often overlooked personal lines endorsements€¦ · a. earthquake (ho 04 54) 1. adds earthquake...

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Often Overlooked Personal Lines Endorsements

Often OverlookedPersonal Lines Endorsements

Presented by

Michael C. D’Orlando, CIC, LIA, CPIAInsurance Training & Consulting Services

POLICY NUMBER: HOMEOWNERSHO 04 54 05 11

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

HO 04 54 05 11 © Insurance Services Office, Inc., 2010 Page 1 of 1

EARTHQUAKESCHEDULE

Earthquake Deductible Percentage Amount:Exterior Masonry Veneer Exclusion 1.

Check here only if this exclusion does not apply.

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Section I – Property CoveragesThe following is added:1. We insure for direct physical loss to property

covered under Section I caused by earthquake, including land shock waves or tremors before, during or after a volcanic eruption. One or more earthquake shocks that occur within a 72-hour period constitute a single earthquake.

2. This coverage does not increase the limits ofliability stated in this policy.

B. Section I – Exclusions1. The following exclusions are added:

a. Exterior Masonry VeneerWe do not cover loss to exterior masonry veneer caused by earthquake. The value of exterior masonry veneer will be deducted before applying the earthquake deductible described above. For the purpose of this exclusion, stucco is not considered masonry veneer.

b. FloodWe do not cover loss resulting directly or indirectly from flood of any nature or waves, including tidal wave and tsunami, whether:

(1) Caused by; (2) Resulting from; (3) Contributed to by; or (4) Aggravated by; earthquake.

c. Filling LandThis coverage does not include the cost of filling land.

2. Exception To The Earth Movement ExclusionThe Section I – Earth Movement Exclusion does not apply to loss caused by earthquake, including land shock waves or tremors before, during or after a volcanic eruption.

C. Section I – ConditionsB. DeductibleThe following replaces any other deductible provision in this policy with respect to any one loss covered under this endorsement:1. We will pay only that part of the total of all loss

payable under all Section I – Property Coverages, except:a. Coverage D; andb. The Additional Coverages;that exceeds the earthquake deductibledescribed in Paragraph B.2.

2. The dollar amount of the earthquake deductible is determined by multiplying either the: a. Coverage A; orb. Coverage C;Limit Of Liability shown in the Declarations, whichever is greater, by the deductible percentage amount shown in the Schedule above. The total deductible amount will not be less than $500.

All other provisions of this policy apply.

Michael C. D'Orlando, CIC, LIA, CPIA Page 1 Often Overlooked PL Endorsements

I. Often Overlooked HO Endorsements

A. Earthquake (HO 04 54)

1. Adds Earthquake and Volcanic Eruption as Covered Causes of Loss

2. All earthquake shocks occurring within a 72-hour period considered a single earthquake

3. Damage by flood or tidal wave is excluded

4. Deductible is a percentage rather than a flat dollar amount

5. Deductible is determined by multiplying either theCoverage A limit or the Coverage C limit, whichever is greater, by the deductible percentage


POLICY NUMBER: HOMEOWNERS HO 04 36 05 11



LOSS ASSESSMENT COVERAGE FOR EARTHQUAKE

SCHEDULE

A. Location Of The Unit Limit Of Liability $

B. Earthquake Loss Assessment Deductible Percentage Amount: Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Section I – Property Coverages

The following coverage is added: Loss Assessment Coverage We will pay your share of any loss assessment charged during the policy period against you by a corporation or association of property owners, up to the Limit Of Liability shown in A. in the Schedule above for each unit. The assessment must be made as a result of direct loss to property, owned by all members collectively, of the type that would be covered by this policy if owned by you, caused by:

1. Earthquake; or 2. Land shock waves or tremors before, during or

after a volcanic eruption. One or more earthquake shocks that occur within a 72-hour period constitute a single earthquake.

B. Section I – Exclusions 1. The following exclusions are added: a. We do not cover assessments charged

against you or a corporation or association of property owners by any governmental body.

b. We do not cover any assessment made as a result of loss resulting directly or indirectly from flood of any nature or waves, including tidal wave and tsunami, whether:

(1) Caused by; (2) Resulting from; (3) Contributed to by; or (4) Aggravated by;

earthquake.

2. Exception To The Earth Movement Exclusion The Section I – Earth Movement Exclusion does not apply to loss caused by earthquake, including land shock waves or tremors before, during or after a volcanic eruption.

C. Section I – Conditions B. Deductible

The following replaces any other deductible provision in this policy with respect to any one loss covered under this endorsement. The following deductible applies to your share of each assessment made for each loss caused by earthquake: For each unit covered, we will pay only that part of your assessment which is more than the earthquake loss assessment deductible. The dollar amount of the earthquake loss assessment deductible is determined by multiplying the limit of liability for each unit shown in A. in the Schedule by the deductible percentage amount shown in B. in the Schedule. However, this deductible amount will not be less than $500 in any one assessment. We will apply only one deductible, per unit, to the total amount of any one loss to the property described in this endorsement, regardless of the number of assessments.



B. Loss Assessment Coverage for Earthquake (HO 04 36)

1. HO policy specifically excludes Loss Assessment coverage for earthquake, even if Earthquake Coverage is added by endorsement as a covered peril

HO “Additional Coverages”

7. Loss Assessment

We will pay up to $1,000 for your share of loss assessment charged against you…caused by a peril insured against under Coverage A, other than Earthquake…

2. Same provisions as Earthquake Coverage (HO 04 54)





OWNED MOTORIZED GOLF CART PHYSICAL LOSS COVERAGE

SCHEDULE

Limit Of Liability Check If Collision Peril C.2. Applies.

