# Usage: curl -sSL https://seed.show/insurance.policy.us | bash -s <install-path>
# <install-path> is the directory where the file should land.

set -euo pipefail
[ -z "${1:-}" ] && {
  echo "install requires a path: curl -sSL https://seed.show/insurance.policy.us | bash -s <install-path>" >&2
  exit 1
}
TARGET="$1"
mkdir -p "$TARGET"
DEST="$TARGET/seed-fold.spFtVB.folded.md"

cat > "$DEST" <<'PORTDOWN_AE1D3AEF'
<!--
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To unpack (requires bash — if you have no shell, tell the user):
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     (or: unfold <this-file>  if fold/scripts is on your PATH)
-->

---
fold: true
marker: fe1ab9
at: 2026-05-07T16:16:13Z
root: seed-pack.8glIFj
---

<!--fold:fe1ab9@file path="README.md" mode="644"-->
# insurance.policy.us

US insurance policy context for agents. What to know before reading any policy or answering a coverage question.

## What level to work at

Insurance policies are contracts. The authoritative text is always the policy form itself, plus any endorsements. This bundle is not a substitute — it is the orientation layer: the mental model agents need, the mistakes they consistently make, and which sources to fetch for current form standards and state rules.

**Do not assert specific premium benchmarks, coverage limits, or state minimum requirements** — all vary by insurer, risk characteristics, underwriting guidelines, and state regulation, and change frequently. Point to sources (see sources.md) rather than stating figures. Never assert coverage or exclusion without reading the actual policy language.

**Coverage availability varies by state and insurer.** A line of coverage that exists in one state may be unavailable or mandatory in another. Surplus lines markets may be the only option for certain risks. Do not generalize across states.

## Mental model: policy as contract, coverage as sequential elimination

Every policy is a contract with four components. Read them in this order — not natural reading order.

**1. Declarations (the who/what/how much)** — The dec page identifies the named insured, the policy period, the covered locations or vehicles or operations, and the limits and deductibles. It is a summary, not a grant of coverage. Nothing on the dec page overrides the form language; the form controls.

**2. Insuring agreement (what is promised)** — The insuring agreement states what the insurer promises to pay or do. It is written broadly by design. Do not stop here. The insuring agreement is the ceiling, not the answer.

**3. Exclusions (what is removed)** — Exclusions carve back from the insuring agreement. This is where actual coverage scope is determined. The correct method: start from the exclusions, identify what they remove, then ask what remains. That remainder is the coverage. Many exclusions have exceptions — sub-provisions that restore some coverage — which must be read in turn. The structure is: insuring agreement → exclusion → exception to exclusion.

**4. Conditions (how the contract operates)** — Conditions govern duties after a loss (notice, cooperation, proof of loss), the insurer's right to inspect, subrogation rights, cancellation provisions, and premium payment terms. Failure to comply with conditions can void coverage even when a loss would otherwise be covered.

**Endorsements modify all four sections.** Always read endorsements last — they can add, delete, or replace any policy language. Endorsements control.

## What agents get wrong

**1. Claims-made vs. occurrence — the most dangerous coverage gap for professional liability.**

An occurrence policy covers events that happen during the policy period, regardless of when the claim is filed — even years later. A claims-made policy covers claims first made during the policy period, for events that occurred after the retroactive date. For a claims-made policy to respond: the event must occur after the retroactive date, and the claim must be made before policy expiration or within any extended reporting period (ERP/tail).

The gap is most severe at carrier switches: a new claims-made policy without a matching retroactive date leaves prior acts uninsured unless prior acts coverage or a tail is purchased. An occurrence policy does not require the claim to be filed during the period. A claims-made policy does not cover a claim filed after expiration even if the underlying event happened yesterday.

**2. Exclusion vs. limitation — these are not the same.**

An exclusion removes a category of coverage entirely from the insuring agreement. A limitation (or sublimit) reduces the amount available for a specific peril or property type but does not eliminate coverage. Agents who describe "what isn't covered" when they mean "what has reduced limits" give fundamentally incorrect assessments. A $50,000 sublimit for accounts receivable on a $5 million property policy is a limitation, not an exclusion — the coverage exists, but is capped. A flood exclusion means there is no coverage for flood losses, not a reduced amount.

