Does a commercial umbrella sit over senior care professional liability?

An operator carrying $1M primary general liability, $1M primary professional liability and a $5M umbrella believes it has $6M available for a serious resident injury. If the umbrella carries an unmodified professional services exclusion, it has $1M for the injury and $6M for a delivery van.

That is not a rare configuration. It is the default outcome when the umbrella is placed by a generalist market against a schedule of underlying policies that lists general liability and auto and stops there.

Open the umbrella policy and find the schedule of underlying insurance. Every policy you expect the umbrella to sit over must be listed by carrier, policy number, limit and period. If the professional liability policy is not on that schedule, it is not underlying.

Then find the exclusions. Look for an exclusion for professional services, medical services, health care services, or rendering or failing to render professional services. If one is present and no endorsement carves it back, the exposure is not covered no matter what the schedule says.

Then read the maintenance of underlying insurance condition. If the underlying limit shown is higher than the limit you actually carry, a gap exists between the two and it is yours.

In this class the usual answer is not an umbrella at all. It is a follow-form excess policy that sits specifically over the combined general and professional liability program and adopts the primary wording, including how the primary treats defense and abuse.

Follow-form matters because the two most important primary provisions in senior care, defense treatment and the abuse sublimit, are exactly the provisions a non-follow-form excess is most likely to handle differently. An excess that does not follow form over abuse is an excess that does not respond to the claim most likely to exhaust the primary.

Is the excess follow-form over the primary professional liability, including the abuse coverage part. Does it follow the primary treatment of defense costs. Does it drop down if the primary is exhausted or if the primary carrier becomes insolvent. Is the attachment point stated as a dollar amount or as exhaustion of the underlying limit by payment of damages only, which is the phrasing that creates an argument when defense erodes the primary.

Get the answers as endorsement numbers in the specimen, not as sentences in a proposal.