North Carolina Personal Automobile Policy

Transcription

1 Nth Carolina Personal Automobile Policy We know how imptant it is f you to stay on move. 500 W 5th Street Winston Salem, NC Integon General Insurance Cpation New South Insurance Company Integon Indemnity Cpation Integon National Insurance Company Integon Casualty Insurance Company Integon Preferred Insurance Company Agent Alliance Insurance Company

2 500 W 5th Street PO Box 3199 WinstonSalem, NC Please refer to your declarations page f name company issuing this policy. This policy is a legal contract between you us. The Personal Auto Policy has been: designed f easy reference; simplified to make it me understable; arranged to better display available coverage. This policy is a legal contract between you us. These policy provisions along with Declarations Page, application endsements, if any, issued to fm a part re, complete this policy. READ YOUR POLICY CAREFULLY To Rept A Claim

3 YOUR PERSONAL AUTO POLICY QUICK REFERENCE DECLARATIONS PAGE Your Name Address Your Auto Trailer Policy Period Coverages Amounts Insurance INDEX OF POLICY PROVISIONS AGREEMENT...1 DEFINITIONS...1 PART A > LIABILITY COVERAGE...2 INSURING AGREEMENT...2 SUPPLEMENTARY PAYMENTS...3 EXCLUSIONS...3 LIMIT OF LIABILITY...5 OUT OF STATE COVERAGE...5 FINANCIAL RESPONSIBILITY REQUIRED...5 OTHER INSURANCE...5 PART B > MEDICAL PAYMENTS COVERAGE...6 INSURING AGREEMENT...6 EXCLUSIONS...7 LIMIT OF LIABILITY...8 NON-DUPLICATION...8 OTHER INSURANCE...8 ARBITRATION...8 PART C1 > UNINSURED MOTORISTS COVERAGE...9 INSURING AGREEMENT...9 EXCLUSIONS...10 LIMIT OF LIABILITY...10 OTHER INSURANCE...11 OUR RIGHT TO RECOVER PAYMENT...11 ARBITRATION...12 PART C2 > COMBINED UNINSURED/UNDERINSURED MOTORISTS COVERAGE...12 INSURING AGREEMENT...12 EXCLUSIONS...14 LIMIT OF LIABILITY...15 OUR RIGHT TO RECOVER PAYMENT...16 OTHER INSURANCE...17 ARBITRATION...17 PART D > COVERAGE FOR DAMAGE TO YOUR AUTO...17 INSURING AGREEMENT...17 TRANSPORTATION EXPENSES...19 SALVAGE CHARGES...19 EXCLUSIONS...19 LIMIT OF LIABILITY...21 PAYMENT OF LOSS...22 NO BENEFIT TO BAILEE...22 OTHER INSURANCE...22 APPRAISAL...22 LOSS PAYEE...22 PART E > DUTIES AFTER AN ACCIDENT OR LOSS - FILING A CLAIM...23 GENERAL DUTIES...23 ADDITIONAL DUTIES FOR COVERAGE FOR DAMAGE TO YOUR AUTO...23 PART F > GENERAL PROVISIONS...24 BANKRUPTCY...24 CHANGES...24 FRAUD OR MATERIAL MISREPRESENTATION...24 LEGAL ACTION AGAINST US...24 OUR RIGHT TO RECOVER PAYMENT...25 POLICY PERIOD AND TERRITORY...25 TERMINATION - CANCELLATION, NONRENEWAL, AUTOMATIC TERMINATION, OTHER TERMINATION PROVISIONS...25 TRANSFER OF YOUR INTEREST IN THIS POLICY..27 AUTO REPAIRS...27 CHOICE OF LAW...27 NC (Ed )

4 (d) to injury death due to war, wher not declared, civil war, insurrection, rebellion revolution, to any act condition incident to any fegoing. Conditions Conditions 1, 2, 3 4 apply to Coverages A, B C. Conditions 5 6 only apply to Coverage A. 1. Policy Provisions: None Insuring Agreements, Exclusions Conditions policy shall apply to insurance affded by this endsement except Part F, General Provisions entitled Policy Period Territy, Changes, Legal Action Against Us Termination. 2. Notice Claim: When loss covered hereunder occurs, written notice re shall be given by on behalf insured beneficiary to Company any its authized agents as soon as practicable. 3. Pro Claim; Medical Repts: As soon as practicable, injured person, beneficiary in event death, someone on his her behalf, shall give to Company written pro claim, under oath if required, shall after each request from Company execute authization to enable Company to obtain medical repts copies recds. Pro claim shall be made upon fms furnished by Company unless Company shall have failed to furnish such fms within fifteen days after receiving notice claim. The injured person shall submit to physical examination by physicians selected by Company when as ten as Company may reasonably require. 4. Death Named Insured: If Named Insured shown in Declarations dies, any insurance affded under this endsement with respect to any surviving insured shall be continued while policy is in effect. 5. Payment Death Indemnity; Autopsy - Coverage A: If decedent insured be survived by a spouse who was a resident same household at time accident, indemnity f death is payable to such spouse; orwise, if decedent insured was a min, indemnity f death is payable to any parent re who was a resident same household at time accident, orwise indemnity f death is payable to decedent insured s estate. The Company shall have right opptunity to make an autopsy where is not fbidden by law. 6. Beneficiary - Coverage A: Consent beneficiary is not requisite to cancellation, assignment, change beneficiary, any or change in policy on in this endsement. Copyright, Nth Carolina Rate Bureau, 1980,

5 PERSONAL AUTO POLICY AGREEMENT In return f payment premium subject to all terms this policy, we agree with you as follows: DEFINITIONS Throughout this policy, you your refer to: 1. The named insured shown in Declarations; 2. The spouse if a resident same household. We, us our refer to Company providing this insurance. F purposes this policy, a private passenger type auto, pickup van shall be deemed to be owned by a person if leased: 1. Under a written agreement to that person; 2. F a continuous period at least 6 months. Or wds phrases are defined. They are boldfaced in quotation marks when used. Bodily injury means bodily harm, sickness disease, including death that results. Business means trade, pression occupation. Family member means a person related to you by blood, marriage adoption who is a resident your household. This includes a ward foster child. Occupying means in; upon; getting in, on, out f. Property damage means physical damage to, destruction, loss use tangible property. Trailer means a vehicle designed to be pulled by a: 1. Private passenger auto station wagon type; 2. Pickup truck van. It also means a farm wagon farm implement while pulled by a vehicle listed in above. Your covered auto means: 1. Any vehicle shown in Declarations. 2. A newly acquired auto. 3. Any trailer you own. 4. Any auto trailer not owned by you while used as a tempary substitute f any or vehicle described in this definition which is out nmal use because its: a. breakdown; b. repair; c. servicing; d. loss; e. destruction. This provision (4.) does not apply to Part D- Coverage f Damage to Your Auto. 1

