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Chapter 3
Tx Claims Adjuster Exam
28
Insurance
Not Applicable
10/14/2015
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Term
Most homeowners insurance policies today have ____ specific sections of coverage that come standard with the policy.
 Definition
Six
Term
Those six coverage's are:
 Definition
  • dwelling
  • other structures
  • personal property
  • loss of use
  • liability
  • medical payments to others
Term
Dwelling
 Definition
This section of your homeowners insurance package covers your house structure, plumbing, heating, air conditioning, and any other attached structures or fixtures. When people seek to acquire home insurance, this is most often the coverage that is the most important to them. _______ coverage does not include land.
Term
Other Structures
 Definition
This section covers any structure on your property that is not attached to your home. This includes but is not limited to a detached garage, fence, mailbox, sheds, retaining wall, driveway, etc. The most you can pay is 10% of the Coverage A limit of liability.
Term
Personal Property
 Definition
This section covers all of the contents of your home. It will cover your bed, TV, applicances, couches, clothes, jewerly, and everything you own in the home.
Term
Loss of Use
 Definition

This section is used when your home has been damaged and you need to relocate to a hotel or another residence while your home is being repaired. On a reimbursement basis, it will cover you for any additional expenses you incur as a result of temporarily liviing away from your home.

The typical expenses that can be reimbursed under this coverage include lodging (hotel or apartment), additional food costs, additional gas for having to commute an extra distance, etc.
Term
Liability
 Definition
This section protects you from lawsuits. The coverage is very broad and will even protect you for liability acts that occur due to your negligence away from your property. (For example: you hit someone on the head with a golf ball at the golf course, and they sue). _________ coverage in your home insurance policy does not typically extend to automobile, watercraft, or slander and libel liability.
Term
Medical Payments to Others
 Definition
This section covers welcomed guests to your residence that get injured while on your property. It will pay for things like x-ray, dental work, ambulance rides, hospital bills, etc.
Term
In addition to the six standard coverage sections that are included in the home insurance policy ( Dwelling, Other Structures, Personal Property, Loss of Use, Liability, and Medical Payments), most companies also offer a _____ of other ______ that come at ___ additional charge.
 Definition
variety; protections; no
Term
Debris Removal
 Definition
_______  ______is included with most insurance policies, free of charge. It provides coverage for the ______ _____ of covered property that was damaged by a covered peril.
Term
Trees, Shrubs, Plants, and Lawns
 Definition
The home insurance coverage can extend to _____, ______, ______ and ______ for damages from specified causes of loss. Normally there is a limity of $250.00 per tree, 5% of the Coverage A limit of liability for all trees.
Term
The _______ _______ does not apply to Trees, Shrubs, Plants, and Lawns..
 Definition
Deductible clause
Term
Trees, shrubs, plants, and lawns are covered for specified named perils. Those peril are:
 Definition
  • Fire or Lightning
  • Explosion
  • Aircraft
  • Vehicles not owned or operated by a resident of the residence premises
  • Vandalism
  • Riot
  • Theft.
Term
Trees, shrubs, plants, and lawns are not covered for _________.
 Definition
Windstorm
Term
HO-B Homeowners insurance policy
 Definition
The _____ _______ ______ is a combination of an "all risk" policy and a named perils policy. With the ____, the dwelling is covered for all risks of physical loss, unless specifically excluded and the personal property (contents) are covered on a named perils basis. An all risk policy does not list the perils dwelling home insurance covers; rather, it lists the perils the home insurance does NOT cover. If the damage to the home is not caused by something on the exclusion list, then coverage will be extended.
Term
Perils Insured Against: COVERAGE A (DWELLING)
 Definition
We insure against all risks of physical loss to property described in Section I Property Coverage, _______ __ (_________) unless the loss is excluded in Section I Exclusions.
Term
Perils Insured Against: COVERAGE B (PERSONAL PROPERTY)
 Definition

We insure against physical loss to the property described in Section I Property Coverage, ________ ____ (_______ _______) caused by a peril listed below, unless the loss is excluded in Section I Exclusions.

