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Senior Living Liability

Question

Is our senior living building insured for enough?

Short answer

Probably not if the value has not been reviewed in the last two or three years, because construction cost inflation, the code upgrades that apply to a licensed care building and the long rebuild period specific to this occupancy have all moved faster than the schedule on most policies.

Replacement cost, actual cash value and the coinsurance trap

Replacement cost pays to rebuild with like kind and quality without deduction for depreciation. Actual cash value deducts depreciation and is materially worse for an older building. Confirm which basis applies, including on the roof specifically, since roof schedules on an actual cash value basis are increasingly common.

Then check the coinsurance percentage. If the policy carries an eighty or ninety percent coinsurance requirement and the insured value is below that share of the true replacement cost, the penalty applies to every loss, including partial ones. Most operators discover this on a two hundred thousand dollar water loss rather than on a total loss.

An agreed value endorsement removes the coinsurance calculation and is worth asking for on any building where the valuation is uncertain.

What is specific about a licensed care building

Rebuilding a licensed care facility is not rebuilding a commercial building. Current code for a health care occupancy governs sprinklers, fire alarm, smoke compartmentation, corridor width, generator capacity and accessibility, and the building being replaced was almost certainly built to an earlier standard.

That gap is the ordinance or law exposure. It has three parts: the value of the undamaged portion you are required to demolish, the cost of demolition, and the increased cost of construction to current code. Each is a separate sublimit and the increased cost part is the one most often set far too low.

The rebuild also takes longer than a comparable commercial building because of the licensure and plan review process, which is why the business income period of restoration matters as much as the property limit.

The business income side of the same question

A community that loses a building loses census, and it does not get census back the day the doors reopen. Residents relocate and do not all return, and the fill-up curve after reopening can run many months.

That means the period of restoration should be measured as the rebuild plus the lease-up, and the extended period of indemnity endorsement is what covers the second part. A twelve month period of indemnity for a licensed care building is usually short. Ask for eighteen or twenty four.

What to do

Get an insurance-specific valuation rather than an appraisal for financing, since the two answer different questions. Update it on a set cycle rather than after a loss. Confirm the ordinance or law sublimits as actual numbers against a realistic code upgrade estimate. And confirm whether the lender or landlord requires a specific valuation basis, because a lease exhibit frequently specifies one.

Primary sources

Sources and references

This answer draws on the following regulatory, statutory, and standards-body sources. Coverage availability and program structure also depend on market appetite and underwriter discretion not captured by these sources.

Related practice areas

Insurance clauses in this area

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