HO 04 35 Supplemental Loss Assessment Coverage

An Insurance Services Office (ISO) standard form. It adds an additional amount of loss assessment insurance for the residence premises and covers your share of loss assessments for additional units or premises listed in the schedule, for assessments arising from a single covered loss.

1. 05 11 edition

   May 2011, compared with 04 91

   • The $1,000 limit on assessments resulting from a deductible in the association's insurance is removed.

     04 91

     “We will not pay more than $1,000 of your assessment that results from a deductible”

     05 11

     Removed

   • Residence premises coverage becomes an additional amount of insurance for assessments arising out of a single loss, rather than an increase to the policy's loss assessment limit.

     04 91

     “Loss Assessment, is increased to”

     05 11

     “We will pay, up to the additional amount of insurance shown in A.”

Filed by one company only: 08 15 (Westfield Group, 7 filings).

5 other edition dates appear in one or two filings each, often carrier-specific versions: 03 23, 03 10, 10 00, 09 95, 08/01/15.

Where filings record what this form replaced, they name earlier edition 03 22 and other forms HO 74 35, ML-50, UNA 04 35. Only some filings record replacements.

• Edition in use: in the past 12 months, 6 companies filed the 03 22 edition and 3 companies filed 05 11.
• The 08 15 edition appears only in filings from Westfield Group (7 filings in 7 states since Oct 23, 2023), which suggests a carrier-specific version.
• HO 04 10 (Additional Interests - Residence Premises) is filed alongside it most often, in 119 of the same filings (86%).

Data from admitted P&C filings with state insurance departments, submitted Oct 2021 to Oct 2026, excluding withdrawn and rejected filings. One filing can cover several affiliated companies.

• Allstate Insurance GroupFiles its own version: AVP632 Supplemental Loss Assessment Coverage (1 state)

• HO 04 10Additional Interests - Residence Premises119 filings
• HO 04 41Additional Insured - Residence Premises118 filings
• HO 04 77Ordinance or Law Increased Amount of Coverage118 filings
• HO 04 48Other Structures on the Residence Premises - Increased Limits116 filings
• HO 00 03Homeowners 3 - Special Form114 filings
• HO 04 40Structures Rented to Others - Residence Premises109 filings
• HO 04 16Premises Alarm, Water Leak Detection or Fire Protection System107 filings
• HO 04 90Personal Property Replacement Cost Loss Settlement105 filings
• HO 04 98Refrigerated Property Coverage92 filings
• HO 04 65Coverage C Increased Special Limits of Liability86 filings