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FILED: ONONDAGA COUNTY CLERK 05/09/2019 11:35 AM INDEX NO. 008588/2018
NYSCEF DOC. NO. 100 RECEIVED NYSCEF: 05/09/2019
Liber
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______*
Mutual Liberty Mutual Insurance
I N S U RA N C E 350 E 96th
Indinner s, IN 46240
Telephone: 317-581-6654
October 16, 2017
JohnDowning
PO Box 515097
Los Angeles CA 90051
Insured Name: Brian C Prusik
Policy Number: H3722833201940
Claim Number: 035768762
Date of Loss: 06/18/2017
Effective Date: 03/24/2017
I hereby certify that the attached is a true and accurate copy of the documeñts requested for the policy
listed above as mainteined by the Liberty Mutual Insurance Group Inc. in the usual and customary course
of its business.
Sincerely,
Kimberly Firszt
Policy Copy
Support
KF
Enclosures
PLPolicy/DecRequest
FILED: ONONDAGA COUNTY CLERK 05/09/2019 11:35 AM INDEX NO. 008588/2018
NYSCEF DOC. NO. 100 RECEIVED NYSCEF: 05/09/2019
Liberty
Policy Declarations
A summary of your homeowners insurance COverage
Thank you for insuring with us. Here is your renewal homaGwñars policy snn y, which is
effective as of 03/24/2017 .
INSURANCE INFORMATION QUESTIONS ABOUT
YOUR POLICY?
Named Insured Policy Number
Brian C Prusik H37-228-332019 -40
By phone
For service:
Mailing Address Policy Period 1-800-225-7014
121 Slosson Rd 03/24/2017 -03/24/2018 12:01AM
West Monroe NY 13167 -3125 Liberty Mutual
standard time at the address of the PO Box 970
Named Insured at Insured Location. Mishawaka IN 46546
Insured Location
Same as Mailing address above Sales Representative
Cindy A Payne
1-315-468-4000
Premium Summary
To report a claim
Stâñdard Policy with HomeProtector Plus $ 1,507.00 By phone
Additional Coverages $ 19.00 1-800-225-2467
Total 12 Month Policy Premium $ 1,526.00
Your discounts and bañafits have been applied to your total policy premium, Please
refer to the Discounts and Benefits section for more details.
Through your affiliation with AmeriCU Credit Union your policy includes savings on
your home insurance through the TruStage™Auto and Homeowñars Insurance
Program.
THIS IS NOT YOUR HOME INSURANCE BILL.
Coverage Information
Your policy includes
Standard Policv with HomeProtector Plus HomeProtector Plus,
which provides enhanced
Section I Coverages LIMITS PREMIUM coverage in case of a loss.
Please see your
A. Dwelling with Expanded Replacement Cost $ 491 ,700 . endorsement for details.
B. Other Structures on Insured Location $ 55,670
C. Personal Property with Replacement Cost $ 368,780
D. Loss of Use of Insured Location Actual Loss Sustained
Section II Coverages
E. Personal Liability (each occurrence) $ 1,000,000
F. Medical Payments to Others (each person) $ 1,000
Policy Deductibles
Losses covered under Section I are subject to a deductible of: $1,000
If losses are a result of Wind they are subject to a deductible of: $1,000
Total Standard Policy with HomePratacter Plus $ 1,507
FMHO 3047 06 11 Policy Number: H37-228-332019 -40 7 5 Declaraticñs Effective: 03/24/2017 Page1 of 2
FILED: ONONDAGA COUNTY CLERK 05/09/2019 11:35 AM INDEX NO. 008588/2018
NYSCEF DOC. NO. 100 RECEIVED NYSCEF: 05/09/2019
Liberty
Mutual.