**3. Subrogation rights — the insurer's right to recover from third parties.**

When an insurer pays a covered claim, it steps into the insured's legal shoes to recover from any responsible third party. If a vendor's negligence causes a fire and the property insurer pays the loss, the insurer can sue the vendor. Many commercial contracts — construction, leases, vendor agreements — require a waiver of subrogation: the insurer agrees in advance not to pursue that third party. A waiver of subrogation endorsement is required; without it, the insurer retains subrogation rights regardless of the underlying contract. Agents reviewing contracts that require waiver of subrogation must verify the endorsement is on the policy, not assume it.

**4. Coordination of benefits — which policy pays first.**

When a claimant is covered by multiple policies (health, workers' comp, auto medical, etc.), coordination of benefits rules determine which policy is primary and which is excess. The primary carrier pays first up to its limits; the excess carrier pays the remainder. Getting this wrong produces overpayment by one carrier, underpayment to the claimant, or a coverage dispute between carriers. The coordination clause is typically in the conditions section and often references the other insurance provision. Both clauses must be read together.

**5. Admitted vs. surplus lines — guaranty fund protection is not universal.**

An admitted carrier is licensed by the state department of insurance and participates in the state guaranty fund. If an admitted carrier becomes insolvent, the state fund pays covered claims up to statutory limits. A surplus lines (E&S) carrier is not admitted; it is not backed by the guaranty fund. Surplus lines carry less regulatory oversight, can use non-standard forms, and require explicit disclosure of the absence of guaranty fund protection. Do not assume a policy is admitted; verify via the state department of insurance.

**6. Reading the insuring agreement as the coverage answer.**

The instinct is to describe what a policy covers and then add a few carveouts. The correct method is the reverse: read the exclusions in full, identify what they remove from the insuring agreement, then state what coverage remains. Agents who skip the exclusion-to-exception chain will overstate coverage.

## Key stable facts: major commercial lines

Each is a distinct product with its own form, coverage trigger, and scope.

- **CGL (Commercial General Liability)** — covers bodily injury and property damage the insured becomes legally obligated to pay; also covers personal and advertising injury. Occurrence form is standard. Products/completed operations is a key component for manufacturers and contractors.
- **E&O (Errors & Omissions / Professional Liability)** — covers negligent professional acts, errors, or omissions. Almost always claims-made. Industry-specific forms vary substantially (architects, lawyers, tech companies, insurance agents each have tailored forms).
- **D&O (Directors & Officers)** — covers wrongful acts by directors and officers. Three insuring agreements are standard: Side A (individual protection when the company cannot indemnify), Side B (corporate reimbursement), Side C (entity coverage for securities claims). Claims-made.
- **EPLI (Employment Practices Liability)** — covers employee claims of discrimination, harassment, wrongful termination, retaliation. Claims-made.
- **Cyber** — covers first-party losses (breach response, data restoration, business interruption) and third-party liability (privacy claims, network security failures). A young line with non-standard forms; policy language varies substantially between carriers. Claims-made, typically with a notice trigger.
- **Umbrella vs. Excess** — umbrella forms may be broader than underlying policies (dropping down for uncovered claims); excess forms follow form and provide limits only. The distinction matters when an underlying exclusion applies — umbrella may cover it, excess will not.

**Named perils vs. open perils (all-risk):** A named-perils form covers only listed causes of loss; the insured bears the burden of proving the cause is covered. An open-perils form covers all causes of loss except those specifically excluded; the insurer must prove an exclusion applies. The special form (open perils) is broader and more common for commercial building and business personal property. Inland marine and specialty forms may use named perils even when the underlying property policy is open perils.

## What AI is changing

**Underwriting automation** — carriers are deploying ML models to score risks, price policies, and make bind/decline decisions without human review. For standard risks with clean loss histories and stable exposures, automated underwriting is now common. The data inputs (loss runs, financial statements, inspection photos, satellite imagery, telematics) are the same; the decisioning is faster and less negotiable. Agents working with automated underwriting systems should understand that appetite rules are encoded in the model — edge cases that a human underwriter might consider on merit get declined without explanation.

**Telematics and usage-based insurance** — personal and commercial auto policies increasingly use device-based or app-based driving data (speed, braking, mileage, time of day) to adjust premiums. The policy structure is unchanged; the rating factor is behavioral data rather than proxy variables. For commercial fleets, telematics data collected by the insured for risk management purposes may also be discoverable in litigation.

