QUICK REFERENCE FLORIDA AUTO POLICY Fredericksburg Road San Antonio, Texas 78288
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- Angelina Jefferson
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1 9800 Fredericksburg Road San Antonio, Texas QUICK REFERENCE FLORIDA AUTO POLICY The automobile insurance contract between the named insured and the company shown on the Declarations page consists of this policy plus the Declarations page and any applicable endorsements. The Quick Reference section outlines essential information contained in the Declarations and the major parts of the policy. This is a participating policy. You are entitled to dividends as may be declared by the company's Board of Directors. If this policy is issued by United Services Automobile Association ("USAA"), a reciprocal interinsurance exchange, the following apply: By purchasing this policy you are a member of USAA and are subject to its bylaws. This is a non-assessable policy. You are liable only for the amount of your premium as USAA has a free surplus in compliance with Article of the Texas Insurance Code of 1951, as amended. The USAA Board of Directors may annually allocate a portion of USAA's surplus to Subscriber's Savings Accounts. Amounts allocated to such accounts remain a part of USAA's surplus and may be used as necessary to support the operations of the Association. A member shall have no right to any balance in the member's account except until following termination of membership, as provided in the bylaws. Beginning on Page Named Insured and Address Policy Period Operators Description of Vehicle(s) Coverages, Amounts of Insurance and Premiums Endorsements Definitions Insuring Agreement Bodily Injury Liability Coverage and Property Damage Liability Coverage Limit of Liability Supplementary Payments Exclusions Out of State Coverage Financial Responsibility Required Other Insurance Definitions Insuring Agreement Limit of Liability Application of Deductible Exclusions Other Insurance Definitions Insuring Agreement Medical Payments Coverage Air Bag and Seat Belt Benefits Limit of Liability Exclusions Other Insurance Special Provisions Arbitration (Quick Reference continued on Page 2) 6-04 Page 1 of 28
2 Definitions Insuring Agreement Limit of Liability Exclusions Other Insurance Non-Duplication Arbitration Definitions Insuring Agreement Comprehensive Coverage Collision Coverage Rental Reimbursement Coverage Towing and Labor Costs Coverage Limit of Liability Payment of Loss Loss Payable Clause Waiver of Collision Deductible Exclusions Mandatory Pre-Insurance Inspection No Benefit to Bailee Other Sources of Recovery Appraisal Air Bag Bankruptcy Changes Duties After an Accident or Loss Legal Action Against Us Mediation Misrepresentation Non-Duplication of Payment Our Right to Recover Payment Ownership Policy Period and Territory Termination Transfer of Your Interest in this Policy Two or More Auto Policies 6-04 Page 2 of 28
3 FLORIDA AUTO POLICY AGREEMENT In return for payment of the premium and subject to all the terms of this policy, we will provide the coverages and limits of liability for which a premium is shown in the Declarations. DEFINITIONS The words defined below are used throughout I. (referred to as ) means this policy. They are in when used. physical injury to, destruction of, or loss of use of tangible property. A. and refer to the "named insured" shown in the Declarations and spouse if a J. means a resident of the same household. private passenger auto, pickup,,, or not B. and refer to the Company owned by or a while it providing this insurance. is used as a temporary replacement for when withdrawn from normal C. means the business of use because of its breakdown, repair, altering, customizing, leasing, parking, servicing, loss, or destruction. repairing, road testing, delivering, selling, servicing, or storing vehicles. K means a vehicle designed to be pulled by a private passenger auto, pickup,, or D. (referred to as ) means bodily. It also means a farm harm, sickness, disease, or death. wagon or implement while towed by such vehicles. E. includes, but is not limited to: L. means a four-wheeled land motor vehicle of the van type with a load capacity 1. A competition against other people, of not more than 2,000 pounds. vehicles, or time; or M. means: 2. An activity that challenges the speed or handling characteristics of a vehicle or 1. Any vehicle shown in the Declarations. improves or demonstrates driving skills, provided the activity occurs on a track or 2. Any of the following types of vehicles course that is closed from acquired by or a non-participants. during the policy period, beginning on the date or a becomes F. means a person related to the owner, but only if no other similar by blood, marriage, or adoption who is a insurance policy provides coverage for resident of household. This includes a such vehicle: ward or foster child. a. A private passenger auto; G. means the following motorized vehicles: a motorcycle, moped or b. A pickup or ; or similar type vehicle; motor home; golfcart; snowmobile; all-terrain vehicle; or dune c. A not used in buggy. any business or occupation. H. means in, on, getting into or out of Page 3 of 28
4 For such newly acquired vehicles, will 3. Any own. automatically provide the broadest coverages as are provided for any 4. Any. Only vehicle shown in the Declarations. If those coverages provided for the vehicle policy does not provide Comprehensive withdrawn from normal use will be and Collision coverages, will provide extended to its each with a $250 deductible. However,. will not provide any coverage for more than 30 days after the date or a becomes the owner of the vehicle. If wish to continue any coverage beyond the 30-day period, must request it prior to the end of the 30-day period. PART A - LIABILITY COVERAGE as used in this Part means: will pay compensatory damages for or for which any becomes 1. or any for the legally liable because of an auto accident. ownership, maintenance, or use of any auto will settle or defend, as consider or. appropriate, any claim or suit asking for these damages. duty to settle or defend ends 2. Any person using. when limit of liability for these coverages has been paid or tendered. have no duty to 3. Any other person or organization, but only defend any suit or settle any claim for or with respect to legal liability imposed on not covered under this policy. them for the acts or omissions of a person for whom coverage is afforded in 1. or 2. above. With respect to an auto or other than, this provision For sustained by any one person in any one only applies if the other person or auto accident, maximum limit of liability for organization does not own or hire the auto all resulting damages, including, but not limited to, or. all direct, derivative or consequential damages recoverable by any persons, is the limit of The following are not under liability shown in the Declarations for "each Part A: person" for Liability. 1. The United States of America or any of its agencies. 2. Any person with respect to or resulting from the operation of an auto by that person as an employee of the United States Government. This applies only if the provisions of Section 2679 of Title 28, United States Code as amended, require the Attorney General of the United States to defend that person in any civil action which may be brought for the or Subject to this limit for "each person", the limit of liability shown in the Declarations for "each accident" for Liability is maximum limit of liability for all damages for resulting from any one auto accident. The limit of liability shown in the Declarations for "each accident" for Liability is maximum limit of liability for all damages to all property resulting from any one auto accident. These limits are the most of the number of: 1. ; will pay regardless 6-04 Page 4 of 28
