OC2 - Assignments 5 - 8
[HO-3] Coverage A - Dwelling
"Residence premises" includes not only a one-family dwelling, but also a two-, three-, or fourfamily dwelling where the named insured resides in at least one of the units. It also applies to structures (such as a garage or a deck) attached to the dwelling and to materials and supplies located on or next to the covered dwelling and used to construct or repair the dwelling.
Perils Insured Against for Coverages A and B
"We insure against direct physical loss to property described in Coverages A and B." so basically everything not excluded below is covered Exclusions a. Any peril excluded in Section I b. Collapse c. Freezing of a plumbing, heating, air conditioning, or sprinkler system or a household appliance d. Freezing, thawing, pressure, or weight of water or ice e. Theft f. Vandalism and malicious mischief g. Mold, fungus, or wet rot h. Natural deterioration i. Smoke from agricultural smudging or industrial operations j. Pollutants k. Settling of the dwelling l. Animals
Exclusions That Apply Only to Coverage E
(1) Contractual Liability - Loss assessment (2) Property Owned by an Insured - Coverage E is meant for 3P only (3) Property in the Care of an Insured - same as above (unless it's property damage caused by fire, smoke, or explosion) (4) Workers Compensation (5) Nuclear liability (6) Bodily Injury to an Insured - Again, coverage E is 3P only
HO-8 Modified Coverage Form Compared With HO-3
- Designed for use where replacement cost of an owner occupied dwelling significantly exceeds its market value - If insured makes repairs after loss, insurer will not pay more than the cost of "common construction materials and methods" that are "functionally equivalent to and less costly than obsolete, antique, or custom construction."
HO-2 (broad form) vs HO-3
- HO-2 is designed for the owner occupant of a house. Has slightly lower premium than HO-3 with similar limits because it covers fewer causes of loss - HO-3 provides special form coverage (i.e. open perils cvg) for coverages A and B and named perils coverage for coverage C. HO-3 provides named perils for coverages A, B, and C - With named perils coverage (HO-2), insured must prove loss was caused by covered peril. With HO-3, just assumed it's covered.
HO-5 Comprehensive Form Compared With HO-3
- HO-5 is the broadest property coverage of any of the standard, unendorsed homeowners forms. HO5 is essentially an HO-3 modified to provide special form coverage additionally for Coverage C
Limit of liability for Coverage E and F
- Limit applies to one occurrence - Continuous or repeated exposure = one occurrence
HO-3 Coverage C Limits
- The standard limit for Coverage C is 50 percent of the Coverage A limit, and it applies in addition to that limit. - Only 10 percent of the Coverage C limit or $1,000 (whichever is greater) is available for property usually located at a residence other than the one listed on the Declarations page. This same limitation applies to property kept by an insured in a self-storage warehouse --- 10% limitation does not apply to personal property removed from the residence b/c the house was being repaired, renovated, or rebuilt. They get full limit for 30 days
Coverage E—Personal Liability
- applies to bodily injury and property damage arising from the insured's activities or premises - defense costs coverage always provided
HO-3 Coverage C - what it applies to
- applies to items the insured owns or uses, anywhere in the world. - can also cover loss of or damage to personal property of others while that property is on the residence premises if the named insured requests such coverage after a loss. - applies to personal property of a guest or residence employee while it is in any residence occupied by an insured.
[HO-3 Section II] Other conditions
- insured bankruptcy: insurer still obligated - Coverage E is excess over any other insurance (unless it's specifically excess) - loss occurs during policy period - fraud = a big no no
Part D - Exclusions
-Use as a public or livery conveyance -Damage from wear and tear, etc. -Radioactive Contamination or war -Electronic equipment (unless it is permanently installed), so phone is excluded -Tapes, records, and discs -Government destruction or confiscation -Trailer, camper body, or motor home not in Declarations -Loss to a nonowned auto used without reasonable belief of permission -Radar detection equipment -Custom furnishings or equipment (van or pickup) -Nonowned auto used in the auto business -Racing vehicle -Rental car if rental agreement includes
Coverage D—Loss of Use: Three Coverages
1. Additional living expense (to maintain household's normal standard of living) 2. Fair rental value (If part of the residence is rented to others, the insurer will reimburse the insured the lost rental value) 3. Loss of use due to civil authority—Even if an insured's property is undamaged, civil authorities may prohibit access to the home because of damage to neighboring property. In this case, the expenses of living elsewhere and lost rental income are covered for a maximum of two weeks.