6 Newly acquired auto means any Table following II types vehicles you become owner during policy period: If applicable 1. a private passenger auto station wagon type; principal sum is F 2. Fracture a pickup truck van that: Bones: a. has a Gross Vehicle Weight as specified by $5, manufactrurer less than $10, Skull (except pounds; bones face b. nose) is not used f delivery transptation goods $ materials unless $ such Thigh use is: Arm, between (1) incidental elbow to your business installing, maintaining repairing furnishings shoulder equipment; Pelvis (except (2) coccyx) f farming ranching Vertebra Any coverage Vertebrae f a newly acquired auto is subject to following: (except 1. If coccyx newly acquired vertebral auto replaces a vehicle shown in Declarations, it will have processes) same coverage as vehicle it replaced except that coverage, if any, under Part D- Coverage f Damage To Your Auto applies only if you ask us to insure it within 30 days Shoulder after Blade you become owner Leg 2. If a newly acquired auto is in addition to any shown in Declarations, it will have Knee broadest Cap coverage we now provide f any vehicle shown in Declarations if you ask Collar us Bone to insure it within 30 days after you become owner Coverage under this policy terminates f any newly acquired auto on effective Fearm, between wrist elbow date time a policy (or than this policy) issued by us any or company that describes such vehicle on its declarations page. Foot (except toes) If you ask us to insure a newly acquired auto within applicable specified time H period (except described fingers) in above, any coverage we provide f newly acquired Sternum auto begins on date you become owner. If you ask us to insure a newly acquired auto after applicable specified time period described above has elapsed, Lower Jaw (except alveolar process) any coverage we provide f newly acquired auto will begin at time you One request me ribs, coverage. fingers toes You must pay us any added amount due f any coverage we F Complete provide f a newly acquired auto. Dislocations: $5, $10, PART A > LIABILITY COVERAGE Bones INSURING face AGREEMENT nose Coccyx We will pay Vertebral damages f Processes bodily injury property damage f which any insured becomes Hip legally Joint responsible because an auto accident. Damages include prejudgment interest Knee awarded Joint against (except patella) insured. We will settle defend, as we consider appropriate, any Bone claim suit Bones asking Foot f se damages. In addition to our limit liability, we will pay all (except defense costs toes) we incur. Our duty to settle defend ends when our limit liability f this coverage has been exhausted. We have no duty to defend any suit settle any claim f Ankle bodily Joint injury property damage not covered under this policy Wrist Joint Insured as used in this Part means: Elbow Joint You any family member f ownership, maintenance use any auto Shoulder trailer. Joint Bone 2. Any person Bones using H your covered auto (except finger) 3. F your covered auto, any person ganization but only with respect to legal Collar Bone responsibility f acts omissions a person f whom coverage is affded under One this me Part. fingers toes

7 F 4. Loss F any by Removal: auto trailer, or than your covered auto, any person ganization Of one but only me with entire respect toes legal responsibility f acts omissions you any family (at least member one f entire whom phalanx) coverage is affded under this Part This provision applies only if person ganization does not own hire auto trailer. F SUPPLEMENTARY a Hospital confining PAYMENTS injury, except as an outpatient In addition to our limit liability: We will pay following on behalf an insured: Coverage C - Total Disability We will a. pay Premiums weekly indemnity on appeal at bonds rate shown bonds in to Schedule release attachments f period in any continuous suit we total disability defend. We insured have no which duty shall to purchase result directly bonds in an independently amount exceeding all or our Limit causes from bodily Liability, injury caused we have by accident no duty to apply sustained f furnish by insured se bonds; while occupying, through b. being All costs struck taxed by, an against auto, provided: insured interest accruing after a judgment is entered in any suit we defend. Costs do not include prejudgment interest. Our (1) Such disability shall commence within twenty days from date accident. duty to pay post-judgment interest ends when we fer to pay that part (2) Any judgment disability which during does not period exceed our 52 limit weeks liability after f date this coverage. accident shall be deemed total disability only if it shall continuously prevent insured from 2. We will pay following to an insured: perfming every duty his her regular occupation. a. Up to $250 f cost bail bonds required because traffic law violations (3) Any disability after 52 weeks after date accident shall be deemed total resulting from an accident. The accident must result in bodily injury property disability only if it shall continuously prevent insured from engaging in any damage covered under this policy. occupation employment f wage prit. b. Up to $200 a day f loss wages salary, but not or income, because (4) The weekly indemnity f total disability as provided above shall in no event attendance at hearings trials at our request; extend beyond number weeks as shown in Schedule from date c. Up commencement to $200 f expenses disability. incurred by an insured f Emergency first aid to ors perfmed at scene an accident that involves any auto covered by this (5) Weekly indemnity f total disability is payable to insured who is disabled, policy; subject to pro claim accrued, weekly indemnity is payable every four weeks d. Or any reasonable balance at expenses termination incurred at disability our request. period f which Company is The amount liable. any costs, wages, salary, or expenses listed above that are incurred by an insured (6) The must amount be repted payable to under us by such this coverage insured befe shall not we be will subject make payment. to any reduction EXCLUSIONS because any benefits available under any Wkers Compensation law similar A. We do law not provide from any Liability or source. Coverage f any insured: Definitions 1. Who - With intentionally respect to causes this insurance: bodily injury property damage. This exclusion auto means applies a l only mot vehicle extent that trailer not limit operated liability on rails this policy crawler-treads, exceeds but does not mean: minimum (1) a limit farm required type tract by financial or equipment responsibility designed law f Nth use Carolina. principally f public 2. roads, F property except while damage actually to upon property public owned roads, being (2) a transpted l mot by vehicle that insured. trailer while located f use as a residence premises not as a vehicle. 3. F property damage to property: insured means person named in schedule. a. rented to; Exclusions b. used by; This insurance c. in does not care apply: ; (a) that to bodily insured. injury This exclusion death sustained does not in apply course to a residence his her private occupation garage. by any person while engaged (1) in duties incident to operation, loading unloading 4. F bodily injury to an employee that insured during course, as an assistant on, a public livery conveyance commercial auto, (2) in employment. This exclusion does not apply to a domestic employee unless duties incident to repair servicing autos; wkers compensation benefits are required available f that domestic (b) to employee. loss caused by resulting f disease except pus fming infection which shall occur through bodily injury to which this insurance applies; 5. F that insured s liability arising out ownership operation a vehicle (c) while to suicide, it is being sane used insane, as a public to any attempt livery conveyance. reat; This exclusion does not apply to a share--expense car pool. 63 3

8 9. external 6. While discharge employed leakage orwise water. engaged This does in not business include : loss resulting from: a. rain; a. selling; b. snow; b. repairing; c. c. sleet; servicing; wher d. sting; not wind driven. Covered e. property parking means: 1. radio vehicles television designed antennas, f use mainly awnings, on cabanas, public highways. equipment This includes designed road to testing create additional delivery. living facilities This exclusion while does auto not is apply f a highway; to ownership, maintenance use 2. household your furniture covered auto or by: personal property owned by you f which you may be liable. a. If you; so elect, property owned by a family member by your employee who resides b. with any you family is covered. member; ADDITIONAL c. any EXCLUSIONS partner, agent employee you any family member. We will not This pay exclusion f loss applies damage only to: to extent that limit liability this policy 1. equipment exceeds accessies minimum limit your required covered by auto financial which are responsibility usual to an law auto Nth private Carolina. passenger truck type; 2. articles 7. Maintaining held as samples using any f vehicle sale, stage, while that repair, insured delivery is employed after sale; orwise exhibition merchise, engaged atrical in any business wardrobes; (or than farming ranching) not described in Exclusion 6. This exclusion does not apply to maintenance use a: 3. business fice equipment; a. private passenger auto; 4. recds accounts, currency, coins, deeds, banknotes, bullion, evidences debt, securities, b. pickup tickets, stamps, van that: manuscripts. LIMIT OF LIABILITY (1) You own; Our limit liability (2) You f do not loss own will while be used lesser as a tempary : substitute f your covered auto which is out nmal use because its: 1. stated amount shown in Schedule in Declarations; (a) breakdown; 2. actual cash value property at time loss damage; (b) repair; 3. amount necessary to repair replace property. (c) servicing; Our payment f loss will be reduced by a $25 deductible. The maximum amount payable is Limit Liability (d) less loss; a $25 deductible. However, deductible will not apply to loss caused by fire lightning. (e) destruction; An adjustment f depreciation physical condition will be made in determining c. trailer used actual with cash a value vehicle at described time in loss. a. b. above. 8. Using a vehicle without a reasonable belief that that insured is entitled to do so. NC (Ed. 7-87) This Exclusion A.8. does not apply to a family member using your covered auto which is owned THIS ENDORSEMENT by you. DOES NOT APPLY UNLESS THIS FORM NUMBER IS LISTED UNDER THE 9. F bodily injury FORMS SECTION property ON damage THE DECLARATIONS f which that PAGE insured: a. is an insured AUTO under DEATH a INDEMNITY, nuclear energy SPECIFIC liability DISABILITY, policy; b. would be AND an TOTAL insured DISABILITY under a BENEFITS nuclear COVERAGES energy liability policy but f its We agree with termination named upon insured exhaustion subject to all its limit provisions liability. this endsement to all provisions A nuclear energy policy liability except policy as is modified a policy herein, issued by as any follows: following ir successs: The insurance affded is only with respect to each following coverages as are indicated a. by a Nuclear specific Energy premium Liability charge Insurance charges, Association; only with respect to person persons designated b. Mutual as Atomic insured. Energy Liability Underwriters; c. Nuclear Insurance Association Canada. 60 4

