05.01 - Risk Management and Insurance
Last Updated on 11/13/2013
A. General. Risk Management includes various activities that reduce the university’s risk of financial loss of property, liability claims, injuries to employees, students or visitors, and/or damage to reputation. The primary elements of risk management—and representative activities—are risk minimization and avoidance, risk transfer and risk assumption.
A-1. Risk Minimization and Avoidance includes activities that increase the awareness of safe practices and identify and reduce or avoid risk of loss. Examples include but are not limited to, the Environmental Health and Safety Program, safety training and adherence to safe work practices, police and night watch services, appropriate lighting, good housekeeping, preventive maintenance, timely repairs, code-compliant construction, activities and programs which are consistent with and appropriate to the university’s mission, standardized business procedures, internal controls, and training and information about risk avoidance.
A-2. Risk Transfer involves the transfer of risk contractually to another party. The most common form of risk transfer is insurance. For a premium, the insurance provider agrees to respond financially to claims of negligence against the insured party, or loss of property or other assets by the insured party. Other forms of risk transfer include Indemnification and Acknowledgement of Risk and Release statements.
A-3. Risk Assumption includes insurance deductibles and other situations where the university has identified the risk associated with a particular activity and determined that the value of the activity warrants assuming the risk of loss from the activity. Risk assumption also includes those situations where risk is not identified and is, therefore, assumed inadvertently.
B. Process. Risk Management coordinates specific risk management activities and promotes awareness of risk management. College deans, directors and departmental administrators are responsible to manage their areas to maintain safe working and learning environments, to request insurance when risk can be transferred, and to report accidents and losses promptly. Insurance premiums for activities funded through, and property used for, general education activities are addressed through institutional insurance budgets administered by the Department of Risk Management. Premiums for insurance coverage for property and activities funded from sources other than general education are charged to those operating units. Premium allocation formulas vary depending on the type of coverage. In general property premiums are allocated on the basis of square feet of property insured and liability premiums are allocated on the basis of the operating unit’s salary expense. [ed. 11-13]
C. Accident Response Procedures. This section discusses general procedures, when to call an ambulance, specific procedures in response to fire emergencies, emergency evacuation, chemical spills, accident reporting, radiation safety, bomb threats, and where to file reports.
C-1. Immediate Actions. Employees observing injury to another party, or involved in an accident where another party is injured or property is damaged, should render emergency assistance, summon professional assistance (fire department, emergency medical personnel, etc.), provide information about liability coverage in the case of a vehicle accident, but otherwise avoid making admissions of responsibility or offering to pay for damages.
C-2. Calling an Ambulance. Any UI employee at the scene of an accident on UI property or in which a UI employee is involved, where a person is injured and the UI employee believes the person to be incapacitated, or who is concerned that attempts to move the injured or incapacitated person may result in additional injury, is authorized to call an ambulance and is encouraged to do so unless the injured person is of age, competent, and specifically declines medical attention or transport. The cost of medical transport in such situations will be assumed by the University or its insurer.
C-3. Additional Information. Information on responding to specific types of emergencies appears in the following sections of the Administrative Procedures Manual:
i) Fire emergencies and response [See 35.21]
ii) Emergency evacuation procedures [See 35.22]
iii) Chemical spill response [See 35.43 when available]
iv) Accident reporting procedures [See 35.71]
v) Radiation safety emergency procedures [See 35.82 when available]
vi) Bomb threat procedures [See 35.91]
C-4. Reporting Required. University employees should report all incidents involving injury or property damage to the Department of Risk Management, 111-7177 or [email protected] as soon as possible following the incident. [ed. 11-13]
D. UI Insurance Coverages and Claims Procedures. This section covers vehicle liability; damage to a university vehicle; crime, bond and faithful performance coverage; fine arts coverage; medical professional liability coverage; property insurance; public liability; directors and officers; and workers compensation.
