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Certificate of Insurance Information


For our insureds that are involved in commercial enterprises, they are often asked to sign contracts that include certain insurance requirements including a certificate of insurance. If the certificate holder requests to be listed as an additional insured under a policy, your agency must send a formal endorsement request, a completed Additional Insured Endorsement Form (Click here to go to form) and a copy of the certificate of insurance in order to add the additional insured to the policy. A certificate alone will not add the party as additional insured. The insurance policies issued by Dryden Mutual are occurrence based and allow for per policy general aggregate limits. Per project, per location and claims made, will not be honored.

Problems often arise when a contract makes demands for wording that are impossible to meet. Requests that agents do not have the authority to execute, or can not legally be complied with, will not be honored. These statements are supported by an Opinion of the New York State Insurance Department where it is cited as a violation of Insurance Regulations to utilize non filed wording and forms.

• What is a Certificate of Insurance: A certificate of insurance is an informational document issued by or on behalf of an insurance company. The certificate indicates that an insurance policy exists, and reflects the liability limits provided. The policy certificates do not modify coverages or change the terms of the insurance contact. A certificate does not constitute a contract between the issuing insurer, authorized representative or producer, and the certificate holder. This means that a certificate does not affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed on it.

• All certificates are required to have the description of operations section completed. The information provided in the description of operations section should include a description of the work to be performed, as well as an approximate length of time the job will take and approximate start/end dates. If the certificate holder/additional insured is out of state, we will need the New York address where the insured is performing the work put in with the description of operations.

When an additional insured is added by endorsement with the necessary premium charged, our policy does the following:

• PRIMARY LIABILITY STATUS: Standard URB Policy Language Does Provide Primary Liability  Status. See The LS-6 Form, Page 12, Section 10 For Detailed Information. Click here to go to form.

         • WAIVER OF SUBROGATION Agreements: Subrogation Waivers Are Valid Only
         When They Are In Writing And Are Completed Prior To The Loss. See the LS-6 form, page
         16, section 8 for detailed information.
Click here to go to form.

• PERSONAL & ADVERTISING INJURY: We Provide Coverage For Up To The Occurrence Limit As Defined In The LS-6 Form. (Does Not Provide Coverage For Those In The Business Of Advertising, Publishing, Broadcasting Or Telecasting)

• CONTRACTUAL LIABILITY (LS-6 Only): Liability Provided If A Contract Or Agreement Is An Insured Contract Or The Insured Would Have Liability In The Absence Of The Contract Or Agreement.

• ADDITIONAL INSUREDS: When Endorsed DRYDEN Allows For The Covered Defense Costs For Additional Insureds And For The Additional Insured To Be On A Primary Basis.

• DEFINITION OF INSURED: Extended To An Employee While Acting In The Scope Of His/Her Duties. Also The Definition Of Insured Is Extended To Automatic Coverage – Newly Acquired Organizations (90 Days)

• COVERAGE TERRITORY: Extended To Anywhere In The World For Products Or Activities Of A Person Whose Home Is The USA But Is Away For A Short Time On Business. Since DMIC Writes Only In New York State, And Because Of Our Claim Service Limitations We Do Not Allow Out Of State Operations That Are Greater Than 10% Of The Insured’s Total Operations. If the certificate holder/additional insured is out of state, we will need the New York address where the insured is performing the work put in with the description of operations box on the certificate.

Our Policy Will NOT: Honor requests looking for alterations or amendments to the policy language. DRYDEN MUTUAL will not be bound by these requests. Certificates and/or endorsement requests that seek to revise policy language with regard to various wording such as Elimination of Cross-Liability, Severability of Liability & Non-Contributory Liability clauses.

It is advisable to have an attorney review contracts on your client’s behalf, prior to signing.

Acceptable Wording:

• Any & All Subsidiaries
• Employees
• Municipal Operations, Employees And Property Shall Not Be Excluded From Coverage
• Owner (Need To Name The Owner On The Certificate And Make Appropriate Charge)
• Primary
• The Certificate Holder Is Named As Additional Insured With Respect To Any & All Activities
• Activities By The Insured & The Insured Agrees To Indemnify & Defend The Certificate Holder With
• Respect To Any & All Actions.
• The Contractor Shall Indemnify, Hold Harmless & Defend The City Of … From Any & All Damages &
• Liability By Reason Of Personal Injury Or Property Damage Arising Directly (INDIRECTLY
• UNACCEPTABLE) From The Work Performed Under The Terms Of This Contract.
• Volunteers
• Waiver Of Subrogation

Unacceptable Wording:

• All Customers
• All Other Parties Required By Contract
• Contractual Coverage For Third Party Liability Assumed In A Business Or Construction
Contract For
q Employees Of The Named Insured At The Job Site
• Contributory
• Cross Liability
• Non-Contributory
• Other Indemnities
• Primary To All Other Insurance Carried
• Severability Of Interest Clause
• Subcontractors’ Policies Will Not Exclude Coverage For Injury To Their Employees Of Their
• Unrestricted Additional Insureds









Dryden Mutual Insurance Company l 12 Ellis Drive l Dryden, NY 13053
Phone: 800-724-0560
l Fax: 607-257-0312 l mail@drydenmutual.com                                                                                  NAIC Company Code: 13919