INSURANCE
Coverage Information (continued)
Additional Coverages
DEDUCTIBLE LIMITS PREMIUM
Credit Card, Fund Transfer Card, $ 1,000 $ 0
Forgery
Other Structures - Increased Limits $ 19
Workers Compensation Coverage INCL
COverags E increased limit INCL
Total Additione! Coverages $ 19
DisCounts and Benefits
Your discounts and beriefits have been applied to your total policy prGmium.
e Inflation Fivicoi;ve Discount e MultI Policy Discount - Auto
• Basic Home Safety
Endorsements - Changes to Your Policy
. LibertyGuard®Deluxe Homeowner Policy • Home Protector Plus (FMHO-2023)
(HO 00 03 04 91)
• Pict6ctive Devices (HO 04 16 04 91) • Pictactiv6 Devices (FMHO 4172 1014)
• Credit Card, Fund Transfer Card, Forgery . Amendmt Pol Pc'!nit|cnc (FMHO-2934 7/04)
(HO 04 53 04 91)
• HGraGGwaõr Amendetory Endorcoment • Special PrGviõiüñs - New York
(FMHO 2810 0411) (FMHO6100NY 1016)
• Workers Compéñsâtica Coverage • Inflation Protection (FMHO-2936 9/04)
(HO 24 93 05 02)
• No Covg-Home Daycare Bus (HO 23 43 04 91) . NY - Ara6ñdâtGrf End (FMHO-2240)
e Améñdatary Seepage End (FMHO-2265) e Fuel Storage Exc|üõ|úñ (FMHO 3181 0309)
e Sexual Mo!eetat!on Excl (FMHO-949 09/91) • Other Gtructursa - Increased Limits
(HO 04 48 04 91)
Mortgage Information
Mortgagee 1: Mortgagee 2:
GEDDES FEDERAL SAVINGS ANDLOAN ASSOC. KEY BANK NATIONAL ASSOCIATION
2208 W Genesee St ISAOA ATIMA
Syracuse, NY 13219 -1620 LOAN NO. 9013088747 5081
4910 Tiedeman Rd
Cleveland, OH 44144-2338
Important Messages
Flood !neurence: Your Homsë ñere policy does not provide coverage for damage caused by flood, even If
the flood is caused by a storm surge. Liberty Mutual can help you obtain this coverage through the
Federal Emsigsñcy Mañãgsmêñt Agency (FEMA) If your commun|‡y part|cipates In the National Flood
Insurance Program. Please call your representative for more :::--sct:z.
LibertyGuard®Deluxe Homeowners Policy DGC!ârat!Oñe This policy, including endorsements
'
Coverage provided and .. rewritten by Liberty !neurence Corporaticñ, Boston MA. listed above, is ccüñ1 by:
Mark C. Touhey David H. Long Ty Harris
Secretary President Authorized flopre:;catative
FMHO 3047 06 11 Policy Number: H37-228-332019 -40 7 5 DecliEuaiioris Effective: 03/24/2017 Page2 of 2
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FILED: ONONDAGA COUNTY CLERK 05/09/2019 11:35 AM INDEX NO. 008588/2018
NYSCEF DOC. NO. 100 RECEIVED NYSCEF: 05/09/2019
Liberty
Mutual.
INSURANCE
. .
LibertyGuard Deluxe Homeowners Policy
Please read your policy and each endorsement carefully.
To serve you best...
Liberty Mutual has 350 service
over offices throughout the United States
and Canada. Please contact your service office shown on your Dac|arations
Page to report losses, or for any changes or questions about your insurance.
Payrñêñts should be sent to the office indicated on your bill.
THIS POLICY IS NON ASSESSABLE
FMHO 943 (ED. 1 1-96) Liberty Mutual Group
FILED: ONONDAGA COUNTY CLERK 05/09/2019 11:35 AM INDEX NO. 008588/2018
NYSCEF DOC. NO. 100 RECEIVED NYSCEF: 05/09/2019
Liberty
Mutual.