9 Coverage B. We do A not - Death provide Indemnity Liability Coverage f ownership, maintenance use : We will 1. pay Any vehicle, principal or sum than stated your in covered Schedule auto, in which event is: death insured which shall a. result owned directly by you; independently all or causes from bodily injury caused by accident b. furnished sustained f by your regular insured use. while occupying, through being struck by, an auto, provided death shall occur (1) within ninety days after date accident, (2) within 2. Any fifty-two vehicle, weeks or after than your date covered accident auto, which is during : a period continuous total disability a. owned by insured any family f member; which weekly indemnity is payable under Total Disability b. Coverage. furnished f regular use any family member. Coverage However, B - Specific this Disability exclusion Benefits (B.2.) does not apply to your maintenance use any (1) Dismemberment vehicle which is: Loss Sight Benefits (2) Fractures a. owned by Dislocation a family member; Benefits We will pay b. furnished highest f applicable regular amount use stated a family f member. loss listed in following Tables. Coverage LIMIT OF LIABILITY applies only to bodily injury caused by accident sustained by insured while The limit occupying, liability shown through in being Declarations struck by, an f auto, each provided person f loss Bodily is sustained Injury Liability by insured Coverage within is our ninety maximum days after limit date liability accident. f all damages f bodily injury, including Any damages amount f payable care, loss under services this Coverage death, shall sustained reduce any by amount any one payable person under in any one Death auto Indemnity accident. Subject Coverage to this this limit endsement. f each person, limit liability shown in Declarations f each accident f Bodily Injury Liability Table Coverage I is our maximum limit liability f all damages f bodily injury resulting from any one auto accident. The limit liability shown F in Loss Declarations f each accident f If Property applicable Damage Liability Coverage If is applicable our maximum limit liability f all damages to all property principal resulting sum from any one auto principal accident. sum This is most we will pay as a result any one is $5,000 auto accident regardless number is $10,000 : Both 1. Insureds; Hs Both Feet Sight Both Eyes $5,000 $10, Claims made; One 3. H Vehicles One premiums Foot shown in Declarations; 5,000 10,000 Eir H Foot Sight 4. One Vehicles Eye involved in auto accident. 5,000 10,000 Eir OUT OF H STATE COVERAGE Foot 2,500 5,000 Sight If an auto One accident Eye to which this policy applies 1,750 occurs in any state province or 3,500 than one in which your covered auto is principally garaged, we will interpret your policy f that accident Thumb as follows: Index Finger Eir H 1,250 2,500 If state province has: Loss shall mean with regard to: 1. A financial responsibility similar law specifying limits liability f bodily injury (1) property hs damage feet, actual higher severance than through limit shown above in wrist Declarations, ankle joints; your policy will (2) provide eyes, entire higher irrecoverable specified limit. loss sight; 2. (3) A thumb compulsy index insurance finger, actual similar severance law requiring through a nonresident above to metacarpophalangeal maintain insurance whenever joints. nonresident uses a vehicle in that state province, your policy will provide at least required minimum amounts types coverage. No one will be entitled to duplicate payments f same elements loss. FINANCIAL RESPONSIBILITY REQUIRED When this policy is certified as future pro financial responsibility, this policy will comply with law to extent required. OTHER INSURANCE If re is or applicable liability insurance, we will pay only our share loss. Our share is proption that our limit liability bears to total all applicable limits. 61 5

10 However, Loss to any any insurance snowmobile: we provide f a vehicle you do not own shall be excess over any or a. collectible operated insurance. in; PART b. B > MEDICAL while in practice PAYMENTS preparation COVERAGE f; INSURING any racing AGREEMENT speed contest regardless wher not such contest is prearranged ganized. We will pay reasonable expenses incurred f necessary medical funeral services because Copyright, bodily Nth Carolina injury: Rate Bureau, 1996, Caused by accident; NC (Ed. 7-87) 2. Sustained by an THIS insured. ENDORSEMENT DOES NOT APPLY UNLESS THIS We will pay only those expenses FORM incurred NUMBER f IS services LISTED UNDER rendered THE within 3 years from date accident. FORMS SECTION ON THE DECLARATIONS PAGE Reasonable medical expenses AUTO do HOMES not include - CONTENTS expenses: COVERAGE 1. The provisions F treatment, services, exclusions products that apply procedures to Part D also that apply are: to this endsement except Exclusion a. Experimental 8 Limit in nature, Liability f provision. research, We not will primarily pay f direct designed to accidental serve a medical loss damage to purpose; covered property while it is: b. in Not attached commonly to; customarily recognized throughout medical pression within 25 within feet United used in States connection as appropriate with f treatment bodily injury; auto shown in Schedule in Declarations f which a specific premium 2. Incurred charge indicates f: that Auto Homes - Contents Coverage is provided. Loss a. damage The use to covered rmography property must or be related caused procedures by: a similar nature; b. fire The lightning; use acupuncture or related procedures a similar nature; c. windstm; The purchase rental equipment not primarily designed to serve a medical hail; purpose. Expenses 4. earthquake; are reasonable only if y are consistent with usual fees charged by majity similar medical providers in geographical area in which expenses were incurred 5. explosion; f specific medical service. Services 6. riot are civil necessary commotion; only if services are rendered by a licensed medical provider within 7. scope fced ling provider s any aircraft practice its parts license equipment; are essential in achieving maximum medical 8. flood improvement rising waters; f bodily injury sustained in accident. We 9. have valism right to malicious make obtain mischief; a utilization review medical expenses services to 10. determine external discharge if y are reasonable leakage water. necessary This does f not bodily include injury loss resulting sustained. from: Insured a. rain; as used in this Part means: 1. You b. snow; any family member: a. c. while sleet; occupying; b. wher as a pedestrian not wind when driven. struck by; Covered a mot property vehicle designed means: f use mainly on public roads a trailer any type Any radio or person television while antennas, occupying: awnings, cabanas, equipment designed to create a. additional your covered living facilities auto; while auto is f a highway; 2. household b. any or furniture mot vehicle: or personal property owned by you f which you may be liable. (1) If you operated so elect, by property you; owned by a family member by your employee who resides with you is covered. (2) operated by a family member if mot vehicle is a private passenger auto trailer. 58 6

