ISO MOTOR CARRIER COVERAGE FORM EXPOSURE ANALYSIS CHECKLIST

(October 2019)

INTRODUCTION

This checklist is designed to assist in beginning the Business Auto Coverage Form analysis. 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.

A list of endorsements may be helpful as you discuss exposures with your client.

ISO Motor Carrier Coverage Form Available Endorsements and Their Uses

ISO Motor Coverage Form Endorsements Checklist

GENERAL CLIENT INFORMATION

Legal business name(s):

______________________________________________________________________________________

Mailing address:

______________________________________________________________________________________

Type of entity:

___ Individual	___ Corporation	___ Sub S. Corporation
___ Partnership	___ Joint Venture
___ Not-For-Profit	___ Limited Liability Company

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 of experience does the owner have in this type of business? _______________________

How many years of 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
Other Decision Makers
Plant/Grounds
Financial
Legal
Claims

The applicant’s primary operations are:

____________________________________________________________________________________

The applicant’s secondary and 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? ___

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.

AUTOMOBILE–MOTOR CARRIERS

DRIVER INFORMATION

List the names of the applicant’s drivers who maintain a Commercial Drivers License (CDL).

____________________________________________________________________________________

Are any of the applicant’s officers, partners, or employees furnished an automobile for their personal use? ___ Yes ___ No

Do individuals with an automobile furnished by the applicant purchase automobile insurance on autos they own personally?
___ Yes ___ No

Does the applicant use its own vehicles to tow special equipment such as air compressors or concrete mixers? ___ Yes ___ No

Are any of the applicant’s automobiles used in parades or other events? ___ Yes ___ No

Are any of the applicant’s vehicles laid up and out of service for more than 30 consecutive days or more due to seasonal operations?
___ Yes ___ No

If the applicant uses subcontractors, are procedures in place to monitor receiving certificates of insurance on a timely basis?
___ Yes ___ No ___ No subcontractors

If yes, describe.

____________________________________________________________________________________

Are any of the applicant’s automobiles equipped with cellular telephones, two-way radios, citizens band radios or similar devices? ___ Yes ___ No

If yes, describe. Attach a separate sheet, if necessary

Vehicle Unit #	Type of device	Actual cash value of device

How many automobiles are parked at one location overnight?

Location Address	Number of vehicles at the location	Total value of all vehicles at the location

Describe lot protection at each location.

____________________________________________________________________________________

Does the applicant lease or rent vehicles with operators to others? ___ Yes ___ No

Does the applicant lease or rent vehicles without operators to others? ___ Yes ___ No

Does the applicant travel to Canada or Mexico? ___ Yes ___ No

Do vehicles have theft alarms? ___ Yes ___ No

Do all drivers receive training in evasive maneuvering? ___ Yes ___ No

How often do drivers receive refresher courses? __________

Is there an established procedure to follow in case of accident? ___ Yes ___ No

Are drivers trained in cleanup procedures? ___ Yes ___ No

What is the maximum radius of operation? __________ miles

What is the average radius of operation? _________ miles

Does the applicant transport red-label adhesives? ___ Yes ___ No

If yes:

Are all drivers required to have Haz-Mat licenses? ___ Yes ___ No

Is transportation done at restricted times of the day? ___ Yes ___ No

Are trucks clearly marked? ___ Yes ___ No

Does the applicant transport chemicals? ___ Yes ___ No

If yes:

Are all drivers required to have Haz-Mat licenses? ___ Yes ___ No

Is transportation done at restricted times of the day? ___ Yes ___ No

Are trucks clearly marked? ___ Yes ___ No

AUTOMOBILE – HIRED AND NONOWNERSHIP

HIRED/BORROWED AUTO

Is the applicant required to provide primary coverage for any hired or borrowed vehicles?
___ Yes ___ No

If yes, answer the following:

Will the applicant hire or borrow the same vehicle for more than six months? ___ Yes ___ No

Note: If yes, the auto should be covered in the same way as an owned vehicle is covered.

Does an employee of the applicant own the vehicle? ___ Yes ___ No

Does the applicant’s employee hire the vehicle in his or her own name to perform the applicant’s business?
___ Yes ___ No

List the states where the applicant may hire or borrow vehicles. Provide the estimated annual cost (enter "if any" if unknown).

State	Estimated cost	State	Estimated cost	State	Estimated cost

Does the applicant require hired auto physical damage coverage? ___ Yes ___ No

Does the applicant hire vehicles with drivers? ___ Yes ___ No

Describe the types of vehicles the applicant hires or borrows and the reason(s) why the applicant hires or borrows them.

____________________________________________________________________________________

NON-OWNED

What is the total number of the applicant’s employees at all locations? ____

If the applicant is a partnership, what is the total number of active and inactive partners? _____

What percentage of employees regularly use their personal vehicles in the applicant’s business? ___%

Does the applicant want to have employees covered as insureds when they are using their automobiles for the applicant’s business? ___ Yes ___ No

Do the applicant’s employees use their personal vehicles to provide "on demand" deliveries to homes and/or businesses?
___ Yes ___ No