The mandatory special provisions discussed herein apply to the 2011 forms, unless otherwise noted. The edition dates of the forms discussed in this article are correct as of this writing; please be aware, though, that legislative changes or new legal interpretations resulting in new edition dates can occur at any time.
We will also include the endorsements required in the various states. Many of the states mandate the water exclusion endorsements HO 16 09 01 09 or HO 16 10 01 09. These endorsements contain the revised language of the water exclusion endorsement that is now contained in the 2011 homeowners forms. But if an insurer has not adopted the 2011 forms, the revised language of the endorsement will still apply. Essentially, the change includes within the description of water that is excluded tidal wave and tsunami and storm surge, as well as water overflowing from a dam, levee, seawall, or other boundary or containment system. The difference between the two is that HO 16 09 refers to ″Section I Exclusions 3.
Water,″ while HO 16 10 refers to Section I Exclusions A.3. Water.” The appropriate form selected is thus dependent upon the numbering system in the particular policy. Alaska, for example, mandates both, but it would appear that one or the other would apply.
Some of the changes in the special provisions reflect various state laws regarding coverage, such as the valued property laws; others, again in accordance with state laws, amend the cancellation or nonrenewal provisions. For example, the unamended policy calls for an underwriting period for new business of sixty days. This is the length of time an insurer has to make a final decision as to the acceptability of the risk. During the sixty days, the insurer may cancel for any reason, giving a ten-day notice. But in some states, notice of cancellation requires only five days if certain conditions exist.
After the sixty-day period is over, the unamended policy limits the reasons for cancellation to nonpayment of premium, material misrepresentation on the part of the insured, or substantial change in the risk. The insurer is required to give a thirty-day notice, if canceling for any reason besides nonpayment of premium. However, the various states may amend the reasons or the time required in the mandatory special provisions. The allowable reasons for cancellation are indicated as numbers in this discussion. In general, proof of mailing is sufficient proof of notice; exceptions are noted.
Please be sure to note the edition date prior to making any coverage determinations based on a special provisions form. The states are described alphabetically, with the current special provisions form number and edition indicated.
Cancellation Reasons
|1. Nonpayment of premium.
2. Material misrepresentation or fraud. (In applying for the policy, in presenting a claim, or both.)
3. Increase in hazard.
4. Substantial change in risk.
5. Conviction of certain crimes, which increase a hazard.
6. Acts (or omissions) by the insured which increase any hazard.
7. Failure by the insured to reduce conditions which have contributed to a loss or may do so in the future.
8. Violation of any local fire, health, or safety code that increases the hazard.
9. Material violation of a policy provision.
10. Vacancy and/or unoccupancy of longer than sixty consecutive days.
11. Failure to begin repairs within thirty days after payment for a previous loss.
12. The building has: an outstanding order to vacate; an outstanding order to be demolished; or been declared unsafe by a governmental authority.
13. Fixed and salvageable items are being removed—but not being replaced—from the home.
14. Failure by the insured to supply the necessary utility service to the home for thirty consecutive days; and failure to pay property taxes.
15. Transfer of the property to another person.
16. Failure to comply with underwriting requirements, as established during the underwriting period.
17. All insureds in the state with this type of policy are being cancelled.
18. A determination by the insurance commissioner that continuation of the policy would be a violation of the law.
19. Breach of contractual duties, conditions, or warranties.
20. Financial impairment of the insurer.
21. Loss of, or inability to obtain, reinsurance on the risk.
22. Evidence of arson.
23. Any reason approved by the insurance commissioner.
24. Physical changes that make the property “uninsurable.”
25. Material changes in the property, its use, or the insured's interest in the property that now make the property uninsurable.
26. Physical changes in the property which are not corrected within a reasonable time after they occur and which result in the property becoming uninsurable.
27. Completion of repairs has not occurred within sixty days of loss payment.
28. The building is in danger of collapse.
29. Property taxes have been delinquent for two or more years.
30. The insurer stops writing homeowners business in the state or ceases operations in the state altogether.
31. Failure of the insured to pay membership dues required by the insurer as a condition of issuance and maintenance of the policy.
32. Claims frequency.
Alabama
Alabama's special provisions endorsement (HO 01 01 05 11) contains a definition of actual cash value that applies wherever the term is used throughout the policy: ACV ″is calculated as the amount it would cost to repair or replace covered property, at the time of loss or damage, with material of like kind and quality, subject to a deduction for deterioration, depreciation and obsolescence.” The definition notes that the ACV valuation applies to covered property whether the property has sustained total or partial loss or damage.
The Section I exclusion for intentional loss is deleted and replaced so that if the named insured (or spouse) commits an act with the intent to cause a loss related to and in furtherance of domestic abuse, an innocent insured victim (as defined in the ″Domestic Abuse Insurance Protection Act″) of such abuse may be afforded coverage.
The suit against us condition is amended; there must be full compliance with all the terms of the policy, and the suit must be brought within the time limitations prescribed under Alabama law.
The subrogation condition is amended. An insured may waive all rights of recovery in writing before a loss, unless that insured is an innocent victim of domestic abuse. In that case, the insurer is entitled to subrogate against the perpetrator to recover for any amounts paid for property damage. The insurer has the right to request an assignment of rights recovery for a loss to the extent that payment was made; in that case the insured must sign and deliver all related papers and cooperate with the insurer.
Alabama does not amend the ISO homeowners cancellation provisions, so a policy may be cancelled for reasons 1, 2, 4, or 23.
Alaska
This special provisions endorsement (HO 01 54 09 01, which modifies the 2000 form) contains an efficient proximate cause provision: if a loss is caused by a series of causes, and a peril insured against is the dominant cause of the loss, then the insurer cannot deny coverage even if a secondary cause is not a peril insured against. This provision supersedes all provisions to the contrary in the body of the policy. Forms HO 00 03 10 00 and HO 00 05 10 00 exclusions are not changed, but are given different numbers.
Amended property provisions are: 1) in the appraisal process each party has ten, rather than twenty, days to choose an appraiser and notify the other party of that choice upon receiving a written demand for an appraisal; 2) losses are payable within thirty (rather than sixty) days following settlement agreement; and 3) the time for a suit against the insurer is extended to three years.
Alaska mandates that the water exclusion endorsements HO 16 09 01 09 or HO 16 10 01 09 be attached, as well as endorsement HO 04 96 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
There is an additional section II exclusion of coverage for bodily injury arising out of failure to supervise, or the negligent supervision of, a person that results in: a) corporal punishment, sexual, or mental abuse, b) transmission of a disease, or c) controlled substance abuse.
The section II additional coverages include the portion of the attorney's fees awarded as costs in accordance with Alaska statute. The concealment or fraud condition is amended to state that the insurer will not provide coverage if misrepresentations were fraudulent, material, or if the insurer would not have issued the policy as requested had the true facts been known.
Reasons for cancellation are: 1 (twenty days notice required), 2 (ten days), 5 (ten days), 6 (thirty days), and 24 (thirty days). Alaska does not limit the underwriting period. If the named insured is seventy or older, another person may be designated to receive notice as well as the named insured.
Arizona
Arizona, in form HO 01 02 05 11, adds a definition of the term actual cash value: “the amount it would currently cost to repair or replace covered property with new material of like kind and quality, less allowance for physical deterioration and depreciation, including obsolescence.”
The additional coverage for fire department service charge is deleted.
The section I exclusion for intentional loss is amended so that it does not apply to an innocent insured's claim for an otherwise covered property loss caused by an act of domestic violence. The innocent insured must cooperate in the investigation of the loss, and cannot have contributed or cooperated in the creation of the loss. If payment is made to an insured who is a victim of domestic violence for a loss caused by an act of domestic violence, the insurer has the right to recover damages from the perpetrator of the violence. Payment is limited to the innocent insured's insurable interest in the property; in no event will more than the limit of liability be paid. Unlike Alabama, no specific law is referenced.
The section I conditions are amended. The appraisal condition specifies that the umpire should be “competent and impartial.” Losses must be paid within thirty days of reaching agreement. The concealment or fraud condition of both sections I and II is amended to include false statements that would have precluded policy issuance, as well as fraudulent conduct relating to the insurance.
Following the sixty-day underwriting period, a policy may be cancelled only for reasons 1 (ten days), 2, 4, and 7. The latter three require thirty days notice. Nonrenewal (giving thirty days notice) may be based on the condition of the premises. The insured is given thirty days to remedy the situation, in which case coverage will be renewed. But if the conditions are not remedied to the insurer's satisfaction, and the insured pays the premium, then the insured has an additional thirty days to rectify the problem.
Condition F. Subrogation has an addition paragraph: in the event that the insurer makes payment to an innocent insured victim of domestic abuse, the rights of that insured are transferred to the insurer. The innocent insured cannot waive such rights to recover against the perpetrator of the domestic violence.
Arkansas
The special provisions endorsement HO 01 03 05 11 amends the appraisal condition so that both insurer and insured must voluntarily agree to the appraisal. The suit against us provision is amended—a suit may be brought within five years, rather than the two years in the basic policy. The subrogation condition states that the insurer is entitled to recovery only after an insured has been fully compensated for a covered loss. The mortgagee provision is amended. The mortgagee is given ten days notice of cancellation for nonpayment of premium or if cancellation is within the sixty-day underwriting period; twenty days in all other cases. If the policy is being nonrenewed the mortgagee must be notified at least thirty days in advance.
The loss payable clause is replaced. If there is a loss payee for certain listed insured personal property, the definition of ″insured″ is changed to include the loss payee with respect to that property. In event of cancellation, the loss payee will be notified in writing (no time limit is given). However, if the policy is to be nonrenewed, the loss payee will be notified in writing at least thirty days before the date of the nonrenewal.
Reasons for midterm cancellation are 1, 2, 3, 8, 9, and 31. Twenty days notice is required except for ten days for non-payment of premium.
California
California's special provisions form HO 01 04 09 06 modifies the 2000 homeowners, and gives notice that throughout the policy, the term “spouse” includes an individual registered under California law as the named insured's domestic partner. The section I intentional loss exclusion is amended so that it does not apply to an innocent insured's claim if arson is the cause of loss.
The section I conditions are amended. Now, if loss or damage relates to a state of emergency under California law (the 2007 wildfires, for example), the insured has 24 months after the insurer's actual cash value payment to notify the insurer of the intent to repair or replace the damaged property (applies to forms HO 00 02, HO 00 03, and HO 00 05). In all other cases, the insured has 12 months. In form HO 00 08, if the insured repairs or replaces the loss to restore the property for the same occupancy and use at the same site within 24 months because of a state of emergency, or 12 months in all other cases, the insurer pays the lesser of the limit of liability, or the necessary amount actually spent to repair or replace using common or functionally equivalent materials.
The appraisal clause is amended; the two appraisers are to select a competent and impartial umpire. An insured has one year from the date of loss to bring suit against the insurer. The loss settlement provision states that a loss is payable within thirty days after settlement is reached, rather than sixty.
In event of loss by fire, the concealment or fraud condition applies only to the insured that has intentionally concealed or misrepresented facts. But if loss is caused by another peril, the concealment or fraud condition precludes coverage for all insureds if one has intentionally concealed or misrepresented facts.
A policy cannot be cancelled during the sixty-day underwriting period or nonrenewed solely because the insured accepts the insurer's offer of earthquake coverage, or because corrosive soil conditions exist on the residence premises, or because the insured cancelled or did not renew an earthquake policy issued by the California Earthquake Association. But if the named insured accepted a new or renewal earthquake policy, and did not pay the premium, the insurer may cancel. The “corrosive soil” provision applies only to special form homeowners (ISO forms HO 00 03 or HO 00 05) or to condominium policies with open perils coverage on real or personal property, which exclude loss caused by corrosive soil conditions. Twenty days notice is required during the underwriting period. Midterm cancellation (thirty days notice) reasons are 1 (ten days required), 2, 5, 6, and 24 (other than corrosive soil conditions). When the insurer cancels the policy, the return premium must be refunded within twenty-five-days after the cancellation date.
Nonrenewal requires at least a forty-five days notice. If the insured accepts an offer of earthquake coverage, the insurer may nonrenew if the insurer's ability to pay claims is jeopardized because of the earthquake exposure, or the nonrenewal is based on sound underwriting principles as filed with the Department of Insurance, or the insurer has lost reinsurance or seen a substantial increase in reinsurance premium.
An insurer may not nonrenew solely because (1) an offer of earthquake coverage was accepted; (2) the insured cancelled or did not renew an earthquake policy through the California Earthquake Authority; (3) of corrosive soil conditions on the insured premises; (4) on the grounds that a claim is pending under the policy; or (5) on the basis of an insured's age.
Additional required endorsements are the water exclusion endorsements HO 16 09 01 09 or HO 16 10 01 09 be attached, as well as endorsement HO 04 96 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business. Workers Compensation Residence Employees—California, HO 24 90 08 01, is also required. This endorsement declares that the insurer will pay when due all benefits required of an insured by the California Workers' Compensation Law, and pay on behalf of an insured all damages for which an insured is liable because of bodily injury sustained by a residence employee. The bodily injury must be caused by accident or disease and arise out of and in the course of employment by the insured.
Colorado
The special provisions endorsement (HO 01 05 05 11) states that the insurer's total liability for all damages arising out of any one occurrence will not be greater than the limit of liability shown in the declarations. Further, the insurer's total liability for any rehabilitation services for a child or minor for which an insured is legally liable because of vicarious liability is $10,000. This amount does not increase the limit of liability. The provision does not apply with respect to damages arising out of fungi, wet or dry rot, or bacteria when endorsements HO 04 26, HO 04 27, or HO 04 28 are attached.
The cancellation and nonrenewal provisions are amended. During the underwriting period (which is amended to thirty business days), the insurer may cancel for any reason. A thirty-day notice is required.
Midterm cancellation reasons are 1 (ten days notice), 2, and 4. The cancellation notice must state the reason for the cancellation. Thirty days notice is required.
A nonrenewal notice (thirty days required) must state the reason for the nonrenewal.
Connecticut
Form HO 01 06 10 10, which modifies the 2000 homeowners, has eliminated the language that “You” and “your” refer to the named insured, spouse, or a party who has entered into a legally-recognized civil union with the named insured, if resident of the same household, previously found in form HO 01 06 03 06. Connecticut on November 12, 2008, became the second state to recognize same-sex marriage, so the language is no longer necessary.