5 2. Claims made; 6. Other reasonable expenses incurred at request. 3. Vehicles or premiums shown in the Declarations; or 7. All defense costs incur. 4. Vehicles involved in the auto accident. However, if a policy provision that would defeat coverage for a claim under this Part is declared to be unenforceable as a violation of the Florida Motor Vehicle Responsibility Statutes governing proof of financial responsibility, limit of liability will be the minimum required by the Florida Motor Vehicle Responsibility Statutes governing proof of financial responsibility. A. do not provide Liability Coverage for any : 1. Who intentionally acts or directs to cause or or who acts or directs to cause with reasonable expectation of causing, or. 2. For to property owned or being transported by a. In addition to limit of liability, will pay on 3. For to property rented to, used by, behalf of a : or in the care of any. This does not apply to damage to a 1. Premiums on appeal bonds and bonds to residence or garage. release attachments in any suit defend. But will not pay the premium for bonds 4. For to an employee of that person with a face value over limit of liability which occurs during the course of shown in the Declarations. employment. This exclusion (A.4.) does not apply to a domestic employee unless 2. Prejudgment interest awarded against the workers' compensation benefits are on that part of the required or available for that domestic judgment pay. If make an offer to employee. pay the applicable limit of liability, will not pay any prejudgment interest based on that 5. For that person's liability arising out of period of time after the offer. the ownership or operation of a vehicle while it is being used to carry persons 3. Interest accruing, in any suit defend, on for a fee. This exclusion (A.5.) does not that part of a judgment that does not exceed apply to a share-the-expense car pool. limit of liability. duty to pay interest ends when offer to pay that part of the 6. While employed or otherwise engaged in judgment that does not exceed limit of the. This exclusion (A.6.) liability. does not apply to the ownership, maintenance, or use of 4. Up to $100 a day for loss of wages because by any, or of attendance at hearings or trials at any partner, agent, or employee of request. or any. 5. The amount a must pay to 7. Maintaining or using any vehicle while that the United States Government because of person is employed or otherwise damage to a government-owned private engaged in any business or occupation passenger auto, pickup, or which occurs other than the, farming, while the vehicle is in the care, custody, or or ranching. control of a. The most will pay is an amount equal to one month of This exclusion (A.7.) does not apply to the the basic salary of the at maintenance or use of a private the time of loss. Only Exclusions A.1. and A.8. passenger auto; a pickup or that apply. own; or a used with these vehicles Page 5 of 28
6 8. Using a vehicle without expressed or C. There is no coverage for for which a implied permission. becomes legally responsible to pay to a member of that 9. For or for which that person is an family residing in that insured under any nuclear energy liability household. policy. This exclusion (A.9.) applies even if that policy is terminated due to D. There is no coverage for liability assumed by exhaustion of its limit of liability. any under any contract or agreement. 10. For or occurring while is rented or leased to others. If an auto accident to which this policy applies 11. For punitive or exemplary damages. occurs in any state or province other than the one in which is principally B. do not provide Liability Coverage for the garaged, policy will provide at least the ownership, maintenance, or use of: minimum amounts and types of coverages required by law. However, no one will be entitled 1. Any vehicle that is not to duplicate payments for the same elements of unless that vehicle is: loss. a. A four or six wheel land motor vehicle designed for use on public roads with a rated load capacity of no more than 2,000 pounds; b. A moving van for personal use; When this policy is certified as future proof of financial responsibility, this policy shall comply with the law to the extent required. c. A having at least four wheels. If there is other applicable liability insurance, d. A vehicle used in the business of will pay only share of the loss. share is farming or ranching; or the proportion that limit of liability bears to the total of all applicable limits. e. A vehicle being used in a medical emergency. With respect to a vehicle or a do not own, any insurance provide 2. Any vehicle, other than to a shall be excess over:, that is owned by, or furnished or available for regular use. 1. Any other applicable liability insurance, or 3. Any vehicle, other than 2. Any self-insurance in compliance with a, that is owned by, or furnished or state's financial responsibility law. available for the regular use of, any. This exclusion (B.3.) However, with respect to a vehicle leased or does not apply to maintenance or rented by, if have agreed to provide use of such vehicle. primary coverage in a written lease or rental agreement, the coverage provided by this policy 4. Any vehicle while being operated in, or in is primary, but only for the statutory minimum practice for, any financial responsibility limits required by the. Florida Responsibility Law and the Florida Motor Vehicle No-Fault Law Page 6 of 28
7 PART B-1 - PERSONAL INJURY PROTECTION COVERAGE (Referred to as PIP) A. as used in this Part means: following: does not include the 1. or any : a. While any ; or 1. Spinal ultrasound, also known as sonography, ultrasonography, and echography; 2. Surface EMG; b. As a for resulting from an accident occurring within the State 3. Somatosensory Evoked Potential for use of Florida. in the diagnosis of radiculopathy or distal nerve entrapment when treating persons 2. Any other person who sustains as a sustaining bodily injury covered by result of an accident occurring within the personal injury protection benefits; and State of Florida and involving : 4. Dermatomal Evoked Potential. a. While D. means reasonable ; or expenses for surgical, medical, X-ray, dental, and rehabilitative b. As a, if a resident of services, including prosthetic devices, and Florida, who is not an of a ambulance, hospital, for which Security is and nursing services. Such benefits shall also required under the Florida Motor include remedial Vehicle No-Fault Law, or is not treatment and services recognized and entitled to PIP benefits from the permitted under the laws of the state for an insurer of the of such a injured person who relies upon spiritual. means through prayer alone for healing, in accordance with his or her religious beliefs; B. as used in this Part means a however, this sentence does not affect the relative of any degree by blood, by marriage, determination of what other services or or by adoption, who usually makes his or her procedures are. home in the same family unit, whether or not temporarily living elsewhere. E. C. refers to a medical 1. Means any self-propelled vehicle with service or supply that a prudent physician four or more wheels which is of a type would provide for the purpose of both designed and required to be licensed preventing, diagnosing, or treating an illness, for use on the highways of the State of injury, disease, or symptom in a manner that Florida and any or semi-trailer is: designed for use with such vehicle. 1. In accordance with generally accepted 2. Does not include a mobile home or any standards of medical practice; which is used in mass transit and designed to transport more 2. Clinically appropriate in terms of type, than five passengers exclusive of the frequency, extent, site, and duration, and operator of the and owned by a municipality, a transit 3. Not primarily for the convenience of the authority, or a political subdivision of the patient, physician, or other health care state. This exception does not apply to a provider. used in public school transportation Page 7 of 28
8 F. means a person or organization who insurance. The database will also reflect, holds the legal title to a and where applicable, (a) the value of the also includes: actual medical services based on a nonspecialty specific relative value scale 1. A debtor having the right to possession, for the services relative to other services in the event a is the and, (b) in the case of new procedures, subject of a security agreement, and services, or supplies, a comparison to commonly-used procedures, services, or 2. A lessee having the right to possession, supplies. in the event a is the subject of a lease with option to J. means, purchase and such lease agreement is for with respect to the period of disability of the a period of six months or more, and, all expenses reasonably incurred in obtaining from others ordinary 3. A lessee having the right to possession, and necessary services in lieu of those that, in the event a is the but for such injury, the subject of a lease without option to would have performed without income for purchase, and such lease agreement is the benefits of the for a period of six months or more, and household. the lease agreement provides that the lessee shall be responsible for securing K. means, with respect to the insurance. period of disability of the any loss of gross income and earning G. means a person while not capacity from inability to work proximately any self-propelled vehicle. caused by the sustained by the However, does not H. means any location include any loss after the death of a within the municipality where the is receiving treatment, or in which the resides, or within 10 miles L. as used in this Part does by road of the residence, not include any for provided such location is within the county in which security is not required under the which the resides. Florida Motor Vehicle No-Fault Law. If there is no qualified physician to conduct the examination in a location to the, then will pay, in accordance with the Florida such examination shall be conducted in an Motor Vehicle No-Fault Law, to or for the area of the closest proximity to the insured's benefit of the : residence % of, and I. is the amount which will pay for charges made by a licensed hospital, 2. 60% of and licensed physician, or other licensed medical provider for services % of, In determining what is reasonable, we will and consider the following: 4. Death benefits of $5,000, 1. The actual charge; incurred as a result of, caused by an accident 2. The charge negotiated with a provider; or arising out of the ownership, maintenance, or use of a and sustained by a 3. The charge determined by a statistically. valid database that is designed to reflect charges for the same or comparable services or supplies in cases involving no 6-04 Page 8 of 28
