Allstate. S Auto Insurance Policy A M P L E D O C U M E N T MAINE. Effective: Policy: Issued to: AFA40

Transcription

1 llstate uto Insurance olicy olicy: Issued to: ffective: I F40

2 llstate Fire and asualty Insurance ompany B F When nd Where he olicy pplies...2 hanges...2 uty o Report utos...2 ombining imits f wo r ore utos rohibited...2 ransfer...2 ancellation...3 onditional Reinstatement...3 ayment...3 What aw Will pply...3 Where awsuits ay Be Brought...3 ction gainst s...4 rbitration...4 art I utomobile iability Insurance (overages and BB) Insuring greement...4 dditional ayments We Will ake...5 Insured ersons...5 Insured utos...5 efinitions...5 xclusions What Is ot overed...6 Financial Responsibility...7 imits f iability...7 If here Is ther Insurance...7 ssistance nd ooperation...7 ction gainst s...7 What o o In ase f n uto ccident r laim...8 art II utomobile edical ayments (overage ) Insuring greement...8 nreasonable r nnecessary edical xpenses...8 Insured ersons...8 Insured utos...9 efinitions...9 xclusions What Is ot overed...9 imits f iability...10 If here Is ther Insurance...10 ssistance nd ooperation...10 ction gainst s...10 ubrogation Rights...11 roof f laim; edical Reports...11 art III utomobile eath Indemnity Insurance (overage ) Insuring greement...11 Insured ersons...11 efinitions...11 xclusions What Is ot overed...11 ayment f Benefits; utopsy...12 onsent f Beneficiary roof f laim; edical Reports...12 art IV utomobile isability Income rotection (overage W) Insuring greement...12 Insured ersons...12 efinitions...12 xclusions What Is ot overed...12 o Whom and When ayment Is ade...13 roof f laim; edical Reports...13 art V ninsured otorists Insurance (overage ) Insuring greement...13 Insured ersons...13 efinitions...14 xclusions What Is ot overed...14 imits f iability...15 If here Is ther Insurance...15 roof f laim; edical Reports...15 ssistance nd ooperation...15 rust greement...16 ur ayment f oss...16 ction gainst s...16 If We annot gree...16 art VI rotection gainst oss o he uto (overages,, HH,H, HF, HG, JJ,, Z, ZZ) Insuring greements For ach overage...17 dditional ayments We Will ake...19 Insured utos...19 efinitions...20 xclusions What Is ot overed...20 Right o ppraisal...21 ur ayment f oss...21 imits f iability...21 If here Is ther Insurance...22 ction gainst s...22 ubrogation Rights...22 What You ust o If here Is oss...22 oss ayable lause...22 IX F IY RVII...23 age 1

3 llstate Fire and asualty Insurance ompany llstate Fire nd asualty Insurance ompany he ompany amed in the olicy eclarations tock ompany Home ffice: orthbrook, Illinois his policy is a legal contract between you and us. coverage applies only when a premium for it is shown on the olicy eclarations. If more than one auto is insured, premiums will be shown for each auto. If you pay the premiums when due and comply with the policy terms, we, relying on the information you have given us, make the following agreements with you. When nd Where he olicy pplies Your policy applies only during the premium period. uring this time, it applies to losses to the auto, accidents and occurrences within the nited tates of merica, its territories or possessions or anada, or between their ports. he premium period is shown on the olicy eclarations. hanges remium hanges he premium for each auto is based on information we have received from you or other sources. You agree to cooperate with us in determining if this information: 1. is correct; 2. is complete; 3. changes during the policy period. You agree that if this information does change or is incorrect or incomplete, we may adjust your premium accordingly during the policy period. hanges which result in a premium adjustment are contained in our rules. hese include, but are not limited to: 1. autos which are insured by the policy. his includes any changes in the use of the autos; 2. drivers who reside in your household, including the ages or marital status of the drivers; 3. coverages or coverage limits; 4. rating territory; or 5. eligibility for discounts. ny calculation or adjustment of your premium will be made using the rules, rates, and forms in effect for our use in your state. overage hanges When we broaden a coverage during the policy period without an additional charge, you have the new feature if you have the coverage to which it applies. he new feature applies on the date the change in coverage is effective in your state. therwise, the policy can be changed only by endorsement. ny change in your coverage will be made using the rules, rates, and forms in effect for our use in your state. uty o Report utos You must tell us within 60 days when you acquire an additional or replacement auto. If you do not, certain coverages of this policy may not apply. ombining imits f wo r ore utos rohibited If you have two or more autos insured in your name and one of these autos is involved in an accident, only the coverage limits shown on the olicy eclarations for that auto will apply. When you have two or more autos insured in your name and none of them is involved in the accident, you may choose any single auto shown on the olicy eclarations and the coverage limits applicable to that auto will apply. he limits available for any other auto covered bythe policy will not be added to the coverage for the involved or chosen auto. ransfer his policy cannot be transferred to anyone without our written consent. However, if you die, coverage will be provided until the end of the premium period for: 1. your legal representative while acting as such; and age 2

