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
SUPPORTED LIVING – GENERAL DEFINITION
Supported Living is a service provided by Support workers, Care Providers, Local Authority etc to help Service Users to live
at home and stay independent.
Supported Living services can be things like:
- an emergency alarm
- help to fill in forms or arrange appointments
- help to keep a home safe and secure
- support and/or training so Service Users can move on to housing with less support
- help to manage money and meet the conditions of tenancy agreements
- help to arrange shopping or cleaning
Unlike Domiciliary Care, Supported Living Services do not include personal care services such as help with washing and dressing, laundry or having meals prepared.
SUPPORTED LIVING - 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 for buildings can only be provided if owned by the Insured.
Typical Extensions- Accidental loss, destruction or damage cover.
- Costs incurred in complying with EEC and public authority requirements.
- Personal effects cover up to £1000.
- Accidental breakage to glass and fixed sanitary ware.
- Trace and access cover for drain problems/blockages, maximum limit £50,000.
- Loss of metered water up to £10,000.
- Theft of keys cover, maximum limit up to £25,000.
- Debris Removal.
- Architects & Surveyors fees.
- Material Damage, theft & Accidental Damage if caused by persons lawfully on the premises.
- Failure to comply with any minimum security conditions.
- Special terms applicable to unoccupied properties.
- Terrorism cover (unless requested).
- Subsidence (unless requested).
- Gradually operating causes e.g. rust, rot, corrosion and gradual pollution.
- Bursting of non domestic steam boilers.
- Loss involving faulty/defective workmanship/operator error/a production process.
- Damage to glass or fixed sanitary ware resulting from repairs or alterations to the premises.
- Excesses vary from £50 to £500.
- Typical subsidence excess £1000.
Contents
Typical Extensions- Accidental loss, destruction or damage cover.
- Personal effects cover up to £1000.
- Accidental breakage to glass and fixed sanitary ware.
- Stock insured on a value basis as advised by Insured.
- Replacement costs of liquid petroleum gas following accidental discharge from storage container up to £5000.
- Loss of metered water up to £10,000.
- Theft of keys cover, maximum limit up to £25,000.
- Money in transit, in the premises during business hours and in any bank night safe up to £6000.
- Money in a safe outside of business hours up to £3000.
- Money in Premises out of business hours out of a safe up to £1000.
- Money at a Principal or authorized employee residence up to £1000.
- Minimum security conditions may apply.
- Special terms applicable to unoccupied properties.
- Terrorism cover (unless requested).
- Gradually operating causes e.g. rust, rot, corrosion and gradual pollution.
- Bursting of non domestic steam boilers.
- Loss involving faulty/defective workmanship/operator error/a production process.
- Theft of contents from unattended vehicles.
- Money left unattended in an unlocked room outside of business hours.
- Safe keys and combinations must be held in personal custody at all times.
- Excesses vary from £50 to £500.
COMPUTER INSURANCE
Typical Extensions- Applicable to computer equipment including laptops within the premises or worldwide from £15,000 to specified sum insured by Insurer.
- Accidental damage and breakdown or failure of computer equipment.
- Accidental damage, breakdown or failure, or erasure of computer records up to £10,000.
- Reinstatement of data in respect of proprietary software and back up records following loss, distortation, corruption or erasure of programme up to £25,000.
- Replacement costs of incompatible undamaged or accidental misuse or contamination of any computer up to £100,000.
- Replacement costs of incompatible undamaged computer records following loss or damage up to £10,000.
- Cost of recharging gas flooding systems installed for the protection of computer equipment following accidental discharge up to £5,000.
- Damage costs recoverable under a maintenance agreement.
- Mechanical or electrical breakdown of machinery.
- Excess up to £100.
SUPPORTED LIVING - 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.
- Cover for outstanding book debts up to £60,000.
- Loss of business income following loss of employee as a result of sudden death, total permanent disablement up to £250,000.
- Loss of income following failure /damage at public utility supplier’s premises.
- Prevention of Access to you premises by certain events.
- Failure of telecommunications services.
- Loss of income as a result of murder, suicide or specified human diseases within a 25 mile radius of the premises.
- No liability for more than 50% of the sum insured in the first three months of any claim
- Loss after business ceases to trade and/or permanently discontinued
- Closure of less than 4 hours
- Claims relating to Aids & HIV
- Excess up to £250
SUPPORTED LIVING - PERSONAL ACCIDENT: (Optional Extension)
Covers 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).
- 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.
SUPPORTED LIVING - 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 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.
SUPPORTED LIVING - LIABILITY 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 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.
- 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.
- Personal Liability of the Service Users
- 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.
- Claims arising from dishonest or fraudulent acts or omissions of any past or present, partner, director or employee.
- Compensation for court attendance.
- Lost Documents.
- 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.
SUPPORTED LIVING - 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.
- 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.
- 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.
- Failure 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.
SUPPORTED LIVING - 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
SUPPORTED LIVING - 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.
- 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.