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A Consumers Guide To Filing A Homeowners
Insurance Claim |
WHERE TO
BEGIN WHAT TO LOOKOUT FOR WHEN TO SETTLE PROTECTING
YOUR RIGHTS |
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FORMS |
LOG
STATEMENT OF LOSS
PHOTOGRAPHS
WITNESS STATEMENT
EMERGENCY WORK CHARGE
PERSONAL PROPERTY SUMMARY
DEPRECIATION SCHEDULE
1. ENTRANCE HALL
2. LIVING ROOM
3. DINING ROOM
4. KITCHEN
5. HALLWAY/STAIRWELL
6. DEN
7. BEDROOM 1
8. BEDROOM 2
9. BEDROOM 3
10. BEDROOM 4
11. BEDROOM 5
12. BATHROOM 1
13. BATHROOM 2
14. BATHROOM 3
RECREATION ROOM
LAUNDRY/BASEMENT
PORCH/PATIO
GARAGE
ATTIC
MEN'S CLOTHING
WOMEN'S CLOTHING
CHILDREN'S CLOTHING
LINENS
ELECTRICAL APPLIANCES
FLOOR COVERING
CABINETS
WALLPAPER
SPORTING EQUIPMENT
JEWELRY
MISCELLANEOUS
MISCELLANEOUS
MISCELLANEOUS
HOMEOWNERS STRUCTURE LIST
CONTRACTOR BID
DEBRIS REMOVAL
TRESS,SHRUBS, OTHER PLANTS
LOSS OF USE
RESTORATION SERVICE CONTRACT
CHANGE ORDER
LIEN WAIVER
EXTRA
EXTRA
EXTRA |
Your
Homeowners Insurance Claim Guide |
| Terms |
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Disclaimer The information, forms, and techniques
herein represent the author's opinions only and is not legal advice. Any and all advise
given herein is not legal advise. The information and forms provide general educational
information only. If legal or other expert advice is required by the reader, the services
of a competent attorney, accountant, insurance agent, or other professional should be
sought. The information, forms, etc. come without warranty of any kind, either express or
implied, including but not limited to implied warrantes for quality, performance,
merchantability, or fitness for any purpose. The author shall not be liable to the user or
any other person or entity with respect to any liability, loss, or damage caused or
alleged to be caused directly or indirectly by this information, forms, etc.
Copyright © 1992 Michael L. Smith, Revised 1998, 2000 All rights
reserved. No part of this publication (except forms) may be reproduced or transmitted in
any form or by any means, electronic or mechanical, without permission in writing from the
author. The forms may be printed out for private, one time, use only. Any and all
commercial use of this site, without prior agreement, is strictly prohibited. All
copyright infringements may result in severe penalties.
Actual Cash Value A
dollar value placed on damaged property equal to replacement cost less depreciation.
Actual cash value is derived by fixing a new price for the same or similar item and
deducting for wear and tear and obsolescence.
Additional Living Expenses Any additional expenses incurred for food,
lodging, transportation, and other daily needs, resulting from an insured loss.
- Adhesion contract Standardized
contract form offered to consumers on a take it or leave it basis. A contract that, by its
nature, prevents the weaker party from having any say regarding its terms.
- Adjuster One who
represents the insurer or homeowner in arranging settlement of a claim. See claims
representative, independent adjusters, public adjuster.
Agent One who solicits insurance business on behalf of the
insurer. An employee of the insurance company for the sale and service of insurance
contracts.
- Appraisal
A valuation of property by disinterested persons of suitable qualifications.
- Appurtenance Something
belonging or incidental to a principal thing, such as a garage to a house, an outboard
motor to a boat, or a protective case to a violin.
- Appurtenant Structures
Something belonging or incidental to a principal structure. An appurtenant structure to a
home may be a garage, barn, playhouse, storage shed, etc. Structures on the property that
are not attached to the home.
- Arbitration A method of
resolving disputes through the assistance of an impartial (third) party. The parties to
the dispute agree on the arbitrator to be used and to abide by the arbitrator's decision.
Insurance arbitration is binding on both parties
Arbitration clause Provision in the homeowner's policy which outlines
the method of resolving a dispute through arbitration. If parties decide to use
arbitration before filing an action in court, and a binding decision is made by the
arbitrator, it will be ruled as a binding agreement in a subsequent court case. The clause
provides that the policyholder and the insurance company agree to one person to act as
arbitrator. If such agreement cannot be made, then each party chooses his own
representative and each representative then chooses an umpire to decide on the issue. The
arbitrator's decision is binding and final on both parties. If the policyholder or the
insurance company cannot agree to the provisions then the matter must go to the courts.
- Average Clause see
coinsurance clause
Bad faith An act of willful deception in
furtherance of a sinister or dishonest motive.