9 will not be liable for subsequent PIP benefits if a unreasonably refuses to submit to a physical or mental examination, as A. do not provide PIP Coverage for required in Part E - General Provisions, Duties sustained by any : After An Accident or Loss. 1. While a of Whenever a person making a claim is charged which are the and which is with committing a felony, shall withhold not under this Part; benefits until, at the trial level, the prosecution makes a formal entry on the record that it will 2. While operating not prosecute the case against the person, the without express or implied consent; charge is dismissed, or the person is acquitted. 3. If such person's conduct contributed to his under any of the following circumstances: Regardless of the number of or, claims made, vehicles or a. Causing to himself intentionally; or premiums shown in the Declarations, or vehicles involved in an auto accident, the total aggregate limit of PIP benefits available under Florida Motor b. While committing a felony; Vehicle No-Fault Law, from all sources 4. For if an entry in the combined, including this policy, for all loss and Declarations indicates such coverage expense incurred by or on behalf of any one does not apply; or person who sustains as the result of one accident shall not exceed the amount indicated in 5. While a the Declarations. located for use as a residence or premises. Any amount payable under this insurance (PIP) shall be reduced by the amount of benefits a B. do not provide PIP Coverage for has recovered or is entitled to sustained by any while recover for the same elements of loss under the or when struck by, any vehicle, workers' compensation laws of any state or the other than, that is owned Federal Government. by or furnished or available for the regular use of, any. This does not apply to. The amount of any deductible stated in the Declarations shall be deducted from the total amount of,, and, before the application of any percentage limitation incurred by or on behalf of each person to whom the deductible applies and who sustains as a result of any one accident. Such deductible shall not apply to: 1. The death benefit; or 2. Any person determined eligible pursuant to the Florida Crime Compensation Act, excluding S of the act. If there is other applicable PIP Coverage, will pay only share of the loss and of expenses incurred in processing the claim. share is the proportion that limit of liability bears to the total of all applicable limits. Notwithstanding any provision of this coverage to the contrary, if a person is injured while or through being struck by, a rented or leased under a rental or lease agreement which does not specify otherwise in bold type on the face of such agreement, the PIP Coverage afforded under the lessor's policy shall be primary Page 9 of 28
10 PART B-2 - MEDICAL PAYMENTS COVERAGE A. means a supplemental passive restraint system commonly referred to as an which is originally installed by the vehicle manufacturer and which, at the time of the accident, had not been made inoperable through modification, deactivation, disconnection, switching off or prior deployment. 1. Consistent with the symptoms, diagnosis, and treatment of the injury and appropriately documented in the medical records; 2. Provided in accordance with recognized standards of care for the injury at the time the charge is incurred; B. means (in order of priority of 3. Consistent with published practice payment): guidelines and technology, and assessment standards of national 1. The surviving spouse if a resident in the organizations or multi-disciplinary medical same household as the deceased at the groups; time of the accident; or 4. Not primarily for the convenience of the 2. If the deceased is an unmarried minor,, his or her physician, either of the surviving parents who had hospital, or other health care provider; legal custody at the time of the accident; or 5. The most appropriate supply or level of service that can be safely provided to the 3. The estate of the deceased. ; and C. as used in this Part, B-2, 6. Not excessive in terms of scope, means: duration, or intensity of care needed to provide safe, adequate, and appropriate 1. or any while diagnosis and treatment. any auto. However, 2. Any other person while do not. include the following: 3. or any while not 1. Nutritional supplements or over-thea motor vehicle if injured by: counter drugs; D. a. A motor vehicle designed for use 2. Experimental services or supplies, which mainly on public roads; means services or supplies that determine have not been accepted by the b. A ; or majority of the relevant medical specialty as safe and effective for treatment of c. A. the condition for which its use is proposed; are those services or 3. Inpatient services or supplies provided to supplies provided or prescribed by a licensed the when these could hospital, licensed physician, or other licensed safely have been provided to the medical provider that, as determined by as an outpatient; or someone on behalf, are required to identify or treat caused by an auto 4. Spinal ultrasound, also known as accident and sustained by a sonography, ultrasonography, and and that are: echography; 6-04 Page 10 of 28
11 5. Surface EMG; 6. Somatosensory Evoked Potential for use A. Medical Payments Coverage. will pay only in the diagnosis of radiculopathy or distal the reasonable fee for nerve entrapment when treating persons and the sustaining bodily injury covered by reasonable expense for funeral services personal injury protection benefits; and because of caused by an auto accident, sustained by a. The medical 7. Dematomal Evoked Potential. services must be rendered within three years of the date of the accident unless those E. is the amount, as services are otherwise covered by PIP determined by or someone on behalf, Coverage, but not payable due to the which will pay for charges made by a co-insurance requirements of that coverage. licensed hospital, licensed physician, or other licensed medical provider for A provider of medical services may charge more than the limits established by this. will pay the lesser of: policy's defined terms, but such additional charges are not covered. or someone on 1. The actual charge; behalf will review, by audit or otherwise, claims for benefits under this coverage to 2. The charge negotiated with a provider; determine whether fees and expenses were reasonable and whether treatment was 3. The charge authorized, established, or medically necessary and appropriate. approved by the Department of Insurance under Florida's PIP law; or will pay under this coverage only if bills and statements are submitted in accordance 4. The charge determined by a statistically with the billing requirements that are valid database that is designed to reflect applicable to claims submitted under PIP charges for the same or comparable Coverage. services or supplies in the same or similar geographic region. The database B. Air Bag and Seat Belt Benefits. will will also reflect, where applicable, (a) the provide the benefits described only if, at the value of the actual medical services based time of the accident, Personal Injury on a nonspecialty specific relative value Protection Coverage was provided by the scale for the services relative to other policy and the for whom services, and (b) in the case of new benefits are sought was: procedures, services, or supplies, a comparison to commonly-used 1. Wearing a ; or procedures, services, or supplies. 2. Wearing a and a F. means manual or automatic safety seat in an automobile in which he was belts or seat and shoulder restraints or a protected by an ; and child restraint device. Both the lap and shoulder restraints must be worn at the time 3. Entitled to collect benefits for medical of the accident for coverage to apply. If the expenses incurred as a result of the is a child, the child restraint accident under the terms of the policy's device must meet federal motor vehicle Personal Injury Protection Coverage. safety standards and must be one recommended by its manufacturer as appropriate for use by children of like age and weight. The child must be properly seated and restrained within the device and the device must be attached to the interior of the vehicle in accordance with the manufacturer's instructions Page 11 of 28
