Comparison of Homeowners Choice Flood Policy and NFIP Dwelling Form
August 14, 2017
With the NFIP due to expire in September, and the past history of flood catastrophes and hurricanes, there is more and more interest in the private market trying to insure flood. It is a difficult subject since many homes in one area could be affected at the same time draining resources including available claim adjusters, builders and building supplies. But there are private flood policies. Some follow closely with the NFIP form, and others do not. This discussion looks at the Homeowners Choice Property & Casualty Insurance Company Inc. form (HCI) compared to the NFIP. It started out as a Florida policy only but is now expanding into Arkansas, California, Maryland, North Carolina, New Jersey, Ohio, Pennsylvania, South Carolina and Texas. As this policy is very similar to the NFIP dwelling form, the below chart identifies where the forms vary from each other.
If the policy sections are identical there is nothing entered. If one policy has a term or coverage that the other one does not, you will see it listed only under that form. If the wording between forms varies, the differing language will be highlighted in the form that is different from the NFIP. The discussions cover the variance between the two policies.
Policy section | Homeowners Choice Form | NFIP |
Definitions | Flood – is defined as a general and temporary condition of partial or complete inundation of two or more acres of normally dry land or of two or more neighboring properties… |
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| Building – adds the following language: b. A manufactured home (a “manufactured home,” also known as a mobile home, is a structure: built on a permanent chassis, transported to its site in one or more sections, and affixed to a permanent foundation); or c. A travel trailer without wheels, built on a chassis and affixed to a permanent foundation, that is regulated under the community's floodplain management and building ordinances or laws. Building does not mean a gas or liquid storage tank or a recreational vehicle, park trailer or other similar vehicle, except as described in B.6.c. above. |
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| Condominium Association. The entity made up of the unit owners responsible for the maintenance and operation of: a. Common elements owned in undivided shares by unit owners; and b. Other real property in which the unit owners have use rights; where membership in the entity is a required condition of unit ownership. |
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| Dwelling. A building designed for use as a residence for no more than four families or a single-family unit in a building under a condominium form of ownership. |
| Elevated Post-Firm Building – means a “building” that has no “basement” and that has its lowest elevated floor raised above ground level by foundation walls, shear walls, posts, piers, pilings, or columns for which construction or substantial improvement occurred after December 31, 1974, or on or after the effective date of an initial Flood Insurance Rate Map (FIRM), whichever is later. | Post-FIRM Building. A building for which construction or substantial improvement occurred after December 31, 1974, or on or after the effective date of an initial Flood Insurance Rate Map (FIRM), whichever is later. |
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| Expense Constant. A flat charge you must pay on each new or renewal policy to defray the expenses of the Federal Government related to flood insurance. |
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| Federal Policy Fee. A flat charge you must pay on each new or renewal policy to defray certain administrative expenses incurred in carrying out the National Flood Insurance Program. This fee covers expenses not covered by the Expense Constant. |
| Private Flood Insurance Policy (PFIP) refers to this policy. |
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| Replacement cost means the cost to replace damaged property with materials of like kind and quality, Without deduction for depreciation. |
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| Regular Program. The final phase of a community's participation in the National Flood Insurance Program. In this phase, a Flood Insurance Rate Map is in effect and full limits of coverage are available under the Act. |
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| Unit. A single-family unit you own in a condominium building. |
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| Valued Policy. A policy in which the insured and the insurer agree on the value of the property insured, that value being payable in the event of a total loss. The Standard Flood Insurance Policy is not a valued policy. |
Deductible | …we will pay only that part of the loss that exceeds your deductible amount, subject to the “flood” limit of liability that applies. The deductible amount is equal to the “flood” deductible shown on the “Declarations Page”. | However, when a building under construction, alteration, or repair does not have at least two rigid exterior walls and a fully secured roof at the time of loss, your deductible amount will be two times the deductible that would otherwise apply to a completed building. B. In each loss from flood, separate deductibles apply to the building and personal property insured by this policy. |
| The deductible does not apply to the following under Property Covered: 1. Flood Coverage C – Other Coverages, Loss Avoidance Measures; 2. Flood Coverage D – Increased Cost of Compliance; or 3. Flood Coverage E – Loss of Use. | C. The deductible does NOT apply to: 1. III.C.2. Loss Avoidance Measures; 2. III.C.3. Condominium Loss Assessments; or 3. III.D. Increased Cost of Compliance. |
Coverage A – Building Property |
| We insure against direct physical loss by or from flood to: 1. The dwelling at the described location, or for a period of 45 days at another location as set forth in III.C.2.b., Property Removed to Safety. |
| A detached garage and/or other structures at the “described location”. Coverage is limited to no more than 10% of the “flood” limit of coverage on the “dwelling”. Use of this insurance is at your option but reduces the “flood” “building” limit of liability. We do not cover any detached garage or other structure used or held for use for business or farming purposes. | We do not cover any detached garage used or held for use for residential (i.e., dwelling), business, or farming purposes. |
| Materials and supplies to be used for construction, alteration, or repair of the “dwelling”, a detached garage or other structures….. |
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| A “building”, other than a “dwelling”, under construction, alteration, or repair at the “described location”. |
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| 6. A manufactured home or a travel trailer as described in the Definitions section (see II.B.6.b. and II.B.6.c.). If the manufactured home or travel trailer is in a special flood hazard area, it must be anchored in the following manner at the time of the loss: a. By over-the-top or frame ties to ground anchors; or b. In accordance with the manufacturer's specifications; or c. In compliance with the community's floodplain management requirements unless it has been continuously insured by the NFIP at the same described location since September 30, 1982. |
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| Elevators, dumbwaiters, and related equipment, except for related equipment installed below the base flood elevation after September 30, 1987; |
Coverage B – Personal Property |
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| If you have purchased personal property “flood” coverage… |
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| At your option, the personal property is owned by guests or residence employees. | At your option, the property is owned by guests or servants. |
| Personal property is also covered for a period of 45 days at another location as set forth in Flood Coverage C – Other Coverages, Property Removed to Safety. |
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| 4. If you are a tenant and have insured personal property under Coverage B in this policy, we will cover such property, including your cooking stove or range and refrigerator. The policy will also cover improvements made or acquired solely at your expense in the dwelling or apartment in which you reside, but for not more than 10% of the limit of liability shown for personal property on the Declarations Page. Use of this insurance is at your option but reduces the personal property limit of liability. 5. If you are the owner of a unit and have insured personal property under Coverage B in this policy, we will also cover your interior walls, floor, and ceiling (not otherwise covered under a flood insurance policy purchased by your condominium association) for not more than 10% of the limit of liability shown for personal property on the Declarations Page. Use of this insurance is at your option but reduces the personal property limit of liability. |
Coverage C – Other Coverages | Debris removal – We will pay no more than $500,000 or the Coverage A limit of liability for “flood”, whichever is less. This coverage does not increase the limit of liability listed for “flood” on the “Declarations Page”. |
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| (1) A general and temporary condition of flooding in the area near the “described location” must occur, even if the “flood” does not reach the insured “building”; or (2) A legally authorized official must issue an evacuation order or other civil order for the community in which the insured “building” is located calling for measures to preserve life and property from the peril of “flood”. |
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| Any property removed, including a moveable home described in II.6.b. and c., must be placed above ground level or outside of the special flood hazard area. This coverage does not increase the Coverage A or Coverage B limit of liability.
