Care, Custody or Control- Self Storage Items- 97307 (2/08)/ Filing at a Glance Companies: American Home Assurance Company, American International South Insurance Company, AIG Casualty Company, Commerce and Industry Insurance Company, Granite State Insurance Company, Illinois National Insurance Co., National Union Fire Insurance Company of Pittsburgh, Pa., New Hampshire Insurance Company, The Insurance Company of the State of Pennsylvania CCC SELF SERFF Tr Num: AGNY-125533560 State: Wisconsin STORAGE102000319 TOI: 17.0 Other Liability-Occ/Claims Made SERFF Status: Closed State Tr Num: Sub-TOI: 17.0001 Commercial General Liability Co Tr Num: State Status: Filing Type: Form Co Status: Reviewer(s): Shasta Hoffhein Author: Lakesha Houser Disposition Date: 05/28/2008 Date Submitted: 03/18/2008 Disposition Status: Deemed Approved Effective Date Requested (New): 04/22/2008 Effective Date (New): Effective Date Requested (Renewal): 04/22/2008 Effective Date (Renewal): General Information Project Name: Care, Custody or Control- Self Storage Items- 97307 Status of Filing in Domicile: (2/08) Project Number: Domicile Status Comments: Reference Organization: NA Reference Number: NA Reference Title: NA Advisory Org. Circular: NA Filing Status Changed: 05/28/2008 State Status Changed: Deemer Date: 06/26/2008 Corresponding Filing Tracking Number: Filing Description: The above-referenced companies submit for your review and approval their Care, Custody or Control Self-Storage Items Endorsement No. 97307 (2/08) to be used with ISO s Commercial Liability Coverage Form on file with your department. Please refer to the attached Forms Listing for information about the form included in this submission.
Company and Contact Care, Custody or Control- Self Storage Items- 97307 (2/08)/ Filing Contact Information Lakesha Houser, lakesha.houser@aig.com 175 Water Street - 17th Floor (212) 458-5950 [Phone] New York, NY 10038 (212) 458-7077[FAX] Filing Company Information American Home Assurance Company CoCode: 19380 State of Domicile: New York 70 Pine Street Group Code: Company Type: New York, NY 10270 Group Name: State ID Number: (212) 770-7000 ext. [Phone] FEIN Number: 13-5124990 --------- American International South Insurance CoCode: 40258 State of Domicile: Pennsylvania Company 70 Pine Street Group Code: Company Type: New York, NY 10270 Group Name: State ID Number: (212) 770-7000 ext. [Phone] FEIN Number: 02-6008643 --------- AIG Casualty Company CoCode: 19402 State of Domicile: Pennsylvania 70 Pine Street Group Code: Company Type: New York, NY 10270 Group Name: State ID Number: (212) 770-7000 ext. [Phone] FEIN Number: 25-1118791 --------- Commerce and Industry Insurance Company CoCode: 19410 State of Domicile: New York 70 Pine Street Group Code: Company Type: New York, NY 10270 Group Name: State ID Number: (212) 770-7000 ext. [Phone] FEIN Number: 13-1938623 --------- Granite State Insurance Company CoCode: 23809 State of Domicile: Pennsylvania 70 Pine Street Group Code: Company Type: New York, NY 10270 Group Name: State ID Number: (212) 770-7000 ext. [Phone] FEIN Number: 02-0140690 --------- Illinois National Insurance Co. CoCode: 23817 State of Domicile: Illinois 70 Pine Street Group Code: Company Type:
Care, Custody or Control- Self Storage Items- 97307 (2/08)/ New York, NY 10270 Group Name: State ID Number: (212) 770-7000 ext. [Phone] FEIN Number: 37-0344310 --------- National Union Fire Insurance Company of CoCode: 19445 State of Domicile: Pennsylvania Pittsburgh, Pa. 70 Pine Street Group Code: Company Type: New York, NY 10270 Group Name: State ID Number: (212) 770-7000 ext. [Phone] FEIN Number: 25-0687550 --------- New Hampshire Insurance Company CoCode: 23841 State of Domicile: Pennsylvania 70 Pine Street Group Code: Company Type: New York, NY 10270 Group Name: State ID Number: (212) 770-7000 ext. [Phone] FEIN Number: 02-0172170 --------- The Insurance Company of the State of CoCode: 19429 State of Domicile: Pennsylvania Pennsylvania 70 Pine Street Group Code: Company Type: New York, NY 10270 Group Name: State ID Number: (212) 770-7000 ext. [Phone] FEIN Number: 13-5540698 ---------
