Acceptability (See also Eligibility) - Battle Creek Mutual ... Injury HO 24 82 G-25 R-16 Personal...

June 2017 G-i Battle Creek Mutual

HOMEOWNER INDEX

Subject HO Number

(If Applicable) Manual Page

Rate Page

Actual Cash Value Loss Settlement Windstorm or Hail Losses to Roof Surfacing

HO 04 93 G-22 R-10

Additional Insured (Residence Premises) HO 04 41 G-17 R-7/R-13Additional Insured—Student Living Away from

the Residence Premises HO 05 27 G-23 R-14

Additional Interests – Residence Premises HO 04 10 G-15 R-6Additional Living Expense—See Loss of Use Additional Residence Rented to Others – 1, 2,

3 or 4 Families HO 24 70 G-24 R-15

Amendatory NE (Special Provisions—Nebraska) FE 007 G-26 R-12/R-16Animal Bites G-11Assisted Living Care Coverage HO 04 59 G-20 R-8/R-14Basic Policy Limits G-13Binding Authority G-1Boats — Use Watercraft policy Building Additions and Alterations HO 04 51 G-18 R-7Building Additions and Alterations (Other

Residence) HO 04 49 G-18 R-7

Business Pursuits HO 24 71 G-24 R-15Cancellation – Homeowner G-2Child Care (Home Day Care Coverage) HO 04 97 G-11/G-23 R-14Children at College G-7Claim Surcharge R-5Commercial Exposures G-11Comparison of Coverages, G-13Condominium-Occupant G-4Contents Coverage—Children at College G-7Coverage C Increased Limits (Personal Property) R-6Coverage C Increased Special Limits of Liability HO 04 65 G-22 R-9Coverage C Increased Special Limits of Liability

Endorsement HO 04 66 G-22 R-10

Coverage D—Increased Limits (Loss of Use) R-6Coverage E—Optional Liability Limits R-13Coverage F—Optional Medical Limits R-13Credit Card, Electronic Fund Transfer Card, or

Access Device Forgery and Counterfeit Money Coverage

HO 04 53 G-19 R-7

Day Care (Home Day Care Coverage) HO 04 97 G-11/G-23 R-14Deductible (minimum by Ins. Score group and level) G-6Deductible Factors R-4Discounts – Rating R-4Dog Exclusion Endorsement CE 006 G-26 R-16Dog Exclusion Endorsement Number 2 CE 008 G-26 R-16Dwelling—Remodeling G-7Dwelling—Renovation G-7Dwelling Replacement Cost Valuation G-32Dwelling Under Construction G-12Dwellings Owned by Corporations G-11

becky

Text Box

August 2016 G-ii Battle Creek Mutual

Subject HO Number


Rate Page

Earthquake HO 04 54 G-19 R-8

Eligibility, New Business G-4 to G-8

Endorsements G-15 to G-26 R-6 to R-16

Equipment Breakdown Enhancement Endorsement HO NE EB G-25 R-11

Excluded Specific Structures (All Coverages) FE 001 G-25 R-11

Excluded Specific Structures (Property) FE 005 G-26 R-12

Exclusion of Cosmetic Loss to Metal Roof Coverings Caused By Hail

HO 118 G-25

Exclusion of Terrorism HO 05 16 G-23 R-11/R-14

Extended Theft Coverage for Residence Premises Occasionally Rented to Others

HO 05 41 G-23 R-11

Farm Exposure G-11

Farm Property G-4

Fire Protection Class Codes G-27 to G-31

Fishhouse G-7

Flat Roofs/T-locks G-11

Functional Replacement Cost Loss Settlement HO 05 30 G-23 R-11

HO-2 rates R-1 to R-2

HO-3 rates R-1 to R-2

HO-4 rates R-3

HO-6 rates R-3

Home Day Care Coverage HO 04 97 G-11/G-23 R-12

House Trailers and Travel Trailers G-11

Incidental Farming Personal Liability HO 24 72 G-25 R-16

Incidental Low Power Recreational Motor Vehicles HO 24 13 G-24 R-14

Incidental Occupancy G-4

Increased Limits on Business Property HO 04 12 G-15 R-6

Increased Limits—Coverage C (Pers. Property) R-6

Increased Limits—Coverage D (Loss of Use) R-6

Increased Limits on Personal Property in Other Residence

HO 04 50 G-18 R-7

Identity Fraud Expense Coverage HO 04 55 G-19 R-8

Information Required to Bind Coverage G-2

Insurance Score Relativity Factors R-4

Jet Skis—Personal Watercraft—Use Watercraft policy

Late Fee G-3

Limited Fungi, Wet or Dry Rot, Or Bacteria Coverage HO 04 26 G-16 R-6



Livestock Collision Coverage HO 04 52 G-19 R-7

Loss Assessment Coverage HO 04 35 G-17 R-7

Loss of Use—Increased Limits (Coverage D) R-6

Manufactured Home Loss Settlement MH NE 04 G-26 R-12

Manufactured Home Risk Qualifications G-10

Mature Homeowner Discount G-12 R-4

Miscellaneous Rating Discounts R-5

Mobile Homes G-10 & G-11

Multi-line Discount G-12 R-4

Names and Addresses G-2

New Business Eligibility G-4 to G-8

New Roof Discount G-12 R-5

New Home Discount R-5

Nonrenewed or Cancelled G-6

Non-Sufficient Funds Checks G-3

May 2018 G-iii Battle Creek Mutual

Subject HO Number


Rate Page

Objective New Business Client Eligibility Requirements G-5 Office, Permitted Incidental Occupancies (Residence Premises)

HO 04 42 G-18 R-14

Optional Liability Limits—Coverage E R-13 Optional Medical Limits—Coverage F R-13 Other Members of Your Household HO 04 58 G-20 R-8/R-14 Other Structures G-4 Other Structures (Increased Limits) HO 04 48 G-18 R-7 Ordinance or Law Coverage HO 04 77 G-22 R-10 Owned Recreational Vehicle CE 001 G-26 R-16 Owner-Occupant G-4 Payment Plans G-3 Permitted Incidental Occupancies (Other Residence) HO 24 43 G-24 R-14 Personal Property—Increased Limits (Cov. C) R-6 Personal Property Replacement Cost HO 04 90 G-22 R-10 Personal Injury HO 24 82 G-25 R-16 Personal Watercraft – Use Watercraft Policy Policy Term G-3 Property Rating Points G-5 Protective Device Credits R-5 Protection Class Codes G-27 to G-31 Rate Level Factors R-4 Rating Discounts R-4 to R-5 Recreational Vehicle, Owned CE 001 G-26 R-16 Refrigerated Property Coverage HO 04 98 G-23 R-11 Reinstatements G-1 Remodeling Dwelling G-7 Renovating Dwelling G-7 Replacement Cost Loss Settlement for Certain Non-Building Structures on the Residence Premises

HO 04 43 G-18 R-7

Satellite Dishes, Outdoor Antennas, Outdoor Equip. G-12 Scheduled Personal Property Endorsement HO 04 61 G-21 R-9 Scheduled Personal Property Endorsement (With Agreed Value Loss Settlement)

HO 04 60 G-20 R-8

Sections I and II Exclusions for Computer-Related Damage or Injury

HO 04 13 G-15 R-6/R-13

Service Line Enhancement Endorsement HO SL G-25 R-11 Solid Fuel Heating Unit G-11 & G-32 to

G-33 R-1 to R-3

Snowmobile HO 24 64 G-24 R-15 Special Computer Coverage HO 04 14 G-16 R-6 Special Loss Settlement (Form HO –2 only) HO 04 56 G-19 R-8 Special Personal Property Coverage (HO-3 only) HO 00 15 G-15 R-6 Special Personal Property Coverage (HO-4 only) HO 05 24 G-23 R-11 Special Provisions—Nebraska FE 007 G-26 R-12/R-16 Specific Structures On or Off Premises FE 002 G-25 R-11 Specific Structures On or Off Premises (Named Perils Only)

FE 011 G-26 R-12

Specifically Rated Risks R-4 Specified Additional Amount of Insurance for Coverage A – Dwelling

HO 04 20 G-16 R-6

Structures Rented to Others HO 04 40 G-17 R-7 Swimming Pool G-11

May 2018 G-iv Battle Creek Mutual

Subject

HO Number (If Applicable)

Manual Page

Rate Page

Tenant G-4 Territory—County list G-12 Territory Factors G-12 R-4 Town Class Codes G-27 to G-31 Trampoline G-11 Trust Endorsement G-23 R-11/R-14 Underwriting Acceptability G-11 Underwriting Engineering G-12 Underwriting Guidelines/Acceptability G-1 to G-2, G-11 Unit-Owner’s Coverage A (Special Coverage) HO 17 32 G-24 R-11 Unit-Owner’s Coverage C HO 17 31 G-24 R-11 Unit-Owner’s Rental to Others Endorsement HO 17 33 G-24 R-11 Unregistered Motor Vehicle Endorsement FE 010 G-26 R-12, R-16 Woodstove G-11 & G-32 to

G-33 R-1 to R-3

Water Backup and Sump Discharge or Overflow FE 003 G-9, G-25 R-12 Windstorm or Hail Exclusion HO 04 94 G-22 R-11

June 2017 G-1 Battle Creek Mutual

HOMEOWNER UNDERWRITING GUIDELINES

BINDING AUTHORITY

As an agent of Battle Creek Mutual Insurance Company, you are authorized to bind the Company for Homeowners which you are licensed to sell, except for limitations listed below.

When you bind coverage on a new Client Account, the completed application(s), with full mode payment (and photos if applicable), must be received by the Home Office within 10 days of the date and time coverage is effective. If not, coverage will be effective the date it is received in the Home Office.

When you bind coverage on existing accounts, the completed applications, reinstatements or changes must be received by the Home Office within 10 days of the date and time coverage is effective. If not, coverage will be effective the date it is received in the Home Office.

For new business and existing business, you have authority to bind up to $750,000 on any one structure for protection classes 1-10.

Money need not be collected if we are to bill escrow.

Do not bind any risk, coverage or limits inconsistent with the rules of this manual without written specific authority.

If an application is not fully completed, we will request the needed information and/or the application will be returned to you. If it is not returned to the Home Office within ten (10) days, we will send a cancellation letter to the insured.

REINSTATEMENTS

A lapsed or expired policy may be reinstated at the Company’s option but is subject to the following rules:

1. If lapsed or expired for more than 60 days, a new application and the necessarysupplemental information must be submitted to rewrite the risk. If the billing departmentreceives payments (submitted by agents and insureds) on policies that have lapsed orexpired for more than 60 days, they will return these checks to the sender along with a formletter stating that no coverage is in force. We will reinstate/renew with no gap in coverage ifpayment is received within 17 days of the due date or expiration date. If payment isreceived between 18 and 60 days after the due date or expiration date, we willreinstate/renew with a gap in coverage.

2. If money (full payment) is sent in by the insured, reinstatement will be effective 12:01 a.m.on the date we receive it.

These rules are applicable to lapsed or expired policies and to policies terminated voluntarily by the policyholder, subject to the rules and rates in effect at that time.

October 2016 G-3 Battle Creek Mutual

POLICY TERM The policy period for a HO policy is twelve months. If acceptable, a renewal billing will be sent approximately 20 days prior to the expiration date. An exception is that renewal billings for EFT policies will be produced 45 days prior to the expiration date. If we bill the named insured for their next policy term and the named insured fails to pay the required renewal premium when due, the policy will be cancelled.

PAYMENT PLAN

Under the HO Policy, the customer may choose from the following payment plans: (If the annual premium is less than $50, only the 1-Pay (annual) payment plan may be selected.)

1 Pay (Annual) – will be billed once a year. No service fee will apply. 2 Pay (Semi-Annual) – will be billed twice a year. A service fee of $5 per billing will be added. 4 Pay (Quarterly) – will be billed four times a year. A service fee of $5 per billing will be added. Monthly via Electronic Funds Transfer (EFT) Requires a one month down-payment. Complete the separate application. No service fee will apply. A policy may be placed on EFT any time during the policy term. See the EFT Billing Manual for complete information. NOTE: Installment fees listed above do not apply if the client chooses the paperless option.