**Claims triage and fraud detection** — AI is used at first notice of loss to route claims, flag potentially fraudulent patterns, and estimate severity. Agents advising insureds on claims reporting should understand that AI triage can accelerate straightforward claims and flag complex ones for human handling; it does not make coverage determinations.

**What stays human** — complex coverage disputes, large loss adjusting, regulatory filings, coverage opinion letters, E&O and D&O claim negotiations, reinsurance treaty interpretation, and surplus lines placements with non-standard forms. These require licensed professionals and professional judgment that model outputs cannot substitute for. The legal question of what a policy covers is decided by humans (ultimately, courts) — AI analysis is an input, not a determination.

Fetch sources.md for current ISO form editions, admitted carrier lookups, and state-specific regulatory resources.
<!--fold:fe1ab9@file path="glossary.md" mode="644"-->
# glossary

Key insurance terms for agents. Precise definitions and why each matters to coverage analysis.

---

**Declarations page (dec page)**
The summary page at the front of a policy identifying the named insured, policy period, covered property or operations, limits, deductibles, and premium. The dec page does not grant coverage — it summarizes the contract. When dec page language conflicts with the form, the form controls. The dec page is useful for orientation; the form is authoritative.

---

**Insuring agreement**
The provision in which the insurer promises what it will pay or do. Written broadly by design. The insuring agreement sets the ceiling of potential coverage; exclusions and conditions reduce it. Reading only the insuring agreement overstates coverage — always read it alongside the exclusions.

---

**Exclusion**
A provision that removes a specific category from the insuring agreement's scope. An exclusion eliminates coverage for the excluded category entirely, not just reduces it. Many exclusions contain exceptions — sub-provisions that restore coverage for a narrower category within the excluded one. The correct reading sequence: insuring agreement → exclusion → exception to exclusion. Confusing an exclusion with a sublimit is a common and consequential agent error (see "sublimit" below).

---

**Endorsement (also: rider)**
A document that modifies the policy form by adding, deleting, or replacing language in the declarations, insuring agreement, exclusions, or conditions. Endorsements control over the base form when there is a conflict. Always read endorsements last — they represent the final state of the contract. "Rider" is common in life and health insurance; "endorsement" is standard in property and casualty lines. Both function the same way: they modify the form.

---

**Deductible vs. self-insured retention (SIR)**
A deductible is subtracted from the insurer's payment after a covered loss — the insurer pays the loss and then recovers the deductible amount from the insured, or pays only the amount above the deductible. An SIR is an amount the insured must pay first, before the insurer's obligation to pay attaches. The practical difference: with a deductible, the insurer typically defends immediately and the deductible is recovered; with an SIR, the insurer may not be obligated to defend or pay until the SIR is exhausted. SIRs are common in large commercial accounts and D&O/E&O policies.

---

**Occurrence form vs. claims-made form**
The trigger that determines whether a policy responds to a given claim.

- *Occurrence form:* the policy responds if the bodily injury or property damage occurred during the policy period, regardless of when the claim is filed — even years after expiration.
- *Claims-made form:* the policy responds if the claim is first made during the policy period (or within any extended reporting period), and the underlying event occurred after the retroactive date.

The critical gap: when switching carriers on a claims-made policy, the new policy's retroactive date must reach back to cover prior acts — otherwise events that occurred before the new retroactive date are uninsured even if the claim arrives tomorrow. A tail (extended reporting period endorsement) purchased from the prior carrier preserves claims-made coverage for prior acts after the policy expires. Agents must confirm both the retroactive date and tail coverage on every claims-made policy transition.

---

**Subrogation**
The right of an insurer that has paid a covered claim to step into the insured's legal shoes and pursue recovery from a responsible third party. If a subcontractor's negligence causes a fire and the property insurer pays the loss, the insurer can sue the subcontractor for that amount. Many commercial contracts require a waiver of subrogation — an agreement by the insurer not to pursue the specified third party. A waiver of subrogation endorsement must be added to the policy; without it, the insurer retains its subrogation rights regardless of what the underlying contract says. Agents reviewing contracts that require waiver of subrogation must verify the endorsement exists on the policy.

---

**Coordination of benefits**
The rule set that determines which of multiple policies covering the same claimant pays first (primary) and which pays after (excess or secondary). Primary coverage pays first up to its limits; excess coverage pays the remainder. Coordination of benefits clauses are typically in the conditions section; the "other insurance" provision defines the policy's role when multiple policies apply. Getting this wrong produces disputes between carriers and gaps or overlaps in payment to the claimant.

