The 'Where You Reside' Exclusion in Homeowner Policies
The three words 'where you reside' can eliminate your homeowner coverage entirely, especially if you move to a nursing home. How courts have ruled.
By Leland Coontz III, Licensed Public Adjuster · June 29, 2026 · Updated June 30, 2026
This Article Is Not Legal Advice
This article is educational commentary by a Licensed California Public Adjuster. It is not legal advice. For legal questions about your specific situation, consult a licensed California attorney.
Three words buried in the definitions section of your homeowner’s insurance policy have the power to eliminate your coverage entirely: “where you reside.”This is not a standard exclusion that appears in bold type under the exclusions section. It is embedded in a definition — the definition of “residence premises” — and most policyholders will never read it until the day their insurer uses it to deny a claim. The Independent Insurance Agents & Brokers of America (the “Big I”) has called this language a “catastrophic homeowners policy exclusion,” and for good reason.
Bill Wilson’s 2009 Big I white paper — “Where You Reside — The ‘Where’s Waldo?’ Catastrophic Homeowners Policy ‘Exclusion’ That Could Bankrupt Your Insureds”— brought national attention to this issue and documented roughly nine court decisions upholding denials and an equal number overturning them. The split has only deepened since.
The Policy Language at Issue
The standard ISO HO-3 homeowner’s policy — the most widely sold homeowner policy form in the United States — defines “residence premises” as the one-family dwelling “where you reside”and which is shown as the “described location” on the declarations page. This definition is the gateway to virtually all coverage under the policy. Your dwelling coverage, other structures coverage, personal property coverage, loss of use coverage, personal liability coverage, and medical payments coverage all flow through the “residence premises” definition.
What makes this language so dangerous is what it does notsay. There is no separate exclusion that reads: “If you stop residing at the described premises, all coverage is void.” Instead, the coverage-defeating language is hidden inside a definition. Most policyholders — and many insurance agents — read the definitions section as merely describing the property being insured. They do not realize that the phrase “where you reside” can be interpreted as a continuing condition of coverage, one that must be satisfied at the time of every loss.
Critically, the term “reside” is almost never defined in the policy itself. This omission is at the heart of the legal battle that has unfolded across dozens of jurisdictions.
This Is Not a Standard Exclusion
Unlike flood, earthquake, or mold exclusions, the “where you reside” language does not appear in the exclusions section of the policy. It appears in the definitions section. This makes it far more difficult for policyholders to identify as a potential coverage trap. The Big I has specifically warned that this language functions as an exclusion even though it is technically a definition, and that most consumers are completely unaware of its existence.
The Descriptive vs. Proscriptive Debate
The central legal question is whether the phrase “where you reside” is descriptive or proscriptive. This distinction determines whether millions of homeowners have coverage or not.
The Proscriptive (Coverage-Defeating) Reading
Under the proscriptive interpretation, “where you reside” establishes a continuing condition that the insured must satisfy at the time of each loss. Insurers argue that dictionary definitions of “reside” uniformly require physical presence at a location plus an intent to treat it as one’s home. If the policyholder is not actually residing at the described premises when the loss occurs, the property does not qualify as a “residence premises,” and coverage does not exist. Under this reading, a homeowner who moves to a nursing home, goes on an extended trip, or relocates for work — while continuing to pay premiums on the home — may find that their coverage has silently evaporated.
Insurers also argue risk assessment: the premium was calculated for an owner-occupied dwelling. An unoccupied home presents higher risks — vandalism, undetected water leaks, fire hazards — that were never priced into the policy.
The Descriptive (Coverage-Preserving) Reading
Under the descriptive interpretation, “where you reside” merely identifies which property is being insured at the inception of the policy. It is a label — a way of pointing at the insured property — not a condition that must be continuously maintained. The policyholder designated this property as their residence when they purchased the policy, and that designation does not dissolve simply because life circumstances change.
This interpretation is supported by the doctrine of contra proferentem, which requires that ambiguous policy language be construed against the insurer who drafted it. In California, that doctrine is statutory: Civil Code §§ 1649 and 1654 supply the rule, and the California Supreme Court applied it to insurance policies in AIU Insurance Co. v. Superior Court (1990) 51 Cal.3d 807 and MacKinnon v. Truck Insurance Exchange(2003) 31 Cal.4th 635. If “where you reside” can reasonably be read as either a description or a condition, California law — and the law of most states — requires that the interpretation favoring coverage prevail. The insurer drafted the policy. If it intended “where you reside” to be a condition of coverage, it could have said so explicitly: “Coverage applies only while you are physically residing at the described premises.” It did not.
