Office of Risk Management
Risk Management Policy and Procedure Manual
Subject: University Certificates of Insurance
The purpose of this policy is to delegate the authority for issuance of certificates of insurance coverage to the campus risk managers and to provide the procedures for this risk management function.
Following the discussion at the 1989 Risk Management and Safety Conference, System Risk Management delegated the authority to issue certificates of coverage to the campus risk managers. This should simplify the procedure for all parties involved while maintaining the necessary control over the State's assumption of liability.
Discretion is to be used in providing certificates, and if for any reason there is a question as to whether a certificate is appropriate, System Risk Management should be consulted. For any situations which are not "run of the mill" feel free to call and ask. Also, when more than one campus is involved with the same certificate holder, the certificate can be issued on a System- wide basis by the System office.
One area which will continue to be administered from the System Risk Management office is that of Workers' Compensation. Very few requests are made for Workers' Compensation certificates and thus the campus risk manager should continue to forward these requests to the System office with the information necessary for approval.
A master certificate has been included in this policy which can be copied as needed. Also the procedures include the standard language and statutory references which should be used. Note, only mark the box and list the statute for the type of coverage which is requested. Also, the term of the certificate is listed under "Dates of Coverage" and may be extended for three years as needed. Under the description of coverage it is required that wording conform to the example as closely as possible. Only the campus risk manager may sign the certificate.
- Obtain the following information from the person requesting the certificate
- Name and address of requester.
- Kind of coverage needed.
- Description of who and what the coverage will apply to in detail; i.e., activity, auto id, department, and person's name.
- Effective dates of coverage of up to three years for an on going situation, but only give the exact dates for events which are short term or one time only.
- Evaluate whether or not this is an exposure which the University and State Risk Management want to cover. Give consideration to statutory wording and its application to the situation.
- Forward all requests for Workers' Compensation coverage, non-routine coverage or multiple campus coverage to System Risk Management for approval. Include all pertinent information.
- Fill out the certificate by designating the type of coverage provided
with an "XX" in the center column and the statutory reference which applies.
Please type all information.
Worker's Compensation Ch. 102 Liability Sec. 895.46 (1) and 893.82 Automobile Liability Sec. 895.46 Property Ch. 20.865 and 16.865
- Designate the effective dates on the certificate.
- Give a thorough description of the coverage afforded using standard
language adapted as follows:
"Coverage as afforded by statutory references listed above for.........(the activity, the parties involved, the vehicles specified, and the way in which these items fall within University scope.)"i.e.
"Coverage as afforded by statutory references listed above for students completing clinical internships as a part of their course study in the school of nursing."
- Finally, complete the other areas of the certificate and have the certificate signed by the campus risk manager.
- A copy of the certificate should be filed with all relevant correspondence in the risk manager's office. This file should be kept in chronological order so that as certificates expire or come up for renewal, the risk manager will know. Certificates should be retained for six months beyond the expiration date and then may be purged from the file.
- Obtain the following information from the person requesting the certificate of coverage:
Certificate of Coverage 4/1/14
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