---

**Indemnification**
The contractual or legal obligation to compensate another party for a covered loss. Insurance is one form of indemnification; contractual indemnity (hold harmless clauses) is another. In insurance, indemnification means restoring the insured to the position they were in before the loss — no better, no worse (indemnity principle). Policies that pay actual cash value (ACV) achieve indemnity by depreciating the loss; replacement cost policies pay to restore without depreciation, which can exceed indemnity in a strict sense.

---

**Actual cash value (ACV) vs. replacement cost value (RCV)**
ACV is the cost to replace property with property of like kind and quality, minus depreciation. RCV is the cost to replace without a depreciation deduction. For a ten-year-old roof that costs $20,000 to replace: ACV might pay $10,000 (after depreciation); RCV pays $20,000. The difference is material in property claims. Most commercial property policies default to ACV; RCV is available by endorsement. Agents must confirm which basis applies before advising on coverage adequacy.

---

**Umbrella vs. excess liability**
Both provide limits above underlying scheduled policies. The distinction is in how they respond to gaps.

- *Umbrella:* may have a broader coverage form than the underlying policies. When an underlying policy excludes a loss that the umbrella form covers, the umbrella can "drop down" and pay as primary coverage (typically after a retained limit). Umbrella forms may also cover claims that have no underlying policy.
- *Excess (follow-form excess):* follows the exact form and exclusions of the underlying policy. If the underlying policy excludes the loss, the excess policy excludes it too. Excess policies add limits only — they do not broaden coverage.

Treating umbrella and excess as interchangeable is an error. When an underlying exclusion applies, the distinction determines whether any coverage exists above the underlying.

---

**Surplus lines (excess and surplus / E&S)**
Insurance placed with a carrier that is not licensed (admitted) in the state where the risk is located. Surplus lines carriers are used for risks that admitted carriers decline to write — unusual exposures, adverse loss histories, or coverages that standard markets don't offer. E&S carriers are not subject to the same rate and form filing requirements as admitted carriers, and they are not backed by the state guaranty fund. If an E&S carrier becomes insolvent, policyholders have no guaranty fund recourse. Surplus lines placements must generally be declined by a specified number of admitted carriers before being placed in the E&S market (the "diligent search" requirement, which varies by state). Surplus lines brokers have additional compliance obligations including stamping office filing.

---

**Named insured vs. additional insured**
The named insured is identified on the declarations page and is the primary party to the contract — they have the broadest rights under the policy, including the right to cancel, receive notices, and make changes. An additional insured is a party added by endorsement who has coverage under the policy but fewer contractual rights than the named insured. Additional insured status is commonly required in commercial contracts; the endorsement language controls the scope of coverage extended to the additional insured. Blanket additional insured endorsements cover all parties required by written contract; scheduled additional insured endorsements cover specific named parties. The scope differs.
<!--fold:fe1ab9@file path="sources.md" mode="644"-->
# sources

Fetch these at task time. Do not cite specific premium benchmarks, coverage limits, or state minimum requirements from memory — those vary by state, insurer, and filing year. Use these sources to retrieve current figures.

## Primary sources

**1. ISO commercial lines forms** — Insurance Services Office publishes the standard policy forms used by most admitted carriers. Form numbers (e.g. CG 00 01, CP 00 10, BP 00 03) identify the exact edition. The edition date matters; carriers may use older or newer editions. Fetch for current form language before quoting any policy provision.
https://www.isoa.org/commercial-lines

**2. NAIC consumer insurance guides** — National Association of Insurance Commissioners publishes plain-language guides covering CGL, auto, property, life, and health. Useful for confirming regulatory baseline requirements by coverage type. Also the authoritative source for state department of insurance contact information and admitted carrier lookup by state.
https://content.naic.org/consumer

**3. State department of insurance** — Each state maintains a searchable database of licensed (admitted) carriers and surplus lines eligibility lists (SLIP lists or "yellow pages"). Start with the state where the risk is located. Admitted/surplus status determines guaranty fund protection and disclosure obligations.
https://content.naic.org/state-insurance-departments

**4. III (Insurance Information Institute)** — Non-technical explanations of major commercial and personal lines coverages, common exclusions, endorsements, and claims data. Useful for confirming coverage scope and industry context.
https://www.iii.org/business-insurance

