5.7 Conditions – Liability Copy

Conditions

Policy Period – The policy applies only to loss which occurs during the policy period.

Insurable Interest and Limit of Liability- Even if more than one person has an insurable interest in the property covered, the insurer will not be liable in any loss:

• For an amount greater than the interest of a person insured under the policy; or
• For more than the applicable limit of liability.

Concealment and Fraud – The policy is void as to the insured, if the insured has intentionally concealed or misrepresented any material fact or circumstance, made false statements or committed fraud relating to this insurance, whether before or after a loss.

Residential Community Property – The policy, subject to all other terms and conditions, when covering residential community property, as defined by state law, shall remain In full force and effect as to the interest of each spouse covered, irrespective of divorce or change of ownership between the spouses unless excluded by endorsement attached to this policy, until the expiration of the policy or until cancelled in accordance with the terms and conditions of the policy.

Duties After Loss – Insured’s Responsibility

• Protect the property from further damage
• Give prompt written notice to the company.
• Call the police, if a law has been broken.
• Make a list of all damaged personal property, including costs.
• If requested, obtain proof of loss form from your agent or the company and submit within 91 days of the request.
• Do not make any voluntary payments except for first aid to others at the time of the accident.
•  Send copies of legal notices you receive to the company.
• Help the company get the necessary information to make a settlement.

The Insurer’s Duties After Loss

Not later than the 15th day after the insurer receives the insured’s written notice of claim, the insurer must:

• Acknowledge receipt of the claim.
• Begin any investigation of the claim.
• Request the information the insured must provide
• After the insurer receives the information they request, they must notify the insured in writing of the status of the insured’s claim:
• Within 15 business days; or
• Within 30 days if the insurer has reason to believe the loss resulted from arson.

IF THE INSURER DOES NOT APPROVE PAYMENT OF THE INSURED’S CLAIM, THEY MUST:

• Give the reason for denying the claim; or
• Give the reasons why the insurer requires additional time to process the claim.

BUT, THE INSURER MUST EITHER APPROVE OR DENY THE CLAIM WITHIN 45 DAYS AFTER THEIR REQUEST FOR ADDITIONAL TIME.

Texas Department of Insurance Homeowners Insurance information can be found at:

http://www.tdi.state.tx.us/home/index.html