Thank you for your purchase!

Important: Be sure to print a copy for your records.

Your class details are:

Texas All-Lines Adjuster License training, plus exam

Date: January 10 - 12, 2014 (fri-sat-sun)
Time: 8:00 am 8:00 pm daily
Location:Denton, TX
*hotel, meals, transportation are not included
There are lots of food, hotel and shopping
choiceswithin minutes of the meeting location.

Important:
Dont forget to spend the required 10 hours of self-study time BEFORE class
begins.
Please bring a copy of your receipt to the event. This will serve as your admission
'ticket.
If you have questions before the class, use the contact form or call 972.837.8621
Thank you again...I look forward to meeting you in class.
Joel Yeatts
InsuranceAdjusterTraining.net
disclaimer: InsuranceAdjusterTraining.net is not affiliated with, nor endorsed by, Xactimate Solutions, Inc.

Texas Adjuster All lines Pre-licensing Course

Part 2 30 Hours Classroom Requirement
presented by

InsuranceAdjusterTraining.net
1816 S. FM 51
Decatur, TX 76234
855-892-3587
Classroom Outline with associated hours of per topic
Part 1 Classroom Study - Terminology and foundational concepts -- 10 Hours
sect1 - a. commonly used adjuster terminology - 1.5 hours
b. the basis of marketing terminology - .5 hours
sect2 - a. Terminology and how to interpret policy laguage - 1.5 hours
sect 3 - a. Terminology and how to interpret policy laguage - 1.5 hours
b. standard fire policy terminology --.5 hours
sect 4 - a. workers compensation concept and terminology - .5
b. Auto policy language - .5 hours
sect 5 - a. Commercial policies concepts and terminology - 1.5
sect 6 - a. Inland marine terminology - .5 hours
b. Ocean marine terminology - . 25 hours
c . Bond language - .25
Part 2 Licensing Regulations -- 1.75 hours
a. Licensing requirements -- .75 hous
b. TDI regulations -- .5 hours
c. Renewal and CE requirements -- .5 hours
Part 3 Adjuster Practices and Responsibilities -- 1.5 hours
a. adjuster role in claim handling - .5 hours
b. knowledge factors - .5 hours
c. Good Faith and bad faith - .5 hours

Part 4 Marketing Practices -- 1.75 hours

a. the business of insurance, the who when and where. -- .25 hrs
b. Unfair claims settlement - rules not to violate -- .75 hours
c Claim handling and payment time frames -- .75 hours
Part 5 HO-A, HO-B, HO-C, ISO forms, Personal Lines Coverages -- 4.5 hours
A. Reading a policy --------------------------------------------------- .3 hours
B. Interpreting the language ------------------------------------------- .3 hours
C. typical policy formats - Broad, Basic, Special, HO and DP -- . 4 hours
D. perils and the HO-A, B and C -------------------------------------- .5 hours
E. Deductibles - which to use and how to calculate --------------- . 3 hours
F. Coverage A, B, C, D, E -------------------------------------------- . 4 hours
G. Limits of Liability and how they affect the claim --------------- . 3 hours
H. Duties after a loss - Policy holder and Insurer ----------------- . 3 hours
I. Loss settlement provision ------------------------------------------ . 4 hours
J. Co-insurance and how to calculate ------------------------------- .3 hours
K. Liability sections ---------------------------------------------------- .3 hours
L. adjuster application of policies ---------------------------------------.3 hours
M. policy differences ------------------------------------------------------ .4 hours
Part 6 Extensions, exclusions, and additional coverages -- 1.75 hours
A. Extensions of coverage ------- .30
B. Exclusions ---------------------- .75
C. Additional coverages --------- . 30
Part 7 Standard Fire Policy -- 1 hrs
A. DP VS. HO ---. 5 hours
B. the four sections -- . 5 hours

Part 8 Basic Workers Compensation -- 1 hours

A. employers rights and responsibilities
B. employees rights and responsibilities
Part 9 Auto Liability -- 1.5 Hours
A. Liability insurance -.4 hours
B. Collision - .4 hours
C. Comprehensive - . 4 hours
D. Other types of coverage - . 3 hours
Part 10 Commercial and Commercial General Liability -- 2.5 hours
A. types of policies and examples ------------------------ .75
B. commercial property coverage's ----------------------- .75
C. Commercial Liability ----------------------------------- 1 hour
Part 11 Inland Marine -- 1 hrs
A. What is covered --------------- .75
B. Conformity and the lack thereof -- .25
Part 12 Ocean Marine -- 1 hrs
A. Main Policy types ------ . 5
B. Other insurable items -- . 5
Part 13 Bonds -- .75
A. Fidelity -- .25
B. Surety --- .25
C. Parties too -- .25
Total Classroom Hours: 30 classroom time
Total Self study Hours : 10 to be completed by students
Total Hours: 40

Texas Adjuster All-Lines License

Pre-Licensing SELF STUDY MATERIALS
Foundational Terminology and Concepts 10 hours
(Part 1 of 40 required hours)
presented by
InsuranceAdjusterTraining.net
1816 S. FM 51
Decatur, TX 76234
972.837.8621
855-892-3587
support@insuranceadjustertraining.net

How to Get Maximum Benefit From Your Training

The material presented in this self-study manual will lay the foundation for the
30 hours of classroom training that will follow.
While we don't expect you to memorize this manual completely, it is extremely
important that you spend the required ten hours (or more) studying the concepts
and reviewing the related materials.
Along with the definitions and related concept materials that follow, there are
also several policies included. Read all of the policies completely they
are considered part of your mandatory 10-hour self study. Much of the
information may not yet make sense, but read all of it before class begins.
You may be surprised to learn that your most valuable new skill has nothing to do
with accurately measuring a roof or writing good scope notes; rather, it is your
ability to read and understand the various insurance policy forms.
You'll need to know what is covered what is not and why.
Do yourself a favor and keep this in mind as you complete your ten hours of selfstudy. Build your foundation with care...and your 30 hours of classroom time will
be much easier.
Thank you for choosing our company . We know that you had many options and
we're honored that you ultimately chose to train with us. Our staff looks forward
to serving you. We wish you great success in your new insurance career!

What is Insurance?
Insurance is a means of transferring risk. Insurance companies, in exchange for a
specified payment (premium), guarantee an amount of compensation for certain
kinds of covered losses.
Examples of losses: property damage, illness, injury and death.
What is Risk?
Risk is the potential that a chosen action or activity (including the choice of
inaction) will lead to a loss (an undesirable outcome). (source: wikipedia.org)
For the purposes of insurance, risk applies only to events that are not certain or
predictable. Examples would be theft, weather damage and illness.
How is Risk Addressed?
Avoidance: (example) A company avoids potential flood risk by not building or
buying property in a known flood plain.
Reduction: (example) An individual reduces the risk of bodily harm by not
engaging in skydiving.
Transfer: (example) The cost of the known risk is transferred to another party;
this may be accomplished by purchasing an insurance policy to cover one or more
known risks.
Acceptance: That is, accept the known risk and accept any losses or
consequences of it.

What is an Insurance Policy?

An insurance policy is a legally-binding contract between an insurance company
(insurer) and an individual, company or party (the policyholder);
the agreement (insurance policy) specifies the types of claims which the Insurer
is legally obligated to pay, in exchange for payment (also known as 'premium').

What Does A Typical Insurance Policy Contain?

Declarations names the insured, the insuring company and the losses covered.
Definitions explanations of the important policy terms.
Insuring Agreement a summary of the policy and the underlying coverages.
Exclusions describes perils, hazards, property and losses not covered.
Conditions rules, duties and obligations; if these are not met, the claim is
denied.
Endorsements additional forms attached to the policy, which modify it.
Policy Riders specifies changes and amendments to the policy.

Perils vs. Hazards

Peril: something that is the direct cause of a loss. For example: lightning, hail,
windstorm or fire. A peril might also be something 'man-made', such as theft or
vandalism.
Put simply, 'perils' are a defined group of damage-causing things that may, or
may not, be covered by the insurance policy.
Hazards: things or conditions that are known to increase the chances for a loss
to occur. Examples of hazards: ice on a walkway, an overloaded electrical outlet,
ice dams on a roof.
What is an Insurance Adjuster?
An Insurance Claims Adjuster is person who works for, or acting on behalf of, an
insurance company for the purpose of documenting, investigating and evaluating
claims for settlement.
The adjuster's role is to determine:

what caused the loss

if the loss is covered by the insured's policy

the dollar amount of the loss

the dollar amount that the policy will pay for the loss

Duties of an Insurance Agent

Insurance agents are involved in the insurance policy process in the following
ways:
3

1.
2.
3.
4.

Sales of policies to policyholders.

Reviews and signs each policy.
Provides premium quotes to current and potential policyholders.
Field Underwriting this is done by applying a set of criteria to the
policyholders needs and making determinations about risk levels that
must be addressed.
5. After the Sale agents are responsible for servicing the policyholder,
making sure that changes are recorded properly; coverages should be
reviewed yearly, to ensure that coverages are appropriate and correct.

Policy Provisions: Policy Period and Non-Renewal

The policy period (policy term) is the time between the 'effective date' and the
'expiration date'. Some types of policies have terms of six months, others may be
one year or multiple years.
If the policy is not renewed by the policyholder, the coverage typically ends at
12:01 am (just after midnight) on the date of expiration.
In order for coverage to be uninterrupted, coverage of the new (or continuing)
policy must fall on the same day as the expiration date of the expiring policy.
Named Insured
The person, company or entity (policyholder) with whom an insurance policy
(contract) has been made, and whose interests are covered by the insurance
policy.
First Named Insured
This insured party has special rights and privileges, above all other named
insureds. This person or entity is listed first on the policy declarations section.
Among their specific privileges:

They are responsible for payment of the premiums;

They are responsible for communications with the insurance agent;
They have the right to make policy changes, including cancellation of the
policy;
They have the right to make decisions on behalf of all other named
insureds on the policy.

Additional Insured
These are other entities or individuals with some type of coverage benefit
extended by the policy; they are typically listed in the endorsements or
declarations portion of the policy.
Policy Limits ( Limit of Insurance, Limit of Coverage or Limit of
Liability)
This is the maximum defined monetary amount that the policy (contract) will
indemnify (pay out) in the event of a covered loss.
Understanding the Insurance Policy Deductible
The amount of money that the policyholder (insured) must pay out of pocket,
before the insurance company (insurer) pays the remaining balance, is known as
the deductible.
What is Subrogation?
Subrogation rights are sometimes exercised by the insurer to obtain monetary
compensation from one or more third parties who were responsible for the
covered loss.
Personal Insurance Contract
This type of policy is issued on the insured person, rather than on the insured
person's property.
Unilateral Insurance Contract
A unilateral contract is one-sided; this means that if a covered loss occurs, the
insurer is obligated to pay out on the claim, pursuant to the insurance contract.
However, if the policyholder (insured) wishes to discontinue the contract, he or
she can do so by no longer making payments. In this way, the insured 'opts out'
of the contract.

Utmost Good Faith Contract

This refers to a contract that is two-sided, where both parties are relying on the
mutual integrity of the other party.
The duty of Utmost Good Faith means that both parties are honest and
forthcoming with one another; for example, the insurance company acting in
good faith will pay claims in a timely fashion and will not misrepresent coverages
and exclusions and the insured acting in good faith will be honest about claimed
losses and cooperate with the insurer's investigations.
Cancellation of an Insurance Policy
Termination of the policy (contract) during the policy period; the termination
may be initiated by the insured or the insurer.
Insurers must provide a written notice of cancellation to the policyholder
(insured). Unearned premiums are returned to the policyholder on a short rate
basis or pro-rata basis.
Why/When an Insurance Company Can Void a Policy
Voiding a policy is different than outright 'cancellation'; an insurer may choose to
void a policy in the event of:

fraudulent information or actions

misrepresentation of facts by the policyholder
concealment of facts by the policyholder(s)

Fair Credit Reporting Act

This federal law provides consumers the right to request and obtain a copy of
their credit report, upon request, if their application for insurance is denied.
Property Insurance vs. Casualty Insurance
Property insurance provides coverage for physical property, along with income
that it may be used to produce;
Casualty insurance is 'non-property' insurance, such as liability, workers
compensation, surety, fidelity and crime.

Personal Lines vs. Commercial Lines

Personal lines coverage relates to property and/or casualty insurance policies for
individuals and/or families.
Commercial lines are business policies; examples of coverages would be
professional liability, business property damage and business income
interruption.
Coverage Components of an Insurance Policy
Policy coverages description of what is insured and specific types of coverage
included.
Additional coverages these covered items may have different amounts of
liability insurance; applicant may have to meet specific requirements.
Named Peril policies insurance contract that only covers a set of 'named' perils;
these perils might include fire, wind, theft, etc. and must be explicitly described
in the contract.
Open Peril policies insurance contract that provides coverage for all perils,
except for specifically excluded perils, listed in the policy documents.
Insurance Concepts: Types of Losses
Direct Loss vs. Indirect Loss
A direct loss is damage or loss caused by perils, such as fire, wind, flood and theft.
An indirect loss, also known as a consequential loss, is a 'side effect' of a direct
loss; a common example of an indirect loss would be the out-of-pocket cost for a
rental car, after a vehicle is damaged or stolen.
Non-accidental Losses
This type of loss is typically excluded from coverage in most policies; nonaccidental losses refer to normal wear and tear, mechanical breakdown and
electrical failure.

Catastrophic Losses
Examples are war, acts of terrorism and some natural or man-made catastrophes;
some policies exclude catastrophic losses, while others cover specific kinds of
catastrophic losses.
Property Covered By Other Insurance Policy
If property is covered by a policy, it is excluded from 'double coverage.'
If a home is insured with a homeowner's policy, the insured may not obtain
another additional policy to cover his home; if an automobile is covered, the
insured may not obtain a second policy, etc.
Concurrent Causation
Refers to a loss that results from two or more different perils, that occur at the
same time or in succession, creating a claim (loss) against one insurance policy;
example would be:
Fire caused by a lightning strike.
Policy Conditions
This wording in a policy sets forth the responsibilities, duties and rights of the
Insured and the Insurance Provider.
ACV (Actual Cash Value)
What it costs to replace an insured item, less depreciation.
RCV (Replacement Cost Value)
What is costs to replace an insured item, with no depreciation withheld.
Coinsurance
A condition of property insurance in which the policyholder shares in losses
proportionately to the extent that the amount of insurance fails to meet a
specified percentage of the value of the insured property. A coinsurance penalty
is assessed when a policyholder under-insures the property.
8

Mortgage Clause
This policy clause sets forth the responsibilities, rights and duties of any
mortgagee who has an interest in the insured property.
Vacancy Provisions vs. Unoccupancy Provisions
Vacancy: the property does not have people or property on the premises.
Unoccupancy: the property may contain property, but people are not present.
These provisions are methods for limiting coverage by the insurer, due to the fact
that empty and vacant properties pose more risk.
Salvage Condition
This policy clause allows the insurer to recover partial claim expenses by taking
ownership of the damaged item and selling it.
Pair or Set Clause
If one component of a set or pair of items is damaged, the insurance company is
not required to reimburse for the full value of the set or pair.
However, the insurer must take into account how the value of the entire pair or
set is affected by the damage; the insurance company must take this into
consideration and reimburse the policyholder appropriately.
Appraisal Clause
If the insurer and the policyholder fail to agree on a settlement offer, either party
may make written demand for Appraisal.
Each party will select an appraiser and notify the other party of the appraiser's
identity; the appraisers mutually select an umpire. The insurance umpire
arbitrates the loss.
Assignment Clause

Policies cannot be assigned to another party, without written consent of the

insurance company.
Negligence
Failure to use reasonable amount of care, when the failure results in injury or
damage to a property or individual.
Liability Insurance
Insurance which covers the policyholder against losses arising from injury or
damage to another person or property.
Casualty Insurance
Insurance which protects the policyholder from liabilities ('civil wrongs') and
pays the costs of legal settlements.
Policy Limits
The maximum coverage that an insurance company will pay out for any single
loss, as specified in the policy declarations. Limits may be applied per person,
per accident or per occurrence.
===============Texas Homeowners Insurance=============
Texas has three standard fire policies:
HO-A
HO-B
HO-C

The HO-A is a standardized Texas homeowners policy. It is a limited actual cash

value policy, designed to cover a home and its contents. (Actual cash value =
replacement cost minus depreciation)
Only specific types of damage, named in the policy, are covered by the HO-A.
('named peril policy')

10

The HO-B is a standardized Texas homeowners policy. The HO-B is a

'replacement cost' policy which covers most kinds of damage, except for damages
that are specifically excluded.
Put simply, this is a policy for the structure and a named perils policy for the
contents.
The HO-C is a standardized Texas homeowners policy. This type of policy
is the most costly of the 3 standardized Texas policies, as it provides the most
extensive coverages: all perils policy for both structure(s) and personal property.
Compare Texas policies, by company, with this free online tool:
http://www.opic.state.tx.us/residential-property/compare-policycoverages/homeowners

Standard Policy Exclusions and Conditions

Most Texas Homeowner's Policies DO cover the following:

Fire
Lightning
Theft
Explosions
Automobile or aircraft contact with the dwelling
Smoke
Windstorm
Hurricane
Hail
Riots/civil unrest
Sudden/accidental water discharge

Most Texas Homeowner's Policies do NOT cover the following:

time

Termites, insect and/or rodent damage

Earthquake
Losses to a house that is vacant in excess of 60 days
Normal wear and tear/maintenance
Frozen pipes, when home is unoccupied
Flooding
Water damage due to continuous leakage/seepage over a period of

11

=======Homeowners Insurance Basics======

Texas HO-A (Basic 10 Perils)
This is the most basic of homeowners policies; it provides coverage for the
structures and the contents of the structures, against ten different named perils,
including fire, wind, rain, theft and vandalism.
Texas HO-B (Broad 16 Perils)
The HO-B policy is provides broader coverage than the HO-A; it includes
coverage for an additional six perils, including damage caused by falling objects
and damage caused by the weight of ice/snow.
Texas HO-C
The HO-C policy provides the broadest coverage for the largest list of perils; this
policy covers all of the 16 perils in HO-B, plus any other perils which are not
specifically excluded by the policy.
Perils and Losses Under Dwelling Policy 1 (DP-1)
Protects against: fire, lightning and internal explosions;
extended coverage may be purchased for the following: windstorm/hail,
explosion, civil unrest/looting, volcanic eruption, aircraft and vehicle contact
with the dwelling, smoke, vandalism.
Coverage for Other Structures
This insures any appurtenant buildings/structures; maximum amount is typically
10% of the HO-A coverage. For other policy types, this coverage must be
purchased additionally.

Earthquake Insurance
Earthquakes are not a covered peril under most dwelling and homeowner
insurance policies; it is available through certain insurance companies as an
optional endorsement or separate policy.
12

Conditions Found in Dwelling Policies:

Other Insurance
Duties After Loss
Intentional Loss
Concealment or Fraud
Our Option
Loss Payable
Loss Settlement

General Exclusions in Homeowners Policies:

Ordinance or Law

Under the Earth

Water Damage

Freezing, thawing, pressure, weight of water/ice under special

dwelling form DP-3
Additional liability Coverages in Homeowners Policies:

Coverage E personal liability (bodily injury and property damage)

Coverage F medical payments to others

Additional Liability Coverages in Homeowners Policies:

Claim Expenses (examples: defense costs, lost bond premiums)

First Aid Expenses
Damage to the Property of Others (property that is borrowed or rented
from others)
Loss Assessment (coverage for loss assessment required by a
homeowners association)

Limited Theft Coverage Endorsements

This coverage applies to on-premises property of tenants or other non-owner,
non-occupants of the dwelling.

13

Broad Theft Coverage

On-premises and off-premises personal property coverage for the owneroccupant of the dwelling. This coverage includes vandalism, theft, attempted
theft and malicious mischief. Certain exclusions and conditions apply.
Dwelling Policy Coverages L & M
Similar to the Liability insurance portion of a homeowner's policy; purchased as
an endorsement or completely separate policy. (Coverage L, personal liability
covering bodily injury or property damage; coverage M, medical payments to
others)
List Coverages A, B, C, E and F on Homeowners Policy

Coverage A:
Coverage B:
Coverage C:
Coverage E:
Coverage F:

the dwelling and attached structures

other structurs
special limits (sub limits) on certain kinds of property
personal liability
medical payments to others

Basic Perils Covered by All Homeowners Policies

Hail/Windstorm
Fire/explosion
Lightning
Smoke
Vehicles (except those owned by the insured)
Aircraft
Riot, vandalism, theft
Volcanic eruption
Civil unrest/riots

List the Named Perils Covered on Broad Form HO-2

Same as 'basic perils' above, plus this expanded list of perils:

Weight of snow, ice, sleet

Falling objects
Frozen plumbing (water systems)
Sudden/accidental discharge of water and/or steam
Accidental damage/breakdown of water systems
Smoke damage due to fireplace
14

Sudden/accidental discharge of electrical current

Damage to fences, driveways, walkways caused by a vehicle

List the Exclusions on HO-3 Special Form

water damage is NOT covered, other than 'sudden and accidental discharge'
only covers contents, based on the named perils (not open perils coverage)
Flood Insurance
This type of coverage was not widely available until 1968, when the US Federal
government created the NFIP (National Flood Insurance Program).
NFIP (National Flood Insurance Program)
Since standard homeowners insurance doesn't cover flooding, it's important to
have protection from the floods associated with hurricanes, tropical storms,
heavy rains and other conditions that impact the U.S.
In 1968, Congress created the National Flood Insurance Program (NFIP) to help
provide a means for property owners to financially protect themselves.
The NFIP offers flood insurance to homeowners, renters, and business owners if
their community participates in the NFIP. Participating communities agree to
adopt and enforce ordinances that meet or exceed FEMA requirements to reduce
the risk of flooding.
(source: www.floodsmart.gov )
An Explanation of NFIP Flood Insurance
Flood insurance can only be purchased through an insurance agent; you cannot
buy it directly from the federal government...
As with any other type of insurance, it's important to know what your policy does
and doesn't cover. For example, damage caused by a sewer backup is only
covered by flood insurance if it's a direct result of flooding. The damage is not
covered if the backup is caused by some other problem. For a complete summary
of coverage, go to Whats Covered.
Deductibles apply separately to building and contents with different amounts to
choose from. Like other insurance plans, a higher deductible will lower the
premium you pay but will also reduce your claim payment...

15

Homes and businesses with mortgages from federally regulated or insured

lenders in high-risk flood areas are required to have flood insurance. While flood
insurance is not federally required if you live in a moderate-to-low risk flood area,
it is still available and strongly recommended.
The NFIP, a federal program, offers flood insurance, which can be purchased
through most leading insurance companies. Rates are set and do not differ from
company to company or agent to agent.
These rates depend on several factors, including the date and type of construction
of your home, along with your area's level of risk. Most premiums include a
Federal Policy Fee and ICC Premium....
There is typically a 30-day waiting period from date of purchase before a new
flood policy goes into effect...
(source: www.floodsmart.gov)
What is Covered By Flood Insurance?

The insured building and its foundation

Electrical and plumbing systems

Central air conditioning equipment, furnaces and water heaters

Refrigerators, cooking stoves and built-in appliances such as

dishwashers

Permanently installed carpeting over unfinished flooring

Permanently installed paneling, wallboard, bookcases and cabinets

Window blinds

Detached garages (up to 10 percent of building property coverage);

detached buildings (other than garages) require separate building

policy

Debris removal
Personal belongings, such as clothing, furniture and electronic equipment...
(source:
http://www.floodsmart.gov/floodsmart/pages/residential_coverage/whats_covered.jsp )

What is NOT Covered by Flood Insurance?

Damage caused by moisture, mildew or mold that could have been

avoided by the property owner...
Currency, precious metals and valuable papers such as stock certificates
Property and belongings outside of an insured building such as trees,
plants, wells, septic systems, walks, decks, patios, fences, seawalls, hot
tubs and swimming pools
Living expenses such as temporary housing
16

Financial losses caused by business interruption or loss of use of insured

property
Most self-propelled vehicles such as cars, including their parts...

Coverage is limited in basements regardless of zone or date of construction. It's

also limited in areas below the lowest elevated floor, depending on the flood zone
and date of construction..
source:
http://www.floodsmart.gov/floodsmart/pages/residential_coverage/whats_cove
red.jsp
What is the 'Write Your Own' Program?
This is a program of the FIA (Federal Insurance Administration), which allows
private insurers to sell NFIP policies.
FIA sets eligibility criteria, coverage conditions and rates; the private insurers
administer the policy, accepting premiums and paying losses.
NOTES:

17

Personal Auto Insurance

Personal auto insurance is a personal policy, with both property and casualty
coverage elements;

Part A- Liability
Part B- Medical Payments
Part C- Uninsured Motorist
Part D- Damage to the covered vehicle

Common Auto insurance terms:

Bodily Injury: In relation to auto insurance, bodily injury refers to injuries
(and death) sustained by people who are not occupants of the insured vehicle
when an accident occurs.
Property Damage: In relation to auto insurance, property damage refers to
the property that is damaged by the insured's vehicle, in the event of an accident.
Covered Auto: the specific vehicle covered by the insurance policy.
Private Passenger Auto
4-wheeled private passenger vehicles, designed for use on public roadways and
highways, subject to motor vehicle registration.
Temporary Substitute Auto
A non-owned auto or trailer that the policyholder is using due to a breakdown,
repair, destruction or loss of a covered vehicle.
Personal Auto Policy: Part A (limits of liability and supplementary payments)
Part A-Liability Coverage: for bodily injury and damage to property, caused
by the insured, as a result of an automobile accident.

18

Personal Auto Policy Part A exclusions

Damage to property or injury to others that is intentional

Damage to personal property which is being carried in the vehicle

Damage to property that is being rented by, or borrowed by, the

insured

Bodily injury to the policyholder's employees

Cannot use the vehicle for paid transportation, such as a taxi service

Use of the vehicle without permission of the owner

Personal Auto Policy Part B and Limited Liability
Medical payments coverage for the named insured, family members and
passengers who are injured in the automobile accident; part B coverage does not
take into account who is at fault.
Personal Auto Policy Exclusions, Part B

Injuries occurred while in a vehicle with less than 4 wheels

Automobile is being used as for-hire transportation

Injuries otherwise covered by workers compensation insurance

Injuries sustained while occupying an uninsured personal vehicle

Injuries sustained while using the vehicle for the insured's business

Injuries that are a result of war or nuclear event

Injuries while in a vehicle that is being used as a residence or

personal premises

Injuries sustained as a result of speed/racing contest

Uninsured Motor Vehicle

Vehicle which has no liability insurance at the time of the accident;
or, vehicle has liability policy, but the coverage amount does not meet the statemandated minimums; or, the vehicle's driver is not identified (hit-and-run
driver).
Explain Auto policy Part C (Uninsured Motorist)
Part C covers damages that the policyholder is legally entitled to recover from the
owner or operator of an Uninsured or Underinsured motor vehicle, due to bodily
injuries and/or property damage, resulting from an accident.
19

Exclusions under Part C (and limit of liability)

Cannot be more than the limits of liability chosen in Part A; also subject to the
deductible.
Collision Coverage
Pays for damage to a car without regard to who caused an accident. The company
must pay for the repair or up to the actual cash value of the vehicle, minus the
deductible.
(source: tdi.texas.gov/consumer/glossary.html)
Auto Policy Part D
Pays for the cost of replacing or repairing a covered vehicle in the event of an
accident in which the insured is at fault.
Uninsured/Underinsured Motorist (UM/UIM) Coverage
Auto insurance coverage that pays for the policyholder's injuries and property
damage caused by a hit-and-run driver or a motorist without liability insurance.
It will also pay when medical and car repair bills are higher than the other
drivers liability coverage. (source: tid.texas.gov/consumer/glossary.html)

Explain Part E and Part F (auto policies)

Part E sets forth the procedure after an accident or loss. Part F pertains to
insurance fraud, bankruptcy of the insured and cancellation of the insurance
policy.
Auto Policy Endorsements
Endorsements sometimes called riders are optional provisions added to an
auto insurance policy to expand the coverage. Examples are: PIP (personal
injury protection) and Towing/Road Service.

20

Personal Inland Marine Insurance

In spite of the name, which implies some type of 'boat or watercraft' insurance,
this is coverage designed to protect high-value property while in transit, such as
tools or art. It is a common policy for business owners. (The insurance policy's
origins trace back to the 17th century and Lloyds of London, when most goods
actually did travel over water.)
Personal Property Form (Inland Marine Insurance)
This coverage is only for the following kinds of property: silverware, stamps,
valuable coins, fine art pieces, jewelry, cameras, furs, golfing equipment and
musical instruments.
Personal Article Form (Inland Marine Insurance)
In contrast to the personal article form of Inland Marine insurance, this policy
includes 'open peril coverage' for 13 different categories of personal property.
These categories include nearly every item that would be commonly found in a
household; each category has a separate limit.
Commercial Package Policy (CPP) and Common Declarations
CPP policies combine or package individual lines of insurance in a single
policy. A CPP policy may include two or more of the following: Commercial
Property; Commercial General Liability; Commercial Crime/Employee
Dishonesty; Commercial Inland Marine; Boiler and Machinery; Commercial
Auto and Farm.
Business owner's Policy (BOP)
In concept, the business owner policy is similar to a homeowners policy; it is a
single form containing multiple lines, suitable to the needs of particular
businesses; the single form includes:

property coverage (A and B)

liability coverage
conditions of the policy
declarations
optional coverage

Typically, the BOP has open perils coverage.

21

Business owner's Policy Coverage A

buildings/structures at the business location
fixtures (indoor and outdoor)
business equipment and machinery (must be permanent, not portable)
personal property of the insured, contained in rooms and common areas
equipment and items used for repair/alterations, within a certain distance
incomplete and complete additions to the premises
Business owner's Policy Coverage B
o business property of the insured
o certain property of others, in the possession of the insured
o tenant improvements, additions, alterations and permanently
attached fixtures
o rental and lease property, which the business owner is obligated to
insure
o exterior building glass
o certain personal property, within a certain distance from the
business premises
BOP Exclusions
Losses which are the result of certain external perils are excluded from coverage:

normal 'wear and tear'

earth movement/settlement

water damage (sewer problems, mudslides, floods,

leaking/seepage)

damage due to animals/insects

acts of war

damage as a result of nuclear accident

changes in the law

certain kinds of collapses

power outage as the result of utility service failure, outside the

business premises
Debris Removal: Business owner's Policy
If debris on the premises is the result of a covered loss, the insured will receive
reimbursement for the costs associated with removal.

22

Business owner's PolicyLiability Coverage

Covers court costs if the insured is held legally liable for property damage,
bodily injury, personal and advertising injury.
BOP Endorsements
utility services direct damage (damage or loss is the result of a covered
utilities interruption)
hired auto and non-owned auto liability
What is Ocean Marine Insurance?
Coverage for risks related to the transporting of goods or persons on the high seas
or traveling by air.
Types of Ocean Marine Insurance

hull insurance
cargo insurance
freight insurance
P&I (protection and indemnity) insurance

Inland Marine Insurance

Coverage for risks to 'moving and moveable' property, over land or inland
waterways.
Types of Risks That Are Covered By Ocean Marine Policies
Named and open peril protection against:

fire
explosion
vandalism/pilferage
perils of the sea
barratry (illegal, willing damage to the cargo, by the crew)
23

jettison
contact by other cargo

Commercial General Liability Insurance (CGL)

Covers businesses against common liabilities that they face on a daily basis; the
policy protects against property damage and bodily injury claims.
CGL policies generally cover legal fees, medical bills, property damage costs and
financial harm (due to libel or slander).
Explain Coverages A, B and C on Commercial Liability Policy
coverage A: bodily injury and property damage
coverage B: personal and advertising injury
coverage C: medical expenses as a result of bodily injury, regardless of
the party at fault
Workers Compensation and Employers Liability Policy
Workmens compensation insurance is 'no-fault' coverage for illness and/or
injury, related to an employee's workplace or job.
The goal of the insurance is to cut down on lawsuits and reduce disputes arising
from work-related injuries and illnesses.
Note: Texas is the only state that currently has an 'elective' workmens
compensation law.
Farm Insurance
The farm policy is hybrid of homeowners coverage, commercial business
insurance and specialty insurance. The basic policy covers property, liability and
medical expenses.
Endorsements can be added to customize coverage, and may include crop
insurance and boarded animals coverage.

24

Aviation Insurance
Insurance policy which protects against losses and claims resulting from the use,
ownership, or maintenance of an aircraft; includes property damage coverage
and liability coverage.
------------------------------------------------------------------------**Additional self-study exercises for application of concepts**
To do: Read your personal Texas homeowners policy, business
owners policy, or automobile policy.
Can you identify:

the declarations pages

covered perils

exclusions

deductible amounts

Disclaimer: The concepts and definitions presented in this document are

provided for educational purposes only. The concepts and definitions provided
should not be construed as legal or professional advice.

Refer to the Texas Department of Insurance should you have specific questions:
http://www.tdi.texas.gov

Questions? support@insuranceadjustertraining.net

25

Texas Department of Insurance

Agent and Adjuster Licensing: Mail Code 107-1A

P.O.Box 12069 Austin, Texas 78711-2069
512-322-3503
www.tdi.texas.gov

Application for Individual Agent License

Applicant General Information Guide beginning on page 11.
This application form is to be used by individuals not required to pass a qualifying examination through Prometric. It must be typed or
printed in ink. Those applicants required to take a qualifying examination must contact Prometric at 866-267-0455 or at www.prometric.
com/texas for application information and examination reservations.
All applications are subject to further review. Any affirmative response to a screening question may extend processing times. Failure to
disclose criminal history information may result in denial of license.

Part ITo be completed by all individual applicants

Applicants must choose only one license type. Those who wish to apply for more than one license type must submit a separate
application and fee for each type. Adjusters should read PART II of this application before continuing.
License Types (check only one per application):
General LinesLife, Accident & Health

Limited Lines

AdjusterAll Lines

General LinesProperty & Casualty

County Mutual

AdjusterProperty & Casualty

Life

Insurance Service Representative

AdjusterWorkers Compensation

Life Insurance Not Exceeding $25,000

Managing General Agent

AdjusterTrainee

Funeral Prearrangement Life

Surplus Lines

AdjusterEmergency

Life & Health Insurance Counselor

Risk Manager

AdjusterAll Lines Designated Home State Texas

Full-Time Home Office Salaried Employee

Public Insurance Adjuster

AdjusterP&C Designated Home State Texas

Personal Lines Property and Casualty

Public Insurance AdjusterTrainee

AdjusterWorkers Compensation
Designated Home State Texas

License Fees: Fees are $50 per license type, or $150 for a temporary license. $75 fee required for license that has been expired for more
than 90 days but less than one year. (Texas Insurance Code (TIC) 4003.007) Make check or money order payable to the Texas Department
of Insurance. All license fees are nonrefundable and nontransferable.
No fee required for Adjuster-Trainee
$20 fee required for Adjuster-Emergency

Applicant InformationPlease read carefully and provide all requested information.

1 Applicants Full Legal Namenicknames and abbreviations are not acceptable.
LAST NAME

FIRST NAME

MIDDLE NAME

SUFFIX

2 Applicants Social Security Number, Date of Birth and Daytime Phone NumberThe application cannot be processed without
this information. Disclosure of Social Security Number is required by the Texas Family Code 231.302.
SOCIAL SECURITY NUMBER

DATE OF BIRTH (MM/DD/YY)

DAYTIME PHONE NUMBER

EXT

3 Official Mailing Address (required)This is the address of record with TDI.

STREET, PHYSICAL LOCATION, ROUTE OR P O BOX

APARTMENT, SUITE, ETC.

CITY

STATE

ZIP CODE

4 Business Address (required)This must be your primary office address where you will maintain business records of Texas
insurance transactions.
NUMBER & STREET (MUST BE PHYSICAL LOCATIONP.O. BOX NOT ACCEPTED)

APARTMENT, SUITE, ETC.

CITY

STATE

ZIP CODE

5 Applicants E-mail Address (required)E-mail will be used only as option when corresponding with TDI.
E-MAIL ADDRESS

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Applications will not be processed until proper documentation or details are received and a review is completed.

All applications are subject to further review. Any affirmative response to a screening question may extend processing times. Failure to
disclose criminal history information may result in denial of license.

6 Excluding traffic violations and first offense DWI:

a Do you currently have any pending misdemeanor or felony charges (by indictment, information, or any other instrument)
filed against you in Texas, in any other state or by the federal government?
No
Yes
b Have you ever been convicted of any misdemeanor or felony offense in Texas, in any other state or by the federal government?
No
Yes
c Have you ever had adjudication deferred on any misdemeanor or felony charge or offense in Texas, in any other state or
by the federal government?
No
Yes
d Have you ever served any period of probation for any misdemeanor or felony offense in Texas, in any other state or by the
federal government?
No
Yes
If you answered Yes to any of questions 6ad, you must submit original certified copies of the charging document, indictment, information, or any other charging document, judgment of conviction, and/or deferred adjudication order, probation
order, order terminating probation, community supervision and/or parole certificate for each and every crime or offense. If the
court states they no longer have the records, please have the court provide us with a letter on their letterhead stating that fact.
If you were arrested only and not prosecuted, please provide a records search from the appropriate jurisdiction indicating a
final disposition. You must submit a statement describing the circumstances leading to the offense(s). You must include your
age at the time(s) of the offense(s).You may provide letters of recommendations from any persons in contact with you that are
aware of your criminal past.
7 Have you ever applied for a letter of consent, as required under 18 U.S.C. 1033(e), from any insurance regulatory official from
Texas or any other State?
No
Yes
If you answer Yes, the application will not be processed until you provide full details of the outcome of that proceeding and
all supporting documents to the department.
If you answer No, and you have been convicted of any criminal felony involving dishonesty or breach of trust, or an offense
under 18 U.S.C. 1033, the application will not be processed until you submit a signed and notarized request for written consent with all supporting documentation to the department.
8 Have you or has any corporation, partnership, association or firm in which you were a director, officer, shareholder, manager,
member or partner, ever been the subject of an administrative or legal action filed by Texas or any other insurance department,
or financial regulatory agency, or of an action filed on behalf of Texas or any other state or by the federal government based on
alleged violations of state or federal insurance, securities or financial regulatory laws that you have not previously reported to
the Texas Department of Insurance?
No
Yes
If you answer Yes, a license will not be issued until full details of the administrative or legal action are provided.
9 Are you indebted to any policyholder, insurance or reinsurance company, insurance agency, general agent, managing general
agency, premium finance company or court appointed liquidator for premiums collected or commissions retained, or have any
claims or judgments been filed against you for retaining premiums or commissions?
No
Yes
If you answer Yes, a license will not be issued until full details of the indebtedness are provided.
10 Have you ever had an agency contract or company appointment cancelled for cause (e.g., misrepresentation, misappropriation, etc.)?
No
Yes
If you answer Yes, a license will not be issued until full details are provided. Cancellation for cause does not include cancellations due to license expiration (nonrenewal).
11 During the last 6 months, have you applied for or received a temporary license of the type for which you are now applying?
No
Yes
If you answer Yes, a temporary license will not be issued. A temporary license may not be renewed or issued more than once
in a consecutive six-month period to the same applicant. Public Insurance Adjuster Trainee applicants see Part III, number 2.

