Chapter 10 Residential Property Claims

Question 1

What are the three types of residential policies?

Answer 1

Homeowners (A, B, C & D)
Tenants (C & D)
Condo (C & D)

Question 2

What is in coverage A of Section I?

Answer 2

Dwelling

• Main building, attached structures, permanently installed outdoor equipment, outdoor swimming pool

Question 3

What is in coverage B of Section I?

Answer 3

Detached Private Structures

• Structures separated from the main building by a clear space (garden shed, greenhouse, gazebo, barn/stable, boathouse)

Question 4

What is in coverage C of Section I?

Answer 4

Personal Property

• Contents usual to a home (located at the property/temp removed)

Question 5

What is in coverage D of Section I?

Answer 5

Additional Living Expenses
- Extra costs incurred when an insured person incurs additional cost while property is unfit to occupy as result of insured peril

Question 6

Under what are swimming pools covered in Quebec?

Answer 6

Endorsement

Question 7

What are the three other coverages specific to a Condo?

Answer 7

Unit improvements and betterments
Loss assessment
Unit additional protection

Question 8

What questions must an adjuster ask when comparing heat and fire?

Answer 8

Has heat been applied?

What resulting products of fire are in evidence?

Question 9

What are the permitted exclusions of the fire peril in Ontario?

Answer 9

Riot,
civil commotion,
war,
invasion,
act of foreign enemy,
hostilities,
civil war,
rebellion,
revolution,
insurrection
military powered

Question 10

What are some typical things an adjuster can recommend to help minimize damage?

Answer 10

There may be some urgency to board up exposed areas
There may be a need to air and deodorize the premises
Washing walls should be attempted as soon as possible to determine what painting would be required
Protective barriers or fencing may be required to limit any trespassing or further damage
Complex or large losses still under investigation, property may require on-site security

Question 11

Define water hammer

Answer 11

Pressure shock wave induced in plumbing supply systems when a sudden change occurs to the stability of the water, causing a banging noise in pipes

Question 12

Explain the water hammer exclusion

Answer 12

Exclusion under explosion

Is not excluded in an all-risk form or Quebec policy forms

Question 13

What is the common exclusion of smoke?

Answer 13

Agricultural smudging or industrial operations

Question 14

What are some common examples of falling objects that may cause damage?

Answer 14

Falling trees, meteorites, aircraft parts and debris from blasting operations

Question 15

What are the four main occurrences covered under the water peril?

Answer 15

Sudden and accidental escape of water from a watermain
Sudden and accidental escape of water or steam from within a plumbing, heating, sprinkler or ac system or domestic water container located inside the dwelling
Sudden and accidental escape of water from a domestic water container located outside the building (not insured if caused by freezing)
Water that enters dwelling from an opening created suddenly and accidentally by another insured peril

Question 16

What must an insured do to obtain coverage for frozen pipes rupturing if they are away for more than four consecutive days?

Answer 16

Insured arranged for someone to enter the house each day to ensure that heating was being maintained
Insured shut off the water supply and drained all the pipes and domestic water containers

Question 17

What are the common water exclusions?

Answer 17

Continuous or repeated seepage or leakage
Backup from a sewer, sump or septic tank
Ground water or rising water table
Surface water
Shoreline ice building
Damage by waterborne ice or other objects, whether by rain or otherwise

Question 18

What are the common roofing problems that have nothing to do with hail?

Answer 18

Moisture trapped in the roofing material may cause bubbling
Sheathing that expands and contracts may cause wrinkling
Oils evaporating from the roofing materials may cause an alligator-type pattern on the roofing surface

Question 19

What are the perils within transportation?

Answer 19

Collision
Derailment
Upset
Stranding
Overturn
Sinking

Question 20

What are the restrictions of the theft peril?

Answer 20

Caused by a tenant in a part that is rented out, the tenants family or tenants employees
Dwelling under construction
Animals, birds, or fish
When by fraud or trickery; a change of ownership in property takes place with the insured’s agreement

Question 21

What are the typical extensions of property?

