EMPLOYMENT-RELATED PRACTICES LIABILITY EXPOSURE ANALYSIS CHECKLIST

(August 2019)

INTRODUCTION

This checklist is designed to assist in beginning the employment-related practices liability exposure 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 as a supplement.

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

ISO Employment-related Practices Liability Coverage Form Endorsements Checklist

ISO Employment-related Practices Liability Coverage Form Available Endorsements and Their Uses

GENERAL CLIENT INFORMATION

Legal business name(s):

____________________________________________________________________________________

Mailing address:

____________________________________________________________________________________

Type of entity:

___ Individual	___ Corporation	___ Sub-S Corp.
___ 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 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:	____________________________	______________
Other Decision Makers:	____________________________	______________
Plant and Grounds:	____________________________	______________
Financial:	____________________________	______________
Legal:	____________________________	______________
Claims:	____________________________	______________

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?___

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.

EMPLOYMENT-RELATED PRACTICES LIABILITY

EMPLOYEE INFORMATION

How many of the applicant’s employees are at each location?

Location # of employees

____________________________________________________________________________________

Attach separate sheet if there are more than three locations.

Provide total number of employees:

___ Full time	___ Seasonal	___ Leased
___ Part time	___ Temporary

What are the percentages of employees who are ____% Exempt ____% Non-exempt?

What are the percentages of employees who are ____% Union ____% Non-union?

Provide the number of employees the applicant hired, the number it terminated, and the turnover rate for each of the past five years.

Year	# Hired	# Terminated	Turnover rate %
_________	_____________	________________	______________
_________	_____________	________________	______________
_________	_____________	________________	______________
_________	_____________	________________	______________

HUMAN RESOURCE DUTIES

Does the applicant maintain a human resources or personnel department? ___ Yes ___ No

If no, how are the human resources job duties handled?

____________________________________________________________________________________

Are all human resource job duties handled in a central location? ___ Yes ___ No

If no, describe how the duties are distributed and where they are addressed.

____________________________________________________________________________________

Does the applicant have a written policy regarding hiring, termination, and disciplinary
procedures? ___ Yes, to all ___ No

If no, explain:

____________________________________________________________________________________

NEW HIRE PROCEDURES

Are applications required of all applicants and new hires? ___ Yes ___ No

Are references routinely asked for all applicants and new hires? ___ Yes ___ No

Are references checked? ___ Yes ___ No

Are past employers checked? ___ Yes ___ No

Is education verified? ___ Yes ___ No

Do new hires receive orientation and training upon hire? ___ Yes ___ No

Does the applicant have an employee handbook? ___ Yes ___ No

If yes, answer the following:

Is the handbook routinely distributed to all new employees at time of hire? ___ Yes ___ No

Are updates distributed to all employees on periodic basis? ___ Yes ___ No

Explain any No answers:

_________________________________________________________________________________

COMPLAINT PROCEDURES

Does the applicant have a procedure in place to address sexual harassment complaints? ___ Yes ___ No

If yes, attach a copy of the procedure.

If no, explain.

____________________________________________________________________________________

Does the applicant provide training on responding to sexual harassment complaints? ___ Yes ___ No

If yes, provide details.

____________________________________________________________________________________

Does the applicant have a procedure in place to address discrimination complaints? ___ Yes ___ No

If yes, attach a copy of the procedure.

If No, explain.

____________________________________________________________________________________

Does the applicant provide training on how to respond to discrimination complaints? ___ Yes ___ No

If yes, provide details.

____________________________________________________________________________________

PROMOTIONS AND EVALUATIONS

Is any testing or screening given to employees prior to promotion? ___ Yes ___ No

Are all employees reviewed and evaluated on a periodic basis? ___ Yes ___ No

If yes, answer the following:

What is frequency of reviews? _____

Is the review/evaluation procedure formal and in writing? ___ Yes ___ No

Are employees informed of the results? ___ Yes ___ No

Does the applicant have a formal procedure for terminations? ___ Yes ___ No

If yes, attach copy.

TERMINATION PROCEDURES

Are all terminations reviewed by or with legal counsel prior to implementation? ___ Yes ___ No

Are layoffs, consolidations, or mergers probable in the next three years? ___ Yes ___ No

If yes, explain.

____________________________________________________________________________________

When the applicant lays off or terminates employees due to downsizing, merger, or consolidation, does it provide job-training, retraining, or placement assistance to all impacted employees? ___ Yes ___ No

If yes, describe.

____________________________________________________________________________________

If the applicant offers this service to only certain employees, provide the criteria for doing so.

____________________________________________________________________________________

DOCUMENTATION

Attach the documentation procedure the applicant uses for each employee. Be sure to specify what information is retained, the length of time it is retained, and the persons who have access to the information.

Attach the documentation procedure the applicant uses for discrimination and harassment complaints. Include information on the items the applicant retains, the length of time they are retained, and the persons who have access to the information.

PRIOR POLICY INFORMATION

List the applicant’s prior employment-related practices insurance, if any.

Period	Insurer	Limit	Premium

Has a lawsuit(s) been filed against the applicant because of employment-related practices such as discrimination (sexual, racial, gender-orientation, religious), sexual harassment, or wrongful termination?

___ Yes ___ No

If yes, provide details. Include dates, describe the lawsuit(s), the final disposition of lawsuit(s), and any awards made. Attach a separate sheet of paper if necessary.

____________________________________________________________________________________

Has the applicant ever had a lawsuit against them for any type of employment-related practice such as discrimination (sexual, racial, gender-orientation, religious), sexual harassment, or wrongful termination?
___ Yes ___ No

If yes, please provide details including dates, description of lawsuit, disposition of lawsuit, and any awards made. Attach a separate sheet of paper if necessary.

____________________________________________________________________________________

Does the applicant know about circumstances or situations that may result in an employment-related claim or lawsuit? ___ Yes ___ No

If yes, describe the situation and why it may result in a claim or lawsuit. Attach a separate sheet of paper if necessary.

____________________________________________________________________________________

Has the applicant had any claim, grievance, charge, or hearing through any of the following agencies or acts?

Civil Rights Act ___ Yes ___ No

Americans with Disabilities Act ___ Yes ___ No

National Labor Relations Board ___ Yes ___ No

Equal Employment Opportunity Commission ___ Yes ___ No

Age Discrimination Employment Act ___ Yes ___ No

Any other federal, state, or local agency relating to employment ___ Yes ___ No

Any other federal, state, or local regulation or legislation relating to employment ___ Yes ___ No

If yes to any of the above, provide all details. Attach a separate sheet of paper if necessary.

_________________________________________________________________________________

Describe any changes in the applicant’s policies and procedures that resulted from the above described claim, grievance, charge, or hearing.

_________________________________________________________________________________