casemark/insurance-certificate-compliance

CRE Insurance Certificate Compliance Review

Analyzes ACORD 25 certificates and endorsement copies against Access Agreement insurance requirements. Produces a compliance determination with broker-ready corrective instructions.

Cardinal rule: A COI is an informational snapshot only — it does not amend, extend, or alter coverage.

Intake

Gather before drafting (unless user says "use defaults" or "just draft"):

1. Executed Access Agreement — all exhibits, insurance schedules, riders
2. Certificates of insurance — ACORD 25; separate forms for auto, WC, umbrella, professional, pollution
3. Endorsement copies — AI (CG 20 10, CG 20 37), primary/non-contributory, waiver of subrogation
4. Broker contact details
5. Project description — scope, dates, locations, hazard level

Defaults if no response: Review against standard CGL/auto/WC/umbrella; flag missing endorsements as non-compliant; produce deficiency instructions for all gaps.

If endorsements are missing, request them. If user insists on proceeding, label the review as preliminary with all conclusions conditional.

Step 1: Build Verification Matrix

Extract the Agreement's insurance clause into testable requirements:

| Category | What to extract | |---|---| | Coverage lines | CGL, auto, WC/EL, umbrella/excess, professional, pollution, cyber | | Limits | Per-occurrence, general aggregate, products/completed-ops aggregate, CSL, EL | | Aggregate structure | Per-project, per-location, or policy-level | | Additional Insured entities | Exact legal names with entity suffixes (owner, manager, lender, affiliates) | | AI scope | Ongoing only vs. ongoing + completed operations | | Required endorsement forms | Specific ISO form numbers or "or equivalent" | | Primary & non-contributory | Required on which lines | | Waiver of subrogation | Required on which lines | | Carrier rating | AM Best minimum (typically A- VII) | | Cancellation notice | Days' notice, to whom | | Deductible/SIR caps | Maximum amounts | | Occurrence vs. claims-made | Which lines must be occurrence form |

Pitfalls: Missing completed-operations AI requirement; entity name mismatches (e.g., "ABC Management" vs. "ABC Management, LLC"); assuming umbrella follows form without proof.

Step 2: Review ACORD 25

| Field | Verify | |---|---| | Named Insured | Matches Recipient entity exactly (legal name + suffix) | | Policy dates | Spans entire access period | | CGL form type | "Occurrence" if contract requires it | | CGL limits | Per-occurrence, general aggregate, products/completed-ops | | Aggregate applies per | Project/location if required (not just "Policy") | | Auto | "Any Auto" or required symbols; CSL meets minimum | | WC/EL | Statutory WC; EL limits; no excluded officers performing work | | Umbrella/Excess | Limits stack to contract total; follows form to required lines | | Certificate Holder | Being listed as Certificate Holder does NOT grant AI status |

Step 3: Verify Additional Insured Status

1. Confirm exact AI entities required (including affiliates language)
2. Determine endorsement type:
   • Blanket ("when required by written contract") — needs executed contract + endorsement copy
   • Scheduled (named entities) — confirm schedule lists correct names
3. Verify scope:
   • Ongoing only (CG 20 10) vs. ongoing + completed (CG 20 10 + CG 20 37)
   • "Caused in whole or in part" vs. vicarious liability only — varies by edition
4. No endorsement copies = non-compliant — issue deficiency notice requesting AI endorsements for entities listed in the Agreement

Step 4: Verify Remaining Requirements

Primary & Non-Contributory:

• Separate from AI status — AI does not automatically mean primary
• COI narrative alone insufficient; require endorsement or policy provision
• Confirm not overridden by umbrella "other insurance" clause

| Requirement | Verification | |---|---| | Waiver of subrogation | Endorsement on each required line — COI checkbox insufficient | | Umbrella AI | Confirm umbrella recognizes AI status; request declarations + endorsement | | Carrier rating | AM Best confirmation or broker attestation | | Cancellation notice | ACORD 25 standard language confers no notice rights; require endorsement | | Deductible/SIR | Request declarations or broker letter; flag credit risk for large SIRs | | Description of Operations | Check for exclusionary language (geographic limits, activity exclusions) |

Step 5: Produce Compliance Determination

INSURANCE COMPLIANCE REVIEW
[Privileged and Confidential — Attorney-Client Communication]

Project: [Name/Address]
Recipient: [Entity]
Agreement Date: [Date]
Review Date: [Date]
Assumptions Used: [list]
Open Items / Needed Inputs: [list]

DETERMINATION: [Compliant / Non-Compliant / Conditionally Compliant]

REQUIREMENT-BY-REQUIREMENT ANALYSIS:
| # | Requirement | Contract Ref | Status | Evidence | Deficiency |
|---|---|---|---|---|---|
| 1 | CGL $1M occ / $2M agg | §[X] | Compliant | COI shows matching limits | — |
| 2 | AI - ongoing + completed ops | §[X] | Non-Compliant | No endorsement provided | Provide CG 20 10 + CG 20 37 |

BROKER INSTRUCTIONS:
[Numbered corrective actions with exact document requests]

ESCALATION ITEMS:
[Issues requiring attorney or coverage counsel review]

Drafting rules: Use "unable to verify" not "coverage will be denied." Distinguish: "confirmed" / "indicated but not verified" / "not shown — non-compliant."

Jurisdiction Flags

| Jurisdiction | Issue | Action | |---|---|---| | New York | Labor Law §§240/241 strict liability (gravity injuries) | Check for "Labor Law"/"Heights"/"Action Over" exclusions; escalate to coverage counsel | | Texas | Anti-Indemnity Act (Ins. Code Ch. 151) | Flag if access involves construction/alteration/repair | | California | Civil Code §2782 limits risk-shifting (active negligence) | Confirm indemnity + AI requirements are consistent | | Florida | Fla. Stat. §627.4137 claimant rights | Note if potential claim identified |

Flag state-law issues for local counsel. Do not assert universal rules about certificate legal effect.

Post-Draft Checklist

After delivering the review, ask:

1. Does the determination match your understanding of coverage posture?
2. Additional entities to verify as AI?
3. Any deficiencies to escalate to coverage counsel instead of broker?
4. Follow-up check needed after broker cures?

Quality Audit

Before finalizing:

• [ ] Every Agreement requirement mapped to a testable check
• [ ] Requirement table complete with status for each coverage line
• [ ] Entity names compared character-by-character (LLC, Inc., LP suffixes)
• [ ] No compliance finding based solely on COI without endorsement verification
• [ ] Broker instructions are specific (not generic "provide adequate coverage")
• [ ] Jurisdiction flags included where applicable
• [ ] Assumptions and open items listed prominently
• [ ] Every assertion traceable to a document or labeled as assumption
• [ ] Disclaimer: not a coverage opinion; requires licensed attorney review

Guardrails

• COI ≠ coverage: Never approve compliance based solely on a certificate
• Entity names must match exactly — mismatches defeat AI coverage at claim time
• No coverage opinions: Compare contract requirements to documentary evidence only
• Privilege: Confirm with supervising attorney; third-party sharing may waive privilege
• Anti-hallucination: Do not invent policy terms or coverage conclusions; use [VERIFY] for unconfirmed details
• Attorney review required: Every deliverable must disclaim that it requires licensed attorney review before reliance