NON-SUFFICIENT FUNDS CHECKS If following a billing, the Company receives a check and the check is returned by the customer’s financial institution for lack of funds, the check will be returned to the insured informing the customer that we will require a certified check, including a $25 charge, to be remitted to the Home Office within 12 days to maintain coverage on the policy or policies.

LATE FEE If the premium is not paid within 5 days of the due date, we will add a $15 late fee. This will apply to our One pay (annual), Two pay (semi-annual), and Four pay (quarterly) direct billing plans only.


HOMEOWNERS NEW BUSINESS ELIGIBILITY

A. Owner-Occupant. A Homeowner Policy may be written only for the owner-occupant of a dwelling which is used exclusively for private residential purposes (except as provided below) and which contains not more than four (4) families and with not more than two (2) boarders or roomers per family. This would include a new dwelling under construction which will be used exclusively for private residential purposes (except as provided below) and which will contain no more than four (4) families and no more than two (2) boarders or roomers per family.

B. Condominium-Occupant. A Homeowner Policy with the Unit-Owners Form may be written for owner-occupied condominium units.

C. Tenant. Except as provided above, a Homeowner Policy with only Contents Broad Form attached may be issued to the tenant (non-owner) of a dwelling or an apartment situated in any building provided for residential purposes (except as provided below) and is not occupied by more than two boarders or roomers.

D. Incidental Occupancy. Office, Professional Private School or Studio occupancy is permitted in certain instances. Such occupancy must be described in the application.

E. Farm Property. A policy shall not be issued covering any property to which farm forms or rates apply. In no event shall a policy be issued to cover any property situated on premises used for farming purposes unless farming conducted therein is only incidental to the occupancy of the premises by the insured as a dwelling, and farming is not the occupation of the insured.

F. Other Structures. Structures in poor repair, not solely utilized for personal use, not being used at all or only being used to a small extent of their capacity should be excluded by endorsement.



Objective New Business Client Eligibility Requirements

Policies can be written only in the state of Nebraska

Risk meets criteria in BCMIC point chart listed below.

The risk is ineligible if the underwriter or the agent’s subjective evaluation determines the risk to be ineligible for BCMIC.

Battle Creek Mutual Insurance Company has three separate levels to insure eligible Homeowner risks. Each higher level requires new business applicants to meet more stringent eligibility criteria. Following are the eligibility requirements for the Ultra-Preferred, Preferred and Standard levels.

Rating Points

Description of Loss * Rating Points

Each weather related claim that occurred during the past five years.

Wind or hail 1

Earthquake or Lightning

1

Each non-weather related claim that occurred:

during the past three years

4

over three years ago, but less than five years ago

2

ULTRA PREFERRED PREFERRED STANDARD

A. Homeowner Forms Eligibility Minimum Value of Home

Year Built

Minimum Value of Home

Year Built

HO-2 Broad Form $40,000 N/A $25,000 N/A HO-3 Special Form $75,000 1950 or later $60,000 1950 or later HO-4 Contents Broad Form $25,000** (Contents) $15,000** (Contents) HO-6 Unit-Owners Form $5,000 (Cov. A)

$30,000(Contents) $5,000 (Cov. A)

$20,000(Contents)

** $10,000 minimum value is available if there is a Personal Auto policy as supporting business in the account.

B. Applicant Information

Prior Insurance 1. No Prior

Homeowner Insurance with another carrier within the last 30 days and own a dwelling

No No

New Business Eligibility Rules (Based upon Rating Points)

1.5 points or less Ultra Preferred 2.5 points or less Preferred 5 points or less Standard

* Any dwelling with more than 2 claims in the past 3 years or more than 3 claims in the past 5 years, regardless of type, is not eligible for coverage.

2017 G-6 Battle Creek Mutual

2. Reinstatements over60 days (Rewrite)

No OK if risk qualifies. New application and supplemental information must be submitted.

Nonrenewed or Cancelled A new business/new client who has been nonrenewed or cancelled by their previous carrier will be subjectively underwritten. A copy of the nonrenewal or cancellation letter from the prior carrier may be requested.

Deductibles – Minimums Ins. Score

Group Ultra Preferred Preferred Standard

0A, 0B, 0C,0D $500 $500 / $1,000* $500 / $1,000* 1A, 1B,1C $500 $500 / $1,000* $500 / $1,000* 2A, 2B, 2C $500 $500 / $1,000* $500 / $1,000* 3A, 3B, 3C $500 / $1,000* $500 / $1,000* $1,000 / $1,000** 4A, 4B, 4C $500 / $1,000* $500 / $1,000* $1,000 / $2,500*** 5A, 5B, 5C $500 / $1,000* $500 / $1,000* $1,000 / $2,500***

No Hit $500 / $1,000* $500 / $1,000* $1,000 / $1,000** Inconclusive $500 / $1,000* $500 / $1,000* $1,000 / $1,000**

* $500 dollar deductible with $1,000 wind and hail deductible** $1,000 dollar deductible with $1,000 wind and hail deductible *** $1,000 dollar deductible with $2,500 wind and hail deductible

Any policy with 3 Wind/Hail claims in the past 5 years must carry a minimum Wind/Hail deductible of $2,500.

ULTRA PREFERRED PREFERRED

STANDARD



Eligibility Requirements

HO-3

HO-2

# of Families 1 to 4 1 to 4 Condition Excellent— Ultra –Preferred and

Preferred Average—Standard

Excellent— Ultra –Preferred and Preferred Average—Standard

Minimum Coverage A $60,000 (Standard) $25,000 (Standard) $75,000 (Ultra Preferred and Preferred) $40,000 (Ultra Preferred and Preferred) Dwelling Age 1950 or newer N/A Electrical 100 amp Circuit Breakers 100 or 60 amp Circuit Breakers Protective System Smoke Detectors Smoke Detectors Roof Age If roof is 20 years old or older, loss

will be paid on an ACV basis—Endorsement HO 04 93 will be added to the policy. If roof is 25 years old or older, the risk is not eligible for HO-3.

If roof is 20 years old or older, loss will be paid on an ACV basis—Endorsement HO 04 93 will be added to the policy.

Roof Condition Excellent Very Good Insurance-to-Value 100% of Replacement

Cost 100 % of Replacement Cost—Ultra Preferred or Preferred 80% of Replacement Cost—Standard

Central Heat/ Masonry Foundation/ Wood Basement/ Interior Plumbing

Yes Yes

October 2016 G-9 Battle Creek Mutual

CRITERIA FOR INCREASED MAXIMUM LIMIT OF WATER BACKUP COVERAGE For any limit in excess of $20,000 coverage for FE 003, Backup of Water, Sump Pump Discharge or Overflow, the following criteria must be met. • There are at least two sump pumps with backup systems for each. • There are safety valves installed on the main pumps. • The sump pump systems are connected to a central reporting alarm system. • There is documentation to prove all systems are functioning and regularly serviced. • The maximum limit that may be written is $100,000.

Battle Creek Mutual reserves the right to require an inspection of the pumping system. No agent may bind coverage for an amount over $20,000 without prior Home Office approval.

May 2017 G-11 Battle Creek Mutual

UNDERWRITING ACCEPTABILITY

Home Office Underwriting reserves the right to make final underwriting decisions on all applications. The following is a general list of risks not written, however, a combination of factors may cause some applications to be unacceptable even though not specified below:

1. ANIMAL BITES. After the first animal bite we will continue on the risk if the owner decides todestroy the animal. If the owner chooses to retain the animal we will not accept the applicationor non-renew the policy. Underwriting may offer to continue on the policy by adding the CE006--Dog Exclusion Endorsement. We underwrite all animals/pets carefully.

2. FLAT ROOFS/T-LOCK SHINGLES. Dwellings with flat roofs or T-lock shingles are unacceptable.

3. HOME DAY CARE. Day care coverage is NOT available if there is an animal, trampoline, orswimming pool on premises or if there are more than three (3) full time children. Submit HomeDay Care Questionnaire with application/change form.

4. SWIMMING POOL. Liability coverages are extended from the HO policy automatically if it is totally enclosed by a four (4) foot fence with a locking gate. An automatic push button track-type pool cover in lieu of a fence is elegible for consideration; requires underwriting approval. Risks with Swimming Pools not meeting these requirements are unacceptable.

5. TRAMPOLINE. The yard or area where the trampoline is located must be entirely fenced offby a four (4) foot fence with a locking gate. A trampoline net in lieu of a fence is acceptable.Risks with trampolines not meeting these requirements are unacceptable.

6. DWELLINGS OWNED BY CORPORATIONS are unacceptable.

7. FARM EXPOSURE. Dwellings with farm exposures that are not incidental activities areunacceptable.

8. COMMERCIAL EXPOSURES. Dwellings with commercial exposures that are not incidentalactivities are unacceptable.

9. HOUSE TRAILERS AND TRAVEL TRAILERS are unacceptable.

10. MOBILE HOMES. Mobile Homes must meet the Manufactured Home Risk.

11. DWELLINGS IN WHICH ANY OF THE FOLLOWING CONDITIONS EXIST UNLESSAPPROVED BY UNDERWRITING:a. Solid fuel burning installation does not meet the manufacturer’s installation and clearance

specifications. (If the manufacturer’s specifications are not known, then the clearance setforth in the most recent N.F.P.A. 211 and N.F.P.A. 90B will apply.);

b. Solid fuel burning unit is located outside of the dwelling;c. Solid fuel burning unit is in a residential garage;d. Substandard or bracket type chimney is used;e. Solid fuel burning appliance is attached to an unlined masonry chimney;f. Access is not available for properly cleaning any part of the installation.g. Chimney, smokepipe or thimble does not meet manufacturer’s installation and clearance

specifications. (If the manufacturer’s specifications are not known, then the clearance setforth in the most recent N.F.P.A. 211 and N.F.P.A. 90B will apply.);

h. Multiple venting of units which burn LP gas, natural gas, or oil and solid fuel heat tocommon flue;

i. Homemade solid fuel burning unit;j. Kit wood stove or anything similar being used; ork. Fireplace conversion does not have a direct connection to the flue.

NOTE: See more information on Solid Fuel Burning units on page G-32.


UNDERWRITING ENGINEERING

Satellite Dishes, Outdoor Antennas, Outdoor Equipment – Normally these items are permanently installed and should be covered under Coverage B, other structures when not affixed to a structure. If the built-in 10% for Coverage B is insufficient, use the HO-48 for the increased amount or FE 002 endorsement for the total limit of liability. If a Satellite Dish, an Outdoor Antenna or some Outdoor Equipment is attached to a structure, the value should be included in the Coverage A limit of liability. Dwelling Under Construction (Builder’s Risk) Coverage will be written as they would be written once the dwelling is completed and occupied (Ex.: HO-3) and full premium would apply. The new home discount would apply. Dwelling construction must be completed within 6 months.

RATING DISCOUNTS

Multi-Line Discount A discount will be allowed on the basic homeowners coverages for policyholders that have their homeowners and automobile insurance (private passenger type) with Battle Creek Mutual. For new HO clients, the Multi-Line Discount may be applied to eligible HO policies at the time of application if the agent writes their PA policy prior to the first HO renewal. If the PA policy is not written, the Multi-Line Discount will be removed from the HO policy at the first renewal. The policy will be reviewed for Multi-Line Discount eligibility annually, prior to billing. If eligible for the Multi-Line Discount, the discount will be given on the basic homeowners coverage premium. (Basic premium is defined on page R-6.) This discount is available for all policy forms. Mature Homeowner Discount applies when Client is age 50 or older. Available at new app and renewal time only. Protective Device Credits are described and outlined on page R-5.

New Home Discount is described and outlined on page R-5.

New Roof Discount is described and outlined on page R-5. Home must be more than 10 years old to qualify.