4 llstate Fire and asualty Insurance ompany 2. persons covered on the date of your death. ancellation You may cancel this policy by notifying us of the future date you wish to stop coverage. uring the policy period, we may cancel part or all of this policy by mailing notice to you at the address shown on the olicy eclarations. We will also mail notice to any lienholder named in the olicy eclarations. If we cancel because you did not pay the premium, we will mail notice of cancellation to you at least 15 days before the cancellation takes effect. therwise, we will mail notice of cancellation to you at least 25 days before the cancellation takes effect. roof of mailing the notice will be proof of notice. refund, if due, will be in proportion to the time your policy has been in effect. ancellation will be effective even if the refund is not made immediately. ny unearned premium amounts under $2.00 will be refunded upon your request. nless you have received a notice of cancellation from us before your original policy has been in effect for 60 days, we will not cancel or reduce your coverage during the policy period unless: 1. you do not pay the premium when it is due; 2. you or anyone else who usually operates an auto insured under the policy has had a driver s license suspended or revoked during the policy period or, if the policy is a renewal, during its period or the preceding 180 days. his does not apply to the first or second suspension of a provisional license under itle 29-, ection 2471, ubsection 2 or itle 29-, ection 2472, ubsection 2 or a suspension under itle 28-, ection 2052; 3. the policy was obtained by misrepresentation or by fraud; 4. the submission of a claim has been misrepresented or fraudulent; or 5. the conditions of the policy have been violated. If we do not intend to continue the policy beyond the current premium period, we will give you notice at least 30 days before the end of the premium period. onditional Reinstatement If we mail a cancellation notice because you did not pay the required premium when due and you then tender payment by check, draft or other remittance which is not justifiably honored upon presentation, your policy will terminate on the date and time shown on the cancellation notice and any notice we issue which waives the cancellation or reinstates coverage is void. his means we will not be liable under this policy for claims or damages after the date and time shown on the cancellation notice. ayment If you tender a check to us for full or partial payment of your premium and the check is returned to us because of insufficient funds or a closed account, a $10.00 charge will be added to your account balance. What aw Will pply his policy is issued in accordance with the laws of aine and covers property or risks principally located in aine. ubject to the following paragraph, any and all claims or disputes in any way related to this policy shall be governed by the laws of aine. If a covered loss to the auto, a covered auto accident, or any other occurrence for which coverage applies under this policy happens outside aine, claims or disputes regarding that covered loss to the auto, covered auto accident, or other covered occurrence may be governed by the laws of the jurisdiction in which that covered loss to the auto, covered auto accident, or other covered occurrence happened, only if the laws of that jurisdiction would apply in the absence of a contractual choice of law provision such as this. Where awsuits ay Be Brought ubject to the following two paragraphs, any and all lawsuits in any way related to this policy, shall be brought, heard, and decided only in a state or federal court located in aine. ny and all lawsuits against persons not parties to this policy but involved in the sale, administration, performance, or alleged breach age 3

