information not in my copy of policy - definitions

[kmac88]

What is the name of your state? MI

Does the insurance company have detailed information about my policy, that they can use to deny a claim that is not included in my copy? Does the company have details, that I don't, that would cover the term, "included but not limited to" ? In a section of my policy that addresses limiting my liability, the term "above average exposure" is used. What is "above average exposure" mean?

 

[Betty]

The insurance company's actual copy of the policy would be the same as yours. However, in a homeowner's policy they sometimes indicate in the policy provisions that certain losses are excluded under the pol. but not limited to them. (they include in pol. what is excluded though not just limited to them). Above average exposure refers to property they believe has a more than average exposure (risk) of damage - such as a home along the coast would have an above avg. exposure to hurricanes than property inland & the ins. co. considers this when deciding if they want to insure the property & if so, at what rate. Your policy provisions should list what IS covered & what is not (though not limited to exclusions included).

 

[moburkes]

What is the name of your state? MI

Does the insurance company have detailed information about my policy, that they can use to deny a claim that is not included in my copy? Does the company have details, that I don't, that would cover the term, "included but not limited to" ? In a section of my policy that addresses limiting my liability, the term "above average exposure" is used. What is "above average exposure" mean?

What, sepcifically, is the situation. You apparently feel that the insurance company won't cover somthing, or didn't cover something, that you expect should be covered.

 

[kmac88]

What, sepcifically, is the situation. You apparently feel that the insurance company won't cover somthing, or didn't cover something, that you expect should be covered.

Raccoons broke into my house, did a considerable amount of damage, fouled every room of my house with urine and feces. I was sent a denial of claim letter that included a passage that states they do not cover for "losses due to... birds, vermin. rodents, or animals...". There is no such language in my copy of my policy or addendum pages.

On the day the adjuster showed up at the house, he showed me a highlighted portion of a paragraph that he said was the support for the denial. The words he had highlighted were, " ...wild and non-domesticated animals...". Those words are in my copy but are part of a point that speaks to the homeowner's "liability exposure". The more complete paragraph is as follows, "Property is free from: above average exposure; includes but are not limited to:animals with a bite history, uncontrolled trained attack/guard dog, wild or non-domesticated animal capable of biting, or dangerous reptile kept as a pet (examples include but are not limited to: alligator or boa constrictor); attractive nuisances(junk cars, non functional appliances);property that increases chances of injury or illness to others. Swimming pools and trampolines must have restricted access."

 

[BelizeBreeze]

Next time give the raccoons a key. Then they won't have to break in.

 

[moburkes]

Raccoons broke into my house, did a considerable amount of damage, fouled every room of my house with urine and feces. I was sent a denial of claim letter that included a passage that states they do not cover for "losses due to... birds, vermin. rodents, or animals...". There is no such language in my copy of my policy or addendum pages.

On the day the adjuster showed up at the house, he showed me a highlighted portion of a paragraph that he said was the support for the denial. The words he had highlighted were, " ...wild and non-domesticated animals...". Those words are in my copy but are part of a point that speaks to the homeowner's "liability exposure". The more complete paragraph is as follows, "Property is free from: above average exposure; includes but are not limited to:animals with a bite history, uncontrolled trained attack/guard dog, wild or non-domesticated animal capable of biting, or dangerous reptile kept as a pet (examples include but are not limited to: alligator or boa constrictor); attractive nuisances(junk cars, non functional appliances);property that increases chances of injury or illness to others. Swimming pools and trampolines must have restricted access."

The section that you should be looking for is not part of liability. The liability section refers to liability to others. You are looking for (something to the effect of) Section 1: Your property..then something about the dwelling and other structures coverage..then losses we do not cover under (those coverages)...

For example, my policy reads (at the beginning of that section):
osses wo do not cover under coverages A and B (which is other structures):
We do not cover loss to the property described in Coverage A-Dwelling Protection or Coverage B-Other Structures Protection consisting of or casued by:

insects, rodents, birds or domestic animals. We DO cover the breakage of glass or safety glazing materials caused by birds;

You should be able to find similar wording in the section I've tried to describe above. Please report back.

 

[kmac88]

The section that you should be looking for is not part of liability. The liability section refers to liability to others. You are looking for (something to the effect of) Section 1: Your property..then something about the dwelling and other structures coverage..then losses we do not cover under (those coverages)...

For example, my policy reads (at the beginning of that section):
osses wo do not cover under coverages A and B (which is other structures):
We do not cover loss to the property described in Coverage A-Dwelling Protection or Coverage B-Other Structures Protection consisting of or casued by:

insects, rodents, birds or domestic animals. We DO cover the breakage of glass or safety glazing materials caused by birds;

You should be able to find similar wording in the section I've tried to describe above. Please report back.

There is no such wording in the section discussing dwelling and other structures, or anyplace else. The words "losses due to... birds, vermin. rodents, or animals..." appears nowhere in my copy of the policy.

 

[moburkes]

I don't know how the PM feature works, and I couldn't find it. D oyou have a fax? If so, email me at motherof1 at gmail dot com. Replace the at w/ @ and the dot with . .