[HO-3 Provisions] Loss payment
1. As provided for in the Loss Payment condition, the insurer will adjust all losses with the insured or the insured's spouse. 2. A loss is payable sixty days after the insurer receives a proof of loss and either an agreement has been reached by the insurer and the insured or a court judgment or an appraisal award has been entered.
Part F—General Provisions of the Personal Auto Policy
1. Bankruptcy of insured - insurer not relieved of any obligations 2. Changes in policy - terms of policy cannot be changed except by endorsement issued by insurer 3. Fraud by insured - No coverage for u 4. Legal action against the insurer - cannot take unless insured has fully complied with policy terms 5. Insurer's right to recover payment - insurer has legal right (subro) - covered person must do whatever is necessary to enable insurer to exercise subro rights - no subro for any person who using a covered auto without reasonable belief that insured is entitled to do so 6. Policy period and territory - no leaving US or territories, canada, or PR 7. Termination - cancellation; non-renewal; automatic termination; other termination provisions 8. Transfer of insured's interest in policy - not an assignable contract w/out insurer's written consent 9. Two or more auto policies - if 2+ policies from same insurer apply to accident, insurer's max liability is the higher limit
How is rating done for homeowners?
1. Base premium - dwelling location, public protection class, construction factors, coverage amount, and the policy form selected 2. Adjustments - endorsements, deductible changes, and unusual construction types 3. Further adjustments lol - claim history, insurance score, and package policy credits.
Termination provision -
1. Cancellation—The named insured normally can cancel anytime during the policy period under these conditions: a. The insurer has sixty days to investigate and determine whether a new applicant meets the insurer's underwriting standards. b. If the cancellation is for nonpayment of premium, the insurer must give the named insured at least ten days' notice; in all other cases, at least twenty days' notice must be given. c. After the policy has been in force for sixty days, or if it is a renewal or continuation policy, the insurer can cancel the policy only for certain reasons. 2. Nonrenewal—The conditions under which the insurer can nonrenew vary according to the length of the policy period: a. If the policy period is less than six months, the insurer has the right to nonrenew every six months, beginning six months after the policy's original effective date. b. If the policy period is six months or longer, but less than a year, the insurer has the right to nonrenew at the end of the policy period. c. If the policy period is one year or longer, the insurer has the right to nonrenew at each anniversary of the policy's original effective date. 3. Automatic termination—If the insurer offers to renew the policy but the named insured does not accept the offer, the policy automatically terminates at the end of the current policy period. Failure to pay the renewal premium means that the named insured has not accepted the insurer's offer to renew the policy. 4. Other termination provisions—The policy contains the following three additional termination provisions: a. The insurer may choose to deliver the cancellation notice rather than mail it. b. If the policy is canceled, the named insured may be entitled to a premium refund. c. The effective date of cancellation stated in the cancellation notice becomes the end of the policy period.
