Coverage Gap Analysis and Exposure Identification Worksheet

Worksheet for comparing a client's exposures against current insurance coverage to identify gaps, document risk analysis, and capture recommended additional protection.

Worksheet Overview

• Client / Account Name
• Review Type
• Review Date
• Reviewer / Agent Name
• Scope of Review
  Briefly describe the lines of business, locations, operations, or assets included in this analysis.

Current Coverage Inventory

• Current Policy Types
• Carrier / Insurer Names
  List the carriers currently providing coverage. Use one per line if multiple carriers apply.
• Current Policy Effective Date
• Current Policy Expiration Date
• Primary Aggregate Limit
  Enter the aggregate limit if known. Use numeric input only.
• Deductible / Self-Insured Retention
  Enter the deductible or SIR amount if applicable.

Exposure Identification

• Exposure Categories Present
• Exposure Summary
  Describe the operations, assets, services, or activities that create the identified exposures.
• Number of Locations
• Approximate Annual Revenue
  Use numeric input only. Do not include currency symbols.
• Approximate Employee Count
• High-Risk Operations or Activities
  List any operations that may require specialized coverage, endorsements, or higher limits.

Coverage Gap Analysis

• Are there any identified coverage gaps or underinsured exposures?
• Gap Categories
• Gap Details
  Describe the specific exposure, the current coverage limitation, and the likely impact if a loss occurs.
• Estimated Financial Impact
• Risk Priority

Recommended Protection

• Recommended Additional Protection
  Describe recommended policies, endorsements, limit increases, deductible changes, or risk controls.
• Recommended Coverage Options
• Follow-Up Owner
  Name or role responsible for next steps.
• Follow-Up Date

Audit Trail and Submission Notes

• Source Materials Reviewed
• Basis for Coverage Analysis
  Summarize the assumptions, limitations, and key facts used to identify the gap.
• Consent to Store Client PII in This Record
  Only check if the form includes client PII and the client has been informed how it will be used and retained.
• Submission Notes
  Add any final notes, including uncertainties, assumptions, or items requiring further underwriting review.