AAIS COMMERCIAL LIABILITY COVERAGE FORM ANALYSIS
(September 2025)
The American
Association of Insurance Services (AAIS) GL-200 - Commercial Liability Coverage
provides occurrence based protection against claims for bodily injury, property
damage, personal injury, or advertising injury arising out of the insured's
business premises or operations. It also covers claims for bodily injury and
property damage related to products and completed work associated with the
insured business.
The copyright of the GL-200 dates back to 2006. To stay
current, AAIS has added several mandatory endorsements over the years for use
with this form. To help understand how these endorsements change coverage, we
have inserted the changes into this analysis.
The endorsements being editorially inserted into the
form are as follows:
Related Article:AAIS Commercial Liability Coverage
Available Endorsements and Their Uses
A table of contents
is included in the coverage form to assist with the review process.
Certain words or
phrases carry specific meanings. They are listed in the Definitions
section, located after the Insuring Agreement, and are highlighted in bold or
quotation marks throughout the coverage form.
NOTE: The bolded words
above were added by the CL-300–Amendatory Endorsement.
The insurance
company agrees to provide the commercial liability coverage specified in the
policy. However, this coverage is subject to the policy's terms and conditions being
fulfilled. All contracts require consideration, and in an insurance contract,
the consideration is the insured’s payment of the required premium.
The policy terms
concerning cancellation, policy alterations, book and record inspections,
surveys, inspections, and the assignment or transfer of rights or
responsibilities are also applicable, even though they are not included within
this coverage part. These terms are listed separately because they are not part
of this specific coverage form. They are outlined in CL 0100–Common Policy
Conditions, which must be attached to every monoline commercial lines policy.
Related Article:CL 0100–Common Policy Conditions Analysis
When any of the
following terms are used in the policy, the explanation in this section takes
precedence over the dictionary definition of the term.
NOTE: The Editors added titles to enhance clarity.
The individual or
entity named as the insured on the declarations. There could be several
individuals or entities identified as 'you' or 'your.'
The insurance
company providing the insurance coverage in this form.
An injury arising from
any or all of the following offenses:
·
Defamation, such as slander or libel, against a
person or organization, whether spoken or written.
·
Verbal or written statements diminishing the
quality or reputation of another's goods, products, or services.
·
The infringement of an individual's right to
privacy in written or spoken communication.
·
Using or copying another person's advertising
concepts or business approach without authorization.
·
The violation of copyright, title, slogan,
trademark, or trade name.
NOTE: Advertising injury does not include bodily injury, property damage, or
personal injury.
A vehicle designed
for operation on public roads, which may be motorized or consist of a trailer
or semi-trailer, and operates on land. Machinery or equipment attached to a vehicle
is also considered an auto.
The United States of
America, including its territories and possessions, as well as Canada and
Puerto Rico.
Bodily harm, illness, or disease to a person. The
necessary care and loss of services they usually provide is also considered
bodily injury. Death resulting from the initial bodily harm, sickness, or
disease is also regarded as bodily injury, regardless of when it occurs. Mental
or emotional injury, suffering, or distress is classified as bodily injury but
only if it results from a physical injury.
Example: Geraldine slips on a lettuce leaf at Smith
Brothers Buffet restaurant, resulting in a compound fracture of her leg. Her
family witnessed the horrifying moment when the bone pierced through her
flesh during the fall. All
medical services provided to Geraldine for the treatment of her injury are
classified as bodily injury. Geraldine works full-time and also cares for her
mother and sister in the evenings. The cost of replacing these services due
to her injury is also considered bodily injury. After
the accident, Geraldine develops an infection in her leg, and despite three
years of treatment, she ultimately passes away. Even though her death
occurred three years after the initial injury, it is still classified as
bodily injury. Maggie, Geraldine's sister, witnessed
the incident and has been receiving psychiatric treatment for the trauma
since the accident. However, since Maggie did not sustain a physical injury,
her condition is not classified as bodily injury. |
The following are
all regarded as the coverage territory:
1) Liability payment
obligations must be confirmed within the basic territory or via a settlement
agreed upon by the insurance company. Otherwise, coverage does not extend
globally.
2) If condition 1)
is met, liability for products produced or sold within the basic territory
applies worldwide, regardless of where the incident occurs.
3) If condition 1) is satisfied, activities of a
person outside the basic territory are covered, but only if the individual is
away for a short period of time.
Example: Marilyn’s Must Haves sells women’s accessories
through multiple retail outlets and online. Scenario
1: Hector, an employee, travels from
Arizona to Paris to meet a retail client. In Paris, he places his bag on a
café floor, and a woman trips over it, breaking her leg. If a lawsuit is
filed related to this injury within the basic territory, coverage applies.
However, if the suit is filed in Paris, this coverage will not respond. Scenario 2: Gretel purchases Marilyn’s product and is injured
by it. She sues Marilyn for the injury. Gretel bought the product online, but
lives in Germany. If the lawsuit is filed in the basic territory this
insurance coverage will respond. However, if the lawsuit is filed in Germany,
there is no coverage. |
Money provided to a
person as compensation for an injury.
Data Records (No number assigned)
(Editorially added
from the mandatory amendment – GL 1353 – Exclusion Data Breach Liability - 09
14 edition date)
Documents, files,
and other data stored electronically on a device used with computer hardware,
networks, programs, or applications. Electronically controlled equipment is
included if it is used with the computer hardware, network, program, or
application.
A broad term meaning
the actual declarations, supplemental declarations, and schedules associated
with this policy.
Designated Insured (No number assigned)
(Editorially added from
the mandatory amendment – GL 0950 – Known Injury or Damage – 12 99 edition date)
There are five types
of entities considered designated insureds. The first four depend on the type
of business entity listed on the Declarations and are similar to the definition
of insured described later in the policy:
NOTE: There is no indication as to who must authorize the employee.
This is an
explanation rather than a definition. The term employee covers leased workers
but excludes temporary workers.
A property is
considered impaired if it fails to meet any of the following criteria.
Related Court Case: Commercial General Liability No Coverage for Damages from
Insured's Inferior Lumber
The first group of
defined insureds is determined by the type of business entity listed on the
Declarations:
The following group
is considered insureds, regardless of their business entity type.
·
The real estate manager of the named insured can be
an individual or organization. However, if it's an individual, that person
cannot be an employee of the named insured.
·
If the named insured dies during the policy term,
their legal representative becomes an insured.
o
The legal representative is covered as an insured,
but only while acting within the scope of their responsibilities.
o
The legal representative takes on all the named
insured's rights and duties under this coverage.
o
A person who
has custody of the insured property will also be considered an insured, but
only with respect to liability for the maintenance or use of that property, and
only until a legal representative is appointed.
·
The following are insureds while using the named
insured’s mobile equipment, but only if they have permission:
o
An employee of the named insured who uses the
equipment during work is covered. However, if a coworker is injured, the
employee responsible for causing the injury is NOT considered an insured.
o
Any individual who is not an employee is covered,
provided they do not have insurance coverage and the liability arises from the
operation of equipment. Organizations or individuals legally responsible for
the conduct of the other individual are also considered insured. However, they
are not covered for damages they cause to equipment owned or rented by their
employer, equipment the employer occupies, or equipment for which the employer
is responsible.
o
Insured status regarding mobile equipment use, as
described above, does not apply to any loss involving damage to the named
insured’s owned or rented equipment, equipment the insured is occupying, or
equipment for which the insured is responsible.
Executive officers
are excluded from being considered employees under this section.
o
This definition does not include newly created or
acquired joint ventures and partnerships. This means they are not considered
insureds.
The organization newly acquired or formed is not insured for any of the
following:
o
When comparable insurance coverage is available.
o
After the policy period during which it was formed
or acquired ends, or 90 days after its formation or acquisition, whichever
comes first.
o
For any bodily injury or property damage occurring
before the date of acquisition or formation.
o
For any personal injury or advertising injury
offense committed before the date of acquisition or formation.
Unless a partnership
or joint venture is specifically named as an insured on the declarations, no
individual or entity is considered an insured for the actions of the
partnership or joint venture, whether in the past or present.
A leased worker is
an individual contracted by the named insured from a labor leasing entity. The
contract must specify the worker will perform duties related to the named
insured's business operations. Temporary workers are not leased workers.
The amount of
coverage this policy provides.
The movement of property starts when it is taken
from the point where it is accepted for transit by a vehicle. Loading or
unloading continues while the property is inside or on the vehicle and stops
when the property is taken off the vehicle at the destination. Movement by any
mechanical device attached to the vehicle and movement by a hand truck are
considered loading and unloading, but movement by any other type of mechanical
device is not considered loading or unloading.
Example: Step 1: Millie moves
a television from its storage location to the loading dock. Step 2: Jason picks
up the television, intending to put it in his box truck. Step 3: Jason loads
the television into the truck. Step 4: Jason drives
his truck to his customer. Step 5: Jason removes
the television from his truck and sets it on the customer’s loading dock. Step 6: Frank moves
the television from the loading dock to another area of the building. Steps
2, 3, 4, and 5 are considered loading and unloading. |
This is an accident, but it is not limited to a single event. It can also
involve repeated exposure to similar or identical conditions.