11 ADDITIONAL EXCLUSIONS EXCLUSIONS We will do not cover pay f Medical loss Payments damage to: Coverage f any insured f bodily injury: 1. equipment Sustained while accessies occupying your covered auto when which it are is being usual used to an as auto a public private livery conveyance. passenger This truck exclusion type; does not apply to a share--expense car pool. 2. articles Sustained held while as samples occupying any f vehicle sale, stage, located repair, f use as delivery a residence after sale; premises. exhibition 3. merchise, Occurring while atrical employed wardrobes; orwise engaged in business : 3. business a. selling; fice equipment; 4. recds b. repairing; accounts, currency, coins, deeds, banknotes, bullion, evidences debt, securities, c. servicing; tickets, stamps, manuscripts. LIMIT d. OF sting; LIABILITY Our limit e. parking; liability f loss will be lesser : 1. stated vehicles amount designed shown f use in mainly Schedule on public in highways. Declarations; This includes road testing 2. actual delivery. cash This value exclusion property applies only at if Wkers time loss Compensation damage; benefits are available 3. amount f bodily necessary injury. to repair replace property. Our 4. payment Sustained f while loss occupying, will be reduced when by a $25 struck deductible. by, any vehicle The maximum (or than amount your covered payable is auto) Limit which Liability is: less a $25 deductible. However, deductible will not apply to loss caused a. by owned fire by lightning. you; An adjustment f depreciation physical condition will be made b. in determining furnished f cash your value regular at use. time loss. 5. Copyright, Sustained Nth while Carolina occupying, Rate Bureau, when 1980, struck 1987 by, any vehicle (or than your covered auto which is: NC (Ed. 7-87) a. owned by any family member; THIS ENDORSEMENT DOES NOT APPLY UNLESS THIS b. furnished f FORM regular NUMBER use any IS family LISTED UNDER member. THE However, this exclusion FORMS does SECTION not apply ON THE to you. DECLARATIONS PAGE 6. Sustained while occupying AUTO HOMES a vehicle - CONTENTS without a reasonable COVERAGEbelief that that insured is entitled to do so. Excluding Malicious Mischief Valism This Exclusion 6. does not apply to a family member using your covered auto which The provisions owned by you. exclusions that apply to Part D also apply to this endsement except Exclusion 8 Limit Liability provision. We will pay f direct accidental loss 7. damage Sustained to covered while property occupying while any it auto is: not owned by, furnished f regular use, you any family member while used to carry persons property f a fee. This 1. exclusion in attached does to; not apply to: 2. a. within a share--expense 25 feet used car in connection pool, with auto b. shown you in any family Schedule member. in Declarations f which a specific premium charge indicates that Auto Homes - Contents Coverage is provided. 8. Resulting from maintenance use any auto not owned by, furnished f Loss damage regular to use covered, you property any family must member caused while by: that insured is engaged in 1. business fire lightning; : 2. a. windstm; selling; 3. b. hail; repairing; 4. c. earthquake; servicing; 5. d. explosion; sting; 6. e. riot parking; civil commotion; 7. vehicles fced ling designed any f aircraft use mainly its on parts public equipment; highways. This includes road testing 8. delivery. flood rising This exclusion waters; does not apply to you any family member. 59 7

12 9. Resulting 2. Any from person maintenance using your covered use any snowmobile. auto not owned by, furnished f regular 3. use F, your covered any family snowmobile, member while any that person insured ganization is employed but orwise only with engaged in respect any business to legal not responsibility described in f Exclusion acts 8. omissions This exclusion a person does not f apply: whom a. to you coverage any family is affded member; under this Part. b. if 4. F bodily any injury snowmobile, results from or than operation your covered a private snowmobile, passenger auto any trailer person by you. ganization but only with respect to legal responsibility f acts 10. Caused by omissions as a consequence you : any family member f whom coverage is affded under this Part. This provision applies only if person ganization does a. war (declared not own hire undeclared) snowmobile. b. B. civil The war; Exclusions Section is amended as follows: c. 1. insurrection; Exclusions A.6. A.7. are replaced by following: d. rebellion We do revolution. not provide Liability Coverage f any insured maintaining using a 11. Sustained snowmobile while occupying any motized business. vehicle having fewer than four wheels. LIMIT OF 2. LIABILITY The following exclusions are added to Section B: The limit liability We do shown not provide in Liability Declarations Coverage f this f coverage ownership, is our maintenance maximum limit use liability f each : person injured in any one accident regardless number : 1. Claims made; Any snowmobile while rented to leased to any insured ganization 2. Vehicles or premiums than you; shown in Declarations; 3. Vehicles involved Any snowmobile: in accident. NON-DUPLICATION a. operated in; No person f b. whom while medical in practice expenses preparation are payable f: under this coverage shall be paid me than once f same any racing medical expense speed contest under this regardless similar vehicle wher insurance, such contest including is any no-fault benefits prearranged required by law. ganized. OTHER INSURANCE 3. The following exclusion applies under Section A. to any snowmobile f If re is or which applicable Schedule auto medical Declarations payments indicates insurance, that we will passenger only pay our hazard share is loss. Our excluded: share is proption that our limit liability bears to total all applicable limits. We do However, not provide any insurance Liability Coverage we provide f with any respect insured to f a bodily vehicle injury you do not own shall to be any excess person over while any or occupying collectible auto while insurance being towed providing by, payments described f medical funeral snowmobile. expenses. ARBITRATION C. The Or Insurance provision is replaced by following: The amount OTHER INSURANCE due under this coverage shall be decided by agreement between insured us. Any If insurance re is we no provide agreement, shall be excess amount over due any shall or be collectible decided by insurance. arbitration upon III. written PART request B - MEDICAL insured PAYMENTS us. COVERAGE Each party shall select a competent impartial arbitrat. These two shall select a third one. If unable to agree on third one within 30 days, Part eir B is amended party may as follows request with a judge respect a to court a snowmobile: recd in county in which arbitration A. The is pending definition to select insured a third is one. replaced The written by decision following: any two arbitrats shall be binding Insured on us, means: insured, any assignee insured any person ganization with whom insured expressly impliedly contracts f rendition medical services. 1. The You arbitrats any family decision member; shall be limited to wher not medical expenses were reasonable a. while occupying; services were necessary, with amount due being equal only to reasonable b. a expenses pedestrian f when necessary struck services. by: The arbitrats shall not award punitive damages a snowmobile. or noncompensaty damages. The cost 2. Any arbitrat or person any while expert occupying witness shall your be paid covered by party snowmobile. who hired m. The cost B. The Exclusions third arbitrat Section is amended or expenses as follows: arbitration shall be shared equally by both parties. 1. Exclusions 3, 8 9 are replaced by following: 56 8