Filing Fees Care, Custody or Control- Self Storage Items- 97307 (2/08)/ Fee Required? Retaliatory? Fee Explanation: Per Company: No No No
Correspondence Summary Care, Custody or Control- Self Storage Items- 97307 (2/08)/ Dispositions Status Created By Created On Date Submitted Deemed Shasta Hoffhein 05/28/2008 05/28/2008 Approved Objection Letters and Response Letters Objection Letters Response Letters Status Created By Created On Date Submitted Responded By Created On Date Submitted Pending Industry response Shasta Hoffhein 03/19/2008 03/19/2008 Lakesha Houser 05/27/2008 05/27/2008
Disposition Care, Custody or Control- Self Storage Items- 97307 (2/08)/ Disposition Date: 05/28/2008 Effective Date (New): Effective Date (Renewal): Status: Deemed Approved Comment: Used with form filings that are not reviewed and where OCI relies on the certification of compliance. The filing is deemed approved for use 30 days after receipt. Please note that this disposition applies only to forms. Property and casualty rates/rules must be submitted as a separate filing. s. 631.20(1), Wis. Stat. and INS 6.05, Wis. Adm. Code DEEMER DATE: 06/26/2008 Rate data does NOT apply to filing. Overall Rate Information for Multiple Company Filings Overall Percentage Rate Indicated For This Filing 0.000% Overall Percentage Rate Impact For This Filing 0.000% Effect of Rate Filing-Written Premium Change For This Program $0 Effect of Rate Filing - Number of Policyholders Affected 0
Care, Custody or Control- Self Storage Items- 97307 (2/08)/ Item Type Item Name Item Status Public Access Supporting Document (revised) Certification of Compliance Yes Supporting Document Certification of Compliance Yes Form Care, Custody, or Control Self-Storage Items Yes
Objection Letter Care, Custody or Control- Self Storage Items- 97307 (2/08)/ Objection Letter Status Pending Industry response Objection Letter Date 03/19/2008 Submitted Date 03/19/2008 Respond By Date Dear Lakesha Houser, The above filing is disapproved pursuant to s. 631.20, Wis. Stat. Pursuant to s. 601.62 (3), Wis. Stat., we are required to advise you that if you desire a hearing to contest this determination, the Office of the Commissioner of Insurance must receive a written request from you within 30 days of the date of this letter. Objection 1 - Certification of Compliance (Supporting Document) Comment: A Certificate of Compliance is required for each company in which a filing is being applied. Please correct this error and resumbit. Thank you. If you wish to pursue this matter, please submit a revised form or corrective amendment within 30 days from the date of this letter. If your company does not respond within 30 days, a complete new filing will be required. Sincerely, Shasta Hoffhein Response Letter Response Letter Status Submitted to State Response Letter Date 05/27/2008 Submitted Date 05/27/2008 Dear Shasta Hoffhein, Comments: Response 1 Comments: please see revised Related Objection 1 Applies To: - Certification of Compliance (Supporting Document)
Care, Custody or Control- Self Storage Items- 97307 (2/08)/ Comment: A Certificate of Compliance is required for each company in which a filing is being applied. Please correct this error and resumbit. Thank you. Changed Items: Supporting Document Schedule Item Changes Satisfied -Name: Certification of Compliance Comment: No Form Schedule items changed. No Rate/Rule Schedule items changed. Sincerely, Lakesha Houser
Form Schedule Care, Custody or Control- Self Storage Items- 97307 (2/08)/ Review Status Form Name Form # Edition Form Type Action Action Specific Readability Attachment Date Data Care, Custody, or 97307 2/08 Endorseme New 0.00 Care Control Self- Storage Items nt/amendm ent/conditi ons Custody form 3.4.pdf
