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Question: The question I have isregarding a loss which occurred in Illinois, and I'm looking at theISO HO-3 10/00 for coverage. The named insured's live-in girlfriendfell off the deck due to poorly-maintained railing. She died as aresult of her injuries. The insured is looking to his homeowner'spolicy to respond to the subsequent lawsuit initiated by her family.I say there is coverage because she is not considered an 'insured'by definition, and Section II exclusion F.6. does not apply. Myco-worker says the policy will not respond because she was aresident of the household.

— IllinoisSubscriber

Answer: You are correct that she is not aninsured by definition. She is not related to the insured by blood,and was not in the care of the insured or another residentrelative. The definition does not change under Section II otherthan for persons having custody of the insured's animals orwatercraft, neither of which is the case here.

Medical payments provides coverage for people on the “insuredlocation” with permission of “the insured,” which fits thissituation.

However, under G. Coverage F Medical Payments to Others:4. coverage does not apply to any person “regularly residing on anypart of the 'insured location.'” So there is no coverage undermedical payments.

Remember that Coverages E and F are separate coverages; CoverageE pays for injury caused by an occurrence to which the coverageapplies. Under the personal liability coverages and exclusions, theexclusion for injury to “insured” does not apply as she was not an“insured” by definition.

There is coverage under personal liability, but no coverageunder medical payments. There is a duty to defend coverage undersection E for Personal Liability.

Related: Your questions answered: Replacement cost vs. cashvalue

Coverage for vehicle left 'in the care of' owner's father

Question: In the Texas auto policy atissue, “family member” means a person related to you by blood,marriage, or adoption who is a resident of your household and whois listed as an authorized driver in theapplication. This includes a ward or fosterchild.

Under the liability exclusions, the policy does not provideliability coverage for any “insured” 2- for “property damage” to property owned or beingtransported by that “insured.” 3. For “property damage” toproperty a-Rented to b- Used by; or c- In the care of; that“insured.”

Our named insured is Larry. His vehicle slipped gear androlled into his son Brad's vehicle at Larry's home. Brad is apart-time resident at Larry's household but is not listed on theapplication for insurance for Larry. Brad works on pipelines and isgone for varied amounts of time, but his permanent address is andhas always been that of Larry. Larry and his wife keep Brad'svehicle in their garage while he is away, and they are both listedas drivers on his dec page. Also, they drive the vehicleoccasionally to keep things running smoothly, and there are twosets of keys left at their home even when Brad is out of town. Theparents also perform routine maintenance on the vehicle if neededwhile Brad is out of town. However, if Brad is in town he takescare of the vehicle.

Should Larry's policy cover damage for Brad's vehicle underpart A liability?

— MichiganSubscriber

Answer: Whether Larry's policy should coverdamage for Brad's vehicle boils down to if it was “in the care of”his parents at the time of the accident. Although what isconsidered “in the care of” may vary by jurisdiction, based on thefacts provided it is our opinion that Brad's vehicle was undeniably“in the care of” his parents at the time of the accident and, thus,precisely one type of scenario meant to be excluded under part Aliability.

Related: Expenses incurred to minimize loss should becovered

Additional insured is non-resident relative

Question: The insured's father cosigned the mortgage andwas placed on the policy as an additional insured per form HO 0441. He did not reside with the insured. The insured's father washelping the insured remodel a porch deck when he fell and wasinjured. HO 04 41 makes the father an additional insured, and themed pay exclusion precludes coverage for an insured. However, sincethe father did not reside with the insured, does med pay coverageapply?

— Ohio Subscriber

Answer: The fact that the father did not livewith the insured does not negate the endorsement making him aninsured. The definition of “insured” is extended to the scheduledindividual for coverages A, B, E, and F, meaning that the fathercannot both be an additional insured and an other person whoreceives benefits. As he is an insured for coverage F, that wouldbe providing benefits to himself. There is no coverage for thefather.

Related: How to calculate deductibles for multiple relatedlosses

Here's what happens when an adult child moves back into aparent's home, then causes property damage. (Photo:iStock)

Relative must be resident in order to covered

Question: Due to recent financial hardship, the namedinsured's 32-two-year-old adult son had been staying in the insuredlocation for two months prior to the covered loss. The insurancecarrier has recently denied coverage for loss of use and for thepersonal property owned by the son.