HO-3 Section II—Additional Coverages
1. Claim Expenses a. "Expenses we incur" b. Premiums on bonds c. Reasonable expenses d. Postjudgment interest 2. First Aid Expenses 3. Damage to Property of Others - voluntary property damage - will not pay if: • The damage is caused intentionally by an insured who is thirteen years old or older. • Property owned by an insured is damaged. • Property owned by or rented to a tenant of an insured or a resident of the named insured's household is damaged. • The damage arises out of a business engaged in by an insured. • The damage is a result of an act or omission in connection with premises that the insured owns, rents, or controls. • The damage arises out of the ownership, maintenance, or use of any motor vehicle, watercraft, aircraft, or hovercraft 4. Loss Assessment - up to 1000 (bodily injury or PD)
[HO-3] Additional coverage other than Coverages A, B, C, and D
1. Debris Removal 2. Reasonable repairs 3. Trees, Shrubs, and Other Plants 4. Fire Department Service Charges (up to $500 if responding unit is far away from service district) 5. Property Removed 6. Credit card fraud, counterfeit money, etc. (up to $500 for legal obligations) 7. Loss Assessment (associations that collectively own property) 8. Collapse of property (not if building was showing visible signs of deterioration) 9. Glass or Safety Glazing Material (incl. breakage caused by earth movement, no coverage if vacant >60 days) 10. Landlord's furnishings (up to 2500 of pol limit to cover dmg caused by insured peril other than theft to appliances, carpeting, and other household furnishings in apartments rented to others) 11. Ordinance or law (10% of coverage A to cover increased costs incurred due to enforcement of any ordinance or law regulating the property, excl. pollution) 12. Grave Markers (covers grave markers, including mausoleums for dmg by insured peril up to 5k)
Three primary components of the HO-3 form
1. Declarations 2. Agreements and definitions 3. Coverages (property and liability)
Six policy forms for ISO HO
1. HO-2—Broad Form - provides named perils coverage for dwellings, other structures, and personal property. - designed for owner-occupants of dwellings 2. HO-3—Special Form -provides special form coverage on dwellings and other structures -designed for owner-occupants of dwellings who want broader coverage on their dwellings and other structures. 3. HO-4—Contents Broad Form - provides coverage for a tenant's personal property on a named perils basis. - designed for tenants obvi 4. HO-5—Comprehensive Form -provides open perils coverage on dwellings, other structures, and personal property. -designed for broadest coverage available among ISO's forms for their property 5. HO-6—Unit-Owners Form -provides coverage for personal property on a named perils basis, with limited dwelling coverage. - designed for condo owners, but it includes special provisions for condo specific risks 6. HO-8—Modified Coverage Form - provides coverage for a dwelling, other structures, and personal property, on a limited, named perils basis - for owners-occupants of dwellings that may not meet insurer underwriting standards required for other policy forms.
[HO-3 Provisions] Mortgage Clause
1. If a loss occurs to property covered by Coverage A—Dwelling or Coverage B—Other Structures, the loss is payable jointly to the mortgagee and the insured. 2. A mortgagee has rights that are independent of the insured's rights. If the insurer denies the insured's loss, the mortgagee retains the right to collect from the insurer its insurable interest in the property. 3. An insurer must mail notice of cancellation or nonrenewal of a policy to the mortgagee at least ten days before the cancellation or nonrenewal.
[HO-3 Provisions] Other Insurance and Service Agreement
1. If two or more insurance policies cover the same loss, the Other Insurance and Service Agreement condition states that the loss will be shared proportionally by all policies. 2. The homeowners policy makes it clear in the Other Insurance and Service Agreement condition that homeowners insurance coverage applies as excess over any amounts payable under any such agreement.
The parties eligible for coverage under the ISO 2011 Homeowners (HO) insurance program fall into three general categories
1. Individuals and families who own private homes in which they reside 2. People who rent or lease the premises in which they reside 3. Individuals and families who own private condominium units used for residential purposes
Conditions Applicable to Sections I and II
1. Liberalization clause -specifies how broadened coverage applies to the policy. Only insureds with the same edition of a policy that is subsequently changed by the insurer are affected by this condition. 2. Waiver or Change of Policy Provisions - waiver or changes of policy provisions valid only if insurer makes it in writing (unless claim rep states orally) 3. Cancellation - PH can cancel at any time - Insurer can only do so for stated reasons (must provide stated 4. Nonrenewal - insurer must provide at least 30 days written notice 5. Assignment - no 6. subrogation - insurer has right 7. Death - If named insured dies, insurer covers dead person's legal representative if decedent had an interest in the property
General duties for insured following an accident
1. Provide prompt notice to the insurer—The insurer must be notified promptly of how, when, and where the accident or loss happened. 2. Cooperate with the insurer—The person seeking coverage must cooperate with the insurer in the investigation, settlement, or defense of any claim or suit related to the accident or loss. 3. Submit legal papers to the insurer—The person seeking coverage must promptly submit to the insurer copies of any notices or legal documentation received in connection with the accident or loss. 4. Submit to physical examination—The person seeking coverage must agree to submit to a physical examination conducted by a doctor chosen by the insurer upon request. 5. Agree to examination under oath—The person seeking coverage must agree to an examination under oath if required by the insurer. 6. Authorize release of medical records—The person seeking coverage must authorize the insurer to obtain medical reports and other pertinent records related to the claim. 7. Submit proof of loss—The person seeking coverage must submit a proof of loss when required by the insurer.
