PREMIER PLUS
HOMEOWNERS
POLICY
AUTO CLUB FAMILY
INSURANCE COMPANY
12901 NORTH FORTY DRIVE
ST. LOUIS, MISSOURI 63141
(314) 523-7350
A STOCK COMPANY
A SUBSIDIARY OF THE AUTOMOBILE
CLUB INTER-INSRUANCE EXCHANGE
THIS POLICY BOOKLET, WITH THE DECLARATIONS CERTIFICATE
AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETES THIS
POLICY.
READ YOUR POLICY CAREFULLY
This policy is the legal contract between you and us.
YOUR PREMIER PLUS POLICY -
QUICK REFERENCE
DECLARATIONS CERTIFICATE
Your Name
Location of Your Residence
Policy Period
Coverages
Amounts of Insurance
Deductible
|
Beginning
On Page
|
AGREEMENT |
|
|
|
DEFINITIONS |
|
|
|
SECTION I - PROPERTY COVERAGES |
|
COVERAGE A - Dwelling
|
|
COVERAGE B - Other Structures
|
|
COVERAGE C - Personal Property
|
|
Special Limits of Liability
|
|
Property Not Covered
|
|
COVERAGE D - Loss Of Use
|
|
ADDITIONAL COVERAGES
|
|
Debris Removal
|
|
Reasonable Repairs
|
|
Trees, Shrubs and Other Plants
|
|
Fire Department Service Charge
|
|
Property Removed
|
|
Credit Card, Fund Transfer Card, Forger and Counterfeit Money
|
|
Loss Assessment
|
|
Collapse
|
|
Glass or Safety Glazing Material
|
|
Landlord's Furnishings
|
|
Ordinance or Law
|
|
|
|
SECTION I - PERILS INSURED AGAINST
|
|
COVERAGE A - Dwelling and
|
|
COVERAGE B - Other Structures
|
|
COVERAGE C - Personal Property
|
|
|
|
SECTION I - EXCLUSIONS
|
|
SECTION I - CONDITIONS
|
|
Insuranble Interest and Limit of Liability
|
|
An Insured's Duties After Loss
|
|
Loss Settlement
|
|
Loss to a Pair or Set
|
|
Glass Replacement
|
|
Appraisal
|
|
Other Insurance
|
|
Suit Against Us
|
|
Our Option
|
|
Loss Payment
|
|
Abandonment of Property
|
|
Mortgage Clause
|
|
No Benefit to Bailee
|
|
Nuclear Hazard Clause
|
|
Recovered Property
|
|
Volcanic Eruption Period
|
|
|
|
SECTION II - LIABILITY COVERAGES
|
|
COVERAGE E - Personal Liability
|
|
COVERAGE F - Medical Payments to Others
|
|
|
|
SECTION II - EXCLUSIONS
|
|
|
|
SECTION II - ADDITIONAL COVERAGES
|
|
Claim Expenses
|
|
First Aid Expenses
|
|
Damage to Property of Others
|
|
Loss Assessment
|
|
|
|
SECTION II - CONDITIONS
|
|
Limit of Liability
|
|
Severability of Insurance
|
|
Duties After Loss
|
|
Duties of an Injured Person - Coverage F - Medical Payments to
OThers
|
|
Payment of Claim - Coverage F Medical Payments to Others
|
|
Suit Against Us
|
|
Bankruptcy of an Insured
|
|
Other Insurance - Coverage E - Personal Liability
|
|
SECTION I AND II - CONDITIONS |
|
Policy Period
|
|
Concealment or Misrepresentation
|
|
Liberalization Clause
|
|
Waiver or Change of Policy Provisions
|
|
Cancellation
|
|
Nonrenewal
|
|
Assignment
|
|
Subrogation
|
|
Death
|
|
HOMEOWNERS 3 - SPECIAL FORM
AGREEMENT
We will provide the insurance described
in this policy in return for the premium and compliance with all applicable
provisions of this policy.
DEFINITIONS
In this policy, "you"
and "your" refer to the named insured shown in the
Declarations and the spouse if a resident of the same household. "We",
"us" and "our" refer to the Company
providing this insurance. In addition, certain words and phrases are
defined as follows:
1. "Bodily injury" means
bodily harm, sickness or disease, including required care, loss of services
and death that results.
2. "Business" includes
trade, profession or occupation.
3. "Insured" means you
and residents of your household who are:
a. Your
relatives; or
b. Other persons under the age of 21 and
in the care of any person named above.
Under Section II, "insured"
also means:
c. With respect
to animals or watercraft to which this policy applies, any person or organization
legally responsible for these animals or
watercraft which are owned by you or any person included in 3.a.
or 3.b. above. A person or organization
using or having custody of these animals or watercraft in the course of
any business or without consent of
the owner is not an insured;
d. With respect
to any vehicle to which this policy applies:
(1)
Persons while engaged in your employ or that of any person included
in 3.a. or 3.b. above;
1
or
(2) Other
persons using the vehicle on an insured location with your
expressed consent.
4. "Insured location" means:
a. The residence
premises;
b. The part of other premises, other structures
and grounds used by you as a residence and:
(1)
Which is shown in the Declarations; or
(2) Which
is acquired by you during the policy period for your use
as a residence;
c. Any premises
used by you in connection with a premises in 4.a. and 4.b. above;
d. Any part of a premises:
(1)
Not owned by an insured; and
(2) Where
an insured is temporarily residing;
e. Vacant
land, other than farm land, owned by or rented to an insured;
f. Land owned by or rented to an insured
on which a one or two family dwelling is being built as a residence for
an insured;
g. Individual or family cemetery plots or
burial vaults of an insured; or,
h. Any part of a premises occasionally rented
to an insured for other than business use.
5. "Occurence" means an
accident, including continuous or repeated exposure to substantially
the same general harmful conditions, which results, during the policy
period, in:
a. Bodily
injury; or
b. Property damage.
6. "Property damage" means
physical injury to, destruction of or loss of use of tangible property.
7. "Residence employee"
means:
a. An
employee of an insured whose duties are related to the maintenance
or use of the residence premises, including
household or domestic services; or
b. One who performs similar duties elsewhere
not related to the business of an insured.
2
8. "Residence premises" means:
a. The one
family dwelling, other structures, and grounds where you reside
and which is shown as the residence premises
in the Declarations; or
b. That part of any other building where
you reside and which is shown as the residence premises
in the Declarations.
"Residence premises" also
means a two, family dwelling where you reside in at least one
of the family units and which is shown as the residence premises
in the Declarations.
The term reside, as used in this
definition, means continous day-to-day occupancy.
SECTION I - PROPERTY COVERAGES
COVERAGE A - Dwelling
We Cover:
1. The dwelling on the residence premises
shown in the Declarations, where you reside on a continuous
day-to-day basis, including structures attached to the dwelling; and
2. Materials and supplies located on or
next to the residence premises used to construct, alter or repair
the dwelling or other structures on the residence premises.
This coverage does not apply to land, including
land on which the dwelling is located.
COVERAGE B - Other Structures
We cover other sructures on the residence premises set apart
from the dwelling by clear space. This includes structures connected
to the dwelling by only a fence, utility line or similar connection.
This coverage does not apply to land, Including land
on which the other structures are located.
We do not cover other structures:
1. Used in whole or in part for business; or
3
2. Rented or held for rental to any person not a tenant
of the dwelling, unless used solely as a private garage.
The limit of liability for this coverage will not be mroe
than 10% of the limit of liability that applies to Coverage A. Use of
this coverage does not reduce the Coverage A limit of liability.
COVERAGE C - Personal Property
We cover personal property owned or used by an insured while
it is anywhere in the world. At your written request, we will
cover personal property owned by:
1. Others while the property is on the part of the residence
premises occupied by an insured; or
2. A guest or a residence employee, while the property
is in any residence occupied by an insured.
