CARE POLICY SUMMARY
The following is a general description of the features and benefits typically available to commercial care policyholders. It is NOT intended to be a complete summary of the policy cover available as such cover will vary between Insurers. With each quotation provided by Aldium a Key Facts Summary of Cover will be supplied for the particular Insurer recommended
PROPERTY COVER
Insured Perils:
- Fire, Lightning, Explosion
- Aircraft
- Earthquake
- Aerial Devices dropped from an aircraft
- Theft/Attempted theft
- Riot, Civil Commotion (Excluding NI), Strikers
- Malicious persons or Vandals
- Flood, Storm
- Escape of Water or oil from specified installations
- Impact by any road vehicle or animal
- Accidental Damage
- Subsidence
BUILDINGS:
Cover is applied to the physical premises of the business including outbuildings, fences, walls, gates and fixtures & fittings up to the specified sum insured
Typical Extensions (Including Optional Extensions):
- Additional costs relating to EU and Local Authority regulations.
- Debris Removal.
- Architects & Surveyors Fees – incurred for reinstatement following an insured loss.
- Capital Additions – cover for alterations and additions for any newly acquired or erected buildings.
- Trace and access cover for drain problems/blockages.
- Bequeathed Property – property handed or left to you covering your interest in the material property.
- Emergency Services Damage.
- Damage to the buildings by Theft.
- Minor Buildings Works – cover for extensions or alterations to the existing structure up to a contract value of £100,000.
- Terrorism.
Typical Exclusions:
- Unoccupied & unused properties.
- Theft from unoccupied & unused properties.
- Terrorism in Northern Ireland.
- Inherent vice, latent defect, gradual deterioration, wear and tear or frost.
- Faulty or defective design, materials, workmanship, or operational error on the part of the policyholder or any employees.
- Damage caused by rust, dry rot, shrinkage, evaporation, gradually operating clauses.
- Excess - As specified in individual policy schedules per Insurance Company.
- £1000 subsidence – typical excess.
CONTENTS:
Cover for contents within the premises relating to the business for which you are legally and financially responsible up to the specified sum insured.
Typical Extensions (Including Optional Extensions):
- Cover for Residents effects up to a requested sum insured.
- Cover for employee effects.
- Accidental breakage of glass, sanitary fittings, signs, glass in furniture, mirrors.
- Theft of keys.
- Temporary removal of contents.
- Debris removal.
- Loss of Metered Water.
- Loss of LPG/Oil.
- Property in the open grounds of the Premises.
- Temporary accommodation of staff.
- Stock in Transit.
- All risks items within the geographical area.
Typical Exclusions:
- Theft of property left in the open.
- Theft from property unoccupied/unused.
- Loss where scaffolding is erected.
- Wear & tear and any gradually operating cause.
- Excess - As specified in individual policy schedules per Insurance Company.
BOOK DEBTS:
Cover for loss or damage to your book of accounts or other books of records.
Limit of Indemnity: Up to £100,000
Typical Extensions:
- The amount of Outstanding Debit Balances in respect of debts due from your customers which cannot be traced.
- The cost of establishing Outstanding Debit Balances incurred with the agreement of the Insurer after the loss or damage.
Typical Exclusions:
- Bad Debts.
- Deliberate erasure or distortion.
REFRIGERATED STOCK:
Covers deterioration of stock in refrigeration units and cold chambers in the Care Home.
Limit of Indemnity – Up to £5000
Typical Extensions:
- Breakdown of the units/cold chambers.
- Accidental Damage.
- Failure of any thermostatic device due to inherent defect.
- Refrigerant and fume leakage.
- Failure of the public electricity supply.
Exclusion:
- Contents purchased for own personal consumption.
GOODS IN TRANSIT:
Cover for goods whilst in transit being transported by your vehicles within the United Kingdom
Limit of Indemnity – Up to £5000
Typical Exclusions:
- Theft from unattended vehicles unless locked and secured.
- Fragile items and electrical or mechanical derangement.
- Employee theft.
MONEY
Allows you to insure against physical loss of cash or cheques.
Cover:
- Non negotiable money such as crossed cheques, money orders and vouchers up to £250,000.
- In transit, bank night safe or in the premises during business hours up to £5,000.
- While in a locked safe at the premises or other specified location up to £2,500.
- While on the premises (not locked in a safe) outside business hours up to £500.
- For any other loss up to £500.
- Losses due to dishonesty of employees up to £5,000.
Typical Exclusions:
- Shortage due to error or omission.
- Loss from an unattended vehicle.
- Loss from any coin operated machines.
- Any loss resulting directly from forgery.
- Loss arising outside Great Britain, Northern Ireland, the Channel Islands or the Isle of Man.
