Completed Operations Liability
Transcription
Completed Operations Liability
Table of Contents Introduction...................................................................................................................... 2 General Liability............................................................................................................... 3 Premises and Operations Liability ................................................................................... 4 Premises Checklist.................................................................................................... 7 Contractors ...................................................................................................................... 9 Contractors Checklist ............................................................................................... 10 Certificates of Insurance........................................................................................... 12 Completed Operations Liability...................................................................................... 15 Completed Operations Checklist............................................................................. 16 Product Liability ............................................................................................................. 17 Product Liability Checklist ........................................................................................ 18 Product Recall Pre-Planning Checklist..................................................................... 23 Employment Practices Liability ...................................................................................... 26 Employment Practices Checklist .............................................................................. 28 Visitor Accident Investigation......................................................................................... 30 Visitor Accident Report............................................................................................ 32 Resources ..................................................................................................................... 34 This publication is not a part of your policy. The information contained in this publication is provided for informational purposes only and does not attempt to identify all potential hazards or remedial actions. The information provided is only to assist you in your compliance and loss control efforts. FCCI Insurance Group* shall not be liable for any loss, death, damage or expense arising out of the use of the suggested loss control measures. FCCI Insurance Group* makes no representations and provides no legal advice regarding federal, state or local requirements. There may be additional federal, state and local requirements with which you are required to comply that are not contained in this material. You are solely responsible for complying with federal, state and local laws, including compliance with any changes in the law, and for the safety of your operations. If you have questions or concerns regarding any legal issues please consult your legal adviser. *The FCCI Insurance Group includes the following carriers: FCCI Insurance Company, FCCI Commercial Insurance Company, National Trust Insurance Company, Monroe Guaranty Insurance Company, and Brierfield Insurance Company. 1 Introduction Legal liability is the legal responsibility that a person or organization faces due to injury or damage suffered by another person or organization. As a business owner, you want to try to minimize your liability exposures. Insurance minimizes exposure after the fact by paying for certain accidental losses covered by the policy. However, insurance is only one means of protection. Loss control is an effective and preemptive risk management technique that should be considered to help minimize exposure. Loss control includes loss prevention, which lowers loss frequency, or the number of losses, and loss reduction, which lowers loss severity, or the dollar amount of losses. This guide will provide you with some risk factors to be aware of when developing your own general liability loss control program. As you read this guide, keep in mind that general liability covers a broad range of exposures that are subject to many types of hazards, depending on the specific industry, and you should develop your own loss control program with those specific risks in mind and with help from your legal counsel. General liability insurance is designed to protect your business from direct financial loss, but accidental losses have indirect consequences, too. Indirect costs can include: • • • • • Disruption of business operations Loss of customer goodwill Missed business opportunities Higher insurance premiums Undesirable image in the community The implementation of a formal general liability loss control program benefits everyone—employee, business owner, public, and insurance carrier. These benefits can include: • • • • • Reduction in loss frequency Reduction in loss severity Increased customer satisfaction Lower insurance premiums Higher employee morale The information in this guide is intended to assist you and your company with the development of an effective general liability loss control program. Each section contains materials that you can use as a starting point. If you have questions that are not addressed in this guide, please contact your agent or FCCI Loss Control Representative. They can answer your questions and help you develop industry-specific materials. 2 General Liability The commercial general liability policy covers sources of liability that are not specifically excluded within the policy. Generally, losses such as those covered by business auto liability insurance or workers compensation insurance are specifically excluded. General liability insurance may cover some of the major liability exposures of a business, including liability related to the premises, operations in progress, products, and completed operations. For example, if your customer enters your building and slips on a newly washed floor, you may face a claim that you were negligent for not putting up a sign indicating the floors were wet. General liability insurance may be needed should you have to defend yourself in court against a claim of negligence. Negligence is a failure to exercise an appropriate degree of care under the circumstances that causes injury or damage. What is an appropriate degree of care is determined not only by common sense but also by legal principles, so you should consult with your legal adviser to develop a legally effective loss control program specific to your circumstances. This publication does not address specific circumstances or provide legal advice but is a tool for you to use to develop an effective loss control program. There are two primary general liability risk control strategies you should employ to protect business, property, and people. First, there are pre-loss activities necessary to either prevent a loss from occurring or to minimize the potential severity or cost of loss. Requiring staff to post a “Caution: Wet Floors” sign in a public area is an example of a pre-loss activity. Second, there are post-loss activities that help minimize the potential size of loss. An employee properly responding to an injured customer or visitor is an example of a post-loss activity. What are some potential causes of loss for general liability? • • • • • • • Failure to keep required records Failure to keep accurate records Failure to properly service and maintain jobsite equipment Failure to properly supervise subcontractors, manufacturers, and suppliers Failure to adequately maintain a secure and safe jobsite Inadequate or missing hold harmless agreements and indemnification clauses Failure to use qualified, financially sound subcontractors, vendors, and manufacturers 3 Premises and Operations Liability Premises Liability In insurance, a hazard is anything that tends to increase the probable severity or frequency of loss. Premises liability hazards refer to those conditions on your property that can cause injury or property damage to others. A premises hazard of great concern is anything that prevents an occupant from exiting a building safely in the event of fire or other emergency. Common examples of other premises hazards include potholes in parking lots, poor lighting in stairwells, slippery floors, and unfenced ponds. When identifying and controlling these types of hazards, it helps to keep in mind that you are trying to minimize loss potential arising from injury to anyone who visits your property. Refer to the Premises Checklist in this guide to help identify and minimize some potential loss exposures. This list is not all inclusive and may not cover every exposure or situation, but