13 The arbitration We shall do take not place provide in Medical county Payments in which Coverage insured f resides any insured unless f bodily parties agree to anor injury place. sustained State court while rules occupying governing a procedure snowmobile admission while it is being evidence used shall be used. in business an insured. 2. The following exclusions are added: PART C1 > UNINSURED MOTORISTS COVERAGE We do not provide Medical Payments Coverage f any insured f bodily INSURING AGREEMENT injury: We will pay compensaty Sustained while damages occupying which an any insured snowmobile is legally entitled while rented to recover leased from to owner operat any person an uninsured ganization mot or vehicle than because you; : 1. Bodily injury Sustained sustained while by occupying an insured any caused snowmobile by an accident; 2. Property a. damage operated caused in; by an accident. The owner s b. operat s while in practice liability f preparation se damages f any must racing arise speed out contest ownership, regardless maintenance use wher uninsured such contest mot is vehicle. prearranged ganized. Any judgment C. The Or f damages Insurance arising provision out a is suit replaced is not by binding following: on us unless we have been served OTHER with INSURANCE a copy summons, complaint or process against uninsured motist. Any insurance we provide shall be excess over any or collectible auto insurance Insured providing as used payments In this f Part medical means: funeral expenses. 1. IV. You PART C any - UNINSURED family member. MOTORISTS COVERAGE 2. Any Part or C is amended person occupying: as follows with respect to a snowmobile: A. a. Except your covered f a snowmobile, auto; a vehicle operated on rails crawler treads is not an b. Any uninsured or auto mot operated vehicle. by you. 3. Any B. person The following f damages exclusions that are person added is entitled to Section to recover A. because Exclusions bodily Section: injury to which We this do coverage not provide applies coverage sustained f property by a person damage described in bodily injury above. sustained Property by damage any insured; as used in this Part means injury to destruction : 1. Your While covered occupying auto. any snowmobile while rented leased to any insured 2. Any property ganization owned or by than a person you; listed in insured. Uninsured While mot occupying vehicle means any snowmobile: a l mot vehicle trailer any type: 1. To which a. neir: operated in; a. b. a liability while bond in practice policy; preparation n f: b. cash any racing securities speed on file contest with regardless Nth wher Carolina such Commissioner contest is prearranged Mot Vehicles; ganized. C. The applies Or at Insurance time provision accident. is replaced by following: 2. OTHER To which INSURANCE a liability bond policy applies at time accident; provided its limit Any f insurance liability is less we than provide minimum shall be limit excess specified over by any or financial collectible responsibility insurance. Nth Carolina. law V. 3. PART Which, D with - COVERAGE respect to FOR damages DAMAGE f bodily TO YOUR injury AUTO only, is a hit--run vehicle whose Part operat D is amended owner by cannot adding be identified following to which Exclusions hits: Section: We a. will you not any pay family f: member; Loss b. to a vehicle any snowmobile which you while any family rented member leased are to occupying; any insured ganization or than c. your you; covered auto. 4. To which a liability bond policy applies at time accident but bonding insuring company: a. denies coverage; b. is becomes insolvent. 57 9

14 However, uninsured mot vehicle NC 03 does 07 not (Ed. include 06-03) any vehicle equipment: 1. Owned by you. THIS ENDORSEMENT DOES NOT APPLY UNLESS THIS 2. Owned operated by FORM a self-insurer NUMBER under IS LISTED any applicable UNDER THE mot vehicle law; except a self-insurer which FORMS is becomes SECTION insolvent. ON THE DECLARATIONS PAGE 3. Owned by: COVERED PROPERTY COVERAGE With a. respect The United to coverage States America; provided by this endsement, provisions policy apply b. unless Canada; modified by this endsement. A. c. Exclusion a state; 8. Part D - Coverage f Damage to Your Auto does not apply to coverage d. provided an agency, by this or endsement. than a political subdivision a., b. c. above. 4. B. Operated We will pay on f rails direct crawler accidental treads. loss to covered property while it is in attached 5. Which to auto is a farm shown type in tract Schedule equipment in Declarations designed mainly f which f use a specific f public premium roads while charge not indicates on public that roads. Covered Property Coverage is provided. Direct accidental loss does not include any reduction in value covered property after it has been 6. While repaired, located as compared f use as to a its residence value befe premises. it was damaged. EXCLUSIONS Covered property means awnings, cabanas equipment designed to create A. We additional do not living provide facilities. Uninsured Motists Coverage f property damage bodily C. injury We will sustained not pay f: by any insured: 1. If Loss that to insured business fice legal equipment. representative settles bodily injury property damage claim without our written consent. 2. Loss to articles which are sales samples used in exhibitions. 2. While occupying your covered auto while it is being used as a public livery D. With conveyance. respect to coverage This exclusion under does this not endsement, apply to a share--expense Limit Liability car pool. Part D is replaced by following: 3. Using a vehicle without a reasonable belief that that insured is entitled to do so. LIMIT OF This LIABILITY Exclusion A.3. does not apply to a family member using your covered auto Our limit which liability is owned f loss by will you. be lesser : 1. Amount 4. F shown first in $100 Schedule amount in Declarations; property damage to property each 2. Actual insured cash value as result stolen any one damaged accident. property; 3. Amount 5. If necessary property to is repair contained replace in struck property by a mot with or vehicle property (or than like your kind quality. covered auto) owned by you any family member. This 6. F amount any punitive does not include exemplary any damages, reduction in legal costs value related reto. covered property after 7. While it has been occupying, repaired, as when compared struck to by, its any value mot befe vehicle it was owned damaged. by you any Our payment family f member loss will be which reduced is not by insured any applicable f this deductible coverage under shown this in policy. Schedule This in Declarations. includes a trailer any type used with that vehicle. An adjustment However, f depreciation this exclusion does physical not apply condition to you will any be family made in member. determining actual cash B. We value do at not provide time Uninsured loss. Motists Coverage f property damage caused by a Copyright, hit--run Nth vehicle Carolina whose Rate operat Bureau, 1990, owner 1996, cannot 2003 be identified. C. This coverage shall not apply directly indirectly to benefit any insurer self-insurer under any following NC any 03 similar 20 (Ed. law: 06-05) a. wker s compensation THIS ENDORSEMENT law; DOES NOT APPLY UNLESS THIS b. disability benefits FORM law. NUMBER IS LISTED UNDER THE FORMS SECTION ON THE DECLARATIONS PAGE LIMIT OF LIABILITY The limit bodily injury liability SNOWMOBILE shown in ENDORSEMENT Declarations f each person f Uninsured This Motists coverage Coverage is subject is to our all maximum provisions limit liability policy with f all respect damages to f snowmobiles bodily injury, including coverages damages described f care, in loss Schedule services in death, Declarations sustained except by any as modified one person as follows: in any one auto accident