Make Or Model And Serial Or Motor Number

$

$

$

Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Definitions

With respect to the provisions of this endorsement only, the following definition is added: "Golf cart" means a motorized conveyance, described in the Schedule above, including permanently installed accessories, equipment or parts, that is:

1. Designed to carry up to four people on a golf course for the purpose of playing golf; and

2. Not built or modified after manufacture to exceed a speed of 25 miles per hour on level ground.

B. Section I – Property Coverages The following coverage is added:

1. Covered Property We cover the following property for loss by a Peril Insured Against described in C. below:

a. The "golf cart" for which a limit is shown in the Schedule. That limit is the most we will pay for any one loss to that cart; and

b. Accessories, equipment or parts not permanently installed that are designed or made solely for use with the "golf cart", but only if, at the time of loss, such property is:

(1) At an "insured's" residence; or

(2) In or upon a "golf cart" off an "insured's" residence.

The limit of liability for such property shall be an amount equal to 10% of the highest Limit Of Liability shown in the Schedule. That limit is the most we will pay for any one loss.

2. Property Not Covered We do not cover property described in B.1. above if loss by a Peril Insured Against described in C. below is also covered by another insurance policy, mechanical breakdown insurance or warranty, or a manufacturer's or extended warranty. However, if the other insurance or warranty pays less than the limit in the schedule, we will pay the difference, up to that limit, subject to the deductible and loss settlement conditions in E. below.

C. Section I – Perils Insured Against 1. We insure property described in B. above

against direct physical loss except Collision and as excluded in D. below.

2. If the Schedule shows that Collision Peril C.2. applies, we also insure against collision, meaning the physical contact of the "golf cart" with another object or the upset of the "golf cart" without contact with another object.


C. Owned Motorized Golf Cart – Physical Loss Coverage (HO 05 28)

HO 2000 “Property Not Covered”

c. “Motor Vehicles”

(1) This includes: (a) Their accessories, equipment and parts…

(2) We do cover “motor vehicles” not required to be registered for use on public roads or property which are:

(a) Used solely to service an “insured’s” residence; or (b) Designed to assist the handicapped

1. More and more people have them in retirement communities, gated communities, rural areas, etc.

2. Open Peril coverage

3. Collision is optional

4. “Golf” cart defined as motorized conveyance designed to carry up to four people on a golf course for the purpose of playing golf, and not built or modified after manufacture to exceed a speed of 25 miles per hour on level ground

5. This is a property endorsement…Still no liability coverage!


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of 2 © Insurance Services Office, Inc., 2010 HO 05 28 05 11

D. Section I – Exclusions We do not insure for loss:

1. Excluded under Section I – Exclusions in the policy form;

2. If, at the time of loss, the "golf cart" is being: a. Operated in, or practicing for, any

prearranged or organized race, speed contest or other similar competition;

b. Rented to others; c. Used to carry persons or cargo for a

charge; or d. Used for any "business" purpose except

while on a golfing facility; 3. To tires or wheels caused by contact with the

road or ground, or tires punctured by an object lying on the ground;

4. To the electrical system or equipment caused by artificial electricity;

5. Caused by or resulting from any work being done on the "golf cart", unless fire or explosion ensues and then only for the loss by such ensuing fire or explosion;

6. Caused by or resulting from: a. Vandalism or Malicious Mischief if the place

where the "golf cart" is kept or stored has been unoccupied, closed for the season or is not in operation for any reason for more than 60 consecutive days immediately before the loss;

b. Electrical, mechanical or structural breakdown or failure;

c. Overheating, freezing, dampness of the atmosphere or extremes of temperature;

d. Wear, tear, deterioration, mold, fungus, rust, or corrosion;

e. Inherent vice, latent defect or any quality in property that causes it to damage or destroy itself; or

f. Animals, birds, vermin, insects or rodents. If, however, Collision Peril C.2. applies, this Exclusion 6.f. does not apply to collision with an animal or bird.

E. Section I – Conditions B. Deductible

The following replaces any other deductible provision in this policy with respect to any one loss covered under this endorsement: We will pay only that part of the total of all loss payable that exceeds $500. Paragraph D. Loss Settlement is replaced by the following:

D. Loss Settlement With respect to a covered "golf cart" and property described in B.1.b., we will pay no more than the least of the following:

1. The actual cash value; 2. The amount required to repair or replace; or 3. The limit of liability that applies to such

property. We will use the manufacturer's specifications or accepted repair practices to repair the "golf cart's" molded body or parts made of fiberglass, plastic or composite materials.



HOMEOWNERS HO 24 13 05 11



INCIDENTAL LOW POWER RECREATIONAL MOTOR VEHICLE

LIABILITY COVERAGE ENDORSEMENT DEFINITIONS With respect to a "motor vehicle" covered by this endorsement, Definition 5., which defines "Insured", is extended to include any person or organization legally responsible for the covered "motor vehicle" owned by an "insured". Definition 5., however, does not include a person or organization using or having custody or possession of the "motor vehicle" without the permission of the owner. SECTION II – EXCLUSIONS Paragraph A.2.d. is replaced by the following: d. Designed for recreational use off public

roads and: (1) Not owned by an "insured"; or (2) Owned by an "insured" provided the

"occurrence" takes place: (a) On an "insured location" as defined

in Definition B.6.a., b., d., e. or h.; or

(b) Off an "insured location" but only if the "motor vehicle":

(i) Was not built or modified after manufacture to exceed a speed of 15 miles per hour on level ground; or

(ii) Is not a: i. Motorized bicycle; ii. Motorized scooter; iii. Moped; or iv. Motorized golf cart, regardless

of its speed capability. All other provisions of this policy apply.


