AAIS PHYSICIANS AND DENTISTS EQUIPMENT COVERAGE
ANALYSIS
(August 2025)
IM 1405–Schedule of
Coverages–Physicians and Dentists Equipment IM 1400–Physicians and Dentists
Equipment Coverage Analysis
What Must Be Done in Case of Loss |
Additionally, the policy covers furniture,
fixtures, and equipment located at a specified premises. If applicable, the
coverage also includes tenant improvements.
This coverage is available
to individuals engaged in the medical or dental professions. Doctors and
dentists who share offices, equipment, and other facilities but are otherwise
engaged in individual practices are also eligible. It is important to be aware,
this coverage form cannot be used to insure
dealers, clinics, hospitals, medical schools, medical facilities, and similar
organizations.
AAIS Physicians and
Dentists Equipment Coverage requires at least these four forms:
Related Article: CL 0100 AAIS
Commercial Lines Common Policy Conditions
This Schedule of
Coverages is used with IM 1400–Physicians and Dentists Equipment Coverage. IM
1405 contains the following information:
Editorial Observation: Medical Equipment is covered under the Property Covered section and is not
location-specific. Coverage is provided for direct physical loss caused by a
covered peril to medical, surgical, or dental equipment. There does not appear
to be a designated location on the Schedule of Coverages to insert the limit
desired for Medical Equipment. Please consult your company's underwriter for
instructions on how to add a specific limit for Medical Equipment.
This section is used to
add furniture, fixtures, equipment, and, if applicable, tenants’ improvements. However,
since there is no space to add the medical equipment limit, this may also be
used to include the limit. A discussion with the company underwriter will be
necessary. The location number and a description of the premises are entered
along with an applicable limit.
Additionally, a
catastrophe limit for all locations in a single occurrence, if desired, must be
entered in the designated spaces. If no catastrophe limit is desired, the words
“void” or “not applicable” may be entered on the schedule of locations under
the space provided for the catastrophe limit.
This is the amount the
named insured retains for each covered loss. It must be entered in the space
provided.
Three optional
endorsements are available.
This endorsement covers
the following property for the very low limits contained in the endorsement:
The endorsement
provides no option for increasing any of these limits.
This endorsement limits
property coverage to only medical equipment, tools, supplies, and scientific
books the named insured typically carries. No space is provided to specify a
limit. Additionally, the Coinsurance, Coverage Extensions for Theft Damage to
Building, and Emergency Removal provisions are removed.
This endorsement covers
loss caused by artificially generated electric current at locations listed on
the schedule of coverages and occurring within 100 feet of the described
premises. It is subject to the deductible specified in the spaces provided on this
schedule of coverages.
Physicians and Dentists
Coverage is written on a non-reporting basis. This section provides spaces to
enter the annual premium, the non-reporting rate per $100, and any applicable
minimum premium.
(01
05 edition)
This section states that the insurance company provides the coverage
described in return for the named insured paying the required premium. This
agreement is subject to all the terms of the coverage form, the schedule of
coverages, and any additional conditions that apply. Endorsements or additional
schedules identified on the schedule of coverages also apply.
There is a statement indicating that certain words and phrases
highlighted in bold print in the coverage form are defined in the Definitions
section immediately following this Agreement.
NOTE: The schedule
of coverages does not have a clearly designated space to list endorsements or
additional schedules that apply at inception.
Defined words are used
throughout the coverage form. When these terms appear in the coverage form, the
meaning provided in this section must be applied.
NOTE: The Editors added
titles to enhance clarity.
The
parties specifically listed on the declarations as insureds.
The
insurance company providing the coverage.
The applicable coverage
amount.
Any page labeled as
such that includes coverage details, including declarations or supplemental
declarations.
A sinkhole occurs
when the earth’s surface suddenly sinks or collapses into an underground cavity
formed by water erosion on limestone or other rock types. This definition of
sinkhole collapse excludes considerations of the land value or expenses involved
in filling sinkholes.
