CPCU 553 Flashcards – Module 4

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[h] CPCU 553 – Module 4

[q] Coverage E – Personal Liability

[a] A coverage section of the HO-3 homeowners policy.  This section provides coverage if a claim is made or a suit is brought against an insured.

[q] Bodily injury

[a] Physical injury to an individual.  Includes disease and death.

[q] Property damage

[a] Physical injury to tangible personal property.  Also includes loss of use of property.

[q] Third-party coverage

[a] Liability coverage purchased by an insured (first party) from an insurer (second party) to protect against claims from other people (third party) for injuries or damages.

[q] Coverage E – Personal Liability coverages

[a] Coverages:

Damages for which an insured is legally liable.

Defense costs, even if a suit is groundless,  false, or fraudulent.

[q] Coverage F – Medical Payments to Others

[a] A coverage section of the HO-3 homeowners policy.  This section provides coverage for medical costs incurred within three years of an injury by those who are not insureds or regular household residents.

[q] Coverage F – Medical Payments to Others expenses covered

[a] Covered expenses generally include:

Medical and surgical expenses.

X-ray costs.

Dental.

Hospital and ambulance.

Nursing costs.

Funeral services.

Prosthetic devices.

[q] Coverage F – Medical Payments to Others coverage conditions

[a] Coverage applies to:

Injuries to a person having permission to be at the insured location.

Injuries to a person away from the insured location, arising out of a condition at the insured location.

Injuries to a person away from the insured location caused by an activity performed by an insured.

[q] HO-3 Section II Additional Coverages

[a] Additional Coverages provides coverage for:

Claim Expenses.

First Aid Expenses.

Loss Assessment.

Damage to Property of Others.

[q] Claim expenses

[a] A type of additional coverage under Section II of an HO-3 policy.  Covers:

Premiums on bonds.

Reasonable expenses.

Postjudgment interest.

[q] Damage to Property of Others exclusions

[a] Excludes:

Intentional damage caused by an insured who is age 13 or older.

Property owned by an insured.

Property owned by or rented to a tenant of an insured.

Damage caused by the insured’s business.

Damage caused by ownership or use of any motor vehicle, watercraft, or aircraft.

[q] Exclusions applicable to HO-3 Coverages E and F

[a] Exclusions:

Motor vehicles.

Watercraft.

Aircraft.

Intentional injury.

Business or professional services.

Insured’s Premises Not an Insured Location.

War.

Communicable Disease, Physical or Mental Abuse.

Controlled Substance.

[q] Exclusions applicable to HO-3 Coverage E only

[a] Exclusions:

Loss Assessment and Contractual Liability.

Damage to the Insured’s Property.

Damage to Property in the Insured’s Care.

Bodily Injury to Persons Eligible for Workers Compensation Benefits.

Nuclear Liability.

Bodily Injury to an Insured.

[q] Exclusions applicable to HO-3 Coverage F only

[a] Exclusions:

Residence Employee Off Premises.

Bodily Injury Eligible for Workers Compensation Benefits.

Nuclear Reaction.

Injury to Residents.

[q] HO-3 conditions applicable to Section II only

[a] Conditions:

Limit of Liability.

Severability of Insurance.

Duties After an Occurrence.

Duties of an Injured Person – Coverage F.

Suit Against Us.

Bankruptcy of an Insured.

Other Insurance.

Policy Period.

Concealment or Fraud.

[q] Duties After an Occurrence

[a] Duties:

Provide notice to the insurer as soon as practical.

Cooperate with the insurer.

Forward legal documents to the insurer promptly.

Provide claims assistance to the insurer in making a settlement.

Submit evidence for damage to property of others when a claim is made under the additional coverage for damage to property of others.

Do not make voluntary payment to a third party for damages.

[q] Duties of an Injured Person-Coverage F- Medical Payments to Others

[a] The injured party must:

Provide the insurer with proof of the claim as soon as possible.

