Term
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Definition
- clause that stipulates the rights and obligatopns of the insurer and the mortgagee
- amends stat con 8 - can give notice of loss and broadens stat con 3 - change of interest
- protects mortgagee if named insured breaches a condition
- mortgagees must inform if vacant over 30 days and of any hazards they are aware of
- same notification rights as insured |
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Term
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Definition
| - go back to beginning, void the contract |
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Term
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Definition
- agreement or promise between 2 or more persons that is intended to be legally enforceaable
-written form of contract is issued by insurer to the insured as a policy - includes indemnity, insurable interest,utmost good faith(uberrime fidei) |
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Term
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Definition
- a risk or probability that the event insured against might occur
- a condition that increases the chance of loss
- ex. cooking hazards, clothes dryer lint, overloaded electrical circuit, unattended candles, wood fireplace and woodstoves, careless smoking, children playing with mtches |
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Term
| extended coverage insurance |
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Definition
endorsement that enlarges the coverage afforded on the primary policy
- windstorm, hail, smoke, and riot |
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Term
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Definition
- not sold on its own today(basis of today's property policies)
- fire policies cover direct physical loss or damage to insured property when it occurs as a result of an insured peril
- original perils = fire, lightning, explosion of natural coal or manufactured gas
- over time additional perils were added |
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Term
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Definition
| statement or stipulation or promise in an insurance contract, the breach of which may nullify the contract |
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Term
| Statutory Condition 3. Change of interest |
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Definition
- under doctrine of privity of contract insured cannot assign his or her right and obligations to another party without the insurers consent
- exceptions inclide authorized assignment under bankruptcy and insolvency act or change of title by succession, operation of law or death of named insured. |
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Term
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Definition
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Term
| Statutory Condition 13. Replacement |
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Definition
| - within 30 days of proof of loss inform if replace or repair; start repairs within 45 days and must complete if after start of repairs cost goes over insurance limit |
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Term
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Definition
-Originating in England
- based on precedent + statute |
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Term
| Statutory Condition 6. Requirement after loss |
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Definition
- insured to provide notice of loss in writing as soon as possible
- requires insured to disclose proof of loss(how/when occurred, inventory, where was property at time of loss, any others with interest) |
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Term
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Definition
| - risks, perils or properties defined in the policy as not covered |
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Term
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Definition
- named perils policies insure against direct physical loss or damage caused by only the listed perils
- named perils coverage onus on insured to proceed the loss or damage was caused by an insured peril that no exclusion of coverage applies
- all risks insure against direct physical loss or damage caused by any peril provided that the peril is not excluded
- all risks insured has to prove that the loss or damage to insured property at an insured location occurred during the policy term and was fortuitous
- all risks onus is on the insurer to prove exclusion apply otherwise damage is insured |
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Term
| Statutory Condition 12.When loss Payable |
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Definition
- 60 ays to pay loss from when proof of loss completed
- may agree to other number days |
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Term
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Definition
- damage caused by the backing up or escape of water from a sump pump system or by ground water or the rising of the water table
- can be added by endorsement |
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Term
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Definition
| - if a loss is attributable to more than one cause any one of which is covered by the policy the loss is payable by the policy |
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Term
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Definition
- chance of loss (possible loss or destruction of property or incurring of a liability)
- subject of an insurance contract |
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Term
| Statutory Condition 8. who may give notice and proof |
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Definition
| - insured, insureds representative(broker/agent) or if unable, any person whom insurance money is payable to |
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Term
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Definition
- always excluded
- earthquake sinkhole, landslide, snow slide can be added by endorsement |
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Term
| Statutory Condition 1. Misrepresentation |
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Definition
- duty to disclose on application material facts that will affect the terms under which the policy may be offered
- eve if question is not asked if a reasonable person ought to have known it was material should be disclosed
- usually discovered after loss may void contract
- onus on insurer to prove misrep is material
- notes key in lieu of signatures in a digital world |
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Term
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Definition
- burst pipe in dwelling causing water to accumulate
- toilet overflow, causing water to accumulate
- dishwasher hose breaks, causing water to accumulate
- sewer backup, causing water to accumulate
sump pump malfunction, causing water to accumulate |
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Term
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Definition
- policy covers mortgagee even if named insd is unable to recover because if breach of policy condition mortgagee is permitted to give notice of loss immediately and proof of loss as soon as is practicable