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Condominium Loss Assessments – NFIP only |
| See text below |
Coverage D – Increased Cost of Compliance |
| Eligible floodproofing activities are limited to: a. Non-residential structures. b. Residential structures with basements that satisfy FEMA's standards published in the Code of Federal Regulations [44 CFR 60.6 (b) or (c)]. |
| This coverage is in addition to the limit of liability listed for Coverage A for “flood” on the “Declarations Page”; however, the most you can collect under this policy for both Coverage A and flood Coverage D cannot exceed $500,000. | Our payment of claims under Coverage D is in addition to the amount of coverage which you selected on the application and which appears on the Declarations Page. But the maximum you can collect under this policy for both Coverage A— Building Property and Coverage D—Increased Cost of Compliance cannot exceed the maximum permitted under the Act. |
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| (a) The structure is covered by a contract of flood insurance issued under the NFIP. |
| (3) The state or community must have a cumulative, substantial damage provision or repetitive loss provision in its floodplain management law or ordinance being enforced against the structure; or | (d) In addition to the current claim, the NFIP must have paid the previous qualifying claim, and the State or community must have a cumulative, substantial damage provision or repetitive loss provision in its floodplain management law or ordinance being enforced against the structure; or |
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| l. Assessments made by a condominium association on individual condominium unit owners to pay increased costs of repairing commonly owned buildings after a flood in compliance with State or local floodplain management ordinances or laws. |
Coverage E – Loss of Use | If a “flood” loss covered by this policy makes your “dwelling” where you reside unfit to live in, we will pay up to $5,000 for Flood Coverage E – Loss of Use. This limit applies on an aggregate per loss basis for Additional Living Expense, Fair Rental Value and Civil Authority Prohibits Use. |
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Property Not Covered | Property not eligible for “flood” insurance pursuant to the provisions of the Coastal Barrier Resources Act and the Coastal Barrier Improvement Act and amendments to these acts; 2. Personal property not inside a fully enclosed “building”; |
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| Recreational vehicles other than travel trailers described in the Definitions section (see II.B.6.c.) whether affixed to a permanent foundation or on wheels; |
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| Those portions of walks, walkways, decks, driveways, patios and other surfaces, all whether protected by a roof or not, located outside the perimeter, exterior walls of the insured building or the building in which the insured unit is located; |
| Properties located in communities not participating in the NFIP or in the NFIP “Emergency Program”. | 16. Personal property you own in common with other unit owners comprising the membership of a condominium association. |
Exclusions | We do not pay for the testing or monitoring of “pollutants”, unless required by law or ordinance. If testing or monitoring of “pollutants” is required by law or ordinance, the cost of testing or monitoring will reduce the limit of Flood Coverage A – BUILDING PROPERTY coverage under this policy. |
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Conditions | We are not liable for “flood” loss that occurs while there is a “flood” hazard that is increased by any means within your control or knowledge. |
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| Loss Settlement – see text | Loss Settlement – see text |
| Mediation. If there is a dispute with respect to a “flood” claim under this policy, you or we may demand a mediation of the loss in accordance with the rules established by the Florida Department of Financial Services. Loss Settlement Mediation or Appraisal Homeowners Choice Property & Casualty Insurance Company, Inc. a. The loss amount must be $500 or more, prior to application of the deductible; or there must be a difference of $500 or more between the loss settlement amount we offer and the loss settlement amount that you request. b. The settlement in the course of the mediation is binding only if: (1) Both parties agree, in writing, on a settlement; and (2) You have not rescinded the settlement within 3 business days after reaching settlement. c. You may not rescind the settlement after cashing or depositing the settlement check or draft we provided to you. d. We will pay the cost of conducting any mediation conference except when you fail to appear at a conference. That conference will then be rescheduled upon your payment of the mediator's fee for that rescheduled conference. e. However, if we fail to appear at a mediation conference, we will pay: (1) Your actual cash expenses incurred while attending the conference; and (2) Also pay the mediator's fee for the rescheduled conference. |
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| If you and we fail to agree on the amount of loss, either may request an appraisal of the loss. However, both parties must agree to the appraisal.
| If you and we fail to agree on the actual cash value or, if applicable, replacement cost of your damaged property to settle upon the amount of loss, then either may demand an appraisal of the loss. ….The appraisers will separately state the actual cash value, the replacement cost, and the amount of loss to each item. If the appraisers submit a written report of an agreement to us, the amount agreed upon will be the amount of loss. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will set the amount of actual cash value and loss, or if it applies, the replacement cost and loss. |
| If a loss covered by this policy is also covered by other insurance, we will pay only the proportion of the loss that the limit of liability that applies under this policy bears to the total amount of insurance covering the loss. If the other policy has a provision stating that it is excess insurance, this policy will be primary. | 1. If a loss covered by this policy is also covered by other insurance that includes flood coverage not issued under the Act, we will not pay more than the amount of insurance you are entitled to for lost, damaged, or destroyed property insured under this policy subject to the following: a. We will pay only the proportion of the loss that the amount of insurance that applies under this policy bears to the total amount of insurance covering the loss, unless C.1.b. or c. immediately below applies. b. If the other policy has a provision stating that it is excess insurance, this policy will be primary. c. This policy will be primary (but subject to its own deductible) up to the deductible in the other flood policy (except another policy as described in C.1.b. above). When the other deductible amount is reached, this policy will participate in the same proportion that the amount of insurance under this policy bears to the total amount of both policies, for the remainder of the loss. 2. If there is other insurance in the name of your condominium association covering the same property covered by this policy, then this policy will be in excess over the other insurance. |
| The word “mortgagee” includes trustee. If a mortgagee is named in this policy, any loss payable under Flood Coverage A will be paid to the mortgagee and you, as interests appear. If more than one mortgagee is named, the order of payment will be the same as the order of precedence of the mortgages. If we deny your claim that denial will not apply to a valid claim of the mortgagee, if the mortgagee: a. Notifies us of any change in ownership, occupancy or substantial change in risk of which the mortgagee is aware. This notice includes notifying us of foreclosure or if a foreclosure has been initiated; Mediation or Appraisal Cont. Other Insurance Suit Against Us Mortgagee Clause Homeowners Choice Property & Casualty Insurance Company, Inc. b. Pays any premium due under this policy on demand if you have neglected to pay the premium; and c. Submits a signed, sworn statement of loss within 60 days after receiving notice from us of your failure to do so. Paragraphs 2. and 4. Duties After Loss, Mediation or Appraisal, Suit Against Us and Loss Payment under – Conditions also apply to the mortgagee. If we pay the mortgagee for any loss and deny payment to you: 1. We are subrogated to all the rights of the mortgagee granted under the mortgage on the property; or 2. At our option, we may pay to the mortgagee the whole principal on the mortgage plus any accrued interest. In this event, we will receive a full assignment and transfer of the mortgage and all securities held as collateral to the mortgage debt. Subrogation will not impair the right of the mortgagee to recover the full amount of the mortgagee's claim. We provide coverage to no mortgagee or its representatives under this policy if, whether before or after a loss, a mortgagee or its representatives has: 1. Intentionally concealed or misrepresented any material fact or circumstance; 2. Engaged in fraudulent conduct; or 3. Made material false statements; relating to this insurance. If we decide to cancel or not to renew this policy, the mortgagee will be notified at least 45 days before the date cancellation or nonrenewal takes effect. | The word “mortgagee” includes trustee. Any loss payable under Coverage A—Building Property will be paid to any mortgagee of whom we have actual notice, as well as any other mortgagee or loss payee determined to exist at the time of loss, and you, as interests appear. If more than one mortgagee is named, the order of payment will be the same as the order of precedence of the mortgages. If we deny your claim, that denial will not apply to a valid claim of the mortgagee, if the mortgagee: 1. Notifies us of any change in the ownership or occupancy, or substantial change in risk of which the mortgagee is aware; 2. Pays any premium due under this policy on demand if you have neglected to pay the premium; and 3. Submits a signed, sworn proof of loss within 60 days after receiving notice from us of your failure to do so. All of the terms of this policy apply to the mortgagee. The mortgagee has the right to receive loss payment even if the mortgagee has started foreclosure or similar action on the building. If we decide to cancel or not renew this policy, it will continue in effect for the benefit of the mortgagee only for 30 days after we notify the mortgagee of the cancellation or non-renewal. If we pay the mortgagee for any loss and deny payment to you, we are subrogated to all the rights of the mortgagee granted under the mortgage on the property. Subrogation will not impair the right of the mortgagee to recover the full amount of the mortgagee's claim. |