Scheduled Personal Property
1. Provides scheduled coverage for specific items, such as jewelry, furs, musical instruments, silverware, fine arts, and rare coins. 2. The Scheduled Personal Property Endorsement covers more causes of loss than the HO-3 and other homeowners forms. The special limits and Coverage C deductible do not apply to the endorsement.
Exclusions That Apply Only to Coverage F
1. Residence employee off premises -bodily injury to a residence employee if an injury occurs off the insured's location and the injury does not arise out of the employee's work. 2. Bodily injury eligible for WC 3. Nuclear reaction 4. Injury to a home-sharing occupant - no pmt for injury to someone who lives there
Credit Card, Electronic Fund Transfer Card or Access Device, Forgery and Counterfeit Money Coverage—Increased Limit
1. Section I of the homeowners policies provides coverage up to a limit of $500 for losses resulting from the unauthorized use of an insured's credit card, bank transfer card, check forgery, or acceptance of counterfeit money. 2. The Credit Card, Fund Transfer Card or Access Device, Forgery and Counterfeit Money Coverage (HO 04 53) provides a higher limit of coverage to as much as $10,000.
[HO-3 Provisions] Insurable Interest and Limit of Liability
1. The Insurable Interest and Limit of Liability condition limits the maximum payment for any single loss 2. This condition further limits loss payment to any insured to the extent of that insured's insurable interest in the property at the time of the loss.
[HO-3 Provisions] Appraisal Process
1. The insurer and the insured each choose an appraiser to prepare an estimate of the value of the loss. Each party pays for its own appraiser. 2. If the estimates differ, the two appraisers submit their differences to an umpire. The umpire is an impartial individual who resolves the differences.
No benefit to bailee
A provision that excludes any assignment or granting of any policy provision to any person or organization holding, storing, repairing, or moving insured property for a fee.
Inflation Guard
An endorsement that automatically updates the level of property coverage based on an index of replacement costs that continually updates the cost of building a home.
Coverage for Damage to Your Auto (Maximum Limit of Liability)
An endorsement to the PAP that allows owners of high-value antique cars or restored show cars to establish the car's insurable value when the policy is written by inserting a stated amount of insurance in the policy
[HO-3] Coverage B - Other Structures
B. Other Structures (10% of Cvg A) -structures on residence premises that are separated from the dwelling by clear space Ex. A detached garage, tool shed, or horse stable. Maybe a fence, utility line?
Broadened Home-Sharing Host Activities Coverage Endorsement
Can be used to provide property and liability coverage for home-sharing host activities. This endorsement provides coverage for loss or damage to the premises and liability to others, subject to policy provisions, for insureds who engage in home-sharing host activities.
[HO-3] Section I—Property Coverages
Coverage A - Applies to dwelling and structures attached to dwelling (e.g. garage or deck) Coverage B - Applies to structures not attached to dwelling (storage sheds, detached garages, swimming pools) Coverage C - contents of premises and personal property owned by insured or used anywhere in world Coverage D - Loss of use
[HO-3] Section I—Liability Coverages
Coverage E - Personal liability... applies to 3P for those who are injured or whose property is damaged by insured Coverage F - Med pay to others: covers medical expenses within 3 years of a injury for not insureds
Coverage F—Medical Payments to Others
Coverage F is "good will" coverage that pays the medical bills incurred by others in an accident, regardless of the fault or liability of the insured. The minimum limit of $1000. Coverage F applies when: 1. Injury occurs to person who has insured's permission to be at the insured location 2. Injured person is away from insured location and injury arises out of a condition at the insured location 3. A person is injured while away from insured location by an activity performed by an insured
Part D - PAP
Coverage for Damage to Your Auto (e.g. collision and other than collision)
Personal Injury for Aircraft Liability Excluded
Excludes "aircraft liability" from personal injury coverage provided by endorsement to homeowners policies. This aircraft exclusion is extended to include any unmanned aircraft, whether or not model or hobby. This optional endorsement can be used to manage loss exposures arising from the operation of such aircraft, including drones.
