Insurer Name: Insurance Company Policy Period: 10/01/ /30/2011 Type of Policy: Homeowners Important 11Things
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1 Insurer Name: Insurance Company Policy Period: 10/01/ /30/2011 Type of Policy: Homeowners Important 11Things YOU NEED TO KNOW ABOUT YOUR HOMEOWNERS POLICY. 1What s covered by my policy? The Property Coverage portion of your policy covers losses resulting from damage to: your residence and structures attached to your residence (Coverage A); other structures on your residence premises set apart from your residence (Coverage B); and personal property owned by you or used by you subject to specific coverage limits based on the location and type of personal property (Coverage C). It also provides coverage for certain additional living expenses and the fair rental value of the part of your residence in which you live if a covered loss makes your residence not fit to live in (Coverage D). The Liability Coverage portion of your policy protects you against claims and legal actions resulting from: property damage or bodily injury to others as a result of an accident and for which you are legally liable (Coverage E); and medical expenses for bodily injury to others (Coverage F). In addition to the basic property and liability coverage, your policy usually contains some additional coverages summarized on the next page. THE TWO GENERAL TYPES OF COVERAGE PROVIDED BY YOUR POLICY ARE: 1. PROPERTY COVERAGE, ALSO REFERRED TO AS SECTION I COVERAGE; AND 2. LIABILITY COVERAGE, ALSO REFERRED TO AS SECTION II COVERAGE. Covered property losses under your homeowners policy are paid on a Replacement Cost (RC) basis; however, the company will initially settle the claim on an Actual Cash Value (ACV) basis. Replacement cost is the amount needed to repair or replace an item damaged by a covered cause of loss with an item of like kind or quality. Actual cash value is the replacement cost minus depreciation. Once the repairs to, or replacement of the property are completed and proof is provided to the company, the difference between RC and ACV, known as the recoverable depreciation, will be paid. Claims for additional living expenses are paid on an actual cash value basis. Each property, liability and additional coverage is subject to the specific terms, conditions, exclusions, limits and deductibles set forth in your policy and the Declaration Page, which is the front page of your policy that provides a listing of all the coverages and limits of those coverages that you have purchased. WHAT S NOT COVERED BY MY POLICY? The policy contains a number of exclusions, which are causes of loss not covered. There are exclusions to the property and liability sections of your homeowners insurance policy. It is important to note that you can purchase coverage for some of the excluded causes of loss for an additional premium. Some of the exclusions that may be contained in your policy are summarized on the next page. This Summary is provided for your general information only. It is not part of your policy and does not create a private right of action. If there is a conflict between this Summary and your policy, the language of your policy will control. Some claims may or may not be covered depending on the facts and circumstances surrounding the loss. You should read your policy for complete information regarding your coverage. PERILS COVERED BY YOUR POLICY [Companies will need to customize this list to match the consumer s policy] The policy insures against risk of sudden and accidental direct physical loss to property described in Coverage A and Coverage B, unless otherwise excluded. The policy insures for direct physical loss to the property described in Coverage C from the following perils, or causes of loss, unless excluded: Fire or lightning Explosion Aircraft Smoke Theft Windstorm or hail Riot or civil commotion Vehicles Vandalism or malicious mischief Falling objects Weight of ice, snow or sleet Freezing Volcanic eruption Accidental discharge or overflow of water or steam (from a plumbing, heating, air conditioning unit, automatic fire protective sprinkler system or from within a household appliance) continued on next page
2 1 Sudden and accidental tearing apart cracking, burning or bulging of a steam or hot water heating system Sudden and accidental damage from artificially generated electrical current ADDITIONAL PROPERTY COVERAGES: [Companies will need to customize this list to match the consumer s policy] Debris removal Tree removal What s covered by my policy? Fire department service charge Reasonable repairs Trees, shrubs or other plants ADDITIONAL LIABILITY COVERAGES: [Companies will need to customize this list to match the consumer s policy] Claim expenses First aid expenses Damage to the property of others Loss assessment EXCLUSIONS [Companies will need to customize this list to match the consumer s policy] Ordinance or law (increased costs to repair or replace property due to changes in building codes) Earth movement, including earthquake, landslide, mudslide, sinkhole or subsidence Intentional loss Governmental action Water damage, including from flood, surface Property removed water, overflow, from backups through sewers Credit card, fund transfer card, forgery and and drains, or water that exerts pressure on counterfeit money the foundation or leaks or seeps through the Loss assessment building, foundation, sidewalk, swimming pool, driveway or other structure Collapse Power failure Glass or safety glazing material Neglect War Nuclear hazard Faulty, inadequate or defective planning, design, construction, renovation, remodeling or maintenance Freezing, thawing, pressure of water or ice on a fence, pavement, patio, footing, foundation, bulkhead, swimming pool, retaining wall, pier, wharf or dock Mold, fungus or wet rot Wear and tear Mechanical breakdown Smog, rust, corrosion or dry rot Discharge, dispersal, seepage, release or escape of pollutants Settling, shrinking, bulging or expansion Birds, vermin, rodents or insects Animals owned or kept by the insured (and the bodily injury or property damage they cause to others) This Summary is provided for your general information only. It is not part of your policy and does not create a private right of action. If there is a conflict between this Summary and your policy, the language of your policy will control. Some claims may or may not be covered depending on the facts and circumstances surrounding the loss. You should read your policy for complete information regarding your coverage. 