Master Policy Deductibles

June 2008

A few years ago I did a Tech Talk on this subject. Based on the emails I have received in the last few months … perhaps it bears repeating and updating …

Condominium Master Policy deductibles … can they be deadly for personal lines clients who live in condominium units? Yes!
First … in a condominium arrangement who insures what??????
That can be an EXCELLENT question! We all know that when one buys into a condominium situation – shared ownership – one receives two different ownership interests. First, the individual unit for living is individually owned. If I buy a condominium unit, it belongs to me. Everything in that unit that I can touch, I own!

I also receive “common” ownership in the non-individual or common areas such as land, roof of building, common walls, common beams, swimming pools, etc. In Massachusetts, as in most other states, the Association is required to purchase insurance on common areas.

How does the individual unit get insured?
That depends. It depends on the bylaws or insuring agreement in the condominium documents. Sometimes the bylaws only require the Association to insure commonly owned area and the individual unit owner must insure ALL of his/her individual unit. The individual unit owner accomplishes this through the purchase of large amounts of Coverage A – Dwelling value under the HO-6 Unit-owner policy. This can be expensive for the unit owner, but insurance coverage can be easily obtained.

In other situations the Association agrees to “take on” the responsibility of insuring individually owned unitbuilding items through a discussion in the bylaws. The Association may insure ALL building items in the individual units or just some of the individually owned unit-building items. One must read the bylaws carefully to determine what, if any, insurance responsibility is left for the unit-owner. Does the Association OWN the items in the individual unit. NO, NO, NO!!! But, through the bylaws, a contract, an insurable interest is granted to the Association allowing the Association’s commercial policy to apply to individual unit-owner items.

There are TWO ways where the Master Policy deductible could be a problem for unitowners

Way one … Let’s suppose … The Association, through it’s bylaws, has chosen to accept responsibility for insuring the individually owned items …
The Association buys a Condominium master policy to cover the building items whether common or individually owned … hopefully on a Special Form basis. Suppose the Association purchases a $250 deductible for the Master policy and there is a loss fully contained in one unit, who pays the deductible?

This is a point that the unit-owner should address when purchasing his/her unit. Or, you should have them look into this issue when you sell them their Unit-Owner Policy covering their contents and liability exposures. If the Association chooses to pay the deductible, great! If the Association makes the unit-owner responsible for the deductible …$250 out of pocket for the unit-owner shouldn’t be too much of a hardship!

What if the Association has a $5,000 deductible for all losses …
The bylaws required the association to cover the individually owned units as well as common areas and the loss happens entirely in your client’s unit … a kitchen fire … who pays the deductible amount here?

Again, your client should check into this issue with the Association. Quite often, the Association bylaws state the Association will provide insurance for unit-owner building items, but will NOT cover the deductible. Generally, a loss that is contained in a specific unit is NOT assessed to other fellow unit-owners. The individual unit-owner suffering the loss is expected to pay for the deductible.

How do we cover the deductible in this situation????
I have NO idea!!! I used to think that I knew. Years ago I had read and had been taught that one buys coverage for one’s unit through Coverage A and it would respond to a loss not covered by the Master Policy.

After all … the definition of “Coverage A – Dwelling” in the HO-6 certainly LEADS ME TO BELIEVE that I can insure my “stuff”!

COVERAGE A – Dwelling

We cover:

1. The alterations, appliances, fixtures and improvements which are part of the building contained within the "residence premises";

2. Items of real property which pertain exclusively to the "residence premises";

3. Property which is your insurance responsibility under a corporation or association of property owners agreement; or

4. Structures owned solely by you, other than the "residence premises," at the location of the "residence premises."


Reading the whole policy can be a drag …
However, it appears that the Other Insurance Provision of the HO-6 is being used to NEGATE the individual’s right to insure his/her own property. It’s almost “un-American”!

The Other Insurance Provision has always stated that if the Association and the unit-owner insure the same property, then the Association Master Policy will be primary and the HO-6 will be excess. How can the Master policy cover the same stuff as the HO-6? Well …through the bylaws/condominium documents. If the bylaws told the association to cover the condominium building ..both common areas and individually owned areas then this “contract” provided an insurable interest to the association IN the individually owned unit property. The Unit Deed gave the unit-owner an insurable interest in the individual unit.

Normally when two entities can insure the same thing … the parties themselves determine WHO should do it … and act accordingly.

The following is the ISO 2000 Other Insurance Language. The only difference between the HO-2000 language and the HO-91 language are those words that I crossed out.

F. Other Insurance And Service Agreement
…
2. If, at the time of loss, there is other insurance or a service agreement in the name of a corporation or association of property owners covering the same property covered by this policy, this insurance will be excess over the amount recoverable under such other insurance or service agreement.



The Other insurance clause states that when both the Master Policy and the HO-6 cover the SAME property then the Master Policy is primary and the HO-6 is excess. Now ... just WHAT does that mean? For years many insurance “pundits” explained this to mean that the loss first goes to the Master Policy and then back to the HO-6 for the amount of the loss not paid by the Master Policy … i.e. the Master Policy deductible.

Unfortunately, ISO has chosen not to interpret their policy in this way and stated in the HO-2000 Homeowner filing:

“The unit owner is only covered for the amount of loss that exceeds the amount recovered by the association under its policy. If the association doesn’t recover because of a high deductible or other reasons, the unit-owner does not recover.”


With this interpretation then Coverage A can ONLY be available at the “high-end”… that Coverage A will NOT pick up any master policy deductible. If the bylaws told the association to cover your client’s unit then the client’s Coverage A will ONLY respond when every last dime of the Master policy has paid out.