it can be used as a starting point. Remember that there may also be building codes, fire codes, and other laws, regulations, or ordinances that you will need to reference and comply with. In addition, you should survey your premises regularly. Surveys should be conducted at different times of the day and various days of the week, since weather, traffic, and customer volume frequently change. Once a hazard has been identified, you will need to establish a priority to correct, eliminate, or minimize the exposure. Consult your FCCI Loss Control Representative for additional assistance. Emergency Evacuation Plan You are responsible for the safety of visitors and guests, whether you operate a huge outdoor arena or a small storefront business. Where would you guide your patrons if immediate evacuation were necessary? There are several important details that must come together for an emergency evacuation to be effective. Readiness must come from pre-planning. There are six distinct processes to consider in any emergency evacuation plan: 1. The decision-making process 2. The information and awareness process 3. The exit preparation process 4. The exit process 5. The return process 6. The evaluation process 4 The following questions can assist you in developing your emergency evacuation plan: Decision Making • Who is the point person who will make the decision of whether and when the evacuation is ordered? Who is this person’s backup? • Who will coordinate the major steps within the evacuation process? • Who will communicate with the community’s fire department, police, and press? • Are all decision-makers aware of their responsibilities and readily accessible? Information and Awareness • What criteria are in place for choosing to act? For example, how long before a storm is expected to strike should the decision be made to evacuate a jobsite or cease outdoor operations? • How best can the critical information be obtained in time for that decision? For outdoor operations, a functional link with the local weather station for receiving and evaluating storm warnings is one suggestion. • For the most part, weather can be tracked; bomb threats represent a different source of threat. How will you manage a bomb threat? How will you manage fires? Earthquakes? Exit Preparation • Egress is defined as an exit, or a coming or going out. Is there exit planning in place to determine in advance how the point person should alert personnel that a decision to evacuate is being considered? • Planning should ensure the best exit routes for the number of evacuees and the preferred area/s of refuge. • Planning should also ensure that inbound lanes are kept open for fire trucks, ambulances, and other emergency personnel. Exit • When emergency staff has been advised of the decision to evacuate, is there a plan to announce directions to guide the evacuation? Pre-planned announcements (given clearly, calmly, and repetitively) can help minimize panic or a disorderly exit. Exit information should also be posted at strategic locations. • Are there planned inspections to check for stragglers, persons with disabilities, and those who may suffer injury during the evacuation? • Is there a contingency plan for those occasions in which an exit route is blocked? Alternative routes need to be thought through well in advance. 5 Return • Does planning allow for emergency evacuation that is considered precautionary and potentially temporary? If it is, how and when is the “all-clear” to be given? • Who has the authority to announce that it is safe to return, and how will this information be communicated among different groups of evacuees? Evaluation • Is your Emergency Evacuation Plan in writing? Can it be easily understood and used for training purposes? • Do you conduct periodic drills, and do you revise your Emergency Evacuation Plan based upon the experience? Any plan can be improved if it is reviewed and tested by either experts in the community or the staff who rely on it. The National Fire Protection Association’s (NFPA) Life Safety Code 101 is a useful resource. The NFPA develops, publishes, and disseminates hundreds of consensus codes and standards intended to minimize the possibility and effects of fire and other risks. For more information, visit the NFPA website at www.nfpa.org. This company is not responsible for and does not endorse the content of this website. Operations Liability Whereas premises liability hazards are created from the conditions on your property, operations liability hazards are created from the activities of your business. These activities may take place at or away from your premises. Therefore, hazards can range from poor traffic control on or around construction jobsites to careless welding on your own property. Third party claims alleging bodily injury or property damage have the potential to be very costly. With this in mind, it is best to be proactive in identifying potential hazards. One way to be proactive is to perform daily walk through inspections of your property. It is a good idea to carry your premises checklist with you when you conduct these regular safety inspections. When you notice potential hazards, do all you can to correct them first, then share the problem with your employees at one of your regularly scheduled safety meetings. Be sure to document all of the issues you discuss during the meeting and assign a target date and a person responsible for reducing or eliminating the hazard. 6 Premises Checklist Building Exit Design and Capacity Exits and egress are adequate for the building occupancy Exit signs provided and illuminated Exit doors open outward in direction of travel Exit doors unlocked during occupancy Exit doors not blocked in any way Location of nearest exit is readily apparent from any point in the building Access to all exits is clear and unobstructed Stairway doors or other fire rated doors are not propped open or prevented from closing as designed Emergency Lighting Provided in all areas Proper type, self-activating, and correctly installed Tested on a scheduled basis Provides adequate general illumination to assure safe egress from building Provides exit identification Stairs and Steps Good condition Free of tripping hazards No obstructions or storage in stairways Adequate/proper handrails Walking surfaces are smooth, level, even, and provide adequate traction All areas evaluated as though it is dark and/or inclement weather Elevators and Escalators Full maintenance contract on all elevators and escalators Emergency communications (telephone and/or alarms) tested and monitored Elevator cars stop level with floors Safety devices operate effectively (i.e., interlocks, reopening devices, and emergency cut-off buttons) Business Practices Floor surfaces level, slip resistant, and hazard free Visitors are escorted Visitors in work areas wear proper protective equipment Visitors required to follow safety rules Keys issued to authorized persons only and retrieved when necessary 7 Premises Checklist - 2 Parking Lots Level, free of potholes and loose gravel Free from tripping hazards Adequately lit Adequately drained Poles (light, sign, power, etc.) protected from impact Traffic control signs and markings present Driver’s view not blocked by shrubbery, signs, etc. Separate entrance and exit Traffic channeled in only one direction per aisle Clearly marked angled parking Driveways at least 12 feet wide Pedestrian lanes clearly marked Sidewalk elevated above the parking surface Vacant Areas Jobsites protected from children and/or trespassers (i.e., fencing, locks, alarms, and/or watchman service) Property periodically evaluated for changes “No Trespassing” signs posted No unfenced ponds Swimming Pools Properly fenced and enclosed Life-saving equipment available Depth marked Rules posted Pool care performed by a qualified technician No diving boards/platforms Pool deck surface offers adequate traction All lighting and electrical circuits protected by ground fault circuit interrupters Use of pool and spa drains that provide proper protection against hair entrapment This publication is not a part of your policy. The information contained in this publication is provided for informational purposes only and does not attempt to identify all potential hazards or remedial actions. The information provided is only to assist you in your compliance and loss control efforts. FCCI Insurance Group* shall not be liable for any loss, death, damage or expense arising out of the use of the suggested loss control measures. FCCI Insurance Group* makes no representations and provides no legal advice regarding federal, state or local requirements. There may be additional federal, state and local requirements with which you are required to comply that are not contained in this material. You are solely responsible for complying with federal, state and local laws, including compliance with any changes in the law, and for the safety of your operations. If you have questions or concerns regarding any legal issues please consult your legal adviser. *The FCCI Insurance Group includes the following carriers: FCCI Insurance Company, FCCI Commercial Insurance Company, National Trust Insurance Company, Monroe Guaranty Insurance Company, and Brierfield Insurance Company. 