We have a client that was denied his claim because in 2020 he moved residencies and the loss location was never switched over to a landlord policy. He continued to pay his premium after moving and the policy was renewed multiple times. Are there any case studies which would support the argument that his claim should be covered? if the only basis for the denial is it being improperly insured as a primary residence?
Pennsylvania Subscriber
Even though the insured continued paying the premium, he does have a duty to notify the insurer of a significant change in condition. You're going to have to look at the policy language here. The ISO HO 00 03 provides coverage for the dwelling on the "residence premises". "Residence premises" is then defined as follows: "Residence premises" means: a. The one-family dwelling where you reside; b. The two-, three- or four-family dwelling where you reside in at least one of the family units; or c. That part of any other building where you reside; and which is shown as the "residence premises" in the Declarations. Therefore, if the insured was not living in the premises, then the property no longer meets the definition of "residence premises" and the insurer is correct in its denial.
There is endorsement HO 06 48, Residence Premises Defintion, which modifies this definition to be the dwelling where the insured resides on the inception date of the policy. We don't know how broadly this endorsement is used, but it does exist.