General Property

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Refer to the Declarations and determine that the property location is listed on the policy. If the property is not at a fixed location it must be described on the policy. Certain personal property, over a certain value, such as jewelry or fine art, must be scheduled. Some equipment, such as boilers and machinery, may be excluded as they are covered under another policy.

Determine the cause of loss and determine if it is a covered peril in the Insuring Agreement. A peril is a cause of loss. Some policies name the perils that are insured against. Under a named-peril policy any cause of the loss that is not named is excluded. The alternative policy form is called all-perils. An all perils policy covers all losses, but only if they are not referenced in the the exclusions. 

After confirming that the peril is covered, check for applicable exclusions. Either certain causes of loss may be excluded or exclusions may apply to certain circumstances. Excluded circumstances might be that the insured had control of the event, the event was not accidental or arose out of extra-hazardous activities. Losses may also be excluded if they are covered by another policy.

The application of exclusionary language of a policy must in many legal jurisdictions consider the reasonable expectation an insured. Any ambiguities in the policy language are resolved in favor of the insured in most jurisdictions. While exclusionary language is generally required to be strictly construed, language granting coverage is allowed broad interpretation. Also, while the insurer generally has the burden to show that an exclusion applies, it is the insured that has the burden to show that the insuring agreement may apply the loss tendered to the insurer.

A full coverage evaluation is completed with a review of the Conditions. Check for any breaches. Fraud, misrepresentation or concealment might occur in the application for coverage or in the reporting of a claim. Conditions requiring ongoing performance by the insured, such as providing a security system should be checked. The methods of valuation of losses, such as by actual cash value or replacement cost, are likely to be found in the Conditions. The coinsurance provision in the Conditions requires that a minimum amount of insurance must be carried in terms of the percentage of the value of the insured property. Inadequate coverage may act to reduce claim payments.

If there are coverage issues or potential issues, it is generally recommended that the insured be advised at the onset of initial communication. This is to avoid waiver or estoppel.

Mortagee or other lien holder provisions must be checked those parties must be properly included in any claim payments.

 
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