8 Contractors Contractors face many different and unique situations that can result in increased risk of claim or loss exposure. For example, failing to provide a safe and secure jobsite can result in various types of claims, and reliance on a hold harmless agreement may be misplaced if such an agreement cannot be enforced. There are many things a contractor can do, however, to limit exposures and prevent claims. A contractor can begin by developing a good record keeping system and sound contracts with subcontractors. Below are some items to consider when developing your arrangements with your subcontractors. You should seek legal assistance when developing contractual agreements with subcontractors and prior to signing agreements with others. • Require all subcontractors to carry general liability insurance with limits no lower than $500,000/$1,000,000 and to produce a Certificate of Insurance (COI). Keep this information in your records. • Your own general liability insurance policy may cover injuries or damage caused by an independent contractor, such as a subcontractor. Therefore, a general liability insurance policy with limits no lower than $500,000/$1,000,000 can help you reduce your liability for such claims. See your FCCI insurance agent for more details on this coverage. • Verify that coverage is still in force by contacting the agency that issued the COI. Note: The COI is for "informational" purposes only and may not truly indicate the coverage that is actually in place. • Require that you be made an additional insured on all subcontractor liability policies and request confirmation from the agency that issued the COI, or directly from the subcontractor's insurance company. It is important for you to obtain and review Certificates of Insurance from the businesses that perform services on your behalf, either for you directly or for your customers. The contractors that you use should have insurance that is in force and (in most cases) have limits of insurance at least equal to yours. 9 Contractors Checklist Staff and Subcontractors o Develop a written hiring and selection program o Conduct criminal background checks on employees who interact with your customers and/or the public, and especially workers who enter the customer’s property. Remember that certain consent and disclosure requirements may apply so you should consult your legal adviser to develop the appropriate procedure o Evaluate the competency of technical staff, including their academic qualifications and job experience o Establish and enforce a policy prohibiting loaning, renting, or borrowing of tools and equipment (store equipment safely and securely) o Make sure there is always an adequate number of properly trained and experienced workers on duty o Only use subcontractors who are reputable and financially sound o Require design consultants to maintain professional liability coverage o Require Certificates of Insurance from all subcontractors o Check Certificates of Insurance for adequate coverage and limits o Implement a formal quality control process for employees and subcontractors Training o Conduct regular meetings and discuss the responsibility everyone has for safety o Develop training programs for all personnel to ensure they are qualified o Provide adequate site supervision by qualified personnel o Develop written job responsibilities for supervisors o Develop written contingency plans and share these plans with personnel Record Keeping o Maintain all records in an orderly record keeping system with defined record retention criteria. The following are examples of records that should be retained pursuant to your record keeping system and retention criteria: o Job specifications o Blueprints o Design criteria o Quality control data o Contracts o Serial numbers of component parts o System test results o Complaint files (including remedial actions) o Hold harmless agreements o Any other supporting information 10 Contractors Checklist – 2 o Develop a good bid process; use bid software o Document the location of utility lines o Use a diary system to be sure all Certificates of Insurance are current o Obtain proof that you are an additional insured on all subcontractors’ policies o Document and make available all change orders and specifications o Require that change orders be approved in writing by the appropriate authority Jobsite Safety o Provide pedestrians with a protected passageway around the jobsite o Provide that blasting is subcontracted to a qualified, licensed and insured contractor o Provide an adequate security system to protect the jobsite and the public o Provide protection or fencing at the jobsite, particularly in metro areas o Check all signs and lights at least daily, more often as conditions warrant o o o o Provide adequate warning signs ahead of the jobsite Ensure that warning signs are adequately anchored Avoid leaving any open excavations, or protect all sides with barricades Implement minimal traffic controls, including at least: o Use of competent employees responsible for directing traffic o Tapering of blocked traffic lanes o Establishment of “safe zones” around workers o Use of barricades around the jobsite o Use of adequate lighting or flashing warning signals at night or in dark conditions For additional information on traffic controls, refer to the Manual of Uniform Traffic Control Devices. This publication is not a part of your policy. The information contained in this publication is provided for informational purposes only and does not attempt to identify all potential hazards or remedial actions. The information provided is only to assist you in your compliance and loss control efforts. FCCI Insurance Group* shall not be liable for any loss, death, damage or expense arising out of the use of the suggested loss control measures. FCCI Insurance Group* makes no representations and provides no legal advice regarding federal, state or local requirements. There may be additional federal, state and local requirements with which you are required to comply that are not contained in this material. You are solely responsible for complying with federal, state and local laws, including compliance with any changes in the law, and for the safety of your operations. If you have questions or concerns regarding any legal issues please consult your legal adviser. *The FCCI Insurance Group includes the following carriers: FCCI Insurance Company, FCCI Commercial Insurance Company, National Trust Insurance Company, Monroe Guaranty Insurance Company, and Brierfield Insurance Company. 11 Certificates of Insurance What is a Certificate of Insurance? A Certificate of Insurance (COI) is a form that outlines the coverage provided for a named insured. It is for informational purposes only. The certificate itself does not provide any rights to the certificate holder. The most widely used certificate is ACORD Form 25-S, and it is published by the Agency-Company Organized Research and Development (ACORD) corporation. Standard language at the top of ACORD Form 25-S clearly states that it is issued for informational purposes only, gives no rights to the certificate holder, and does not amend, extend, or alter the coverage afforded by the policies shown on it. Why do I need a Certificate of Insurance? In most construction contracts, there are indemnity agreements whereby the party performing the work agrees to legally defend and hold harmless the other party to the contract against claims for certain damages arising from that work. For example, an electrical subcontractor may hold harmless a general contractor (GC) for work the electrical subcontractor performs. In this situation, the electrical subcontractor is known as the “indemnitor” and the GC is known as the “indemnitee.” If a third party makes a claim against the subcontractor and the GC alleging bodily injury or property damage resulting from the subcontractor’s work, both parties may seek to rely on the subcontractor’s insurance policy to provide for their legal defense and to pay damages they are legally obligated to pay. When the GC hires the subcontractor, the GC will usually require a Certificate of Insurance that shows that the subcontractor has liability coverage with adequate policy limits to cover payment and defense costs for any claims that may arise. Once the subcontractor produces a Certificate of Insurance to the GC (this is usually accomplished through the subcontractor’s insurance agent or insurance company), the GC becomes a “certificate holder.” 