In section I property coverages the following changes are made: (1) water or steam are deleted as property not covered; (2) vehicles not subject to motor vehicle registration used to service an insured's residence or designed for assisting the handicapped are covered [note that the vehicles used to service an insured's residence was amended in the 2011 homeowners form]); and (3) the additional coverage for collapse is amended. The additional coverage does not increase the applicable limit of liability, nor does it reduce or eliminate coverage with respect to a loss caused by a coverage C named peril. Collapse caused by use of defective materials or methods in construction, remodeling, or renovation need not occur during the course of the remodeling, renovation, or construction.
The exclusion for intentional loss is modified to state that the insurer does not provide coverage for the insured who commits an act with the intention of causing a loss.
The section I conditions are modified. The appraisal provision is modified so that each party is to choose a competent and disinterested appraiser. If the insurer pays a claim to the mortgagee, the insurer can cancel with ten days written notice to the mortgagee. If the mortgagee provides proof of loss, the appraisal, suit against us, and time of payment provisions become the province of the mortgagee. The concealment or fraud condition is deleted.
The section II exclusion for motor vehicle liability is modified so that the exclusion does not apply to a motor vehicle used to service an insured's residence (the unendorsed 2000 policy states “vehicle used solely to service an insured's residence,” but, as noted earlier, this has been amended in the 2011 homeowners form). Exclusion E.1. expected or intended injury is modified to eliminate coverage only for the insured who intended or expected the injury or property damage. In the standard homeowners, the exclusion refers to ″an″ insured, which means one or many. Exclusion F.6. is deleted in all forms and in endorsement HO 24 73 10 00. Therefore, the exclusion for bodily injury to the named insured or an insured (as defined) is eliminated, thus leaving the possibility for intrafamily suits.
A condition precluding coverage for the insured who, whether before or after a loss, intentionally concealed or misrepresented any material fact or circumstance, engaged in fraud, or made material false statements relating to the insurance is deleted.
Cancellation during the sixty-day underwriting period requires a thirty-day notice. Midterm cancellation is permitted for reasons 1 (ten days notice), 2, or 4; thirty days notice is required. Excess premium (if not tendered) is refunded on demand.
Notice of nonrenewal must be sent at least sixty days prior and must include the reason for the nonrenewal.
Additional endorsements required in Connecticut are the water exclusion endorsements HO 16 09 01 09 or HO 16 10 01 09, HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business, and one of HO 04 74, HO 04 75, or HO 04 76 Limited Fungi, Wet or Dry Rot, or Bacteria Coverage—Connecticut.
Delaware
Delaware's special provisions form is HO 01 07 05 11. The suit against us condition is amended so that the action must be brought within two years after the date of loss. Any action brought as the result of the denial of a claim must be started within two years after the date of loss, or one year after the date of denial, whichever is later.
Cancellation may be delivered, or mailed to the named insured at the last known address. After the sixty-day underwriting period, cancellation reasons are 1 (ten days), 2, or 4. A thirty-day notice is required. However, if any of the following conditions are present at an insured premises, cancellation can be sent with only a five-day notice: 10, 11, 12, 13, 14, or 29 (owing for more than one year, instead of two). Cancellation notice may be delivered or mailed to the insured's last known address.
A nonrenewal requires at least a thirty-day notice delivered or mailed to the insured's last known address.
District of Columbia
The District of Columbia uses form HO 01 08 02 10, which modifies the 2000 homeowners. The definition of the named insured is amended to include ″a party who, with the 'named insured', has entered into a domestic partnership recognized under District of Columbia law.” The section II conditions are amended—the phrase “This limit is the same regardless of the number of 'insureds', claims made or persons injured” is deleted from condition A. but added under the special limit of liability. The special limit of liability of $10,000 is for damages for which an insured is legally liable because of vicarious liability, unless the vicarious liability is otherwise excluded. However, this condition does not apply when the home-based business endorsement HO 07 01 10 00 is attached. The condition does not apply with respect to damages arising out of fungi, wet or dry rot, or bacteria when HO 04 26, HO 04 27, or HO 04 28 are attached.
The condition for coverage in event of death is amended to reflect a domestic partner as recognized under DC law.
The underwriting period is thirty days (as opposed to sixty) with a thirty-day notice required for cancellation. A midterm cancellation may be for reasons 1, 2, 15, or 25. A thirty-day notice is required.
The District of Columbia also requires the water exclusion endorsements HO 16 09 01 09 or HO 16 10 01 09, and HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
Florida
Because of the hurricane damage inflicted in Florida in recent years, the special provisions (HO 01 09 04 11) have been substantially amended to reflect this. Three definitions are added: fungi (any type or form of fungus, including mold or mildew, and any mycotoxins, spores, scents, or by-products produced or released by the fungi, except for, in Section II, fungi contained in a product intended for consumption); and hurricane occurrence (which begins at the time a watch or warning is issued for any part of Florida by the National Weather Service, continues for the time hurricane conditions exist for any part of Florida, and ends seventy-two hours following the termination of the last watch or warning issued for any part of Florida). Catastrophic ground cover collapse means “geological activity that results in all of the following: (1) the abrupt collapse of the ground cover; (2) a depression in the ground cover clearly visible to the naked eye; (3) structural damage, other than settling or cracking, of a building or structure insured under this policy, including the foundation; and (4) the building or structure being condemned and ordered to be vacated by the governmental agency authorized by law to issue such an order for that building or structure.” Catastrophic ground cover collapse is added as peril 17 on forms HO 00 02, HO 00 04, and HO 00 06. The exclusion for earth movement does not apply to catastrophic ground cover collapse, so form HO 00 03 provides this coverage by exception.
Coverage for $10,000 for fungi, wet or dry rot caused by a peril insured against that occurs during the policy period is an additional coverage. Although fungi, wet rot, or bacteria are excluded, the exclusion does not apply to a fungi loss caused by fire or lightning, or to the extent the additional coverage provides coverage.
An added coverage for form HO 00 06 is $2,000 loss assessment. The lesser of $250 or the deductible amount applying to the peril of fire is to be applied to loss covered under the additional coverage.
Loss caused by constant or repeated seepage or leakage is excluded unless unknown to all insureds and hidden within walls or ceilings or beneath floors or above ceilings. This applies to both the dwelling and to personal property.
Damage to covered property from sinkhole collapse was included on the prior special provisions forms. It was then removed and endorsement HO 23 94 Sinkhole Loss Coverage—Florida was used to provide coverage, since Florida law mandated that coverage be available to all. Now, as noted, the coverage is included as ″catastrophic ground cover collapse.” For older homeowners forms, HO 23 94 is still available.
The appraisal provision is modified by adding a mediation provision. If agreement on the amount of a loss is not reached, either party may demand mediation. The loss amount must be $500 or more prior to the application of the deductible, or there must be a difference of $500 or more between the amount of loss settlement offered by the insurer and the amount requested by the insured. The results of the mediation are binding only if both parties agree in writing. The insured has three business days in which to rescind the settlement. If the insurer demanded the mediation and either party rejects the results, the insured is not required to submit to or participate in an appraisal as a precondition to action against the insurer.
The other insurance and service agreement provision in form HO 00 06 is modified so that if a loss is covered by other insurance or service agreement this insurance is excess; in the event the other insurance is excess, then the insurer pays the proportion that the limit under this policy bears to the total of insurance covering the loss.
The suit against us condition is modified to allow the insured up to five years to bring suit against the insurer.
The loss settlement provisions applicable to the insurer's option are amended. If the policy does not cover a mobile home, loss settlement is paid according to the loss settlement provisions 2.a. and 2.b. whether or not actual repair or replacement is complete. If the policy is on a mobile home, no more than actual cash value is paid until actual repair or replacement is complete. In Form HO 00 06, the terms “repaired” or “replaced” do not include increased costs incurred to comply with enforcement of any ordinance or law, except to the extent that coverage is provided in D.10 Ordinance or Law in the property coverages.
Losses are payable within twenty days after settlement is reached, or sixty days after there is an entry of final judgment or appraisal or mediation settlement.
The section II exclusion for controlled substances is modified to “a Controlled Substance as defined under federal law,” rather than giving the cite reference to the law as in the unmodified form.
A sublimit of $10,000 applies to statutorily imposed vicarious parental liability not otherwise excluded. This condition does not apply with respect to damages arising out of fungi, wet or dry rot, or bacteria when endorsement HO 03 34 is attached.
The underwriting period is ninety days. During that time, cancellation may be effective immediately for material misrepresentation or for failure to comply with underwriting requirements. Nonpayment within the first ninety days requires a ten-day notice. For any other cancellation within the underwriting period, twenty days notice must be given. However, the insurer cannot cancel for property claims resulting from acts of God, unless the insured fails to take steps to prevent further such losses. Likewise, a single claim for water damage, or on the basis of filing claims for partial sinkhole loss regardless of whether the claim was made under this policy, unless the total of such claims exceeds the current policy limits, or the insured has failed to repair the damage in accordance with engineering recommendations, cannot be used as reasons for cancellation. After the policy has been in effect for ninety days, it may be cancelled for reasons 1 (ten days notice), 2, 4, 16, 17, or for claims that are “acts of God,” but the insured has failed to act to prevent a recurrence, or a single claim for water damage, if the insured has failed to act to prevent a recurrence, or for failure to repair sinkhole damage, or if the total of sinkhole-related claims exceed the policy limits. If the residence premises has been insured by the insurer or an affiliate for at least 5 years immediately prior to the date of cancellation, then 180 days notice is required. If that situation does not apply, then if the date of cancellation becomes effective on or after December 1 and before June 1, one hundred days notice is given. If the date of cancellation falls on or after June 1 and before December 1, one hundred days notice is given, or before June 1, whichever is earlier.
Special cancellation provisions apply in event of a state of emergency declared by the Governor and an emergency order filed by the Commissioner of Insurance. If the insured residence premises has been damaged by hurricane or wind loss that is the subject of the declared emergency, the insurer can decide to cancel beginning from the date the state of emergency is declared to the expiration of ninety days following repairs to the dwelling or other structure only for nonpayment of premium (ten days), material misrepresentation of fraud related to the claim, if the insured has unreasonably caused a delay in repair of the dwelling or other structure, or if the insurer has paid the applicable limits. In this event, forty-five days notice is required. If the date of cancellation becomes effective during a hurricane occurrence (as defined), the cancellation will not become effective until the end of the hurricane occurrence, and the insurer is entitled to collect additional premium for the additional coverage, unless the insured has obtained other coverage.
Nonrenewal requires the same notice as in the cancellation provisions. If the date of nonrenewal becomes effective on or after December 1 and before June 1, 100 days notice is given. If on or after June 1 and before December 1, 100 days prior to renewal date or June 1, whichever is earlier, will be the number of days notice. An offer of renewal must be given in writing and accompanied by the amount of renewal premium at least forty-five days prior to renewal date. Although nonrenewal cannot be solely for “acts of God,” the insurer may demonstrate through claims frequency that the insured has failed to take reasonable action as requested by the insurer to prevent further damage. Likewise, a single claim for water damage cannot be used as a reason, unless the insured failed to act to prevent a recurrence. Filing sinkhole claims cannot be used unless the total of such claims exceeds the current policy limits, or the insured has failed to repair the structure in accordance with engineering recommendations. If the nonrenewal date occurs during a hurricane occurrence (as defined), the expiration date will not be effective until the end of the occurrence. The insurer has the right to collect additional premium, unless replacement coverage has been obtained.
If a state of emergency has been declared and the residence premises has been damaged, nonrenewal may be based only on nonpayment of premium, material misrepresentation or fraud with regard to the claim, an unreasonable delay in repair caused by the insured, or the applicable limits have been paid. The insurer has ninety days from the period beginning from the date of the declared state of emergency to decide to nonrenew. In this instance, forty-five days notice is required.
A condition of renewal notification is added: the insurer must notify the insured in writing of the decision to renew, including the amount of premium due.
Additional required forms in Florida are the HO 16 09 01 09 or 16 10 01 09 water exclusions, HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business, and HO 22 66 01 06, which advises the insured that additional ordinance or law and flood insurance should be considered.
Georgia
Georgia's special provisions endorsement HO 01 10 05 11 amends the ISO homeowners definition of collapse. It adds the statement (in additional coverage 8, paragraph c.(2.)) that “if any part of the interior dwelling building separates from another part of the interior of the dwelling building with the result that any part of the interior dwelling building cannot be occupied for its intended purpose, then this paragraph c.(2) does not apply to that part of the building.”
The section I intentional loss exclusion is modified so that innocent insureds may recover for damage if the damage arises out of family violence and is caused by an intentional act of an insured against whom a family violence complaint is filed for the act. Payment is limited to the innocent co-insured's insurable interest.
The mortgage clause is amended. The mortgagee must be notified at least thirty days prior to a cancellation or nonrenewal, unless within the sixty-day underwriting period or for nonpayment of premium. In that case the mortgagee receives ten days notice.
The exclusion for bodily injury or property damage arising out of the use, etc., of any controlled substance is modified to provide coverage if the involvement with the controlled substance is without the knowledge of any insured.
The cancellation provision is amended. If the insured requests cancellation, then the effective date will be the later of the requested date or the date the insurer receives the request. If the policy cannot be cancelled—even at the insured's request—without first notifying a third party (such as a governmental agency or mortgagee), the insurer will send a notice showing the effective date as either ten days from the date of mailing or the date the insured specified, whichever is later.
Within the sixty-day underwriting period, cancellation may be for any reason. Ten days notice is required. Reasons for midterm cancellation are 1 (ten days), 2, 4, or 9. A thirty-day notice is required in these instances.
Nonrenewal requires a thirty-day notice. A receipt or evidence of mailing as prescribed or accepted by the U.S. Postal Service constitutes proof of notice.
The insurer has the right to recompute premium if information is received which affects the premium charged.
Additional required endorsements in Georgia are the HO 03 35 05 11, HO 03 36 05 11, or HO 03 37 05 11 Limited Fungi, Wet or Dry Rot or Bacteria Coverage—Georgia, (as appropriate).
Guam
Guam special provisions form HO 01 51 04 02 modifies the 2000 forms. deletes the exclusion for neglect in all forms. A condition called the “valuation clause” is added to all forms. This clause is a valued policy clause; if a peril insured against causes total loss to real property, then the amount of insurance is taken to be the true amount of loss. If the policy insures personal property, and a peril insured against causes total loss to the property, then the following applies: if the amount of loss (as established by appraisal or by agreement between insured and insurer) is less than the amount of insurance, the insurer is to refund any unearned premium for the amount of insurance exceeding the amount of the loss.