12 will pay a Death Benefit of $15,000 to the of a who dies as the direct result of sustained in an automobile accident while wearing a. will pay an Additional Death Benefit of $10,000 to the of a who dies as a direct result of sustained in an automobile accident while wearing a and a seat protected by an. In either case, death must occur within three years of the date of the accident. do not provide Medical Payments Coverage under this Part for any for : 1. Sustained while any vehicle that is not unless that vehicle is: a. A four or six wheel land motor vehicle designed for use on public roads with a rated load capacity of no more than 2000 pounds; b. A moving van for personal use; The following provisions represent the most will pay regardless of the number of or, claims made, vehicles or premiums shown in the Declarations, or vehicles involved in an auto accident. A. Medical Payments. 1. The limit of liability shown in the Declarations for Medical Payments Coverage is the maximum limit of liability for each injured in any one accident. 2. No one will be entitled to receive duplicate payments for the same elements of loss under this coverage and Part A or Part C of the policy. B. Air Bag and Seat Belt Benefits. 1. The maximum Death Benefit will pay under Air Bag & Seat Belt Benefits is $15,000 for death of any one. The maximum Additional Death Benefit will pay for death of any one is $10,000. These amounts are the most will pay regardless of the number of vehicles to which this coverage applies, the number of coverages or premiums shown in the Declarations, or any other factor. 2. No one will be entitled to duplicate payments for the same elements of loss. c. A having at least four wheels; or d. A vehicle used in the business of farming or ranching. 2. Sustained while when it is being used to carry persons for a fee. This does not apply to a share-the-expense car pool. 3. Sustained while any vehicle located for use as a residence. 4. Occurring during the course of employment if workers' compensation benefits are required or available. 5. Sustained while or when struck by, any vehicle, other than that is owned by or furnished or available for regular use. 6. Sustained while, or when struck by, any vehicle, other than that is owned by or furnished or available for the regular use of any This does not apply to. 7. Sustained while a vehicle without expressed or implied permission. 8. Sustained while a vehicle when it is being used in the business or occupation of a. This does not apply to sustained while a private passenger auto; a pickup or own; or a used with these vehicles Page 12 of 28
13 9. Caused by or as a consequence of war, insurrection, revolution, nuclear reaction, or radioactive contamination. If and a do not agree: 10. Sustained while 1. On the ; while it is rented or leased to others. 2. That expenses are reasonable; 11. Sustained while a participant in, or in practice for, any. 3. Whether services or supplies are ; or If there is other applicable auto medical payments insurance, will pay only share of the loss. share is the proportion that limit of liability bears to the total of all applicable limits. However, any insurance provide with respect to a vehicle or a do not own, shall be excess over any other collectible auto insurance providing payments for medical or funeral expenses. The Death Benefit and Additional Death Benefit under Air Bag and Seat Belt Benefits will be paid in addition to any death benefit payable under the policy's PIP Coverage. If there are other applicable air bag or seat belt death benefits, the maximum limit of liability for the death of any one under all such policies shall not exceed $15,000 for the Death Benefit and $10,000 for the Additional Death Benefit. 4. Whether there is coverage under the terms of the Insuring Agreement for Part B - 2 Medical Payments Coverage, then, that disagreement may be arbitrated, provided both parties so agree. This arbitration shall be limited to the aforementioned issues and shall not address any other coverage questions. Any arbitration finding that goes beyond the aforementioned issues shall be voidable by or the involved in the disagreement. If both parties agree to arbitrate, each party will select an arbitrator, and those two arbitrators will select a third. If the two arbitrators cannot agree on a third within 30 days, either may request that selection be made by a judge of a court having jurisdiction. Each party will pay the expenses it incurs and bear the expenses of the third arbitrator equally. Unless both parties agree otherwise, arbitration will take place in the county in which the A. If and every other motor lived at the time of the vehicle own are within the policy accident, and local rules of law as to procedure territory referred to in Part E - General and evidence will apply. A decision agreed to by Provisions, then coverage under Part B-2 two or more of the arbitrators will be binding up Medical Payments Coverage will apply to to an amount that, when added to amounts and any anywhere in the previously paid by does not exceed the limit world. of liability for this coverage. B. Any coverage under Part B-2 Medical Payments Coverage, shall pay the portion of any claim for PIP medical expenses which are otherwise covered but not payable due to the limitation of 80% of medical expenses regardless of whether the full amount of PIP benefits have been exhausted. However, Medical Payments shall not be payable for the amount of any deductible which has been selected under PIP Page 13 of 28
14 PART C - UNINSURED MOTORISTS COVERAGE (STACKED) (referred to as UM Coverage) A. as used in this Part means: 1. or any. (1) or any (2) A vehicle which or any are or (3) 2. Any other person. d. To which a liability bond or policy applies at the time of the accident but 3. Any person for damages that person is the bonding or insuring company entitled to recover because of to denies coverage or is or becomes which this coverage applies sustained by insolvent within 4 years after the a person described in 1. or 2. above. accident. However, the definition of 2. does not does not include the Government of the include any vehicle or equipment: United States of America. a. Owned by or furnished or available B.. for the regular use of or any, unless it is 1. means a land to which Part A of the motor vehicle or of any type: policy applies and liability coverage is excluded for any person other than a. To which no liability bond or policy or any for applies at the time of the accident. damages sustained in the accident by or any. b. To which a liability bond or policy applies at the time of the accident but b. Operated on rails or crawler treads. its limit for bodily injury liability is not enough to pay the full amount the c. Designed mainly for use off public is legally entitled to roads while not upon public roads. recover as damages. d. While located for use as a residence c. That is a hit-and-run vehicle. This or premises. means a motor vehicle whose owner or operator cannot be identified and that hits or that causes an accident resulting in without hitting: 6-04 Page 14 of 28
15 Coverage, multiplied by the number of premiums shown in the Declarations for A. will pay compensatory damages which a UM Coverage. is legally entitled to recover from the owner or operator of an 3. Subject to the maximum limits of liability because of sustained by a for "each person" and "each accident" set and caused by an auto forth in A.1. and A.2. above, for accident. However, will not pay damages sustained in any one accident by a for pain, suffering, mental anguish, or other than or any inconvenience unless the consists in whole, maximum limit of or in part of: liability for all resulting damages, including, but not limited to, all direct, derivative, or consequential damages (1) Significant and permanent loss of an recoverable by any persons is the lesser important bodily function; of: (2) Permanent injury within a reasonable degree of medical probability, other than a. The "each person" limit of liability scarring or disfigurement; shown in the Declarations applicable to the vehicle that person was (3) Significant and permanent scarring or at the time of the disfigurement; or accident; or (4) Death. b. That pro-rata B. The owner's or operator's liability for these share of the "each accident" limit of damages must arise out of the ownership, liability applicable to that vehicle. maintenance, or use of the. Any judgment for damages arising or any who out of a suit brought without written sustains in the accident will also be consent is not binding on. entitled to a pro-rata share of the "each accident" limit of liability to that vehicle. A person's pro-rata share shall be the proportion that that person's damages A. Accidents involving to or any. bears to the total damages sustained by all. B. Accidents not involving to or any 1. For sustained by or any in any one accident, maximum limit of liability for all resulting 1. For sustained by any damages, including, but not limited to, all other than or any in direct, derivative, or consequential any one accident, maximum limit of damages recoverable by any persons, is liability for all resulting damages, the limit of liability shown in the including, but not limited to, all direct, Declarations for "each person" for UM derivative, or consequential damages Coverage, multiplied by the number of recoverable by any persons, is the limit 2. premiums shown in the Declarations for of liability shown in the Declarations for UM Coverage. "each person" for UM Coverage applicable to the vehicle that the Subject to the maximum limit for "each was at the time of the person" set forth in A.1. above, accident. maximum limit of liability for all damages for resulting from any one accident is the limit of liability shown in the Declarations for "each accident" for UM 6-04 Page 15 of 28