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12 Do you currently hold any insurance agent license, adjuster or public insurance adjuster license in any state other than Texas
or have you held any insurance agent license, adjuster or public insurance adjuster license in any state other than Texas within
the last five years?
No
Yes
If you answer Yes, you must provide the following:
Applicants who have held a resident license in another state within the previous five years from the date of this application
must attach a Clearance Letter from the Insurance Commission in the state(s) in which the applicant was previously licensed.
A Producer Database printout showing the termination of the license in the applicants previous resident state(s) can take the
place of a Clearance Letter.
Applicants holding a current resident license in another state must attach an original Certificate of Good Standing from the
Insurance Commission in the applicants state of residence. The Certificate of Good Standing must be dated within 90 days of
receipt of the completed application. A Producer Database print out showing that a current license is held in the applicants
resident state can take the place of a Letter of Certification.
13 This application is for a license I previously held that is expired for more than 90 days but less than one year. I will attach the
required $75 license fee. (TIC 4003.007)
No

Yes
Previous License Number

Part IIAdjusters, Adjuster Trainees and Emergency Adjusters

Public Insurance Adjusters use Part III

All Lines Adjusters, Property & Casualty Adjusters, and Workers Compensation Adjusters Only

Adjusters may add additional qualifications without completing a new application by submitting to TDI a copy of the existing adjuster license along with a copy of the approved course certificate, or by passing the Texas examination provided by Prometric. The
Certificate of Completion must show that within the past 12 months the adjuster has completed a certified adjuster prelicensing
education program and passed an examination.
1 Adjuster applicants Must be completed with the name of the firm or insurer with whom they will be employed or, if self employed, with the applicants name.
NAME OF FIRM OR INSURER (OR APPLICANT NAME, IF SELF-EMPLOYED)

2 I have qualified for the adjuster license selected on page 1 and have;
attached a course Certificate of Completion certifying that within the past 12 months I completed a Texas adjuster
prelicensing education program and passed its examination, or
a current resident adjuster license in good standing in the State of
similar to Texas as reflected in the National Association of Insurance Commissioners Producer Database or by the attached Letter of Certification from the licensing state, or
attached my CPCU designation or Associate in Claims (AIC) certification.
3 Nonresident Adjuster Designated Home State Texas Applicants Only I am a resident of another state that does not license
adjusters for the line of authority sought , I reside in a state that permits residents of Texas to act as an adjuster in that state,
and I request that Texas be the designated home state of the adjuster license for which I am applying. (TIC 4101)
I have qualified for the Texas adjuster designated home state Texas license selected on page 1 and have
attached a course Certificate of Completion certifying that within the past 12 months I completed a certified adjuster
prelicensing education program and passed an examination, or
attached my CPCU designation or Associate in Claims (AIC) certification.
I understand that by designating Texas as the home state, I am subject to Texas license qualifying examination and compliance
with Texas adjuster continuing education and fingerprinting requirements. (Texas Insurance Code (TIC) 4101.054,
4101.059 and 28 Texas Administrative Code (TAC) 19.1001-19.1020, Texas Insurance Code (TIC) 4001.103)
No

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Yes

3 of 13

4 Adjuster Trainee RegistrationAn Adjuster Trainee is required to undergo education and training as an adjuster under the
direction and supervision of a licensed sponsoring adjuster. Authorization to act as an Adjuster Trainee may not exceed
12 months. The Adjuster Trainee registration may not be renewed. An Adjuster Trainee must be sponsored by a licensed
adjuster.
The sponsoring licensed adjuster must complete the following certification.
This is to certify that the above-mentioned applicant will undergo education and training as an adjuster under my direction and
supervision as required in Texas Insurance Code7,&, 4101.003.

SIGNATURE OF SPONSORING LICENSED ADJUSTER '$7(6,*1('00''<<

PRINT LEGAL NAME OF SPONSORING LICENSED ADJUST(57DI LICENSE NUMBER OF SPONSORING ADJUSTER

5 Emergency AdjusterAn Emergency Adjuster License may be issued to an individual to adjust losses as a result of a catastrophe or emergency. The sponsoring licensed adjuster or insurance company must provide specific details of the catastrophe
requiring the issuance of an Emergency Adjuster License. The details must include the date, location, type of catastrophe,
and a copy of official notice or other similar third party notice(s) of the catastrophe or emergency. An Emergency Adjuster
must be sponsored by either a licensed adjuster or a licensed and approved insurance company. The mailing address of the
Emergency Adjuster sponsor must be provided. Emergency Adjuster Licenses are issued for 90 days. Emergency Adjuster applicants are not required to provide fingerprints.
Provide location(s) and details of the catastrophe that the above-named applicant intends to work.

6 This is to certify that the above-named applicant will be working catastrophe claims at the above location(s) resulting from the
catastrophe named in the attached official notice. I will be responsible for the loss or claims practices of the Emergency Adjuster License holder as required in Texas Insurance Code7,&, 4101.101.

SIGNATURE OF SPONSORING LICENSED ADJUSTER OR SPONSORING COMPANY OFFICIAL

DATE SIGNED (MM/DD/YY)

Print legal name of sponsoring licensed adjuster or company official and sponsoring company

NAME

TDI LICENSE NUMBER OF SPONSORING ADJUSTER

SPONSORING COMPANY NAIC NUMBER

MAILING ADDRESS OF SPONSORING ADJUSTER OR SPONSORING INSURANCE COMPANY

BUSINESS PHONE NUMBERG (10 DIGIT)

CITY

STATE

FIN506 Rev. 0/2012

ZIP CODE

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Part IIIPublic Insurance Adjusters Only

Public Insurance Adjuster license applicants and trainee registration applicants must complete this part of this application.
1 Provide the name of the currently licensed firm or person for whom you will be employed as a public insurance adjuster (PIA),
or if self-employed, enter your name.
NAME OF EMPLOYER (OR APPLICANT NAME, IF SELF-EMPLOYED)

EMPLOEYERS TEXAS PIA LICENSE NUMBER

2 Public Insurance Adjuster Trainee RegistrationA public insurance adjuster trainee is required to register and undergo education and training as a public insurance adjuster under the direction and supervision of a licensed sponsoring public insurance
adjuster. Authorization to act as a public insurance adjuster trainee may not exceed 180 days, but may be renewed, so long as
the registrant does not hold any more than two certificates, including renewals, within an 18 month period. A trainee certificate
may be renewed by filing another fully completed application with the required $50 fee with the department not more than 30
days prior to the expiration of an existing trainee certificate.
The sponsoring licensed public insurance adjuster must complete the following certification.
I certify that the above-mentioned public insurance adjuster trainee registration applicant will undergo education and training
as an adjuster under my direction and supervision as required in Texas Insurance Code, 4102.069 and that I continue to
meet the public insurance adjuster financial responsibility requirement.
SIGNATURE OF SPONSORING LICENSED PUBLIC INSURANCE ADJUSTER

DATE SIGNED (MM/DD/YY)

PRINT LEGAL NAME OF SPONSORING LICENSED PUBLIC INSURANCE ADJUSTER

TDI LICENSE NUMBER OF SPONSORING PUBLIC INSURANCE ADJUSTER

3 Financial ResponsibilityEach public insurance adjuster license applicant and trainee registration applicant must demonstrate proof of financial responsibility with a surety bond executed with the applicant as sole principal in the amount of not less
than $10,000 payable to the Texas Department of Insurance on a bond form available at www.tdi.texas.gov/forms/form11.
html. See Texas Insurance Code, 4102.105 and 28 Texas Administrative Code 19.70519.707. The original bond must
be attached to this application.
I have attached my original Public Insurance Adjuster Bond.
No

Yes

4 FingerprintsAll resident and nonresident public insurance adjuster license applicants and trainee registration applicants
must file with this application an electronic fingerprint receipt or a receipt from L1 Enrollment Services confirming an original
fingerprint card and completed FAST Fingerprint Card Scan Authorization Form with a $41.45 check or money order payable
to L1 was sent to L1 Enrollment Services. If fingerprints were previously submitted to TDI for another application and the applicant continues to hold an active license, then a fingerprint receipt is not required. For complete information regarding fingerprinting, see page 12 of this form.
Fingerprint Receipt from L1 or Prometric (see page 12 for complete fingerprinting instructions) is attached, or
I hold active TDI License Number______________________, and previously submitted fingerprints to TDI.
Fingerprints provided for this application shall be used to check criminal history records of the Texas Department of Public
Safety and the Federal Bureau of Investigation in accordance with applicable statutes.
5 Criminal History RecordEach nonresident public insurance adjuster license applicant and nonresident trainee registration
applicant must file with this application an original criminal history record of the applicant obtained from the state law enforcement agency of the applicants state of residence. I have attached my original criminal history records.
No, I am a resident of Texas

Yes, the record is attached.

6 Agent for Service of ProcessAll nonresident applicants for a public insurance adjuster license must provide the name and
address of their agent for service of process in the State of Texas as required in Texas Insurance Code, 4102.107.
NAME OF TEXAS AGENT FOR SERVICE OF PROCESS

TEXAS ADDRESS OF AGENT FOR SERVICE OF PROCESS

CITY

FIN506 Rev. 07/2012

STATE

ZIP CODE

5 of 13

Part IVSurplus Lines Agents Only

To qualify for a Texas Surplus Lines License, you must hold a current Texas General Lines-Property and Casualty License or a current Texas Managing General Agent License (TIC 981.203).
Provide your underlying license type and current Texas license number.
UNDERLYING LICENSE TYPE

TDI LICENSE NUMBER

Part VInsurance Service Representatives Only

Certificate for Insurance Service RepresentativesMust be completed by the appointing licensed General LinesProperty and
Casualty Agent or Personal Lines Property and Casualty Agent or an officer or partner of a licensed General LinesProperty and
Casualty Agency or Personal Lines Property and Casualty Agency.

CERTIFICATE FOR INSURANCE SERVICE REPRESENTATIVES

This is to certify that the above-mentioned applicant is appointed to act as an Insurance Service Representative (ISR) for this
General LinesProperty and Casualty Agent/Agency or Personal Lines Property and Casualty Agent/Agency in the State of
Texas, subject to the applicants qualifying for a license. If and when this appointment is terminated or canceled, the Department must be notified immediately of such termination. The ISR Transfer/Cancel Employment Form LHL208 may be found
at the agent page of www.tdi.texas.gov.
Appointing General LinesProperty and Casualty or Personal Lines Property and Casualty AGENT:
SIGNATURE OF SPONSORING AGENT

PRINT OR TYPE SPONSORING AGENTS LEGAL NAME

(AS IT APPEARS ON THE CURRENT LICENSE)

AGENTS TDI LICENSE NUMBER

Appointing General LinesProperty and Casualty or Personal Lines Property and Casualty AGENCY:
SIGNATURE OF AGENCY OFFICER OR PARTNER

PRINT OR TYPE SPONSORING AGENCYS NAME

(AS IT APPEARS ON THE CURRENT LICENSE)

PRINT OR TYPE SIGNING OFFICERS OR PARTNERS NAME

AGENCYS TDI LICENSE NUMBER

DATE SIGNED (MM/DD/YY)

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Part VINotice of Appointment (General Lines Agents [GL], Life Agents [LAGT], Limited Lines Agents [LL],Funeral Prear-

rangement Life Agents[PN], Life Insurance Not Exceeding $25,000 Agents[LI], County Mutual Agents [CM], Managing General
Agents[MGA], Personal Lines Property and Casualty Agents[PLPC] and Full-Time Home Office Salaried Employees [HOSE] Only)

Notice of Appointment. To make a company or subagent appointment with the license application, the Notice of Appointment
form on Page 8 of 13 must be signed in ink by an authorized appointing official of the appointing INSURANCE COMPANY, AN EXECUTIVE OFFICER OR PARTNER OF THE SPONSORING AGENCY, OR THE SPONSORING INDIVIDUAL AGENT. The form will be rejected
if it does not contain the title and original signature of the signing representative. The applicants signature will not be accepted.
The Notice of Appointment must include the date the form is signed. A Notice of Appointment does not apply to Insurance Adjuster,
Public Insurance Adjuster, Risk Manager, Surplus Lines, Insurance Service Representative, or Life and Health Insurance Counselor
Licenses.
Temporary License. Only applicants for a Funeral Prearrangement Life Agent, Life Insurance Not Exceeding $25,000 Agent, or
County Mutual Agent License may apply for a temporary license with this application. If a temporary license is requested by the
appointing company and if the company and applicant are eligible, TDI will issue such a license for a period of 90 days, without
examination. A temporary license may not be renewed or issued more than once in a consecutive six-month period to the same
applicant. A temporary license application must include a completed Notice of Appointment. The temporary licensee must
provide to TDI a certification by the appointing insurance company that the temporary agent has completed the required course
of study and passed the written examination with a copy of the temporary license within one year of the temporary licenses issue
date in order to obtain the permanent license without a new application.
A Registration of Full-Time Home Office Salaried Employee application must include a completed Notice of Appointment.
Insurance Company Appointments. If a completed Notice of Appointment is not received with a General Lines Agent, Life Agent,
Limited Lines Agent, Funeral Prearrangement Life Agent, Life Insurance Not Exceeding $25,000 Agent, County Mutual Agent, Managing General Agent or Personal Lines Property and Casualty Agent License application, the license may be issued. However, not
later than the 30th day after the effective date of the agents appointment by the insurance company, a TDI Notice of Appointment
with the $10.00 fee must be submitted to TDI.
Subagent Appointments. ONLY GENERAL LINES AGENTS, PERSONAL LINES PROPERTY AND CASUALTY AGENTS AND LIFE AGENTS
MAY APPOINT SUBAGENTS OR BE APPOINTED AS SUBAGENTS.
A General Lines Life, Accident and Health Agent may appoint a General Lines Life Accident and Health Agent or a Life
Agent.
A Life Agent may appoint a General Lines Life Accident and Health Agent or a Life Agent.
A General Lines Property and Casualty Agent may appoint a General Lines Property and Casualty Agent or a Personal Lines
Property and Casualty Agent.
A Personal Lines Property and Casualty Agent may appoint a General Lines Property and Casualty Agent or a Personal Lines
Property and Casualty Agent.
Applicants for a Limited Lines, Funeral Prearrangement Life, Life Insurance Not Exceeding $25,000, County Mutual, Managing
General Agent License, or a Full-Time Home Office Salaried Employee Registration cannot be appointed by an agency or agent.
NOTICE OF APPOINTMENT FOLLOWS ON THE NEXT PAGE.

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7 of 13

PLEASE FOLLOW INSTRUCTIONS ON PREVIOUS PAGE.

NOTICE OF APPOINTMENT FOR GL, LAGT, LL, PN, LI, CM, MGA, PLPC AND HOSE APPLICANTS
FULL LEGAL NAME OF APPLICANT (PRINT OR TYPE) LAST NAME

FIRST NAME

MIDDLE NAME

SUFFIX

Only ONE sponsor per application. Enter company, agency or agent information.
Name of Insurance Company appointing a GL, LAGT, LL, PN, LI, CM, MGA, PLPC or HOSE applicant:

APPOINTING COMPANY NAME (GROUP NAMES NOT ACCEPTABLE)

NAIC NUMBER OF APPOINTING COMPANY

ORName of Agency sponsoring a GL, LAGT or PLPC as a Subagent:

SPONSORING AGENCY NAME

(AS IT APPEARS ON THE CURRENT AGENCY LICENSE)

AGENCY TAX ID NUMBER

ORName of Individual Agent sponsoring a GL, LAGT or PLPC as a Subagent:

SPONSORING AGENT NAME

(AS IT APPEARS ON THE CURRENT AGENT LICENSE)

SSN OF SPONSORING INDIVIDUAL AGENT

Temporary License: (for PN, LI, or CM license types only):

Does this company want the above named applicant to receive a temporary license to act as a full-time agent in accordance with
the provisions of the Texas Insurance Code?
Yes
No
If Yes, please provide the telephone number of the office where the agent will be assigned: (______) __________________
Managing General Agent: This section must be completed by an officer of the appointing company or carrier having personal
knowledge that the applicant has had experience or instruction that would qualify the applicant as a managing general agent.
Will the above managing general agent applicant have claim settlement authority for the company or carrier?
Yes
No
Does the claim settlement authority exceed $25,000 on any one claim?
Yes
No
Does the claim settlement authority include third-party liability other than property damage?
Yes
No
Are funds exceeding $100,000 customarily held by the managing general agent for the purpose of paying losses and loss
adjustment expenses for the company or carrier?
Yes
No
The Appointing Official must read and sign the following statements:
This is to certify that the above-mentioned applicant is appointed to act as an agent for this company OR a subagent for my agency
OR a subagent for me in the State of Texas subject to the applicants qualifying for a license. If and when this appointment is
terminated or canceled, the Department will be notified immediately of such termination.
This applicant meets the requirements as set out in the Texas Insurance Code and the rules and regulations promulgated by the
Texas Department of Insurance for the type of license applied for herein.
I acknowledge my responsibility for ensuring that the applicant receives training if required by the Texas Insurance Code.

SIGNATURE OF APPOINTING OFFICIAL OF APPOINTING INSURANCE COMPANY

OR EXECUTIVE OFFICER OR PARTNER OF APPOINTING AGENCY
OR APPOINTING INDIVIDUAL AGENT

PRINT OR TYPE APPOINTING OFFICIALS FULL LEGAL NAME AND TITLE

OR OFFICERS OR PARTNERS FULL LEGAL NAME AND TITLE
OR INDIVIDUAL AGENTS FULL LEGAL NAME

DATE SIGNED (MM/DD/YY)

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Part VIIBackground Information and Fingerprints

This part must be completed by all applicants except Emergency Adjuster, Full-Time Home Office Salaried Employee, Public Insurance Adjuster and Public Insurance Adjuster Trainee registrants. Public insurance adjuster license applicants and trainee registration applicants must complete Part III and skip this part.
1 I am a resident of Texas and:
a I have attached a copy of my fingerprint receipt from L-1 or Prometric evidencing that my fingerprints have been submitted to the Texas Department of Public Safety (see page 12 for complete fingerprinting instructions) or
b I have an active TDI agent/adjuster license and I have already submitted fingerprints to TDI or
c I have an active TDI license or registration, other than an agent/adjuster license, and I have already submitted my fingerprints to TDI with a
on

TYPE OF APPLICATION OR FILING

DATE FINGER PRINTS SUBMITTED TO TDI (MM/DD/YY)

Resident applicants must include a copy of their fingerprint receipt unless the applicant (1) has an active TDI license or registration and (2) submitted fingerprints to TDI with another license application or TDI filing. Fingerprints will be used to check
criminal history records of the Texas Department of Public Safety and the Federal Bureau of Investigation in accordance
with applicable statutes.
2 I am a nonresident of Texas, and I meet the background information requirement as follows:
a I hold an active license in good standing in my resident state as reflected on the National Association of Insurance Commissioners Producer Database or
b I have attached my criminal history records that I have acquired from my resident states law enforcement agency or
c I have attached a current Certificate of Good Standing from my resident state or
d I have attached a copy of my fingerprint receipt from L-1 or Prometric evidencing that my fingerprints have been submitted to the Texas Department of Public Safety.
All nonresident license applicants who do not hold a current insurance license in good standing in the applicants state of
residence shall, through the law enforcement agency of the state of residence, submit a copy of the applicants criminal
history records. If the resident state will not provide a criminal history record for licensing purposes, the applicant must provide
a fingerprint receipt from L1 or Prometric evidencing that fingerprints have been submitted to the Texas Department of Public
Safety (see page 12 for complete fingerprinting instructions).
3 I am a nonresident of Texas applying for a Designated Home State Adjuster License, and I am a resident of another state that
does not license adjusters for the line of authority sought on page 1. I meet the Texas fingerprint requirement by either a or b
or c as I have indicated below.
a I have attached a copy of my fingerprint receipt from L-1 or Prometric evidencing that my fingerprints have been submitted to the Texas Department of Public Safety (see page 12 for complete fingerprinting instructions) or
b I have an active TDI agent/adjuster license and I have already submitted fingerprints to TDI or
c I have an active TDI license or registration, other than an agent/adjuster license, and I have already submitted my fingerprints to TDI with a
on

TYPE OF APPLICATION OR FILING

DATE FINGER PRINTS SUBMITTED TO TDI (MM/DD/YY)

FIN506 REV. 07/2012

9 of 13

Part VIIIIndividual Applicant Signature Page (to be completed by all applicants)

All Applicants must read, sign, and have this section notarized before submitting the license application.
I hereby certify that I have personally answered each of the questions herein and that the answers are true and correct to the
best of my knowledge and belief. I further certify that I am aware of the provisions of the Texas Insurance Code and the rules and
regulations promulgated by the Texas Department of Insurance which relate to the issuance of the license for which I am applying
and the grounds under which such license may be denied, suspended, revoked or non-renewed, and that I meet the requirements
for the license type applied for herein. I further acknowledge that I am subject to both disciplinary action and criminal prosecution
if my application contains a false, fictitious, or fraudulent statement or entry with regard to any material fact.
I understand that fingerprints provided with this application shall be used to check criminal history records of the Texas Department of Public Safety and the Federal Bureau of Investigation in accordance with applicable statutes.
I acknowledge and understand that I have the duty to inform the Commissioner of Insurance of any disciplinary action taken
against me in any other state in which I may be licensed within thirty (30) days of the happening of such disciplinary action.
I fur ther acknowledge that I have the duty to update the information contained on this application, including a change of my address, and that failure to do so may constitute grounds for revocation or suspension of my insurance license(s).
I understand all applications are subject to further review. Any affirmative response to a screening question may extend processing times. Failure to disclose criminal history information may result in denial of license.

SIGNATURE OF APPLICANT

FULL LEGAL NAME OF APPLICANT (PRINT OR TYPE) LAST NAME

FIRST NAME

MIDDLE NAME

SUFFIX

The State of, ________________________________________County of _______________________________________________ ,

Before me,

, on this day personally appeared

(PRINTED NAME OF NOTARY PUBLIC)

, known to me (or proved to me

(PRINTED FULL LEGAL NAME OF APPLICANT)

on the oath of _____________________________________________or through _________________________________________)

(PRINTED NAME OF WITNESS KNOWN TO NOTARY PUBLIC)

(DESCRIPTION OF IDENTITY CARD OR OTHER DOCUMENT)

to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that (s)he executed the same
for the purposes and consideration therein expressed.
Given under my hand and seal of office this ________ day of ________________________________ , A.D. ___________________

(NOTARY SEAL)

(NOTARY PUBLIC SIGNATURE)

Notary Public, State of _______________________________

Send completed application, check or money order, made payable to the Texas Department of Insurance, and other required documents to: Texas Department of Insurance Agent and Adjuster Licensing MC 107-1A P.O.Box 12069 Austin, Texas 78711-2069

FIN506 Rev. 07/2012

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General Information
LICENSE TYPE
General LinesLAH ( 4054.051)
General LinesP&C ( 4051.051)
Life Agent (Chapter 4054)
Life Insurance Not Exceeding $25,000 ( 4054.201)
Funeral Prearrangement Life ( 4054.151)
Life & Health Insurance Counselor (Chapter 4052)
Full-Time Home Office Salaried Employee ( 4051.301)
Personal Lines Property and Casualty (Chapter 4051)
Limited Lines ( 4054.101 and 4051.101)
County Mutual ( 4051.201)
Insurance Service Representative ( 4051.151)
Managing General Agent (Chapter 4053)
Surplus Lines Agent (Chapter 981)
Risk Manager (Chapter 4153)
Public Insurance Adjuster (Chapter 4102)
Public Insurance AdjusterTrainee (Chapter 4102)
AdjusterAll Lines (Chapter 4101)
AdjusterP&C (Chapter 4101)

PART I

PART II

PART III

PART IV

PART V

PART VI PART VII PART VIII

AdjusterWorkers Comp (Chapter 4101)

AdjusterTrainee ( 4101.003)
AdjusterEmergency ( 4101.101)
AdjusterAll Lines Designated Home State Texas (Chapter 4101)
AdjusterP&C Designated Home State Texas (Chapter 4101)
AdjusterWorkers Comp Designated Home State (Chapter 4101)

Required parts
A temporary license is available for this license type. A Part VI, Notice of Appointment is required for a temporary license, otherwise
the Notice of Appointment is optional on this original application.
Notice of Appointment is optional for these types on an original application. However, not later than the 30th day after the effective
date of the agents appointment by an insurance company, or subagents appointment by a General Lines agent/agency, a Notice of
Appointment with the $10 fee must be submitted to TDI, if the Notice of Appointment is not made on this application.
If Notice of Appointment is not submitted, then company certification must be provided certifying the applicant has (1) completed a
course of study and instructions and (2) passed without aid a written examination administered by the insurer as required in the Texas
Insurance Code.

License type information and descriptions, including examination requirements and exemptions, may be found at
www.tdi.texas.gov/licensing/agent/aglityp.html
This application with fee and required attachments must be mailed to:
Texas Department of Insurance,
Agent and Adjuster Licensing
MC 107-1A
P O Box 12069
Austin TX 78711-2069
Notice About Certain Information Laws and Practices
With few exceptions, you are entitled to be informed about the information that the Texas Department of Insurance (TDI)
collects about you. Under Sections 552.021 and 552.023 of the Texas Government Code, you have a right to review or receive copies of information about yourself, including private information. However, TDI may withhold information for reasons
other than to protect your right to privacy. Under Section 559.004 of the Texas Government Code, you are entitled to request
that TDI correct information that TDI has about you that is incorrect. For more information about the procedure and costs
for obtaining information from TDI or about the procedure for correcting information kept by TDI, please contact the Agency
Counsel Section of TDIs Legal and Regulatory Affairs Program at AgencyCounsel@tdi.state.tx.us or you may refer to the
Corrections Procedure section on our websites.

Fees: 28 Texas Administrative Code 19-80119.802: All $50 application and $150 temporary license application fees are
nonrefundable and nontransferable as authorized by the Texas Insurance Code. Make check or money order payable to the Texas
Department of Insurance.
Applicants with Expired Licenses: If a persons license has been expired for more than 90 days but less than one year, the person
may not renew the license, but is entitled to a new license without taking the applicable examination if the person submits to TDI
a new application, the license fee, and an additional fee equal to one-half of the license fee. If a persons license has been expired
for one year or more, the person may obtain a new license by submitting to reexamination, if examination is required for original
issuance of the license, and complying with the requirements and procedures for obtaining an original license.
FIN506 Rev. 07/2012

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General Information (continued)

Temporary License Applicants: Only applicants applying for a Funeral Prearrangement Life License, Life Insurance Not Exceeding
$25,000 License or County Mutual License may apply for a temporary license with this application. All other temporary license applicants must submit a Prometric application form to Oak Hill Technology, Inc., 5508 Hwy. 290 West, Suite 202, Austin, TX 78735.
The temporary license application must include a completed Notice of Appointment, Part VI, signed by the appointing company.
The temporary license is valid for 90 days after the date of issuance.
A temporary license holder must submit to the Department a certification by the appointing insurance company that the temporary
agent has completed the course of study and examination as required by the Texas Insurance Code with a copy of the temporary
license to obtain a permanent Funeral Prearrangement Life License, Life Insurance Not Exceeding $25,000 License or the County
Mutual License.
A temporary license may not be renewed or issued more than once in a consecutive six-month period to the same applicant.
Public Insurance Adjuster Trainee RegistrationsA public insurance adjuster trainee registration expires after 180 days. A public
insurance adjuster trainee who wishes to obtain a public insurance adjuster license must pass the Prometric examination and
complete the Prometric application and submit it to Oak Hill Technology, Inc. with the required $50.00 fee. You may obtain information on the Prometric examination and the Prometric application at
www.prometric.com/texas
Nonresident Adjuster Designating Texas as Resident State Some states do not license adjusters. A resident of one of those
states may obtain a Texas adjuster license by meeting all Texas resident license requirements and then designating Texas as the
home state for the adjuster license only. Nonresident Adjuster Designating Texas as Resident State must comply with the continuing education requirements as outlined in Texas Insurance Code 4101.059 and 28 Texas Administrative Code 19.100119.1020.
Names: Applicants must supply their full, legal name and not a nickname. For instance, a Christopher may not apply as Chris.
Addresses: The official mailing address provided in Part I, number 3 must be your permanent mailing address and is the address
of record to which licenses, official correspondence, forms, notices and other information will be sent. Address changes must be
reported to TDI as required in the Texas Insurance Code, 4001.252 and 4003.009. If this official mailing address changes,
the applicant/agent must notify TDI, in writing, either by fax to
512-490-1029
or by mail to
Texas Department of Insurance
Agent and Adjuster Licensing
Mail Code 107-1A
P O Box 149104
Austin TX 78714-9104
You may obtain the Licensee Address Change Request Form LHL389 at
www.tdi.texas.gov/forms/form11.html
All address change requests must be dated and signed by the license holder.
Fingerprinting: The fingerprint requirement is authorized in Texas Insurance Code 801.056 and amended 28 TAC 1.501 and
1.503 1.509. The complete text of the rule may be accessed at http://www.tdi.texas.gov/rules/2006/1003e-059.html.
Applicants claiming exemption from the fingerprint requirement based on 28 TAC 1.504(b) must provide information on the type
of license application or TDI filing with which the fingerprints were submitted and the date the fingerprints were submitted to TDI.
The Texas Department of Insurance strongly encourages applicants to utilize electronic fingerprinting through approved vendors as authorized under the rule. Electronic fingerprinting is fast and accurate, and in most cases will avoid potential delays in
the processing of your submission.
Fingerprint cards are no longer accepted by TDI. Please see Exception to Electronic Fingerprinting on next page when it is not
possible for you to get electronically fingerprinted.

FIN506 Rev. 07/2012

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Electronic Fingerprinting:
The general process for electronic fingerprinting is:
1 Print and complete the FAST Pass form from TDIs website, www.tdi.texas.gov/forms/form11.html. You will need information from the FAST Pass form to make your electronic fingerprint appointment.
2 Schedule an appointment to be electronic fingerprinted. You must schedule a fingerprint appointment by visiting www.L1enrollment.com or by calling 1-888-467-2080. Pursuant to DPS requirements on the vendor, you will be photographed as part of
the fingerprint process. You must pay the $41.45 fee to the vendor in a manner that is acceptable to the vendor. All electronic
fingerprint appointments must be made by DPS vendor, L1. The vendor has 90+ Texas fingerprint locations, including the Prometric testing centers which administer the TDI agent/adjuster licensing examinations. See the FAST Pass form for complete
instructions to obtain an electronic fingerprint appointment.
3 Arrive at your scheduled appointment with your FAST Pass. After your fingerprints and photograph are taken, the technician
will give you a receipt stating that you were fingerprinted. Do not throw away the receipt. You will not get a printed fingerprint
card. Your fingerprints will be sent electronically to DPS and the FBI.
4 Attach a copy of the fingerprint receipt to your application. A FAST Pass receipt must be attached to your application if you
are required to provide fingerprints. Keep the original FAST Pass receipt for your records.
Exception to Electronic Fingerprinting:
When electronic fingerprinting is not available, the following process must be followed.
1 Print and complete the FAST Fingerprint Card Scan Authorization Form from TDIs website, www.tdi.texas.gov/forms/
form11.html. ALL information requested on the FAST Fingerprint Card Scan Authorization Form MUST be provided. That includes sex, race, date and place of birth, home address, etc. If the required information is not provided, the fingerprint card
cannot be processed.
2 Get fingerprinted by a criminal law enforcement agency on an original APPLICANT fingerprint card that includes Texas
Department of Insurance ORI TX920540Z. ALL requested information must be provided on the fingerprint card and you and
the official taking the fingerprints must sign the card. Blank cards may be obtained from TDI by calling 512-322-3503 or e-mail
request to License at www.tdi.texas.gov. All fingerprints MUST be captured by a law enforcement agency.
3 Make check for $41.45 payable to L1 Enrollment Services.
4 Mail the completed Fingerprint Card Scan Authorization Form, original fingerprint card and check to:
L1 Enrollment Services
1650 Wabash Avenue, Suite D
Springfield, IL 62704
5 Wait for a FAST receipt from L1 Enrollment Services. The FAST receipt must be attached to the completed Application for
Individual Agent License at the time it is mailed to the Texas Department of Insurance. The FAST receipt allows TDI to locate
criminal history information on the individual.
Fingerprints provided for this application shall be used to check criminal history records of the Texas Department of Public
Safety and the Federal Bureau of Investigation, in accordance with applicable statutes.
TDI cannot complete processing an application until it receives a criminal history report from DPS and FBI for applicants
required to provide fingerprints.

References: You may view the Texas Insurance Code at http://www.statutes.legis.state.tx.us/?link=IN and the Texas Administrative Code at http://info.sos.state.tx.us/pls/pub/readtac$ext.ViewTAC?tac_view=3&ti=28&pt=1.

FIN506 Rev. 07/2012

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Texas Department of Insurance

Fingerprint Card Scan Authorization Form
Please print legibly and complete all fields in Section 2 (Applicant Information). Your fingerprint cards must include
the following personal data: Date of Birth, Sex, Race, Height, Weight, Eye Color, Hair Color, Place of Birth, Home
Address, and Social Security Number. Requested data is required by the Texas Department of Public Safety and the
Texas Department of Insurance to process your background check.
Mail this form, along with your completed fingerprint card and a check or money order payable to L-1 Enrollment
Services for $41.45 to:
L-1 Enrollment Services
1650 Wabash Avenue, Suite D
Springfield, IL 62704
Section One: Qualified Entity Information
Agency ORI: TX920540Z__

Agency Name: Texas Department of Insurance

RFP: _Government Code 411.106

Original TCN __________________________________________________________________________________________________________
(if resubmission for rejected prints)

Section Two: Applicant Information (To be completed by Applicant) Please Print Legibly
Applicant Last Name

First Name _______________

Middle Name __________________

(please print)

Sex

Male

Female

Race _________

Ethnicity __________________ Skin Tone ______________________________

(W, B, A, I, O)

(Hispanic or Non-Hispanic)

Date of Birth _____________________ Height ___________ Weight ___________ Hair Color __________ Eye Color ___________
(feet and inches)

Place of Birth __________________

(state or country)

Home Address _______________________________________________________________________________________________________

Street Address

City

State

Zip

Section Three: Waiver Information (To be signed by applicant)

I certify that all information I provided in relation to this criminal history record check is true and accurate. I authorize the Texas
Department of Public Safety (DPS) to access Texas and Federal criminal history record information that pertains to me and disseminate
that information to the designated Authorized Agency or Qualified Entity with which I am or am seeking to be employed or to serve as a
volunteer, through the DPS Fingerprint-based Applicant Clearinghouse of Texas and as authorized by Texas Government Code
Chapter 411 and any other applicable state or federal statute or policy.
I authorize the Texas Department of Public Safety to submit my fingerprints and other application information to the FBI for the purpose
of comparing the submitted information to available records in order to identify other information that may be pertinent to the
application. I authorize the FBI to disclose potentially pertinent information to the DPS during the processing of this application and for
as long hereafter as may be relevant to the activity for which this application is being submitted. I understand that the FBI may also
retain my fingerprints and other applicant information in the FBIs permanent collection of fingerprints and related information, where all
such data will be subject to comparisons against other submissions received by the FBI and to further disseminations by the FBI as
may be authorized under the Federal Privacy Act (5USC 552a(b)). I understand I am entitled to obtain a copy of any criminal history
record check and challenge the accuracy and completeness of the information before a final determination is made by the Qualified
Entity. I also understand the Qualified Entity may deny me access to children, the elderly, or individuals with disabilities until the
criminal history record check is completed.

Signature ___________________________________________________________________________________ Date____________________________________

Texas Department of Insurance

This document is your FAST Fingerprint Pass for a state and national criminal history record check. Please schedule a fingerprint appointment by
visiting www.L1enrollment.com or by calling 1-888-467-2080. When scheduling an appointment you will be prompted by L-1 Enrollment Services
for the following additional personal data: Date of Birth, Sex, Race, Ethnicity, Skin Tone, Height, Weight, Eye Color, Hair Color, Place of Birth
and Home Address. During your Fingerprint appointment you will also be prompted for Social Security Number and Driver License Number.
Requested data is required by the Texas Department of Public Safety and the Texas Department of Insurance to process your background
check. These data elements have been omitted from this document in order to better protect the security of your personal information. You may pay for
FAST services online with a credit card or onsite with a check or money order only. Your fingerprints will be submitted to the Texas Department of
Public Safety and the Federal Bureau of Investigation (TXDPS/FBI) with results delivered to the Texas Department of Insurance (TDI).
1.
2.
3.
4.

Logon to www.L1enrollment.com
Select: Texas
Select: Online Scheduling
Select: English or Espanol

5.
6.
7.

8.

Enter: First and Last Name

Select: Insurance Licensing
Follow the prompts to enter requested information.
Bring this completed form with you to your appointment.

Section One: Qualified Entity Information

ORI#: TX920540Z

RFP: _Government Code 411.106___

Original TCN: ________________________________________

(If resubmission for rejected fingerprints)

Agency/Entity/Organization Name: _ Texas Department of Insurance _____________________________________________________________

Section Two: Applicant Name (To be completed by applicant)

Last: ______________________________________
(Please print)

First: _________________________________
(Please print)

Middle: ________________________
(Please print)

Section Three: Waiver Information (To be completed and signed by applicant)

I certify that all information I provided in relation to this criminal history record check is true and accurate. I authorize the Texas
Department of Public Safety (DPS) to access Texas and Federal criminal history record information that pertains to me and disseminate
that information to the designated Authorized Agency or Qualified Entity with which I am or am seeking to be employed or to serve as a
volunteer, through the DPS Fingerprint-based Applicant Clearinghouse of Texas and as authorized by Texas Government Code
Chapter 411 and any other applicable state or federal statute or policy.
I authorize the Texas Department of Public Safety to submit my fingerprints and other application information to the FBI for the purpose
of comparing the submitted information to available records in order to identify other information that may be pertinent to the
application. I authorize the FBI to disclose potentially pertinent information to the DPS during the processing of this application and for
as long hereafter as may be relevant to the activity for which this application is being submitted. I understand that the FBI may also
retain my fingerprints and other applicant information in the FBIs permanent collection of fingerprints and related information, where all
such data will be subject to comparisons against other submissions received by the FBI and to further disseminations by the FBI as
may be authorized under the Federal Privacy Act (5USC 552a(b)). I understand I am entitled to obtain a copy of any criminal history
record check and challenge the accuracy and completeness of the information before a final determination is made by the Qualified
Entity. I also understand the Qualified Entity may deny me access to children, the elderly, or individuals with disabilities until the
criminal history record check is completed.
Signature: ______________________________________________________

Date: __________________________________________

Section Four: Service Center Information (To be completed by FAST Enrollment Officer)
Date Prints Taken _______________________

Paid by:

Check

Money Order

Visa

Amount Charged For Service: _$41.45__

MasterCard

Billing Acct _____________________________________________________

TCN: ____________________________________________________________

I HAVE COMPARED THE GOVERNMENT-ISSUED IDENTIFICATION PRESENTED BY THE APPLICANT AND ATTEST THAT TO MY BEST
DETERMINATION; I HAVE FINGERPRINTED THE SAME PERSON.
E.O. Name: ________________________________________________

E.O. Signature: ________________________________________________

(Please print)
Revised 12/09

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

IMPORTANT NOTICE

AVISO IMPORTANTE

To obtain information or make a complaint:

Para obtener informacion o para someter una queja:

You may contact your Agent at the telephone number

indicated on the Declaration Page attached to this policy.

Puede comunicarse con su Agente al numero de telefono

indicado en la pagina de Declaraciones adjunta a esta
poliza.

You may call Farmers Texas County Mutual's toll-free

telephone number for information or to make a complaint
at

Usted puede llamar al numero de telefono gratis de

Farmers Texas County Mutual para informacion o para
someter una queja al

1-800-225-0011

1-800-225-0011
Puede comunicarse con el Departamento de Seguros de
Texas para obtener informacion acerca de companias,
coberturas, derechos o quejas al

You may contact the Texas Department of Insurance to

obtain information on companies, coverages, rights or
complaints at
1-800-252-3439

1-800-252-3439

You may write the Texas Department of Insurance

Puede escribir al Departamento de Seguros de Texas

P.O. Box 149104
Austin, TX 78714-9104
FAX: (512) 475-1771

P.O. Box 149104

Austin, TX 78714-9104
FAX: (512) 475-1771

Web: http://www.tdi.state.tx.us
E-mail: ConsumerProtection @tdi.state.tx.us

Web: http://www.tdi.state.tx.us
E-mail: ConsumerProtection @tdi.state.tx.us

PREMIUM
OR CLAIM DISPUTES:

DISPUTAS SOBRE PRIMAS O RECLAMOS:

Should you have a dispute concerning your premium or

about a claim you should contact the agent first. If the
dispute is not resolved, you may contact the Texas
Department of Insurance.

Si tiene una disputa concerniente a su prima o a un

reclamo, debe comunicarse con el agente primero. Si no se
resuelve la disputa, puede entonces comunicarse con el
departamento (TDI).

ATTACH THIS NOTICE TO YOUR POLICY:

UNA ESTE AVISO A SU POLIZA:

Este aviso es solo para proposito de informacion y no se
convierte en parte o condicion del documento adjunto.

This notice is for information only and does not become a

part or condition of the attached document.