D-1. Vehicle liability insurance, accident reporting and claims filing.
i) Vehicle liability coverage is provided for all University-owned vehicles through the Retained Risk Fund administered by the State of Idaho Office of Insurance Management. Limits of liability are $500,000 Combined Single Limits as specified in the Idaho Tort Claims Act, Idaho Code d 6-901 through 6-928. Secondary liability coverage is extended to vehicles of employees when used for university business (this means that the owner’s vehicle liability insurance is primary).
ii) In case of accident:
a) Render emergency assistance, notify law enforcement personnel, and follow other duties prescribed by law. Be caring and solicitous about the welfare of others involved in the situation, but avoid acknowledging responsibility or making any commitment to pay for damages.
b) If possible, ensure that any accident involving UI vehicles where anyone sustains bodily injury or either vehicle sustains property damage estimated to exceed $500 is investigated by law enforcement personnel.
c) Complete an Auto Accident Report Guide for all incidents involving injury or property damage and forward to the Department of Risk Management, (111) 111-7177 or [email protected] as soon as possible following the incident. [ed. 11-13]
d) Refer any demands for payment for damages to the Department of Risk Management (111) 111-7177 or [email protected]. [ed. 11-13]
D-2. Filing claims for damage to a UI vehicle.
i) Collision coverage pays for repair or replacement of the vehicle with “like kind and quality.” Collision coverage is maintained by the Department of Risk Management for UI vehicles five years old and newer; collision coverage for older vehicles must be requested by the department to which the vehicle is assigned and the department pays the collision insurance premium. The deductible of $500 is always the responsibility of the employee’s department. [ed. 11-13]
ii) Comprehensive coverage pays for repair or replacement with “like kind and quality” for physical damage of a UI vehicle resulting from causes other than collision, subject to a $50 deductible. Vehicles covered with collision coverage are also covered by comprehensive coverage.
iii) Report all accidents immediately to the Department of Risk Management, (111) 111-7177, or [email protected]. All accidents occurring off campus must be reported to the local law enforcement agency. Complete an Auto Accident Report Guide: http://divinedestinations.info/public-safety-and-security/risk-management-and-insurance/accident-incident-reports/accident-incident-report-form. [ed. 11-13]
iv)The Department of Risk Management will process the claim with the insurance carrier and notify the department when repairs are authorized. [ed. 11-13]
v) Arrange for repair of the vehicle when authorization is received from the Department of Risk Management. [ed. 11-13]
vi) Claims for reimbursement for collision or comprehensive damage claims must be submitted to the Department of Risk Management within a year of the date of the accident. [ed. 11-13]
D-3. Crime and Faithful Performance Insurance covers loss of UI cash, securities, bonds or other negotiable instruments as a result of theft as well as theft of any UI property as a result of employee dishonesty. This coverage is subject to a deductible, the amount of the deductible varies with the type of occurrence.
i) Procedures in the event of loss
a) Report all incidents involving loss of cash, securities, bonds or other negotiable instruments to Campus Division, Moscow Police Department (111) 111-7072 and to the Department of Risk Management (111) 111-7177 or [email protected]. [ed. 11-13]
b) Complete a “Property Loss Reporting Form” and forward to the Department of Risk Management, together with documentation supporting the claim. [ed. 11-13]
D-4. Fine Arts Insurance covers art objects and collections owned by, or loaned to, the University under an agreement of loan that specifies an appraised value. To be insured, fine arts pieces must be scheduled with the Department of Risk Management by providing the title, artist, value, location and the account to be charged. Coverage is not automatic, and non-scheduled property cannot be presumed to be insured. Transit coverage is separate and must be confirmed prior to each time covered property is transported.
i) Procedures in the event of loss
a) Report all incidents of loss to Campus Division, Moscow Police Department ((111) 111-7072 (or to the appropriate local law enforcement agency in the case of losses from locations other than Moscow) and to the Department of Risk Management (111) 111-7177 or [email protected]. [ed. 11-13]
b) Complete a “Property Loss Reporting Form” and forward to the Department of Risk Management at Mail Stop 3162 or (111) 111-9490 (fax), or submit electronically to [email protected], additional documentation may be requested. [ed. 11-13]
D-5. Medical Professional Liability Insurance responds to claims of malpractice occurrence arising out of the treatment of patients by UI medical personnel.