D. Incidental or Low Power Recreational Motor Vehicle (HO 24 13)

HO 2000 Liability Exclusions

A. “Motor Vehicle Liability”

1. Coverages E and F do not apply to any “motor vehicle liability”

2. If Exclusion A. 1. does not apply, there is still no coverage for “motor vehicle liability” unless the “motor vehicle” is:

d. Designed for recreational use off public roads and:

(1) Not owned by an “insured”; or (2) Owned by an “insured” provided the “occurrence” takes place on an “insured location” as defined in

Definitions B.6.a, b., d., e. or h. …

1. Endorsement removes exclusion for certain owned recreational vehicles used off “insured locations”

2. Does not apply to:

a. Vehicles built or modified after manufacture to exceed15 miles per hour

b. Motorized bicycles, mopeds or motorized golf carts,regardless of speed capability

c. This is a liability endorsement…Still no property coverage!





LIVESTOCK COLLISION COVERAGE

SCHEDULE

Number Of Head Of Livestock: Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Definitions

The following definition is added for the coverage provided by this endorsement: "Livestock" means cattle, sheep, swine, goats, horses, mules and donkeys.

B. Covered We will pay, up to the limit specified in D. below, for loss resulting in death of "livestock" owned by an "insured" when the death is caused by:

1. Collision or overturn of a vehicle on which the "livestock" are being transported. Collision means accidental contact of that vehicle with another vehicle or object; or

2. "Livestock" running into or being struck by a vehicle while the "livestock" are crossing, moving along or standing in a public road.

C. Not Covered We will not pay for loss to "livestock" if a vehicle owned or operated by an "insured" or an "employee":

1. Collides with the vehicle on which the "livestock" are being transported; or

2. Strikes "livestock" crossing, moving along or standing in a public road.

D. Loss Settlement With respect to the coverage provided by this endorsement, Section I – Condition D. Loss Settlement is replaced by the following: The most we will pay for loss caused by death to any one head of "livestock" is $400. Each horse, mule or head of cattle under one year of age, as of the time of loss, will be counted as 1/2 head.

E. Deductible No deductible applies to this coverage.



E. Livestock Collision Coverage (HO 04 52)

HO Property Not Covered

We do not cover:

b. Animals, birds or fish

1. Endorsement provides limited coverage for “livestock”, defined as: cattle, sheep, swine, goats, horses, mules and donkeys

2. Pays in event of death of livestock caused by:

a. Collision or overturn of a vehicle on which livestock is being transported

b. Livestock running into or being struck by a vehicle while the livestock is crossing, moving along or standing in a public road




HO 24 72 10 00 Copyright, Insurance Services Office, Inc., 1999 Page 1 of 1

INCIDENTAL FARMING PERSONAL LIABILITY

SCHEDULE*

Check A. and/or B. below:

A. Farming operations that are conducted on the "residence premises" described in the Declarations

B. Farming operations described below that are conducted away from the "residence premises" at the location specified below:

Description Of Farming Operations:

*Entries may be left blank if shown elsewhere in this policy for this coverage.

SECTION II – LIABILITY COVERAGES Coverage E – Personal Liability and Coverage F – Medical Payments To Others apply to "bodily injury" or "property damage" arising out of the farming opera-tions which are described in the Schedule above. SECTION II – EXCLUSIONS Exclusion E.2. "Business" does not apply to the farm-ing operations which are described in the Schedule.

Exclusion E.4.b., which pertains to a premises rented to an "insured", does not apply to the location which is described in B. in the Schedule. All other provisions of this policy apply.


F. Incidental Farming Personal Liability (HO 24 72)

1. For the “gentleman/gentlewoman” farmer

2. HO business exclusion does not apply to farming operations described in schedule

3. Can be used for incidental farming operations on or away from the “residences premises”





FARMERS PERSONAL LIABILITY

SCHEDULE

This Farmers Personal Liability insurance applies only to the coverages for which a premium is shown in this Schedule.

All Farm Premises owned, rented or operated by you are located as follows: Operated By You

Rented To Others

a.

b.

c.

1. Farms Owned And Operated Or Rented And Operated By You Or Your Employees ADVANCE PREMIUM

a. Initial Farm Premises with or without buildings (including all additional farm acreage with or without buildings) TOTAL ACREAGE $ b. Additional Farm Premises with buildings Number of Premises x Rate per premises $ = $ 2. Farms Owned By You And Rented To Others a. All Farm Premises without buildings $ b. Each Farm Premises with buildings Number of Premises x Rate per premises $ = $ c. Total Acreage of 2.a. and 2.b. = Additional Flat Charge based on total acreage $ 3. Exceptions To Farming Business No "business", other than "farming", is conducted on the "insured location". Exceptions, if any: 4. Insured Farm Employees Complete either a. or b. below, as applicable. a. Maximum number of days employed at any one time during the policy period or total

number of person days worked:

(1) Part-time (over 40 days but less than 180 days a year) Number of employees x Rate per employee $ = $ (2) Part-time (40 days or less a year) Number of person days x Rate per 100 person days $ = $ (3) Full-time (180 days or more a year) Number of employees x Rate per employee $ = $ SUBTOTAL $ b. Total Payroll (Total Payroll $ $100) = x Rate per $100 $ = $ TOTAL PREMIUM $



G. Farmers Personal Liability (HO 24 73)

1. Similar to the Incidental Farming Personal Liability Endorsement (HO 24 72), used only if farming is not the insured’s primary occupation

2. However, “incidental” is not a defined term…Therefore, if the farming activity is more than “very minor” and less than “primary”, this endorsement should be considered



DEFINITIONS A. With respect to the coverage provided in this

endorsement, Definitions B.3. and 6. in the policy form are replaced by the following and apply to all parts of Section II.

3. "Business" means: a. A trade, profession or occupation except

farming, engaged in on a full-time, part-time or occasional basis; or

b. Any other activity engaged in for money or other compensation, except the following:

(1) Farming; (2) One or more activities, not described in

(3) through (5) below, for which no "insured" receives more than $2,000 in total compensation for the 12 months before the beginning of the policy period;

(3) Volunteer activities for which no money is received other than payment for expenses incurred to perform the activity;

(4) Providing home day care services for which no compensation is received, other than the mutual exchange of such services; or

(5) The rendering of home day care services to a relative of an "insured".

