Chapter 6 Personal Auto Policy

Ace your homework & exams now with Quizwiz!

Why was the personal auto policy designed?

to provide insurance for eligible vehicles that are owned by one or more individuals. Eligible vehicles are private passenger vehicles including cars, SUVs, passenger vans, and pickups with a gross vehicle weight of 10,000 pounds or less.

PART B: MEDICAL PAYMENTS COVERAGE: How does the policy define the insured?

-The named insured or any family member occupying any auto or as a pedestrian when struck by a motor vehicle designed for use mainly on public roads. These vehicles do NOT have to be owned by the insured and include any type of trailer. -Any other person, such as a passenger, while occupying the insured auto

Extended non-owned coverage for a named individual (PP 03 06)

-This endorsement provides coverage by removing or altering some of the Personal Auto Policy's exclusions or limitations. It also covers non-owned autos furnished or available for the insured's regular use. -The endorsement provides excess liability coverage, for the individual named on the endorsement and for the business use of a commercial type vehicle that the named insured does not own. It can be used to provide excess liability coverage for the use of a vehicle as a public or livery conveyance. -An extra premium charge applies for liability and medical payments purchased by this endorsement

PART A: LABILITY COVERAGE: How are personal auto policy liability limits written?

-A split Limit -A combined single limit

PART C: UNINSURED MOTORIST COVERAGE: in the insuring agreement, what is not included in the definition of uninsured motor vehicle?

-A vehicle that's owned by the named insured or a family member OR a vehicle that's furnished or available for the regular use of the named insured or a family member, such as a company car -A vehicle that is owned or operated by someone who is self-insured, unless the owner or operator is or becomes insolvent -A vehicle owned by any government agency -A vehicle that operates on rails or crawler treads, such as a train or piece of mobile equipment like a bulldozer -A vehicle designed mainly for use off public roads, such as a snowmobile or ATV -A vehicle permanently located for use as a residence, such as a motor home or trailer in a campground

PART D: COVERAGE FOR DAMAGE TO YOUR AUTO: What are the exclusions?

-An insured vehicle being used as a public or livery conveyance. The exclusion does not apply to a share-the-expense car pool. -Damage solely a result of wear and tear, freezing, equipment breakdown, mechanical or electrical breakdown or road damage to tires. These are all maintenance issues and are excluded under other types of property insurance. -Losses due to war or nuclear hazard or radioactive contamination -Electronic equipment, unless it's permanently installed in the vehicle. Examples of electronic equipment include radios, stereos, tape decks, CD systems, navigation systems, Internet access systems, computers, telephones, televisions, two-way mobile radios, scanners, and CB radios -Tapes, records, disks, or other media used with electronic equipment -A total loss to Your Covered Auto due to destruction or confiscation or non-owned auto by government or civil authorities -A trailer, camper, or motor home if it isn't shown on the Declarations, unless the vehicle is a non-owned trailer, or is acquired during the policy period and the insured reports the purchase within 14 days -A non-owned auto when used by the insured or a family member who doesn't have a belief of entitlement to use the non-owned auto -Loss to radar and laser detection devices and equipment -Custom furnishings and equipment in any pickup/van. Custom furnishings and equipment include special carpeting and insulation, furniture or bars, height-extending roofs, and custom murals, paintings, decals, and graphics. The following items are not considered custom furnishings or equipment: any cap, bed liner, or cover in or upon any pickup. -A non-owned auto being used in the auto business -Any auto when located at a racing facility for organized racing -Under Part D if either state law or the rental agreement prevent the rental car company from recovering damages from the insured. Many insurers automatically cover a rental vehicle with the same coverage as the insured has on his/her own personal auto policy. If the insured only has liability coverage on a personal auto policy and rents a car for vacation, the rental car is not fully insured by the insured's PAP. The insured will need to fill this gap by buying the rental agency's insurance or upgrading his or her own policy.

PART D: COVERAGE FOR DAMAGE TO YOUR AUTO: How does the policy define non-owned auto as?

-Any private passenger auto, pickup, van, or trailer not owned by, furnished, or available for the regular use of the named insured or a family member, while being used by the named insured or a family member. -Any auto or trailer being used as a temporary substitute for the covered auto, while the covered auto is out of normal use due to: -Breakdown -Repair -Servicing -Loss -Destruction

PART C: UNINSURED MOTORISTS COVERAGE: What are the exclusions in which coverage will not provide coverage to an insured that sustains bodily injury?

