Statement of Self Insurance
If you are required to provide a Statement of Self Insurance to a vendor, contractor, or other entity for any reason, please submit an Assistance Request Form (PDF) with the following information:
- Statement Holder (name, address)
- Start/End Date of Contract/Agreement/Activity
- Time(s)
- Location(s)
- Description of activities
- For equipment leases: Model Number, Serial Number, Description and Dollar value
- Attach copy of Contract/Agreement/Application Form/Permit/License/Other
Please allow at least 10 days for processing.
Automobile
The State Risk Management and Insurance Administration program (Risk Management Program) provides both liability and physical damage coverage (comprehensive/collision and fire/theft) for University-owned and leased vehicles.
Automobiles covered by the Risk Management Program
- University-owned vehicles
- Leased, hired, rented, and other non-owned automobiles when authorized by the University and operated under the name of the University.
- Employee-owned automobiles while used in the course and scope of employment and in the name of the State will have excess liability over the employee’s own personal automobile insurance policy. Physical damage to employee’s own vehicle is not covered.
Authorized drivers
- University of Hawaiʻi employees, officers, Board members
- Official volunteers
- Student employee drivers
- Any other authorized individuals (except independent contractors) licensed to operate an automobile covered under this policy
Scope of Coverage
- No-fault coverage as required by State law for bodily injury and property damage resulting from accidents involving autos covered under the Program.
- Coverage for physical damage to University-owned automobiles from collision, fire, theft or comprehensive loss is not provided unless the auto has been specifically designated for coverage and approved by UH Risk Management and RMO-DAGS.
- Claim payments will not exceed the actual cash value (ACV) of the covered vehicle. ACV is obtained by averaging the blue book value and market sales on comparable vehicles.
- Medical and income benefits will be provided under the State Workers’ Compensation Law for injuries sustained by State employees in autos covered under the Program from accidents arising out of and in the course of their employment.
Automobile Rentals
- In-State: University employees should not purchase a Loss Deductible Waiver (also referred to as “Collision Deductible Waiver”) or Personal Accident Insurance.
- Out-of-State: It is advisable to purchase Loss Deductible Waiver (also referred to as “Collision Deductible Waiver”).
- Foreign Country: It is highly advisable to purchase both Loss Deductible Waiver (also referred to as “Collision Deductible Waiver”) insurance AND liability insurance.
- Comptroller’s Memorandum 2009–03, dated January 20, 2009 (PDF)
- UH Administrative Procedure No. A8.400, dated August 2002 (PDF)
Property
The State Risk Management and Insurance Administration program (Risk Management Program) provides insurance coverage for University-owned property, and property in the care, custody and control of UH.
Property Covered by the Risk Management Program
- Buildings
- Contents
- Equipment
Exclusions
- Intentional, fraudulent or dishonest acts
- Ordinary wear and tear
- Faulty design, material or workmanship
- Watercraft over 30 feet only while waterborne
- Aircraft
- Growing crops, standing timer used for industrial purposes, live animals not used for research
- Export and import shipments in ocean transit
- Infrastructure (e.g. lights, electricity, sewage)
- Fences, trees
Conditions for Coverage
- Items must be listed on the UH inventory system, or supported by accounting documents
- Buildings must be on State of Hawaiʻi Inventory (to add a building to inventory, submit a Data Requirements—Property (DOC) form to the Office of Risk Management).
- Item must be not more than 7 years old or scheduled for replacement
Purchasing Insurance
Vice Presidents and Chancellors are responsible for determining the nature and extent of insurance coverage necessary for their respective programs. The Office of Risk Management is responsible for processing the purchase of all insurance policies for compliance with University purchasing requirements. All insurance purchases should be routed to the Office of Risk Management via KFS.
Third Party Minimum Insurance Requirements
The Office of Risk Management recommends that vendors (third parties who will be performing work or providing services to the University), exhibitors, and external users of University facilities be required to carry certain types of insurance coverage at specified minimum limits:
- Commercial General Liability: $1 million each occurrence, $2 million general aggregate (coverage must be provided for bodily injury liability, property damage liability, personal & advertising injury liability, and products & completed operations coverage); $250,000 each occurence Damage to Rented Premises (applicable to facilities use agreements).
- Worker’s Compensation: if required by law, contractors and suppliers should carry limits complying with Hawaiʻi law
- Employer’s Liability: $1,000,000 Bodily Injury – Each Accident; $1,000,000 Disease – Policy Limit; $1,000,000 Disease – Each Employee
- Automobile Liability (if the outside party uses a vehicle that is integral to work performed or will be operating a vehicle on UH property): $1,000,000 combined single limit, OR $1,000,000 Bodily Injury – Per Person, $1,000,000 Bodily Injury – Per Accident, $1,000,000 Property Damage – Each Accident, to include either “ANY AUTO” or “SCHEDULED, HIRED, OWNED, NON-OWNED AUTOS”
- Professional Liability (if applicable): $1 million per claim, $2 million annual aggregate (will vary by project)
- The type and minimum amounts of insurance coverage required may vary based on the type of work performed, service provided or activity. The University reserves the right to require higher limits or additional types of insurance from a contractor or vendor for a particular project or event.
Certificate of Insurance
A Certificate of Insurance is a document that provides information about insurance policies. Generally speaking, certificates list one or more lines of insurance, the limits associated with these coverages, and the insurer providing coverage.
- Third parties who are required to carry insurance should provide a duly executed Certificate of Insurance evidencing the requisite types and limits of insurance no less than two weeks prior to the date of event/contract/service.
- Each certificate shall specify: the University of Hawaiʻi is named as an additional insured on General Liability, Automobile Liability, and Umbrella/Excess Liability Policies; that the insurer waives any and all subrogation rights against the University of Hawaiʻi; and that liability coverage shall be primary and non-contributory to any insurance maintained by the University of Hawaiʻi. If the certificate does not contain these statements, policy endorsements reflecting the required coverage are required.
- Sample Certificate of Insurance
- Insurance Agreement
