Transcript How did the loss occur - Insurance Community University

Topics Covered in Presentation
1. Discussion of the procedures for determining if a
claim is covered
2. The course utilizes ISO forms as a reference point to
discuss the Cause of Loss forms. The presentation
will review of the types of coverage provided in the
Basic, Broad and Special Cause of Loss Forms
3. Review of the endorsements available to modify the
Cause of Loss Forms
4. Specific review of the exclusions/limitations for
building ordinances will be examined and the
endorsement available in the ISO form series.
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1
Procedure to determine if
there is coverage
Who
How
Where
What
When
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2
Who is insured
 Naming Insured’s Correctly
 Whose Property (insured/others)
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3
What is insured
 Property is Covered
 Property Not Covered
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4
When did the loss occur
 Was it within the policy period
 There are situations when it must be both in
the policy period and reported in the policy
period
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5
Where did the loss occur
 Where was the property when the loss
occurred
 Located at the insured premises?
 Within the coverage territory?
 Did the cause of loss stem on premises or off
premises due to a “power loss”
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How did the loss occur
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This is what the cause of loss forms deal with
What caused the loss
Was the cause of loss a covered situation
Was the cause of loss NOT a covered situation
Was there an endorsement added to the
policy to add back the cause of loss or sublimit a recovery
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Comparison Chart
BASIC
(10 10)
BROAD
(10 20)
SPECIAL
(10 30)
Fire
X
X
X
Lightning
X
X
X
Explosion
X
X
X
Windstorm or Hail
X
X
X
Smoke
X
X
X
Aircraft or Vehicles
X
X
X
Riot or Civil Commotion
X
X
X
Vandalism
X
X
X
Sprinkler Leakage
X
X
X
Sinkhole Collapse
X
X
X
Volcanic Action
X
X
X
Additional Coverage – limited coverage
for Fungus, Wet Rot, Dry Rot and
Bacteria
X
X
X
CAUSES OF LOSS
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Comparison Chart
CAUSES OF LOSS
BASIC
(10 10)
BROAD
(10 20)
SPECIAL
(10 30)
X
X
X
Falling Objects
X
X
Weight of Snow, Ice, or Sleet
X
X
Water Damage
X
X
Additional Coverage – Collapse
X
X
Additional Coverage – limited coverage
for Fungus, Wet Rot, Dry Rot and
Bacteria
Risks of Physical Loss
X
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