-Any underinsured motorist -An insured or family member is injured when occupying, or struck by, a vehicle owned by the named insured or a family member and the vehicle is not insured by this policy -An insured or a legal representative settles an Uninsured Motorists Bodily Injury Liability claim and that settlement impairs the insurance company's ability to recover payments made to any insured -An insured is occupying a "your covered auto" while it is being used as a public or livery conveyance -An insured is using a vehicle without a reasonable belief that he or she is entitled to drive it. Family members always have a reasonable belief of entitlement to drive a "your covered auto" under this coverage. -While insured by Workers' Compensation or disability insurance. No payment will be made under this coverage for injuries that might benefit any insurer, or self-insurer, under any Workers' Compensation or disability benefits law. This means that if Workers' Compensation or disability insurance is in place, that coverage must pay before this coverage applies. -If the insured is legally responsible for punitive or exemplary damages, this coverage does not apply.

PART C: UNINSURED MOTORIST COVERAGE: How does the policy define the insured for uninsured motor vehicle?

-Doesn't have insurance or a bond in place at the time of the accident -Has insurance in place at the time of the accident. However, the bodily injury liability limits are less than those required by the financial responsibility or compulsory insurance laws in place in the state where the insured's "your covered auto" is principally garaged. -Is a hit-and-run vehicle. The owner or operator of the vehicle can't be identified AND must hit:The named insured or a family memberA vehicle occupied by the named insured or a family member; or"Your covered auto" -Has insurance, but the insurer either denies the claim or becomes insolvent

PART E: DUTIES AFTER AN ACCIDENT OR LOSS: in an event of a covered loss, persons submitting claims to the insurance company must do what?

-Notify the insurer promptly about how, when, and where the accident or loss occurred. In addition, the insurer must be provided with the names and addresses of anyone with injuries or anyone who witnessed the accident or loss. -Cooperate with the investigation and settlement of any claim -Promptly send to the insurer any copies of notices or legal papers received -Submit to a physical exam as reasonably required by the insurer -Authorize the insurer to obtain copies of medical reports and other pertinent records -Submit a proof of loss when required by the insurer **When seeking Uninsured Motorists Coverage, the insured must promptly notify the police if a hit-and-run driver is involved and provide legal papers if a lawsuit is filed. An insured making a claim under Part D must protect the property from further damage, notify the police promptly if the vehicle is stolen, and allow the insurer to inspect and appraise the damaged vehicle before its repair or disposal.

PART F: GENERAL PROVISIONS: TERMINATION: other termination provisions

-Proof of mailing of any notice constitutes sufficient proof of notice -If the policy is cancelled, the insured may be entitled to a premium refund. If so, the insurer will send the refund -The effective date of cancellation stated in the notice will become the end of the policy period

PART F: GENERAL PROVISIONS: TERMINATION: define cancellation

-The named insured may cancel the policy for any reason by either returning it to the insurer or giving the insurer advance written notice of the date the cancellation is to take effect -During the first 60 days of a new policy, an insurer may cancel the policy for any reason by mailing notice to the named insured shown on the Declarations. Notice of at least 10 days is required for cancellation due to non-payment of premium, and at least 20 days advance written notice for all other reasons. -After the policy has been in effect for 60 days, the insurer may cancel only for the following reasons: *Non-payment of premium **The policy was obtained through fraud or material misrepresentation, meaning the application contained false information and, had the insurer been provided with accurate information, would not have issued the policy **Suspension or revocation of the driver's license of the named insured, any driver who is a household resident of the named insured, any driver who regularly uses a Your Covered Auto -State law will supersede this provision

PART A: LIABILITY COVERAGE: How does the policy define the insured?

-The named insured or any family member for the ownership, maintenance, or use of any auto (even if not licensed) -Any person using the covered auto with permission -A person or organization, for "your covered auto," if legally responsible for an insured EX: A mechanic would not be covered

What are the common (PAP) exclusions?

