1. Forms
2. DS
3. DS-00-04

What the Form Is

The form DS 00 04, commonly titled "Common Declarations," serves as the declarations page for various insurance policies. It is a foundational part of an insurance contract that personalizes the policy to a specific insured. This form provides a summary of key information agreed upon by the insurer and the policyholder. It typically includes:

• The Named Insured and mailing address
• The policy number
• The policy period (effective and expiration dates)
• A description of the business or property insured
• A listing of coverage parts or forms that constitute the policy
• Limits of insurance for each coverage
• Premium amounts for each coverage part and the total policy premium
• Deductibles
• A list of applicable endorsements
• Name and address of the agent or broker

Essentially, the DS 00 04 acts as the "who, what, when, where, and how much" summary of the insurance agreement.

Classes of Business It Applies To

The DS 00 04 is a versatile declarations form identifier used across various lines of insurance. Its applicability is often indicated by a prefix to the form number (e.g., "MP" for Management Protection, "IL" for general Commercial Lines, "FC" for Commercial Flood). Examples of its use include:

• Commercial General Liability: As seen with ISO's "IL DS 00 04 98 Common Policy Declarations."
• Management Protection Liability: Such as Directors and Officers (D&O) policies, where "MP DS 00 04 03 Management Protection Liability Policy Common Declarations Form" is used.
• Commercial Flood Insurance: For instance, "FC DS 00 04 18 COMMERCIAL FLOOD POLICY DECLARATION."
• Package Policies: For Homeowners Associations or other business types, as illustrated by "AF DS 00 04 06 COMMON DECLARATIONS" used by American Family Mutual Insurance Company.
• Capital Assets Programs: ISO has used this for newer coverage concepts replacing Manufacturer's Output Policies.

It can be part of monoline or multiline/package policies for a wide array of commercial enterprises and sometimes other types of organizations.

Special Considerations

Several important points to consider regarding the DS 00 04 include:

• Accuracy is Critical: Since the Declarations page outlines the specific terms and limits of coverage, any errors can lead to significant coverage disputes. All information must be meticulously verified.
• Policy Structure: The DS 00 04 is not a standalone coverage form; it works in conjunction with various coverage forms, conditions forms, and endorsements that together make up the entire policy. It will list these other forms.
• Edition Dates and Prefixes: The edition date (e.g., "04 03", "11 98") and any alphabetical prefixes (e.g., "MP", "IL") are crucial as they denote the specific version of the declarations form being used, which can vary by insurer, program, or regulatory updates.
• Governing Document: In case of discrepancies between the declarations and other parts of the policy, the terms of the entire contract are usually considered, but the declarations often carry significant weight in interpreting intent.

Real-world example: If a business's address changes, the DS 00 04 must be updated via an endorsement to reflect the new location, as this can impact rating and coverage applicability for location-specific risks.

Key Information for Agents and Underwriters

For insurance professionals, the DS 00 04 is a vital document:

• Agents:
  • Must ensure all information provided by the applicant is accurately reflected on the Declarations.
  • Use it to explain policy specifics (coverages, limits, premium) to the insured.
  • Verify that all requested coverages and endorsements are correctly listed.
• Underwriters:
  • Rely on the Declarations to confirm that the policy is issued in accordance with their underwriting approval and pricing.
  • Use it as a quick reference for the policy's structure and key risk details.
  • The information on the Declarations (e.g., limits, business description) is fundamental for risk assessment and portfolio management.
• Premium Calculation and Audit: The Declarations often state the initial premium. For policies subject to audit, the basis for premium calculation (e.g., payroll, sales) might be referenced or tied to information summarized here.
• Identifying Coverage Gaps: By reviewing the listed forms and limits on the Declarations, professionals can help identify potential coverage gaps for the insured.

Real-world example: An underwriter reviewing a renewal might compare the expiring DS 00 04 with the new application and proposed new Declarations to identify any significant changes in exposure, such as a large increase in sales (for CGL) or a change in the number of directors and officers (for D&O).