Homeowner's insurance usually covers the following when they are due to accident or specific

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1 Insurance TYPES OF POLICIES There are as many types of insurance policies as there are risks. During a disaster people may draw upon health, property and casualty and life insurance. These types of policies cover accidents or Acts of God that cause personal injury, and property damage. The basic policies which deal with these issues are homeowner's, renter's, automobile and othervehicle insurance. Each of these policies provides a certain dollar amount of coverage for damage or injury usually with a specified "deductible" -- the amount of loss the insured must pay before the insurer begins to pay. Homeowner's insurance usually covers the following when they are due to accident or specific causes such as fire or theft: - accidental damage to the residence - loss of personal property belonging to the insured - bodily injury to the insured or guests - increased living expenses if the residence is uninhabitable Renter's insurance differs from homeowner's insurance in that it does not cover damage to the residence itself. In all other respect renter's insurance may cover similar types of loss or damage such as bodily injury, loss of personal property, and increased living expenses if the place of residence is uninhabitable. Business insurance usually comes in the form of a comprehensive general liability policy. This coverage provides protection against property damage and loss of business income. Vehicle insurance normally covers accidental damage to the vehicle, bodily injury to the driver and passengers, wage loss, and medical expenses. Damage to a vehicle would be covered by vehicle insurance if the insured has "comprehensive" coverage. Personal property in the vehicle may be covered by the vehicle or homeowner's policies. Despite similarities, policies can differ substantially depending on the type and amount of coverage selected by the insured. PARTS OF AN INSURANCE POLICY Declarations Page

2 The Declarations Page is usually the first page of the policy. includes: it - name of the insurance company - name and address of the agent or broker (unless the policy was sold directly by the insurer) - name of the insured - policy coverage period - name of any mortgage lender (for real estate) - address of property (for real estate) - description of property (for personal property, vehicles, etc.) - policy number - policy coverage (e.g., earthquake damage, uninsured motorist) - Coverage amounts, including liability limits and deductible. Liability limits include the maximum amounts that the insurance company will pay. There is often a limit per person and per occurrence. There may also be limits on amounts for a given time period. -list of endorsements (these are often referred to by form number, with the endorsements themselves being printed on separate forms that may or not have been provided with the declarations page) Body of the Policy The main body of the policy delineates the insurancecoverage and exclusions from coverage except as modified or deleted by the endorsements. Conditions Conditions control whether claims will be defended, losses paid or the policy canceled (if conditions are violated). While the conditions normally are contained in separate section, they may appear throughout the body of the policy as well. There are three types of conditions: - general conditions that apply to all losses and claims - conditions that apply when property is lost or damaged - conditions that apply when a claim is made against the insured. Endorsements Endorsements may add coverage specifically excluded in the body of the policy, delete or modify coverage provided in the body.

3 Endorsements govern the main body of the policy and a list of them should be included on the declarations page. The actual endorsements are usually loose pages located at the back of the policy. They are sometimes mailed to the policyholder separately as they are introduced. The declarations page or an amended declarations page should set forth the form numbers for all applicable endorsements.

4 COLORADO LAW Colorado has enacted statutes which govern control of rates, prevention of unfair practices, and prevention of insolvency of insurance companies. Day to day regulation of the insurance industry is handled by the Colorado Department of Regulatory Agencies, Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202, (303) The personnel at the Division of Insurance can assist with resolving claim disputes, locating out of state insurers, filing complaints or a myriad of other insurance issues. Insurance Policy Interpretation Insurance policies are viewed as contracts and courts interpret them as such. Marez V. Dairyland Ins. Co., 638 P.2d 286 (Colo. 1981). Listed below are examples of the types of rules that courts have developed about interpreting insurance policies: Vagueness, uncertainty or ambiguity in the policy must be interpreted in favor of the policy holder and against the insurance carrier (who wrote the policy). Northern Ins. Co. v. Ekstrom, 784 P.2d 320 (Colo. 1989). A policy term is ambiguous if it is reasonably susceptible to more than one meaning. Terranova v. State Farm, 800 P.2d 58 (Colo. 1990). Insurance contracts must be interpreted in light of the reasonable expectations of the policy holder. Leland V. Travelers, 712 P.2d 1060 (Colo. App. 1985). In close situations, policies will be interpreted in a way which favors coverage. Coxen v. Western Empire Life Ins. Co.,_ 168 Colo. 444, 452 P.2d 16 (1969). "Coverage" sections must be broadly interpreted, while "exclusions" must be read narrowly. Farmers Alliance v. Reeves, 775 P.2d 84 (Colo. App. 1989). Insurer has a duty to defend unless there is no factual or legal basis on which insurer might eventually be held liable to indemnify insured. Hecla Mining Co. v. New Hampshire Ins., 811 P.2d 1083 (Colo. 1991). UNFAIR CLAIMS SETTLEMENT PRACTICES C.R.S. S , et seq. Insurance carriers must follow certain procedures in handling claims made under the insurance policies. The intent is to protect insureds, who, as a general proposition, are not as informed as the insurance carriers on insurance matters. S (l)(h) prohibits the following actions by an insurance carrier: (h) Unfair claim settlement practices: Committing or performing, either in willful violation of this part 11 or with such frequency as to indicate a tendency to engage in a general business practice,