TERRITORIES AND FACTORS (all forms)

1 (Eastern) – 1.00

2 (Western) – 1.45

3 (West Central) – 1.20

5 (East Central) – 1.10

Antelope Boone Burt

Butler Cass Cedar Clay

Colfax Cuming Dakota Dixon Dodge

Fillmore Gage

Hamilton Jefferson Johnson

Knox Madison

Merrick Nance

Nemaha Nuckolls

Otoe Pawnee Pierce Platte Polk

Richardson Saline

Saunders Seward Stanton Thayer

Thurston Washington

Wayne York

Arthur Banner

Box Butte Chase Cherry

Cheyenne Dawes Deuel Dundy Frontier Garden Grant Hayes

Hitchcock

Hooker Keith

Kimball Lincoln Logan

McPherson Morrill

Perkins Red Willow Scotts Bluff Sheridan

Sioux Thomas

Blaine Buffalo Custer

Dawson Furnas Garfield Gosper Kearney

Loup Phelps

Sherman Valley

Adams Boyd Brown

Franklin Greeley

Hall Harlan

Holt Howard

Keya Paha Rock

Webster Wheeler

4 (Omaha) – 1.30

6 (Lincoln) – 1.05

Douglas Sarpy

Lancaster

April 2013 G-15 Battle Creek Mutual

ENDORSEMENTS

The following are coverages which may be added to the Homeowner Policy in accordance with the amounts and premiums as described in the Premium Section of this manual.

Form No. Edition Endorsement Name Description of Endorsement HO 00 15

HO507 11 Special Personal Property

Coverage Form HO-3.

This form adds provisions that change the loss settlement for Coverage C to “risk of direct loss to property” instead of Named Perils. The liability and medical limits are increased as are the percentages of the Coverage A limit that are included for Coverages B, C and D. (See previous page.)

HO 04 10 10 00 Additional Interests – Residence PremisesAll forms.

This form merely allows one or two more parties who have an insurable interest in the insured home to be added to the homeowner policy. Besides identifying other additional interests, it also obligates the insurer to give the listed parties advance notice if and when the homeowner policy is to be cancelled or is not going to be renewed.

HO 04 12 IBP

10 00 Increased Limits on Business Property All forms.

This endorsement allows an insured to apply additional coverage for business property. The form modifies the policy by increasing the special limit of $2,500 on business property on the residence premises. The amount that appears on the policy declarations is added to the $2,500 special limit for business property that is kept on the insured’s premises. Increased coverage is also made available for business property that is away from the premises. By attaching the endorsement, the basic special limit of $250 on business property away from the premises is automatically increased to equal 20% of the total on-premises business property limit. Coverage can be increased up to a maximum limit of $5,000 which includes the built-in $2,500 limit.

HO 04 13 XCR

10 00 Sections I and II Exclusions for Computer-Related Damage or Injury All forms.

This form is meant to limit the additional coverages granted to an insured for permitted businesses operated on the insured premises. When a “business” endorsement has been added to a policy to cover businesses such as offices, studios or day care the HO 04 13 acts to exclude any computer hardware or software loss that is related to the business. Specifically, the endorsement bars coverage for any bodily injury or property damage caused by a computer, accessories, peripherals or similar equipment which fails due to programming or similar malfunctions. However, the form still permits coverage for “bodily injury” that either occurs on the residence premises or away from the residence as long as the “bodily injury” occurs at the premises where the insured’s described business is located. This endorsement will automatically be added to a policy endorsed with (HO 24 71) Business Pursuits, (HO 04 97) Home Day Care Coverage, (HO 04 42) PermittedIncidental Occupancy (Residence Premises) or (HO 24 43) Permitted Incidental Occupancy (Other Residence).

HO 04 14 COM

10 00 Special Computer Coverage All Forms Except HO-4 with HO 05 24 and HO-6 with HO 17 31.

This endorsement expands the protection that applies to its definition of computer equipment. Instead of being covered by the Coverage C perils, this endorsement extends coverage on, roughly, the same basis as the protection which applies to Coverage A, Dwelling and Coverage B, Other Structures. Computer equipment includes computer hardware, software operating systems or networks. Peripheral equipment such as scanners, monitors, printers and modems are also protected since the coverage also applies to electronic parts, equipment or systems solely designed for use with or connected to the computer equipment.

HO 04 20 ADA

10 00 Specified Additional Amount of Insurance for Coverage A – Dwelling Forms HO-2 and HO-3.

This form provides an automatic increase in protection under Coverage A. The increase is 25% of the Coverage A insurance limit which is specified on the policy declarations. This is an especially useful endorsement when the insured is making improvements or adding on to the building and a loss occurs before the insured has had the chance to notify the insurer. This endorsement could also be used if the insured has concerns about preserving replacement cost coverage for an insured building and assets. The dwelling must be insured to 100% of replacement cost to qualify for this endorsement.

HO 04 26 FAO

04 02 Limited Fungi, Wet or Dry Rot, or Bacteria Coverage All forms except HO-3

The HO 04 26 endorsement adds a specified Section I and Section II limit of liability for Fungi, Wet or Dry Rot, or Bacteria if the loss or damage is caused by constant or repeated seepage or leakage of water or the presence or condensation of humidity, moisture or vapor, over a period of weeks, months or years and if such seepage or leakage of water or the presence or condensation of humidity, moisture or vapor and the resulting damage is unknown to all ―insureds‖ and is hidden within the walls or ceilings or beneath the floors or above the ceilings of a structure. This endorsement will be attached to all homeowner policies with a $1,000 Section I and a $1,000 Section II limit of liability. Up to an additional $5,000 worth of coverage can be purchased for a maximum $6,000 limit of liability.

HO 04 27 F35

04 02 Limited Fungi, Wet or Dry Rot, or Bacteria Coverage Form HO-3


HO 04 28 F46

04 02 Limited Fungi, Wet or Dry Rot, or Bacteria Coverage Forms HO-4 with HO 05 24 and HO-6 with HO 17 31 or HO 17 32


HO 04 35 LA

10 00 Loss Assessment Coverage Form HO-6.

This endorsement extends a policy to cover loss assessment, up to a stated limit, levied by the association for an occurrence not covered by association insurance AND which involves perils covered under the policy. The form increases the insurance limit for assessments related to the described premises. The form may be extended to cover condominium units other than the residence premises. The form does not reimburse an insured for loss assessments related to earthquake damage. The limit shown in the policy declarations is the TOTAL amount that could be paid for all assessments that are the result of a single occurrence.

HO 04 40 SRO

10 00 Structures Rented to Others Endorsement Forms HO-2 and HO-3.

This endorsement provides coverage for appurtenant structures on the residence premises, rented or held for rental to others, provided that such structures are used for residential purposes and are not occupied by more than two families or more than two roomers or boarders per family. Provision is made in the endorsement for as many as three structures held for rental. Each structure is insured with its own limit of insurance. The coverage applies only to structures which are either currently occupied by renters or are being held out for rental. Either the entire structures or just a portion of the structures may be rented out and the purpose of the rental MUST be for use as a residence.

HO 04 41 10 00 Additional Insured (Residence Premises) All forms.

This endorsement extends a homeowners policy, without additional premium charge, to cover the interest of a non-occupant joint owner in the building and for premises liability. Only liability losses directly connected to the building are eligible for coverage. However, no coverage is provided for injury to an insured’s employees (including residence employees and their replacements) who are hurt during the course of their employment duties. The additional interest also receives advanced notice if the policy is to be canceled or not to be renewed.

HO 04 42 OCC, OCS

10 00 Permitted Incidental Occupancies (Residence Premises) All forms.

This endorsement may be used to cover incidental business activity performed by an insured on the residence premises. The activity may take place either in the insured dwelling or in an other structure such as a detached garage or utility building. The endorsement also changes the homeowners policy provisions so that coverage exists for personal property associated with the activity. If the activity takes place in an ―other‖ structure, the endorsement provides coverage to the structure as specific insurance (the Coverage B insurance limit will not respond to losses to the described ―other‖ structure). Finally, the form expands the policy coverage to provide protection against the legal liability related to the incidental business. The full Coverage C limit applies to property of the business that is described in the endorsement. Eligible occupancies include, but are not limited to, accounting and tax service, music or dancing lessons, tutoring or sewing (seamstress). Not eligible are service, sales, warehousing, and manufacturing activities. Beauty shops, salesrooms, sale barns, or farm equipment dealerships are examples of incidental occupancies that are ineligible.

HO 04 43 RCS

10 00 Replacement Cost Loss Settlement for Certain Non-Building Structures on the Residence Premises Forms HO-2 and HO-3.

This endorsement provides replacement cost coverage for reinforced masonry walls, metal & plastic & fiberglass fences, patios, walks, and driveways.

HO 04 48 OST

10 00 Other Structures (Increased Limits) Forms HO-2 and HO-3.

This endorsement provides an additional amount of insurance on a specific ―other‖ structure located on the residence premises. The HO forms providing dwelling coverage include other structures coverage under Coverage B, which covers garages, storage sheds, gazebos, playground equipment and the like on an unspecified basis in the amount of 10% of the limit for Coverage A, Dwelling. Several structures may be identified on the declarations, with a specific amount of insurance applicable to each as an additional limit of insurance. Farm related buildings may be covered at ACV with FE 002.

HO 04 49 BAO

10 00 Building Additions and Alterations (Other Residence) Forms HO-2 and HO-3.

This endorsement may be used to cover at another location, additions, alterations and improvements made at the insured’s expense, to that part of a building rented to the insured as a residence. The location and limit of liability are specified.

HO 04 50 PPI

10 00 Increased Limits on Personal Property in Other Residences All forms.

This endorsement is used to increase the basic limit of insurance under Coverage C – Personal Property, that applies to personal property that is located at another residence owned by an insured (normally 10% of Coverage C). The location of each such residence and the increased limit applicable to it are specified on the declarations.

HO 04 51 BA4

10 00 Building Additions and Alterations Form HO-4.

This endorsement gives an insured the option to increase the coverage for building additions and alterations at the additional premium developed from the Premium Section of the Homeowners Manual. This endorsement may only be used with Form HO-4.

HO 04 52 LVC

10 00 Livestock Collision Coverage Forms HO-2, HO-3 and HO-4. .

This endorsement is designed for gentlemen or hobby farmers. $400 is the maximum payable for one head of livestock. No deductible applies to this protection. This endorsement handles either a loss caused by a collision with a vehicle during the transportation of the animal or damage suffered by livestock that is struck after wandering onto a public road. Animals eligible for coverage are cattle, sheep, swine, goats, horses, mules and donkeys. The form excludes coverage for livestock struck by a vehicle that is operated by an insured or an employee of an insured.

HO 04 53 CC

10 00 Credit Card, Electronic Fund Transfer Card, or Access Device Forgery and Counterfeit Money Coverage All forms.

This endorsement increases the limit of liability for such property and occurrences to the optional specified limit. While Federal law limits the financial risk faced by the loss or theft of a credit card, it has not eliminated the need for the total coverage provided by the HO 04 53. Coverage is provided for loss by forgery or alteration of any personal checks or similar written instruments made or drawn by or upon an insured’s accounts. The endorsement also protects the insured for losses caused by his or her acceptance, in good faith, of counterfeit U.S. or Canadian paper currency. Finally, protection is included for losses arising from the unauthorized use of electronic fund transfer cards and electronic fund access devices.

HO 04 54 EQ

10 00 Earthquake All forms.

Payment is only after making the applicable deductible. This endorsement provides protection under Coverages A, B and C against losses caused by earthquake, including land shock waves or tremors which occur either before, during or after a volcanic eruption. Coverage for masonry veneer may be included. The deductible is 5% - 25% of Coverage A or C, whichever is greater. One or more shocks occurring within 72 hours are considered to be a single loss event.

HO 04 55 IDF

03 03 Identity Fraud Expense Coverage This endorsement provides up to $15,000 for expenses incurred by an insured as the direct result of any one identity fraud discovered or first learned of during the policy period. A special deductible of $250 applies to any occurrence covered by this endorsement.

HO 04 56 SLS

10 00 Special Loss Settlement Form HO-2.