56-5048 13TH EDITION 6-07

C5048D01

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

THIS PAGE LEFT

INTENTIONALLY BLANK.

56-5048 13TH EDITION 6-07

C5048D02

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

Index of Policy Provisions

Declarations
Your Personal Coverage Page is attached.
Agreement
Definitions

PART D - COVERAGE FOR DAMAGE TO YOUR

AUTO

5
5

Insuring Agreement
Transportation Expenses
Towing and Labor Costs Coverage
Exclusions
Limit of Liability
Payment of Loss
No Benefit to Bailee
Other Insurance
Appraisal

PART A - LIABILITY COVERAGE

Insuring Agreement
Supplementary Payments
Exclusions
Limit of Liability
Out of State Coverage
Financial Responsibility Required
Other Insurance

6
6
6
7
8
8
8

PART E - DUTIES AFTER AN

ACCIDENT OR LOSS

PART B1 - MEDICAL PAYMENTS

COVERAGE
Insuring Agreement
Exclusions
Limit of Liability
Other Insurance
Assignment of Benefits

8
8
9
9
10

General Duties
Additional Duties for Uninsured/
Underinsured Motorists Coverage
Additional Duties for Coverage for
Damage to Your Auto

PART B2 - PERSONAL INJURY

PROTECTION COVERAGE
Insuring Agreement
Exclusions
Limit of Liability
Other Insurance
Assignment of Benefits
Other Provisions

PART C - UNINSURED/
UNDERINSURED MOTORISTS
COVERAGE
Insuring Agreement
Exclusions
Limit of Liability
Other Insurance

13
14
14
14
15
15
15
15
16

16
17
17

PART F - GENERAL PROVISIONS

10
10
11
11
11
11

11
12
12
13

Bankruptcy
Changes
Legal Action Against Us
Our Right to Recover Payment
Policy Period and Territory
Termination
Transfer of Your Interest in this Policy
Two or More Auto Policies
Provisions Applicable to Farmers Texas
County Mutual Insurance Company
Mexico Coverage - Limited

17
17
17
18
18
18
19
19

Additional Exclusions

20

Special Conditions

20

20
20

ANY ADDITIONAL PROVISIONS AFFECTING YOUR POLICY ARE ATTACHED AS "ENDORSEMENTS."

This policy is a legal contract between you (the policyholder) and us (the Company).
IT CONTAINS CERTAIN EXCLUSIONS.

READ YOUR POLICY CAREFULLY.

56-5048 13TH EDITION 6-07

C5048D03

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

THIS PAGE LEFT

INTENTIONALLY BLANK.

56-5048 13TH EDITION 6-07

C5048D04

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

TEXAS PERSONAL AUTO POLICY

AGREEMENT
In return for payment of the premium and subject to all the terms of this policy we agree with you as follows:

DEFINITIONS
A. Throughout this policy, "you" and "your" refer to:
1. The "named insured" shown in the Declarations, and
2. The spouse if a resident of the same household.
B. "We," "us" and "our" refer to the Company providing this insurance.
C. For purposes of this policy, a private passenger type auto or pickup or van shall be deemed to be owned by a
person if leased:
1. Under a written agreement to that person; and
2. For a continuous period of at least 6 months.
Other words and phrases are defined. They are boldfaced when used.
D. "Family member" means a person who is a resident of your household and related to you by blood, marriage or
adoption. This definition includes a ward or foster child who is a resident of your household, and also includes
your spouse even when not a resident of your household during a period of separation in contemplation of
divorce.
E. "Occupying" means in, upon, getting in, on, out or off.
F. "Trailer" means a vehicle designed to be pulled by a:
1. Private passenger auto; or
2. Pickup or van.
It also means a farm wagon or farm implement while towed by a vehicle listed in F.1. or F. 2. above.
G. "Your covered auto" means:
1. Any vehicle shown in the Declarations;
2. I. Any of the following types of vehicles on the date you became owner:
a. a private passenger auto; or
b. a pickup or van with a G.V.W. of 10,000 Ibs. or less not used for the delivery or transportation of goods,
materials or supplies other than samples; unless (1) the delivery of goods, materials or supplies is not the
primary usage of the vehicle, or (2) used for farming or ranching.
II This provision (G.2) applies only if you:
. a. acquire the vehicle during the policy period; and
b. notify us within 30 days after you become the owner.
If the vehicle you acquire replaces one shown in the Declarations, it will have the same coverage as the vehicle
it replaced. You must notify us of a replacement vehicle within 30 days only if you wish to add or continue
Coverage for Damage to Your Auto.
If the vehicle you acquire is in addition to any shown in the Declarations, it will have the broadest coverage we
now provide for any vehicle shown in the Declarations.
3. Any trailer you own.
4. Any auto or trailer you do not own while used as a temporary substitute for any other vehicle described in this
definition which is out of normal use because of its
a. breakdown;
b. repair;
c. servicing;
d. Ioss; or
e. destruction.
H. "Business day" means a day other than a Saturday, Sunday or holiday recognized by the state of Texas.
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C5048D05

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

PART A - LIABILITY COVERAGE

Insuring Agreement
A. We will pay damages for bodily injury or property damage for which any covered person becomes legally
responsible because of an auto accident. Property damage includes loss of use of the damaged property. Damages
include prejudgment interest awarded against the covered person. We will settle or defend, as we consider
appropriate, any claim or suit asking for these damages. In addition to our limit of liability, we will pay all defense
costs we incur. Our duty to settle or defend ends when our limit of liability for this coverage has been exhausted.
B. "Covered person" as used in this Part means:
1. You or any family member for the ownership, maintenance or use of any auto or trailer.
2. Any person using your covered auto.
3. For your covered auto, any person or organization but only with respect to legal responsibility for acts or
omissions of a person for whom coverage is afforded under this Part.
4. For any auto or trailer, other than your covered auto, any person or organization but only with respect to legal
responsibility for acts or omissions of you or any family member for whom coverage is afforded under this
Part. This provision (B.4.) applies only if the person or organization does not own or hire the auto or trailer.

Supplementary Payments
In addition to our limit of liability, we will pay on behalf of a covered person:
1. Up to $250 for the cost of bail bonds required because of an accident including related traffic law violations. The
accident must result in bodily injury or property damage covered under this policy.
2. Premiums on appeal bonds and bonds to release attachments in any suit we defend.
3. Interest accruing after a judgment is entered in any suit we defend. Our duty to pay interest ends when we offer to
pay that part of the judgment which does not exceed our limit of liability for this coverage.
4. Up to $50 a day for loss of earnings, but not other income, because of attendance at hearings or trials at our
request.
5. Other reasonable expenses incurred at our request.

Exclusions
A. We do not provide Liability Coverage for any person:
1. Who intentionally causes bodily injury or property damage;
2. For damage to property owned or being transported by that person;
3. I. For damage to property:
a. rented to
b. used by; or
c. in the care of; that person
II This exclusion (A.3.1.) does not apply to damages to:
. a. a residence or private garage; or
b. any of the following type vehicles not owned by or furnished or available for the regular use of you or any
family member:
(1) private passenger autos;
(2) trailers; or
(3) pickups or vans.
However, this exclusion (3.I.) does apply to a loss due to or as a consequence of a seizure of an auto listed in
3.II.b. above by federal or state law enforcement officers as evidence in a case against you under the Texas
Controlled Substances Act or the federal Controlled Substances Act if you are convicted in such case.
4. For bodily injury to an employee of that person during the course of employment.
This exclusion (A.4.) does not apply to bodily injury to a domestic employee unless workers' compensation
benefits are required or available for that domestic employee.
5. For that person's liability arising out of the ownership or operation of a vehicle while it is:

56-5048 13TH EDITION 6-07

C5048D06

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

a. being used to carry persons for a fee; this does not apply to a share-the-expense car pool; or
b. being used to carry property for a fee; this does not apply to you or any family member unless the primary
usage of the vehicle is to carry property for a fee; or
c. rented or leased to another; this does not apply if you or any family member lends your covered auto to
another for reimbursement of operating expenses only.
6. While employed or otherwise engaged in the business or occupation of:
a. selling,
b. repairing,
c. servicing,
d. storing, or
e. parking vehicles designed for use mainly on public highways.
This includes road testing and delivery.
This exclusion (A.6.) does not apply to the ownership, maintenance or use of your covered auto by:
1. you;
2. any family member; or
3. any partner, agent or employee of you or any family member.
7. Maintaining or using any vehicle while that person is employed or otherwise engaged in any business or
occupation not described in Exclusion A.6.
This exclusion (A.7.) does not apply to the maintenance or use of a:
a. private passenger auto;
b. pickup or van that is your covered auto; or
c. trailer used with a vehicle described in a. or b. above.
8. Using a vehicle without a reasonable belief that that person is entitled to do so.
This exclusion (A.8.) does not apply to you or any family member while using your covered auto.
9. I. For bodily injury or property damage for which that person:
a. is an insured under a nuclear energy liability policy; or
b. would be an insured under a nuclear energy liability policy but for its termination upon exhaustion of its
limit of liability.
II A nuclear energy liability policy is a policy issued by any of the following or their successors:
. a. American Nuclear Insurers;
b. Mutual Atomic Energy Liability Underwriters; or
c. Nuclear Insurance Association of Canada.
B. We do not provide Liability Coverage for the ownership, maintenance or use of:
1. Any motorized vehicle having fewer than four wheels;
2. Any vehicle, other than your covered auto, which is:
a. owned by you; or
b. furnished or available for your regular use.
3. I. Any vehicle, other than your covered auto, which is:
a. owned by any family member; or
b. furnished or available for the regular use of any family member.
II However, this exclusion does not apply to your maintenance or use of any vehicle which is:
. a. owned by a family member; or
b. furnished or available for the regular use of a family member.
C. We do not provide Liability Coverage for you or any family member for bodily injury to you or any family
member, except to the extent of the minimum limits of Liability Coverage required by Texas Civil Statutes
Article 6701h, entitled "Texas Motor Vehicle Safety - Responsibility Act."

Limit of Liability
A. If separate limits of liability for bodily injury and property damage liability are shown in the Declarations for this
coverage the limit of liability for "each person" for bodily injury liability is our maximum limit of liability for all
damages for bodily injury sustained by any one person in any one auto accident. Subject to this limit for "each
person," the limit of liability shown in the Declarations for "each accident" for bodily injury liability is our
maximum limit of liability for all damages for bodily injury resulting from any one auto accident. The limit of
liability shown in the Declarations for "each accident" for property damage liability is our maximum limit of
liability for all damages to all property resulting from any one auto accident.
56-5048 13TH EDITION 6-07

C5048D07

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

If the limit of liability shown in the Declarations for this coverage is for combined bodily injury and property
damage liability, it is our maximum limit of liability for all damages resulting from any one auto accident.
This is the most we will pay regardless of the number of:
1. Covered persons;
2. Claims made;
3. Vehicles or premiums shown in the Declarations; or
4. Vehicles involved in the auto accident.
We will apply the limit of liability to provide any separate limits required by law for bodily injury and property
damage liability. However, this provision will not change our total limit of liability.
B. Any payment under the Uninsured/Underinsured Motorists Coverage or the Personal Injury Protection Coverage
of this policy to or for a covered person will reduce any amount that person is entitled to recover under this
coverage.

Out of State Coverage

If an auto accident to which this policy applies occurs in any state or province other than the one in which your
covered auto is principally garaged, we will interpret your policy for that accident as follows:
A. If the state or province has:
1. A financial responsibility or similar law specifying limits of liability for bodily injury or property damage higher
than the limit shown in the Declarations, your policy will provide the higher specified limit.
2. A compulsory insurance or similar law requiring a nonresident to maintain insurance whenever the nonresident
uses a vehicle in that state or province, your policy will provide at least the required minimum amounts and
types of coverage.
B. No one will be entitled to duplicate payments for the same elements of loss.

Financial Responsibility Required

When this policy is certified as future proof of financial responsibility, this policy shall comply with the law to the
extent required.

Other Insurance
If there is other applicable insurance we will pay only our share of the loss. Our share is the proportion that our limit
of liability bears to the total of all applicable limits. However, any liability insurance we provide to a covered person
for the maintenance or use of a vehicle you do not own shall be excess over any other applicable liability insurance.

PART B1- MEDICAL PAYMENTS COVERAGE

Insuring Agreement
A. We will pay reasonable expenses incurred for necessary medical and funeral services because of bodily injury:
1. Caused by accident; and
2. Sustained by a covered person.
We will pay only those expenses incurred within three years from the date of the accident.
B. "Covered person" as used in this Part means:
1. You or any family member:
a. while occupying; or
b. when struck by;
a motor vehicle designed for use mainly on public roads or a trailer of any type.
2. Any other person while occupying your covered auto.

Exclusions
We do not provide Medical Payments Coverage for any person for bodily injury:
1. Sustained while occupying any motorized vehicle having fewer than four wheels.

56-5048 13TH EDITION 6-07

C5048D08

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

2. Sustained while occupying your covered auto when it is:

a. being used to carry persons for a fee; this does not apply to a share-the-expense car pool; or
b. being used to carry property for a fee; this does not apply to you or any family member unless the primary
usage of the vehicle is to carry property for a fee; or
c. rented or leased to another; this does not apply if you or any family member lends your covered auto to
another for reimbursement of operating expenses only.
3. Sustained while occupying any vehicle located for use as a residence or premises.
4. Occurring during the course of employment if workers' compensation benefits are required or available for the
bodily injury.
5. Sustained while occupying or, when struck by, any vehicle (other than your covered auto) which is:
a. owned by you; or
b. furnished or available for your regular use.
6. Sustained while occupying or, when struck by, any vehicle (other than your covered auto) which is:
a. owned by any family member; or
b. furnished or available for the regular use of any family member.
However, this exclusion (6.) does not apply to you.
7. Sustained while occupying a vehicle without a reasonable belief that that person is entitled to do so.
This exclusion (7.) does not apply to you or any family member while using your covered auto.
8. Sustained while occupying a vehicle when it is being used in the business or occupation of a covered person.
This exclusion does not apply to bodily injury sustained while occupying a:
a. private passenger auto;
b. pickup or van that you own; or
c. trailer used with a vehicle described in 8.a. or 8.b. above.
9. Caused by or as a consequence of:
a. discharge of a nuclear weapon (even if accidental):
b. war (declared or undeclared);
c. civil war;
d. insurrection; or
e. rebellion or revolution.
10. From or as a consequence of the following whether controlled or uncontrolled however caused:
a. nuclear reaction
b. radiation; or
c. radioactive contamination.

Limit of Liability
A. The limit of liability shown in the Declarations for this coverage is our maximum limit of liability for each person
injured in any one accident. This is the most we will pay regardless of the number of:
1. Covered persons;
2. Claims made;
3. Vehicles or premiums shown in the Declarations; or
4. Vehicles involved in the accident.
B. Any amounts otherwise payable for expenses under this coverage shall be reduced by any amounts paid or payable
for the same expenses under any Auto Liability or Uninsured/Underinsured Motorists Coverage provided by this
policy.
C. No payment will be made unless the injured person or that person's legal representative agrees in writing that any
payment shall be applied toward any settlement or judgment that person receives under any Auto Liability or
Uninsured/Underinsured Motorists Coverage provided by this policy.

Other Insurance
If there is other applicable auto medical payments insurance we will pay only our share of the loss. Our share is the
proportion that our limit of liability bears to the total of all applicable limits. However, any insurance we provide with
respect to a vehicle you do not own shall be excess over any other collectible auto insurance providing payments for
medical or funeral expenses.
56-5048 13TH EDITION 6-07

C5048D09

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

Assignment of Benefits
Payments for medical expenses will be paid directly to a physician or other health care provider if we receive a written
assignment signed by the covered person to whom such benefits are payable.

PART B2 - PERSONAL INJURY PROTECTION COVERAGE

Insuring Agreement
A. We will pay Personal Injury Protection benefits because of bodily injury:
1. resulting from a motor vehicle accident; and
2. sustained by a covered person.
Our payment will only be for losses or expenses incurred within three years from the date of accident.
B. Personal Injury Protection benefits consist of:
1. Reasonable expenses incurred for necessary medical and funeral services.
2. I. Eighty percent of a covered person's loss of income from employment. These benefits apply only if, at the
time of the accident, the covered person
a. was an income producer; and
b. was in an occupational status.
These benefits do not apply to any loss after the covered person dies.
II. Loss of income is the difference between
a. income which would have been earned had the covered person not been injured; and
b. the amount of income actually received from employment during the disability.
II If the income being earned as of the date of accident is a salary or fixed remuneration, it shall be used in
I. determining the amount of income which would have been earned. Otherwise, the average monthly income
earned during the period (not more than 12 months) preceding the accident shall be used.
3. I. Reasonable expenses incurred for obtaining services. These services must replace those a covered person
would normally have performed:
a. without pay;
b. during a period of disability; and
c. for the care and maintenance of the family household.
II. These benefits apply only if, at the time of the accident, the covered person:
a. was not an income producer; and
b. was not in an occupational status.
These benefits do not apply to any loss after the covered person dies.
C. "Covered person" as used in this Part means:
1. You or any family member:
a. while occupying; or
b. when struck by;
a motor vehicle designed for use mainly on public roads or a trailer of any type.
2. Any other person while occupying your covered auto with your permission.

Exclusions
We do not provide Personal Injury Protection Coverage for any person for bodily injury sustained:
1. In an accident caused intentionally by that person.
2. By that person while in the commission of a felony.
3. By that person while attempting to elude arrest by a law enforcement official.
4. While occupying, or when struck by, any motor vehicle (other than your covered auto) which is owned by you.
5. By a family member while occupying, or when struck by any motor vehicle (other than your covered auto)
which is owned by a family member.

56-5048 13TH EDITION 6-07

10

C5048D0A

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

Limit of Liability
The limit of liability shown in the Declarations for this coverage is our maximum limit of liability for each person
injured in any one accident. This is the most we will pay regardless of the number of:
1. Covered persons;
2. Claims made;
3. Vehicles or premiums shown in the Declarations; or
4. Vehicles involved in the accident.

Other Insurance
If there is other Personal Injury Protection insurance, we will pay only our share. Our share is the proportion that our
limit of liability bears to the total of all applicable limits. However, any insurance we provide with respect to a vehicle
you do not own shall be excess over any other collectible Personal Injury Protection insurance.

Assignment of Benefits
Payments for medical expenses will be paid directly to a physician or other health care provider if we receive a written
assignment signed by the covered person to whom such benefits are payable.

Other Provisions
A. Loss Payments. Benefits are payable:
1. Not more frequently than every two weeks; and
2. Within 30 days after satisfactory proof of claim is received.
B. Modification. The General Provision part of this policy entitled "Our Right to Recover Payment" does not apply
to this coverage.

PART C - UNINSURED/UNDERINSURED MOTORISTS COVERAGE

Insuring Agreement
A. We will pay damages which a covered person is legally entitled to recover from the owner or operator of an
uninsured motor vehicle because of bodily injury sustained by a covered person, or property damage, caused
by an accident.
The owner's or operator's liability for these damages must arise out of the ownership, maintenance or use of the
uninsured motor vehicle.
Any judgment for damages arising out of a suit brought without our written consent is not binding on us. If we
and you do not agree as to whether or not a vehicle is actually uninsured, the burden of proof as to that issue shall
be on us.
B. "Covered person" as used in this Part means:
1. You or any family member;
2. Any other person occupying your covered auto;
3. Any person for damages that person is entitled to recover because of bodily injury to which this coverage
applies sustained by a person described in 1. or 2. above.
C. "Property Damage" as used in this Part means injury to, destruction of or loss of use of:
1. Your covered auto, not including a temporary substitute auto.
2. Any property owned by a person listed in 1. or 2. of covered person while contained in your covered auto.
3. Any property owned by you or any family member while contained in any auto not owned, but being operated, by
you or any family member.
D. I. "Uninsured motor vehicle" means a land motor vehicle or trailer of any type,
1. To which no bodily injury liability bond or policy applies at the time of the accident,
2. Which is a hit and run vehicle whose operator or owner cannot be identified and which hits:
a. you or any family member;
b. a vehicle which you or any family member are occupying; or
c. your covered auto.

56-5048 13TH EDITION 6-07

11

C5048D0B

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

3. To which a liability bond or policy applies at the time of the accident but the bonding or insuring company:
a. denies coverage; or
b. is or becomes insolvent.
4. Which is an underinsured motor vehicle. An underinsured motor vehicle is one to which a liability bond or
policy applies at the time of the accident but its limit of liability either:
a. is not enough to pay the full amount the covered person is legally entitled to recover as damages; or
b. has been reduced by payment of claims to an amount which is not enough to pay the full amount the
covered person is legally entitled to recover as damages.
II However, "uninsured motor vehicle" does not include any vehicle or equipment:
. 1. Owned by or furnished or available for the regular use of you or any family member.
2. Owned or operated by a self-insurer under any applicable motor vehicle law.
3. Owned by any governmental body unless:
a. the operator of the vehicle is uninsured; and
b. there is no statute imposing liability for damage because of bodily injury or property damage on the
governmental body for an amount not less than the limit of liability for this coverage.
4. Operated on rails or crawler treads.
5. Designed mainly for use off public roads while not on public roads.
6. While located for use as a residence or premises.

Exclusions
A. We do not provide Uninsured/Underinsured Motorists Coverage for any person:
1. For bodily injury sustained while occupying, or when struck by, any motor vehicle or trailer of any type
owned by you or any family member which is not insured for this coverage under this policy.
2. If that person or the legal representative settles the claim without our consent.
3. When your covered auto is:
a. being used to carry persons for a fee; this does not apply to a share-the-expense car pool; or
b. being used to carry property for a fee; this does not apply to you or any family member unless the primary
usage of the vehicle is to carry property for a fee; or
c. rented or leased to another; this does not apply if you or any family member lends your covered auto to
another for reimbursement of operating expenses only.
4. For the first $250 of the amount of damage to the property of that person as the result of any one accident.
5. Using a vehicle without a reasonable belief that the person is entitled to do so. This exclusion does not apply to
you or any family member while using your covered auto.
6. For bodily injury or property damage resulting from the intentional acts of that person.
B. This coverage shall not apply directly or indirectly to benefit:
1. Any insurer or self-insurer under any workers' compensation, disability benefits or similar law;
2. Any insurer of property.

Limit of Liability
A. I. If separate limits of liability for bodily injury and property damage liability are shown in the Declarations for
this coverage, the limit of liability for "each person" for bodily injury liability is our maximum limit of liability
for all damages for bodily injury sustained by any one person in any one motor vehicle accident. Subject to this
limit for "each person," the limit of liability shown in the Declarations for "each accident" for bodily injury
liability is our maximum limit of liability for all damages for bodily injury resulting from any one motor vehicle
accident. The limit of liability shown in the Declarations for "each accident" for property damage liability is
our maximum limit of liability for all damages to all property resulting from any one motor vehicle accident.
If the limit of liability shown in the Declarations for this coverage is for combined bodily injury and property
damage liability, it is our maximum limit of liability for all damages resulting from any one motor vehicle
accident:

56-5048 13TH EDITION 6-07

12

C5048D0C

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

This is the most we will pay regardless of the number of:

a. Covered persons;
b. Claims made;
c. Policies or bonds applicable;
d. Vehicles or premium shown in the Declarations; or
e. Vehicles involved in the accident.
II Subject to this maximum, our limit of liability will be the lesser of;
. a. The difference between the amount of a covered person's damages for bodily injury or property damage
and the amount paid or payable to that covered person for such damages, by or on behalf of persons or
organizations who may be legally responsible; and
b. The applicable limit of liability for this coverage.
B. In order to avoid insurance benefits payments in excess of actual damages sustained, subject only to the limits set
out in the Declarations and other applicable provisions of this coverage, we will pay all covered damages not paid
or payable under any workers' compensation law, disability benefits law, any similar law, auto medical expense
coverage or Personal Injury Protection Coverage.
C. Any payment under this coverage to or for a covered person will reduce any amount that person is entitled to
recover for the same damages under the Liability Coverage of this policy.

Other Insurance
A. If there is other applicable similar insurance we will pay only our share of the loss. Our share is the proportion
that our limit of liability bears to the total of all applicable limits. However, any insurance we provide with respect
to a vehicle you do not own shall be excess over any other collectible insurance.
B. For any property damage to which the Coverage for Damage to Your Auto of this policy (or similar coverage
from another policy) and this coverage both apply, you may choose the coverage from which damages will be
paid. You may recover under both coverages, but only if:
1. Neither one by itself is sufficient to cover the loss;
2. You pay the higher deductible amount (but you do not have to pay both deductibles); and
3. You will not recover more than the actual damages.

PART D - COVERAGE FOR DAMAGE TO YOUR AUTO

Insuring Agreement
A. We will pay for direct and accidental loss to your covered auto, including its equipment less any applicable
deductible shown in the Declarations. However, we will pay for loss caused by collision only if the Declarations
indicate that Collision Coverage is provided.
B. "Collision" means the upset, or collision with another object of your covered auto. However, loss caused by
the following are not considered "collision."
1. Missiles or falling objects;
2. Fire;
3. Theft or larceny;
4. Explosion or earthquake;
5. Windstorm;
6. Hail, water or flood;
7. Malicious mischief or vandalism;
8. Riot or civil commotion;
9. Contact with bird or animal; or
10. Breakage of glass.
If breakage of glass is caused by a collision or if loss is caused by contact with a bird or animal, you may elect to
have it considered a loss caused by collision.

56-5048 12TH EDITION 1-01

13

C5048C0D

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

Transportation Expenses
In addition, we will pay up to $20 per day, to a maximum of $600 for transportation expenses incurred by you. This
applies only in the event of the total theft of your covered auto. We will pay only transportation expenses incurred
during the period:
1. Beginning 48 hours after the theft; and
2. Ending when your covered auto is returned to use or we pay for its loss.

Towing and Labor Costs Coverage

We will pay towing and labor costs incurred each time your covered auto is disabled, up to the amount shown in the
Declarations as applicable to that vehicle. We will only pay for labor performed at the place of disablement.
This coverage applies only to your covered auto for which a premium charge is shown in the Declarations for
Towing and Labor Costs Coverage.

Exclusions
We will not pay for:
1. Loss to your covered auto while it is:
a. being used to carry persons for a fee; this does not apply to a share-the-expense car pool; or
b. being used to carry property for a fee; this does not apply to you or any family member unless the primary
usage of the vehicle is to carry property for a fee; or
c. rented or leased to another; this does not apply if you or any family member lends your covered auto to
another for reimbursement of operating expenses only.
2. Damage due and confined to:
a. wear and tear;
b. freezing;
c. mechanical or electrical breakdown or failure; or
d. road damage to tires.
This exclusion does not apply if the damage results from the total theft of your covered auto.
3. Loss due to or as a consequence of:
a. radioactive contamination;
b. discharge of any nuclear weapon (even if accidental);
c. war (declared or undeclared);
d. civil war;
e. insurrection; or
f. rebellion or revolution.
4. Loss to stereos, radios and other sound reproducing equipment.
This exclusion (4.) does not apply if the equipment is permanently installed in your covered auto.
5. Loss to tapes, records or other devices for use with equipment designed for the reproduction of sound.
6. Loss to a camper body or trailer not shown in the Declarations.
This exclusion (6.) does not apply to a camper body or trailer you:
a. acquire during the policy period; and
b. notify us within 30 days after you become the owner.
7. Loss to any vehicle while used as a temporary substitute for a vehicle you own which is out of normal use because
of its:
a. breakdown;
b. repair;
c. servicing;
d. loss; or
e. destruction
8. When in or upon any trailer, loss to:
a. TV antennas;
b. awnings or cabanas; or
c. equipment designed to create additional living facilities.

56-5048 12TH EDITION 1-01

14

C5048C0E

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

9. Loss to any of the following or their accessories:

a. citizens band radio;
b. two-way mobile radio;
c. telephone;
d. scanning monitor receiver; or
e. any device or instrument used for detection of radar or other speed measuring equipment.
This exclusion (9.) does not apply if the equipment is permanently installed in the opening of the dash or console
of the auto. This opening must be normally used by the auto manufacturer for the installation of a radio.
10. Loss to any custom furnishings or equipment in or upon any pickup or van. Custom furnishings or equipment
include but are not limited to:
a. special carpeting and insulation, furniture, bars or television receivers;
b. facilities for cooking and sleeping;
c. height-extending roofs; or
d. custom murals, paintings or other decals or graphics.
This exclusion (10.) does not apply if the value of the custom furnishings or equipment has been reported to us
prior to a loss and included in the premium for this coverage.
11. Loss due to or as a consequence of a seizure of your covered auto by federal or state law endorsement officers
as evidence in a case against you by the Texas Controlled Substances Act or the federal Controlled Substances Act
if you are convicted in such case.

Limit of Liability
Our limit of liability for loss will be the lesser of the:
1. Actual cash value of the stolen or damaged property;
2. Amount necessary to repair or replace the property with other of like kind and quality; or
3. Amount stated in the Declarations of this policy.
The most we will pay for loss to equipment listed in Exclusion 4. is $1,500.
Our payment for loss will be reduced by any applicable deductible shown in the Declarations.

Payment of Loss
We may pay for loss in money or repair or replace the damaged or stolen property. We may, at our expense, return
any stolen property to:
1. You; or
2. The address shown in this policy.
If we return stolen property we will pay for any damage resulting from the theft. We may keep all or part of the
property at an agreed or appraised value.

No Benefit to Bailee
This insurance shall not directly or indirectly benefit any carrier or other bailee for hire.

Other Insurance
A. If other insurance also covers the loss we will pay only our share of the loss. Our share is the proportion that our
limit of liability bears to the total of all applicable limits.
B. For any loss to which Uninsured/Underinsured Motorists Coverage (from this or any other policy) and this
coverage both apply, you may choose the coverage from which damages will be paid.
You may recover under both coverages, but only if:
1. Neither one by itself is sufficient to cover the loss;
2. You pay the higher deductible amount (but you do not have to pay both deductibles); and
3. You will not recover more than the actual damages.

56-5048 13TH EDITION 6-07

15

C5048D0F

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

Appraisal
If we and you do not agree on the amount of loss, either may demand an appraisal of the loss. In this event, each
party will select a competent appraiser. The two appraisers will select an umpire.
The appraisers will state separately the actual cash value and the amount of loss. If they fail to agree, they will submit
their differences to the umpire. A decision agreed to by any two will be binding. Each party will:
1. Pay its chosen appraiser; and
2. Bear the expenses of the appraisal and umpire equally.
We do not waive any of our rights under this policy by agreeing to an appraisal.

PART E - DUTIES AFTER AN ACCIDENT OR LOSS

General Duties
A. We must be notified promptly of how, when and where the accident or loss happened. Notice should also include
the names and addresses of any injured persons and of any witnesses. If we show that your failure to provide
notice prejudices our defense, there is no liability coverage under the policy.
B. A person seeking any coverage must:
1. Cooperate with us in the investigation, settlement or defense of any claim or suit.
2. Promptly send us copies of any notices or legal papers received in connection with the accident or loss.
3. Submit, as often as we reasonably require, to physical exams by physicians we select. We will pay for these
exams.
4. Authorize us to obtain:
a. medical records which are reasonably related to the injury or damage asserted; and
b. other pertinent records.
5. When required by us:
a. submit a sworn proof of loss;
b. submit to examination under oath.
C. Within 15 days after we receive your written notice of claim, we must:
1. Acknowledge receipt of the claim.
If our acknowledgment of the claim is not writing, we will keep a record of the date, method and content of
our acknowledgment.
2. Begin any investigation of the claim.
3. Specify the information you must provide in accordance with paragraph B. above.
We may request more information, if during the investigation of the claim such additional information is
necessary.
D. After we receive the information we request, we must notify you in writing whether the claim will be paid or has
been denied or whether more information is needed:
1. Within 15 business days; or
2. Within 30 days if we have reason to believe the loss resulted from arson.
E. If we do not approve payment of your claim or require more time for processing your claim, we must:
1. Give the reasons for denying your claim, or
2. Give the reasons we require more time to process your claim. But, we must either approve or deny your claim
within 45 days after our requesting more time.
F. In the event of a weather-related catastrophe or major natural disaster, as defined by the Texas Department of
Insurance, the claim-handling deadlines as stated above are extended for an additional 15 days.
G. Loss Payment.
1. If we notify you that we will pay your claim, or part of your claim, we must pay within 5 business days after
we notify you.
2. If payment of your claim or part of your claim requires the performance of an act by you, we must pay within 5
business days after the date you perform the act.

56-5048 13TH EDITION 6-07

16

C5048D0G

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

H. Notice of Settlement of Liability Claim.

1. We will notify you in writing of any initial offer to compromise or settle a claim against you under the liability
section of this policy. We will give you notice within 10 days after the date the offer is made.
2. We will notify you in writing of any settlement of a claim against you under the liability section of this policy.
We will give you notice within 30 days after the date of the settlement.

Additional Duties for Uninsured/Underinsured Motorists Coverage

A person seeking Uninsured/Underinsured Motorists Coverage must also:
1.
2.
3.
4.

Promptly notify the police if a hit and run driver is involved;

Promptly send us copies of the legal papers if a suit is brought;
Take reasonable steps after loss, at our expense, to protect damaged property from further loss; and
Permit us to inspect and appraise the damaged property before its repair or disposal.

Additional Duties for Coverage for Damage to Your Auto

A person seeking Coverage for Damage to Your Auto must also:
1. Take reasonable steps after loss to protect your covered auto and its equipment from further loss. We will pay
reasonable expenses incurred to do this;
2. Promptly notify the police if your covered auto is stolen; and
3. Permit us to inspect and appraise the damaged property before its repair or disposal.

PART F - GENERAL PROVISIONS

Bankruptcy
Bankruptcy or insolvency of the covered person shall not relieve us of any obligations under this policy.

Changes
A. This policy contains all the agreements between you and us. Its terms may not be changed or waived except by
endorsement issued by us.
B. If a change requires a premium adjustment, we will adjust the premium as of the effective date of change in
accordance with rules prescribed by the Texas Department of Insurance or its successor. Changes during the
policy term that may result in a premium increase or decrease include, but are not limited to, changes in:
1. The number, type or use classification of the insured autos;
2. Operators using insured autos;
3. The place of principal garaging of insured autos;
4. Coverage, deductible or limits.
C. If this policy form is revised to provide more coverage without additional premium charge, we will automatically
provide the additional coverage as of the date the revision is effective.
D. We will compute the premium at the rates in effect on each anniversary date of the policy's inception date for a
policy written for more than a full year.

Legal Action Against Us

A. No legal action may be brought against us until there has been full compliance with all the terms of this policy. In
addition, under Liability coverage, no legal action may be brought against us until:
1. We agree in writing that the covered person has an obligation to pay; or
2. The amount of that obligation has been finally determined by judgment after trial.
B. No person or organization has any right under this policy to bring us into any action to determine the liability of a
covered person.

56-5048 13TH EDITION 6-07

17

C5048D0H

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

Our Right to Recover Payment

A. If we make a payment under this policy and the person to or for whom payment was made has a right to recover
damages from another we shall be subrogated to that right. That person shall do:
1. Whatever is necessary to enable us to exercise our rights; and
2. Nothing after loss to prejudice them.
(A release of the insurer of an underinsured motor vehicle does not prejudice our rights.)
However, our rights in this paragraph do not apply under Part D, against any person using your covered auto
with a reasonable belief that that person is entitled to do so.
B. If we make a payment under this policy and the person to or for whom payment is made recovers damages from
another, that person shall:
1. Hold in trust for us the proceeds of the recovery; and
2. Reimburse us to the extent of our payment. (However, we may not claim the amount recovered from an insurer
of any underinsured motor vehicle.)

Policy Period and Territory

A. This policy applies only to accidents and losses which occur:
1. During the policy period as shown in the Declarations; and
2. Within the policy territory.
B. The policy territory is:
1. The United States of America, its territories or possessions;
2. Puerto Rico; or
3. Canada.
The policy also applies to loss to, or accidents involving, your covered auto while being transported between
their ports.

Termination
A. Cancellation. This policy may be cancelled during the policy periods as follows:
1. The named insured shown in the Declarations may cancel by:
a. returning this policy to us; or
b. giving us advance written notice of the date cancellation is to take effect.
2. We may cancel by mailing at least 10 days notice to the named insured shown in the Declarations at the address
shown in this policy.
3. After this policy is in effect for 60 days, or if this is a renewal or continuation policy, we will cancel only:
a. for nonpayment of premium; or
b. if your driver's license or motor vehicle registration or that of:
(1) any driver who lives with you; or
(2) any driver who customarily uses your covered auto
has been suspended or revoked. However, we will not cancel if you consent to the attachment of an
endorsement eliminating coverage when your covered auto is being operated by the driver whose license
has been suspended or revoked.
c. if you submit a fraudulent claim.
4. We may not cancel this policy based solely on the fact that you are an elected official.
B. Non-renewal. If we decide not to renew or continue this policy, we will mail notice to the named insured shown
in the Declarations at the address shown in this policy. Notice will be mailed at least 30 days before the end of the
policy period. If the policy period is other than 1 year, we will have the right not to renew or continue it only at
each anniversary of its original effective date. We will not refuse to renew because of a covered person's age. We
may not refuse to renew this policy based solely on the fact that you are an elected official.

56-5048 13TH EDITION 6-07

18

C5048D0I

The sample document is not a contract, agreement or policy of insurance - only an issued and signed policy from the insuring entity is
the agreement of the issuing company.

NON-RENEWALS FOR NOT-AT-FAULT ACCIDENT OR CLAIMS (28 TAC 5.7016)

We may not use any of the following types of accidents or claims as the only reason for refusing to renew your
personal auto policy:
1. a claim involving damage from a weather-related incident that does not involve a collision (some examples
being hail, flood, tornado, winds or hurricanes);
2. an accident or claim involving damage by contact with an animal or a fowl;
3. an accident or claim involving damage caused by flying gravel, missiles or falling objects; however, if you have
three of these losses in any 36-month period, we may increase your deductible to the higher of $250 or the next
available deductible increment higher than your present deductible amount, at your renewal date;
4. a claim under towing and labor protection; however, if you have four claims of this type in any 36-month
period, we have the option of eliminating this coverage from your policy;
5. any other not-at-fault accident or claim unless there are two or more of these accidents or claims in any
12-month period.
"Refusal to renew" means our refusal to renew your personal auto policy in the same company which originally
issued the policy.
To the extent of any possible conflict between this notice and the Texas Administrative Code (28 TAC 5.7016),
the latter will be controlling.
C. Automatic Termination. If, at any time, you obtain other insurance on your covered auto, any similar
insurance provided by this policy will terminate as to that auto on the effective date of the other insurance.
If we offer to renew or continue and you or your representative do not accept, this policy will automatically
terminate at the end of the current policy period. Failure to pay the required renewal or continuation premium
when due shall mean that you have not accepted our offer.
D. Other Termination Provisions.
1. Proof of mailing shall be sufficient proof of notice. We may deliver any notice instead of mailing it.
2. If this policy is cancelled you may be entitled to a premium refund. If so, we will send you the refund promptly.
The premium refund, if any will be computed pro rata, subject to the policy minimum premium. However,
making or offering to make the refund is not a condition of cancellation.
3. The effective date of cancellation stated in the notice shall become the end of the policy period.
4. Any cancellation or restriction of coverage made without your consent will be of no effect, except as:
a. provided for in this Termination provision under:
(1) Cancellation;
(2) Non-renewal; or
(3) Automatic Termination; or
b. required by the Texas Department of Insurance.

Transfer of Your Interest in This Policy

A. Your rights and duties under this policy may not be assigned without our written consent. However, if a named
insured shown in the Declarations dies, coverage will be provided for:
1. The surviving spouse if resident in the same household at the time of death. Coverage applies to the spouse as
if a named insured shown in the Declarations;
2. The legal representative of the deceased person as if a named insured shown in the Declarations. This applies
only with respect to the representative's legal responsibility to maintain or use your covered auto.
B. Coverage will be provided until the end of the policy period.
NOTE: Refer to Medical Payments and/or Personal Injury Protection Coverages for Assignment of Benefits.

Two or More Auto Policies

If this policy and any other auto insurance policy issued to you by us apply to the same accident, the maximum limit
of our liability under all the policies shall not exceed the highest applicable limit of liability under one policy.

