May 2011 Intro Page
Dec Page
The article of the month deals with retrospective rating. Retrospective rating plans are available for use with various types of insurance, but the more common usage is with workers compensation. These rating plans offer a system for determining premiums after the policy period; they adjust premiums at the expiration of the policy period by comparing losses incurred during the current policy year with those expected during the same period. In effect, the intent of retrospective rating is to charge a premium that reflects losses so that there can be a reward for the insured through lower premiums. For information on retrospective rating plans, along with eligibility, terms, and steps to determine a retrospective premium, see the designated article in the Bulletins.
The court cases in the Dec Page discuss the doctrine of inferred intent in relation to the intentional acts exclusion, the intentional acts exclusion and the actual intent to harm, the owned property exclusion, and the products exclusions in the general liability policy.
The cases dealing with the intentional acts exclusion come from Ohio and Colorado . Both cases had the insureds intending their acts, but the courts differed on whether the intentional acts meant the insureds also intended the harmful results. The owned property exclusion was discussed by a United States Court of Appeals in a case where the insured was sued by purchasers of property once owned by the insured; the alleged property damage occurred while the insured owned the property. The insurer denied coverage based on the exclusion and the court had to decide if there was a duty to defend and indemnify. The last case comes from Texas , and the United States District Court used the “your product” exclusion and the impaired property exclusion to deny coverage for a claim of property damage to signs that the insured manufactured and sold to the government. Whether these exclusions are the appropriate ones to use in this instance is an issue.
In other insurance news, the Dec Page offers information on Chinese drywall fumes and their effect on electrical systems, and various state laws that have an impact on insurance coverage.
Questions and Answers
Does the fourteen-day exclusion for repeated seepage apply to a water loss resulting from a water heater suddenly spilling a large amount of water? See Mold Damage Following Water Heater Breakdown. Can an insurer, under functional replacement cost, replace undamaged trim with that of lesser quality? See Functional Replacement Cost Insurance and Property Coverage.
Is extra salary stolen by an employee considered to be earned in the course of employment? See Employee Dishonesty and Overpayment of Wages. Would water that seeps through cracks in a floor be considered a sump pump backup? See Sump Pump and Water Backup Claim.
Meaning of Collapse
A question that often arises has to do with the meaning of the word “collapse” that appears in various insurance policies. Does a collapse of a building mean the whole structure has to actually fall into a heap of rubble? Or, does a collapse occur when a wall or foundation is so fundamentally weakened that a collapse is more or less imminent unless repairs are made? Meaning of Collapse reviews court decisions from around the country to see how collapse is legally defined. The article provides a discussion of the current definition of collapse that is found in today's property insurance forms, and then analyzes court rulings that are favorable to the insured and court rulings that are favorable to the insurer.
Yacht Coverage
Many insurers who write coverage for yachts commonly draft their own policies, particularly with regard to large vessels that typically are navigated by a paid captain and crew. There are, however, two policies, products of Insurance Services Office (ISO) and American Association of Insurance Services (AAIS), that are designed to fill the need for a policy for yachts. Yacht Coverage is a discussion of the two policies, with an overview of underwriting these boats.
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