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Compare Coverage & Rates For Commercial Umbrella Liability Insurance Coverage Before You Buy

To Get A Quick Quote With Several Leading Insurance Companines Just Complete A Short Online Information Form

Safeco Insurance

 

Are You Getting The Best Available Coverage & Rates ?

We offer Commercial Umbrella Liability Insurance Policies with several leading insurance carriers.

   

                                 

                            Commercial Umbrella Liability Insurance Coverage

      

 

Please fill out as much information as possible.

If you have any questions regarding this form please contact us.

 Commercial Umbrella Liability Insurance Quote Request Form

(* Indicates a required field)

All information provided will be regarded as strictly confidential, and will be used only to secure an accurate quotation for insurance coverage.

Named Insured:

General Information:

* Business Name   

Type of Business :

*Contract - Full Name:

Describe Operations :

  * Title / Position:   Business Model:  
 * Employers Federal Tax Id # (FEIN) 

 Select Any Other Kinds Of  Coverage Below That You Need Quoted:

*Contact Phone:

 Cell # 

Building / Contents / Liability

Business Owners Policy     :

Flood Insurance :                     

Workers Comp:                           Fidelity/Surety Bond                      

   *Fax:

   Commercial Auto:                          Cargo / Freight  Heavy Equipment                                                Cargo ( Inland/Ocean)

Web Site Address:

 

Umbrella Liability:                        Professional Liability :

Other - Please specify or describe:

*Email:

         

*Send Quick Quote By : Email Fax Both

 

 

Current Insurance Carriers Name :  

Policy Number

Expiration Date:  

 *Business Address:          

 Address:  

City:

 State: Zip :

County:

Mailing Address:          Same as Mailing Address
 Address:
 

City :

State:    Zip: 

County : 

 

Business Information: Need help with these questions call 1-800-361-8734 !

 

Years in Business:

Total Number of          Employees:  

Employees :  # Full Time:  # Part Time:

 Approx. Annual Gross Sales / Revenue $

Approx. Annual Payroll $

                     

 
Umbrella Liability Coverage Type & Limits Requested:  Need help with selecting coverage limits or understanding coverages offered call 1-800-361-8734 !    

Select Policy Type: Claims Made - Covers claims submitted from retroactive date & reported while policy is in force or any extended reporting period (if applicable ).

                                     Occurrence -Only covers claims incurred during the policy period.

*Umbrella Policy Liability Limit  $

                                              $

                                          Limit Per Each Occurrence

Aggregate Limit All Claims

Requested Effective Date   

     

1st Dollar Defense Coverage Requested:

Yes No

 * Amount of Self Insured Retained Limit Before Any Claim Payments Begin ( a retained limit is very similar to a deductible under other type insurance policies )                                                 $

 

 

If Claims Made Policy -                         Please Provide Policy Retroactive Date With Effective Date Shown On Current Policy And Any Other Date You Wish To Propose. Current     

Proposed

 
CURRENTLY IN FORCE BASIC (UNDERLYING) LIABILITY INSURANCE COVERAGE                       In Force Policy Information: Need help with completeing the rating information section call 1-800-361-8734 !   

List All Liability Insurance Policies For Which Your Firm Currently Has In Force Underlying Liability Insurance Protection

Type

 Insurance Company

Policy Number

      Effective     Date       Expiration      Date

Coverage Limits

Annual Premium

 

Claims Experience

Rating Modifier 

( If Applicable)

Automobile Liability

Bodily Injury Per Person $
Bodily Injury Per Accident $
Property Damage    Per Accident $
Or  -Combined Single Limit $
$
$
$

Underlying Auto Liability Vehicle Information ( Explain All " Yes" responses in remarks/comments section at bottom of this page ).

VEHICLES Need help with these questions call 1-800-361-8734 !