56-5048 13TH EDITION 6-07

19

C5048D0J

QUICK REFERENCE
TEXAS HOMEOWNERS POLICY - FORM A
Insuring Agreement .......................................................
Definitions .......................................................................
SECTION I-PROPERTY
Coverage A
Dwelling ..................................................................
Other Structures ......................................................
Coverage B
Personal Property ...................................................
Personal Property Off Premises .............................
Special Limits of Liability ................................................
Property Not Covered ...................................................
Extensions of Coverage
Debris Removal .......................................................
Loss of Use ..............................................................
Reasonable Repairs ................................................
Trees, Shrubs, Plants and Lawns ..........................
Property Removed ...................................................
Consequential Loss .................................................
Automatic Removal .................................................
Perils Insured Against
Coverage A (Dwelling) ............................................
Coverage B (Personal Property) ............................

1
1

Additional Coverages
Claim Expenses .......................................................
Imperative Medical Expenses to Others .................
Damage to Property of Others ................................

8
8
8

1
1

Section II Conditions
Limit of Liability ........................................................
Severability of Insurance .........................................
Duties After Loss ...................................................
Duties of an Injured Person ..................................
Payment of Claim under Cov. D .............................
Suit Against Us ......................................................
Bankruptcy of the Insured .....................................
Other Insurance .......................................................

9
9
9
9
9
9
9
9

Exclusions .......................................................................

Deductibles .....................................................................

POLICY CONDITIONS
APPLYING TO SECTIONS I AND II
Policy Period ................................................................
Concealment or Fraud .................................................
Liberalization .................................................................
Waiver or Change of Policy Provisions .........................
Cancellation ..................................................................
Non-Renewal .................................................................
Assignment ..................................................................
Subrogation ..................................................................
Death
..................................................................

10
10
10
10
10
10
10
10
10

Section I Conditions
Insurable Interest and
Limit of Liability ..................................................
Residential Community
Property Clause ...............................................
Your Duties After Loss .........................................
Loss Settlement ......................................................
Loss to a Pair or Set ................................................
Our Option ...............................................................
Appraisal ..................................................................
Loss Payment ..........................................................
Other Insurance .......................................................
Suit Against Us .......................................................
Abandonment of Property .......................................
Vacancy-Suspension of Coverage .....................
Mortgage Clause ....................................................
No Benefit to Bailee ................................................
SECTION II-LIABILITY
Coverage C
Personal Liability .....................................................
Coverage D
Medical Payments to Others ..................................
Exclusions
Coverage C and D Exclusions ...............................
Coverage C Exclusions
...................................
Coverage D Exclusions ..........................................

Prescribed by the State Board of Insurance

Homeowners Form A - First Reprint April 1, 1991

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2
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2
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3
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3
3

YOUR DUTIES AFTER A LOSS

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5
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6

6
6
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8
8

Section I:
1. Protect the property from further damage.
2. Call your agent or company & report the loss.
3. Call the police if a law has been broken.
4. Make a list of all damaged personal property,
including costs.
5. If requested, obtain proof of loss form from
your agent or the company and submit within
91 days of the request.
Section II:
1. Do not make any voluntary payments except
for first aid to others at the time of the
accident.
2. Give written notice to agent or company, including details about the accident and any
witnesses.
3. Send copies of legal notices you receive to
the company.
4. Help the company get the necessary information to make settlement.

FOR A COMPLETE LIST OF YOUR DUTIES

SEE PAGES 5 AND 9 OF YOUR POLICY.

HOMEOWNERS FORM A
AGREEMENT
We will provide the insurance described in this policy in return for the premium and compliance with all applicable provisions
of this policy.

DEFINITIONS
In this policy, "you" and "your" refer to the "named insured"
shown on the declarations page and the spouse if a
resident of the same household. "We", "us" and "our" refer
to the Company providing this insurance. In addition, certain
words and phrases are defined as follows:
1. "Bodily injury" means bodily harm, sickness or
disease. This includes required care, loss of services
and death that results.
2. "Business" includes trade, profession or occupation.
3. "Insured" means you and residents of your household
who are:
a. your relatives; or
b. other persons under the age of 21 and in the care
of any person named above.
Under Section II Liability, "insured" also means:
c. any person or organization legally responsible for
animals or watercraft to which this policy applies.
You or a person included in 3.a. or 3.b. above must
own the animal or watercraft. A person or
organization using or having custody of these
animals or watercraft without consent of the owner
is not an insured.
d. any employee of an insured while engaged in the
employment of the insured, but only with respect
to the use of farm tractors and trailers or other farm
equipment.
4. "Insured location" means:
a. the residence premises.
b. the part of other premises, other structures and
grounds you use as a residence and:
(1) which is shown on the declarations page; or
(2) which you acquire during the policy period for
your use as a residence.

c.

5.

6.
7.

8.

any premises you use in connection with a

premises in 4.a. or 4.b. above
d. any part of a premises:
(1) not owned by an insured; and
(2) where an insured is temporarily residing.
e. vacant land, other than farm land, owned by or
rented to an insured.
f. land owned by or rented to an insured on which a
one or two family dwelling is being built as a
residence for an insured.
g. individual or family cemetery plots or burial vaults
of an insured.
h. any part of a premises occasionally rented to an
insured for other than business use.
"Occurrence" means an accident, including exposure
to conditions, which results in bodily injury or property
damage during the policy period.
"Property damage" means injury to, destruction of, or
loss of use of property.
"Residence employee" means an employee of an
insured who performs duties related to the ownership,
maintenance or use of the residence premises,
including maintenance or use of a motor vehicle. This
includes employees who perform similar duties
elsewhere for an insured. This does not include
employees while performing duties related to the
business of an insured.
"Residence premises" means the residence premises
shown in the declarations page. This includes the one
or two family dwelling, including other structures, and
grounds where you reside or intend to reside within 60
days after the effective date of this policy.

SECTION I-PROPERTY COVERAGE

b. if an insured intends to occupy the dwelling within
60 days after the effective date of this policy.
2. other structures on the residence premises set apart
from the dwelling by clear space. This includes
structures connected to the dwelling by only a fence,
utility line or similar connection. The total limit of liability
for other structures is the limit of liability shown on the
declarations page or 10% of the Coverage A (Dwelling)
limit of liability, whichever is greater. This is additional
insurance and does not reduce the Coverage A
(Dwelling) limit of liability.

COVERAGE A (DWELLING)
We cover:
1. the dwelling on the residence premises shown on the
declarations page including structures attached to the
dwelling:
a. while occupied by an insured as a dwelling; or

We do not cover other structures:

a. used for commercial, manufacturing or farming
purposes; or
b. wholly rented to any person, unless used solely as
a private garage.
3. wall to wall carpeting attached to a building on the
residence premises.
COVERAGE B (PERSONAL PROPERTY)
We cover:
1. a. personal property owned, worn or used by an
insured while on the residence premises. This
includes window or wall air conditioning units.
b. at your request, property of others while the
property is on the part of the residence premises
occupied by an insured.
2. a. personal property owned, worn or used by an
insured anywhere in the world.
b. at your request, personal property of a residence
employee when:
(1) the property is away from the residence
premises of the residence employee and in
the control of the residence employee; and
(2) while the residence employee is performing
work for you.
Our total limit of liability under 2.a. and 2.b. above is
10% of the Coverage B (Personal Property) limit of
liability or $1,000, whichever is greater. This is
additional insurance and does not reduce the Coverage
B (Personal Property) limit of liability.
SPECIAL LIMITS OF LIABILITY. These limits do not
increase the Coverage B (Personal Property) limit of
liability. The special limit for each numbered category below
is the total limit for each loss for all property in that
category.
1. Money/Bank Cards. $100 on money or numismatic
property or loss by theft or unauthorized use of bank
fund transfer cards registered to an insured.
2. Bullion/Valuable Papers. $500 on gold or silver bullion,
manuscripts, notes, securities, stamps, philatelic
property, accounts, bills, deeds, evidences of debt,
letters of credit, passports, documents, transportation
or other tickets.
3. Jewelry/Watches/Furs. $500 for loss by theft of gems,
watches, jewelry, or furs.
4. Business Personal Property. $2,500 on business
property or farm and ranch property.
We will not cover any business property or farm and
ranch property:
a. that consists of samples or articles for sale or
delivery; or
b. if the property is away from the residence
premises.

PROPERTY NOT COVERED. We do not cover:

1. articles separately described and specifically insured by
this or other insurance.
2. animals or birds.
3. motor or engine propelled vehicles or machines
designed for movement on land, including attached
machinery or equipment.
However, we do cover such vehicles which are not
subject to motor vehicle registration and are:
a. devices and equipment for assisting the
handicapped.
b. power mowers.
c. golf carts.
d. vehicles or machines used for recreational
purposes while located on the residence
premises.
e. farm equipment not designed for use principally on
public roads.
4. trailers, semi-trailers or mobile homes.
However, we do cover:
a. trailers and semi-trailers that are designed for use
principally off public roads.
b. boat trailers while on the residence premises.
5. aircraft meaning any device used or designed for flight,
except model or hobby aircraft not used or designed to
carry people or cargo.
6. watercraft, including outboard motors and furnishings
or equipment.
We do cover watercraft, including outboard motors and
furnishings or equipment, while located on land on the
residence premises.
7. property of roomers or tenants.
8. property usually rented to others off the residence
premises.
EXTENSIONS OF COVERAGE.
1. DEBRIS REMOVAL. We will pay your expense for the
removal from the residence premises of:
a. debris of covered property if a Peril Insured Against
causes the loss.
b. a tree that has damaged covered property if a Peril
Insured Against causes the tree to fall.
This does not increase the limit of liability that applies to
the damaged property.
2. LOSS OF USE. If a loss caused by a Peril Insured
Against under Section I makes the residence
premises wholly or partially untenantable, we cover:
a. additional living expense, meaning any necessary
and reasonable increase in living expense you incur
so that your household can maintain its normal
standard of living.

b. fair rental value, meaning the fair rental value of

that part of the residence premises usually rented
to others by you, less any expenses that do not
continue.
The total limit of liability for all loss of use is 10% of the
Coverage A (Dwelling) limit of liability. This is additional
insurance and does not reduce the Coverage A
(Dwelling) limit of liability. The deductible clause does
not apply to loss of use coverage.
Payment will be for the reasonable time required to
repair or replace the damaged property. If you
permanently relocate, payment will be for the
reasonable time required for your household to
become settled.
The periods of time for loss of use are not limited by
expiration of this policy.
3. REASONABLE REPAIRS. If a Peril Insured Against
causes the loss, we will pay the reasonable cost you
incur for necessary repairs made solely to protect
covered property from further damage. This coverage
does not increase the limit of liability that applies to the
property being repaired.
4. TREES, SHRUBS, PLANTS AND LAWNS. We cover
trees, shrubs, plants and lawns, on the residence
premises, only for loss caused by the following Perils
Insured Against: Fire or Lightning, Explosion, Aircraft,
Vehicles not owned or operated by a resident of the
residence premises, Vandalism and Malicious
Mischief, Riot and Civil Commotion and Theft or
attempted theft.
The limit of liability for this coverage is 5% of the
Coverage A (Dwelling) limit of liability. We will not pay
more than $250 for any one tree, shrub or plant,
including the cost of removal. We do not cover property
grown for business purposes.
This is not additional insurance and does not increase
the Coverage A (Dwelling) limit of liability. The
deductible clause does not apply to trees, shrubs,
plants and lawns.
5. PROPERTY REMOVED. We pay for expense and
damage incurred in the removal of covered property
from an insured location endangered by a Peril

Insured Against. This coverage exists on a pro rata

basis for 30 days at each location to which such
property is removed for preservation. This is not
additional insurance and does not increase the
Coverage B (Personal Property) limit of liability.
6. CONSEQUENTIAL LOSS. We insure:
a. property contained in a building on the residence
premises against loss due to change in
temperature as the direct result of physical damage
to the dwelling, or any equipment contained in the
dwelling, caused by a Peril Insured Against. The
deductible clause does not apply to this coverage.
b. property contained in a building on the residence
premises against a loss due to change in
temperature as a direct result of physical damage
to any power, heating or cooling equipment
(including connections and supply pipes) not
contained in or on the dwelling, caused by a Peril
Insured Against.
The total limit of liability for the coverage described
in 6.b. above is $500. This is not additional
insurance and does not increase the Coverage B
(Personal Property) limit of liability.
7. AUTOMATIC REMOVAL. If you move from the
residence premises shown on the declarations page
to another location within the United States, to be
occupied as your principal residence, we cover:
a. the personal property under Coverage B (Personal
Property) at each location in the proportion that the
value at each location bears to the total value of all
the personal property covered under Coverage B
(Personal Property).
b. property in transit up to 10% of the Coverage B
(Personal Property) limit of liability or $1,000,
whichever is greater.
We provide coverage for only 30 days from the date the
removal begins.

SECTION I-PERILS INSURED AGAINST

COVERAGE A (DWELLING) AND COVERAGE B
(PERSONAL PROPERTY)
We insure against physical loss to the property described in
Coverage A (Dwelling) and Coverage B (Personal Property)
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.
This peril does not cover loss caused by smog or by
smoke from industrial or agricultural operations.
3. Windstorm, Hurricane, and Hail.
This peril does not cover:
a. loss to the following:

(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, masts and antennas, including lead-in
wiring, wind chargers and windmills.
b. loss caused by rain, snow, sand or dust, whether or
not driven by wind, unless the direct force of wind
or hail makes an opening in the roof or wall and the
rain, snow, sand or dust enters through this
opening and causes the damage.
4. Explosion.
5. Aircraft and Vehicles.
3

This peril does not cover loss caused by any vehicle

owned or operated by an occupant of the residence
premises.
6. Vandalism and Malicious Mischief.
7. Riot and Civil Commotion.
8. Theft, including attempted theft and loss of property
from a known place when it is likely that the property
has been stolen.
This peril does not cover:
a. 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.
b. personal property while away from the residence
premises and unattended in or on any motor
vehicle or trailer, other than a public conveyance,
unless all its doors, windows and other openings
are closed and locked and there are visible marks
of forcible entry.
Property is not unattended when the insured has
entrusted the keys of the vehicle to a custodian.
c. building materials and supplies not on the
residence premises.

SECTION I-EXCLUSIONS
1. We do not cover property described under Coverage A
(Dwelling) or Coverage B (Personal Property) for loss
caused by any of the following. These exclusions do not
apply to an ensuing loss caused by fire, smoke or
explosion.
a. We do not cover loss to electrical devices or wiring
caused by electricity other than lightning.
b. We do not cover loss caused by or resulting from
flood, surface water, waves, tidal water or tidal
waves, overflow of streams or other bodies of water
or spray from any of these whether or not driven by
wind.
We do cover an ensuing loss by theft or attempted
theft or any act or attempted act of stealing.
2. GOVERNMENTAL ACTION.
We do not cover loss caused by the destruction of
property by order of governmental authority.
But we do cover loss caused by acts of destruction
ordered by governmental authority taken at the time of
a fire to prevent its spread, if the fire would be covered
under this policy.

3. BUILDING LAWS.
We do not cover loss caused by or resulting from the
enforcement of any ordinance or law regulating the
construction, repair or demolition of a building or
structure.
4. WAR DAMAGE.
We do not cover loss resulting directly or indirectly from
war. This includes undeclared war, civil war,
insurrection, rebellion, revolution, warlike act by military
personnel, destruction or seizure or use for a military
purpose, and any consequence of these. Discharge of
a nuclear weapon will be deemed a warlike act even if
accidental.
5. NUCLEAR DAMAGE.
We do not cover loss resulting directly or indirectly from
nuclear reaction, radiation or radioactive contamination,
all whether controlled or uncontrolled or however
caused. We cover direct loss by fire resulting from
nuclear reaction, radiation or radioactive contamination.

SECTION I-DEDUCTIBLE
DEDUCTIBLE CLAUSE 1-WINDSTORM, HURRICANE OR
HAIL -The amount shown on the declarations page for
Deductible Clause 1 will be deducted from the combined
amount of each loss under Coverage A (Dwelling) and
Coverage B (Personal Property) that results from
windstorm, hurricane or hail.
DEDUCTIBLE CLAUSE 2-ALL OTHER PERILS-The
amount shown on the declarations page for Deductible

Clause 2 will be deducted from the combined amount of

each loss under Coverage A (Dwelling) and Coverage B
(Personal Property) unless the loss results from windstorm,
hurricane or hail.
If a single event causes loss by windstorm, hurricane or hail
and loss by lightning, only the larger deductible will apply.

SECTION I-CONDITIONS
1. Insurable Interest and Limit of Liability. Even if more
than one person has an insurable interest in the
property covered, we will not be liable in any one loss:
a. to the insured for more than the amount of the
insured's interest at the time of loss; or

b. for more than the applicable limit of liability.

Each time there is a loss to any building insured under
Coverage A (Dwelling), the amount of insurance
applicable to that building for loss by fire will be
reduced by the amount of the loss. As repairs are
made, the amount of insurance will be reinstated up to
the limit of liability as shown on the declarations page.

Art. 6. 13. Policy a Liquidated Demand. A fire insurance

policy, in case of a total loss by fire of property insured,
shall be held and considered to be a liquidated demand
against the company for the full amount of such policy.
The provisions of this article shall not apply to personal
property.
2. Residential Community Property Clause. This policy,
subject to all other terms and conditions, when covering
residential community property, as defined by state law,
shall remain in full force and effect as to the interest of
each spouse covered, irrespective of divorce or change
of ownership between the spouses unless excluded by
endorsement attached to this policy until the expiration
of the policy or until canceled in accordance with the
terms and conditions of this policy.
3. Your Duties After Loss. In case of a loss to covered
property caused by a peril insured against, you must:
a. give prompt notice to us or our agent.
b. notify the police in case of loss by theft.
c. (1) protect the property from further damage.
(2) make reasonable and necessary repairs to
protect the property.
(3) keep an accurate record of repair expenses.
d. furnish a complete inventory of damaged personal
property showing the quantity, description and
amount of loss. Attach all bills, receipts and related
documents which you have that justify the figures in
the inventory.
e. as often as we reasonably require:
(1) provide us access to the damaged property.
(2) provide us with pertinent records and documents we request and permit us to make
copies.
(3) submit to examination under oath and sign and
swear to it.
f. send to us or our agent, if we request, your signed
sworn proof of loss within 91 days of our request on
a standard form supplied by us. If we do not
request a signed sworn proof of loss within the first
60 days after you notify us or our agent of the loss,
we waive our right to require a proof of loss. Such
waiver will not waive our other rights under this
policy.
This proof of loss shall state, to the best of your
knowledge and belief:
(1) the time and cause of loss.
(2) the interest of the insured and all others in the
property involved including all liens on the
property.
(3) other insurance which may cover the loss.
(4) the actual cash value of each item of property
and the amount of loss to each item.
4. Loss Settlement. Our limit of liability and payment for
covered losses under Section I Property Coverage will
not exceed the smallest of the following:

5.

6.

7.

8.

9.

10.

a. the actual cash value at the time of the loss

determined with proper deduction for depreciation;
b. the cost to repair or replace the damaged property
with material of like kind and quality, with proper
deduction for depreciation; or
c. the specified limit of liability of the policy.
Loss to a Pair or Set. In case of loss to an item which
is part of a pair or set, the measure of loss shall be a
reasonable and fair proportion of the total value of the
pair or set. The importance of the item will be
considered in assessing the loss. Such loss will not be
considered a total loss of the pair or set.
Our Option. If we give you notice within 30 days after
we receive your signed, sworn Proof of Loss, we may
repair or replace any part of the damaged property with
property of like kind and quality, within a reasonable
time, rather than make payment for the loss or we may
take all or part of the property at the appraised or
agreed value.
Appraisal. If you and we fail to agree on the actual
cash value, amount of loss or the cost of repair, either
can make a written demand for appraisal. Each will
then select a competent, independent appraiser and
notify the other of the appraiser's identity within 20 days
of receipt of the written demand. The two appraisers
will choose an umpire. If they cannot agree upon an
umpire within 15 days, you or we may request that the
choice be made by a judge of a district court of a
judicial district where the loss occurred. The two
appraisers will then set the amount of loss, stating
separately the actual cash value and loss to each item.
If the appraisers fail to agree, they will submit their
differences to the umpire. An itemized decision agreed
to by any two of these three and filed with us will set the
amount of the loss. Such award shall be binding on you
and us.
Each party will pay its own appraiser and bear the other
expenses of the appraisal and umpire equally.
Loss Payment. After we receive your Proof of Loss
and:
a. we reach an agreement with you, in writing; or
b. there is a filing of an appraisal award with us;
loss will be payable within 60 days.
Other Insurance-Section I. Other insurance is
permitted on property covered by this policy, but other
insurance covering the dwelling is not permitted. If a
loss covered by this policy is also covered by other
insurance we will pay only the proportion of the loss
that the limit of liability that applies under this policy
bears to the total amount of insurance covering the
loss.
Suit Against Us. No suit or action can be brought
unless the policy provisions have been complied with.
Action brought against us must be started within two
years and one day after the cause of action accrues.

11. Abandonment of Property. There can be no abandonment of property to us.

12. Vacancy. If the insured moves from the dwelling and
a substantial part of the personal property is removed
from that dwelling, the dwelling will be considered
vacant. Coverage that applies under Coverage A
(Dwelling) will be suspended effective 60 days after the
dwelling becomes vacant. This coverage will remain
suspended during such vacancy.
13. Mortgage Clause (without contribution).
a. The word "mortgagee" includes trustee.
b. We will pay for any covered loss of or damage to
buildings or structures to the mortgagee shown on
the declarations page as interests appear.
c. The mortgagee has the right to receive loss
payment even if the mortgagee has started
foreclosure or similar action on the building or
structure.
d. If we deny your claim because of your acts or
because you have failed to comply with the terms
of this policy, the mortgagee has the right to receive
loss payment if the mortgagee:
(1) at our request, pays any premiums due under
this policy, if you have failed to do so.
(2) submits a signed, sworn statement of loss
within 91 days after receiving notice from us of
your failure to do so.
(3) has notified us of any change in ownership,
occupancy or substantial change in risk known
to the mortgagee.
All of the terms of this policy will then apply directly
to the mortgagee. Failure of the mortgagee to
comply with d.(1), d.(2) or d.(3) above shall void
this policy as to the interest of the mortgagee.
e. If we pay the mortgagee for any loss or damage
and deny payment to you because of your acts or
because you have failed to comply with the terms
of this policy:

(1) the mortgagee's rights under the mortgage will

be transferred to us to the extent of the amount
we pay.
(2) the mortgagee's right to recover the full
amount of the mortgagee's claim will not be
impaired.
At our option, we may pay to the mortgagee the
whole principal on the mortgage plus any accrued
interest. In this event, your mortgage and note will
be transferred to us and you will pay your
remaining mortgage debt to us.
f. If this policy is canceled, we will give the mortgagee
specifically named on the declarations page:
(1) 14 days written notice of cancellation if the
reason for cancellation is for non payment of
premium.
(2) 30 days written notice of cancellation if the
cancellation is for any other reason.
We will not give notice of cancellation to any
successors or assignee of the mortgagee named in
this policy.
g. If the property described under Coverage A
(Dwelling) is foreclosed upon under the deed of
trust, the mortgagee may cancel this policy of
insurance and will be entitled to any unearned
premiums from this policy.
The mortgagee must credit any unearned premium
against any deficiency owed by the borrower and
return any unearned premium not so credited to
the borrower. The unearned premium will be
figured using the customary short rate procedures.
h. If we elect not to renew this policy, the mortgagee
specifically named on the declarations page will be
given 30 days written notice of the non-renewal.
14. No Benefit to Bailee. We will not recognize any
assignment or grant any coverage for the benefit of a
person or organization holding, storing or moving
property for a fee.

SECTION II-LIABILITY COVERAGE

COVERAGE C (Personal Liability)
If a claim is made or a suit is brought against an insured for
damages because of bodily injury or property damage
caused by an occurrence to which this coverage applies,
we will:
1. pay up to our limit of liability for damages for which the
insured is legally liable.
2. provide a defense at our expense by counsel of our
choice even if the suit is groundless, false or fraudulent.
We may investigate and settle any claim or suit that we
decide is appropriate.
COVERAGE D (Medical Payments To Others)
We will pay the necessary medical expenses incurred or
medically determined within three years from the date of an

accident causing bodily injury. Medical expenses means

reasonable charges for medical, surgical, x-ray, dental,
ambulance, hospital, professional nursing, prosthetic
devices and funeral services. This coverage does not apply
to you or regular residents of your household. This
coverage does apply to residence employees. As to
others, this coverage applies only:
1. to a person on the insured location with the
permission of an insured.
2. to a person off the insured location, if the bodily
injury:
a. arises out of a condition on the insured location or
the ways immediately adjoining.
b. is caused by the activities of an insured.

c.

is caused by a residence employee in the course

of the residence employee's employment by an
insured.

d. is caused by an animal owned by or in the care of

an insured.

SECTION II-EXCLUSIONS
1. COVERAGE C (Personal Liability) and Coverage D
(Medical Payments to Others) do not apply to:
a. bodily injury or property damage which is caused
intentionally by or at the direction of the insured;
b. bodily injury or property damage arising out of or
in connection with a business engaged in by an
insured. But this exclusion does not apply to
activities which are ordinarily incidental to
non-business pursuits.
c. bodily injury or property damage arising out of
the rental or holding for rental of any part of any
premises by an insured. This exclusion does not
apply to the rental or holding for rental of an
insured location:
(1) on an occasional basis if used only as a
residence.
(2) in part for use only as a residence, unless a
single family unit is intended for use by the
occupying family to lodge more than two
roomers or boarders.
(3) in part, as an office, school or studio.
(4) if the rental is for not more than three car
spaces or stalls garages or stables.
d. bodily injury or property damage arising out of
the rendering of or failure to render professional
services.
e. bodily injury and property damage arising out of
a premises:
(1) owned by an insured;
(2) rented to an insured; or
(3) rented to others by an insured;
that is not an insured location.
This exclusion does not apply to bodily injury to a
residence employee arising out of and in the course of
the residence employee's employment by an
insured.
f. bodily injury or property damage arising out of
the ownership, maintenance, operation, use,
loading or unloading of:
(1) motor or engine propelled vehicles or
machines designed for movement on land,
including attached machinery or equipment.
(2) trailers, semi-trailers or mobile homes;
which are owned or operated by or rented or
loaned to an insured.
However, this exclusions does not apply to:
(1) motor vehicles which are not subject to motor
vehicle registration and are:

(a) used for assisting the handicapped.

(b) used to service an insured location.
(c) golf carts while on the residence
premises or used for golfing purposes.
(d) designed and used for recreational
purposes, and are:
(i) not owned by an insured; or
(ii) owned by an insured while on the
residence premises.
(e) in dead storage on the residence premises.
(f) used exclusively on the residence premises.
(2) trailers or semi-trailers while not being towed
by or carried on a motor vehicle.
This exclusion does not apply to bodily injury to a
residence employee arising out of and in the course of
the residence employee's employment by an
insured.
g. bodily injury or property damage arising out of
the ownership, maintenance, operation, use,
loading or unloading of watercraft:
(1) with inboard or inboard-outdrive motor power of
more than 50 horsepower owned by or rented
to an insured.
(2) powered by one or more outboard motors with
more than 25 total horsepower if the outboard
motor is owned by an insured. But, outboard
motors of more than 25 total horsepower are
covered for the policy period if:
(a) you acquire them prior to the policy period
and:
(i) you declare them at policy inception; or
(ii) your intention to insure is reported to
us in writing within 45 days after you
acquire the outboard motors.
(b) you acquire them during the policy period.
(3) that is a sailing vessel, with or without auxiliary
power, which is 26 feet or more in length
owned by or rented to an insured.
This exclusion does not apply while the watercraft is on
the residence premises.
This exclusion does not apply to bodily injury to a
residence employee arising out of and in the course of
the residence employee's employment by an
insured.

h. bodily injury or property damage arising out of

the ownership, maintenance, operation, use,
loading or unloading of aircraft.
Aircraft means any device used or designed for
flight, except model or hobby aircraft not used or
designed to carry people or cargo.
This exclusion does not apply to bodily injury to a
residence employee arising out of and in the course of
the residence employee's employment by an
insured.
i. bodily injury or property damage arising out of:
(1) the entrustment by an insured to any person;
or
(2) the negligent supervision by an insured of any
person;
with regard to the ownership, maintenance or use
of any motor vehicle, watercraft or aircraft which is
excluded in paragraph f., g. or h. above.
This exclusion does not apply to bodily injury to a
residence employee arising out of an in the course of
the residence employee's employment by an
insured.
j. bodily injury or property damage caused directly
or indirectly by war. This includes undeclared war,
civil war, insurrection, rebellion, revolution, warlike
act by a military force or military personnel,
destruction or seizure or use for military purpose,
and any consequence of these. Discharge of a
nuclear weapon will be deemed a warlike act even
if accidental.
k. bodily injury and property damage arising out of
the transmission of sickness or disease by an
insured through sexual contact.
l. bodily injury to any person eligible to receive any
benefits voluntarily provided or required to be
provided by an insured under any workers'
compensation law or occupational disease law.
2. Coverage C (Personal Liability) does not apply to:
a. liability under any contract or agreement.

However, this exclusion does not apply to written

contracts:
(1) that directly relate to the ownership,
maintenance or use of an insured location; or
(2) where the liability of others is assumed by an
insured:
unless excluded elsewhere in this policy.
b. property damage to property owned by an
insured.
c. property damage to property rented to, occupied
or used by or in the care of the insured.
This exclusion does not apply to property damage
caused by fire, smoke or explosion.
d. bodily injury or property damage for which an
insured under this policy is also an insured under a
nuclear energy liability policy or would be an
insured under that policy but for the exhaustion of
its limit of liability.
A nuclear energy liability policy is one issued by
American Nuclear Insurers, Mutual Atomic Energy
Liability Underwriters, or Nuclear Insurance
Association of Canada.
e. bodily injury to you or an insured within the
meaning of part a. or part b. of insured as defined.
3. Coverage D (Medical Payments to Others) does not
apply to:
a. bodily injury to a residence employee if the
bodily injury:
(1) occurs off the insured location; and
(2) does not arise out of or in the course of the
residence employee's employment by an
insured.
b. bodily injury to any person, other than a
residence employee of an insured, regularly
residing on any part of the insured location.

SECTION II-ADDITIONAL COVERAGES

We cover the following in addition to the limits of liability:
1. Claim Expenses. We pay:
a. expenses we incur and costs taxed against an
insured in any suit we defend.
b. premiums on bonds required in a suit we defend
but not for bond amounts more than the limit of
liability for Coverage C (Personal Liability). We
need not apply for or furnish any bond.
c. reasonable expenses incurred by an insured at our
request, including actual loss earnings (but not loss
of other income) up to $50 per day, for assisting us
in the investigation or defense of a claim or suit.
d. interest on the entire judgment which accrues after
entry of the judgment and before we pay or tender,

or deposit in court that part of the judgment which

does not exceed the limit of liability that applies.
2. Imperative Medical Expenses to Others. We pay
expenses incurred by an insured for immediate
medical and surgical relief to others if imperative at the
time of the accident.
3. Damage to Property of Others. We pay replacement
cost up to $500 per occurrence for property damage
to property of others caused by an insured.
We do not pay for property damage:
a. caused intentionally by an insured who is 13 years
of age or older.
b. to property owned by an insured.

c.

to property owned by or rented to a tenant of an

insured or a resident in your household.
d. arising out of:
(1) a business engaged in by an insured.
(2) any act or omission in connection with a premises owned, rented or controlled by an
insured, other than the insured location.

(3) the ownership, maintenance, use, loading or

unloading of aircraft, watercraft or motor
vehicles or all other motorized land conveyances.
This exclusion does not apply to any motorized
land conveyance designed for recreational use off
public roads, not subject to motor vehicle
registration and not owned by an insured.

SECTION II-CONDITIONS
1. Limit of Liability. The limit of liability for Coverage C
(Personal Liability) shown on the declarations page is
our total liability under Coverage C (Personal Liability)
for all damages resulting from any one occurrence.
This limit is the same regardless of the number of
insureds, claims made or persons injured.
The limit of liability for Coverage D (Medical Payments
to Others) shown on the declarations page is our total
liability under Coverage D (Medical Payments to
Others) for all medical expense payable for bodily
injury to one person as the result of one accident. The
total limit of our liability for all expenses payable to two
or more persons injured in one accident is $25,000.
2. Severability of Insurance. This insurance applies
separately to each insured. This condition will not
increase our limit of liability for any one occurrence.
3. Duties After Loss. In case of an accident or
occurrence, the insured will perform the following
duties that apply or will help us by seeing that these
duties are performed:
a. Give written notice to us or our agent as soon as is
practical, which sets forth:
(1) the identity of the policy and insured.
(2) reasonably available information on the time,
place and circumstances of the accident or
occurrence.
(3) names and addresses of any claimants and
witnesses.
b. Promptly forward to us every notice, demand,
summons or other process relating to the accident
or occurrence.
c. At our request, help us:
(1) to make settlement.
(2) to enforce any right of contribution or indemnity
against any person or organization who may be
liable to an insured.
(3) with the conduct of suits, including attending
hearings and trials.
(4) to secure evidence and obtain the attendance
of witnesses.
d. The insured will not, except, at the insured's own
cost, voluntarily make payment, assume obligation
or incur expense other than for immediate medical
and surgical relief to others at the time of the
bodily injury.

4. Duties of an Insured Person-Coverage D (Medical

Payments to Others).
The injured person or someone acting for the injured
person will:
a. give us written proof of claim, under oath if
required, as soon as is practical.
b. authorize us to obtain copies of medical reports
and records.
The injured person will submit to a physical exam by a
doctor of our choice when and as often as we
reasonably require.
5. Payments of Claim-Coverage D (Medical Payments
to Others). Payment under this coverage is not an
admission of liability by an insured or us.
6. Suit Against Us. No action can be brought against us
unless there has been compliance with the policy
provisions.
No one will have the right to join us as a party to any
action against an insured. Also, no action with respect
to Coverage C (Personal Liability) can be brought
against us until the obligation to the insured has been
determined by final judgment or agreement.
Under Coverage D (Medical Payments to Others), no
action can be brought until 30 days after the required
proofs of claim have been filed with us.
7. Bankruptcy of the Insured. Bankruptcy or insolvency
of the insured or of the insured's estate will not relieve
us of our obligations under this policy.
8. Other Insurance-Section II. If the insured has other
insurance under Coverage C (Personal Liability), we
will not be liable for a greater proportion of a loss than
the limit of liability shown on the declarations page
bears to the total limit of all valid and collectible
insurance against such loss.
However, with respect to loss arising out of the
ownership, maintenance, operation, use, loading or
unloading of:
a. any motor vehicle or recreational motor vehicle at
the residence premises; or
b. watercraft,
this policy, will not apply to the extent that any valid and
collectible insurance is available to the insured.

QUICK REFERENCE
TEXAS HOMEOWNERS POLICY - FORM B
I nsuring Agreement
Definitions

1
1

SECTION I - PROPERTY COVERAGE

Coverage A
Dwelling
Other Structures
Coverage B
Personal Property
Personal Property Off Premises
Special Limits of Liability
Property Not Covered
Extensions of Coverage
Debris Removal
Loss of Use
Reasonable Repairs
Trees, Shrubs, Plants and Lawns
Property Removed
Consequential Loss
Automatic Removal
Perils Insured Against
Coverage A (Dwelling)
Coverage B (Personal Property)

1
1
2
2
2
2
2
2
3
3
3
3
3
3
3

Exclusions

Deductibles

Section I - Conditions
6
I nsurable Interest and Limit of Liability
Residential Community Property Clause.... 6
Duties After Loss
Your Duties After Loss
6
7
Our Duties After Loss
7
Loss Settlement
7
Loss to a Pair or Set

8
Salvage Rights
8
Appraisal
8
Loss Payment
8
Catastrophe Claims
8
Other Insurance
8
Suit Against Us
8
Abandonment of Property
8
Vacancy - Suspension of Coverage
8
Mortgage Clause
9
No Benefit to Bailee
SECTION II - LIABILITY COVERAGE
Coverage C (Personal Liability)
Coverage D (Medical Payments to Others)

9
9

Exclusions
Coverage C and D Exclusions

Prescribed by the Texas Department of Insurance

Homeowners Form B - Effective July 8, 1992
( Revised January 1, 2002)

Coverage C Exclusions
Coverage D Exclusions

10
11

Additional Coverages
Claim Expenses
I mperative Medical Expenses to Others
Damage to Property of Others

11
11
11

Section 11 - Conditions
Limit of Liability
Severability of Insurance
Duties After Loss
Duties of an Injured Person
Payment of Claim under Coverage D
Suit Against Us
Bankruptcy of the Insured
Other Insurance
Notice of Settlement of Liability Claim

11
11
11
12
12
12
12
12
12

POLICY CONDITIONS
APPLYING TO SECTIONS I AND II
Policy Period
Concealment or Fraud
Liberalization Clause
Waiver or Change of Policy Provisions
Cancellation
Refusal to Renew
Assignment
Subrogation
Death

Section 1:

12
12
12
12
12
13
13
13
13

YOUR DUTIES AFTER A LOSS

1. Protect the property from further damage.

2. Give prompt written notice to the company.
3. Call the police if a law has been broken.
4. Make a list of all damaged personal property,
i ncluding costs.
5. I f requested, obtain proof of loss form from
your agent or the company and submit within
91 days of the request.

Section II:

Do not make any voluntary payments except

for first aid to others at the time of the
accident.
2. Give written notice to agent or company,
i ncluding details about the accident and any
witnesses.
3. Send copies of legal notices you receive to the
company.
4. Help the company get the necessary
i nformation to make settlement.
1.

FOR A COMPLETE LIST OF YOUR DUTIES SEE

PAGES 6 AND 11 OF YOUR POLICY.

HOMEOWNERS FORM B
AGREEMENT
We will provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of
this policy.
DEFINITIONS
In this policy, you and your refer to the named insured
shown on the declarations page and the spouse if a resident
of the same household. We, us and our refer to the Company providing this insurance. In addition, certain words and
phrases are defined as follows:
1.

Bodily injury means bodily harm, sickness or

disease. This includes required care, loss of services
and death that results.

2.

Business includes trade, profession or occupation.

3.

Business day, when used in this policy means a day

other than a Saturday, Sunday or holiday recognized
by the state of Texas.

4.

Insured means you and residents of

household who are:

(1) which is shown on the declarations page; or

(2) which you acquire during the policy period for
your use as a residence.
c.

d. any part of a premises:

(1) not owned by an insured; and
(2) where an insured is temporarily residing.
e. vacant land, other than farm land, owned by or rented
to an insured.
f.

your

a. your relatives; or

land owned by or rented to an insured on which a

one or two family dwelling is being built as a residence for an insured.

g. individual or family cemetery plots or burial vaults

of an insured.

b. other persons under the age of 21 and in the

care of any person named above.

h. any part of a premises occasionally rented to an

insured for other than business use.

Under Section II Liability, insured also means:

c. any person or organization legally responsible
for animals or watercraft to which this policy
applies. You or a person included in 4.a. or 4.b.
above must own the animal or watercraft. A
person or organization using or having custody
of these animals or watercraft without consent
of the owner is not an insured.

6.

Occurrence means an accident, including exposure

to conditions, which results in bodily injury or property damage during the policy period.

7.

Property damage means injury to, destruction of, or

loss of use of property.

8.

Residence employee means an employee of an insured who performs duties related to the ownership,
maintenance or use of the residence premises, including maintenance or use of a motor vehicle. This
includes employees who perform similar duties elsewhere for an insured. This does not include employees while performing duties related to the business of
an insured.

9.

Residence premises means the residence premises shown on the declarations page. This includes
the one or two family dwelling, including other structures, and grounds where an insured resides or intends
to reside within 60 days after the effective date of this
policy.

d. With respect to any vehicle to which this

policy applies:
(1) any employee of an insured while engaged in
the employment of the insured; or
(2) any other person using the vehicle on an insured location with your consent.
5.

any premises you use in connection with a

premises in 5.a. or 5.b. above.

Insured location means:

a. the residence premises.
b. the part of other premises, other structures
and grounds you use as a residence and:

SECTION I - PROPERTY COVERAGE

tures connected to the dwelling by only a fence, utility line or
similar connection.

