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policy-2.0's Issues

Commercial Arbitration Rules vs. Consumer Arbitration Rules

The choice of the Commercial Arbitration Rules rather than the Consumer Arbitration Rules seems unusually hostile to consumer policyholders given the policy's attempt to be consumer friendly, and the commercial rules are not very well suited to a controversy of the type likely to arise under this policy.

A claim under the Commercial Arbitration Rules, for example, carries a minimum filing fee is $925, whereas the Consumer Arbitration Rules carry a minimum (and maximum) filing fee of $200. The commercial rules are also more complex and generally lead to higher-fee options/outcomes, which is great if you're an insurance company but not so great if you're an average joe.

Separate and Define "Bodily Injury" and "Property Damage"

The present policy wording reads: "We cover claims of bodily injury or property damage, not stress, mental anguish or reputational damage."

It'd be wise to specify what "Bodily Injury" and "Property Damage" are intended to mean, and to do it individually--for example, your standard ISO HO policy covers physical injury, sickness, and disease. It'll also cover mental anguish and death, but only as a result of a physical injury. Will Policy 2.0 refuse to cover a claimant/plaintiff's claim for general damages for the pain and suffering, emotional distress, and mental anguish that followed their trip and fall, for example?

With "Property Damage", the door is currently wide open for allegations of both tangible and intangible property damage. When Ben drops his roommate's MacBook and fries the hard drive, you'll see a claim for the MacBook, but what about the roommate's future NYT-bestseller that's now lost forever? What about when Ben knocks Sara's cello out of her hands while she's on her way to a gig? She's losing out on income until it's replaced, but loss of use isn't defined as a covered issue on the policy as present.... but should it be?

Since a policy is a contract of adhesion, it's the insurer's duty to be clear, and questions of interpretation can/will be answered to the benefit of the insured, even in arbitration.

Firearm Liability Coverage

Hopefully I'm not coming off as being too critical for hammering so many liability issues--to be clear, I do like what's going on here and the idea of more user-friendly personal lines policies. I didn't see any dialogue on the firearm liability exclusion and I think it's probably worth discussing.

On firearm liability, the current exclusion reads as follows: We don’t cover damage caused by assault weapons (as defined by the Federal Assault Weapons Ban of 1994). Harm caused by other licensed firearms is covered, as long as they were stored securely and used responsibly.

Firstly, there are a number of exclusions that open with essentially, "We don't cover damage..." and I think "damage" should be replaced in these instances with "bodily injury or property damage" as defined in the coverage document for the sake of clarity on the consumer side. On excluding coverage for claims involving assault weapons as defined by the AWB, this seems really tricky. This legislation was notorious for being full of loopholes, so utilizing the AWB definition for firearms brings those loopholes into the policy. For one, it doesn't define what an assault weapon is so much as it defines certain specific guns as being assault weapons--the legislation includes a list of specific weapons, but the list is limited to weapons that were manufactured in 1994 and earlier, so coverage for weapons introduced after the ban expired would be covered, right? They certainly wouldn't be on the list of weapons in the 1994 AWB, but is covering those under the policy the intent? Now I don't think including a schedule of continuously changing firearms on the policy is logical or practical, but it's worth discussing.

Finally, the exclusion carries a caveat covering "other licensed firearms" as long as they were "stored securely and used responsibly" based on recommendations from the California Office of the Attorney General's website. Unlike the 1994 AWB, this website isn't static--as is, your definition of secure storage and responsible use will change every time an edit is made to the site. Maybe it'll create an issue, maybe it won't, but it'll be a lot for the adjuster to have to weigh when making a coverage decision. ISO's exception to the intentional bodily injury or property damage exclusion allows coverage for the use of "reasonable force" to protect persons or property, maybe something to that effect would be sufficient in this policy? Otherwise, do you expect an adjuster to determine if the policyholder was keeping their firearm and ammunition stored separately using California-approved lock boxes and trigger locks as part of their coverage decision? Should an Illinois or New Jersey policyholder be held to that same standard? Are all policyholders expected to ensure they're complying with the latest California OAG recommendations to continue coverage? If so, is a compliance review something you'd expect them to do at renewal? Or continuously?

If the goal is to know a risk and limit exposure, why not use something like, "We will not provide coverage for bodily injury or property damage caused by any firearm not scheduled on the policy, but this exclusion will not apply to the use of reasonable force of a scheduled firearm to protect persons or property." Firearms are usually a topic of discussion for producers writing property coverage, if there are certain firearms that fall outside of Lemonade's property or liability risk appetite, this gives Underwriting the opportunity to keep them out of the portfolio.

Clarification around adding coverage to others living at the same address

Hello,

In the "Who's covered" section, you state the following:

This policy covers Jane Doe. You can add more people, as long as they permanently live at 5 Crosby St.

After reading the entirety of the rest of the policy, the following questions come to mind:

  1. How do I add more people to the policy?
  2. How much does it cost, if anything, to add more people to the policy?
  3. Are the deductibles separate? That is, say the policy has a deductible of $500, and both I and my parent (who lives in the property full time and is on the policy) both suffer individual losses of $1000. Does the policy pay out $1000, or $1500? What about the annual maximums -- are they joint or separate?

Furthermore, in the "For how much?" section, the coverage limits are described as:

Damage or theft of your stuff, up to $10,000 in total, and $2,500 per item.

Does "your" in this case refer to only me and thus only my property, or does it also include any others who may be added onto the property?

Thank you.

Deductible

Deductible - can it be a percentage of the item claim rather than a nominal amount? This is policy holder knows exactly what the deductible is no matter if one item or multiple items are damaged.

Liability Coverage for Insured's Bodily Injury/Property Damage

The liability section opens with: This policy protects you if someone claims you’ve caused them bodily injury or property damage.