Multiple courts have also recognized that a person can “reside” in more than one location for insurance purposes — a principle that directly benefits a nursing home resident who maintains ties to their home, keeps belongings there, and intends to return.
The Nursing Home Problem
No scenario illustrates the cruelty of the proscriptive interpretation more starkly than the nursing home problem. Consider the following hypothetical, drawn directly from the Big I’s analysis of this issue:
The Devastating Scenario
An elderly homeowner has lived in the same home for 30 years and has paid homeowner insurance premiums faithfully for every one of those years. She suffers a medical emergency and is involuntarily admitted to a nursing home or assisted living facility. Days later, a fire destroys her home. Under the proscriptive interpretation, she has no coverage — because at the time of the fire, she was no longer “residing” at the described premises. Thirty years of premiums purchased nothing.
The Big I has advanced several arguments for why coverage should exist in this scenario. Summarized, the core argument is that the “where you reside” requirement is not set forth clearly and conspicuously as an exclusion or condition — it sits inside a definition — and that a policyholder has no reasonable expectation that an involuntary move to a care facility will void coverage on a home insured for decades.
The Big I further argued that the “where you reside” language should be understood as establishing eligibility for the policy at inception, not as a continuing conditionof coverage. When the insurer issued the policy, it verified that the applicant resided at the premises. That eligibility criterion was satisfied. Transforming it into an ongoing condition that the policyholder must satisfy at the moment of every loss is a fundamentally different interpretation — and one that was never disclosed to the policyholder.
The most pointed argument is the unconscionability angle. The Big I’s analysis develops a hypothetical that exposes the problem: under the proscriptive reading, an insurer could deny coverage to the elderly homeowner whose home burns while she is in a nursing home, while remaining liable for the same fire if the home were being used as a clandestine drug operation by squatters. The named insured loses coverage in the nursing-home scenario because she no longer “resides” at the property; in the squatter scenario the named insured is still arguably a resident, even if she is unaware of the criminal use, and the property is still the “described location.” The result — insurer pays in the criminal-use scenario but retains decades of premiums and pays nothing in the nursing-home scenario — is the kind of outcome that supports unconscionability and reasonable-expectations arguments in court.
Case Law: A Genuine Split Across Jurisdictions
This issue has been litigated across the country, and the results are far from uniform. Courts have reached conflicting conclusions about whether “where you reside” is a condition of coverage or merely a descriptive identifier. The outcome often turns on the specific facts — particularly whether the insured maintained ties to the property, whether they rented it out, and whether the insurer knew about the change in living circumstances.
Courts That Found Coverage for the Policyholder
Durkheimer v. Safeco Ins. Co. of Illinois, No. 3:24-cv-1333-SB (D. Or. 2025):The Durkheimers owned homes in Portland, on the Oregon coast, and in Carmel, California, all insured by Safeco. During the January 2024 freeze, their Portland home suffered hundreds of thousands of dollars in water damage from burst pipes. Safeco raised an affirmative defense that the Durkheimers did not “reside” at the Portland home. On February 14, 2025, Magistrate Judge Stacie Beckerman issued Findings and Recommendation concluding that the “residence premises” definition was ambiguous and that under Oregon law a homeowner is entitled to specific and unequivocal notice in the policy that coverage will be forfeited if the insured does not reside at the home. On April 1, 2025, District Judge Michael H. Simon adopted the Findings and Recommendation and granted the motion to strike, agreeing the policy was ambiguous and did not put the Durkheimers on notice that coverage would be forfeited if they did not reside at the property.
Lamonica v. Hartford Insurance Co. of the Midwest, No. 5:19-cv-78 (N.D. Fla. June 15, 2021):The plaintiff inherited his mother’s home. He did not live there full-time but routinely returned, stayed at the house, and regarded it as the family homestead. Hartford denied a property claim, arguing the home was not his “residence premises.” The court denied Hartford’s motion for summary judgment, holding that the policy does not require the home to be the insured’s sole or even primary residence — “any residence will do.” The court distinguished this from cases where the insured rented out the property, noting that Lamonica never used it inconsistently with treating it as a permanent residence. The court declined to find that Hartford was estopped from raising the residence-premises defense on the record before it, but the underlying coverage holding remains a leading federal authority for the “any residence will do” framing.