COVERAGE A (DWELLING)
We cover:
1.

the dwelling on the residence premises shown on the

declarations page including structures attached to the
dwelling.

2.

other structures on the residence premises set apart

from the dwelling by clear space. This includes struc-

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The total limit of liability for other structures is the limit of

liability shown on the declaration page or 10% of the Coverage A (Dwelling) limit of liability, whichever is greater. This is
additional insurance and does not reduce the Coverage A
(Dwelling) limit of liability.
We do not cover other structures:
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3.

a.

used for business purposes; or

b.

wholly rented to any person, unless used solely

as a private garage.

3.

motor or engine propelled vehicles or machines designed for

movement on land, including attached machinery or equipment.
However, we do cover such vehicles which are not subject to
motor vehicle registration and are:

wall to wall carpeting attached to a building on the residence

premises.

a.

devices and equipment for assisting the handicapped.

COVERAGE B (PERSONAL PROPERTY)

b. power mowers.

We cover:

c. golf carts.

1.

d. vehicles or machines used for recreational purposes while

located on the residence premises.

a. personal property owned, worn or used by an insured

while on the residence premises. This includes window
or wall air conditioning units.

e. farm equipment not designed for use principally on public

roads.

b. at your request, property of others while the property is on

the part of the residence premises occupied by an insured.
2.

4. trailers, semi-trailers or mobile homes.

However, we do cover:

a. personal property owned, worn or used by an insured

anywhere in the world.

a.

trailers and semi-trailers that are designed for use principally off public roads.

b.

b.

boat trailers while on the residence premises.

at your request, personal property of a residence employee when:

(1)

(2)

the property is away from the residence premises of

the residence employee and in the control of the
residence employee; and

5.

aircraft meaning any device used or designed for flight, except

model or hobby aircraft not used or designed to carry people or
cargo.

6.

watercraft, including outboard motors and furnishings or equipment.

while the residence employee is performing work

for you.

We do cover watercraft, including outboard motors and furnishings or equipment, while located on land on the residence
premises.

Our total limit of liability under 2.a. and 2.b. above is 10% of
the Coverage B (Personal Property) limit of liability or $1000,
whichever is greater. This is additional insurance and does
not reduce the Coverage B (Personal Property) limit of liability.

7. property of roomers or tenants.

8. property usually rented to others off the residence premises.
EXTENSIONS OF COVERAGE.

SPECIAL LIMITS OF LIABILITY. These limits do not increase the

Coverage B (Personal Property) limit of liability. The special limit for
each numbered category below is the total limit for each loss for all
property in that category.

1. DEBRIS REMOVAL. We will pay your expense for the

removal from the residence premises of:

1. Money/Bank Cards. $100 on money or numismatic property

or loss by theft or unauthorized use of bank fund transfer cards
registered to an insured.

a.

debris of covered property if a Peril Insured Against causes

the loss.

b.

a tree that has damaged covered property if a Peril Insured

Against causes the tree to fall.

2.

Bullion/Valuable Papers. $500 on gold or silver bullion, manuscripts, notes, securities, stamps, philatelic property, accounts,
bills, deeds, evidences of debt, letters of credit, passports, documents, transportation or other tickets.

3.

Jewelry/Watches/Furs. $500 for loss by theft of gems,

watches, jewelry or furs.

LOSS OF USE. If a loss caused by a Peril Insured Against

under Section I makes the residence premises wholly or partially untenantable, we cover:

4.

Business Personal Property. $2,500 on business property.

a.

additional living expense, meaning any necessary and reasonable increase in living expense you incur so that your
household can maintain its normal standard of living.

b.

fair rental value, meaning the fair rental value of that part of
the residence premises usually rented to others by you,
less any expenses that do not continue.

This does not increase the limit of liability that applies to the
damaged property.
2.

We do not cover any business property:

a.

that consists of samples or articles for sale or delivery; or

b.

if the property is away from the residence premises.

PROPERTY NOT COVERED. We do not cover:

1.

The total limit of liability for all loss of use is 20% of the Coverage A (Dwelling) limit of liability. This is additional insurance
and does not reduce the Coverage A (Dwelling) limit of liability.
The deductible clause does not apply to loss of use coverage.

articles separately described and specifically insured by this or

other insurance.

2. animals or birds.
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6.

Payment will be for the reasonable time required to repair or

replace the damaged property. If you permanently relocate,
payment will be for the reasonable time required for your household to become settled.

CONSEQUENTIAL LOSS. We insure:

a.

property contained in a building on the residence premises against loss due to change in temperature as a
direct result of physical damage to the dwelling, or any
equipment contained in the dwelling, caused by a Peril
Insured Against. The deductible clause does not apply to
this coverage.

b.

property contained in a building on the residence premises against a loss due to change in temperature as a
direct result of physical damage to any power, heating or
cooling equipment (including connections and supply pipes)
not contained in or on the dwelling, caused by a Peril Insured Against.

The periods of time for loss of use are not limited by expiration
of this policy.
3.

REASONABLE REPAIRS. If a Peril Insured Against causes

the loss, we will pay the reasonable cost you incur for necessary repairs made solely to protect covered property from further damage. This coverage does not increase the limit of
liability that applies to the property being repaired.

4.

TREES, SHRUBS, PLANTS AND LAWNS. We cover trees,

shrubs, plants and lawns, on the residence premises, only
for loss caused by the following Perils Insured Against: Fire or
Lightning, Explosion, Aircraft, Vehicles not owned or operated
by a resident of the residence premises, Vandalism and
Malicious Mischief, Riot and Civil Commotion and Theft or attempted theft.

The total limit of liability for the coverage described in 6.b.

above is $500. This is not additional insurance and does
not increase the Coverage B (Personal Property) limit of
liability.
7.

The maximum limit of liability for this coverage is 5% of the Coverage A (Dwelling) limit of liability. We will not pay more than
$250 for any one tree, shrub or plant, including the cost of
removal. We do not cover property grown for business purposes.
This is not additional insurance and does not increase the Coverage A (Dwelling) limit of liability. The deductible clause does
not apply to trees, shrubs, plants and lawns.
5.

PROPERTY REMOVED. We pay for expense and damage

incurred in the removal of covered property from an insured
location endangered by a Peril Insured Against. This coverage exists on a pro rata basis for 30 days at each location
to which such property is removed for preservation. This is not
additional insurance and does not increase the Coverage B
(Personal Property) limit of liability.

AUTOMATIC REMOVAL. If you move from the residence

premises shown on the declarations page to another location
within the United States, to be occupied as your principal residence, we cover:
a.

the personal property under Coverage B (Personal Property) at each location in the proportion that the value at
each location bears to the total value of all the personal
property covered under Coverage B (Personal Property).

b.

property in transit up to 10% of the Coverage B (Personal

Property) limit of liability or $1,000, whichever is greater.

We provide coverage for only 30 days from the date the removal
begins.

SECTION I - PERILS INSURED AGAINST

COVERAGE A (DWELLING)

9. Accidental Discharge, Leakage or Overflow of Water or Steam from within a plumbing, heating or air conditioning system or household appliance.

We insure against all risks of physical loss to the property

described in Section I Property Coverage, Coverage A (Dwelling) unless the loss is excluded in Section I Exclusions.

A loss resulting from this peril includes the cost of tearing

out and replacing any part of the building necessary to
repair or replace the system or appliance. But this does
not include loss to the system or appliance from which
the water or steam escaped.

COVERAGE B (PERSONAL PROPERTY)

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

Exclusions 1.a. through 1.h. under Section I Exclusions

do not apply to loss caused by this peril.

1. Fire and Lightning.

10. Falling Objects.

2. Sudden and Accidental Damage from Smoke.

This peril does not include loss to property contained in a

building unless the roof or outside wall of the building is
first damaged by the falling object.

3. Windstorm, Hurricane and Hail.

4. Explosion.

11. Freezing of household appliances.

5. Aircraft and Vehicles.

12. Theft, including attempted theft and loss of property from

a known place when it is likely that the property has been
stolen.

6. Vandalism and Malicious Mischief.

7. Riot and Civil Commotion.
8. Collapse of Building or any part of the building.
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SECTION I - EXCLUSIONS
1. 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.
a.

We do not cover loss to electrical devices or wiring caused

by electricity other than lightning.

b.

We do not cover loss caused by smog or by smoke from

industrial or agricultural operations.

c.

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,

masts and antennas, including lead-in wiring,
windchargers and windmills.

(3)

d.

or any part of the building, water damage or breakage of

glass which is part of the building if the loss would otherwise be covered under this policy.
h. We do not cover loss under Coverage A (Dwelling) caused
by settling, cracking, bulging, shrinkage, or expansion of
foundations, walls, floors, ceilings, roof structures, walks,
drives, curbs, fences, retaining walls or swimming pools.
We do cover ensuing loss caused by collapse of building
or any part of the building, water damage or breakage of
glass which is part of the building if the loss would otherwise be covered under this policy.
i.

We do cover an ensuing loss by theft or attempted theft or

any act or attempted act of stealing.

personal property contained in a building unless

direct force of wind or hail makes an opening in a
roof or wall and rain, snow, sand or dust enters
through this opening and causes the damage.

j. We do not cover loss caused by or resulting from freezing

while the building is unoccupied unless you have used
reasonable care to:
(1)

We do not cover loss of 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)

k. We do not cover loss caused by earthquake, landslide or

earth movement.
l.

(2) building materials and supplies not on the residence

premises.
We do not cover loss to machinery, appliances and mechanical devices caused by mechanical breakdown.

f.

We do not cover loss caused by:

(1)

rust or rot.

(3)

dampness of atmosphere, extremes of temperature.

(4)

contamination.

(5)

rats, mice, termites, moths or other insects.

Sudden and accidental shall include a physical loss

that is hidden or concealed for a period of time until it
is detectable. A hidden loss must be reported to us no
later than 30 days after the date you detect or should
have detected the loss.
For purposes of this exclusion, ensuing mold, fungi or
other microbial losses covered under this policy include reasonable and necessary repair or replacement
of property covered under Coverage A (Dwelling) and/
or Coverage B (Personal Property).

We do cover ensuing loss caused by collapse of building

or any part of the building, water damage or breakage of
glass which is part of the building if the loss would otherwise be covered under this policy.

We do not cover the cost for remediation, including

testing of ensuing mold, fungi or other microbes. We
do not cover any increase in expenses for Loss of Use
and/or Debris Removal due to remediation and testing
of ensuing mold, fungi or other microbes.

g. We do not cover loss caused by animals or birds owned

or kept by an insured or occupant of the residence
premises.
We do cover ensuing loss caused by collapse of building
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We do not cover loss caused by or resulting from mold,

fungi or other microbes.
However, we do cover ensuing mold, fungi or other
microbial losses caused by or resulting from sudden
and accidental discharge, leakage or overflow of water
or steam if the sudden and accidental discharge, leakage or overflow of water or steam loss would otherwise
be covered under this policy.

wear and tear, deterioration or loss caused by any

quality in property that causes it to damage or destroy itself.

(2)

maintain heat in the building; or

(2) shut off the water supply and drain plumbing, heating and air conditioning systems of water.

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.

e.

We do not cover loss caused by or resulting from flood,

surface water, waves, tidal water or tidal waves, overflow of
streams or other bodies of water or spray from any of these
whether or not driven by wind.

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We will not pay for the increased cost of construction:

Remediation means to treat, contain, remove or dispose of mold, fungi or other microbes beyond that which
is required to repair or replace the covered property
physically damaged by water or steam. Remediation
includes any testing to detect, measure or evaluate
mold, fungi or other microbes and any decontamination of the residence premises or property.

(1) if the building or structure is not rebuilt or repaired;

(2) if the rebuilt or repaired building or structure is
not intended for the same type occupancy as
the current building or structure;

2. GOVERNMENTAL ACTION.

(3) until the building or structure is actually repaired

or rebuilt at the same premises; or

We do not cover loss caused by the destruction of property by

order of governmental authority.

(4) unless the rebuilding or repairs are made as soon

as reasonably possible after the loss or damage, not to exceed 365 days after loss unless
you have requested in writing that this time limit
be extended for an additional 180 days.

But we do cover loss caused by acts of destruction ordered by

governmental authority taken at the time of a fire to prevent its
spread, if the fire would be covered under this policy.
3. BUILDING LAWS.
We do not cover loss caused by or resulting from the enforcement of any ordinance or law regulating the construction, repair or demolition of a building or structure.

(c) We do not cover:

(1) the loss in value to any covered building or other
structure due to the requirements of any ordinance or law; or

Building Laws exclusion is modified to provide coverage only to the extent described under Perils Insured
Against.

(2) the costs to comply with any ordinance or law

which requires any insured or others to test
for, monitor, clean up, remove, contain, treat,
detoxify or neutralize, or in any way respond to,
assess the effects of, pollutants on any covered
building or other structure.

(a) Coverage Provided.

You may use up to $5,000 (at no additional premium) for
the increased costs that you incur due to the enforcement of any ordinance or law, which requires or regulates:

Pollutants means any solid, liquid, gaseous or thermal

irritant or contaminant, including smoke, vapor, soot,
fumes, acids, alkalis, chemicals and waste. Waste includes material to be recycled, reconditioned or reclaimed.

(1) the construction, demolition or repair of that part

of a covered building or other structure damaged by a Peril Insured Against;

(d) If the insured property is located in an area which is

eligible for coverage through the Texas Windstorm
Insurance Association, the coverage described above,
also applies to the increased cost you incur due to
the repair, replacement or demolition required for the
dwelling to comply with the building specifications
contained in the Texas Windstorm Insurance
Associations plan of operation.

(2) the demolition and reconstruction of the undamaged part of a covered building or other structure, when that building or other structure must
be totally demolished because of damage by a
Peril Insured Against to another part of that covered building or other structure; or
(3) the remodeling, removal or replacement of the
portion of the undamaged part of a covered building or other structure necessary to complete the
remodeling, repair or replacement of that part of
the covered building or other structure damaged
by a Peril Insured Against.

All other Terms of the policy apply.

4. WAR DAMAGE.
We do not cover loss resulting directly or indirectly from war.
This includes undeclared war, civil war, insurrection, rebellion,
revolution, warlike act by military personnel, destruction or
seizure or use for military purpose, and any consequence of
these. Discharge of a nuclear weapon will be deemed a warlike act even if accidental.

You may use all or part of this coverage to pay for the
increased costs you incur to remove debris resulting from
the construction, repair or replacement of property as
stated in (a). above.
This is additional insurance and does not reduce Coverage A (Dwelling) the limit of liability.

5. NUCLEAR DAMAGE.

(b) Building Ordinance or Law Coverage Limitations.

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We do not cover loss resulting directly or indirectly from nuclear

reaction, radiation or radioactive contamination, all whether
controlled or uncontrolled or however caused. We cover direct loss by fire resulting from nuclear reaction, radiation or
radioactive contamination.
SECTION I - DEDUCTIBLES
deducted from the combined amount of each loss under Coverage A (Dwelling) and Coverage B (Personal Property), unless
the loss results from windstorm, hurricane, hail or wind driven
rain.

DEDUCTIBLE CLAUSE 1 - WINDSTORM, HURRICANE, HAIL

OR WIND DRIVEN RAIN - The amount shown on the declarations page for Deductible Clause 1 will be deducted from the
combined amount of each loss under Coverage A (Dwelling) and
Coverage B (Personal Property) that results from windstorm, hurricane, hail or wind driven rain.

If a single event causes loss by windstorm, hurricane, hail or

wind driven rain and loss by lightning, only the larger deductible
will apply.

DEDUCTIBLE CLAUSE 2 - ALL OTHER PERILS - The amount

shown on the declarations page for Deductible Clause 2 will be

SECTION I - CONDITIONS
1. Insurable Interest and Limit of Liability. Even if more
than one person has an insurable interest in the property covered, we will not be liable in any one loss:
a. to the insured for more than the amount of the
insureds interest at the time of loss; or

(5)

as often as we reasonably require:

(6)

a. Your Duties After Loss. In case of a loss to covered

property caused by a peril insured against, you must:

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notify the police in case of loss by theft.

(3)

(a)

(b)

provide us with pertinent records and documents we request and permit us to make
copies.

(c)

submit to examination under oath and sign

and swear to it.

send to us if we request, your signed sworn

proof of loss within 91 days of our request on a
standard form supplied by us. We must request a signed sworn proof of loss within 15
days after we receive your written notice, or we
waive our right to require a proof of loss. Such
waiver will not waive our other rights under this
policy.
(a)

3. Duties After Loss.

(2)

keep an accurate record of repair ex penses.

(a) provide us access to the damaged

property.

2. Residential Community Property Clause. This policy,

subject to all other terms and conditions, when covering
residential community property, as defined by state law,
shall remain in full force and effect as to the interest of
each spouse covered, irrespective of divorce or change of
ownership between the spouses unless excluded by endorsement attached to this policy, until the expiration of
the policy or until cancelled in accordance with the terms
and conditions of this policy.

give prompt written notice to us of the facts relating to the claim.

(c)

furnish a complete inventory of damaged personal property showing the quantity, description and amount of loss. Attach all bills, receipts and related documents which you have
that justify the figures in the inventory.

Article 6.13. Policy A Liquidated Demand. A fire insurance policy, in case of a total loss by fire of property
insured, shall be held and considered to be a liquidated
demand against the company for the full amount of such
policy. The provisions of this article shall not apply to
personal property.

(1)

make reasonable and necessary repairs

to protect the property.

(4)

b. for more than the applicable limit of liability.

Each time there is a loss to any building insured under
Coverage A (Dwelling), the amount of insurance applicable
to that building for loss by fire will be reduced by the amount
of the loss. As repairs are made, the amount of insurance will be reinstated up to the limit of liability shown on
the declarations page.

(b)

This proof of loss shall state, to the best

of your knowledge and belief:
(i)

the time and cause of loss;

(ii)

the interest of the insured and all

others in the property involved including all liens on the property.

(iii) other insurance which may cover the

loss.

protect the property from further

damage.

(iv)
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the actual cash value of each item

(b)

b.

of property and the amount of loss

to each item.

(1)

the actual cash value at the time of loss determined

with proper deduction for depreciation.

If you elect to make claim under the

Replacement Cost Coverage of this policy,
this proof of loss shall also state, to the
best of your knowledge and belief:

(2)

the cost to repair or replace the damaged property

with material of like kind and quality, with proper deduction for depreciation; or

(3)

the specified limit of liability of the policy.

(i)

the replacement cost of the described dwelling.

(ii)

the replacement cost of any other

building on which loss is claimed.

(iii)

the full cost of repair or replacement

of loss without deduction for depreciation.

b.

Our limit of liability for covered losses to dwelling and other

structure(s) under Coverage A (Dwelling), except wall to wall
carpeting, cloth awnings and fences, will be at replacement
cost settlement subject to the following:
(1)

If, at the time of loss, the Coverage A (Dwelling) limit of

liability is 80% or more of the full replacement cost of
the dwelling, we will pay the repair or replacement
cost of the damaged building structure(s), without deduction for depreciation.

(2)

If, at the time of loss, the Coverage A (Dwelling) limit of

liability is less than 80% of the full replacement cost of
the dwelling, we will pay only a proportionate share of
the full replacement cost of the damaged building
structure(s). Our share is equal to:

Our Duties After Loss.

(1) Within 15 days after we receive your written notice of
claim, we must:
(a)

acknowledge receipt of the claim.

If our acknowledgement of the claim is not in writing,

we will keep a record of the date, method and content
of our acknowledgement.
(b)

begin any investigation of the claim.

(c)

specify the information you must provide in

accordance with Your Duties After Loss (item
3.a. above).

Replacement Cost of the Loss

X
Coverage A (Dwelling) Limit of Liability
80% of Replacement Cost of the Dwelling
(3)

We may request more information, if during the investigation of the claim such additional information is necessary.
(2)

(3)

In determining the amount of insurance required to equal

80% of the full replacement cost of the dwelling, do not
include the value of excavations, underground pipes, and
wiring and foundations which are below the surface of the
ground.

After we receive the information we request, we must

notify you in writing whether the claim will be paid or
has been denied or whether more information is
needed:
(a)

within 15 business days; or

(b)

within 30 days if we have reason to believe the

loss resulted from arson.

We will pay only the actual cash value of the damaged

building structure(s) until repair or replacement is completed.
Repair or replacement must be completed within 365 days
after loss unless you request in writing that this time limit be
extended for an additional 180 days. Upon completion of
repairs or replacement, we will pay the additional amount
claimed under replacement cost coverage, but our payment
will not exceed the smallest of the following:

If we do not approve payment of your claim or require

more time for processing your claim, we must:
(a)

give the reason for denying your claim; or

(b)

give the reasons we require more time to process your claim. But, we must either approve
or deny your claim within 45 days after requesting more time.

(1)

the limit of liability under this policy applicable to the

damaged or destroyed building structure(s);

(2)

the cost to repair or replace that part of the building

structure(s) damaged, with material of like kind and
quality and for the same use and occupancy on the
same premises; or

(3)

the amount actually and necessarily spent to repair or

replace the damaged building structure(s).

4. Loss Settlement. Covered property losses are settled as

follows:
a.

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If, at the time of loss, the actual cash value of the

damaged building structure(s) is greater than the replacement cost determined under (1) or (2) above, we
will pay the actual cash value up to the applicable limit
of liability.

Our limit of liability and payment for covered losses to personal property, wall to wall carpeting, cloth awnings and
fences will not exceed the smallest of the following:

5.
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Loss to a Pair or Set. In case of loss to an item which is part of

a pair or set, the measure of loss shall be a reasonable and fair

property covered by this policy, but other insurance covering

the dwelling is not permitted. If a loss covered by this policy is
also covered by other insurance, we will pay only the proportion
of the loss that the limit of liability that applies under this policy
bears to the total amount of insurance covering the loss.

proportion of the total value of the pair or set. The importance of

the item will be considered in assessing the loss. Such loss will
not be considered a total loss of the pair or set.
6. Salvage Rights. If we notify you that we will pay your claim or
part of your claim, the notice must also state whether we will or
will not take all or any part of the damaged property. We must
bear the expense of our salvage rights.
7.

Appraisal. If you and we fail to agree on the actual cash value,

amount of loss, or cost of repair or replacement, either can make
a written demand for appraisal. Each will then select a competent, independent appraiser and notify the other of the appraisers
identity within 20 days of receipt of the written demand. The two
appraisers will choose an umpire. If they cannot agree upon an
umpire within 15 days, you or we may request that the choice be
made by a judge of a district court of a judicial district where the
loss occurred. The two appraisers will then set the amount of
loss, stating separately the actual cash value and loss to each
item. If you or we request that they do so, the appraisers will also
set:

11.

Suit Against Us. No suit or action can be brought unless the

policy provisions have been complied with. Action brought against
us must be started within two years and one day after the cause
of action accrues.

12.

Abandonment of Property. There can be no abandonment

of property to us.

13.

Vacancy. If the insured moves from the dwelling and a substantial part of the personal property is removed from that dwelling, the dwelling will be considered vacant. Coverage that applies under Coverage A (Dwelling) will be suspended effective 60
days after the dwelling becomes vacant. This coverage will
remain suspended during such vacancy.

14.

Mortgage Clause (without contribution).

a.

the full replacement cost of the dwelling.

a. The word mortgagee includes trustee.

b.

the full replacement cost of any other building upon which

loss is claimed.

c.

the full cost of repair or replacement of loss to such building,

without deduction for depreciation.

b. We will pay for any covered loss of or damage to buildings or

structures to the mortgagee shown on the declarations page
as interests appear.
c. The mortgagee has the right to receive loss payment even if
the mortgagee has started foreclosure or similar action on
the building or structure.

If the appraisers fail to agree, they will submit their differences to

the umpire. An itemized decision agreed to by any two of these
three and filed with us will set the amount of the loss. Such
award shall be binding on you and us.

d. If we deny your claim because of your acts or because you

have failed to comply with the terms of this policy, the mortgagee has the right to receive loss payment if the mortgagee:

Each party will pay its own appraiser and bear the other expenses of the appraisal and umpire equally.
8. Loss Payment.

(1)

at our request, pays any premiums due under this

policy, if you have failed to do so.

a.

If we notify you that we will pay your claim, or part of your

claim, we must pay within 5 business days after we notify
you.

(2)

submits a signed, sworn statement of loss within 91

days after receiving notice from us of your failure to
do so.

b.

If payment of your claim or part of your claim requires the

performance of an act by you, we must pay within 5 business days after the date you perform the act.

(3)

has notified us of any change in ownership, occupancy or substantial change in risk known to the
mortgagee.

9. Catastrophe Claims.

All of the terms of this policy will then apply directly to

the mortgagee. Failure of the mortgagee to comply
with d.(1), d.(2) or d.(3) above shall void this policy as
to the interest of the mortgagee.

If a claim results from a weather related catastrophe or a major

natural disaster, each claim handling deadline shown under the
Duties After Loss and Loss Payment provisions is extended for
an additional 15 days.

e. If we pay the mortgagee for any loss or damage and deny

payment to you because of your acts or because you have
failed to comply with the terms of this policy:

Catastrophe or Major Natural Disaster means a weather related

event which:
a.

is declared a disaster under the Texas Disaster Act of 1975;

or

(1)

the mortgagees rights under the mortgage will be

transferred to us to the extent of the amount we pay.

b.

is determined to be a catastrophe by the State Board of

Insurance.

(2)

the mortgagees right to recover the full amount of the

mortgagees claim will not be impaired.

10.
HO-B

At our option, we may pay to the mortgagee the

Other Insurance - Section I. Other insurance is permitted on

-8-8-

f.

whole principal on the mortgage plus any accrued

interest. In this event, your mortgage and note will
be transferred to us and you will pay your remaining
mortgage debt to us.

g. If the property described under Coverage A (Dwelling)

is foreclosed upon under the deed of trust, the mortgagee may cancel this policy of insurance and will be
entitled to any unearned premiums from this policy.

If this policy is cancelled, we will give the mortgagee

specifically named on the declarations page written
notice of cancellation.
If we cancel the policy, we will give the mortgagee the
same number of days notice of cancellation we give you.

The mortgagee must credit any unearned premium

against any deficiency owed by the borrower and return
any unearned premium not so credited to the borrower.
The unearned premium will be figured using the customary pro rata procedures.

If you cancel the policy, we will give the mortgagee

notice of cancellation to be effective on the date stated
in the notice. The date of cancellation cannot be before
the 10th day after the date we mail notice.

h. If we elect not to renew this policy, the mortgagee specifically named on the declarations page will be given 30
days written notice of the non-renewal.
15. No Benefit to Bailee. We will not recognize any assignment or grant any coverage for the benefit of a person or
organization holding, storing or moving property for a fee.

We will not give notice of cancellation to any successor

or assignee of the mortgagee named in this policy.

SECTION II - LIABILITY COVERAGE

funeral services. This coverage does not apply to you or regular residents of your household. This coverage does apply to
residence employees. As to others, this coverage applies
only:

COVERAGE C (Personal Liability)

If a claim is made or a suit is brought against an insured for
damages because of bodily injury or property damage
caused by an occurrence to which this coverage applies, we
will:
1. pay up to our limit of liability for the damages for which
the insured is legally liable. Damages include prejudgment interest awarded against the insured; and

1.

to a person on the insured location with the permission of an insured.

2.

to a person off the insured location, if the bodily injury:

2. provide a defense at our expense by counsel of our choice

even if the suit is groundless, false or fraudulent. We
may investigate and settle any claim or suit that we decide is appropriate.

a. arises out of a condition on the insured location or

the ways immediately adjoining.

COVERAGE D (Medical Payments to Others)

c. is caused by a residence employee in the course

of the residence employees employment by an
insured.

b. is caused by the activities of an insured.

We will pay the necessary medical expenses incurred or

medically determined within three years from the date of an
accident causing bodily injury. Medical expenses means
reasonable charges for medical, surgical, x-ray, dental, ambulance, hospital, professional nursing, prosthetic devices and

d. is caused by an animal owned by or in the care of

an insured.

SECTION II - EXCLUSIONS
(2)
1. Coverage C (Personal Liability) and Coverage D (Medical
Payments to Others) do not apply to:
a.

bodily injury or property damage which is caused intentionally by or at the direction of the insured;

b.

bodily injury or property damage arising out of or in connection with a business engaged in by an insured. But
this exclusion does not apply to activities which are ordinarily incidental to non-business pursuits.

c.

HO-B

(3)

in part, as an office, school or studio.

(4)

if the rental is for not more than three car spaces or

stalls in garages or stables.

d. bodily injury or property damage arising out of the rendering of or failure to render professional services.

bodily injury or property damage arising out of the rental

or holding for rental of any part of any premises by an insured. This exclusion does not apply to the rental or holding for rental of an insured location:
(1)

in part for use only as a residence, unless a single

family unit is intended for use by the occupying family
to lodge more than two roomers or boarders.

e. bodily injury or property damage arising out of a premises:

on an occasional basis if used only as a residence.

-9-9-

(1)

owned by an insured;

(2)

rented to an insured; or

(3)

writing within 45 days after you acquire

the outboard motors.

rented to others by an insured;

that is not an insured location.

(b)

This exclusion does not apply to bodily injury to a residence

employee arising out of and in the course of the residence
employees employment by an insured.
f.

(3)

bodily injury or property damage arising out of the ownership, maintenance, operation, use, loading or unloading of:
(1)
motor or engine propelled vehicles or machines designed for movement on land, including attached
machinery or equipment;
(2)

This exclusion does not apply to bodily injury to a residence

employee arising out of and in the course of the residence
employees employment by an insured.

trailers, semi-trailers or mobile homes;

h.

However, this exclusion does not apply to:

(a) used for assisting the handicapped.

used to service an insured location.

(c)

golf carts while on the residence premises or

used for golfing purposes.

(d)

This exclusion does not apply to bodily injury to a residence

employee arising out of and in the course of the residence
employees employment by an insured.
i.

(1) the entrustment by an insured to any person; or

(i)

not owned by an insured; or

(2) the negligent supervision by an insured of any person;

(ii)

owned by an insured while on the residence premises.

with regard to the ownership, maintenance or use of any motor

vehicle, watercraft or aircraft which is excluded in paragraph
f., g. or h. above.

(e)

in dead storage on the residence premises.

(f)

used exclusively on the residence premises.

This exclusion does not apply to bodily injury to a residence

employee arising out of and in the course of the residence
employees employment by an insured.

trailers or semi-trailers while not being towed by or

carried on a motor vehicle.
This exclusion does not apply to bodily injury to a residence employee arising out of and in the course of the
residence employees employment by an insured.

HO-B

j.

bodily injury or property damage arising out of the ownership, maintenance, operation, use, loading or unloading of
watercraft:
(1)

with inboard or inboard-outdrive motor power of more

than 50 horsepower owned by or rented to an insured.

(2)

powered by one or more outboard motors with more

than 25 total horsepower if the outboard motor is owned
by an insured. But, outboard motors of more than 25
total horsepower are covered for the policy period if:
(a)

bodily injury or property damage arising out of:

designed and used for recreational purposes;

and are:

(2)

g.

bodily injury or property damage arising out of the ownership, maintenance, operation, use, loading or unloading of
aircraft.
Aircraft means any device used or designed for flight, except
model or hobby aircraft not used or designed to carry people
or cargo.

motor vehicles which are not subject to motor vehicle

registration and are:

(b)

that is a sailing vessel, with or without auxiliary power,

which is 26 feet or more in length owned by or rented
to an insured.

This exclusion does not apply while the watercraft is on the residence premises.

which are owned or operated by or rented or loaned to an

insured.

(1)

you acquire them during the policy period.

k.

l.

you declare them at policy inception; or

(ii)

your intention to insure is reported to us in

bodily injury to any person eligible to receive any benefits

voluntarily provided or required to be provided by an insured
under any workers compensation law or occupational disease law.

2. Coverage C (Personal Liability) does not apply to:

you acquire them prior to the policy period and:

(i)

bodily injury or property damage caused directly or indirectly by war. This includes undeclared war, civil war, insurrection, rebellion, revolution, warlike act by a military force or
military personnel, destruction or seizure or use for a military
purpose, and any consequence of these. Discharge of a
nuclear weapon will be deemed a warlike act even if accidental.
bodily injury or property damage arising out of the transmission of sickness or disease by an insured through sexual
contact.

a.

liability under any contract or agreement.

However, this exclusion does not apply to written contracts:

-10-10-

(1)

that directly relate to the ownership, maintenance or

use of an insured location; or

(2)

where the liability of others is assumed by an insured;

Nuclear Insurers, Mutual Atomic Energy Liability Underwriters, or Nuclear Insurance Association of Canada.
e. bodily injury to you or an insured within the meaning of part
a. or part b. of insured as defined.

unless excluded elsewhere in this policy.

b.

3.

property damage to property owned by an insured.

a. bodily injury to a residence employee if the bodily injury:

c.

property damage to property rented to, occupied or used

by or in the care of an insured.
This exclusion does not apply to property damage caused by
fire, smoke or explosion.
d.

Coverage D (Medical Payments to Others) does not apply

to:

(1) occurs off the insured location; and

(2)

bodily injury or property damage for which an insured

under this policy is also an insured under a nuclear energy
liability policy or would be an insured under that policy but for
the exhaustion of its limit of liability.

does not arise out of or in the course of the residence

employees employment by an insured.

b. bodily injury to any person, other than a residence

employee of an insured, regularly residing on any
part of the insured location.

A nuclear energy liability policy is one issued by American

SECTION II - ADDITIONAL COVERAGES

We cover the following in addition to the limits of liability:

of others caused by an insured.

1. Claim Expenses. We pay:

We do not pay for property damage:

a.

expenses we incur and costs taxed against an insured in

any suit we defend.

a. caused intentionally by an insured who is 13 years of age

or older.

b.

premiums on bonds required in a suit we defend but not for

bond amounts more than the limit of liability for Coverage C
(Personal Liability). We need not apply for or furnish any
bond.

b. to property owned by an insured.

reasonable expenses incurred by an insured at our request, including actual loss of earnings (but not loss of
other income) up to $50 per day, for assisting us in the
investigation or defense of a claim or suit.

d. arising out of:

c.

d.

2.

3.

c. to property owned by or rented to a tenant of an insured or

a resident in your household.

(1) a business engaged in by an insured.

interest on the entire judgment which accrues after entry of

the judgment and before we pay or tender, or deposit in
court that part of the judgment which does not exceed the
limit of liability that applies.

Imperative Medical Expenses to Others. We pay expenses

incurred by an insured for immediate medical and surgical
relief to others if imperative at the time of the accident.

(2)

any act or omission in connection with a premises

owned, rented or controlled by an insured, other
than the insured location.

(3)

the ownership, maintenance, use, loading or unloading of aircraft, watercraft or motor vehicles or all other
motorized land conveyances.

This exclusion does not apply to any motorized land conveyance designed for recreational use off public roads, not
subject to motor vehicle registration and not owned by an
insured.

Damage to Property of Others. We pay replacement cost

up to $500 per occurrence for property damage to property

SECTION II - CONDITIONS
of our liability for all expenses payable to two or more
1. Limit of Liability. The limit of liability for Coverage C
persons injured in one accident is $25,000.
(Personal Liability) shown on the declarations page is our
total liability under Coverage C (Personal Liability) for all
2. Severability of Insurance. This insurance applies separately
damages resulting from any one occurrence. This limit
to each insured. This condition will not increase our limit of
is the same regardless of the number of insureds, claims
liability
for any one occurrence.
made or persons injured.
3.

The limit of liability for Coverage D (Medical Payments to

Others) shown on the declarations page is our total liability under Coverage D (Medical Payments to Others)
for all medical expense payable for bodily injury to
one person as the result of one accident. The total limit
HO-B

Duties After Loss. In case of an accident or occurrence, the

insured will perform the following duties that apply or will help us
by seeing that these duties are performed:
a. Give written notice to us or our agent as soon as is practical,
which sets forth:

-11-11-

(1)

there has been compliance with the policy provisions.

the identity of the policy and insured.

(2)

reasonably available information on the time, place

and circumstances of the accident or occurrence.

(3)

names and addresses of any claimants and witnesses.

No one will have the right to join us as a party to any action against
an insured. Also, no action with respect to Coverage C (Personal
Liability) can be brought against us until the obligation of the insured has been determined by final judgment or agreement.
Under Coverage D (Medical Payments to Others), no action can
be brought until 30 days after the required proofs of claim have
been filed with us.

b. Promptly forward to us every notice, demand, summons or

other process relating to the accident or occurrence.
c. At our request, help us:

4.

7.

Bankruptcy of the Insured. Bankruptcy or insolvency of the

insured or of the insureds estate will not relieve us of our obligations under this policy.

8.

with the conduct of suits, including attending hearings

and trials.

Other Insurance - Section II. If the insured has other insurance

under Coverage C (Personal Liability), we will not be liable for a
greater proportion of a loss than the limit of liability shown on the
declarations page bears to the total limit of all valid and collectible
insurance against such loss.

to secure evidence and obtain the attendance of witnesses.

However, with respect to loss arising out of the ownership, maintenance, operation, use, loading or unloading of:

(1)

to make settlement.

(2)

to enforce any right of contribution or indemnity against

any person or organization who may be liable to an
insured.

(3)
(4)

d. The insured will not, except at the insureds own cost, voluntarily make payment, assume obligation or incur expense
other than for immediate medical and surgical relief to others
at the time of the bodily injury.

a.

any motor vehicle or recreational motor vehicle at the residence premises; or

b.

watercraft,

Duties of an Injured Person - Coverage D (Medical Payments to Others).

this policy will not apply to the extent that any valid and collectible
insurance is available to the insured.
9.

The injured person or someone acting for the injured person will:
a. give us written proof of claim, under oath if required,
as soon as is practical.

Notice of Settlement of Liability Claim.

a.

We will notify the insured in writing of any initial offer to compromise or settle a claim against the insured under the liability section of this policy. We will give the insured notice
within 10 days after the date the offer is made.

b.

We will notify the insured in writing of any settlement of a

claim against the insured under the liability section of this
policy. We will give the insured notice within 30 days after
the date of the settlement.

b. authorize us to obtain copies of medical reports and records.

5.

The injured person will submit to a physical exam by a doctor of

our choice when and as often as we reasonably require.
Payment of Claim - Coverage D (Medical Payments to
Others). Payment under this coverage is not an admission of
liability by an insured or us.

6.

Suit Against Us. No action can be brought against us unless

SECTION I AND II - CONDITIONS

Policy Period. This policy applies only to loss in Sec4. Waiver or Change of Policy Provisions. Changes in
tion I or bodily injury or property damage in Section
this policy may be made and perils added only by attachII which occurs during the policy period stated on the
ing a written endorsement properly executed by our audeclarations page.
thorized agent. No provision of this policy may be waived
unless the terms of this policy allow the provision to be
2. Concealment or Fraud. This policy is void as to you
waived. Our request for an appraisal or examination will
and any other insured, if you or any other insured unnot waive any of our rights.
der this policy has intentionally concealed or misrepresented any material fact or circumstance, made false
5. Cancellation.
statements or committed fraud relating to this insurance,
a. You may cancel this policy at any time by notifying us of the
whether before or after a loss.
date cancellation is to take effect. We will send you any
3. Liberalization Clause. If the State Board of Insurance
refund due when the policy is returned to us.
adopts a revision which would broaden or extend the covb. We may cancel this policy for the reasons stated in this conerage under this policy without additional premium within
dition by mailing you notice in writing of the date cancellation
45 days prior to or during the policy period, the broadtakes effect.
ened or extended coverage will immediately apply to this
policy.
1.

HO-B

-12-12-

(1)

If this policy has been in effect for less than 90 days

and is not a renewal policy, we may cancel this policy
for any reason.

If you have filed two claims in a period of less than three years,
we may notify you in writing, that if you file a third claim during
the three year period, we may refuse to renew this policy by
providing you proper notice of our refusal to renew as provided
in d. below. If we do not notify you after the second claim, we
may not refuse to renew this policy because of losses.

The effective date of cancellation cannot be before:

(a)
(b)
(2)

the 10th day after we mail notice if we cancel for

non-payment of premium.

A claim does not include a claim that is filed but is not paid or
payable under the policy.

the 30th day after we mail notice if we cancel for

any other reason.

d.