| 1. With respect to any “insureds” covered under this policy, this policy is void and we will provide no coverage for loss under this policy if, before or after a loss, any “insured” has: a. Intentionally concealed or misrepresented any material fact or circumstance; b. Engaged in fraudulent conduct; or c. Made material false statements; relating to this policy. 2. This policy will be void as of the date the wrongful acts described above were committed. 3. Fines, civil penalties, and imprisonment under applicable Florida laws may also apply to the acts of fraud or concealment described above. 4. We will not deny a claim based on credit information available in public records, whether disclosed or undisclosed, if the policy has been in effect for more than 90 days. | With respect to all insureds under this policy, this policy: a. Is void; b. Has no legal force or effect; c. Cannot be renewed; and d. Cannot be replaced by a new NFIP policy, if, before or after a loss, you or any other insured or your agent have at any time: (1) Intentionally concealed or misrepresented any material fact or circumstance; (2) Engaged in fraudulent conduct; or (3) Made false statements; relating to this policy or any other NFIP insurance. 2. This policy will be void as of the date wrongful acts described in B.1. above were committed. 3. Fines, civil penalties, and imprisonment under applicable Federal laws may also apply to the acts of fraud or concealment described above. 4. This policy is also void for reasons other than fraud, misrepresentation, or wrongful act. This policy is void from its inception and has no legal force under the following conditions: a. If the property is located in a community that was not participating in the NFIP on the policy's inception date and did not join or reenter the program during the policy term and before the loss occurred; or b. If the property listed on the application is otherwise not eligible for coverage under the NFIP. |
| 1. When you have not paid the premium, we may cancel the policy at any time by letting you know at least 45 days before the date of cancellation takes effect. 2. When the policy has been in effect for 90 days or less: a. We may cancel with 45 days' notice if there has been: (1) A material misstatement or misrepresentation; or (2) Failure to comply with underwriting requirements; and your residential structure has not been insured by us for at least a five (5) year period immediately prior to the date of the written notice. b. At least 45 days before the date the cancellation takes effect in all other cases. 3. This policy can be canceled according to the same cancellation guidelines as a National Flood Insurance Program (NFIP) policy, with the exception that this policy may be subject to a 25% minimum earned premium upon cancellation. No minimum earned premium applies if this policy was either: a. Not accepted by your lender, and a written statement from that lender is provided within 45 days of the policy effective date stating they do not accept the HC Private Flood Policy. b. Purchased for a loan closing that did not occur. c. Cancelled prior to the policy effective date for whatever reason. 4. Cancellation of policy by you: a. You may cancel this policy in accordance with the applicable rules and regulations of the “NFIP”. b. If you cancel this policy, you may be entitled to a full or partial refund of premium also under the applicable rules and regulations of the “NFIP”. 5. Non-renewal of the policy: Your policy will not be renewed: a. If the community where your covered property is located stops participating in the “NFIP”; or b. If your “building” has been declared ineligible under Section 1316 of the Act. 6. We may elect not to renew this policy: a. We may do so by delivering to you or mailing to you at your mailing address shown in the Declarations, written notice, together with the specific reason(s) for nonrenewal. b. We shall give at least 120 days' written notice before the expiration of this policy. | E. CANCELLATION OF THE POLICY BY YOU 1. You may cancel this policy in accordance with the applicable rules and regulations of the NFIP. 2. If you cancel this policy, you may be entitled to a full or partial refund of premium also under the applicable rules and regulations of the NFIP. F. NON-RENEWAL OF THE POLICY BY US Your policy will not be renewed: 1. If the community where your covered property is located stops participating in the NFIP, or 2. If your building has been declared ineligible under Section 1316 of the Act. |
| If we elect to renew this policy, we will let you know, in writing: 1. Of our decision to renew this policy; and 2. The amount of renewal premium payable to us. This notice will be delivered to you or mailed to you at your mailing address shown in the Declarations at least 45 days before the expiration date of this policy. Proof of mailing will be sufficient proof of notice. | H. POLICY RENEWAL 1. This policy will expire at 12:01 a.m. on the last day of the policy term. 2. We must receive the payment of the appropriate renewal premium within 30 days of the expiration date. 3. If we find, however, that we did not place your renewal notice into the U.S. Postal Service, or if we did mail it, we made a mistake, e.g., we used an incorrect, incomplete, or illegible address, which delayed its delivery to you before the due date for the renewal premium, then we will follow these procedures: a. If you or your agent notified us, not later than 1 year after the date on which the payment of the renewal premium was due, of non-receipt of a renewal notice before the due date for the renewal premium, and we determine that the circumstances in the preceding paragraph apply, we will mail a second bill providing a revised due date, which will be 30 days after the date on which the bill is mailed. b. If we do not receive the premium requested in the second bill by the revised due date, then we will not renew the policy. In that case, the policy will remain an expired policy as of the expiration date shown on the Declarations Page. 4. In connection with the renewal of this policy, we may ask you during the policy term to recertify, on a Recertification Questionnaire we will provide to you, the rating information used to rate your most recent application for or renewal of insurance. |
| You must see that the following are done in the event of loss or damage to covered property: 1. Give prompt notice to us or our agent; 2. Protect the property from further damage. If repairs to the property are required, you must: a. Make reasonable and necessary repairs to protect the property; and b. Keep an accurate record of repair expenses; 3. Cooperate with us in the investigation of a claim; 4. Prepare an inventory of damaged personal property showing the: a. Quantity; b. Description; c. Age; d. Actual cash value; and e. Amount of loss. Attach all bills, receipts and related documents that justify the figures in the inventory; 5. As often as we reasonably require: a. Show the damaged property; b. Provide us with records and documents we request and permit us to make copies; c. You or any “insured” under this policy must; (1) Submit to examinations under oath and/or recorded statements, while not in the presence of any other “insured”; and (2) Sign the same; d. If you are an association, corporation or other entity; any members, officers, directors, partners or similar representatives of the association, corporation or other entity must: (1) Submit to examinations under oath and/or recorded statements, while not in the presence of any other “insured”; and (2) Sign the same; e. Your agents, your representatives, and anyone engaged with your claim on your behalf, including any public adjusters and anyone insured under this policy, other than an “insured” in c. or d. above, must: (1) Submit to examinations under oath and/or recorded statements, while not in the presence of any “insured”; and (2) Sign the same; f. Send to us, within 60 days after our request, your signed, sworn proof of loss which sets forth, to the best of your knowledge and belief: (1) The time and cause of loss; (2) The interests of all “insureds” and all others in the property involved and all liens on the property; (3) Other insurance which may cover the loss; (4) Changes in title or occupancy of the property during the term of the