The suit against us condition is modified so that suit may be brought to recover on a final judgment or settlement against an insured signed by the insurer. The insurer is not responsible for damages that are not payable or are in excess of the limit of liability.
Cancellation for nonpayment is ten days. The underwriting period is sixty days; cancellation during that period may be for any reason. After that, cancellation is for reasons 1, 2, or 4; thirty days notice is required. An affidavit setting forth the facts of the mailing is evidence of notice. The insurer can cancel for any reason at the policy's anniversary by giving at least thirty days notice. Nonrenewal requires thirty days before expiration date; an affidavit setting forth the facts of the mailing is evidence of notice.
Guam also requires HO 16 09 01 09 or HO 16 10 01 09 water exclusions, and HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
Hawaii
This form HO 01 52 07 05 is promulgated by the Hawaii Insurance Bureau, Inc., 2005, and includes copyrighted material of ISO Properties Inc.
A definition of “domestic abuse” is added: physical harm, bodily injury, assault or the infliction of fear of imminent physical harm, bodily injury or assault between family members, sexual assault of one family or household member by another, stalking of one family or household member by another family or household member, or intentionally, knowingly or recklessly causing damage to property so as to intimidate or attempt to control the behavior of another family or household member.
The intentional loss exclusion is modified similarly to that of Georgia to protect the rights of an innocent insured. If the insurer pays an innocent insured because of an act of domestic abuse, the insurer may recover from the perpetrator. The insured must file a police report and cooperate with any law enforcement investigation relating to the act of domestic abuse that caused the loss. Any payment is then limited to the innocent insured's interest.
Loss settlement provisions 2.d. of forms HO 00 02 10 00, HO 00 03 10 00, and HO 00 05 10 00 are modified; no more than the actual cash value of the damage will be paid unless (rather than until) the actual repair or replacement is complete; or the cost to repair or replace is both less than 5 percent of the amount of insurance on the building and less than $2500. The insurer has thirty days from the time settlement is reached to pay a claim.
Under section II liability coverages, the phrase “Damages include prejudgment interest awarded against the 'insured'” is deleted. There is a limit of $10,000 for statutorily imposed vicarious parental liability not otherwise excluded. The amended limit of liability provision does not apply to losses covered under the home business endorsement HO 07 01 10 00 or with respect to damages arising out of fungi, wet or dry rot, or bacteria when HO 04 26, HO 04 27, or HO 04 28 are attached.
The sections I and II concealment and fraud provisions are amended. If, whether before or after a loss, there is misrepresentation or concealment made with actual intent to deceive, or that materially affects the insurer's acceptance of the risk, coverage is precluded.
There is a sixty-day underwriting period. Notice of cancellation during that time requires ten days notice. Midterm cancellation normally requires a thirty-day notice (except for nonpayment of premium); cancellation may be for reasons 2 or 4. If the insurer cancels, return premium is pro rata; if the insured cancels, then short rate cancellation is used.
Additionally, endorsement HO 05 18 07 01 informs the insured that damage from hurricanes is excluded; if desired, separate coverage must be purchased. Water exclusion endorsements HO 16 09 01 09 or HO 16 10 01 09 must be attached to the homeowners policy.
Idaho
Cancellation for nonpayment of premium (ten days notice, which begins to run five days following the date of postmark, if the U.S. mail is utilized) or for any reason within the sixty-day underwriting period requires a thirty-day notice. This is the only change form HO 01 11 12 07 makes to the 2000 forms.
Illinois
Form HO 01 12 05 11 modifies the intentional loss exclusion, similarly to many other states, so that the rights of an innocent victim of “a pattern of criminal domestic violence” are protected in event of a loss to covered property. The loss must arise out of the pattern, and the perpetrator of the loss must be criminally prosecuted for the act causing the loss. The insurer's payment is limited to the innocent insured's insurable interest.
The appraisal provision is amended. If the insured requested the appraisal, and the amount is agreed to by the insurer's appraiser or by the umpire, then the insurer bears the cost of the appraisal. The time limit of two years for bringing a suit against the insurer is extended by the “number of days between the date proof of loss is submitted and the date the claim is denied in whole or in part.” Loss payment is required within thirty days of reaching an agreement, a final judgment, or the filing of an appraisal award.
The concealment or fraud provision is amended (in both sections I and II) to state that this condition does not apply once the policy has been in effect for one year, or one policy period, whichever is less. However, the insurer may still cancel in accordance with the cancellation provisions.
Section II modifications include: prejudgment interest is not included in the damages payable under section II; the exclusion for communicable disease is modified so that only loss resulting from sexually transmitted disease is excluded. The exclusion for bodily injury arising out of sexual molestation, corporal punishment or physical or mental abuse is modified so that coverage E and F do not apply “to an 'insured' who inflicts, or directs another person to inflict, upon any person, sexual molestation, corporal punishment or physical or mental abuse which results in 'bodily injury' or 'property damage'.” Exclusion F.6 is modified; it does not apply to the maintenance or use of a motor vehicle by an insured as defined under definition 5.a. or 5.b., or when a third party acquires a right of contribution against an insured. The vehicle must be one covered under the policy.
Following a loss, the insured's duty is to secure and give evidence (C.4.d.) rather than to “obtain the attendance of witnesses.”
The underwriting period is sixty days. After that, a policy may be cancelled for these reasons: 1 (ten days notice), 2, or 6. The latter reasons require thirty days notice. The insurer must also send notice to the agent. Once a policy has been in force for five years or more, it can only be nonrenewed for misrepresentation or fraud, measurable increase in risk, or if sixty days notice is given. In the case of either a cancellation or a nonrenewal, the insurer must obtain a certificate of mailing.
Indiana
Indiana's special provisions endorsement HO 01 13 03 11 modifies the ordinance or law coverage to state that the cost to comply with any ordinance regarding pollutants is not covered whether or not the “irritant or contaminant has any function with respect to your property or 'business'.” This same provision, that any reference to pollutants applies whether or not the irritant or contaminant has any function with respect to the named insured's property or business, also applies to the HO 00 03, HO 00 05, HO 04 14, HO 05 24, HO 17 31, and HO 17 32.
Exclusion F.4. in the section II exclusions is modified so that coverage does not apply to bodily injury arising out of the failure of the insured to obtain a certificate from a contractor or subcontractor showing that the contractor or subcontractor has complied with the applicable workers' compensation insurance requirements. This same modification appears in the medical payments to others section.
The underwriting period is sixty days. A midterm cancellation for the following reasons requires twenty days notice: 2 or 4. Ten days notice is required for nonpayment of premium.
Condition H. adds that the insured's notice to the insurer's agent of a loss is deemed to be notice to the insurer.
Iowa
The special provisions endorsement is HO 01 14 05 11. The insurer has thirty days from the receipt of the proof of loss and an agreement is reached, a final judgment is entered, or a filing of an appraisal award is made to pay a claim.
Section II condition suit against us is amended to give a judgment creditor a right of action against the insurer in event that an execution on a judgment is returned unsatisfied.
During the sixty-day underwriting period, cancellation for any reason requires a thirty day notice. Iowa adds a cancellation paragraph stating that if the policy insures a dangerous wild animal as defined by Iowa law, the named insured must notify the Iowa Department of Agriculture and Land Stewardship if the policy is cancelled, or if the minimal amount of liability insurance, as required by the state, is no longer maintained.
Nonrenewal requires a thirty-day notice.
Kansas
The special provisions endorsement HO 01 15 11 04, modifying the 2000 forms, adds a definition of actual cash value: “the amount which it would cost to repair or replace covered property with material of like kind and quality, less allowance for physical deterioration and depreciation, including obsolescence.” The appraisal condition is amended so that both insured and insurer must agree voluntarily to have the loss appraised.
A suit against the insurer must be brought within five years after the date of loss. Losses are payable within thirty days after reaching settlement agreement with the insured.
The section II liability coverage for “damages” has been changed; the coverage for prejudgment interest is moved to the section II additional coverages claims expense as provision A.5.
Cancellation during the sixty-day underwriting period requires a thirty-day notice. If the insurer cancels, any return premium will be sent with the notice. If the insured cancels, any return premium will be sent within a reasonable time.
Additional required endorsements in Kansas are the HO 16 0901 09 or HO 16 10 01 09 water exclusion endorsement, and HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
Kentucky
Form HO 01 16 05 11 amends the additional coverage for fire department service charge to state that the charges are not covered if the insured does not have a contract or agreement with the responding department.
The section I exclusion for intentional loss is amended so that payment will not be denied to the innocent coinsured victim of a pattern of criminal domestic abuse, if the loss arises out of the criminal domestic violence and the perpetrator is criminally prosecuted for the act causing the loss. The insurer may then subrogate against the perpetrator. Any claim based on this provision is limited to the innocent insured's insurable interest, less any payment made to a mortgagee or other with a secured interest.
The loss settlement provision is changed; losses are payable thirty days after settlement is reached.
The section II exclusion F.6. for bodily injury to an insured is deleted in both the homeowners and endorsements HO 24 73 and HO 06 12. Paragraph 1.i. is deleted in endorsements HO 24 10 and HO 24 82. .
A cancellation during the sixty-day underwriting period requires a fourteen-day notice. A midterm cancellation for nonpayment also requires a fourteen-day notice. Other midterm cancellation reasons are: 2, 6, 4, 8, or 21. A seventy-five-day notice is required. Notice of nonrenewal must be sent at least seventy-five days prior to renewal date.
If a renewal notice is sent and the renewal premium is not received by the due date, the policy terminates without further notice; however, within fifteen days of the due date notice will be sent stating the policy was not renewed and was terminated.
Louisiana
Special provisions form HO 01 17 04 10 amends the 2000 homeowners. First, in the section I property coverages, a motor vehicle not required to be registered and used to service an insured's residence is now covered (the unamended 2000 homeowners form states the vehicle must be used solely to service an insured's residence). The additional coverage for reasonable repairs is amended; the provision states that the insurer will pay the reasonable cost incurred by the named insured for necessary repairs (rather than measures taken to protect covered property) made solely to protect covered property from further damage if a peril insured against has caused the loss. The additional coverage for credit card, etc. has been amended but only with regard to a slight change in wording.
Section I property exclusion A.8. intentional loss is modified into loss caused by fire (by or at the direction of the insured), and loss caused by a peril other than fire (with respect to all insureds). The distinction is reflected in the section I concealment or fraud condition. No coverage with respect to a fire loss is provided to the insured who intentionally concealed or misrepresented any material fact; with respect to any other loss no coverage is provided to any insured if one or more insureds intentionally concealed or misrepresented any material fact. However, if any intentional concealment or material misrepresentation was in relation to procurement of the policy, and if known to the insurer would have resulted in nonissuance of the policy, coverage is denied only if the conduct was committed with intent to deceive. If the insurer pays an insured for a fire loss intentionally caused by another insured, the insurer has the right to recover from that insured.
The duties following a loss condition has been modified. If the loss results from a catastrophic event for which a state of disaster or emergency was declared, then the insured has 180 days following the insurer's request for the proof of loss. However, the 180 day period does not commence until the state of disaster or emergency has ended and the insured has access to his or her property. In all other cases, the insured has sixty days following the insurer's request.
Losses must be paid within thirty days after settlement is reached. The insured has 180 days after the date of loss to notify the insurer of the intent to replace, unless the loss has resulted from a catastrophic event for which a state of emergency was declared. The 180 days period does not then commence until the state of emergency has ended and the insured can access the premises.
The mortgagee cancellation clause is changed so that cancellation for nonpayment requires ten days notice; other cancellations require thirty days notice. A nonrenewal requires thirty days notice to the mortgagee.
The Louisiana form does not specify that, under section II liability, damages include prejudgment interest. The section II exclusion for use of a motor vehicle is amended—the vehicle does not need to be used solely to service an insured's residence. Exclusion E.1. expected or intended injury is broken into two separate provisions, one applying with respect to loss caused by fire which is expected or intended by the insured; the other with respect to loss caused by a peril other than fire and which is expected or intended by one or more insureds. The exclusion of coverage for bodily injury to an insured is deleted in its entirety.
The suit against us condition is deleted. The section II concealment or fraud condition will not preclude coverage unless there was a deliberate attempt to deceive on the part of an insured. If the insurer pays one insured for a fire loss intentionally caused by another insured, the insurer has the right to subrogate against that insured.
If the insured's premium payment check or other negotiable instrument is returned because it is uncollectible, the policy may be cancelled from the date the premium was due. Ten days notice must be given. But if the insured sends a cashier's check or money order within ten days of the date the cancellation notice was mailed, the policy is reinstated with no lapse.
During the sixty-day underwriting period, a thirty-day notice of cancellation is required. Midterm cancellation reasons are 2 or 4 before the policy has been in effect for three years. Cancellation at anniversary date can be for any reason if the policy has not been in effect for three years. After that, cancellation reasons are 2, 4, 20, or 32. However, cancellation is not allowed solely for “acts of God,” defined as incidents “due directly to natural causes and exclusively without human intervention.”
After a policy has been in effect for more than three years, the insurer cannot nonrenew except for reasons: 1, 2, 4, 20, or 32 (except for claims due to forces of nature). A nonrenewal cannot be based solely upon a loss caused by an act of God.
The subrogation clause gives the insurer the right to subrogate on behalf of one insured against another insured who has intentionally caused a loss by fire.
Additional required endorsements are the HO 16 0901 09 or HO 16 10 01 09 water exclusion endorsement, and HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
Maine
The first modification in form HO 01 18 12 09 to the 2000 forms is that two definitions are added. The first is for actual cash value: “the replacement cost of covered property at the time of loss, less the value of physical depreciation as to the damaged property.” The second is for physical depreciation, which is defined as “a value as determined according to standard business practices.”
Coverage D is amended so that an insured may elect either additional living expense or fair rental value, unless the residence premises is not the insured's principal place of residence. In that case, only additional living expense is available. The additional coverage for a fire department service charge is modified. The exclusion for payment of the charge if the property is located within city limits is deleted. The additional coverage for ordinance or law is deleted.
An additional coverage ″Post-Judgment Interest″ is added, which states that the insurer will pay, in accordance with Maine law, interest on the entire judgment which accrues after entry of the judgment and before the insurer pays the part of the judgment not exceeding the limit of liability which applies.