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ENDORSEMENT # This endorsement, effective 12:01 A.M. issued to by forms a part of Policy No. CARE, CUSTODY OR CONTROL SELF-STORAGE ITEMS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM I. SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. - Exclusions, j. Damage To Property, (4), is hereby deleted in its entirety and replaced with the following: (4) Personal property in the care, custody or control of the insured; provided, however, that this exclusion does not apply to property damage to a renter s personal property that is being stored in the insured s self-storage location arising from the insured s wrongful or negligent act, error or omission in (i) removing any such items of personal property from self-storage; (ii) selling or disposing of any such items; and/or (iii) ordering a lockout. II. With respect to the coverage provided by this endorsement, Section III - Limits of Insurance is hereby amended to add: 8. Subject to 4. above, the Care, Custody or Control Maximum Item Value of $ within an Occurrence Limit of $ and an Aggregate Limit of $ is the most we will pay under Coverage A. for damages to personal property while in your care, custody or control. The Care, Custody or Control Occurrence Limit will be subject to a $ deductible at each occurrence. III. The following definition is added to Section V Definitions: Lockout means depriving a renter access to any of his/her/its personal property. IV. Commercial General Liability Declarations page is hereby amended to add: CARE, CUSTODY OR CONTROL MAXIMUM ITEM VALUE OF $ WITHIN AN OCCURRENCE LIMIT OF $ AND AN AGGREGATE LIMIT OF $. All other terms, conditions and exclusions of this policy shall remain the same. AUTHORIZED REPRESENTATIVE 97307 (2/08) Includes copyrighted material of Insurance Services Office, Inc., with its permission
Rate Information Care, Custody or Control- Self Storage Items- 97307 (2/08)/ Rate data does NOT apply to filing.
Care, Custody or Control- Self Storage Items- 97307 (2/08)/ Supporting Document Schedules Review Status: Satisfied -Name: Certification of Compliance 05/27/2008 Comments: Attachments: Form Listing.pdf cert of compliance.pdf
Form Listing Form Title Form No. Form Type New or Replacement Form No. Being Replaced Mandatory or Optional Restricts, Broadens or Clarifies Rate or Premium Impact Description of Form Care Custody or Control Self- 1 Storage 97307 (2/08/) Endorsement New n/a Optional Restricts NO The endorsement is an exclusion which relieves the insurer of any responsibility for property damage to a renter's personal property that is being stored in the insured's selfstorage location arising from the Insured's wrongful or negligent act. A = Application D = Declarations E = Endorsement P = Policy O = Other (Please explain) Yes or No 1 of 1
Superseded Attachments Care, Custody or Control- Self Storage Items- 97307 (2/08)/ Please note that all items on the following pages are items, which have been replaced by a newer version. The newest version is located with the appropriate schedule on previous pages. These items are in date order with most recent first. Original Date: Schedule Document Name Replaced Date Attach Document No original date Supporting Document Certification of Compliance 03/10/2008 cert of compliance.pdf Form Listing.pdf
Form Listing Form Title Form No. Form Type New or Replacement Form No. Being Replaced Mandatory or Optional Restricts, Broadens or Clarifies Rate or Premium Impact Description of Form Care Custody or Control Self- 1 Storage 97307 (2/08/) Endorsement New n/a Optional Restricts NO The endorsement is an exclusion which relieves the insurer of any responsibility for property damage to a renter's personal property that is being stored in the insured's selfstorage location arising from the Insured's wrongful or negligent act. A = Application D = Declarations E = Endorsement P = Policy O = Other (Please explain) Yes or No 1 of 1