5 llstate Fire and asualty Insurance ompany of this policy, or involved in any other way with this policy, shall be brought, heard, and decided only in a state or federal court located in aine, provided that such persons are subject to or consent to suit in the courts specified in this paragraph. If a covered loss to the auto, a covered auto accident, or any other occurrence for which coverage applies under this policy happens outside aine, lawsuits regarding that covered loss to the auto, covered auto accident, or other covered occurrence may also be brought in the judicial district where that covered loss to the auto, covered auto accident, or other covered occurrence happened. othing in this provision, Where awsuits ay Be Brought, shall impair any party s right to remove a state court lawsuit to a federal court. ction gainst s o one may bring an action against us unless: 1. there is full compliance with all policy terms; and 2. the action is commenced within two years of the date the cause of action accrues. However, if an action is in any way related to the existence or amount of coverage, or the amount of loss for which coverage is sought, under a particular coverage that is shown on the olicy eclarations, such action must be commenced within the time period specified in the ction gainst s provision of that particular coverage. If an action is brought asserting claims relating to the existence or amount of coverage, or the amount of loss for which coverage is sought, under different coverages of this policy, the claims relating to each coverage shall be treated as if they were separate actions for the purpose of the time limit to commence action. rbitration ny claim or dispute in any way related to this policy, by a person insured under this policy against us or us against a person insured under this policy, may be resolved by arbitration only upon mutual consent of the parties. rbitration pursuant to this provision shall be subject to the following: 1. no arbitrator shall have the authority to award punitive damages or attorney s fees; 2. neither of the parties shall be entitled to arbitrate any claims or disputes in a representative capacity or as a member of a class; and 3. no arbitrator shall have the authority, without the mutual consent of the parties, to consolidate claims or disputes in arbitration. his provision shall not apply to claims or disputes to which the art V ninsured otorist Insurance overage, If We annot gree provision applies. art I utomobile iability Insurance Bodily Injury overage roperty amage overage BB Insuring greement We will pay for damages an insured person is legally obligated to pay because of: 1. bodily injury sustained by any person; and 2. damage to, or destruction of, property. nder these coverages, your policy protects an insured person from liability for damages arising out of the: 1. ownership; 2. maintenance or use; 3. loading or unloading; of an insured auto. We will defend an insured person sued for damages which are covered by this policy. We will provide a defense even if the suit is groundless or false. We will choose the counsel. We may settle any claim or lawsuit if we believe it is proper. We will not defend an insured person sued for damages which are not covered by this policy. age 4

6 llstate Fire and asualty Insurance ompany dditional ayments We Will ake When we defend an insured person under this part, we will pay: 1. up to $100 a day for loss of wages or salary if we ask that person to attend hearings or trials to defend against a bodily injury suit. We will not pay for loss of other income. We will pay other reasonable expenses incurred at our request. 2. court costs for defense. 3. interest accruing on damages awarded. We will pay this interest only until we have paid, offered, or deposited in court the amount for which we are liable under this policy. We will only pay interest on damages not exceeding our limits of liability. 4. premiums on appeal bonds and on bonds to release attachments, but not in excess of our limit of liability. We are not required to apply for or furnish these bonds. We will repay an insured person for: 1. the cost of any bail bonds required due to an accident or traffic law violation involving the use of the insured auto. We will not pay more than $300 per bond. We are not required to apply for or furnish these bonds. 2. any expense incurred for first aid to others at the time of an auto accident involving the insured auto. Insured ersons 1. While using your insured auto: a) you; b) any resident; and c) any other person using it with your permission. 2. While using a non-owned auto: a) you; and b) any resident. 3. ny other person or organization liable for the use of an insured auto provided: a) the auto is not owned or hired by the person or organization; and b) the use is by an insured person under 1. or 2. above. Insured utos 1. ny auto described on the olicy eclarations. his includes the four wheel private passenger auto or utility auto you replace it with. 2. n additional four wheel private passenger auto or utility auto you become the owner of during the premium period. his auto will be covered if we insure all other private passenger autos or utility autos you own. You must, however, tell us within 60 days of acquiring the auto. You must pay any additional premium. 3. substitute four wheel private passenger auto or utility auto, not owned by you or a resident, being temporarily used while your insured auto is being serviced or repaired, or if your insured auto is stolen or destroyed. 4. non-owned auto used by you or a resident relative with the owner s permission. his auto must not be available or furnished for the regular use of an insured person. 5. trailer while attached to an insured auto. he trailer must be designed for use with a private passenger auto or utility auto. his trailer cannot be used for business purposes with other than a private passenger auto or utility auto. efinitions 1. We, us, or our means the company shown on the olicy eclarations of the policy. 2. uto means a land motor vehicle designed for use on public roads. 3. Resident means the physical presence in your household with the intention to continue living there. nmarried dependent children while temporarily away from home will be age 5