policy; (5) Specifications of damaged buildings and detailed repair estimates; (6) The inventory of damaged personal property described in 4. above; and (7) Receipts for additional living expenses incurred and records that support the fair rental value loss. | In case of a flood loss to insured property, you must: 1. Give prompt written notice to us; 2. As soon as reasonably possible, separate the damaged and undamaged property, putting it in the best possible order so that we may examine it; 3. Prepare an inventory of damaged property showing the quantity, description, actual cash value, and amount of loss. Attach all bills, receipts, and related documents; 4. Within 60 days after the loss, send us a proof of loss, which is your statement of the amount you are claiming under the policy signed and sworn to by you, and which furnishes us with the following information: a. The date and time of loss; b. A brief explanation of how the loss happened; c. Your interest (for example, “owner”) and the interest, if any, of others in the damaged property; d. Details of any other insurance that may cover the loss; e. Changes in title or occupancy of the covered property during the term of the policy; f. Specifications of damaged buildings and detailed repair estimates; g. Names of mortgagees or anyone else having a lien, charge, or claim against the insured property; h. Details about who occupied any insured building at the time of loss and for what purpose; and i. The inventory of damaged personal property described in J.3. above. 5. In completing the proof of loss, you must use your own judgment concerning the amount of loss and justify that amount. 6. You must cooperate with the adjuster or representative in the investigation of the claim. 7. The insurance adjuster whom we hire to investigate your claim may furnish you with a proof of loss form, and she or he may help you complete it. However, this is a matter of courtesy only, and you must still send us a proof of loss within 60 days after the loss even if the adjuster does not furnish the form or help you complete it. 8. We have not authorized the adjuster to approve or disapprove claims or to tell you whether we will approve your claim. 9. At our option, we may accept the adjuster's report of the loss instead of your proof of loss. The adjuster's report will include information about your loss and the damages you sustained. You must sign the adjuster's report. At our option, we may require you to swear to the report. |
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| K. OUR OPTIONS AFTER A LOSS Options we may, in our sole discretion, exercise after loss include the following: 1. At such reasonable times and places that we may designate, you must: a. Show us or our representative the damaged property; b. Submit to examination under oath, while not in the presence of another insured, and sign the same; and c. Permit us to examine and make extracts and copies of: (1) Any policies of property insurance insuring you against loss and the deed establishing your ownership of the insured real property; (2) Condominium association documents including the Declarations of the condominium, its Articles of Association or Incorporation, Bylaws, rules and regulations, and other relevant documents if you are a unit owner in a condominium building; and (3) All books of accounts, bills, invoices and other vouchers, or certified copies pertaining to the damaged property if the originals are lost. 2. We may request, in writing, that you furnish us with a complete inventory of the lost, damaged or destroyed property, including: a. Quantities and costs; b. Actual cash values or replacement cost (whichever is appropriate); c. Amounts of loss claimed; d. Any written plans and specifications for repair of the damaged property that you can reasonably make available to us; and e. Evidence that prior flood damage has been repaired. 3. If we give you written notice within 30 days after we receive your signed, sworn proof of loss, we may: a. Repair, rebuild, or replace any part of the lost, damaged, or destroyed property with material or property of like kind and quality or its functional equivalent; and b. Take all or any part of the damaged property at the value that we agree upon or its appraised value. |
| An “insured” may waive in writing before a loss all rights of recovery against any person. If not waived, we may require an assignment of rights of recovery for a loss to the extent that payment is made by us. If an assignment is sought, an “insured” must sign and deliver all related papers and cooperate with us. | Whenever we make a payment for a loss under this policy, we are subrogated to your right to recover for that loss from any other person. That means that your right to recover for a loss that was partly or totally caused by someone else is automatically transferred to us, to the extent that we have paid you for the loss. We may require you to acknowledge this transfer in writing. After the loss, you may not give up our right to recover this money or do anything that would prevent us from recovering it. If you make any claim against any person who caused your loss and recover any money, you must pay us back first before you may keep any of that money. |
| If we need access to an “insured” or claimant or to the insured property, we will provide you or the claimant 48 hours' notice before scheduling a meeting or onsite inspection. You or the claimant may deny access to the property if the notice has not been provided. You or the claimant may waive the 48-hour notice requirement. |
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| If we make a change which broadens coverage under this edition of our policy without additional premium charge, that change will automatically apply to your insurance as of the date we implement the change in your state, provided that this implementation date falls within 60 days prior to or during the policy period stated in the Declarations. This Liberalization Clause does not apply to changes implemented through introduction of a subsequent edition of our policy. | If we make a change that broadens your coverage under this edition of our policy, but does not require any additional premium, then that change will automatically apply to your insurance as of the date we implement the change, provided that this implementation date falls within 60 days before or during the policy term stated on the Declarations Page. |
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| In NFIP ONLY |
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| We are not liable for loss that occurs while there is a hazard that is increased by any means within your control or knowledge. |
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| A. PAIR AND SET CLAUSE In case of loss to an article that is part of a pair or set, we will have the option of paying you: 1. An amount equal to the cost of replacing the lost, damaged, or destroyed article, minus its depreciation, or 2. The amount that represents the fair proportion of the total value of the pair or set that the lost, damaged, or destroyed article bears to the pair or set. |
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| Reduction and Reformation of Coverage – see text. |
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| U. DUPLICATE POLICIES NOT ALLOWED 1. We will not insure your property under more than one NFIP policy. If we find that the duplication was not knowingly created, we will give you written notice. The notice will advise you that you may choose one of several options under the following procedures: a. If you choose to keep in effect the policy with the earlier effective date, you may also choose to add the coverage limits of the later policy to the limits of the earlier policy. The change will become effective as of the effective date of the later policy. b. If you choose to keep in effect the policy with the later effective date, you may also choose to add the coverage limits of the earlier policy to the limits of the later policy. The change will be effective as of the effective date of the later policy. In either case, you must pay the pro rata premium for the increased coverage limits within 30 days of the written notice. In no event will the resulting coverage limits exceed the permissible limits of coverage under the Act or your insurable interest, whichever is less. We will make a refund to you, according to applicable NFIP rules, of the premium for the policy not being kept in effect. 2. Your option under Condition U. Duplicate Policies Not Allowed to elect which NFIP policy to keep in effect does not apply when duplicates have been knowingly created. Losses occurring under such circumstances will be adjusted according to the terms and conditions of the earlier policy. The policy with the later effective date must be canceled. |
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| This policy and all disputes arising from the handling of any claim under the policy are governed exclusively by the flood insurance regulations issued by FEMA, the National Flood Insurance Act of 1968, as amended (42 U.S.C. 4001, et seq.), and Federal common law. |
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Insuring Agreement
The insuring agreement states that the policy will pay for “direct physical loss by or from flood” to the insured property if the correct premium has been paid, the insured has complied with all terms and conditions, and has furnished accurate information and statements. The carrier has the right to review such provided information at any time and revise the policy based on that review. This is virtually identical to the NFIP dwelling form.