The definition contains the following
specifically named perils:
•
aircraft
•
civil commotion
•
explosion
•
falling objects
•
fire
•
hail
•
leakage from fire
extinguishing equipment
•
lightning
•
riot
•
sinkhole collapse
•
smoke
•
sonic boom
•
vandalism
•
vehicles
•
volcanic action
•
water damage
•
weight of sleet,
snow, or ice
•
windstorm
Two terms require
further clarification:
This coverage does
not extend to personal property stored outdoors. Additionally, it does not
cover damage to the interiors of buildings or personal property stored inside
buildings unless a falling object first breaches the building's exterior.
This refers to the
sudden or accidental release or leakage of water or steam. However, it must
directly result from a crack or break in a part of the system or appliance that
contains the water or steam.
All provisions, limitations, exclusions, conditions, and definitions
relevant to the coverage provided.
An airborne volcanic blast or shock wave,
which also includes ash, dust, and particulate matter, as well as any lava
flow. The term does not include the expenses for removing dust, ash, or
particulate matter from the covered property unless there is direct
physical damage to the property.
|
Example of dentist's equipment |
The insurance company
covers property described below unless it is excluded or subject to limitations.
This is the primary
coverage provided under this form. It protects against direct physical loss
caused by a covered peril to the named insured’s medical, surgical, or dental
equipment, tools, supplies, scientific books, and related property. It also
covers damage to similar property of others in the care, custody, or control of
the insured.
The property described
in item a. above is covered only if the named insured uses it as part of their
medical or dental practice.
NOTE: There is no location-specific
limitation.
Example: Dr.
Mabel works at three different offices. To avoid having duplicate items
at each location, she chooses to carry her most valuable and comfortable
equipment with her. In addition to this, she also brings her laptop and other
electronic devices essential for her work. All of these items are covered by
her insurance, even when she takes them to conferences, as long as she stays
within the territorial limits specified in her coverage policy. |
Direct physical loss
caused by a covered peril to the office furniture, fixtures, and equipment
owned by the named insured is covered.
NOTE: Although it is not stated, this would
appear not to include the Medical Equipment covered in item 2. above. An
inventory of location-specific equipment vs
medical equipment carried by the named insured should be maintained to prevent
duplication of coverage and potential concerns regarding coinsurance.
Coverage applies only
to furniture, fixtures, and equipment located at the described premises as
listed on the schedule of coverages.
This coverage is
available only if the named insured is a tenant. It covers direct physical loss
caused by a covered peril to improvements the insured has made to the scheduled
premises. However, the insured must have an insurable interest in these improvements.
Coverage applies only
to locations listed on the coverage schedule, provided the insured does not own
the building.
NOTE: Being able to include
furniture, fixtures, equipment, and tenants' improvements is an advantage for
the insured. All such personal property in which it has an insurable interest
can be covered under a single coverage form.
This helps prevent
potential issues if two or more coverage forms or policies are involved and a
dispute arises over which policy provides coverage for each type of property in
the event of a loss. When one insurance company manages all coverages, it
responds to the loss and later allocates the costs of the different categories
of personal property internally.
There is no coverage
for the following property:
Property owned by a
clinic, hospital, medical school, or similar organization is not covered.
NOTE: This is a very important restriction, considering
the policy states coverage for medical equipment is provided if it is owned by
others, in the insured's care, custody, or control, and being used in the
insured's medical profession. However, the eligibility rules clearly state
coverage owned by the above types of organizations are not covered.
This
refers to anything containing any amount of radium.
Coverage includes direct physical loss or damage caused by thieves to
the part of the building the insured occupies, as well as damage to equipment
used for maintenance or servicing the building.
This coverage is only applicable if the named
insured owns the building or is legally responsible to the building owner for
this type of damage. The property covered under this form must be located in
the premises listed on this schedule of coverages.
Damage or loss caused by fire is not covered. Similarly, damage to glass,
glass lettering, or glass decorations is excluded.
This is not
additional insurance. Any payment made counts toward the property's coverage
limit.
Example: Dr. Mabel’s primary office is in a
multi-tenant building. She is dismayed to discover the door to her office has
been shattered, her computers are missing, and cabinets have been torn from
the walls. The walls and door are owned by the building owner. The damage to
these items is covered because Mabel is legally responsible for the damage,
which was caused by an incident. |
This covers direct
physical loss to covered property removed from a scheduled location to
prevent damage from an impending covered peril. The loss can occur while the
property is in transit between the scheduled and sanctuary locations. This
coverage is unique because the property being moved is not subject to any
exclusion while in transit or at the sanctuary location. However,
the reason for moving the property must be due to a covered
peril.
