How to Read Your Insurance Policy How to Read Your Insurance Policy Understanding What You Bought & How it Works National Hurricane Conference New Orleans,

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Presentation transcript:

How to Read Your Insurance Policy How to Read Your Insurance Policy Understanding What You Bought & How it Works National Hurricane Conference New Orleans, LA March 2013

How Insurance Works Insurance is an agreement – a contract.  For a specific payment (the premium), one party (the insurer) agrees to pay the other party (the policyholder or designated beneficiary) a defined amount (the claim payment or benefit) upon the occurrence of a specific loss. 12/01/09 - 9pmeSlide – P6466 – The Financial Crisis and the Future of the P/C 2 Why does my insurance policy read like some type of legal document? Q: Why does my insurance policy read like some type of legal document? Because it is a contract. A: Because it is a contract.

How Insurance Works Rates are based on the risk pool.  To charge the right premium, insurers consider the annual losses expected for the pool – and potential variation. Your premium represents your share of the pool’s total premium. Losses are paid out of the premiums collected from the pool of policyholders.  The entire pool compensates the few policyholders who experience losses. 12/01/09 - 9pmeSlide – P6466 – The Financial Crisis and the Future of the P/C 3 Is “everyone in the pool” or are there parameters? Q: Is “everyone in the pool” or are there parameters? Some companies may segment risks to give better rates to those who earn them. Each state is a pool of its own. A: Some companies may segment risks to give better rates to those who earn them. Each state is a pool of its own.

Each state has its own pool Insurance is regulated at the state level.  Every state has its own rules and statutes. State regulators oversee insurer solvency, review market conduct, rule on rate increase requests, to name a few of the duties. Model rules and regulations for the insurance industry are developed by the National Association of Insurance Commissioners.  Before these rules are implemented, they must first be approved by state legislatures. 12/01/09 - 9pmeSlide – P6466 – The Financial Crisis and the Future of the P/C 4

Insurance principles Risk transfer.  The risk of an unanticipated loss is transferred from the policyholder to the insurance company. Frequency & Severity.  The number of losses that occur over a specified period & the size of the loss. Indemnity.  Provide financial compensation to return the policyholder to pre-loss condition. 12/01/09 - 9pmeSlide – P6466 – The Financial Crisis and the Future of the P/C 5 Does the frequency & severity of loss change? Q: Does the frequency & severity of loss change? Yes. More people and more expensive homes are being built in coastal areas, and storms are more intense. A: Yes. More people and more expensive homes are being built in coastal areas, and storms are more intense.

Enough to rebuild your home, if it is destroyed.  Find out what rebuilding costs are in your area. –Rebuilding costs are NOT decreasing! –Rebuilding costs are not the same as real estate value. Shop around, but don’t select an insurer on price alone.  Check reputation for claims handling and financial rating. How much insurance do you need? What if I insure my house for less than rebuilding costs? Q: What if I insure my house for less than rebuilding costs? It means more out-of-pocket costs for you, slower recovery or only partial recovery. A:It means more out-of-pocket costs for you, slower recovery or only partial recovery.

“Must read” information in your policy Important Messages section.  Policy changes.  Regulatory changes and mandated language, such as: –Your policy does not cover flood damage, –Assessments have been charged, or –There is a separate deductible for hurricane losses. 12/01/09 - 9pmeSlide – P6466 – The Financial Crisis and the Future of the P/C 7 BIG TYPE IMPORTANT TIP: Note the sentences in BIG TYPE. These are…..IMPORTANT! Typically, state regulators dictate the language and size of these messages so you are informed.

“Must read” information (continued) Declarations page.  Shows coverage and limits of liability.  Displays any credits you are getting, such as for a burglar alarm.  Details your deductible.  Lists your premium amount. –Check to see if there are surcharges, which some states have for state-run insurance pools.  Identifies your mortgage company.  Outlines separate endorsements and additional coverage you may have purchased.  Lists your total annual premium. 12/01/09 - 9pmeSlide – P6466 – The Financial Crisis and the Future of the P/C 8

Damage to Property  Coverage A – damage or destruction to residence.  Coverage B – damage or destruction to detached structures.  Coverage C – damage, destruction or theft of personal property.  Coverage D – Additional living expenses as a result of losses under Coverage A, B or C. Damage to People  Coverage E – personal liability.  Coverage F – medical payments to guests. Coverage types in a homeowners policy

Coverage A – damage or destruction to residence. 12/01/09 - 9pmeSlide – P6466 – The Financial Crisis and the Future of the P/C 10 Insurance should be sufficient to cover the cost to repair or rebuild your home.  Replacement cost of your home is not the same as its real estate value. Coverage included for attached structures, such as a garage or deck. Older homes may need to be brought up to current building code if damaged. Consider:  Inflation guard coverage.  Building Ordinance and Law coverage.