i) Procedures for responding to inquiries, claims and lawsuits
a) Report incidents that may lead to a claim to the Department of Risk Management or to the Office of General Counsel. [ed. 11-13]
b) Refer all inquiries by patients--or members of patients’ families—to the Department of Risk Management. [ed. 11-13]
c) Refer inquiries regarding procedures for filing malpractice claims against the University to the Director of Risk Management. [ed. 11-13]
d) In the event a Notice of Tort Claim is received, forward it immediately to the Director of Risk Management. [ed. 11-13]
e) Notify General Counsel immediately in the event of a lawsuit (service of Summons and Complaint.) [ed. 11-13]
f) Refer all inquiries regarding malpractice liability or the existence of malpractice liability insurance to the Department of Risk Management. [ed. 11-13]
D-6. All Risk Property Insurance. (See property covered; risks insured; reimbursement basis; limitations and exclusions; and transit.)
i) Property covered. Coverage applies to University property, or property owned by others that is within the care, custody and control of the University for which the University has agreed, in writing, to accept responsibility and/or to insure. Coverage is subject to various deductibles and is provided in part through a pooled statewide self-insured fund and in part through overlying commercial property insurance.
ii) Risks insured include all risks of loss or damage except exposures specifically excluded or limited under terms and conditions of the property policy. The deductible of $2,000 per loss is allocated between the University and the department. (See fire, theft, business interruption, loss of rental income, boiler and machinery.)
a) Fire. Coverage for direct expense incurred to respond to the fire and mitigate loss, cleanup and debris removal, and restoration or replacement of damaged property is provided for loss by fire.
b) Theft. Coverage for losses due to theft (except theft of cash, securities, bonds or other negotiable instruments or theft of any UI property by a UI employee), subject to applicable deductibles, will be reimbursed by the Idaho Office of Insurance Management upon presentation and acceptance of a properly documented claim. Police and the Department of Risk Management should be notified immediately upon determining that property appears to have been taken. [ed. 11-13]
1) “Mysterious disappearance” or “unexplained loss” is not covered. “Mysterious disappearance” is a situation where property is discovered to be missing from inventory or otherwise unaccounted for, with no indication as to specific time or circumstances under which it disappeared. To avoid the possibility that coverage may be denied on this basis, it is important to report loss or damage immediately and secure police investigation of warranted.
c) Business interruption coverage provides reimbursement for lost revenues resulting from covered property loss, subject to applicable deductibles and presentation of an appropriately documented claim.
d) Loss of Rental Income coverage provides reimbursement for the fair rental value and expected rental income during a period of restoration from a covered property loss, subject to applicable deductibles and presentation of an appropriately documented claim. Coverage must be pre-arranged through the Department of Risk Management by the filing of an annual statement of expected rental income. [ed. 11-13]
e) Boiler and Machinery coverage covers boiler and related machinery for direct damage or physical loss following a sudden and accident event arising from within the covered object. Covered losses include explosion and bursting of boilers and steam pipes, failure of large electric motors and refrigeration units, and rupture of pipes due to freezing, with subsequent water damage. Reimbursement for the actual cost of replacing or restoring the damaged property to service, or the actual cash value of the damaged object, plus other direct expenses resulting from the loss.
iii) Reimbursement basis. Replacement cost or actual cash value of damaged or lost property, subject to applicable deductibles, plus other direct expenses, will be reimbursed by the Idaho Office of Insurance Management upon presentation and acceptance of a properly documented claim.
iv) Limitations and exclusions. Claims must be processed within one year from the date of loss. Exclusions include, but are not limited to, the following:
a) Loss of any personal property of a tenant residing in University housing (tenants are responsible to insure their own personal property against all risks of loss).
