A Few Policy Forms are Not Sufficient: You Need Every Page of your Policy

The eight or twelve pages of documents you keep in your file labeled “homeowners insurance” is not enough. In order to truly understand the insurance coverage you have purchased, you must have the complete policy. This is a contract between you and your insurance company. You can’t rest assured that indemnity will be coming your way, or understand a request from an insurance company without the entire agreement.

You and your adjuster need the complete policy with the correct coverage dates—the agreement in place during the loss. Often the way it works is that a carrier will send you a policy booklet the first year you purchase insurance with a few extra forms. You will look at the declarations page, see your name and your address with effective dates and feel comfortable that you have the “replacement cost coverage” or “deluxe homeowners premier policy” that you understood the agent was selling you. But the years go by and every now and then you get a few more updated forms in the mail in a big envelope. You see the new coverage forms for the current year and you make a file. The problem is your current declaration page references forms not sent in the renewal package. It may refer to forms from the inception of the policy or from a year or two later. Forms you may not have in your file. If you are like some, you scan in your insurance forms but have changed computers or storage systems and finding every single form the insurance company has ever sent you is not easily done. If you are a business owner with many buildings, hopefully you have a specialist helping you with your insurance, but locating your policy form will become urgent when you have a loss. And then the scramble begins.

To help policyholders, some insurance companies allow you to login and see your insurance policies online but I give the same warning, the only way to make sure you have the complete policy is by checking off each form and endorsement listed on the declaration page.

See the example here:

The renewal paperwork is just not going to carry the day.

One form or endorsement can change coverage drastically. It can limit or exclude the claimed damages or, it an increase your indemnity. One form can also be a state-specific change that shows the limitation on how long you have to bring an action against the carrier. This form has important legal rights that you would not be aware of if you only have a few introductory pages of the policy. Missing the form called “Duties after a Loss” can have a significant impact on your claim if you fail to follow a requirement for payment, like a Proof of Loss form deadline. Other forms allow for additional coverage for Ordinance and Law or Code Upgrade Coverage. These forms can significantly affect the claim’s final resolution.

The best practice is to request a complete or certified policy from your insurance company to make sure that both parties are referring to the same document as a claim goes on.

A certified copy of a policy will be signed by an insurance company representative and state that the policy and all the forms are correct, and is attached to the full insurance contract. When you have a certified copy of the policy there is much less confusion about the forms, and the carrier is bound to the policy forms it certified.

A carrier should always be willing to provide you an extra copy of your insurance policies but sometimes there is improper resistance. The agent may be helpful but most of the time the best place to request your policy from is the actual insurance company. But don’t be surprised if they send you just a few documents. Asking for a certified copy, may take a little longer but it will be the full document.

Public insurance adjusters often make the request for the certified policy in their initial contact with the company after being retained. This is a good practice, but make sure this is being followed up on and that the policy is sent. The most critical document in these cases is the policy, the pubic insurance adjuster and policyholder need it, and counsel will make it exhibit 1 to the case.

We have seen a trend where certain insurance companies now request that a policyholder pay for a copy of the policy. Requests of $50 and $100 dollars have come across my desk. This is ridiculous and tells me that the carriers who do this are trying to put some unnecessary burden/requirement on the insureds. Usually a phone call questioning why this fee is being imposed and reminding the representative that the policy is needed because this is something that the policyholder must see to comply with the obligations under the policy, makes the fee go away.
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