Is my Agent Wrong?

[BigIVU]

Have the insurer point to the very specific language in the policy that would preclude coverage for loss by allowing someone to use your home.

In the "ISO standard" HO-3 policy, there is no exclusion for accidental damage TO the home caused by anyone living there. There is an exclusion for "Property in an APARTMENT regularly rented or held for rental to others by an 'insured'...." This does not sound like your situation. There is an exclusion for damage TO a "tenant's" property in your home.

There is a liability exclusion but it also applies to rental exposures and an exception is made for "occasional" rentals. Again, this does not sound like your situation.

Again, the important thing is what your policy actually says, not what the carrier "considers" unless they can cite policy language chapter and verse. Of course, it's possible that your policy may not follow the "ISO standard."

This is another good example of why insurance -- auto or home in particular -- is not a commodity. The WORDING of the insurance contract is critical and coverage can hinge on the tense of a verb or a punctuation mark.

 

[b61mack]

No good deed, goes unpunished!

 

[djs]

Have the insurer point to the very specific language in the policy that would preclude coverage for loss by allowing someone to use your home.

In the "ISO standard" HO-3 policy, there is no exclusion for accidental damage TO the home caused by anyone living there. There is an exclusion for "Property in an APARTMENT regularly rented or held for rental to others by an 'insured'...." This does not sound like your situation. There is an exclusion for damage TO a "tenant's" property in your home.

There is a liability exclusion but it also applies to rental exposures and an exception is made for "occasional" rentals. Again, this does not sound like your situation.

Again, the important thing is what your policy actually says, not what the carrier "considers" unless they can cite policy language chapter and verse. Of course, it's possible that your policy may not follow the "ISO standard."

This is another good example of why insurance -- auto or home in particular -- is not a commodity. The WORDING of the insurance contract is critical and coverage can hinge on the tense of a verb or a punctuation mark.

While this is a very old thread that has been responded to, I caution anyone about using the advice above. There are different risks associated with having tenants as the main occupants in a home as compared to having someone stay with you in your own home. I'm not going to rehash an old thread, but I didn't want to leave a technically correct but still very inaccurate answer because its very incomplete as the closing thought.

A couple of claims to think about for anyone who is wondering what I'm talking about:
- Tenant trips, falls, sues the homeowner for the back injury that was just sustained.
- Tenant overstays their welcome, homeowner doesn't know it. Goes to the home, enters, finds tenant still there, gets sued for illegal entry.

Many things a homeowner is suddenly exposed for and may be willing to accept that exposure, but this needs to be part of the answer, not just what the policy language is, but what the risk is.

Dan

 

[BigIVU]

djs, I don't follow your point. My point was that coverage is determined by what the policy says. In the example I gave, that particular policy should cover the situation as described. Other policies may not. That's why it's important to reference the contract language to determine coverage.

 

[SingingSabre]

I don't know if simply telling the client the contract says NO, is being more detailed as an agent. I certainly don't see it that way, but to each agent their own.

Sorry, LGilmore, but I have to agree with Accelerated.

As soon as you said "publicly a black eye for the company" it inferred that you were recommending either the CEO make an exception or the agent and client going public with the perceived unfairness of the policy.

I understand you meant it without that malicious undertone, but it's super easy to infer it from your wording.

 

[djs]

djs, I don't follow your point. My point was that coverage is determined by what the policy says. In the example I gave, that particular policy should cover the situation as described. Other policies may not. That's why it's important to reference the contract language to determine coverage.

My point was different. An agents job isn't so much to interpret policy language, but to explain risk exposures. After you talk about risks, then you can talk about whether that risk is covered by policy language, and on that part, I agree with you.

As an agent, if a client calls you and asks if they need to do anything if they have tenants living in the house instead of the homeowner, you really should talk about a few things. Yes, if wiring shorts out and catches the house on fire, who lived there may not matter, it should be a covered claim (probably). On the other hand, if the tenant gets drunk one night and decides to light the place on fire himself, this may not be covered on a homeowner / dwelling style policy. It is much more likely covered on a landlord style policy.

I'm not disagreeing with what you said at all, just it needs a bit more. Yes, I'm having one of those days where I'm nitpicking stuff. Not a big deal......

Dan

 

[LGilmore]

"As soon as you said "publicly a black eye for the company" it inferred that you were recommending either the CEO make an exception or the agent and client going public with the perceived unfairness of the policy."


Again, if you actually read more than a brief anything of the back and forth it just simply is about asking the question.... The worst they can say is NO. I don't know how long you've been in the business but several times over the years I have asked "the question", you'd be surprised that I've been given an "OK, just this once."


It happens and it comes back to the most basic aspect of our work as agents... we don't know till we ask... Should have been one of the main points in career school. You actually do it everyday. You ask. What's the worst that can happen?


Would it happen in this case? I don't know not my client, and don't know that they asked or not as this is sorta old.


And you don't have to be sorry at all. I would ask the question, maybe you wouldn't. I'd rather come back with an official "no" from the carrier, than just blow off the client. Even if you think you know the answer in advance, asking for the client, is showing that you have empathy for the situation.


Accel has a different viewpoint because he is not an agent. He does something else. His view is going to be different than mine because we have different POVs. So cheers and congrats for bringing up an old post that hasn't had comments for months...

 

[jessicakappor]

It's very unlikely that your agent is wrong about this. Another point they may have covered with you is that if you leave the home vacant for a period if time (usually 30-60 days) it's considered a vacant property and also needs a different type of policy.

If you and your wife are thorough, take an hour or so and sit down and read your policy. Yes, it's boring, but it's all in there. If there is some reason you'd be going to court over it, that's the document that would be referenced in your agreement.

Let's also be clear, it doesn't look like they're saying you can't have friends stay, it's saying that if you have a homeowners policy, the homeowner needs to live in it.

That's all just based on what little information you shared, but that's my take.

yes you are right because its not mandatory that our friends or relatives cannot stay in our property.

 

[xrac]

yes you are right because its not mandatory that our friends or relatives cannot stay in our property.

Yes you are right because it is not necessary to understand anything to post on this forum. Posts do not have to make any sense at all and we are all free to resurrect 6 month old threads by posting gibberish.

 

[stevo17]

Yes you are right because it is not necessary to understand anything to post on this forum. Posts do not have to make any sense at all and we are all free to resurrect 6 month old threads by posting gibberish.

LOL... Right on, xrac