- mortgagee included among those who acquiring title to the insured property are covered under the policy until cancelled or expired
- mortgagee to be notified of cancellation or alteration to prejudice of mortgagee
- same notice required to mortgagee as insured |
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Term
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Definition
- personal information protection and electronics documents act(pipeda)
- freedom of information and protection of privacy act(foippa)
- personal information protection act(pipa)
- access to information and protection of privacy act)
- act respecting access to documents held by public bodies and protection of personal information |
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Term
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Definition
| - a fact that would affect the contract enough to influence an insurers decision regarding whether to accept or reject the risk or the premium to be settled |
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Term
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Definition
| - utmost good faith- both parties to the contract are bound to exercise good faith and do so by full disclosure of all information material to the proposed contract |
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Term
| Statutory Condition 9. Salvage |
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Definition
- insured required to mitigate damage(to prevent further damage)
- when claim paid insurer is entitled to salvage(indemnity)
- if coverage inadequate insured may retain salvage |
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Term
| Personal Information Protection and Electronics Documents(PIPEDA) |
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Definition
- act that governs collection and use of personal information
-personal information collected must be relevant
- all info collected, being collected or has been collected must be held in strict confidence
-can only be used for the purpose it is collected for
- must obtain permission to use for any other purpose |
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Term
| Statutory Condition 11. Appraisal |
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Definition
| - when disagreement of value of loss both parties hire appraiser and one umpire to resolve, if still disagree share cost |
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Term
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Definition
- Homeowners basic
- Homeowners broad
- Tenants basic
- Mobile homeowners
- Condominium unit owners basic form |
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Term
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Definition
| - a policy in which perils insured against are listed |
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Term
| Statutory Condition 4.Material Change |
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Definition
- applies after bound and facts change
- inform promptly of change of use, occupancy etc
- after loss, burden of proof on insurer that change was material and cause of loss
- mortgagee also bears responsibility to inform insurer of material change |
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Term
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Definition
| - insured must have interest in the subject mater of the insurance purchased, the insured will suffer economic loss |
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Term
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Definition
- works of art
- jewellery
- fur garments
- collectible cards
- bicycles, equipment and accessories |
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Term
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Definition
| - perils insured against that are specifically named in a policy losses resulting from the perils listed are covered under the policy |
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Term
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Definition
| - temperature at which fire will ignite |
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Term
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Definition
- covered if caused by:
1. sudden and accidental escaoe of water from water main
2. escape from plumbing, heating, sprinkler, or air conditioning unit
3. Escape from water container outside dwelling
4. entrance of water through aperture created by other peril |
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Term
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Definition
- when more than 1 policy covers the same interest each insurer is liable to the insured for its rateable proportion of the loss unless the insurers in writing agree otherwise if 1 contract has deductible will be applied to determine amount of insds recovery under that contract
- 2 contract with deductibles - insurers share of loss determined, then highest deductible is pro rated among insurers that have deductibles and pro rated amount applied to determined amount of insureds recovery |
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Term
| application of deductible |
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Definition
- deductile is insureds portion of a covered loss and is intended to prevent small, frequent claims, reducing administrative costs and premiums
- deductible may apply seperately to the amount recoverable under each item, if total amount of insurance is subdivided into more than one item deductible may be subtracted from the total amount of loss or damage arising from a single event(most common)
-policy may also state that no oss be paid below a specified amount(deductible) but a loss greater than this amount paid in full
- or policy may indicate deductible and also amount beyond which no deductible applies |
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Term
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Definition
| - any ambiguity in contract must be interpreted against the person who wrote the contract |
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Term
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Definition
- to return to same condition as prior to loss
- cannot gain or lose |
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Term
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Definition
-insurer may argue that insured failure to comply with conditions forfeits insureds claim
- Insured may argue that the condition is unjust/unreasonable and apply to court for relief from forfeiture
- Marche v Halifax Ins Co |
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Term
| Statutory Condition 14. Action |
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Definition
- limitation period(originally had to sue within 1 yr of loss)
- after KP Pacific Holdings vs Guardian insurance extended to 2 years after the insured knew or ought to have known that damage to property occured |
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Term
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Definition
| - insurance coverage that indemnifies for loss or damage at the current market price rather than at a depreciated value |
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Term
| Sever storm(hurricane/tornado) |
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Definition
flood caused by storm that overwhelms local storm sewers= not covered
- flood caused by local rver overflow- not covered
- damage caused by wind= covered
