn them about the Co-Insurance penalty where the carrier only pays a portion of a partial loss.

• Create a checklist for items to address