(July 2019)
This checklist is designed to assist in beginning the analysis of the commercial crime coverages. This is only a starting point and additional risk specific questions may arise as the exposures are developed. This analysis should be combined with exposure analysis checklists for other coverages to develop a complete picture of the insured’s operations.
This checklist is designed to supplement the ACORD application.
Related Article: ISO Commercial Crime Coverages ACORD Form Considerations
A list of endorsements may be helpful as you discuss exposures with your client.
Related Articles:
ISO Commercial Crime Coverages Available Endorsements and Their Uses
ISO Commercial Crime Coverages Endorsements Checklist
GENERAL
INFORMATION
Legal business name(s):
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Mailing address:
______________________________________________________________________________________
______________________________________________________________________________________
Type of entity:
___ Individual |
___ Corporation |
___ Sub-S Corp |
___ Partnership |
___ Joint Venture |
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___Not-for-profit |
___ Limited Liability Company |
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SIC Code(s): ___________________________________________________________________________
NAICS Code(s): _________________________________________________________________________
Federal ID Number: ______________________________________________________________________
When did the applicant start business operations? ______________________________________________
When did the present management assume control? ____________________________________________
How many years’ experience does the owner have in this type of business? __________________________
How many years’ experience does the manager have in this type of business? ________________________
Has the applicant ever been involved in a bankruptcy procedure? ___ Yes ___ No
If yes, explain including the type of bankruptcy, the filing date,
and the resolution.
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Names of subsidiary companies or joint ventures that are not part of this application:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Important People |
Name |
Phone Number |
Owner/Principal |
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Other Decision Makers |
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Plant and Grounds |
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Financial |
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Legal |
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Claims |
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The applicant’s primary operations are:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
The applicant’s secondary and/or incidental operations are:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
The applicant used to be involved in the following operations, but they have been discontinued:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
The hours of operations are: ________________________________________________________________
How many days per week is the applicant open for business? _____
Is this a seasonal operation? ___ Yes ___ No
If yes, what is the season? From ____________________________ to _____________________________
Does the applicant have a safety program? ___ Yes ___ No
If yes, answer the following:
Name of safety director: ____________________________________________________________
Safety
director phone number: _______________________________________________________
Safety
director email address: _______________________________________________________
Attach a copy of the safety program.
Does the applicant have a disaster plan? ___ Yes ___ No
If yes, answer the following:
Name of disaster coordinator: ________________________________________________________
Disaster
coordinator phone number: ___________________________________________________
Disaster
coordinator email address: ___________________________________________________
Attach a copy of the disaster plan.
Describe any burglary exposures beyond what is usual to the applicant’s business.
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Describe any special features of the applicant’s the burglary alarm or safe or vault systems that are not noted elsewhere.
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
PRIOR POLICY
Provide the policy number, carrier, limits, and the inception and expiration dates of any policy that provided employee dishonesty coverage for the applicant over the last five years.
Policy Number |
Carrier |
Employee Dishonesty Limit |
Inception Date |
Expiration Date |
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Note: This
information is needed when a loss is discovered in the current policy year for
an occurrence in prior years.
Does the applicant employ any person who has committed a theft or dishonest act? ___ Yes ___ No
Note: These employees are excluded from coverage and should not be included
for rating purposes.
Are all potential employees screened prior to employment? ___ Yes ___ No
Are references required and verified? ___ Yes ___ No
Does applicant contract with another firm to lease employees? ___ Yes ___ No
Does applicant lease employees without using an outside agency? ___ Yes ___ No
Does applicant use volunteers? ___ Yes ___ No
Note: Temporary leased employees who
substitute for regular employees are covered. Others, including volunteers, are
excluded and should not be included for rating purposes.
Does a person outside of the applicant’s accounts payable
unit verify the accuracy of all monthly paid invoices? ___ Yes ___ No
Are invoices marked “paid” at the time payments are made in
order to prevent issuing duplicate payments to fictitious entities? ___ Yes ___
No
Does the applicant implement improvements in internal
controls that auditors suggest? ___ Yes ___ No
Does the applicant maintain an adequate separation of duties
between employees who:
Receive money and those who keep
books? ___ Yes ___ No
Disperse money and those who keep
books? ___ Yes ___ No
Reconcile bank accounts and those
who deposit or withdraw? ___ Yes ___ No
Are checks and drafts kept in a locked area? ___ Yes ___ No
If yes, describe the area
where they are kept and the person(s) who controls the keys.
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Does the applicant use
electronic signatures? ___ Yes ___ No
If yes, describe security methods utilized.
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Does the applicant use facsimile signatures? ___ Yes ___ No
If yes, describe security procedures in place.
