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?