7 llstate Fire and asualty Insurance ompany considered residents, if they intend to continue to live in your household. 4. tility auto means an auto of the pick-up body, sedan delivery or panel truck type. his auto must have a rated load capacity of not more than 2,000 pounds. 5. You or your means the policyholder named on the olicy eclarations and that policyholder s resident spouse. 6. Bodily injury means: a) bodily injury; b) sickness; c) disease; or d) death. xclusions What Is ot overed We will not pay any damages an insured person is legally obligated to pay because of: 1. bodily injury or property damage arising out of: a) the use of your insured auto while used to carry persons or property for a charge; or b) any auto you are driving while available for hire by the public. his exclusion does not apply to shared-expense car pools. 2. bodily injury or property damage arising out of business operations such as: a) repairing; b) servicing; c) testing; d) washing; e) parking; f) storing; or g) the selling; of autos. However, this exclusion does not apply to: (1) you; (2) resident relatives; or (3) partners or employees of the partnership of you or a resident relative; when using your insured auto. 3. bodily injury or property damage arising out of the use of a non-owned auto in any business or occupation of an insured person. However, this exclusion does not apply while you, your chauffeur, or your domestic employee are using a private passenger auto or trailer. 4. bodily injury to an employee of any insured person arising in the course of employment. overage does not apply to a domestic employee who is not required to be covered by workers compensation law or similar law. 5. bodily injury to a co-worker in the course of employment. his exclusion does not apply to you 6. damage to or destruction of property an insured person owns, is in charge of, or rents. his exclusion will not apply to: a) a private residence or a garage rented by that person; or b) verifiable and actual loss of use of a rented auto for 30 days from the date of the accident. 7. bodily injury or property damage which: a) may reasonably be expected to result from the intentional acts of an insured person; or b) are in fact intended by an insured person. 8. bodily injury or property damage which would also be covered under nuclear energy liability insurance. his applies even if the limits of that insurance are exhausted. 9. bodily injury or property damage arising out of the participation in any prearranged, organization, or spontaneous: a) racing contest; b) speed contest; or c) use of an auto at a track or course designed or used for racing or high performance driving; or in practice or preparation for any contest or use of this type. age 6

8 llstate Fire and asualty Insurance ompany Financial Responsibility When this policy is certified as proof under any motor vehicle financial responsibility law, this policy will comply with the provisions of that law. imits f iability he limits shown on the olicy eclarations are the maximum we will pay for any single auto accident. he limit stated for each person for bodily injury is our total limit of liability for damage because of bodily injury sustained by one person in any single auto accident. his includes damages sustained by anyone else as a result of that bodily injury. ubject to the limit for each person the limit stated for each occurrence is our total limit of liability for damages for bodily injury sustained by two or more persons in any single auto accident. For property damage, the liability limits apply to each insured auto as shown on the olicy eclarations. he insuring of more than one person or auto under this policy will not increase our liability limits beyond the amount shown for any one auto. his applies even though a separate premium is charged for each auto. he limits will not be increased if you have other auto insurance policies that apply. here will be no duplication of payments made under the Bodily Injury iability and roperty amage iability and ninsured otorists overages of this policy. n auto and an attached trailer are considered one auto. lso, an auto and a mounted camper unit, topper, cap or canopy are considered one auto. If a single each occurrence limit is stated on the olicy eclarations for utomobile iability Insurance, the limit will be the maximum amount of our liability for both bodily injury and property damage arising out of any single auto accident. If here Is ther Insurance If an insured person is using a substitute private passenger auto or non-owned auto, our liability insurance will be excess over other collectible insurance. If more than one policy applies on a primary basis to an accident involving your insured auto, we will bear our proportionate share with other collectible liability insurance. ssistance nd ooperation When we ask, an insured person must cooperate with us in the investigation, settlement and defense of any claim or lawsuit. If we ask, that person must also help us obtain payment from anyone who may be jointly responsible. We cannot be obligated if an insured person voluntarily takes any action or makes any payments other than for covered expenses for bail bonds or first aid to others. ction gainst s o insured person may bring any action against us in any way related to the existence or amount of coverage, or the amount of loss for which coverage is sought, under art I utomobile iability Insurance, unless there is full compliance with all the policy terms and such action is commenced no later than the last of the following to occur: 1. two years after the date of the accident; 2. two years after entry of final judgment or other court order terminating a lawsuit against the insured to determine the insured s liability or the amount of the insured s liability arising out of the accident; 3. two years after we agree to a settlement; or 4. if we have denied coverage and the insured person has thereafter settled with the claimant without any lawsuit being filed to determine the insured s liability or the amount of the insured s liability arising out of the accident, within two years after the denial of coverage. If the insured person is subject to claims arising out of the same accident by more than one person claiming bodily injury or property damage, the time for the insured person to bring an action against us shall be determined separately as to the coverage sought or provided with respect to the claims of each of those claiming against the insured person. If liability has been determined by judgment after trial, or by written agreement among the insured, the other person, and us, then whoever obtains this judgment or agreement against an insured person, age 7