Authorize the insurer to obtain copies of medical reports and records.

Submit to a physical examination by an insurer-chosen doctor.

[q] Liberalization Clause condition

[a] A condition applicable to both Sections I and II of a standard HO-3 homeowners policy.  This condition stipulates that when an insurer broadens coverage on any new or renewal policies, current policies of the insurer also receive the broader coverage automatically.

[q] Waiver or Change of Policy Provision condition

[a] A condition applicable to both Sections I and II of a standard HO-3 homeowners policy.  This condition stipulates that a waiver of a right or a change of a policy provision is valid only if the insurer makes it in writing.

[q] Death condition

[a] A condition applicable to both Sections I and II of a standard HO-3 homeowners policy. Under this condition, if the insured or their spouse should die, the insurer agrees to cover the decedent’s legal representative (executor) as an insured.

[q] Home Business Insurance Coverage endorsement

[a] An endorsement available in an HO-3 policy used to insure business loss exposures.  This endorsement provides protection for insureds who conduct business at or from their home.  Additional coverage is provided for business property and liability arising from certain business operations.

[q] Additional Insured – Managers or Lessors of Premises Leased to an Insured endorsement

[a] An endorsement available in an HO-3 policy used to insure business loss exposures.  This endorsement adds a lessor to the definition of insured under the policy.

[q] Additional Insured – Vendors endorsement

[a] An endorsement available in an HO-3 policy used to insure business loss exposures.  This endorsement adds a vendor to the definition of insured with respect to specific product being sold.

[q] Exclusion – Personal and Advertising Injury endorsement

[a] An endorsement available in an HO-3 policy used to insure business loss exposures.  This endorsement excludes personal and advertising injury liability coverage from the Home Business endorsement.

[q] Liquor Liability Exclusion and Exception for Scheduled Activities endorsement

[a] An endorsement available in an HO-3 policy used to insure business loss exposures.  This endorsement excludes liquor liability if the insured manufactures, sells, or distributes alcoholic beverages, or serves alcoholic beverages for a charge.

[q] Special Coverage – Spoilage of Perishable Stock endorsement

[a] An endorsement available in an HO-3 policy used to insure business loss exposures.  This endorsement provides coverage for perishable stock against direct physical loss resulting from breakdown, contamination, or power outage.

[q] Valuable Papers and Records Coverage Increased Limits endorsement

[a] An endorsement available in an HO-3 policy used to insure business loss exposures.  This endorsement increases the limit for the Valuable Papers and Records additional coverage from $2,500 to the amount shown in the schedule.

[q] Permitted Incidental Occupancies – Residence Premises endorsement

[a] An endorsement available in an HO-3 policy used to insure business loss exposures.  This endorsement covers permitted incidental occupancy (such as a music studio).

[q] Home Day Care Coverage endorsement

[a] An endorsement available in an HO-3 policy used to insure business loss exposures.  This endorsement covers home day care business being conducted at residence premises.

[q] Business Pursuits endorsement

[a] An endorsement available in an HO-3 policy used to insure business loss exposures.  This endorsement provides coverage for a liability arising out of business activities, provided the insured does not own the business.

[q] Structures Rented to Others endorsement

[a] An endorsement available in an HO-3 policy used to insure rental loss exposures.  This endorsement provides coverage for other structures located on insured premises that are rented to anyone not a tenant of the dwelling.

[q] Extended Theft Coverage for Residence Premises Occasionally Rented to Others endorsement

[a] An endorsement available in an HO-3 policy used to insure rental loss exposures.  This endorsement covers theft committed by occasional tenant.

[q] Landlord’s Furnishings endorsement

[a] An endorsement available in an HO-3 policy used to insure rental loss exposures.  This endorsement allows an insured who holds one or more apartments on the residence premises for rental to increase the $2,500 limit on the Landlord’s Furnishings additional coverage.

