June 23, 2016
Summary: In addition to coverage restrictions incorporated into the coverage agreements and definitions of named perils, standard homeowners forms contain other section I exclusions. All homeowners forms contain a set of general exclusions, but those with coverage on an open perils basis contain another set of exclusions that apply to the coverages written on that basis. Open perils coverage is defined by the exclusions that apply to coverage. It is the broadest form of coverage because loss that results from a cause that is not specifically excluded in the form is covered. Named perils coverage, on the other hand, covers only those losses caused by specifically named causes of loss. With named peril coverage, the burden of proof of coverage is on an insured; with open perils, the burden of proving a loss is not covered is on the insurer.
The open perils coverages and exclusions that apply to coverages A and B of the HO 00 03 05 11 and coverages A, B, and C of the HO 00 05 05 11 also apply to forms HO 00 06 05 11, coverages A and C, and HO 00 04 05 11, coverage C, when these forms are endorsed. The following discussion incorporates changes made to the standard homeowners forms in the homeowners 2011 program.
Topics covered:
Only a few forms provide open perils coverage. Special form HO 00 03 provides open perils coverage for the dwelling and other structures. Form HO 00 05 provides open perils coverage for dwelling, other structures, and personal property. Form HO 00 06 (unit owners) normally provides named perils coverage, but can be endorsed by HO 17 32 05 11 to cover building items on an open perils basis, and by HO 17 31 05 11 to provide this coverage for personal property. New with the 2000 program was endorsement HO 05 24 05 11, which may be attached to the HO 00 04 05 11 to provide open perils coverage for a tenant homeowner's contents. The HO 05 24 was updated in 2011 for easier reading and added an exclusion for nesting, infestation, or discharge or release of any waste products or secretions by any animal.
The "perils insured against" provisions of section I contain the exclusions that specifically limit the open perils coverages of standard homeowners forms. Some of these have been discussed previously (see ISO Homeowners Section I, and see Homeowners Perils) since equivalent exclusionary language is incorporated into the provisions of individual named perils, such as smoke from agricultural smudging or industrial operations or theft from a building under construction or of building materials.
This discussion centers on the general exclusions applying to coverages A and B of the HO 00 03 and HO 00 05, and coverage C of the HO 00 05. The policy language quoted is taken from the HO 00 03, except with regard to the open perils exclusions that apply to personal property. This is found in the HO 00 05, HO 17 31, and HO 05 24.
A Coverage A—Dwelling and Coverage B—Other Structures
1.We insure against risk of direct physical loss to property described in Coverages A and B. (form HO 00 05: We insure against risk of direct physical loss to property described in coverages A, B, and C.)
2.We do not insure, however, for loss:
a.Excluded under Section I – Exclusions;
b.Involving collapse, including any of the following conditions of property or any part of the property:
(1)An abrupt falling down or caving in;
(2)Loss of structural integrity, including separation of parts of the property or property in danger of falling down or caving in; or
(3)Any cracking, bulging, sagging, bending, leaning, settling, shrinkage or expansion as such condition relates to (1) or (2) above; except as provided in E.8. Collapse under Section I – Property Coverages; or (form HO 00 05: 2. Involving collapse, other than as provided in E.8. Collapse under Section I Property Coverages. However, any ensuing loss to property described in Coverages A and B not precluded by any other provision in this policy is covered.)
Analysis
In conjunction with the additional coverage of collapse, which applies only to collapse damage resulting from specific perils, a collapse exclusion applies to open perils coverage for buildings and other structures. The exclusion rules out coverage for collapse losses other than those listed in the additional coverage. Despite the collapse exclusion, ensuing loss is covered unless it too is the subject of a specific exclusion.
The section I exclusions will be addressed later in this discussion.
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