Notice of the availability of flood insurance under NFIP is stated as an alternative to this policy. Also it is stated that this policy meets the private flood requirements specified in 42 U.S.C. s. 4012a(b) and that no provisions in the policy do not comply with this code. This code provides purchase and compliance requirements for flood insurance and escrow account requirements.
Definitions
The flood definition is identical to the NFIP definition except for the inundation of two or more properties; this policy states that they must be neighboring properties, one of which is the insureds while the NFIP form simply says it must be an inundation of two or more properties, one of which is the insureds. In the NFIP form the properties do not have to be neighboring; if a house four doors down floods and the insured property floods, it would be considered a flood under the NFIP policy but not under the HCI form. This is broader coverage.
The definition of building does not include the NFIP language that includes manufactured homes built on a permanent chassis, transported in one or more sections and affixed to a permanent foundation or a travel trailer without wheels, built on a chassis and affixed to a permanent foundation that is regulated under the community's floodplain management and building ordinances or laws. The NFIP policy is providing broader coverage by expanding the definition of building.
Condominium association is not defined at all in the HCI form, and the definition of dwelling does not include the language specific to single-family units in condominiums. The NFIP form defines condominium association as the entity of unit owners responsible for the maintenance of common elements and real property in which all unit owners have rights. Because it is a federal program, the NFIP policy is designed to cover a broad range of properties.
The Elevated Post-FIRM definition and Post-FIRM building definitions both relate to improvements to buildings after 1974 or the effective date of an initial Flood Insurance Rate Map (FIRM). The HCI policy provides a little more detail and explains that the lowest elevated floor is raised above ground level by foundation or other walls, posts, or columns and has no basement.
Expense Constant and Federal Policy Fee are only found in the NFIP form. They are both flat charges to help defray government costs of running the program. The federal fee covers expenses; the expense constant does not.
The HCI policy defines replacement cost. The policy provides coverage on a replacement cost basis which is not available under the NFIP. The NFIP defines “regular program” which is the final phase of a community's participation in the flood program. A Flood Insurance Rate Map is in effect and full limits of coverage are available.
Deductible
The HCI policy specifically refers to the flood limit in the deductible section whereas the NFIP policy simply refers to the limit of liability that applies. The NFIP policy doubles the deductible amount if the building is under construction and does not have at least two rigid exterior walls and a full roof at the time of loss. Both policies exclude the deductible from certain coverages. In the HCI policy the excluded coverages are other coverages, loss avoidance measures, increased cost of compliance and loss of use, while in the NFIP policy loss avoidance measures, condominium loss assessments and increased cost of compliance are the coverages excluded from deductibles.
Coverage A
The NFIP policy provides coverage for 45 days for property that has been removed to safety. The property must have been moved to a location other than the described location to protect the property from flood or imminent danger of flood. The property is covered for 45 consecutive days from the date the insured starts to move the property. The property must be in a fully enclosed building or otherwise reasonably protected from the elements.
The HCI policy provides coverage for other structures which the NFIP policy does not. Again, the HCI refers to the flood limit, and not just the limit of liability. The exclusion for the use of the garage in the NFIP includes use of the garage as a dwelling or for residential purposes; the HCI does not include this exclusion, and it also provides coverage for other structures as well as garages. Again, this is a huge broadening of coverage. The NFIP covers the main structure but not garages or other structures. In the HCI policy an insured can have gazebos, sheds, and any other structure covered for flood damage as well as the main residence.
While the NFIP policy will provide coverage for a building under construction, the HCI policy will only cover buildings other than a dwelling. The NFIP will also provide coverage for a manufactured home or travel trailer as defined, but certain parameters must be met. Here the NFIP is providing broader coverage. Again, being a federal program the NFIP policy is trying to provide coverage for multiple types of property, whereas the HCI policy can be more selective in the properties it covers. The home must be anchored to the ground by over-the-top or frame ties to ground anchors, or in accordance with the manufacturer's specifications, or in compliance with the community's flood plain management unless it has continuously been insured since September 30, 1982.
In the list of covered items if they are installed in their functioning locations and connected to a power source if necessary are elevators, dumbwaiters and related equipment. The NFIP policy lists an exception for related equipment installed below the base flood elevation after September 30, 1987. Older equipment is grandfathered in, but newer equipment below the base flood elevation will not be covered.
Coverage B
Under coverage B the policies vary slightly in the coverage of others; the HCI policy will provide coverage at the insured's option for property of guests or residence employees, and the NFIP will provide coverage for property owned by guests or servants. Nether residence employees nor servants are defined terms, so in case of dispute the common dictionary definition or common use of the term would be used.
The NFIP policy contains coverage for tenants and unit owners not provided in HCI policy. This is another example of the NFIP providing coverage for multiple types of dwellings and residences. Without the NFIP coverage, tenants and unit owners might not be able to obtain any flood coverage. While at times the NFIP policy is restrictive, it does provide coverage for a wide variety of structures and occupants. First, a tenant with personal property insured on the policy will be covered for cooking stoves, ranges or refrigerators along with the already listed air conditioners, washers, dryers, or freezers. Improvements made by the tenant solely at his expense are covered as well but not for more than ten percent of the personal property limit of liability listed on the declarations. Use of this coverage reduces the personal property limit.
Similar coverage is provided for unit owners. A unit owner with a NFIP policy with personal property coverage also has coverage for interior walls, floors, and ceilings (not otherwise covered by the condo association policy) for no more than ten percent of the personal property limit of liability. Again, this reduces the personal property limit of coverage.
