Personal Umbrellas - How Do They Work... and When Don't They Work? - SPONSORED BY
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Personal Umbrellas -
How Do They Work...
and When Don’t
They Work?
SPONSORED BYPersonal Umbrellas
How Do They Work?…
…and When Don’t They Work???
Michael C. D’Orlando, CIC, LIA, CPIA
Insurance Training & Consulting Services
11 Lake Shore Drive
Amesbury, MA 01913
(978) 314-5743
mcdorlando@aol.comGeneral Overview
* Special Note: Umbrellas are not standardized and they can vary dramatically
from carrier to carrier. With regard to coverages, exclusions and other provisions,
if you represent ten different carriers, you are probably writing ten different
Umbrellas! In this outline, we will focus on the general terms and concepts which
apply to most Umbrellas and Excess Policies, however, it is very important that
every Umbrella and Excess policy is carefully reviewed to assure that it meets
the needs of our clients.
Historical Overview
The term “Umbrella” is like the terms “All-Risk”, “Comprehensive” and “Dinosaur”.
When Lloyds first introduced the Commercial Umbrella in the 1940’s, there were
very few exclusions and the word “Umbrella” may have been an appropriate
term.
In the 1960s, Lloyds and American insurers began writing Personal Umbrella
Policies. Numerous unanticipated losses generated more and more exclusions
and today’s “Umbrellas” might be better described as “Excess” liability policies.
As a starting point, we will take a look at the original concept of the “true”
Umbrella as compared with a “following form” Excess Liability policy. Today’s
“Umbrellas” are better categorized as “Hybrids”, but we will use the term
“Umbrella” for discussion purposes.
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODI. WHY PURCHASE AN UMBRELLA?
Umbrellas can serve two primary functions:
A. Provide Excess Limits Over Primary Liability Insurance for Many
Exposures
¾ Most primary policies (Auto, Homeowners, Watercraft, etc.) are limited
by manual rules and/or company specific filings and underwriting rules
regarding the maximum dollar amount which can be written
B. Can Provide Broader Coverage Than the Primary Policies
¾ There are a wide range of exclusions and limitations on all primary
policies ... the following are examples of exposures where coverage
is broader in many Umbrellas than the primary policies:
1. Worldwide auto liability
2. Personal Injury
3. Property in the insured’s care, custody or control
4. Loss Assessment
5. Watercraft
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODII. Personal Umbrella, Excess Personal Liability and “Hybrid” Personal
Liability Policies
A. Traditional “True” Umbrella
1. Provides excess coverage over underlying primary policies
2. Can provide primary coverage in areas not covered by the underlying
policies
3. It is a stand-alone policy with its own insuring agreement, own definitions,
own provisions, own exclusions and own limitations
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODB. “Following Form” Excess Personal Liability Policy
1. Provides excess coverage only over areas covered by the
underlying policies
2. Generally has the same insuring agreement, definitions, provisions,
exclusions and limitations as the underlying policies
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODC. “Hybrid” Excess Personal Liability Policy
1. Contains broader (“True” Umbrella) coverage for some exposures
2. Contains excess “Following Form” coverage for specific exposures
x Typical “Following Form” exposures are autos, watercraft,
and recreational vehicles:
3. Contains language which is narrower than underlying coverage in
some areas
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0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODDECLARATIONS
Policy Number:_____________________________
Named Insured & Mailing Address: Agency Name & Address:
Primary Residence Address: (If different than above)
Policy period: From ___________ To____________
(12:01 a.m. Standard time at the address of the Named Insured as stated herein)
Limit of Coverage: $ ______________________ each occurrence
$ ______________________ Aggregate
Premium $ _____________ Self-insured Retention: $ _________ each occurrence
Forms included at issue:
REQUIRED BASIC POLICIES It is agreed by you and your Relatives that you will carry an Automobile
liability policy and a comprehensive personal liability policy (or homeowners policy) covering both you and
your Relatives for at least the minimum limits listed below. If your Relatives are not covered under your
polices for at least the minimum limits listed below, they must be covered under another automobile liability
policy and another comprehensive personal liability policy (or homeowners policy) for at least the minimum
limits below. If you or your Relatives own Recreational Vehicles, Watercraft or have any household
employees, you or your Relatives, as the case may be, agree to carry the appropriate policy (or
endorsements) listed below covering both you and your Relatives for at least the minimum limits listed
below.