The exclusion of coverage for any loss committed by or at the direction of an insured with the intent to cause a loss is modified so that coverage is excluded for the insured who committed the act or directed that it be committed.
Losses are payable thirty days following settlement. In event of a covered loss, if the insured fails to provide proof of loss the mortgagee may do so. If a loss is made payable to a designated mortgagee, its interest in the policy may be cancelled by giving ten days notice. If the insurer cancels the policy, the mortgagee will be given the same number of days notice as the cancellation or nonrenewal provisions of the policy require.
The concealment or fraud condition is deleted in both sections I and II; however, it is in the conditions applicable to both sections I and II. The insurer will not provide coverage for the insured who has intentionally concealed or misrepresented any material fact or circumstance, engaged in fraud, or made false statements relating to the insurance.
The section II exclusion for expected or intended injury is amended. Excluded is “bodily injury or property damage which is intended or reasonably (italics added) expected by an insured.” The exclusion for bodily injury to an insured is limited to “you or to any son or daughter of yours, if a resident of your household.” In the section II additional coverages, the provision for the inclusion of prejudgment interest is added as a claims expense.
The underwriting period is ninety days, except for a seasonal or secondary residence “expected to be continuously unoccupied for 3 or more months in an annual period,” in which case the underwriting period is 120 days. Cancellation during the underwriting period for nonpayment of premium requires ten days notice; all other reasons require twenty days notice.
Midterm cancellation may be for these reasons: 1 (ten days required), 2, 5, 6, or 25. Maine also allows cancellation for the following: insured property is vacant and there is no custodial care; a trampoline or unfenced or improperly fenced swimming pool remaining on the property for thirty days or more after the insurer has notified of the intent to cancel if not removed or, in the case of the pool, properly fenced; a loss caused by a dog bite and the dog remains after notice of intent to cancel; or the insured's failure to comply with reasonable loss control recommendations within ninety days after receipt of intent to cancel. Twenty days notice is required.
The insurer must provide thirty days notice of nonrenewal. The notice must include the reason for nonrenewal. A postal service certificate of mailing is proof of notice for both cancellation and nonrenewal.
The Maine form includes provisions exempting the insurer, its agents, employees, or service contractors from liability resulting from furnishing or failing to furnish inspection services, unless there is negligence on the part of the insurer's agent, employees, or service contractor. There are certain other circumstances when the exemption does not apply; consult the endorsement.
Other required endorsements are the HO 16 0901 09 or HO 16 10 01 09 water exclusion endorsement, and HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business. The lead poisoning exclusion HO 23 61 04 01 must be attached. This endorsement adds exclusion F.7., which eliminates coverage for bodily injury to a person caused by an occurrence of lead poisoning starting 31 days or more after an authorized inspector has ordered that lead-based substances at the insured location be removed, or upon expiration of an extension of that order. Once the authority has stated that the hazard no longer exists, the exclusion no longer applies.
Maryland
The Maryland special provisions form HO 01 19 12 09 applies to the 2000 homeowners. It amends the coverage D provision for civil authority prohibiting use of the insured premises. The maximum that will be paid is $3,000. If the loss involves fair rental value, then no more than two weeks is covered.
The form replaces the appraisal condition. Each party may choose a competent, rather than a competent and impartial, appraiser. The other insurance condition deletes the service agreement wording and refers only to other insurance. In form HO 00 06, the other insurance condition states that a loss will be prorated between the insurers if there is other insurance, unless the other insurance is in the name of a corporation or association of property owners. In that event, the HO 00 06 is excess over the amount recoverable.
The time period in which suit may be brought is changed from one to three years after the date of loss.
Section II liability exclusion 9. is added, which eliminates coverage for bodily injury or property damage arising out of written or oral statements material to the sale of any property made by an insured or a representative of an insured.
Cancellation at any time for nonpayment of premium requires ten days notice. Within the forty-five-day underwriting period, a fifteen-day notice is required. The insurer may cancel for any reason. After that, a midterm cancellation requires forty-five days (except for nonpayment), and may be for reasons 2 or 4. A nonrenewal requires forty-five days notice.
Maryland also requires the water exclusion endorsement, HO 16 0901 09 or HO 16 10 01 09, and HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
Massachusetts
Form HO 01 20 09 01, modifying the 2000 homeowners, contains a definition of vermin: “animals that tend to access, or enter into or under, structures for foraging or shelter, and, as a result, cause loss. Such animals include, but are not limited to, armadillos, bats, beavers, coyotes, lizards, opossums, porcupines, raccoons, skunks, snails, snakes, slugs, or squirrels.”
The insured's duties after a covered loss are amended. These are the section I conditions 4., 6., 7., and 8. The insured is required to protect the property from further damage, and make reasonable and necessary repairs. Some or all of these expenses may be reimbursed. Additionally, the loss settlement provisions are modified. In order to receive replacement cost coverage the insured is required to repair or replace the damaged building on the residence premises “or some other location within the Commonwealth of Massachusetts within a reasonable time but not more than two years from the date of loss.” (This provision is not applicable to the HO 00 04 10 00 or HO 00 06 10 00.)
The appraisal provision is amended—the insurer, upon written request from the insured, refers the matter to a three member board of referees. The suit against us provision is modified. The insured may bring suit within two years after the loss date; however, if for some reason a court prevents the start or continuance, but later allows the action to continue, it must resume within one year. If a request for appraisal is brought within two years of the date of loss, the insured has ninety days following the board's decision to bring suit.
The insurer has the option, if written notice is sent to the insured within fifteen days after the proof of loss is received, to repair or replace the damaged property with like property.
Losses are payable within thirty days after the proof of loss is received. If the insurer does not pay the claim within the allotted time, the insured is to receive interest at the rate of 1 percent over prime for so long as the claim remains unpaid. Sales taxes are considered a part of any loss under the policy.
If the policy is cancelled, the mortgagee must be given twenty days notice; if the policy is nonrenewed, then the mortgagee must be given ten days notice.
The Massachusetts provisions add two conditions: (1) City or Town Liens: The insurer must notify the local building inspector or board of health at least ten days prior to making a payment of over $1,000 for a building or structure, or if damage makes the building a health or safety hazard. If there is a pending or official lien on the property, payment may be delayed until the matter is settled. (2) Vacancy: If the insured building has three or fewer units and is intended for residential purposes, the insurer is not liable for loss from fire or lightning while the building is vacant. The vacancy must extend beyond a period of sixty consecutive days. For all other residential buildings, the vacancy must extend beyond a period of thirty consecutive days.
The section II condition 4.a. requiring the insured to help the insurer reach a settlement is deleted. The duty of an injured person (or someone acting for the person) is changed from “authorize us to obtain copies of medical records” to “executive authorization to allow us….”
Cancellation for nonpayment of premium requires ten days notice. During the sixty-day underwriting period, cancellation for any reason other than nonpayment requires a five day notice. A midterm cancellation requires a 5 day notice, and may be for reasons 1 (ten days required), 2, 5, 6, 18, or 24. A U.S. Postal Service certificate of mailing is proof of notice. Nonrenewal requires a forty-five-day notice. Endorsement HO 05 23 09 01 states that ordinarily the renewal will be sent to the insured. However, if the policy was executed on behalf of the insurer or on behalf of the insured's agent or the insurer's broker then notice of nonrenewal goes only to the agent or broker. The agent or broker must then send notice within fifteen days to the insured unless the agent or broker has replaced the policy.
The special provisions endorsement also modifies the pair and set clause of the HO 04 61, if it is attached to the policy.
Massachusetts also requires the water exclusion endorsement, HO 16 0901 09 or HO 16 10 01 09, and HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
Michigan
The first of the modifications form HO 01 21 05 11 makes is that the coverage under the policy does not become effective until other coverage has terminated, if the termination is noon standard time on the inception date.
A definition is added: If the spouse ceases to be a resident of the same household during the policy period, the spouse will be considered ″you″ and ″your″ only until the earlier of the end of the policy period, or until the effective date of another policy listing the spouse as a named insured.
The section I exclusion for intentional loss does not apply to an innocent insured with respect to loss to covered property caused by fire, but only to the extent of that insured's insurable interest. Unlike other states with this exception, there is no requirement to be a victim of domestic abuse. Likewise, the concealment or fraud condition does not apply to an insured who was innocent with respect to loss caused by fire, although it applies with respect to other losses. The insurer has the right to subrogate against the insured who caused the loss by fire.
The appraisal condition is amended to state that each party must choose “a competent and independent appraiser.” A suit against the insurer may be brought within two years after the date of loss. The time for beginning an action is tolled (that is, suspended) from the time the insured notifies the insurer of a loss until the insurer formally denies liability.
Loss payment is required within thirty days following settlement agreement. If the insured property is in a municipality applying the provisions of Public Act 217, a part of the payment will be withheld and paid either to the municipality, a licensed contractor repairing the loss, or to the insured and the mortgagee. This provision applies only if the loss was caused by fire, explosion, windstorm or hail, vandalism or malicious mischief, or riot or civil commotion. This same provision is in the amended mortgagee condition.
The concealment or fraud condition is amended so that with respect to loss caused by fire, the insured who intentionally concealed or misrepresented material facts or engaged in fraud is not covered; however, other insureds are covered. There is no coverage for any insured for a loss caused by another peril if an insured engaged in fraudulent conduct or made material misrepresentations.
The section II liability coverage for damages because of bodily injury or property damage is amended; prejudgment interest is deleted as a part of damages and added as an additional coverage under claims expense, A.5.
The exclusion of coverage for bodily injury and property damage arising out of a controlled substance is amended so that it does not apply to the legitimate use of prescription drugs by a person following the lawful orders of a licensed health care professional, or to an insured who has no knowledge of the involvement with the substance. An insured's knowledge of the involvement must be shown by us by competent evidence of such knowledge.
The section II loss conditions are amended. Someone acting “on behalf of” the insured may perform the loss duties. Under damage to property of others, the insured cannot be held to submitting a statement of loss within sixty days, if it is not reasonably possible to do so.
The suit against us provision is amended. No action with respect to coverage E can be brought against the insurer until the obligation of the insured has been determined by final judgment or agreement signed by the insurer.
The other insurance paragraph is replaced so that the insurer's share will be in proportion to any other liability insurance, except for a vehicle or watercraft covered under the policy. In that event the insurance is excess.
Cancellation during the 55 day underwriting period requires a thirty day notice except for nonpayment. When the policy has been in effect for 55 days, cancellation is based on reasons 1 (ten days notice), 2, or 4 with a thirty day notice. The form adds the provision that the minimum earned premium for the expired time will be the pro-rated premium or $25, whichever is greater. Notice of nonrenewal must be sent at least thirty days prior.
If the insurer pays an insured for a fire loss committed by another insured, the rights of the innocent insured are transferred to the insurer.
Minnesota
Minnesota form HO 01 22 06 08 applies to the 2000 forms. It adds a deductible provision to the effect that in event of a total loss to a building covered under section I, no deductible will be applied to the building loss. This does not preclude application of a deductible to other property covered under section I, such as personal property. Under “property not covered” a vehicle used to service the insured's residence is covered only while being operated on the residence premises. Under the additional coverage for ordinance or law, the statement is added that the coverage provided under the additional coverage does not reduce any similar coverage provided elsewhere in the policy. The section I insuring agreement states the insurer insures for all loss caused by fire or any damage caused by lightning.
Section I exclusions are amended. The ordinance or law exclusion states that exclusion A.1.a. does not apply to all forms other than HO 00 08 with respect to the damaged portion of a building in event of a partial loss, or for all forms with respect to the entire building in event of a constructive total loss. The intentional loss exclusion does not apply to an insured who does not commit, conspire to commit, or direct another to commit any act resulting in a loss by fire. The subrogation condition is amended so that the insurer may subrogate against the insured who committed the act resulting in a fire loss. Likewise, the concealment or fraud condition is amended so that loss by fire is not covered for the insured who concealed or misrepresented material facts or circumstances; loss caused by all other perils is not covered if any insured has committed fraud or material misrepresentation.
The section I condition dealing with an insured's duties after loss has been changed to require the insured to provide records and documents “reasonably related to the loss” or certified copies thereof. Before submitting to an examination under oath, the insured must be informed of his or her right to counsel and that the insured's answers may be used against him or her in future proceedings, either civil or criminal. After agreement is reached, loss payment must be made within 5 working days. The insurer may deny the insured's claim but may still honor the valid claim of a mortgagee or contract for deed vendor. The insurer promises to notify the mortgagee of changes to the policy resulting in a substantial reduction of coverage.
In event of loss caused by fire, the insurer will not provide coverage for the insured who either before or after the loss concealed or misrepresented any material fact or circumstance relating to the insurance. In event of loss caused by a peril other than fire, no insured will be covered if any insured concealed or misrepresented any material fact or circumstance relating to the insurance.
A valuation clause has been added as condition S. In the event of a total loss, the amount of coverage A is agreed to represent the value of the dwelling, and no deductible applies to the loss to that building.
Payment of prejudgment interest has been removed from section II liability coverages and moved into section II, additional coverages, as a part of claims expense. Damages include loss caused by an intoxicated person to whom an insured furnished or permitted the consumption of alcohol leading to the intoxication. This is in compliance with Minnesota Statutes 340A.90.
The exclusion for motor vehicle liability provides coverage only for a vehicle used to service an insured's residence and only while being operated on the residence premises.
The medical payments to others exclusion for those eligible to receive workers compensation benefits includes residence employees paid $1,000 or more in any three-month period during the current calendar year or during the preceding calendar year. The insured is required by law (Minn. Statute 176.181, Subd.2) to purchase a standard workers compensation policy.
The bankruptcy of an insured condition is amended to state that bankruptcy, insolvency or dissolution of an insured will not relieve the insurer of its duties.
A cancellation during the sixty-day underwriting period requires a twenty-day notice. A midterm cancellation may be for reasons 1 (twenty days notice), 2, 6, and 26; a thirty day notice is required. Notice of nonrenewal requires a sixty-day notice.
Minnesota adds the provision that the insurer has no right of subrogation against any insured or against anyone else that has a policy with the same company, covering the same loss, provided the loss was not intentionally caused by such insureds.
If farmers personal liability HO 24 73 10 00 is attached the insurer has the right to examine and audit the insured's records with regard to that coverage.