If this policy has been in effect 90 days or more, we

may not cancel this policy unless:
(a)

you do not pay the premium or any portion of

the premium when due.

(b)

the State Board of Insurance determines that

continuation of the policy would violate the Texas
Insurance Code or any other laws governing the
business of insurance in this state.

7.

Assignment . Assignment of this policy will not be valid unless

we give our written consent.

(c)

you submit a fraudulent claim.

8.

(d)

there is an increase in hazard covered by this

policy that is within your control and that would
produce an increase in the premium/rate of this
policy.

Subrogation. An insured may waive in writing before a loss all

rights of recovery against any person. If not waived, we may require an assignment of rights of recovery for a loss to the extent
that payment is made by us.
If an assignment is sought, an insured must sign and deliver all
related papers and cooperate with us.

The effective date of cancellation cannot be before the

10th day after we mail the notice. Our notice of cancellation must state the reason for cancellation.
c.

Subrogation does not apply under Section II to Medical Payments

to Others or Damage to Property of Others.
9.

If we cancel, our notice to you will state that if the refund is not
included with the notice, it will be returned on demand.

We may not cancel this policy solely because you are an

elected official.
6. Refusal to Renew.

Death. If the named insured dies, we insure:

a.

the named insureds spouse, if a resident of the same household at the time of death.

b.

the legal representative of the deceased. However, if this legal

representative was not an insured at the time of death of the
named insured, this policy will apply to such legal representative only with respect to the premises of the original named
insured.

c.

any person who is an insured at the time of such death,

while a resident of said premises.

d.

a.

We may not refuse to renew this policy because of claims for

losses resulting from natural causes.

b.

We may not refuse to renew this policy solely because you

are an elected official.

c.

We may refuse to renew this policy if you have filed three or

more claims under the policy in any three year period that do
not result from natural causes.

Prescribed by the Texas Department of Insurance

Homeowners Form B - Effective July 8, 1992
(Revised January 1, 2002)
HO-B

If we refuse to renew this policy, we must deliver to you, or

mail to you at your mailing address shown on the declarations page and any mortgagee named in the declarations
page, written notice of our refusal to renew not later than the
30th day before the date in which this policy expires. Proof of
mailing will be sufficient proof of notice. If we fail to give you
proper notice of our decision not to renew, you may require us
to renew the policy.

-13-13-

QUICK REFERENCE
TEXAS HOMEOWNERS POLICY - FORM C
Insuring Agreement 1
Definitions 1

Coverage C Exclusions. 11
Coverage D Exclusions. 11

SECTION I - PROPERTY COVERAGE

1
1

Section II Conditions
Limit of Liability
Severability of Insurance..
Duties After Loss.
Duties of an Injured Person..
Payment of Claim under Coverage D.
Suit Against Us
Bankruptcy of the Insured.
Other Insurance..
Notice of Settlement of Liability Claim.

2
2
2
2
2
2
3
3
3
3
3
3
3

Policy Period..
Concealment or Fraud..
Liberalization Clause
Waiver or Change of Policy Provisions.
Cancellation
Refusal to Renew.
Assignment.
Subrogation
Death..

Exclusions.. 3

Deductibles. 6

6
6

SECTION II LIABILITY COVERAGE

Coverage C (Personal Liability)... 9
Coverage D (Medical Payments to Others).. 9
Exclusions
Coverage C and D Exclusions. 10
Prescribed by the Texas Department of Insurance
Homeowners Form C - Effective July 8, 1992
(Revised January 1, 2002)

13
13
13
13
13
13
14
14
14

YOUR DUTIES AFTER A LOSS

en

6
7
7
8
8
8
8
8
8
8
9
9
9
9

im

Section I - Conditions
Insurable Interest and Limit of Liability.
Residential Community Property Clause.
Duties After Loss
Your Duties After Loss..
Our Duties After Loss
Loss Settlement
Loss to a Pair or Set
Salvage Rights.
Appraisal..
Loss Payment..
Catastrophe Claims.
Other Insurance..
Suit Against Us
Abandonment of Property.
Vacancy - Suspension of Coverage.
Mortgage Clause.
No Benefit to Bailee

12
12
12
12
12
12
12
12
13

POLICY CONDITIONS
APPLYING TO SECTIONS I AND II

ec

sp

Coverage A
Dwelling.
Other Structures..
Coverage B
Personal Property
Personal Property Off Premises
Special Limits of Liability...
Property Not Covered
Extensions of Coverage
Debris Removal
Loss of Use..
Reasonable Repairs
Trees, Shrubs, Plants and Lawns.
Property Removed..
Consequential Loss.
Automatic Removal.
Perils Insured Against
Coverage A (Dwelling)
Coverage B (Personal Property)..

Section II Additional Coverages

Claim Expenses.. 11
Imperative Medical Expenses to Others. 12
Damage to Property of Others. 12

Section I:
1.
2.
3.
4.

Protect the property from further damage.

Give prompt written notice to the company.
Call the police if a law has been broken.
Make a list of all damaged personal property,
including costs.
5. If requested, obtain proof of loss form from
your
agent or the company and submit within 91
days of the request.

Section II:
1. Do not make any voluntary payments except
for
first aid to others at the time of the accident.
2. Give written notice to agent or company,
including details about the accident and any
witnesses.
3. Send copies of legal notices you receive to the
company.
4. Help the company get the necessary
information to make settlement.
FOR A COMPLETE LIST OF YOUR DUTIES SEE
PAGES 6 AND 12 OF YOUR POLICY.

HOMEOWNERS FORM C
AGREEMENT
We will provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of
this policy.
DEFINITIONS
In this policy, you and your refer to the named insured
shown on the declarations page and the spouse if a resident of the same household. We, us and our refer to
the Company providing this insurance. In addition, certain
words and phrases are defined as follows:
c.
1. Bodily injury means bodily harm, sickness or disease.
This includes required care, loss of services and death
that results.

(1)

which is shown on the declarations page; or

(2)

which you acquire during the policy period

for your use as a residence.

any premises you use in connection with a premises in 5.a. or 5.b. above.

d. any part of a premises:

2. Business includes trade, profession or occupation.

(1)

not owned by an insured; and

3. Business day, when used in this policy means a day

other than a Saturday, Sunday or holiday recognized
by the state of Texas.

(2)

where an insured is temporarily residing.

e. vacant land, other than farm land, owned by or

rented to an insured.

4. Insured means you and residents of your household

who are:

sp

f.

a.

your relatives; or

b.

other persons under the age of 21 and in the

care of any person named above.

g. individual or family cemetery plots or burial vaults

of an insured.

ec

Under Section II Liability, insured also means:

c.

any person or organization legally responsible for

animals or watercraft to which this policy applies.
You or a person included in 4.a. or 4.b. above
must own the animal or watercraft. A person or
organization using or having custody of these
animals or watercraft without consent of the owner
is not an insured.

h. any part of a premises occasionally rented to an

insured for other than business use.
6. Occurrence means an accident, including exposure
to conditions, which results in bodily injury or property damage during the policy period.

im

d.

land owned by or rented to an insured on which a

one or two family dwelling is being built as a residence for an insured.

7. Property damage means injury to, destruction of, or

loss of use of property.

With respect to any vehicle to which this policy

applies:

en

8. Residence employee means an employee of an insured who performs duties related to the ownership,
maintenance or use of the residence premises, including maintenance or use of a motor vehicle. This
includes employees who perform similar duties elsewhere for an insured. This does not include employees while performing duties related to the business of
an insured.

(1) any employee of an insured while engaged

in the employment of the insured; or
(2)

any other person using the vehicle on an

insured location with your consent.

5. Insured location means:

a.

the residence premises.

b.

the part of other premises, other structures and

grounds you use as a residence and:

9. Residence premises means the residence

premises shown on the declarations page. This
includes the one or two family dwelling, including
other structures, and grounds where an insured
resides or intends to reside within 60 days after the
effective date of this policy.

SECTION I PROPERTY COVERAGE

COVERAGE A (DWELLING)

The total limit of liability for other structures is the limit

of liability shown on the declaration page or 10% of the
Coverage A (Dwelling) limit of liability, whichever is
greater. This is additional insurance and does not reduce the Coverage A (Dwelling) limit of liability.
We do not cover other structures:
a. used for business purposes; or

We cover:
1.

the dwelling on the residence premises shown on

the declarations page including structures attached
to the dwelling.

2.

other structures on the residence premises set apart

from the dwelling by clear space. This includes structures connected to the dwelling by only a fence, utility
line or similar connection.

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b. wholly rented to any person, unless used solely

as a private garage.
3.
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wall to wall carpeting attached to a building on the resi-

equipment.

dence premises.

However, we do cover such vehicles which are not

subject to motor vehicle registration and are:

COVERAGE B (PERSONAL PROPERTY)

We cover:
1.

2.

3.

4.

personal property owned, worn or used by an insured

while on the residence premises. This includes window or wall air conditioning units.
at your request, property of others while the property
is on the part of the residence premises occupied by
an insured.
personal property owned, worn or used by an insured
anywhere in the world. Our limit of liability for personal
property usually located at an insureds residence
other than the residence premises is 10% of the limit
of liability for Coverage B (Personal Property) or $1,000,
whichever is greater. This is additional insurance and
does not reduce the Coverage B (Personal Property)
limit of liability.

4.

a.

devices and equipment for assisting the handicapped.

b.

power mowers.

c.

golf carts.

d.

vehicles or machines used for recreational purposes while located on the residence premises.

e.

farm equipment not designed for use principally

on public roads.

trailers, semi-trailers or mobile homes.

However, we do cover:

at your request, personal property of a residence

employee when:

a.

trailers and semi-trailers that are designed for use

principally off public roads.

b.

boat trailers while on the residence premises.

the property is away from the residence

premises of the residence employee and in the
control of the residence employee; and

5.

aircraft, meaning any device used or designed for flight,

except model or hobby aircraft not used or designed
to carry people or cargo.

b.

while the residence employee is performing work

for you.

6.

watercraft, including outboard motors and furnishings

or equipment.

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a.

This is additional insurance and does not reduce the

Coverage B (Personal Property) limit of liability.

7.

property of roomers or tenants.

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SPECIAL LIMITS OF LIABILITY. These limits do not increase the Coverage B (Personal Property) limit of liability.
The special limit for each numbered category below is the
total limit for each loss for all property in that category.

We do cover watercraft, including outboard motors and

furnishings or equipment, while located on land on the
residence premises.

Money/Bank Cards. $100 on money or numismatic

property or loss by theft or unauthorized use of bank
fund transfer cards registered to an insured.

2.

Bullion/Valuable Papers. $500 on gold or silver bullion,

manuscripts, notes, securities, stamps,
philatelic property, accounts, bills, deeds, evidences
of debt, letters of credit, passports, documents, transportation or other tickets.

3.

Jewelry/Watches/Furs. $500 for loss by theft or mysterious disappearance of gems, watches, jewelry or
furs.

4.

Business Personal Property. $2,500 on business

property.

8.

EXTENSIONS OF COVERAGE.
1.

that consists of samples or articles for sale or delivery; or

b.

if the property is away from the residence premises.

DEBRIS REMOVAL. We will pay your expense for

the removal from the residence premises of:
a.

debris of covered property if a Peril Insured

Against causes the loss.

b.

a tree that has damaged covered property if a

Peril Insured Against causes the tree to fall.

This does not increase the limit of liability that applies

to the damaged property.
2.

We do not cover any business property:

a.

property usually rented to others off the residence

premises.

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1.

LOSS OF USE. If a loss caused by a Peril Insured

Against under Section I makes the residence premises wholly or partially untenantable, we cover:
a.

additional living expense, meaning any necessary and reasonable increase in living expense
you incur so that your household can maintain its
normal standard of living.

b.

fair rental value, meaning the fair rental value of

that part of the residence premises usually
rented to others by you, less any expenses that
do not continue.

PROPERTY NOT COVERED. We do not cover:

1.

articles separately described and specifically insured

by this or other insurance.

2.

animals or birds.

3.

motor or engine propelled vehicles or machines designed

for movement on land, including attached machinery or

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The total limit of liability for all loss of use is 20% of the
Coverage A (Dwelling) limit of liability. This is additional
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insurance and does not reduce the Coverage A (Dwelling) limit of liability. The deductible clause does not
apply to loss of use coverage.

days at each location to which such property is removed

for preservation. This is not additional insurance and
does not increase the Coverage B (Personal Property)
limit of liability.

Payment will be for the reasonable time required to

repair or replace the damaged property. If you permanently relocate, payment will be for the reasonable time
required for your household to become settled.

6.

a. property contained in a building on the residence

premises against loss due to change in temperature as a direct result of physical damage to the
dwelling, or any equipment contained in the dwelling, caused by a Peril Insured Against. The deductible clause does not apply to this coverage.

The periods of time for loss of use are not limited by

expiration of this policy.
3.

4.

REASONABLE REPAIRS. If a Peril Insured Against

caused the loss, we will pay the reasonable cost you
incur for necessary repairs made solely to protect covered property from further damage. This coverage
does not increase the limit of liability that applies to
the property being repaired.

b. property contained in a building on the residence

premises against a loss due to change in temperature as a direct result of physical damage to
any power, heating or cooling equipment (including connections and supply pipes) not contained
in or on the dwelling, caused by a Peril Insured
Against.

TREES, SHRUBS, PLANTS AND LAWNS. We cover

trees, shrubs, plants and lawns, on the residence premises, only for loss caused by the following Perils Insured Against: Fire or Lightning, Explosion, Aircraft,
Vehicles not owned or operated by a resident of the
residence premises, Vandalism and Malicious Mischief, Riot and Civil Commotion and Theft or attempted
theft.

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The total limit of liability for the coverage described

in 6.b. above is $500. This is not additional insurance and does not increase the Coverage B (Personal Property) limit of liability.
7.

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The maximum limit of liability for this coverage is 5%

of the Coverage A (Dwelling) limit of liability. We will
not pay more than $250 for any one tree, shrub or
plant, including the cost of removal. We do not cover
property grown for business purposes.

AUTOMATIC REMOVAL. If you move from the residence premises shown on the declarations page to
another location within the United States, to be occupied as your principal residence, we cover:
a.

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This insurance is not additional insurance and does

not increase the Coverage A (Dwelling) limit of liability.
The deductible clause does not apply to trees, shrubs,
plants and lawns.

the personal property under Coverage B

(Personal Property) at each location in the proportion that the value at each location bears to the
total value of all the personal property covered
under Coverage B (Personal Property).

b. property in transit up to the Coverage B (Personal

Property) limit of liability.

PROPERTY REMOVED. We pay for expense and

damage incurred in the removal of covered property
from an insured location endangered by a Peril Insured
Against. This coverage exists on a pro rata basis for 30

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5.

CONSEQUENTIAL LOSS. We insure:

We provide coverage for only 30 days from the date the

removal begins.

SECTION I PERILS INSURED AGAINST

COVERAGE A (DWELLING) and
COVERAGE B (PERSONAL PROPERTY)

described in Section I Property Coverage, Coverage A (Dwelling) and Coverage B (Personal Property) unless the loss is
excluded in Section I Exclusions.

We insure against all risks of physical loss to the property

1.

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SECTION I EXCLUSIONS
The following exclusions apply to loss to property
b. We do not cover loss caused by smog or by smoke
described under Coverage A (Dwelling) or Coverage
from industrial or agricultural operations.
B (Personal Property), but they do not apply to an ensuing loss caused by fire, smoke or explosion.
This exclusion does not apply to loss caused by
accidental discharge, leakage or overflow of waa. We do not cover loss to electrical devices or wirter or steam from within a plumbing, heating or
ing caused by electricity other than lightning.
air conditioning system or household appliance.
This includes the cost of tearing out and replacThis exclusion does not apply to loss caused by
ing any part of the building necessary to repair or
accidental discharge, leakage or overflow of wareplace the system or appliance.
ter or steam from within a plumbing, heating or
air conditioning system or household appliance.
c. We do not cover loss caused by windstorm, hurThis includes the cost of tearing out and replacricane or hail to:
ing any part of the building necessary to repair or
replace the system or appliance.
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(2) rust or rot.

(1) cloth awnings, greenhouses and their contents,

buildings or structures located wholly or partially over water and their contents.
(2)

(3) dampness of atmosphere, extremes of temperature.

radio and television towers, outside satellite

dishes, masts and antennas, including leadin wiring, windchargers and windmills.

(4) contamination.
(5) rats, mice, termites, moths or other insects.

This exclusion does not apply to loss caused by

accidental discharge, leakage or overflow of water from within a plumbing, heating or air conditioning system or household appliance. This includes the cost of tearing out and replacing any
part of the building necessary to repair or replace
the system or appliance.
d.

This exclusion does not apply to loss caused by accidental discharge, leakage or overflow of water or
steam from within a plumbing, heating or air conditioning system or household appliance. This includes
the cost of tearing out and replacing any part of the
building necessary to repair or replace the system or
appliance.

We do not cover loss caused by or resulting

from flood, surface water, tidal water or tidal
waves, overflow of streams or other bodies of
water, or spray from any of these whether or not
driven by wind.

We do cover ensuing loss caused by the collapse of

building or any part of the building, water damage or
breakage of glass which is part of the building, if the
loss would otherwise be covered under this policy.

This exclusion does not apply to:

(1)

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(2)

j.

loss by theft or attempted theft or any act

or attempted act of stealing and loss of
property from a known place when it is likely
that the property has been stolen.

This exclusion does not apply to loss caused by accidental discharge, leakage or overflow of water or steam
from within a plumbing, heating or air conditioning system or household appliance. This includes the cost of
tearing out and replacing any part of the building necessary to repair or replace the system or appliance.

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loss to personal property located at premises

which are not owned, rented, occupied or
controlled by an insured or any other person whose property is insured under this
policy.

We do cover ensuing loss caused by the collapse of

building or any part of the building, water damage or
breakage of glass which is part of the building, if the
loss would otherwise be covered under this policy.

e. We do not cover loss caused by or resulting from freezing while the building is unoccupied unless you have
used reasonable care to:
maintain heat in the building; or

(2)

shut off the water supply and drain plumbing,

heating and air conditioning systems of water.

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f.

(1)

k. We do not cover loss under Coverage A (Dwelling)

caused by settling, cracking, bulging, shrinkage, or expansion of foundations, walls, floors, ceilings, roof structures, walks, drives, curbs, fences, retaining walls or
swimming pools.

We do not cover loss by theft or attempted theft or

mysterious disappearance of building materials or
supplies not on the residence premises.

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This exclusion does not apply to loss caused by accidental discharge, leakage or overflow of water or steam
from within a plumbing, heating or air conditioning system or household appliance. This includes the cost of
tearing out and replacing any part of the building necessary to repair or replace the system or appliance.

This exclusion does not apply to loss caused by accidental discharge, leakage or overflow of water or
steam from within a plumbing, heating or air conditioning system or household appliance. This includes
the cost of tearing out and replacing any part of the
building necessary to repair or replace the system or
appliance.

We do cover ensuing loss caused by the collapse of

building or any part of the building, water damage or
breakage of glass which is part of the building, if the
loss would otherwise be covered under this policy.

g. We do not cover loss caused by earthquake, landslide or earth movement.

l.

h. We do not cover loss to machinery, appliances and

mechanical devices caused by mechanical breakdown.
This exclusion does not apply to loss caused by accidental discharge, leakage or overflow of water or
steam from within a plumbing, heating or air conditioning system or household appliance. This includes
the cost of tearing out and replacing any part of the
building necessary to repair or replace the system or
appliance.
i.

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We do not cover loss under Coverage B (Personal Property) caused by or resulting from cleaning, refinishing,
restoring, renovating or repairing property other than
gems, watches, jewelry and furs.
This exclusion does not apply to loss caused by accidental discharge, leakage or overflow of water or steam
from within a plumbing, heating or air conditioning system or household appliance. This includes the cost of
tearing out and replacing any part of the building necessary to repair or replace the system or appliance.

We do not cover loss caused by:

(1)

We do not cover loss caused by animals or birds

owned or kept by an insured or occupant of the residence premises.

m. We do not cover loss under Coverage B

(Personal Property) caused by:

wear and tear, deterioration or loss caused by

any quality in property that causes it to damage
or destroy itself.

(1) the seizure or destruction of property under quarantine or customs regulations.

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fungi or other microbes and any decontamination of

the residence premises or property.

(2) confiscation of property by order of any governmental authority.

This exclusion does not apply to loss caused by accidental discharge, leakage or overflow of water or steam
from within a plumbing, heating or air conditioning system or household appliance. This includes the cost of
tearing out and replacing any part of the building necessary to repair or replace the system or appliance.

2. GOVERNMENTAL ACTION.
We do not cover loss caused by the destruction of property by order of governmental authority.
But we do cover loss caused by acts of destruction ordered by governmental authority taken at the time of a fire
to prevent its spread, if the fire would be covered under
this policy.

n. We do not cover loss under Coverage B (Personal

Property) caused by breakage, marring or scratching of:
(1) eyeglasses, glassware, statuary, marbles.

3. BUILDING LAWS.

(2) bric-a-brac, porcelains and similar fragile articles

other than jewelry, watches, bronzes, cameras
and photographic lenses.

We do not cover loss caused by or resulting from the

enforcement of any ordinance or law regulating the construction, repair or demolition of a building or structure.

We do cover breakage, marring or scratching of covered property caused by or resulting from:

(2) explosion, riot, strikers.

(a) Coverage Provided.

(3) aircraft, vehicles, vandalism or malicious mischief.

You may use up to $5,000 (at no additional premium) for

the increased costs that you incur due to the enforcement of any ordinance or law, which requires or regulates:

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(1) fire, lightning, windstorm.

Building Laws exclusion is modified to provide cover

age only to the extent described under Perils Insured
Against.

(4) collapse of building or any part of a building.

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(5) accident to conveyance, theft or attempted

theft.
(6) any other similar casualty.

(2) the demolition and reconstruction of the undamaged part of a covered building or other structure, when that building or other structure must
be totally demolished because of damage by a
Peril Insured Against to another part of that covered building or other structure; or

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o. We do not cover loss caused by or resulting from mold,

fungi or other microbes.

(1) the construction, demolition or repair of that part

of a covered building or other structure damaged by a Peril Insured Against;

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However, we do cover ensuing mold, fungi or other

microbial losses caused by or resulting from sudden
and accidental discharge, leakage or overflow of water
or steam if the sudden and accidental discharge, leakage or overflow of water or steam loss would otherwise
be covered under this policy.

(3) the remodeling, removal or replacement of the

portion of the undamaged part of a covered building or other structure necessary to complete the
remodeling, repair or replacement of that part of
the covered building or other structure damaged
by a Peril Insured Against.

Sudden and accidental shall include a physical loss

that is hidden or concealed for a period of time until it
is detectable. A hidden loss must be reported to us no
later than 30 days after the date you detect or should
have detected the loss.

You may use all or part of this coverage to pay for the
increased costs you incur to remove debris resulting from
the construction, repair or replacement of property as
stated in (a). above.

For purposes of this exclusion, ensuing mold, fungi or

other microbial losses covered under this policy include reasonable and necessary repair or replacement
of property covered under Coverage A (Dwelling) and/
or Coverage B (Personal Property).

This is additional insurance and does not reduce Coverage A (Dwelling) the limit of liability.

We do not cover the cost for remediation, including for

testing of ensuing mold, fungi or other microbes. We
do not cover any increase in expenses for Loss of Use
and/or Debris Removal du to remediation and testing
of ensuing mold, fungi or other microbes.

(b) Building Ordinance or Law Coverage Limitations.

We will not pay for the increased cost of construction:

Remediate means to treat, contain, remove or dispose

of mold, fungi or other microbes beyond that which is
required to repair or replace the covered property physically damaged by water or steam. Remediation includes any testing to detect, measure or evaluate mold,
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(1) if the building or structure is not rebuilt or repaired;

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(2) if the rebuilt or repaired building or structure is

not intended for the same type occupancy as
the current building or structure;

fumes, acids, alkalis, chemicals and waste. Waste includes material to be recycled, reconditioned or reclaimed.
(d) If the insured property is located in an area which is
eligible for coverage through the Texas Windstorm
Insurance Association, the coverage described above,
also applies to the increased cost you incur due to
the repair, replacement or demolition required for the
dwelling to comply with the building specifications
contained in the Texas Windstorm Insurance
Associations plan of operation.

(3) until the building or structure is actually repaired

or rebuilt at the same premises; or
(4) unless the rebuilding or repairs are made as soon
as reasonably possible after the loss or damage, not to exceed 365 days after loss unless
you have requested in writing that this time limit
be extended for an additional 180 days.

All other Terms of the policy apply.

(c) We do not cover:
4. WAR DAMAGE.
(1) the loss in value to any covered building or other
structure due to the requirements of any ordinance or law; or

We do not cover loss resulting directly or indirectly from

war. This includes undeclared war, civil war, insurrection,
rebellion, revolution, warlike act by military personnel, destruction or seizure or use for a military purpose, and any
consequence of these. Discharge of a nuclear weapon
will be deemed a warlike act even if accidental.

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(2) the cost to comply with any ordinance or law

which requires any insured or others to test
for, monitor, clean up, remove, contain, treat,
detoxify or neutralize, or in any way respond to,
assess the affects of, pollutants on any covered
building or other structure.

5. NUCLEAR DAMAGE.

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Pollutants means any solid, liquid, gaseous or thermal

irritant or contaminant, including smoke, vapor, soot,

We do not cover loss resulting directly or indirectly from

nuclear reaction, radiation or radioactive contamination,
all whether controlled or uncontrolled or however caused.
We cover direct loss by fire resulting from nuclear reaction, radiation or radioactive contamination.

SECTION I DEDUCTIBLES

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DEDUCTIBLE CLAUSE 1 - WINDSTORM, HURRICANE,

HAIL OR WIND DRIVEN RAIN - The amount shown on the
declarations page for Deductible Clause 1 will be deducted
from the combined amount of each loss under Coverage A
(Dwelling) and Coverage B (Personal Property) that results
from windstorm, hurricane, hail or wind driven rain.

Clause 2 will be deducted from the combined amount of

each loss under Coverage A (Dwelling) and Coverage B
(Personal Property), unless the loss results from windstorm,
hurricane, hail or wind driven rain.

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If a single event causes loss by windstorm, hurricane, hail

or wind driven rain and loss by lightning, only the larger
deductible will apply.

DEDUCTIBLE CLAUSE 2 - ALL OTHER PERILS - The

amount shown on the declarations page for Deductible

SECTION I CONDITIONS
1. Insurable Interest and Limit of Liability. Even if more
than one person has an insurable interest in the property covered, we will not be liable in any one loss:

demand against the company for the full amount of such

policy. The provisions of this article shall not apply to
personal property.

a. to the insured for more than the amount of the

insureds interest at the time of loss; or

2. Residential Community Property Clause. This policy,

subject to all other terms and conditions, when covering residential community property, as defined by state
law, shall remain in full force and effect as to the interest of each spouse covered, irrespective of divorce or
change of ownership between the spouses unless excluded by endorsement attached to this policy, until the
expiration of the policy or until cancelled in accordance
with the terms and conditions of this policy.

b. for more than the applicable limit of liability.

Each time there is a loss to any building insured under
Coverage A (Dwelling), the amount of insurance applicable to that building for loss by fire will be reduced by
the amount of the loss. As repairs are made, the amount
of insurance will be reinstated up to the limit of liability
shown on the declarations page.

3. Duties After Loss.

Article 6.13. Policy A Liquidated Demand. A fire insurance policy, in case of a total loss by fire of property
insured, shall be held and considered to be a liquidated
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a. Your Duties After Loss. In case of a loss to covered property caused by a peril insured against, you
must:
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(1)

give prompt written notice to us of the facts

relating to the claim.

(2)

notify the police in case of loss by theft.

(iii)

b.
(3)

(4)

(5)

(a) protect the property from further

damage.

Our Duties After Loss.

(1)

(a)

(c) keep an accurate record of repair expenses.

If our acknowledgement of the claim is not in writing,

we will keep a record of the date, method and content
of our acknowledgement.

furnish a complete inventory of damaged personal property showing the quantity, description and amount of loss. Attach all bills, receipts and related documents which you have
that justify the figures in the inventory.

(b)
(c)

as often as we reasonably require:

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(c)

submit to examination under oath and

sign and swear to it.

(2)

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provide us with pertinent records and

documents we request and permit us to
make copies.

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send to us if we request, your signed sworn

proof of loss within 91 days of our request on a
standard form supplied by us. We must request a signed sworn proof of loss within 15
days after we receive your written notice, or we
waive our right to require a proof of loss. Such
waiver will not waive our other rights under this
policy.

(3)

the time and cause of loss.

(ii)

the interest of the insured and all

others in the property involved including all liens on the property.

(a)

within 15 business days; or

(b)

within 30 days if we have reason to believe

the loss resulted from arson.

If we do not approve payment of your claim or require

more time for processing your claim, we must:
(a)

give the reason for denying your claim; or

give the reasons we require more time to process your claim. But, we must either approve
or deny your claim within 45 days after requesting more time.

4. Loss Settlement. Covered property losses are settled as

follows:
a.

(iv) the actual cash value of each item

of property and the amount of loss
to each item.
If you elect to make claim under the
Replacement Cost Coverage of this
policy, this proof of loss shall also state,
to the best of your knowledge and belief:

(ii)

specify the information you must provide in

accordance with Your Duties After Loss (item
3.a. above).

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(i)

(i)

begin any investigation of the claim.

After we receive the information we request, we must

notify you in writing whether the claim will be paid or
has been denied or whether more information is
needed:

(b)

This proof of loss shall state, to the best

of your knowledge and belief:

(iii) other insurance which may cover

the loss.

(b)

acknowledge receipt of the claim.

We may request more information, if during the investigation of the claim such additional information is necessary.

(b)

(a)

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Within 15 days after we receive your written notice of

claim, we must:

(b) make reasonable and necessary repairs

to protect the property.

(a) provide us access to the damaged

property.

(6)

the full cost of repair or replacement

of loss without deduction for depreciation.

Our limit of liability and payment for covered losses to personal property, wall to wall carpeting, cloth awnings and
fences will not exceed the smallest of the following:
(1)

the actual cash value at the time of loss determined

with proper deduction for depreciation.

(2)

the cost to repair or replace the damaged property

with material of like kind and quality, with proper deduction for depreciation; or

(3) the specified limit of liability of the policy.

the replacement cost of the described dwelling.

b.

the replacement cost of any other

building on which loss is claimed.
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Our limit of liability for covered losses to dwelling and other

structure(s) under Coverage A (Dwelling), except wall to
wall carpeting, cloth awnings and fences, will be at replacement cost settlement subject to the following:

(1)

If, at the time of loss, the Coverage A (Dwelling) limit of

liability is 80% or more of the full replacement cost of
the dwelling, we will pay the repair or replacement
cost of the damaged building structure(s), without
deduction for depreciation.

(2)

If, at the time of loss, the Coverage A (Dwelling) limit

of liability is less than 80% of the full replacement
cost of the dwelling, we will pay only a proportionate
share of the full replacement cost of the damaged
building structure(s). Our share is equal to:

make a written demand for appraisal. Each will then select a

competent, independent appraiser and notify the other of the
appraisers identity within 20 days of receipt of the written demand. The two appraisers will choose an umpire. If they cannot
agree upon an umpire within 15 days, you or we may request
that the choice be made by a judge of a district court of a judicial
district where the loss occurred. The two appraisers will then set
the amount of loss, stating separately the actual cash value and
loss to each item. If you or we request that they do so, the
appraisers will also set:
a. the full replacement cost of the dwelling.

Replacement Cost of the Loss

X
Coverage A (Dwelling) Limit of Liability
80% of Replacement Cost of the Dwelling
(3)

b. the full replacement cost of any other building upon which

loss is claimed.
c.

If, at the time of loss, the actual cash value of the

damaged building structure(s) is greater than the replacement cost determined under (1) or (2) above, we
will pay the actual cash value up to the applicable limit
of liability.

the full cost of repair or replacement of loss to such building, without deduction for depreciation.

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If the appraisers fail to agree, they will submit their differences

to the umpire. An itemized decision agreed to by any two of
these three and filed with us will set the amount of the loss.
Such award shall be binding on you and us.

In determining the amount of insurance required to equal

80% of the full replacement cost of the dwelling, do not
include the value of excavations, underground pipes, and
wiring and foundations which are below the surface of the
ground.

Each party will pay its own appraiser and bear the other expenses of the appraisal and umpire equally.
8. Loss Payment.

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a.

If we notify you that we will pay your claim, or part of

your claim, we must pay within 5 business days after we
notify you.

b.

If payment of your claim or part of your claim requires the

performance of an act by you, we must pay within 5 business days after the date you perform the act.

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We will pay only the actual cash value of the damaged

building structure(s) until repair or replacement is completed. Repair or replacement must be completed within
365 days after loss unless you request in writing that this
time limit be extended for an additional 180 days. Upon
completion of repairs or replacement, we will pay the additional amount claimed under replacement cost coverage,
but our payment will not exceed the smallest of the following:

the limit of liability under this policy applicable to the

damaged or destroyed building structure(s);

(2)

the cost to repair or replace that part of the building

structure(s) damaged, with material of like kind and
quality and for the same use and occupancy on the
same premises; or

(3)

If a claim results from a weather related catastrophe or a major

natural disaster, each claim handling deadline shown under
the Duties After Loss and Loss Payment provisions is extended
for an additional 15 days.

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(1)

9. Catastrophe Claims.

Catastrophe or Major Natural Disaster means a weather related event which:

a. is declared a disaster under the Texas Disaster Act of
1975; or

the amount actually and necessarily spent to repair

or replace the damaged building structure(s).

b. is determined to be a catastrophe by the State Board of

Insurance.

5. Loss to a Pair or Set. In case of loss to an item which is part

of a pair or set, the measure of loss shall be a reasonable and
fair proportion of the total value of the pair or set. The importance of the item will be considered in assessing the loss. Such
loss will not be considered a total loss of the pair or set.
6.

10. Other Insurance - Section I. Other insurance is permitted

on property covered by this policy, but other insurance
covering the dwelling is not permitted. If a loss covered by
this policy is also covered by other insurance, we will pay only
the proportion of the loss that the limit of liability that applies
under this policy bears to the total amount of insurance covering the loss.

Salvage Rights. If we notify you that we will pay your claim or

part of your claim, the notice must also state whether we will or
will not take all or any part of the damaged property. We must
bear the expense of our salvage rights.

11.

7. Appraisal. If you and we fail to agree on the actual cash

value, amount of loss or cost of repair or replacement, either can
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-8-

Suit Against Us. No suit or action can be brought unless the

policy provisions have been complied with. Action brought
against us must be started within two years and one day after
the cause of action accrues.

12. Abandonment of Property. There can be no abandonment

of property to us.

(1)

the mortgagees rights under the mortgage will be

transferred to us to the extent of the amount we pay.

13. Vacancy. If the insured moves from the dwelling and a substantial part of the personal property is removed from that
dwelling, the dwelling will be considered vacant. Coverage
that applies under Coverage A (Dwelling) will be suspended
effective 60 days after the dwelling becomes vacant. This
coverage will remain suspended during such vacancy.

(2)

the mortgagees right to recover the full amount of

the mortgagees claim will not be impaired.

At our option, we may pay to the mortgagee the

whole principal on the mortgage plus any accrued
interest. In this event, your mortgage and note will
be transferred to us and you will pay your remaining mortgage debt to us.

14. Mortgage Clause (without contribution).

a. The word mortgagee includes trustee.

f.

b. We will pay for any covered loss of or damage to buildings

or structures to the mortgagee shown on the declarations
page as interests appear.

If we cancel the policy, we will give the mortgagee the

same number of days notice of cancellation we give you.

c. The mortgagee has the right to receive loss payment even

if the mortgagee has started foreclosure or similar action
on the building or structure.

If you cancel the policy, we will give the mortgagee notice

of cancellation to be effective on the date stated in the
notice. The date of cancellation cannot be before the
10th day after the date we mail notice.

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d. If we deny your claim because of your acts or because

you have failed to comply with the terms of this policy, the
mortgagee has the right to receive loss payment if the mortgagee:
at our request, pays any premiums due under this
policy, if you have failed to do so.

(2)

submits a signed, sworn statement of loss within 91

days after receiving notice from us of your failure to
do so.

(3)

has notified us of any change in ownership, occupancy or substantial change in risk known to the
mortgagee.

We will not give notice of cancellation to any successor

or assignee of the mortgagee named in this policy.
g. If the property described under Coverage A (Dwelling) is
foreclosed upon under the deed of trust, the mortgagee
may cancel this policy of insurance and will be entitled to
any unearned premiums from this policy.
The mortgagee must credit any unearned premium
against any deficiency owed by the borrower and return any unearned premium not so credited to the borrower. The unearned premium will be figured using
the customary pro rata procedures.

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(1)

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All of the terms of this policy will then apply directly

to the mortgagee.

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h. If we elect not to renew this policy, the mortgagee specifically named on the declarations page will be given 30
days written notice of the non-renewal.

Failure of the mortgagee to comply with d.(1), d.(2)

or d.(3) above shall void this policy as to the interest
of the mortgagee.
e.

If this policy is cancelled, we will give the mortgagee

specifically named on the declarations page written
notice of cancellation.

15. No Benefit to Bailee. We will not recognize any assignment or grant any coverage for the benefit of a person or
organization holding, storing or moving property for a fee.

If we pay the mortgagee for any loss or damage and deny

payment to you because of your acts or because you have
failed to comply with the terms of this policy:

SECTION II LIABILITY COVERAGE

COVERAGE C (Personal Liability)

COVERAGE D (Medical Payments to Others)

If a claim is made or a suit is brought against an insured for

damages because of bodily injury or property damage
caused by an occurrence to which this coverage applies,
we will:

We will pay the necessary medical expenses incurred or

medically determined within three years from the date of an
accident causing bodily injury. Medical expenses means
reasonable charges for medical, surgical, x-ray, dental, ambulance, hospital, professional nursing, prosthetic devices and
funeral services. This coverage does not apply to you or regular residents of your household. This coverage does apply to
residence employees. As to others, this coverage applies
only:

1. pay up to our limit of liability for the damages for which

the insured is legally liable. Damages include prejudgment interest awarded against the insured; and
2. provide a defense at our expense by counsel of our
choice even if the suit is groundless, false or fraudulent. We may investigate and settle any claim or suit
that we decide is appropriate.
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1.

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to a person on the insured location with the permission of an insured.

to a person off the insured location, if the bodily injury:

2.

c. is caused by a residence employee in the course

of the residence employees employment by an
insured.

a. arises out of a condition on the insured location or

the ways immediately adjoining.

d. is caused by an animal owned by or in the care of

an insured.

b. is caused by the activities of an insured.

SECTION II EXCLUSIONS
However, this exclusion does not apply to:
1. Coverage C (Personal Liability) and Coverage D (Medical
Payments to Others) do not apply to:
(1)
motor vehicles which are not subject to motor vehicle registration and are:
a. bodily injury or property damage which is caused intentionally by or at the direction of the insured.
(a) used for assisting the handicapped.
b. bodily injury or property damage arising out of or in
(b) used to service an insured location.
connection with a business engaged in by an insured.
But this exclusion does not apply to activities which are
(c) golf carts while on the residence premises or
ordinarily incidental to non-business pursuits.
used for golfing purposes.
c.

bodily injury or property damage arising out of the rental

or holding for rental of any part of any premises by an insured. This exclusion does not apply to the rental or holding for rental of an insured location:

(d)

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on an occasional basis if used only as a residence.

(2)

in part for use only as a residence, unless a single

family unit is intended for use by the occupying family
to lodge more than two roomers or boarders.

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(1)

in part, as an office, school or studio.

(4)

if the rental is for not more than three car spaces or

stalls in garages or stables.

(2)

bodily injury or property damage arising out of the rendering of or failure to render professional services.

e.

bodily injury or property damage arising out of a premises:

(ii)

owned by an insured while on the residence premises.

(e)

in dead storage on the residence premises.

(f)

used exclusively on the residence premises.

trailers or semi-trailers while not being towed by or

carried on a motor vehicle.

(1)

owned by an insured;

(2)

rented to an insured; or

(3)

rented to others by an insured;

This exclusion does not apply to bodily injury to a residence employee arising out of and in the course of the
residence employees employment by an insured.

g.

that is not an insured location.

bodily injury or property damage arising out of the ownership, maintenance, operation, use, loading or unloading of watercraft:
(1)

with inboard or inboard-outdrive motor power of more

than 50 horsepower owned by or rented to an insured.

