Sample output: Certificate of Insurance Review
This is an illustrative sample of what the Certificate of Insurance Review skill produces. Every party, date, document, and fact is fictional — invented for illustration only.
The fictional scenario
Sample Request — certificate-of-insurance-review
Fictional illustration. All parties, facts, figures, forms, and documents below are invented for this example. The example contains no real or invented legal authority.
Please run certificate-of-insurance-review on a certificate of insurance our vendor provided, and check it against our services agreement's insurance requirements.
Matter facts
- Certificate holder: Northgate Property Group LLC (fictional) — our company.
- Named insured on the certificate: Cedar Lane Maintenance Co. (fictional) — our vendor.
- The user's role: in-house counsel for the certificate holder.
- Relationship: a fictional facilities services agreement between the parties.
Materials provided (fictional)
- A certificate of insurance from the vendor, with the standard fields and a disclaimer paragraph.
- The services agreement's insurance clause, §12, which requires:
- Commercial general liability with stated per-occurrence and aggregate limits.
- Commercial auto liability with a stated limit.
- Workers' compensation as required.
- The certificate holder named as an additional insured on the CGL.
- A waiver of subrogation in favor of the certificate holder.
- Primary and noncontributory CGL coverage.
The certificate (fictional)
- Shows CGL and auto liability with limits and policy periods.
- Shows workers' compensation.
- The "additional insured" box is checked, but no additional insured endorsement form is attached or referenced.
- No waiver of subrogation endorsement is shown.
- No primary and noncontributory endorsement is shown.
- The CGL limit shown is below the limit required by §12.
Please: extract the certificate fields; build a comparison table against §12; list missing endorsements and mismatches; surface the certificate's disclaimer; and do not confirm that coverage exists or that requirements are met.
What the skill produced
Sample Output — certificate-of-insurance-review
Draft work product for attorney review. Not legal advice. Every party, fact, figure, form, document, and reference below is fictional and illustrative. This example contains no real or invented legal authority. It shows the shape of the skill's deliverable — not a model answer for any matter.
Capability and Reliance Notice
This is a draft review of a certificate of insurance for a qualified, licensed attorney. A certificate is evidence only of what it states; it is not proof of coverage and typically confers no rights and does not amend the underlying policies. This review does not provide legal advice, confirm that coverage exists or is in force, determine additional insured, waiver of subrogation, or primary/noncontributory status, or conclude that contract requirements are met. A qualified attorney must review it before reliance.
Gates Table
| Gate | Status | Source |
|---|---|---|
| Certificate(s) | One certificate provided | Provided set |
| Contract requirements available? | Yes — services agreement §12 | Services Agreement §12 |
| User's role | In-house counsel; certificate holder | User request |
| Relationship | Facilities services agreement between the parties | User request |
| Certificate / policy dates | As shown [deadline verification required] | Certificate |
Certificate Summary
The certificate names Cedar Lane Maintenance Co. as the named insured and Northgate Property Group LLC as the certificate holder. It shows commercial general liability, commercial auto liability, and workers' compensation with limits and policy periods. The "additional insured" box is checked, but no additional insured endorsement form is attached or referenced. No waiver of subrogation endorsement and no primary and noncontributory endorsement are shown. The CGL limit shown is below the limit required by §12.
COI Comparison Table
| Requirement (§12) | Certificate / endorsement shows | Source | Match status | Note |
|---|---|---|---|---|
| CGL at the required per-occurrence and aggregate limits | CGL shown; per-occurrence limit below the §12 figure | Certificate; §12 | Mismatch | Limit shortfall — see Mismatch List |
| Commercial auto liability at the required limit | Auto liability shown at a limit | Certificate; §12 | ambiguous | Confirm the shown limit meets §12 |
| Workers' compensation as required | Workers' compensation shown | Certificate; §12 | Matches | Confirm statutory compliance separately |
| Certificate holder as additional insured on the CGL | "Additional insured" box checked; no endorsement attached or referenced | Certificate; §12 | not found | A checked box is not the endorsement — see Missing Endorsement List |
| Waiver of subrogation in favor of the holder | No waiver of subrogation endorsement shown | Certificate; §12 | not found | See Missing Endorsement List |
| Primary and noncontributory CGL coverage | No primary and noncontributory endorsement shown | Certificate; §12 | not found | See Missing Endorsement List |
Missing Endorsement List
- Additional insured endorsement on the CGL — the box is checked but no endorsement form is attached or referenced. A checked box on a certificate is not the endorsement itself.
- Waiver of subrogation endorsement in favor of the certificate holder — not shown.
- Primary and noncontributory endorsement — not shown.
Mismatch List
- CGL per-occurrence limit shown is below the limit required by §12 — limit shortfall.
- Commercial auto limit shown is
ambiguousagainst §12 — confirm whether it meets the required figure.
Disclaimer and Limitations
The certificate carries a disclaimer (fictional) stating in substance that it is issued as a matter of information only, confers no rights on the holder, and does not amend, extend, or alter the coverage afforded by the policies. This review treats the certificate as evidence only of what it states. Whether coverage actually exists, is in force, and extends to the certificate holder can be confirmed only from the underlying policies and endorsements.
Attorney Verification Checklist
- [ ] Obtain the underlying additional insured, waiver of subrogation, and primary/noncontributory endorsement forms — the certificate is not proof of them.
- [ ] Confirm the CGL limit shortfall against §12 and the auto limit.
- [ ] Confirm the policy periods
[deadline verification required]. - [ ] Confirm whether the certificate's disclaimer affects reliance.
- [ ] Do not treat this review as confirmation that coverage exists or that §12 is satisfied.
Assumptions
- Assumed §12 as quoted is the operative insurance clause —
[CONFIRM]. - No confirmation of coverage and no conclusion that §12 is met is drawn; the review compares the certificate's contents to the stated requirements only.