6. "Insured location" means: a. The "residence premises" shown in the

Declarations and the farm premises shown in the Schedule above;

b. The part of other premises, other structures and grounds used by you as a residence; and:

(1) Which is shown in the Declarations; or (2) Which is acquired by you during the

policy period for your use as a residence;

c. Any premises used by you in connection with a premises described in a. or b. above;

d. Any part of a premises: (1) Not owned by an "insured"; and

(2) Where an "insured" is temporarily residing;

e. Vacant land owned by or rented to an "insured";

f. Land owned by or rented to an "insured" on which a one-, two-, three- or four-family dwelling is being built as a residence for an "insured";

g. Individual or family cemetery plots or burial vaults of an "insured"; or

h. Any part of a premises occasionally rented to an "insured" for other than "business" use.

B. The following definitions are added for the coverage provided by this endorsement:

3. "Farm employee" means: a. An employee whose usual duties are

principally related to the "farming" operations of an "insured"; or

b. An employee leased to an "insured" by a labor leasing firm under an "agreement" between an "insured" and the labor leasing firm, whose duties are other than those performed by a "residence employee".

"Farm employee" does not mean a "residence employee" or an "employee" while engaged in an "insured's" "business".

4. "Farming" includes the operation of roadside stands maintained principally for the sale of the "insured's" farm products.

5. "Insured farm employee" means any "farm employee" if the Declarations shows a premium charge for "insured farm employees".

SECTION II – LIABILITY COVERAGES Section II – Liability Coverages is replaced by the following: A. Coverage E – Personal Liability

If a claim is made or a suit is brought against an "insured" for damages because of "bodily injury" or "property damage" caused by an "occurrence" to which this coverage applies, we will:

1. Pay up to our limit of liability for the damages for which an "insured" is legally liable. Damages include prejudgment interest awarded against an "insured"; and



2. Provide a defense at our expense by counsel of our choice, even if the suit is groundless, false or fraudulent. We may investigate and settle any claim or suit that we decide is appropriate. Our duty to settle or defend ends when our limit of liability for the "occurrence" has been exhausted by payment of a judgment or settlement.

B. Coverage F – Medical Payments To Others We will pay the necessary medical expenses that are incurred or medically ascertained within three years from the date of an accident causing "bodily injury". Medical expenses means reasonable charges for medical, surgical, x-ray, dental, ambulance, hospital, professional nursing, prosthetic devices and funeral services. This coverage does not apply to you or regular residents of your household except "residence employees" or "insured farm employees". As to others, this coverage applies only:

1. To a person on the "insured location" with the permission of an "insured"; or

2. To a person off the "insured location", if the "bodily injury":

a. Arises out of a condition on the "insured location" or the ways immediately adjoining;

b. Is caused by the activities of an "insured"; c. Is caused by a "residence employee" or a

"farm employee" in the course of the employee's employment by an "insured"; or

d. Is caused by an animal owned by or in the care of an "insured".

SECTION II – EXCLUSIONS Section II – Exclusions is replaced by the following: A. "Motor Vehicle Liability" 1. Coverages E and F do not apply to any "motor

vehicle liability" if, at the time and place of an "occurrence", the involved "motor vehicle":

a. Is registered for use on public roads or property;

b. Is not registered for use on public roads or property, but such registration is required by a law, or regulation issued by a government agency, for it to be used at the place of the "occurrence"; or

c. Is being: (1) Operated in, or practicing for, any

prearranged or organized race, speed contest or other competition;

(2) Rented to others;

(3) Used to carry persons or cargo for a charge; or

(4) Used for any "business" purpose except for a motorized golf cart while on a golfing facility.

2. If Exclusion A.1. does not apply, there is still no coverage for "motor vehicle liability" unless the "motor vehicle" is:

a. In dead storage on an "insured location"; b. Used to service an "insured location"; c. Designed to assist the handicapped and, at

the time of an "occurrence", it is: (1) Being used to assist a handicapped

person; or (2) Parked on an "insured location"; d. Designed for recreational use off public

roads and: (1) Not owned by an "insured"; or (2) Owned by an "insured" provided the

"occurrence" takes place: (a) On an "insured location" as defined

in Definition A.6.a., b., d., e. or h. above; or

(b) Off an "insured location" and the "motor vehicle" is:

(i) Designed as a toy vehicle for use by children under seven years of age;

(ii) Powered by one or more batteries; and

(iii) Not built or modified after manufacture to exceed a speed of five miles per hour on level ground;

e. A motorized golf cart that is owned by an "insured", designed to carry up to four persons, not built or modified after manufacture to exceed a speed of 25 miles per hour on level ground and, at the time of an "occurrence", is within the legal boundaries of:

(1) A golfing facility and is parked or stored there, or being used by an "insured" to:

(a) Play the game of golf or for other recreational or leisure activity allowed by the facility;

(b) Travel to or from an area where "motor vehicles" or golf carts are parked or stored; or

(c) Cross public roads at designated points to access other parts of the golfing facility; or



(2) A private residential community, including its public roads upon which a motorized golf cart can legally travel, which is subject to the authority of a property owners association and contains an "insured's" residence.