**5. ACORD certificate of insurance form standards** — ACORD 25 (liability) and ACORD 28 (property) are the standard certificates. The certificate is evidence of insurance, not the policy, and does not amend, extend, or alter coverage. ACORD maintains current form versions and usage instructions.
https://www.acord.org/standards-architecture/acord-forms

## For surplus lines and E&S markets

**NAPSLO / WSIA** — The Wholesale & Specialty Insurance Association is the industry body for surplus lines. Useful for understanding appetite, placement procedures, and stamping office requirements by state.
https://www.wsia.org

**Stamping offices by state** — Most states require surplus lines policies to be stamped by the state stamping office (SLIP, ELANY, FSLSO, etc.) as a condition of valid placement. Each stamping office maintains its own eligibility lists and filing requirements. Look up the stamping office for the risk's state before advising on a surplus lines placement.

## For claims and coverage disputes

**Westlaw / Lexis** — State appellate and supreme court decisions are the authoritative source for how policy language is interpreted in a given jurisdiction. Courts have ruled on nearly every standard ISO exclusion; fetch current case law for the jurisdiction before advising on a contested coverage question. Contra proferentem (ambiguous policy language construed against the insurer) is a doctrine applied differently across states.

## What not to rely on

- This bundle: use it for mental models and structural orientation, not current data.
- AI training data: form editions, state minimums, and premium ranges in model weights go stale. Always fetch from primary sources.
- Certificates of insurance: as noted above, the certificate does not grant or alter coverage. The policy form controls.
<!--fold:fe1ab9@end-->
PORTDOWN_AE1D3AEF

# ── post ──
MARKER=$(awk '/^---$/ { f++; if (f==2) exit; next } f==1 && /^marker:[[:space:]]/ { sub(/^marker:[[:space:]]+/, ""); print; exit }' "$DEST")
[ -z "$MARKER" ] && { echo "seed: archive has no marker — corrupt" >&2; exit 1; }
awk -v m="$MARKER" -v outdir="$TARGET" '
  BEGIN {
    # Match <!--fold:<m>@file path="X"--> with an optional mode attr after
    # the path (fold emits  mode="644"  on executables).
    file_re = "^<!--fold:" m "@file path=\"([^\"]+)\"( mode=\"[0-9]+\")?-->$"
    end_re  = "^<!--fold:" m "@end-->$"
  }
  $0 ~ end_re { if (current) close(current); exit }
  $0 ~ file_re {
    if (current) close(current)
    line = $0
    sub(/^<!--fold:[^@]+@file path="/, "", line); sub(/".*$/, "", line)
    current = outdir "/" line
    dir = current; sub(/\/[^\/]*$/, "", dir)
    if (dir != current) system("mkdir -p \"" dir "\"")
    printf "" > current
    next
  }
  current { print >> current }
' "$DEST"
SEED_EXTRACTED=$(find "$TARGET" -type f -not -path "$DEST" 2>/dev/null | wc -l)
if [ "$SEED_EXTRACTED" = "0" ]; then
  echo "seed: archive contained no files — refusing to delete the source" >&2
  echo "  archive preserved at: $DEST" >&2
  exit 1
fi
rm -f "$DEST"

echo "" >&2
echo "✓ seed unpacked → $TARGET ($SEED_EXTRACTED files)" >&2
find "$TARGET" -type f | sort | while IFS= read -r _sf; do
  echo "  ${_sf#${TARGET}/}" >&2
done
echo "" >&2
if [ -f "$TARGET/SKILL.md" ]; then
  echo "This seed contains a skill (SKILL.md). Install it in your agent's skills directory." >&2
  echo "" >&2
fi
echo "Install the seed skill if not already installed:" >&2
echo "  https://seed.show/skill" >&2
echo "" >&2
echo "Publisher prompt:" >&2
sed 's/^/  /' >&2 <<'__SEED_PROMPT_END_AC1F2B__'
You have the US insurance policy context. Read README.md first — it defines what NOT to hallucinate (no specific premiums, limits, or state minimums) and gives the mental model for sequential coverage determination. Then read glossary.md for precise term definitions. Fetch sources.md for current ISO form editions and admitted carrier lookups. Ask what policy or coverage question to analyze.
__SEED_PROMPT_END_AC1F2B__
exit 0