This is an injury not
involving bodily injury, property damage, or advertising. The injury must arise
from any or all of the following offenses:
Example: Millie
asks a customer to stay in the store, but the customer refuses. Believing the
customer has shoplifted, Millie grabs her arm and escorts her to the back of
the store. Millie calls the police, convinced that a crime has taken place.
After the customer proves she did not take any items from the store, she is
released. Consequently, the customer files a lawsuit against the store for
false arrest and detention. |
Example:
Paul, the property manager at Golden Acres, often uses his master key to
access tenants’ apartments when they are not home. Pauline sues Golden Acres
and Paul for invasion of privacy after finding Paul in her apartment. |
18. Products/Completed Work Hazard:
The work of the
named insured excludes projects still ongoing or abandoned. Work is considered
completed on the earliest date of the following:
o
Once all contract work the named insured is
responsible for is completed.
o
When a single contract covers multiple jobs, the
work at a specific jobsite is deemed complete once the named insured has
finished their work at that jobsite.
o
When the named insured's work at a job site is put
to its intended purpose by any person or organization. However, completed work
does not include instances where a subcontractor or contractor is still working
at the same jobsite.
Work is considered
completed even if it needs additional service, maintenance, correction, repair,
or replacement due to a defect or deficiency.
The products and completed
work hazard does not include bodily injury or property damage arising from any
of the following:
o
Transportation of property. However, coverage
applies if injury or damage is due to a condition in or on the vehicle caused
by loading or unloading.
Example:
Glen secured goods at the rear of his box truck to prevent shifting during
transit. However, the tie-down was not tight enough, and the items came
loose. Any resulting damage is considered a product hazard because it
occurred during the loading process. |
o
When tools, uninstalled equipment, or abandoned and
unused materials are present.
o
When products or work are a part of the
classification shown on the declarations, and it specifies Products/Completed
Work is included.
NOTE: This product and work are
classified as premises-type losses, not as products or completed work, and
included in the General Aggregate instead of the products or completed work
Aggregate.
Example: Kelly’s Consulting designed and manufactured
small, liquid-center paperweights for a promotional event. One of the
paperweights leaked and caused damage to a customer’s mahogany desk. The
property damage claim is considered premises coverage because the Consulting
classification included Products/Completed operations within the premises code. |
Goods or merchandise
produced, sold, handled, disposed of, or distributed by the named insured are
considered products. This also includes goods and merchandise belonging to
others traded under the named insured's name for the purposes of manufacturing,
selling, handling, disposing of, or distributing. Additionally, products
include goods and merchandise acquired by the named insured for the purpose of these
activities.
Products are also all
the following:
·
Anytime warranties or representations about the
product’s fitness, quality, durability, or performance are provided.
·
Containers, materials, parts, or equipment
furnished with the products.
NOTE: Vehicles are not considered containers.
·
Instructions and warnings provided or that should
have been provided.
However, real property is never classified as a
product. Furthermore, vending machines or other property rented or placed for
the use of others, but not sold to them, are also not considered products.
|
Example: Peter sells ready-to-assemble furniture, which is
classified as products. The instruction manual for assembling the furniture
is also considered products. Additionally, the warnings that accompany the
furniture are also regarded as products. Likewise, the box used to ship the
ready-to-assemble furniture is also considered products. |
Physical injury to or destruction of tangible
property, including the loss of use of such property. The property does not
need to be damaged for there to be a loss of use property damage claim. Loss of
use occurs simultaneously with the event that caused the loss.
Example:
Piper Broadcasting’s antenna fell onto the sidewalk of Penny’s Fine
Furniture, blocking its entrance. Customers couldn’t enter Penny’s store for
two days while Piper coordinated with contractors to remove it. This two-day
loss of access is regarded as property damage, even though Piper’s antenna
did not physically damage Penny’s furniture or store. |
A temporary replacement provided to the insured for a regular employee
who is a natural person.
All provisions, limitations, exclusions, conditions, and definitions relevant to the coverage provided.
Any or all of the following:
·
Work or operations carried out either by the named
insured or on its behalf.
·
Materials, parts, or equipment provided for the
insured’s work or operations.
·
Warranties or representations concerning the
quality, fitness, durability, or performance of the materials, parts, or
equipment provided and related to the insured’s work or operations. These
warranties or representations must be in writing and can be made at any time.
Example:
Peter is very upset. In October, he hired Justin’s Fire Safety to prepare the
extinguishing system for winter. Justin assured Peter the system could
withstand temperatures as low as -30°F. Although temperatures drop, they
never fall below –15°F. When temperatures rise above freezing, the sprinkler
system begins to leak. Peter sues Justin’s for the damages caused by the
leak. However, Justin’s insurance company denies the claim because the
warranty was verbal, not in writing. |
The insurance
company provides insurance coverage for the following, but only if a specific
limit or premium is indicated on the declarations.
Coverage L–Bodily Injury Liability and Property Damage Liability
The insurance
company will pay the amounts an insured is legally required to pay as damages
for bodily injury or property damage covered by this policy. The injury or
damage must be caused by an occurrence and occur within the coverage area.
Additionally, the bodily injury or property damage must occur during the policy
period.
(Editorially added wording from GL 0950–Known Injury or Damage
Amendments)
Insurance for Coverage L only applies when the designated insured, as defined, is
unaware of any bodily injury or property damage incidents prior to reporting a
claim.
However, any
prior knowledge of such incidents prior to the policy's inception date is not
covered, and the insurance company will not have a duty to defend or pay a
claim. Additionally, continuation, resumption, or
change in such prior bodily injury or property damage is regarded as known by
the designated insured within the relevant prior policy period.
Example: Paula falls at Penny’s Place. She
sustains a head injury but makes it home before collapsing and slipping into
a coma. She never regains consciousness. One year later, she dies from those
injuries. Scenario 1: Paula’s estate investigated her actions before her
accident and found out that Paula fell at Penny’s Place. The family hired an
investigator and was able to file a claim against Penny’s Place. This is
covered under the current policy because no one at Penny’s was aware of the
injury. Scenario 2: Jill, a partner at Penny’s, saw the fall
and was concerned. She asked Paula if she wanted an ambulance, but Paula
declined and requested a cab instead. Since Jill is a designated insured and
was aware of the bodily injury, her current policy does not cover the
incident, though the previous policy might respond. |
Example:
Mavis crashes her golf cart into her neighbor’s carport. The damage seems
minor, and her insurance company covers the cosmetic repairs. Six months
later, heavy snow overload causes the carport to collapse. An investigation
by the neighbor’s insurance adjuster finds that Mavis’s earlier accident
weakened the support beam, which contributed to the collapse. Mavis’s policy
that paid for the cosmetic repairs will also cover the carport collapse
claim, even though it occurred in a different policy period. |
Certain medical
expenses are covered when bodily injury results from an accident, regardless of
whether negligence is involved. The accident must occur on the insured’s owned
or rented property or on nearby ways such as streets, alleys, or sidewalks
adjacent to those premises. Additionally, medical expenses incurred
off-premises but arising from the named insured's operations are also covered.
The expenses covered
by the policy must be related to an accident occurring during the policy period
and within the designated coverage territory. Only expenses incurred and
reported to the insurance company within one year of the accident date will be
paid.
Medical expenses must
be both reasonable and necessary, and include the following:
·
medical
·
surgical
·
x-ray
·
dental services
·
prosthetic devices
·
eyeglasses
·
ambulance
·
hospital
·
professional nursing
·
funeral services
·
first aid provided at the time of the accident
|
Example: Marcy is jogging past a new construction site.
Milton, an employee of Brickmasters, Inc., is building a wall. He loses his
grip and drops a heavy trowel, which hits Marcy, causing her to fall. Milton immediately calls 911 and
insists Marcy be taken to a hospital.
All medical expenses related to the 911 transport and hospital stay are
covered by Brickmasters, Inc.’s insurance, subject to the medical payments
limit of the policy. |
Coverage N–Products/Completed Work
The insurance carrier covers the amount the insured
is legally required to pay for damages due to bodily injury or property damage
related to the products or completed work hazard covered by this insurance. The
injury or damage must be caused by an occurrence taking place within the
coverage territory and during the policy period.
|
Example: Jelly Spot produces candy sold worldwide. On
August 1, 2025, while in Paris, Kelly bites into a Jelly Spot and breaks a
tooth after encountering a piece of metal in the candy. Kelly sues Jelly
Spot. An
investigation reveals that an incident at the Jelly Spot Pennsylvania
location on October 1, 2024, resulted in metal contamination of some of the
candy. The plant believed they had identified all the problematic boxes, but
this one slipped through. The policy in effect on August 1, 2025,
will cover this loss because it is the policy in effect at the time of the
injury. |
(Editorially added wording from GL 0950–Known Injury or Damage
Amendments)
Insurance for Coverage N (if applicable) only applies when the designated insured, as defined, is
unaware of any bodily injury or property damage incidents prior to reporting a
claim.