Personal Injury Coverage
Expands the liability coverage of a homeowners policy by adding the definition of personal injury and then adding coverage for personal injury. Personal injuries are defined as: 1. False arrest, detention, or imprisonment 2. Malicious prosecution 3. Invasion of privacy, wrongful eviction, or wrongful entry 4. Publication, in any manner, of material that slanders or libels another party or disparages the other party's goods, products, or services 5. Publication, in any manner, of material that violates a person's right to privacy
Additional Residence Rented to Others—1, 2, 3, or 4 Families
Extends Coverage E—Personal Liability and Coverage F—Medical Payments to Others to one- to four-family residences that are owned by the insured and rented to others.
Severability of Insurance for Coverage E and F
For some occurrences, a claim can involve several insureds. Under the Severability of Insurance condition, each insured seeking protection is treated as if he or she has separate coverage under the policy
HO-4 Contents Broad Form Compared With HO-3
HO-4 is meant for people who live in rented houses or apartments. Basically the same as HO-3 but without Coverage A and B. Also different in the following ways: a. HO-4 Coverage C is written at a limit the insured selects as adequate to cover personal property. b. Coverage D in the HO-4 is provided automatically at 30 percent of the Coverage C limit. c. The HO-4 provides an additional coverage for building additions and alterations, with a limit up to 10 percent of Coverage C. d. The HO-4 does not include additional coverage for furnishings provided by a landlord, because the occupant-insured of the apartment does not have an insurable interest in such property. e. Both the HO-3 and the HO-4 provide additional coverage for "ordinance or law," which would be either a local law (ordinance) or state or federal law imposing new responsibility on a property owner. The HO-3 limit is up to 10 percent of Coverage A
HO-6 Unit-Owners Form Compared With HO-3
HO-6 meant for people in condos - Coverage A (basic limit = 5k): (1) alterations, appliances, fixtures and improvements that are part of insured unit, (2) items of real property that pertain exclusively to insured unit, (3) property that is the unit owner's responsibility, (4) structures owned solely by insured at residence location - Coverage B: Other structures cvg is eliminated - Coverage C: same but limit insured selects - Coverage D: loss of use is provided automatically at 50% of coverage C limit - Section I: named perils coverage, replacement cost basis - Trees, shrubs, other plants are covered at 10% of Coverage C limit - Glass/safety glazing material covered if part of insured's unit
[HO-3 Provisions] deductible
Highest deductible applies when 2 or more apply to a loss - Only applies to section 1 losses - min dedl = 500
Public or Livery Conveyance Exclusion Endorsement
ISO has an endorsement which is basically not an endorsement but basically explains what a "transportation network platform" is and how PAP does not apply. Public or Livery Conveyance Exclusion Endorsement does the same thing: reinforces the exclusion. It's meant to be attached to all PAPs.
Duties of an Injured Person—Coverage F—Medical Payments to Others
If an individual makes a claim for an occurrence under Medical Payments to Others coverage, the injured person must fulfill these requirements: a. Give the insurer written proof of the claim as soon as possible. b. Authorize the insurer to obtain copies of medical reports and records. c. Submit (the injured person) to a physical exam by a doctor chosen by the insurer as often as the insurer requires such examinations.
[HO-3 Provisions] Loss Payable Clause
In the Loss Payable Clause condition, the insurer agrees to include the named loss payee when a claim is paid involving that personal property.
Part D - Transportation Expenses
Insurer will reimburse the insured for temporary transportation expenses, such as auto rental fees or taxi fares, up to $20 per day, to a maximum of $600 for each covered loss. - Also applies to non-owned auto for that owner's transportation (and rental car loss of income) - no deductible but there is a waiting period (48 hours for theft, 24 hours loss that falls under "other" peril
Other than collision losses
Insures auto physical damage losses that are not caused by collision and are not specifically excluded in the policy - Less expensive than COLL and lower dedl - PAP does not define OTC... causes of loss incl. falling objects, fire, theft, explosion, wind, vandalism, contact with a bird or animal, and glass breakage. - any direct and accidental loss that is not COLL and is not excluded = OTC
Home-Sharing Host Activities Amendatory Endorsement
Intent is to clarify that the HO-3 policy does not provide any property or liability coverage for home-sharing exposures. The endorsement adds new definitions for home-sharing activities and revises the existing definition of "business" to specifically address home-sharing host activities.