TYPE OF POLICY MINIMUM LIMIT OF COVERAGE
A. Automobile Liability Bodily Injury $ each person
$ each occurrence
Property Damage $ each occurrence
or Bodily Injury and Property Damage Combined
$ each occurrence
B. Personal Liability
Homeowners or Comprehensive Personal Liability
(Including watercraft liability for boats 25 ft. or less and 50 HP or less)
Bodily Injury and Property Damage Combined
$ each occurrence
C. Other Coverage Limit
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODIII. DECLARATIONS PAGE
A. Policy Period
B. Named Insured
C. Policy Limits
1. Per Occurrence
2. Aggregate (may be a new term for personal lines client)
D. Self Insured Retention (if policy has one)
E. Underlying requirements and limits
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODIV. “UNDERLYING” COVERAGE
A. Umbrella Policies require the insured to maintain underlying (i.e. primary)
policies which must respond first for certain exposures … Once the
underlying limits are exhausted, the Umbrella Policy will respond as
excess coverage
B. Most Umbrellas require underlying policies for:
1. Existing exposures
Ex. Homeowners, Auto and Watercraft when the insured owns a
home, auto or watercraft
2. Potential (probable) exposures
Ex. A Non-owned Auto policy for someone who doesn’t own an
auto, but may rent or borrow one on occasion, or a
Comprehensive Personal Liability policy for someone who
doesn’t have a Homeowners policy
C. Underlying “primary” policies typically must be listed on the Declarations…
Examples:
1. Personal Auto Policy
2. Homeowners or Comprehensive Personal Liability
3. Watercraft Policy if “insured” owns a boat
4. Other liability policies for owned exposures such as recreational
vehicles, snowmobiles, motorcycles, motor homes, etc.
5. Types of underlying policies required may vary by carrier
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODD. Required Minimum Underlying Limits
1. Homeowners or CPL – typically $300,000 (some carriers require as
little as $100,000 and others as much as $500,000)
2. Auto – typically $250/$500/$100 or $300,000 CSL (some carriers
as low as $100/$300/$50 and others as high as $500/$500/$100)
3. Watercraft – typically $300,000 (again ranging from $100,000 to
$500,000)
E. Maintenance of underlying insurance
1. Failure to maintain the required underlying coverages and limits will
obligate the insured to pay the difference between the actual limit in
force and the required limit, before the Umbrella policy will pay
2. Some Umbrella contracts require that the carrier be notified if the
underlying limits are not maintained, are changed or are replaced
3. Concurrency of the underlying policies and the Umbrella is a
major concern
F. Underlying carrier considerations
1. Financial condition of the underlying carrier
2. Umbrella carrier may not be responsible for required
underlying limit if underlying carrier goes bankrupt
3. Some Umbrella carriers will only write coverage over their own
underlying policies
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODSample Wording
Example #1:
We will not be required to assume any obligation of any primary insurance
company which is deemed uncollectible or invalid by its bankruptcy or insolvency. If
you do not maintain the other insurance, this policy will apply the same way it would
have applied had you maintained the other insurance. The bankruptcy or insolvency
of an insurance company providing the other insurance will not affect this condition.
Example #2:
B. Primary Insurance Requirements - You must have primary insurance,
including liability insurance for:
1. any premises owned by, leased to, furnished or available for the regular
use of, you or a family member;
2. any auto or recreational vehicle owned by, leased to, furnished or
available for the regular use of, you or a family member:
3. any watercraft owned by, leased to, furnished or available for the use
of you or a family member.