Answer 21

Debris removal
Cost of removing property from premises to protect it from loss for up to 30 days or until the policy term ends (whichever is first)
Property removed from insured’s property to protect it from damage
Personal property in transit to another home
Fire department assessments
Property coverage from change in temperature due to insured peril
Loss of freezer food due to interruption of electrical power or mechanical breakdown up to $2000
Replacement or re-keying of locks if keys are stolen
Tearing out for repair due to water damage (swimming pool & watermain not covered)
Arson conviction rewards
Coverage for credit card, debit card, forgery and counterfeit money up to $1000

Question 22

What is the difference between vacant and unoccupied?

Answer 22

Vacant - no contents & no occupants

Unoccupied - contents & no occupants

Question 23

What facts would an adjuster want to determine regarding a property a claim?

Answer 23

When the loss occurred
Specific location from which the loss occurred
Who discovered the loss and what time of day it was
How the loss was discovered
Whether police were notified
Name of the landlord, if applicable
Brief description of the residence, to include its age and the type of construction
Names of household occupants
Nature of any repairs already completed
Insured’s story of what they believe happened
Description of item or items damaged that includes the following: ownership of the item, location of the item, make/model/size/serial number, identifying marks on item, details of purchase, storage/repair
Whether a financing contract exists for damaged items: amount owed, to whom

Question 24

What additional information is required for theft and burglary claims?

Answer 24

How entry was gained to the premises
Whether visible signs of the entry exist
Confirmation whether doors and windows are kept locked
Whether an alarm is in place
Whether an alarm is kept activated

Question 25

What background info can be confirmed from the application?

Answer 25

Name of prior carrier and policy number
Whether insured had prior losses
Details of prior claims
Whether insured ever had insurance cancelled
Details related to why a cancellation occurred

Question 26

What does the adjuster need to do to get the info required for the estimate?

Answer 26

Note cause and severity of damage
Measure dimensions of floors, walls & ceilings
Documents the number of doors, windows & other openings
Details each restoration activity with a description of the material (identifies whether floor coverings need cleaning, repair or replacement)
Details damage and what must be done to restore the property, starting w/ floor & moving to walls then ceilings
Identify all damaged areas, including framing, windows, doors, vapour barrier, sheathing and exterior finish, insulation, interior finish, walls, ceilings, floor finishes, trim, moulding, finish carpentry, wall & ceiling finishes, staircases, shelving and cabinetry
Identifies what kinds of subcontractor will be needed, such as those specializing in broadloom, wood flooring, plumbing, electrical, heating, ventilation & ac
Consider other damage way ensue because of repairs
Identify how much demolition, debris removal & final cleanup required

Question 27

In property, What are the four items that repair activities are categorized in?

Answer 27

Function
Unit amount (area, volume, length)
Cost per unit
Total cost

Question 28

What is P & O?

Answer 28

Profit and overhead

Question 29

What are the two most common roofs?

Answer 29

Gable and hip

Question 30

What is the line at the top of the roof called?

Answer 30

Ridge

Question 31

What are the lower edges of a roof called?

Answer 31

Eaves

Question 32

What makes up a gable roof?

Answer 32

Two rectangles

Question 33

How much more do hip roofs cost than gable roofs?

Answer 33

10 to 15 percent to cover the waste factor

Question 34

What are the conditions of replacement of a home at replacement cost?

Answer 34

Repairs or replacement must take place at the same location
Same occupancy must be maintained
Materials of the same quality must be used
Repairs or replacement must take place within a reasonable time after the loss

Question 35

What is guaranteed replacement cost called in Quebec?

Answer 35

Enhanced replacement cost

Question 36

How can lightning damage be assessed?

Answer 36

A direct strike can cause physical damage to property by vaporizing material.
Lightning damage is sometimes evidenced by a hole in the roof or wall.
Lightning damage can be tracked through the property.
Lightning generally follows a defined path through electrical equipment.
A loss adjuster may appoint a qualified expert to differentiate between lightning damage and other causes of electrical failure in appliances.

Question 37

How does the loss of freezer food extension work?

Answer 37

Most residential policies provide this extension of coverage; it is essential that the actual wording in force, at the time of the loss, be examined to determine whether an extension applies.
Typically these extensions do not increase the limit of insurance available under the policy.
Where the extensions are in addition to other loss or damage, the deductible applies to the entire loss and not specifically to the extension.
Loss of food in a freezer caused by an interruption of electrical power or mechanical breakdown is covered for up to $2,000 without a deductible.
This extension contains some exclusions, and the amounts insured may vary by policy.