This endorsement is useful for covering older dwellings having a market value that is less than their replacement cost. With this form an insured can maintain broader coverage, while gaining limits flexibility With the HO 04 56 form, the insured can choose to insure a home between 50 to 79% of its replacement cost value and not be penalized under a requirement to carry limits equaling 80% to replacement value. Any loss settlement will NOT include payment for expenses that result from a local authority enforcing a building ordinance or law that affects repairing or rebuilding the covered property EXCEPT for any coverage provided under the Ordinance or Law Additional Coverage. The coverage also extends to grave markers and mausoleums. As clarification, the form mentions that it will not pay for increased costs caused by rebuilding property at a different location and that there is no coverage for footings, foundations and similar devices that support a covered building.

HO 04 58 MEM

10 00 Other Members of Your Household All forms.

This endorsement is attached to provide coverage for a member of a household not included by the standard policy wording. (Not an insured guest, residence employee, tenant, roomer, or border) This endorsement also insures a person under the age of 21 who lives with and is in the legal custody of the person named on the declarations.

HO 04 59 ALC

10 00 Assisted Living Care Coverage All forms.

This endorsement provides limited property and liability coverage for a person related to the insured by blood, marriage or adoption. This person cannot be a member of your household and must regularly reside in a living care facility. Endorsement Coverage E limit of liability is required to be consistent with the policy Coverage E limit of liability.

HO 04 60 SPV

10 00 Scheduled Personal Property Endorsement (With Agreed Value Loss Settlement) All forms.

This endorsement may be attached to a homeowners policy to provide coverage for scheduled personal property on a special form basis. The coverage is subject to certain exceptions and to individual company guidelines. This coverage becomes particularly important where expensive jewelry and furs are at risk because of the restricted theft coverage provided by the basic homeowner policies. Jewelry. When insuring jewelry over $5,000 under

this endorsement, we require that the item beappraised by a person from a jewelry store who hasknowledge in the preparation of the acceptableappraisal. The appraisal will include the CLARITY

and COLOR. Musical Instruments: The usual descriptive

information is required. In case of high-valued orunusual instruments, an appraisal by an expert shallbe requested. Musical instruments used bystudents in grades 1-12 can be scheduled. (Musthave receipt.)

Furs: The value confirmation requirements for fursare the same as for jewelry. A full description ofeach item is required and shall include type ofgarment, type and color of fur, length and any otherdistinguishing details.

Cameras: A complete description is necessaryincluding manufacturer’s name, model number andserial number.

Guns: The usual descriptive information is requiredon guns – manufacturer’s name, serial number,size, kind, etc.

Fine Arts – Only authentic antiques or works of artor items of authenticated rarity qualify for thiscoverage. A complete description, including thename of the artist, period, condition, and any otherunusual identification marking, is required on each

item to be insured.NOTE: Computer games cannot be scheduled, even if we’re scheduling the computer. Snow skis and water skis cannot be scheduled. Also excluded — cell phones, golf clubs, and bicycles. Full description required for all insured items under $5,000 in value. Appraisal required for all insured items valued at or over $5,000. On articles valued at $5,000 or more, a photograph of the article is to be included.

Appraisals should be updated every five years. This information is necessary in order for the Claims Department to adjust a loss on such items. HO 04 60 is subject to Home Office approval prior to binding coverage.

HO 04 61 SPP

10 00 Scheduled Personal Property Endorsement All forms.

This endorsement may be attached to a homeowner policy to provide coverage for scheduled personal property on a special form basis. The coverage is subject to certain exceptions and to individual company guidelines. This coverage becomes particularly important where expensive jewelry and furs are at risk because of the restricted theft coverage provided by the basic homeowner policies. The endorsement is also valuable for protecting camera equipment, musical instruments, silverware, fine arts, collectible stamps and rare and collectible coins. Jewelry. When insuring jewelry over $5,000 under

this endorsement, we require that the item be appraised by a person from a jewelry store who has knowledge in the preparation of the acceptable appraisal. The appraisal will include the CLARITY and COLOR.

Musical Instruments: The usual descriptive information is required. In case of high-valued or unusual instruments, an appraisal by an expert shall be requested. Musical instruments used by students in grades 1-12 can be scheduled. (Must have receipt.)

Furs: The value confirmation requirements for furs are the same as for jewelry. A full description of each item is required and shall include type of garment, type and color of fur, length and any other distinguishing details.

Cameras: A complete description is necessary including manufacturer’s name, model number and serial number.

Guns: The usual descriptive information is required on guns – manufacturer’s name, serial number, size, kind, etc.

Fine Arts – Only authentic antiques or works of art or items of authenticated rarity qualify for this coverage. A complete description, including the name of the artist, period, condition, and any other unusual identification marking, is required on each item to be insured.

NOTE: Computer games cannot be scheduled, even if we’re scheduling the computer. Snow skis and water skis cannot be scheduled. Also excluded — cell phones, golf clubs, and bicycles. Full description required for all insured items under $5,000 in value. Appraisal required for all insured items valued at or over $5,000. On articles valued at $5,000 or more, a photograph of the article is to be included. Appraisals should be updated every five years. This information is necessary in order for the Claims Department to adjust a loss on such items.

HO 04 65 CIL

10 00 Coverage C Increased Special Limits of Liability All forms except HO-4 with endorsement HO 05 24 attached or HO-6 with endorsement HO 17 31 attached.

This endorsement may be used to increase the special limits of liability provided under the homeowners forms. The coverage for guns is extended to include related equipment. The coverage applying to electronic apparatus has been clarified to show that it includes accessories but does not cover such equipment that should be covered under an automobile policy. The increased limit of liability and the total limit of liability will be shown on the policy declarations for each class of property for which an insured wishes additional protection.

HO 04 66 CI

10 00 Coverage C Increased Special Limits of Liability Forms HO-4 with endorsement HO 05 24 attached or HO-6 with endorsement HO 17 31 attached.

The form provides the same coverage as the HO 04 65, Coverage C Increased Special Limits of Liability Endorsement. The difference is that this form is used with endorsements:

HO-4 endorsed with the HO 05 24, or

HO-6 endorsed with the HO 17 31. Please refer to the description of these forms that are found in this section.

HO 04 77 ORD

10 00 Ordinance or Law Coverage All forms.

This endorsement may be used with all homeowner policy forms and it applies to Coverage A, Coverage B and, under form HO-4, to building additions and alterations. It provides coverage for contingent liability due to the operation of building laws. Loss is settled on the basis of any ordinance or law regulating the construction, repair or demolition of a covered structure.

HO 04 90 PPR

10 00 Personal Property Replacement Cost All forms.

This endorsement changes the loss settlement basis under Coverage C from actual cash value to full replacement cost. Antiques, fine arts, paintings, collectors items and obsolete articles are not covered for replacement cost. Further, the endorsement’s replacement cost provision is nullified if any of the scheduled articles have been insured at an agreed upon value. Along with typical personal property, other items that qualify for replacement cost coverage are awnings, household appliances, outdoor antennas and equipment, and carpeting.

HO 04 93 ACW

10 00 Actual Cash Value Loss Settlement Windstorm or Hail Losses to Roof Surfacing All Forms except HO-4.

This form converts the loss settlement provision to an actual cash value (ACV) basis when the force of winds or hail cause direct damage to a roof’s surface materials. Except for the coverage provided under Additional Coverage 10. Ordinance or Law, there’s no coverage for expenses caused by having to comply with a building ordinance or law. This endorsement will be added to all new business policies when the shingles are 20 years old or older.

HO 04 94 WEX

10 00 Windstorm or Hail Exclusion All forms except HO-4.

This endorsement bars coverage for damage caused by winds (including hurricanes) or hail. The form also considers the time when a hurricane watch or warning is announced until 72 hours after the official end of an announced watch or warning to be a single hurricane exposure.


HO 04 97 DAY, DAS

10 00 Home Day Care Coverage All forms.

This endorsement provides property coverage as well as day care liability protection. Insurance is found under Coverages E and F for bodily injury and property damage arising out of home day care coverages for which the insured receives compensation. $2,500 of business personal property is included. Under the unendorsed homeowners policy, other structures (Coverage B) are not covered when used for business. HO 04 97 has a provision to provide a separate coverage limit to the other structures where day care is performed. We will not write day care coverage if there is an animal, trampoline or swimming pool on premise or if day care is provided for over 3 children. Submit completed Home Day Care Questionnaire to bind coverage.

HO 04 98 RPC

10 00 Refrigerated Property Coverage All forms.

This endorsement covers up to $500 for property on the “residence premises” that is stored in freezers or refrigerators for damage from interruption of electrical service or mechanical failure of the unit. A separate $100 deductible applies to this endorsement.

HO 05 16 01 02 Exclusion of Terrorism (With Limited Exception) and Exclusion of War All forms

The HO 05 16 endorsement excludes coverage for terrorism. Limited exceptions are contained in the policy language. If the total of insured damage does not exceed $25,000,000 and the act of terrorism is not nuclear, chemical or biological, this endorsement may not apply. Please refer to policy language for coverage specifics. This endorsement will be attached to all homeowner policies.

HO 05 24 SP4

10 00 Special Personal Property Coverage Form HO-4.

The HO 05 24 endorsement changes an HO-4 policy to all risk versus named perils.

HO 05 27 AIS

10 00 Additional Insured—Student Living Away from the Residence Premises All forms.

This endorsement extends the definition of insured to include a student not enrolled in school full time (defined by school) or is a student age 24 or older.

HO 05 30 FRC

10 00 Functional Replacement Cost Loss Settlement Forms HO-2 and HO-3.

This form transforms an HO-2 or an HO-3 into a policy that settles losses under Coverage A (Dwelling) and Coverage B (Other Structures) on a REPAIR cost basis. This is an option that allows an insurer to make the most economical repair or replacement of covered property that is damaged or destroyed.

HO 05 41 EXT

10 00 Extended Theft Coverage For Residence Premises Occasionally Rented to Others All forms.

This endorsement covers loss by theft of covered property from that part of a “residence premises” occupied by an occasional tenant, roomer or boarder, members of the tenant’s household, or their employees.

HO 16 09 01 09 Water Exclusion Endorsement Mandatory endorsement for HO-2, HO-4 and HO-6. HO 16 10 01 09 Water Exclusion Endorsement Mandatory endorsement for HO-3. HO 06 15 TRS

05 11 Trust Endorsement This endorsement facilitates writing a homeowners policy for an insured risk that is occupied under a trust agreement. Paragraph 5. of the definition of insured is amended to include the Trust or the Trustee but only for the following coverages A, B, E, and F. In addition, the Trustee is an insured only with respect to the Trustee's duties as a Trustee of the Trust named in the schedule.


HO 17 31 UOC

10 00 Unit-Owner’s Coverage C Form HO-6.

This form is used to upgrade the Perils Insured Against (named perils) under the HO-6 for personal property from a broad form to a special form basis in which there is coverage for all physical causes of loss which are not specifically excluded.

HO 17 32 UOA

10 00 Unit-Owner’s Coverage A (Special Coverage) Form HO-6.

May be attached to convert the “built-in” coverage under HO-6 that applies to additions and alterations made by an insured from a broad form to a special form basis.

HO 17 33 UOR

10 00 Unit-Owner’s Rental to Others Endorsement Form HO-6.

This removes pertinent policy exclusions and extends coverage for personal property, including theft (but not theft of silver, platinum, or gold plated ware or personal records) when the premises is regularly rented to others. The endorsement also extends personal liability coverage to the rental of the residence premises.

HO 24 13 REC

10 00 Incidental Low Power Recreational Motor Vehicles All forms.

This form adds off premises coverage for vehicles (not golf carts, motorized bicycles or mopeds) not licensed for road use and incapable of going more than 15 MPH, or those used in business. Besides covering the named insured and his resident relatives, protection extends to persons or organizations that are legally responsible for a covered “motor vehicle.”

HO 24 43 OCO

10 00 Permitted Incidental Occupancies (Other Residence) All forms.

This endorsement is available to provide liability insurance for an insured’s incidental business activity that’s performed at a premises situated at another location (not the described premises appearing on the declarations). Both the address and a description of the activity must appear on the policy declarations. This endorsement can be utilized for an Office, Professional Private School or Studio occupancy.

HO 24 64 SNO

10 00 Snowmobile All forms.

