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Run: Coverage Gap Analysis and Exposure Identification Worksheet

Use this worksheet to compare a client’s known exposures against current insurance coverage, document gaps, and capture recommended next steps in one review ...

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Worksheet Overview

Client / Account Name (required)

Review Type (required)

Review Date (required)

Reviewer / Agent Name (required)

Scope of Review

Briefly describe the lines of business, locations, operations, or assets included in this analysis.

Current Coverage Inventory

Current Policy Types (required)

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 (required)

Exposure Summary (required)

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? (required)

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 (required)

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 (required)

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.

Yes No N/A

Submission Notes

Add any final notes, including uncertainties, assumptions, or items requiring further underwriting review.

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