You must keep the primary insurance coverage at or above the minimum
limits shown on the Declarations. If the primary insurance does not provide
at least the limits indicated, you will be responsible for the loss up to the
required limits. We will only pay for the amount of loss which is:
1. above the required primary insurance limits; and
2. above any other insurance collectible for an occurrence.
Example #3:
Maintenance of Underlying Insurance
You must maintain the "underlying insurance" at the full limits stated in the
Declarations with no change to more restrictive conditions during the term of this
policy. If any "underlying insurance" is cancelled or not renewed and not replaced,
you must notify us at once.
If you fail to maintain "underlying insurance", we will not be liable under this policy
for more than we would have been liable if that "underlying insurance" was in effect.
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODG. Examples of Umbrella/Excess Liability loss situations
1. EXAMPLE #1: SAMUEL SOUTHBY
PERSONAL UMBRELLA UNDERLYING REQUIREMENTS:
Personal Auto Policy $300,000
Homeowners/Personal Liability Policy $300,000
Watercraft Policy If Insured Owns Watercraft $100,000
Self-Insured Retention $250
Mr. Southby fails to renew his Homeowners policy and a visitor subsequently
falls on the front steps of his home and suffers a serious injury. The visitor's
bodily injury claim is held to be worth $500,000.
Homeowners Policy pays… $_________
Mr. Southby pays… $_________
Umbrella policy pays… $_________
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOOD2. EXAMPLE #2: SAMUEL SOUTHBY
PERSONAL UMBRELLA UNDERLYING REQUIREMENTS:
Personal Auto Policy $300,000
Homeowners/Personal Liability Policy $300,000
Watercraft Policy If Insured Owns Watercraft $100,000
Self-Insured Retention $250
Mr. Southby renews his homeowners policy with a Section II – Liability limit of
$100,000 and a visitor subsequently falls on the front steps of his home and
suffers a serious injury. The visitor's bodily injury claim is held to be worth
$500,000.
Homeowners policy pays… $_________
Mr. Southby pays $_________
Umbrella policy pays $_________
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODV. SELF-INSURED RETENTION (SIR)
A. Definition
¾ An amount indicated in the Declarations of the Umbrella which will be
paid by the insured for loss which is not covered by the underlying policy,
but is covered by the Umbrella with no underlying requirement
x Ex. Libel and slander are not covered on the unendorsed ISO
Homeowners policy, but are covered on many Umbrella policies
without a requirement for underlying coverage
x Ex. The PAP does not provide worldwide coverage, but many
Umbrellas do provide worldwide coverage with no underlying
requirement while outside the auto coverage territory
Sample wording
“We will be liable for only that portion of damages, subject to the Each
Occurrence limit stated in the Declarations, in excess of the “retained limit”,
which is the greater of:
The total amounts stated as applicable limits of underlying policies listed in the
Schedule of Underlying Insurance and applicable limits of any other insurance
providing coverage to the “insured” during the policy period; or
The amount stated in the Declarations as Self-Insured Retention as a result of
any one occurrence not covered by the underlying insurance listed in the
Schedule of Underlying Insurance nor by any other insurance providing
coverage to the “insured” during the policy period.”
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODB. Application of the Self-Insured Retention
1. Similar to a deductible, but … Only applies if loss is not covered by an
underlying policy and there is no underlying requirement for that coverage
2. Insured is responsible for paying the SIR, however, unlike most
deductibles, the carrier often pays the claim and seeks reimbursement of
the SIR from the insured
3. Most common SIR amounts are $250, $500 or $1,000
4. No SIR in “following form” policies
EXAMPLE: SELF INSURED RETENTION - SAMUEL SOUTHBY
PERSONAL UMBRELLA UNDERLYING REQUIREMENTS:
Personal Auto Policy $300,000
Homeowners/Personal Liability Policy $300,000
Watercraft Policy If Insured Owns Watercraft $100,000
Self-Insured Retention $250
Mr. Southby calls the local high school principal incompetent at a Parent's night
reception. The principal sues Mr. Southby for $500,000 for slander and wins.