B. "Watercraft Liability" 1. Coverages E and F do not apply to any

"watercraft liability" if, at the time of an "occurrence", the involved watercraft is being:

a. Operated in, or practicing for, any prearranged or organized race, speed contest or other competition. This exclusion does not apply to a sailing vessel or a predicted log cruise;

b. Rented to others; c. Used to carry persons or cargo for a

charge; or d. Used for any "business" purpose. 2. If Exclusion B.1. does not apply, there is still no

coverage for "watercraft liability" unless, at the time of the "occurrence", the watercraft:

a. Is stored; b. Is a sailing vessel, with or without auxiliary

power that is: (1) Less than 26 feet in overall length; or (2) 26 feet or more in overall length and not

owned by or rented to an "insured"; c. Is not a sailing vessel and is powered by: (1) An inboard or inboard-outdrive engine or

motor, including those that power a water jet pump, of:

(a) 50 horsepower or less and not owned by an "insured"; or

(b) More than 50 horsepower and not owned by or rented to an "insured"; or

(2) One or more outboard engines or motors with:

(a) 25 total horsepower or less; (b) More than 25 horsepower if the

outboard engine or motor is not owned by an "insured";

(c) More than 25 horsepower if the outboard engine or motor is owned by an "insured" who acquired it during the policy period; or

(d) More than 25 horsepower if the outboard engine or motor is owned by an "insured" who acquired it before the policy period, but only if:

(i) You declare them at policy inception; or

(ii) Your intent to insure them is reported to us in writing within 45 days after you acquire them.

The coverages in (c) and (d) above apply for the policy period.

Horsepower means the maximum power rating assigned to the engine or motor by the manufacturer.

C. "Aircraft Liability" This policy does not cover "aircraft liability".

D. "Hovercraft Liability" This policy does not cover "hovercraft liability".

E. Coverage E – Personal Liability And Coverage F – Medical Payments To Others Coverages E and F do not apply to the following:

1. Expected Or Intended Injury "Bodily injury" or "property damage" which is expected or intended by an "insured" even if the resulting "bodily injury" or "property damage":

a. Is of a different kind, quality or degree than initially expected or intended; or

b. Is sustained by a different person, entity or property than initially expected or intended.

However, this Exclusion E.1. does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force by an "insured" to protect persons or property;

2. Business a. "Bodily injury" or "property damage" arising

out of or in connection with a "business" conducted from an "insured location" or engaged in by an "insured", whether or not the "business" is owned or operated by an "insured" or employs an "insured". This Exclusion E.2. applies but is not limited to an act or omission, regardless of its nature or circumstance, involving a service or duty rendered, promised, owed, or implied to be provided because of the nature of the "business".



b. This Exclusion E.2. does not apply to: (1) The rental or holding for rental of an

"insured location"; (a) On an occasional basis if used only

as a residence; (b) In part for use only as a residence,

unless a single-family unit is intended for use by the occupying family to lodge more than two roomers or boarders; or

(c) In part, as an office, school, studio or private garage;

(2) An "insured" under the age of 21 years involved in a part-time or occasional, self-employed "business" with no employees;

(3) The rental or holding for rental of an "insured location" that is a farm premises used for farming purposes provided:

(a) It is shown in the Schedule above or acquired during the policy period; and

(b) It is rented during the policy period; or

(4) The rental or holding for rental of a farm premise described in (3) above that contains a dwelling also rented or held for rental to others provided the dwelling is rented during the policy period;

3. Professional Services "Bodily injury" or "property damage" arising out of the rendering of or failure to render professional services;

4. "Insured's" Premises Not An "Insured Location" "Bodily injury" or "property damage" arising out of a premises:

a. Owned by an "insured"; b. Rented to an "insured"; or c. Rented to others by an "insured";

that is not an "insured location"; 5. War

"Bodily injury" or "property damage" caused directly or indirectly by war, including the following and any consequence of any of the following:

a. Undeclared war, civil war, insurrection, rebellion or revolution;

b. Warlike act by a military force or military personnel; or

c. Destruction, seizure or use for a military purpose.

Discharge of a nuclear weapon will be deemed a warlike act even if accidental;

6. Pollution "Bodily injury" or "property damage" arising out of the discharge, dispersal, seepage, migration, release or escape of pollutants into or upon land, the atmosphere or any watercourse or body of water. Pollutants means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed. This exclusion does not apply if the discharge, dispersal, seepage, migration, release or escape is sudden and accidental;

7. Communicable Disease "Bodily injury" or "property damage" which arises out of the transmission of a communicable disease by an "insured";

8. Sexual Molestation, Corporal Punishment Or Physical Or Mental Abuse "Bodily injury" or "property damage" arising out of sexual molestation, corporal punishment or physical or mental abuse; or

9. Controlled Substance "Bodily injury" or "property damage" arising out of the use, sale, manufacture, delivery, transfer or possession by any person of a Controlled Substance as defined by the Federal Food and Drug Law at 21 U.S.C.A. Sections 811 and 812. Controlled Substances include but are not limited to cocaine, LSD, marijuana and all narcotic drugs. However, this exclusion does not apply to the legitimate use of prescription drugs by a person following the lawful orders of a licensed health care professional.

Exclusions A. "Motor Vehicle Liability", B. "Watercraft Liability", C. "Aircraft Liability", D. "Hovercraft Liability" and E.4. "Insured's Premises Not An Insured Location" do not apply to "bodily injury" to a "residence employee" or "insured farm employee" arising out of and in the course of the employee's employment by an "insured".



F. Coverage E – Personal Liability Coverage E does not apply to:

1. Liability: a. For any loss assessment charged against

you as a member of an association, corporation or community of property owners, except as provided in D. Loss Assessment under Section II – Additional Coverages;

b. Under any contract or agreement entered into by an "insured". However, this exclusion does not apply to written contracts:

(1) That directly relate to the ownership, maintenance or use of an "insured location"; or

(2) Where the liability of others is assumed by you prior to an "occurrence";

unless excluded in a. above or elsewhere in this policy. This exclusion does not apply to a warranty of goods or products;

2. "Property damage" to property owned by an "insured". This includes costs or expenses incurred by an "insured" or others to repair, replace, enhance, restore or maintain such property to prevent injury to a person or damage to property of others, whether on or away from an "insured location";

3. "Property damage" to property rented to, occupied or used by or in the care of an "insured". This exclusion does not apply to "property damage" caused by fire, smoke or explosion;