- damage caused by lightning strike = covered |
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Term
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Definition
| - a cause that in a natural and continuous sequence produces an event and without which the event would not have happened |
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Term
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Definition
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Term
| Limitation of Liability: Co-insurance |
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Definition
- amount of insurance carried/minimum amount of insurance required X amount of loss = amount recoverable by insured
- Coinsurance obliges insured to maintain a specified minimum amount of insurance in relation to property value (usually 80%) or not; insured will share in loss
- encourages to insure to value, keeps premiums lower |
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Term
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Definition
- waves, tides, tidal waves, tsunami, dam breaks, seiche, or the rising, breaking out or overflow of any body of water or watercourse whether natural or human made
- coverage for flood added y extended water endorsement
- do not need to purchase both extended water and limited SBU as extended water provides coverage for both perils (sbu+ flood, ground water, rising of water table, surface water)
- removes 72 hr limitation on sbu losses that occur before or after flood |
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Term
| Statutory Condition 7. Fraud |
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Definition
- if fraudulent about part of loss, whole loss is denied
- if 1 named insured commits fraud and 2nd relied on first = innocent co-insured gets full amount |
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Term
| Statutory Condition 10. Entry, control, abandonment |
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Definition
entry= insurer can enter property after loss for assessment; insured must allow
abandonment= insured cannot make repairs, or abandon
control =insurer can't take control of property |
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Term
| Statutory Condition 2. Property of Others |
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Definition
- insurer is not liable to pay for losses to any person other than the insured unless his or her interest is stated in the contract
-insurable interest must exist |
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Term
| Statutory Condition 13. Termination |
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Definition
- can request anytime, usually ask for signed request(not legally required)
- short rate- premium refund with penalty
- pro rate - proportional earned premium may keep minimum retained |
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Term
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Definition
| - the event that caused a loss covered by the policy ex fire, windstorm |
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Term
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Definition
- aviation
- habitational
- equipment breakdown
- earthquake
- builders risk |
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Term
| Statutory Condition 15. Notice |
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Definition
- insurer must have an identified chief agent or head office in province
- send notice to insured by person or registered mail |
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Term
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Definition
| - first party insurance, indemnifies owner or user of property for its loss, or the loss of its income producing ability when damage is caused by covered peril |
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Term
| Structure of Property Policy |
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Definition
1st section - declaration or coverage summary (States the coverage and limits agreed to by the insured and the insurer, as well as the location of the property, the name of the insured and the property insured)
2nd section- policy wording(Outlines the perils insured against, the perils and property that are excluded, how claims are to be settled, and the conditions of the policy.)
3rd section - wording applicable to any endorsements or floaters added to the policy(Outlines additional insurance provided for items that may be limited in coverage, not covered or excluded from coverage in the policy contract.) |
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Term
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Definition
| any insurance policy that covers two or more lines or types of insurance in the same policy (ex homeowners covers building+ liability) |
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Term
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Definition
| For those ineligible for broader coverage or prefer simpler policies. Simpler and more modest than package policies(ex. Residential basic form) |
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Term
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Definition
| Single policy covering a risk that is divided among a number of insurers; the policy is issued by the “lead” company (usually one with largest percentage) and signed by all participating companies |
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Term
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Definition
| Type of habitation policy where separate insurance amounts are shown for the building and for the personal property |
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Term
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Definition
| Shows one amount encompassing the building and personal property . |
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Term
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Definition
| includes named perils(theft, glass breakage, and transportation) |
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Term
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Definition
| all risks on dwelling building and detached private structures, same named perils as insured under the basic form |
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Term
| Homeowners Comprehensive Form |
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Definition
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Term
| Limitation of Liability: Deductible |
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Definition
- insured's portion of the loss
- used to avoid nuisance claims and reduce premiums |
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Term
| Limitation of Liability: Special limits of insurance |
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Definition
Limit personal property insurance where otherwise blanket limit would apply; before had own special forms/policies
Money including gift and cash cards
Securities
Watercraft (specified perils and theft)
Garden-type tractors
Wine and spirits
Spare auto parts
Business property
Cannabis |
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Term
| Special Limits Theft only |
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Definition
Works of art
Jewellery, gems, watches and pearls
Fur garments
Numismatic property, manuscripts and philatelic property
Collectible cards
Collections not subject to other limitations
