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JimF
USA
1014 Posts |
 Posted - 04/06/2003 : 03:15:31
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Jack and Jill have been dating for some time, and Jack has recently moved into an apartment which Jill has been renting for several years and which she has covered under an HO-4 insurance policy.
Short of marrying Jill, under what circumstances if any, can Jack be considered "an insured" under Jill's HO-4 policy?
If a fire severely damages Jill's apartment, can Jack recover for his personal property including his expensive stereo system also damaged from Jill's HO-4 carrier? Why or why not?
We run into "live in" (or "shack up" as we call them here in NC) situations all the time as claim adjusters, so knowing the pitfalls created by gaps in insurance coverage can make our jobs easier and our insureds more trusting of our knowledge. |
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RLott
USA
5 Posts |
Posted - 04/06/2003 : 08:52:44
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| Being that Jack was "servicing" the Insured he could be considered an employee therefore the coverage would be applicable. |
Russ |
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inside man
45 Posts |
Posted - 04/06/2003 : 08:58:45
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Jim,
Is this a trick question?
The obvious answer is that by definition of the policy Jackie boy is not an insured. Under "Definitions" an insured is described as "Your relatives or any person that is in the care of the insured under age 21"
How old is Jack by the way? If he is under 21 and being "taken care of" we might stretch it and make Jack an insured.
Good news for Jack though if Jill requests coverage for Jacko's stereo system and it's on the residence premises for then we have coverage up to the limits of Coverage C.
Is there more to this question that I am missing?
This one seems too easy.
Maybe Jack should get over his fear of commitment and buy the cow. |
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JimF
USA
1014 Posts |
Posted - 04/06/2003 : 09:25:42
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Steve, OK for starters, let's assume Jack is 25 years old.
Let's also assume that Jack has now been living with Jill for the past 15 months. What effect does THAT KNOWLEDGE have on personal property coverage for Jack's stereo system?
Trick question? Moi?
The reason I posed the question is because upon the face of it, Jack would not meet the definition of "an insured" according to definitions contained within the policy language.
BUT
Before we leave it at that, go back and read my question again:
under what circumstances can Jack be considered "an insured" under Jill's HO-4 policy?
AND......
I am suggesting THERE ARE circumstances as outlined in the policy wherein Jack can be considered "an insured" under Jill's HO-4.
Now your job is to find, understand and explain those circumstances.
A Trick Question? Nahhh......... |
Edited by - JimF on 04/06/2003 10:02:11 |
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KileAnderson
USA
875 Posts |
Posted - 04/06/2003 : 09:32:16
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Well, having done research into this topic for personal reasons, if Jill is insured with her good neighbors or the good hands people then Jack could be covered. These were the only two companies that I found that offered renters coverage for cohabitants. It seems they are very progressive in their thinking on social issues.
In regards to RLott's post, was he servicing the insured as an employee or as a sub-contractor? Did Jill supply the tools and supervision or was Jack required to bring his own equipment and did he work unsupervised? |
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JimF
USA
1014 Posts |
Posted - 04/06/2003 : 09:45:27
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Kile, I'll leave Russ to fill in the details of Jack's servicing equipment and procedures, to allow you two to reach a consensus on looking at the question from that angle.
I appreciate your sharing as well the information about Allstate and State Farm, but I suggest that many if not most carriers will insure situations involving non-marital partners, life partners, significant others, or whatever coinage in language one chooses to use. In fact, ISO has an endorsement to fill the gap in this very situation (HO 04 58).
The new ISO endorsement (Other Members of Your Household) would have a similar effect to writing a separate HO-4 policy. Coverage is provided for the person named in the schedule as well as persons under the age of 21 who live with and are in the legal care of the person named in the schedule.
However, I suggest to you, that there are circumstances within the (ISO) HO-4 wherein Jack can become "an insured" under some circumstances. Now I don't want to have to address each and every carrier's policy (some of which are slightly modified by carrier), but I do suggest, that probably even the State Farm and Allstate policies contain the same or similar language as I am suggesting.