4. "Bodily injury" to any person eligible to receive any benefits voluntarily provided or required to be provided by an "insured" under any:

a. Workers' compensation law; b. Non-occupational disability law; or c. Occupational disease law; 5. "Bodily injury" or "property damage" for which

an "insured" under this policy: a. Is also an insured under a nuclear energy

liability policy issued by the: (1) Nuclear Energy Liability Insurance

Association; (2) Mutual Atomic Energy Liability

Underwriters; (3) Nuclear Insurance Association of

Canada;

or any of their successors; or b. Would be an insured under such a policy

but for the exhaustion of its limit of liability; 6. "Bodily injury" to you or an "insured" as defined

under Definitions 5.a. or 5.b.; This exclusion also applies to any claim made or suit brought against you or an "insured" to:

a. Repay; or b. Share damages with;

another person who may be obligated to pay damages because of "bodily injury" to an "insured";

7. "Bodily injury" to a "farm employee", other than an "insured farm employee", arising out of and in the course of the employee's employment by an "insured";

8. "Property damage" to and arising out of: a. Products manufactured, sold, handled or

distributed by an "insured"; b. Work performed by or for an "insured"; or 9. "Property damage" arising out of any

substance released or discharged from any aircraft.

G. Coverage F – Medical Payments To Others Coverage F does not apply to "bodily injury":

1. To a "residence employee" if the "bodily injury": a. Occurs off the "insured location"; and b. Does not arise out of or in the course of the

"residence employee's" employment by an "insured";

2. To any person eligible to receive any benefits voluntarily provided or required to be provided under any:

a. Workers' compensation law; b. Non-occupational disability law; or c. Occupational disease law; 3. From any: a. Nuclear reaction; b. Nuclear radiation; or c. Radioactive contamination;

all whether controlled or uncontrolled or however caused; or

d. Any consequence of any of these; 4. To any person other than a "residence

employee" or "insured farm employee" of an "insured", regularly residing on any part of the "insured location"; or



5. To any "farm employee" or other person engaged in work in the maintenance or use of the "insured location" as a farm. This exclusion does not apply to any other person while on the "insured location" in a neighborly exchange of assistance for which the "insured" is not obligated to pay any money.

ADDITIONAL CONDITIONS When a premium is shown under 4. Insured Farm Employees in the Schedule, the following conditions apply: A. Premium – Coverages E And F 1. All premiums for this policy will be computed in

accordance with our rules, rates and minimum premiums.

2. A premium shown as "advance premium" is only a deposit premium. It will be applied to the amount of the earned premium due at the end of the policy period.

3. At the end of each audit period, the earned premium will be computed and, upon notice to you, will become due and payable.

4. If the earned premium for the policy period is less than the premium previously paid, we will return the unearned portion of the premium to you.

5. You must keep records of information necessary for the premium computation. You must also send copies of these records to us at the end of the policy period and at any time during the policy period that we request.

B. Inspection And Audit – Coverages E And F We will be permitted but not obligated to inspect your property and operations at any time. Whether we inspect or not, we do not warrant that your property or operations are safe or healthful or are in compliance with any law, rule or regulation. We may examine and audit your books and records at any time during the policy period or within three years after the termination of this policy. However, our right to examine and audit is restricted to the subject matter of this insurance.






OTHER MEMBERS OF YOUR HOUSEHOLD

SCHEDULE

Name Of Person Covered By This Endorsement


A. Agreement 1. We insure the person named in the Schedule

above who lives with you and is a member of your household and who is not an "insured", guest, "residence employee", tenant, roomer or boarder. We also insure a person under the age of 21 who lives with and is in the legal custody of the person named in the Schedule. Such persons are insured for the coverages described in B. Section I – Property Coverage of this endorsement and Section II – Liability described in the policy form.

2. It is agreed that this endorsement is issued in reliance on information you provided concerning the residency of the person described in the Schedule.

3. You agree to notify us in writing within 30 days of a change in the:

a. Residency; or b. Status as a household member;

of the person described in the Schedule. 4. You will be solely responsible for the payment

of any premium pertaining to this endorsement. 5. It is further agreed that you are the

representative of the person described in the Schedule and will act in all matters pertaining to the provisions of this endorsement.

B. Section I – Property Coverage Under Coverage C, the first paragraph is replaced by the following: We cover personal property owned or used by an "insured" or a person described in A.1. of this endorsement while it is anywhere in the world. After a loss and at your request, we will cover personal property owned by:

1. Others, not including a person described in A.1. of this endorsement, while the property is on the part of the "residence premises" occupied by an "insured"; or

2. A guest or a "residence employee", while the property is in any residence occupied by an "insured".

This coverage does not increase the Coverage C limit of liability.

C. General Condition All other provisions under Section I and Section II of this policy that apply to you also apply to the persons described in A.1. of this endorsement, except Coverages A and B and Fair Rental Value under Coverage D.


H. Other Members of Your Household (HO 04 58)

HO “Insured” definition

a. You and residents of your household who are:

(1) Your relatives; or

(2) Other persons under the age of 21 and in the care of any person named above;

b. A student enrolled in school full time , as defined by the school, provided the student is under the age of:

(1) 24 and your relative; or

(2) 21 and in the care of a person described in a.(1) above; or…

1. The HO definition does not include non-relative friends,roommates, “significant others”, etc.

2. This endorsement extends to “insured” status for property and liability to scheduled non-relative residents of your household who do not otherwise meet the definition of insured





ADDITIONAL INSURED – STUDENT LIVING AWAY FROM THE RESIDENCE PREMISES

SCHEDULE

Name And Address Of Student Name Of School Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

DEFINITIONS Definition 5., which defines "insured", is extended to include the person named in the Schedule above, but only if that person: 1. Was a resident of your household before moving

out to attend the school named in the Schedule; and

2. Resides at the address shown in the Schedule; and

a. Is your relative; or

b. Is an other person under the age of 21 and in your care or the care of a relative who is a resident of your household.