This endorsement may be attached to a homeowners policy to provide personal liability coverage and medical payments coverage for owned, scheduled snowmobiles 500 CC or less. A premium charge applies separately to each snowmobile. Complete coverage for snowmobiles, including physical damage insurance, may be arranged under a separate policy designed for snowmobiles and other recreational vehicles.

HO 24 70 ARR

10 00 Additional Residence Rented to Others – 1, 2, 3 Or 4 Families All forms.

This endorsement provides coverage for additional one or two, three or four family residence premises, rented to others, owned by the named insured or spouse. The endorsement extends the definition of “insured premises” contained in the policy to include designated premises under Coverage E (personal liability coverage). We will allow only three (3) rental units per policy (at different locations). If there are over three (3), a General Liability policy must be taken out. If four (4) or more locations, we will not extend liability to any locations. At this point, it is more of a business.

HO 24 71 BUS

10 00 Business Pursuits All forms.

This endorsement may be attached to a homeowners policy to provide coverage for the liability of an insured arising out of incidental business activities, other than a business of which the insured is sole owner or a partner. Eligible business pursuits are outlined on page R-15. Teachers have the option of including liability coverage for corporal punishment. If it is the insured’s main occupation, this endorsement would not apply. Incidental means less than $5,000 in receipts.


HO 24 72 IFL

10 00 Incidental Farming Personal Liability All Forms.

This endorsement extends coverage to incidental farming at or away from the residence premises. Farming on a commercial basis is not eligible under homeowner policies. Farms which are owned and operated by the insured may not be covered. The HO 24 72 is required when the insured owns a horse.

HO 24 82 PI

10 00 Personal Injury All forms.

Endorsement extends coverage for personal injury when coverage applies. Coverage is also extended to provide a defense up to the limit of liability. This endorsement is required when the client has an ELNE policy on his account.

HO 118 XMR

08 12 Section I --Exclusion of Cosmetic Loss to Metal Roof Coverings Caused By Hail

This endorsement excludes cosmetic damage to metal roof coverings of buildings and structures caused by hail.

HO NE EB EB

05 09 Equipment Breakdown Enhancement Endorsement All forms except HO-4.

This endorsement is attached to all policies except HO-4 amending the basic policy language to provide coverage for mechanical breakdown such as failure of a furnace, central air system, kitchen appliance, television, etc. This coverage is subject to a $500 deductible per occurrence.

HO SL SLC

05 18 Service Line Enhancement Endorsement

This endorsement covers direct physical loss to “service line covered property” that is caused by a "service line occurrence" at a “residence premises”. Service Line Coverage extends to any additional living expense or fair rental value coverage provided in the policy to which this endorsement attaches. The Service Line Coverage Per Occurrence Limit of $10,000 is the most we pay for any one loss, regardless of the number of "service line occurrences." This coverage is subject to a $500 deductible per occurrence.

FE 001 XST

05 02 Excluded Specific Structures All forms except HO-4.

Excludes all coverages for any structures described on the declarations.

FE 002 SST

05 02 Specific Structures On or Off Premises All Forms.

This endorsement establishes a separate limit of insurance for structures located on or off of the insured premises. Covered losses will be settled at Actual Cash Value, but not more than the amount required to repair or replace. FE 002 (or FE 011) is required when covering a structure originally constructed for agricultural use (barn, granary, farm structure, etc.) that is no longer utilized for its original purpose.

FE 003 BKU

01 09 Water Backup and Sump Discharge Or Overflow All forms.

This form adds protection against losses caused to covered property by water or water-borne material which either backs up through drains or sewers, or which overflows or is discharged from a sump, sump pump or related equipment. FYI – a sump is a pit or well where water is allowed to drain or to collect. This form provides coverage even when the overflow or discharge from a sump, sump pump or related equipment is due to the mechanical breakdown of a sump pump. Further, any water damage connected to flooding is ineligible for coverage. A special deductible of $1000 applies to any occurrence covered by this endorsement. However, no coverage is available for damage to the sump pump or similar equipment. This coverage, or any increase in this coverage, is only available at the inception date of a policy or on the renewal date of the policy. For a limit in excess of $20,000, see the special underwriting criteria on page G-9.

September 2014 G-26 Battle Creek Mutual

FE 005

XSP

04 03 Excluded Specific Structures (Property Only) All forms except HO-4.

This endorsement excludes all property coverages for any structures described on the declarations under this endorsement. A request can be sent to the underwriter when this endorsement is desired. Underwriting reserves the right to make the final decision on all requests for the FE 005. FE 001 will be required for structures that are uninsurable for property and liability.

FE 007 11 13 Special Provisions—Nebraska All forms.

This endorsement is attached to all policies modifying and changing the basic policy language. Policy language has been changed due to Nebraska State Law and coverage decisions made by Battle Creek Mutual. Please read this endorsement carefully as it alters coverage under the basic policies.

FE 010 UMV

11 13 Unregistered Motor Vehicle Endorsement All forms.

This endorsement extends the allowable maximum horsepower for unregistered motor vehicles used to service an insured’s residence to 75 total horsepower. The change applies to both property and liability coverages.

FE 011 SNP

11 13 Specific Structures On or Off Premises (Named Perils Only) All Forms.

This endorsement establishes a separate limit of insurance for structures located on or off of the insured premises. The coverage is for the perils named in the endorsement only. Covered losses will be settled at Actual Cash Value, but not more than the amount required to repair or replace. FE 011 (or FE 002) is required when covering a structure originally constructed for agricultural use (barn, granary, farm structure, etc.) that is no longer utilized for its original purpose.

CE 001 RVL

05 02 Owned Recreation Vehicles All forms.

This endorsement may be attached to a homeowners policy to provide personal liability coverage and medical payments coverage for owned, scheduled recreational vehicles. Acceptable recreational vehicles that would be covered by this endorsement when scheduled are mopeds, mini-bikes, 4 wheel ATVs, and golf carts. A premium charge applies separately to each recreational vehicle. Complete coverage, including physical damage insurance, may be arranged under a separate policy designated for recreational vehicles. Maximum 500 cc for 4 wheel ATVs. Maximum 100 cc for mopeds and mini-bikes.

CE 006 DE1

09 14 Dog Exclusion Endorsement All forms.

This endorsement excludes all Section II Liability Coverages for any claims caused by a dog or dogs owned by or in the care of any insured. A signed copy of form HO Excl-D1 must be kept on file in the agent’s office.

CE 008 DE2

09 14 Dog Exclusion Endorsement Number 2 All forms.

If an insured has had a Battle Creek Mutual Claim in which a dog or dogs owned by them or in their care were involved, we require that the dog(s) be destroyed and that the insured sign an affirmation of that fact. Should this affirmation prove to be false, any further claim of “bodily injury” or “property damage” caused by any dog or dogs owned by or in the care of any “insured” will void and nullify all coverages for those claims under Section II – Liability Coverages of the policy. A signed copy of form HO Excl-D3 must be kept on file in the agent’s office.

MH NE 04 MHL

01 09 Manufactured Home Loss Settlement Forms HO-2 and HO-3.

If attached, we will permit a mobile/ manufactured home situated on a permanent foundation or on recommended piers to be written as a form HO-2 or HO-3. If the amount of insurance is less than 80% of full replacement cost, the loss settlement is changed to pay the lesser of the listed amounts.

February 2014 G-27 Battle Creek Mutual

PUBLIC FIRE PROTECTION CLASS

Classification of Public Fire Protection A. If the jurisdiction has a single number, all properties within the jurisdiction receive that number. B. If the jurisdiction has multiple numbers called “split classification”:

1. If the split classification is “X/9” or “X/8B” (ex. 6/9 or 6/8B):a. For properties located five road miles or less from their responding fire station and within 1000 feet of a

fire hydrant, use the first number.b. For properties located five road miles or less from their responding fire station and more than 1000 feet

from a hydrant, use the second number.c. For properties not qualifying under 1.a. or 1. b. use class 10.

2. If the split classification is “X/10”:a. For properties located five road miles or less from their responding fire station, use the first number.b. For properties not qualifying under 2.a. use class 10.

C. For jurisdictions or areas not listed use class 10.

Protection classes are subject to change upon notification from Insurance Services Office (ISO).

Class City (County)

7 Abie (Butler) 7/9 Adams (Gage)

6 Ainsworth (Brown) 5 Albion (Boone) 6 Alda (Hall) 7 Alexandria (Thayer)

+ 7 Allen (Dixon) 7 Allen Waterbury (Dixon) 4 Alliance (Box Butte) 5 Alma (Harlan) 9 Alvo (Cass) 7 Amherst (Buffalo) 7 Anselmo (Custer) 7 Ansley (Custer) 5 Arapahoe (Furnas) 7 Arcadia (Valley) 6 Arlington (Washington) 7 Arnold (Custer) 4 Ashland (Saunders) 7 Ashton (Sherman) 5 Atkinson (Holt) 5 Auburn (Nemaha) 5 Aurora (Hamilton) 9 Avoca (Cass) 5 Axtell (Kearney) 6 Ayr (Adams) 6 Bancroft (Cuming) 9 Barneston (Gage) 8 Bartlett (Wheeler) 7 Bartley (Red Willow) 6 Bassett (Rock) 7 Battle Creek (Madison) 7 Bayard (Morrill) 3 Beatrice (Gage) 6 Beaver City (Furnas) 8 Beaver Crossing (Seward) 7 Bee (Seward) 5 Beemer (Cuming) 8 Belden (Cedar) 7 Belgarde (Nance)

Class City (County)

3 Bellevue (Sarpy) 7 Bellwood (Butler) 8 Belvidere (Thayer) 6 Benedict (York) 6 Benkelman (Dundy) 7 Bennet (Lancaster) 5 Bennington (Douglas) 7 Bertrand (Phelps)

9/10 Berwyn (Custer) 7 Big Spring (Deuel) 8 Bladen (Webster) 4 Blair (Washington) 6 Bloomfield (Knox) 8 Bloomington (Franklin) 6 Blue Hill (Webster) 6 Blue Springs (Gage) 8 Boelus (Howard) 4 Boys Town (Douglas) 7 Bradshaw (York) 6 Brady (Lincoln) 7 Brainard (Butler) 7 Bridgeport (Morrill) 8 Bristow (Boyd) 8 Brock (Nemaha) 6 Broken Bow (Custer) 7 Brownville (Nemaha) 6 Brule (Keith) 8 Bruning (Thayer) 7 Bruno (Butler) 6 Brunswick (Antelope) 8 Burchard (Pawnee) 9 Burr (Otoe) 6 Burwell (Garfield) 7 Bushnell (Kimball) 6 Butte (Boyd) 8 Byron (Thayer) 8 Cairo (Hall) 6 Callaway (Custer) 6 Cambridge (Furnas) 6 Campbell (Franklin)

* Protection class changes+ New additions


* Protection class changes + New additions

Class City (County)

9 Hadar (Pierce) 6 Haigler (Dundy) 6 Hampton (Hamilton) 9 Harrisburg (Banner) 8 Harrison (Sioux) 6 Hartington (Cedar) 6 Harvard (Clay) 3 Hastings (Adams) 7 Hay Springs (Sheridan) 6 Hayes Center (Hayes) 7 Hebron (Thayer) 6 Hemingford (Box Butte) 7 Henderson (York) 8 Henry (Scotts Bluff) 6 Herman (Washington) 6 Hershey (Lincoln) 5 Hickman (Lancaster) 7 Hildreth (Franklin) 7 Holbrook (Furnas) 5 Holdrege (Phelps) * 5 Holland (Lancaster) 7 Holstein (Adams) 7 Homer (Dakota) 6 Hooper (Dodge) 7 Hordville (Hamilton) 8 Hoskins (Wayne) 6 Howells (Colfax) 9 Hubbard (Dakota) 8 Hubbell (Thayer) 6 Humboldt (Richardson) 7 Humphrey (Platte) 8 Hyannis (Grant) 6 Imperial (Chase) 6 Indianola (Red Willow) 7 Ithaca (Saunders) 7 Jansen (Jefferson) 7 Johnson (Nemaha) 9 Julian (Nemaha) 6 Juniata (Adams) 2 Kearney (Buffalo) 2 Kearny Municipal Airport (Buffalo) 6 Kenesaw (Adams) 5 Kennard (Washington) 5 Kimball (Kimball) 7 Laurel (Cedar) 3 La Vista (Sarpy) 7 Lawrence (Nuckolls) 7/9 Leigh (Colfax, Platte, Stanton) 9 Lewellen (Garden) 5 Lexington (Dawson) 3 Lincoln (Lancaster) 8 Lindsay (Platte) 9 Linwood (Butler) 6 Litchfield (Sherman) 6 Lodgepole (Cheyenne) 8 Long Pine (Brown)