Bicycle |
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Term
| Steps to reading a policy |
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Definition
Review definitions clause
Review property that is covered and property that is not covered
Review perils that are and are not insured
Review basis of claim settlement, duties after a loss and statutory conditions |
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Term
| Homeowners Form: Opening Statement |
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Definition
| Advises insured that the policy contains a clause that may limit the amount payable under the policy. Notes provisions that limit the policy’s coverage (deductibles, coinsurance etc). Concludes with reminder to the insured that insurance cannot be a source of profit |
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Term
| Homeowners Form: Explanatory Statements |
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Definition
1st- Describes the insurance under Section I as consisting of property coverages(dwelling, detached private structures, personal property, additional living expenses)
2nd - Describes insurance under Section II - liability coverage. Also includes voluntary medical payments, voluntary payments for damage to property, and voluntary compensation for “residence employees” if injured while working for the insured |
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Term
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Definition
| Simplify policy preparation and ensure clarity and uniformity in the use of certain words in the forms. Provides better protection for insureds, brokers and agents, as similarity in definitions leads to fewer misunderstandings. |
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Term
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Definition
| An accumulation of similar objects gathered for novelty, personal interest, rarity, or value among other possibilities |
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Term
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Definition
| Erasure, destruction, corruption, misappropriation, misinterpretation of data. Error in creating, amending, entering, deleting, or using data OR inability to receive, transmit, or use data. Not defined in the basic form because the exposure it represents is not named in that named perils form and so need not to be excluded. |
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Term
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Definition
Hot water heating tank and their piping and radiators
Hot water storage tanks and associated piping
Water reservoirs and dispensers, whether contained in an appliance or not
Bathtubs, sinks or toilets,
Aquariums or water beds
Also includes outdoor swimming pool, or wading pool, ornamental pools or fish ponds or hot tubs |
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Term
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Definition
| Includes but not limited to any form or type of mould, yeast, mushroom, or mildew, whether or not allergenic, pathogenic, or toxigenic, and any substance, vapour, or gas produced by emitted from, or arising out of any fungi or spores or resultant mycotoxins, allergens or pathogens. Not defined in basic form. |
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Term
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Definition
| Water found in the cracks and spaces in soil, sand, and rock beneath the ground surface |
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Term
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Definition
| Includes named insured and people other than named insured. Include, while living in the same household - insured’s spouse, relatives of either the insured or insured’s spouse, and any person under 21 in their care. Also includes dependent children temporarily away from home. |
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Term
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Definition
| Part of fungi or mould that can form as quickly as 24 hours after a loss. Includes but not limited to one or more reproductive particles or microscopic fragments produced by, emitted from, or arising out of any fungi |
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Term
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Definition
| Works for insured part-time or full-time, in connection with the maintenance or use of the premises but not with the insured’s business. Does not include anyone who acts as a contractor, such as someone who determines when and how such work is done. |
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Term
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Definition
| deologically motivated unlawful act or acts including but not limited to use of violence or force or threat of violence or force, committed by or on behalf of any group(s), organization(s) or government(s) for the purpose of influencing any government and/or instilling fear in the public or section of the public. |
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Term
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Definition
| Legally married partners AND partners who live together in a conjugal relationship outside marriage and have continuously done so for at least three years, if the partners are the natural or adoptive parents of a child the period is reduced to one year |
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Term
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Definition
-dwelling and other property on the premises. Includes structures attached to the house such as carports, solariums, conservatories, patio covers, decks, outdoor swimming pools, and their attached equipment and permanently installed outdoor equipment on the premises materials and supplies on or adjacent to the premises intended for use in construction, alteration or repair of the dwelling or private structures on the premises. Theft is covered only when the work on the dwelling has been completed and the dwelling is ready to be occupied
- Up to 10% of the amount of insurance on Coverage A - Dwelling Building may be applied to building fixtures temporarily removed from the premises for repair or seasonal storage
-Insured may apply up to 5% of the amount of insurance on the insured dwelling to trees, plants, and shrubs, on the premises, but outside the dwelling building |
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Term
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Definition
- detached structures
- Detached private structures must be separated from the dwelling building by a clear space or be connected to the building by a fence utility line or other similar connection. Cannot be used for business purposes. Common detached structures: detached garages, garden sheds, greenhouses, pergolas, free standing sundecks etc |
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Term
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Definition
Includes all movable or temporary property- furniture, clothing, even stocks or bonds
1. Contents of dwelling and personal property owned, worn, or used, on the premises
2. Property away from the premises - Comprehensive form - coverage for personal property stored in a warehouse is not restricted to loss by theft but is limited to 30 days for any peril other than theft. Basic and Broad form - property stored in a warehouse is insured only against theft.