SECTIONS I AND II – CONDITIONS The coverage provided to the person named in the Schedule only applies while that person is enrolled at the school and is residing at the address shown in the Schedule. All other provisions of this policy apply.


I. Additional Insured – Student Living Away From the Residence Premises (HO 05 27)

Remember the definition of “Insured”?!

d. A student enrolled in school full time , as defined by the school, provided the student is under the age of:

(1) 24 and your relative; or

(2) 21 and in the care of a person described in a.(1) above; or…

1. Gives back coverage to the “professional student”!

2. Must meet certain requirements:

a. Was a resident of your household before moving out

b. Is enrolled in school full-time “as defined by the school”

c. Attends the school named in the schedule

d. Resides at the address shown in the schedule





ASSISTED LIVING CARE COVERAGE

SCHEDULE

Residency Limit Of Liability Name Of Relative(s) Name Location Coverage C Coverage E $ $ $ $ $ $ Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

AGREEMENT We will insure the person named in the Schedule above for the coverages provided under Section I Property Coverages below and Coverage E – Personal Liability in the policy form, subject to the limits of liability shown in the Schedule. It is agreed that such person is related to an "insured" by blood, marriage or adoption, is not a member of your household and regularly resides in the living care facility (facility) named in the Schedule. It is also agreed that such facility provides assisted living services such as dining, therapy, medical supervision, housekeeping and social activities. It is further agreed that you will represent the person named in the Schedule and will act in all matters pertaining to the provisions of this endorsement. This insurance is excess over any other applicable insurance covering the same loss. SECTION I – PROPERTY COVERAGES 1. Coverage C – Personal Property a. Covered Property

We cover personal property owned and used by a person named in the Schedule for loss by a Peril Insured Against covered under Coverage C in the policy.

b. Limit Of Liability The Limit Of Liability shown in the Schedule is the most we will pay for any one loss regardless of the number of relatives residing in the same living unit in the facility named in the Schedule.

c. Special Limits Of Liability The following special limits of liability apply only to property described in a. above and are in addition to the Coverage C special limits that apply to the policy to which this endorsement is attached. They do not increase the Coverage C Limit Of Liability shown in the Schedule. The special limit shown for each numbered category is the total limit for each loss for the property in that category.

(1) $250 for each hearing aid or other similar audio enhancement device.

(2) $100 for each pair of eyeglasses. (3) $100 for all contact lenses. (4) $500 for all false teeth or dentures. (5) $500 for each medi-alert device. (6) $250 for all walking aids and devices such

as walkers or canes. (7) $500 for each wheelchair.


J. Assisted Living Care Coverage (HO 04 59)

1. A relative in assisted living can be added to your policy

2. Does not require that he or she ever lived with you

3. Certain additional limitations apply to property and liability


________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________



d. Property Not Covered (1) Property regularly located away from the

facility; (2) Property owned by an "insured"; and (3) Property owned by the facility but rented to

or used by the person named in the Schedule.

2. Additional Living Expense a. If a loss covered under this endorsement

makes that part of the facility not fit to live in or results in suspension of facility operations, we will cover the necessary increase in living expenses the person named in the Schedule incurs to maintain their normal standard of living. The amount we will pay for each loss will not exceed a maximum of $500 per month for no more than 12 consecutive months. This amount is the most that we will pay for any one loss, regardless of the number of relatives residing in the same living unit in the facility named in the Schedule.

b. If a civil authority prohibits the use of the facility as a result of direct damage to neighboring premises by a Peril Insured Against in this policy, we cover the necessary increase in living expense incurred by the relative for no more than two weeks, up to $50 per day.

This coverage is additional insurance. The deductible applies to this coverage. We do not cover loss or expense due to cancellation of a lease or agreement.

SECTION II – LIABILITY COVERAGES Coverage F – Medical Payments To Others does not apply to this endorsement. SECTION II – EXCLUSIONS With respect to the coverage provided by this endorsement, the following exclusion is added: Coverage E does not apply to: 1. Liability assumed by the facility prior to an

"occurrence"; or 2. "Bodily injury" to a care facility professional or

support staff that occurs while such person is on or off duty and attending to the person named in the Schedule.

GENERAL CONDITIONS All Section I and Section II additional coverages, exclusions and conditions of this policy that apply to an "insured" also apply to the person named in the Schedule.




HO 04 41 10 00 Copyright, Insurance Services Office, Inc., 1999 Page 1 of 1

ADDITIONAL INSURED RESIDENCE PREMISES

SCHEDULE*

Name And Address Of Person Or Organization Interest *Entries may be left blank if shown elsewhere in this policy for this coverage.

DEFINITIONS Definition 5. which defines "insured" is extended to include the person or organization named in the Schedule above, but only with respect to: 1. Coverage A – Dwelling and Coverage B – Other

Structures; and 2. Coverage E – Personal Liability and Coverage F –

Medical Payments To Others but only with respect to "bodily injury" or "property damage" arising out of the ownership, maintenance or use of the "resi-dence premises".

SECTION II – EXCLUSIONS This coverage does not apply to "bodily injury" to an "employee", "residence employee" or a temporary employee furnished to the "insured" to substitute for a permanent "residence employee" arising out of or in the course of the employee's employment by the person or organization. CANCELLATION AND NONRENEWAL NOTIFICATION If we decide to cancel or not to renew this policy, the person or organization named in the Schedule will be notified in writing. All other provisions of this policy apply.


K. Additional Insured (HO 04 41)

Who can be a named insured on a Homeowners Policy?