Mr. Southby's homeowners policy does not provide personal injury coverage, but
his Umbrella policy does, with no underlying requirement.
Homeowners policy pays… $_________
Mr. Southby pays… $_________
Umbrella policy pays $_________
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODVI. KEY DEFINITIONS
A. “Insured”
Ex. #1
1. “Insured” means you and the following residents of your household:
a. a relative of yours
b. any person under the age of 21 who is in your care or the care
of an “insured” in a. above
a. You (which includes resident spouse)
b. Resident relatives
c. Anyone under 21 in the care of anyone above
Ex. #2
1. You and your “relatives” are covered
2. ……………………………………………….
…………………………………………………….
K. “Relative” means a person related to you by blood, marriage or
adoption who lives in your household and anyone else in your or a
“Relative’s” care living in your household.
a. You (which includes resident spouse)
b. Resident relatives
c. Anyone in the care of anyone above, regardless of age
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODEx. #3
J. "Insured" means:
1. "You"; but, with respect to use of an "auto" "you" do not own which is
furnished or available for "your" regular use, only if "you" are insured for
"your" use of that "auto" under one or more "underlying policies" for not
less than the auto liability deductible amount shown in Schedule A of this
endorsement.
2. A "family member", but with respect to use of an "auto" furnished or
available for the regular use of a "family member", only if the "family
member" is insured for his or her use of that "auto" under one or more
"underlying policies" for not less than the auto liability deductible amount
shown in Schedule A of this endorsement.
x Exclusions and limitations concerning certain exposures, such as
auto, can be found in various definitions
Ex. #4
"Insured" means:
(a) the named insured
(b) the following residents of the named insured's household:
(1) the named insured's relatives; and
(2) anyone under the age of 21 under the care of the person named above; and
(c) a person or organization while using or holding an automobile, recreational
motor vehicle, or watercraft owned by, rented by, or loaned to the named
insured, provided that the named insured has permission for the type of use. A
person or organization is not an insured if the use or custody is in the course of
an automobile sales or service business or without the named insured's
permission.
x “Insured” includes anyone using, with permission, a vehicle or
watercraft owned, rented or borrowed by the named insured
Ex. #5
"Covered person" means:
(a) You;
(b) A family member;
(c) A person using an auto, recreational vehicle or watercraft you own with
your permission "Family member" means a person related to you by
blood, marriage or adoption who resides in your home.
x “Insured” includes anyone using, with permission, a vehicle or
watercraft owned by the named insured
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODB. “Personal Injury”
1. Most Umbrella forms have separate definitions for “personal
injury” and “bodily injury”
2. Some Umbrella forms broaden the definition of “personal injury”
to include “bodily injury”
3. Carefully read the policy exclusions which can affect the interpretation of
the definition of “personal injury” (check for intentional injury exclusions)
Ex. #1:
K. "Personal injury" means injury arising out of one or more of the following offenses:
1. False arrest, detention or imprisonment;
2. Malicious prosecution;
3. The wrongful eviction from, wrongful entry into, or invasion of the right of
private occupancy of a room, dwelling or premises that a person occupies,
committed by or on behalf of its owner, landlord or lessor.
4. Oral or written publication of material that slanders or libels a person or
organization or disparages a person's or organization's goods, products or
services; or
5. Oral or written publication of material that violates a person's right of privacy.
Ex. #2:
“Personal injury” means:
a. bodily injury, shock, mental anguish, or sickness or death;
including death resulting from any of the above.
b. false arrest, detention or imprisonment;
c. malicious prosecution;
d. wrongful entry or eviction;
e. humiliation;
f. libel, slander, defamation of character;
g. invasion of privacy.
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODC. Policy Territory
1. Worldwide in most Umbrellas
2. Limitations may apply to certain exposures such as auto, recreational
vehicles and watercraft
Ex. #1
Coverage applies to an “occurrence” which takes place anywhere in
the world.
a. Worldwide coverage
b. No requirement to carry underlying auto, recreational vehicle or
watercraft coverage outside the U.S.
EX. #2
This coverage protects you wherever in the world you happen to be…
For automobiles, recreational motor vehicles and boats, we will cover
you and your family only if you have coverage for them on a policy
listed on the Declarations Page. If there is a claim involving an
automobile, recreational motor vehicle or boat that is not covered by
your other liability insurance, we will not cover it either.
It is important that you realize that most automobile policies only
cover you while in the United States and Canada. If you drive in
another country you must carry insurance that will cover you in that
country. This includes Mexico. If you do not, we will not cover you
under this policy.
a. Worldwide coverage, but…
b. Underlying is still required for auto, recreational vehicles and
watercraft
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODVII. POLICY PROVISIONS
A. “Pay on Behalf Of” vs “Indemnify”
1. “Pay on behalf of” = “Stand in your shoes”
x Company will pay for ongoing expenses, supplemental payments
and actual damages owed as they occur or become payable
Example
Subject to our limit of liability, we will pay on behalf of the insured
damages in excess of the retained limit, for which an insured becomes
legally liable.
2. “Indemnify” = “Make you whole again” … i.e. “Pay you back”
a. Insurance company is not obligated to provide any payment for
damages until the “insured” is legally obligated to pay for such
b. “Insured” may have to use own money for defense and supplemental
payments
c. Many “indemnify” agreements do not actually require the insured to
pay for damages, but only be obligated
Example
We will indemnify the insured for ultimate net loss in excess of the
retained limit which the insured shall become legally obligated to pay as
damages due to personal injury or property damage.
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODB. Defense
1. Underlying carrier conducts defense if loss is covered by underlying
policy
2. Umbrella carrier conducts defense in cases:
a. Of a loss not covered by underlying policy
b. Where the limits of the underlying policy are exhausted
3. Defense may be in addition to the limits as Supplementary Expenses or
may be within the limits
Sample wording – In Addition to Limits
We have the right and duty to assume control of the investigation, settlement or
defense of any claim or suit against the insured for damages covered by this
policy … In those circumstances where the above paragraph applies, we will pay
our expenses in addition to the applicable limits of insurance…
Sample wording – Within Limits
We will defend any suit against the insured alleging liability insured under the
provisions of this policy … Any payment of amounts incurred above will serve
to reduce the limits of liability of this policy…
a. Most policies cover defense in addition to the Limit of Liability
b. Many will pay defense and legal costs if there is no primary
coverage
c. If there is primary coverage, the umbrella carrier may elect to
participate in defense while being covered in the underlying policy
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODC. Exclusions
¾ Umbrella exclusions are not standardized and will vary by carrier,
however, many are very similar to those found in the underlying policies
The following are common exclusions found in most Umbrella policies:
1. Workers Compensation benefits required or voluntarily provided
2. Property Owned by the “Insured”
3. Property in the care, custody or control of the “insured”
x Some forms may provide a give-back of contractual property
damage
Example
This exclusion does not apply to any property damage to
property:
a. used by;
b. rented to; or
c. in the care, custody or control of;
any insured to the extent that the insured is under contract to
provide insurance for such damage.
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOOD4. Intentional Injury or Property Damage
x May or may not give back coverage for the use of reasonable force to
protect persons or property.
5. Aircraft Liability
x Policies vary, but aircraft is almost always excluded
Ex. #1:
any personal injury or property damage arising out of:
a. ownership;
b. maintenance; or
c. use (including loading or unloading);
of an aircraft of an insured.