Part D Limit of Liability
Lesser of actual cash value of loss or amount necessary to replace property to like kind or quality - Nets out depreciation - Caps @ 1k for electronic equipment - Caps @ 1.5k for nonowned trailer
Perils Insured Against for Coverage C
Named perils: 1. Fire or lightning 2. Windstorm or hail 3. Explosion 4. Riot or civil commotion 5. Aircraft 6. Vehicles 7. Smoke 8. Vandalism or malicious mischief 9. Theft 10. Falling objects 11. Weight of ice, snow, or sleet 12. Accidental discharge or overflow of water or steam 13. Sudden and accidental tearing apart, cracking, burning, or bulging 14. Freezing 15. Sudden and accidental damage from artificially generated electrical current 16. Volcanic eruption
[Part D] Nonowned vehicles
Nonowned vehicles are covered in Part D. An insured can occasionally (not regular use) drive a rented or borrowed auto and insured's physical damage insurance will cover vehicle.
Assisted Living Care Coverage endorsement
Provides Section I—Coverage C—Personal Property and Section II—Coverage E—Personal Liability Coverage to a relative of the insured who is a resident of a facility that provides assisted living services, such as meals, medical supervision, housekeeping, and social activities. This scheduled person must not be a resident of the insured's household.
Named Non-Owner Coverage
Provides coverage for the use of non-owned autos to individuals who do not own a car (applies only to person named in endorsement, must indicate family members)
Transportation Network Driver Coverage (No Passenger) Endorsement
Replaces the public or livery conveyance exclusion in the standard PAP with wording from the Public or Livery Conveyance Exclusion endorsement. It includes an exception that covers share-the-expense car pooling and operation of an auto without passengers while the driver is logged in to a "transportation network platform." The exceptions apply to Parts A-D and provide coverage after an insured has logged in to a transportation network platform but before a passenger is occupying the vehicle
Limited Transportation Network Driver Coverage (No Passenger) Endorsement
Similar to the Transportation Network Driver Coverage endorsement; both provide coverage when the insured is logged in to a transportation network platform but has not yet picked up a passenger. The limited version's coverage ends once the driver accepts a passenger, which occurs before the passenger enters the vehicle. Both versions exclude coverage when a passenger is occupying the vehicle
[HO-3 Section II] Suit Against Us
Suit Against Us condition states that an insurer cannot be sued under the homeowners policy until certain provisions and terms have been met: a. The insured has met all of its obligations under Section II of the policy. b. The insurer cannot be joined as a party to any action against an insured. c. The obligation of the insured has been determined by a final judgment or agreement signed by the insurer.
[HO-3 Provisions] Abandonment of Property
The Abandonment of Property condition provides that if the insured abandons the property after it is damaged or destroyed, the insurer need not take responsibility for it.
Broadened Residence Premises Definition Endorsement
The Broadened Residence Premises Definition Endorsement (HO 06 49) indicates a starting date and an ending date within the policy period when the residency requirement will be removed from the definition of residence premises in a homeowners policy. This definition requires that the insured reside in the premises on the inception date of the policy period.
Earthquake endorsement
The Earthquake endorsement (HO 04 54) provides a means to buy coverage for this cause of loss. The mandatory deductible is usually 5 percent of the limit that applies to either Coverage A or Coverage C, whichever is greater, but not less than $500.
[HO-3 Provisions] No Benefit to Bailee
The No Benefit to Bailee condition states that a bailee who holds the property of an insured is responsible for the care of that property.
[HO-3 Provisions] Our Option
The Our Option condition reserves the right for the insurer to repair or replace damaged property with similar property, should it choose to do so.
Optional limits transportation expenses coverage endorsement
The PAP provides coverage up to a limit of $20 per day for temporary transportation expenses. This endorsement allows the insured to increase coverage to one of three limits, which can be applied to the costs of a substitute vehicle for the period reasonably required to repair or replace the auto a. $30 per day, subject to a maximum of $900 b. $40 per day, subject to a maximum of $1,200 c. $50 per day, subject to a maximum of $1,500
HO-3 Declarations
The declarations provide essential information about the insured, the property covered, and the limits of coverage by answering these questions: a. Who is the policyholder? b. Where is the policyholder's residence? c. What are the coverage limits? d. What is the premium? e. What is the Section I deductible? f. What is the effective date of the policy? g. Which forms and endorsements apply to the policy? h. Who is the mortgage holder?