9 llstate Fire and asualty Insurance ompany may sue us up to the limits of this policy. However, no one has the right to join us in a suit to determine legal responsibility of an insured person. What o o In ase f n uto ccident r laim If an insured person has an auto accident, we must be informed promptly of all details. If an insured person is sued as the result of an auto accident, we must be informed immediately. art II utomobile edical ayments overage Insuring greement We will pay to or on behalf of an insured person all reasonable expenses for medical services actually incurred by an insured person for necessary medical treatment, services, or products actually provided to the insured person. ayments will be made only when bodily injury, sickness, disease, or death is caused by an auto accident. overed expenses are: 1. ambulance; 2. medical; 3. surgical; 4. X-ray; 5. dental; 6. orthopedic and prosthetic devices; 7. professional nursing services; 8. pharmaceutical; 9. eyeglasses; 10. hearing aids; and 11. funeral expenses. he treatment, services, or products must be rendered within one year after the accident. his will be extended to five years if the amount of insurance shown on the olicy eclarations for this coverage is more than $5,000. his coverage does not apply to any person to the extent that a treatment is covered under any workers compensation law. nreasonable r nnecessary edical xpenses If the insured person incurs medical expenses which are unreasonable or unnecessary, we may refuse to pay for those medical expenses. We may also contest the charges. nreasonable medical expenses are fees for medical services which are substantially higher than the usual and customary charges for those services. nnecessary medical expenses are fees for medical services which are not usually and customarily performed for treatment of the injury. nnecessary expenses include fees for an excessive 1. number; 2. amount; or 3. duration; of medical services. If the insured person is sued by a medical services provider because we refuse to pay contested medical expenses, we will pay defense costs. We will also pay any resulting judgment against the insured person. We will choose the counsel. he insured person must cooperate with us in the defense of any claim or lawsuit. If we ask the insured person to attend hearings or trials, we will pay up to $100 per day for the loss of wages or salary. We will also pay any other reasonable expense incurred at our request. Insured ersons 1. You and any resident relative who sustains bodily injury while in, on, getting into or out of, or when struck by, an auto or trailer. he use of non-owned auto must be with the owner s permission. 2. ny other person who sustains bodily injury while in, on, getting into or out of: age 8