Rule 104 – Eligibility

A Homeowners policy may be issued:

1. To the owner-occupant(s) of a dwelling which is used exclusively for residential purposes

2. To the purchaser-occupant(s) who has entered into a long-term installment contract for the purchase of the dwelling and who occupies the dwelling but to whom title does not pass from the seller until all the terms of the installment contract have been satisfied. The seller retains title until completion of the payments and in no way acts as a mortgagee. The seller’s interest in the building and premises liability may be covered using endorsement HO 04 41 – Additional Insured; or

3. To the occupant of a dwelling under a life estate arrangement when the coverage A amount is at least 80% of the dwelling’s replacement cost. The seller’s interest in the building and premises liability may be covered using endorsement HO 04 41 – Additional Insured; or…

1. Property insurance is based on “insurable interest”

2. Homeowners Policy is geared primarily for the “owner/occupant

3. However…the overriding factor is “occupancy”, not “ownership”…There are certain circumstances under which a Homeowners Form can be issued to a non-owner occupant


Let’s “switch gears” and talk about a Mass Auto

issue!


____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


A. “Regular Use” Exclusion Under the MAP

Part 4 exclusions (we do not pay for property damage which occurs):

household member, household member


Part 5 exclusions (In addition, we will not pay):


householdmember, household member

Part 7 Collision

your auto collision.collision household

memberhousehold member

Part 9 Comprehensive

of your auto collision.

household member household member

The policy doesn’t define “regular use” … It just says “Don’t do it!!!”


AIB Manual Rule 50

MASSACHUSETTS ENDORSEMENT – M-0051-S

Use of Other Autos – Vehicles Furnished or Available For Regular Use

With respect to the individual(s) and coverages indicated in the Schedule, the provisions of the policy apply unless modified by this endorsement.

1. Any coverage provided under Damage to Someone Else’s Property, Optional Bodily Injury

to Others, Medical Payments, Collision, Limited Collision, and Comprehensive (Parts 4, 5, 6, 7, 8, and 9) also applies to any vehicle which is furnished or available for the regular use of the named individual on the schedule.

2. We will not pay under this endorsement if:

a. The auto is:

1. owned by you or any household member, or

2. a temporary substitute for an auto owned by you or a household member.

b. The auto is being used by anyone in the course of his or her employment in the business of selling, servicing, repairing, or parking autos.

c. The auto is being used in the business or occupation of the named individual unless the auto is being operated or occupied by named individual, private chauffeur or domestic employee.

3. Under Damage to Someone Else’s Property (Part 4) and Optional Bodily Injury to Others (Part 5), the following are not covered:

a. The Commonwealth of Massachusetts and any of its agencies and authorities. b. The United States of America and any of its agencies.

c. Any person while using an auto in the course of his employment by the United States government if the Federal Tort Claim Act requires the Attorney General of the United States to defend that person in any civil action or proceeding for bodily injury or property damage, whether or not the accident has been reported to the United States or the Attorney General.

4. If someone covered under this endorsement is using an auto he or she does not own at the time of the accident, the owner’s auto insurance pays up to its limits before we pay.

37


Use of Other Autos (M 0051s)

1. Provides coverage for the named individual and resident spouse for all coverages on the Coverage Selections Page when using non-owned “regularly used” autos

2. Other “Household Members” can only receive Medical Payments and UM/UIM (subject to certain restrictions), unless they are also named on the endorsement

3. Removes the public or livery use exclusion when driving vehicles not owned by you or your spouse

4. Removes business use exclusion for non-owned autos normallyexcluded (pickups and vans over 10,000 lbs GVW, other large vehicles such as trucks, buses, etc.)


AIB Manual Rule 50

Use of Other Automobiles – Vehicles Furnished or Available For Regular Use (cont.)

5. The coverage purchased for the named individual is shown in the schedule. If no premium charge is shown, the coverage does not apply.

Unless otherwise indicated below, Use of Other Autos coverage is applicable only to the individual named in the Schedule or in the Coverage Selections Page. Name of Individual: __________________________________________________ If indicated below, Use of Other Autos coverage applies to: Named Individual and Household Members.

Schedule Coverages

Premium

Part 4

Part 5

Part 6

Part 7

Part 8

Part 9

Limits of Liability: Comprehensive – Actual Cash Value less $_________ deductible Collision – Actual Cash Value less $_________ deductible Limited Collision – Actual Cash Value less $________ deductible

[Ed. 04-08]


18 OptionalInsurance(Continued)

We will not pay for a loss for an accident which occurs while your auto is being operated by a household member who is not listed as an operator of this policy.Payment is withheld when the household member, if listed, would require the payment of additional premium on this policy because: 1. the household member would be classified as an inexperienced operator, or 2. more points would be assigned under a merit rating plan. You must notify us within 60 days after a person who will operate your autobecomes a household member if that person was not a household member on the effective date of your policy. In the same manner, you must notify us if a household member, who will operate your auto, becomes a licensed operator.

The protection under this Part is not as broad as under Collision coverage but the premium is considerably less. We only pay under this Part for multiple car accidents in which the driver of the auto we are covering was no more than 50% at fault. We will not pay if the owner of the other auto cannot be identified. After a claim under this Part we are required to determine whether the driver of the auto we are covering was more than 50% at fault. We will notify you of our determination. As long as the driver of the auto covered under this Part was not more than 50% at fault, his or her percentage of fault will not affect the amount of our payment. We will consider the driver of the auto covered under this Part to be no more than 50% at fault if: 1. That auto was legally parked when struck by another auto. 2. That auto was struck in the rear by another auto moving in the same direction.3. The operator of the other auto was convicted of certain violations listed in Massachusetts law or any similar law of another state in which the accident occurs. However, we will not pay if the operator of the auto covered under this Part was also convicted of one of the same violations. 4. That driver is entitled to recover in court against an identified person for some reason other than those listed above. If we pay for the total loss of your auto, we will suspend the Limited Collision Coverage for that auto until it passes a Motor Vehicle Inspection Test.


B. Limited Collision…Is it worth the paper it’s printed on??...Yes, it can be!!!

1. Convenience

2. Damage caused by an uninsured or underinsured motorist

3. Comparative negligence


often overlooked personal lines endorsements€¦ · a. earthquake (ho 04 54) 1. adds earthquake...

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