Dean v. Tower Insurance Co. of New York, 19 N.Y.3d 704 (N.Y. 2012):In this decision from New York’s highest court, the Deans purchased a home and obtained a homeowner policy but had not yet moved in when damage occurred during renovations. Tower denied coverage because the Deans did not “reside” at the property. The Court of Appeals held that the term “reside” was not defined in the policy, making “residence premises” ambiguous under the circumstances. It reversed summary judgment for the insurer, finding the insured’s reasonable expectations were relevant.
Craft v. New York Central Mutual Fire Insurance Co., 164 A.D.3d 1120 (N.Y. App. Div. 3d Dep’t 2018):The plaintiff and her husband built their home in 1967. When the home was damaged by fire in 2014, the plaintiff’s daughter-in-law was residing in the premises, but not the named insured. The court held that because the policy did not define “reside,” the term was ambiguous, and noted that a person can have more than one residence for insurance purposes.
Shank v. Safeco Insurance Co. of America, No. 2:15-cv-09033 (S.D. W. Va. 2016):A married couple owned their primary home and inherited a second home from a relative. They used the second home weekly — cooking, watching TV, using the workshop, collecting mail. A fire destroyed it. Safeco denied the claim based on the “residence premises” definition. The court ruled that Safeco’s “residence premises” provision was more restrictive than permittedunder West Virginia law. West Virginia requires fire policies to conform to the Standard Fire Policy, which only suspends coverage when a building has been “vacant or unoccupied beyond a period of sixty consecutive days.” Requiring “residence” imposed a stricter standard, and the court held Safeco breached the policy.
Lundquist v. Allstate Insurance Co., 314 Ill. App. 3d 240 (Ill. App. Ct. 1st Dist. 2000): The First District Illinois Appellate Court treated residency as a flexible concept under which a person can remain a resident of a dwelling despite a temporary absence. Later Illinois decisions, including Dardar v. Farmers Auto. Ins. Ass’n (5th Dist. 2023), cite Lundquist for the proposition that while physical presence is a necessary component of residence, the degree of presence required is fact-intensive, with temporary absences not automatically defeating coverage. The decision is widely cited as a pro-coverage ambiguity authority on the residence-premises requirement.
Epstein v. Hartford Casualty Insurance Co., 566 So. 2d 331 (Fla. 1st DCA 1990):The Florida First District Court of Appeal held that “residence” is ambiguous and does not require the property to be the insured’s sole or primary residence.
The Pattern in Pro-Coverage Decisions
Courts that find coverage share several common threads: (1) the policy does not define “reside,” creating ambiguity that must be construed against the insurer; (2) a person can have more than one residence; (3) the insured maintained meaningful ties to the property; and (4) the insurer accepted premiums while knowing the insured’s living situation. Any one of these arguments can be enough. Together, they are formidable.
Courts That Denied Coverage
Pour v. Liberty Mutual Personal Insurance Co., No. 24-1824, 2025 WL 3440993 (8th Cir. Dec. 1, 2025):The Eighth Circuit affirmed summary judgment for Liberty Mutual on a homeowner’s claim arising from a fire at a Champlin, Minnesota home. The named insured Pour Sr. had moved from Minnesota to Georgia in 2019, updated all formal records to reflect Georgia residency, and visited the Minnesota home only briefly thereafter, staying elsewhere during those visits. The court held the phrase “where you reside” was unambiguous and required actual residence at the property, not merely ownership. The court further held that Pour Sr.’s adult children who continued to live in the Minnesota home were not “residents of [Pour Sr.’s] household” for purposes of insured status, because they did not live under the same roof as the named insured.
Arguelles v. Citizens Property Insurance Corp., 278 So. 3d 108 (Fla. 3d DCA 2019): Arguelles owned a condominium insured by Citizens. At the time of a plumbing leak, he was living in New York and the condo was occupied by two tenants. The policy defined “residence premises” as “the unit where you reside.” The Third District Court of Appeal affirmed summary judgment for Citizens, finding the policy language unambiguous. The distinguishing factor: Arguelles was not merely absent from the property — he had rented it out, which is inconsistent with any reasonable claim of “residing” there.
American Risk Insurance Co. v. Serpikova, 522 S.W.3d 497 (Tex. App. — Houston [14th Dist.] 2016, pet. denied):The Texas Court of Appeals ruled that coverage required the insured to reside at the property or intend to reside there within 60 days of the policy’s effective date. Neither condition was met. The Texas Supreme Court denied the petition for review.