Our limit of liability for personal property usually
located at an insured's residence, other than the residence
premises, is 10% of the limit of liability for Coverage C or $1000,
whichever is greater. Personal property in a newly acquired principal
residence is not subject to this limitation for the 30 days from the time
you begin to move the property there.
Special Limits of Liability
These limits do not increase the Coverage C limit of liability.
The special limit for each numbered category below is the total limit
for each loss for all property in that category.
1. $200 on money, bank notes, bullion, gold other than
goldware, silver other than silverware, platinum, coins and medals.
2. $1000 on securities, accounts, deeds, evidences of
debt, letters of credit, notes other thank bank notes, manuscripts, personal
records, passports, tickets and stamps. This dollar limit applies to these
categories regardless of the medium (such as paper or computer software)
on which the material exists.
This limit includes the cost to research, replace
or restore the information from the lost or damaged material.
3. $1000 on watercraft, including their trailers,
coverings, furnishings, equipment and outboard engines or motors.
4. $1000 on trailers not used with watercraft.
5. $1000 for loss by theft of jewelry, watches, furs,
precious and semi-precious stones.
6. $2000 for loss by theft of firearms.
7. $2500 for loss by theft of silverware, silver-plated
ware, goldware, gold-plated ware and pewterware. This includes flatware,
hollowware, tea sets, trays and trophies made of or including silver,
gold or pewter.
8. $2500 on property, on the residence premises,
used at any time or in any manner for any business purpose.
9. $250 on property, away from the residence premises,
used at any time or in any manner for any business purpose.
However, this limit does not apply to loss to adaptable electronic
apparatus as described in Special Limits 10. and 11. below.
10. $1000 for loss to electronic apparatus,
while in or upon a motor vehicle or other motorized land conveyance,
if the electronic apparatus is equipped to be operated by power from
the electrical system of the vehicle or conveyance while retaining its
capability of being operated by other sources of power. Electronic apparatus
includes:
a. Accessories
and antennas; or
b. Tapes,
wires, records, discs or other media;
for use with any electronic apparatus described in
this item
10. 11. $1000 for loss to electronic apparatus, while
not in or upon a motor vehicle or other motorized land conveyance,
if the electronic apparatus:
a. Is
equipped to be operated by power from the electrical system of the vehicle
or conveyance while retaining its capability
of being operated by other
5
sources of
power;
b. Is away
from the residence premises; and
c. Is used
at any time or in any manner for any business purpose.
Electronic apparatus includes:
a. Accessories
and antennas; or
b. Tapes,
wires, records, discs or other media;
for use with any electronic apparatus
described in this item 11.
Property Not Covered
We do not cover:
1. Articles separately described and specifically insured
in this or other insurance;
2. Animals, birds or fish;
3. Motor vehicles or all other motorized land conveyances.
This includes:
a. Their
equipment and accessories; or
b. Electronic apparatus that
is designed to be operated solely by use of the power from the electrical
system of motor vehicles or all other motorized
land conveyances. Electronic apparatus includes:
(1)
Accessories or antennas; or
(2) Tapes,
wires, records, discs or other media;
for use with
any electronic apparatus described in this item 3.b.
The exclusion of property described in 3.a. and 3.b.
above applies only while the property is in or upon the vehicle or conveyance.
We do cover vehicles or conveyances not subject
to motor vehicle registration which are:
a. Used to
service an insured's residence; or
b. Designed
for assisting the handicapped;
4. Aircraft and parts. Aircraft means any contrivance
used or designed for flight, except model or hobby aircraft not used
or designed to carry people or cargo;
5. Property of roomers, boarders and other tenants,
6
except property of roomers and boarders related to an
insured;
6. Property in an apartment regularly rented or held
for rental to others by an insured, except as provided in Additional
Coverages 10.;
7. Property rented or held for rental to others off
the residence premises;
8. Business data, including such data stored in:
a. Books
of account, drawings or other paper records; or
b. Electronic
data processing tapes, wires, records, discs or other software media;
However, we do cover the cost
of blank recording or storage media and of pre-recorded computer programs
available on the retail market; or
9. Credit cards or fund transfer cards except as provided
in Additional Coverages 6.
COVERAGE D - Loss Of Use
The limit of liability for Coverage D is the total limit for all the
coverages that follow.
1. If a loss covered under this Section makes that
part of the residence premises where you reside not
fit to live in, we cover, at your choice, either of the following.
However, if the residence premises is not your principal
place of residence, we will not provide the option under paragraph
b. below.
a. Additional
Living Expense, meaning any necessary increase in living expenses
incurred by you so that your household
can maintain its normal standard of living; or
b. Fair
Rental Value, meaning the fair rental value of that part of the
residence premises where you reside less any
expenses that do not continue while the premises is not fit to live
in.
Payment under a. or b. will be for the shortest time
required to repair or replace the damage or, if you permanently
relocate, the shortest time required for your household to
permanently relocate elsewhere.
7
2. If a loss covered under this Section makes that
part of the residence premises rented to others or held for
rental by you not fit to live in, we cover the:
Fair
Rental Value, meaning the fair rental value of that part of the
residence premises rented to others or held for
rental by you less any expenses that do not continue while
the premises is not fit to live in.
Payment will be for
the shortest time required to repair or replace that part of the premises
rented or held for rental.
3. If a civil authority prohibits you from
use of the residence premises as a result of direct damage
to neighboring premises by a Peril Insured Against in this policy,
we cover the Additional Living Expense and Fair Rental Value
loss as provided under 1. and 2. above for no more than two weeks.
The periods of time under 1., 2. and 3. above are
not limited by expiration of this policy.
We do not cover loss or expense due to cancellation
of a lease or agreement.
ADDITIONAL COVERAGES
1. Debris Removal. We will pay your
reasonable expense for the removal of:
a. Debris
of covered property if a Peril Insured Against, that applies to the
damaged property, causes the loss; or
b. Ash,
dust or particles from a volcanic eruption that has caused direct
loss to a building or property contained in a
building.
This expense is included in the limit of liability
that applies to the damaged property. If the amount to be paid for
the actual damage to the property plus the debris removal expense
is more than the limit of liability for the damaged property, an
additional 5% of that limit of liability is available for debris
removal expense.
We will also pay your reasonable expense,
up to $500, for the removal from the residence premises of:
8
a. Your
tree(s) felled by the peril of Windstorm or Hail;
b. Your
tree(s) felled by the peril of Weight of Ice, Snow or Sleet; or
c. A neighbor's
tree(s) felled by a Peril Insured Against under Coverage C;
Against under Coverage C;
provided the tree(s) damages a covered structure.
The $500 limit is the most we will pay in any one loss regardless
of the number of fallen trees.
2. Reasonable Repairs. In the event that covered
property is damaged by an applicable Peril Insured Against, we
will pay the reasonable cost incurred by you for necessary measures
taken solely to protect against further damage. If the measures taken
involve repair to other damaged property, we will pay for those
measures only if that property is covered under this policy and the damage
to that property is caused by an applicable Peril Insured Against.
This coverage:
a. Does not
increase the liimt of liability that aplies to the covered property;
b. Does
not relieve you of your duties, in case of a loss to covered
property, as set forth in SECTION I - CONDITION 2.d.
3. Trees, Shrubs and Other Plants. We cover trees,
shrubs, plants or lawns, on the residence premises, for loss
caused by the following Perils Insured Against: Fire or lightning, Explosion,
Riot or civil commotion, Aircraft, Vehicles not owned or operated by
a resident of the residence premises, Vandalism or malicious
mischief or Theft.
We will pay upt to 5% of the limit of liability
that applies to the dwelling, for all trees, shrubs, plants or lawns.
no more than $500 of this limit will be available for any one tree,
shrub or plant. We do not cover property grown for business
purposes.
This coverage is additional insurance.
4. Fire Department Service Charge. We
will pay up to $500 for your liability assumed by contract or
agreement
9
for fire department charges incurred when the fire department
is called to save or protect covered property from a Peril Insured Against.
We do not cover fire department service charges if the property
is located within the limits of the city, municipality or protection district
furnishing the fire department response.
This coverage is additional insurance. No deductible applies
to this coverage.
5. Property Removed. We insure covered property
against direct loss from any cause while being removed from a premises
endangered by a Peril Insured Against and for no more than 30 days while
removed. This coverage does not change the limit of liability that applies
to the property being removed.
6. Credit Card, Fund Transfer Card, Forgery and Counterfeit Money.
We will pay up to $500 for:
a. The
legal obligation of an insured to pay because of the theft or
unauthorized use of credit cards issued to or registered
in an insured's name;
b. Loss
resulting from theft or unauthorized use of a fund transfer card used
for deposit, withdrawal or transfer of funds,
issued to or registered in an insured's name;
c. Loss
to an insured caused by forgery or alteration of any check or
negotiable instrument; and
d. Loss
to an insured through acceptance in good faith of counterfeit
United States or Canadian paper currency.
We do not cover use of a credit
card or fund transfer card:
a. By a
resident of your household;
b. By a
person who has been entrusted with either type of card; or
c. If an
insured has not complied with all terms and conditions under
which the cards are issued.
All loss resulting from a series of acts committed
by any one person or in which any one person is concerned or implicated
is considered to be one loss.
We do not cover loss arising out of business
use or
10
dishonesty of an insured or an employee of
an insured.
This coverage is additional insurance. No deductible
applies to this coverage.
Defense:
a. We
may investigate and settle any claim or suit that we decide is
appropriate. Our duty to defend a claim or suit ends
when the amount we pay for the loss equals our limit of
liability.
b. If a
suit is brought against an insured for liability under the Credit
Card or Fund Transfer Card coverage, we will
provide a defense at our expense by counsel of our choice, subject
to a. above.
c. We
have the option to defend at our expense an insured or
an insured's bank against any suit for the enforcement
of payment under the Forgery coverage.
7. Loss Assessment. We will pay up to $1000
for your share of loss assessment charged during the policy
period against you by a corporation or association of property
owners, when the assessment is made as a result of direct loss to
the property, owned by all members collectively, caused by a Peril
Insured Against under COVERAGE A - DWELLING, other than earthquake
or land shock waves or tremors before, during or after a volcanic
eruption.
This coverage applies only to loss assessments charged
against you as owner or tenant of the residence premises.
We do not cover loss assessments charged against
you or a corporation or association of property owners by any
governmental body.
The limit of $1000 is the most we will pay
with respect to any one loss, regardless of the number of assessments.
Condition 1. Policy Period, under SECTION I AND
II CONDITIONS, does not apply to this coverage.
8. Collapse. We insure for direct
physical loss to covered property involving collapse of a building or
any part of a building caused only by one or more of the following:
a. Perils
Insured Against in COVERAGE C - PERSONAL PROPERTY. These perils
apply to cov-
11
ered
buildings and personal property for loss insured by this additional
coverage;
b. Hidden
decay;
c. Hidden
insect or vermin damage;
d. Weight
of contents, equipment, animals or people;
e. Weight
of rain which collects on a roof; or
f. Use
of defective material or methods in construction, remodeling or renovation
if the collapse occurs during the course
of the construction, remodeling or renovation.
Loss to an awning, fence, patio, pavement, swimming
pool, underground pipe, flue, drain, cesspool, septic tank, foundation,
retaining wall, bulkhead, pier, wharf or dock is not included under
items b., c., d., e. and f. unless the loss is a direct result of
the collapse of a building.
Collapse does not include settling, cracking, shrinking,
bulging or expansion.
This coverage does not increase the limit of liability
applying to the damaged covered property.
9. Glass or Safety Glazing Material.
(1)
The breakage of glass or safety glazing material which is part of
a covered building, storm door or storm window;
(2)
The breakage, caused directly by Earth Movement, of glass or safety
glazing material which is part of a covered
building, storm door or storm window; and
(3)
The direct physical loss to covered property caused solely by the pieces,
fragments or splinters of broken glass
or safety glazing material which is part of a building, storm door or
storm window.
b. This coverage
does not include loss:
(1)
To covered property which results because the glass or safety glazing
material has been broken, except as provided
in a. (3) above; or
(2)
On the residence premises if the dwelling has been vacant or
unoccupied for more than 30 consecutive days
immediately before the loss,
12
except
when the breakage results directly from Earth Movement as provided
for in a. (2) above. A dwelling being
constructed is not considered vacant.
Loss to glass covered under this ADDITIONAL COVERAGE
9. will be settled on the basis of replacement with safety glazing
materials when required by ordinance or law.
This coverage does not increase the limit of liability
that applies to the damaged property.
10. Landlord's Furnishings. We will pay up to
$2500 for your appliances, carpeting and other household furnishings,
in an apartment on the residence premises regularly rented
or held for rental to others by an insured, for loss caused
only by the following Perils Insured Against:
b. Windstorm
or hail. This peril does not include loss to the property contained
in a building caused by rain, snow,
sleet, sand or dust unless the direct force of wind or hail damages
the building causing an opening in a roof or
wall and the rain, snow, sleet, sand or dust enters through this opening.
This peril includes loss to watercraft
and their trailers, furnishings, equipment, and outboard engines or
motors, only while inside a fully enclosed building.
c.
Explosion.
d. Riot
or civil commotion.
e. Aircraft,
including self-propelled missiles and spacecraft.
f. Vehicles.
g. Smoke,
meaning sudden and accidental damage from smoke.
This peril does not include loss caused
by smoke from agricultural smudging or industrial operations.
h. Vandalism or malicious mischief.
i. Falling
objects. This peril does not include loss to property contained
in a building unless the roof or an outside wall
of the building is first damaged by a falling object. Damage to the
falling object itself is not included.
13
j. Weight of ice, snow
or sleet which causes damage to property contained in a building.
k. Accidental discharge
or overflow of water or steam from within a plumbing, heating, air
conditioning or automatic fire protective
sprinkler system or from within a household appliance.
This peril does not include loss:
(1)
To the system or appliance from which the water or steam escaped;
(2) Caused
by or resulting from freezing except as provided in the peril of freezing
below; or
(3) On the
residence premises caused by accidental discharge or overflow which
occurs off the residence premises.
In this peril, a plumbing
system does not include a sump, sump pump or related equipment.
1. Sudden and accidental tearing apart,
cracking, burning or bulging of a steam or hot water heating system,
an air conditioning or automatic fire protective
sprinkler system or an appliance for heating water.
We do not cover loss
caused by or resulting from freezing under this peril.
m. Freezing of a
plumbing, heating, air conditioning or automatic fire protective sprinkler
system or of a household appliance.
This peril does not include
loss on the residence premises while the dwelling is unoccupied,
unless you have used reasonable care
to:
(1)
Maintain heat in the building; or
(2) Shut off
the water supply and drain the system and appliances of water.
n. Sudden and accidental
damage from artificially generated electrical current. This peril does
not include loss to a tube, transistor or
similar electronic component.
o. Volcanic eruption other than loss
caused by earthquake, land shock waves or tremors.
The $2500 limit is the most we will pay in any
one loss regardless of the number of appliances, carpeting or other household
furnishings involved in the loss.