This coverage applies
for up to ten days after the property is moved and will not extend past the expiration date of the policy.
NOTE: Coverage does not
extend past the expiration date. If the named insured has property at an
emergency location when coverage renews, the emergency location must be listed
as a premises, or coverage no longer
applies
This coverage is part
of the limit for the coverage described under Property Covered, not in addition
to it.
Coverage applies to
risks of direct physical loss unless the loss is limited or caused by an
excluded peril.
Coverage
for collapse is provided when caused by one or
more of the following:
Collapse
refers to the sudden and unexpected sinking or caving in of a building,
structure, or parts of it, making the structure unusable for its intended
purpose.
The
following buildings and structures are not considered to be in a
state of collapse:
The covered property
limit does not increase for this coverage.
There is no coverage
for loss resulting from an order issued by any civil or government
authority. These orders may include seizure, confiscation, destruction, or
quarantine of property, but this list is not exhaustive. The only exception is
when a civil authority destroys property to control a fire that causes loss or
damage. This exception applies only if the fire is caused by a covered peril.
The insurance company does not
cover loss or damage caused by any act of war. This includes undeclared wars,
civil wars, or warlike actions by military forces, all of which are considered
war. Additionally, measures taken to hinder or defend against actual or
expected attacks by any government or sovereign authority using military
personnel or agents are also classified as war and are not covered.
NOTE: This means the exception for fire resulting from a
nuclear hazard does not apply when it is caused by war.
The second group of exclusions pertains
to loss or damage caused by or resulting from specific events listed below.
Some of these exclusions include exceptions, conditions, or limitations
that should be noted and carefully reviewed. The insurance company will
not cover any loss or damage caused by or resulting from any of these events.
There is no coverage for losses caused by or resulting from acts or
decisions made by any person, organization, or government entity. This
exclusion also applies to instances where there is a failure to act or decide.
However, there is an exception to this exclusion. If an act or decision,
or a failure to act or decide, leads to a covered peril, then the loss or
damage caused by that peril is covered.
Coverage does not apply to loss or damage due to nesting, infestation,
or the discharge or release of waste, secretions, or other substances by
animals. In this context, animals include, but are not limited to, birds,
insects, and vermin. However, if any of these excluded events result in a
covered peril, the loss or damage that peril causes is covered.
Loss or damage caused
by the breaking of glass objects or items primarily made of glass are not
covered. Additionally, there is no coverage for loss or damage caused by
property being marred, scratched, or exposed to light.
However, the following
are exceptions:
·
Breakage
of lenses is not excluded.
·
If
any of the excluded events lead to a specified peril, theft, or attempted
theft, the loss caused by these perils is covered.
·
Property
damaged by any of these events is not excluded if it is in the custody of a
carrier for hire.
Loss
caused by collapse is not covered unless the collapse is included under Other
Coverages - Collapse, in which case coverage applies. Additionally, if an
excluded collapse results in a covered peril, coverage extends to the damage or
loss caused by that peril.
Loss or damage caused by contamination or deterioration
is excluded. This includes corrosion, decay, fungus, mildew, mold, rot, and
rust. It also applies to any quality, fault, or weakness in the covered
property that leads to self-damage or destruction. This exclusion is not
limited to just these causes. However, if contamination or deterioration
results in a covered peril, the resulting loss or damage from that peril is
covered.
Coverage does not apply
to loss caused by, or resulting from, criminal, fraudulent, dishonest, or
illegal acts committed by any of the following, whether alone or in collusion
with others:
·
The
named insured
·
Others
with an interest in the property
·
Others
to whom the property has been entrusted
·
The
named insured's partners, officers, directors, trustees, joint venturers,
members, or managers, as applicable, based on the named insured’s type of
business organization
·
Employees
of any of the groups listed above. Employees are excluded even if the act
occurs when they are not considered to be working.
However, this exclusion
does not apply to covered property in the care of a hired carrier.
There is no coverage for loss or damage due to artificially generated
electrical currents damaging electrical equipment or wiring inside the insured
property. This exclusion only applies to the property that generates the
current artificially. However, electrical currents can cause a fire or
explosion. In such cases, the loss or damage resulting from the fire or
explosion is covered.
There is an important
provision. This exclusion applies both on and off the designated premises and
regardless of negligence. However, if loss or damage from one of these events
results in a covered peril, then the loss or damage caused by that peril is
covered.
Coverage does not apply to
losses from delays, loss of use, or loss of market.
Loss due to mechanical breakdown is excluded, but
there is an exception: if an excluded loss leads to a covered peril, then the
resulting loss from that covered peril is covered.
Coverage is excluded if loss or damage to covered property is caused by
dryness, dampness, humidity, or temperature extremes or fluctuations. However,
if one of these events causes a covered peril, the resulting loss or damage
from that peril is covered.
Loss or damage caused
by wear and tear is not covered. However, if wear and tear leads to a covered
peril, the resulting loss or damage from that peril is covered.
Loss or damage due to weather conditions is excluded, but
only when the loss results from a weather condition combined with a cause of
loss excluded in 1–Primary Exclusion above. However, if weather conditions lead
to a covered peril, then the loss caused by that peril is covered.
Additionally, there is no coverage for repairs or emergency
measures taken for property not already damaged by a covered peril.
NOTE: It is important to realize that any such costs
incurred will reduce the amount available to pay the actual loss.
The proof of loss must also specify the named insured’s
interest and the interests of others in the property involved, including liens
and mortgages. Any changes to the title of the property during the policy
period must be disclosed, along with any other reasonable information the
company may need, such as inventories, specifications, and estimates for
settling the loss.
The
value of the covered property is its
actual cash value on the date of loss. Actual Cash Value is replacement cost
new minus depreciation. This item is subject to items 2. through 4. of this
section.
Tenants’ improvements
are valued at their actual cash value, but only if the named insured repairs or
replaces the damaged improvements at their own expense and within a reasonable
timeframe.
If the improvements are
not repaired or replaced within a reasonable time, the value is based on only a
portion of their original cost. That value is computed using the following
formula:
Step 1: Determine the number of
days between the lease’s expiration date and the date of loss.
Step 2: Determine the number of
days from the date the improvement was installed to the lease’s expiration
date.
Step 3: Divide Step 1 by Step
2.
Step 4: Multiply Step 3 by the improvement’s
original cost.
The procedure above
changes if the lease has a renewal option. Instead of the original lease's
expiration date, the renewal option's expiration date is used in Step 1.
No payment will be made if another party
repairs or replaces lost or damaged property at its own expense.
Example:
A fire in the office on December 1, 2024, convinces Mabel that it is time to
move. Although she enjoyed the improvements she had made in her office, she
is not permitted to remove them. She requests a cash settlement for her loss.
The company calculates it as follows: Step
1: Mabel’s lease expires on January 1, 2029, so there are 1,491 days between the
date of loss and the expiration date of the lease. Step
2: The improvements were installed when she
occupied the premises in January 1, 2019. As a result, there are 3,652 days
between the installation date and the lease's expiration date. Step
3: 1,491/3,652 = .408 Step 4: The original cost of the improvements and
betterments was $10,000. Mabel can expect to receive $4,080 ($10,000 X .408).
|
The value of a loss
involving damage or loss of one item from a pair or set is determined by a
fair proportion of the total value of the entire pair or set. However, losing
one part of a pair or set does not constitute a total loss.
NOTE: This recognizes the value of the whole is
greater than the value of individual parts, but the remaining part still has
value as a separate.
The value of a lost
or damaged part, which comprises several parts, is determined by the cost to
repair or replace just the lost or damaged part.
NOTE: This recognizes that the whole is more
valuable than the sum of its parts, but the individual parts still retain value
on their own.
The insurance company will not pay more than the
insured's insurable interest in the covered property at the time of loss.
The insurance company pays only the amount of loss
exceeding the deductible amount shown on the Schedule of Coverages.
The loss settlement
terms will be subject to items 1., 2., 4., and 5. under this section.
The insurance company
pays the least of the following:
·
The
amount determined based on the Valuation section – 1. Actual Cash Value, 2.
Tenant’s Improvements, 3. Pair or Set, or 4. Loss to Parts.
·
Costs
of repairing, replacing, or rebuilding the damaged property.
·
Limit
applicable to the covered property.
If there is a
catastrophe limit on the schedule of coverages, and a covered peril causes loss
or damage at more than one premises listed on the schedule, the most paid in a
single occurrence is the lesser of the following:
·
The
total of the limits for covered property
at all locations where the loss occurred
·
The
catastrophe limit
Example: Mabel operates out of
three different offices. Some of her equipment is stationed at these offices,
while other equipment travels with her depending on the scheduled procedures.
She requests that there be no catastrophe limit on the coverage schedule, as
this restriction does not accommodate her mobile equipment. |
This provision applies to
losses occurring at a covered premises
listed on the schedule of coverages. There is no coinsurance provision for
property in transit.
The insurance company
does not pay the full amount of any loss if the value, at the time of the loss,
of all covered property multiplied by .80 exceeds the limit of insurance.
The following are the
steps the insurance company takes to determine the amount it pays:
Step 1: Determine the value of
items, at the time of the loss, of all covered property at the loss premises
subject to coinsurance.
Step 2:
Multiply Step 1 by the coinsurance percentage of 80.
Step 3.
Divide the limit for the covered property at the premises subject to
coinsurance by the result determined in Step 2.
Note: Stop
here if the result is 1.00 or higher because no coinsurance penalty applies. Go
to Step 4 only if the result is less than 1.00.
Step 4.
Multiply the total amount of loss, prior to the application of a deductible, by
the percentage determined in Step 3.
Step 5.
Subtract the applicable deductible from Step 4.
The insurance company does not
pay more than the amount determined in Step 5. or the limit of insurance,
whichever is less. It does not pay any remaining part of the loss.
The
named insured may have other coverage subject to the same terms as this
coverage form. In such case, this coverage form pays only its portion of the
covered loss. That portion is determined by the ratio of its limit of insurance
to the total limits of all such insurance covers on the same basis.
There
may be another policy available to cover the loss, aside from what is described
in item 7.a. above. In such cases, this coverage will apply on an excess basis.
It will only pay the amount of the covered loss that exceeds the amount
provided by the other policy, regardless of whether that other coverage can be
collected. Any payment made is subject to the applicable limit of insurance.
The insurance company has the following loss payment
options if a covered loss occurs:
·
Pay the value of the property
that sustained loss or damage.
·
Pay the cost to repair or
replace the property that sustained loss or damage.
·
Rebuild, repair, or replace the
property with similar property, to the extent possible, and it must be
accomplished within a reasonable period.
·
Take any part or all of the
property based on the value agreed upon or determined through appraisal.
The insurance company is required to inform the named
insured of its intent to rebuild, repair, or replace within 30 days after
receiving a properly completed proof of loss.
The insurance company
settles all claims with the named insured. It will also only pay the named
insured, unless a loss payee is listed on the policy.
The insurance company
settles a covered loss within 30 days of receiving a properly prepared proof of
loss, and the loss amount is confirmed. The amount is determined either through
a written agreement with the insured or after an appraisal award is filed with
the company.
The insurance company
can adjust and pay losses involving others' property to either the named
insured on behalf of the property owner or directly to the property owner.
The insurance company
is not obligated to pay the named insured if it has already paid the property
owner. Additionally, if the property owner sues the named insured, the company
can choose to defend the named insured in the lawsuit.
Either party can
request an appraisal to determine the value of the disputed claim. Once a
request is made, both parties have 20 days to choose their own independent
appraisers and notify the other party of their appraiser's name. The two
appraisers then have 15 days to select a competent and impartial umpire. If
they cannot agree on an umpire within that time, either party can ask a judge
in the court of record in the state where the property is located to appoint
one.
The appraisers will
then determine the value of the claim and submit any differences to the umpire.
Once any two of the three parties (the two appraisers and the umpire) agree,
the amount of loss is finalized.
Each party is responsible for paying its own
appraiser, while the costs associated with the umpire and other shared expenses
are divided equally between both parties.
The insurance does not provide any benefit, directly or
indirectly, to any party with custody of the insured's property.
Any condition in this coverage form that conflicts with any
applicable law is amended to conform to that law.
This condition is applicable only when the
insured is an individual.
a. Your Death
When the named
insured passes away, the individual in custody of the insured's property
remains an insured for that property until a qualified legal representative is
appointed. After the appointment of the legal representative, that person
becomes an insured, but only for the property covered under this policy.
b. Policy Period is not Extended
This coverage
does not extend past the policy’s expiration date.
Any revisions to this
coverage form or applicable endorsements that become effective during the
policy period or within six months of the coverage effective date that broaden
coverage without an additional premium will apply to this policy.
This
coverage is void if any insured at any time willfully concealed or
misrepresented a material fact that relates to the insurance provided, the
property covered, or its interest in the property. It is also void if any
insured engaged in fraud or false swearing with respect to the insurance
provided or the property covered.
NOTE: The named insured must
deal with the insurance company honestly. Its rights of recovery may be voided
if it intentionally misrepresents or conceals a material fact or information.
This means the insurance is treated as simply having never existed versus a
particular claim being denied.
Only covered losses occurring during the policy period are
paid.
Payment of the loss
does not end the obligations of the named insured and the insurance company
toward each other. Additional provisions apply if the insurance company pays a
loss and the lost or damaged property is later recovered, or if the party
responsible for the loss reimburses for the damage.
Either party that
recovers property or payment must notify the other. Recovery expenses incurred
are reimbursed first. If the named insured keeps the recovered property, they
must repay the amount the insurance company paid on the claim, unless the company
agrees to a different amount.
If the paid claim is
less than the agreed loss because of a deductible or other limit, any recovery
is prorated between the named insured and the insurance company based on the
company's respective interests in the loss.
Payment of a claim does not
reduce the limit available for future claims.
The insurance company
acquires the named insured's rights of recovery from third parties after it
pays a loss. The named insured must assist the company in securing those
rights. The insurance company is not obligated to pay the loss if the named
insured hinders or impairs its rights of subrogation.
The named insured has the right
to agree in writing to waive recovery rights from any party, provided such
waiver is made before a loss occurs.
The insurance company
cannot be sued by anyone for any coverage until all the terms of the coverage
form have been met. Suits must be brought within two years after the named
insured first became aware of a loss. If a state law invalidates this condition,
any suit brought must comply with that law’s provisions and begin within the
shortest period allowed by law.
NOTE: It is common
for a basic coverage form to be modified by required state-specific
endorsements that address issues related to that state.
Additionally,
failure to activate the device when the business is closed will automatically
suspend coverage at the location where the device is not in use. Coverage will
automatically resume once the device is operational again.
Example: When burglars broke into Mabel’s
office, her operating premises' burglar alarm system rang at the security
attendant's desk at the front of the building. Unfortunately, the attendant
was helping another tenant when the alarm rang. When the attendant returned
to his post, the alarm had ceased, and the police were never notified.
However, this was the alarm system and arrangement that had been warranted to
be in place, and it operated properly when the burglars broke into the
premises. As a result, the loss was fully paid. |
AAIS has developed four
endorsements to use with Physicians and Dentists Equipment Coverage.
Coverage for five
additional classes of property for relatively small limits are added. The added classes are Office
Furniture Away From Premises, Money and
Stamps, Personal Effects, Records, and Extra Expense.
This endorsement restricts
coverage to only medical equipment, tools, supplies, and scientific books normally
carried by the insured. Coinsurance does not apply.
When this endorsement
is attached, no coverage for office furniture, fixtures, and improvements is
eligible for coverage. Additionally, Theft Damage to Building, Emergency
Removal and Coinsurance are deleted from policy form.
The schedule of
coverages does not include a space for a limit to be entered for this option.
This endorsement
provides coverage for damage to covered property caused by artificially
generated electric current. It modifies the exclusion for Electric Currents
under Perils Excluded so that it still applies, except where this endorsement
provides coverage. Additionally, it revises the How Much We Pay section to
clarify that coverage only applies to the loss amount exceeding the deductible
listed in the coverage schedule.
This endorsement
revises the coinsurance clause to apply to the value of all covered property
across all listed premises, instead of only the value at the premises where the
loss occurred. This provision does not apply to property in transit.
The insurance coverage
provided by this form is underwritten primarily as an office exposure, unless
the off-premises exposure is significant or unusual. The equipment’s location,
when it is not at the main location, is the most critical issue. The following
are other prominent issues to consider: