The purpose of the Loss Control and Prevention Office is to protect assets and prevent insurance losses to the Diocese in the most effective and economical way.

Our goal is to provide increased awareness for a safer and healthier environment and to correct unsafe conditions through education, training, and the reduction of claims which drives our insurance premiums.

Our current insurance program incorporates certain self insurance features which are intended to reduce our overall costs. Every parish, school and agency within the Diocese of San Jose is participating in the payments through their premiums. It means the cost of claims has a direct affect to the premiums we pay. The importance of compliance with our Loss Control & Prevention programs correlates with the reduction of total claims which has a direct impact on future insurance costs.

Quick Reference Guide – Insurance Program


AED – Automated External Defibrillator

As the technology has become more affordable, parishes and schools have expressed increased interest in purchasing Automatic External Defibrillators (AED) to offer immediate aid to individuals suffering heart attacks.

The documents below outline a new policy and the procedures that are to be followed at any diocesan location that wishes to install AEDs.  Key among these are the training, record-keeping and proper maintenance.  It is essential that any parish or school or other institution contract directly with the approved third-party supplier, currently Cintas.

For information concerning the use of AED’s contact;
Ian Abell, Director of Facilities, Insurance and Risk Management
Office (408) 983-0223 or at email: ian.abell@dsj.org

Theresa La Voun, Loss Control and Prevention Coordinator
Office (408) 983-0237 or at email: theresa.lavoun@dsj.org

AED Policy
Master Agreement
Location Agreement(parish / school signature)
Cintas service description
DSJ Property Change Form

Certificate or Proof of Insurance

Most often when you are planning an event or retreat for your parish or school group the event location or retreat center will request a certificate of insurance from the Diocese of San Jose. Below are the procedures and form for requesting a certificate. Please allow two weeks for processing these certificates.

Certificate of Insurance Request Procedures
Certificate of Insurance Request Form

Event Space Rental to Parishioners or Organizations

The TULIP Program (Tenant User Liability Insurance Policy) provides low cost general liability insurance to “third party” outside users of various venues and facilities for events. It protects both the user and the facility against claims by guests who may be injured as a result of attending an event.

Events may range from seminars, receptions, birthday celebrations, to sporting events and concerts. Your premium quote is based upon the risk associated with the given event or activity, the number of days coverage is needed, the number of attendees and if there are any special requirements, such as alcohol liability, food service, etc.

Tenant Users Liability Insurance Policy, or TULIP, is an easy to use, fast method of insuring most types of events and activities taking place at various facilities and venues throughout the United States. Please use the link below to assist your Outside User in purchasing a liability policy for their event.

TULIP – K & K Event Insurance

The Diocese of San Jose has standard forms (below) that must be completed when permission is given to others to use our premises.  This form is to be filled out by the parish administrator or pastor and returned to the Risk Management Department after purchasing the Tulip event insurance policy (as stated above).

Category 1 Outside User Agreement (Rental of Church or School Property to Parishioners or For Profit Organizations)

All non-profit, religious, educational or charitable groups (i.e. Knights of Columbus, Italian Catholic Federation, St. Vincent de Paul Society, etc.) who rent or use our facilities for a single event, charitable or meeting place may do so using their organization’s insurance and by providing to us a certificate of insurance naming the Roman Catholic Bishop of San Jose as additional insured and meet our insurance requirements as stated on the Category 2 Organization/Outside User Agreement.  This form should be filled out by the administrator or pastor/principal and returned to the Facilities, Risk and Insurance Department along with the certificate of insurance at least two weeks prior to the event.

Category 2 Outside User Agreement (Rental of Church or School Property by Non Profits Only)

Events Open to the Public – Insurance Planning

Events that take place on the parish or school property must have the proper general liability insurance coverage, permits and/or licensing on file. Contact theresa.lavoun@dsj.org to discuss these requirements prior to scheduling the event at least 45 days in advance.