14
11. Ordinance or Law.
a. You may use up to 10% of the
limit of liability that applies to COVERAGE A for the increased costs
you incur due to the enforcement
of any ordinance or law which requires or regulates:
(1)
The construction, demolition, remodeling, renovation or repair of that
part of a covered building or other structure
damaged by a Peril Insured Against;
(2) The demolition
and reconstruction of the undamaged part of a covered building or other
structure, when that
building or other structure must be totally demolished because of damage
by a Peril Insured Against to another
part of that covered building or other structure; or
(3) The remodeling,
removal or replacement of the portion of the undamaged part of a covered
building or other
structure necessary to complete the remodeling, repair or replacement
of that part of the covered building or
other structure damaged by a Peril Insured Against.
b. You
may use all or part of this ordinace or law coverage to pay for the increased
costs you incur to remove debris
resulting from the construction, demolition, remodeling, renovation, repair
or replacement of property as stated in
a. above.
c. We do not cover:
(1)
The loss in value to any covered building or other structure due to
the requirements of any ordinance or
law; or
(2) The
costs to comply with any ordinance or law which requires any insured
or others to test for, monitor, clean
up, remove, contain, treat, detoxify or neutralize, or in any way respond
to, or assess the effects of, pollutants
on any covered building or other structure.
Pollutants means any solid, liquid, gaseous
or thermal irritant or contaminant, including smoke, vapor, soot, fumes,
acids, alkalis, chemicals and waste. Waste includes materials to be recycled,
reconditioned or reclaimed.
This coverage is additional insurance.
15
SECTION I - PERILS INSURED AGAINST
COVERAGE A - DWELLING and
COVERAGE B - OTHER STRUCTURES
We insure against risk of direct loss to property described in
Coverage A and B only if that loss is a physical loss to property. We
do not, however, insure for loss:
1. Involving collapse, other than as provided in Additional
Coverage 8.;
2. Caused by:
a. Freezing of a plumbing,
heating, air conditioning or automatic fire protective sprinkler system
or of a household appliance, or by discharge,
leakage or overflow from within the system or appliance caused by freezing.
This exclusion applies only while the dwelling
is vacant, unoccupied or being constructed unless you have used
reasonable care to:
(1)
Maintain heat in the building; or
(2) Shut off
the water supply and drain the system and appliances of water;
b. Freezing, thawing, pressure or
weight of water or ice, whether driven by wind or not, to a:
(1)
Fence, pavement, patio or swimming pool;
(2)
Foundation, retaining wall or bulkhead; or
(3) Pier,
wharf or dock;
c. Theft in or to a dwelling
under construction, or of materials and supplies for use in the construction
until the dwelling is finished and occupied;
d. Vandalism and malicious mischief if the
dwelling has been vacant or unoccupied for more than 30 consecutive days
immediately before the loss. A dwelling being constructed is not considered
vacant;
e. Any of the following:
(1)
Wear and tear, marring, deterioration;
(2)
Inherent vice, latent defect, mechanical breakdown;
(3)
Smog, rust or other corrosion, mold, wet or dry rot;
(4)
Smoke from agricultural smudging or industrial operations;
(5)
Discharge, dispersal, seepage, migration, release or escape of pollutants
unless the discharge, dispersal, seepage,
migration, release or
16
escape
is itself caused by a Peril Insured Against under coverage C of this
policy.
Pollutants
means any solid, liquid, gaseous or thermal irritant or contaminant,
including smoke, vapor, soot, fumes,
acids, alkalis, chemicals and waste. Waste includes materials to be
recycled, reconditioned or reclaimed;
(6) Settling,
shrinking, bulging or expansion, including resultant cracking, of
pavements, patios, foundations, walls,
floors, roofs or ceilings;
(7) Birds,
vermin, rodents or insects; or
(8) Animals
owned or kept by an insured.
If any of these cause
water damage not otherwise excluded, from a plumbing, heating, air
conditioning or automatic fire protective
sprinkler system or household appliance, we cover loss caused
by the water including the cost of tearing
out and replacing any part of a building necessary to repair the system
or appliance. We do not cover
loss to the system or appliance from which this water escaped.
3. Excluded under SECTION I - EXCLUSIONS.
4. Which occurs at a time when the residence premises
has been vacant or unoccupied by you for a period of time in
excess of 60 consecutive days before the loss.
Under items 1. and 2., any ensuing loss to property
described in Coverages A and B not excluded or excepted in this policy
is covered.
COVERAGE C - PERSONAL PROPERTY
We insure for direct physical loss tot he property described
in Coverage C caused by a peril listed below unless the loss is excluded
in SECTION I - EXCLUSIONS.
1. Fire or lightning.
2. Windstorm or hail. This peril does not include
loss to the property contained in a building caused by rain, snow,
sleet, sand or dust unless the direct force of wind or hail damages
the building causing an opening in a roof or wall and the rain, snow,
sleet, sand or dust enters through
17
this opening.
This peril includes loss to watercraft and their trailers,
furnishings, equipment, and outboard engines or motors, only while inside
a fully enclosed building.
3. Explosion.
4. Riot or civil commotion.
5. Aircraft, including self-propelled missiles
and spacecraft.
6. Vehicles.
7. Smoke, meaning sudden and acidental damage
from smoke.
This peril does not include loss caused by smoke from
agricultural smudging or industrial operations.
8. Vandalism or malicious mischief.
9. Theft, including attempted theft and loss
of property from a known place when it is likely that the property has
been stolen.
This peril does not include loss caused by theft:
a. Committed
by an insured;
b. In or to a dwelling under construction,
or of materials and supplies for use in the construction until the dwelling
is finished and occupied; or
c. From that part of a residence premises
rented by an insured to other than an insured.
This peril does not include loss caused by theft that
occurs off the residence premises of:
a. Property
while at any other residence owned by, rented to or occupied by an insured,
except while an insured is temporarily
living there. Property of a student who is an insured is covered
while living away from home if the student
has been there at any time during the 45 days immediately before the loss;
b. Watercraft, and their furnishings, equipment
and outboard engines or motors; or
18
10. Falling objects. This peril does not include
loss to property contained in a building unless the roof or an outside
wall of the building is first damaged by a falling object. Damage to
the falling object itself is not included.
11. Weight of ice, snow or sleet which causes
damage to property contained in a building.
12. Accidental discharge or overflow of water or
steam from within a plumbing, heating, air conditioning or automatic
fire protective sprinkler system or from within a household appliance.
This peril does not include loss:
a. To the system or appliance
from which the water or steam escaped;
b. Caused by or resulting from freezing
except as provided in the peril of freezing below; or
c. On the residence premises caused
by accidental discharge or overflow which occurs off the residence
premises.
In this peril, a plumbing system does not include a
sump, sump pump or related equipment.
13. Sudden and accidental tearing apart, cracking,
burning or bulging of a steam or hot water heating system, an air
conditioning or automatic fire protective sprinkler system, or an appliance
for heating water.
We do not cover loss caused by or resulting from
freezing under this peril.
14. Freezing of a plumbing, heating, air conditioning
or automatic fire protective sprinkler system or of a household appliance.
This peril does not include loss on the residence
premises while the dwelling is unoccupied, unless you have
used reasonable care to:
a. Maintain
heat in the building; or
b. Shut off the water supply and drain the
system and appliances of water.
19
15. Sudden and accidental damage from artificially
generated electrical current. This peril does not include loss to
a tube, transistor or similar electronic component.
16. Volcanic eruption other than loss caused by
earthquake, land shock waves or tremors
SECTION I - EXCLUSIONS
1. We do not insure for loss caused directly or indirectly by
any of the following. Such loss is excluded regardless of any other cause
or event contributing concurrently or in any sequence to the loss.
a. Ordinance or Law, meaning any
ordinance or law:
(1)
Requiring or regulating the construction, demolition, remodeling, renovation
or repair of property, including removal
of any resulting debris. This exclusion 1.a.(1) does not apply to the
amount of coverage that may be provided
for under ADDITIONAL COVERAGES, Glass or Safety Glazing Material or
Ordinance or Law;
(2) The
requirements of which result in a loss in value to property; or
(3) Requiring
any insured or others to test for, monitor, clean up, remove,
contain, treat, detoxify or neutralize, or
in any way responsd to, or assess the effects of, pollutants.
