Personal Auto
The negligent third party is also exempt from liability for
"non-economic" loss (i.e. pain and suffering), unless certain serious conditions exist.
Part A, Liability Coverage The inclusion of Defense Costs is extremely important. The insurer is basically becomes the insured's defense attorney and any costs associated with the defense are in addition to the liability limits selected. (________ Bodily Injury claim, ______cost to defend means the insurer pays $_________)
$100,000; $20,000; $120,000
COVERAGE MODIFICATIONS: 1. Deductibles
$250, $500 or $1,000
Basic PIP consists of 4 components:4. Death- _______. The _______ death benefit is in addition to the______ in medical and disability benefits.
$5000; $5000; $10,000
COVERAGE MODIFICATIONS: 2. Elimination of lost wages benefit
(no earned income source)
Calculating the PIP Benefit: 2 Very important that you know this 3 step procedure
1.Apply the appropriate percent (80% medical, 60% work loss, or 100% replacement services); (In some cases 100% and 80%)
Calculating the PIP Benefit: 1. Very important that you know this 3 step procedure
1.Apply the deductible; (To the loss, not to the payment!)
Part A, Liability Coverage oWho is "an insured", one who is entitled to the aforementioned protection, when does the coverage apply and with respect to what vehicles does it apply? There are basically 4 classes or groups of "insured":
1.The named insured and any resident family member, with respect to any auto or trailer; 2.Any person using a covered auto with permission; 3.Any person or organization for any liability arising out of an insured's use of a covered auto on their behalf (vicarious liability); 4.Any person or organization responsible for the named insured or relative's use of an auto other than a covered auto or one owned by the person or organization.
Basic PIP consists of 4 components: 3. Replacement services- ___ (Lawn maintenance, cooking, cleaning)
100%
YOUR COVERED AUTO means:2D For Collision Coverage, if that coverage is currently on the policy, the insured must ask the insurer within ___ days to cover the add or replacement vehicle in order to have the broadest coverage under the policy. If Collision it is not currently provided by the policy, the insured has ___ days to ask the insurer for it and for those __ days the insured has the coverage with a ____ deductible.
14 days; 4 days; 4 days; $500
Basic PIP consists of 4 components: 2. Work Loss-____ of gross earnings or earning capacity
60%
Basic PIP consists of 4 components: 1. Medical- _____ of reasonable and necessary expenses-extensive list of what is covered. Individuals seeking PIP medical benefits are required to receive initial services and care within ____ days of the accident. The law also provides that an individual who is not diagnosed with an emergency medical condition, the PIP medical benefit is _____.
80%; 14 days; $2500. Medical: includes medical, surgical, dental, x-rays, rehabilitative services, prosthetic devices, ambulance, hospital and nursing services.
Eligible vehicles unclude private passenger autos (PPA0, pick up or van wiht an GVW of
< 10,000 lbs
YOUR COVERED AUTO means: 4
A temporary substitute auto being used because of breakdown, repair, servicing, loss or destruction of any other vehicle described by this definition. This provision does not apply to Coverage for Damage to Your Auto.
The requirements of the law are triggered by any of the following
Accident involving bodily injury; Accident rendering the vehicle inoperative; Conviction of certain serious violations, such as DUI drugs or alcohol
COVERAGE MODIFICATIONS: 5. Extended: Medical 80%-100% & Wages 60% to 80%;
Additional: Can increase up to as much as $100,000. Extended PIP must be purchased before adding additional PIP.
YOUR COVERED AUTO means: 3
Any Trailer you own
YOUR COVERED AUTO means: 1.
Any vehicle shown in the Declarations
Part A, Liability Coverage Liability Insurance also includes supplementary payments: Boys Always Increase Liability Exposure: mnemonic for:
Bail Bonds; Attachment Premiums; Interest on Judgments; Lost Wages; Expenses
Those convicted of DUI must carry 100/300/50 or a $350,000 bond for 3 years before
standard requirements are satisfactory. Proof of insurance must be carried at all times.
Calculating the PIP Benefit: 3. Very important that you know this 3 step procedure
Consider the PIP limit
All insurance contracts contain a section in which the key phrases and words used in the policy are listed and clearly defined.
DEFINITIONS
Injured party still has a claim to the extent that:
Damages exceed the PIP limit; For the 20% medical not paid for by PIP; For the 40% lost wages not paid for by PIP.
The PAP includes the following sections
Declarations, Agreements and Definitions, Part A, liabilty; Part B, Med Pay; Part C, Uninsured Motorist; Part D, Damage to your Auto; Part E, Duties after a loss and Part F, General Provisions.