12 Does an insurance company providing coverage have to inform the certificate holder when a policy is canceled either by the carrier or the insured? No. An insurance company is usually under no obligation to notify certificate holders when a policy is canceled or expires. ACORD Form 25-S states that the insurance company issuing a policy will endeavor to provide written notice to certificate holders named on the certificate, but will not be obligated or liable for failure to do so. It seems there are considerable limitations on the benefits afforded by a Certificate of Insurance. What are other limitations a certificate holder should be aware of? With regard to coverage, all a certificate holder can really be sure of is that the policies shown on the certificate were in effect at the time the certificate was issued. Certificates of Insurance are merely evidence of insurance in lieu of an actual copy of the insurance policy. They are not to be used to attempt to modify the terms of the policy itself. No insurer or agent should issue or sign a Certificate of Insurance that contains terms or conditions that differ from those in the underlying policy. You should not rely upon a Certificate of Insurance to determine if aggregate limits (i.e., the most the insurance company will pay out per policy or per project during the policy period) have been reduced. For example, if a subcontractor has a policy with a $300,000 general aggregate and has already had claims totaling $250,000, there would only be $50,000 left to pay for a claim that might arise from work the subcontractor is performing for you. You would not know this by looking at the Certificate of Insurance. Discrepancies may exist between coverage shown on the Certificate of Insurance and the actual coverage provided by the policy. For example, there may be exclusions on the subcontractor policy (e.g., the Total Pollution Exclusion) that further limit policy coverage, and these exclusions will not normally be shown on the certificate. Often, it is the agent or broker who issues the Certificate of Insurance and not the insurance company. If the agent or broker issues a certificate showing you have been named as an additional insured, but they have not notified the insurer or the policy has not been endorsed for other reasons, you may not, in fact, be an additional insured. Be careful: Inaccurate or fraudulent certificates may be issued showing policies that do not even exist. 13 I know I need certificates if I subcontract work out to others, and I know certificates are at best an imperfect means for being sure my subcontractors have insurance. How do I obtain them? • Speak with your agent to assess your entire Certificate of Insurance needs • Establish a written Certificate of Insurance program to handle the certificates you receive from other companies. Assign a specific person to be accountable for implementing the certificate control process and for obtaining and maintaining the required certificates • Develop a follow-up system as part of the certificate control process to ensure the certificates you have on file are valid. Make sure you do this before a subcontractor begins any work and monitor the certificates for the duration of the job. Include a review process to ensure that the certificates you receive show all coverages, limits, and additional insured statuses that you require • Accept only original certificates, or a fax that is followed shortly by an original. Do not accept photocopies • Do not allow uninsured subcontractors on the job • Save old certificates in case a coverage issue arises in the future • Pre-qualify your subcontractors to make sure they are financially sound • Document all persons brought on the jobsite by the subcontractor 14 Completed Operations Liability Completed operations liability refers to the liability that businesses have if work they have completed is defective and causes bodily injury to another, or damages another's property. Determining when a service or a project has actually been completed can be difficult. Sometimes it is determined according to the terms and conditions specified in a contract. Other times it is based on the customer's authorization or simply when the work at a jobsite has been put to its intended use or occupancy. Completed operations claims can result from faulty plumbing repairs or faulty installation that results in water damage to a customer's property. They can be more serious or even catastrophic in other cases, such as when faulty brake repair work results in a serious auto accident, or if a building collapses because of failure to build to construction specifications. It is important to keep in mind that completed operations losses like these can occur long after a job is finished. Proper selection, inspection, and testing of materials and equipment are vital to reduce completed operations losses. Careful evaluation and selection of qualified subcontractors is critical. For additional ideas that will help you protect business, property, and people from completed operations losses, refer to the Completed Operations Checklist in this guide. 15 Completed Operations Checklist Material & Equipment Materials are used in accordance with design specifications Materials are within code of the appropriate jurisdiction Equipment used on the job is appropriate for the task Employees and contractors are trained to use the proper equipment to do the job Quality Assurance A skilled full-time supervisor is on the job at all times Design work is performed by a licensed engineer A written quality assurance program is in place and is followed Inspection and testing procedures comply with specifications, codes, and standards Certification, inspecting, and testing are done by qualified, independent companies Inspection equipment is regularly serviced and calibrated Applicable codes and standards are met Work approval obtained via signoff by an engineering firm Work approval obtained via letter of acceptance from the customer Documentation Customer training and written instructions are provided Warnings are provided in the instructions and on the product All instructions, manuals, warnings, and warranties are reviewed by legal counsel Record retention criteria is approved by legal counsel Work quality and performance conforms to all warranties This publication is not a part of your policy. The information contained in this publication is provided for informational purposes only and does not attempt to identify all potential hazards or remedial actions. The information provided is only to assist you in your compliance and loss control efforts. FCCI Insurance Group* shall not be liable for any loss, death, damage or expense arising out of the use of the suggested loss control measures. FCCI Insurance Group* makes no representations and provides no legal advice regarding federal, state or local requirements. There may be additional federal, state and local requirements with which you are required to comply that are not contained in this material. You are solely responsible for complying with federal, state and local laws, including compliance with any changes in the law, and for the safety of your operations. If you have questions or concerns regarding any legal issues please consult your legal adviser. *The FCCI Insurance Group includes the following carriers: FCCI Insurance Company, FCCI Commercial Insurance Company, National Trust Insurance Company, Monroe Guaranty Insurance Company, and Brierfield Insurance Company. 16 Product Liability Product liability refers to the legal liability for bodily injury or property damage that arises out of a defect in the design, manufacture, distribution, or sale and disposal of a product you manufacture, sell, or supply to others that makes it unreasonably dangerous. The party seeking damages can be the buyer, any foreseeable user, or even a bystander. Strict liability is a legal concept applied in product liability cases in which legal liability arises from inherently dangerous activities or dangerously defective products that cause injury or harm to another, regardless of how much care was used in the activity. Seven key performance areas that will help business owners ensure product safety and minimize product liability loss potential include: 1. 2. 3. 4. 5. 6. 7. Management leadership and support Design evaluation Legal review and counsel Quality assurance and control Product labels, packaging, and warnings Marketing and customer service Product recall planning and implementation The Product Liability Checklist and the Product Recall Pre-Planning Checklist in this guide will provide you with an overview of factors you need to plan for in each of these seven key areas. 