Special limits of liability for Coverage C HO-3
The special limits for three personal property categories (jewelry and furs; firearms and related items; and silverware, goldware, platinumware, and pewterware) apply only when loss is caused by theft These items pose a higher-than-average risk of loss.
Extended Non-Owned Coverage—Vehicles Furnished or Available for Regular Use
The unendorsed PAP excludes liability and medical payments coverage for non-owned vehicles furnished or made available for the regular use of the named insured and family members.
Payment of Claim - Coverage F - Medical Payments to Others
This Coverage F condition stipulates that the insurer's payment of a Medical Payments to Others claim is not an admission of liability by the insured or the insurer.
Other sources of recovery in Part D
This provision allows a PAP insurer to pay only the proportion that its limit of liability bears to the total applicable limits if other insurance coverage is available.
Appraisal Part D
This provision can be used if the insured and insurer disagree on the amount of the loss.
Three reasons for Part D deductible
To reduce small claims, to hold down premiums, and to encourage insureds to be careful in protecting their cars against damage or theft.
Limited Water Back-Up and Sump Discharge or Overflow Coverage
Unendorsed homeowners policies exclude property coverage for water or waterborne materials that originate from within the insured's dwelling and back up through sewers or drains, or that overflow from a sump, sump pump, or related equipment. This endorsement adds coverage back into policy.
[HO-3] Coverage B - Other Structures Exclusions
a. A structure rented to anyone who is not a resident of the dwelling. However, a structure that is rented to others for use as a private garage is covered. b. A structure from which any business is conducted c. A structure used to store business property
Losses to personal property listed under Coverage C—Personal Property are settled at the lesser of what two amounts
a. Actual cash value (ACV) at the time of the loss b. The amount required to repair or replace the items
Exclusions on Coverage C Personal Property
a. Articles separately described and specifically insured in this or other insurance b. Animals, birds, or fish c. Motor vehicles, parts, and electronic equipment that operates solely from the vehicle's electrical system d. Aircraft and hovercraft e. Property of a home-sharing occupant f. Property of any other person occupying the residence as a result of any home-sharing host activities g. Property of roomers and boarders unrelated to the insured h. Property in an apartment rented to others i. Property rented or held for rental to others off the residence premises j. Business data, including drawings, stored either on paper or electronically k. Credit cards or electronic fund transfer cards l. Water or steam m. Property primarily used for home-sharing host activities
Fault in collision losses
a. Collision losses are paid regardless of fault. b. An insurer that pays an insured for collision losses has the right to recover payment from the driver who caused the accident through subrogation.
[HO-3 Provisions] Your Duties After Loss
a. Give prompt notice b. Notify the police c. Notify the credit card, electronic fund transfer card company, or access device company d. Protect the property from further damage e. Cooperate with the insurer f. Prepare an inventory g. Verify the loss h. Sign a sworn proof of loss
[Section II Coverage E and F] Duties After "Occurrence"
a. Give written notice to the insurer as soon as practical. b. Cooperate with the insurer's investigation, settlement, and defense activities. c. Forward legal documents promptly to the insurer. d. Provide claims assistance to the insurer in making a settlement, enforcing any right of contribution against another party, attending hearings and trials, securing and giving evidence, and obtaining the attendance of witnesses. e. Submit evidence for damage to property of others when a claim is made under the additional coverage for damage to property of others; the insured must submit to the insurer a sworn statement of loss and show the damaged property to the insurer. f. Do not make voluntary payment; if the insured does so, it will be at the insured's own expense.
