How to Read a Certificate of Insurance How to Read a Certificate The numbers outlined below correspond to blocks of information on the sample Acord form Certificate of Insurance on page VII-4.

1. Date the Certificate of Insurance is prepared

2. Producer is the insurance broker that wrote the insurance policy(ies) for the insured

3. Insured is the person or entity for whom the insurance policy is written, and to which primary insurance coverage is extended

4. Insurance company providing commercial general liability insurance coverage to the insured

5. Boxes marked indicate the type of general liability coverage and whether coverage is extended on a “claims made” or “occurrence” basis (commercial general liability insurance on an occurrence basis)

6. Commercial general liability policy number (GIC 1231 BG-01)

7. Date on which the commercial general liability insurance policy became effective (01/01/01)

8. Date on which the commercial general liability policy will expire (01/01/03)

9. Commercial general liability insurance limits which include the general aggregate amount ($2,000,000), products and completed operations aggregate amount ($1,000,000), personal and advertising injury amount ($1,000,000), per occurrence amount ($1,000,000), fire legal liability or rented structure fire damage amount ($100,000)

Limits may often be shown in “thousands” of dollars rather than the complete dollar amount. Check the format carefully.

10. Date on which the automobile liability policy became effective (01/01/01)

11. Date on which the automobile liability policy expires (01/01/03)

12. Automobile liability limits for bodily injury and property damage outlined either in combined form or separately

13. Insurance company(ies) providing excess liability insurance, i.e., layers above commercial general liability insurance

14. Boxes specify whether or not the excess liability coverage is written in umbrella form (umbrella form)

15. Excess liability insurance policy number (WE052ICC-01)

16. Date(s) on which the excess policy(ies) became effective (01/01/01)

17. Date(s) on which the excess policy(ies) expires (01/01/03)

18. Excess liability limits for each occurrence and in aggregate ($50,000,000)

Multiple listings may be shown such as: $10,000,000; $15,000,000 x $10,000,000; $25,000,000 x $25,000,000. This means that the first layer of excess liability insurance is $10,000,000; the second layer (above the $10,000,000 layer) is $15,000,000; and the third layer (above the first two layers totaling $25,000,000) is $25,000,000. In this example, the total amount of excess coverage is $50,000,000

19. Insurance company providing workers’ compensation and employers’ liability insurance

20. Workers’ compensation insurance policy number (LGIC0313-01)

21. Date on which the workers’ compensation policy became effective (01/01/01)

22. Date on which the workers’ compensation policy expires (01/01/03)

23. Workers’ compensation/employers’ liability insurance limits (statutory limits including $1,000,000 per accident, $1,000,000 disease policy limit and $1,000,000 disease each employee)

24. Insurance company providing crime insurance to the insured

25. Crime insurance policy number (BI-1222-01)

26. Date on which the crime insurance policy became effective (01/01/01)

27. Date on which the crime insurance policy expires (01/01/03)

28. Employee dishonesty limit ($3,000,000)

29. Special descriptions and requirements are included such as site codes, location codes, additional insureds, waivers, etc.

This example shows that Anonymous Life Insurance Company is an additional insured on all policies as their interests may appear (ATIMA) except for workers’ compensation insurance. Occasionally, certificates may state “Certificate holder is an additional insured” instead of listing an entity in this description box.

30. A certificate holder is simply the person or company to whom the Certificate of Insurance is being mailed. No rights, privileges or insurance coverages are extended to a certificate holder.

31. The cancellation clause outlines the terms for providing notice about cancellation of the policy

Contracts and agreements typically require a minimum of 30 days’ written notice of policy cancellation, the language in the section must be modified to meet our requirements. We require the insured to provide a certificate that either deletes or strikes through the language “endeavor to” and “but failure to mail such notice shall

impose no obligation or liability of any kind upon the company, its agents or representatives.”

The insurance broker signs the original certificate as an authorized representative