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INS22 CH 6 - Homeowners Ins
Sec II and Sec's I&II of conditions
18
Other
Undergraduate 1
08/27/2008

Additional Other Flashcards

 


 

Cards

Term
Who is covered under Section II coverages?
Definition

A. Section II provides (2) types of third party coverage.

 

1. Coverage E—Personal Liability coverage.

2. Coverage F—Medical Payments to Others

Term

 

 

The following are included as insureds for Section II coverages:

Definition

1.The policyholder (the namned insured)

2.Residents of the household who are relatives

3.Residents < 21& in the care of the namned insured or resident relatives.

4.full-timne student

5.animnals or watercraft owned by 1, 2, or 3
6.Anyone employed by a person defined in 1, 2, or 3,

7.any1 using any vehicle covered by the policy on
location, with the consent of the namned insured

Term

 

 

Coverage F applies to people who are injured in the following situations:

Definition

1. A person on an “insured location” with the permission of an insured. The definition of “insured location” has 8 variations.

 2. A person off the insured location is injured:

a. b/c conditions on the insured location.
b. By insured’s activities.
c. By a “residence employee” of the insured during the course of employment.

d. By an animal owned by or in the care of an insured.

Term
Section II (nine) exclusions that apply to both Coverage E and Coverage F:
Definition

 

1. Motor vehicle, watercraft, aircraft, and hovercraft liability exclusions.
2. Expected or intended injury or damage exclusion—Section II is protection .... resulting from an accident.

3. Business exclusion—Excludes business activities of any insured, but provides coverage for occasional or part-time activities.

4. Professional services exclusion

5. Locations that are not insured

6. War exclusion

7. Communicable disease exclusion

8. Sexual molestation and physical or mental abuse exclusion

9, Controlled substances exclusion

Term
Exclusions (seven) that apply only to Coverage E—Personal Liability:
Definition

1. Loss assessment exclusion

2. Liability assumed under contract exclusion  

3. Damage to the insured’s property

4. Property in the insured’s care exclusion

5. Bodily injury to persons eligible for workers compensation benefits exclusion

6. Nuclear liability exclusion

7. Bodily injury to an insured exclusion

Term
Exclusions (four) that apply only to Coverage F—Medical Payments to
Others:
Definition

 

1. Residence employee off-premises exclusion

2. Bodily injury to persons eligible for workers compensation benefits exclusion

3. Nuclear reaction exclusion

4. Injury to residents exclusion

Term
Section II—Additional coverages—These (four) coverages are in addition to the limits for Coverage E and Coverage F
Definition

 

1. Claim expense additional coverage.

2. First-aid expenses additional coverage

3. Damage to property of others additional coverage.

4. Loss assessment additional coverage

Term
(Ten) Parts under Section II—Conditions are:
Definition

A. Limit of liability - Coverage E

B. Severability of insurance

C. Duties after loss

D. Duties of an injured person - Coverage F

E. Payment of claim - Coverage F

F Suit against the insurer

G. Bankruptcy of an insured

H. Other insurance—Coverage E—Coverage E limits are paid in excess over any other collectible insurance unless the other insurance is written specifically to provide excess coverage.
I. Policy period—Coverage

J. Concealment or fraud condition

Term
(Seven) parts under Section I and II—Conditions are:
Definition

A. Liberalization clause

B. Waiver or change of policy provisions

C. Cancellation

D. Nonrenewal

E. Assignment

F Subrogation

0. Death

 

Term

 

 

 

Definition of Severability of insurance

Definition

 

 

Policy condition that applies insurance separately to each insured;
does not increase the insurer’s limit of liability for any one occurrence.

Term
Describe Limits, triggers and defense costs of Coverage E - personal Liability under Section II—Liability Coverages:
Definition

FYI - No deductible applies to Section II coverages.

1. Limits—automatically include a basic limit generally set at $100,000 per occurrence.

2. Coverage trigger—Coverage is provided, up to the policy limit, for damages for which an insured is legally liable.

3. Defense costs coverage—the insurer pays defense costs if an insured is presented with a lawsuit that involves a claim that is covered under the policy.
a. Even if the suit is groundless, false, or fraudulent.
b. Insurer has the right to investigate and settle any
claim in a way that the insurer decides is appropriate.

Term

E (personal Liab) & F (pmts to others) Coverage does not apply to motor vehicles
that :

 

Note: It's a homeowners policy, not a car, motorcycle policy!

Definition
• Must he registered for use on public roads or property
• Are involved in an organized race
• Are rented to others
• Are used to carry persons or cargo for a charge
• Are used for any business purpose, except for motorized golf carts used on a golf course
Term
 Describe Limits and triggers for Coverage F - 'medical payments to others' under Section II—Liability Coverages:
Definition

1. Limits—automatically included in all homeowners policies for a limit generally set at 1,000 per person for a single accident.

2. Coverage trigger—Coverage is provided, up to the policy limit, for the necessary medical expenses incurred by others (not an insured) within three years of an inj ury. It does not apply to the named insured or other regular residents of the household except “residence employees.”

Term
Definition of Residence employee is...
Definition

 

 

A domestic worker whose duties include maintaining or using the household premises or performing domestic or household services.

Term

E (pers liab) & F (pmts to others) does apply to motor vehicles that are:

Definition
• In dead storage on an insured’s location
• Used solely to service an insured’s residence
• Designed for assisting people who are handicapped
• Designed for recreational use off public roads and owned by an insured and on an insured location
• Motorized golf carts, not capable of exceeding 25 mph, owned by an insured and used to play golf on a golf
course or legally used within a private residential association
• Trailers not towed by, hitched to, or carried on a motor vehicle
Term

Limits under Section II - Additional coverages are....

Definition

1. Damage to property of others additional coverage—The insurer will pay up to $1,000 per occurrence for damage to the property of others caused by an insured, Coverage is provided on a replacement cost basis.

2. Loss assessment additional coverage—Loss assessment coverage is provided up to $1,000 for an insured’s share of loss assessment charged against a policyholder during the policy period

Term
For both sections I and II, the Duties after loss are:
Definition
1. Give written notice identify the policy and the named insured, provide information about the occurrence, and state the names and addresses of the claimants and witnesses.
2. Cooperate with the insurer’s investigation, settlement, and defense activities.
3. Forward promptly to the insurer legal documents relating to an occurrence.
4. Submit evidence for damage to property of others.
5. Not make voluntary payments, assume any obligations, or incur expenses on behalf of the insurer.
Term
Duties of an injured person—Coverage F—If a person makes a claim for a loss under Coverage F, the injured person must:
Definition

 

 

1. Give the insurer written proof of the claim as soon as possible (under oath if required).


2. Authorize the insurer to obtain copies of medical reports and records.

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