Additional required endorsements are the HO 16 0901 09 or HO 16 10 01 09 water exclusion endorsement, and HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
Mississippi
The special provisions endorsement HO 01 23 05 11 amends the suit against us condition. The insured has three years after the date of loss to file suit, providing there has been full compliance with all of the terms of Section I. The form changes the mortgage clause to require that a thirty day notice of cancellation be given to any mortgagee. If the declarations show a loss payee for certain listed personal property, the definition of “insured” is amended to include the loss payee with respect to that property. The loss payee will be notified of cancellation or nonrenewal; ten days for nonpayment and thirty days in all other cases.
The thirty day notice of nonrenewal remains unchanged. During the sixty-day underwriting period, a thirty day notice is required. Midterm cancellation reasons are 1 (ten days required), 2, or 4.
Missouri
Missouri special provisions endorsement HO 01 24 05 11 amends the additional coverage for ordinance or law; pollutant losses are excluded even if the irritant or contaminant has a function with respect to the insured's property or business. This same wording precluding coverage is carried into the pollution exclusion (except for pollutants resulting from a coverage C named peril) and the section I ordinance or law exclusion.
The section I exclusion for intentional loss does not apply to an innocent insured victim of domestic violence, if the innocent insured files a police report, and completes a sworn affidavit indicating the cause of loss and pledging to cooperate in any criminal prosecution of the person committing the act that caused the loss. Payment to an innocent coinsured may be limited to that insured's ownership interest. The rights of that insured to recover against the perpetrator are transferred to the insurer to the extent of the payment (Section I and II subrogation paragraph.
A paragraph is added to D. loss settlement: if the insured fails to notify the insurer of his or her intent to replace the property within 180 days, the failure will not invalidate the claim unless the failure operates to prejudice the rights of the insurer.
The appraisal condition allows an appraisal if either party disagrees on the amount of the loss or the actual cash value. Suit against the insurer may be brought within ten years after the date of loss. Condition I. our option adds wording for loss by fire only. If the insured suffers a partial loss from fire, the insurer has the option of paying the actual cost of the damage or repairing the damage. The result must be that the damaged property “is returned to the same condition it was prior to the fire.”
Prejudgment interest is deleted from inclusion in section II damages, but is added as a claims expense in the additional coverages. Exclusions 9. and 10. are added to the section II exclusions. There is no coverage for negligent supervision or failure to supervise a person where an act results in excluded events in 6. communicable disease; 7. sexual molestation; corporal punishment or physical or mental abuse, or 8. controlled substance
Exclusion 10. states that there is no coverage for bodily injury or property damage arising out of any written or oral statement made by an insured or others on his behalf which is material to any financial transaction.
During the sixty-day underwriting period, notice of cancellation requires thirty days (except for nonpayment, which requires ten days). Midterm cancellation reasons are 1 (ten days required), 2, and 4.
Condition G death is amended. ″Insured″ includes an insured who is a member of the named insured's household at the time of death, but only while that person remains a resident. With respect to the named insured's property, ″insured″ includes the person having property temporary custody until appointment and qualification of a legal representative, or the grantee beneficiary designated under a duly recorded beneficiary for the earliest of: thirty days from the date of death; the date that alternative coverage is obtained on the property; or the end of the policy period.
Montana
Montana's special provisions endorsement HO 01 25 05 11 includes this prominent announcement: If the Declarations indicates that the policy provides medical payments, then a statement in bold type declares that they are available only for certain medical expenses for persons other than the named insured or regular residents of the named insured's household, except for residence employees and insured farm employees (when endorsement HO 24 73 is attached). Medical expenses exceeding the coverage limit may not be covered by the policy.
The loss payment condition is amended. The loss payment condition states that loss is payable within thirty days after the proof of loss is received. If the insurer requests additional information, payment or denial must be made within sixty days unless the insurer notifies the insured, or a claimant, or unless fraud is suspected and this is reported to the commissioner. There are two additional conditions. The first applies to scheduled property. In event of total loss or total damage, the loss is computed on the stated valuation with no deductions or offsets except for the deductible, if any. This clause does not affect the insurer's right to repair or replace the property. The second condition applies to real property. In event of a total loss to covered property, the amount of insurance will be considered the amount of loss and the measure of damages.
The coverage for medical payments to others states that ″reasonable″ means those expenses which are consistent with the treatment and standards for ″bodily injury.”
During the sixty days underwriting period, notice of cancellation for any reason except nonpayment of premium (twenty days required) requires a forty-five-day notice. After that, a midterm cancellation (forty-five-day notice required) may be for reasons 1 (twenty days), 2, 4, 18, 19, 20, or 23. Nonrenewal requires forty-five days. Notification of nonrenewal to the insured's insurance producer via electronic transfer meets the requirements of a mailed or delivered copy.
Conditions H. and I are added to the sections I and II conditions. Condition H. states that the provisions of the policy conform to Montana statute, and that these provisions control over those of any other state in which the insured resides on or after the policy's effective date. All provisions are amended to conform to Montana statute. Condition I states that if the insurer proposes to renew at less favorable terms or with a higher rate then a notice with the new terms or rate must be sent at least forty-five days prior to the expiration date of the policy.
Nebraska
Special provisions form HO 01 26 05 11 states that any provision using the term “actual cash value” has the following added: “In our determination of the actual cash value of Covered Property at the time of loss, an adjustment will be made for factors such as depreciation, deterioration and/or obsolescence.”
The special provisions endorsement amends the section I intentional loss exclusion. The exclusion does not apply to deny coverage to an innocent insured if the damage arises out of fire and the innocent insured did not contribute or cooperate in the loss, or if the loss arises out of the abuse of the innocent insured by a current or former family member or household member. “Abuse” means intentionally causing damage to property to intimidate or control the behavior of another, including a minor child. If the insurer pays an innocent coinsured, then the rights of the coinsured to recover are transferred to the insurer.
The appraisal condition requires that both insured and insurer agree in writing to the appraisal and to be bound by the results. The Nebraska form adds a valuation clause that spells out how the insurer will settle certain losses, in accordance with Nebraska's valued policy law. In the event that the home is a total loss from fire, tornado, windstorm, lightning, or explosion, the policy limit is to be paid to the insured provided there has been no criminal fault on the part of the insured.
Nebraska adds an exclusion of liability and medical payments to others coverage for an insured who inflicts, or directs another person to inflict, corporal punishment or sexual abuse which results in bodily injury or property damage. Sexual abuse includes physical or mental harassment or assault of a sexual nature.
The section I and II conditions are modified so that the policy is voided if the named insured or someone on the named insured's behalf made a material misrepresentation with intent to deceive, and the insurer relied on it to the insurer's injury. A breach of warranty or condition voids the policy if the breach exists at the time of a loss and contributes to the loss. Because of this, the concealment or fraud conditions in both sections I and II are deleted.
During the sixty-day underwriting period, the insurer may cancel for any reason, giving sixty days notice, except for nonpayment of premium, which requires ten days.
Midterm reasons for cancellation are 1 (ten days notice required), 2, 4, 9, 18, and 21. A sixty-day notice is required. Notice of nonrenewal requires a sixty-day notice. Both cancellation and nonrenewal notices require the reason for the action to be shown.
Nevada
Nevada form HO 01 27 05 11 changes the definition of ″you″ and ″your″ so that it refers to the named insured, spouse, or a party who has entered into a domestic partnership recognized under Nevada law with the named insured.
The form adds a sublimit of liability of $10,000 for statutorily imposed vicarious parental liability not otherwise excluded. This sublimit is within the coverage E limit of liability. However, this amendment to the limit of liability does not apply with respect to damages arising out of fungi when endorsements HO 04 26, HO 04 27, or HO 04 28 limited coverage for fungi are attached.
The cancellation provisions are amended. After the sixty-day underwriting period, midterm cancellation reasons are 1 (ten days notice required), 2, and 4; however, the substantial change in the risk must “warrant a substantial difference in the premium charged.” A thirty-day notice is required.
Condition G. death is modified to apply to the named insured, spouse, or a domestic partner.
New Hampshire
New Hampshire special provisions HO 01 28 05 08, modifying the 2000 homeowners, declares that “you” and “your” refer to the named insured and spouse, or a party who has entered into a civil union with the named insured as recognized under New Hampshire law, if resident of the same household.
The $2,500 special limit for theft of silver is deleted.
An intentional loss will not be covered, unless the loss involves fire. In that case, an insured who did not commit or conspire to commit an act resulting in fire will be covered, but only to the extent of the insured's legal interest.
The endorsement adds a valuation clause as section I condition S: total destruction of an insured building by fire or lightning results in the insured amount being paid, provided there was no criminal fault. In the event of a partial loss, the insured will be entitled to actual loss sustained, but no more than the policy amount. Buildings insured under a blanket form are not subject to this valuation clause.
Section II liability coverage is amended. Prejudgment interest is removed as a part of the amount of damages payable, and added as an additional coverage under claims expense (5.). The section II exclusion (6.) of bodily injury to any insured is deleted, thus allowing coverage for intrafamily lawsuits. The deletion also deletes the exclusion of coverage for any claim brought against an insured to share in or repay damages with another person obligated to pay damages because of bodily injury to an insured.
The condition for concealment or fraud is deleted from sections I and II, and added into the conditions applying to both sections. It has been modified so that coverage for the insured is precluded, rather than for one or more insureds who intentionally conceal or misrepresent a material fact.
The underwriting period is 90 days. During that time, ten days notice of cancellation is required. After that, ten days notice is required for nonpayment of premium. Other midterm cancellation reasons are 2, 5, 6 (the acts must be “grossly negligent”), or 24. A forty-five-day notice is required. Notice of nonrenewal requires a forty-five-day notice.
The death condition is amended to provide coverage for the civil union partner.
Following a covered loss, any undisputed incidental costs incurred by the insured that are directly related to the loss are payable by the insurer within fifteen days after receipt of proof of loss.
Additional required endorsements are the HO 16 0901 09 or HO 16 10 01 09 water exclusion endorsement, and HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
New Jersey
Special provisions form HO 01 29 05 11 declares that in the policy, “you” and “your” refer to the named insured, and spouse, or a party who has entered into a civil union with the named insured as recognized under New Jersey law, if resident of the same household.
The form modifies the section I exclusion for intentional loss: coverage is precluded for all insureds, but there is coverage for a coinsured who did not cooperate in or contribute to the creation of the loss provided the loss arose out of domestic violence. Payment for such loss is limited to the innocent insured's insurable interest. If the insurer pays an insured victim of domestic violence for a loss caused by domestic violence, the insured has a right to recover from the perpetrator.
The section I loss payment condition is amended; loss is payable within ten working days after reaching agreement with the insured, there is entry of a final judgment, or there is a filing of an appraisal award. The mortgage clause adds that the insurer will notify the mortgagee at least thirty days prior to the date cancellation or nonrenewal takes effect.
The policy states that the insurer will pay up to its limit of liability for damages for which an insured is legally liable; prejudgment interest as a part of this is deleted. Prejudgment interest is added as a claims expense.
The exclusion for expected or intended injury is modified to state that it applies with respect to all insureds, regardless of the severability of insurance clause. The exclusion for bodily injury or property damage arising out of a controlled substance is modified, so that the insured who has no knowledge of the involvement with a controlled substance is covered.
The maximum amount of coverage for damages because of vicarious liability is $10,000. Notice of cancellation or nonrenewal to the mortgagee requires thirty days. The New Jersey underwriting period is sixty days. During that time, if the insurer cancels for nonpayment of premium or for “the existence of a moral hazard” (as defined in the New Jersey code), a ten-day notice is required; all other reasons during the underwriting period require a thirty-day notice. After the underwriting period, cancellation reasons are 1 (ten-day notice required), 2, 3, 8 (including any federal or state law), 9, 16, 19, 20, and 21.
Additional reasons include: the existence of a moral hazard as defined by New Jersey code (ten days notice), lack of cooperation by the insured on loss control matters materially affecting the nature of the insured risk, material increase in exposure arising out of changes in statutory or case law subsequent to the issuance of the policy, failure to provide reasonable and necessary underwriting information to the insurer, agency termination, or any other reason in accordance with underwriting guidelines for cancellation. A thirty-day notice is required.
Notice of nonrenewal requires a thirty-day notice. Nonrenewal must be by certified mail, or first class mail if the insurer has obtained a date stamped proof of mailing showing the named insured and address. Any cancellation reason may also be used as a reason for nonrenewal.
However, under New Jersey law, any reason cannot be “arbitrary, capricious, or unfairly discriminatory” or without prior notice. The insurer must maintain the underwriting reasons or guidelines used to cancel or nonrenew and must furnish them to the insured on request. This provision does not apply to a policy in force less than sixty days.
If the insurer pays an insured victim of domestic violence for a loss caused by domestic violence, the insured has a right to recover from the perpetrator.
The special provisions adds that the policy provides at least the equivalent, or greater coverage, that that mandated by New Jersey law. The death condition is amended to include a spouse or party who has entered into a civil union with the named insured as recognized by New Jersey law.
New Mexico
New Mexico form HO 01 30 05 11 modifies the intentional loss exclusion. If an insured commits an act with the intent to cause a loss, the innocent insured victim of domestic abuse (as defined by New Mexico law) is protected if the damage is “proximately related to and in furtherance of domestic abuse.” In this case, the insurer is subrogated to the rights of the innocent coinsured to recover for any losses paid for property damage.
Loss settlement provisions are modified. Under forms HO 00 02, HO 00 03, and HO 00 05, losses to buildings under coverage B that are not used as residences are subject to the usual replacement or actual cash value (if the 80 percent insurance to value provision is not met) settlement. However, buildings insured under coverage A dwelling or coverage B other structures used as a residence are settled at not more than the limit of liability, the replacement cost of the damaged building, or the necessary amount actually spent. There is no reference to the 80 percent insurance to value provision.
If the cost to repair the damage is both more than 5 percent of the amount of insurance and more than $2,500, then no more than actual cash value is paid until the actual repair or replacement is complete. However, if the actual cash value amount is insufficient to begin repair, the necessary amount will be advanced by the insurer, provided the insured forwards evidence of an agreement with the party repairing or replacing the damage. The loss provisions governing loss under the HO 00 06 are similarly worded. If property is rebuilt at a new premises, replacement is limited to the cost that would have been incurred at the residence premises.