However, any
prior knowledge of such incidents prior to the policy's inception date is not
covered, and the insurance company will not have a duty to defend or pay a
claim. Additionally, continuation, resumption, or change in such prior bodily
injury or property damage is regarded as known by the designated insured within
the relevant prior policy period.
If
no prior knowledge exists, or if the event is a continuation, resumption, or
change of a previous bodily injury or property damage, then the insurance
company has a duty to defend against any suit or claim seeking damages. Additionally,
any resumption, change, or continuation of a bodily injury or property damage
first known in the prior policy period is covered under the current policy.
Coverage O–Fire Legal Liability
The insurance covers property damage caused by
fire when the named insured is legally responsible, including damage to
buildings or parts of buildings rented or loaned to them. Buildings encompass
any fixtures permanently attached to the building.
This coverage is not limited by any property
damage exclusions, except as follows:
·
Liability
when it arises from any contract or agreement in which the insured agrees to
indemnify any person or organization for fire damage to the premises.
NOTE: A misunderstanding could occur if the insured signs such a contract and a
loss occurs. If the only reason for the obligation is the contract, the
exclusion applies. However, if the insured is also legally liable beyond the scope
of the contract, the exclusion may not apply.
·
Liability
when the insured expected, directed, or intended the property damage.
·
Liability
when the damage to the property is caused by acts of the insured that are both
intentional and malicious.
Coverage P–Personal Injury Liability and Advertising Injury Liability
The insurance
carrier will pay the sums an insured is legally required to pay as damages for
personal injury or advertising injury covered by this policy.
Coverage applies
when an offense occurs during the named insured’s business activities. However,
offenses related to advertising, publishing, broadcasting, or telecasting, if
committed by or on behalf of the insured, are not covered. The injury must occur
during the policy period and in the coverage territory.
Coverage applies when
an offense is committed and the named insured’s goods, products, or services
are being advertised. The injury must occur during the policy period and in the
coverage territory.
Related Court Case: Advertising Injury Coverage Held Applicable To
Misappropriation of Product Style Promoted In Ads
The insurance
company provides three supplemental coverages, which are subject to all the
terms of the Principal Coverages. These Supplemental Coverages do not increase
the limits of the Principal Coverages.
Liability for bodily
injury and property damage assumed under the following contracts or agreements
is covered:
·
Premises leases.
·
Agreements for easements or licenses are included.
However, agreements related to construction or demolition within 50 feet of a
railroad are excluded.
·
Municipal indemnification agreements apply, but
only when required by ordinance. Agreements for work done for the municipality
are excluded.
·
Sidetrack agreements. These are agreements between
a party with a sidetrack on its premises and the railroad providing the track.
·
Agreements for the maintenance of elevators.
·
Any assumption of tort liability for damages
resulting from bodily injury or property damage related to a contract or
agreement involving the conduct of the named insured’s business. This also
includes indemnification agreements with a municipality when work is performed
for that municipality.
NOTE: Tort liability in this policy refers to the liability imposed by law
when there is no contract or agreement in place.
This supplemental
coverage does not apply to any part of the following types of contracts or
agreements.
o
The process of preparing, approving, or not
preparing or approving maps, drawings, opinions, reports, surveys, changes,
orders, designs, or specifications.
o
Providing directions or instructions, or failing to
do so, but only if this action or inaction is the main cause of injury or
damage.
Incidental Medical Malpractice Injury
Bodily injury
arising from providing or failing to provide the following medical-related
services is covered:
o
drugs
o
medical, dental, or surgical supplies or appliances
Example: Jessica is shopping at Simply Chic
when she starts to feel faint and mentions she might pass out. Patty, a
nursing student and part-time worker at Simply Chic, thinks Jessica might be
diabetic and gives her some orange juice. However, Jessica is allergic to
orange juice. This coverage will provide protection if Jessica sues Simply
Chic. |
This supplemental
coverage does not cover any of the following:
The insurance
company covers amounts the insured is legally liable for due to bodily injury
or property damage resulting from mobile equipment or any machinery and
attachments.
To be eligible for
coverage, the mobile equipment must be a land motor vehicle and meet at least
one of the following criteria. Additionally, the equipment must be permanently
attached to the vehicle.
NOTE: It can be used on public roads, but the main
point is that it must be primarily designed for off-road use.
o
cranes, shovels, loaders, diggers, or drills.
o
concrete mixers, excluding mix-in-transit.
o
graders, scrapers, rollers.
o
other road construction or road repair equipment.
If the equipment is
not self-propelled but primarily used to provide mobility to the following, it
must also be permanently attached to the vehicle.
This supplemental
coverage does not apply to self-propelled vehicles if any of the following
machinery and equipment are permanently attached.
NOTE: *The insurance company will cover bodily injury or property damage
arising from the operation of any of this equipment, but it does NOT cover
damage or injuries resulting from the vehicle's operation.
The insurance
company also provides liability, uninsured motorists, no-fault, or other
coverages mandated by motor vehicle insurance laws, including the coverage
limits specified by those laws.
NOTE: Providing uninsured motorist, no-fault, or other mandatory coverages
could be costly because this item does not specify a liability limit for those
coverages. The insurance carrier may be considering state minimums, while the
insured may be considering CGL occurrence limits.
Related Article: CA 20 15-Mobile Equipment
Payments under this
coverage are in addition to the Commercial Liability Limits. The insurer has
the right and obligation to defend any lawsuit seeking damages potentially
covered by this insurance.
The insurance
company has the right to conduct investigations and settle claims or lawsuits.
NOTE: The settlement decision is entirely at the discretion of the insurance
company.
The term “suit” in
this coverage is expanded to include arbitration or other alternative dispute
resolution processes involving bodily injury, property damage, personal injury,
or advertising injury, in which the named insured is required to participate or
is permitted to participate by the insurance carrier.
Once the insurance limit has been exhausted due to
a judgment or written settlement, this defense coverage is no longer provided.
Example: Piedmont Fireworks holds Commercial Liability
Coverage with a $1,000,000 General Aggregate Limit. During
a fireworks display on their premises, explosions caused property damage to
nearby buildings and injuries to several pedestrians. Each injured individual
and property owner filed separate claims for their losses due to the
explosion. The insurance company started settling with the injured parties. After paying $1,000,000, the policy
limit was exhausted, and the insurer no longer had an obligation to defend or
cover any remaining lawsuits. Therefore, Piedmont was responsible for
defending and paying all subsequent claims on its own. |
(Editorially added
wording from GL 0950 12 99 – Known Injury or Damage Amendments)
The insurance company is not obligated to defend
suits or claims for damages if a designated insured was aware of the bodily
injury or property damage before the policy inception date.
When the insurance company
defends a suit, it pays the following:
The insurance
company will not cover a loss if one or more of the excluded events listed
below occur. This remains true regardless of other causes or factors that may
contribute to or worsen the loss, whether these causes occur before, during, or
after the excluded event.
EXCLUSIONS APPLYING TO BODILY INJURY, PROPERTY DAMAGE, PERSONAL INJURY AND/OR ADVERTISING INJURY
NOTE: The Editors added titles to enhance clarity.
Coverage does not
apply to bodily injury, property damage, personal injury, or advertising injury
liabilities the insured assumed through a contract or agreement.
However, there are exceptions
to this exclusion as follows:
·
If a liability existed independent of a contract,
coverage applies.
Example: Preston Furs, LLC owns the building it
occupies, and it leases additional space in the building to Kevin’s Stamp and
Coin Shop. Kevin requires a written lease of the premises to ensure the
premises is safe and complies with all life and public safety regulations and
requirements. Because Preston Furs holds this obligation, even though it is
also included in the lease, coverage applies. |
·
This exclusion also does not apply to bodily injury
or property damage covered under the Contractual Liability Supplemental
Coverages. However, for such injuries or damages to be covered, they must occur
after the effective date of the covered contract or agreement.
There is no coverage
for bodily injury, property damage, personal injury, or advertising injury
arising out of the providing or failing to provide any professional service.
However, limited coverage is available under the Incidental Medical Malpractice
Injury Supplemental Coverage.
The insurance
company will not cover bodily injury, property damage, personal injury, or
advertising injury resulting from the use of mobile equipment in racing,
stunts, or similar contests. Additionally, this exclusion applies not only
during the event itself but also during practice and preparation for the event.
Coverage does not apply to bodily injury, property
damage, personal injury, or advertising injury associated with transporting
mobile equipment by a vehicle owned, operated, rented, or loaned to any
insured.
|
Example: Merle, an employee of Juniper Construction, uses a
company truck to transport a trailer with a skid steer to a job site. When
the trailer hitch breaks, the trailer overturns, and the skid steer ends up
in the path of multiple vehicles. This coverage form does not cover any
property damage or bodily injury for Juniper Construction. However, the
automobile liability policy covering the towing vehicle might provide
coverage. |
This
is a wide-ranging exclusion. It excludes coverage for bodily injury, property
damage, personal injury, or advertising injury arising out of not only the
ownership of auto, aircraft, watercraft, or mobile equipment but also their operation,
occupancy, renting, loaning, supervision, maintenance, use, entrusting, loading,
or unloading. Additionally, the coverage for the auto, aircraft, watercraft, or
mobile equipment is excluded if owned or operated by, or rented or loaned to,
any insured.