The intent is to make drivers financially responsible for damage they cause to others.
FINANCIAL RESPONSIBILITY LAW
Why is the address important?
For legal notification, such as cancellations or non-renewals, Note that under the PAP we talk about a Loss Payee, not a Mortgagee.
My son and I are driving in Georgia in my PIP insured car and he is injured. He does not own his own car.
He collects his PIP from my policy. (He's not a named insured, so he doesn't fit #1 above.
My grandson is going to a soccer game in a neighbor's car and is hurt in an accident...where does his PIP coverage come from?
His parents car.
I'm driving with my son, who lives with me, in his PIP insured vehicle in Georgia and an accident takes place.
I get PIP from my policy, he gets PIP from his policy. (Since my son is a named insured under his policy, he fits #1 above. I also fit #1 above, since I am a named insured and am injured in a PIP insured vehicle owned by a resident relative)
I'm driving with my son in Georgia in my car and an accident takes place. My son is driving in Georgia with a neighbor who has a car insured with Florida PIP, and is injured in an accident. He is not entitled to PIP benefits-he is not injured in his car and he is not injured in a PIP insured vehicle of a resident relative. He is not entitled to PIP benefits from the neighbor's car in an out of state accident.
I get my PIP from my policy.
oIf financial responsibility did not exist at the time of the loss, 2 things must happen to avoid penalty:
Legally valid claims up to the 10/20/10 requirements must be satisfied; Owner & Operator must provide certification of financial responsibility for future accidents.
Penalties for non-compliance with the no-fault law
Loss of immunity from lawsuits; Owner becomes personally responsible for payment of PIP benefits to those entitled to such benefits; Owner's license and registration are subject to suspension.
I'm a passenger in my friend's car and am involved in an accident...where does the PIP coverage come from, my policy or his?
Mine
The No Fault Law applies to
Motor vehicles—4 wheel self propelled vehicle designed to be licensed for use on Florida highways; Trailers and Semi-trailers used with such vehicles; NOT: Motorcycles, mobile homes, gov't vehicles for >5 passengers, limos, school busses, and taxis.
YOUR COVERED AUTO means:2E The same rule applies for
Other Than Collision (Comprehensive) coverage.
Who is covered and where does the coverage come from. FOR LOSSES IN-STATE A resident relative collects
PIP benefits from the policy under which he or she is covered.
Florida No Fault Law details information about
PIP or Personal Injury Protection
The point at which one retains the right to sue a negligent party for non-economic loss is called the
THRESHOLD
Why do you think that no-fault is added as an endorsement to the policy? Do you think No-fault insurance is the exception or the rule?
The exception. Currently 12 states (plus Puerto Rico) have no-fault, 38 do not. (We'll talk about it a bit more in a little bit.)
My aunt lives in a retirement home and does not own a car. She goes out with a fellow resident and that resident's niece for lunch and is hurt in an accident...where does her PIP coverage come from?
The niece's car.
A PAP written in the name of John Ingersoll. Is my wife, who lives with me a NAMED insured?
Yes. Remember, while getting in and out of the car you are occupying it.
The Declarations section also shows the coverages that
apply, the limits of those coverages/deductibles and the premium charged for the coverage. Any loss payee is also identified
YOUR COVERED AUTO means:2C Physical Damage Coverage on a Newly Acquired Auto applies on the date you become the owner, but there
are notification requirements with which the insured must comply and certain coverage limits/restrictions exist until the notification is made.
In these cases, Insurer must file an SR-22 form,
certifying coverage, for 3 years. If coverage terminates, a notice of cancellation is required
Those subject to the law are responsible for persons who
do not own vehicles and are therefore not subject to the law
No Fault or PIP is added via
endorsement to the policy
Medical payments coverage is
excess over PIP.
COVERAGE MODIFICATIONS: 4. Expansion of benefits through
extended and additional PIP;
Who is covered and where does the coverage come from. FOR LOSSES IN-STATE An insured collects PIP benefits
from his or her own policy when injured in a vehicle or by a vehicle as a pedestrian.
DEFINITIONS: BI
harm, sickness or disease and resulting death
Who is covered and where does the coverage come from. FOR LOSSES IN-STATE An insured person carries
his or her own PIP with them.
YOUR COVERED AUTO means: With the non-physical damage coverages, With the non-physical damage coverages, With physical damage coverages,
if the newly acquired auto is a replacement vehicle, no notification is required. if the newly acquired auto is an Add car, notification is required within 14 days; notification is required as stated above.