1.) Intentional Loss 2.) War 3.) Auto's used for hire "Public Livery" vehicles (Taxi, limo, etc) 4.) Nuclear Hazard 5.) Vehicle Used w/o permission 6.) Road Damage to tires 7.) Wear and tear 8.) Freezing, mechanical, or electrical breakdown 9.) Racing

Define Family Member

A person related to the named insured by blood, marriage, or adoption who is a resident of the named insured's household. A family member includes a ward or foster child.

Define Trailer

A vehicle designed to be pulled by a private passenger auto or a pickup or van. Trailer also includes a farm wagon or farm implement while it's being towed by a private passenger auto pickup, or van.

Define Newly Acquired Auto

Any vehicle acquired by the insured during the policy period. -A private passenger auto -A pickup or van, for which no other insurance policy provides coverage, if the auto: Has a gross vehicle weight of less than 10,000 pounds Is not used for delivery or transportation of goods and materials, unless such use is incidental to the insured's business of installing, maintaining, or repairing furnishings or equipment. For example, if the insured is a plumber; he may use his pickup or van for the transportation of his tools. -Liability, Med Pay, and Uninsured Motorist Coverage -Physical Damage Coverage

PART F: GENERAL PROVISIONS: define bankruptcy

Bankruptcy or insolvency of an insured does not relieve the insurer of its obligations under the policy. If the insured declares bankruptcy, the insurer must still comply with all obligations of the policy.

Define Bodily Injury

Bodily harm, sickness, or disease, including death that results.

PART D: COVERAGE FOR DAMAGE TO YOUR AUTO: What is it?

Coverage Part D of the personal auto policy addresses coverage for damage to the insured's auto, also known as physical damage coverage. Part D provides first-party property damage coverage for the insured's covered autos and also provides some coverage for non-owned vehicles being operated or used by the insured and family members.

PART D: COVERAGE FOR DAMAGE TO YOUR AUTO: What is the no benefit to bailee?

If a bailment relationship exists with respect to the covered vehicle, the policy will not make payment for the benefit of anyone who had care, custody, or control of the covered auto. For example, if the insured's vehicle was in the repair shop for servicing and the mechanic damaged the vehicle, this policy wouldn't make payment; the repair shop's insurance would have to pay because of its legal liability as a bailee.

PART E: DUTIES AFTER AN ACCIDENT OR LOSS:

If an insured person, or anyone else, wishes to seek coverage under the personal auto policy, he/she must comply with certain duties. Failure to comply with these duties may result in claim denial if the failure to comply harms the insurance company.

PART C: UNINSURED MOTORISTS COVERAGE: WHAT IS THE OTHER INSURANCE?

If more than one policy is in place and provides Uninsured Motorists Coverage, the total amount the insured may collect cannot exceed the highest limit applying to any one vehicle. For example, if the insured's limits are 100/300 and the limits on the other policy are 50/100, the most the insured may collect is 100/300. If the loss occurs while the insured is occupying a non-owned vehicle, the policy covering the non-owned vehicle is primary, and the insured's coverage is excess. If more than one policy applies, the insurer pays only its share of the loss, which is the proportion that its limit of liability bears to the total amount of all applicable coverage.

PART B: MEDICAL PAYMENTS COVERAGE: Wha is the other insurance?

If there is other applicable auto Medical Payments insurance, the insurer will pay only the proportion that its limit of liability bears to the total of all applicable limits. However, coverage for non-owned vehicles shall be excess over any other collectible auto insurance providing payment for medical or funeral expense.

PART A: LIABILITY COVERAGE: Define other insurance

If other auto liability insurance is in place at the time of the loss, the personal auto policy will only pay its share of the loss. This policy pays liability losses on an excess basis for non-owned vehicles. For example, the covered loss involves a car the insured borrowed from his neighbor. The insurance in place on the neighbor's car must pay first (it's primary insurance) and then this policy will pay (it's excess insurance).

PART D: COVERAGE FOR DAMAGE TO YOUR AUTO: What is the other sources of recovery?

If other insurance is in place, or if another party is available to make payment for a covered loss, this policy only pays its proportionate share of the loss (as we've seen in the other coverage parts). -If a loss occurs and the covered auto is a non-owned auto, this policy will pay on an excess basis. Primary coverage is considered insurance provided by the vehicle's owner, any other property coverage that may be in place, and any other source of recovery, such as the insurance purchased by the driver of the vehicle.