Example: Michael and Michelle, proud owners of
a sleek boat, decided to share their adventure by loaning it to Peter and
Jane. However, things took a turn for the worse when disaster struck—the boat
sank! In the chaos, Jane sustained injuries, but to Michael and Michelle’s
dismay, their Commercial General Liability (CGL) policy didn’t cover Jane's
injuries. |
However, there are exceptions to this exclusion
as follows:
Example: A modified pickup truck with
permanently installed well drilling equipment accidentally hits the side of a
building while maneuvering into position over a well, causing damage to the
building. The damage to the building is covered. |
Example: Gerald is announcing the opening of
his newest location with a large catered celebration. He asks employees Janet
and Max to handle valet parking. While parking a car, Janet accidentally
shifts it into reverse instead of park, pinning a guest between it and
another vehicle. Coverage applies in this situation. |
Example:
Pete charters an emergency flight to meet an important client, and the
charter company requires a hold-harmless agreement. |
Example: A pontoon boat is stored on the insured's property
during winter. The neighborhood children think it's fun to slide off the
ice-covered boat. When one is seriously injured and the insured is sued,
there is coverage. |
·
Coverage applies to watercraft not owned by the named
insured if it is less than 26 feet long and not used to carry either persons or property for a fee.
Example:
Power Dynamics rents a pontoon boat for an afternoon sales event and uses a
small grill to prepare appetizers. Unfortunately, the grill causes a fire. As
guests move away from the fire, the boat shifts, throwing several guests
overboard and causing injuries. Since the pontoon is less than 26 feet and is
non-owned, there is coverage for the injuries. |
This exclusion
applies only if the named insured is in the business of manufacturing,
distributing, selling, or servicing alcoholic beverages.
The insurance
company does not cover bodily injury, property damage, personal injury, or
advertising injury if any insured is found liable for these claims due to the
following reasons:
|
Examples: Scenario 1: The insured
is a medical supplies distributor hosting a Christmas party where alcoholic
beverages are served for free. Scenario 2: The owner of
a printing business takes a client out to lunch and pays for a bottle of wine
to accompany the meal. Both
scenarios are covered by liquor liability if an alcohol-related loss or
injury occurs to clients or guests. |
On
the other hand, consider this:
Example: Backinthewoods Liquor
Manufacturing, Inc. is sponsoring a fundraiser called "Casino
Night." The event features betting and gambling opportunities,
accompanied by food and alcoholic beverages available for a fee. However,
Backinthewoods has not obtained the necessary permits and licenses required
for this event. A patron who consumed alcoholic
beverages at the event was injured on the way home. Due to various state and
local statutes and ordinances, as well as the fact that the insured is in the
alcoholic beverage business, coverage for this situation does not apply. |
NOTE: An alternative way to address an
insured's liquor liability risk is by using a separate Liquor Liability Policy.
Related Article: CG 00 33 and
CG 00 34–Liquor Liability Coverage Forms Analysis
Related Court Cases:
Liquor Liability Exclusion Held
Applicable to Nonprofit VFW
Liquor Liability Suit Based on
Failure to Restrain Patron Did Not Circumvent Exclusion
(Editorially changed wording from GL 0163 01 08
– Exclusion – War and Military Action)
The following wording in the GL-200 is deleted.
Coverage does not apply to bodily injury,
property damage, personal injury, or advertising injury arising out of war. War
includes civil war, undeclared war, insurrection, revolution, rebellion, or any
act or condition of war.
The replacement wording from GL 0163 – Exclusion – War and
Military Action is analyzed as follows:
Loss
or damage from any of the following activities is specifically excluded:
a. War, encompassing civil
conflicts and undeclared hostilities.
b. Warlike action refers to any
aggressive activity carried out by a military force, including actions taken to
prevent or disrupt actual or anticipated wartime activities. Additionally, the
military force involved must be part of a government, a sovereign state, or
another authoritative body employing military personnel or agents.
NOTE: The last sentence of Paragraph b. is important because without it,
coverage for riot and civil commotion could be excluded.
Example: A group of cat
enthusiasts petitioned and received approval to hold a rally in the local
park to oppose a new law mandating license tags for cats. Some dog owners
were very upset, believing the law was unfair since they had already paid the
license fee. They petitioned for a counter-protest. Things quickly escalated, and
Millie’s Dog Parlor, situated right next to the park, became caught in the
chaos. A fight in the parking lot between a large Persian cat and a Chihuahua
resulted in several bystanders, who tried to break up the fight, getting
injured. These injured bystanders sued Millie. Since a military force must
be involved in the conflict for the war exclusion to apply, Millie had
coverage for the suits. |
c. War also encompasses
insurrection, rebellion, revolution, usurpation of power, or any actions by
governmental authorities intended to hinder or defend against any of the above
activities.
NOTE: There are
no exceptions to the War exclusion. All loss or damage related to war is
excluded.
Coverage does not apply if the insured
expected, directed, or intended the injury or damage. Additionally, there is no
coverage if the injury or damage results from an act by the insured that is
both intentional and malicious.
This exclusion protects the insurance company
from covering intentional damages or injuries caused by an insured. It serves
the public interest by ensuring the insured does not misuse the insurance
policy for personal gain, such as theft, harming competitors, seeking revenge,
or pursuing other selfish or self-serving purposes.
Related Court Case: Intentional
Damage Exclusion Barred Claims against Liability Insurer of Store Owner
However,
there is an exception for bodily injury. If the insured causes bodily injury
while protecting persons or property, coverage applies, provided the force used
is considered reasonable.
|
Example: Oscar
hears a strange sound outside his store and goes out the back door to
investigate. Scenario 1: He
notices three young men trying to open his basement window. He warns them by
firing a shot over their heads before calling 911. The shot hits a nearby
pedestrian, but although it was intentional, it was not malicious and was
meant to defend his property, so it is covered. Scenario 2: He
notices three young men passing by his basement window and fires his shotgun
at them, hitting one. Since there was no reason to defend the property, this
deliberate act would not be covered if the injured man sues. |
Coverage is not applicable to bodily injury or
property damage for products/completed operations hazard. However, an exception
is provided under Coverage N, which offers specific protections for
Products/Completed Work Hazard.
This prevents duplicate coverage under Coverage
L – Bodily Injury/Property Damage and Coverage N – Products/Completed Work.
Coverage does not apply to bodily injury or
property damage arising out of the actual, alleged, or threatened discharge,
dispersal, seepage, migration, release, or escape of pollutants from any of the
following:
However, there is an exception:
NOTE: Pollution from
friendly fire is still excluded.
|
Example: The Jones family lives in an apartment building as
tenants. A fire breaks out in a neighboring unit, causing the family to
become ill from the smoke and fumes. They develop serious, long-term health
problems as a result. The family decides to sue their landlord. The landlord’s commercial liability
coverage includes protection for bodily injuries sustained by the family, as
these injuries resulted from a hostile fire in the apartment building.
Additionally, the family claims the smoke caused the deaths of their pet dog
and cat. These losses may be covered under property damage, as pets are
considered property. |
NOTE: The hostile fire
exception does not apply in this case.
NOTE: There is no exception
to this section.
However, this part of
the exclusion applies only under the following circumstances:
o
Pollutants
brought onto the premises, site, or location as part of the work performed by
the insured, but there is an exception.
› If
injury or damage is due to a fire's heat, smoke, or fumes becoming
uncontrollable or escaping from the container in which it was meant to be
confined, coverage is provided. This type of fire is commonly known as hostile
fire.
o
The
work involves testing, monitoring, cleanup, removal, containment, treatment,
detoxification, neutralization, or any response to or assessment of pollutant
effects.
The insurance company will not cover any loss,
cost, or expense caused by, resulting from, or arising out of either of the
following:
·
Any
manner of response to or evaluation of the effects of pollutants.
·
Any
lawsuit or claim by a government authority related to responding to or
assessing the effects of pollutants.
Pollutants are defined in this exclusion as
follows:
·
Any
solid, liquid, gaseous, thermal, or radioactive irritant or contaminant.
·
Acids,
alkalis, chemicals, fumes, smoke, soot, vapor, and waste.
·
Waste
not only includes items to be disposed of but also encompasses those to be
recycled, reclaimed, or reconditioned.
·
Electrical
or magnetic emissions, whether visible or not, and sound emissions.
Related Court Cases:
Contaminant Clarified With Respect to
Application of Pollution Exclusion
Environmental Cleanup Costs Held Not
Covered by CGL Insurance
Coverage does not apply to bodily injury or
personal injury to an employee of the insured if the injury occurs during
employment by the insured. Additionally, coverage does not apply to
consequential injuries to a spouse, child, parent, brother, or sister related
to the injury of an employee.
This exclusion applies regardless of whether
the insured is liable because of their role as an employer or any other
relationship. If a third party pays and then seeks recovery against the insured
for an injury to the insured’s employee, there is still no coverage.
The only exception to this exclusion is if the
insured assumed liability under a contract covered in Contractual Liability
Supplemental Coverage.
NOTE: The purpose of this
exclusion is to prevent duplicate coverage for injuries that should be covered
by employers liability insurance. The exclusion of work-related injuries
applies regardless of the reason for which the insured might be held liable.
Liability applies regardless of whether it
arises from direct employment, indirect employment, or a contract. All bodily
injuries and personal injuries related to an insured’s work are excluded. This
is especially important to understand due to the widespread use of contractors,
subcontractors, independent contractors, or leased employees, as well as the
uncertainty about who is responsible for such workers.
It
is important to be cautious in monopolistic states where workers compensation
is provided or required, but coverage for the Employer’s Liability is not
necessarily required, available, or needed. This discrepancy can create a
significant gap in coverage for the insured. Many insurance companies in these
states offer their own endorsements to add Employer’s Liability coverage to the
commercial liability policy.
Example:
Lizzie works at the Greater Cake Emporium. While taking a break and admiring
one of the newest multi-tiered cakes, the bottom holder unexpectedly breaks,
causing the cake to fall and severely injure her wrist. Lizzie believes the
injury resulted from Greater Cake using the cheapest possible holders. She
files a lawsuit against Greater Cake as a retailer, not as her employer.
However, there is no coverage for the lawsuit due to the employee exclusion. |
Coverage
does not apply to bodily injury or personal injury when the insured either does
or should provide benefits under laws such as workers compensation, disability
benefits, occupational disease, and unemployment compensation. The purpose of
this exclusion is to prevent duplicate coverage for injuries that should be
provided under workers compensation and other mandatory types of insurance
policies.
|
Example: John’s Roofing has no direct employees. Instead,
it uses independent contractors who work exclusively for John’s Roofing, wear
clothing required by John’s Roofing, use its tools, and follow the schedule
provided by John’s Roofing. When
one of the independent contractors falls off a roof and injures himself, he
files a benefit claim with the workers compensation board. The board rules
all of John’s Roofing’s independent contractors are actually employees. John
is then required to compensate the injured worker and pay a fine for failing
to maintain workers compensation coverage. The commercial general liability policy
will not cover this because of the exclusion. |
Coverage does not apply to bodily injury or
personal injury arising out of any employment-related practices, including such
activities as policies, actions, or omissions. Examples of such practices are as
follows:
·
refusal
to employ
·
termination
of employment
·
coercion
·
demotion
·
evaluation
·
reassignment
·
discipline
·
defamation
·
harassment
·
humiliation
·
discrimination
·
sexual
misconduct
·
consequential
injury resulting from any of the above
This exclusion applies if the insured is liable
as an employer, in any other capacity, or must reimburse a third party fully or
partially for damages resulting from any of the above. It clarifies that liability
is not limited to just being an employer.
Related Article: Overview of the
ISO Employment-Related Practices Liability Program
Related Court Case: Termination of
Employee Was Not a Covered Occurrence
NOTE: Editors added number 14 for clarity.
This is a Mandatory Amendment to
the GL 200 Edition 1.0.
Editor's
Note: This is editorially added wording from GL 1353 09 14 – Exclusion
– Data Breach Liability.
Any
expenses resulting from one of the following, related to either of the above,
are also excluded:
NOTE: Editors added number 15 for clarity.
This is a Mandatory Amendment to
the GL 200 Edition 1.0.
Editor's Note: This is editorially added wording
from GL 1022 09 09 – Information Distribution and Recording Violations
Exclusion.
There is no coverage for property
damage, bodily injury, personal injury, or advertising injury from actual or
alleged direct or indirect violations of any of the following:
o Recording
o Printing
o Collecting
o Transmitting
o Communicating
o Sending
o Disposing
o Distributing
·
Amendments to any of the above acts,
as well as any similar federal, state, or local laws or regulations, are also
excluded.
NOTE: Editors added number 16 for clarity.
This is a Mandatory Amendment to
the GL 200 Edition 1.0.
Editor's Note: This is editorially added wording from GL 890 – 2.0 – Lead
Liability Exclusion.
There is no coverage
for the following:
o
Any type of response to
or assessment of the effects of lead.
o
Any lawsuit or claim
from the government or on behalf of any government related to any response to
or assessment of the effects of lead.
ADDITIONAL EXCLUSIONS APPLYING ONLY TO PERSONAL INJURY AND/OR ADVERTISING INJURY
NOTE: The Editors added titles to enhance clarity.
There
is no coverage for personal injury or advertising injury if the insured intentionally
violates an ordinance, law, regulation, or statute. Additionally, there is no
coverage if someone other than the insured violates the regulation with the
insured’s consent.
Example: Joiner, Inc. has secured a restraining
order preventing John Smith, a persistent salesman, from entering its
premises. However, John’s supervisors want him to continue approaching Joiner
employees. If John is caught on the premises and his employers are sued,
there is no coverage for either John or his employers because they are in
violation of the court order. |
There is no coverage for personal injury or
advertising injury when known false material is published (oral or written) by
or at the direction of the insured. Coverage also does not apply when the
offense is based on any material published by any party prior to the policy
period.
Coverage
excludes advertising injury caused by a breach of contract. However, it covers
cases where an advertising idea is misappropriated through an implied contract.
Example: Jerry submitted a suggestion for an
advertising campaign to Make My Day Enterprises. In response, the company
sent him a letter thanking him for his idea. Three years later, Jerry noticed
their ad campaign closely resembled his original suggestion. Based on the
letter he received, he believed there was a binding agreement, so he decided
to sue them for breach of contract. Since the contract was only implied,
there is coverage for the suit. |
Coverage does not apply to advertising injury
when the goods or services fail to meet the advertised quality or performance
standards.
Coverage does not apply to advertising injury
when the insured’s business operation is publishing, advertising, telecasting,
or broadcasting.
Coverage does not apply if an advertising
injury arises from inaccurate price descriptions of the insured's goods,
products, or services in an advertisement.
This is an absolute pollution exclusion. Coverage
does not apply to any personal injury or advertising injury arising out of the
actual, alleged, or threatened discharge, dispersal, seepage, migration,
release, or escape of pollutants at any time.
The insurance company does not pay any loss,
cost, or expense caused by, resulting from, or arising out of either of the
following:
·
Any
manner of response to or evaluation of the effects of pollutants.
·
Any
governmental authority, or on behalf of it, involving lawsuits or claims
related to responding to or assessing the effects of pollutants.
Pollutants are defined in this exclusion as any
of the following:
·
Solid,
liquid, gaseous, thermal, or radioactive irritant or contaminant.
·
Acids,
alkalis, chemicals, fumes, smoke, soot, vapor, or waste.
o
Waste
includes items to be recycled, reclaimed, or reconditioned.
·
Electrical
or magnetic emissions, regardless of whether they are visible.
·
Sound
emissions.
NOTE: Due to specific language in earlier
versions of personal injury and advertising injury liability forms, there have
been efforts to include coverage for pollution-related losses by labeling them
as trespass, wrongful entry, or invasion of private occupancy rights. However,
the personal or advertising injury coverage was never meant to cover pollution
damages or cleanup expenses. This exclusion confirms no coverage is provided
for any pollution exposure arising from the personal and advertising injury provisions
in the policy.
ADDITIONAL EXCLUSIONS APPLYING ONLY TO PROPERTY DAMAGE
NOTE: The Editors added titles to enhance clarity.
Coverage does not apply to property owned or occupied
by or rented to the named insured unless it is covered under Coverage O–Fire
Legal Liability.
Coverage does not apply to property damage for premises
sold, given away, or abandoned by the named insured if the property damage
arises out of any part of those premises. However, this exclusion does not
apply to premises related to the named insured's work that were never occupied,
rented, or held for rent by the insured.
NOTE: This exclusion is especially relevant to
homebuilders. Prior to adding this exception, homebuilders lacked coverage for
buildings they constructed and sold. However, they should understand that once
a building is put into use—like a model home with an office or as a rental—the
exception no longer applies.
Coverage does not apply to property damaged
when the property is used by or loaned to the named insured. However, this
exclusion does not apply to any liability assumed under a sidetrack agreement.
NOTE: A sidetrack agreement is between a
property owner and a railroad company regarding a railroad sidetrack on the
insured's premises. A sidetrack is a transfer or access track. The railroad
company permits the property owner to use the sidetrack if the owner guarantees
access by the railroad and agrees to certain maintenance conditions. A mutual
hold-harmless agreement between the railroad and the property owner may also be
required.
Coverage does not apply to property damage for any
type of personal property while in the insured's care, custody, or control. However,
this exclusion does not apply to any liability assumed under a sidetrack
agreement.