 

  1. Fire and Lightning
  2. Sudden and Accidental Damage from Smoke
  3. Windstorm, Hurricane and Hail
  4. Explosion
  5. Aircraft and Vehicles
Term
The list of perils included within Coverage B described in Section I Property Coverage.
 Definition
  1. Fire and Lightning
  2. Sudden and Accidental Damage from Smoke
  3. Windstorm, Hurricane and Hail
  4. Explosion
  5. Aircraft and Vehicles
  6. Vandalism and Malicious Mischief
  7. Riot and Civil Commotion
  8. Collaspe of Building or any part of the building
  9. Accidental Discharge, Leakage or Overflow of Water or Steam from within a plumbing, heating or air conditioning system or household appliance.
  10. Falling Objects
  11. Freezing of household appliances.
  12. Theft, including attempted theft and loss of property from a known place when it is likely that the property has been stolen.

 
Term
The following exclusions apply to loss to property described under Coverage A (Dwelling) or Coverage B (Personal Property), but they do not apply to an ensuing loss caused by fire, smoke or explosion:
 Definition
  • We do not cover loss to electrical devices or wiring caused by electricity other than lightning
  • We do not cover loss caused by smog or by smoke from industrial or agricultural operations.
  • We do not cover loss caused by windstorm, hurricane or hail to:
  1. Cloth awnings, greenhouses, and their contents, buildings or structures located wholly or partially over water and their contents.
  2. Radio and television towers, outside satellite dishes.
  3. Personal Property contained in a building unless direct force of wind or hail creates an opening in the roof or wall.
  • We do not cover loss to the following property by theft, including attempted theft and loss of property from a known place when it is likely that the property has been stolen:
  1. Personal property while away from the residence premises at any other residence owned by, rented to or occupied by an insured, except while an insured is temporarily living there.
  2. Building material not on the residence premises.
  • We do not cover loss to machinery, appliances and mechanical devices caused by mechanical breakdown

 

 
Term
We do not cover loss caused by:
 Definition
  • Wear and tear, deterioration
  • Rust or rot
  • Dampness of atmosphere, extremes of temperature
  • Contamination
  • Rats, mice, termites, moths or other insects.
  • We do not cover loss caused by animals or birds owned or kept by an insured or occupant of the residence premises.
  • We do not cover loss under Coverage A (Dwelling) caused by settling or cracking.
  • We do not cover loss caused by Flood.
  • We do not cover loss caused by or resulting from freezing while the building is unoccupied unless you have used reasonable care to:
  1. Maintain heat in the building
  2. Shut off the water supply and drain plumbing, heating and air conditioning systems of water.
  • We do not cover loss caused by earthquake, landslide or earth movement.
  1. Governmental Action
  2. Building Laws
  3. War Damage
  4. Nuclear Damage
Term
Special Limits of Liability
 Definition
These limits do not increase the Coverage B (Personal Property) limit of liability.
Term
The special limit for each numbered category below is the total limit for each loss for all property in that category:
 Definition
  1. Money/ Bank Cards- $100 on money or numismatic property
  2. Bullion/ Valuable Papers- $500 on gold or silver bullion, manuscripts, notes, secrurities, stamps, bills, deeds, evidence of debts, credits, passport documents.
  3. Jewelry/Watches/Furs- $500 for loss by theft of gems, watches, jewerly or furs.
  4. Business Personal Property- $2,500 on all personal property/ contents that used for business use.
  5. We do not cover any business property:
  • That consists of samples or articles for sale or delivery
  • If the property is away from the residence premises.
Term

Section I Deductibles:

When you are adjusting a property claim, __ deductibles will be listed on the __________ _____. It's up to ___, the adjuster to determine which one deductible that you will use on this claim.

 Definition
two; Declarations Page; you
Term
You choose the _______ ______ __ for losses caused by Windstorm, Hurricane, Hail or Wind Driven Rain.
 Definition
Deductible Clause 1
Term
You choose the _________ ______ __ for losses caused by All Other Perils.
 Definition
Deductible Clause 2
Term
The majority of Homeowner's policies in Texas have a ________ deductible.
 Definition
percentage
Term
Remember, if you have a percentage deductible, that percentage is always taken from the ________ ____ limit of liability.
 Definition
Term

You are handling a claim and the limits of liability on the Declarations page are as follows:

  • Coverage A - $90,000
  • Coverage B- $40,000 with a 2% deductible

2% of $90,000 is $1,800.

 Definition
This is an example of taking a deductible from Coverage A limit of liability.
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