16 2. Subject to the maximum limit for "each 1. If that person or legal representative person" set forth in B.1. above, settles the claim without written maximum limit for all damages for consent. However, this exclusion (A.1.) resulting from any one accident is the does not apply: limit of liability shown in the Declarations for "each accident" for UM Coverage a. if such settlement does not prejudice applicable to the vehicle that the right to recover payment; or was at the time of the accident. b. if that person or legal representative provides with advance notice of C. The limits of liability described in Paragraphs any proposed settlement as required A. and B., above, are the most we will pay by Part E - Duties After An Accident regardless of the number of: Or Loss. 1. Covered persons; 2. While when it is being used to carry persons 2. Claims made; for a fee. This exclusion (A.2.) does not apply to a share-the-expense car pool. 3. Vehicles or premiums shown in the Declarations; or 3. Using a vehicle without expressed or implied permission. 4. Vehicles involved in the accident. D. Any amount otherwise payable for damages 4. While is rented or leased to others. under UM Coverage shall be reduced by all sums payable because of the : 5. While any vehicle when it is being operated in, or in practice for, any 1. Under any workers' compensation,. disability benefits law, or similar law; or B. UM coverage shall not apply directly or 2. Under any PIP Coverage, automobile indirectly to benefit any insurer or medical expense coverage, or motor self-insurer under any of the following or vehicle liability insurance. similar law: E. Any amount otherwise payable for damages under UM shall be reduced by all sums paid because of the by or on behalf of persons or organizations who may be legally responsible. This includes all sums under Part A. 1. worker's compensation law; or 2. disability benefits law. C. do not provide UM Coverage for punitive or exemplary damages. A. do not provide UM Coverage for sustained by any : If there is other applicable similar insurance will pay only share of the loss. share is the proportion that limit of liability bears to the total of all applicable limits. However, any insurance provide with respect to a vehicle or a do not own, shall be excess over any other collectible insurance Page 16 of 28
17 2. The amount of damages that the is legally entitled to collect from No will be entitled to receive that owner; duplicate payments under this coverage for the same elements of loss which were: then, that disagreement may be arbitrated, provided both parties so agree. This A. Paid because of the by or on behalf of arbitration shall be limited to the two persons or organizations who may be legally aforementioned factual issues and shall not responsible. address any other issues, including but not limited to, coverage questions. Any B. Paid or payable under any workers' arbitration finding that goes beyond the two compensation law or similar disability aforementioned factual issues shall be benefits law. voidable by or a. C. Paid under another provision or coverage in B. If both parties agree to arbitration, each this policy. party will select an arbitrator, and those two arbitrators will select a third. If the two D. Paid under any PIP Coverage or under any arbitrators cannot agree on a third within 30 automobile medical expense coverage. days, either may request that selection be made by a judge of a court having jurisdiction. Each party will pay the expenses it incurs and bear the expenses of the third arbitrator equally. A. If and a disagree as to: 1. Whether the is legally entitled to recover damages from the owner or operator of an or an ; or C. Unless both parties agree otherwise, arbitration will take place in the county in which the lived at the time of the accident, and local rules of law as to procedure and evidence will apply. A decision agreed to by two of the arbitrators will be binding up to the coverage limit of liability. PART D - PHYSICAL DAMAGE COVERAGE window glass is caused by a may elect to have it considered a A. the amount that it caused by. would cost, at the time of, to buy a comparable vehicle. As applied to C. means the, a comparable vehicle is one following while in or upon of the same make, model, model year, body : type, and options with substantially similar mileage and physical condition. 1. Any item usual and incidental to the use of a motor vehicle as a motor vehicle. B. means the impact with an object and includes upset of a vehicle. caused 2. Any device or instrument for transmitting, by the following is covered under recording, receiving, or reproducing data, Comprehensive Coverage and is not sound, or pictures that is capable of considered fire; missiles or falling being operated by power from the objects; hail, water or flood; malicious electrical system of, mischief or vandalism; theft or larceny; riot including: or civil commotion; explosion or earthquake; contact with bird or animal; windstorm; or a. Cassettes, compact discs, and other breakage of window glass. If breakage of media for use with any such device or instrument; and 6-04 Page 17 of 28
18 b. Antennas and other accessories for 2. A. If there is a use with any such device or to a, will provide instrument. the broadest coverage shown in the Declarations. D. means direct and accidental damage to the operational safety, function, or appearance of, or theft of, or that A. Comprehensive Coverage (excluding are not permanently installed in ).. includes a total loss, but does not include any damage other than the 1. Physical damage. will pay for cost to. does not caused by other than to include any loss of use, or diminution in value, and that would remain after that are not permanently of the damaged or stolen installed in minus any property. applicable deductible shown in the Declarations. E. means any private passenger auto,, pickup,, or will pay under Comprehensive not owned by, or Coverage for the cost of repairing or furnished or available for the regular use of, replacing the damaged windshield on or any. This applies without a deductible. only when such vehicle is in the custody of will pay only if the Declarations indicates or being operated by or a that Comprehensive Coverage applies.. A does not include a or 2. Transportation expenses. will also any of the following vehicles used in any pay: business or occupation other than farming or ranching - pickup,, or a. Up to $15 a day, to a maximum of. $450, for transportation expenses incurred by. This applies only in F. means restoring the the event of a total theft of damaged property to its pre-accident. will pay only operational safety, function, and appearance. transportation expenses incurred However, may at option during the period beginning 48 hours with parts of like kind and quality, after the theft and ending when including used or non-oem parts (non-oem is returned to use or, if parts are those produced by someone other not recovered or not repairable, when than the original equipment manufacturer). pay for its loss. does not include: 1. A return to the pre-accident market value of the property; or 2. Restoration, alteration, or replacement of undamaged property, unless such is needed for the operational safety of the vehicle. G. as used in this Part includes: 1. permanently installed in. b. If Increased Rental Reimbursement Coverage is afforded, limits for transportation expenses are increased up to $30 per day to a maximum of $900. B. Collision Coverage. will pay for caused by to and that are not permanently installed in, minus any applicable deductible shown in the Declarations Page 18 of 28