Class City (County)

7 Loomis (Phelps) 6 Louisville (Cass) 7 Loup City (Sherman) 6 Lyman (Scotts Bluff) 7 Lynch (Boyd) 5 Lyons (Burt) 5 Madison (Madison) 7 Madrid (Perkins) 8 Magnet (Cedar) 6 Malcolm (Lancaster) 5 Malmo (Saunders) 9 Manley (Cass) 8 Marquette (Hamilton) 6 Martinsburg (Dixon) 7 Mason City (Custer) 6 Maxwell (Lincoln) 6 Maywood (Frontier) 4 McCook (Red Willow) 5 McCool Junction (York) 9 McGrew (Scotts Bluff) 6 Mead (Saunders) 7 Meadow Grove (Madison) 9 Melbeta (Scotts Bluff) 8 Merna (Custer) 8 Merriman (Cherry) 5 Milford (Seward) 7 Miller (Buffalo) 7 Milligan (Fillmore) 7 Minatare (Scotts Bluff) 5 Minden (Kearney) 6 Mitchell (Scotts Bluff) 6 Monroe (Platte) 7 Morrill (Scotts Bluff) 6 Morse Bluff (Saunders) 6 Mullen (Hooker) 7 Murdock (Cass) 5 Murray (Cass) 9 Naper (Boyd) 6 Naponee (Franklin) 4 Nebraska City (Otoe) 7 Nehawka (Cass) 4 Neligh (Antelope) 6 Nelson (Nuckolls) 9 Nemaha (Nemaha) 8 Newcastle (Dixon) 6 Newman Grove (Madison) 6 Newman Grove (Platte) 7 Newport (Rock) 9 Nickerson (Dodge) 7 Niobrara (Knox) 2 Norfolk (Madison) 7 North Bend (Dodge) 7 North Loup (Valley) 3 North Platte (Lincoln) 8 Oakdale (Antelope) 5 Oakland (Burt)


* Protection class changes + New additions

Class City (County)

8 Oconto (Custer) 6/9 ODell (Gage) 4 Offut (Sarpy) 4 Ogallala (Keith) 7 Ohiowa (Fillmore) 2/9 Omaha (Douglas) 4 O’Neill (Holt) 9 Ong (Clay) 8 Orchard (Antelope) 5 Ord (Valley) 6 Orleans (Harlan) 6 Osceola (Polk) 7 Oshkosh (Garden) 9 Otoe (Otoe) 6 Overton (Dawson) 6 Oxford (Furnas) 6 Oxford (Harlan) 7 Page (Holt) 6 Palisade (Hayes) 6 Palisade (Hitchcock) 6 Palmer (Merrick) 7 Palmyra (Otoe) 7 Panama (Lancaster) 3/9 Papillion (Sarpy) 6 Pawnee City (Pawnee) 6 Paxton (Keith) 7 Pender (Thurston) 5/9 Peru (Nemaha) 7 Petersburg (Boone) 6 Phillips (Hamilton) 6 Pickrell (Gage) 5 Pierce (Pierce) 7 Pilger (Stanton) 5 Plainview (Pierce) 7 Platte Center (Platte) 5 Plattsmouth (Cass) 7 Pleasant Dale (Seward) 6 Pleasanton (Buffalo) 6 Plymouth (Jefferson) 7 Polk (Polk) 6 Ponca (Dixon) 6 Potter (Cheyenne) 6 Prague (Saunders) 7 Primrose (Boone) 9 Prosser (Adams) 6/8 Ragan (Harlan) 4 Ralston (Douglas) 6 Randolph (Cedar) 5 Ravenna (Buffalo) 5 Raymond (Lancaster) 5 Red Cloud (Webster) 7 Republican City (Harlan) 7 Rising City (Butler) 8 Riverton (Franklin) * 5 Roca (Lancaster) 8 Rockville (Sherman) 9/10 Rokeby (Lancaster) 7 Rosalie (Thurston)

Class City (County)

5 Roseland (Adams) 7 Royal (Antelope) 9 Rulo (Richardson) 6 Rushville (Sheridan) 7 Ruskin (Nuckolls) 7 Saint Edward (Boone) 9 Saint Helena (Cedar) 5 Saint Paul (Howard) 9 Salem (Richardson) 9 Santee (Knox) 7 Sargent (Custer) 5 Schuyler (Colfax) 7 Scotia (Greeley) 3 Scottsbluff (Scotts Bluff) 5 Scribner (Dodge) 4 Seward (Seward) 7 Shelby (Polk) 5 Shelton (Buffalo) 7 Shickley (Fillmore) 9 Shubert (Richardson) 5 Sidney (Cheyenne) 7 Silver Creek (Merrick) 6 Snyder (Dodge) 5 South Sioux City (Dakota) 7 Spalding (Greeley) 8 Spencer (Boyd) 9 Sprague (Lancaster) 6 Springfield (Sarpy) 8 Springview (Keya Paha) 7 Stamford (Harlan) 7 Stanton (Stanton) 7 Staplehurst (Seward) 7 Stapleton (Logan) 9 Steele City (Jefferson) 6 Steinauer (Pawnee) 8 Stella (Richardson) 7 Sterling (Johnson) 7 Stratton (Hitchcock) 6 Stromsburg (Polk) 6 Stuart (Holt) 8 Sumner (Dawson) 4 Superior (Nuckolls) 7 Sutherland (Lincoln) 5 Sutton (Clay) 7 Swanton (Saline) 5 Syracuse (Otoe) 7 Table Rock (Pawnee) 8 Talmage (Otoe) 9 Tamora (Seward) 9 Taylor (Loup) 6 Tecumseh (Johnson) 6 Tekamah (Burt) 6 Terrytown (Scotts Bluff) 8 Thedford (Thomas) 8 Thurston (Thurston) 6 Tilden (Antelope)

May 2018 R-1 Battle Creek Mutual

BASIC PREMIUM CHART MASONRY* AND FRAME CONSTRUCTION

HOMEOWNERS FORMS HO-2 and HO-3 — Ultra Preferred rate level***, Group 3B**** ANNUAL PREMIUMS - $500 DEDUCTIBLE WITH $1500 WIND/HAIL DEDUCTIBLE **; $100,000 LIABILITY; $1,000 MEDICAL

Basic Premium Groups

Frame Construction Class 1-8

Frame Construction Class 9-10 Basic

Premium Groups

Frame Construction Class1-8


Ultra Preferred Ultra Preferred Ultra Preferred Ultra Preferred

Dwg. Amt. HO-2 HO-3 HO-2 HO-3 Dwg.

Amt. HO-2 HO-3 HO-2 HO-3

25,000 326 -- 410 -- 70,000 657 658 827 829 26,000 333 -- 420 -- 71,000 663 665 836 838 27,000 341 -- 430 -- 72,000 670 672 845 847 28,000 349 -- 440 -- 73,000 677 679 853 855 29,000 357 -- 450 -- 74,000 684 686 862 864 30,000 365 -- 460 -- 75,000 691 693 871 873 31,000 391 -- 493 -- 76,000 685 687 863 865 32,000 398 -- 502 -- 77,000 692 693 872 874 33,000 405 -- 511 -- 78,000 699 700 880 883 34,000 412 -- 519 -- 79,000 705 707 888 890 35,000 419 -- 528 -- 80,000 712 714 897 899 36,000 426 -- 537 -- 81,000 719 721 906 908 37,000 432 -- 545 -- 82,000 726 728 915 917 38,000 439 -- 553 -- 83,000 732 734 922 925 39,000 446 -- 562 -- 84,000 739 741 931 933 40,000 453 -- 571 -- 85,000 746 748 940 942 41,000 460 -- 579 -- 86,000 753 755 949 951 42,000 466 -- 587 -- 87,000 759 761 956 959 43,000 473 -- 596 -- 88,000 766 768 965 967 44,000 480 -- 605 -- 89,000 773 775 974 976 45,000 487 -- 613 -- 90,000 780 782 983 985 46,000 494 -- 622 -- 91,000 786 788 991 993 47,000 501 -- 631 -- 92,000 793 795 999 1002 48,000 507 -- 639 -- 93,000 800 802 1008 1010 49,000 514 -- 648 -- 94,000 807 809 1017 1019 50,000 521 -- 656 -- 95,000 813 815 1025 1027 51,000 528 -- 665 -- 96,000 820 822 1033 1036 52,000 535 -- 674 -- 97,000 827 829 1042 1044 53,000 541 -- 682 -- 98,000 834 836 1051 1053 54,000 548 -- 690 -- 99,000 840 842 1059 1061 55,000 555 -- 699 -- 100,000 847 849 1067 1070 56,000 562 -- 708 -- 101,000 850 852 1071 1074 57,000 569 -- 716 -- 102,000 855 857 1077 1079 58,000 575 -- 725 -- 103,000 860 862 1083 1086 59,000 582 -- 733 -- 104,000 864 866 1089 1091 60,000 589 590 742 743 105,000 869 871 1095 1098 61,000 596 597 750 752 106,000 873 876 1101 1103 62,000 603 604 759 761 107,000 879 881 1107 1110 63,000 609 611 768 770 108,000 883 885 1112 1115 64,000 616 617 776 778 109,000 888 890 1119 1121 65,000 623 624 785 786 110,000 892 894 1124 1127 66,000 630 631 793 795 111,000 897 899 1131 1133 67,000 636 638 802 804 112,000 902 904 1136 1139 68,000 643 645 811 813 113,000 907 909 1143 1145 69,000 650 652 819 821 114,000 911 913 1148 1151

* Brick (Masonry) dwelling: Multiply FRAME premium by .92 and round to nearest dollar before any adjustment for deductible. All dwellings that contain a solid fuel burning unit will have an annual charge of $30 per unit. The dwelling and any detached garage should be written at 100% of replacement cost. New Home Discount — see page R-5. ** see deductible factors on page R-4 Note: some of the amounts of insurance printed are *** see Rate level factors on page R-4 only valid for the Standard level. Use them only with **** see Insurance Score Group factors on page R-4 the Standard level factor. (See p. G-5 for minimums.) SEE TERRITORY factors on page R-4


BASIC PREMIUM CHART MASONRY* AND FRAME CONSTRUCTION

HOMEOWNERS FORMS HO-2 and HO-3 — Ultra Preferred rate level***, Group 3B**** ANNUAL PREMIUMS - $500 DEDUCTIBLE WITH $1500 WIND/HAIL DEDUCTIBLE **; $100,000 LIABILITY; $1,000 MEDICAL







Ultra Preferred Ultra Preferred Ultra Preferred Ultra Preferred

Dwg. Amt. HO-2 HO-3 HO-2 HO-3 Dwg.