Pollutants
means any solid, liquid, gaseous or thermal irritant or contaminant, including
smoke, vapor, soot, fumes,
acids, alkalis, chemicals and waste. Waste includes materials to be recycled,
reconditioned or reclaimed.
This exclusion applies
whether or not the property has been physically damaged.
b. Earth Movement, meaning earthquake
including land shock waves or tremors before, during or after a volcanic
eruption; landslide; mine subsidence; mudflow; earth sinking, rising
or shifting; or any earth movement caused
by man or man-made forces unless direct loss by:
(1)
Fire; or
(2) Explosion;
20
ensues and then we
will pay only for the ensuing loss. This exclusion does not apply to
loss by theft.
c. Water Damage, meaning:
(1)
Flood, surface water, waves, tidal water, overflow of a body of water
or spray from any of these, whether or
not driven by wind;
(2) Water
which backs up through sewers or drains or which overflows from a sump;
or
(3) Water
below the surface of the ground, including water which exerts pressure
on or seeps or leaks through a
building, sidewalk, driveway, foundation, swimming pool or other structure.
Direct loss
by fire, explosion or theft resulting from water damage is covered.
d. Power Failure, meaning the failure
of power or other utility service if the failure takes place off the residence
premises. But, if the failure of power
or other utility service results in a loss, from a Peril Insured Against
on the residence premises, we
will pay for the loss or damage caused by that Peril Insured Against.
e. Neglect, meaning neglect
of the insured to use all reasonable means to save and preserve
property at and after the time of a
loss.
f. War, including the following and
any consequences of any of the following:
(1)
Undeclared war, civil war, insurrection, rebellion or revolution;
(2) Warlike
act by a military force or military personnel; or
(3) Destruction,
seizure or use for a military purpose.
Discharge
of a nuclear weapon will be deemed a warlike act even if accidental.
g. Nuclear Hazard, to the extent
set forth in the Nuclear Hazard Clause of SECTION I - CONDITIONS.
h. Intentional Loss, meaning any
loss arising out of any act committed:
(1)
By or at the expressed or implied direction of any insured; and
(2) With
the intent to cause a loss.
2. We do not insure for loss to property described
in
21
Coverages A and B caused by any of the following. However,
any ensuing loss to property described in Coverages A and B not excluded
or excepted in this policy is covered.
a. Weather conditions.
However, this exclusion only applies if weather conditions contribute
in any way with a cause or event excluded
in paragraph 1. above to produce the loss;
b. Acts or decisions, including the
failure to act of decide, or any person, group, organization or governmental
body;
c. Faulty, inadequate or defective:
(1) Planning,
zoning, development, surveying, siting;
(2) Design,
specifications, workmanship, repair, construction, renovation, remodeling,
grading, compaction;
(3) Materials
used in repair, construction, renovation or remodeling; or
(4) Maintenance;
of part or all of any property whether on or off the residence
premises.
SECTION I - CONDITIONS
1. Insurable Interest and Limit of Liability. Even
if more than one person has an insurable interest in the property covered,
we will not be liable in any one loss.
a. To any insured
for more than the amount of the insured's interest at the time of loss;
or
b. For more than the applicable limit of
liability.
2. An Insured's Duties After Loss. In case of a
loss to covered property, you must see that the following duties
are complied with. We have no duty or obligation to provide any coverage
under this policy unless you or any insured making a claim
under this policy have fully complied with the following conditions and
duties.
a. Give prompt notice to
us;
b. Notify the police in case of loss by
theft;
c. Notifty the credit card or fund transfer
card company in case of loss under Credit Card or Fund Transfer Card coverage;
d. Protect the property from further damage.
If
22
repairs to the property
are required, you must:
(1)
Make reasonable and necessary repairs to protect the property; and
(2) Keep
an accurate record of repair expenses;
e. Prepare
and submit to us within 60 days of the loss an inventory of damaged
personal property using the forms we
provide showing the quantity, description, place of purchase, date of
purchase, original cost, actual cash value, replacement
cost and amount you are claiming as a loss. You must attach
all bills, receipts and related documents that
justify the figures in the inventory;
f. As often as we
reasonably require:
(1)
Show the damaged property;
(2) Provide
us with records and documents we request and permit us
to make copies; and
(3) Any
insured must submit to examination under oath, as often as we
may reasonably request, while not in the
presence of any other insured, and sign the same;
g. Send
to us, within 60 days after our request, your signed,
sworn proof of loss, using the form we provide, which
sets forth, to the best of your knowledge and belief:
(1)
The time and cause of loss;
(2) The
interest of the insured and all others in the property involved
and all liens on the property;
(3) Other
insurance which may cover the loss;
(4) Changes
in title or occupancy of the property during the term of the policy;
(5) Specifications
of damaged buildings an detailed repair estimates;
(6) The
inventory of damaged personal property described in 2.e. above;
(7) Receipts
for additional living expenses incurred and records that support the
fair rental value loss; and
(8) Evidence
or affidavit that supports a claim under the Credit Card, Fund Transfer
Card, Forgery and Counterfeit
Money coverage, stating the amount and cause of loss.
h. All
insureds must help us and cooperate with us in
the investigation of any claim presented under this policy.
23
3 . Loss Settlement. Covered property losses are settled
as follows:
a. Property of the following
types:
(1)
Personal property;
(2) Awnings,
carpeting, household appliances, outdoor antennas and outdoor equipment,
whether or not attached
to buildings; and
(3) Structures
that are not buildings;
at actual
cash value at the time of loss but not more than the amount required
to repair or replace.
b. Buildings under Coverage A or B at
replacement cost without deduction for depreciation, subject to the
following:
(1)
If, at the time of loss, the amount of insurance in this policy on the
damaged building is 80% or more of the full
replacement cost of the building immediately before the loss, we
will pay the cost to repair or replace, after application
of deductible and without deduction for depreciation, but not more than
the lesser of the following amounts:
(a)
The limit of liability under this policy that applies to the building;
(b)
The replacement cost of that part of the building damaged for like construction
and use on the same premises;
or
(c)
The necessary amount actually spent to repair
or replace the damaged building.
(2)
If, at the time of loss, the amount of insurance in this policy on the
damaged building is less than 80% of the full
replacement cost of the building immediately before the loss, we
will pay the greater of the following amounts,
but not more than the limit of liability under this policy that applies
to the building:
(a)
The actual cash value of that part of the building damaged; or
(b)
That proportion of the cost to repair or replace, after application
of deductible and without deduction for
depreciation, that part of the building damaged, which the total amount
of insurance in this policy on the damaged
building bears to 80% of the replacement cost of the building.
(3)
To determine the amount of insurance
24
required
to equal 80% of the full replacement cost of the building immediately
before the loss, do not include the
value of:
(a)
Excavations, foundations, piers or any supports which are below the
undersurface of the lowest basement
floor;
(b)
Those supports in (a) above which are below the surface of the ground
inside the foundation walls, if there
is no basement; and
(c)
Underground flues, pipes, wiring and drains.
(4)
We will pay no more than the actual cash value of the damage until
actual repair or replacement cost is complete.
Once actual repair or replacement is complete, we will settle the
loss according to the provisions of b.
(1) and b. (2) above.
However,
if the cost to repair or replace the damage is both:
(a)
Less than 5% of the amount of insurance in this policy on the building;
and
(b)
Less than $2500;
we
will settle the loss according to the provisions of b.(1) and b.(2)
above whether or not actual repair or replacement
is complete.