17 Product Liability Checklist Management Involvement There is a written policy statement that clearly expresses the company’s commitment to producing safe and reliable products Authority for implementing the program is delegated to top-level management Product Safety budgets are prepared and properly funded as part of normal operating functions Culture Specific product safety objectives are established and linked to total quality management There is a product safety committee that involves employees from engineering, production, purchasing, quality control, legal, sales, service, etc. There is companywide awareness and concern regarding product liability and the legal pitfalls to be avoided in the design, manufacture, marketing, distribution, sale, and disposal of a product Communication Product safety responsibilities are clearly communicated to each department in the company An effective procedure is in place for communicating pertinent information to all parties (including subcontractors, suppliers, vendors, etc.) Training courses and effective methods of communication are in place for all personnel, commensurate with their responsibilities in an integrated product safety program Accountability Audits are performed periodically to ensure that all company functions and external organizations are effectively performing their assigned duties Product incident reports and product liability claims are reviewed and appropriate corrective action is taken Compensation for operating unit management is directly impacted by accomplishment of product safety objectives Documentation Product safety program and product recall procedures are written, current, and available to employees at all levels Records and documentation required by law are properly maintained Records of all formal product safety program activities are maintained at least for the expected life of a product or as required by law 18 Product Liability Checklist - 2 Safety Design Design Criteria Design criteria are well documented and meet all applicable laws, regulations, codes, and standards Design is “fail safe” (i.e., failure or malfunction will not cause injury or harm to user) Product is designed to be safe for intended use, and reasonable misuse or abuse, for its expected life Safe design criteria are applied to packaging, shipping, storage, assembly, installation, serviceability, and disposal Safe operating procedures or user instructions and adequate warnings are stipulated when critical hazards cannot be engineered out or fully safeguarded Design Reviews Reviews are made of similar products to avoid problems or losses associated with those products Industry or trade literature is continuously reviewed for new developments or information that can help improve product safety Reviews consider how recent or pending court decisions or laws might affect product design or safety requirements A systems analysis method is used to identify critical hazards and “safety-critical” components—materials or procedures requiring special safeguarding, testing, or design considerations Documented reviews continue throughout stages of product development, testing, manufacturing, and post sale-service to identify and incorporate needed design improvements Design Evaluation and Testing Testing, examinations, and analysis, whether done in-house or by outside laboratories, are conducted according to applicable laws, regulations, standards, codes, and certification requirements Testing is conducted to ensure safeguards function as intended and that the product is “fail-safe” Testing anticipates the impact of the operating environment, operator-user limitations, and foreseeable misuse or abuse on product safety Test results are documented and analyzed to evaluate need for design improvements Legal Considerations Legal Counsel Services of an attorney experienced in product liability law are employed Management is kept informed on all current or pending court decisions, laws, and regulations that may impact product liability potential or product safety requirements Attorney prepares all contracts, hold harmless agreements, warranties, guarantees, warnings, disclaimers and other legal documents Attorney has helped prepare a contingency plan for a product recall campaign Attorney maintains liaison with trade associations to stay current on developments affecting company’s products 19 Product Liability Checklist - 3 Review Possible mergers or acquisitions are reviewed for potential product liability implications Advertising, sales brochures, and marketing literature are reviewed for “sales puffery” or unintended misrepresentations Labels are reviewed for compliance with codes and regulations and to be sure they clearly warn of product hazards and how to avoid them All product manuals and instructions are reviewed for compliance with codes and regulations and to ensure they clearly warn against product misuse or modification Claims Management All pertinent records (e.g., design, production, quality control, etc.) are reviewed for usefulness in defense of suits, and adequacy for product recall purposes Effective procedures are in place for responding to and handling product liability claims Effective procedures are in place for receiving and recording customer complaints and product incidents and actions taken to address them Data on customer complaints, claims, and product incidents are analyzed to pinpoint trends and potential problems Product liability claims are discussed at product safety committee meetings so corrective action can be planned and taken Quality Assurance and Control Production Adequate supervision, procedures, and controls are in place to prevent any deviation from design specifications Precision, accuracy, and condition of equipment and tooling is commensurate with product requirements Procedures are in place to ensure prescribed materials are used and are not modified or degraded during storage, handling, or production Work instructions for production or testing operations affecting product safety are in writing, detailed, and clear Procedures are in place to verify and document qualifications of personnel Procedures Quality assurance program is in writing, adhered to, and periodically revised Quality standards and test sample sizes are statistically validated Procedures are in place for calibration of all test equipment and measuring devices Non-conforming materials and rejects are clearly labeled and segregated Products are tested, inspected or certified by an independent testing laboratory or agency Testing and Recordkeeping Quality control testing and inspection procedures are performed on raw materials, component parts, work in process, and finished products 20 Product Liability Checklist - 4 Quality control testing and inspection procedures are in place for packaging, manuals, labels, and customer service work Complete records are maintained for “traceability” from supplier and receipt of raw materials or components through finished product and ultimate user-consumer Adequate records are maintained to identify all activities performed during processing, manufacturing, inspection, testing, packaging, shipping, service, marketing, and sale Adequate records are maintained of all decisions made regarding design, standards, and product improvements Product Labels and Packaging Product Labeling Labels conform with applicable laws, regulations, codes, and standards Labels effectively warn against all product hazards the user may be unaware of Warnings are conspicuous, concise, clear, and repeated in various languages of primary user populations Labels are firmly attached so they will remain legible and in place for the product’s life cycle Labels include adequate instructions for proper use, avoiding misuse, proper disposal, and antidotes Packaging Product packaging is given the same product safety-liability consideration given to the product it contains Effective procedures are in place to ensure that necessary manuals, instructions, labels, parts, material safety data sheets, etc., are packaged with the product Package labeling includes considerations such as warnings, use, disposal, handling, storage, and possible deterioration Procedures are in place to ensure packaging conforms to customer specifications Plant staff are instructed on how to package properly so that warnings and instructions are on top and opened first Shipping Packages meet standard shipping requirements of the Department of Transportation (DOT), US Postal Service, states, municipalities, and others Records are adequate to identify and trace product shipments for product recall or retrofit purposes Shipping and handling instructions are clear, conspicuous, and adequate to minimize