MACHINERY & COMPUTER BREAKDOWN:
Cover for breakdown of machinery & computer equipment in the premises for the use of the business:
Typical Extensions:
- Insured plant.
- Boilers.
- Office equipment.
- Lifts, stair lifts, heating systems.
- Reinstating data.
- Maintenance & operations of computers.
Typical Exclusions:
- Explosion and breakdown of boilers.
- Computer viruses.
- Wear & tear.
- Premises unoccupied & unused.
BUSINESS INTERRUPTION
Loss of Revenue
Cover trading loss including ongoing and justifiable increased costs to your business following a loss caused by any insured peril within the Property Cover section
Cover is for a specified amount over a selected period e.g. 12, 18, 24 or 36 months
Additional Increased Cost of Working
Reasonable extra expenses to keep the business running to minimise loss of income and other costs up to a maximum of £25,000
Typical Extensions:
- Loss of income as a result of murder, suicide, disease, food poisoning, vermin & defective sanitation.
- Bomb scares (excluding Northern Ireland).
- Denial of access to your Premises.
- Failure of gas, water & electricity supplies.
Typical Exclusions
- Loss after business ceases to trade and/or is permanently discontinued.
- Closure of less than 4 hours.
- Claims relating to Aids & HIV.
LIABILTY COVER
EMPLOYER’S LIABILITY:
Covers legal liability of the policyholder for accident, injury and illness of employees sustained during the course of employment
Limit of Indemnity: £10,000,000
Typical Extensions:
- Unsatisfied Court Judgments - payable to an employee for amounts awarded in court but not yet paid.
- Court Attendance Expenses.
- Indemnity to Principal - Indemnity for any principal for whom the policyholder is carrying out work under contract.
- Indemnity to Directors and Employees – indemnity cover for any claims against any directors or employees.
- Cross Liabilities – cover if more than one party exists, each individual partner will be indemnified against liability incurred to the other as if a separate policy had been issued.
- Contingent Motor Liability – cover for any legal liability for injury or damage arising out of the use of an employee in the course of the business of any mechanically propelled vehicle which is neither owned nor provided by you.
- Corporate Manslaughter Defence – cover for defence in respect of a prosecution, or appeal against conviction resulting from prosecution brought for a breach of the Corporate Manslaughter and Corporate Homicide Act 2007.
Typical Exclusions
- Offshore Work
- Fines & penalties.
- Technical & Professional instructions/advice.
- Cover for which compulsory motor insurance is required under the Road Traffic Act 1988.
- Intentional or deliberate acts.
- If the Insured is entitled to indemnity under any other insurance.
- If the Insurer is already providing indemnity under the Legal Expenses Section.
PUBLIC & PRODUCTS LIABILITY:
Covers Legal liability of the policyholder for accidental bodily injury or property damage to the public and third properties
Limit of Indemnity: £5,000,000
Typical Extensions:
- Court attendance Expenses.
- Health and Safety at Work – Legal Defence Costs
- Data Protection Act 1998 - indemnity if the policyholder becomes legally liable to pay in respect of compensation for damages or distress under the Data Protection Act and defence costs relating to a prosecution brought under the Data Protection Act.
- Indemnity to Principal -Indemnity for any principal for whom the policyholder is carrying out work under contract.
- Defective Premises Act 1972 – indemnity for liability incurred in respect of property disposed of by the policyholder.
- Overseas Personal Liability – cover for any liability arising for any employee, director or partner whilst temporarily outside the geographical limits whilst in connection with the business.
- Consumer Protection Act 1987/Food Safety Act 1990 – indemnity provided includes costs and expenses incurred in defending any prosecution for breach of safety requirements or safety regulations.
- Cross Liabilities – cover if more than one party exists, each individual partner will be indemnified against liability incurred to the other as if a separate policy had been issued.
- Contingent Motor Liability – cover for any legal liability for injury or damage arising out of the use of an employee in the course of the business of any mechanically propelled vehicle which is neither owned nor provided by you.
Typical Exclusions:
- Professional & technical advice.
- Liability for the sale or supply of products.
- Medical malpractice.
- Surgery carried out at the premises.
- Any claims relating to Asbestos.
- Workmen’s compensation.
- Liability arising from the use of a mechanically propelled vehicle, watercraft or aircraft.
MISTREATMENT:
Covers Legal liability of the policyholder to pay damages for death, accidental injury and illness incurred in provision of
treatment given in connection with the business:
Limit of Indemnity: £5,000,000
Typical Exclusions:
- Goods sold/supplied other than those in your or your employee’s possession.
- Surgery and prescription/administration of drugs and medicines.
- Medical Malpractice.
- Diagnosis other than diagnosis by a qualified registered nurse.
