HOMEOWNERS EXPOSURE ANALYSIS CHECKLIST

(July 2020)

Individual insurance company homeowners applications include most of the essential information to allow a company to evaluate and underwrite new business. However, the following checklist may be useful in helping a client determine the amount of insurance that is necessary for adequate coverage. It may also identify a need for endorsements to meet either a new or existing insured’s specific exposures.

ISO Homeowners Optional Coverage Endorsements

ISO Homeowners Endorsements Checklist

Brochure: Understanding the Homeowners Policy

GENERAL INFORMATION - PERSONAL

Account Name: _______________________________________________________________________

Account number: ______________________________________________________________________

Agency: _____________________________________________________________________________

Agency number: ______________________________________________________________________

Producer: ___________________________________________________________________________

Producer number: _____________________________________________________________________

Named Insured(s):

____________________________________________________________________________________

Mailing address:

____________________________________________________________________________________

Home:	Telephone:	_________________________
	Email:	_________________________
	Fax:	_________________________

Work:	Telephone:	_________________________
	Email:	_________________________
	Fax:	_________________________

Cell phone numbers:	Named Insured:	_________________________
	Spouse:	_________________________
	Others:	_________________________

Marital Status:

___ Married ___ Single ___ Divorced ___ Separated ___ Widow ___ Other

Describe other:

____________________________________________________________________________________

If married or separated, name of spouse: ___________________________________________________

List below all people who currently reside in the household. This should include:

Family members
Persons under 21 in the applicant’s care. This includes foster children.
Other residents who are not related. Some examples are significant others, roomers, boarders, tenants, and domestic employees.

Name	Age	Relationship to Applicant	Occupation

List below all family members not currently residing in the household, including noncustodial children, college students away at school, or any family who lives in an assisted living/skilled care facility.

Name	Address	Relationship to Applicant

Is any property held in a trust? ___ Yes ___ No

If yes, answer the following:

Trust Name: _________________________________________________________________

Trustee(s): ___________________________________________________________________

Property: ____________________________________________________________________

Is the residence a historical landmark or showcase home? ___ Yes ___ No

If yes, answer the following:

Are tours conducted? ___ Yes ___ No

How many tourists visit annually? _______

What is the maximum number of visitors on a single day? _______

Is the property used for community activities? ___ Yes ___ No

If yes, answer the following:

Describe the activities.

_____________________________________________________________________________

How often is the property used for this purpose? _________

What is the maximum number of visitors who might attend? _______

Does the applicant belong to a homeowners or condominium owners association? ___ Yes ___ No

If yes, attach a copy of the Association agreement and bylaws.

Is the residence located in a flood plain? ___ Yes ___ No

If yes, does the applicant carry flood insurance? ___ Yes ___ No

Is the residence located in a known earthquake area? ___ Yes ___ No

If yes, does the applicant carry earthquake insurance? ___ Yes ___ No

Does the applicant carry firearms or have firearms in the residence? ___ Yes ___ No

If yes, complete the firearms supplement.

Have there been any water-related (including backup of sewers or drains) losses? ___ Yes ___ No

If yes, answer the following:

List items damaged by water that remain in the residence.

_____________________________________________________________________________

Is there any evidence of water leaking or seeping in the residence? ___ Yes ___ No

Are there odors in the residence that could suggest the presence of mold? ___ Yes ___ No

Are underground or above ground storage tanks on the premises? ___ Yes ___ No

Are flammables, chemicals, or fuel stored on the premises? ___ Yes ___ No

If yes, describe the property stored, where it is stored, and procedures to prevent ignition.

____________________________________________________________________________________

Is lead paint in the residence? ___ Yes ___ No

Are chemicals sprayed on the premises? ___ Yes ___ No

If yes, describe is the chemical(s) sprayed and state whether the applicant or contractor does the spraying.

____________________________________________________________________________________

Does the applicant own, lease, or rent additional residences? ___ Yes ___ No

If yes, prepare a separate questionnaire for each residence.

Does the applicant own rental property? ___ Yes ___ No

If yes, prepare a questionnaire for rental property.

DWELLING – COVERAGE A

Location Address:

____________________________________________________________________________________

What is the approximate size of the lot? __________________acres

What is the dwelling’s square foot area? ____________________________________

Does the applicant own the dwelling? ___ Yes ___ No

If no, answer the following:

Who owns the dwelling?