2Additional Optional Coverages Not Included in the Standard Homeowners Insurance Policy What s covered by my policy? Your standard homeowners policy does not cover all risks. You may need to obtain additional insurance to cover loss or damage to your home, property, and the contents of your home, or to cover risks related to business or personal activities on your property. This statement provides a list of the types of additional insurance coverage that may be available. Contact the insurance company or insurance producer to discuss these additional coverages. LIST OF OPTIONAL INSURANCE COVERAGES THAT MAY BE AVAILABLE: [Companies will need to list all coverges that insured may purchase by endorsement] Additional limits of liability for Coverages A, B, C, and D Special computer coverage Theft coverage increase Office, permitted incidental occupancies (residence premises) Inflation guard Building additions and alterations Credit card, electronic fund transfer card, or access device forgery and counterfeit money coverage Earthquake Scheduled personal property Endorsement Coverage C increased special limits of liability Ordinance or law coverage Water backup and sump discharge or overflow Home day care coverage Refrigerated property coverage Sinkhole collapse Functional replacement cost loss settlement Home business insurance coverage Incidental low power recreational motor vehicles Snowmobile Business pursuits Incidental farming personal liability Watercraft Personal injury
3 3Optional coverage for water back-up FOR AN ADDITIONAL PREMIUM, YOU CAN PURCHASE COVERAGE FOR LOSSES ARISING FROM WATER THAT BACKS UP THROUGH SEWERS AND DRAINS AND IS NOT DUE TO THE NEGLIGENCE OF THE INSURED. [Companies will need to customize to match what their policy covers] This coverage protects your home when water overflows a sump pit or sewage enters your home through pipes designed to carry it away. 4 Your HOWEVER, COVERAGE FOR LOSSES DUE TO FLOODING CAN BE PURCHASED THROUGH THE NATIONAL FLOOD INSURANCE PROGRAM (NFIP). homeowners insurance policy does NOT cover losses from flooding In simple terms, a flood is an excess of water on land that is normally dry. Please contact your insurance representative to apply for coverage, or you can apply to the NFIP directly. You must complete a separate application for flood insurance and if you want coverage for the dwelling and its contents, you must indicate that on the application. Claims made under flood insurance policies may be adjusted and paid on a different basis than claims made under your homeowners policy. For more information on flood insurance, contact your producer, or visit or call FEMA(3362). Here s the official definition used by the National Flood Insurance Program. A flood is A general and temporary condition of partial or complete inundation of two or more acres of normally dry land area or of two or more properties (at least one of which is your property) from: Overflow of inland or tidal waters; Unusual and rapid accumulation or runoff of surface waters from any source; Mudflow; or Collapse or subsidence of land along the shore of a lake or similar body of water as a result of erosion or undermining caused by waves or currents of water exceeding anticipated cyclical levels that result in a flood as defined above. 5Losses caused by discharge of water from a water main break There is no coverage under your homeowners policy for water damage resulting from a water main break occurring off the insured premises. This type of damage is considered flood or surface water and is excluded from coverage under your policy. There is coverage under a homeowners policy for the water damage that occurs as a result of the: Accidental discharge or overflow of water or steam from a plumbing, heating, air conditioning unit, automatic fire protective sprinkler system or from within a household appliance Sudden and accidental tearing apart, cracking, burning or bulging of a steam or hot water heating system within the household
4 6Deductibles for losses caused by hurricane or other storm THIS POLICY INCLUDES A HIGHER DEDUCTIBLE FOR LOSSES THAT ARE CAUSED BY HURRICANE OR OTHER STORM EQUAL TO % OF THE COVERAGE A - DWELLING LIMIT OF $ ON YOUR POLICY. The deductible is the amount you agree to be responsible for every time a covered cause of loss damages your property. In the case of loss caused by hurricane or other storm, if the National Weather Service issues a hurricane warning for the part of the state where your home is located, your deductible under this policy will be $. Under any other circumstances, your deductible is $. 7How can I apply for a premium discount for improvements made to the insured dwelling to reduce the risk of loss from hurricanes or other severe storms? CONTACT YOUR INSURANCE REPRESENTATIVE FOR ADDITIONAL INFORMATION REGARDING THIS DISCOUNT AND WHAT IS REQUIRED TO HAVE IT APPLIED TO YOUR POLICY. You may be entitled to a premium discount on your homeowners insurance policy if you make certain repairs or improvements to your home which may mitigate loss or damage from a hurricane or storm. Some examples of mitigation efforts include the installation of certain types of approved or qualifying: hurricane shutters, secondary water barriers, reinforced roof coverings, braced gable ends, reinforced roof to wall connections, tie downs and reinforced opening protections. Other efforts include the repair or replacement of certain types of approved or qualifying: exterior doors (including garage doors), hurricane resistant trusses, studs and other structural components and manufactured home piers, anchors and tie down straps. 8 Insurance Company considers claims history for the purposes of canceling or refusing to renew your homeowners policy. Under Maryland law, we may cancel or non-renew your policy: If you fail to pay your premium when due. Based upon the number of nonweather-related claims you have filed within three years of your policy renewal. If you have filed three or more weather-related claims within three years before the policy renewal date. If you have filed one or more weather-related claims within three years before the policy renewal date, we provided you with written notice that you needed to make reasonable repairs or replacements of specific property, you failed to make those repairs or replace the property, and the repairs or replacements would have prevented the loss.