Take another look at any of the HO-4 policies you have (or even an HO-3 policy, which works the same BTW), and see if you can find policy language which sets up circumstances wherein Jack can become "an insured" in very limited situations.
The answer(s) we are searching for are right there in your HO-4 or HO-3 policy.
I guarantee it! |
Edited by - JimF on 04/06/2003 09:57:40 |
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CCarr
Canada
1200 Posts |
Posted - 04/06/2003 : 10:31:14
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Well seeing that the HO3 is equally applicable, I cann't stay away from questions like this.
25 year old Jack, has been co-habitating with Jill for 15 months.
In the "preamble" of the "Definitions" section of the HO4 (unfortunately, I don't have one) is there mention of, "you" and "your", then is there any reference to; ".... and the spouse if a resident of the same household ...."? If so, what is the definition of "spouse", in whatever state you want this claim to have occurred?
Failing that, based on the mention of the issue applying equally to the HO3, look at Coverage C - Personal property, ".... at your request, we will cover ....".
If the aforementioned is useful to find coverage for Jack's stereo, then consider Section I - Conditions, "Other Insurance".
I'd be satisfied that Jack is not (or his property is not) that of a "roomer, boarder, and other tenant", if J&J were sharing the same sheets, or at least the same bedroom, or similar demonstrations relative to a "spousal" relationship.
In considering the aforementioned 2 paragraphs, aside from the necessary answers to complete the indemnity puzzle; they are things worthy of mentioning in your reporting to illustrate you have considered those issues. |
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Ghostbuster
476 Posts |
Posted - 04/06/2003 : 10:34:22
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???Shackin'up??? I never heard Sheriff Andy Taylor of Mayberry, North Carolina call it 'Shackin Up'.
The correct technical term for this arrangement of convienence is 'Co-a-habitating-in-Sin'.
Now, out here in the more civilized Great State of TEXAS, it is a legal beast called 'Common Law Marriage'. The iron clad premise is that one must only present that marital bliss is taking place for the blessed estate of matrimony to exist. And that 'presentation' ain't much. As such, our boy Jack may be in the tender trap deeper than he suspects.
I would suggest a detailed written statement from the Named Insured as to their status, as well as a legal review of the matrimonial statutes of the particular state this takes place in, AND the state where this arrangement of convienece may have started.
(Ya see there, Bozo, this here is whatcha call real add-justin', reqiuren' real-live investigatory type gumshoe abilities. Here's where you get to wear your Colombo trench coat and drive your Rockford Firebird company car. Or, for a change of pace, wear your Rockford polyester sport coat and drive your Colombo Peugeot company car. The choice is yours.) |
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JimF
USA
1014 Posts |
Posted - 04/06/2003 : 10:54:23
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| Deleted as duplicate by Author. |
Edited by - JimF on 04/06/2003 10:58:50 |
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JimF
USA
1014 Posts |
Posted - 04/06/2003 : 10:57:31
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Ghostbuster, all that time, you probably believed that 'Aunt Bea' was really Andy's 'auntie' instead of the hottie she really was underneath those frumpy clothes she wore?
(By the way, Ol' Andy went to school down at my old alma mater UNC-CH were he was and still is a legend. Stories abound about how he would sit at the piano in the frat house, and play and sing long into the night as long his beer glass was full. He's retired now and living down on the NC coast in Manteo, so if a hurricane ever hits NC, one of you may be lucky enough to meet him and handle his claim. Aunt Bea died a few years ago and lived in Siler City, NC where she left all of her worldly possessions to the local Fire Department, having never married. Little Opie and Barney live on, though not in NC. 'Mayberry' was based on Mt Airy where Andy grew up, and it's downtown still to this day looks similar to the Mayberry television set; complete with a Floyd's barbershop for those who have hair!)