b) Loss or damage to other student or employee personal property unless:
1) the loss is due to clear negligence of the University, or
2) in the case of employee property, the employee has been requested in writing, by an authorized representative of the University, prior to the loss, to bring personal property to the workplace for employment purposes.
c) Inventory shortage or unexplained disappearance of University property.
d) Theft of University property by an employee.
e) Ordinary wear and tear of University property, inherent vice, moths, termites, or vermin.
f) Mechanical breakdown of University property.
g) Nuclear reaction.
v) Transit. Property owned by the University (or property for which the University has assumed a legal obligation) is insured in transit, subject to certain exclusions, special conditions and limitations. Fine arts objects must be scheduled, and transit cover must be specifically requested in advance, prior to each time such objects are shipped.
D-7. Public Liability Coverage and Procedures. (See types of coverage; liability claims procedures.)
i) Types of Liability Coverage (See comprehensive general liability; premises liability; contractual liability; product liability):
a) Comprehensive General Liability coverage covers all amounts the University is legally obligated to pay, including judgments, settlements, and costs of defense arranged by or approved by the Idaho Department of Insurance Management, due to negligence of the University or its employees or authorized volunteers which results in claims for bodily injury, property damage or personal injury to others. Coverage is provided for bodily injury, property damage, personal injury, medical malpractice and professional errors and omissions claims. [ed. 11-13]
(1) Comprehensive general liability insurance will not respond to fines for violations of statutes.
b) Premises Liability coverage responds to claims of bodily injury or property damage occurring on property owned or leased by the Regents.
c) Contractual Liability provides for payment of damages, including defense costs approved by the Department of Insurance Management, which the University is legally obligated to pay as the result of indemnification and/or agreement to extend liability insurance to another party through a fully-executed and written contract. All contractual insurance and indemnification provisions must be pre-approved by the Office of General Counsel, the Department of Risk Management, Office of Sponsored Programs, Fiscal Office, or the Purchasing Department. [ed. 11-13]
d) Product Liability provides coverage for damages, including defense costs approved by the Department of Insurance Management, which the University is legally obligated to pay as a result of loss involving a product designed, manufactured or distributed by the University, subject to exclusions. [ed. 11-13]
ii) In the event of a liability claim:
a) All incidents involving bodily injury or property damage must be reported to the Department of Risk Management or the Environmental Health and Safety Office. [ed. 11-13]
b) All situations where a person has inquired regarding the procedures for filing a claim against the University must be reported to the Department of Risk Management or the Office of General Counsel. [ed. 11-13]
c) All demands for payment or notices of tort claim must be forwarded immediately to the Department of Risk Management. Any Summons and Complaint received by any University employee or unit where the Regents, Board of Education, University of Idaho or any university employee is named and which relates to actions within the scope and course of employment must be forwarded immediately to the Office of General Counsel. [ed. 11-13]
D-8. Directors’ and Officers’. (See entities/persons covered; coverage provided.)
i) Entities/Persons Covered. This coverage applies only to the following entities, and their directors and officers. This coverage does not apply to the University of Idaho, or regents or employees except insofar as they may be serving as directors or officers of the following entities: [ed. 11-13]
a) The Idaho Research Foundation, Inc.
b) The University of Idaho Alumni Association, Inc.
c) Vandal Boosters, Inc.
ii) For covered entities and individuals, this coverage covers amounts the entity is legally obligated to pay (subject to policy limits) for the legal defense and damages incurred as a result of a claim against the entity, any director or officer or authorized volunteer arising from any alleged error, misstatement, misleading statement, act, omission, neglect or breach of duty arising while acting in good faith during the performance of their assigned duties.