15 With Subject respect to this limit to f each snowmobiles person, limit coverages bodily injury listed liability in shown Schedule in Declarations in Declarations, f each accident provisions f Uninsured Motists policy apply Coverage unless is modified our maximum by this limit endsement. liability f all damages I. DEFINITIONS f bodily injury resulting from any one accident. The limit property damage liability shown in Declarations f each accident f Uninsured Motist Coverage is our maximum The Definitions limit liability Section f is all amended damages as to follows: all property resulting from any one accident. This A. is F most purpose we will pay f coverage bodily injury provided by property this endsement, damage regardless terms auto, number : mot vehicle vehicle are replaced by term snowmobile except 1. Insureds; f Uninsured Motists Coverage. In Uninsured Motists Coverage, term uninsured mot vehicle includes a snowmobile. 2. Claims made; B. The reference to Declarations in Limit Liability provisions policy 3. Vehicles includes premiums Schedule. shown in Declarations; 4. Vehicles C. The involved following in definition accident. is added: Snowmobile means: The limit 1. liability A l orwise mot vehicle applicable which under is: this coverage shall be reduced by all sums: 1. Paid because a. designed bodily f use injury mainly property f public damage roads on by snow on behalf ice; persons ganizations b. Propelled who may solely be by legally means responsible. following This includes similar all mechanical sums paid devices; under Part A; (1) wheels 2. Paid payable because bodily injury under any wkers compensation law. However, (2) this reduction crawler-type does treads; not apply to extent that an employer s lien is required to be paid (3) under belts. Nth Carolina s wkers compensation law; Paid A trailer payable because designed f being bodily towed injury by, under but any not disability f transpting, benefits law a vehicle any similar described law. in 1. above. No payment However, will be made snowmobile f loss paid does payable not include to any insured vehicle under which Part is D propelled any policy by property airplane insurance. type propellers fans. D. Any payment The term your to any covered person under auto this replaced coverage by will term reduce your any covered amount snowmobile. that person is entitled Your to recover snowmobile f means: same damages under Part A. This coverage 1. Any snowmobile is excess over shown shall in not Schedule duplicate any in amount Declarations. paid payable under Part B. 2. Any snowmobile on date you become owner. This provision applies OTHER INSURANCE only if you: If this policy a. acquire any or snowmobile auto insurance policy during apply policy to period; same accident, maximum amount payable b. ask under us to insure all applicable it within 30 policies days after f injuries you become to an insured owner. caused by an uninsured mot vehicle shall be sum highest limit liability f this coverage under 3. each Any such snowmobile policy. you do not own while used as a tempary substitute f any or snowmobile described in this definition which is out nmal use In addition, because if re is its: or applicable similar insurance, we will pay only our share loss. Our a. share breakdown; is proption that our limit liability bears to total all applicable limits. However, any insurance we provide with respect to a vehicle you do not own shall be excess over b. any repair; or collectible insurance. OUR RIGHT c. TO servicing; RECOVER PAYMENT A. If we d. make loss; a payment under this coverage person to f whom payment was made e. destruction has a right to recover damages from anor, we shall be subrogated to II. PART that right. A - LIABILITY Furr, COVERAGE execution a covenant not to enfce judgment by injured Part party A shall is amended not preclude as follows us from with pursuing respect our to a right snowmobile: to sue f orwise recover any payment made under this coverage from anyone else who may be liable. The person A. to The f whom definition payment insured was made is replaced shall do: by following: 1. Insured Whatever is means: necessary to enable us to exercise our rights; Nothing You after any loss family to prejudice member m. f ownership, maintenance use any snowmobile

16 B. PART If 6 we - AMBULANCE make a payment EXPENSE under BENEFIT this coverage person to f whom payment is If a covered made recovers person suffers damages injuries from as anor, described that in person Part 2 shall: needs emergency ambulance service, 1. Hold Company in trust f will us pay proceeds expense actually recovery; incurred f transptation from accident 2. scene Reimburse to us hospital, to extent not to exceed our payment. amount shown in Schedule Benefits. ARBITRATION PART 7 - DAILY INCOME FOR LOSS OF TIME BENEFITS If we a covered an person insured suffers do not injuries agree: as described in Part 2 is reby totally disabled, 1. Company Wher will that pay this insured benefit. is legally Total entitled Disability to recover means compensaty being certified damages by a physician from as being owner unable to driver perfm an all uninsured nmal duties mot vehicle; your wk. The disability must begin within 10 days after accident. The Company will pay amount shown in Schedule 2. Benefits As to f each amount day Total such damages; Disability. Payment will not exceed a limit five days. PART 8 - insured EXCLUSIONS may dem to settle dispute by arbitration. The A. following Losses due procedures to following will be causes used: are not covered: 1. Each (1) intentionally party will select self-inflicted a competent injuries arbitrat. (sane The insane); two so selected will select a third. 2. If (2) any third loss arbitrat caused directly is not selected indirectly within by 30 disease days, insured bodily mental we may infirmity, request a judge medical a court surgical recd treatment to name one. diagnostic The court procedure must be in refe; county (3) voluntary state in which asphyxiation; arbitration is (4) pending. war (declared undeclared any act re); (5) driving in a 3. Each race party will speed pay contest. its chosen arbitrat. Each will pay half all or expenses B. arbitration. No benefits are Fees payable to lawyers under this coverage expert witnesses f: are not considered arbitration expenses are to be paid by party hiring se persons. (1) injuries received while operating a vehicle used to carry persons property f 4. Unless a fee, or insured than a we share--expense agree orwise, car arbitration pool; (2) any will treatment take place rendered in county in a state Veteran s in which Hospital; insured (3) any lives. injury Arbitration f which will insured be subject is covered to usual by Wkers rules procedure Compensation; evidence (4) in treatment such county f injuries state. covered The arbitrats by Medicare will resolve Medicaid; issues. (5) A written any insured decision while on which wking two as arbitrats an employee agree will an be auto binding dealership, on insured repair shop, us. service station, stage garage, public parking place, if injury death arises 5. Any arbitration out operation action against re; (6) Company losses sustained must begin within contracted time while limit operating allowed a f bodily mot injury vehicle after death consuming actions alcoholic state beverages, where accident marijuana, occurred. narcotics or 6. Judgment intoxicants, upon award while may riding be entered as a passenger in any proper in a mot court. vehicle operated by a person 7. As an after alternative, consuming insured alcoholic beverages, we may agree marijuana, to arbitrate narcotics by rules or or intoxicating than stated above. substances, unless administered on advice a physician. PART 9 - GENERAL PROVISIONS PART A. Notice C2 > COMBINED Claim: Written UNINSURED/UNDERINSURED notice claim must be given MOTORISTS within 20 COVERAGE days after a loss as INSURING soon as AGREEMENT is reasonably possible. This notice by f you should include your full name, We will date pay compensaty birth, policy number damages which address. an insured It should is legally be sent entitled to to Home recover Office from owner Company operat given an to uninsured our agent. mot vehicle because : 1. B. Bodily Claim Fms: injury sustained When by Company insured gets notice caused claim, by an it accident; may send claimant fms f filing pro loss. If se are not sent within 15 days after Company receives 2. Property notice claim, damage caused insured by may an submit accident. a written description nature extent The owner s loss f which operat s claim liability is made. f Such se a writing damages must must be arise submitted out within ownership, time maintenance required below. use uninsured mot vehicle. C. We Pro will also Loss; pay Time compensaty Limits: The damages Company which must be an given insured written is legally pro entitled loss: to recover from F loss owner disability within operat 90 days an after underinsured end mot period vehicle f which because Company bodily injury is liable sustained, by an insured caused by an accident. The owner s operat s liability f se damages must arise out ownership, maintenance use F any underinsured or loss, within mot 90 vehicle. days from We will pay date f se loss. damages only after limits If pro liability is not under given any within applicable such time, liability bonds claim will not policies be reduced have been denied exhausted if it was by payments not reasonably judgments possible to give settlements, pro within unless we: required time pro is given to Company as soon as possible. In no case will Company pay benefits if delay 12 52