(5) you
may disregard the replacement cost loss settlement provisions and make
claim under this policy for loss
or damage to buildings on an actual cash value basis. You may
then make claim within 180 days after loss for
any additional liability according to the provisions of this Condition
3. Loss Settlement.
4. Loss to a Pair or Set. In case of loss to a pair or set we
may elect to:
a. Repair
or replace any part to restore the pair or set to its value before the
loss; or
b. Pay the difference between actual cash
value of the property before and after the loss.
5. Glass Replacement. Loss for damage to glass
caused by a Peril Insured Against will be settled on the basis of
replacement with safety glazing materials when required by
25
ordinance or law.
6. Appraisal. If you and
we fail to agree on the amount of loss, and any insured
claiming coverage has complied with all other conditions of the policy,
either may demand an appraisal of the loss in writing. If both parties
agree in writing to appraisal, and to be bound by the results, each
party will choose a competent and disinterested appraiser within 20
days after receiving a written request from the other. The two appraisers
will choose a disinterested and impartial umpire. If they cannot agree
upon an umpire within 15 days, you or we, upon written
notice to the other, may request that the choice be made by a judge
of a court of record in the state where the residence premises
is located. The appraisers shall separately set the amount of the
loss as defined in the policy. If the appraisers submit a written
report of an agreement to us, the amount agreed upon will be
the amount of loss. If they fail to agree, they will submit their
differences to the umpire. A decision agreed to by any two will set
the amount of loss.
Each party will:
a. Pay
its own appraiser; and
b. Bear the other expenses
of the appraisal and umpire equally.
7. Other Insurance. If a loss covered by this
policy is also covered by other insurance, we will pay only
the proportion of the loss that the limit of liability that applies
under this policy bears to the total amount of insurance covering
the loss.
8. Suit Against Us. No action can be brought
unless the policy provisions have been fully complied with and the
action is started within one year after the date of loss.
9. Our Option. If we give you
written notice within 30 days after we receive your
signed, sworn proof of loss, we may repair or replace any part
of the damaged property with like property, at our option.
10. Loss Payment. We will adjust all losses
with you. We will pay you unless some other person is
named in the policy or is legally entitled to receive payment. Loss
will be payable 60 days after we receive your proof
of loss, all
26
conditions of the policy of insurance
have been complied with and:
a. We reach an
agreement with you;
b. There is an entry of a final judgment;
or
c. There is a filing of an appraisal
award with us.
11. Abandonment of Property. We
need not accept any property abandoned by an insured.
12. Mortgage Clause. The word
mortgagee includes trustee.
If a mortgagee is named in this policy,
any loss payable under Coverage A or B will be paid to the mortgagee
and you, as interests appear. If more than one mortgagee is
named, the order of payment will be the same as the order of precedence
of the mortgages.
If we deny your claim,
that denial will not apply to a valid claim of the mortgagee, if the
mortgagee:
a. Notifies
us in writing of any change in ownership, occupancy or substantial
change in risk of which the mortgagee
is aware;
b. Pays any premium due under this policy
on demand if you have neglected to pay the premium; and
c. Submits a signed, sworn statement of
loss within 60 days after receiving notice from us of your
failure to do so. Policy conditions relating
to An Insured's Duties After Loss, Appraisal, Suit Against Us and Loss
Payment apply to the mortgagee.
If we decide to cancel or not to renew this
policy, the mortgagee will be notified at least 10 days before the
date cancellation or nonrenewal takes effect.
If we pay the mortgagee for any loss and deny
payment to you:
a. We
are subrogated to all the rights of the mortgagee granted under the
mortgage on the property; or
b. At our option, we may
pay to the mortgagee the whole principal on the mortgage plus any accrued
interest. In this event, we will
receive a full assignment and transfer of the mortgage and all
27
securites
held as collateral to the mortgage debt.
Subrogation will not impair the right of
the mortgagee to recover the full amount of the mortgagee's claim.
13. No Benefit to Bailee. We will
not recognize any assignment or grant any coverage that benefits a person
or organization holding, storing or moving property for a fee regardless
of any other provision of this policy.
14. Nuclear Hazard Clause.
a. Nuclear
Hazard means any nuclear reaction, radiation or radioactive contamination,
all whether controlled or uncontrolled or
however caused, or any consequence of any of these.
b. Loss caused by the nuclear hazard will
not be considered loss caused by fire, explosion or smoke, whether these
perils are specifically named in or otherwise included within the Perils
Insured Against in Section I.
c. This policy does not apply under Section
I to loss caused directly or indirectly by nuclear hazard, except that
direct loss by fire resulting from the nuclear
hazard is covered.
15. Recovered Property. If you
or we recover any property for which we have made payment
under this policy, you or we will notify the other of
the recovery. At your option, the property will be returned to
or retained by you or it will become our property. If
the recovered property is returned to or retained by you, the
loss payment will be adjusted based on the amount you received
for the recovered property.
16. Volcanic Eruption Period. One
or more volcanic eruptions that occur within a 72-hour period will be
considered as one volcanic eruption.
SECTION II - LIABILITY COVERAGES
COVERAGE E - Personal Liability
If a claim is made or a suit is brought against an insured for
damages because of bodily injury or property damage caused
by an occurrence to which this coverage applies, we will:
28
1. Pay up to our limit of liability
for the damages for which the insured is legally liable. Damages
include prejudgment interest awarded against the insured; and
2. Provide a defense at our expense
by counsel of our choice, even if the suit is groundless, false
or fraudulent. We may investigate and settle any claim or suit
that we decide is appropriate. Our duty to settle or
defend ends when the amount we pay for damages resulting from
the occurence equals our limit of liability.
COVERAGE F - Medical Payments to Others
We will pay the necessary medical
expenses that are incurred or medically ascertained within three years
from the date of an accident causing bodily injury. Medical
expenses means reasonable charges for medical, surgical, x-ray, dental,
ambulance, hospital, professional nursing, prosthetic devices and
funeral services. This coverage does not apply to you or regular
residents of your household except residence employees.
As to others, this coverage applies only:
1. To a person on the insured location
with the permission of an insured; or
2. To a person off the insured location,
if the bodily injury:
a. Arises
out of a condition on the insured location or the ways immediately
adjoining;
b. Is caused by the activities of an insured;
c. Is caused by a residence employee
in the course of the residence employee's employment by an insured;
or
d. Is caused by an animal owned by or
in the care of an insured.
SECTION II - EXCLUSIONS
1. Coverage E - Personal Liability and
Coverage F - Medical Payments to Others do not apply to bodily
injury or property damage:
a. Which
is expected or intended by one or more insureds;
b. Arising out of or in connection with
a business
29
engaged in by an insured.
This exclusion applies but is not limited to an act or omission, regardless
of its nature or circumstance, involving
a service or duty rendered, promised, owed or implied to be provided because
of the nature of the business;
c. Arising out of the rental or holding
for rental of any part of any premises by an insured. This exclusion
does not apply to the rental or holding
for rental of an insured location:
(1)
On an occasional basis if used only as a residence;
(2) In part
for use only as a residence, unless a single family unit is intended for
use by the occupying family to lodge
more than two roomers or boarders; or
(3) In part,
as an office, school, studio or private garage;
d. Arising
out of the rendering of or failure to render professional services;
e. Arising
out of a premises:
(1)
Owned by an insured;
(2) Rented
to an insured; or
(3) Rented
to others by an insured;
that is not
an insured location;
(1)
The ownership, maintenance, use, loading or unloading of any motor vehicles
or all other motorized land conveyances,
including trailers, owned or operated by or rented or loaned to an insured;
(2) The entrustment
by an insured of any motor vehicle or any other motorized land
conveyance to any person;
or
(3) Vicarious
liability, whether or not statutorily imposed, for the actions of a child
or minor using a vehicle or conveyance
excluded in paragraph (1) or (2) above.