These types of events include and are not limited to;

Carnivals
Concerts
Festivals
Fundraising Dinners or Breakfast
Health & Wellness Fairs
Holiday Boutique
Pioneer Days
Rummage Sales

Carnival companies and all vendors at the Carnival must provide evidence of insurance naming the Roman Catholic Bishop of San Jose as an ‘additional insured’ on their policy.  Alcohol License must be obtained if alcohol is made available.  Food Permit must be obtained if food is sold.  Coordinate early (45 days in advance) with the Risk Management Department theresa.lavoun@dsj.org

Carnival Festival Event Procedures 2019 2020
Carnival Addendum

Field Trip or Retreat Insurance Planning, Procedures and Forms

Student, Catechetical and Youth & Young Adult Retreat Procedures
Student Activity Waivers
Volunteer Driver Form Please note the minimum insurance limits
Volunteer Driver Acknowledgment

Incident Reporting Guidelines and Forms

An important aspect of accident response is reporting the incident for future reference. If an accident occurs, the Safety Coordinator must be sure that there is a report. It should be completed for every accident or incident and filed with any pertinent information. A list of the names and phone numbers of witnesses should always be included, as well as photos of the site where the incident took place prior to any needed repairs being done. If there is a claim presented later, or a lawsuit filed, there should be enough information in the file to begin the investigation of the case.

This information can help prevent future incidents and may be essential if a claim against the Diocese of San Jose is filed. The incident report is helpful in ensuring that all details are recorded.

  • Document all details of the incident; who, what, when, where, why
  • Collect the names of the victims and witnesses.
  • Record victims and witnesses accounts.
  • Take photographs of the incident site – slips, trips and falls do no
    always “just happen.”

Incident Report

PROHIBITED HIGH RISK ACTIVITIES

Every parish or school sponsored event creates a potential liability for the Diocese.  Before planning parish / school functions, we encourage you to balance the benefits anticipated with the unavoidable risks.  Some activities create such a great risk that they cannot be justified.  Sponsorship or involvement in the following activities are strictly prohibited :

•    Raft, Kayak, Canoe, watercraft or similar trips
•    Use of Parachutes
•    Inflatable Bouncing Houses/Games/Slides
•    Water/Snow Skiing
•    Wind/Water Surfing and Boogie Boarding
•    Parachute Sailing/Jumping
•    Climbing Walls
•    Motorcycles or all terrain vehicles
•    Any event involving Livestock
•    Boxing or Wrestling matches, Martial Arts, etc.
•    Dunk Tanks
•    Fire Performers, Firework Sales and Displays
•    Trampolines
•    Mountaineering and Rock Climbing
•    Use of Drones on Diocesan Property
•    Bungee Jumping
•    Skate Boarding, Ice and Roller Skating
•    Amusement Parks
•    Aircraft, including Hot Air Balloon rides
•    Water Parks
•    Ropes or Adventure Courses more than 12 feet above the ground.

Safety for Parishes and Schools

Injury Illness and Prevention Program (IIPP)
IIPP, Injury & Illness Protection Program 2016
IIPP Code of Safe Practices
IIPP Monthly Safety Topics
IIPP Forms
Phase I – Pastors and Principals
Phase II – Appointed Safety Coordinators

Safety Bulletins
DSJ Safety Bulletins August 2019 – Qtr 1

Student and Volunteer Accident Insurance – Philadelphia Insurance Company

Student and Volunteer Claim form Philadelphia Insurance

A claim form must be filed for any student injured (while participating in a Diocesan approved activity) and taken for medical attention. to be filled out by an administrator, pastor/principal and given to the child’s guardian.  The child’s guardian will submit the claim form and all (medical) out of pocket receipts per the instructions on the form.This insurance is secondary to the family’s primary medical insurance.

Additional insurance for field trips and retreats (single or multiple day) is NO longer required as of August 1, 2019.

Events where participants engage in physical activity may require waiver and release forms.  Contact theresa.lavoun@dsj.org if you have any questions.

Village House Ministry – Insurance Requirements

  1. Diocesan Memo – Village House Ministry
  2. Property Use and Change Form, locations use that to inform DSJ Insurance that they are hosting the ministry
  3. Volunteer Management Insurance Guidelines
  4. Adult Volunteer Waiver Form
  5. Vendor Insurance Requirement; those non-diocesan locations that are hosting the program and the shower unit/trailer are to provide their Certificate of Insurance that meets the diocesan Vendor Insurance Requirements.

Volunteer Management Insurance Guidelines

The history of the Catholic Church is built on people volunteering their time and talent. Volunteers are vital to the success of parish ministries and to our catholic schools.

A volunteer is a valued part of the church. The volunteer should be at least 18 years of age. If under 18, the volunteer should be accompanied by a parent or have been given permission by the parent to perform volunteer activities while supervised by other adults.

Every volunteer should go through a screening process which will be covered within the Guidelines below. A volunteer is not someone who is compensated for their service or under contract for their service. A volunteer is also not an employee functioning under their job description. Please make sure to contact the Office of Protection of Children and Vulnerable Adults and verify that your volunteer been registered with their office.

Volunteer Management Insurance Guidelines
Volunteer Insurance Appendix