Betterment An improvement to property which increases
its value. The improvement is characterized by increasing the value more than would mere
replacement, repair or maintenance.
- Bid Promise to
perform work for a certain price. An offer to provide services which become legally
binding upon acceptance.
Board up Emergency repairs to secure property from further damages or
loss.
Boilerplate Standardized language in a contract that is
identical throughout the industry.
- Broker One who
solicits insurance on behalf of several insurers. See Agent.
- Claim
Notification of loss and extent of damages suffered. Includes information relating to
coverage, type of peril, what was lost, value of loss, and evidence of loss.
- Claims Representative
Employee of insurance company, who negotiates settlement on behalf of his
employer.
- Coinsurance clause
Provision in policy that specifies a minimum 80% replacement coverage in order to be
protected fully for any size loss up to the policy limit.
- Coinsurer Homeowner
who shares the risk of loss by not carrying enough insurance to comply with the
coinsurance clause in the policy.
Concealment The intentional withholding of information that one
has a duty to reveal. Such information being necessary for the determination of coverage
but withheld for purposes of benefiting either; from something not entitled to under the
policy, or something entitled to in the policy but not known to the insured.
- Condition A
provision in an insurance policy which sets out the rights and duties of the parties
involved, or describes the events under which protection is granted.
- Contribution Clause See
coinsurance clause
Coverage The amount and extent of protection under an insurance
contract.
Damages The dollar amount awarded to an
injured party for losses suffered at the hands of an others unlawful acts, omissions or
negligence. Damages are for compensating injured party for their loss (Compensatory) and
in some cases for punishing the wrongdoer (Punitive).
- Deductible An
amount, usually $100 or $250, which is subtracted from the claim before homeowner is
entitled to compensation.
- Depreciation A
reduction of worth arising from age, use or obsolescence.
- Endorsement
Provisions that add nonstandard coverage's to a homeowner's policy.
- Estimate A rough
approximation of restoration costs having no promise to perform.
- Exclusion Provisions
in the policy which state certain circumstances that bar coverage.
- Fiduciary
Business relations between parties, in which one party has practically
full control over terms of contract, and is thereby held to the highest degree of trust,
confidence, fairness and good faith to the other.
- Floater Policy
endorsement, which covers items that have no fixed location such as jewelry or personal
property while traveling. The terms floater policy and floating policy are often used in
place of endorsement.
- Fraud A deceptive
representation, whether by word, conduct, concealment or implication, which another relies
on to his detriment. See Bad faith.
- Guaranty
A pledge or promise that materials and workmanship meet accepted standards, and in the
event of a discovered defect or default, the primrose will replace or repair.
- Homeowner
The owner-occupier of an insured dwelling.
- Homeowners policy A
multi-peril insurance policy covering such hazards as fire, water, burglary, liability,
etc.
- Hidden Damage Damages
which are not discoverable under reasonable inspection.
- Independent
Adjuster A person or firm who holds himself or itself out for the
employment of claims adjustment to more than one insurance company.
- Illusory promise
A promise which appears to provide something of substance but on closer examination
has little or no redeeming value.
- Indemnify To
make good, to restore a victim of a loss, by payment, repair or replacement.
- Inflation protection clause
Provision which adjusts the coverage due to inflation. The premium is adjusted
accordingly.
- Insured The
buyer of an insurance policy, the homeowner.
- Insured loss Damages
or loss covered by homeowner's policy.
- Insurer The
insurance company or underwriter.
- Joint
and several liability Liability where each of several joint
wrong-doers are responsible either; on a combined, undivided basis, or on an individual
basis, for the full amount of damages for which the several wrong-doers are all
responsible.
- Knowledge
A clear understanding of the truth. A firm belief of things to be correct or
incorrect.
- Liability
insurance Insurance protection that covers injuries to
others.
- Lien Release A
waiver of lien rights, signed by subcontractors, so that the general contractor can
receive a progress payment for work completed.
- Limits The maximum
amount an insurance company will pay on a particular loss.
- Line Item Bid A
detailed bid for restoration work listing each area of restoration and its cost.
- Loss Injury or damage
sustained by policyholder which is the basis for filing a claim.
- Loss department That
part of an insurance company responsible for the settlement of claims. Also referred as
Claims Department.
- Loss of Use Additional
expenses incurred as a result of the homeowner's loss of property. See Additional Living
Expenses.
- Loss Payable Clause
Provision in homeowner's policy which authorizes payment to others (mortgage company, deed
of trust, etc.) having legal interest in the property.
- Mediator
One who intermediates between disputants to affect a mutual understanding and
agreement.
- Mediation A
voluntary, legally non-binding, method of resolving a dispute with the assistance of a
neutral party.
- McCarran Act United
States Congressional Act of 1945, which exempts insurance companies from federal antitrust
laws and permits each state to regulate and tax insurers from within and without the
state.
