1. Forms
2. DP
3. DP-04-59

What the form is

The DP 04 59 Assisted Living Care Coverage endorsement is designed to be added to an ISO Dwelling Policy (DP 00 01, DP 00 02, or DP 00 03). Its primary purpose is to extend coverage for personal property and provide additional living expenses for a person named in the endorsement who resides in an assisted living care facility. This acknowledges that individuals moving into such facilities still own personal belongings that require protection and may incur extra costs if the facility becomes uninhabitable due to a covered loss.

Classes of business it applies to

This endorsement is used in personal lines insurance. It's applicable when an insured under a dwelling policy, or a family member for whom they wish to provide coverage (like an elderly parent), moves into an assisted living facility.

Real-world example: An individual maintains a dwelling policy on their primary home but their elderly mother, who is named in this endorsement, moves into a local assisted living facility. If a fire at the assisted living facility damages her personal belongings (clothing, electronics, furniture she brought) and she needs to temporarily live elsewhere, this endorsement could provide coverage for her damaged property and the increased cost of her temporary accommodation.

Special considerations

• Scheduled Coverage: The endorsement requires scheduling the name of the person residing in the assisted living facility and the description of the facility.
• Coverage Limits: A specific limit of liability must be selected for this coverage, and this limit is separate from the main policy's Coverage C (Personal Property) limit for the dwelling.
• Sublimits: The form includes sublimits for certain categories of personal property, such as hearing aids, eyeglasses, contact lenses, and wheelchairs.
• Additional Living Expense: Coverage for additional living expenses is provided if the part of the assisted living facility where the named person resides becomes uninhabitable due to a covered loss. There are typically monthly and total maximums for this coverage.
• Deductible: The 07 14 edition of this form was revised to remove the application of the policy deductible to the coverage provided by this endorsement in a single loss event.
• Liability: This endorsement typically does not provide liability coverage for the resident of the assisted living facility; liability coverage is not automatically part of dwelling property forms.

Key information for agents and underwriters

• Needs Assessment: Agents should carefully discuss with the insured the value of personal property being taken to the assisted living facility to ensure an adequate limit is selected, keeping in mind the specific sublimits for items like medical devices.
• Understanding Scope: It's crucial to explain that this endorsement primarily covers personal property and additional living expenses for the resident at the assisted living facility, not the physical structure of the facility itself (which should have its own insurance).
• Risk Assessment: Underwriters should consider the concentration of value in assisted living facilities and the potential for multiple small claims. The types of personal property (e.g., electronics, mobility aids) are relevant.
• Deductible Clarification: For the 07 14 edition, it's important to note that the policy deductible may not apply to losses covered solely under this endorsement, which is a broadening of coverage compared to some prior interpretations or editions.
• Coordination with Other Policies: Determine if the resident has any other applicable insurance (e.g., a separate tenant's policy, though this endorsement is designed to fill a specific need related to the dwelling policy).