19 C. Rental Reimbursement Coverage and it would be greater than Increased Rental Reimbursement Coverage its minus its salvage value (for other than total theft). after the. 1. will reimburse for expenses B. For a other than a total loss to incur to rent a substitute for, limit of liability under. These coverages apply Comprehensive and Collision Coverages is only if: the amount necessary to the damaged or stolen property without a. is withdrawn deduction for depreciation. from use for more than 24 hours due to a, other than a total theft, to C. For to that auto; and that are not permanently installed in, limits of liability are described below. These limits are separate b. The is covered under Comprehensive Coverage or caused by, and the cause of is not otherwise excluded under Part D of this policy. 2. will reimburse only for that period of time reasonably required to. If determine is a total loss, the rental period will end when pay for its loss. D. Towing and Labor Costs Coverage. will pay the reasonable costs incur for one of the following each time is disabled: 1. Mechanical labor up to one hour at the place of breakdown. 2. Towing, to the nearest place where necessary repairs can be made during regular business hours, if the vehicle will not run or is stranded on or immediately next to a public road. 3. Delivery of gas to, or a change of tire on the disabled vehicle. However, do not pay for the cost of these items. from the limits available for a : 1. For cassettes, compact discs, and other media as described in Definition C.2.a, without deduction for depreciation, limit of liability is the lesser of: a. The amount necessary to such damaged or stolen property; or b. $ For to all other that are not permanently installed in, without deduction for depreciation, limit of liability is the lesser of: a. The amount necessary to such damaged or stolen ; or b. The of. D. Under Rental Reimbursement Coverage, limit of liability is $15 a day, to a maximum of $450. Under Increased Rental Reimbursement Coverage, limit of liability is $30 a day, to a maximum of $900. E. Under Towing and Labor Costs Coverage, A. For a total loss to, limit of liability is the reasonable price for the limit of liability under Comprehensive and covered service. Collision Coverages is its will declare to be a total loss if, in judgment, the cost to to 6-04 Page 19 of 28
20 may pay for in money, or will not pay for: the damaged or stolen property. may, at expense, return any stolen property 1. to which occurs to or to the address shown in the while it is used to carry persons for a fee. Declarations. If return stolen property, This does not apply to a share-the-expense will pay for any damage resulting from the theft. car pool. may keep all or part of the damaged or stolen property and pay an agreed or 2. Damage due and confined to wear and tear, appraised value for it. cannot be required to freezing, or road damage to tires. This does assume the ownership of damaged property. not apply if the damage results from the total may settle a claim either with or with the theft of This exclusion owner of the property. (2.) does not apply to Towing and Labor Costs Coverage. 3. Damage due and confined to mechanical or or damage under this policy will be paid, as electrical breakdown or failure, including such interest may appear, to the named insured and damage resulting from negligent servicing or the loss payee shown in the Declarations. This repair of or its insurance, with respect to the interest of the equipment. will pay for ensuing damage loss payee, will not become invalid because of only to the extent the damage occurs outside fraudulent acts or omissions unless the of the major component (such as results from conversion, secretion, or transmission/transaxle, electrical system, embezzlement of. may engine including cooling and lubrication cancel the policy as permitted by policy terms thereof, air conditioning, computer, and the cancellation will terminate this agreement suspension, braking, drive assembly, and as to the loss payee's interest. will give the steering) in which the initial mechanical or same advance notice of cancellation to the loss electrical breakdown or failure occurs. payee as give to the named insured shown in the Declarations. When pay the loss payee This exclusion (3.) does not apply if the will, to the extent of payment, be subrogated damage results from the total theft of to the loss payee's rights of recovery., and it does not apply to Towing and Labor Costs Coverage. 4. due to or as a consequence of war, insurrection, revolution, nuclear reaction, or will not apply the deductible to caused radioactive contamination. by with another vehicle if all of these conditions are met: 5. to a camper body or own which is not shown in the Declarations. This 1. The to is greater does not apply to one acquire during the than the deductible amount; and policy period and ask to insure within 30 days after become the owner. 2. The owner and driver of the other vehicle are identified; and 6. to any or when used by 3. The owner or driver of the other vehicle has any person without a reasonable belief that a liability policy covering the ; and that person is entitled to do so. 4. The driver of is not 7. to equipment designed or used to legally responsible, in any way, for causing or evade or avoid the enforcement of motor contributing to the. vehicle laws Page 20 of 28
21 8. to any arising out of its use by or a while employed or otherwise engaged in This insurance shall not directly or indirectly operations. benefit any carrier or other bailee for hire. 9. to while it is rented or leased to others. 10. to any vehicle while it is being operated in, or in practice for, any. 11. resulting from: a. The acquisition of a stolen vehicle; b. Any legal or governmental action to return a vehicle to its legal owner; or c. Any confiscation or seizure of a vehicle by governmental authorities. This exclusion (11.) does not apply to innocent purchasers of stolen vehicles for value under circumstances that would not cause a reasonable person to be suspicious of the sales transaction or the validity of the title. 12. resulting from use in any illicit or prohibited trade or transportation where or any is a willing participant. If other sources of recovery also cover the will pay only share of the share is the proportion that limit of liability bears to the total of all applicable limits. However, any insurance provide with respect to a or will be excess over any other collectible source of recovery including, but not limited to: 1. Any coverage provided by the owner of the or 2. Any other applicable physical damage insurance. 3. Any other source of recovery applicable to the This provision does not apply to Towing and Labor Costs Coverage. If and do not agree on the amount of 13. Any arising out of any act committed:, either may demand an appraisal. In this event, each party will select a competent a. By or at the direction of or any appraiser. The two appraisers will select an ; and umpire. The appraisers will state separately the and the amount of. b. With the intent to cause a. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will be binding. Each party will pay its have the right to inspect any private chosen appraiser and share the expenses of the passenger motor vehicle which insure or umpire equally. Neither nor waive any of intend to insure for Physical Damage Coverage rights under this policy by agreeing to an under this policy. This right applies only in appraisal. accordance with Florida Statute When require an inspection must cooperate and make the vehicle available for the inspection Page 21 of 28
22 PART E - GENERAL PROVISIONS If an air bag in any reason, replace it. deploys for will pay without deductible to 5. Addition or deletion of an operator. 6. Change, addition, or deletion of any coverage or limits. C. will make any calculations or adjustments of premium using the applicable rules, rates, and forms as of the effective date of Bankruptcy or insolvency of the the change., as defined in this policy, shall not relieve of any obligations under this policy. D. If make a change which broadens coverage under this edition of policy without additional premium charge, that change will automatically apply to insurance as of the date implement that A. The premium is based on information change in location. This paragraph does have received from and other sources. not apply to changes implemented with a agree to cooperate with in revision that includes both broadenings and determining if this information is correct and restrictions in coverage. Otherwise, this complete. agree that if this information policy includes all of the agreements changes, or is incorrect or incomplete, between and. Its terms may not be may adjust premiums accordingly changed or waived except by endorsement during the policy period. issued by. B. If, during the policy period, the risk exposure changes for any of the following reasons, the necessary premium adjustments will be made effective the date of change in A. must be notified promptly of how, when, exposure. agree to give notice of and where an accident or loss happened. such exposure changes as soon as is Notice should also include the names and reasonably possible: addresses of any injured persons and of any witnesses. 1. Change in location where any vehicle is garaged. B. A person seeking any coverage must: 2. Change, addition, or deletion relating to 1. Cooperate with in the investigation, the description, equipment, purchase settlement, or defense of any claim or date, registration, cost, usage, miles suit. driven annually, or operators of any vehicle. 2. Promptly send copies of any notices or legal papers received in connection 3. Replacement, deletion, or addition of any with a suit, accident, or loss. vehicle. must request coverage for a newly acquired vehicle within 30 days 3. Submit, as often as reasonably from the date the vehicle is acquired if require: wish to continue any coverage. See DEFINITIONS -. a. To physical exams by physicians select. will pay for these exams. 4. Change, addition, or deletion relating to the date of birth, marital status, or driving b. To examination under oath. The record of any operator. examination must be signed Page 22 of 28