- Mortgage Clause Clause
in an insurance policy which protects the mortgagee's rights. See Loss payable clause.
- Mortgage Inspector
A representative of a mortgage holder who verifies work progress of restorations to an
insured dwelling, in order to release some or all funds for payment.
- Mortgagee The
person or company who loans money to the homeowner for the purchase of a house and uses
the value of the house as collateral for the loan.
- Mortgagor The
homeowner who conveys his property as collateral on a loan.
- Mysterious Disappearance
The vanishing or disappearance of property that cannot be explained. A form of theft
coverage that insures not only for theft, but also for loss due to any disappearance under
unknown, puzzling or baffling circumstances.
- Negligence
Failure to use a reasonable amount of care. Falling below that standard of care used
by a reasonably prudent and careful person under similar circumstances.
- Other
Insurance Clause Clause in the insurance policy that identifies
any and all other insurance companies which insure the same property as described in the
policy, and apportions any claim amount accordingly.
- Outbuilding Something
used in conjunction with a main building. An appurtenant structure such as a storage shed,
garage, etc.
- Peril
The hazard insured against, the cause of the loss such as fire, flood, bursting pipe.
- Precedent A
course of conduct or decision making based on prior decisions. In case law, legal
decisions based on prior decisions of analogous issues.
- Premium The
amount of money a homeowner pays for insurance, the cost of coverage.
- Proof of Loss A
claimant's formal statement to the insurer which is used to determine the insurer's extent
of liability.
- Puffing An
undue or exaggerated opinion regarding quality or performance and not considered a legally
binding promise.
- Quasi Contract
Situation imposed by law to prevent unjust enrichment or injustice and not dependent
on agreement of the parties to the contract.
- Replacement
Cost An amount equal to the price of a new item without
deduction for depreciation.
- Rider An addition or
amendment to a policy which is attached to and incorporated into the terms of the policy.
See endorsement
- Scope of
damages A contractor's list of structural damages,
combined with an explanation of the method of repair and their cost.
- Serviceability That
degree of restoration made to older homes under the homeowner's (HO-8) policy. Replacement
of structure using methods and materials which are inferior in quality, simpler in design
and without the aesthetic value of the original.
- Subrogation The
transference of legal rights from the homeowner to the insurance company in order to
recover from a third party. For example, an insurance company pays you on a claim and then
sues a third party to recover the claim amount. The claim you have against the third party
is transferred, or subrogated, to the insurer.
- Subsidence The
sinking, upheaval or movement of land and the damages attributed to such. For example,
cracks in foundation caused by settling is a form of subsidence.
- Sudden and Accidental
An unexpected, unforeseen casualty or loss, as opposed to something that results from a
continuous action. A requirement for recovery in a homeowner's claim.
- Supplemental An
addition to the original claim for newly discovered hidden damages.
- Tenant
One who has temporary use and occupation of another's real property (land and/or dwelling)
for a fixed period of time as agreed to under the terms of a lease.
- Tort A civil wrong
committed, independent of a contract, which is a breach of a legal duty owed to another
and causes harm or injury.
- Umpire
A third person appointed to decide an arbitration.
- Underinsurance An
amount of coverage which is less than the value of the property, or less than the minimum
amount required to prevent the coinsurance clause from taking effect.
- Verify
To establish the truth by means of demonstration or use of reliable evidence.
- Void Having no legal
force as in an unenforceable contract.
- Warranty
The statement by the insured, the truth of which becomes a condition of the validity
of the policy. Statement in a policy as to the existence of a fact or a condition of the
subject of the insurance, which, if untrue, will void the policy.
- X-Bracing Cross
bracing in a partition to provide rigidity.
- Youthful
Insured An insured (male or female) under the age of 25.
- Zoning
Ordinance Exercise of police power of a municipality in
regulating and controlling the character and use of property.
Disclaimer The information, forms, and techniques
herein represent the author's opinions only and is not legal advice. Any and all advise
given herein is not legal advise. The information and forms provide general educational
information only. If legal or other expert advice is required by the reader, the services
of a competent attorney, accountant, insurance agent, or other professional should be
sought. The information, forms, etc. come without warranty of any kind, either express or
implied, including but not limited to implied warrantes for quality, performance,
merchantability, or fitness for any purpose. The author shall not be liable to the user or
any other person or entity with respect to any liability, loss, or damage caused or
alleged to be caused directly or indirectly by this information, forms, etc.
Copyright © 1992 Michael L. Smith, Revised 1998, 2000 All rights
reserved. No part of this publication (except forms) may be reproduced or transmitted in
any form or by any means, electronic or mechanical, without permission in writing from the
author. The forms may be printed out for private, one time, use only. Any and all
commercial use of this site, without prior agreement, is strictly prohibited. All
copyright infringements may result in severe penalties.