This exclusion does not apply to:
(1)
A trailer not towed by or carried on a motorized land conveyance.
(2) A motorized
land conveyance designed for recreational use off public roads, not subject
to motor vehicle registration
and:
(a)
Not owned by an insured; or
30
(b)
Owned by an insured and on an insured location;
(3)
A motorized golf cart when used to play golf on a golf course;
(4) A vehicle
or conveyance not subject to motor vehicle registration which is:
(a)
Used to service an insured's residence;
(b)
Designed for assisting the handicapped; or
(c)
In dead storage on an insured location;
g. Arising
out of:
(1)
The ownership, maintenance, use, loading or unloading of an excluded watercraft
described below;
(2)
The entrustment by an insured of an excluded watercraft described
below to any person; or
(3)
Vicarious liability, whether or not statutorily imposed, for the actions
of a child or minor using an excluded watercraft
described below.
Excluded
watercraft are those that are principally designed to be propelled by
engine power or electric motor or are
sailing vessels, whether owned by or rented to an insured. This
exclusion does not apply to watercraft:
(1)
That are not sailing vessels and are powered by:
(a)
Inboard or inboard-outdrive engine or motor power of 50 horsepower or
less not owned by an insured;
(b)
Inboard or inboard-outdrive engine or motor power of more than 50 horsepower
not owned by or rented
to an insured;
(c) One or more outboard engines or motors with 25 total horsepower or
less;
(d)
One or more outboard engines or motors with more than 25 total horsepower
if the outboard engine or motor
is not owned by an insured;
(e)
Outboard engines or motors of more than 25 total horsepower owned by an
31
insured
if:
(i)
You acquire them prior to the policy period; and
(a)
You declare them at policy inception; or
(b)
Your intention to insure is reported to us in writing within
45 days after you acquire the outboard engines
or motors.
(ii)
You acquire them during the policy period.
This
coverage applies for the policy period.
(2)
That are sailing vessels, with or without auxiliary power:
(a)
Less than 26 feet in overall length;
(b)
26 feet or more in overall length, not owned by or rented to an insured.
(3)
That are stored;
h. Arising out of:
(1)
The ownerhsip, maintenance, use, loading or unloading of an aircraft;
(2) The entrustment
by an insured of an aircraft to any person; or
(3) Vicarious
liability, whether or not statutorily imposed, for the actions of a child
or minor using an aircraft.
An aircraft means
any contrivance used or designed for flight, except model or hobby aircraft
not used or designed to carry people or
cargo;
i. Caused directly
or indirectly by war, including the following and any consequence of any
of the following:
(1)
Undeclared war, civil war, insurrection, rebellion or revolution;
(2)
Warlike act by a military force or military personnel; or
(3)
Destruction, seizure or use for a military purpose.
Discharge of a nuclear
weapon will be deemed a warlike act even if accidental;
j. Which arises out
of the transmission of a communicable disease by an insured;
k. Arising out of
sexual molestation, corporal punishment of physical or mental abuse; or
l. Arising out of the use,
sale, manufacture,
32
delivery, transfer or
posession by any person of a Controlled Substance(s) as defined by
the Federal Food and Drug Law at 21
U.S.C.A. Sections 811 and 812. Controlled Substances include but are
not limited to cocaine, LSD, marijuana
and all narcotic drugs. However, this exclusion does not apply to
the legitimate use of prescription drugs
by a person following the orders of a licensed physician.
Exclusions e., f., g. and h. do not apply to bodily
injury to a residence employee arising out of and in the
course of the residence employee's employment by an insured.
2. Coverage E - Personal Liability, does not apply
to:
(1)
For any loss assessment charged against you as a member of an
association, corporation or community of property
owners;
(2)
Under any contract or agreement. However, this exlcusion does not apply
to written contracts:
(a)
That directly relate to the ownership, maintenance or use of an insured
location; or
(b)
Where the liability of others is assumed by the insured prior
to an occurrence;
unless
excluded in(1) above or elsewhere in this policy;
b. Property
damage to property owned by the insured;
c. Property
damage to property rented to, occupied or used by or in the care
of the insured. This exclusion does
not apply to property damage caused by fire, smoke or
explosion;
d. Bodily injury to any person
eligible to receive any benefits:
(1)
Voluntarily provided; or
(2)
Required to be provided;
by the
insured under any:
(1)
Workers' compensation law;
(2)
Non-occupational disability law; or
(3)
Occupational disease law;
e. Bodily
injury or property damage for which an insured under
this policy:
(1)
Is also an insured under a nuclear energy
33
liability
policy; or
(2)
Would be an insured under that policy but for the exhaustion of
its limit of liability.
A nuclear energy liability
policy is one issued by:
(1)
American Nuclear Insurers;
(2)
Mutual Atomic Energy Liability Underwriters;
(3)
Nuclear Insurance Association of Canada;
or any of
their successors; or
f. Bodily injury
to you or an insured within the meaning of part a. or b.
of insured as defined.
3. Coverage F - Medical Payments to Others, does not apply to bodily
injury:
a. To a residence
employee if the bodily injury:
(1)
Occurs off the insured location; and
(2)
Does not arise out of or in the course of the residence employee's
employment by an insured;
b. To any
person eligible to receive benefits:
(1)
Voluntarily provided; or
(2)
Required to be provided;
under any:
(1)
Workers' compensation law;
(2)
Non-occupational disability law; or
(3)
Occupaitonal disease law;
c. From any:
(1)
Nuclear reaction;
(2)
Nuclear radiation; or
(3)
Radioactive contamination;
all whether
controlled or uncontrolled or however caused; or
(4)
Any consequence of any of these; or
d. To any person, other
than a residence employee of an insured, regularly residing
on any part of the insured location.
SECTION II - ADDITIONAL COVERAGES
We cover the following in addition to the limits
of liability:
1. Claim Expenses. We pay:
a. Expenses
we incur and costs taxed against an insured in any suit
we defend;
b. Premiums
on bonds required in a suit we defend, but not for bond amounts
more than the limit of liability for Coverage
E. We need not apply for or furnish any bond;
c. Reasonable expenses incurred by an insured
at our request, including actual loss of earnings (but not loss
of other income) up to $50 per day, for
assisting us in the investigation or defense of a claim or suit;
and
d. Interest on the entire judgment which
accrues after entry of the judgment and before we pay or tender,
or deposit in court that part of the judgment
which does not exceed the limit of liability that applies.
2. First Aid Expenses. We will pay expenses for
first aid to others incurred by an insured for bodily injury
covered under this policy. We will not pay for first aid to you
or any other insured.
3. Damage to Property of Others. We will pay,
at replacement cost, up to $500 per occurrence for property
damage to property of others caused by an insured.
We will not pay for property damage:
a. To the
extent of any amount recoverable under Section I of this policy;
b. Caused intentionally
by an insured who is 13 years of age or older;
c. To property owned
by an insured;
d. To property owned
by or rented to a tenant of an insured or a resident in your
household; or
e. Arising out of:
(1)
A business engaged in by an insured;
(2)
Any act or omission in connection with a premises owned, rented or controlled
by an insured, other than the
insured location; or
(3)
The ownership, maintenance, or use of aircraft, watercraft or motor vehicles
or all other motorized land conveyances.
This
exclusion does not apply to a motorized land conveyance designed for recreational
use off public roads, not
subject to motor vehicle registration and not owned by an insured.
35
4. Loss Assessment. We will pay up to $1000 for your
share of loss assessment charged during the policy period against you
by a corporation or association of property owners, when the assessment
is made as a result of:
a. Bodily
injury or property damage not excluded under Seciton II of this
policy; or
b. Liability for an act of a director,
officer or trustee in the capacity as a director, officer or trustee,
provided:
(1)
The director, officer or trustee is elected by the members of a corporation
or association of property owners;
and
(2) The
director, officer or trustee serves without deriving any income from
the exercise of duties which are solely
on behalf of a corporation or association of property owners.