Type # Owned # Non-Owned # Leased Property Hauled  # Operating Within  0-50 Miles # Operating Within  50-200 Miles # Operating Over    200 Miles

Private Passenger

Trucks

    Light     GVW <10,000

 Medium GVW 10,000 to 20,000

 Heavy  GVW 20,001 to 45,000

 Ex. Heavy GVW 45,000+

Trucks/Tractors

 Heavy  GVW 20,001 to 45,000

 Ex. Heavy GVW 45,000+

 Buses

1. Are any explosives, caustics , flammables or other dangerous cargo hauled ? YesNo                                                                                                                                                              2. Are passengers carrier for a fee ?  YesNo                                                                                                                                                                                                                                          3. Any any vehicles not insured under underlying auto policy ? YesNo                                                                                                                                                                                              4. Are any vehicles leased or rented to others ? YesNo                                                                                                                                                                                                                         5. Is hired and non-owned coverage provided under underlying commercial auto policy ? YesNo                                                                                                                                            6. Employees use their own vehicles on company business ? YesN

 

General Liability

Claims Made  Occurrence

Per Occurrence Limit $
Aggregate Limit    All Claims $
Product / Completed Operations Aggregate Limit $
Personal & Advertising Injury $
Damage To     Rented Premises $
Medical Expense (Per Person With No Fault Required) $

   General Liability  $

  Product/Com Ops $

       All Other General Liability Premiums $

Underlying General Liability Information ( Explain All " Yes" responses in remarks/comments section at bottom of this page ). Need help with these questions call 1-800-361-8734 !

Defense Cost Are : Included within aggregate limits A separate limit Unlimited                                                                                                                                                                                        Has any product, work, accident, or location been excluded, uninsured or self insured from any previous general liability policy ? Yes No                                                                                                        If prior general liability policy was issued as a Claims Made Policy has any extended reporting period coverage been purchased at policy expiration ? Yes No

 

Employers Liability     

(Workers Comp)

Each Accident $
Disease            Each Employee $
Disease           Policy Limit $
 Employers Liability Workers Comp Prem. $

Underlying Employer Liability / Workers Compensation Information ( Explain All " Yes" responses in remarks/comments section at bottom of this page ). Need help with these questions call 1-800-361-8734 !                                  

Is your firm self-insured for Employer Liability / Workers Compensation in any state ? Yes No                                                                                                                                                                        Check Box If Your Firm Is Subject To : Jones Act - US Longshoremen & Harbors workers Maritime Employers Act Federal Employers Liability Act

 

 

Professional Liability

 

 

 

 

Per Occurrence Limit $
Aggregate Limit    All Claims $
Professional Liability $
Underlying Professional Liability Information ( Explain All " Yes" responses in remarks/comments section at bottom of this page ). Need help with these questions call 1-800-361-8734 !

Claims Made - Covers claims submitted from retroactive date & reported while policy is in force or any extended reporting period (if applicable ).

Occurrence -Only covers claims incurred during the policy period.

Defense Cost Are : Included within aggregate limits A separate limit Unlimited                                                                                                                                                                                        Has any product, work, accident, or location been excluded, uninsured or self insured from previous professional liability policy ? Yes No                                                                                                        If prior general liability policy was issued as a Claims Made Policy has any extended reporting period coverage been purchased at policy expiration ? Yes No

 

List Any Other Liability Insurance - Name Type:

 

Per Occurrence Limit $
Aggregate Limit    All Claims $
Any Other Liability Insurance Premium $
Check Applicable Box(s) If Your Firms Has Any Exposure To The Following Type Risks : Need help with these questions call 1-800-361-8734 !
Aircraft  Liability - Rental or Operation Medical Malpractice - including but not limited to incidental risk exposure 
Aircraft Passenger Liability Liquor Liability - including but not limited to host liquor liability associated with client entertainment company sponsored parties or other functions
Additional Interests - Endorsement Naming Another Party As An Additional Insured Under Your Umbrella Policy Per A Written Contract Requiring Such Coverage. Pollution Liability
Care, Custody, or Control - Your firm has any exposures for the property belonging to others Vendors Liability
Employee Benefit Liability - Does your firm offer employees any employee benefit programs such as 401K retirement plan ; group life/health/dental/vision plan. Watercraft Liability
Foreign Liability / Travel Other - Describe Nature Of Liability Risk
Garagekeepers Liability - Auto Repair Shops , Auto Sales , and/ or Valet Parking Of Any Nature
 