_____________________________________________________________________________

Is the applicant contractually obligated to insure the dwelling? ___ Yes ___ No

If yes, attach a copy of the contract.

Identify the type of dwelling.

___ Single family ___ Duplex ___ 3-family ___ 4-family ___ Other

Describe other.

____________________________________________________________________________________

What is the dwelling’s construction?

___ Wood frame ___ Masonry veneer ___ Masonry ____ Other

Describe other.

____________________________________________________________________________________

What is the dwelling’s roofing material? ________________________________

When was the dwelling built? _________

What is the dwelling’s number of stories? _______

Provide the year when each of the following was updated.

Heating _______ Electrical _____ Roof ______ Plumbing _______

What type(s) of fuel is/are used for heating? If more than one, provide the percentage of each.

___ % Electric ___ % Natural Gas ___ % LPG ___ % Fuel Oil ___ % Wood ___ % Solar ___ % Other

Describe other.

____________________________________________________________________________________

Identify the number of the following in the dwelling.

___ Wood burning fireplaces ___ Wood stoves

Is either used as the primary source of heating? ___ Yes ___ No

Year the chimney was last inspected/cleaned: _____

Does the dwelling have an operating alarm system? ___ Yes ___ No

If yes, answer the following:

Type of alarm: ___ Fire ___ Burglar ___ Carbon Monoxide

Does the police department or an alarm company monitor the alarm? ___ Yes ___ No

Does the dwelling have an operating fire suppression system? ___ Yes ___ No

If yes, is the system monitored and inspected regularly? ___ Yes ___ No

Identify which and the number of these rooms that are in the dwelling:

_____ Bedroom	_____ Bathrooms	_____ Living Room	_____ Dining Room
_____ Kitchen	_____ Family Room	_____ Great Room	_____ Library/Study
_____ Sauna	_____ Exercise Room	_____ Recreation Room	_____ Sunroom
_____ Home Office	_____ Other	_____ Other	_____ Other

Describe other.

____________________________________________________________________________________

Identify the automobile parking arrangements and the number of spaces available.

_____ On-street parking	_____ Off-street parking	_____ Carport
_____ Attached garage	_____ Detached garage	_____ Reserved space(s) in parking garage

Has the applicant made any improvements or betterments to the dwelling while he or she occupied it? ___ Yes ___ No

If yes, describe the improvement(s) and include the date(s):

____________________________________________________________________________________

ADDITIONAL STRUCTURES – COVERAGE B

Location Address:

____________________________________________________________________________________

Which of the following structures are at this location address and are not attached to the residence?

Structure	Year Built	Construction	How Used	Rebuild After Loss? (Y/N)
Garage
Gazebo
Pool (above ground)
Pool (in ground)
Pool House
Guest House
Greenhouse
Pump House
Play Equipment
Satellite Dish
Fence
Storage Unit
Outdoor Fireplace
Barn
Tennis Court
Piers, Wharves, Docks
Other:

PERSONAL PROPERTY – COVERAGE C

Location Address:

____________________________________________________________________________________

Dwelling square foot area: ____________________________________

Identify the type of dwelling.

___ Single Family ___ Duplex ___ 3-Family ___ 4-Family ___ Other

Describe other.

____________________________________________________________________________________

What valuation is to be used for personal property?

___ Actual Cash Value ___ Replacement Cost

Does the applicant have any of the following types of personal property?

Jewelry valued in excess of $1,500	___ Yes	___ No
Firearms valued in excess of $2,500	___ Yes	___ No
Silverware valued in excess of $2,500	___ Yes	___ No
Furs valued in excess of $1,500	___ Yes	___ No
Property used in business	___ Yes	___ No
Collections	___ Yes	___ No
Antiques	___ Yes	___ No
Fine Arts	___ Yes	___ No
Unusual property that should be scheduled	___ Yes	___ No
More than $250 in cash on the premises	___ Yes	___ No

If the answer to any of the above is yes, complete the appropriate supplement.

Is any personal property regularly off premises? ___ Yes ___ No

If yes, where will it be and what is the value?

$ __________ College student	$ __________ Storage facility
$ __________ Another residence	$ __________ Gym/Club
$ __________ At work	$ __________ In a vehicle
$ __________ Other	$__________ Other

Describe other.

____________________________________________________________________________________

LIVING EXPENSES – COVERAGE D

Location Address:

____________________________________________________________________________________

How many individuals live in the primary residence? _____

Does the applicant own other dwellings? ___ Yes ___ No

If yes, could the applicant live in those dwellings after a loss to the primary residence? ___ Yes ___ No

Could the applicant live with family or friends following a loss? ___ Yes ___ No

If yes, what is the longest the applicant could live there? _________

Are there hotels, motels, or lodging in the immediate area? ___ Yes ___ No

Are there apartments or rental housing in the immediate area? ___ Yes ___ No

Would the applicant rebuild the primary residence following a loss? ___ Yes ___ No

If yes, how long would it take to rebuild the primary residence after a total loss? ________________

PERSONAL LINES INVENTORY

This listing is intended to provide guidance in three areas:

Placing all exposures in the proper coverage category
Insuring to value
Identifying possible loss of use concerns

Dwelling (Coverage A)

The applicant must carry limits equal to 80% of the replacement value of the dwelling if a loss is to be adjusted on a replacement cost basis. Land is excluded and its value should not be included in any replacement cost calculation. Foundations, excavations, underground wiring, and fixtures are covered but are not considered when determining the 80% insurance to value requirement.

	Replacement Cost Value	Actual Cash Value	Market Value
Dwelling	$	$	$
Building additions	$	$	$
Total dwelling value	$	$	$

Total Coverage A

Replacement Cost Value	Actual Cash Value	Market Value
$	$	$

Additional Structures (Coverage B)

The automatic limit for all additional structures is 10% of the dwelling limit. Because HO-4 does not cover dwellings, additional structures are not covered. Under HO-6, there is a $1,000 limit for outdoor sheds or garages. List all additional structures:

Structure	Value (ACV or RC)	Rebuild? (Yes or No)
Barn
Fence
Garage
Gazebo
Pool
Pool House
Guest House
Greenhouse
Outdoor Fireplace
Piers, Wharves, Docks
Pump House
Play Equipment
Satellite Dish
Storage Unit
Tennis Courts
Other (describe)

Total Coverage B $ _______________

Personal Property (Coverage C)

Personal property is usually covered for up to 50% of the dwelling value when the policy includes Coverage A. This limit can be increased. Unit owners, tenants, and others who do not purchase Coverage A must specifically schedule their personal property. Losses are settled based on actual cash value. Replacement cost valuation basis is available for a significant premium surcharge.

It is important to complete a property inventory to determine the actual limit needed. Items specifically scheduled, such as furs, silverware, golf equipment, coin collections, firearms, and jewelry should not be part of determining the general personal property's total value. Carpeting, cabinets, countertops, appliances, and bathroom fixtures are all personal property.

Section	Replacement Cost Value	Actual Cash Value
Living Room	$	$
Dining Room	$	$
Family Room	$	$
Kitchen	$	$
Recreation Room	$	$
Basement	$	$
Master Bedroom	$	$
Bedroom 2	$	$
Bedroom 3	$	$
Bedroom 4	$	$
Bedroom 5	$	$
Library/Study	$	$
Bathrooms	$	$
Attic	$	$
_____________________ Room	$	$
_____________________ Room	$	$
_____________________ Room	$	$
Personal Property in additional structures	$	$

	Replacement Cost Value	Actual Cash Value
Total on-premises Coverage C	$	$

Off-Premises Personal Property (Coverage C)

Personal property usually off-premises is covered for up to 10% of the personal property limit. The following inventory assists to determine if additional limits are needed:

Property Situation/Location	Replacement Cost Value	Actual Cash Value
Student living at school	$	$
Property kept at business locations	$	$
Commuting applicant	$	$
Property at other non-owned locations	$	$
Total off-premises Personal Property	$	$

Loss of Use (Coverage D)

Coverage to insure the cost to live elsewhere after a covered loss is not subject to a specific limit. The limit is based on a percentage of either the dwelling limit or the personal property limit, as follows:

Based on Dwelling Limit	Based on Personal Property Limit
HO-2 (Broad); 30%	HO4 (Broad Form Contents): 30%
HO3 (Special): 30%	HO6 (Unit-owners): 50%
HO5 (Comprehensive): 30%
HO8 (Modified): 10%

Unfortunately, suitable accommodations may be hard to find because of a particular family’s special life considerations. These families may be underinsured unless an inventory of needs and available resources is developed in advance and additional coverage purchased.

a. Evaluate the household’s extraordinary needs.

What items must be considered that add to the cost or the ability to find suitable temporary accommodations?

Description	Yes	No
Handicapped accessible
Allergy concerns
Pets
Number of family members
Home business
Other

b. Evaluate the availability of accommodations.

Does the applicant own property where the family can stay after a loss? ___Yes ___No

Can the applicant stay with friends or family? ___Yes ___No

Is temporary rental housing available in the surrounding communities? ___Yes ___No

Is temporary lodging (hotels, motels, etc.) available in the surrounding communities? ___Yes ___No

If the answer to any of the above is yes, what is the maximum length of stay? _____ Days

Are other facilities available to meet the applicant’s temporary housing needs?
___Yes ___No

If yes, what are the vacancy rates? ____%

If readily accessible temporary housing is not available, what will the applicant do if the residence cannot be occupied?

____________________________________________________________________________________

c. Determine the costs of temporary housing.

Add the housing and other expenses together and multiply by the maximum number of days needed to rebuild the dwelling. Add this to the premium or bonus costs to estimate the amount of coverage needed.

"Premium" or "bonus" cost to get space quickly			$ __________
Daily cost of rental unit that meets minimum requirements	$ __________
Per diem costs (other than room expenses)	+$ ___________
Total per diem costs		= $ _________
Maximum number of days to rebuild		X _____
Maximum living expenses during reconstruction			+ $___________
Bonus cost plus living expenses			= $ ___________

d. Compare the Bonus cost plus living expenses above to the limit provided and adjust the limits accordingly.

PERSONAL LIABILITY EXPOSURES

ON-PREMISES EXPOSURES

List all animals kept at the primary residence.

Type	Breed	Age	Weight	Gender (M or F)	Neutered/Spayed (Y/N)

Is any of the following outdoor equipment on the premises?

Trampolines ___ Yes ___ No

If yes, provide the diameter of each trampoline. ___________

Playground Equipment ___ Yes ___ No

If yes, provide the height of each separate item. _____________

Tree House ___ Yes ___ No

If yes, provide the height and dimensions. ______________

Swimming Pool ___ Yes ___ No

If yes, complete the swimming pool supplement.

Do activities that regularly involve non-family members take place at the residence? ___ Yes ___ No

If yes, describe.

____________________________________________________________________________________

Do any household members host a blog, group forum, or other type of Internet activity that goes beyond individual/personal usage?
___ Yes ___ No

Do any household members own and use a 3D printer? ___Yes ___No

Does any printing involve the use of copyrighted plans without permission? ___Yes ___No

Are any products created via 3D printing sold to others? ___Yes ___No

Are any 3D printers owned by the insured rented to others? ___Yes ___No

Are there bodies of water (such as rivers, creeks, lakes, or ponds) on the premises? ___ Yes ___ No

If yes, describe the exposure and any protection that surrounds it.

____________________________________________________________________________________

Are any other features of the applicant’s property unusually appealing yet dangerous for
children or adolescents? ___ Yes ___ No

If yes, describe the feature and measures to limit or prevent access to it.

____________________________________________________________________________________

OFF-PREMISES EXPOSURES

What are the occupations of household members?

Name	Occupation	Name	Occupation

List all organizations where household members take active roles as unpaid volunteers. Describe their job duties.

Name	Organization	Job Duties

Does the organization provide liability and directors and officers liability coverage for its volunteers?

Does any applicant act as a trustee or executor of an estate? ___ Yes ___ No

If yes, answer the following questions:

Does the trust or estate provide a bond and other insurance for the applicant’s benefit?

___ Yes ___ No

Describe the trust or estate property.

_____________________________________________________________________________

CONTRACTS

Does the applicant hire others for construction projects, landscaping, housekeeping, babysitting.?

___ Yes ___ No

If yes, answer the following questions.

Is there a written contract? ___ Yes ___ No

Does the contractor provide a certificate of insurance for work it performs? ___ Yes ___ No

DOMESTIC HELP

Does the applicant employ domestic help? ___ Yes ___ No

If yes, answer the following:

List the name of each individual, the duties performed, if the individual lives on premises, and the number of hours the individual works per week.

Name	Duties performed	Live on premises? (Y/N)	Hours worked per week

Does the applicant purchase workers compensation coverage?

If yes, list the carrier’s name and the policy period.

_____________________________________________________________________________

VACANT LAND

Does the applicant own vacant land? ___ Yes ___ No

If yes, list the vacant land’s location or legal description, a description of it, and its total acreage.

Location/Legal Description	Description	Total Acreage