Adkisson v. Safeco Insurance Co. of Indiana, No. 6:23-cv-00146 (E.D. Tex. Nov. 15, 2024):Adkisson owned a home in Longview, Texas, which suffered water damage during the February 2021 Texas freeze. He primarily lived in a home he had purchased in Godley, Texas, closer to his workplace as an essential worker during the COVID-19 pandemic. The Longview home showed limited furnishings and minimal utility usage. The court ruled for Safeco, finding the limited evidence of occupancy insufficient to establish that the Longview property was Adkisson’s residence premises under the policy.
Davani v. Travelers Personal Insurance Co., No. 22-1244 (D. Kan. 2023):The insured never actually lived at the insured premises. The court held that “residence” requires physical presence at the location and an intent to remain for an indefinite period. Summary judgment was granted for Travelers.
Heniser v. Frankenmuth Mutual Ins. Co., 534 N.W.2d 502, 449 Mich. 155 (Mich. 1995): The insured had purchased a Honor, Michigan vacation home with his wife, retained possession after a divorce, and in November 1988 sold the property on a land contract. The home was destroyed by fire in January 1989, after the sale. The insured nonetheless filed a claim under the homeowner policy that was still in force. The Michigan Supreme Court found the policy unambiguous and denied coverage, holding that the insured could not satisfy a residency requirement at a property he had already sold. The case is frequently cited in Michigan insurance law, but its facts — a completed sale on land contract — are well outside the ordinary nursing-home or temporary-absence pattern that drives the modern debate.
The Pattern in Denial Decisions
Courts that deny coverage share their own pattern: (1) the insured had clearly and voluntarily relocated to a different primary residence; (2) the insured rented the property to tenants; (3) the property was largely unfurnished or showed minimal use; or (4) the insured never lived at the property at all. Note that none of these cases involve the sympathetic nursing home scenario — they involve voluntary relocation and, in some cases, conversion to a rental property. The distinction matters enormously.
The ISO Fix: Endorsements HO 06 48 and HO 06 49
The insurance industry itself has acknowledged that the “where you reside” language creates an unfair coverage gap. In 2015, the Insurance Services Office (ISO) — the organization that drafts the standard policy forms used by most insurers — issued a countrywide revision to address the problem.
HO 06 48: Residence Premises Definition Endorsement
This mandatoryendorsement, effective October 1, 2015 in most states, modifies the definition of “residence premises” so that the “where you reside” requirement is evaluated only “on the inception date of the policy period shown in the Declarations.”Once the policy incepts, the insured can move out — to a nursing home, to another state, anywhere — and the property remains a “residence premises” for the remainder of that policy period.
This is the most directly helpful development for the nursing home scenario. If the policyholder was residing at the home when the policy last renewed, coverage continues through the policy period even if a nursing home placement occurs mid-term.
The HO 06 48 Limitation
The HO 06 48 endorsement still requires residency at the inception of each policy period. If a policyholder has already been in a nursing home when the policy renews, and they were not residing at the property on the renewal date, the endorsement may not protect them. For policyholders already in care at renewal time, additional steps — discussed below — are critical.
HO 06 49: Broadened Residence Premises Definition Endorsement
This optionalendorsement goes further. It allows the insurer and policyholder to designate specific starting and termination dates during which the residency requirement is suspended entirely. It was designed for situations where the owner does not reside at the home at policy inception — homes being remodeled, transitional periods, and, critically, extended nursing home or care facility placements.
The availability of HO 06 49 varies by carrier and by state. Not all insurers offer it, and not all agents know to ask for it. But it exists, and it should be requested whenever a policyholder’s living situation has changed or is expected to change.
Practical Guidance: How to Protect Yourself
Whether you are a policyholder, a family member managing an elderly parent’s affairs, an insurance agent, or a practitioner, this issue requires proactive attention. The following steps can significantly reduce the risk of a coverage denial based on the “where you reside” language.
Professional Guidance Recommended
The legal strategies discussed in this section should be pursued with the guidance of a licensed attorney experienced in insurance coverage disputes. A Public Adjuster can assist with the claims-handling, documentation, and negotiation aspects of your claim. If you need help finding a qualified professional, contact us for a referral.