[HO-3 provisions] methods for determining the loss settlement for a building
a. If limit > 80% of replacement cost, insurer pays replacement cost up to limit b. If limit < 80% of replacement cost, insurer pays greater of two amts: ---- ACV of damage ---- Proportion of cost to repair/replace damage that the limit of insurance bears to 80% of replacement cost
[HO-3] Coverage E and F exclusions
a. Motor vehicle and other motorized craft b. Expected or intended injury c. Business (>$2k income; does not include daycare not involving compensation or daycare rendered to relative; does include rentals) d. Insured's failure to render professional services e. Insured's premises not an insured location f. War g. Communicable disease h. Sexual molestation/abuse i. Controlled substances
The HO-3 Section I exclusions that apply to Coverages A, B, and C:
a. Ordinance or law—This exclusion eliminates coverage for losses resulting from any ordinance or law that reduces the value of the property; requires testing for or cleaning up of pollutants; or requires demolition, construction, or debris removal. b. Earth movement (fire following is covered) c. Water - flood, sewer backup d. Power failure (unless interrupted by insured peril) e. Neglect f. War g. nuclear hazard h. intentional loss i. govt action
The HO-3 Section I exclusions that apply only to Coverages A (dwelling) and B (other structures):
a. Weather is an excluded peril only if it contributes to any of the previously excluded perils that apply to A,B,C b. Acts or decisions, including the failure to act c. Damage that results from an improperly built house.. except if a faulty chimney results in a fires
Miscellaneous Type Vehicle Endorsement
can be added to the PAP to insure motorcycles, mopeds, motor scooters, golf carts, motor homes, dune buggies, etc.
Aircraft Liability Definition Revised to Remove Exception for Model and Hobby Aircraft
can be used to manage the loss exposures created by the increasing personal use of drones, a type of unmanned aircraft, such as the potential for collision with manned aircraft or possible invasion of privacy concerns. This optional endorsement amends the definition of "aircraft liability" to include unmanned aircraft, "whether or not model or hobby." The endorsement excludes liability for bodily injury or property damage arising from the operation of unmanned aircraft
Auto Loan/Lease Coverage
covers the difference between the outstanding loan amount and the amount that would have been paid None of these would be included in any loss payment: a. Lease or loan payments that were overdue at the time of loss b. Penalties imposed under a lease for excessive use, abnormal wear and tear, or high mileage c. Security deposits not refunded by a lessor d. Costs for extended warranties; credit life insurance; or health, accident, or disability insurance purchased with the loan or the lease e. Balances transferred from previous loans or leases
Towing and Labor Costs Coverage
covers the towing of a disabled covered or nonowned auto, including costs for labor performed at the place of disablement
trailer / camper body coverage
covers trailers or camper bodies, including related facilities or equipment Loss to clothing or luggage, business or office equipment, and sales samples or articles used in exhibitions is excluded.
Excess Electronic Equipment Coverage
increases the $1,000 limit that applies to electronic equipment installed in the vehicle in locations not intended for that purpose by the auto manufacturer
Ordinance or Law—Increased Amount of Coverage
increases the coverage that is provided by an HO-3 policy of 10 percent of Coverage A by increments of 25 percent.
Additional Duties for Uninsured Motorists Coverage
notify police; submit legal papers
Additional Duties for Physical Damage Coverage
prevent further loss; notify police in case of theft; permit inspection and appraisal
Home Business Insurance Coverage (HOMEBIZ)
provides a comprehensive business package policy when attached to a homeowners form a. Section I—Property Coverage provides full Coverage C— Personal Property limits for business property, accounts receivable, loss of business income, extra expense, and increased Coverage C limits for other property. b. Section II—Liability Coverages provides products-completed operations coverage up to an annual aggregate limit equal to the Coverage E—Personal Liability limit; provides all other business liability coverage.
Snowmobile Endorsement
provides coverage for snowmobiles other than vehicles propelled by airplane-type propellers or fans
Limited Mexico Coverage
provides excess liability coverage over Mexican auto insurance for an insured who is involved in an acident or loss in Mexico within twenty-five miles of the United States border on a trip of ten days or less
Personal Property Replacement Cost Loss Settlement
provides replacement cost coverage on personal property. This endorsement lists certain types of personal property, such as antiques and fine art, ineligible for replacement cost coverage For losses with a replacement value of more than $500, the insured must repair or replace the lost or damaged items before the insurer will pay the replacement cost. The insured can make an actual cash value (ACV) claim at the time of loss and later make a claim for the additional replacement cost
Supplemental Loss Assessment Coverage
supplements Section I—Property Coverages and Section II—Liability Coverages additional coverages with an additional amount of insurance for the premises named in the endorsement.
Motorized Vehicle Liability Exclusion for Section II liability HO-3 ... when does coverage not apply to a motor vehicle?
• It is required by law to be registered for use on public roads or property. • It is involved in an organized race. • It is rented to others. • It is used to carry persons or cargo for a charge. • It is used for any business purpose, except for motorized golf carts used on a golf course.