Now, back to the question at hand:
Jill’s Coverage C covers not only personal property she owns or uses, it also covers personal property of certain other persons who are not “insureds” in her policy. Her Coverage C thus applies to personal property: (1) “owned by others, while the property is on the part of the residence premises occupied by an insured” (Jill); and (2) “personal property owned by a guest or residence employee while the property is in any residence occupied by an insured” (Jill).
On the other hand, Jill’s Coverage C still will not cover Jack’s personal property. In her policy, under Property Not Covered, there is an exclusion for property of roomers, boarders and other tenants and Jack's tenure of 15 months in her apartment, makes his status more than just an overnight guest or occasional visitor.
Ghost is correct that in some 15 states, such a Co-a-habitating-in-Sin situations can rise to the creation of a common law marriage. I knew you were going to ask, so here are the 15 states: Alabama, Colorado, Georgia – if created before 1/1/97, Idaho – if created before 1/1/96, Iowa, Kansas, Montana, New Hampshire – for inheritance purposes only, Ohio – if created before 10/10/91, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Texas, Utah, and the District of Columbia.
Now we still have left unanswered the circumstances under which Jack can become "an insured" (under very limited conditions) under Jill's HO-3 or HO-4 policy.
Or as Goober would say, Goooollllllyyyy, this sure is harder than changing tires and pumping gas.
And as a last resort, if you didn't know the answer to the insurance question, you could no doubt talk Barney into throwing Jack into the Mayberry slammer with Otis to avoid having to deal with this whole sordid mess! |
Edited by - JimF on 04/06/2003 11:03:36 |
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JimF
USA
1014 Posts |
Posted - 04/06/2003 : 11:17:09
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Oh I forgot to mention this conversation overheard between Barney and Andy:
(Barney) "Andy, didn't I see where that Jill woman just bought a dog to watch over that new little fishin' boat she just bought?"
(Andy) "You know Barn, I think you're right, and that dog sure does look like a mean un. Thank goodness she said Jack would be legally responsible for the dawg, I think she said his name is Ol' Blue. Next thing you know, she and Jack and Ol' Blue will have taken all of our fish out of our fishin hole with that new fishin' boat. 'Member we saw she and that Jack feller she is a shackin up with last week down at Grover's pond? And I'll tell you another thing Barn, Mayberry just ain't ready for such a floozie a'flittin and a'floopin' around town actin that way and not wearin a bra underneath her tight tops."
(Barney) "Well you know Ang, she better be talkin to Lester, her insurance agent, to let him know about that dog before someone gets bit and complains. We might just have to lock them both up."
Now what does all of this have to do with the question posed about under what circumstances Jack can become "an insured" under Jill's HO-4 policy or an HO-3 policy?
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Edited by - JimF on 04/06/2003 11:22:33 |
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jcc1138
12 Posts |
Posted - 04/09/2003 : 18:32:31
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In MD (the land of pleasant living and unlimited RCV time) Jack could be paid for his contents under Jill's policy if Jill so requests. This would reduce the amount available to her, but Jack is not a tenant if he is not paying rent (and doing the nasty is not paying rent). This also applies if Jill is living with Jane or Jack lives with Dick.
Jack is not an insured, but that does not mean that he cannot recover against Jill's policy |
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JimF
USA
1014 Posts |
Posted - 04/09/2003 : 19:10:01
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JC, Thanks for your response and for reminding me as well, that I had not posted the answer to the coverage question which I was seeking, which is included below.
I do agree with you that Jack is not an insured, except that there are three circumstances whereby Jack can become "an insured" for limited purposes under Jill's HO-4 or HO-3 policy, which I have outlined below.
Jill has an HO-4 or an HO-3, and is the only Named Insured. Jack has extremely limited coverage under Jill’s policy. He is not an “insured,” since he is not a “resident spouse” or “resident relative.”
However, there is one exception in that if Jack were to be legally responsible for Jill’s animals, watercraft, or certain vehicles, he is an “insured” under Jill's homeowners policy. Otherwise, he has no coverage status as an “insured” for Section I – Property or Section II – Liability.