Who is covered and where does the coverage come from. FOR LOSSES OUT OF STATE Named insured collects from their own PIP when
in their vehicle or a PIP insured vehicle owned by a resident relative.
DEFINITIONS: Occupying
in, upon, getting in, on, out or off
Who is covered and where does the coverage come from. FOR LOSSES OUT OF STATE A resident relative collects from the insured's PIP only when
injured in the named insured's vehicle and they are not a named insured under their own policy.
When PIP does not apply,
legal remedies and other insurance are to be relied upon.
PIP is primary over all other
medical & disability insurance EXCEPT Worker's Compensation.
Personal Auto policy may only be written in the
name of an individual, related persons or unrelated persons living together.
DEFINITIONS. You/your
named insured and resident spouse
YOUR COVERED AUTO means: 2A Except for physical damage coverage, the newly acquired auto has,
non the date ownership is acquired, the broadest coverage provided to any auto shown in the Declarations.
Who is covered and where does the coverage come from. FOR LOSSES IN-STATE A person not required to carry PIP and
not part of a PIP insured household obtains coverage from the car in which they are injured.
The "TAG LAW" requires that
o$10,000 PIP and $10,000 PD be in effect in order to register the automobile.
Part A, Liability Coverage Liability pays on behalf of an insured, damages for which the insured is legally obligated to pay as a result
of Bodily Injury or Property Damage. Liability coverage also includes Defense Costs.
The Declarations section identifies
oth named insured, gives the mailing address and provides the policy period or coverage dates and times.
There are exclusions for
owned, non- insured vehicles, persons driving a car without permission, for intentional self injury or in commission of a felony
DEFINITIONS: An auto leased for 6 or more months
owned.
DEFINITIONS: PD
physical injury to or loss of use of tangible property.
One who retains the right to sue for non-economic loss is said to have
pierced the threshold
YOUR COVERED AUTO means: 2. A "newly acquired auto" is one you acquire ownership of during the policy period and which is a
private passenger type, pickup or van with a gross vehicle weight of less than 10,000 lbs. There are restrictions on using the pickup or van to transport business materials.
While a taxi, limo, school bus are motor vehicles for the payment of PIP benefits (which an injured driver collects from their own PIP), they are specifically exempted from
requirement to buy no fault coverage. This definition is important because it is those who are injured by motor vehicles who are entitled to PIP benefits.
If, at the time of an occurrence a policy exists with 10/20/10 limits,
requirements are satisfied.
Part A, Liability Coverage: Liability Exclusions There is no coverage for vehicles used in the automobile business, with
some exceptions for use of "Your covered auto".
Non-residents of Florida who are here for more than 90 cumulative of the past 365 days are
subject to the law.
YOUR COVERED AUTO means: Notes A newly acquired auto does not include a pickup or van w/GVW of <10,000 if the vehicle is used to transport goods or material, unless
such use is "Incidental to your business of installing, maintaining or repairing furnishing or equipment or used for farming or ranching"
Failure to meet the requirements results in
suspension of the operator's license and all the registrations of the owner.
Part A, Liability Coverage: Liability Exclusions When thinking of exclusions, it helps to think about what exposure is anticipated by the rate being charged. If an exposure is not anticipated by the rate being charged,
the exposure may be excluded.
Part A, Liability Coverage: Liability Exclusions Liability is excluded for intentional acts and for damage to the insured's own property. Except for damage to a residence or private garage,
there is no coverage for damage to property rented to, used by or in the care of the insured.
COVERAGE MODIFICATIONS:3. Modifications apply only
to insured &/or relatives, not others eligible for insured's PIP benefits;
The OWNER of a vehicle, including Lessees of more than 6 months, are required
to provide PIP insurance for the vehicle.
DEFINITIONS: Business
trade, profession or occupation
Passengers in your vehicle with no PIP will fall
under your PIP.
DEFINITIONS: Trailer
vehicle designed to be pulled by a private passenger auto, pickup or van, or a farm wagon or implement while towed by any such vehicle.
Part A, Liability Coverage: Liability Exclusions There is no coverage for injury to an employee (WC) or
when a vehicle is used for hire. (Not car-pools).
YOUR COVERED AUTO means:2B If the newly acquired auto is an add car, insurer must be notified
within 14 days to have liability coverage; if it is a replacement vehicle, notification is not required. (Physical Damage Coverage info follows)