In event of a catastrophe declared by the superintendent of insurance and covered by the policy, a claim is payable within 90 days of the declaration of the catastrophe provided the insured reported the claim prior to the declaration of the catastrophe. If the claim is reported after the declaration, then the insurer has 90 days following the report of the loss. In both instances, the insurer may extend that time if fraud is suspected and further investigation is necessary.
New Mexico amends the cancellation provisions so that within the sixty-day underwriting period any cancellation requires only a ten-day notice, provided that the cancellation itself falls within the sixty-day period. A midterm cancellation for reasons 2 or 4 requires thirty days; a cancellation for nonpayment requires ten days notice.
New York
New York special provisions form HO 01 31 02 10 modifies the 2000 homeowners forms. It increases the additional coverage for credit card loss to $1,000. The section I perils are amended. For forms HO 00 02, HO 00 04 and HO 00 08, there is no vandalism coverage if the dwelling has been vacant for more than thirty consecutive days before the loss. For form HO 00 06, there is no coverage for vandalism if the building containing the residence premises has been vacant for more than thirty consecutive days. For form HO 00 02, the “accidental discharge” peril will not apply if the dwelling has been vacant for more than thirty consecutive days; similarly, for form HO 00 06 if the building has been vacant more than thirty consecutive days. In all the forms, where the ISO 2000 program broadened coverage for certain named perils to sixty days, New York has retained a thirty-day limitation. All references to an exception for coverage for mold, fungus or wet rot that is covered if hidden and caused by covered accidental discharge or overflow have been removed in all forms. The definition of “pollutant” is taken out of the open perils coverage for pollution loss resulting from a coverage C named peril.
The section I exclusion of coverage for an intentional loss is modified to preclude coverage only for “an 'insured' who commits or directs an act with the intent to cause a loss.”
The section I concealment or fraud condition is deleted; it is added in the conditions applicable to both section I property and section II liability. A condition is added that upon request the insurer will furnish the insured (or a representative) with a written estimate of damages to real property if the insurer has had one prepared.
Defense coverage of section II liability is amended to delete the statement that the insurer's duty to settle or defend ends when the amount paid for damages equals the limit of liability. The insurer must therefore continue to provide a defense after limits are tendered.
Exclusion E.1. is modified—coverage is excluded for bodily injury or property damage expected or intended by an “insured”; the exception for reasonable force to protect persons or property is deleted.
The section II liability conditions are amended. Notice of a claim may be given to the insurer by the insured, someone acting for the insured, or by any claimant. Notice may be given to the insurer or the insurer's agent so long as the agent is in the state of New York. Under coverage F medical payments, an injured person may give notice to the insurer or to the insurer's agent; again, the agent must be in New York.
The section I and II concealment or fraud condition precludes coverage for the insured who has intentionally concealed or misrepresented any material fact, or engaged in fraud relating to the insurance.
A fifteen-day notice is required for cancellation because of nonpayment of premium. There is a sixty-day underwriting period. During that time, cancellation may be for any reason; a thirty-day notice is required. A midterm cancellation (thirty days notice required) may be for reasons 1 (fifteen-day notice required), 2, 5, 6, 18, or 24. A thirty-day notice is required. In New York, if the insurer has the right to cancel, the insurer may elect instead to amend the limits of liability or reduce coverage not otherwise required by law. Notice of this action requires twenty days. The insurer may cancel, giving a twenty-day notice, if the insured property is subject to the Anti-Arson Application in accordance with New York Insurance Department Regulation 96, and the insured fails to return the completed, signed and affirmed application.
A nonrenewal notice or notice of amendment of policy limits or coverage must be in accordance with the laws of the state of New York, and requires a forty-five-day notice. If the home business endorsement is attached, the insurer cannot refuse to renew because of underwriting reasons relating to the endorsement; however, the insurer can renew the policy without the endorsement.
If farmers personal liability endorsement HO 24 73 is attached, the exclusion for pollution is modified to cover pollution that is “sudden and accidental.”
Additional required endorsements are the HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business and HO 24 93 05 02 Workers' Compensation. This endorsement notes that a covered residence employee is one engaged in regular employment of fewer than forty hours per week, or in casual employment. Coverage under the endorsement does not apply to an employee who is not required to be covered. The insurance applies to bodily injury which occurs during the policy period.
North Carolina
The North Carolina form HO 32 32 05 10 is promulgated by the North Carolina Rate Bureau, and includes ISO material.
The definition for “business” is amended to state that “business” includes any full or part-time activity of any kind engaged in for economic gain, including the use of any part of any premises for such purposes. A definition of “fungi” is added; it means “any type or form of fungus, including mold or mildew or any mycotoxins, spores, scents or byproducts produced or released by fungi.” (This does not include, under section II, any fungi that are intended for consumption, such as mushrooms.)
Two of the special limits of liability are modified. Theft of firearms and related equipment is limited to 10 percent of coverage C or a maximum of $10,000. Theft of silver-, gold-, or pewterware is limited to 25 percent of the coverage C limit or $10,000. Under property not covered, the word solely is removed from c.(2)(a) so that the insurer will cover motor vehicles used to service an insured's residence.
The additional coverage for debris removal is amended; the insurer will pay no more than $500 for debris removal of a fallen tree that damages a covered structure or blocks a drive or ramp for the handicapped. In form HO 00 06, debris removal for fallen trees applies only to trees the insured solely owns, or a neighbor's trees, that damage a covered structure. In form HO 00 08, the additional coverage for debris removal applies to the insured's trees felled by windstorm (no coverage for trees felled by the weight of ice, snow, or sleet).
The additional coverage for landlord's furnishings is amended in form HO 00 05: under accidental discharge, paragraph 2.(d) which eliminates coverage for mold, fungus, or wet rot unless hidden is replaced to exclude coverage if damage is caused by constant or repeated seepage or leakage over weeks, months, or years. However, an additional coverage of up to $5,000 for loss to property covered under coverages A, B, or C caused by “fungi” as defined that results from an insured peril is included.
For forms HO 00 03 and HO 00 05, an exclusion for “constant or repeated discharge, seepage or leakage” which applies to both dwelling and contents is added. The exclusion of coverage for loss caused by smog, rust, or other corrosion does not include dry rot among the causes.
The water damage exclusion has been amended to eliminate coverage for flood, which includes flash flood, surface water, waves, including tidal wave and tsunami, seiche (according to Meriam-Webster Online Dictionary, this is means an oscillation of the surface of a landlocked body of water [as a lake] that varies in period from a few minutes to several hours), tides, tidal water, overflow of any body of water, or spray from any of these, all whether or not driven by wind, including storm surge. The remaining part of the exclusion mirrors the ISO form, except it adds that the exclusion applies to escape, overflow, or discharge for any reason of water from a dam, etc.
The section I exclusion of intentional loss has been reworded to eliminate coverage only for the insured who committed or conspired to commit an act with the intent to cause a loss. An exclusion for fungi, wet or dry rot, or bacteria is added except with regard to the coverage provided under the additional coverages.
The duties after loss condition has been amended. If a state of disaster is declared for the state or within the state, and the covered property is within the designated area, then the sixty-day period for returning a proof of loss does not commence until the expiration of the proclamation, including all renewals of that proclamation, or forty-five days, whichever is later.
Loss settlement provision C.2.a. of the HO 00 02, HO 00 03, and HO 00 05 is modified, so that the insured can be reimbursed the amount actually spent to repair or replace the damaged building on the residence premises or some other premises within the state of North Carolina. Losses are payable within sixty days after the amount of the loss is finally determined.
The appraisal provision is modified to state that an appraisal is not to be used to interpret any policy provision or determine coverage. Suit can be brought against the insurer within three years after the date of loss.
The section II exclusion for coverage for a motor vehicle unless used solely to service an insured's residence is changed to “used to service an 'insured's' residence. The section II exclusion of liability for bodily injury or property damage expected by one or more insureds is modified. Excluded is injury or property damage intended by or “which may reasonably be expected to result from the intentional acts or omissions or criminal acts or omissions of one or more 'insured' persons.” The exclusion applies: (1) whether or not the perpetrator lacks the mental capacity to govern their own conduct; (2) whether or not the results are different from what was intended; or (3) whether or not the injury or damage is sustained to a different person or entity than intended. The exclusion applies regardless of whether or not one or more insured persons was actually charged with or convicted of a crime.
The section II exclusion for bodily injury or property damage arising out of or in connection with a business does not apply to an insured minor (as defined) engaged in a part-time, self-employed business. There is no coverage for any bodily injury or property damage arising out of any exposure to fungi, wet or dry rot, or bacteria.
The cancellation and nonrenewal provisions are those of the homeowners forms; they are not amended.
The final amended condition declares that the policy is issued in accordance with the laws of North Carolina, and covers property principally located in North Carolina.
An additional required endorsement is the HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
North Dakota
Form HO 01 33 05 11 modifies the section I exclusion for intentional loss. An innocent coinsured will be given coverage if a loss arises out of domestic violence and the perpetrator is criminally prosecuted for the act causing the loss. The insurer has the right to subrogate against the perpetrator. Payment is limited to the innocent insured's insurable interest, less any payment to a mortgagee.
In North Dakota, suit against the insurer may be brought within three years of a loss. A valuation clause is added to the section I conditions. In the event of a covered total loss to real property, the amount of insurance on the property is taken to be both the value of the property and amount of the loss, except in two circumstances. The first of these is loss to a covered other structure, which is settled on a replacement cost or actual cash value basis, depending on the policy. The second is if the loss occurs within 90 days after: (1) the policy's issuance; or (2) the limit of liability applying to the real property is increased by more than 25 percent at the insured's request. In that event, the insurer will pay no more than the least of the cost to repair or replace, the actual cash value, or the limit of liability.
In section II liability, prejudgment interest is deleted as a part of damages payable, and added to the additional coverages as a claims expense.
The underwriting period is sixty days. During that time, the insurer may cancel for any reason, giving ten days notice. A midterm cancellation may be for reasons 1 (ten days notice), 2, 4, 5, 6, 8, or 18. Except as noted, thirty days notice must be given. North Dakota adds additional reasons for cancellation that require only a 5 day notice. These are: at least 65 percent of rental units in a building are unoccupied; the insured or the passage of time has indicated that repairs will not be made following a loss; permanent repairs have not begun within sixty days following a fire loss; the building has been unoccupied sixty consecutive days, except for seasonal occupancy, or the building is in the course of repair; the building is in danger of collapse; the building has an outstanding order to vacate; fixed and salvageable items have been or are being removed without reasonable explanation; buildings on which there is knowledge the property is endangered and unprotected from possible arson with intent to defraud the insurer; failure to correct dangerous conditions or maintain the building in accordance with applicable law; failure to pay property taxes for more than one year; or failure to furnish heat, water, sewer service or public lighting for thirty consecutive days or more.
Nonrenewal requires a forty-five-day notice.
Ohio
Ohio's special provisions HO 01 34 05 11 amends the cancellation provisions. The underwriting period is sixty days. During that time, cancellation may be for any reason; thirty days notice is required (ten days for nonpayment of premium). After the underwriting period, the policy may be cancelled by giving ten days notice for reasons 1, 2, or 22, and by giving thirty days notice for reason 4.
Oklahoma
The special provisions endorsement HO 01 35 03 01, modifying the 2000 forms, amends the loss settlement provisions. In all forms except the HO 00 04 and HO 00 06, roof surfacing is added as an item covered at actual cash value.
The appraisal provision is modified—only the party demanding the appraisal is bound by the results. Covered losses are payable with sixty days after agreement is reached, or within thirty days if there is an entry of final judgment.
Following receipt of proof of loss, the insurer must submit a written rejection or offer of settlement within forty-five days.
The cancellation provisions are not modified.
Oklahoma Notice HO 03 forty-five states that any person who knowingly and with intent to injure or defraud an insurer is guilty of a felony.
Additional required endorsements are the HO 16 0901 09 or HO 16 10 01 09 water exclusion endorsement, and HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
Oregon
Oregon special provisions form HO 01 36 01 08 applies to the 2000 forms. It changes the definition of “you” and “your” to include the spouse, or a party who has entered into a domestic partnership, as recognized by Oregon law, with the named insured, if resident of the same household. This party is also recognized in condition G. death. The form amends the special limits of liability for personal property. The $2,500 for property on the residence premises for property primarily used in business does not apply to property used in a home day care business. The limit of $500 for property primarily used in a business and away from the premises does not apply to property used in a home day care business or to electronic apparatus as described. In fact, loss to all property primarily used with a home day care business is excluded, except when Oregon Home Day Care Coverage Endorsement HO 05 97 is attached.
The loss settlement provisions are modified. The insured has 90 days following the insurer's request to furnish a proof of loss. If the insured does not do so, the mortgagee may furnish this. The appraisal provision is modified to state that both parties must agree to the process, and must agree to be bound by the results. The mortgage clause is amended to comply with Oregon law. The concealment or fraud clause is deleted from the section I (and section II) conditions, and is added to the conditions applying to both sections I and II (discussed later).
Prejudgment interest is deleted from damages payable in the section II liability coverage. But, unlike other state provisions where this coverage is added as an additional coverage under claims expense, there is no further mention in the Oregon endorsement. Presumably, therefore, the amount is not payable.
Oregon retains the section I and II conditions clause that voids the entire policy if before or after a loss the insured has willfully concealed or misrepresented a material fact or circumstance regarding the insurance. However, any statements arising from an error in the application cannot be used to defend denial of a claim unless the statements are in a written application attached to the policy when issued. Further, the insurer must demonstrate the representations are material and that the insurer relied on them.
There is a sixty-day underwriting period. During that time, the insurer may cancel for any reason except for the sole reason that a home day care business is operated on the premises. Thirty days notice is required. A midterm cancellation may be for reasons 1 (ten days notice), 2, or 4; a thirty-day notice is required. Again, however, cancellation cannot be solely for the reason a home day care business is being operated on the premises. Nonrenewal notice must be sent thirty days prior to the renewal date; operation of a home day care business cannot be the sole reason for the nonrenewal.
Oregon also requires the HO 16 09 01 09 or HO 16 10 01 09 water exclusion endorsement, and HO 05 96 05 02—Oregon No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
Pennsylvania
Pennsylvania previously contained any amended provisions or conditions in the policy forms themselves. (Pennsylvania still maintains its own forms, such as the HO 00 03 05 01, rather than the standard HO 00 03 10 00.) Now, there is state special provisions endorsement HO 01 37 06 07. This form adds a definition of actual cash value: “Actual cash value is calculated as the amount it would cost to repair or replace covered property, at the time of loss or damage, with material of like kind and quality, subject to a deduction for deterioration, depreciation and obsolescence. Actual cash value applies to valuation of covered property regardless of whether that property has sustained partial or total loss or damage. The actual cash value of the los or damaged property may be significantly less than its replacement cost.”