NOTE: While the commercial liability coverage form does not include an
endorsement for property in the insured's care, custody, or control, many
insurance companies have developed their own forms or endorsements to address
this gap. Additionally, Inland Marine Bailees insurance is available, covering
the property of customers or clients under the insured's care, custody, or
control.
Various versions of
this coverage are offered through organizations such as the American
Association of Insurance Services (AAIS) and the Insurance Services Office
(ISO), or through specific endorsements developed and filed by individual
insurance companies, depending on the insured’s operational needs.
Related Articles:
AAIS Bailee Customers Floater
Coverage–Dry Cleaners And Laundry Form Coverage Analysis
ISO Bailees Customers Coverage Form
Analysis
Coverage
does not apply to property damage to the specific part of real property being
worked on if the damage results from that work. This exclusion applies whether
the work is performed by the named insured or a contractor or subcontractor
acting directly or indirectly on behalf of the insured. However, this exclusion
does not apply to liability assumed under a railroad sidetrack agreement.
Example:
Sally hired Fred to install a skylight in her roof.
While he was cutting the opening for the skylight, Fred accidentally nicked a
water line. He finished the installation and received payment. However, Fred
was surprised to receive a lawsuit claiming he caused a major leak in the
piping, which led to water and mold damage to the roof, insulation, ceiling,
and walls. Although there would be no coverage for damage to the roof or
skylight, coverage would apply to all the damage because the only item Fred
damaged was the piping, which was not part of the real property he was
working on. |
Coverage
does not apply to property damage affecting a specific part of any property
requiring restoration, replacement, or repair due to errors in the insured’s
work. However, this exclusion does not apply to property damage when it is
covered by the products/completed work hazards, as well as liability assumed
under a sidetrack agreement.
Example: Fred damaged the piping in the example
above, which must be repaired due to his mistake. As a result, the repair and
replacement of the piping is not covered under the policy because of this
exclusion. |
Related Court Case: Property
Damage Exclusion Held Applicable To Entire Renovation
Area
Coverage
does not apply to property damage to the named insured’s products when the
damage arises from the products themselves or their parts.
Example: Green Furnace and Design manufactures gas
furnaces. One of their installed furnaces malfunctioned and caught fire.
There is no coverage for the furnace itself, but there is coverage for the
damage it causes. |
Coverage
does not apply to property damage to the named insured's work if the damage
arises from that work and the work is considered a products/completed work
hazard. However, this exclusion does not apply if the property damage arises
from work by a subcontractor working on behalf of the named insured.
Example: Gene’s Builders handles electrical
wiring repairs in buildings. If the wiring overheats and needs replacement,
there is no coverage. However, if a subcontractor performs the wiring repair
for Gene’s Builders, coverage applies for the benefit of Gene’s Builders but
not the subcontractor. |
Related Court Cases:
Work Project Exclusion Held
Applicable To Control of Project by Construction Manager, in Court Cases
NOTE: Property damage includes loss of use of property. Coverage for loss of
use can apply even in the absence of tangible damage. This exclusion applies to
such situations.
This policy does not cover specific situations
where loss of use property damage occurs.
However,
this exclusion does not apply to property damage of products already in use for
their intended purpose, when the loss of use of other property results from
sudden physical injury or destruction of the insured’s product or work.
Example: Jerry was hired to install an entry
system at Sally’s store. Scenario 1: Jerry installed the locking mechanism
but did not provide Sally with the combination before leaving for his
vacation. As a result, Sally was unable to access her store for a week. This
loss of use property damage is not covered since Jerry failed to fulfill his
contractual obligations. Scenario 2: Jerry installed the locking mechanism
and gave Sally the lock's combination. She was able to open the lock
successfully at first, but it short-circuited on the second try, making it
unusable. Jerry had to order replacement parts to fix the problem, which
prevented Sally from accessing her store for a week. This loss of use
property damage is covered since it was sudden, accidental, and occurred
after the work was completed. |
Additionally,
expenses related to product recall or withdrawal are also excluded. These costs
include loss of use, disposal, withdrawal, recall, inspection, repair,
replacement, adjustment, or removal of the insured's work, products, or
impaired property. This exclusion applies even if the loss results from a known
or suspected defect, deficiency, or unsafe condition.
Example: Continuing with the previous example,
because of the issue with Sally’s entry system, Jerry believes he must notify
his other customers using that device. He schedules visits to all of them to
replace the faulty mechanism. His insurance company will not reimburse him
for his work, but his customers are very pleased with his proactive approach
to their security. |
ADDITIONAL EXCLUSIONS APPLYING ONLY TO MEDICAL PAYMENTS
The following medical payment exclusions apply
in addition to the bodily injury exclusions.
NOTE: The Editors added titles to enhance clarity.
Coverage
for bodily injury does not apply to the medical expenses of an insured.
Example:
Jim Maxwell, of Maxwell and Maxwell, slips and falls on ice on the front
steps of the building he owns and needs X-rays to determine the extent of his
injuries. The X-ray expenses are not covered by Maxwell and Maxwell’s policy. |
Coverage
excludes medical expenses for bodily injury to anyone hired by or on behalf of
an insured to do work for either the insured or a tenant of the insured.
Example:
A painter hired by the insured to paint the building falls from a ladder and
injures his wrist. This incident is not covered under medical payments loss. |
Coverage
does not include medical expenses for bodily injury to individuals injured on
the insured's premises if that person normally occupies that specific part of
the premises.
Example:
A tenant in the insured's building falls down the
stairs in their own apartment and sustains an injury. The policy does not
cover their injuries or medical costs in this case. However, if the same
tenant falls in a different apartment building nearby, coverage would apply. |
Coverage
excludes medical expenses for bodily injury sustained by a person during
athletic activities.
Example: The
insured permits a little league team to practice on their premises, but when
a girl injures her leg while sliding into third base, medical payments
coverage will not cover her medical expenses. |
Coverage
excludes medical payments for bodily injury covered under the
products/completed work hazard.
Example: An appliance made by the insured
catches fire due to faulty wiring and burns the purchaser's fingers at their
home. Medical payments coverage does not cover his injuries or expenses. |
Coverage does not apply for medical expenses
when the named insured is a club and bodily injury occurs to its members.
Coverage does not apply for medical expenses
related to bodily injury sustained by guests at a hotel, motel, or tourist
court owned or operated by the named insured.
If a person qualifies for benefits under
workers compensation, non-occupational disability, occupational disease, or
similar laws, there is no coverage for medical payments.
NOTE: This exclusion applies
even if the insured is not the party required to provide the benefits.
Example: Mike is carrying a supply of beer into Luke’s
liquor store when he slips on ice outside the entrance. Since Mike is
eligible for workers compensation from his employer, Luke’s medical payments
will not cover the injury. |
Coverage does not apply to medical expenses for
bodily injury to:
·
A
student or camper participating in a program operated by or on behalf of the
named insured.
·
A
patient or inmate who receives treatment or is held at a facility owned or
operated by or on behalf of the named insured.
o
Name of the insured and policy number.
o
Time, place, and circumstances of the loss, event,
or situation suggesting a claim may be imminent.
o
Names and addresses of all potential claimants and
witnesses known to the insured.
Any insured involved
in an occurrence or offense must cooperate with the insurance company and
comply with all requirements, as outlined in this coverage form.
Volunteer payments and obligations can be made by an insured, but only at
its own expense. However, this exclusion does not apply to expenses incurred
for providing first aid to others at the time of an injury.
If a claim is made
or legal action is brought, the insured must promptly provide the insurance
company with all of the following:
·
copies of all legal papers
·
demands
·
notices
The insured must
also take the following actions if requested by the insurance company:
·
Assist it in settlements.
·
Assist in the conduct of lawsuits, including attending
trials or hearings.
·
Enforce its rights against any parties that might
be liable to the insured for the injury or damage.
·
Assist the insurance company in gathering and
providing evidence.
·
Securing the attendance of all witnesses.
NOTE: Remember, assistance to
the insurance company is only required when requested. It is not the insured's
responsibility to act on their own, as such actions could hinder the insurance
company.
If a medical payment
loss occurs, the injured person or the person acting on behalf of the injured
person must provide the following:
·
Provide the insurance company with written proof of
the claim as soon as possible.
·
If required, provide a statement under oath.
·
Provide the insurance company with permission to
obtain copies of medical records.
·
Agree to medical examinations by a doctor chosen by
the insurance company.
o
More than one examination may be required, but the
number and the type of examination must be reasonable.
NOTE: Enforcing these obligations could be challenging since the injured party
is not a signatory to this contract. However, failure by the injured party to
fulfill these obligations might result in denial of coverage under medical
payments coverage.
NOTE: The Editors added titles to enhance clarity.
1. Maximum Amount Paid
The limits of insurance shown on the
declarations represent the maximum amount the insurance company will pay,
regardless of the number of insureds, persons, or organizations sustaining
injury or damage, the number of claims made, or the number of suits brought.