The following circumstances apply:

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      • Our named insured is the owner of the building on record,the insurance is in her name, and the home is the named insured'sprimary residence.
      • The named insured was temporarily living in a rental homeand was remodeling her primary residence.
      • The insured's contents remained in the home including allthe furniture as well as personal articles and clothing.
      • While staying in the rental home, she maintainedelectricity, water, and gas at the insured location. All bills forutilities remained in the name of the named insured.
      • The intention of the insured was to move back into the homeonce the remodeling was complete.

The insurance carrier states that “the son would not beconsidered an insured as the residence premise is not occupied bythe insured and the insured is living at the rental location.” Ourposition is that the thirty-two-year-old son is an insured bydefinition of “insured” as offered in the policy. Therefore webelieve his personal property would be covered as well asadditional living expenses.

— Pennsylvania Subscriber

Question: The problem is that in the definitionof “insured,” the resident must be part of the insured's household.Merriam-Webster defines “household” as those living under the sameroof or living together in the same dwelling. In your situation,they were not living together since the named insured was at aseparate property. Had they both be in the house then the son'sproperty and loss of use would be covered, but since the insuredwas not living on premises, the son technically does not meet thedefinition of “insured.”

Related: Here's why fighting crime causes uninsured propertydamage

Son and dog are tenants, not resident relatives

Question: The insured owns a rental home that is insuredon a Dwelling Fire policy. The liability for the rented home isendorsed to the Dwelling Fire policy. The tenant of the rented homeis the insured's adult son. The adult son owns a dog that bitanother individual. How do you see liability coverage, if any,applying in this situation? The Dwelling Fire liability policy hasthe following wording:

Definitions: “Insured” means you and residents ofyour household who are a. Your relatives; b. Other persons underthe age of 21 and in the care of any person named above c. withrespect to animals or watercraft to which this policy applies, anyperson or organization legally responsible for these animals orwatercraft which are owned by you or any person included above. Aperson or organization using or having custody of these animals orwatercraft in the course of any “business” or without consent ofthe owner is not an “insured.”

— Ohio Subscriber

Answer: Unless the insured is living in thedwelling with the son, the son is not considered an insured. He isa tenant like anyone else. Therefore, the son would need to havehis own liability policy in order to have coverage for the dogbite. The liability is for the insured, the father, not histenants. Being a relative does not automatically make one aninsured, especially when they live in separate residences. This issomething most insureds do not understand. Unless the father issomehow found legally liable, there is no coverage.

Related: Coverage question concerning 'non-owned auto'use

Named insured does not occupy residence

Question: Our agent placed a homeowners policy with our company. The namedinsured has never occupied the residence, and the tenant pays her amonthly rent. We now have a substantial fire loss. Do we owe ourinsured the monthly rent she has lost?

— Idaho Subscriber

Answer: The ISOhomeowners policy HO 00 03 10 00 states that coverage isavailable if that part of the “residence premises” rented to othersor held for rental is not fit to live in. “Residence premises” isdefined as the “one [or two, three, or four] family dwelling whereyou reside [in at least one of the units], or that part of anyother building where you reside.”

The definition is not met, so, no coverage for loss ofrents.

Owners, named insureds, and additional insureds

Question: We have a policy where four siblings owna home. The mother lives in the house but deeded the property overto all the kids. One adult child resides with the mother. Thequestion is who should be listed as the named insured on thehomeowners policy?

The agent wants everyone listed as named insureds, but webelieve that the owner living in the home is the named insured,with the other siblings being additional insureds. Please shareyour thoughts.

— ConnecticutSubscriber

Answer: Most likely, the agent thinks all thechildren should be listed as named insureds because they are all onthe deed as owners of the property. However, the homeowner policydefines insured as “you and residents of your household.” Thesiblings are not residents of the household even though they dohave an interest in the property.

The HO 04 41, additional insured endorsement, provides thesiblings with the necessary coverage as part owners of theproperty, even though they are non-residents. The sibling living inthe house is the named insured; the brothers and sisters areadditional insureds.

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