3. Property of a student- Insures property of a dependent child who is a student temporarily living away from home to attend school. |
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Term
| Types of property excluded under Coverage C |
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Definition
1. Motorized vehicles or their Equipment
2. Camper units, truck caps, trailers, or their equipment,
3. Aircraft or their equipment |
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Term
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Definition
1. Additional living expenses - Insurer pays for any necessary increase in living expenses, including moving expenses incurred by the insured, so that the insured’s household can maintain its normal standard of living. Additional living expenses incurred continue to be covered, up to the limit of Coverage D or until the dwelling is fit for occupancy whichever comes first
2. Fair rental value - Insured is permitted to rent a part of the dwelling or detached private structures to a tenant or hold it available for rent, even if the insured has not informed the insurer, so long as the insured still personally occupies the premises
3. Prohibited access - Prohibited access applies when a civil authority such as the police or other authorized emergency personnel, government reps, or military reps, orders the insured dwelling’s occupants to move out for one of two reasons: Neighbouring premises sustained damage that poses a danger to the insured premises or mass evacuation |
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Term
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Definition
| Extends coverage to a number of losses that are incidental to the main loss or are minor losses in their own right |
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Term
| Extension:Moving to Another Home |
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Definition
| If insured acquires a new dwelling in Canada that is to be occupied as a principal residence by the named insured, the homeowners forms will extend coverage to personal property while ins transit from the existing residence to the new residence and for up to 30 days thereafter or until the policy expires whichever comes first |
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Term
| Extension: Property Removed |
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Definition
| Basic Fire policy - extension applied for 7 days from date of removal or until policy expires. Homeowners form- extension applies for 30 days or until the policy expiry whichever occurs first |
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Term
| Extension:Credit or Debit Cards, Forgery and Counterfeit Money |
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Definition
| Covers losses suffered by the insured for accepting in good faith counterfeit Canadian or American paper currency - limited to $200 per transaction and $1000 during policy period |
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Term
| Extension: Change of Temperature |
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Definition
| Applied to indirect loss involving personal property kept in the dwelling that would not normally be recoverable under the policy |
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Term
| Extension:Refrigerator or Freezer Food |
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Definition
| Applies when there is a change in temperature within a food freezer that causes spoilage and resultant loss of food items.Indemnifies for: value of spoiled food, damage to freezer caused by spoilage of food, reasonable expenses incurred to prevent food spoilage(moving food to public cold storage).Must have been caused by: accidental interruption of electrical power on or off premises or mechanical breakdown. Does not cover: cost to acquire replacement food, spoilage caused by disconnection of power supply , or spoilage caused by operation of electrical circuit breaker or fuse |
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Term
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Definition
| Insurer will pay up to a specific amount for duty or licensing fees for the cost of downloading or restoring data for which the insured has paid duty or licensing fees |
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Term
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Definition
| Homeowners forms apply an additional 5% to the sum of the amounts of insurance for coverages A,B, C. Coverage D not included |
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Term
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Definition
| Will not pay to repair all parts of the building torn apart to find the leak, rather extension will pay to repair only the parts that must be torn apart to repair damage and prevent further damage by an insured peril |
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Term
| Extension: Fire Department Charges |
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Definition
| Extend coverage for up to a specified dollar limit for charges incurred to have the fire department attend the insured premises to save or protect insured property from loss or damage from further loss |
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Term
| Extension:Lock Replacement |
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Definition
| Financial assistance- up to a specified amount - available to rekey locks or replace them at the insurer’s option. Policy requires insured report theft of keys to law enforcement authorities as a condition of coverage |
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Term
| Extension:Outdoor Trees, Plants and Shrubs |
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Definition
| May apply up to a specific percentage of the amount of insurance carried on the insured dwelling to trees, plants shrubs on the insured premises |
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Term
| Extension:Arson Conviction Reward |
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Definition
| Can be paid to insured or anyone who provides information that leads to the conviction of the guilty party |
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Term
| Extension:Inflation Protection |
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Definition
| After loss or at policies renewal automatically increases the amounts of insurance for inflation since the inception or most recent renewal |
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Term
| Guaranteed Replacement Cost |
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Definition
An undertaking by the insurer to pay the cost of repairs to or replace the dwelling building even if it is more than the amount of insurance on the dwelling building provided certain conditions are met in addition to those that normally govern settlement at replacement cost. Conditions include:
Amount of insurance on the dwelling building be kept at not less than the cost to replace the dwelling building
Amount of insurance on the dwelling not be reduced below the amount determined by the valuation guide
Insured notify the insurer within 90 days of start of the work on any improvements extensions, or additions to the dwelling |
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Term
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Definition
| The cost of replacing the property less any depreciation to it. Most insurers expand definition to recognize that a fair estimate of depreciation at the time of loss depends on several factors, not only the life expectancy of the property but also physical condition, resale value and its obsolescence |
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Term
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Definition
| Any articles that are lost or damaged that are part of a set the homeowners form calculate the loss as a reasonable and fair proportion of the total value of the set |
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Term
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Definition
| Loss or damage to any part of property that consists of several parts will be settled for not more than the insured value of the part lost or damaged, including cost of installation |
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Term
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Definition
| Transfers the insured’s rights of recovery against others to insurer and entitles it to sure in the insured’s name when the insurer has made payment or assumed liability |
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Term
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Definition
| i) types of property and ii) perils never/sometimes not insured against |
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Term
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Definition
- Exceptions to exclusions
-Exceptions are placed within exclusions to restore policy coverage under certain circumstances |
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Term
| Buildings for Business or Farming exclusion |
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Definition
| Excluding buildings or structures used for business or farming helps ensure that insureds who present business exposure will be covered instead under a commercial or farm policy |
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Term
| Property on Exhibit exclusion |
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Definition
| Exhibits are insured under an exhibition floater at terms reflective of the risk and according to the circumstances |
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Term
| Property Illegally Acquired or Subject to Forfeiture exclusion |
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Definition
| If an insured steals property or buys it from someone who stole it, the insured has no legal claim to indemnity for its loss. In order for an insurer to prove that the possession is illegal, the insured must first be convicted under the law.Against public policy to provide coverage for property that can be lawfully subject to forfeiture. Property is subject to forfeiture for 6 years after it is illegally imported into Canada. |
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Term
| Evidence of Debt or Title exclusion |
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Definition
| Exclusion for evidence of debt or title denies coverage for property that may be insured by other forms specifically designed for it |
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Term
| Sporting Equipment exclusion |
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Definition
| Sporting equipment, where the loss or damage is due to its use is excluded |
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Term
| Property Lawfully Seized exclusion |
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Definition
| exclude loss to property lawfully seized or confiscated, especially if the policy covers loss by theft.Coverage is restored if the property was seized and destroyed by government agencies to prevent the spread of fire. |
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Term
| Outdoor Radio and TV Antennae, Including Satellite Receivers exclusion |
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Definition
| Loss or damage to outdoor radio and TV antenna including satellite receivers and their attachments is not covered when caused by winds or or hail; weight of ice, snow, or sleet; or collapse |
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Term
| Marring, Scratching, Abrasion, Chipping, or Breakage exclusion |
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Definition
| Excluded, unless caused by a specified peril: accident by a land vehicle, watercraft or aircraft or theft/attempted theft |
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Term
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Definition
| excluded as it is not unexpected event, just requires maintenance |
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Term
| Faulty Design, Material, or Workmanship exclusion |
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Definition
| Excluded as insurers do not want to pay for someone else’s poor workmanship |
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Term
| Settling, Expansion, Contraction, Moving, Bulging, Buckling, or Cracking exclusion |
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Definition
| excludes loss or damage caused by or resulting from pressure exerted by ground water, except resulting damage to glass of the dwelling and of the detached private structures, unless directly or indirectly caused by earthquake. |
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Term
| Data or Data Problem exclusion |
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Definition
| Main threats: hackers and virus. Excludes data and any damage (direct or indirect) from data problems.However does cover loss from fire, explosion, smoke or water damage (as defined in specified perils clause) |
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Term
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Definition
| Excluded loss or damage if vacant for 30 consecutive days and lasts as long as vacancy exists, if policy is not terminated |
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Term
| Nuclear Incident exclusion |
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Definition
| Direct or indirect loss caused by nuclear incident are excluded, except for ensuing loss or damage which results directly from fire or explosion |
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Term
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Definition
| Riot is not included under war risks |
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Term
| Intentional or Criminal Acts Exclusion |
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Definition
| Historically excluded even if only one of the named insured did the criminal act: Scott v. Wawanesa Mutual Insurance Co [1989], SCR: insured’s 15 year old child set fire; coverage was excluded.Recently, some provinces protect innocent co-insured - protects and co-operates and only to his/her proportional interest (not committed, abetted/colluded or consented/failed to act to stop). |
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Term
| Property Being Worked on Exclusion |
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Definition
| Excludes damage to property undergoing any process or while being worked on, where amage results from that process or work. Resulting damage to other property is still covered. |
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Term
| Exception to water damage due to freezing |
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Definition
| If the building is not heated, not covered. Covered if in heated area and no unoccupancy for 4 days if unoccupied for more than 4 days, covered if got someone to check heating system or water supply was shut off and pipes and containers were drained |
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Term
| Water System or Domestic Water Container Exclusion |
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Definition
| Loss or damage to a system, which includes plumbing, heating, cooling, sprinkler, or air conditioning systems likely excluded due to mechanical failure, wear and tear, deterioration, or corrosion and would be excluded |
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Term
| Building Under Construction or Vacant Exclusion |
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Definition
| Loss or damage caused by the escape of water or steam is not covered if it occurs while the dwelling or detached private structure is under construction or vacant- even if written permission was given for construction or vacancy by the insurer |
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Term
| Freezing Involving Domestic Water Containers Exclusion |
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Definition
| Any loss or damage when the escape of water is caused by freezing or any loss or damage caused directly or indirectly to a “domestic water container” as a result of freezing |
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Term
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Definition
| Ground water excluded. Could be considered unnecessary because water escape must be sudden to be covered, groundwater is more likely to seep. |
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Term
| Shoreline Ice Buildup and Water-Borne Ice Exclusion |
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Definition
| Strong winds can blow water borne ice that has broken free of large frozen areas onto the shore, where it may be pushed farther ashore by other ice floes and destroy nearby structure |
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Term
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Definition
| Escape of water: covered; damage to water main itself is not |
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Term
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Definition
| Damage or loss due to birds, vermin, raccoons, insects or rodents except loss/damage to glass. However if a rodent chews wire, short circuits and causes fire is covered. |
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Term
| Smudging and Industrial Smoke exclusion |
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Definition
| Loss caused by smudging and industrial smoke is excluded because it comes from a friendly fire |
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Term
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Definition
| Loss or damage caused by snow slide, earthquake, landslide, or any other earth movement is not covered. |
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Term
| Theft from Part of the Dwelling Rented to Others |
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Definition
| Loss or damage due to theft or attempted theft is excluded if part of the insured’s dwelling is rented to others partially or fully furnished and the tenant or a tenant’s employee or household steals insured property from the rented portion. |
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Term
| Electrical, Electronic, and Mechanical Breakdown exclusion |
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Definition
| Exclude losses caused by electrical, electronic, and mechanical breakdown or disturbance with the exception that loss or damage resulting from fluctuations in artificially generated electric current is covered. |
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Term
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Definition
| An amendment added to a written document, particularly an agreement between parties, altering provisions. |
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Term
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Definition
-Coverage for mudslide, landslide, volcanic eruption, or other earth movement that occurs at the same time as an earthquake and covers aftershocks for the period specified in the policy.
Rates are based on the exposures to damage a building faces from shock waves. -Factors include geographic location, building design, construction, and age. occupancy, soil conditions
- IBC defines a single earthquake to mean all earthquake shocks within 168 consecutive hours during the policy period. An event that occurs after the specified period is deemed a new occurrence and subject to a separate deductible amount if the building sustains additional damage. |
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Term
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Definition
Bylaw endorsement will pay the costs of demolition and removal of undamaged area of the building/detached structures, the increased costs to repair to comply with the minimum code requirement at time of loss, the increased costs of installation or repair to comply with minimum requirements for the installation of a sprinkler system.
does not increase the limits of the policy, it covers only those costs actually incurred by the policyholder to comply with the minimum code requirements. |
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Term
| identity theft endorsement |
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Definition
Legal costs to notify appropriate authorities
Liaison between insured and credit bureaus/credit-card companies
Lost wages to mitigate losses; usually up to $500/week
Loan application feeds
Legal fees to defend against lawsuit due to identity theft
Long-distance phone charges
Sometimes: credit-monitoring service for certain time after
Limited to dollar amount; usually $10,000 - $30,000 |
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Term
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Definition
Additional coverage for moveable items, like jewellery or antiques beyond what is included in basic homeowners policy
1st way: enhance limits or perils for property insured in policy wordings (to increase limits for items such as jewellery, fine art and collectibles); appraisals after required verify existence, value of ownership and condition
2nd way: provide coverage for scheduled items (schedule of insurance: list of items individually covered by a policy)
3rd way: offer coverage on property that otherwise is not covered |
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Term
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Definition
| A list of items individually covered by a policy; for example a list of jewels under a jewelry floater, a list of cars under one automobile policy or a list of buildings under a fire policy. |
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Term
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Definition
| Insures property against all risks, excludes breakage of fragile articles unless the loss is caused by specified perils such as fire, falling objects, or vehicle impact |
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Term
| personal articles floater |
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Definition
Covers certain kinds of personal property in a principal residence more broadly or for higher limits than do policies, such as a homeowners policy of more general scope. A property appraisal is required.
