Coverage description
An Insurance Services Office (ISO) standard form. It extends Coverage B to structures you own away from the residence premises that you use with it, excluding dwelling, business and rental use, within the Coverage B limit and with actual cash value loss settlement.
How the form has changed
1 change across 1 revision, newest first. Each edition is compared with the one before it, using wording from filed copies.
02 17 edition
Feb 2017, compared with 05 11When the Broadened Home-sharing Host Activities endorsement is attached, structures used mainly for home-sharing host activities or rented to home-sharing occupants are no longer excluded.
05 11
Not in this edition
02 17
“except structures used primarily for "home-sharing host activities"”
Editions
Edition dates as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed |
|---|---|---|---|---|
| 03 22Mar 2022Latest | 12 | 4 | 11 | May 2022 to Aug 2024 |
| 02 17Feb 2017 | 9 | 6 | 8 | Jan 2022 to Sep 2024 |
| 05 11May 2011 | 10 | 8 | 9 | Jul 2022 to Aug 2026 |
| 10 00Oct 2000 | 3 | 14 | 3 | Nov 2022 to Jan 2025 |
| 04 91Apr 1991 | 8 | 10 | 4 | May 2022 to Aug 2025 |
Filed by one company only: 02 22 (Armed Forces Insurance Exchange, 32 filings).
3 other edition dates appear in one or two filings each, often carrier-specific versions: 08 24, 03 24, 09 95.
Where filings record what this form replaced, they name other forms N/A. Only some filings record replacements.
What the filings show
- Edition in use: in the past 12 months, 2 companies filed the 05 11 edition and 1 company filed 02 22.
- The 02 22 edition appears only in filings from Armed Forces Insurance Exchange (32 filings in 32 states since Jan 7, 2022), 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 71 of the same filings (95%).
Data from admitted P&C filings with state insurance departments, submitted Oct 2021 to Aug 2026, excluding withdrawn and rejected filings.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 91, out of 21 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| Armed Forces Insurance Exchange | 32 | 32 | 02 2204 91 | Aug 27, 2026 |
| Insurance Services Office, Inc.Advisory Organization | 8 | 8 | 03 22 | Aug 16, 2024 |
| Encova Mutual Insurance Group4 group companies filed it, led by Motorists Mutual Insurance Company and Iowa Mutual Insurance Company | 7 | 7 | 02 17 | Apr 24, 2023 |
| THE Hanover Insurance Group3 group companies filed it, led by Massachusetts Bay Insurance Company and The Hanover Insurance Company | 5 | 3 | 04 9105 11 | Feb 3, 2026 |
| Tiptree Financial GroupLyndon Southern Insurance Company | 3 | 2 | 04 9105 1108 24 | Jul 2, 2024 |
| Germantown Mutual Insurance Company | 2 | 1 | 05 11 | Jan 17, 2024 |
| Liberty Mutual Group5 group companies filed it, led by American Fire and Casualty Company and Liberty Mutual Fire Insurance Company | 2 | 2 | 04 9110 00 | Aug 26, 2025 |
| Midwest Family GroupMidwest Family Mutual Insurance Company | 2 | 2 | 05 11 | Jul 25, 2022 |
| Utica GroupUtica Mutual Insurance Company | 2 | 2 | 03 22 | Dec 5, 2023 |
| American Family Insurance Group3 group companies filed it, led by Grain Dealers Mutual Insurance Company and NGM Insurance Company | 1 | 1 | 04 9110 00 | Jan 17, 2025 |
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States
Number of filings that include HO 04 91 in each state, Oct 2021 to Aug 2026. 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 Settlement71 filings
- HO 04 48Other Structures on the Residence Premises - Increased Limits67 filings
- HO 04 10Additional Interests - Residence Premises66 filings
- HO 04 40Structures Rented to Others - Residence Premises66 filings
- HO 04 50Increased Amount of Insurance for Personal Property at Other Residences66 filings
- HO 00 03Homeowners 3 - Special Form65 filings
- HO 04 41Additional Insured - Residence Premises64 filings
- HO 24 70Additional Residence Rented to Others 1,2,3 or 4 Families64 filings
- HO 04 99Sinkhole Collapse Coverage63 filings
- HO 24 71Designated Business Pursuits Liability Coverage63 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Aug 27, 2026 | Armed Forces Insurance Exchange | CA | 02 22 | ARMD-134961669 |
| Aug 14, 2026 | Builder Reciprocal Insurance Exchange | NM | 05 11 | BRIE-135052376 |
| May 14, 2026 | Armed Forces Insurance Exchange | MO | 02 22 | ARMD-134865546 |
| Mar 23, 2026 | Armed Forces Insurance Exchange | AR | 02 22 | ARMD-134879857 |
| Feb 27, 2026 | Armed Forces Insurance Exchange | NE | 02 22 | ARMD-134795835 |
| Feb 3, 2026 | Massachusetts Bay Insurance Company | ME | 05 11 | HNVR-G134821698 |
| Aug 26, 2025 | Liberty Mutual Fire Insurance Companyand 1 more | WY | 04 91 | LBPM-134639054 |
| Jun 30, 2025 | Armed Forces Insurance Exchange | PA | 02 22 | ARMD-134580982 |
| Feb 24, 2025 | Wayne Mutual Insurance Company | IN | 05 11 | WMIN-134429496 |
| Jan 17, 2025 | Grain Dealers Mutual Insurance Companyand 2 more | NH | 10 0004 91 | NGMC-134384684 |
| Dec 20, 2024 | Armed Forces Insurance Exchange | DC | 02 22 | ARMD-134309624 |
| Oct 11, 2024 | Armed Forces Insurance Exchange | CT | 02 22 | ARMD-134242640 |
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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