17 1. Have in giving been pro given written loss is me notice than in advance 1 year, unless settlement delay between is caused an insured by lack legal capacity. owner operat underinsured mot vehicle; D. 2. Time Consent Payment to advance Claims: payment Benefits to payable insured under in this amount coverage equal will be to paid within tentative 60 settlement. days after we receive due written pro loss. Any E. judgment Payment f Claims: damages The arising Company out will pay a suit benefits is not to binding you on your us estate unless if we no beneficiary have been served has with been a copy designated. summons, If any benefit complaint is payable or to a payee process who against cannot execute uninsured a valid underinsured release, motist. Company may pay up to $1,000 that benefit to someone related to you Insured by blood as used in marriage this Part who means: Company believes has a right to it. Payments made in good faith under this provision will fully discharge Company to extent such 1. You payment. any family member. 2. F. Any Physical or Examinations person occupying: Autopsy - We have right to have you any or covered a. person your examined covered by auto; a physician our choice. Such examinations will be conducted at b. reasonable any or intervals auto operated expense by you. Company. We can also require an autopsy where not prohibited by law. 3. Any person f damages that person is entitled to recover because bodily injury to G. which Legal Action: this coverage No legal applies action sustained shall be by brought a person to listed recover in 1. under 2. above. this coverage befe 60 days after written pro loss has been furnished to Company. No legal action Property shall damage be brought as to used recover in this on Part this means policy injury me to than destruction 3 years after : written pro loss 1. Your has been covered furnished auto. to Company. 2. Any property owned by a person listed in 1. 2 insured. NC (Ed. 7-80) Underinsured mot vehicle means a l mot vehicle trailer any type: THIS ENDORSEMENT DOES NOT APPLY UNLESS THIS 1. The ownership, maintenance FORM NUMBER use IS which LISTED is UNDER insured THE bonded f liability at time accident; FORMS SECTION ON THE DECLARATIONS PAGE 2. The sum EXTENDED limits NON-OWNED liability under COVERAGE all bodily FOR injury NAMED liability INDIVIDUAL bonds insurance policies applicable at time accident is equal to greater than minimum limit specified by financial responsibility SCHEDULE law Nth Carolina; : Name a. is Individual less than limit liability f this Premium coverage; b. total limit liability available has been reduced to less than limit liability f this coverage by payment damages to or persons. However, Liability underinsured mot vehicle does $ not include any vehicle equipment: 1. Medical Operated Payments on rails crawler treads. $ 2. Total Which Premium is a farm-type tract or $ vehicle designed f use principally f public roads while not upon public roads. 3. I. While LIABILITY located COVERAGE f use as a residence premises. 4. Part A Which is amended is an uninsured as follows mot with respect vehicle. to individual named in Schedule spouse if a resident same household: Exclusions A.5., A.7., B.1 B.2 do not apply. 5. Which is insured under Liability Coverage this policy if such policy s limit liability f II. MEDICAL Combined PAYMENTS Uninsured/Underinsured COVERAGE Motists Coverage is equal to less than its limit Part B is liability amended f Liability as follows Coverage. if a premium is shown in Schedule f Medical Payments with Uninsured respect mot vehicle individual means named a l in mot Schedule vehicle trailer spouse any type: if a resident same household. 1. To which neir: Exclusions do not apply. a. a liability bond policy; n III. This endsement does not affd coverage under Part A Part B policy f b. cash securities on file with Nth Carolina Commissioner Mot any accident involving a vehicle owned by individual named in Schedule by Vehicles; a member same household, any accident involving a tempary substitute vehicle applies f at such time owned vehicle. accident. Copyright, Nth Carolina Rate Bureau,

18 2. B. To Or which Coverage a liability Available bond policy applies at time accident; provided its limit f If or liability alternative is less than economic minimum loss coverage limit specified applies: by financial responsibility law Nth Carolina. 1. The total limits liability shall not exceed highest limit liability any one 3. Which, with coverages respect that to damages applies; f bodily injury only, is a hit--run vehicle whose operat owner cannot be identified which hits: 2. We are liable only f our share. Our share is that percent economic loss a. benefits you any that family member; limit liability this coverage bears to total all or b. alternative a vehicle which economic you loss any coverage family member applicable are to occupying; accident. DUTIES c. AFTER your covered AN ACCIDENT auto. OR LOSS - FILING A CLAIM General 4. To which Dutiesa liability bond policy applies at time accident, but bonding We must insuring be notified company: promptly how, when where accident loss happened. Notice a. should denies also coverage; include names addresses any injured persons any witnesses. b. is becomes insolvent. A However, person uninsured seeking any mot coverage vehicle must: does not include any vehicle equipment: 1. Cooperate Owned by you. with us in investigation, settlement defense any claim suit. 2. Promptly Owned send operated us copies by a self-insurer any notices under legal any papers applicable received mot in vehicle connection law; except with a self-insurer accident which loss. is becomes insolvent. 3. Owned Submit as by: ten as we reasonably require: a. The To physical United exams States by America; physicians we select. We will pay f se exams. b. Canada; To examination under oath subscribe same. 4. Authize c. a state; us to obtain: d. a. an Medical agency, repts; or than a political subdivision a., b. c above. 4. Operated b. Or on pertinent rails crawler recds. treads. 5. Which Submit is a pro a farm type loss when tract required equipment by us. designed mainly f use f public roads Additional while not Duties on public F Alternative roads. Economic Loss Coverage 6. A person While seeking located Alternative f use as Economic a residence Loss premises. Coverage must also: EXCLUSIONS 1. Promptly notify police if a hit--run driver is involved. A. 2. We Promptly do not send provide us copies coverage f legal property papers damage if a suit is brought. bodily injury A suit caused may not by be an uninsured brought by mot an insured vehicle until 60 sustained days after by any that insured: person notifies us his her belief 1. that If that prospective insured defendant legal is representative an uninsured motist. settles bodily injury property damage claim without our written consent. 2. While occupying your covered auto (Ed. while 5-94) it is being used as a public livery conveyance. THIS This ENDORSEMENT exclusion does DOES not apply NOT APPLY to a share--expense UNLESS THIS car pool. 3. Using a vehicle without FORM NUMBER a reasonable IS LISTED belief UNDER that that THE insured is entitled to do so. FORMS SECTION ON THE DECLARATIONS PAGE This Exclusion A.3. does not apply to a family member using your covered auto which ACCIDENTAL is owned by you. DEATH AND DISMEMBERMENT COVERAGE This coverage 4. F is subject first $100 to all amount provisions property policy damage except as to modified property herein. each insured as result any one accident. BENEFICIARY: Unless orwise designated, Named Insured shall be beneficiary 5. If property or insured is contained persons; in struck Named by a Insured s mot vehicle beneficiary (or shall than be your Named Insured s covered auto) estate. owned by you any family member. PART COVERED F any punitive PERSONS exemplary damages, legal costs related reto. Coverage is provided under this endsement f eir: (A) named insured if Individual Plan is checked on application f this policy; (B) named insured, 14 50