product damage potential Procedures are in place to ensure that shipping methods conform to legal, industry, and customer requirements Packaging is designed specifically for the product it contains and is adequate to protect both product and handler during shipment and storage 21 Product Liability Checklist - 5 Marketing and Customer Service Advertising Advertising claims about the product do not exceed product capabilities and can be readily substantiated Advertisements, sales literature, product photographs, TV ads, and oral sales presentations promote safe and proper use of products Advertising, sales literature, and oral sales presentations avoid use of terms such as “absolutely safe,” “foolproof,” “safest made,” and “fireproof” Marketing and sales staff, distributors, retailers, and service personnel are fully informed regarding the product liability climate and their responsibilities in product liability loss prevention Marketing, sales staff, distributors, retailers, and service personnel receive training regarding product development, performance, applications, limitations, warranties, and warnings Warranties Marketing, sales staff, distributors, retailers, service personnel, and management receive training regarding the statements they may make about a product to avoid making any unauthorized warranties Written warranties or guarantees regarding quality, reliability, suitability, or safety are clear and can be substantiated by test results or other data Written warranties or guarantees clearly spell out their limitations as well as end user responsibilities for proper maintenance, care, and use Certification to a standard is not cited or indicated unless the product complies with all requirements of the certifying agency or laboratory Customer Service Procedures are in place to promptly review and respond to customer complaints A current and comprehensive library of reference materials including shop manuals, bulletins on service modifications, and service standards are available to and used by service personnel Detailed service records are maintained, showing full extent of work performed, including materials used and repairs needed but not desired by customer Service department policy should not accept an order for repair or modification that may compromise product safety Service procedures in place for analyzing faulty or defective products for analysis This publication is not a part of your policy. The information contained in this publication is provided for informational purposes only and does not attempt to identify all potential hazards or remedial actions. The information provided is only to assist you in your compliance and loss control efforts. FCCI Insurance Group* shall not be liable for any loss, death, damage or expense arising out of the use of the suggested loss control measures. FCCI Insurance Group* makes no representations and provides no legal advice regarding federal, state or local requirements. There may be additional federal, state and local requirements with which you are required to comply that are not contained in this material. You are solely responsible for complying with federal, state and local laws, including compliance with any changes in the law, and for the safety of your operations. If you have questions or concerns regarding any legal issues please consult your legal adviser. *The FCCI Insurance Group includes the following carriers: FCCI Insurance Company, FCCI Commercial Insurance Company, National Trust Insurance Company, Monroe Guaranty Insurance Company, and Brierfield Insurance Company. 22 Product Recall Pre-Planning Checklist Yes 1. Has your company formulated a written policy in anticipation of the recall of possible defective products?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Has such written policy been circulated among officers, executives, and key personnel? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Has an executive been named as responsible for coordination of any future recall campaign? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. Does your recall plan include predetermined collection points for return of the product? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Have supervisory personnel at these collection points been advised and made familiar with your proposed plan? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If your recall plan requires prompt cooperation and assistance from dealer/ distributors, primary equipment manufacturers, sales agencies, wholesalers, jobbers, and/or retail outlets, have you acquainted them with the essential details of your plan? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Have you predetermined fees for dealers, distributors, retailers or other channels of distribution for essential services in event of recall?. . . . . . . . . . . . . . . 8. Have you formulated and distributed forms to company personnel, dealers, distributors, wholesalers, and retailers which would give you required details of malfunction incidents? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Has the company staged a “dry run” or mock recall of a specific product to test the functional efficiency of your recall plan? . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Are your products coded and marked indestructibly to enable you to rapidly identify the “suspect” product as to model, production lot, and factory? . . . . . . . . . 11. Are suppliers of components and parts required to mark and code each unit to identify their components or parts without delay? . . . . . . . . . . . . . . . . . . . . . . . . 12. Can suppliers determine details of factory, production lot, etc., from their coding? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will your records give you this information without need to consult suppliers? . . . . 14. Do your purchase agreements with component and parts suppliers cover the contingency of defective components or parts requiring recall or other correction action? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. Are you indemnified by suppliers against costs of recall or corrective action and other losses relating to recall? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. Are your field personnel and branches instructed to immediately forward all safety related complaints to your safety committee and your recall coordinator? . . 17. Have you set up a central point in the home office to receive any complaints or reports of malfunctions of your product? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Product Recall Pre-Planning Checklist - page 2 Yes 18. Is there a system for evaluating the urgency of such complaints or their significance? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. Has management organized a product safety committee to consider recall and other related issues? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. Is there a process in place to order a recall speedily? . . . . . . . . . . . . . . . . . . . . . . . 21. Do you have a communication system in place to promptly notify all parties of a recall? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22. Do you have a single point of contact for all product recall news releases to public media? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23. Do you have a system in place to maintain and retain production records for a period greater than the duration of the service life of the products plus 30 years or as otherwise required by law or advised by legal counsel? . . . . . 24. Do you review your recall plan anytime new products are developed? . . . . . . . . . . 25. Will your internal records, in conjunction with the incident reports from the field, enable you to determine the following: a) Critical components and their suppliers? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b) Model, production lot, and factory or supplier of “suspect” item? . . . . . . . . . . . . c) Quantities of “suspect” unit in hands of ultimate consumer? . . . . . . . . . . . . . . . d) Quantities of “suspect” unit in hands of dealers, distributors, jobbers, wholesalers, retail outlets, warehouses, and in-transit? . . . . . . . . . . . . . . . . . . . e) Geographic distribution of product nationwide and in specific areas and state? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f) History of the safety performance of the unit? (any recurrence of malfunction, injuries resulting, etc.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . g) Exact description of any incident of “accident” or malfunction? . . . . . . . . . . . . . 26. Will incident reports from the field, along with your investigation and internal records disclose: a) Whether the defect is caused by improper manufacturing? . . . . . . . . . . . . . . . . b) Whether the defect is one of design? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c) Whether it is one caused by misuse of the product by the consumer? . . . . . . . d) Whether it is caused by consumer’s failure to heed warnings on your labels or in your manuals? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e) Whether it is caused by consumer’s failure to follow your directions? . . . . . . . . f) Does your product conform to applicable generally accepted national standards, for example, American National Standards Institute (ANSI)? . . . . . . g) Does your product conform to industry standards? . . . . . . . . . . . . . . . . . . . . . . 24 Product Recall Pre-Planning Checklist - page 3 Yes h) Does your product conform to government standards or regulations? . . . . . . . . i) Can you identify potential problems, such as: A factory production oversight? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Laxity in inspection? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Improper testing? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Poor quality assurance? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If you identify areas of improvement make an action plan to implement the desired changes. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ This publication is not a part of your policy. The information contained in this publication is provided for informational purposes only and does not attempt to identify all potential hazards or remedial actions. The information provided is only to assist you in your compliance and loss control efforts. FCCI Insurance Group* shall not be liable for any loss, death, damage or expense arising out of the use of the suggested loss control measures. FCCI Insurance Group* makes no representations and provides no legal advice regarding federal, state or local requirements. There may be additional federal, state and local requirements with which you are required to comply that are not contained in this material. You are solely responsible for complying with federal, state and local laws, including compliance with any changes in the law, and for the safety of your operations. If you have questions or concerns regarding any legal issues please consult your legal adviser. *The FCCI Insurance Group includes the following carriers: FCCI Insurance Company, FCCI Commercial Insurance Company, National Trust Insurance Company, Monroe Guaranty Insurance Company, and Brierfield Insurance Company. 25 Employment Practices Liability The area of Employment Practices Liability (EPL) risk control is one of the most difficult and problematic for employers to manage. Typically, these suits allege that an employer has engaged in a "wrongful act" against their employees in one or more of the following areas: • Discrimination • Wrongful termination • Sexual harassment • Other workplace related wrongful acts, such as invasion of privacy and defamation of character Studies show that many employers who are at a high risk for employment practices claims are aware they need EPL insurance; however, employers may not be aware that they need to periodically evaluate their insurance programs to make sure that they 1) have adequate coverage in place; and 2) understand what their coverage does and does not include. In addition to evaluating your own EPL insurance, it is important that you implement a risk control program to help minimize the frequency and severity of EPL claims. Sound EPL risk control programs typically begin with the establishment of written human resources policies and procedures that address at least the following: • Hiring practices, including interviewing, reference checks, drug testing, motor vehicle record (MVR) checks, criminal background checks, and the employment-at-will statement and all associated consent and disclosure procedures • Salary administration, employee benefits, and wage and hour compliance • Work assignments, position descriptions, performance evaluations, and reviews • Workplace conduct procedures and workplace harassment procedures for reporting allegations of wrongdoing without fear of retribution or embarrassment • Procedures to properly address, investigate, and manage alleged wrongdoing promptly, fully, fairly, and internally • Discipline, discharge, exit interviews, grievance procedures, and post-employment rights 26 • Compliance with applicable federal, state, and local laws, including: – Equal Pay Act of 1963 – Title VII of the Civil Rights Act of 1964 – Age Discrimination in Employment Act (ADEA) of 1967 – Civil Rights Act of 1991 – Americans With Disabilities Act (ADA) – Family and Medical Leave Act of 1993 (FMLA) • • Training to ensure that supervisors, managers, and employees are aware of company policies and procedures Training to ensure that supervisors and managers are aware of the potential legal implications of their statements and actions with respect to employees Nothing guarantees the avoidance of employment practices claims; however there are steps that you can take to reduce the potential for a claim. Use the Employment Practices Checklist in this guide as a starting point. 27 Employment Practices Checklist Hiring o Use an employment application that is germane to your industry and complies with the Americans with Disabilities Act (ADA), Title VII, and state law o Use a formal interviewing process that requires all applicants to complete an application, sign the application, and advise that, if hired, employment is “at will” o Conduct reference checks on all applicants prior to hire o If applicable, conduct MVR, criminal and credit background checks prior to hire o Obtain consent pursuant to the Fair Credit Reporting Act before collecting credit information o If conducting drug testing, be sure it is done in accordance with applicable federal, state, and industry-specific laws o Create a comprehensive employee handbook o Use the employee handbook to help meet your legal obligation to inform employees about various personnel issues, including standards of conduct and your antiharassment, anti-discrimination, anti-retaliation, reporting, vacation, and absenteeism policies o Review the handbook at least every two years to be sure it still complies with all new employment laws and publish updates as needed o Develop written job descriptions that indicate specific limits for physical requirements o Present job descriptions to potential applicants during the screening process so they are aware of working conditions prior to hire o If a pre-employment medical exam is required, send a copy of the job description to the physician so he or she is aware of the job’s requirements Wage & Hour Compliance o Employ a payroll staff member who is proficient in wage and hour law and is aware of garnishment, overtime, and other payroll compliance issues o Identify all exempt and non exempt employees and review for compliance within the past 12 months o Communicate normal working hours and normal pay periods o Develop a policy for employees under the age of 18 regarding vehicle use, heavy equipment operation, and child labor law restrictions o Review your pay policy to be sure that all deductions made from pay are in accordance with applicable state laws Harassment o With legal counsel, develop an anti-harassment, anti-discrimination, and antiretaliation policy o Be sure all employees sign the policy o Develop and publish a reporting procedure so employees understand how to make a complaint o Conduct annual mandatory training on harassment and require that employees sign a form indicating that they have attended the training and understand your company’s policy 28 Employment Practices Checklist – 2 o Train all managers on how to handle harassment issues o Thoroughly investigate and document every harassment claim Americans with Disabilities Act (ADA) o Be sure you are in compliance with all ADA requirements for your building o Develop written job descriptions for all positions, including specifics regarding mental and physical restrictions o Require employees sign a copy of their job description Health Insurance Portability and Accountability Act (HIPAA) o Be sure you are in compliance with all HIPAA requirements o Maintain separate files for all employee medical information, including insurance applications Family Medical Leave Act (FMLA) o Review your FMLA policy and be sure to display a FMLA Act poster in a common area of your workplace o Conduct annual training for Human Resources (HR) specialists regarding FMLA legal requirements, including when to issue an employer designation of FMLA leave, requirements and procedures for reinstatement, etc. o Review with your HR department which notices to hand out and when o Be sure your employee handbook includes your FMLA procedures COBRA Compliance o Make sure you have a complete and updated COBRA notice on