- may apply sub limits |
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Term
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Definition
Modest amount of coverage against named perils only for watercraft and their furnishings equipment, accessories, and motors
Exclude damage by vermin, insects and marine life; loss by flood (direct or indirect) including waves, tidal wave, high water or ice not covered |
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Term
| vacation or recreational trailer floater |
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Definition
When towed, liability extends from vehicle however no damage coverage
Additional living expenses is included, limited to the lesser of:
Additional expenses while the unit is being repaired or replaced
The sub limit specified in the policy or
The anticipated duration of the vacation only |
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Term
| High Value: Kidnap Expense Coverage |
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Definition
| Coverage up to a specified limit for costs resulting from child abduction, including travel costs and medical, dental, and psychiatric fees |
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Term
| High Value:Equipment Breakdown |
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Definition
| Provides a specified amount of insurance for accidental breakdown of the equipment or system even if caused by human error, improper installation or lack of maintenance. Usually no age restriction, insured may choose to replace the item with environmentally friendly or safer equipment and systems when the older equipment breaks down |
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Term
| High Value: Home Invasion Coverage |
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Definition
| Should the insured’s family be present during a home invasion high valued insurance may offer up to a specified amount of coverage to help pay medical, psychiatric, home security and other expenses associated with trauma |
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Term
| High Value: Disappearing deductible/cashout |
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Definition
waive deductibles for a loss of a specified amount and pay the loss in full
Insured can receive cash payment up to the policy limit without deduction for depreciation and without having to rebuild or replace the damaged or destroyed building |
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Term
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Definition
Manufactured housing usually placed in one location and left there permanently, but retaining the ability to be moved as required in many areas. Behind the cosmetic fitted installation to hide the base, there are strong trailer frames, axls, wheels, and tow hitches
- furnishing built in
- Mobile homeowners form- includes property and liability coverage. Insures against named perils comparable to homeowners basic form.(Cov A includes furniture b/c it is built in) |
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Term
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Definition
- Home bought as an investment with income from renting to a tenant
- Residential basic form- covers only building or both the building and contents |
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Term
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Definition
| Can be added as a separate location on the same policy or on a seperate dwelling separately on a seasonal residence form |
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Term
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Definition
Small farm, less than 25 acres, maximum 5 farm animals, maximum 10 poultry, no employees. No custom farming, horse boarding, training or riding facilities
- Coverage for outbuildings used for farming purposes, livestock, poultry and eggs, farm produce, farm equipment
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Term
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Definition
-Covers the entire building, including individual units, common property for loss or damage caused by major perils, such as fire, lightning, smoke, windstorm, hail, explosion, water escape, riot or civil commotion, impact by aircraft or vehicles and vandalism or malicious acts
-U1 = betterment and improvements
- U2= loss assessments
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Term
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Definition
Unit Owners FormsOffered in both basic and comprehensive forms; omits coverage A and B. Coverage C and D is similar to homeowners forms.
-U1 = betterment and improvements
- U2= loss assessments |
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Term
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Definition
Cover insureds who do not own the buildings or units they occupy as principal residences, provide coverage for the tenant’s personal belongings not covered by the landlord’s policy
- includes betterments and improvments
- since no Cov A, Cov D is a set percent of Cov C |
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Term
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Definition
| Continues coverage of transportation risks once cargo is on dry land |
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Term
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Definition
| buildings, equipment, stock, contents or all property |
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Term
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Definition
| Fire and additional perils named on the policy form |
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Term
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Definition
| Insured may have option of insuring all property on a blanket limit. Done by combining the coverage at a single location, or at multiple locations into a single property of every description(POED) limit or using a contents of very description(COED) limit |
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Term
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Definition
| Policy is issued for the highest anticipated value of stock on hand, and a reporting clause is used to adjust the premium |
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Term
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Definition
| ncreased the limit of insurance at a specified or unspecified location for a specific period |
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Term
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Definition
| A listing of the maximum amounts of exposure an insurance company is prepared to accept on various classes of risk |
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Term
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Definition
Evaluate the risk
Making the underwriting decision
Pricing the risk |
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Term
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Definition
| How often losses are likely to occur in the future, assuming the average size of loss is constant, the higher the frequency, the worse the loss experience |
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Term
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Definition
| Average size of the losses. The larger the average loss, the higher the loss severity is said to be. |
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Term
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Definition
construction:Type of material used in the walls and roof of the applicants or the insured’s building. Also includes, size of the building, age, number of storeys, type of heating system, and fuel used.
Occupancy:Use of the property by its occupants. Includes, number of occupants, space each occupies, hazards associated with each occupancy, and measures taken to reduce those hazards
Protection:Public fire protection and private protection(sprinklers or other extinguishing systems and fire alarm systems)
Exposure:Chance applicant or insured will suffer a loss as a result of proximity to one or more other risks or potential causes of loss |
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Term
| Role Of Broker: Claims Process |
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Definition
Help report a loss to the insurer by taking first notice of loss
Explain the claims process to the insured
Monitor the progress of the claim
Advocate on the insured’s behalf when insured has concerns |
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Term
| Role of Claims Adjuster:Claims Process |
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Definition
| Communicate with insured and assess policy coverage, seriousness of claim, what must be done immediately and who should be assigned to handle the loss |
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Term
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Definition
Step 1 - insured reports loss to the broker, agent, or insurer
Step 2- claims handler records preliminary information and asks for details
Step 3 - Claims handler does an initial check of the policy coverage
Step 4- If insured reported the loss to the broker or agent the broker or agent would then report to the insurer
Step 5- Insurer may need to advise the insured that the loss is not covered
Step 6 - If the loss falls within the policy period and insuring agreement insurer will assign an adjuster to the claim |
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