[q] Unit-Owners Rental to Others endorsement

[a] An endorsement available in an HO-6 policy used to insure rental loss exposures.  This endorsement modifies Coverage C of HO-6 to cover the insured premises, even when it is rented to others.

[q] Additional Residence Rented to Others 1, 2, 3 or 4 Families endorsement

[a] An endorsement available in an HO-3 policy used to insure rental loss exposures.  This endorsement modifies the definition of insured location to include the location of the additional residence listed in the schedule.

[q] Home-sharing host activities

[a] The renting of a premises by the insured to an occupant.

[q] Home-sharing network platform

[a] An online tool that facilitates the exchange of money for the rental of part or all of a dwelling.

[q] Home-sharing occupant

[a] A person entering into a home sharing agreement with the insured.

[q] Home-sharing Host Activities Amendatory endorsement

[a] An endorsement that changes the definition of business in the homeowners policy to include home-sharing.  Clarifies that the HO-3 policy form does not apply to home-sharing arrangements.

[q] Broadened Home-Sharing Host Activities endorsement

[a] An endorsement that provides coverage for a home-sharing host for:

Damage to the insured residence and personal property.

Liability for injury to others.

Lost rental value because of damage to the residence due to a covered loss.

Certain theft losses.

[q] Damage to Property of Others – Increased Limits endorsement

[a] An endorsement that covers damage to the property of others caused by the insured when the insured is using a home-sharing service or staying in a hotel.

[q] Assisted Living Care Coverage endorsement

[a] An endorsement that extends homeowners coverage to a relative who regularly resides in an assisted living facility.

[q] Coverage B – Other Structures Away From the Residence Premises endorsement

[a] An endorsement that extends homeowners coverage to other structures located away from residence premises.

[q] Specific Structures Away From the Residence Premises endorsement

[a] An endorsement that extends homeowners coverage to an other structure located away from the residence premises and for which the insured wants a limit of insurance separate from the limit for other structures on the residence premises.

[q] Additional Insured – Student Living Away From the Residence Premises endorsement

[a] An endorsement that covers an individual who formerly resided in the insured’s household before moving out to attend school.

[q] Watercraft endorsement

[a] An endorsement that extends liability coverage to:

Watercraft with more than 25 horsepower.

Sailing vessels 26 feet or longer.

[q] Canine Liability Exclusion endorsement

[a] An endorsement that excludes liability for a dog owned by or in the care of an insured.

[q] Personal Injury Coverage endorsement

[a] An endorsement to a homeowners policy that adds coverage for slander, libel, false imprisonment, wrongful eviction, or violation of right of privacy.

[q] Owned Motorized Golf Cart Physical Loss Coverage endorsement

[a] An endorsement to a homeowners policy that covers physical loss to a golf cart of the type covered under Section II – Liability Coverages.

[q] Owned Snowmobile endorsement

[a] An endorsement to a homeowners policy that extends Section II Liability Coverages to a snowmobile owned by an insured and used away from an insured location.

[q] Umbrella policy

[a] A policy designed to provide bodily  and personal injury coverage, and property damage liability coverage.  Provides additional liability limits over any underlying insurance policies.

[q] Bodily injury

[a] Bodily harm, sickness, disease, and death.

[q] Property damage

[a] Physical injury to or destruction of tangible personal property, including loss of use.

[q] Umbrella policy exclusions

[a] Typical exclusions:

Intentional injury.

Business property and professional liability.

Aircraft, watercraft, and recreational vehicles.

Transmission of communicable diseases.

Directors and officers liability.

Damage to insured’s property.

Obligations for which insured is legally liable under a workers compensation law.

[q] Umbrella policy conditions

[a] Conditions:

The insured must maintain underlying coverage.

The insured must give the insurer written notice of loss as soon as practicable.

The umbrella policy is excess over any other insurance, whether collectible or not.

The policy territory is worldwide.

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