D-9. Work related injuries and Workers Compensation Insurance. (See responsibilities of injured person; responsibilities of supervisors; annual summary of work-related injuries.)
i) Responsibilities of injured person. Any employee who sustains, or suspects he or she has sustained, an on-the-job, work-related injury or occupational illness is responsible to:
a) report the injury to his or her supervisor; and
b) promptly seek medical attention; and
c) complete a Notice of Injury and Claim for Benefits form available from Human Resource Services.
ii) Responsibility of supervisor. Any supervisor of an employee who sustains, or suspects her or she has sustained, an on-the-job injury or occupational illness is responsible to immediately notify the Environmental Health and Safety Office of the incident.
iii) of work-related injuries and occupational illnesses, by department, is provided to deans and directors by the Environmental Health and Safety Office.
E. Certificates of Insurance/Additional Insured Endorsements. The University is often asked to provide certificates of insurance in connection with leases, contracts or intergovernmental agreements. In some cases, UI is asked to provide an additional insured endorsement. All such requests should be forwarded to the Department of Risk Management (MS 3162 or fax (111) 111-9490) with a copy of the document or agreement requesting the certificate. Include the following information: [ed. 11-13]
E-1. The name of the entity to whom the certificate is to be issued;
E-2. The covered event or services including purpose, location and time period; and
E-3. The type of insurance for which proof is needed.
F. Indemnification and Hold Harmless Certifications
F-1. All statements of indemnification and hold harmless must be issued by, and only by, the Department of Risk Management or authorized designees. Such statement will be in the University’s standard form unless alternate language is specified and approved by General Counsel, the Director of Risk Management, or the State of Idaho Office of Insurance Management. [ed. 11-13]
F-2. Any contract or agreement that contains reference to indemnification or hold harmless within the text of the document must be reviewed and approved by the Department of Risk Management. [ed. 11-13]
G. Student Sport Clubs. Please refer to the Sport Club Federation Handbook, available from the Campus Recreation Department, (111) 111-7921, for information and insurance requirements pertaining to student sport clubs and intramural activities.
H. Response to Tort Claims Against UI for Violations of Laws or Regulations. From time-to-time the University receives claims for money damages based on an alleged negligence, discrimination on the basis of race or gender, and injuries related to accidents or physical conditions on campus. Claims may also involve violation of state or federal law or regulation and may include complaints filed with government agencies. These claims are managed by the Director for Risk Management, (111) 111-7177, and the Office of General Counsel (111) 111-6125, and require the involvement of the Idaho Office of Insurance Management (OIM). Below are some guidelines for the roles played by these offices and agency in the management of claims against UI. (See letters alleging tort claims; notice of tort claim; tort claim management; litigation; attorney-client relationships.) [ed. 11-13]
H-1. Letters alleging tort claims
i) Any letter received by any UI employee regarding a potential claim against the University should be directed to the Director of Risk Management, with a copy to general counsel. [ed. 11-13]
ii) The Director of Risk Management is responsible for communicating with OIM about any claims or letters alleging potential claims received by the University. [ed. 11-13]
iii) Response letters to people who allege claims must be signed by the Director of Risk Management and receive prior approval from the general counsel. [ed. 11-13]
H-2. Notice of Tort Claim. The Idaho Code requires that anyone alleging a tort claim against a state agency file a "notice of tort claim" with the secretary of state in Boise. This notice is the University’s formal notification that an action or inaction of the university may become the subject of a lawsuit at a later date.
i) The Director of Risk Management and general counsel should be notified immediately of any tort claim filed with the secretary of state, the regents of the university or the state board of education office. General counsel is responsible for notifying the board/regents office and the president, provost, and vice presidents, as appropriate, of the filing of any tort claims. The Director of Risk Management is responsible for notifying the OIM of the filing of any notice of tort claim. [ed. 11-13]
ii) The Director of Risk Management will tender the claim to the OIM. [ed. 11-13]
iii) The Director of Risk Management and general counsel cooperate in the investigation of claims and in coordination with OIM. [ed. 11-13]
H-3. Tort claim management.
