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C110 Essentials of Loss Adjusting > Study 10 - Residential Property Claims > Flashcards

Study 10 - Residential Property Claims Flashcards

1
Q

What are the three types of residential policies?

A

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

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2
Q

What is in coverage A of Section I?

A

Dwelling

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

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3
Q

What is in coverage B of Section I?

A

Detached Private Structures

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

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4
Q

What is in coverage C of Section I?

A

Personal Property

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

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5
Q

What is in coverage D of Section I?

A

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

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6
Q

Under what are swimming pools covered in Quebec?

A

Endorsement

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7
Q

What are the three other coverages specific to a Condo?

A

Unit improvements and betterments
Loss assessment
Unit additional protection

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8
Q

What is the name for the condo corporation in Quebec and BC?

A

Quebec - Syndicate

BC - Strata corporation

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9
Q

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

A

Has heat been applied?

What resulting products of fire are in evidence?

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10
Q

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

A

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

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11
Q

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

A

Civil war, riot or civil disturbance, nuclear explosion, volcanic eruption, earthquake, or other cataclysm

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12
Q

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

A
  • 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
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13
Q

Define water hammer

A

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

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14
Q

Explain the water hammer exclusion

A

Exclusion under explosion

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

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15
Q

What is the common exclusion of smoke?

A

Agricultural smudging or industrial operations

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16
Q

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

A

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

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17
Q

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

A
  • 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
18
Q

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

A
  • 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
19
Q

What are the common water exclusions?

A
  • 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
20
Q

What precedent was set in Easton v. Lanark Mutual Co?

A

An insured is not required to accept a method of payment that diminishes the value of his home

21
Q

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

A
  • 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
22
Q

What are the perils within transportation?

A
  • Collision
  • Derailment
  • Upset
  • Stranding
  • Overturn
  • Sinking
23
Q

What are the restrictions of the theft peril?

A
  • 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
24
Q

What are the typical extensions of property?

A
  • 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
25
Q

What is the difference between vacant and unoccupied?

A

Vacant - no contents & no occupants

Unoccupied - contents & no occupants

26
Q

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

A
  • 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
27
Q

What are the additional requirements of theft and burglary claims?

A
  • 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
28
Q

What background info can be confirmed from the application?

A
  • 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
29
Q

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

A
  • 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
30
Q

What are the four items that repair activities are categorized in?

A

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

31
Q

What is P & O?

A

Profit and overhead

32
Q

What are the two most common roofs?

A

Gable and hip

33
Q

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

A

Ridge

34
Q

What are the lower edges of a roof called?

A

Eaves

35
Q

What makes up a gable roof?

A

Two rectangles

36
Q

How much more do hip roofs cost than gable roofs?

A

10 to 15 percent to cover the waste factor

37
Q

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

A
  • 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
38
Q

What is guaranteed replacement cost called in Quebec?

A

Enhanced replacement cost

39
Q

How can lightning damage be assessed?

A
  • 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.
40
Q

How does the loss of freezer food extension work?

A
  • 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.

C110 Essentials of Loss Adjusting (11 decks)

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