  Loss History Information:

Most Of Our Insurance Company Underwriters Require Prior Carrier Generated Loss History Reports For Last 5 Years Prior To Binding Coverage.

 *Has your business had any losses or filed a claim in the last five (5)  years? YesNo

  If "Yes" Please Briefly Provide Details ( amount paid / carrier / policy # /  date of loss or claim  / nature of claim / pending or settled) 

 

 Additional Comments/Remarks You Wish Us To Consider When Preparing Your Quote: Need help with these questions call 1-800-361-8734 !

Submission of quote request form to Hemphill Insurance Agency does not constitute a binding confirmation of new or revised insurance coverage.  To confirm binding or current policy revisions you must receive a written confirmation for any  new or change in coverage from our agency staff.

 
Submitting Agent/ Producer  - Name: Tel: Email:

 

       

 

 

Commercial Umbrella Liability Insurance

 

Insurance Service Office (ISO) SAMPLE Policy Forms

Note: These Are Sample Policy Forms That Represent Insurance Industry Standardized Commercial Lines Policies.

Coverage proposals presented to you by our Agency may differ; as each insurer represented may offer modified coverage by endorsement or have filed it's own unique policy forms with the Texas Department Of Insurance. Please carefully read any carrier prepared proposal presented to you and where necessary request a copy of each insurance company policy form presented; so that you may compare any differences in coverage offered.

 

Commercial Umbrella Policy " ISO Form - CU 00 01 1207" 
 

 

Commercial Umbrella Liability Insurance is also known as Excess Liability Insurance; as it provides extended liability insurance coverage to a firm that has basic underlying Commercial Auto , General Liability , Employers Liability ,and other insured liability exposures.

Umbrella Liability Insurance only provides additional coverage when the limits of insurance on an underlying policy are exceeded.

For instance, if  you have $1,000,000 coverage under a underlying basic General Liability Policy and you have a covered claim settlement or judgment against your firm for $1,600,000 the umbrella policy would pick up the additional amount of $ 600,000 of excess loss above the $1 million limit of your underlying liability coverage.

Commercial Umbrella Liability Policies offers excess extended coverage for Commercial Auto , General Liability,  and Employer's Liability for a single premium.

The average premium for most main street small business policies per $1,000,000 of incremental liability coverage is approximately $250-$350 per year. Premiums may be dramatically increased for larger employers or high risk industries, high risk classes of business , or higher than average claims history.

It is important to note that Umbrella Liability Polices do not typically provide excess coverage for  Professional Liability ( often referred to Errors & Omissions ) , Employment-Related Practices, Property Of Other In Your Care/Custody/Control ,  Recall Of Product , or Product Liability.

Such risks are typically insured via a separate stand alone policy with increased coverage limits or by special endorsement to an underlying policy ( subject to underwriting approval of the underlying insurance carrier )

The key issue with umbrella insurance is that there is no industry standard umbrella policy form that any insurance carrier is required to offer; so policy terms and premiums vary from company to company.

Coverage provided an umbrella policies will usually follow the provisions, exclusions, and limitations of the " underlying insurance"; unless otherwise stated in the umbrella policy.

However; insurers are free to come up with their own policy forms language , provisions, exclusions , or limitations along with establishing rates they deem appropriate for such terms.

However; the pricing of umbrella insurance is getting lower, and many insurance companies will offer very reasonable terms of coverage and highly competitive rates to secure your business in this line of insurance.