Step 1: Notify Your Agent Immediately
The moment a homeowner is admitted to a nursing home, assisted living facility, or similar care facility — whether voluntarily or involuntarily — their insurance agent should be notified in writing. This is the single most important step. Written notification creates a record that the insurer was aware of the change in circumstances and continued to accept premiums. If a claim is later denied, this creates a powerful estoppel argument: having accepted premiums with knowledge of the situation, the insurer cannot disclaim coverage when it comes time to pay. Save every premium notice, payment confirmation, renewal letter, and correspondence.
Step 2: Request the Residence Premises Endorsements
Ask your agent specifically about ISO endorsement HO 06 48 (Residence Premises Definition) and HO 06 49(Broadened Residence Premises Definition). If HO 06 48 is already on the policy — it has been mandatory since 2015 in most states — confirm that coverage is locked in through the current policy period. If the policyholder will still be in care at the next renewal, request HO 06 49 to suspend the residency requirement for a designated period.
Step 3: Consider Converting to a Dwelling Fire Policy
If the insurer will not add the broadened endorsement, or if the policyholder’s move to a care facility is permanent, the property can be re-insured under a Dwelling Fire policy(DP-1 or DP-3) rather than a homeowner policy. Dwelling Fire policies do not require the named insured to reside at the property. They are the standard product for rental properties, seasonal homes, and unoccupied dwellings. The coverage may differ — often more limited liability coverage, and possibly named-perils rather than open-perils on a DP-1 — but the property protection remains in place. This is the recognized fallback when the homeowner policy becomes untenable due to a residency issue.
Step 4: Determine Whether a Family Member Still Resides in the Home
If a spouse, adult child, or other family member continues to live at the insured property, the “where you reside” problem may not arise at all. Under many policy forms, an “insured” includes family members who reside in the household. If any insured still resides at the property, the residence premises definition remains satisfied. Even if the policy defines “you” as only the named insured and spouse, having a family member occupy the home strengthens the argument that the property remains a “residence premises.”
Step 5: Maintain Evidence of Continuing Ties
If the homeowner cannot return to the property, maintain as many ties as possible:
- Keep the home address as the legal and mailing address
- Maintain voter registration at the home address
- Keep belongings, furniture, and personal effects in the home
- Continue all utilities
- Have family members regularly maintain the property — mowing, snow removal, checking for issues
- Do not change the address on legal or financial documents
- Document the homeowner’s stated intent to return
If the homeowner’s health allows it, periodic returns to the home — even brief stays — can help establish an ongoing connection. However, courts have found that “sporadic interactions” may be insufficient when the insured has taken affirmative steps to disassociate from the property. Return visits should be genuine and documented.
Step 6: If You Rent the Property, Convert the Policy First
Families often need rental income from the property to help pay for the care facility. That is understandable — but renting the property while maintaining a homeowner policy is the single biggest factor that courts use to rule against coverage. In Arguelles, the Florida court denied coverage specifically because the insured had rented out the property to tenants while keeping a homeowner policy. Once a property is rented under a homeowner policy, the insured has unambiguously stopped “residing” there, and the proscriptive interpretation becomes nearly impossible to overcome.
The solution is not to avoid renting altogether — it is to convert the insurance before placing tenants. If the family decides to rent the property:
- Contact the insurance agent and obtain a landlord or dwelling fire policy (DP-1 or DP-3) beforeany tenant moves in. A landlord policy is designed for non-owner-occupied rental properties and does not contain the “where you reside” language.
- Cancel or replace the existing homeowner policy.Do not maintain the old homeowner policy in the elderly insured’s name while renting to tenants. If a loss occurs, the insurer will deny the claim under the homeowner policy because the named insured does not reside there, and the family will have paid premiums on a worthless policy. The old homeowner policy must be replaced with the appropriate landlord or dwelling fire form.
- Consider requiring tenants to carry renter’s insurance.A landlord policy covers the dwelling and the owner’s liability, but it does not cover the tenant’s personal property or the tenant’s liability to others. Requiring tenants to carry an HO-4 renter’s policy protects everyone.
The key point: renting is not fatal to the property being insured. It is fatal to a claim under a homeowner policy. Get the right policy for the right situation, and the property stays covered.
Step 7: Review the Vacancy Provisions Separately
The “where you reside” issue is distinct from the 60-day vacancy exclusion that exists in most homeowner policies. Even if you win the residency argument, the insurer may assert the separate vacancy exclusion if the home has been unoccupied for an extended period. Some insurers offer a vacancy permit endorsement that extends coverage during periods of vacancy. This does not address the residence premises definition directly, but it prevents a separate vacancy-based denial. Review both provisions and address them independently.