23 4. Authorize to obtain medical reports D. A person seeking coverage under Part C - and other pertinent records. UM Coverage must also comply with the following: 5. Submit a proof of loss when required by 1. If the and the owner or operator of the legally liable for the 6. Promptly notify the police if a reach a settlement hit-and-run driver is involved. agreement to pay the such person's limits of liability, the C. A person seeking coverage under Part B-1 must submit the Personal Injury Protection Coverage must agreement to in writing for also: approval prior to final execution of such settlement agreement if: 1. As soon as practicable, give to written proof of claim, under oath if a. The settlement would not fully satisfy required, which may include full the claim for particulars of the nature and extent of and the injuries and treatment received and contemplated, and such other information b. An claim as may assist in determining the has been or will be made against. amount due and payable. 2. The may file suit against 2. Submit to mental examinations by and the legally liable person if, within physicians select at expense 30 days after receipt of the when and as often as may reasonably settlement agreement do not: require. Mental exams or physical exams as required by in B.3.a. above will be a. Approve the settlement; scheduled in a location reasonably accessible to such person, and a copy of b. Waive rights of recovery against the medical report shall be forwarded to the person or organization legally such person if requested. Reasonably liable for the ; accessible means any location: c. Authorize the signing of a full release; a. Within the municipality where such and person is receiving treatment or in which that person resides; or d. Agree to arbitrate the claim. b. Within 10 miles by road of such person's residence, provided such The suit shall decide if the location is within the county in which is legally entitled to collect that person resides. damages and if so, the amount. If there is no qualified physician to E. A person seeking coverage under Part D - conduct the examination in a location Physical Damage Coverage must also: reasonably accessible to such person, then the examination shall be conducted 1. Take reasonable steps after loss to in an area of the closest proximity to that protect and its person's residence. equipment from further loss. will pay reasonable expenses incurred to do this Page 23 of 28
24 2. Promptly notify the police if The Florida Department of Financial Services will is stolen. appoint a mediator. Each party may reject one mediator whether before or after the other party 3. Permit to inspect and appraise the has made a rejection. The mediator will notify the damaged property before its repair or parties of the date, time, and place of the disposal. mediation conference, which will be held within 45 days of the request for mediation. The mediation will be conducted informally and may be held by telephone if feasible. Participants must have authority to make a binding decision, A. No legal action may be brought against and must mediate in good faith. Information and until there has been full compliance with all disclosures provided during mediation are not the terms of this policy. admissible in any subsequent action or proceeding relating to the claim or cause of 1. In addition, under Part A, no legal action action giving rise to the claim. Costs of the may be brought against until agree mediator shall be shared equally by each party in writing that the, as unless the mediator determines a party has not defined in Part A, has an obligation to mediated in good faith. pay, or the amount of that obligation has been finally determined by judgment after If a person files suit which relates to facts trial. already mediated, such facts shall not be mediated again. Only one mediation may be 2. In addition, under Part B-1 PIP and Part requested for each claim, unless all parties agree B-2 Medical Payments, if fail to deny to further mediation. or pay a claim within 30 days of receiving adequate proof of that claim, The filing of a request for mediation tolls the the will not file suit for applicable time requirements for filing suit for a those benefits until providing with a period of 60 days following the conclusion of written demand for payment and giving the mediation process or the time prescribed in 15 days in which to respond to that the Limitation of Actions, whichever is later. demand. B. No person or organization has any right under this policy to bring into any action to determine the liability of a, as defined in this policy. do not provide coverage for any, as defined in this policy, who has knowingly concealed or misrepresented any material fact or circumstance relating to this insurance: or the insured may request mediation of any 1. At the time application was made; or claim for personal injury in an amount of $10,000 or less or a claim for in any amount 2. At any time during the policy period; or arising out of the ownership, operation, use, or maintenance of a motor vehicle prior to the 3. In connection with the presentation or institution of litigation. settlement of a claim. Such request shall be filed with the Florida Department of Financial Services on a form approved by the department. The request must When a claim, or part of a claim, is payable state why mediation is being requested and the under more than one provision of this policy, issue in dispute. will pay the claim only once under this policy Page 24 of 28
25 share in the recovery, will pay share of the legal expenses. share is that A. If make a payment under this policy and percent of the legal expenses that the the person to or for whom payment was amount recover bears to the total made has a right to recover damages from recovery. This does not apply to any amounts another, will be subrogated to that right. recovered or recoverable by from any That person shall do whatever is necessary other insurer under any inter-insurer to enable to exercise rights, and shall arbitration agreement. do nothing after loss to prejudice them. However, rights in this paragraph do not E. If make payment for a claim under Part apply under Part D - Physical Damage A, and the, as defined in Coverage, against any person using Part A: with a reasonable belief that that person is entitled to do so nor under 1. Failed or refused to comply with the Part B-2 Medical Payments Coverage, Air duties specified in this provision; and Bag and Seat Belt Benefits. 2. Prejudiced defense of the liability B. If make a payment under this policy and claim by such failure or refusal; the person to or for whom payment was made recovers damages from another, that then, the shall reimburse person shall hold in trust for the to the extent of payment and cost of proceeds of the recovery and reimburse defense. to the extent of payment. However, this paragraph does not apply to Part B-2 Medical Payments Coverage, Air Bag and Seat Belt Benefits. For purposes of this policy, a private passenger type auto, pickup, or is deemed to be C. rights do not apply under Paragraph A. owned by a person if leased under a written with respect to coverage under Part C - UM agreement to that person for a continuous Coverage, Section 2. of the definition of period of at least six months., if : 1. Have been given prompt written notice of a tentative settlement between a A. This policy applies only to accidents and, as defined in Part C, and the losses which occur during the policy period insurer of an ; as shown in the Declarations and within the and policy territory. The policy territory is the United States of America (USA), its territories 2. Fail to advance payment to such person in and possessions, Puerto Rico, and Canada, an amount equal to the tentative including transportation of settlement within 30 days after receipt of between any ports of these locations. notification. However, PIP benefits under Part B-1 PIP If advance payment to the Coverage apply only to accidents occurring in an amount equal to the tentative within the State of Florida with respect to settlement within 30 days after receipt of any, as defined in Part B-1 notification, that payment will be separate PIP, other than or any. from any amount the is entitled to recover under the provisions of B. The policy territory also includes Mexico, Part C - UM Coverage. However, shall subject to the following conditions: have a right to recover such advance payment. 1. All coverages afforded by the policy, except PIP Coverage, are extended to D. If the, as defined in this include coverage during trips into Mexico. policy, recovers from the party at fault and This applies only to loss or accident that occurs within 75 miles of the USA border. 6-04