Coverage C
Under debris removal, the HCI policy stipulates that it will pay no more than $500,000 or the coverage A limit of liability for “flood”, whichever is less. It also states that this does not increase the limit of liability for “flood” listed on the declarations page. This is generous coverage for debris removal. The NFIP policy simply states that this coverage does not increase the coverage A or B limits, and does not mention any sort of limit.
The insured can move property to safety in event of a flood or imminent flood. Because the NFIP policy provides coverage for moveable homes, even they are covered if they are moved to safety before a flood starts or while it is taking place.
Condominium Loss Assessments
Coverage for Condominium Loss Assessment is provided in the NFIP policy only, as the NFIP provides coverage for condominiums and the HCI policy does not. For the sake of space the language is presented here instead of in the chart.
3. Condominium Loss Assessments
a. If this policy insures a unit, we will pay, up to the Coverage A limit of liability, your share of loss assessments charged against you by the condominium association in accordance with the condominium association's articles of association, declarations and your deed.
The assessment must be made as a result of direct physical loss by or from flood during the policy term, to the building's common elements.
b. We will not pay any loss assessment charged against you:
(1) And the condominium association by any governmental body;
(2) That results from a deductible under the insurance purchased by the condominium association insuring common elements;
(3) That results from a loss to personal property, including contents of a condominium building;
(4) That results from a loss sustained by the condominium association that was not reimbursed under a flood insurance policy written in the name of the association under the Act because the building was not, at the time of loss, insured for an amount equal to the lesser of:
(a) 80% or more of its full replacement cost; or
(b) The maximum amount of insurance permitted under the Act;
(5) To the extent that payment under this policy for a condominium building loss, in combination with payments under any other NFIP policies for the same building loss, exceeds the maximum amount of insurance permitted under the Act for that kind of building; or
(6) To the extent that payment under this policy for a condominium building loss, in combination with any recovery available to you as a tenant in common under any NFIP condominium association policies for the same building loss, exceeds the amount of insurance permitted under the Act for a single-family dwelling.
Loss assessment coverage does not increase the Coverage A limit of liability.
The language is straightforward; loss assessments charged by the condominium association in accordance with the articles of association, declarations and the insured's deed are covered. The exclusions are standard as well; assessment from a government body, related to the association deductible, resultant from personal property loss, loss not reimbursed under a flood policy because the property was not properly insured, and loss exceeding policy limits. This coverage does not increase the coverage A limit of liability.
Coverage D – Increased Cost of Compliance
The NFIP policy limits floodproofing activities that are eligible for coverage. Floodproofing activities are limited to non-residential structures or residential structures with basements that comply with FEMA's standards in the Code of Federal Regulations [44 CFR 60.6(b) or (c).
While there are similarities between the limit of liability under the increased cost of compliance section, the policies differ. The HCI policy states that coverage D amount is in addition to the amount listed for coverage A, although the most that can be collected under coverages A and D is $500,000. The NFIP policy in contrast states that the amount paid under coverage D is in addition to the amount of coverage selected on the application and that appears on the declarations. The maximum that can be collected under both A and D is the maximum permitted under the Act.
Under the eligibility section for coverage D, the NFIP includes in its definition of a “repetitive loss structure” one that is covered by a contract of flood insurance under the NFIP. The HCI policy has no similar statement. The NFIP policy also requires that the NFIP has paid a previous qualifying claim.
Because the NFIP policy provides coverage for condominiums, under the exclusions section of part D assessments made by the condominium association for the unit owner to pay increased costs to repair common areas is excluded. These assessments stem from state or local floodplain management ordinances or laws.
Coverage E – Loss of Use
Loss of Use coverage is only provided in the HCI policy; such coverage is not available in the NFIP policy. Coverage is fairly standard; additional living expenses are covered if the dwelling becomes uninhabitable and coverage is for the shortest time to either repair or replace or for the household to relocate. Fair rental value is covered as well, again for the shortest length to repair or replace. As always, expenses that do not continue due to the loss are not covered. The standard civil authority coverage for two weeks is provided if authorities prohibit access to the property due to direct damage or damage to neighboring premises. Cancellation of a lease or agreement is not covered.
Property Not Covered
Under Property Not Covered the HCI policy lists property not eligible for coverage pursuant to the provisions of the Coastal Barrier Resources Act and Coastal Barrier Improvement Act and amendments to both. The resources act protects coastal areas that serve as barriers against wind and tidal forces, and limits such areas from development. The Coastal Barrier Improvement Act renewed the resources act and restricted flood insurance in high-risk, storm-prone coastal areas and barrier islands. The NFIP has the same language but puts it at the end of the section instead of at the beginning.
The HCI policy does not cover property not inside a fully enclosed building. The NFIP policy does not cover property not inside a building, with no indication that the property must be fully enclosed. So if property is in a building under construction that is not complete and that property is damaged there is coverage. The HCI policy wording is such that only personal property that is in a fully enclosed building is covered; property in buildings under construction would not be covered. The NFIP policy does not cover property not inside a building. A building is defined as a property with two or more rigid outside walls and a secure roof on a permanent site, so that if a building was at least halfway constructed and met these parameters, that personal property inside such a building would be covered.
Recreational vehicles not covered under the NFIP policy does not include travel trailers as defined in the policy. In the NFIP policy the limitation of coverage for walls, walkways, driveways, patios and other surfaces includes such features located not only outside the exterior walls of the insured building but outside the building in which the insured unit is located. This is listed in the NFIP policy because the NFIP policy covers condominium units.
The HCI policy does not cover properties that are not participating in the NFIP or its emergency program. Because the NFIP policy is the NFIP this language is unnecessary in that form.
Exclusions
The exclusions in the two policies are not presented in the same order. We will follow the order in the HCI policy. Most of the exclusions are identical and standard. Pollution is excluded on both policies unless required by law or ordinance, but the HCI policy also states that if testing or monitoring is required by law that coverage for such testing will reduce the limits of coverage A.
Conditions
Again as in the exclusions sections, the two policies have things arranged in a different order. We will again follow the HCI policy and discuss the NFIP sections accordingly.
Both policies state that they are not liable for loss that occurs while there is a hazard that is increased by any means within the insured's control or knowledge. The HCI policy goes a step further and specifies that they are not liable for “flood” loss that occurs while there is a “flood” hazard that is increased within the insured's control or knowledge. While it would seem that this opens the NFIP policy to cover more losses, since it is a flood policy it does not broaden coverage significantly.
The loss settlement provisions vary greatly. Under the HCI policy, loss settlement is handled at replacement cost value as long as the building was insured at eighty percent or more of the full replacement cost of the building immediately before the loss, Actual cash value is paid until repairs begin. The remainder above actual cash value will be paid as repairs or replacement work is performed and expenses are incurred, but no more than the least of the Coverage A amount, replacement cost of the part of the building damaged for like kind and use, or the necessary amount to repair or replace the dwelling. Increased costs for ordinance or law are not included other than what is provided in the Coverage D-Increased Cost of Compliance section.