Amt. HO-2 HO-3 HO-2 HO-3

115,000 916 918 1154 1157 165,000 1172 1175 1477 1480 116,000 921 923 1160 1163 166,000 1178 1180 1484 1487 117,000 926 928 1166 1169 167,000 1183 1186 1490 1494 118,000 930 932 1172 1175 168,000 1188 1191 1497 1501 119,000 935 937 1178 1181 169,000 1194 1197 1504 1508 120,000 939 942 1184 1187 170,000 1199 1202 1511 1515 121,000 945 947 1190 1193 171,000 1205 1207 1518 1521 122,000 949 951 1196 1198 172,000 1210 1213 1525 1528 123,000 954 956 1202 1205 173,000 1215 1218 1531 1535 124,000 958 961 1207 1210 174,000 1219 1222 1536 1539 125,000 963 966 1214 1217 175,000 1223 1225 1540 1544 126,000 968 970 1219 1222 176,000 1226 1229 1545 1548 127,000 973 975 1226 1229 177,000 1230 1233 1549 1553 128,000 977 979 1231 1234 178,000 1233 1236 1554 1558 129,000 982 985 1238 1240 179,000 1237 1240 1558 1562 130,000 987 989 1243 1246 180,000 1240 1243 1563 1567 131,000 992 994 1249 1252 181,000 1244 1247 1567 1571 132,000 996 998 1255 1258 182,000 1248 1250 1572 1576 133,000 1001 1003 1261 1264 183,000 1251 1254 1576 1580 134,000 1005 1008 1267 1270 184,000 1255 1258 1581 1585 135,000 1010 1013 1273 1276 185,000 1258 1261 1586 1589 136,000 1015 1017 1279 1282 186,000 1262 1265 1590 1594 137,000 1020 1023 1286 1289 187,000 1266 1269 1595 1598 138,000 1026 1028 1293 1296 188,000 1269 1272 1599 1603 139,000 1031 1034 1299 1302 189,000 1273 1276 1604 1607 140,000 1037 1039 1306 1309 190,000 1276 1279 1608 1612 141,000 1042 1045 1313 1316 191,000 1280 1283 1613 1616 142,000 1047 1050 1320 1323 192,000 1283 1286 1617 1621 143,000 1053 1055 1327 1330 193,000 1287 1290 1622 1625 144,000 1058 1061 1334 1337 194,000 1291 1294 1626 1630 145,000 1064 1066 1340 1343 195,000 1294 1297 1631 1635 146,000 1069 1072 1347 1350 196,000 1298 1301 1635 1639 147,000 1075 1077 1354 1357 197,000 1301 1304 1640 1644 148,000 1080 1083 1361 1364 198,000 1305 1308 1644 1648 149,000 1085 1088 1368 1371 199,000 1309 1312 1649 1653 150,000 1091 1093 1374 1378 200,000 1312 1315 1653 1657 151,000 1096 1099 1381 1385 210,000 1348 1351 1699 1703 152,000 1102 1104 1388 1391 220,000 1384 1387 1744 1748 153,000 1107 1110 1395 1398 230,000 1420 1423 1789 1793 154,000 1113 1115 1402 1405 240,000 1467 1471 1849 1853 155,000 1118 1121 1409 1412 250,000 1523 1527 1919 1924 156,000 1123 1126 1415 1419 Each

Additional $10,000

in excess of $250,000

157,000 1129 1131 1422 1426 158,000 1134 1137 1429 1432 56 56 70 71 159,000 1140 1142 1436 1439 160,000 1145 1148 1443 1446 161,000 1150 1153 1450 1453 162,000 1156 1159 1456 1460 163,000 1161 1164 1463 1467 164,000 1167 1169 1470 1473

* Brick (Masonry) dwelling: Multiply FRAME premium by .92 and round to nearest dollar before any adjustment for deductible. All dwellings that contain a solid fuel burning unit will have an annual charge of $30 per unit. The dwelling and any detached garage should be written at 100% of replacement cost. New Home Discount — see page R-5. ** see deductible factors on page R-4 SEE TERRITORY factors on page R-4 *** see Rate level factors on page R-4 **** see Insurance Score Group factors on page R-4

June 2017 R-3 Battle Creek Mutual

BASIC PREMIUM CHARTS

HO-4 — CONTENTS BROAD FORM — Ultra Preferred rate level**, Group 3B**** ANNUAL PREMIUMS - $1000 DEDUCTIBLE**; $100,000 LIABILITY; $1,000 MEDICAL

Coverage C

Amount

1 Family Dwelling *

2 Apts. and Over In Building Mobile Home ***

Protection Class Protection Class Protection Class

1-6 7-8 9-10 1-6 7-8 9-10 1-6 7-8 9-10 10,000† 41 43 46 54 56 61 76 78 85 15,000 62 64 68 81 85 91 113 118 127 16,000 65 68 73 87 90 97 121 125 135 17,000 69 72 78 92 96 103 129 133 144 18,000 74 76 83 98 101 109 135 141 152 19,000 77 80 87 103 107 116 143 149 161 20,000 81 85 91 109 112 121 151 157 169 21,000 86 89 96 114 119 128 158 165 177 22,000 90 94 100 119 124 133 166 173 186 23,000 94 98 105 124 130 140 174 180 195 24,000 98 101 110 130 135 145 182 188 202 25,000 102 106 114 135 141 152 189 196 211 26,000 106 110 119 141 146 158 196 204 220 27,000 110 114 123 146 152 164 204 212 228 28,000 114 119 128 152 157 171 211 220 237 29,000 119 123 132 157 163 176 219 228 245 30,000 122 128 138 163 169 183 227 235 253 Each

Additional 1,000

4.08

4.24

4.57

5.42

5.63

6.07

7.55

7.83

8.45

* If apartment is in a commercial building, rate as “Standard”.

HO-6 UNIT OWNER’S FORM — Ultra Preferred rate level**, Group 3B**** ANNUAL PREMIUMS - $1000 DEDUCTIBLE**; $100,000 LIABILITY; $1,000 MEDICAL

Coverage C

Amount

1 Family Dwelling

Multi-Family Dwelling

Protection Class Protection Class1-6 7-8 9-10 1-6 7-8 9-10

20,000 80 83 89 103 108 117 25,000 100 103 112 130 135 145 30,001 107 111 120 140 145 156 35,001 116 120 130 151 156 168 40,001 123 128 138 160 166 179 45,001 127 132 142 165 171 184 50,001 139 144 155 180 187 202 55,001 151 157 169 196 204 220 60,001 168 175 188 218 227 244 65,001 184 191 206 239 249 267 70,001 197 205 221 256 266 287 75,001 211 220 238 275 286 308 Each

Additional 1,000

2.99

3.11

3.36

3.89

4.05

4.36

s For HO-4 and HO-6

** see deductible factors on page R-4 *** see Rate level factors on page R-4 **** see Insurance Score Group factors on page R-4

SEE TERRITORY factors on page R-4

For HO-4 and HO-6 All dwellings that contain a solid fuel

burning unit will have an annual charge of $30 per unit.

A $5,000 Coverage A limit is built into the HO-6 form for a $27.57 premium (ultra preferred rate). This limit may be increased for $.56 per $100 of Coverage (ultra preferred rate).

Minimum Coverage C Amount of Insurance for HO-4 is $15,000 for Standard and $25,000 for Preferred and Ultra Preferred.

† If there is a Personal Auto policy in the account, a $10,000 minimum value is available for all three rate levels.

Minimum Coverage C Amount of Insurance for HO-6 is: $20,000 for Standard and $30,000 for Preferred and Ultra Preferred.


Territory Factors (all forms)

Territory Factor Territory Factor Territory Factor 1 East 1.00 3 West Central 1.20 5 East Central 1.10 2 West 1.45 4 Omaha 1.30 6 Lancaster Cty 1.05

Rate Level Factors (all forms)

Ultra Preferred 1.00 Preferred 1.15 Standard 1.30 Deductible Factors (all forms) Deductible Factor Deductible Factor $500 Ded. 1.20 $500 Ded. with $1,000 Wind/Hail 1.10 $1,000 Ded. 1.10 $500 Ded. with $1,500 Wind/Hail 1.00 $2,500 Ded. .85 — MAX $900 $500 Ded. with $2,500 Wind/Hail .93 — MAX $500 $5,000 Ded. .80 — No MAX $1,000 Ded. with $1,500 Wind/Hail .95 — MAX $600 $10,000 Ded. .70 — No MAX $1,000 Ded. with $2,500 Wind/Hail .90 — MAX $900

Insurance Score Relativity (Group) Factors – New Business (all forms)

Insurance Score Group

Insurance Score Factor







0A 0.750 0B 0.750 0C 0.750 0D 0.750 1A 0.750 1B 0.800 1C 0.830 2A 0.890 2B 0.910 2C 0.940 3A 0.960 3B 1.000 3C 1.020 4A 1.050 4B 1.100 4C 1.120 Inconclusive 1.000 5A 1.150 5B 1.200 5C 1.350 No Hit 1.000

SPECIFICALLY RATED RISKS

a. The Premiums for specially rated dwellings of fire resistive or fireproof construction shall be 85% of the otherwise applicable brick or masonry Homeowners premium from the Basic Premium Chart.

b. To develop the premium for an eligible one- or two-family owner-occupied dwelling in a townhouse or row house, apply the appropriate factor to the premium shown on the Basic Premium Chart. (Forms HO-2 and HO-3)

Protection Number of Individual Family Units within a Fire Division * Class 1-2 3-4 5 and over 1-8 BASE 110% 125% 9-10 BASE 115% 130%

* An eligible two-family owner-occupied dwelling would be considered two individual family units when determining the number of individual family units within a fire division.

MULTI-LINE DISCOUNT: The multi-line discount factor is .85 and is applied to the basic homeowners coverage premium. (Basic premium is defined on page R-6.) This discount is available for all policy forms. MATURE HOMEOWNER DISCOUNT: The Mature Homeowner discount factor is .95 and is applied to the basic homeowners coverage premium. (Basic premium is defined on page R-6.) This discount is available for all policy forms.


MISCELLANEOUS RATING DISCOUNTS Forms HO-4 and HO-6 are not eligible for protective device or new home discounts.

PROTECTIVE DEVICE CREDITS: Protective Device Discount

Local Smoke Alarm on Each Level and Fire Extinguisher 2% Central/Direct Fire Alarm (to Central Station) 10% Dead Bolt Locks on All Exterior Doors 2% Burglar Alarm System (Local) 5% or, Burglar Alarm (Central/Direct) 10% Full Automatic Sprinklers--in all areas & in all attached structures 10% or, Partial Sprinklers-- omitted in bathrooms, attics, closets or attached structures 5%

Central Direct = smoke or burglar alarm reporting to either fire department, police department or a central station.

Smoke and/or burglar alarm –maximum discount 10% NEW HOME DISCOUNT: The new home discount will be adjusted annually, prior to billing. Discount Built In: Discount Built In: 40% Current Calendar Year 15% Six years preceding current calendar year 36% One year preceding current calendar year 11% Seven years preceding current calendar year 32% Two years preceding current calendar year 9% Eight years preceding current calendar year 28% Three years preceding current calendar year 7% Nine years preceding current calendar year 23% Four years preceding current calendar year 5% Ten years preceding current calendar year 19% Five years preceding current calendar year Add the protective device discount to the new home discount to determine the total Miscellaneous rating discount. The maximum allowed miscellaneous rating discount is 40%.