5 any of the following: (I) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; or (II) Failing to acknowledge and act reasonably promptly upon communications with respect to claims arising under insurance policies; or (III) Failing to adopt and implement reasonable standards for the prompt investigation of claims arising under insurance policies; or (IV) Refusing to pay claims without conducting a reasonable investigation based upon all available information; or (V) Failing to affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed; or (VI) Not attempting in good faith to effectuate prompt, fair, and equitable settlements of claims in which liability has become reasonably clear; or (VII) Compelling insureds to institute litigation to recover amounts due under an insurance policy by offering substantially less than the amounts ultimately recovered in actions brought by such insureds; or (VIII) Attempting to settle a claim for less than the amount to which a reasonable man would have believed he was entitled by reference to written or printed advertising material accompanying or made part of an application; or (IX) Attempting to settle claims on the basis of an application which was altered without notice to, or knowledge or consent of, the insured; or (X) Making claims payments to insureds or beneficiaries not accompanied by statement setting forth the coverage under which the payments are being made; or (XI) Making known to insureds or claimants a policy of appealing from arbitration awards in favor of insureds or claimants for the purpose of compelling them to accept settlements or compromises less than the amount awarded in arbitration; or (XII) Delaying the investigation or payment of claims by requiring an insured or claimant, or the physician of either of them, to submit a preliminary claim report, and then requiring the subsequent submission of formal proof of loss forms, both of which submissions contain substantially the same information; or (XIII) Failing to promptly settle claims, where liability has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage; or (XIV) Failing to promptly provide a reasonable explanation of the basis in the insurance policy in relation to the facts or applicable law for denial of a claim or for the offer of a compromise settlement; or (XV) Raising as a defense or partial offset in the adjustment of a third-party claim the defense of comparative negligence as set forth in section , C.R.S., without conducting a reasonable investigation and developing substantial evidence in support thereof. At such time as the issue is raised under this subparagraph (XV), the insurer shall furnish to the commissioner a written statement setting forth reasons as to why a defense under the comparative negligence doctrine is valid.

6 (XVI) Excluding medical benefits under health care coverage subject to article 16 of this title to any covered individual based solely on that individual's casual or nonprofessional participation in the following activities: Motorcycling; snowmobiling; off-highway vehicle riding; skiing; or snowboarding; or (XVII) Failing to adopt and implement reasonable standards for the prompt resolution of medical payment claims. Bad Faith Colorado requires an insurance company to act in good faith with its insureds. Failure to do so may give rise to the tort of bad faith. Farmers Group v. Trimble, 691 P.2d 1138 (Colo. 1984). Bad faith is unreasonable conduct by an insurance carrier such as: - unreasonable denial of an insurance claim that should have been paid - unreasonable failure to defend a policy holder who has been sued under a policy - unreasonable failure to protect the assets of a policy holder who has been sued. Bad faith conduct is separate from the original claim. When an insurance company has caused substantial additional loss or damage to the claimant as a result of bad faith conduct, the company can be held liable for bad faith even if it paid the original claim and even, in limited situations, if the insurer might have been justified in concluding that there was no coverage at all had it acted in good faith 8 Colorado Practice If a company engages in bad faith conduct, the insured could recover the following damages depending on the facts of the case: the policy benefits all additional financial loss caused by the loss of benefits general damages attorneys' fees (in rare cases) exemplary damages if the insurers' actions were willful and wanton See generally American Family Mutual Ins. Co. v. Allen, 102 P. 3d 333 (2004); Cary v. United of Omaha Life Ins. Co., 68 P. 3d 462 (2003); Farmers v. Trimble, 691 P.2d 1138 (Colo. 1984) and C.R.S (exemplary damages).

7 INSURANCE CLAIMS CHECKLIST The following list is a guide to actions that you should take when filing a claim for loss. Contact the agent, broker or insurance company to make a claim even if you are uncertain as to the extent of coverage and whether or not the claims will exceed the deductible. Let the agent know where you can be reached if you have had to move from your home. If you make the initial claim by telephone, follow up in writing and list all losses. Provide any receipts, appraisals or photographs of the property. Take pictures of the damage if possible. Take any reasonable steps to protect the property from further damage and do not dispose of the property or any documents or physical evidence that might help support the insurance claim. Get estimates for repair and replacement damages. Have an adjustor look at the property before any significant repairs are made Get receipts for all repairs or additional living expenses incurred. If your situation is desperate and the insurance company agrees that there is coverage, ask for an advance. Consult a lawyer before you sign a release or a waiver, or before you cash a check that may be considered full and final payment of the claim. If the insurance company denies coverage or the insured agrees with the amount the company is offering to settle the claim: Ask the company to give the reasons in writing. Reread the policy carefully to determine if the company's position makes sense to you. If there is dispute over the settlement offer, consult a lawyer.

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