Learning About Your Credit Union

Scott Simmonds CPCU, ARM

Learning About Your Credit Union

We have started the insurance review process. Thanks for your trust and faith. Now, I need to get to know your credit union. The following questions have proven to help. Some give me info. Some prompt me to ask more questions. Don’t worry about making this pretty. I’m looking for the info so I can help you improve your insurance.

Contact me if you have any questions. Part of the service you are paying for from me is information and advice. I see my role as including education. I am only a phone call or email away.

By the way, as with all my work, the information you provide here is strictly confidential. This form will never be shared with an insurance agent or an insurance company – this info is for my eyes only.

Scott Simmonds, CPCU, ARM

Insurance Assurance Consulting

Phone: 207-284-0085

General / Operational Issues

Provide a list of all of your corporate entities - indicate the ownership of the entity and the operations of each entity - include holding companies, credit union, subsidiaries, joint ventures, charitable foundations, real estate holding companies, CUSOs, etc.

Entity / Activity / Ownership of Entity

Who in your team will be involved in the meeting where we review the insurance issues I identify? Names and role/title please.

Do you have a charitable foundation that is funded by you? ___ Yes ___ No

Any regulatory actions taken against you in the past 2 years? ___ Yes ___ No

Are you operating under any kind of regulatory restrictions? ___ Yes ___ No

Please describe any construction projects or renovations planned for the next two years.

Please provide contact info for your insurance agent(s) - including email.

Please describe your relationship with your current insurance agent(s)

Would you consider changing insurance agents under the right set of circumstances?

Any mergers or acquisitions planned? ___ Yes ___ No If so, describe

Are you closing any locations? ___ Yes ___ No If so, describe

Any new locations planned? ___ Yes ___ No If so, describe

Any new ventures planned? ___ Yes ___ No If so, describe

Any joint ventures with other organizations? ___ Yes ___ No If so, describe

Any layoffs planned? ___ Yes ___ No If so, describe

Do you have any leased employees? ___ Yes ___ No If so, describe

Are any of your employees attorneys? ___ Yes ___ No If so, describe

Do you have a courier who delivers mail, supplies, etc. between branches? ___ Yes ___ No

If so, is the courier an employee or contractor? ___ Contractor ___ Employee

Which of the following services do you provide:

___ Telefacsimile Funds Transfer

___ Voice Funds Transfer

___ Internet Banking Funds Transfer

___ Automated Voice Funds Transfer

___ Remote Deposit

___ Internet Banking Bill Pay

___ Auto Loans

___ Auto Leasing

___ Equipment Leasing

___ Recreational Vehicle Loans

___ Safe Deposit Boxes

___ Investments/Investment Advice

___ Life Insurance

___ Disability Insurance

___ Auto of Home Insurance

___ Crop Insurance

___ Travel Services

Do you have ATMs at non-credit union locations? ___ Yes ___ No

Do you have safe deposit boxes at non- credit union locations? ___ Yes ___ No

Do you have an exposure to foreign currency losses? ___ Yes ___ No If so, describe

Your Board:

How many board members do you have?

___ Management Board Members

___ Outsider Board Members

Is insurance / directors’ and officers’ insurance an issue of worry by the board? ___ Yes ___ No

If so, describe how I can help. Would a conference call with the board help answer questions and allay fears?

Was this insurance review project initiated at the direction of the board? ___ Yes ___ No

Insurance Issues:

What are your specific insurance concerns and questions?

When was the last time you bid your insurance?

Do you have any claims that are pending or that you are worried about?

Property Issues:

Are any of your buildings built to "green" or LEED standards? ___ Yes ___ No If so, describe

Do you own a portable generator, tractors, mowers, or other portable equipment? (One of my clients has their own $3,000 BBQ smoker. Another owns two $6,000 inflatable pigs used in marketing.)?

___ Yes ___ No If so, describe

Do you own a mobile ATM unit? ___ Yes ___ No If so, describe

Please provide a list of all real estate the credit union owns or leases - include branch locations, offices, vacant land, ATM locations, foreclosed property

Do you receive rental income at any of your locations? ___ Yes ___ No If so, describe

General Liability & Auto Issues:

Do you charge employees or customers for parking? ___ Yes ___ No If so, describe

Does your credit union own any airplanes, boats, or other such property? ___ Yes ___ No If so, describe

Does your credit union (or any employees) lease or use airplanes, boats, or other such property in bank business? ___ Yes ___ No If so, describe

Workers' Compensation Issues:

In what states do you have employees?

Are any of your employees residents of other states?

Do any employees work full or part time from home offices? ___ Yes ___ No If so, describe

Contractual Liability Issues:

Send me any contracts you want me to review for indemnification language and / or insurance requirements - leases, rental agreements, website maintenance, e-banking provider, core processors.

Let me know if you have any questions or if anything is not clear. I'm always a phone call or email away.

Person Completing This Form: Date:

Contact me if you have any questions. I am always available for my clients.

Scott Simmonds, CPCU, ARM

Insurance Assurance Consulting

Phone: 207-284-0085

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