If the master policy bylaws do NOT insure certain items for the unit-owner, then Coverage A will be the PRIMARY and the ONLY coverage responding to the loss. If the bylaws tell the Association to cover some or all of the unitowner building items, then Coverage A will NOT pick up any Master Policy deductible for damage to these items.

This interpretation is ESPECIALLY dangerous in the light of increasing Master Policy deductibles!!!!!!

What should you do????
If I were you, I would ASK my HO-6 carriers HOW they interpret the Other Insurance Provision. If your carriers agree with the ISO interpretation of the mechanics of the Other Insurance Provision, then Coverage A will NOT respond to a Master policy deductible situation when damage to the individual unit occurs.

How can this loss under the Master Policy deductible be covered?
Under the HO-2000 ISO “addressed” this situation by creating an endorsement to “fix” the Other Insurance Provision. The endorsement that ISO created to fix this situation is HO 17 34 Unit Owner Modified Other Insurance condition. The endorsement merely recites the Other Insurance Clause and adds “whether they can collect on it or not”. I’m not sure what this wording really does … but the filing states that it fixes the problem. Will your carriers sell it? Who knows?

Under the HO-91 this endorsement does not “officially” exist and therefore there is NO WAY to fix this if your carriers take a non-user friendly interpretation. HOWEVER, I was just told by an agent last week that one of his HO-91 carriers had filed the HO 17 34 for use on its HO-6 policies. So …evidentially ..more personal condominium insurance carriers are agreeing with ISO’s interpretation and opting for a “premium generating” endorsement to provide coverage for this situation.

Just what IS the premium for this endorsement?
The ISO premium for the HO 17 34 Unit-Owners Modified Other Insurance condition is 25% of the base premium -- Rule 529 tells you to multiply the HO-6 base premium by 1.25!!! Isn’t that INTERESTING … The “base premium” for an HO-6 is the premium for the Coverage C limit … How ridiculous is this…we are buying an endorsement that applies to BUILDING coverage and rating it based on the amount of CONTENTS the client has.

So ... the MORE contents you have the MORE this endorsement costs … the premium has NOTHING to do with the SIZE of the Master Policy deductible and the amount of Coverage A purchased!!!

WAY TWO …that the Master policy deductible can be a problem…
How is the Master Policy deductible paid when the loss happens to COMMON property?
Suppose a fire burns the commonly owned clubhouse and there is a $10,000 deductible on the Master Policy, how does the Association get this first $10,000 to rebuild? Well, hopefully, there is a “slush fund” to cover deductibles, but I suspect in many associations that is NOT the case. What does the Association management do? They assess the unit-owners since each unit owner owns a share of the clubhouse and other common areas.

Can the unit-owner insure his/her assessment responsibility?
Yes … and no. The unit-owner can insure his/her share of assessments due to “insurance related situations.” Loss Assessment is an additional coverage provided under the HO-6.

7. Loss Assessment

a. We will pay up to $1,000 for your share of loss assessment charged during the policy period against you, as owner or tenant of the "residence premises", by a corporation or association of property owners. The assessment must be made as a result of direct loss to property, owned by all members collectively, of the type that would be covered by this policy if owned by you, caused by a Peril Insured Against under Coverage A, other than:

(1) Earthquake; or
(2) Land shock waves or tremors before, during or after a volcanic eruption.
The limit of $1,000 is the most we will pay with respect to any one loss, regardless of the number of assessments. We will only apply one deductible, per unit, to the total amount of any one loss to the property described above, regardless of the number of assessments.

b. We do not cover assessments charged against you or a corporation or association of property owners by any governmental body.

c. Paragraph P. Policy Period under Section I – Conditions does not apply to this coverage.

This coverage is additional insurance


If a loss that would be a covered peril under the unit-owners HO-6 damages COMMON PROPERTY, then the loss assessment additional coverage will pay the unit-owners assessment responsibility up to $1,000. The unit-owner can increase this assessment coverage up to $50,000 with HO 04 35 Increased Loss Assessment Endorsement for only $25 or so.

What if the Association has a Percentage Windstorm deductible and there is MAJOR windstorm damage to common property??????
Suppose your client purchased HO 04 35 Increased Loss Assessment coverage in the amount of $50,000 and his/ her assessment share of this Master Policy windstorm deductible is $10,000, will the HO 04 35 respond for the whole $10,000? NO, NO, NO per the following clause in the HO 04 35 Increased Loss Assessment Endorsement:

SPECIAL LIMIT – We will not pay more than $1,000 of your assessment that results from a deductible in the policy of insurance purchased by a corporation or association of property owners.


The HO 04 35 under both the HO-91 as well as the HO-2000 program has a restriction for assessments that are due SOLEY to master policy deductibles.

This endorsement should always be sold for it can be very helpful in other property assessment situations as well as many liability assessment situations but it is NOT helpful in “deductible” assessment situations. The insured will ONLY receive the “free” $1,000 loss assessment coverage that is found under his/her HO-6 unit-owner policy towards an assessment that is due SOLELY to a Master Policy deductible. The rest of the assessment will come “out of pocket.”

Make sure that you address this restriction with your client when selling this endorsement.

I have to admit that I do agree this restriction is NECESSARY in the HO 04 35 Increased Loss Assessment endorsement. Otherwise, the Association would buy commercial property EXCESS policies assuming that each loss will be assessed BACK to the individual unit-owner who has been TOLD to carry HIGH Loss Assessment coverage.

So, back to the original issue… Who pays the Master Policy deductible????
As usual ... the answer is …”it depends.”

Buying a one family house has FEWER insurance headaches than buying into a condominium situation!

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