Coverage description
An Insurance Services Office (ISO) standard form. It changes homeowners loss settlement so covered property losses are paid at actual cash value at the time of loss, but not more than the cost to repair or replace.
How the form has changed
The 05 11 and 03 22 editions update the paragraph reference and form date. The loss settlement wording is the same as 05 96.
Editions
Edition dates as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed |
|---|---|---|---|---|
| 10 22Oct 2022 | 10 | 3 | 10 | Oct 2022 to Dec 2023 |
| 03 22Mar 2022Latest | 9 | 4 | 8 | May 2022 to Mar 2025 |
| 05 11May 2011 | 10 | 6 | 8 | Jan 2022 to Sep 2024 |
| 05 96May 1996 | 18 | 3 | 18 | Jan 2022 to Aug 2025 |
Filed by one company only: 02 23 (American Family Insurance Group, 5 filings).
2 other edition dates appear in one or two filings each, often carrier-specific versions: 10 23, 01 19.
What the filings show
- 18 of the 54 filings (33%) list the 05 96 edition, from 3 companies.
- The newer 10 22 edition first appears Oct 18, 2022 and has been filed by 3 companies in 10 states so far.
- The 02 23 edition appears only in filings from American Family Insurance Group (5 filings in 5 states since Mar 30, 2023), which suggests a carrier-specific version.
- HO 04 92 (Specific Structures Away From the Residence Premises - Actual Cash Value Loss Settlement) is filed alongside it most often, in 53 of the same filings (98%).
Data from admitted P&C filings with state insurance departments, submitted Oct 2021 to Aug 2025, excluding withdrawn and rejected filings. One filing can cover several affiliated companies.
Carriers filing this form
The 10 carrier groups with the most filings that include HO 04 81, out of 12 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| Armed Forces Insurance Exchange | 17 | 17 | 05 96 | Sep 16, 2024 |
| American Family Insurance Group3 group companies filed it, led by American Family Insurance Company and American Family Mutual Insurance Company, S.I. | 16 | 16 | 10 2202 2310 23 | Mar 5, 2024 |
| Encova Mutual Insurance Group4 group companies filed it, led by Motorists Mutual Insurance Company and Iowa Mutual Insurance Company | 7 | 7 | 05 11 | Apr 24, 2023 |
| Insurance Services Office, Inc.Advisory Organization | 6 | 6 | 03 22 | Aug 16, 2024 |
| Universal Insurance Holding GroupUniversal Property and Casualty Insurance Company | 2 | 2 | 05 11 | Oct 20, 2023 |
| Alamance Farmers' Mutual Insurance Company | 1 | 1 | 01 19 | Mar 4, 2022 |
| Hastings Mutual Insurance Company | 1 | 1 | 03 22 | Mar 13, 2025 |
| Hawaii Insurance Bureau, Inc. | 1 | 1 | 03 22 | Nov 6, 2023 |
| Liberty Mutual Group2 group companies filed it, led by Liberty Mutual Fire Insurance Company and The First Liberty Insurance Corporation | 1 | 1 | 05 96 | Aug 26, 2025 |
| Property Insurance Association of Louisiana | 1 | 1 | 03 22 | Aug 19, 2024 |
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States
Number of filings that include HO 04 81 in each state, Oct 2021 to Aug 2025. Darker states have more filings.
Often filed with
Standard-style form numbers that appear in the same filings most often.
- HO 04 92Specific Structures Away From the Residence Premises - Actual Cash Value Loss Settlement53 filings
- HO 04 90Personal Property Replacement Cost Lost Settlement48 filings
- HO 17 33Unit-Owners Rental to Others38 filings
- HO 04 10Additional Interests - Residence Premises37 filings
- HO 04 65Coverage C Increased Special Limits of Liability37 filings
- HO 17 31Unit-Owners Coverage C Special Coverage37 filings
- HO 17 32Unit-Owners Coverage a Special Coverage37 filings
- HO 00 06Unit-Owners 6 - Broad Form36 filings
- HO 04 12Increased Limits on Business Property36 filings
- HO 04 16Premises Alarm, Water Leak Detection or Fire Protection System36 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Aug 26, 2025 | Liberty Mutual Fire Insurance Companyand 1 more | WY | 05 96 | LBPM-134639054 |
| Mar 13, 2025 | Hastings Mutual Insurance Company | IL | 03 22 | HAST-134095856 |
| Sep 16, 2024 | Armed Forces Insurance Exchange | VT | 05 96 | ARMD-134197778 |
| Sep 14, 2024 | United Mutual Insurance Company | WI | 05 11 | OHMG-134246358 |
| Aug 19, 2024 | Property Insurance Association of Louisiana | LA | 03 22 | PIAL-134215742 |
| Aug 16, 2024 | Insurance Services Office, Inc. | LA | 03 22 | ISOF-134204798 |
| Jul 29, 2024 | Armed Forces Insurance Exchange | SD | 05 96 | ARMD-134149297 |
| Jul 11, 2024 | Armed Forces Insurance Exchange | MT | 05 96 | ARMD-134174541 |
| Jun 14, 2024 | Armed Forces Insurance Exchange | HI | 05 96 | ARMD-133955093 |
| Jun 4, 2024 | Armed Forces Insurance Exchange | UT | 05 96 | ARMD-134118452 |
| Apr 26, 2024 | Armed Forces Insurance Exchange | ND | 05 96 | ARMD-134085482 |
| Mar 5, 2024 | American Family Insurance Company | WA | 02 23 | AMFC-134018898 |
Most filed ISO HO forms
- HO 00 03 Homeowners 3 Special Form
- HO 04 90 Personal Property Replacement Cost Loss Settlement
- HO 04 10 Additional Interests - Residence Premises
- HO 04 41 Additional Insured - Residence Premises
- HO 04 48 Other Structures on the Residence Premises - Increased Limits
- HO 04 16 Premises Alarm Water Leak Detection or Fire Protection System
- HO 04 98 Refrigerated Property Coverage
- HO 04 35 Supplemental Loss Assessment Coverage
- HO 04 77 Ordinance or Law Increased Amount of Coverage
- HO 00 06 Homeowners 6 - Unit- Owners Form
- HO 24 13 Incidental Low Power Recreational Motor Vehicle Liability Coverage Endorsement
- HO 04 40 Structures Rented to Others - Residence Premises
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