This is put into really clear layman's terms, but "What's not covered" really should lead with something to the effect of "We don't cover for your bodily injury or damage to your property, or for that of any other insured." If Brian accidentally trips his wife while she's playing TwoDots and she falls breaking her wrist and her phone, can she claim for her phone? Her wrist? At present, there's no reason she couldn't--after all, this policy protects when "someone" claims you've caused them bodily injury or property damage. Likewise, if Dave drops an InstaPot of chili on his foot causing a severe burn and breaking his InstaPot, what stops him from making a claim against his policy when his negligence causes him bodily injury and property damage?

You might think, "Sure, we'll see a claim for scratching the landlord's floor, but no way would someone report a claim for their own bodily injury or property damage! That's just not what liability insurance is for." It happens.

Release the 1.0 policy's specs

When going open-source, even when the decision is to create something new, it would be useful to have a base now, as you refer this policy as 2.0. So, where is the 1.0? Release public at least the specs to people inspire and help you and the community.

Maya Personal Insurance Assistant freezes during insurance price check process

Overview:
When a user begins the price check process for homeowner's insurance on the mobile app, the automated Personal Insurance Assistant (Maya) freezes at the "Do you have any other safety devices installed?" question.

Environment:
Model: iPhone SE
Version: iOS 15.3.1

Steps to Reproduce:

  1. Open mobile Lemonade app
  2. Tap the house-shaped icon at the bottom of the screen.
  3. Tap the "Check our Prices" button.
  4. Answer questions posed by automated assistant.

Expected Result:
User should be able to complete questions and receive an insurance quote.

Actual Result:
Screen completely freezes when automated assistant asks "Do you have any other safety devices installed?" Back arrow on top of screen stops responding as well, and app must be quit by pressing the Home button on the phone, then swiping the app to close it.

Dog Breeds

A lot of “vicious” dog breeds are not predisposed biologically or statistically for violence! For instance, chihuahuas are more statistically common to bite, but that’s not there!! I think that if we get our dog certified with full training and socialization, it shouldn’t matter the breed! That’s how State Farm plays it..

Clarification around "add coverage for some of these here"

The base policy covers my stuff for water damage due to a pipe burst, fire, theft and vandalism, but not stuff like accidental damage, loss, etc. Then it says "you can add coverage for some of these here" - what are the "some of these"? How does the language in the policy change when I add that additional coverage?

Define Item

Are a pair of earrings one item or two items. Is a set of golf clubs one or 4 items.

What is the plan?

Hi folks,

This is going to be a pretty interesting case study to watch unfold if it gets legs, and I applaud Lemonade for dipping their toe into this thought-leadership with this experiment. I'm wondering about the longer run plan for the execution and implementation details, juxtaposed against the blurb below. It would impact if, how, and how much, I and likely others contribute. As is, there isn't enough for me to jump in to help, since its too early.

This draft was created in consultation with state regulators, and will be submitted to all states once the community has had its say. Until the approvals are in, Lemonade will continue to offer an industry-standard policy, with a view to letting users switch to Policy 2.0 once its available in their state.

Let me expand:

Right now, this repository is an example of one single policy for Jane. I'm not an expert on how insurance policies work, nor am I American. From your blurb above, and the contents of this repo, does this mean you're expecting contributors to only help author a document which would be used as some kind of appendix in a proposal to a new standard for the entire industry, just in the US? Or is this example renters insurance something Lemonade can sell with or without a government's approval? And how are you going to organize other Countries? Or even just edge cases required for individual states? etc.

Maybe my question lacks context of the industry and your vision here, but whatever the answers are, I'm not actually personally concerned with which way the answer goes. But the answers, in my humble opinion, should be captured at the principle-level, in both a Vision statement, perhaps in the README.md as well as a contributor's guide. These sections would evolve over time, and that's okay.

I personally stumbled into this repo, expecting to contribute to a template system of some kind, not one example. I instantly assumed, insurance policies would end up versioned like software. And built custom to me via config files, or a web app Lemonade would create for non-software-dev consumers. I was immediately wondering to myself "This isn't a template, this is just an example", then froze.

Clarification around "stuff that's used for your business"

"We don’t cover cash, assault weapons, stuff that’s used for your business, or things that you willingly handed over to someone else to look after."

Does this mean company-issued equipment, such as the laptop issued to me that I often take home to finish work? Does this refer to physical goods that I sell? Does it cover a mahogany desk that I use in my home office?

Clarity about Duty to Defend

Standard Insurance Policies include a duty to defend provision under the liability policy, the insurance will cover the associated legal defense costs.

Simple Language: The policy will cover you up to you liability limits (state limit) if you are accused of causing harm, even if you are not responsible.

It should also clarify if coverage is claims made or claims occurred basis in simple language.

Clarification around cannabis coverage

"We don't cover damage caused by illegal activity by someone listed on this policy, nor property that is illegal for you to own."

Please clarify whether or not this intends to provide coverage for finished cannabis products, plants, or grow equipment in the event of an otherwise covered loss. Property can be illegal to own per the federal government, but legal per the state government.

Clarification of "per year" aggregate reimbursement limit

Several part of the policy mention "per year" limits, e.g.:

These amounts indicate the maximum we will reimburse you, in total, per year - even if the losses you suffer are larger.

Your policyholders might misinterpret this to mean per calendar year (e.g., 2017, 2018) rather than per policy year, which is the meaning that I suspect that you intend. Moreover, if you sell a policy for longer than a 12-month term (maybe in the plans down the road), your policyholder may expect to re-up the limits after 12 months.

Also, the deductible section doesn't specify whether it's per claim, per item, or per policy year. It's unclear whether it applies to items or also to things like accommodations while the home is unlivable.

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