26 2. Any liability coverage afforded by the b. The named insured transfers policy, except PIP Coverage, is extended ownership of ; or to include the remainder of Mexico, but only if have valid and collectible c. The named insured purchases another liability coverages from a licensed policy covering Mexican insurance company at the time which was covered under the policy of loss. Also, for this Part to be being cancelled; or effective, the original liability suit for or must be brought in the USA. d. are a member of the United States Armed Forces and are called 3. This coverage does not extend: to or on active duty outside the United States in an emergency a. To any, as defined situation. in this policy, who does not live in the USA. 2. may cancel for any reason after this policy is in effect for 60 days, but the b. To any, as defined effective date of cancellation cannot be in this policy, an auto earlier than the date of request. which is not principally garaged and used in the USA. 3. may cancel by mailing a notice to the named insured shown in the Declarations c. To any auto which is not principally at the address shown in the policy: garaged and used in the USA. a. At least ten days notice if cancellation 4. The words "state or province" as used in is for nonpayment of premium; or the Out of State Coverage provision in Part A of the policy do not include a b. At least 45 days notice in all other "state or province" of Mexico. cases. 5. Losses payable under Part D of the policy 4. If this is a new policy providing PIP and will be paid in the USA. If the auto must liability coverage, will not cancel be repaired in Mexico, limit of liability for nonpayment of premium during the will be determined at the nearest point in first 60 days following the date of the USA where repairs can be made. issuance. However, may cancel if a check used to pay is dishonored for 6. Any insurance provide will be excess any reason. over any other similar valid and collectible insurance. 5. After this policy is in effect for 60 days, or if this is a renewal policy, will cancel only: A. Cancellation. This policy may be cancelled during the policy period as follows: a. For nonpayment of premium; b. For material misrepresentation or fraud; or 1. may not cancel a new or renewal policy providing PIP and liability coverage during the first 60 days this c. If driver's license, or that of any policy is in effect unless: driver who lives with or customarily uses, a. has been totally has been suspended or revoked. This destroyed so that it is no longer must have occurred: operable on the roads of Florida; or (1) During the policy period or during the 180 days immediately preceding its effective date; or 6-04 Page 26 of 28
27 (2) If the policy is a renewal, during C. Automatic Termination. If offer to renew its policy period. and or representative do not accept, this policy will automatically terminate 6. If this policy is issued to meet the at the end of the current policy period. requirements of Florida Statute Failure to pay the required renewal premium (2) (a) to reinstate a driver's when due will mean that have not license because of failure to maintain the accepted offer. required security, the following special provisions apply and supersede any If obtain other insurance on contrary provisions in the policy:, any similar insurance provided by this policy will terminate as to that auto on a. may not cancel this policy for the effective date of the other insurance. any reason. This does not apply to liability coverage purchased for travel in Mexico. b. Effective when underwriting is completed or 30 days from the D. Other Termination Provisions. effective date of the policy, 1. Mailing of any notice by registered or whichever comes first: certified mail or United States Post (1) may not cancel this policy for Office proof of mailing will be sufficient any reason. proof of notice. (2) No refund or premium will be 2. If this policy is cancelled, may be allowed. entitled to a premium refund. The premium refund, if any, will be computed (3) This policy may not be changed according to manuals. However, for any reason that materially making or offering to make the refund is increases the risk, including but not a condition of cancellation. not limited to, changing to a high risk vehicle, adding vehicles, 3. The effective date of cancellation stated adding new drivers or moving to a in the notice will become the end of the different rating territory. policy period. (4) If there is a material change in the policy, must obtain a new six-month non-cancelable policy. If obtain the policy from, will give a credit on the rights and duties under this policy may not new policy for any unearned be assigned without written consent. premium paid on the previously However, if the named insured shown in the issued policy. Declarations dies, will provide coverage until the end of the policy period for: 7. may cancel for any other reason permitted by law. 1. The surviving spouse if resident in the same household at the.time of death. Coverage B. Nonrenewal. If decide not to renew this applies to the spouse as if the named insured policy will mail notice by registered or shown in the Declarations; and certified mail or United States Post Office proof of mailing to the named insured shown in the Declarations at the address shown in this policy. Notice will be mailed at least 45 days before the end of the policy period Page 27 of 28
28 2. The legal representative of the deceased person as if the named insured shown in the Declarations. This applies only with respect If this policy and any other auto insurance policy to the representative's legal responsibility to issued to apply to the same accident, maintain or use. the maximum limit of liability under all the policies will not exceed the highest applicable limit of liability under any one policy. This provision does not apply to stacked UM Coverage. Copyright, USAA, All rights reserved. Includes copyrighted material of Insurance Services Office, used with permission Page 28 of 28
29 , any cancellation or nonrenewal of a policy providing Personal Injury Protection (PIP) or Property Damage (PD) coverage will be reported by the insurer to the Department of Highway Safety and Motor Vehicles., failure to maintain Personal Injury Protection (PIP); and, failure to maintain Personal Injury Protection (PIP) and Property Damage (PD) coverage on a motor vehicle when required by law may result in the loss of registration and driving privileges in the state of Florida., Personal Injury Protection (PIP) is no longer required by law. failure to maintain Personal Injury Protection (PIP) and Property Damage (PD) coverage on a motor vehicle when required by law may result in the suspension of driver's license and vehicle registration. Any operator or owner whose driver's license or registration has been suspended may effect its reinstatement upon compliance with the required evidence of coverage and upon payment to the Department of Highway Safety and Motor Vehicles of a nonrefundable reinstatement fee as follows: $150 for the first reinstatement $250 for the second reinstatement $500 for each subsequent reinstatement during the 3 years following the first reinstatement If the person does not have a second reinstatement within 3 years after the initial reinstatement, the reinstatement fee shall be $150 for the first reinstatement after that 3 year period REV Page 1 of 1
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AUTOMOBILE CLAIMS PROCEDURES A. AUTO GLASS CLAIMS 1. Report the claim to our Claims Dispatcher in Saskatoon at 653-4232 or use our toll-free number at 1-800-667-3067 for coverage confirmation and instructions.
OREGON MUTUAL INSURANCE GROUP G0240AI (7-14) CUSTOM SHIELD AUTO POLICY
OREGON MUTUAL INSURANCE GROUP G0240AI (7-14) CUSTOM SHIELD AUTO POLICY TABLE OF CONTENTS Declarations... attached inside front cover Agreement... 1 Definitions... 1 Your Duties After an Accident or Loss...