Any claim paid under
medical payments coverage does not constitute an acknowledgment or admission of
liability under any other coverage.
2. Per Policy Term – General Aggregate Limit
The general aggregate limit is the maximum amount
the insurance company will pay for all damages during the policy period. This
includes total damages for bodily injury and property damage, all medical
expenses under medical payments, all damages for fire legal liability, and all
damages for personal injury and advertising injury liability coverages.
However, it does not include damages related to bodily injury or property
damage under the products/completed operations hazard.
Example: Growing Strong, Inc. has a commercial
liability policy with a $2,000,000 general aggregate limit. During one policy
period, there was a covered premises loss of $1,000,000, as well as two
covered personal injury and advertising injury losses of $1,000,000 each,
totaling $3,000,000. The most the insurance company will pay is the
$2,000,000 general aggregate limit. |
3. Products/Completed Work Hazard Aggregate Limit
The aggregate limit for the products/completed work
hazard is the maximum amount the insurance company will pay during a policy
period for damages due to bodily injury or property damage covered under
Coverage N – Products/Completed Work liability.
Example: Microfilament, LLC holds a commercial
liability policy with a $3,000,000 products/completed work aggregate limit.
During one policy period, eight separate claims for covered products occur.
The total of all eight payments amounts to $4,000,000. The $3,000,000
aggregate limit for products/completed work is the maximum the insurance
company will pay. |
4. Each Occurrence Limit
The limit for each
occurrence is the maximum amount the insurance company will pay for damages
covered under Coverage L – Bodily Injury/Property Damage, Coverage N –
Products/Completed Work, Coverage O – Fire Legal Liability, and Coverage M –
Medical Payments in a single occurrence.
NOTE: This limit is
subject to the general aggregate limit and the products/completed work hazard
aggregate limit.
Example:
Marmy Associates is a manufacturer carrying a
commercial liability policy with an occurrence limit of $1,000,000. While a
tour group is visiting the premises, an explosion occurs, resulting in
injuries to 25 members of the group. The total claims amount to nearly
$5,000,000. Since this incident is a single occurrence, the insurance policy
will cover a maximum of $1,000,000. Consequently, Marmy Associates is
responsible for covering the remaining $4,000,000 in claims using its own
financial resources. |
5. Personal and Advertising Injury Liability Limit
The limit for
Coverage P – Personal Injury/Advertising Injury liability represents the
maximum amount the insurance company will pay for personal injury or
advertising injury sustained by an individual or organization. This limit is
also subject to the policy's General Aggregate Limit.
6. Fire Legal Liability
Coverage O – Fire
Legal Liability has a limit of $50,000 per occurrence. This limit can be
increased, but is subject to both the Each Occurrence and General Aggregate
Limits.
7. Medical Payments
The limit for Coverage M – Medical Payments is the
maximum amount the insurance company will pay for all covered medical expenses
incurred by a single person. This limit is subject to both the Each Occurrence
and General Aggregate Limits.
|
Example: Piddlewink, Inc. has a commercial liability policy
with a $5,000 medical expense limit per person. The day after a snowstorm
dumps 5 inches of snow and ice on Piddlewink’s parking lot and sidewalks, 15
people suffer injuries falling on the slippery walk and parking lot. Since the medical expense limit is
applied on a per-person basis, each injured customer has up to $5,000
available to cover their medical expenses. |
8. General and Products/Completed Work Hazard Aggregate Limits
The General Aggregate Limit and the
Products/Completed Work Hazard Aggregate Limit are treated separately for each
consecutive 12-month period indicated on the declarations. These limits also
apply to any remaining policy period shorter than 12 months, unless the
commercial liability coverage is extended after the coverage inception date. If
coverage is extended after the inception date, the extended period is treated
as part of the most recent prior period when determining limits.
Example: Bottia
Limited’s policy was issued with effective dates from January 1 to January 1.
At renewal, Bottia wants to change the policy expiration date to align its
insurance with its accounting period. Scenario 1: Bottia requests the policy expiration
date be extended to July 1. The policy aggregates apply to the first annual
12-month policy period from January 1 to January 1. The renewal aggregate
period starts on January 1 and extends for 18 months to July 1. Scenario 2: Bottia requests a short-term policy be
issued from January 1 to July 1, followed by an annual policy from July 1 to
July 1. She will have an aggregate for the initial policy period, a second
aggregate for the January to July short-term policy, and another aggregate
for the July to July policy. |
If an insured
becomes bankrupt or insolvent, the insurance company must continue to fulfill
all its commitments under this policy. It remains responsible for all duties,
responsibilities, and obligations.
2. Insurance
under More Than One Policy
This condition
applies to all coverages except Coverage M – Medical payments.
o
If the other insurance is contributed by equal
share, the insurance company will pay equally with the other insurer(s) until
the lowest limit applying to one policy is reached or the loss is paid in full.
If part of the loss remains unpaid, the insurance
company will contribute an equal share with other insurers until the total
payout equals the full amount or the insurance company reaches its maximum
insurance limit.
Example: Originality Inc. carries three primary commercial
liability policies as follows: ·
Policy A has a
$50,000 limit for each occurrence. ·
Policy B has a
$150,000 limit for each occurrence. ·
Policy C has a
$1,000,000 limit for each occurrence. Originality
Inc. is liable for a loss and is ordered to pay $500,000. Their policies are
based on equal shares, resulting in each of the three policies contributing equally
to the loss as follows: Step
1: Each company contributes $50,000,
totaling $150,000 of the $500,000 needed. NOTE: Once the limits of Policy A are exhausted, it no
longer contributes to the loss. Step
2: Policy B and Policy C then each
contribute an additional $100,000, bringing their combined contribution to
$200,000. NOTE: At this point, the coverage provided by Policy B
is fully exhausted, so it will no longer contribute to the loss. Step
3: The remaining $200,000 must then be
paid by Policy C to make the total of $500,000. The resulting equal contributions for Policy
A is $50,000, Policy B is $150,000, and Policy C is $300,000. |
o
If the other insurance is not considered a
contribution by equal share, the insurance company will pay up to the full
limit of coverage, but no more than the proportionate part of the loss for the
applicable policy limit, which is the total limit applicable for all insurance
covering the loss.
o
If the other insurance does not require equal
contribution shares, the insurance company pays proportionally. This means each
primary insurer pays the part of the loss that corresponds to the proportion of
its limit relative to the total primary limits carried.
Example: Originality Inc. carries three primary commercial
liability policies as follows: ·
Policy A has a
$50,000 limit per occurrence. ·
Policy B has a
$150,000 limit per occurrence. ·
Policy C has a
$1,000,000 limit per occurrence. Originality
Inc. is liable for a loss and ordered to pay $500,000. However, this time their
policies are based on proportional shares rather than equal shares, resulting
in a total limit of $1,200,000 available to pay the claim. ·
Company A has
50,000/1,200,000 of the obligation or 4.2% of the loss. ·
Company B has
150,000/1,200,000 of the obligation or 12.5% of the loss. ·
Company C has 1,000,000/1,200,000
of the obligation or 83.3% of the loss. The
resulting proportional shares for the loss are as follows: ·
Company A pays $21,000 ·
Company B pays
$62,500 ·
Company C pays $416,500 |
Editor's Note: The
following is editorially replaced wording from the GL 1020 09 09 – Other
Insurance Amendment.
This is an amendment to the GL
200 Edition 1.0 - Mandatory Endorsement and has been incorporated here. It
pertains to item 2.c. of the policy Conditions section, which addresses excess
insurance coverage in relation to other policies. The original policy language
has been replaced with the following:
The Commercial Liability Coverage under this
policy will be excess over any other insurance in the following
circumstances:
·
Regardless of whether the other insurance is
primary, excess, contingent, or on any other basis, if the insured has other
insurance providing the following coverage:
o
Fire, extended coverage, builder’s risk
installation risk, or any similar coverage for the insured’s work.
o
Fire insurance for premises rented to the insured.
·
Any
loss arising out of the maintenance or use of aircraft, automobiles, or
watercraft insured under this policy.
·
When
the insured has other primary insurance available that covers liability related
to the premises, operations, completed work, or products, and the insured is
named as an additional insured through a policy endorsement.
Example: T&R Contracting maintains a commercial
liability policy for its contracting business. They are building a home for
Pam and John, who purchased a builder's risk policy for the project.
Initially, the project's value was estimated at $500,000. However, after
several client-requested modifications, the estimated value of the unfinished
building has risen to $750,000, yet the builder's risk policy has not been
adjusted accordingly. T&R keeps a salamander heater
running overnight, which causes an explosion, destroying the building. At the
time of the incident, the building's value was $650,000. The builder's risk
policy is primary and covers $500,000. The commercial liability policy then
pays the remaining $150,000. |
We
have now returned to the GL 200 1.0 Edition of the policy under Conditions 2.d.
·
When this insurance is considered excess over any
other insurance applicable to a loss, the insurance company is not obligated to
defend any claims or legal proceedings for which another insurer is
responsible. However, if no other insurer provides a defense, this insurance
company may choose to do so, but only after securing the insured's rights
against the other insurer.