5 9Change in Physical Condition or Contents Your policy also may be cancelled or nonrenewed if there is a change in the physical condition or contents of the premises or dwelling that increases a hazard insured against where, had we known about the increase in the hazard we would not have issued the policy. For example, the deck supports, brackets or fasteners that attach your deck to the house are not securely attached to your house. 10 Exclusions: Concurrent Causation [This portion will need to be customized by the companies. The language below is merely an example of the language that can be used.] Option A Option B If damage to your property is partially caused by a covered peril and partially caused by an excluded peril (for example, flooding; wear and tear), then your insurance will not pay for the damage to your property, whether the excluded peril occured at the same time as, before, or after the covered peril. If damage to your property is predominately caused by any peril that is excluded by your policy (for example, flooding; wear and tear), then your insurance will not pay for this damage, even if it also was partially caused by a covered peril. [This portion will need to be customized by the companies. The language below is merely an example of language that could be used.] 11 [This disclosure shall be included by any insurer that offers a homeowners insurance or renter s insurance policy in the state that does not provide coverage for losses caused by specific breeds or specific mixed breeds of dogs.] Your policy does not provide coverage for losses caused by [insert breed(s) of dog.]
6 Frequently Asked Questions AM I COVERED IF: THE HOT WATER HEATER BURSTS AND LEAKS WATER ALL OVER THE BASEMENT? Generally speaking yes, as long as you are living in the home and the loss was sudden and accidental rather than a slow leak that occurs over a period of time. Your insurance will not pay to repair or replace the hot water heater itself. Your insurance covers only the damage to your home caused by the water coming out of the water heater. Different rules may apply if the home was unoccupied or vacant at the time of loss. Refer to your policy for additional information. THE SEWER LINE GETS CLOGGED AND THE SEWAGE BACKS UP INTO THE HOUSE? Generally speaking, no. However, you can purchase an optional coverage by endorsement for water/sewer back-up for an additional premium. If you purchase the endorsement, your insurer will pay for the damage done by the water and sewage that backs up in your home; however, your insurer will not cover the cost to clear or replace the pipe. If your policy does not include this endorsement, contact your insurer or insurance representative for more information to decide if you want to purchase this additional coverage. THE WASHING MACHINE HOSE CRACKS AND THE WATER LEAKS OUT? Generally speaking, yes, as long as you are living in the home and the loss was sudden and accidental rather than a slow leak that occurs over a period of time. Your insurance will not pay to repair or replace the broken hose. Your insurance covers only the damage to your home from the water leaking out. Different rules may apply if the home was unoccupied or vacant at the time of loss. Please refer to your policy for additional information. IT RAINS STEADILY AND WATER ENTERS MY BASEMENT THROUGH THE FOUNDATION OR UNDER THE DOOR WHEN THE DRAIN COULD NOT KEEP UP? No. This type of water damage is excluded from coverage under the policy. THE SWIMMING POOL CRACKS AND WATER ENTERS MY HOME? No. This type of water damage is excluded from coverage under the policy. MY SUMP PUMP OR FRENCH DRAIN SYSTEM IS LOCATED OUTSIDE THE FOOTPRINT OF THE DWELLING AND WATER BACKS UP INTO MY HOME? No. Water that backs up through sewer and drains is excluded from coverage under the policy; however, you may be able to purchase optional coverage by endorsement for water/sewer back-up for an additional premium. IF I AM UNHAPPY WITH THE AMOUNT MY INSURER PAYS FOR A CLAIM, WHAT SHOULD I DO? Contact your insurer, insurance representative or adjuster. Sometimes a mistake has been made and it will be corrected as soon as the insurer is made aware of the error. When you make an inquiry, be sure to give your name, address, telephone number, policy number, type of policy and explain the nature of your complaint. You can request the insurance company to send a letter explaining the basis for the action; that is, why it is denying your claim or any part of your claim. AFTER I BROUGHT MY CONCERNS TO MY INSURER S ATTENTION, I STILL AM NOT SATISFIED. WHAT CAN I DO? The Maryland Insurance Administration can investigate your complaint to be sure you received the full benefits of your policy. You can contact the Maryland Insurance Administration by telephone at , or ext. 2340, or you can send a written complaint by mail to the Maryland Insurance Administration, 200 Saint Paul Place, Suite 2700, Baltimore, MD Attn: P&C Complaints or on-line at
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