NEW ROOF DISCOUNT/SURCHARGE: Forms HO-4 and HO-6 are not eligible for this discount or surcharge. The new roof discount or surcharge will be adjusted annually, prior to billing. Surcharge is not applicable to Metal Roofs. Discount Roof Replaced: Discount Roof Replaced: 11% Current Calendar Year 7% Five years preceding current calendar year 11% One year preceding current calendar year 5% Six years preceding current calendar year 10% Two years preceding current calendar year 4% Seven years preceding current calendar year 9% Three years preceding current calendar year 2% Eight years preceding current calendar year 8% Four years preceding current calendar year 1% Nine years preceding current calendar year

Surcharge Roof Replaced: Surcharge Roof Replaced: 0% Ten years preceding current calendar year 5% Fifteen years preceding current calendar year 1% Eleven years preceding current calendar year 6% Sixteen years preceding current calendar year 2% Twelve years preceding current calendar year 7% Seventeen years preceding current calendar year 3% Thirteen years preceding current calendar year 8% Eighteen years preceding current calendar year 4% Fourteen years preceding current calendar year 9% Nineteen years preceding current calendar year Once 20 years old, the 10% surcharge will remain until the roof is replaced. Homeowner Claim Surcharge Program

Policyholders who have submitted one or more chargeable claims in the last 3 years will be surcharged under this program. This surcharge applies to the basic premium after the applicable discounts. Basic premium is defined on page R-6. Experience Period – 3 year period immediately preceding the policy term effective date. Chargeable Claims – All claims submitted by a named insured except the following:

1. Claims for which payments are less than $500; 2. Claims for which subrogation payments have been received; 3. Claims for which payments have been made only under Medical Expense coverage or Equipment

Breakdown coverage; 4. Claims resulting from one of the following weather related perils: Lightning, wind, hail or earthquake; and


5. Catastrophe losses as defined by Battle Creek Mutual Ins. Co.

The amount of surcharge to be applied is determined by the following schedule:

Number of Chargeable Claims in the Last 3 Years 0 1 2 3 4 or more

0% 10% 30% 60% 100%

Section I (Physical Damage) Optional Coverages

Basic premium = premium generated after application of the deductible or specific rate, and prior to the application of any surcharges or discounts. It includes HO 00 15 premium. Personal Property (Coverage C) – Increased limits on Forms HO-2 and HO-3. (ADC) Can be increased at the charge of $.20 per $100 of insurance. Loss Of Use (Coverage D) – Increased limits on All Forms. (ADD) When the limit of liability for Coverage D is increased, use the following rate per $100: HO-2 and HO-3 Form HO-4 Form HO-6 Masonry/Fire Res., Class 1-8 $.20 1 Family Dwelling $.40 1 Family Dwelling $.40 Masonry/Fire Res., Class 9-10 $.30 2 Apts. & over in Blg. $.60 Multiple Family Frame, Class 1-8 $.30 Mobile Homes $.80 Dwelling $.50 Frame, Class 9-10 $.40 HO 00 15 Special Personal Property Coverage. Form HO-3 only (HO5) The factor is +12.4%, applied to the dwelling premium after the deductible calculation. This

endorsement premium is included in “basic premium”. HO 04 10 Additional Interests—Residence Premises. All Forms. This is a no charge endorsement. HO 04 12 Increased limits on Business Property. All Forms. (IBP) Can be increased from the special limit of $2,500 at the charge of $.50 per $100 of insurance. Maximum

limit allowed for HO 04 12 is $5,000 and we only charge on additional limit above the built-in $2,500. HO 04 13 Sections I and II Exclusions for Computer-Related Damage or Injury. All Forms. (XCR) This is a no charge endorsement. It will automatically be added to a policy endorsed with Business

Pursuits, Home Day Care Coverage, Permitted Incidental Occupancy (Residence Premises) or Permitted Incidental Occupancy (Other Residence).

HO 04 14 Special Computer Coverage. All Forms except HO-4 with HO 05 24, and HO-6 with (COM) HO 17 31. Flat $38 charge. HO 04 20 Specified Additional Amount of Insurance for Coverage A—Dwelling. Forms HO-2 and HO-3 only (ADA) This is a no charge endorsement. However, the dwelling must be insured to 100% of replacement cost. HO 04 26 Limited Fungi, Wet or Dry Rot, or Bacteria Coverage. All forms except HO-3. (FAO) $1000 limit of liability for Section I and a $1000 limit of liability for Section II is included at no charge. Up

to an additional $5,000 worth of coverage can be purchased for a maximum $6,000 limit of liability on each Section. Limit for Section I and Section II must be the same.

Rate is $1.00 per $100 of insurance. HO 04 27 Limited Fungi, Wet or Dry Rot, or Bacteria Coverage. Form HO-3. (F35) $1000 limit of liability for Section I and a $1000 limit of liability for Section II is included at no charge. Up

to an additional $5,000 worth of coverage can be purchased for a maximum $6,000 limit of liability on each Section. Limit for Section I and Section II must be the same. Rate is $1.00 per $100 of insurance

Fungi, Wet or Dry Rot, or Bacteria Coverage. Form HO-4 with HO 05 24 and Form HO-6 with HO 17 31 or HO 17 32.


HO 04 94 Windstorm or Hail Exclusion. All Forms except HO-4. (WEX) There is a 10% credit of basic premium for this endorsement. HO 04 98 Refrigerated Property Coverage. All Forms. (RPC) $25 flat premium charge. HO 05 16 Exclusion of Terrorism (With Limited Exception) and Exclusion of War. All Forms. This is a no charge endorsement. HO 05 24 Special Personal Property Coverage. Form HO-4 only. (SP4) 25% of basic premium. HO 05 30 Functional Replacement Cost Loss Settlement. Forms HO-2 and HO-3. (FRC) 25% of basic premium. HO 05 41 Extended Theft Coverage for Residence Premises Occasionally Rented to Others. All Forms. (EXT) $50 flat premium charge. HO 06 15 Trust Endorsement. All Forms except HO 4. (TRS) This is a no charge endorsement. It provides both property and liability coverage for the trustee. HO 17 31 Unit Owner’s Coverage C. Form HO-6. (UOC) 25% of basic premium. HO 17 32 Unit Owner’s Coverage A (Special Coverage). Form HO-6. (UOA) 25% of premium for Coverage A. This would be 25% of the premium for the initial $5,000 Coverage A

limit of liability and any additional premium for Coverage A limits of liability purchased above the $5,000. ($5,000 Coverage A limit is included in the basic HO-6.) HO 17 33 Unit Owner’s Rental to Others Endorsement. Form HO-6. (UOR) 25% of basic premium. HO 118 Exclusion Of Cosmetic Loss To Metal Roof Coverings Caused By Hail All Forms except HO-4. (XMR) This is a no charge endorsement. HO NE EB Equipment Breakdown Enhancement Endorsement. All Forms except HO-4. (EB) $17 flat premium charge included with Coverage A premium. HO SL Service Line Enhancement Endorsement. Forms HO-2, and HO-3. (SLC) $20 flat premium charge included with Coverage A premium. FE 001 Excluded Specified Structures (All Coverages) All Forms except HO-4. (XST) This is a no charge endorsement.

FE 002 Specific Structures On or Off Premises. All Forms. (SST) $.60 per $100 of insurance. When an additional amount of insurance is written on a specific other structure, the premiums listed per

$100 shall apply separately to each such structure.

October 2016 R-12 Battle Creek Mutual

FE 003 Water Backup and Sump Discharge or Overflow. All Forms. (BKU)

Territory Limit Premium All Territories $5,000 $25

We require a dwelling to have drain tile and an operable sump pump in the dwelling in order to obtain coverages over $5,000. This must be indicated on the App or Change.

$.50 per $100 (over $5000) up to $20,000.

For limits over $20,000, refer to Home Office. Coverage cannot be bound.

FE 005 Excluded Specified Structures (Property Only) All Forms except HO-4. (XSP) This is a no charge endorsement. FE 007 Special Provisions—Nebraska. All Forms.

This is a no charge endorsement. This endorsement is required for all policies. FE 010 Unregistered Motor Vehicle Endorsement (Property and Liability) All Forms. (UMV) $35 flat premium charge. FE 011 Specific Structures On or Off Premises (Named Perils Only). All Forms. (SNP) $.40 per $100 of insurance. When an additional amount of insurance is written on a specific other structure, the premiums listed per

$100 shall apply separately to each such structure. MH NE 04 Manufactured Home Loss Settlement. Forms HO-2, and HO-3. (MHL) 20% of basic premium.

Section II (Liability) Optional Coverages

(XCR) Permitted Incidental Occupancy (Residence Premises) or

Permitted Incidental Occupancy (Other Residence).

Fungi, Wet or Dry Rot, or Bacteria Coverage. All forms except HO-3. (FAO)

Fungi, Wet or Dry Rot, or Bacteria Coverage. Forms HO-3. (F35)

Fungi, Wet or Dry Rot, or Bacteria Coverage. Forms HO-4 with HO 05 24 and HO-6 with (F46) HO 17 31 or HO 17 32.


HO 04 42 Permitted Incidental Occupancies (Residence Premises) All forms. (OCC) (HO 04 13 (XCR) Sections I and II Exclusions for Computer-Related Damage or Injury must be added.)

Limits of Liability Coverage E $25,000 $50,000 $100,000 $200,000 $300,000 $500,000 $1,000,000

Exposure

Coverage F

$1000

$2000

$5000

$1000

$2000

$5000

$1000

$2000

$5000

$1000

$2000

$5000

$1000

$2000

$5000

$1000

$2000

$5000

$1000

$2000

$5000

* Described Premises 10 13 19 11 14 20 12 15 21 13 16 22 14 17 23 15 18 24 22 25 31

(OCS) If the activity takes place in an “other structure”, the endorsement can provide coverage to the structure

for $.50 per $100 of insurance.

HO 04 58 Other Members of Your Household. All Forms. (MEM) This is a no charge endorsement. It provides both Section I and Section II coverages. HO 04 59 Assisted Living Care Coverage. All Forms. (ALC) See rate under Section I endorsements. This endorsement has both Section I and Section II coverages.

HO 04 97 Home Day Care Coverage. All Forms. (DAY) Provides Section II coverages to the insured while providing child care services. $5,000 medical is

mandatory. Liability limits must be at least $100,000. (HO 04 13 (XCR) Sections I and II Exclusions for Computer-Related Damage or Injury must be added.)

Limits of Liability

Coverage E $100,000 $200,000 $300,000 $500,000 $1,000,000

Exposure Coverage F $5000 $5000 $5000 $5000 $5000

Child Care 1 - 3 children 50 60 75 100 125

(DAS) Separate coverage limit for other structures where day care is performed can be purchased at a rate of

$1.00 per $100 of coverage. HO 05 16 Exclusion of Terrorism (With Limited Exception) and Exclusion of War. All Forms. This is a no charge endorsement. HO 05 27 Additional Insured—Student Living Away from the Residence Premises. All Forms. (AIS) $25 flat premium charge per student. HO 06 15 Trust Endorsement. All Forms except HO-4. (TRS) This is a no charge endorsement. It provides both property and liability coverage for the trustee. HO 24 13 Incidental Low Power Recreational Motor Vehicles. All Forms. (REC) $25 flat premium charge per unit. HO 24 43 Permitted Incidental Occupancies (Other Residence). All Forms. (OCO) This endorsement can be utilized for an Office, Professional Private School or Studio occupancy.

$20 flat premium charge. (HO 04 13 (XCR) Sections I and II Exclusions for Computer-Related Damage or Injury must be added.)

September 2014 R-16 Battle Creek Mutual

HO 24 72 Incidental Farming Personal Liability. All Forms. (IFL) Provides Section II coverages to the eligible insured who has farming interests.

Limits of Liability Coverage E $25,000 $50,000 $100,000 $200,000 $300,000 $500,000 $1,000,000

Exposure Coverage F

$100

0

$200

0

$500

0

$100

0

$200

0

$500

0

$100

0

$200

0

$500

0

$100

0

$200

0

$500

0

$100

0

$200

0

$500

0

$100

0

$200

0

$500

0

$100

0

$200

0

$500

0

Farm Premises rented to others—Up to 500 acres 10 13 19 11 14 20 12 15 21 13 16 22 14 17 23 15 18 24 22 25 31

Farm Premises rented to others—Over 500 acres 18 21 27 19 22 28 21 24 30 23 26 32 25 28 34 27 30 36 34 37 43

HO 24 82 Personal Injury. All Forms. (PI) (Add to Base Liability Premium)

Limits of Liability Coverage E $100,000 $200,000 $300,000 $500,000 $1,000,000

8 10 12 14 21

FE 010 Unregistered Motor Vehicle Endorsement (Property and Liability) All Forms. (UMV) See rate under Section I endorsements. This endorsement has both Section I and Section II coverages.

FE 007 Special Provisions—Nebraska. All Forms. This is a no charge endorsement. This endorsement is required for all policies.

CE 001 Owned Recreational Vehicle. All Forms. (RVL) Maximum 500 cc for 4 wheel ATVs.

Maximum 100 cc for mopeds and mini-bikes. $50 flat premium charge per recreational vehicle.

CE 006 Dog Exclusion Endorsement. All Forms. DE1 This is a no charge endorsement. Form HO Excl-D1 must be signed by the insured.

CE 008 Dog Exclusion Endorsement Number 2. All Forms. DE2 This is a no charge endorsement. Form HO Excl-D3 must be signed by the insured.

Acceptability (See also Eligibility) - Battle Creek Mutual ... Injury HO 24 82 G-25 R-16 Personal...

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Transcript of Acceptability (See also Eligibility) - Battle Creek Mutual ... Injury HO 24 82 G-25 R-16 Personal...