The insurance
company pays its share of any loss that exceeds the total amount that should
have been covered by all other insurance, including all deductibles and
self-insured amounts required by the other insurance. It will also share in the
remaining loss with any other insurance not described in this provision and not
specifically purchased to act as excess coverage over the limits stated in the
declaration.
3. Misrepresentation, Concealment, or Fraud
All coverage under
this policy becomes void for all insureds if any
insured intentionally hides or distorts a material fact related to the
insurance or its subject. It is also void if an insured's interest is
misrepresented or concealed. Additionally, coverage is void if any insured
commits false swearing or fraud concerning the insurance or the subject of the
insurance.
NOTE: This condition clarifies when the named
insured accepts the policy, they confirm the declaration information is
accurate and complete. They also affirm the policy is based on the
representations made in the application, which the insurance company relied
upon when issuing the policy. Additionally, it is crucial to understand that
policy voidance can result not only from the named insured’s fraud but also
from fraud committed by other insureds.
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4. Motor Vehicle Financial Responsibility Certification
When this insurance
is presented as proof of financial responsibility under any motor vehicle law,
it will meet the law's requirements for both coverage and limits regarding
bodily injury liability and property damage liability.
NOTE: Using a CGL for motor vehicle coverage can be
quite difficult. It's better to provide this coverage through an automobile
policy that clearly states the coverage and limits. Misunderstandings about
coverage and limits can be very costly.
Example: Jerry,
the named insured, is riding his snowmobile on his property when he is hit.
He is later found by an employee who did not see the accident. Jerry files a
claim with his CGL carrier for uninsured motorist coverage because, although
tire tracks indicate he was struck by a vehicle, it was a hit-and-run
incident involving an unidentified person. Jerry’s injuries are serious, so
he is requesting the full CGL occurrence limits, but the CGL carrier is
offering only the minimum limits. |
When the premium
listed on the declarations is considered a deposit premium, the insurance
company anticipates a change in the final premium. The actual earned premium is
determined at the end of the audit period, as reflected on the declarations.
If the earned
premium exceeds the deposit premium, the insurer bills the named insured for
the difference. However, if the earned premium is lower than the deposit
premium, the insurer refunds the overpayment to the insured.
The named insured is
responsible for maintaining records of the information necessary to calculate
the premium and submitting this data to the insurance company at the end of the
audit period or when requested by the insurance company.
NOTE: It’s essential for the insured to provide the most accurate exposure information
possible to avoid large fluctuations up or down. Additionally, it’s important
for the insured to supply the necessary information for their audit. Often, the
premium audit department will add a 25% increase in exposure if the insured
fails to provide the requested audit information.
The coverage applies
to each insured individually in the event of a claim or lawsuit. However, this
does not change or increase the limits outlined in the How Much We Pay section
of the form. Essentially, aside from the specified limits, coverage is treated
as if each insured is the only one covered, with separate coverage for each
insured against whom a claim or lawsuit is filed.
If the insurance
company pays under this coverage, the insurer may require the insured to
relinquish all rights to recover from another party. However, these rights are
limited to those related only to the loss paid. If the insured impairs or
otherwise hinders the insurance company’s ability to exercise these rights, the
insurer is not required to make any payments for the loss. A key exception is
that the insured may waive their recovery rights against a third party in
writing prior to the occurrence of a loss or incident.
NOTE:
The subrogation transfer right is automatically
granted upon payment. If the insured wishes to retain this right or prefers the
insurance company not to use it, they should refuse the payment. The insured may
also need to assist in filing a lawsuit, transferring these rights, or helping
to enforce them, which may not be what the insured prefers to do.
Example: The side door at McDuff’s was left propped open.
This allowed someone to enter unnoticed, attack a customer, and then leave.
The customer sues McDuff’s for trauma, and Friendly Insurance Company covers
the claim. During the investigation, it was found that Nancy, a family
friend, had propped the door open while making a delivery and had forgotten
to remove the prop. Friendly then sues Nancy for
negligence. McDuff’s states it will not help in this lawsuit since Nancy is a
family friend. Friendly warns McDuff’s if it does not assist, it will be
required to reimburse Friendly for the expenses incurred in investigating and
settling the claim. |
The insurance
company can be sued, but only after certain requirements are satisfied. First,
all terms and conditions of the coverage form must be fulfilled. Second, the
liability amount must be determined either by a final judgment against the
insured in a trial or by a written agreement between the insured, the party
filing the claim, and the insurance company.
No party is
authorized to join the insurance company in any legal actions or designate it
as a defendant in proceedings to establish an insured's liability.
NOTE: While the
insurance company may be sued to recover an agreed-upon settlement or final
judgment against an insured, it is not liable for damages if the insured has
not satisfied the policy's conditions and terms.
9. Knowledge or Bodily Injury or
Property Damage
NOTE: Editors
added number 9 for clarity.
This is a Mandatory Amendment to
the GL 200 Edition 1.0.
Editor's Note: This is
editorially added wording from GL 0950 12 99 – Known Injury or Damage
Amendments.
It is essential
to know exactly when an insured is considered to be aware of bodily injury and
property damage, since the timing of such awareness determines which policy
responds to a loss. Coverage under this policy does not include any bodily
injury or property damage loss that occurred and was known by a designated
insured to have occurred before the policy period. A loss is considered known
at the earliest of the following:
a. When the insured
is also an insured under a Nuclear Energy Liability policy issued by Nuclear
Energy Liability Insurance Association, Mutual Insurance Association, Mutual
Atomic Energy Liability Underwriters, Nuclear Insurance Association of Canada,
or any of their successors. This exclusion applies if coverage would be
available under any such policy, except it has been terminated due to its
limits being exhausted.
b. When resulting from
the dangerous nature of nuclear material concerning any person or organization
required to maintain financial coverage, as described in the Atomic Energy Act
of 1954. As well as, when resulting from the hazardous nature of nuclear
material, the insured would, without this policy, be entitled to indemnity from
the United States of America due to agreements between the United States of
America and any person or organization.
2. Coverage does not
apply to M–Medical Payments for bodily injury resulting from the hazardous
properties of nuclear material or injuries resulting from a nuclear facility
operated by any person or organization.
3. Coverage does not
apply to bodily injury or property damage resulting from the hazardous
properties of nuclear material if:
a. Nuclear material
is considered to be at a nuclear facility owned or operated by an insured, or
managed on its behalf, if the material was discharged or dispensed from that
facility.
b. Nuclear material
is contained within spent fuel or waste, and at any point, it may be possessed,
handled, used, stored, processed, transported, or disposed of by an insured or
others acting on their behalf.
c. Bodily injury or
property damage arising from an insured providing services, materials, parts,
or equipment involved in planning, constructing, maintaining, operating, or
using any nuclear facility. If the facility is within the United States, its
territories, possessions, or Canada, this exclusion applies only to property
damage to that specific nuclear facility and property at that site.
The following definitions apply only
to this Nuclear Energy Liability Exclusion:
This includes, but is not limited to, radioactive,
toxic, or explosive properties.
This is source material, special
nuclear material, or by-product material, which are defined terms as outlined
in the Atomic Energy Act of 1954.
These terms have the meanings assigned
to them by the Atomic Energy Act of 1954 or any amendatory law.
This refers to any solid or liquid
fuel element or component used in or exposed to radiation within a nuclear
reactor.
This refers to waste material
containing by-product material, excluding tailings or wastes from uranium or
thorium extraction, which are primarily processed for source material. Waste
also covers any waste material generated during the operation of a nuclear
facility. The definition of a nuclear facility is provided below and within the
first two paragraphs.
This refers to any nuclear reactor and
associated equipment used to separate uranium or plutonium isotopes, as well as
for the processing, utilization, waste management, or packaging of spent fuel.
It also involves equipment or devices
used in the processing, fabrication, or alloying of special nuclear materials.
This is determined by the total amount of such material at any time, which must
be either (or contain not more than) 25 grams of plutonium or uranium-233 (or
any combination thereof) or more than 250 grams of uranium-235.
Finally, it includes any structure,
basin, excavation, premises, or area used for waste storage or disposal,
including the sites where these activities take place and all premises involved
in such operations.
This refers to any device engineered
or utilized to maintain a nuclear fission process in a self-sustaining chain
reaction. It also serves to contain a critical mass of fissionable material.
This is all forms of radioactive
contamination of property.
NOTE: The Nuclear
Energy Liability Exclusion is a broad and detailed exclusion covering incidents
and materials linked to nuclear energy in all forms. It includes specific
definitions relevant only to this exclusion. Its purpose is to exclude coverage
for bodily injury or property damage covered by any nuclear liability insurance
policy. It also excludes coverage for companies legally required to maintain
financial protection under various federal laws and acts related to nuclear
energy. Additionally, it disallows all types of medical payments and covers
issues such as discharges, leaks, waste, or work carried out at nuclear
facilities.