(2)

powered by one or more outboard motors with more

than 25 total horsepower if the outboard motor is
owned by an insured. But, outboard motors of
more than 25 total horsepower are covered for the
policy period if:

This exclusion does not apply to bodily injury to a residence

employee arising out of and in the course of the residence
employees employment by an insured.
bodily injury or property damage arising out of the ownership, maintenance, operation, use, loading or unloading of:
(1)
motor or engine propelled vehicles or machines designed for movement on land, including attached
machinery or equipment;

(a)

(2) trailers, semi-trailers or mobile homes;

(b)

which are owned or operated by or rented or loaned to an

insured.
(3)
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not owned by an insured; or

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d.

f.

(i)

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(3)

designed and used for recreational purposes,

and are:

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you acquire them prior to the policy period and:

(i)

you declare them at policy inception; or

(ii)

your intention to insure is reported to us

in writing within 45 days after you acquire the outboard motors.

you acquire them during the policy period.

that is a sailing vessel, with or without auxiliary power,

which is 26 feet or more in length owned by or rented

to an insured.

by an insured under any workers compensation law

or occupational disease law.

This exclusion does not apply while the watercraft is on the residence premises.

2. Coverage C (Personal Liability) does not apply to:

a.

This exclusion does not apply to bodily injury to a residence

employee arising out of and in the course of the residence
employees employment by an insured.
h.

However, this exclusion does not apply to written

contracts:
(1) that directly relate to the ownership, maintenance or use of an insured location; or

bodily injury or property damage arising out of the ownership, maintenance, operation, use, loading or unloading of aircraft.

(2)

Aircraft means any device used or designed for flight, except model or hobby aircraft not used or designed to carry
people or cargo.

where the liability of others is assumed by an

insured;
unless excluded elsewhere in this policy.

b. property damage to property owned by an insured.

c. property damage to property rented to, occupied or
used by or in the care of an insured.
This exclusion does not apply to property damage
caused by fire, smoke or explosion.

This exclusion does not apply to bodily injury to a residence

employee arising out of and in the course of the residence
employees employment by an insured.

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i.

liability under any contract or agreement.

bodily injury or property damage arising out of:

(1) the entrustment by an insured to any person; or

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(2) the negligent supervision by an insured of any person;

with regard to the ownership, maintenance or use of any
motor vehicle, watercraft or aircraft which is excluded in
paragraph f., g. or h. above.

d. bodily injury or property damage for which an

insured under this policy is also an insured under
a nuclear energy liability policy or would be an insured under that policy but for the exhaustion of its
limit of liability.
A nuclear energy liability policy is one issued by
American Nuclear Insurers, Mutual Atomic Energy
Liability Underwriters, or Nuclear Insurance Association of Canada.

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e. bodily injury to you or an insured within the meaning of part a. or part b. of insured as defined.

This exclusion does not apply to bodily injury to a residence

employee arising out of and in the course of the residence
employees employment by an insured.

k.

l.

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j.

3. Coverage D (Medical Payments to Others) does not

apply to:

bodily injury or property damage caused directly or indirectly by war. This includes undeclared war, civil war, insurrection, rebellion, revolution, warlike act by a military force or
military personnel, destruction or seizure or use for a military purpose, and any consequence of these. Discharge of
a nuclear weapon will be deemed a warlike act even if accidental.
bodily injury or property damage arising out of the transmission of sickness or disease by an insured through
sexual contact.

a. bodily injury to a residence employee if the bodily

injury:
(1) occurs off the insured location; and
(2)

does not arise out of or in the course of the residence employees employment by an insured.

b. bodily injury to any person, other than a residence

employee of an insured, regularly residing on any
part of the insured location.

bodily injury to any person eligible to receive any

benefits voluntarily provided or required to be provided

SECTION II ADDITIONAL COVERAGES

We cover the following in addition to the limits of liability:
c. reasonable expenses incurred by an insured at our request, including actual loss of earnings (but not loss of
1. Claim Expenses. We pay:
other income) up to $50 per day, for assisting us in the
investigation or defense of a claim or suit.
a. expenses we incur and costs taxed against an insured
in any suit we defend.
d. interest on the entire judgment which accrues after entry
of the judgment and before we pay or tender, or deposit in
b. premiums on bonds required in a suit we defend but not
court that part of the judgment which does not exceed the
for bond amounts more than the limit of liability for Covlimit of liability that applies.
erage C (Personal Liability). We need not apply for or
furnish any bond.
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2.

3.

Imperative Medical Expenses to Others. We pay expenses

incurred by an insured for immediate medical and surgical
relief to others if imperative at the time of the accident.

d. arising out of:

Damage to Property of Others. We pay replacement cost

up to $500 per occurrence for property damage to property
of others caused by an insured.
We do not pay for property damage:

(1)

a business engaged in by an insured.

(2)

any act or omission in connection with a premises

owned, rented or controlled by an insured, other
than the insured location.

(3)

the ownership, maintenance, use, loading or unloading of aircraft, watercraft or motor vehicles or all other
motorized land conveyances.

a. caused intentionally by an insured who is 13 years of age

or older.

This exclusion does not apply to any motorized land conveyance designed for recreational use off public roads, not
subject to motor vehicle registration and not owned by an
insured.

b. to property owned by an insured.

c. to property owned by or rented to a tenant of an insured or
a resident in your household.
1.

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SECTION II CONDITIONS
(4) to secure evidence and obtain the attendance of witLimit of Liability. The limit of liability for Coverage C
nesses.
(Personal Liability) shown on the declarations page is
our total liability under Coverage C (Personal Liability)
d. The insured will not, except at the insureds own cost, volfor all damages resulting from any one occurrence. This
untarily make payment, assume obligation or incur expense
limit is the same regardless of the number of insureds,
other than for immediate medical and surgical relief to others
claims made or persons injured.
at the time of the bodily injury.
The limit of liability for Coverage D (Medical Payments
4. Duties of an Injured Person - Coverage D (Medical Payto Others) shown on the declarations page is our total
ments to Others).
liability under Coverage D (Medical Payments to Others) for all medical expense payable for bodily injury
The injured person or someone acting for the injured person will:
to one person as the result of one accident. The total
limit of our liability for all expenses payable to two or
a. give us written proof of claim, under oath if required,
more persons injured in one accident is $25,000.
as soon as is practical.

3.

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2.

Severability of Insurance. This insurance applies separately

to each insured. This condition will not increase our limit of
liability for any one occurrence.

b.

The injured person will submit to a physical exam by a doctor of

our choice when and as often as we reasonably require.

5.

a. Give written notice to us or our agent as soon as is practical, which sets forth:

6.

(1) the identity of the policy and insured.

(3) names and addresses of any claimants and

witnesses.

Under Coverage D (Medical Payments to Others), no action

can be brought until 30 days after the required proofs of claim
have been filed with us.

b. Promptly forward to us every notice, demand, summons or

other process relating to the accident or occurrence.
c. At our request, help us:

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(2)

to enforce any right of contribution or indemnity against

any person or organization who may be liable to an
insured.

(3)

with the conduct of suits, including attending hearings

and trials.

Suit Against Us. No action can be brought against us unless

there has been compliance with the policy provisions.
No one will have the right to join us as a party to any action
against an insured. Also, no action with respect to Coverage C
(Personal Liability) can be brought against us until the obligation
of the insured has been determined by final judgment or agreement.

(2) reasonably available information on the time, place

and circumstances of the accident or occurrence.

to make settlement.

Payment of Claim - Coverage D (Medical Payments to

Others). Payment under this coverage is not an admission of
liability by an insured or us.

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Duties After Loss. In case of an accident or occurrence, the

insured will perform the following duties that apply or will help
us by seeing that these duties are performed:

(1)

authorize us to obtain copies of medical reports and records.

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7.

Bankruptcy of the Insured. Bankruptcy or insolvency of the

insured or of the insureds estate will not relieve us of our
obligations under this policy.

8.

Other Insurance - Section II. If the insured has other insurance under Coverage C (Personal Liability), we will not be liable for
a greater proportion of a loss than the limit of liability shown on the
declarations page bears to the total limit of all valid and collectible
insurance against such loss.

However, with respect to loss arising out of the ownership, maintenance, operation, use, loading or unloading of:
a.

any motor vehicle or recreational motor vehicle at the residence premises; or

b.

watercraft,

9.

this policy will not apply to the extent that any valid and collectible
insurance is available to the insured.

Notice of Settlement of Liability Claim.

a.

We will notify the insured in writing of any initial offer to compromise or settle a claim against the insured under the liability section of this policy. We will give the insured notice
within 10 days after the date the offer is made.

b.

We will notify the insured in writing of any settlement of a

claim against the insured under the liability section of this
policy. We will give the insured notice within 30 days after
the date of the settlement.

SECTION I AND II CONDITIONS

1. Policy Period. This policy applies only to loss in Section I or bodily injury or property damage in Section II
which occurs during the policy period stated on the declarations page.

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2. Concealment or Fraud. This policy is void as to you

and any other insured, if you or any other insured under
this policy has intentionally concealed or misrepresented
any material fact or circumstance, made false statements
or committed fraud relating to this insurance, whether before or after a loss.

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3. Liberalization Clause. If the State Board of Insurance

adopts a revision which would broaden or extend the
coverage under this policy without additional premium
within 45 days prior to or during the policy period, the
broadened or extended coverage will immediately apply
to this policy.

you do not pay the premium or any portion of

the premium when due.

(b)

the State Board of Insurance determines that

continuation of the policy would violate the
Texas Insurance Code or any other laws governing the business of insurance in this state.

(c)

you submit a fraudulent claim.

(d)

there is an increase in hazard covered by this

policy that is within your control and that would
produce an increase in the premium/rate of
this policy.

The effective date of cancellation cannot be before

the 10th day after we mail the notice. Our notice of
cancellation must state the reason for cancellation.
c.

If we cancel, our notice to you will state that if the refund is

not included with the notice, it will be returned on demand.

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4. Waiver or Change of Policy Provisions. Changes in

this policy may be made and perils added only by attaching a written endorsement properly executed by our
authorized agent. No provision of this policy may be
waived unless the terms of this policy allow the provision to be waived. Our request for an appraisal or examination will not waive any of our rights.

(a)

6. Refusal to Renew.

Cancellation.
a.

You may cancel this policy at any time by notifying us of the

date cancellation is to take effect. We will send you any
refund due when the policy is returned to us.

b.

We may cancel this policy for the reasons stated in this

condition by mailing you notice in writing of the date cancellation takes effect.
(1)

a.

We may not refuse to renew this policy because of claims

for losses resulting from natural causes.

b.

We may not refuse to renew this policy solely because you

are an elected official.

c.

We may refuse to renew this policy if you have filed three or

more claims under the policy in any three year period that
do not result from natural causes.
If you have filed two claims in a period of less than three
years, we may notify you in writing, that if you file a third
claim during the three year period, we may refuse to renew
this policy by providing you proper notice of our refusal to
renew as provided in d. below. If we do not notify you after the
second claim, we may not refuse to renew this policy because of losses.

If this policy has been in effect for less than 90 days

and is not a renewal policy, we may cancel this policy
for any reason.
The effective date of cancellation cannot be before:
(a)
(b)

(2)

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We may not cancel this policy solely because you are an

elected official.

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5.

d.

the 10th day after we mail notice if we cancel

for non-payment of premium.

A claim does not include a claim that is filed but is not paid
or payable under the policy.

the 30th day after we mail notice if we cancel

for any other reason.

d.

If this policy has been in effect 90 days or more, we

may not cancel this policy unless:
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If we refuse to renew this policy, we must deliver to you, or

mail to you at your mailing address shown on the declarations page and any mortgagee named in the declarations
page, written notice of our refusal to renew not later than
the 30th day before the date in which this policy expires.

Subrogation does not apply under Section II to Medical Payments

to Others or Damage to Property of Others.

Proof of mailing will be sufficient proof of notice. If we fail to

give you proper notice of our decision not to renew, you may
require us to renew the policy.
7.

Assignment. Assignment of this policy will not be valid unless

we give our written consent.

8.

Subrogation. An insured may waive in writing before a loss all

rights of recovery against any person. If not waived, we may
require an assignment of rights of recovery for a loss to the extent
that payment is made by us.

9.

If an assignment is sought, an insured must sign and deliver all

related papers and cooperate with us.

Death. If the named insured dies, we insure:

a.

the named insureds spouse, if a resident of the same household at the time of death.

b.

the legal representative of the deceased. However, if this

legal representative was not an insured at the time of death
of the named insured, this policy will apply to such legal
representative only with respect to the premises of the original named insured.

c.

any person who is an insured at the time of such death,

while a resident of said premises.

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Prescribed by the Texas Department of Insurance
Homeowners Form C - Effective July 8, 1992
(Revised January 1, 2002)
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HOMEOWNERS
HO 00 03 10 00

HOMEOWNERS 3 SPECIAL FORM

AGREEMENT
We will provide the insurance described in this policy
in return for the premium and compliance with all
applicable provisions of this policy.
DEFINITIONS
A. In this policy, "you" and "your" refer to the "named
insured" shown in the Declarations and the spouse
if a resident of the same household. "We", "us"
and "our" refer to the Company providing this insurance.
B. In addition, certain words and phrases are defined
as follows:
1. "Aircraft Liability", "Hovercraft Liability", "Motor
Vehicle Liability" and "Watercraft Liability",
subject to the provisions in b. below, mean the
following:

3. "Business" means:
a. A trade, profession or occupation engaged
in on a full-time, part-time or occasional basis; or
b. Any other activity engaged in for money or
other compensation, except the following:
(1) One or more activities, not described in
(2) through (4) below, for which no "insured" receives more than $2,000 in
total compensation for the 12 months
before the beginning of the policy period;
(2) Volunteer activities for which no money
is received other than payment for expenses incurred to perform the activity;

SA
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PL
E

a. Liability for "bodily injury" or "property damage" arising out of the:

2. "Bodily injury" means bodily harm, sickness or

disease, including required care, loss of services and death that results.

(1) Ownership of such vehicle or craft by an

"insured";
(2) Maintenance, occupancy, operation,
use, loading or unloading of such vehicle or craft by any person;

(3) Entrustment of such vehicle or craft by

an "insured" to any person;
(4) Failure to supervise or negligent supervision of any person involving such vehicle or craft by an "insured"; or

(5) Vicarious liability, whether or not imposed by law, for the actions of a child
or minor involving such vehicle or craft.
b. For the purpose of this definition:

(1) Aircraft means any contrivance used or

designed for flight except model or
hobby aircraft not used or designed to
carry people or cargo;
(2) Hovercraft means a self-propelled motorized ground effect vehicle and includes, but is not limited to, flarecraft
and air cushion vehicles;

(3) Watercraft means a craft principally

designed to be propelled on or in water
by wind, engine power or electric motor;
and

(3) Providing home day care services for

which no compensation is received,
other than the mutual exchange of such
services; or
(4) The rendering of home day care services to a relative of an "insured".

4. "Employee" means an employee of an "insured", or an employee leased to an "insured"

by a labor leasing firm under an agreement
between an "insured" and the labor leasing
firm, whose duties are other than those performed by a "residence employee".
5. "Insured" means:

a. You and residents of your household who

are:
(1) Your relatives; or
(2) Other persons under the age of 21 and
in the care of any person named above;

b. A student enrolled in school full time, as

defined by the school, who was a resident
of your household before moving out to attend school, provided the student is under
the age of:
(1) 24 and your relative; or
(2) 21 and in your care or the care of a
person described in a.(1) above; or

(4) Motor vehicle means a "motor vehicle"

as defined in 7. below.

HO 00 03 10 00

Copyright, Insurance Services Office, Inc., 1999

Page 1 of 22

c. Under Section II:

(1) With respect to animals or watercraft to
which this policy applies, any person or
organization legally responsible for
these animals or watercraft which are
owned by you or any person included in
a. or b. above. "Insured" does not mean
a person or organization using or having
custody of these animals or watercraft in
the course of any "business" or without
consent of the owner; or
(2) With respect to a "motor vehicle" to
which this policy applies:
(a) Persons while engaged in your employ or that of any person included in
a. or b. above; or
(b) Other persons using the vehicle on
an "insured location" with your consent.

6. "Insured location" means:

a. The "residence premises";

b. The part of other premises, other structures

and grounds used by you as a residence;
and
(1) Which is shown in the Declarations; or

(2) Which is acquired by you during the

policy period for your use as a residence;

c. Any premises used by you in connection

with a premises described in a. and b.
above;
d. Any part of a premises:

7. "Motor vehicle" means:

a. A self-propelled land or amphibious vehicle;
or
b. Any trailer or semitrailer which is being
carried on, towed by or hitched for towing
by a vehicle described in a. above.
8. "Occurrence" means an accident, including
continuous or repeated exposure to substantially the same general harmful conditions,
which results, during the policy period, in:
a. "Bodily injury"; or
b. "Property damage".
9. "Property damage" means physical injury to,
destruction of, or loss of use of tangible property.
10. "Residence employee" means:
a. An employee of an "insured", or an employee leased to an "insured" by a labor
leasing firm, under an agreement between
an "insured" and the labor leasing firm,
whose duties are related to the maintenance or use of the "residence premises",
including household or domestic services;
or

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Under both Sections I and II, when the word an

immediately precedes the word "insured", the
words an "insured" together mean one or more
"insureds".

h. Any part of a premises occasionally rented

to an "insured" for other than "business"
use.

b. One who performs similar duties elsewhere

not related to the "business" of an "insured".

A "residence employee" does not include a

temporary employee who is furnished to an
"insured" to substitute for a permanent "residence employee" on leave or to meet seasonal
or short-term workload conditions.

11. "Residence premises" means:

(1) Not owned by an "insured"; and

a. The one family dwelling where you reside;

(2) Where an "insured" is temporarily residing;

b. The two, three or four family dwelling where

you reside in at least one of the family units;
or

e. Vacant land, other than farm land, owned

by or rented to an "insured";

f. Land owned by or rented to an "insured" on

which a one, two, three or four family
dwelling is being built as a residence for an
"insured";
g. Individual or family cemetery plots or burial
vaults of an "insured"; or

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c. That part of any other building where you

reside;
and which is shown as the "residence premises" in the Declarations.
"Residence premises" also includes other
structures and grounds at that location.

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HO 00 03 10 00

C. Coverage C Personal Property

DEDUCTIBLE
Unless otherwise noted in this policy, the following
deductible provision applies:
Subject to the policy limits that apply, we will pay only
that part of the total of all loss payable under Section I
that exceeds the deductible amount shown in the
Declarations.
SECTION I PROPERTY COVERAGES
A. Coverage A Dwelling
1. We cover:
a. The dwelling on the "residence premises"
shown in the Declarations, including structures attached to the dwelling; and
b. Materials and supplies located on or next to
the "residence premises" used to construct,
alter or repair the dwelling or other structures on the "residence premises".
2. We do not cover land, including land on which
the dwelling is located.
B. Coverage B Other Structures

2. We do not cover:

a. Land, including land on which the other

structures are located;

b. Other structures rented or held for rental to

any person not a tenant of the dwelling,
unless used solely as a private garage;

c. Other structures from which any "business"

is conducted; or

d. Other structures used to store "business"

property. However, we do cover a structure
that contains "business" property solely
owned by an "insured" or a tenant of the
dwelling provided that "business" property
does not include gaseous or liquid fuel,
other than fuel in a permanently installed
fuel tank of a vehicle or craft parked or
stored in the structure.
3. The limit of liability for this coverage will not be
more than 10% of the limit of liability that applies to Coverage A. Use of this coverage does
not reduce the Coverage A limit of liability.

HO 00 03 10 00

We cover personal property owned or used by

an "insured" while it is anywhere in the world.
After a loss and at your request, we will cover
personal property owned by:
a. Others while the property is on the part of
the "residence premises" occupied by an
"insured"; or
b. A guest or a "residence employee", while
the property is in any residence occupied by
an "insured".
2. Limit For Property At Other Residences
Our limit of liability for personal property usually
located at an "insured's" residence, other than
the "residence premises", is 10% of the limit of
liability for Coverage C, or $1,000, whichever is
greater. However, this limitation does not apply
to personal property:
a. Moved from the "residence premises" because it is being repaired, renovated or rebuilt and is not fit to live in or store property
in; or
b. In a newly acquired principal residence for
30 days from the time you begin to move
the property there.

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1. We cover other structures on the "residence

premises" set apart from the dwelling by clear
space. This includes structures connected to
the dwelling by only a fence, utility line, or
similar connection.

1. Covered Property

3. Special Limits Of Liability

The special limit for each category shown below is the total limit for each loss for all property in that category. These special limits do
not increase the Coverage C limit of liability.
a. $200 on money, bank notes, bullion, gold
other than goldware, silver other than silverware, platinum other than platinumware,
coins, medals, scrip, stored value cards
and smart cards.

b. $1,500 on securities, accounts, deeds,

evidences of debt, letters of credit, notes
other than bank notes, manuscripts, personal records, passports, tickets and
stamps. This dollar limit applies to these
categories regardless of the medium (such
as paper or computer software) on which
the material exists.
This limit includes the cost to research, replace or restore the information from the
lost or damaged material.

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Page 3 of 22

c. $1,500 on watercraft of all types, including

their trailers, furnishings, equipment and
outboard engines or motors.
d. $1,500 on trailers or semitrailers not used
with watercraft of all types.
e. $1,500 for loss by theft of jewelry, watches,
furs, precious and semiprecious stones.
f. $2,500 for loss by theft of firearms and
related equipment.
g. $2,500 for loss by theft of silverware, silverplated ware, goldware, gold-plated ware,
platinumware, platinum-plated ware and
pewterware. This includes flatware, hollowware, tea sets, trays and trophies made of
or including silver, gold or pewter.
h. $2,500 on property, on the "residence
premises", used primarily for "business"
purposes.

c. "Motor vehicles".
(1) This includes:
(a) Their accessories, equipment and
parts; or
(b) Electronic apparatus and accessories designed to be operated solely
by power from the electrical system
of the "motor vehicle". Accessories
include antennas, tapes, wires, records, discs or other media that can
be used with any apparatus described above.
The exclusion of property described in
(a) and (b) above applies only while
such property is in or upon the "motor
vehicle".
(2) We do cover "motor vehicles" not required to be registered for use on public
roads or property which are:
(a) Used solely to service an "insured's"
residence; or
(b) Designed to assist the handicapped;

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i. $500 on property, away from the "residence

premises", used primarily for "business"
purposes. However, this limit does not apply to loss to electronic apparatus and other
property described in Categories j. and k.
below.

b. Animals, birds or fish;

j. $1,500 on electronic apparatus and accessories, while in or upon a "motor vehicle",

but only if the apparatus is equipped to be
operated by power from the "motor vehicle's" electrical system while still capable of
being operated by other power sources.

Accessories include antennas, tapes, wires,

records, discs or other media that can be
used with any apparatus described in this
Category j.

k. $1,500 on electronic apparatus and accessories used primarily for "business" while
away from the "residence premises" and
not in or upon a "motor vehicle". The apparatus must be equipped to be operated by
power from the "motor vehicle's" electrical
system while still capable of being operated
by other power sources.
Accessories include antennas, tapes, wires,
records, discs or other media that can be
used with any apparatus described in this
Category k.

We do cover model or hobby aircraft not

used or designed to carry people or cargo;

e. Hovercraft and parts. Hovercraft means a

self-propelled motorized ground effect vehicle and includes, but is not limited to, flarecraft and air cushion vehicles;
f. Property of roomers, boarders and other
tenants, except property of roomers and
boarders related to an "insured";

g. Property in an apartment regularly rented or

held for rental to others by an "insured", except as provided in E.10. Landlord's Furnishings under Section I Property Coverages;
h. Property rented or held for rental to others
off the "residence premises";
i. "Business" data, including such data stored
in:
(1) Books of account, drawings or other
paper records; or

4. Property Not Covered

We do not cover:
a. Articles separately described and specifically insured, regardless of the limit for
which they are insured, in this or other insurance;

Page 4 of 22

d. Aircraft meaning any contrivance used or

designed for flight including any parts
whether or not attached to the aircraft.

(2) Computers and related equipment.

We do cover the cost of blank recording or
storage media, and of prerecorded computer programs available on the retail market;

Copyright, Insurance Services Office, Inc., 1999

HO 00 03 10 00

j. Credit cards, electronic fund transfer cards

or access devices used solely for deposit,
withdrawal or transfer of funds except as
provided in E.6. Credit Card, Electronic
Fund Transfer Card Or Access Device,
Forgery And Counterfeit Money under Section I Property Coverages; or
k. Water or steam.
D. Coverage D Loss Of Use
The limit of liability for Coverage D is the total limit
for the coverages in 1. Additional Living Expense,
2. Fair Rental Value and 3. Civil Authority Prohibits
Use below.
1. Additional Living Expense
If a loss covered under Section I makes that
part of the "residence premises" where you reside not fit to live in, we cover any necessary
increase in living expenses incurred by you so
that your household can maintain its normal
standard of living.

2. Fair Rental Value

1. Debris Removal
a. We will pay your reasonable expense for
the removal of:
(1) Debris of covered property if a Peril
Insured Against that applies to the damaged property causes the loss; or
(2) Ash, dust or particles from a volcanic
eruption that has caused direct loss to a
building or property contained in a
building.
This expense is included in the limit of liability that applies to the damaged property.
If the amount to be paid for the actual damage to the property plus the debris removal
expense is more than the limit of liability for
the damaged property, an additional 5% of
that limit is available for such expense.
b. We will also pay your reasonable expense,
up to $1,000, for the removal from the
"residence premises" of:
(1) Your tree(s) felled by the peril of Windstorm or Hail or Weight of Ice, Snow or
Sleet; or

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Payment will be for the shortest time required

to repair or replace the damage or, if you permanently relocate, the shortest time required
for your household to settle elsewhere.

E. Additional Coverages

If a loss covered under Section I makes that

part of the "residence premises" rented to others or held for rental by you not fit to live in, we
cover the fair rental value of such premises
less any expenses that do not continue while it
is not fit to live in.
Payment will be for the shortest time required
to repair or replace such premises.
3. Civil Authority Prohibits Use

If a civil authority prohibits you from use of the

"residence premises" as a result of direct damage to neighboring premises by a Peril Insured
Against, we cover the loss as provided in 1.
Additional Living Expense and 2. Fair Rental
Value above for no more than two weeks.
4. Loss Or Expense Not Covered

We do not cover loss or expense due to cancellation of a lease or agreement.

The periods of time under 1. Additional Living Expense, 2. Fair Rental Value and 3. Civil Authority
Prohibits Use above are not limited by expiration
of this policy.

(2) A neighbor's tree(s) felled by a Peril

Insured Against under Coverage C;
provided the tree(s):

(3) Damage(s) a covered structure; or

(4) Does not damage a covered structure,
but:
(a) Block(s) a driveway on the "residence premises" which prevent(s) a
"motor vehicle", that is registered for
use on public roads or property, from
entering or leaving the "residence
premises"; or

(b) Block(s) a ramp or other fixture

designed to assist a handicapped
person to enter or leave the dwelling
building.

The $1,000 limit is the most we will pay in

any one loss regardless of the number of
fallen trees. No more than $500 of this limit
will be paid for the removal of any one tree.
This coverage is additional insurance.
2. Reasonable Repairs
a. We will pay the reasonable cost incurred by
you for the necessary measures taken
solely to protect covered property that is
damaged by a Peril Insured Against from
further damage.

HO 00 03 10 00

Copyright, Insurance Services Office, Inc., 1999

Page 5 of 22

b. If the measures taken involve repair to

other damaged property, we will only pay if
that property is covered under this policy
and the damage is caused by a Peril Insured Against. This coverage does not:
(1) Increase the limit of liability that applies
to the covered property; or
(2) Relieve you of your duties, in case of a
loss to covered property, described in
B.4. under Section I Conditions.
3. Trees, Shrubs And Other Plants
We cover trees, shrubs, plants or lawns, on the
"residence premises", for loss caused by the
following Perils Insured Against:
a. Fire or Lightning;
b. Explosion;
c. Riot or Civil Commotion;
d. Aircraft;
e. Vehicles not owned or operated by a resident of the "residence premises";
f. Vandalism or Malicious Mischief; or

a. We will pay up to $500 for:

(1) The legal obligation of an "insured" to
pay because of the theft or unauthorized
use of credit cards issued to or registered in an "insured's" name;
(2) Loss resulting from theft or unauthorized
use of an electronic fund transfer card
or access device used for deposit, withdrawal or transfer of funds, issued to or
registered in an "insured's" name;
(3) Loss to an "insured" caused by forgery
or alteration of any check or negotiable
instrument; and
(4) Loss to an "insured" through acceptance
in good faith of counterfeit United States
or Canadian paper currency.
All loss resulting from a series of acts
committed by any one person or in which
any one person is concerned or implicated
is considered to be one loss.
This coverage is additional insurance. No
deductible applies to this coverage.

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g. Theft.

6. Credit Card, Electronic Fund Transfer Card

Or Access Device, Forgery And Counterfeit
Money

We will pay up to 5% of the limit of liability that

applies to the dwelling for all trees, shrubs,
plants or lawns. No more than $500 of this limit
will be paid for any one tree, shrub or plant. We
do not cover property grown for "business"
purposes.
This coverage is additional insurance.
4. Fire Department Service Charge

We will pay up to $500 for your liability assumed by contract or agreement for fire department charges incurred when the fire department is called to save or protect covered
property from a Peril Insured Against. We do
not cover fire department service charges if the
property is located within the limits of the city,
municipality or protection district furnishing the
fire department response.
This coverage is additional insurance. No deductible applies to this coverage.
5. Property Removed

We insure covered property against direct loss

from any cause while being removed from a
premises endangered by a Peril Insured
Against and for no more than 30 days while
removed.
This coverage does not change the limit of liability that applies to the property being removed.

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b. We do not cover:

(1) Use of a credit card, electronic fund

transfer card or access device:
(a) By a resident of your household;

(b) By a person who has been entrusted

with either type of card or access
device; or
(c) If an "insured" has not complied with
all terms and conditions under which
the cards are issued or the devices
accessed; or

(2) Loss arising out of "business" use or

dishonesty of an "insured".

c. If the coverage in a. above applies, the

following defense provisions also apply:
(1) We may investigate and settle any claim
or suit that we decide is appropriate.
Our duty to defend a claim or suit ends
when the amount we pay for the loss
equals our limit of liability.
(2) If a suit is brought against an "insured"
for liability under a.(1) or (2) above, we
will provide a defense at our expense by
counsel of our choice.
(3) We have the option to defend at our
expense an "insured" or an "insured's"
bank against any suit for the enforcement of payment under a.(3) above.

Copyright, Insurance Services Office, Inc., 1999

HO 00 03 10 00

7. Loss Assessment
a. We will pay up to $1,000 for your share of
loss assessment charged during the policy
period against you, as owner or tenant of
the "residence premises", by a corporation
or association of property owners. The assessment must be made as a result of direct loss to property, owned by all members
collectively, of the type that would be covered by this policy if owned by you, caused
by a Peril Insured Against under Coverage
A, other than:
(1) Earthquake; or
(2) Land shock waves or tremors before,
during or after a volcanic eruption.
The limit of $1,000 is the most we will pay
with respect to any one loss, regardless of
the number of assessments. We will only
apply one deductible, per unit, to the total
amount of any one loss to the property described above, regardless of the number of
assessments.

c. Paragraph P. Policy Period under Section I

Conditions does not apply to this coverage.
This coverage is additional insurance.
8. Collapse

a. With respect to this Additional Coverage:

(1) Collapse means an abrupt falling down

or caving in of a building or any part of a
building with the result that the building
or part of the building cannot be occupied for its current intended purpose.
(2) A building or any part of a building that
is in danger of falling down or caving in
is not considered to be in a state of collapse.
(3) A part of a building that is standing is
not considered to be in a state of collapse even if it has separated from another part of the building.
(4) A building or any part of a building that
is standing is not considered to be in a
state of collapse even if it shows evidence of cracking, bulging, sagging,
bending, leaning, settling, shrinkage or
expansion.

HO 00 03 10 00

(1) The Perils Insured Against named under

Coverage C;
(2) Decay that is hidden from view, unless
the presence of such decay is known to
an "insured" prior to collapse;
(3) Insect or vermin damage that is hidden
from view, unless the presence of such
damage is known to an "insured" prior to
collapse;
(4) Weight of contents, equipment, animals
or people;
(5) Weight of rain which collects on a roof;
or
(6) Use of defective material or methods in
construction, remodeling or renovation if
the collapse occurs during the course of
the construction, remodeling or renovation.
c. Loss to an awning, fence, patio, deck,
pavement, swimming pool, underground
pipe, flue, drain, cesspool, septic tank,
foundation, retaining wall, bulkhead, pier,
wharf or dock is not included under b.(2)
through (6) above, unless the loss is a direct result of the collapse of a building or
any part of a building.

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b. We do not cover assessments charged

against you or a corporation or association
of property owners by any governmental
body.

b. We insure for direct physical loss to covered property involving collapse of a building or any part of a building if the collapse
was caused by one or more of the following:

d. This coverage does not increase the limit of

liability that applies to the damaged covered
property.

9. Glass Or Safety Glazing Material

a. We cover:

(1) The breakage of glass or safety glazing

material which is part of a covered
building, storm door or storm window;
(2) The breakage of glass or safety glazing
material which is part of a covered
building, storm door or storm window
when caused directly by earth movement; and
(3) The direct physical loss to covered
property caused solely by the pieces,
fragments or splinters of broken glass or
safety glazing material which is part of a
building, storm door or storm window.

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Page 7 of 22

b. This coverage does not include loss:

(1) To covered property which results because the glass or safety glazing material has been broken, except as provided in a.(3) above; or
(2) On the "residence premises" if the
dwelling has been vacant for more than
60 consecutive days immediately before
the loss, except when the breakage results directly from earth movement as
provided in a.(2) above. A dwelling being constructed is not considered vacant.
c. This coverage does not increase the limit of
liability that applies to the damaged property.
10. Landlord's Furnishings
We will pay up to $2,500 for your appliances,
carpeting and other household furnishings, in
each apartment on the "residence premises"
regularly rented or held for rental to others by
an "insured", for loss caused by a Peril Insured
Against in Coverage C, other than Theft.

This coverage does not increase the limit of liability applying to the damaged property.
11. Ordinance Or Law

c. We do not cover:
(1) The loss in value to any covered building or other structure due to the requirements of any ordinance or law; or
(2) The costs to comply with any ordinance
or law which requires any "insured" or
others to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, pollutants in or on
any covered building or other structure.
Pollutants means any solid, liquid,
gaseous or thermal irritant or contaminant, including smoke, vapor, soot,
fumes, acids, alkalis, chemicals and
waste. Waste includes materials to be
recycled, reconditioned or reclaimed.
This coverage is additional insurance.

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This limit is the most we will pay in any one

loss regardless of the number of appliances,
carpeting or other household furnishings involved in the loss.

b. You may use all or part of this ordinance or

law coverage to pay for the increased costs
you incur to remove debris resulting from
the construction, demolition, remodeling,
renovation, repair or replacement of property as stated in a. above.

a. You may use up to 10% of the limit of liability that applies to Coverage A for the increased costs you incur due to the enforcement of any ordinance or law which
requires or regulates:

(1) The construction, demolition, remodeling, renovation or repair of that part of a

covered building or other structure
damaged by a Peril Insured Against;

(2) The demolition and reconstruction of the

undamaged part of a covered building
or other structure, when that building or
other structure must be totally demolished because of damage by a Peril Insured Against to another part of that
covered building or other structure; or
(3) The remodeling, removal or replacement of the portion of the undamaged
part of a covered building or other
structure necessary to complete the remodeling, repair or replacement of that
part of the covered building or other
structure damaged by a Peril Insured
Against.

12. Grave Markers

We will pay up to $5,000 for grave markers, including mausoleums, on or away from the
"residence premises" for loss caused by a Peril
Insured Against under Coverage C.
This coverage does not increase the limits of
liability that apply to the damaged covered
property.

SECTION I PERILS INSURED AGAINST

A. Coverage A Dwelling And Coverage B
Other Structures
1. We insure against risk of direct physical loss to
property described in Coverages A and B.

2. We do not insure, however, for loss:

a. Excluded under Section I Exclusions;

b. Involving collapse, except as provided in

E.8. Collapse under Section I Property
Coverages; or
c. Caused by:
(1) Freezing of a plumbing, heating, air
conditioning or automatic fire protective
sprinkler system or of a household appliance, or by discharge, leakage or
overflow from within the system or appliance caused by freezing. This provision does not apply if you have used
reasonable care to:
(a) Maintain heat in the building; or

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HO 00 03 10 00

(b) Shut off the water supply and drain

all systems and appliances of water.
However, if the building is protected by
an automatic fire protective sprinkler
system, you must use reasonable care
to continue the water supply and maintain heat in the building for coverage to
apply.
For purposes of this provision a plumbing system or household appliance does
not include a sump, sump pump or related equipment or a roof drain, gutter,
downspout or similar fixtures or equipment;
(2) Freezing, thawing, pressure or weight of
water or ice, whether driven by wind or
not, to a:
(a) Fence, pavement, patio or swimming
pool;
(b) Footing, foundation, bulkhead, wall,
or any other structure or device that
supports all or part of a building, or
other structure;

For purposes of this provision, a

plumbing system or household appliance does not include a sump, sump
pump or related equipment or a roof
drain, gutter, downspout or similar fixtures or equipment; or
(6) Any of the following:
(a) Wear and tear, marring, deterioration;
(b) Mechanical breakdown, latent defect, inherent vice, or any quality in
property that causes it to damage or
destroy itself;
(c) Smog, rust or other corrosion, or dry
rot;
(d) Smoke from agricultural smudging or
industrial operations;
(e) Discharge, dispersal, seepage, migration, release or escape of pollutants unless the discharge, dispersal,
seepage, migration, release or escape is itself caused by a Peril Insured Against named under Coverage C.

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(c) Retaining wall or bulkhead that does

not support all or part of a building or
other structure; or

(b) A storm drain, or water, steam or

sewer pipes, off the "residence
premises".

(d) Pier, wharf or dock;

(3) Theft in or to a dwelling under construction, or of materials and supplies for use
in the construction until the dwelling is
finished and occupied;

(4) Vandalism and malicious mischief, and

any ensuing loss caused by any intentional and wrongful act committed in the
course of the vandalism or malicious
mischief, if the dwelling has been vacant
for more than 60 consecutive days immediately before the loss. A dwelling
being constructed is not considered vacant;

(5) Mold, fungus or wet rot. However, we do

insure for loss caused by mold, fungus
or wet rot that is hidden within the walls
or ceilings or beneath the floors or
above the ceilings of a structure if such
loss results from the accidental discharge or overflow of water or steam
from within:
(a) A plumbing, heating, air conditioning
or automatic fire protective sprinkler
system, or a household appliance,
on the "residence premises"; or

HO 00 03 10 00

Pollutants means any solid, liquid,

gaseous or thermal irritant or contaminant, including smoke, vapor,
soot, fumes, acids, alkalis, chemicals and waste. Waste includes
materials to be recycled, reconditioned or reclaimed;

(f) Settling, shrinking, bulging or expansion, including resultant cracking, of

bulkheads, pavements, patios, footings, foundations, walls, floors, roofs
or ceilings;

(g) Birds, vermin, rodents, or insects; or

(h) Animals owned or kept by an "insured".

Exception To c.(6)
Unless the loss is otherwise excluded, we
cover loss to property covered under Coverage A or B resulting from an accidental
discharge or overflow of water or steam
from within a:
(i) Storm drain, or water, steam or sewer
pipe, off the "residence premises"; or

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(ii) Plumbing, heating, air conditioning or

automatic fire protective sprinkler system or household appliance on the
"residence premises". This includes the
cost to tear out and replace any part of a
building, or other structure, on the "residence premises", but only when necessary to repair the system or appliance.
However, such tear out and replacement coverage only applies to other
structures if the water or steam causes
actual damage to a building on the
"residence premises".