If coverage is less than eighty percent of the replacement cost limit and less than the maximum policy limit, then the greater of the actual cash value of the damaged part of the building, the proportion of the cost to repair/replace without deduction for depreciation after the deductible has been applied. The calculation for the proportion is the amount of actual insurance divided by eighty percent of the replacement cost. However, if the eighty percent is more than the policy limit, then the proportion is calculated by dividing the amount of insurance by the maximum amount available under the policy. For example, the property's replacement cost is $200,000. The policy limit is $145,000. Eighty percent of the replacement cost is $160,000. The proportion is determined by dividing the $145,000 by $160,000 resulting in 90% of the loss that will be paid. If 80% of the replacement cost is more than the maximum amount of insurance, then the coverage A amount is divided by the policy limit. So if coverage A was for $110,000, then $110,000 would be divided by $145,000 and 75% of the loss would be covered. When determining replacement cost of the building before the flood loss, the value of excavation, footings, foundations, supports, piers, underground flues, pipes, wiring and drains, and the increased cost to comply with ordinances is not included.
The NFIP policy has three methods of loss settlement; Replacement Cost, Special Loss Settlement, and Actual Cash Value. The three different settlement types apply to different types of property. Replacement cost applies to single-family dwellings that are the insured's principal residence and the insured lived there for eighty percent of the 365 days immediately before the loss or the insured lived there for eighty percent of ownership if the dwelling has been owned less than 365 days. If the amount of insurance is eighty percent or more of replacement cost immediately before the loss, then the policy limit is the maximum coverage that applies. If the property is repairable, repairs will be no more than the least of the limit shown on the declarations, the replacement cost of the damaged part of the dwelling using like kind and quality materials or the necessary amount actually spent to repair or replace the damaged part. Depreciation is not deducted. If the structure is rebuilt at a new location, then the cost is limited to what it would have cost to rebuild at the original site. When the full cost of repair exceeds $1,000 or five percent of the amount of insurance that applies to the dwelling, then the carrier is not liable for repairs until the actual repair or replacement is completed. As always, the insured may opt to settle on an actual cash value basis and claim additional coverage if the carrier is notified of the intent to repair within 180 days of the date of loss.
The special loss settlement applies to single-family manufactured or mobile homes or trailers. It must be at least sixteen feet wide when fully assembled and have at least six hundred square feet within its perimeter walls when fully assembled, and be the insured's principal residence as outlined earlier. If the property is totally destroyed, then the least of the lesser of replacement cost, or 1.5 times actual cash value, or the limit of liability will be paid. If the structure is repairable, then it is settled according to the replacement cost parameters.
Actual cash value settlement applies to single-family dwellings not subject to either replacement cost of special loss settlement. It applies to dwellings that at the time of the loss the amount of insurance on the dwelling is less than 80% of its full replacement cost and less than the maximum amount under the NFIP. When this applies, then no more than the actual cash value of the damaged portion is paid or a proportion of the cost to repair or replace without deduction for depreciation and after the deductible has been applied. If 80% of the replacement cost is less than the maximum under NFIP, then the amount of insurance on the dwelling is divided by 80% of the full replacement cost. For example, full replacement cost is $200,000; 80% of that is $160,000. The NFIP maximum is $225,000 and the coverage amount is $150,000. So the proportion is $160,000 divided by $200,000 for 80% of the loss to be paid.
If 80% of the replacement cost is more than the NFIP maximum, the actual amount of insurance is divided by the NFIP maximum. In the second example, where 80% of replacement cost is above the NFIP maximum, replacement cost is $275,000, then 80% of 275,000 is $220,000, NFIP maximum of $215,000, and actual insurance on the dwelling is $200,000. The amount of insurance which is $200,000 is divided by $215,000 so 93% of the claim amount is paid.
Also subject to actual cash value calculations are two-, three- or four-family dwellings, units that are not used exclusively for single-family dwelling purposes, detached garages, personal property, appliances, carpets, carpet pads, outdoor awnings, antennas or aerials of any type and other outdoor equipment, covered property that is abandoned after a loss and remains as debris, and dwellings that are not principal residences.
The NFIP policy has the same wording regarding not including footings, foundations, supports and excavations in the determination of amount of insurance as the HCI policy does. This is standard language in dwelling policies to not include footings, foundations, supports, flues and pipes in that calculation.
The HCI policy provides procedures for mediation when a dispute arises about a flood claim. Either the insured or the carrier may demand a mediation, and the rules established by the Florida Department of Financial Services must be followed. The loss must be $500 or more before the deductible, and there must be more than $500 different between the offered settlement and what the insured requests for settlement amount. Mediation is binding only if both parties agree, and the carrier has not rescinded the offer after three business days of reaching settlement. Settlement may not be rescinded once the settlement check has been cashed or deposited. Costs of mediation are paid by the carrier unless the insured fails to appear. If the carrier fails to appear it will pay the mediator and the insured's expenses.
Each policy has the option of appraisal and the language is fairly standard. The NFIP policy is slightly different in that due to the multiple settlement options, the appraisal clause must address them. Instead of the HCI policy which states: “If you and we fail to agree on the amount of loss, either may request an appraisal of the loss” the NFIP policy states that “If you and we fail to agree on the actual cash value or, if applicable, replacement cost of your damaged property to settle upon the amount of loss, then either may demand an appraisal of the loss”. Minor, but important differences. Likewise in the NFIP policy the appraisers will separately state the actual cash value, replacement cost and amount of loss to each item, and not just the amount of the loss.
Both policies contain the standard language regarding other insurance that states the policy will pay only the proportion of the loss that the limit bears to the total amount of insurance covering this loss, and that if the other policy states it is excess than this policy is primary. If the other policy states it is excess coverage, then this policy is primary. After this the NFIP policy diverges. It states that if there is other coverage that includes flood coverage not issued under the flood act, that no more than the amount of insurance the insured is entitled to will be paid subject to three provisions. The first provision states that it will pay only the proportion that this policy bears to the total amount of coverage, unless one of the other provisions apply. The second provision states that if the other policy states it is excess that this policy is primary. The third provision is unique to the NFIP policy. It states that this policy is primary subject to its deductible, up to the deductible in the other flood policy. When the other deductible is reached, then this policy pays in proportion to the total amount of both policies for the remainder of the loss. For example, the other policy has limits of $110,000 with a $5,000 deductible. The NFIP policy has a limit of $160,000 with a deductible of $2,000. The amount of loss is $40,000. The NFIP policy will pay first; the deductible for the other policy is $5,000 and the NFIP deductible is $2,000 so the after the application of the NFIP deductible, the NFIP policy will pay $3,000 of the other policy's deductible. Then, the two policies will pay proportionally. The total amount of coverage available for the loss is $110,000 plus $160,000 or $270,000. The other policy of $110,000 is divided by $270,000 for 40% of the loss. The NFIP policy of $160,000 divided by $270,000 is 60% of the loss. Therefore the other policy will pay 40% of the $40,000 loss, or $16,000 and the NFIP policy will pay 60% or $24,000 of the loss. The final clause states that if there is other insurance in the name of the condominium association that covers the same property covered in this policy, that this policy is excess over that policy.