The intentional loss exclusion is modified so that there is coverage for an innocent insured, if the loss arises out of abuse to that insured by another insured.
The homeowners forms contain the following changes. The additional coverage for debris removal includes coverage for removal of felled trees, provided the trees are felled by a covered peril and damage a covered structure or windstorm, hail, or weight of ice, snow or sleet damages a covered structure and the Pennsylvania governor declares the area in which the residence premises is located a disaster area because of the weather conditions.
The loss settlement provisions are modified. The insurer has the option of repairing or replacing the damaged property with like property provided the insured receives written notice within fifteen working days.
Prejudgment interest is deleted as a part of damages payable in section II liability, and added as an additional coverage for claims expense. Funeral expenses are not included as a part of medical payments to others.
The underwriting period is sixty days. Cancellation during that time, which may be for any reason, requires a thirty-day notice. A midterm cancellation reason may: 1, 2, 3, 4, 6, or 23. A thirty-day notice is required. A nonrenewal may only be for one of the mid-term cancellation reasons.
Additional required endorsements are the HO 16 0901 09 or HO 16 10 01 09 water exclusion endorsement, and HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business. The state also mandates that Pennsylvania Notice IL 09 10 07 02 be attached, which states that an insurer may provide surveys, consultation, or inspections; however, the insurer is not to be held liable for damages as a result of any act or omission of persons furnishing these services.
Puerto Rico
Form HO 01 58 05 02 deletes the additional coverage for fire department service charge. The appraisal condition is deleted. The form applies to the 2000 homeowners.
Section II liability coverage adds that a sublimit of $10,000 applies to any statutorily imposed vicarious liability.
Any valid reason may be used to cancel a policy during the sixty-day underwriting period. Ten days notice must be given. A midterm cancellation may be for reasons 1 (ten days notice), 2, 4, 6 (but the acts must be willful and negligent), and 20. A thirty-day notice is required. A thirty-day notice is also required for nonrenewal.
Puerto Rico also requires endorsement HO 03 44 05 04, mandatory premium and coverage conditions endorsement. The endorsement describes different premium payment arrangements and their possible effects on cancellation.
Rhode Island
Rhode Island special provisions form HO 01 38 02 05 modifies the 2000 forms. It changes the section I conditions mortgagee clause to state that any claim payable under coverages A or B equal to or in excess of $3,500 will be paid to insured and mortgagee as interests appear. If the claim equals less than $3,500, the claim will be paid to the insured unless no liability exists as to the mortgagor.
No suit can be brought for recovery of any claim for direct loss or damage by fire or lightning unless the provisions have been complied with, and the action is begun within two years after the date of loss. Presumably, therefore, a suit for any other loss can be brought at any time. Losses are payable within thirty days after the insurer reaches agreement with the insured. Condition S. is added—there is no coverage for loss caused by fire or lightning while an insured building is vacant beyond a period of thirty consecutive days, whether or not the building is intended for occupancy. However, the thirty days must be subsequent to the issuance of an order by the local building inspector in accordance with Rhode Island law.
In the section II liability coverages, prejudgment interest is removed from the damages for which the insured is legally liable. Prejudgment interest is additional coverage A.5.a. and A.5.b. The insurer is liable for prejudgment interest on: (1) the entire judgment if the insurer rejects a written settlement offer by the plaintiff that is equal to or less than the applicable limit of liability; or (2) that part of the judgment the insurer pays.
There is an additional section II condition. The insurer is directly liable for the damages to the injured party to which the insurance applies. In event of that party's death, the insurer is obligated to the party entitled to sue as a result of the injured party's death.
During the sixty-day underwriting period, cancellation may take place for any reason, provided thirty days notice is given. Nonpayment of premium requires ten days notice. A midterm cancellation requiring thirty days notice may be for reasons 2, 4, 10, 11 (except that the insured has sixty days to begin repairs following payment), 12, 13, or 14. Nonrenewal requires thirty days notice. The subrogation clause is modified. If a loss is successfully subrogated, the insurer must first reimburse the insured the deductible portion less the prorated share of any subrogation expenses, and then may retain the recovered amount.
Additional required endorsements are the HO 16 0901 09 or HO 16 10 01 09 water exclusion endorsement, and HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
South Carolina
Two of the section I conditions are modified by special provisions form HO 01 39 02 08, applying to the 2000 forms. A suit against the insurer may be brought within three years after the date of loss. A valuation clause is added to the section I conditions: the limit of liability as stated in coverage A (except for forms HO 00 04 and HO 00 06) is considered to be the value of the dwelling with regard to the perils of fire and lightning.
Except for nonpayment of premium, which requires a ten-day notice, any cancellation is subject to a thirty-day notice. Reasons are 1, 2, 4, 19, and 21. The underwriting period is 90 days. Notice of nonrenewal requires a thirty-day notice. Both cancellation and nonrenewal notices must contain the precise reason for the cancellation or nonrenewal.
Additional required endorsements are the HO 16 0901 09 or HO 16 10 01 09 water exclusion endorsement, and HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
South Dakota
South Dakota form HO 01 40 05 11 amends the section I conditions. The appraisal provision provides that both parties must agree to the appraisal procedure, although the outcome is not binding on either party. A suit against the insurer may be brought within six years after the loss.
South Dakota adds a valuation clause. The amount of insurance on the insured real property is considered to be the true value of the property if the property is wholly destroyed by fire, tornado, or lightning. This provision does not apply to a fire loss: (1) which occurs less than 90 days after the policy was initially issued; or (2) the limit of liability was increased at the insured's request by 25 percent or more less than 90 days after the policy's issuance. However, if the increase was in accordance with an inflation adjustment the provision will apply. The provision will apply as well if the insured is upgrading coverage to replacement cost basis, provided that the insurer agrees in writing that the policy will be written on a valued basis. The valued basis does not apply to covered other structures unless a value is specifically stated in the declarations, or in various endorsements insuring other structures. (See the special provisions endorsement for a comprehensive list.) If the valuation clause does not apply to an other structure, then a claim will be settled on replacement cost or ACV, according to the applicable policy provisions. If there is other insurance on the property, then the insurer pays on a pro rata basis. Property in the process of being newly constructed for a residence will be valued, and a claim settled, according to the terms and conditions of the policy for valuation of the portion of completed construction at the time of the fire, tornado, or lightning loss.
The cancellation provisions allow twenty days for notice if the premium is not paid. A twenty-day notice is also required during the sixty-day underwriting period. A midterm cancellation may be for reasons 1 (twenty days notice), 2, 3, 4, 6, 8, or 9; a thirty-day notice is required.
Tennessee
Tennessee's special provisions endorsement HO 01 41 05 11 contains only one added condition, and that is that the rights and obligations as outlined in the mortgage clause apply to any party who is not an insured but who has an insurable interest in the residence premises.
Texas
There are two added definitions in form HO 01 42 06 04, which modifies the 2000 homeowners. First, a definition of “fungi”—”any type or form of fungus, including mold or mildew, and any mycotoxins, spores, scents or by-products produced or released by fungi.” Second, there is a definition of “business day”—”a day other than a Saturday, Sunday or holiday recognized by the state of Texas.”
Throughout the property coverages at any time the exclusion for hidden mold, fungus, or wet rot (see, for example, A.2.c.(5) in the 2000 edition HO 00 03) appears, it is replaced with an exclusion for constant or repeated seepage or leakage of water, including condensation, humidity, moisture, or vapor. In all forms except the HO 00 08, ordinance or law coverage applies to repair, replacement or demolition to property located in an areas eligible for coverage and as required by the Texas Windstorm Insurance Association following a windstorm disaster.
The section I exclusion for intentional loss is modified to provide coverage for an innocent coinsured provided the coinsured has filed a police report and cooperated with law enforcement investigation and prosecution relating to any other insured causing the loss. An exclusion for “fungi” is added; an exception provides coverage if it results from accidental discharge covered by the policy. A hidden loss of this type must be reported within thirty days of its being detected.
The property conditions are modified substantially. First, in event of a total loss by fire, the insurance policy is held to be a liquidated demand for the full amount of the policy, except for personal property. Following a loss, the insured has 91 days after the insurer's request to send the proof of loss. If replacement cost coverage is being claimed, the proof must include the replacement cost of the dwelling. A set of duties for the insurer following a loss is listed. The insurer has fifteen days to acknowledge receipt of the claim, begin any investigation, or request any additional information. Then the insurer has fifteen “business days” to notify the insured whether the claim will be paid, denied, or still more information is needed. If the insurer suspects arson, there is an additional fifteen days. The claim must either be approved or denied within forty-five days after requesting more time.
The loss settlement provisions are modified. A loss to jewelry is settled at replacement cost at the time of loss. Loss to a jewelry pair or set is settled at replacement cost at the time of loss.
The insured has two years and one day after a cause of action accrues to bring suit. The insurer has 5 “business days” to pay an agreed-upon claim. But if a declared catastrophe or major natural disaster occurs, claim handling deadlines are extended an additional fifteen days.
The mortgagee clause is revised. If the mortgagee cancels the policy because of a foreclosure, the mortgagee must credit any unearned premium against any deficiency owed by the borrower; any return premium not so credited must be returned to the borrower.
Because of Texas' residential community property law, the policy continues to protect the interest of each spouse, unless excluded by endorsement, until the policy expires or is cancelled.
Section II exclusions 1., 6., and 7. are modified. In 1., the language precluding coverage even if the bodily injury or property damage is of a different kind or sustained by another person (paragraphs 1.a. and b.) are removed. The exclusion for communicable disease applies only to transmission by sexual contact. In exclusion 7., “abuse” is defined as “an act which is committed with the intent to cause harm.”
The underwriting period is sixty days, and cancellation may be for reasons 1 (ten days), 2 (thirty days; ten days for claim fraud), 3 (ten days), 18 (ten days), for an unacceptable required inspection report completed by an authorized inspection and within the allotted time frame (thirty days). Following sixty days, the policy may be cancelled for reasons 1, 2, 6, or 18; ten days notice is required.
Nonrenewal cannot be based on claims resulting from natural causes, or because the insured is an elected official. If the insured has filed three or more claims in any three year period that do not result from natural causes, the insurer can nonrenew the policy. However, following a second claim in a period of less than three years, the insurer must notify the insured that the policy might not be renewed if a third claim is filed; if the insurer fails to do this, then the insurer must renew the policy. Thirty days notice is required.
Additional required endorsements are the HO 16 0901 09 or HO 16 10 01 09 water exclusion endorsement, and HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
Utah
Form HO 01 43 05 11 amends the section I conditions, duties after loss. The insured may give prompt notice to the insurer or to his or her agent; one way of doing this is by mailing the notice through prepaid first class mail. The proof of loss may also be mailed (prepaid) via first class United States mail. Failure to submit proof of loss within sixty days following the loss will not invalidate the claim, if the insured demonstrates it was not reasonably possible to do so, and that the proof was submitted as soon as reasonably possible. Similar wording appears in the section II conditions—duties after loss.
The insured has up to three years following the date of loss to bring suit. A loss is payable within thirty days after agreement is reached.
The concealment or fraud condition is amended: the provision eliminates coverage if an insured has concealed or misrepresented any fact upon which the insurer has relied, or concealed or misrepresented any fact and that fact contributes to a loss.
Section II watercraft liability is not covered if arising out of any watercraft owned by an insured for which security is required under the Utah Financial Responsibility Motorboat Owners and Operators Act.
The section II exclusion for bodily injury or property damage arising out of a controlled substance is amended to delete the reference to the Federal Food and Drug Law at 21 U.S.C.A. Sections 811 and 812.
The condition “duties after occurrence” is amended similarly to the duties after loss in the property conditions.
Cancellation for any reason during the sixty-day underwriting period requires a ten-day notice. A midterm cancellation, with a thirty-day notice required, may be for reasons 1 (ten days required), 2, 4, or 19. A policy written for more than one year or for an indefinite term may be cancelled at any reason at anniversary with a thirty-day notice. A nonrenewal requires a thirty-day notice.
Vermont
Vermont special provisions form HO 01 44 05 11 amends the lead-in to the definitions. “You” and “your” now refer to the named insured, spouse, or a party who has entered into a civil union under Vermont law with the named insured, if a resident of the same household. The definitions of aircraft liability, hovercraft liability, motor vehicle liability, and watercraft liability are amended. “Failure to supervise” is an excluded cause of loss only with respect to motor vehicle liability. The definition of “occurrence” is amended; the wording that the same general harmful conditions which result, during the policy period, is altered to eliminate ″during the policy period.”
The exclusion for loss caused by freezing (peril 14. in form HO 00 02; exclusion A.2.c.(1) and B.14 in form HO 00 03; A.2.a in the HO 00 05) is modified to apply “only while the dwelling is vacant, unoccupied or being constructed” unless reasonable care has been used to maintain heat or shut off the water, providing there is no automatic fire protective device. The named peril of freezing in forms HO 00 04 and HO 00 06 (and coverage C in form HO 00 03) is also modified to provide coverage only if the insured has used reasonable care to maintain heat or shut off water (unless there is a sprinkler system) while the dwelling is unoccupied.
The section I exclusion of coverage for intentional loss is modified to exclude coverage only for an insured who commits or directs an act with the intent to cause a loss. Other insureds not committing or intending to commit a loss are covered.
Four section I conditions are modified. First, the suit against us provision notes that the insured's right to bring suit is not conditioned upon compliance with the appraisal provisions. Second, losses are payable within ten working days after receipt of the proof of loss and an agreement is reached, there is entry of a final judgment, or there is the filing of an appraisal award. Third, in event of cancellation the insurer must notify the mortgagee: fifteen days for nonpayment of premium or substantial increase in hazard (except after sixty days approval from the insurance commissioner must be obtained to cancel for the substantial increase in hazard); or forty-five days for fraud or material misrepresentation regarding presentation of a claim. A nonrenewal requires forty-five days notice to the mortgagee. Fourth, the concealment or fraud clause is deleted from section I.