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Premises # _______ Building # _______
Location address: _______________________________________________________________________
INSIDE THE PREMISES
Does the applicant keep money and securities in a locked
safe, vault, or other type of receptacle? ___ Yes ___ No
If yes, describe the safe, vault, or other receptacle.
______________________________________________________________________________________
______________________________________________________________________________________
If no, where are they kept?
______________________________________________________________________________________
______________________________________________________________________________________
Does this location require a different limit than other
locations? ___ Yes ___ No
If yes, what is this location’s limit? $
____________________
Does the applicant have any peak periods with significant
increases in the amount of cash on hand? ___ Yes ___ No
(Examples:
Churches/synagogues – high holy days; nonprofits – fund raising events)
If yes, amount $____________ Time period(s)
___________________________________________
Does the applicant place all cash registers in well-lit
areas that are easily seen from the street and/or other parts of the premises?
___ Yes ___ No
Are customers' credit/debit cards checked for validity? ___
Yes ___ No
Does the applicant accept personal checks? ___ Yes ___ No
Does the applicant have a safe deposit box? ___ Yes ___ No
If yes, answer the following.
Where is the applicant’s safe deposit
box? Name and address of depository:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
What is the minimum value of the
contents in the safe deposit box? $_______________
What is the maximum value of the
contents in the safe deposit box? $_______________
OUTSIDE THE PREMISES
What is the maximum amount of money and securities that any
one person can carry off premises?
$________________
Do these individuals vary:
the time of day when they go to the
bank? ___ Yes ___ No
the conveyance they use to go to
the bank? ___ Yes ___ No
the route they take to the bank? ___ Yes ___ No
Do salespersons, truck drivers, or any other employees keep money or other valuables away from premises at night or on weekends? ___ Yes ___ No
If yes, who does the applicant authorize to do so and what
is the maximum amount of money exposed?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Do the applicant’s salespersons, delivery persons, or others
collect money off premises? ___ Yes ___ No
If yes, what are the average and the maximum amounts any
person may carry?
$___________________Average $________________ Maximum
Does the applicant use an armored car service? ___ Yes ___
No
If yes, describe the armored car service.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Describe the hardware that is a part of the applicant’s computer system.
___ Main Frame ___ LAN ___ Desktop ___ Laptop ___ Other
Describe other.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Do the applicant’s employees have access to the computer database from off-site locations? ___ Yes ___ No
If yes, which employees and the databases(s) they are allowed to access?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Do vendors and customers have access to the applicant’s computer database from off-site locations?___ Yes ___ No
If yes, identify the databases(s) that they are allowed to access?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Describe all firewall or encryption protection that the applicants uses to prevent security breaches.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Describe the applicant’s computer security protocol when employees leave the company.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Does the applicant use the Internet to transfer money, securities or goods? ___ Yes ___ No
If yes, describe the applicant’s security methods it uses to monitor usage and prevent fraud and identity theft.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
If the applicant uses a main frame, answer the following:
Are computer room door entry codes regularly changed? ___ Yes ___ No
Are source documents secured when not in use? ___ Yes ___ No
Are operations/procedure manuals secured when not in use? ___Yes ___No
Do the applicant’s employees sign a nondisclosure statement? ___ Yes ___ No
If the applicant uses an application service provider (ASP) provide a copy of the contract.
Does the applicant use an outside service to maintain the computers? ___ Yes ___ No
If yes, provide a copy of the contract.
Are the applicant’s accounting
and ordering computer systems controlled separately from the other computer
operations?
___ Yes ___ No
If yes, describe the applicant’s accounting and ordering controls and person(s) who have access to them.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
How many of the following does the applicant receive in a normal week?
____ Money orders ____ $20 bills ____ $50 bills ____ $100 bills ____ Foreign currency
Does the applicant check all currency $20 and over with a counterfeit checker? ___ Yes ___ No
If yes, describe method the applicant uses to insure that all employees use the checker.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
If the applicant accepts foreign currency, describe the methods it uses to verify authenticity..
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Does the applicant or any
of the applicant’s officers, partners, managers, or members work outside of the
If yes, list the countries.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Has the applicant received extortion threats in the past five years? ___ Yes ___ No
If yes, describe the threats in detail. Include dates and resolution.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Does the applicant have a protocol in place in case there is an extortion attempt? ___ Yes ___ No
If yes, describe the protocol.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Does the applicant have security procedures in place to
protect at-risk individuals? ___ Yes ___ No
If yes, describe the procedure(s).
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Does the applicant or any
of the applicant’s officers, partners, managers, or members travel outside of
the United States, Puerto Rico, or Canada on a regular basis? ___ Yes ___ No
If yes, list those countries._____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________