The mortgage clause between the two policies is similar with some phrasing differences but the intent is the same. The HCI policy states that the mortgagee must notify the carrier of any foreclosure proceedings, and that if the mortgagee is paid they may pay the whole principal and accrued interest on the property. The carrier will then receive full assignment and transfer of the mortgage and all securities held as collateral for the debt. If the mortgagee or its representative intentionally conceals or misrepresents material facts or circumstances, engages in fraudulent conduct, or makes false statements the carrier will not provide any coverage to the mortgagee. The HCI policy will notify the mortgagee 45 days before cancellation or nonrenewal while the NFIP policy will provide 30 days' notice of cancellation or nonrenewal.
Misrepresentation of material facts and fraudulent conduct will void either policy. The HCI policy states that it will not void a policy based on credit information in public records whether or not the information was disclosed if the policy has been in effect for 90 days. Not only will the NFIP void a current policy for fraudulent conduct or misrepresentation, but it will also refuse to issue a new NFIP policy. Also, if the policy was located in a community not participating in the NFIP on the inception date, and the community did not join or re-enter the program during the policy term and before the loss occurred, or if the property was not eligible for coverage, the policy will be voided.
Cancellation and nonrenewal policies vary between the two policies. The HCI policy contains a nonpayment provision that does not appear in the NFIP policy. If payment is not made, HCI can cancel the policy with 45 days' notice. They may also cancel with 45 days' notice if the policy has not been in effect for 90 days and the insured has made a material misstatement or misrepresentation, failed to comply with underwriting requirements and the property has not been insured with HCI for at least 5 years prior to the date of notice. Cancellation is in accordance with the NFIP guidelines, but this policy may enforce a 25% minimum earned premium upon cancellation. However, if the policy was not accepted from the lender, or the policy was purchased for a loan closing that did not occur or the policy was cancelled before the effective date no minimum earned premium will apply. Cancellation by the insured falls under the NFIP procedures.
Under HCI the policy will be nonrenewed if the community stops participating in the NFIP program or the building has been declared ineligible under the flood act. If the carrier decides to nonrenew, the insured is give written notice including reasons for nonrenewal at least 120 days before expiration. Renewal notices will be issued 45 days before the expiration date of the policy. Proof of mailing is sufficient notice.
Payment for NFIP policies is expected at time of application or renewal, so there are no cancellation or nonrenewal for nonpayment provisions. The insured may cancel the policy in accordance with the NFIP regulations, and the insured may be entitled to a full or partial refund, again in accordance with NFIP rules and regulations. Policies will not be renewed if the community stops participating in the NFIP or if the building has been declared ineligible, the same as in the HCI policy. Policies automatically expire on the last day of the policy term, and payment must be received within 30 days of the expiration date in order for the policy to renew. Next is unusual language that addresses the failure of the NFIP to mail the renewal notice of if they made a mistake and used an incorrect or incomplete address so that the insured did not receive the notice before the premium due date, that certain procedures will be followed. If the insured does not receive the notice if the insured or the agent notifies the NFIP no later than one year after the date the premium was due of non-receipt of a renewal notice, and the NFIP determines that mailing was an issue, they will mail a second notice with a revised due date which will be 30 days after the date the bill is mailed. If they do not receive the premium by the date on the second bill, then the policy remains nonrenewed as of the original expiration date. The insured may also be requested to complete a questionnaire recertifying rating information that was used to establish the rate for the policy.
Duties after a loss are similar between the two policies but there are some differences, although the duties in general are fairly common and standard. The HCI policy requires the insured to make necessary repairs to prevent further losses; show the damaged property to the carrier, submit to examination under oath if required including public adjusters and associates, partners or directors if the insured is a company, and provide receipts for additional living expenses. The NFIP policy requires the insured to separate the damaged from the undamaged property and put it in the best possible order for examination, give details as to who occupied the building at the time of loss and for what purpose, the adjuster may provide a proof of loss form and assist with completion but this is a courtesy, and the insured must provide a proof of loss within 60 days even if the adjuster does not assist with completion, adjusters are not authorized to approve or disapprove claims, and the NFIP may accept the adjuster's report instead of the insured's proof of loss.
“Our Options after a Loss” is a section in the NFIP policy that does not appear in the HCI policy. These options are at the sole discretion of the NFIP. They include the insured's showing of damaged property, submitting to examination under oath, allowing examination and copying of policies and deeds of ownership and condominium association documents as well as books of accounts, bills, invoices and other documents, providing a complete inventory including quantities, costs, plans for repair of property, evidence that damaged property has been repaired, the option to repair, rebuild or replace any damaged property with like kind and quality if written notice is provided within 30 days of receipt of the proof of loss, and take any part of the damaged property at an agreed upon value. Some of these requirements are included in the HCI duties after a loss.
The subrogation clauses differ between the two policies. The HCI policy allows the insured to waive the rights in writing before a loss, and if not waived it may require an assignment of rights based on the payments made by the carrier. If such an assignment is sought, the insured must sign and deliver all papers to the carrier and cooperate in the assignment. On the other hand the NFIP policy is automatically subrogated to the insured's rights of recovery against another party. The right is automatically transferred to the extent of payment for the loss. The NFIP may require acknowledgement of the transfer in writing, and after the loss the insured may not do anything that would give up the carrier's right to recover funds or would prevent such recovery. If the insured makes a claim against the person who caused the loss and recovers any money, the insured is to reimburse the carrier for any payments before retaining any of the recovered funds.
A notice provision exists in the HCI policy that states that if the carrier needs access to an insured, claimant or the insured property, that 48 hours' notice will be given before scheduling a meeting or onsite inspection. If notice has not been given then the insured or claimant may deny access to the property. The 48-hour notice requirement may be waived by the insured or the claimant.
Each policy has a fairly standard liberalization clause. The HCI policy states that the clause does not apply to changes implemented through introduction of a subsequent edition of the policy. The NFIP policy is the same except it does not have the wording regarding changes in subsequent policies. Both policies state that the insured may not abandon any damaged or undamaged property to the carrier. This is where the HCI policy ends. The NFIP policy however has some additional conditions.
The NFIP policy states that it is not liable for any loss that occurs when there is a hazard that has been increased by any means within the insured's control or knowledge. If the insured knows of an increase in hazard he should rectify the situation or advise the carrier of change in condition of the property.
A pair and set clause is in the NFIP policy; if loss occurs to a pair or set, the NFIP has the option of paying an amount equal to the cost of replacing the lost, damaged, or destroyed article minus depreciation, or the amount that represents the fair proportion of the total value of the pair or set that the lost, damaged or destroyed article bears to the pair or set. This is the standard pair and set clause. With some pairs or sets the remaining parts are still usable, so the amount to replace the damaged item would work well. With other sets the pair may be useless once part of the pair is damaged; then the amount of the proportion of value of the damaged part to the entire set might be the better settlement option.
Reduction and reformation of coverage is a large section in the NFIP policy.
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