i) Tort claims are managed on campus by the Director of Risk Management in consultation with general counsel. The Director of Risk Management will be the primary contact for OIM and will alert officers on an as-needed basis of problems or concerns. Any inquiries from opposing counsel or direct communications with opposing counsel should be directed to general counsel. All university employees should discuss all inquiries from anyone regarding tort claims with the Director of Risk Management or general counsel before responding. [ed. 11-13]
ii) Billing of expenses and costs associated with claims will be handled through the Department of Risk Management. [ed. 11-13]
iii) A tort claim may be either settled or denied. If it is denied, the claimant may subsequently initiate a lawsuit. Often there can be a period of many months and perhaps as much as two years between the filing of a notice of tort claim and the initiation of a lawsuit and the filing of a complaint in court. During this period it is important that all communications about the claim be handled through the Department of Risk Management and the Office of General Counsel. [ed. 11-13]
H-4. Litigation. A notice of tort claim becomes a lawsuit through the filing of a complaint in a court. Once this has occurred, a tort claim will be considered pending litigation by the university. Lawsuits may, of course, involve claims other than—or in addition to—torts.
i) Unless the matter has previously been tendered, the Director of Risk Management will tender the claim to OIM. If OIM accepts responsibility for defending the university, the Director of Risk Management and general counsel will work with OIM to secure outside counsel and subsequently work with outside counsel on the case. [ed. 11-13]
ii) All inquiries from opposing counsel must be referred to the Office of General Counsel. UI employees while acting in the course and scope of employment are represented by the Office of General Counsel. No employee of the university directly involved in matters related to a claim against the university should have contact with opposing counsel without advice or presence of counsel representing the university. It is unethical for an attorney to contact an employee represented by legal counsel without going through that employee’s lawyer. [ed. 11-13]
iii) All inquiries for information from the OIM must be routed through the Director for Risk Management. [ed. 11-13]
iv) Settlement of all litigation must receive the approval of the president and the provost or vice president responsible for the area in which the litigation arose. The recommendation to settle a case should involve the Director of Risk Management, general counsel and outside counsel representing the university at a minimum. [ed. 11-13]
H-5. Attorney-client privileged communications
i) The legal system protects the confidentiality of communications between lawyers and their clients that are in anticipation of litigation. To allow for the free flow of information needed by the university to respond to a claim, it is important that attorneys representing the university direct the sharing of information internally and be responsible for the sharing of any information about a claim externally.
I. Information. (See other coverages; loss information; policy and statutory bases, questions.)
I-1. Other Coverages. Additional insurance coverages are provided through the Department of Risk Management on a request basis. Any requests for additional coverage, all requests for verification of insurance or certificates of insurance, must be processed through the Department of Risk Management (111) 111-7177 or [email protected]. [ed. 11-13]
I-2. Loss Information. Information on the status of any claims, or of cumulative loss information for a year or period of years is available to deans and directors.
I-3. Policy and Statutory Bases Applicable to Liability Exposures and Claims
i) The Idaho Tort Claims Act (ITCA), Idaho Code 6-901 through 6-929, specifies the limits of liability assumed by the state of Idaho for bodily injury, property damage or personal injury resulting from the negligence of the state, a state agency or institution, or employees, agents and authorized volunteers thereof.
ii) The ITCA requires that claims for damages resulting from allegedly negligent acts of the University, its employees and authorized volunteers must be filed in writing with the Idaho Secretary of State within 180 days of the accident or injury; the notice of claim must identify the date, time, place and circumstances of the alleged incident together with a brief statement as to why the claimant believes the University is at fault.
I-4. Information provided is for general information only. Information in this section has been provided for general information and guidance only and is not intended to create a binding obligation.
I-5. Questions. For questions regarding insurance and notices of tort claims, contact the Department of Risk Management, (111) 111-7177, [email protected]. For legal questions or questions regarding lawsuits, litigation, or any requests for information regarding matters of pending or potential litigation, call the Office of General Counsel, (111) 111-6125, [email protected] [ed. 11-13]nigh