Ex. #2:
…due to the ownership, maintenance or use including loading or
unloading, of any, aircraft...except to the extent that coverage therefore is
provided by underlying insurance specified in Schedule A.
6. Professional Services
7. Business
a. May follow underlying
b. May provide broader coverage than underlying
c. May be narrower than underlying
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODEx. #1:
DEFINITION:
"Business" includes trade, profession or occupation.
EXCLUSION:
4. "Bodily injury", "personal injury" or "property damage" arising out of or in
connection with a "business" engaged in by an "insured". This Exclusion (A.4.)
applies but is not limited to an act or omission, regardless of its nature or
circumstance, involving a service or duty rendered, promised, owed, or implied
to be provided because of the nature of the "business". However, this Exclusion
(A.4.) does not apply to:
a. Civic or public activities performed by an "insured" without compensation
other than reimbursement of expenses;
b. An insured minor involved in self-employed "business" pursuits, which are
occasional or part-time and customarily undertaken on that basis by minors. A
minor means a person who has not attained his or her:
(1) 18th birthday; or (2) 21st birthday if a full-time student;
c. The providing of home day care service, but only when:
(1) An "insured" renders such service to a relative of an "insured"; or
(2) A mutual exchange of home day care services agreement exists which
involves no monetary or other compensation;
d. The use of an "auto" you own, or a temporary substitute for such "auto", by
you, a "family member" or a partner, agent or employee of you or a "family
member" while employed or otherwise engaged in the "business" of:
(1) Selling; (2) Repairing; (3) Servicing; (4) Storing; or (5)
Parking;
vehicles designed for use mainly on public highways;
e. The use of an "auto" for "business" purposes, other than an auto business, by
an "insured". However, we do not provide coverage for liability arising out of
the ownership or operation of an "auto" while it is being used as a public or
livery conveyance. This Exclusion (A.4.e) does not apply to a share-the-
expense car pool;
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODEx. #2
DEFINITION
2. "Business" includes trade profession or occupation.
However, it does not include farming.
Ex. #3:
DEFINITION
"Business" includes trade, profession or occupation.
EXCLUSION
(k) Business activity or business property. Business property
Does not include farms.
This exclusion does not apply to:
1. Your or a family member's use of a private passenger auto;
or
2. Activities which are ordinarily incident to non-business
pursuits.
8. Watercraft
a. Can vary considerably from company to company
b. Most exclude non-owned watercraft over 26 feet in length
c. Many cover watercraft only if insured in the underlying
d. Some will cover watercraft of any size and horsepower for rented
or borrowed watercraft
e. Often follows the Homeowners Policy
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODEx. #1:
This exclusion does not apply to:
1. Watercraft with an inboard or inboard/outboard motor(s) of 50
horsepower or less, outboard motor(s) of 25 horsepower or less or to
sailboats less than 26 feet long; or
2. All other watercraft up to 46 feet long, which you rent or borrow on a
temporary, short-term basis.
Ex. #2
EXCLUSION
…to the ownership, maintenance or use, including loading and unloading of
watercraft 50 feet or more in overall length owned by an insured.
This exclusion does not apply:
a. if, on this policy's effective date, the watercraft is covered by underlying
insurance; or
b. if we are informed within 30 days after the watercraft is obtained and an
additional premium is paid to us; or
c. while the watercraft is stored on premises owned or leased to you.
9. Activities of Insureds as Directors & Officers
a. An exception to the exclusion gives an insured coverage for
“Personal Injury” (including Bodily Injury) and “Property Damage” for
activities as a director or officer, but does not give true Directors and
Officers Coverage
b. Some Umbrellas will give back D&O coverage for directors, board
members, trustees, or officers of non-profit corporations or associations
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOOD10. War, civil war, insurrection, rebellion, etc.