19 spouse, 7. While any occupying, unmarried child when under struck age by, any 19 if mot Family vehicle Plan owned is checked by you on any application family f this member policy. which is not insured f this coverage under this policy. This The term includes spouse does a trailer not include any type one used who with is divced that vehicle. separated. Separated means physically However, living apart this regardless exclusion does wher not apply a separation to you any agreement family member. has been signed B. decree We do separation not provide entered. coverage Child f includes property stepchildren damage caused adopted by a hit--run children as long vehicle as y whose (children, operat stepchildren owner cannot adopted be children) identified. live in named insured s household. C. PART We 2 - INSURING do not provide CLAUSE coverage f bodily injury caused by an underinsured mot The Company vehicle will sustained pay benefits by any as insured: provided in Parts 3, 4, 5, 6 8 f loss due to bodily injury 1. caused If that solely insured through accidental legal representative means directly, settles independently bodily injury exclusively claim without all or causes our in consent. manner However, described this exclusion below: does not apply if we: (a) Any injury a. have suffered been by given a covered written person notice while in advance riding in a on, settlement getting in between out an a mot vehicle insured owned by owner Insured; operat underinsured mot vehicle; (b) Any injury suffered by a covered person while riding in on, getting in out, being b. struck we by fail any to advance mot vehicle. payment to insured in an amount equal to tentative Mot Vehicle, settlement as used in within this endsement, thirty days following means receipt private passenger such written vehicles, notice. including but not 2. limited While occupying to autos, station your covered wagons, auto vans while pickup it is being trucks used duly as licensed a public f use livery on public highways. conveyance. All or This vehicle exclusion types, does including not apply but to a not share--expense limited to commercial car pool. vehicles motcycles, 3. Using a vehicle are excluded. without reasonable belief that that insured is entitled to do so. PART 3 - DEATH, This Exclusion DISMEMBERMENT C.3. does not AND apply LOSS to a OF family SIGHT member BENEFITusing your covered auto If, within 90 which days is owned accident, by you. a covered person suffers injuries as described in Part 2 which 4. result F in any punitive losses listed exemplary below, damages, Company will legal pay costs related specified reto. amount reach loss as 5. shown While below: occupying, when struck by, any mot vehicle owned by you any F family Loss member which Percent is not Benefit insured f this coverage under this policy. This Both Hs, includes Both Feet a trailer Sight any type Both used Eyes with that vehicle. 100% One H However, One this Foot, exclusion One H does not Sight apply to you any family member. D. This coverage shall not apply directly indirectly to benefit any insurer self-insurer One under Eye any One Foot following Sight any One similar Eye law: 100% Life 1. wkers compensation law; 100% One H 2. disability One Foot benefits Sight law. One Eye 50% Only LIMIT one OF amount, LIABILITY largest, will be paid f losses due to one accident. The loss a h The foot limit means bodily complete injury liability severance shown at in above Declarations wrist f each ankle. person Loss f Combined sight one Uninsured/Underinsured eye means total Motists unrecoverable Coverage loss is our maximum entire sight limit liability that eye. f all damages PART f bodily 4 - DAILY injury, HOSPITAL including INDEMNITY damages f LOSS care, OF loss SIGHT services BENEFIT death, sustained by any one If person a covered in any person one auto suffers accident. injuries as described in Part 2 which require hospital confinement, Subject Company to this will limit pay f benefits each as person, shown in limit Schedule bodily injury Benefits. liability Such shown confinement must Declarations begin within f each 10 days accident after f Combined accident. Uninsured/Underinsured Payments will begin with Motists first day Coverage confinement is our maximum but limit not exceed liability five f days. all damages f bodily injury resulting from any one PART accident. 5 - MEDICAL The limit EXPENSE property BENEFIT damage liability shown in Declarations f each accident f Combined Uninsured/Underinsured Motists Coverage is our maximum limit liability If f a all covered damages person f property suffers damage injuries as caused described by an in uninsured Part 2 mot refe vehicle needs resulting medical treatment, from any one we accident. will pay this benefit up to maximum listed in Schedule Benefits. This part covers expenses f medical, surgical, Xray, hospital, pressional nursing dental services This is incurred most within we will 90 pay days f after bodily injury date property accident. damage regardless number : 1. Insureds; 51 15

20 2. Claims c. THE made; PURCHASE OR RENTAL OF EQUIPMENT NOT PRIMARILY DESIGNED TO SERVE 3. Vehicles A MEDICAL premiums PURPOSE. shown in Declarations; 4. Expenses Vehicles are involved reasonable in only accident. if y are consistent with usual fees charged by majity similar medical providers in geographical area in which expenses were The incurred limits f bodily specific injury medical liability service. shown in Declarations f each person each accident f this coverage shall be reduced by all sums: Services are necessary only if services are rendered by a licensed medical provider 1. within Paid because scope provider s bodily injury practice by on behalf license are persons essential ganizations in achieving maximum who may medical be legally improvement responsible. f This bodily includes injury all sums sustained paid under in Part accident. A; 2. Paid payable because bodily injury under any wkers compensation law. We have However, right this reduction to make does obtain not apply a utilization to extent review that an employer s medical lien expenses is required services to be to paid determine under Nth if y Carolina s are reasonable wkers compensation necessary f law; bodily injury sustained. 3. We will Paid pay only payable those because expenses incurred bodily f injury services under rendered any disability within 5 years benefits from law date any similar accident. law. The 2. most Compensation we will pay f f lost bodily earnings. injury Such damages compensation to an insured shall under be calculated this coverage based is on lesser : monthly income, after taxes, that insured would have earned from gainful employment except f injury. If insured was unemployed at time a. accident, limit compensation bodily injury shall liability be based shown on in employment Declarations compensation f each person benefits f this insured coverage would reduced have received, by all sums but described did not receive in items because 1., bodily preceding injury. Compensation paragraph; f lost earnings shall not exceed a maximum $5,000 per month per b. insured. damages sustained by insured f bodily injury reduced by all sums 3. Payment described up in to items $50 per 1., 2. day per 3. in insured, preceding f a period paragraph. not to exceed one year from The limit date property accident damage causing liability under injury, this f expenses coverage shall reasonably be reduced incurred by all in sums obtaining paid because dinary property necessary damage services by in lieu on behalf those persons insured ganizations would have who perfmed may be legally except responsible. f injury. This includes These services all sums shall payable be only under f Part A. benefit insured his No payment family, will cannot be made be f obtained loss paid to produce payable income to f insured insured. under Part D any policy 4. property Payment insurance. a death benefit in an amount equal to greater $5,000 15% Any payment per person to limit any person liability under f this this coverage coverage part will shown reduce in any Declarations amount that if person death is entitled one to recover me f insureds same is damages proximately under Part directly A. caused by an accident to which this coverage applies. In event that one accident causes death two me This coverage insureds, is excess this benefit over shall shall be divided not duplicate equally any between amount each paid insured. payable In under event Part B. an insured dies, all benefits under C.1., C.2. C.3 will terminate f that insured. OUR INSURING RIGHT AGREEMENT TO RECOVER PAYMENT A. We will If we pay make economic a payment loss benefits, under this subject coverage to limit person liability to determined f whom below, payment an insured was made is legally has entitled a right to recover from damages owner from anor, operat we shall an uninsured be subrogated mot vehicle that because right. Furr, bodily execution injury: a covenant not to enfce judgment by injured party shall not preclude us from pursuing our right to sue f orwise recover any 1. payment Sustained made by an under insured; this coverage from anyone else who may be liable. The person 2. to Caused f by whom an accident. payment was made shall do: The owner 1. Whatever operat s is necessary liability to f enable se us economic to exercise loss our benefits rights; must arise out ownership, 2. Nothing maintenance, after loss to use prejudice uninsured m. mot vehicle. There However, is no coverage our rights until under this limits paragraph liability do not apply all bodily against injury owner liability operat bonds insurance underinsured policies that apply mot have vehicle been if used we have up by been payment given written judgments notice in settlements. advance a EXCLUSIONS settlement fail to advance payment in an amount equal to tentative settlement A. within Economic 30 days loss following benefits receipt are not payable such notice. to an insured f bodily injury sustained: B. If 1. we While make occupying a payment under when this coverage struck by any mot person vehicle to owned f whom by you payment any is made family recovers member damages which from is anor, insured that person f this shall: coverage under this policy. This 1. Hold includes trust a trailer f us any proceeds type used with that recovery; vehicle