This coverage applies only to loss assessments charged
against you as owner or tenant of the residence premises.
We do not cover loss assessments charged against
you or a corporation or association of property owners by any
governmental body.
Regardless of the number of assessments, the limit
of $1000 is the most we will pay for loss arising out of:
a. One
accident, including continuous or repeated exposure to substantially
the same general harmful condition; or
b. A covered act of a director, officer
or trustee. An act involving more than one director, officer or trustee
is considered to be a single act.
The following do not apply to this coverage:
1. Section II - Coverage E -
Personal Liability Exclusion 2.a.(1);
2. Condition 1. Policy Period, under SECTIONS I AND
II - CONDITIONS.
SECTION II - CONDITIONS
1. Limit of Liability. Our total liability
under Coverage E for all damages resulting from any one occurrence
will not be more than the limit of liability for Coverage E as
36
shown in the Declarations. This limit is the same
regardless of the number of insureds, claims made or persons
injured. All bodily injury and property damage resulting
from any one accident or from continuous or repeated exposure to substantially
the same general harmful conditions shall be considered to be the
result of one occurrence.
Our total liability under Coverage F for all
medical expense payable for bodily injury to one person as
the result of one accident will not be more than the limit of liability
for Coverage F as shown in the Declarations.
2. Severability of Insurance. This insurance
applies separately to each insured. This condition will not
increase our limit of liability for any one occurrence.
3. Duties After Loss. In case of an accident
or occurrence, the insured will perform the following
duties that apply. You will help us by seeing that these
duties are performed:
a. Give
written notice to us as soon as is practical, which sets forth:
(1)
The identity of the policy and insured;
(2) Reasonably
available information on the time, place and circumstances of the accident
or occurrence; and
(3) Names
and addresses of any claimants and witnesses;
b. Promptly
forward to us every notice, demand, summons or other process
relating to the accident or occurrence;
c. At our request, hep us;
(1)
To make settlement;
(2) To enforce
any right of contribution or indemnity against any person or organization
who may be liable to an
insured;
(3) With
the conduct of suits and attend hearings and trials; and
(4) To secure
and give evidence and obtain the attendance of witnesses;
d. Under
the coverage - Damage to Property of Others - submit to us within
60 days after the loss, a sworn statement
of loss and show the damaged property, if in the insured's
control;
e. The insured will not, except
at the insured's
37
own cost, voluntarily make payment, assume
obligation or incur expense other than for first aid to others at the
time of the bodily injury.
4. Duties of an Injured Person - Coverage F - Medical
Payments to Others. The injured person or someone acting for the
injured person will:
a. Give us
written proof of claim, under oath if required, as soon as is practical;
and
b. Authorize us to obtain copies
of medical reports and records.
The injured person will submit to a physical exam by
a doctor of our choice when and as often as we reasonably
require.
5. Payment of Claim - Coverage F - Medical Payments
to Others. Payment under this coverage is not an admission of liability
by an insured or us.
6. Suit Against Us. No action can be brought
against us unless there has been full compliance with the policy
provisions.
No one will have the right to join us as a party
to any action against an insured. Also, no action with respect
to Coverage E can be brought against us until the obligation
of the insured has been determined by final judgment or agreement
signed by us.
7. Bankruptcy of an Insured. Bankruptcy or insolvency
of an insured will not relieve us of our obligations
under this policy.
8. Other Insurance - Coverage E - Personal Liability.
This insurance is excess over other valid and collectible insurance
except insurance written specifically to cover as excess over the limits
of liability that apply in this policy.
SECTION I AND II - CONDITIONS
1. Policy Period. This policy applies only to
loss in Section I or bodily injury or property damage
in Section II, which occurs during the policy period.
38
2. Concealment or Misrepresentation.
This entire policy will be void and all coverages forfeited, and payment
will not be made to any insured, if before or after a loss, any
insured has knowingly concealed or misrepresented any material
fact or circumstance relating to this insurance, the insurance application,
the loss, the presentation of the claim or any other fact or circumstance
material to the investigation and adjustment of the claim.
3. Liberalization Clause. If we make a
change which broadens coverage under this edition of our policy
without additional premium charge, that change will automatically apply
to your insurance as of the date we implement the change
in your state, provided that this implementation date falls within
60 days prior to or during the policy period stated in the Declarations.
This Liberalization Clause does not apply to changes
implemented through introduction of a subsequent edition of our
policy.
4. Waiver or Change of Policy Provisions. A waiver
or change of a provision of this policy must be in writing by us
to be valid. Our request for an appraisal or examination will
not waive any of our rights.
5. Cancellation.
a. You
may cancel this policy at any time by returning it to us or by
letting us know in writing of the date cancellation
is to take effect.
b. We may cancel this policy only
for the reasons stated below by letting you know in writing of
the date cancellation takes effect. This
cancellation notice may be delivered to you or mailed to you
at your mailing address shown in
the Declarations.
Proof of mailing will be sufficient proof
of notice.
(1) When you have
not paid the premium, we may cancel at any time by letting you
know at least 10 days before the date
cancellation takes effect.
(2) When this policy has been in effect
for less than 60 days and is not a renewal with us, we
may cancel for any reason by letting you
know
39
at
least 10 days before the date cancellation takes effect.
(3) When this
policy has been in effect for 60 days or more, or at any time if it is
a renewal with us, we may cancel:
(a)
If there has been a material misrepresentation of fact which if known
to us would have caused us not to issue
the policy; or
(b)
If the risk has changed substantialy since the policy was issued.
This
can be done by letting you know at least 30 days before the date
cancellation takes effect.
(4) When this
policy is written for a period of more than one year, we may cancel
for any reason at anniversary by
letting you know at least 30 days before the date cancellation
takes effect.
c. When this
policy is cancelled, the premium for the period from the date of cancellation
to the expiration date will be refunded
pro rata.
d. If the
return premium is not refunded with the notice of cancellation or when
this policy is returned to us, we will refund
it within a reasonable time after the date cancellation takes effect.
6. Nonrenewal. We may elect not to renew this
policy. We may do so by delivering to you, or mailing
to you at your mailing address shown in the Declarations,
written notice at least 30 days before the expiration date of this policy.
Proof of mailing will be sufficient proof of notice.
7. Assignment. Assignment of this policy will
not be valid unless we give our written consent.
8. Subrogation. An insured may waive in
writing before a loss all rights of recovery against any person. If
not waived, we may require an assignment of rights of recovery
for a loss to the extent that payment is made by us.
If an assignment is sought, an insured must sign
and deliver all related papers and cooperate with us.
Subrogation does not apply under Section II to Medical
Payments to Others or Damage to Property of Others.
40
9. Death. If any person named in
the Declarations or the spouse, if a resident of the same household,
dies; we insure the legal representative of the deceased, but
only with respect to the premises and property of the deceased covered
under the policy at the time of death.
Insured includes:
a. Any member of your household
who is an insured at the time of your death, but only while
a resident of the residence premises; and
b. With respect to your property,
the person having proper temporary custody of the property until appointment
and qualification of a legal representative.
In Witness Whereof, we have caused this policy to be
executed and attested, and, if required by state law, this policy shall
not be valid unless countersigned by our authorized representative.
William
Erdman
|
Secretary
|
Kenneth A. Johnson
|
President
|
41
Please keep your Declarations Certificates
and
Endorsements with your policy.
Includes copyrighted material of Insurance
Services Office, Inc. with its permission.
Copyright, Insurance Services Office,
Inc. 1995
Form No. 5105 (Ed. 1/96)
|