Jill’s Coverage C covers not only personal property she owns or uses, it also covers personal property of certain other persons who are not “insureds” in her policy. Her Coverage C thus applies to personal property: (1) “owned by others, while the property is on the part of the residence premises occupied by an insured” (Jill); and (2) “personal property owned by a guest or residence employee while the property is in any residence occupied by an insured” (Jill).
On the other hand, most authorities believe that Jill’s Coverage C still will not cover Jack’s personal property. In her policy, under Property Not Covered, there is an exclusion for “property of roomers, boarders and other tenants.”
Admittedly, this is a "gray area" of coverage, and it seems to me, an adjuster would be wise to investigate thoroughly the exact nature of Jill and Jack's relationship, including whether Jack pays rent to Jill, in which case, there is a clear exclusion for contents damages. Further, the wise adjuster would document the coverage question and the adjuster's investigation regarding their relationship back to the carrier for a final determination of coverage.
JC, I am curious if you would still feel that there is coverage for Jack's contents damage after you read these remarks and compare with your policy language in the Maryland forms?
While I acknowledge some "gray area" in the instant coverage question regarding damage to Jack's personal property, it seems to me to hinge on one's definition of "roomer, boarder or other tenant." Especially if Jack were paying rent, it seems to me, that would trigger the exclusion. Further by definition, is one who is considered a "roomer" inferred to make payment of rent or not?
Finally, under Section II - Liability, Jill's Section II Medical Payments coverage will not apply to injuries Jack might have on the premises, due to the exclusion in Coverage F for persons who “regularly reside” at the residence.
Likewise, her Section II Damage to Property of Others will not apply to damage Jill might cause to Jack’s property, due to the exclusion for damage to “property owned by or rented to a tenant of an insured, or a resident in your household.”
Now share your feedback gang and let me know what you think! |
Edited by - JimF on 04/09/2003 19:15:09 |
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fivedaily
USA
258 Posts |
Posted - 04/10/2003 : 10:55:49
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I heard that Jack gave that stereo system as a gift to Jill. :-)
I don't think that, under the scenario presented, most carriers would deny the coverage. It seems that generally it would be provided under the "instant" coverage you talked about. I can bet that most insureds would not be amenable to me prying into their personal life to the extent you might be suggesting. I think that Jack might fall under some sort of other "title" besides "roomer, boarder, or tenant."
http://www.m-w.com defines
"roomer" as
"Main Entry: room·er Pronunciation: 'rü-m&r, 'ru- Function: noun Date: circa 1871
: one who occupies a rented room in another's house
"boarder" as
Main Entry: board·er Pronunciation: 'bOr-d&r, 'bor- Function: noun Date: 1530
: one that boards; especially : one that is provided with regular meals or regular meals and lodging
"tenant" as
Main Entry: 1ten·ant Pronunciation: 'te-n&nt Function: noun Etymology: Middle English, from Middle French, from present participle of tenir to hold Date: 14th century
1 a : one who holds or possesses real estate or sometimes personal property (as an annuity) by any kind of right b : one who has the occupation or temporary possession of lands or tenements of another; specifically : one who rents or leases (as a house) from a landlord
By my way of thinking, unless Jack pays rent on a scheduled basis, he doesn't fall under any of these definitions. So where does that leave us??? Probably extending coverage under the "instant" coverage Jim referrs to.
Leaving my unstudied, first response opinion & contribution, Jennifer |
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fivedaily
USA
258 Posts |
Posted - 04/10/2003 : 19:36:40
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The only defition that doesn't involve "rent" is boarder. And depending on how much cooking Jill does, Jack may not be a boarder under this definition. I read that, if he just gets lodging but not regular meals, than he is not a boarder.
So what is this guy? Are freeloaders covered?
Jennifer |
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fivedaily
USA
258 Posts |
Posted - 04/15/2003 : 08:45:27
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I know you are all at the CADO convention now, but if someone, maybe JimF, has "the answer" I would love to know.
Jennifer |
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Shackin' Up With Jack and Jill
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