file o Within the required time frame, send a certified copy of the updated COBRA notice to both the former employee and the former employee’s spouse Posters o Be sure to post the five federally required posters. (Title VII, Wage and Hour, OSHA, Polygraph, and FMLA). You will also need any applicable state posters, such as workers compensation. Supervisor Training o Train all supervisors to be sure they are aware of the potential legal implications of their statements and actions with respect to employees o Have supervisors sign and date an acknowledgement that they have received training on company policies and procedures This publication is not a part of your policy. The information contained in this publication is provided for informational purposes only and does not attempt to identify all potential hazards or remedial actions. The information provided is only to assist you in your compliance and loss control efforts. FCCI Insurance Group* shall not be liable for any loss, death, damage or expense arising out of the use of the suggested loss control measures. FCCI Insurance Group* makes no representations and provides no legal advice regarding federal, state or local requirements. There may be additional federal, state and local requirements with which you are required to comply that are not contained in this material. You are solely responsible for complying with federal, state and local laws, including compliance with any changes in the law, and for the safety of your operations. If you have questions or concerns regarding any legal issues please consult your legal adviser. *The FCCI Insurance Group includes the following carriers: FCCI Insurance Company, FCCI Commercial Insurance Company, National Trust Insurance Company, Monroe Guaranty Insurance Company, and Brierfield Insurance Company. 29 Visitor Accident Investigation Your exposure to liability is significantly increased when the public has access to your building. To protect business, property, and people, it is important that you take reasonable steps to provide a safe and secure environment for all visitors. If an accident does occur, you will want to control the cost of claims by conducting a thorough accident investigation. You should gather all the pertinent data and report the claim with all the details, including photographs and other supporting documentation, as soon as possible to your claim adjuster. Many legal liability issues can arise from one accident, so gathering as much information and data as possible is important. Responsibility for various duties arising from customer accident investigation should be clearly assigned to either employees or management. Employee responsibilities: • Show compassion and concern for the injured person. • Do not argue, assign blame, or admit fault. If the injured party asks whether the accident will be reported, tell them that will be determined by a manager or your corporate office. If you have a corporate office, let the injured party know that your corporate office will be notified. • Offer to telephone a local physician, paramedic, and a friend or relative of the injured person. You should not transport an injured person in a company vehicle or your own vehicle. Management responsibilities: • Complete and submit a claim to your insurance company no later than 24 hours after the accident. • Write down the visitor's statements about what happened. As manager, you should separately submit your own statement of the facts as related by your employees. When describing the injured person’s version of how the accident occurred, use the phrase "alleged." When there is no witness, use statements such as, "the visitor allegedly..." or "the visitor alleges..." to describe what happened. • Preserve the accident scene. After the visitor has left the premises, inspect the area and take photographs of the site. The backside of each photograph should have the date and time the photograph was taken, as well as the signature of the manager handling the case, and the name of the person who took the photograph. 30 • For food related incidents, save alleged contaminated food in a plastic bag and refrigerate or otherwise preserve the specimen for examination. • Do not argue, assign blame, or admit fault. • If you are sending a report to your corporate office, be sure to attach all photographs and supporting documentation. • Identify and document all witnesses, including addresses, phone numbers, and relationship to the company. • Take reasonable measures to help prevent a recurrence of the accident. Remember: The primary purpose of an investigation is to identify facts, not to assess blame or fault. The discovered facts can often reduce the ultimate cost of a claim. Please refer to the sample Visitor Accident Report in this guide. You can use it to report injury or damage that may result from any alleged accident. 31 VISITOR ACCIDENT REPORT ACCIDENT INFORMATION ACCIDENT DATE TIME OF LOSS POLICYHOLDER NAME POLICYHOLDER NUMBER LOCATION OF ACCIDENT VISITOR INFORMATION NAME OF VISITOR ADDRESS PHONE NUMBER DATE OF BIRTH CURRENT AGE DOES VISITOR WEAR GLASSES? Yes HEIGHT WEIGHT IF "YES," WHAT ARE THE GLASSES WORN FOR? No Reading Driving WAS VISITOR WEARING GLASSES AT THE TIME OF THE ACCIDENT? Other: Yes No WAS VISITOR TAKING OR USING Alcohol Prescription Drugs Non-Prescription Drugs IF CHECKED, EXPLAIN LIST ANY PHYSICAL DISABILITIES NOTED ADDITIONAL ACCIDENT INFORMATION DESCRIBE WALKWAY/FLOOR WHERE ACCIDENT OCCURRED (INCLUDE FLOOR COVERINGS, IF ANY), AND PHOTOGRAPHS TAKEN AT TIME OF ACCIDENT WAS FLOOR CLEAN, DRY AND FREE OF DEBRIS? Yes DESCRIBE WEATHER AT TIME OF ACCIDENT DESCRIBE LIGHTING AT TIME OF ACCIDENT No DID VISITOR MAKE ANY COMMENTS ABOUT THE CAUSE OF THE ACCIDENT? Yes No IF "YES," EXPLAIN WHAT WAS VISITOR DOING AT TIME OF ACCIDENT (Check all that apply) Walking Running Carrying heavy, bulky or awkward objects Other: WHAT HAPPENED? GIVE DETAILED DESCRIPTION OF ALLEGED INJURY GIVE DETAILED DESCRIPTION OF TYPE OF SHOES WORN AND CONDITION AT TIME OF ACCIDENT (sneakers, sandals, high heels, leather or rubber soles, etc.) WAS AN INSPECTION DONE? WERE PHOTOGRAPHS TAKEN? Yes No Yes No WITNESS INFORMATION (If more than one witness, list information on separate sheet of paper) NAME(S) OF WITNESS ADDRESS(ES) PHONE NUMBER(S) IF WITNESS(ES) TALKED ABOUT INCIDENT, WHAT WAS SAID AND TO WHOM? 1-UNOT-7606, 10/04 Page 1 of 2 EMPLOYEE INFORMATION DID ANY EMPLOYEE ASSISTING THE INJURED VISITOR SPEAK TO THE VISITOR? Yes No IF "YES," WHAT WAS SAID BY THE EMPLOYEE? TO THE EMPLOYEE? NAME OF EMPLOYEE DEPARTMENT ADDRESS PHONE NUMBER IF THERE WAS A SPILL, NAME OF EMPLOYEE WHO CLEANED IT UP DEPARTMENT ADDRESS PHONE NUMBER TREATMENT INFORMATION WERE PARAMEDICS OR AN AMBULANCE CALLED? Yes IF "YES," NAME OF PERSON WHO CALLED THEM TIME CALL WAS MADE No AM APPROXIMATELY HOW LONG AFTER THE CALL DID THEY ARRIVE? PM APPROXIMATELY HOW LONG AFTER ACCIDENT DID THEY ARRIVE? NAME OF AMBULANCE SERVICE AND/OR NAME(S) OF PARAMEDICS IF TREATMENT WAS PERFORMED ON SITE, WHAT WAS DONE? IF VISITOR WAS TRANSPORTED TO HOSPITAL, GIVE NAME, ADDRESS AND PHONE NUMBER OF HOSPITAL TREATMENT GIVEN AT HOSPITAL WAS DESCRIPTION/HISTORY OF ACCIDENT GIVEN AT HOSPITAL? Yes IF "YES," NAME OF PERSON WHO GAVE IT No IF VISITOR TOLD PARAMEDICS/HOSPITAL PERSONNEL WHAT CAUSED THE ACCIDENT, WHAT WAS SAID? NOTE ANY COMMENTS MADE BY THE PARAMEDICS/HOSPITAL STAFF REGARDING THE ACCIDENT WAS VISITOR HOSPITALIZED? Yes No NAME(S) OF TREATING PHYSICIAN(S) AND PHONE NUMBER(S) (Attach additional sheet if necessary) ADDITIONAL COMMENTS SIGNATURE OF PERSON COMPLETING REPORT PRINT OR TYPE NAME A.M. P.M. TITLE 1-UNOT-7606, 10/04 DATE SIGNED TIME COMPLETED Page 2 of 2 Resources* Building Egress and Exits Federal Emergency Management Administration National Fire Protection Association Employment Liability Americans with Disabilities Act (ADA) Health Insurance Portability and Accountability Act (HIPPA) Family Medical Leave Act (FMLA) Consolidated Omnibus Budget Reconciliation Act (COBRA) Product Liability American National Standards Institute Underwriters Laboratories Food and Drug Administration Traffic Control American Traffic Safety Services Association Manual of Uniform Traffic Control Devices National Safety Council * The FCCI Insurance Group does not endorse and is not responsible for the content or accuracy of these resources. These resources are listed only for your reference and information. There may be additional, federal, state or local requirements with which you are required to comply that are not contained in these resources. You are solely responsible for complying with federal, state and local laws, including any changes in the law, and for the safety of your operations. If you have questions or concerns regarding any legal issues, please consult your legal adviser. 34