Step 8: If the Home Is Held in a Trust
When a home is transferred into a revocable living trust or any other ownership entity, the homeowner policy needs to be updated to reflect the new ownership. A policy that still names the individual after the trust takes title is open to a coverage defense based on the mismatch between the named insured and the titleholder, and the “where you reside” analysis interacts with the trust ownership in ways that can compound the problem (for example, a trust does not “reside” anywhere, so a carrier may argue the residence-premises requirement cannot be satisfied by a trust-owned property without an individual co-named insured living there).
The detail of how to insure trust-owned property — how to name the trust, who to add as additional named insureds, and the arguments that defeat a mismatch defense after a loss — is its own topic. See our article on trust-owned property and insurance claims. For the insurable-interest mechanics when only a partial interest (like a retained life estate) is involved, see our article on insurable interest.
The trust-administration side — how the trust was set up, who the trustees are, what happens at the settlor’s death, how distributions to beneficiaries work — is a California estate planning or trust attorney’s territory, not the insurance carrier’s and not the Public Adjuster’s. Whenever the home is being moved into or out of a trust, the estate planning attorney and the insurance broker both need to be in the conversation; getting the estate plan right but the insurance wrong can be just as devastating as the reverse.
Additional Arguments for Practitioners
Attorneys handling a denied claim based on this language should consider:
- Contra proferentem:The ambiguity in “reside” — which is not defined in the policy — must be resolved in favor of coverage. Dean v. Tower (N.Y. 2012) and Lundquist v. Allstate(Ill. 2000) both turned on this principle.
- Estoppel and waiver: If the insurer or its agent knew the policyholder was in a care facility and continued to accept premiums without disclaiming coverage, estoppel may bar the denial. Lamonica relied on this.
- Reasonable expectations: No reasonable policyholder expects that a medical emergency will immediately terminate property coverage on the home they have insured for decades.
- Standard Fire Policy conformity:In states that require conformity with the Standard Fire Policy, the “residence premises” requirement may be more restrictive than the statutory framework allows. Shank v. Safeco(S.D. W. Va. 2016) is the leading authority on this argument.
- Review the declarations page:In some cases, the declarations page identifies the property by address alone without using the phrase “residence premises.” If the declarations page description does not incorporate the “where you reside” language, that is an additional argument against the insurer’s position.
Conclusion
The “where you reside” language is a coverage trap embedded in the most widely sold homeowner policy form in America. It is not flagged as an exclusion. It is not explained at the point of sale. It does not appear in the policy summary or outline of coverage. It sits quietly in the definitions section until the day a policyholder — often elderly, often in a care facility, often at the most vulnerable point of their life — files a claim and discovers that decades of faithfully paid premiums may have purchased nothing.
The case law is mixed, but the trend favors policyholders — particularly in cases involving involuntary absence, maintained ties to the property, and insurer knowledge of the living situation. Courts are increasingly reluctant to allow insurers to deny coverage based on definitional language that was never clearly disclosed as a condition of coverage. The doctrines of contra proferentem, reasonable expectations, estoppel, and unconscionability all weigh heavily in the policyholder’s favor.
ISO’s 2015 endorsements — HO 06 48 and HO 06 49 — represent the industry’s own acknowledgment that the original language was unfair. But these endorsements are not a complete fix. They require awareness, proactive requests, and in many cases agent involvement that may not happen without the policyholder or their family taking the initiative. State legislatures should consider legislation requiring insurers to notify policyholders that their coverage may be affected by a change in residency status. And insurance agents should affirmatively counsel their clients about this risk, particularly when clients are aging and may be approaching the point where a transition to a care facility is foreseeable.
Until those changes happen, the burden falls on policyholders and their advocates to identify this risk early, preserve their arguments, and push back hard when an insurer attempts to use three words in a definition to void decades of coverage.
Disclaimer
This article is for general educational purposes only and does not constitute legal advice. Insurance policies and applicable law vary by state and by policy form. The case law discussed in this article reflects reported court decisions as of the date of publication, but outcomes in any individual case will depend on the specific policy language, the facts, and the applicable state law. Always consult with a licensed attorney in your jurisdiction about your specific situation.
Author: Leland Coontz III, Licensed Public Adjuster, CA License #2B53445
Coverage Denied Because You Moved to a Care Facility?
If your insurer has denied a property claim because you or a family member no longer “resides” at the insured home, you may still have coverage. A licensed Public Adjuster can review your policy, document the facts that support coverage, and help you fight the denial.
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