10 llstate Fire and asualty Insurance ompany a) your insured auto while being used by you, a resident relative, or any other person with your permission. b) a non-owned auto if the injury results from your operation or occupancy. c) a non-owned auto if the injury results from the operation on your behalf by your private chauffeur or domestic employee. d) a non-owned private passenger auto or trailer if the injury results from the operation or occupancy by a resident relative. he use of non-owned autos must be with the owner s permission. Insured utos 1. ny auto described on the olicy eclarations. his includes the four wheel private passenger auto or utility auto you replace it with. 2. n additional four wheel private passenger auto or utility auto you become the owner of during the premium period. his auto will be covered if we insure all other private passenger autos or utility autos you own. You must, however, tell us within 60 days of acquiring the auto. You must pay any additional premium. 3. substitute four wheel private passenger auto or utility auto, not owned by you or a resident, temporarily used while your insured auto is being serviced or repaired, or if your insured auto is stolen or destroyed. 4. non-owned four wheel private passenger auto used with the owner s permission. he auto must not be available for or furnished for the regular use of an insured person. 5. trailer while attached to an insured auto. he trailer must be designed for use with a private passenger auto or utility auto. his trailer cannot be used for business purposes with other than a private passenger auto or utility auto. efinitions 1. We, us, or our means the company shown on the olicy eclarations of the policy. 2. uto means a land motor vehicle designed for use on public roads. 3. Resident means the physical presence in your household with the intention to continue living there. Your unmarried dependent children while temporarily away from home will be considered residents, if they intend to continue to live in your household. 4. tility auto means an auto of the pick-up body, sedan delivery or panel truck type. his auto must have a rated load capacity of not more than 2,000 pounds. 5. You or your means the policyholder named on the olicy eclarations and that policyholder s resident spouse. xclusions What Is ot overed his coverage does not apply to bodily injury, sickness, disease or death to: 1. you or a resident relative while in, on, getting into or out of an auto you or a resident relative own but do not insure for this coverage. 2. you or a resident relative while in, on, getting into or out of, or struck as a pedestrian by: a) a vehicle operated on rails or crawler-treads; or b) a vehicle or other equipment designed for use off public roads, while not on public roads. 3. any person while in, on, getting into or out of: a) an owned auto while available for hire to the public. his exclusion does not apply to shared-expense car pools. b) an auto or trailer while used as a residence or premises. 4. any person, other than you or a resident relative, while using a non-owned auto: a) which is available for hire by the public; or age 9

11 llstate Fire and asualty Insurance ompany b) in auto business operations such as repairing, servicing, testing, washing, parking, storing or selling of autos. overage is provided for you, your private chauffeur or domestic employee while using a private passenger auto or trailer in any other business or occupation. 5. any person resulting from any act of war, insurrection, rebellion, or revolution. 6. any person arising of the participation in any prearranged, organized, or spontaneous: a) racing contest; b) speed contest; or c) use of an auto at a track or course designed or used for racing or high performance driving; or in practice or preparation for any contest or use of this type. imits f iability he limit shown on the olicy eclarations is the maximum we will pay for all expenses incurred by or for each person as the result of any one auto accident. he medical payments limit applies to each insured auto as shown on the olicy eclarations. he insuring of more than one person or auto under this policy will not increase our limit beyond the amount shown for any one auto, even though a separate premium is charged for each auto. he limit also will not be increased if you have other auto insurance policies that apply. If an insured person dies as the result of a covered auto accident, we will pay the least of the following as a funeral service expenses benefit: 1. $2,000; or 2. the overage limit of liability stated on the olicy eclarations; or 3. the remaining portion of the overage limit of liability not expended for other covered medical expenses. his funeral service expenses benefit does not increase, and will not be paid in addition to, the limits of liability stated on the olicy eclarations for overage. his benefit is payable to the deceased insured person s spouse if a resident of the same household at the time of the accident. However, if the deceased is a minor, the benefit is payable to either parent if that parent is a resident of the same household at the time of the accident. In all other cases, the benefit is payable to the deceased insured person s estate. here will be no duplication of payments made under the Bodily Injury iability and utomobile edical ayments coverages of this policy. ll payments made to or on behalf of any person under this coverage will be considered as advance payments to that person. he damages payable under the Bodily Injury iability coverage of this policy will be reduced by that amount. If here Is ther Insurance When this coverage applies to a substitute auto or non-owned auto, we will pay only after all other collectible auto medical insurance has been exhausted. When this coverage applies to a replacement auto or additional auto, this policy will not apply if you have other collectible auto medical insurance. ssistance nd ooperation When we ask, an insured person must cooperate with us in an investigation, settlement and defense of any claim or lawsuit. If we ask, that person must also help us obtain payment from anyone who may be jointly responsible. We cannot be obligated if an insured person voluntarily takes any action or makes any payments other than for covered expenses for first aid to others. ction gainst s o one may bring an action against us in any way related to the existence or amount of coverage, or the amount of loss for which coverage is sought, age 10