PROFESSIONAL INDEMNITY
Covers Legal Liability of the policyholder for any breach in professional advice resulting in a financial Loss.
Limit of Indemnity: £1,000,000 (higher amounts can be requested)
Typical Cover:
- Professional Liability – damages resulting from any breach of duty of the policyholder.
- Intellectual Property – damages resulting from any infringement by the policyholder.
- Defamation – damages resulting from libel or slander committed unintentionally by the policyholder or employee.
- Fraud/Dishonesty – damages resulting from fraud/dishonesty of any employee.
- Defence – the Insurer will pay any defence costs in defending any claim under its Cover or Extensions.
Typical Extensions:
- Claims arising from dishonest or fraudulent acts or omissions of any past or present, partner, director or employee.
- Compensation for court attendance.
- Lost Documents.
Typical Exclusions:
- Any negligent, dishonest or fraudulent act or omission of any personnel supplied or recommended by you in the course of the business.
- Bodily Injury/Property Damage.
- Computer Virus – any computer virus, malicious code or failure to prevent unauthorised access to or use of an electronic system or program.
- Contractual Liability – arising out of contract beyond normal scope, which creates a liability which would not otherwise exist and/or is in respect of delay or failure to perform.
- Costs Assessment – failure by the policyholder or other party acting for the policyholder to make and accurate pre-assessment of the cost of performing Employment Agency Services.
- Discrimination – actual or alleged employment related practices, harassment or discrimination or intentional or systematic harassment or discrimination.
- Employers’ Liability.
- Infrastructure – mechanical failure, electrical failure, including any electrical power interruption, surge, brown out or black out, or telecommunications or satellite systems failure.
- Insolvency – insolvency, administration or receivership of the policyholder.
- Internet Content – material which is published or posted on the internet where, prior to publishing or posting, the policyholder has no knowledge of either the content or source of the material.
- Joint Ventures – work carried out by the policyholder for and in the name of any association or joint venture of which a policyholder forms part.
- Patent/Trade Secret – breach of licences concerning, infringement of or misappropriation of patents or Trade Secrets.
- Trade Deeds – trading debt incurred by a policyholder or guarantee given by a policyholder for a debt.
- USA/Canada.
LEGAL EXPENSES
Cover for legal fees, compensation awards and appeals from legal disputes you are involved in up to the specified amount in the policy schedule
Typical Cover:
- Employment Disputes –cover for defending your legal rights in a dispute with an employee arising from their dismissal or redundancy, or any other legal proceedings relating to their contract of employment. Cover includes defence of your legal rights against a prospective employee claiming sex discrimination.
- Compensation Awards - cover for any case taken up by insurers under Employment Disputes, insurers will pay any compensation award made at Tribunal should you lose the case.
- Legal Defence –cover for defence of criminal prosecutions brought by the Police, the Health & Safety Executive and/or Local Authority Health & Safety Enforcement Officer.
- Bodily Injury - cover for you and your family members’ legal rights following an event which causes the death of or bodily injury to them.
- Property Protection – cover for any civil action relating to material property owned or for which you are responsible following an event which may cause physical damage to that property or nuisance and trespass.
- Tax and VAT enquiries –cover to represent your rights throughout an enquiry by HM Revenue & Customs into your business accounts (and PAYE or Social Security contributions). Also to represent your rights in appeals against VAT assessments.
- Contract Disputes – cover for contractual disputes arising from an agreement which has been entered into by or on your behalf.
- Debt Recovery – cover for recovery of money and interest due from the sale or provision of goods and services including enforcement judgement.
- Confidential Counselling helpline.
- Appeals against prohibition notices under the Health & Safety at Work Act 1974.
Typical Exclusions
- Matters where a recovery or successful defence is unlikely.
- Claims occurring outside of the insurance period.
- Costs incurred not agreed by the Legal Expenses Company.
- Failure to seek and act on the advice of the advisory line if you are considering taking action against an employee and in response to a notification of an employee problem.
- Breach of professional duty or failure to take reasonable steps to avoid and prevent claims or legal proceedings.
- Any claim arising out of intellectual property or breach of confidentiality or in connection with a judicial review.
- Failure to follow the ACAS Code of Disciplinary Practice and Procedures in Employment. Certain compensation awards are not covered.
- Computer operating systems or packaged software tailored by a supplier to your special order.
- Deliberate mis-statements in respect of accounts, returns or any other submissions made to the relevant authorities with intent to deceive.
- Claims where you have failed to maintain or submit accurate, truthful and up-to-date records and returns or have failed to observe statutory time limits or requirements
- Enquiries by HM Revenue and Customs relating to investigations by Special Civil Investigations, Civil Investigation of Fraud, tax avoidance.
LOSS OF REGISTRATION CERTIFICATE
Cover for the policyholder if the value of your interest in the premises depreciates if your Registration Certificate is
forfeited or refused renewal for reasons beyond your control, including any appeal against any refusal or renewal
Limit of Indemnity: Between £100,000 and £250,000 as specified by your Insurer on the policy schedule
Typical Exclusion:
- Losses caused by your own acts or omissions.
Typical General Conditions:
- Insurers to be notified immediately of proceedings against the registration certificate holder, manager, tenant or occupier.
- Insurers to be notified immediately of change in tenancy or management.
- Insurers to be notified immediately of objections to renewal of the registration of certificate.
PERSONAL ACCIDENT: (Optional Extension)
Cover for you and your employees for accidental bodily injury and accidents during the Operative Times requested.
- Can provide cover from one employee to all employees (group cover).
- Cover on a 24-hour basis (whilst in work or not for full time staff only).
- Cover on an occupational basis (whilst at work only).
Cover provided for:
- Death.
- Loss of limbs.
- Loss of eyes.
- Temporary partial disablement.
- Temporary full disablement.
- Permanent partial disablement.
- Permanent full disablement.
- Medical Expenses.
Each policy schedule will list the value of the benefits within the policy schedule.
Typical Exclusions:
- Only liable for one benefit per individual in connection with one incident.
- Any self inflicted of pre-existing injury.
- Any injury due to disease or sickness.
- Injury or death arising from the use of alcohol or drugs.
- Injury or death caused by engaging in hazardous pursuit.
FIDELITY GUARANTEE: (Optional Extension)
Covers the policyholder for loss of money and goods for which you are responsible arising from the dishonesty of your employees
Limit of Indemnity Up to£25,000
Typical Exclusions:
- Loss by an act caused by an employee prior to the commencement of cover applicable to that employee.
- Loss by any employee not normally resident in Great Britain, Northern Ireland, Channel Islands or Isle of Man.
- Loss of interest or consequential loss of any kind.
- Where a sum insured has been reinstated, cover will not apply previous to the date of reinstatement.
- Claims where you have been aware of a material fact relating to an employee’s dishonesty.
TYPICAL GENERAL EXCLUSIONS
- Radioactive Contamination – damage to any property whatsoever or any loss or expense whatsoever resulting or arising there from or any consequential loss.
- War Risks – any contingency liability or damage occasioned by or happening through war invasion act or foreign enemy hostilities or warlike operations.
- Sonic Bangs – damage directly occasioned by pressure waves caused by aircraft and other aerial devices travelling at sonic or supersonic speeds.
- Date recognition – any consequential or other loss costs and expenses and any legal liability accidental bodily injury or loss destruction or damage to property directly or indirectly caused by or contributed to by or consisting of or in any way relating to or connected with the failure of any computer to correctly recognize any date as its true calendar date, or capture, save or retain any data or information.
- Water Table Level – loss or damage attributed solely to change in the water level table.
TYPICAL GENERAL CONDITIONS
- Reasonable Care – The policyholder shall take all reasonable precautions to prevent any form of loss
- Alterations of Risk – immediate notice must be given to the Insurer of any material alteration to the risk.
- Fraud –benefits under the policy shall be forfeited in the event of fraud.
- Cancellation – The Insurer may cancel the policy by sending written notification within a specified period at the last known address and make a proportionate return of any premium for the unexpired period. You may cancel the policy if written notice is provided. A refund of the part of the premium which covers the cancelled period will be available as long as you have not made a claim. If you have made a claim the full annual premium is due.
- Cooling off period - you may change your mind 14 days after insuring and receiving any documentation by writing and any premium you have paid will be refunded subject only to an administration charge.
- Contribution – The Insurer shall not be liable for more than its ratable proportion of any claim arising under the policy if at any time of the event causing the claim the policyholder is insured by any other policy wholly or partly.
- Arbitration – Any dispute as to the amount to be paid shall be referred to an arbitrator provided that liability has been accepted.
- Felt Roof condition – If any Building has a felt roof it is a requirement the roof must be inspected at least every 6 months
- Portable Heaters – In respect of destruction or damage by fire that there be no portable heating appliances used anywhere in the building unless approved by the Insurer
- Minimum Security Requirements – The Insurer shall not be liable in respect of loss or damage by or in consequence of theft or attempted theft unless security requirements stipulated in the policy are put in place.
Wherever Typical Extensions and Typical Exclusions are recorded above, it should be noted that they do not represent a complete list of all policy extensions/exclusions and neither do all Insurers provide/impose all of the above. They are intended to be representative of the most significant extensions/exclusions which usually appear. You should also read the General Conditions and General Exclusions Sections of any relevant policy.