The section II exclusion for bodily injury or property damage which is expected or intended is amended to exclude coverage even if the resulting bodily injury or property damage “is of a different kind, quality or degree than a reasonable person would have expected or intended, or is sustained by a different person, entity, or property than a reasonable person would have expected or intended.” The exclusion for sexual molestation, physical or mental abuse is amended. The exclusion applies to sexual molestation of any person, or to corporal punishment or physical or mental abuse inflicted upon an insured by an insured. Exclusion F.6. is deleted in all forms. This exclusion eliminates coverage for bodily injury to the named insured or any insured as defined.
The section II conditions are modified. The concealment or fraud clause is deleted. Two conditions are added: one, if a suit against the insured is continued by the insurer after a judgment is rendered against the insured, no limitation of liability is valid unless the insured agrees to the continuation; and two, the insured's payment of any judgment for any of the insurer's liability does not bar the insured from suit against the insurer.
The section I and II concealment or fraud condition is amended so that there is no coverage for the insured who has intentionally concealed or misrepresented any material facts or circumstances relating to the insurance. The death condition is modified to include a party, if resident of the named insured's household, who has entered into a civil union under Vermont law with the person named in the declarations.
During the sixty-day underwriting period, the insurer may cancel for any reason, giving a forty-five-day notice. Nonpayment of premium requires a fifteen-day notice. After sixty days, the policy may be cancelled at any time for nonpayment of premium or substantial increase in hazard, provided that, in the case of the increase in hazard, the insurer has secured approval from the commissioner of insurance. A fifteen-day notice is required. For reason 2, a forty-five-day notice is required. A notice of nonrenewal requires a forty-five-day notice.
If the insurer elects to renew the policy, forty-five days prior to renewal the intent to renew with the renewal premium must be sent to the insured. If this condition is not met, the insured is granted renewal coverage at the premium in effect on the expiration date. This continues for forty-five days after the insurer confirms renewal coverage and premium, unless the insured accepts the renewal policy, in which case this provision does not apply.
Virginia
The special provisions endorsement HO 01 45 07 09 modifies the 1991 edition of the homeowners forms. Coverage C personal property is amended. The personal property coverage for a residence employee has been expanded to include while the property is in any residence occupied by an insured, or is in the control of the employee and he or she is “engaged in the service of an insured.”
The special limits of liability of coverage C have been changed as follows: in item 1. medals are deleted; in item 2. personal records are deleted; in item 5. the limit for loss by theft of jewelry is increased to $1,500; in items 7., 8., 9., and 11. the sublimits for theft of silverware, on business property (both on and off-premises), and on electronic apparatus not in a motor vehicle are deleted. The property not covered section in the Virginia form amends the sections on motor vehicles, aircraft, property of roomers, and business property. The Virginia form does not exclude devices for the transmitting, etc. of pictures (only sound). The only exception to aircraft is model (rather than model or hobby) aircraft. Property of roomers is expanded to include as not covered the property of residence employees (this property is covered under coverage C). The form excludes the following classes of business property: in storage or held as a sample or for delivery; pertaining to a business that is conducted on the residence premises; and all such property away from the residence premises.
Coverage D, loss of use, is amended to show that no deductible applies.
Debris removal is modified. There is no mention of volcanic ash. Debris removal of fallen trees that damage covered property is included in the limit applying to the covered property, with an additional 5 percent available. The additional coverage of collapse is deleted entirely; however, the peril of collapse is added as a covered cause of loss for personal property in forms HO 00 03, HO 00 04, and HO 00 06. The exclusion of collapse as a peril does not apply to coverages A and B on the HO 00 03.
In forms HO 00 02, HO 00 03, HO 00 04, and HO 00 06 the exclusion of theft from that part of the residence premises the insured rents to others is replaced with a lengthier limitation. Where the ISO policy excludes theft from “that part of a residence premises rented by an insured to other than an 'insured',” the Virginia form is much more specific. The limitation applies while “the portion of the residence premises customarily occupied exclusively by an 'insured' is rented to others.”
Theft caused by a “tenant, members of the tenant's household, or the tenant's employees” is not covered. Theft of any of the following items is not covered: money, bank notes, bullion, gold, goldware, gold-plated ware, silver, silverware, silver-plated ware, pewterware, platinum, and coins; securities, accounts, deeds, evidences of debt, letters of credit, notes other than bank notes, manuscripts, passports, tickets, and stamps; and jewelry, watches, furs, precious and semi-precious stones.
In forms HO 00 02, HO 00 03, and HO 00 04 the limitation of coverage for the peril of windstorm and hail to watercraft, etc. does not apply to rowboats and canoes that are on the residence premises. Form HO 00 06 deletes the exclusion for vandalism coverage if the unit has been vacant.
The exclusion of coverage for an intentionally caused loss is modified to exclude coverage for the particular insured who commits or directs the act. The exclusions for weather conditions, acts or decisions, or faulty or inadequate construction or maintenance are added to the HO 00 02, HO 00 04, and HO 00 06.
The section I condition that requires an insured to submit to an examination under oath while not in the presence of another insured is not in the Virginia form. A modification of the loss settlement provisions allows the insured to make an initial claim for an actual cash value settlement, and within six months of the later of the last date the insured received an ACV payment, or the date of entry of a court order declaring the insured's right to replacement cost, make a claim for replacement cost. The appraisal condition stipulates that if the demand for an appraisal is made by the insurer, then the insurer must bear the cost of the insured's appraiser as well as that of the insurer. The insurer retains the right to deny the claim. An insured may bring suit against an insurer within two years after a loss. Losses must be settled within thirty days of reaching an agreement. A mortgagee must receive a thirty-day notice of nonrenewal. Payment of a loss does not reduce the amount of insurance.
In section II liability, prejudgment interest is deleted as a part of the damages for which an insured may be legally liable. It is not added as a claims expense. The section II exception to the exclusion of motor vehicles (f.(2) and (4)c.) is changed so that it applies to nonowned golf carts or snowmobiles or to any such vehicles that the insured owns, if they are on an insured location. Liability arising out of a motor vehicle in dead storage is covered; the wording “not subject to motor vehicle registration” is removed.
The exception to the watercraft exclusion of nonowned watercraft powered by inboard or inboard-outdrive motors of 50 horsepower or less is changed so that both owned and nonowned watercraft meeting the motor specification are covered.
Added as covered section II claim expenses are premiums on bonds to release attachments and the cost of bail bonds an insured incurs because of an automobile accident. The $50 per day loss of earnings includes loss of “vacation time or other benefit loss.”
The additional coverage of damage to property of others is amended to specifically remove snowmobiles, golf carts, and other motorized land conveyances not subject to motor vehicle registration and designed for off-road use from the motor vehicle exclusion.
The Virginia form changes two section II conditions. The suit against us provision states that if a plaintiff has secured a judgment against the insured, that plaintiff is entitled to recovery under the policy. The other insurance provision calls for the policy to contribute on a pro-rata basis with other valid and collectible insurance. However, the policy is still excess over other policies covering motor vehicles and watercraft.
Virginia also changes some of the conditions that apply to sections I and II. The liberalization clause calls for any broadened coverage to apply immediately, regardless of when that change takes place during the policy period.
During the 90 day underwriting period, the policy may be cancelled for any reason. A midterm cancellation is allowed only for the following reasons: 1 (ten-day notice), 2, 5, 6, and 24. A thirty-day notice is required. If the policy is endorsed with any of the following, the notice must be fifteen days for nonpayment and forty-five days for other reasons: HO 23 42, HO 24 43, HO 24 71, and HO 23 39. Likewise, nonrenewal requires a forty-five-day notice if one of those forms applies. The insurer is required to send notice of cancellation or nonrenewal by registered or certified mail, and obtain a written receipt from the U. S. Postal Service.
Virginia also requires endorsement HO 23 37 04 91 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
Virgin Islands
The special provisions form for the Virgin Islands is HO 01 50 03 08. The form amends the appraisal provision. Both parties must agree to the appraisal process. Loss is payable thirty days after receipt of the proof of loss and the insurer reaches an agreement with the insured, there is an entry of a final judgment, or there is a filing of an appraisal award.
The concealment or fraud condition in both sections I and II allows the insurer to void the policy if, whether before or after a loss, an insured has intentionally concealed or misrepresented any material fact or circumstance; engaged in fraudulent conduct; or made false statements regarding the insurance. The provision does not apply to any misrepresentation or warranty in negotiation of the policy unless made with intent to deceive.
The underwriting period is sixty days. Cancellation reasons are 1, 2, (fifteen days notice) or 4 (thirty days notice). Cancellation at anniversary can be for any reason. Nonrenewal requires thirty days notice. Cancellation or nonrenewal notices will also be sent to any mortgagee or other person shown on the policy to have an interest. If the insurer cancels, a refund will be made on a pro rata basis. If the first named insured cancels, a refund may be less than pro rata (sometimes referred to as a short rate cancellation).
Additional required endorsements are the HO 16 0901 09 or HO 16 10 01 09 water exclusion endorsement, and HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
Washington
The State of Washington, through the Washington Surveying and Rating Bureau, promulgates its own forms. The current homeowners edition date is May, 2008. The forms incorporate ISO 2000 homeowners material, but are modified. There is no special provisions form; all modifications are contained within the homeowners forms themselves.
However, required forms are the HO 46 09 03 09 or HO 46 10 03 09 Water Exclusion Endorsement—Washington, and the HO 04 96 10 10 No Section II – Liability Coverages for Home Day Care Business Limited Section I – Property Coverages for Home Day Care Business.
West Virginia
West Virginia special provisions HO 01 47 05 11 modifies the loss settlement condition to reflect the West Virginia valued policy law, in that a total loss to real property situated in West Virginia is settled at policy limits. In event of a partial loss to real property, payment will be the total amount of the partial loss, but not to exceed the limit of liability applying to the real property. Loss to personal property is settled at actual cash value but not exceeding the amount necessary to repair or replace. The loss payment condition is amended by removing all reference to a time limit for settlement. However, condition H. is added to the sections I and II conditions calling for payment by the insurer within fifteen working days of reaching an agreement, or date of the performance by the claimant of any condition set by such agreement. All losses are adjusted with the named insured, unless some other person is named in the policy or is legally entitled to receive payment. The appraisal condition calls for a written demand of either party for an appraisal.
During the sixty-day underwriting period, the insurer may cancel for any reason; a ten-day notice is required. Ten days notice is required for nonpayment of premium. Following the underwriting period, the insurer may cancel with a thirty-day notice for the following reasons: 2, 4, 5, 6, 8, 18, 19, 29, and 30. A nonrenewal notice must contain the reason for nonrenewal. After the policy has been in force for four years, the insurer may nonrenew only for these reasons which would also allow cancellation: 2, 3, 4, 5, 6, 8, 18, 19, 29, and 30. The other permissible reasons for nonrenewal are any other “valid underwriting reasons which involve a substantial increase in the risk,” or payment of two or more claims within a period of thirty-six months, each of which occurred after July 1, 2005.
West Virginia has an alternative nonrenewal provision IL 02 81 04 89 deletes the statement that ″proof of mailing will be sufficient proof of notice″ in the cancellation condition.
Wisconsin
Wisconsin form HO 01 48 05 11 amends the definition of a motor vehicle. A motor vehicle means “a self-propelled land or amphibious vehicle, whether or not it is operated on rails, skis, sleds, tracks, or treads; or any trailer or semitrailer which is being carried on towed by or hitched for towing by [such a vehicle].”
Section I exclusion 1.a. in the HO 00 02, 00 06, 00 08, and exclusion A.1.a. in the HO 00 03 and HO 00 05 does not apply to both total and constructive total losses to the dwelling building only. The exclusion of intentional loss is slightly reworded to preclude coverage for an insured who commits or directs the act causing the loss.
Four of the section I conditions are changed. First, the insured is required to give notice of loss as soon as reasonably possible to the insurer or to the agent. Losses are payable within thirty days of reaching agreement. The concealment or fraud condition states that the insurer must rely on the misrepresented fact and such misrepresentation must be either “material or made with intent to deceive,” or the misrepresentation must contribute to the loss. The other insurance and service agreement condition is modified so that if both the insurance and service agreement state they are excess, then the insurer pays only the proportion of the loss that the limit of liability that applies under this policy bears to the total amount of insurance.
The section II concealment or fraud condition is amended similarly to the section I condition. The suit against us condition does not apply in Wisconsin.
During the sixty-day underwriting period the insurer may cancel for any reason upon giving a ten-day notice. The midterm cancellation condition is amended by limiting cancellation to the following: 1 (ten days required), 2, 4, and 19. Thirty days notice is required. Nonrenewal requires a sixty-day notice. If a policy has been written for a period of more than one year or for an indefinite term, the insurer can cancel for any reason at anniversary with a sixty-day notice. This is in addition to the reasons already noted. Nonrenewal must include the reason and requires a sixty-day notice.
Subrogation allows the insurer to collect from the negligent party only after the insured is fully compensated.
Three conditions are added. The first states that knowledge by an agent of any act that “breaches a condition of this policy” will be considered as knowledge to the insurer if the action is known by the agent at the time of application or issuance, or becomes known thereafter. However, such knowledge will not “defeat a recovery.” The second added condition makes it clear that any provision of the policy in conflict with Wisconsin law is changed to conform to that law. The third condition states that failure to comply with a policy condition before a loss and “no breach of a promissory warranty” affects the insurer's obligations, unless that failure or breach increases the risk at the time of the loss or contributes to the loss. This condition does not apply to failure to pay the premium.
Wyoming
Wyoming form HO 01 49 05 11 changes additional coverage 6., credit cards. In Wyoming the insurer's duty to defend does not end with the tender of policy limits prior to judgment or settlement.
The suit against us provision is modified; action must be brought within four years after discovery of the loss. Claims must either be paid or rejected within forty-five days of “receipt of the claim and supporting bills.”
The cancellation and nonrenewal provisions are amended. The insurer can cancel for any reason during the sixty-day underwriting period, giving ten days notice. After the sixty-day underwriting period, cancellation reasons are: 1 (ten days notice), 2 (forty-five days notice), and 19 (forty-five days notice). Nonrenewal requires a forty-five-day notice.
Endorsement HO 23 26 05 11 is required. It amends the loss settlement provision to state that any amount payable for loss under coverages A and B will be reduced if the damaged property was previously damaged, and payment was made for that damage but the insured did not have it repaired or replaced. The amount payable for the new damage will be reduced by the amount previously paid for the previous damage.
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