6. Vehicles
7. Smoke
This peril means sudden and accidental damage from smoke, including the emission or
puffback of smoke, soot, fumes or vapors from
a boiler, furnace or related equipment.
This peril does not include loss caused by
smoke from agricultural smudging or industrial
operations.
8. Vandalism Or Malicious Mischief
9. Theft

We do not cover loss to the system or appliance from which this water or steam escaped.

a. This peril includes attempted theft and loss

of property from a known place when it is
likely that the property has been stolen.

For purposes of this provision, a plumbing

system or household appliance does not
include a sump, sump pump or related
equipment or a roof drain, gutter, down
spout or similar fixtures or equipment.

b. This peril does not include loss caused by

theft:

Under 2.b. and c. above, any ensuing loss to

property described in Coverages A and B not
precluded by any other provision in this policy
is covered.
B. Coverage C Personal Property

We insure for direct physical loss to the property

described in Coverage C caused by any of the
following perils unless the loss is excluded in Section I Exclusions.
1. Fire Or Lightning
2. Windstorm Or Hail

This peril includes loss to watercraft of all types

and their trailers, furnishings, equipment, and
outboard engines or motors, only while inside a
fully enclosed building.

This peril does not include loss to the property

contained in a building caused by rain, snow,
sleet, sand or dust unless the direct force of
wind or hail damages the building causing an
opening in a roof or wall and the rain, snow,
sleet, sand or dust enters through this opening.
3. Explosion

(3) From that part of a "residence premises"

rented by an "insured" to someone other
than another "insured"; or
(4) That occurs off the "residence premises" of:
(a) Trailers, semitrailers and campers;

(b) Watercraft of all types, and their

furnishings, equipment and outboard
engines or motors; or
(c) Property while at any other residence
owned by, rented to, or occupied by
an "insured", except while an "insured" is temporarily living there.
Property of an "insured" who is a
student is covered while at the residence the student occupies to attend
school as long as the student has
been there at any time during the 60
days immediately before the loss.

10. Falling Objects

This peril does not include loss to property
contained in a building unless the roof or an
outside wall of the building is first damaged by
a falling object. Damage to the falling object itself is not included.
11. Weight Of Ice, Snow Or Sleet

4. Riot Or Civil Commotion

5. Aircraft
This peril includes self-propelled missiles and
spacecraft.

Page 10 of 22

(2) In or to a dwelling under construction, or

of materials and supplies for use in the
construction until the dwelling is finished
and occupied;

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Section I Exclusion A.3. Water Damage,

Paragraphs a. and c. that apply to surface
water and water below the surface of the
ground do not apply to loss by water covered
under c.(5) and (6) above.

(1) Committed by an "insured";

This peril means weight of ice, snow or sleet

which causes damage to property contained in
a building.

Copyright, Insurance Services Office, Inc., 1999

HO 00 03 10 00

12. Accidental Discharge Or Overflow Of Water

Or Steam
a. This peril means accidental discharge or
overflow of water or steam from within a
plumbing, heating, air conditioning or automatic fire protective sprinkler system or
from within a household appliance.
b. This peril does not include loss:
(1) To the system or appliance from which
the water or steam escaped;
(2) Caused by or resulting from freezing
except as provided in Peril Insured
Against 14. Freezing;
(3) On the "residence premises" caused by
accidental discharge or overflow which
occurs off the "residence premises"; or
(4) Caused by mold, fungus or wet rot unless hidden within the walls or ceilings
or beneath the floors or above the ceilings of a structure.

d. Section I Exclusion A.3. Water Damage,

Paragraphs a. and c. that apply to surface
water and water below the surface of the
ground do not apply to loss by water covered under this peril.
13. Sudden And Accidental Tearing Apart,
Cracking, Burning Or Bulging

This peril means sudden and accidental tearing apart, cracking, burning or bulging of a
steam or hot water heating system, an air conditioning or automatic fire protective sprinkler
system, or an appliance for heating water.
We do not cover loss caused by or resulting
from freezing under this peril.
14. Freezing

a. This peril means freezing of a plumbing,

heating, air conditioning or automatic fire
protective sprinkler system or of a household appliance but only if you have used
reasonable care to:
(1) Maintain heat in the building; or

(2) Shut off the water supply and drain all

systems and appliances of water.
However, if the building is protected by an
automatic fire protective sprinkler system,
you must use reasonable care to continue
the water supply and maintain heat in the
building for coverage to apply.

HO 00 03 10 00

15. Sudden And Accidental Damage From

Artificially Generated Electrical Current
This peril does not include loss to tubes, transistors, electronic components or circuitry that
are a part of appliances, fixtures, computers,
home entertainment units or other types of
electronic apparatus.
16. Volcanic Eruption
This peril does not include loss caused by
earthquake, land shock waves or tremors.
SECTION I EXCLUSIONS
A. We do not insure for loss caused directly or indirectly by any of the following. Such loss is excluded regardless of any other cause or event
contributing concurrently or in any sequence to the
loss. These exclusions apply whether or not the
loss event results in widespread damage or affects a substantial area.

SA
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c. In this peril, a plumbing system or household appliance does not include a sump,
sump pump or related equipment or a roof
drain, gutter, downspout or similar fixtures
or equipment.

b. In this peril, a plumbing system or household appliance does not include a sump,
sump pump or related equipment or a roof
drain, gutter, downspout or similar fixtures
or equipment.

1. Ordinance Or Law

Ordinance Or Law means any ordinance or

law:
a. Requiring or regulating the construction,
demolition, remodeling, renovation or repair
of property, including removal of any resulting debris. This Exclusion A.1.a. does
not apply to the amount of coverage that
may be provided for in E.11. Ordinance Or
Law under Section I Property Coverages;

b. The requirements of which result in a loss

in value to property; or
c. Requiring any "insured" or others to test for,
monitor, clean up, remove, contain, treat,
detoxify or neutralize, or in any way respond
to, or assess the effects of, pollutants.
Pollutants means any solid, liquid, gaseous
or thermal irritant or contaminant, including
smoke, vapor, soot, fumes, acids, alkalis,
chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed.

This Exclusion A.1. applies whether or not the

property has been physically damaged.
2. Earth Movement
Earth Movement means:
a. Earthquake, including land shock waves or
tremors before, during or after a volcanic
eruption;

Copyright, Insurance Services Office, Inc., 1999

Page 11 of 22

b. Landslide, mudslide or mudflow;

c. Subsidence or sinkhole; or
d. Any other earth movement including earth
sinking, rising or shifting;
caused by or resulting from human or animal
forces or any act of nature unless direct loss by
fire or explosion ensues and then we will pay
only for the ensuing loss.
This Exclusion A.2. does not apply to loss by
theft.
3. Water Damage
Water Damage means:
a. Flood, surface water, waves, tidal water,
overflow of a body of water, or spray from
any of these, whether or not driven by wind;
b. Water or water-borne material which backs
up through sewers or drains or which overflows or is discharged from a sump, sump
pump or related equipment; or

caused by or resulting from human or animal

forces or any act of nature.

Direct loss by fire, explosion or theft resulting

from water damage is covered.
4. Power Failure

Power Failure means the failure of power or

other utility service if the failure takes place off
the "residence premises". But if the failure results in a loss, from a Peril Insured Against on
the "residence premises", we will pay for the
loss caused by that peril.
5. Neglect

7. Nuclear Hazard
This Exclusion A.7. pertains to Nuclear Hazard
to the extent set forth in M. Nuclear Hazard
Clause under Section I Conditions.
8. Intentional Loss
Intentional Loss means any loss arising out of
any act an "insured" commits or conspires to
commit with the intent to cause a loss.
In the event of such loss, no "insured" is entitled to coverage, even "insureds" who did not
commit or conspire to commit the act causing
the loss.
9. Governmental Action
Governmental Action means the destruction,
confiscation or seizure of property described in
Coverage A, B or C by order of any governmental or public authority.
This exclusion does not apply to such acts ordered by any governmental or public authority
that are taken at the time of a fire to prevent its
spread, if the loss caused by fire would be
covered under this policy.

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c. Water or water-borne material below the

surface of the ground, including water
which exerts pressure on or seeps or leaks
through a building, sidewalk, driveway,
foundation, swimming pool or other structure;

Discharge of a nuclear weapon will be deemed

a warlike act even if accidental.

Neglect means neglect of an "insured" to use

all reasonable means to save and preserve
property at and after the time of a loss.
6. War

B. We do not insure for loss to property described in

Coverages A and B caused by any of the following. However, any ensuing loss to property described in Coverages A and B not precluded by
any other provision in this policy is covered.
1. Weather conditions. However, this exclusion
only applies if weather conditions contribute in
any way with a cause or event excluded in A.
above to produce the loss.

2. Acts or decisions, including the failure to act or

decide, of any person, group, organization or
governmental body.
3. Faulty, inadequate or defective:
a. Planning, zoning, development, surveying,
siting;

b. Design, specifications, workmanship, repair, construction, renovation, remodeling,

grading, compaction;

War includes the following and any consequence of any of the following:

c. Materials used in repair, construction, renovation or remodeling; or

a. Undeclared war, civil war, insurrection,

rebellion or revolution;

d. Maintenance;

b. Warlike act by a military force or military

personnel; or

of part or all of any property whether on or off

the "residence premises".

c. Destruction, seizure or use for a military

purpose.

Page 12 of 22

Copyright, Insurance Services Office, Inc., 1999

HO 00 03 10 00

SECTION I CONDITIONS
A. Insurable Interest And Limit Of Liability
Even if more than one person has an insurable
interest in the property covered, we will not be liable in any one loss:
1. To an "insured" for more than the amount of
such "insured's" interest at the time of loss; or
2. For more than the applicable limit of liability.
B. Duties After Loss
In case of a loss to covered property, we have no
duty to provide coverage under this policy if the
failure to comply with the following duties is prejudicial to us. These duties must be performed either by you, an "insured" seeking coverage, or a
representative of either:
1. Give prompt notice to us or our agent;
2. Notify the police in case of loss by theft;

e. Specifications of damaged buildings and

detailed repair estimates;
f. The inventory of damaged personal property described in 6. above;
g. Receipts for additional living expenses
incurred and records that support the fair
rental value loss; and
h. Evidence or affidavit that supports a claim
under E.6. Credit Card, Electronic Fund
Transfer Card Or Access Device, Forgery
And Counterfeit Money under Section I
Property Coverages, stating the amount
and cause of loss.
C. Loss Settlement
In this Condition C., the terms "cost to repair or
replace" and "replacement cost" do not include the
increased costs incurred to comply with the enforcement of any ordinance or law, except to the
extent that coverage for these increased costs is
provided in E.11. Ordinance Or Law under Section
I Property Coverages. Covered property losses
are settled as follows:

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3. Notify the credit card or electronic fund transfer

card or access device company in case of loss
as provided for in E.6. Credit Card, Electronic
Fund Transfer Card Or Access Device, Forgery And Counterfeit Money under Section I
Property Coverages;

d. Changes in title or occupancy of the property during the term of the policy;

4. Protect the property from further damage. If

repairs to the property are required, you must:

a. Make reasonable and necessary repairs to

protect the property; and
b. Keep an accurate record of repair expenses;

5. Cooperate with us in the investigation of a

claim;

6. Prepare an inventory of damaged personal

property showing the quantity, description, actual cash value and amount of loss. Attach all
bills, receipts and related documents that justify the figures in the inventory;
7. As often as we reasonably require:
a. Show the damaged property;

b. Provide us with records and documents we

request and permit us to make copies; and

c. Submit to examination under oath, while not

in the presence of another "insured", and
sign the same;
8. Send to us, within 60 days after our request,
your signed, sworn proof of loss which sets
forth, to the best of your knowledge and belief:
a. The time and cause of loss;
b. The interests of all "insureds" and all others
in the property involved and all liens on the
property;
c. Other insurance which may cover the loss;

HO 00 03 10 00

1. Property of the following types:

a. Personal property;

b. Awnings, carpeting, household appliances,

outdoor antennas and outdoor equipment,
whether or not attached to buildings;
c. Structures that are not buildings; and

d. Grave markers, including mausoleums;

at actual cash value at the time of loss but not

more than the amount required to repair or replace.

2. Buildings covered under Coverage A or B at

replacement cost without deduction for depreciation, subject to the following:
a. If, at the time of loss, the amount of insurance in this policy on the damaged building
is 80% or more of the full replacement cost
of the building immediately before the loss,
we will pay the cost to repair or replace, after application of any deductible and without
deduction for depreciation, but not more
than the least of the following amounts:
(1) The limit of liability under this policy that
applies to the building;
(2) The replacement cost of that part of the
building damaged with material of like
kind and quality and for like use; or
(3) The necessary amount actually spent to
repair or replace the damaged building.

Copyright, Insurance Services Office, Inc., 1999

Page 13 of 22

If the building is rebuilt at a new premises,

the cost described in (2) above is limited to
the cost which would have been incurred if
the building had been built at the original
premises.
b. If, at the time of loss, the amount of insurance in this policy on the damaged building
is less than 80% of the full replacement
cost of the building immediately before the
loss, we will pay the greater of the following
amounts, but not more than the limit of liability under this policy that applies to the
building:
(1) The actual cash value of that part of the
building damaged; or
(2) That proportion of the cost to repair or
replace, after application of any deductible and without deduction for depreciation, that part of the building damaged,
which the total amount of insurance in
this policy on the damaged building
bears to 80% of the replacement cost of
the building.

D. Loss To A Pair Or Set

In case of loss to a pair or set we may elect to:
1. Repair or replace any part to restore the pair or
set to its value before the loss; or
2. Pay the difference between actual cash value
of the property before and after the loss.
E. Appraisal
If you and we fail to agree on the amount of loss,
either may demand an appraisal of the loss. In this
event, each party will choose a competent and impartial appraiser within 20 days after receiving a
written request from the other. The two appraisers
will choose an umpire. If they cannot agree upon
an umpire within 15 days, you or we may request
that the choice be made by a judge of a court of
record in the state where the "residence premises"
is located. The appraisers will separately set the
amount of loss. If the appraisers submit a written
report of an agreement to us, the amount agreed
upon will be the amount of loss. If they fail to
agree, they will submit their differences to the umpire. A decision agreed to by any two will set the
amount of loss.

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c. To determine the amount of insurance

required to equal 80% of the full replacement cost of the building immediately before the loss, do not include the value of:

e. You may disregard the replacement cost

loss settlement provisions and make claim
under this policy for loss to buildings on an
actual cash value basis. You may then
make claim for any additional liability according to the provisions of this Condition
C. Loss Settlement, provided you notify us
of your intent to do so within 180 days after
the date of loss.

(1) Excavations,
footings,
foundations,
piers, or any other structures or devices
that support all or part of the building,
which are below the undersurface of the
lowest basement floor;

(2) Those supports described in (1) above

which are below the surface of the
ground inside the foundation walls, if
there is no basement; and
(3) Underground flues, pipes, wiring and
drains.

d. We will pay no more than the actual cash

value of the damage until actual repair or
replacement is complete. Once actual repair or replacement is complete, we will
settle the loss as noted in 2.a. and b.
above.

However, if the cost to repair or replace the

damage is both:
(1) Less than 5% of the amount of insurance in this policy on the building; and
(2) Less than $2,500;
we will settle the loss as noted in 2.a. and
b. above whether or not actual repair or replacement is complete.

Page 14 of 22

Each party will:

1. Pay its own appraiser; and

2. Bear the other expenses of the appraisal and
umpire equally.

F. Other Insurance And Service Agreement

If a loss covered by this policy is also covered by:
1. Other insurance, we will pay only the proportion
of the loss that the limit of liability that applies
under this policy bears to the total amount of
insurance covering the loss; or
2. A service agreement, this insurance is excess
over any amounts payable under any such
agreement. Service agreement means a service plan, property restoration plan, home warranty or other similar service warranty agreement, even if it is characterized as insurance.

G. Suit Against Us
No action can be brought against us unless there
has been full compliance with all of the terms under Section I of this policy and the action is started
within two years after the date of loss.

Copyright, Insurance Services Office, Inc., 1999

HO 00 03 10 00

H. Our Option
If we give you written notice within 30 days after
we receive your signed, sworn proof of loss, we
may repair or replace any part of the damaged
property with material or property of like kind and
quality.
I. Loss Payment
We will adjust all losses with you. We will pay you
unless some other person is named in the policy
or is legally entitled to receive payment. Loss will
be payable 60 days after we receive your proof of
loss and:
1. Reach an agreement with you;
2. There is an entry of a final judgment; or
3. There is a filing of an appraisal award with us.
J. Abandonment Of Property
We need not accept any property abandoned by
an "insured".
K. Mortgage Clause

5. Subrogation will not impair the right of the

mortgagee to recover the full amount of the
mortgagee's claim.
L. No Benefit To Bailee
We will not recognize any assignment or grant any
coverage that benefits a person or organization
holding, storing or moving property for a fee regardless of any other provision of this policy.
M. Nuclear Hazard Clause
1. "Nuclear Hazard" means any nuclear reaction,
radiation, or radioactive contamination, all
whether controlled or uncontrolled or however
caused, or any consequence of any of these.
2. Loss caused by the nuclear hazard will not be
considered loss caused by fire, explosion, or
smoke, whether these perils are specifically
named in or otherwise included within the Perils Insured Against.

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1. If a mortgagee is named in this policy, any loss

payable under Coverage A or B will be paid to
the mortgagee and you, as interests appear. If
more than one mortgagee is named, the order
of payment will be the same as the order of
precedence of the mortgages.

b. At our option, we may pay to the mortgagee

the whole principal on the mortgage plus
any accrued interest. In this event, we will
receive a full assignment and transfer of the
mortgage and all securities held as collateral to the mortgage debt.

2. If we deny your claim, that denial will not apply

to a valid claim of the mortgagee, if the mortgagee:
a. Notifies us of any change in ownership,
occupancy or substantial change in risk of
which the mortgagee is aware;
b. Pays any premium due under this policy on
demand if you have neglected to pay the
premium; and

c. Submits a signed, sworn statement of loss

within 60 days after receiving notice from us
of your failure to do so. Paragraphs E. Appraisal, G. Suit Against Us and I. Loss
Payment under Section I Conditions also
apply to the mortgagee.

3. If we decide to cancel or not to renew this

policy, the mortgagee will be notified at least 10
days before the date cancellation or nonrenewal takes effect.
4. If we pay the mortgagee for any loss and deny
payment to you:
a. We are subrogated to all the rights of the
mortgagee granted under the mortgage on
the property; or

HO 00 03 10 00

3. This policy does not apply under Section I to

loss caused directly or indirectly by nuclear
hazard, except that direct loss by fire resulting
from the nuclear hazard is covered.

N. Recovered Property

If you or we recover any property for which we

have made payment under this policy, you or we
will notify the other of the recovery. At your option,
the property will be returned to or retained by you
or it will become our property. If the recovered
property is returned to or retained by you, the loss
payment will be adjusted based on the amount you
received for the recovered property.

O. Volcanic Eruption Period

One or more volcanic eruptions that occur within a
72 hour period will be considered as one volcanic
eruption.

P. Policy Period
This policy applies only to loss which occurs during the policy period.
Q. Concealment Or Fraud
We provide coverage to no "insureds" under this
policy if, whether before or after a loss, an "insured" has:
1. Intentionally concealed or misrepresented any
material fact or circumstance;

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Page 15 of 22

2. Engaged in fraudulent conduct; or

SECTION II EXCLUSIONS

3. Made false statements;

A. "Motor Vehicle Liability"

relating to this insurance.

R. Loss Payable Clause
If the Declarations show a loss payee for certain
listed insured personal property, the definition of
"insured" is changed to include that loss payee
with respect to that property.
If we decide to cancel or not renew this policy, that
loss payee will be notified in writing.
SECTION II LIABILITY COVERAGES
A. Coverage E Personal Liability
If a claim is made or a suit is brought against an
"insured" for damages because of "bodily injury" or
"property damage" caused by an "occurrence" to
which this coverage applies, we will:
1. Pay up to our limit of liability for the damages
for which an "insured" is legally liable. Damages include prejudgment interest awarded
against an "insured"; and

a. Is registered for use on public roads or

property;
b. Is not registered for use on public roads or
property, but such registration is required by
a law, or regulation issued by a government
agency, for it to be used at the place of the
"occurrence"; or
c. Is being:
(1) Operated in, or practicing for, any prearranged or organized race, speed contest
or other competition;
(2) Rented to others;
(3) Used to carry persons or cargo for a
charge; or
(4) Used for any "business" purpose except
for a motorized golf cart while on a golfing facility.
2. If Exclusion A.1. does not apply, there is still no
coverage for "motor vehicle liability" unless the
"motor vehicle" is:

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2. Provide a defense at our expense by counsel

of our choice, even if the suit is groundless,
false or fraudulent. We may investigate and
settle any claim or suit that we decide is appropriate. Our duty to settle or defend ends
when our limit of liability for the "occurrence"
has been exhausted by payment of a judgment
or settlement.

1. Coverages E and F do not apply to any "motor

vehicle liability" if, at the time and place of an
"occurrence", the involved "motor vehicle":

B. Coverage F Medical Payments To Others

We will pay the necessary medical expenses that

are incurred or medically ascertained within three
years from the date of an accident causing "bodily
injury". Medical expenses means reasonable
charges for medical, surgical, x-ray, dental, ambulance, hospital, professional nursing, prosthetic
devices and funeral services. This coverage does
not apply to you or regular residents of your
household except "residence employees". As to
others, this coverage applies only:
1. To a person on the "insured location" with the
permission of an "insured"; or
2. To a person off the "insured location", if the
"bodily injury":
a. Arises out of a condition on the "insured
location" or the ways immediately adjoining;
b. Is caused by the activities of an "insured";
c. Is caused by a "residence employee" in the
course of the "residence employee's" employment by an "insured"; or
d. Is caused by an animal owned by or in the
care of an "insured".

Page 16 of 22

a. In dead storage on an "insured location";

b. Used solely to service an "insured's" residence;

c. Designed to assist the handicapped and, at
the time of an "occurrence", it is:
(1) Being used to assist a handicapped
person; or
(2) Parked on an "insured location";

d. Designed for recreational use off public

roads and:
(1) Not owned by an "insured"; or
(2) Owned by an "insured" provided the
"occurrence" takes place on an "insured
location" as defined in Definitions B.
6.a., b., d., e. or h.; or

e. A motorized golf cart that is owned by an

"insured", designed to carry up to 4 persons, not built or modified after manufacture to exceed a speed of 25 miles per hour
on level ground and, at the time of an "occurrence", is within the legal boundaries of:
(1) A golfing facility and is parked or stored
there, or being used by an "insured" to:
(a) Play the game of golf or for other
recreational or leisure activity allowed by the facility;

Copyright, Insurance Services Office, Inc., 1999

HO 00 03 10 00

(b) Travel to or from an area where

"motor vehicles" or golf carts are
parked or stored; or
(c) Cross public roads at designated
points to access other parts of the
golfing facility; or
(2) A private residential community, including its public roads upon which a motorized golf cart can legally travel, which
is subject to the authority of a property
owners association and contains an "insured's" residence.
B. "Watercraft Liability"
1. Coverages E and F do not apply to any "watercraft liability" if, at the time of an "occurrence",
the involved watercraft is being:
a. Operated in, or practicing for, any prearranged or organized race, speed contest or
other competition. This exclusion does not
apply to a sailing vessel or a predicted log
cruise;
b. Rented to others;

d. Used for any "business" purpose.

2. If Exclusion B.1. does not apply, there is still no

coverage for "watercraft liability" unless, at the
time of the "occurrence", the watercraft:
a. Is stored;

b. Is a sailing vessel, with or without auxiliary

power, that is:
(1) Less than 26 feet in overall length; or

(2) 26 feet or more in overall length and not

owned by or rented to an "insured"; or
c. Is not a sailing vessel and is powered by:

(1) An inboard or inboard-outdrive engine or

motor, including those that power a water jet pump, of:
(a) 50 horsepower or less and not
owned by an "insured"; or
(b) More than 50 horsepower and not
owned by or rented to an "insured";
or
(2) One or more outboard engines or motors with:
(a) 25 total horsepower or less;
(b) More than 25 horsepower if the
outboard engine or motor is not
owned by an "insured";
(c) More than 25 horsepower if the
outboard engine or motor is owned
by an "insured" who acquired it during the policy period; or

HO 00 03 10 00

(i) You declare them at policy inception; or

(ii) Your intent to insure them is
reported to us in writing within 45
days after you acquire them.
The coverages in (c) and (d) above apply for the policy period.
Horsepower means the maximum power
rating assigned to the engine or motor by
the manufacturer.
C. "Aircraft Liability"
This policy does not cover "aircraft liability".
D. "Hovercraft Liability"
This policy does not cover "hovercraft liability".
E. Coverage E Personal Liability And Coverage
F Medical Payments To Others
Coverages E and F do not apply to the following:
1. Expected Or Intended Injury

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c. Used to carry persons or cargo for a

charge; or

(d) More than 25 horsepower if the

outboard engine or motor is owned
by an "insured" who acquired it before the policy period, but only if:

"Bodily injury" or "property damage" which is

expected or intended by an "insured" even if
the resulting "bodily injury" or "property damage":
a. Is of a different kind, quality or degree than
initially expected or intended; or

b. Is sustained by a different person, entity,

real or personal property, than initially expected or intended.

However, this Exclusion E.1. does not apply to

"bodily injury" resulting from the use of reasonable force by an "insured" to protect persons or
property;

2. "Business"

a. "Bodily injury" or "property damage" arising

out of or in connection with a "business"
conducted from an "insured location" or engaged in by an "insured", whether or not the
"business" is owned or operated by an "insured" or employs an "insured".
This Exclusion E.2. applies but is not limited to an act or omission, regardless of its
nature or circumstance, involving a service
or duty rendered, promised, owed, or implied to be provided because of the nature
of the "business".

b. This Exclusion E.2. does not apply to:

(1) The rental or holding for rental of an
"insured location";

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Page 17 of 22

(a) On an occasional basis if used only

as a residence;
(b) In part for use only as a residence,
unless a single family unit is intended for use by the occupying
family to lodge more than two roomers or boarders; or
(c) In part, as an office, school, studio or
private garage; and
(2) An "insured" under the age of 21 years
involved in a part-time or occasional,
self-employed "business" with no employees;
3. Professional Services
"Bodily injury" or "property damage" arising out
of the rendering of or failure to render professional services;
4. "Insured's" Premises Not An "Insured
Location"
"Bodily injury" or "property damage" arising out
of a premises:
a. Owned by an "insured";
c. Rented to others by an "insured";
that is not an "insured location";
5. War

"Bodily injury" or "property damage" caused directly or indirectly by war, including the following and any consequence of any of the following:

a. Undeclared war, civil war, insurrection,

rebellion or revolution;

b. Warlike act by a military force or military

personnel; or
c. Destruction, seizure or use for a military
purpose.
Discharge of a nuclear weapon will be deemed
a warlike act even if accidental;
6. Communicable Disease

"Bodily injury" or "property damage" arising out

of the use, sale, manufacture, delivery, transfer
or possession by any person of a Controlled
Substance as defined by the Federal Food and
Drug Law at 21 U.S.C.A. Sections 811 and
812. Controlled Substances include but are not
limited to cocaine, LSD, marijuana and all narcotic drugs. However, this exclusion does not
apply to the legitimate use of prescription drugs
by a person following the orders of a licensed
physician.
Exclusions A. "Motor Vehicle Liability", B. "Watercraft Liability", C. "Aircraft Liability", D. "Hovercraft
Liability" and E.4. "Insured's" Premises Not An "Insured Location" do not apply to "bodily injury" to a
"residence employee" arising out of and in the
course of the "residence employee's" employment
by an "insured".
F. Coverage E Personal Liability
Coverage E does not apply to:
1. Liability:
a. For any loss assessment charged against
you as a member of an association, corporation or community of property owners, except as provided in D. Loss Assessment
under Section II Additional Coverages;

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b. Rented to an "insured"; or

8. Controlled Substance

"Bodily injury" or "property damage" which

arises out of the transmission of a communicable disease by an "insured";
7. Sexual Molestation, Corporal Punishment
Or Physical Or Mental Abuse
"Bodily injury" or "property damage" arising out
of sexual molestation, corporal punishment or
physical or mental abuse; or

b. Under any contract or agreement entered

into by an "insured". However, this exclusion does not apply to written contracts:
(1) That directly relate to the ownership,
maintenance or use of an "insured location"; or
(2) Where the liability of others is assumed
by you prior to an "occurrence";
unless excluded in a. above or elsewhere in
this policy;

2. "Property damage" to property owned by an

"insured". This includes costs or expenses incurred by an "insured" or others to repair, replace, enhance, restore or maintain such property to prevent injury to a person or damage to
property of others, whether on or away from an
"insured location";
3. "Property damage" to property rented to, occupied or used by or in the care of an "insured".
This exclusion does not apply to "property
damage" caused by fire, smoke or explosion;
4. "Bodily injury" to any person eligible to receive
any benefits voluntarily provided or required to
be provided by an "insured" under any:
a. Workers' compensation law;

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b. Non-occupational disability law; or

SECTION II ADDITIONAL COVERAGES

c. Occupational disease law;

We cover the following in addition to the limits of

liability:

5. "Bodily injury" or "property damage" for which

an "insured" under this policy:
a. Is also an insured under a nuclear energy
liability policy issued by the:
(1) Nuclear Energy Liability Insurance Association;
(2) Mutual Atomic Energy Liability Underwriters;
(3) Nuclear Insurance Association of Canada;
or any of their successors; or
b. Would be an insured under such a policy
but for the exhaustion of its limit of liability;
or
6. "Bodily injury" to you or an "insured" as defined
under Definitions 5.a. or b.
This exclusion also applies to any claim made
or suit brought against you or an "insured":

We pay:
1. Expenses we incur and costs taxed against an
"insured" in any suit we defend;
2. Premiums on bonds required in a suit we defend, but not for bond amounts more than the
Coverage E limit of liability. We need not apply
for or furnish any bond;
3. Reasonable expenses incurred by an "insured"
at our request, including actual loss of earnings
(but not loss of other income) up to $250 per
day, for assisting us in the investigation or defense of a claim or suit; and
4. Interest on the entire judgment which accrues
after entry of the judgment and before we pay
or tender, or deposit in court that part of the
judgment which does not exceed the limit of liability that applies.
B. First Aid Expenses
We will pay expenses for first aid to others incurred by an "insured" for "bodily injury" covered
under this policy. We will not pay for first aid to an
"insured".

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a. To repay; or
b. Share damages with;

A. Claim Expenses

another person who may be obligated to pay

damages because of "bodily injury" to an "insured".
G. Coverage F Medical Payments To Others
Coverage F does not apply to "bodily injury":

1. To a "residence employee" if the "bodily injury":

a. Occurs off the "insured location"; and

b. Does not arise out of or in the course of the

"residence employee's" employment by an
"insured";
2. To any person eligible to receive benefits voluntarily provided or required to be provided under any:

C. Damage To Property Of Others

1. We will pay, at replacement cost, up to $1,000
per "occurrence" for "property damage" to
property of others caused by an "insured".
2. We will not pay for "property damage":
a. To the extent of any amount recoverable
under Section I;

b. Caused intentionally by an "insured" who is

13 years of age or older;
c. To property owned by an "insured";

b. Non-occupational disability law; or

d. To property owned by or rented to a tenant

of an "insured" or a resident in your household; or

c. Occupational disease law;

e. Arising out of:

a. Workers' compensation law;

3. From any:

(1) A "business" engaged in by an "insured";

a. Nuclear reaction;
b. Nuclear radiation; or
c. Radioactive contamination;
all whether controlled or uncontrolled or however caused; or
d. Any consequence of any of these; or
4. To any person, other than a "residence employee" of an "insured", regularly residing on
any part of the "insured location".

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(2) Any act or omission in connection with a

premises owned, rented or controlled by
an "insured", other than the "insured location"; or
(3) The ownership, maintenance, occupancy, operation, use, loading or unloading of aircraft, hovercraft, watercraft
or "motor vehicles".

Copyright, Insurance Services Office, Inc., 1999

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This exclusion e.(3) does not apply to a

"motor vehicle" that:
(a) Is designed for recreational use off
public roads;
(b) Is not owned by an "insured"; and
(c) At the time of the "occurrence", is
not required by law, or regulation issued by a government agency, to
have been registered for it to be
used on public roads or property.
D. Loss Assessment
1. We will pay up to $1,000 for your share of loss
assessment charged against you, as owner or
tenant of the "residence premises", during the
policy period by a corporation or association of
property owners, when the assessment is
made as a result of:
a. "Bodily injury" or "property damage" not
excluded from coverage under Section II
Exclusions; or
b. Liability for an act of a director, officer or
trustee in the capacity as a director, officer
or trustee, provided such person:

A. Limit Of Liability
Our total liability under Coverage E for all damages resulting from any one "occurrence" will not
be more than the Coverage E limit of liability
shown in the Declarations. This limit is the same
regardless of the number of "insureds", claims
made or persons injured. All "bodily injury" and
"property damage" resulting from any one accident
or from continuous or repeated exposure to substantially the same general harmful conditions
shall be considered to be the result of one "occurrence".
Our total liability under Coverage F for all medical
expense payable for "bodily injury" to one person
as the result of one accident will not be more than
the Coverage F limit of liability shown in the Declarations.
B. Severability Of Insurance
This insurance applies separately to each "insured". This condition will not increase our limit of
liability for any one "occurrence".
C. Duties After "Occurrence"
In case of an "occurrence", you or another "insured" will perform the following duties that apply.
We have no duty to provide coverage under this
policy if your failure to comply with the following
duties is prejudicial to us. You will help us by seeing that these duties are performed:

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(1) Is elected by the members of a corporation or association of property owners;

and

SECTION II CONDITIONS

(2) Serves without deriving any income

from the exercise of duties which are
solely on behalf of a corporation or association of property owners.

2. Paragraph I. Policy Period under Section II

Conditions does not apply to this Loss Assessment Coverage.
3. Regardless of the number of assessments, the
limit of $1,000 is the most we will pay for loss
arising out of:
a. One accident, including continuous or repeated exposure to substantially the same
general harmful condition; or

b. A covered act of a director, officer or trustee. An act involving more than one director, officer or trustee is considered to be a
single act.

4. We do not cover assessments charged against

you or a corporation or association of property
owners by any governmental body.

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1. Give written notice to us or our agent as soon

as is practical, which sets forth:
a. The identity of the policy and the "named
insured" shown in the Declarations;

b. Reasonably available information on the

time, place and circumstances of the "occurrence"; and
c. Names and addresses of any claimants
and witnesses;

2. Cooperate with us in the investigation, settlement or defense of any claim or suit;

3. Promptly forward to us every notice, demand,
summons or other process relating to the "occurrence";
4. At our request, help us:
a. To make settlement;
b. To enforce any right of contribution or indemnity against any person or organization
who may be liable to an "insured";

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c. With the conduct of suits and attend hearings and trials; and
d. To secure and give evidence and obtain the
attendance of witnesses;
5. With respect to C. Damage To Property Of
Others under Section II Additional Coverages, submit to us within 60 days after the
loss, a sworn statement of loss and show the
damaged property, if in an "insured's" control;
6. No "insured" shall, except at such "insured's"
own cost, voluntarily make payment, assume
obligation or incur expense other than for first
aid to others at the time of the "bodily injury".
D. Duties Of An Injured Person Coverage F
Medical Payments To Others
1. The injured person or someone acting for the
injured person will:
a. Give us written proof of claim, under oath if
required, as soon as is practical; and
b. Authorize us to obtain copies of medical
reports and records.

E. Payment Of Claim Coverage F Medical

Payments To Others

Payment under this coverage is not an admission

of liability by an "insured" or us.
F. Suit Against Us

1. No action can be brought against us unless

there has been full compliance with all of the
terms under this Section II.

2. No one will have the right to join us as a party

to any action against an "insured".
3. Also, no action with respect to Coverage E can
be brought against us until the obligation of
such "insured" has been determined by final
judgment or agreement signed by us.
G. Bankruptcy Of An "Insured"

Bankruptcy or insolvency of an "insured" will not

relieve us of our obligations under this policy.
H. Other Insurance

This insurance is excess over other valid and collectible insurance except insurance written specifically to cover as excess over the limits of liability
that apply in this policy.
I. Policy Period
This policy applies only to "bodily injury" or "property damage" which occurs during the policy period.

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We do not provide coverage to an "insured" who,

whether before or after a loss, has:
1. Intentionally concealed or misrepresented any
material fact or circumstance;
2. Engaged in fraudulent conduct; or
3. Made false statements;
relating to this insurance.
SECTIONS I AND II CONDITIONS
A. Liberalization Clause
If we make a change which broadens coverage
under this edition of our policy without additional
premium charge, that change will automatically
apply to your insurance as of the date we implement the change in your state, provided that this
implementation date falls within 60 days prior to or
during the policy period stated in the Declarations.
This Liberalization Clause does not apply to
changes implemented with a general program revision that includes both broadenings and restrictions in coverage, whether that general program
revision is implemented through introduction of:

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2. The injured person will submit to a physical

exam by a doctor of our choice when and as
often as we reasonably require.

J. Concealment Or Fraud

1. A subsequent edition of this policy; or

2. An amendatory endorsement.

B. Waiver Or Change Of Policy Provisions

A waiver or change of a provision of this policy
must be in writing by us to be valid. Our request
for an appraisal or examination will not waive any
of our rights.

C. Cancellation

1. You may cancel this policy at any time by returning it to us or by letting us know in writing of
the date cancellation is to take effect.

2. We may cancel this policy only for the reasons

stated below by letting you know in writing of
the date cancellation takes effect. This cancellation notice may be delivered to you, or
mailed to you at your mailing address shown in
the Declarations. Proof of mailing will be sufficient proof of notice.
a. When you have not paid the premium, we
may cancel at any time by letting you know
at least 10 days before the date cancellation takes effect.
b. When this policy has been in effect for less
than 60 days and is not a renewal with us,
we may cancel for any reason by letting you
know at least 10 days before the date cancellation takes effect.

Copyright, Insurance Services Office, Inc., 1999

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c. When this policy has been in effect for 60

days or more, or at any time if it is a renewal with us, we may cancel:

E. Assignment

(1) If there has been a material misrepresentation of fact which if known to us

would have caused us not to issue the
policy; or

F. Subrogation

(2) If the risk has changed substantially

since the policy was issued.
This can be done by letting you know at
least 30 days before the date cancellation
takes effect.
d. When this policy is written for a period of
more than one year, we may cancel for any
reason at anniversary by letting you know at
least 30 days before the date cancellation
takes effect.

Assignment of this policy will not be valid unless

we give our written consent.
An "insured" may waive in writing before a loss all
rights of recovery against any person. If not
waived, we may require an assignment of rights of
recovery for a loss to the extent that payment is
made by us.
If an assignment is sought, an "insured" must sign
and deliver all related papers and cooperate with
us.
Subrogation does not apply to Coverage F or
Paragraph C. Damage To Property Of Others under Section II Additional Coverages.
G. Death
If any person named in the Declarations or the
spouse, if a resident of the same household, dies,
the following apply:

4. If the return premium is not refunded with the

notice of cancellation or when this policy is returned to us, we will refund it within a reasonable time after the date cancellation takes effect.

1. We insure the legal representative of the deceased but only with respect to the premises
and property of the deceased covered under
the policy at the time of death; and

D. Nonrenewal

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3. When this policy is canceled, the premium for

the period from the date of cancellation to the
expiration date will be refunded pro rata.

We may elect not to renew this policy. We may do

so by delivering to you, or mailing to you at your
mailing address shown in the Declarations, written
notice at least 30 days before the expiration date
of this policy. Proof of mailing will be sufficient
proof of notice.

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2. "Insured" includes:

a. An "insured" who is a member of your

household at the time of your death, but
only while a resident of the "residence
premises"; and

b. With respect to your property, the person

having proper temporary custody of the
property until appointment and qualification
of a legal representative.

Copyright, Insurance Services Office, Inc., 1999

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Self Study Affidavit

I,

hereby affirm that I have received and

(Your name here)

completed the 10 hour self study portion of the Texas pre-licensing

course being administered by Insurance Adjuster Training.net.

Student further affirms that he/she will remit this page to the instructor
of said pre-licensing training course before the beginning of the final
exam.

______________________________
Printed Name

______________________________
Signature

______________________
Date