Coverage B – damage or destruction to detached structures Covers an unattached garage, shed and your pool.  Most insurers provide discounts for detached garages, due to the reduced fire hazard.  Some companies may exclude coverage for pool enclosures. 12/01/09 - 9pmeSlide – P6466 – The Financial Crisis and the Future of the P/C 11 Why are detached garages less expensive to insure than one that is attached? Q: Why are detached garages less expensive to insure than one that is attached? The risk of fire is considerably less when gasoline-powered cars and tools are not stored in places that connect to living quarters. A: The risk of fire is considerably less when gasoline-powered cars and tools are not stored in places that connect to living quarters.

Coverage C – damage, destruction or theft of personal property. This is for your “stuff,” and it typically is 50 – 70 percent of the amount of coverage on the structure of your home.  If your house is insured for $200,000, you may have $100,000 coverage on the contents.  Some insurers allow you to increase or decrease the amount of coverage for contents. Coverage travels wherever your stuff goes and is not limited to your property while it is inside your home.  It also applies to your guest’s “stuff” while it is at your home. on your residence premises as well. 12/01/09 - 9pmeSlide – P6466 – The Financial Crisis and the Future of the P/C 12

It helps ensure you select the right amount of coverage – and it speeds the claim process. Free home inventory software at: Conduct a home inventory Store your home inventory some place other than your residence. TIP: Store your home inventory some place other than your residence.

Options for coverage Actual cash value.  This takes depreciation into account. –Claims payment would deduct for age on your 15-year-old roof with a life expectancy of 25 years. Replacement cost coverage.  Repairs or replaces your damaged property with materials of similar kind and quality, without deducting for depreciation. Most companies require the policyholder to insure for at least 80 percent of replacement cost. 12/01/09 - 9pmeSlide – P6466 – The Financial Crisis and the Future of the P/C 14

Coverage D – Additional living expenses as a result of losses If your home is damaged so badly that you cannot live there, this coverage pays the extra expenses you incur to live away.  Pays for costs above the normal expenses, such as the costs of eating out since you cannot eat at home, relocation and storage costs, furniture rental and additional transportation costs. Check your policy to see the limits of this coverage. 12/01/09 - 9pmeSlide – P6466 – The Financial Crisis and the Future of the P/C 15

Coverage E – personal liability. Protects you against a claim or lawsuit resulting from bodily injury or property damage to others, which could be considered your “slip and fall” coverage. It applies to damage to people, rather than property. Coverage is for all family members in the household.  Intentional damage by you or family members is not covered. 12/01/09 - 9pmeSlide – P6466 – The Financial Crisis and the Future of the P/C 16

Coverage F – medical payments to guests Provides for reasonable medical care to people who are not insured under the policy.  Differs from Coverage E in that it pays claims when the insured is not necessarily “at fault,” such as when a neighbor falls over your front stairs and breaks an arm. –If the neighbor sued because your crooked stairs caused the fall, Coverage E applies because the neighbor is saying you were at fault. Medical payments under a homeowners policy are different from those under an auto policy.  Med pay for auto policies cover all passengers who are injured, including people insured on the policy (first party), while medical payments on a homeowners policy only go towards people not insured on the policy (third-party coverage). 12/01/09 - 9pmeSlide – P6466 – The Financial Crisis and the Future of the P/C 17

Always consider insuring for 100 percent replacement cost. Consider the following coverage:  Extended or guaranteed replacement costs.  Building ordinance and law.  Inflation guard.  Umbrella or excess liability.  Sewer back-up. Insuring your home

Master policy vs. individual coverage.  Unit owner covers own belongings, PLUS whatever is not covered in the master policy. Loss assessment and deductible assessment coverage. Condo insurance Always get a copy of the condo’s master insurance policy so you can identify any gaps in coverage that you may need to fill for your own protection and peace of mind. TIP: Always get a copy of the condo’s master insurance policy so you can identify any gaps in coverage that you may need to fill for your own protection and peace of mind.