11. Nuclear and radioactive exposures
12. Discrimination
13. Communicable disease
14. Sexual molestation
15. Controlled substances
Example
13. "Bodily injury" or "personal injury" arising out of:
a. The transmission of a communicable disease by an "insured";
b. Sexual molestation, corporal punishment or physical or mental abuse;
or
c. The use, sale, manufacture, delivery, transfer or possession by any
person of a Controlled Substance(s) as defined by the Federal Food
and Drug Law at 21 U.S.C.A. Sections 811 and 812. Controlled
Substances include but are not limited to cocaine, LSD, marijuana and
all narcotic drugs. However, this exclusion does not apply to the
legitimate use of prescription drugs by a person following the orders
of a licensed physician;
16. Intra family
17. Racing – Autos? Recreational Vehicles? Watercraft?
18. Pollution
Example
19. "Bodily injury", "personal injury" or "property damage" caused by an
"occurrence" or offense involving the escape of fuel from a "fuel system";
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOOD19. Uninsured/Underinsured Motorists
a. Many Umbrella policies totally exclude UM/UIM
b. Some carriers will add the coverage for UM/UIM via endorsement
c. Some carriers have a sub limit for UM/UIM
d. This is an area with considerable litigation requiring careful analysis of
of the Umbrella policy exclusions and policy provisions
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODDeja VU
1. What are the two primary functions of an Umbrella Policy?
2. What is “underlying” insurance and how does it relate to the Umbrella
Policy?
3. What is a “Self-Insured Retention”, and how and when does it apply in
an Umbrella claim?
4. What is the difference between a policy that “pays on behalf of the
insured” and a policy that “indemnifies” the insured?
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOOD5. How would the following losses be paid?
Umbrella Limit $1,000,000
SIR $ 500
Underlying requirements:
Homeowners Liability $ 300,000
Auto Liability $250/$500/$100
a. Fred purchases a new car and carries limits of $250/$500/$100. While
he and Wilma are driving to the movies, Fred hits a pedestrian who sues
and is awarded $750,000.
Auto Policy pays $__________
Umbrella pays $__________
Fred pays $__________
b. Due to Fred’s busy schedule, he somehow missed a few payments on
his auto policy and the policy was cancelled for non-payment. He
hopped into his car to drive over to the insurance agency to make a
payment and in his haste, he rear-ended another vehicle at a stop light,
injuring the driver and totaling the vehicle. Fred was responsible for
$500,000 in Bodily Injury and $20,000 Property Damage.
Auto Policy pays $__________
Umbrella pays $__________
Fred pays $__________
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODc. While Fred was home recovering, he received a renewal notice for his
Homeowners Policy. He decided to do a little comparison shopping over
the internet. He ended up buying a policy which had a Personal Liability
limit of $100,000. Subsequently, Fred’s dog bit the paperboy and Fred
was sued for $200,000.
Homeowners Policy pays $__________
Umbrella pays $__________
Fred pays $__________
d. After a busy year in court, Fred and Wilma decide to get away and take a
vacation in France. They rent a car to drive through the countryside and
while looking at the gorgeous view, Fred loses control of the car and
drives through the wall of a quaint little roadside café, causing $100,000
damage. Fred turns to Wilma and says, “Well, it was certainly a good
thing we got our auto policy reinstated before we left!”
Auto Policy pays $__________
Umbrella pays $__________
Fred pays $__________
e. Fred mistakenly thought his next door neighbor walked off with some of
his silverware during a party at Fred’s house one night. Fred began telling
everyone he knew about it and it destroyed the neighbor’s reputation. The
neighbor sued Fred for slander and was awarded $1,000,000! (at the
time, Fred had an unendorsed Homeowners Policy with a Personal
Liability limit of $300,000)
Homeowners Policy pays $__________
Umbrella pays $__________
Fred pays
$__________
0LFKDHO&' 2UODQGR&,&/,$&3,$ 3DJH 3HUV8PEUHOODYou can also read