INSURANCE
LIBERTYGUARD DELUXE HOMEOWNERS POLICY
HO 00 03 EDITION 04 91
TABLE OF CONTENTS Page Page
Agreement............................................. 1 Other Insurance ................................. 10
Definitions............................................. 1 Suit Against Us.................................. 10
Our Option ........................................ 10
SECTION I - PROPERTY COVERAGES
Loss Payment..................................... 10
Coverage A Dwelling.........................., 1
Abandonment of Property..................... 10
Coverage B Other Structures................ 2
Mortgage Clause................................. 10
Coverage C Personal Property............... 2-3
No Benefit To Bailee............................ 10
Coverage D Loss of Use....................... 3 Nuclear Hazard Clause......................... 10-11
Additional Coverages........................... 3 Recovered Property............................. 11
Debris Removal................................ 3 Volcanic Eruption Period...................... 11
Reasonable Repairs........................... 3-4 SECTION II - LIABILITY COVERAGES
Trees, Shrubs and Other Plants.......... 4 Coverage E Personal Liability................ 11
Fire Department Service Charge.......... 4 Coverage F Medical Payments to Others. 11
Property Removed............................ 4 SECTION II - EXCLUSIONS
Credit Card, Fund Transfer Card, Forgery Coverage E Personal Liability and Coverage F
and Counterfeit Money.................... 4
Medical Payments to Others ............11-13
Loss Assessment ............................. 4-5 Coverage E Personal 13
Liability................
Collapse ......................................... 5 Coverage F Medical Payments to Others. 13
Glass or Safety Glazing Material......... 5 SECTION II - ADDITIONAL COVERAGES
Landlord's Furnishings ...................... 5-6
Claim Expenses .................................. 13
SECTION I - PERILS INSURED AGAINST
First Aid Expenses .............................. 14
Coverage A Dwelling and Coverage B
Damage to Property of Others .............. 14
Other Structures............................. 6
Loss Assessment................................ 14
Coverage C Personal Property............... 6-7
SECTION I - EXCLUSIONS SECTION II - CONDITIONS
Ordinance or Law................................ 7 Limit of Liability.................................. 14
Earth Movement................................. 7-8 severability of Insurance....................., 14
Water ................................... 8 Duties After Loss ............................... 14-15
Damage
Duties of an Injured Person .................. 15
Power Failure ..................................... 8
Payment of Claim ............................... 15
Neglect ............................................. 8
Suit Against Us.................................. 15
War.................................................. 8 of an Insured ..................... 15
Bankruptcy
Nuclear Hazard...............................x.. 8 Other Insurance.................................. 15
Intentional Loss.................................. 8 SECTIONS I AND II - CONDITIONS
Weather Conditions............................. 8 Period ...................................... 15
Policy
Acts or Decisions................................ 8 Concealment or Fraud ......................... 15
Faulty, Inadequate or Defective............. 8 Liberalization Clause .......................... 15
SECTION I - CONDITIONS Waiver or Change of Policy Provisions ... 15
Insurable Interest and Limit of Liability ... 8 Cancellation....................................... 15-16
Your Duties After Loss ......................., 8-9 Non-Renewal ..................................... 16
Loss Settlement.................................. 9-10 Assignment ....................................... 16
Loss to a Pair or Set ........................... 10 Subrogation ....................................... 16
Glass Replacement ............................. 10 Death................................................ 16
Appraisal .......................................... 10 *MUTUAL POLICY CONDITIONS ............. 16
*These cónditións apply only if Liberty Mutual Fire Insurance Company is shown in the Dee!arations as the
insurer.
FILED: ONONDAGA COUNTY CLERK 05/09/2019 11:35 AM INDEX NO. 008588/2018
NYSCEF DOC. NO. 100 RECEIVED NYSCEF: 05/09/2019
Liberty
Mutual.
INSURANCE
HOMEOWNERS 00 03 04 91
AGREEMENT
We will provide the insurance desciibed in this policy in return for the premium and compliance with all
applicable provisions of this policy.
DEFINITIONS
"you" "your"
In this policy, and refer to the c. Any premises used by you in cGanectica
insured"
"named shown in the Decia atiGns and with a premises in 4.a. and 4.b. above;
the spouse if a resident of the same household. d. Any part of a premises:
"We," "us" "our"
and refer to the Company (1) Not owned by an "insured"; and
"insured"
providing this insurance. In additian, certain words (2) Where an is temperailly
and phrases are defined as follows: residing;
injury"
1. "Bodily means bodily harm, sickness or e. Vacant land, other than farm land, owned
disease, including required care, loss of by or rented to an "insured";
"insured"
services and death that results. f. Land owned by or rented to an
"Business"
2. includes trade, profession or on which a one or two family dwelling is
occupation. being built as a residence for an "insured";
"Insured"
3. means you and residents of your g. Individual or family cemetery plots or burial
household who are: vaults of an "insured"; or
a. Your relatives; or h. Any part of a premises occasionally rented
"insured" "business"
b. Other persons under the age of 21 and in to an for other than
the care of any person named above. use.
"insured" "Occurrence"
Under Section II, also means: 5. means an accident, including
c. With respect to animals or watercraft to continuous or repeated exposure to
which this policy applies, any person or substantially the same general harmful
organization legally responsible for these conditions, which results, during the policy
animals or watercraft which are owned by period, in:
you or any person included in 3.a. or 3.b. a. "Bodily injury"; or
damage."
above. A person or organization using or b. "Property
damage"
having custody of these animals or 6. "Property means physical injury to,
"business"
watercraft in the course of any destruction of, or loss of use of tangible
or without consent of the owner is not an property.
employee"
"insured"; 7. "Residence means:
"insured"
d. With respect to any vehicle to which this a. An employee of an whose duties
policy applies: are related to the maintenance or use of
premises,"
(1) Persons while engaged in your employ the "residence including
or that of any person included in 3.a. household or domestic services; or
or 3.b. above; or b. One who performs similar duties elsewhere
"business"
(2) Other persons using the vehicle on an not related to the of an
location" "insured."
"insured with your consent.
location" premises"
4. "Insured means: 8. "Residence means:
a. The "residence premises"; a. The onefamily dwelling, other structures,
b. The part of other premises, other and grounds; or
structures and grounds used by you as a b. That part of any other building;
residence and: where you reside and which is shown as the
premises"
(1) Which is shown in the Declarations; or "residence in the Declarations.
premises"
(2) Which is acquired by you during the "Res|dence also means a two family
policy period for your use as a dwelling where you reside in at least one of the
residence; family units and which is shown as the
premises"
"residence in the Declarations.
SECTION I - PROPERTY COVERAGES
COVERAGE A - Dwe!!!ng 2. Materials and supplies located on or next to
premises"
We cover: the "residence used to construct,
premises"
1. The dvve|||ng on the "residence alter or repair the dwõ|||ng or other structures
shown in the Declarations, on the "residence premises.
including structures attached to the dvvo||;ng, This coverage does not apply to land, including
and land on which the dwelling is located.
Page 1 of 16
FILED: ONONDAGA COUNTY CLERK 05/09/2019 11:35 AM INDEX NO. 008588/2018
NYSCEF DOC. NO. 100 RECEIVED NYSCEF: 05/09/2019
u ual
INSURANCE
COVERAGE B - Other Structures furs, precious and semi-precious stones.
We cover other structures on the "residence 6. $2000 for loss by theft of firearms.
premises"
set apart from the dwelling by clear 7. $2500 for loss theft of
by silverware,
space. This includes structures connected to the silver-plated gold-plated ware
ware, goldware,
dwelling by only a fence, utility line, or similar and pewterware. This includes flatware,
connection. tea sets, trays and trophies made
hollowware,
This coverage does not apply to land, including of or including gold or pewter.
silver,
land on which the other structures are located.
8. $2500 on property, on the "residei ce
We do not cover other structures: premises,"
used at any time or in any manner
1. Used in whole or in part for "business"; or "business"
for any purpose.
2. Rented or held for rental to any person not a
9. $250 on property, away from the "residence
tenant of the dwelling, unless used solely as a premises,"
used at any time