Deductibles for hurricanes/other perils.  Take the highest deductible you can afford. Most homeowners insurance policies do not cover flood damage.  Flood insurance is from the federal government’s National Flood Insurance Program.  Check costs at Exclusions and coverage What if I don’t live in a flood zone? Q: What if I don’t live in a flood zone? Keep in mind that 25% of floods occur in “low-risk” zones. A: Keep in mind that 25% of floods occur in “low-risk” zones.

Estimating your flood risk

Check on multi-policy discounts if you buy several policies from one company. Ask about credits for:  Smoke detectors and sprinkler systems.  Burglar and fire alarms.  Deadbolt locks.  Long-time policyholder discounts.  Upgrades to plumbing, heating and electrical systems.  Wind-resistant features, such as windows and garage doors. Tips for lowering costs

Most insurers have preparedness information on their websites. Insurance industry resources include:  Insurance Information Institute – –  Insurance Institute for Business & Home Safety –  Federal Alliance for Safe Homes – Preparedness Resources

Number of Federal Disaster Declarations, * *Through Jan. 31, Source: Federal Emergency Management Administration; Insurance Information Institute. The Number of Federal Disaster Declarations Is Rising and Set New Records in 2010 and Hurricane Sandy Produced 13 Declarations in 2012/13. The number of federal disaster declarations set a new record in 2011, with 99, shattering 2010’s record 81 declarations. There have been 2,084 federal disaster declarations since The average number of declarations per year is 35 from , though that few haven’t been recorded since federal disasters were declared in /01/09 - 9pm 24

25 Federal Disasters Declarations by State, 1953 – 2013: Highest 25 States* Over the past 60 years, Texas has had the highest number of Federal Disaster Declarations 12/01/09 - 9pm *Through Jan. 31, Includes Puerto Rico and the District of Columbia. Source: FEMA: Insurance Information Institute. Other top states: CA, OK, NY, FL, LA

Wind damage from thunderstorms and tornadoes account for the majority of insured catastrophe losses in most years, including 2012 Number of Severe Weather Reports in US, by Type, 2012 Source: NOAA Storm Prediction Center; 12/01/09 - 9pm 26

12/01/09 - 9pm 27 Top 12 Most Costly Hurricanes in U.S. History (Insured Losses, 2012 Dollars, $ Billions) *Estimate as of 12/09/12 based on estimates of catastrophe modeling firms and reported losses as of 1/12/13. Estimates range up to $25B. Sources: PCS; Insurance Information Institute inflation adjustments to 2012 dollars using the CPI. Hurricane Sandy could become the 3 rd costliest hurricane in US insurance history Hurricane Irene became the 12 th most expensive hurricane in US history in of the 12 most costly hurricanes in insurance history occurred over the past 9 years (2004—2012)

12/01/09 - 9pmeSlide – P6466 – The Financial Crisis and the Future of the P/C 28 Total Value of Insured Coastal Exposure (2007, $ Billions) Source: AIR Worldwide In 2007, Florida Ranked as the #1 Most Exposed State to Hurricane Loss, with $2.459 Trillion Exposure. The Insured Value of All Coastal Property Was $8.9 Trillion in 2007, Up 24% from $7.2 Trillion in 2004

Insured Coastal Exposure As a % Of Statewide Insured Exposure In 2007 Source: AIR Worldwide Most of Florida’s Exposure is Considered Coastal – 79%.

Population Growth Projections for Hurricane Exposed States (2000 to 2030) (000) The U.S. as a whole is expected to have a population increase of 82.1 million, or 29.2 percent during the same period. Source: U.S. Census Bureau, accessed at By 2030, Florida is expecting a population increase of 12.7 million, closely followed by Texas with an expected increase of 12.5 million.

Why property insurance rates have not dropped in hurricane-free years Emphasis is on strategic underwriting in a down economy.  In a vibrant economy, healthy investments make up for any gaps in insurance rates. Today, rates have to hold their own. Insurers must have money on hand in advance to pay anticipated claims.  Private insurers do not borrow money to pay claims, nor can they charge rates to make up for past losses. 12/01/09 - 9pmeSlide – P6466 – The Financial Crisis and the Future of the P/C 31

Thank you for your time and attention! Insurance Information Institute Online: