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The “Property Coverage Fundamentals” course teaches insurance professionals a five-
step process for coverage analysis. The module is presented by Tim Havlir, Property
Coverage Counsel at PLRB.

The course begins by explaining the five-step process for coverage analysis. First,
was there a loss to covered property? Second, was it a direct physical loss? Third, was
it a covered cause of loss? (This step discusses both coverages and exclusions.)
Fourth, were any policy conditions breached? Fifth, do any additional coverages apply?
The course then proceeds through a number of case studies examining each one of these
steps in turn and in detail. Sometimes these case studies lead to broad discussions of
coverage analysis; other times, specific exploration of sample policy language; and
other times, a review of relevant case law. Each case study or hypothetical is designed
to get at interesting and important issues surrounding each of the five steps of
coverage analysis.

After completing the course, the attendee will be able to work a coverage issue
through step by step; handle situations in which covered and uncovered property are
both involved; interpret ambiguous policy language using the principle of nascitur a
sociis; determine when the “physical” of “direct physical damage” does and does not
apply; apply the appropriate exclusions for a pandemic scenario; predict which side of
a coverage lawsuit will have burden of proof based on the type of peril in the policy;
handle insurable interest scenarios using a set of key factors; apply context and
government bulletins to claims situations; apply deductibles appropriately in
additional coverage scenarios; and distinguish backup from overflow. The course is
designed for insurance professionals working in the area of property adjusting.

What CE Credit is available?

Note: To qualify for credit, you must submit completion (including a passed final exam if required) within five days of completing the last quiz. No partial credits will be awarded.

State:
Adjuster General
CE Hours:
Adjuster Ethics
CE Hours:
Attorney General
CLE Hours:
State's Course ID:
NH 2.0 General 6000106959
TX (classroom equivalent) 2.0 136940
NC 2.0 General 215269
FL * ( Provider Number: 364169 ) 1.0 Optional 1205542
IL 2.0 485272
WY 2.0 General 33092
OK 2.0 General 6000107907

* This course has been approved by the Florida Department of Financial Services for insurance continuing education credit.

Course Content

Lesson Content
  1. Introduction and Policy As Checklist
  2. The Five Steps of Coverage Analysis
  3. A Word of Caution
  4. Hypothetical: Dwelling Rented Out
  5. Can Coverage Be Denied?
  6. Recap
Lesson Content
  1. Introduction
  2. Covered Property
  3. Property Not Covered
  4. “What Was Damaged?”
  5. Hypothetical: Lightning to Pipe
  6. Hypothetical: Excavation
  7. Hypothetical: Metered Water
    1. Analysis of Specific Policy Language
  8. Recap
Lesson Content
  1. Introduction
  2. Dictionary Definition of “Direct Physical Loss”
  3. Hypothetical: COVID-19 and a Dentist’s Office
    1. Legal Definition of “Direct Physical Loss” with Case Law
  4. Virus or Bacteria Exclusion
  5. Pollutant Exclusion
  6. Ordinance or Law Exclusion
  7. Recap
Lesson Content
  1. Burden of Proof for Named Peril vs. Open Peril
  2. Hypothetical: Leak Under Slab
    1. Various Potential Exclusions
  3. Case Law on Anti-Concurrent Language
  4. Hypothetical: Food Spoilage
    1. Various Potential Exclusions
  5. Recap
Lesson Content
  1. Common Policy Conditions at Issue
  2. Hypothetical: Father Insures Son’s Dwelling
    1. Establishing Insurable Interest in Case Law
  3. Hypothetical: Vacant Building During Pandemic
    1. Interpreting Policy Using Context and DOI Bulletins
  4. Is Prejudice Required?
  5. Recap
Lesson Content
  1. Common Pairings of Exclusions and Additional Coverages
  2. Reminder on Priority of Main Coverage
  3. Hypothetical: Overflow of Drain
    1. Understanding Backup vs. Overflow
  4. Taking Deductibles from Additional Coverages
  5. Hypothetical: Off-Premises Loss Under BP Policy
  6. Final Reminders and Conclusion
  7. Recap