PART F: GENERAL PROVISIONS: define right to recover payment (Subrogation)

If the insurance company makes a claim payment, the person on behalf of whom payment was made must assign its rights to recover damages from another party to the insurance company. If a claimant recovers from another party after the insurer has made payment, that claimant must reimburse the insurance company.

PART D: COVERAGE FOR DAMAGE TO YOUR AUTO: What is the Appraisal?

If the insured and the insurance company are unable to agree about the amount of a loss, either party may demand an appraisal. Each party selects, and pays for, its own appraiser. The appraisers prepare separate appraisals of the actual cash value and amount of loss. If they fail to agree, they select an umpire to whom they submit their differences. -If any two of the three parties agree, that decision is binding. The insured and insurer share the expenses of the umpire and appraisal.

PART C: UNINSURED MOTORISTS COVERAGE: What is arbitration.

If the insurer and the insured do not agree on the recovery of damages or the amount recoverable by the insured, each party may select an arbitrator (at each party's expense) who then jointly select a third arbitrator (with the expense split equally by each party). A decision agreed upon by the arbitrators will be binding as to the insured's entitlement to, and the amount of, damages.

Define Liability, Med Pay, and Uninsured Motorist Coverage

If the newly acquired auto replaces one listed in the Declarations, the new auto automatically has the broadest coverage provided for any vehicle already listed in the Declarations. If the auto does not replace one that is already insured, coverage must be requested within 14 days after acquiring the auto.

PART F: GENERAL PROVISIONS: Two or more auto policies

If two or more policies issued by the same insurer apply to the same accident, the maximum limit of liability that will be paid will not exceed the policy with the highest limit.

Define Your Covered Auto

If your vehicle meets any go the following 4 definitions, it is your covered auto 1: Any car on Declarations 2: Newly Acquired Auto 3: Any auto the insured does not own, but the insured is driving, provided the owner of the car does not have any auto coverage or an inadequate amount of coverage. This is known as the Primary-Excess Rule. 4:Any auto or "trailer" the named insured doesn't own while being used as a temporary substitute for any other vehicle described in this definition, which is out of the normal use because of: Breakdown, loss, repair...

PART C: UNINSURED MOTORIST COVERAGE: How does the policy define the insured for uninsured motorist's coverage?

In addition to the definition of "insured" that applies to the entire policy, the definition of "insured" for uninsured motorist's coverage means: -The named insured or any family member -Any person occupying a "your covered auto" -Any person who is entitled to recover damages because of bodily injury sustained by an insured and covered by the policy. For example, if Sue sustains bodily injury in an accident caused by an uninsured motorist, her children will be entitled to recover damages for loss of care when Sue is unable to care for them because she broke both her legs in the accident.

PART A: LIABILITY COVERAGE: What are the supplementary Payments?

In addition to the limit of liability, the Insurer will also pay the following: -bail bond is required because of an accident, the policy will pay up to $250 for the cost of the bail bond so long as the accident resulted in a covered bodily injury or property damage claim -If defending a suit, the insurer will pay premiums on appeal bonds and bonds to release attachments -Any interest that accumulates after a judgment has been entered will also be paid by the insurer if it defends a suit -The policy pays up to $200 a day for loss of earnings because the insurer requests attendance at hearings or trials. This does not include loss of other earnings. -The policy will also pay for reasonable expenses incurred at the insurer's request. This does NOT include traffic fines.

Define Business

Includes trade, profession, or occupation. The courts have determined that business activities have two components: they are continuous in nature and offer the opportunity for profit.

Define Physical Damage Coverage

It doesn't matter if the new auto is a replacement or an additional auto. If the insured already has at least one vehicle insured for Physical Damage coverage under the policy, coverage begins on the date the auto is acquired as long as the insured requests coverage within 14 days after acquiring the auto. The new auto will automatically have the broadest coverage provided for any vehicle already listed in the Declarations.

PART A: LIABILITY COVERAGE: What is excluded in this policy for those insured?

Liability coverage is not provided for any insured who: -Intentionally causes bodily injury or property damage -Causes property damage to property he or she owns or is transporting -Causes property damage to property rented to, used by, or in the care of that insured. An exception exists for damage to a residence or private garage - this is the care, custody, or control exclusion. -Is responsible for causing bodily injury to an employee (of that insured) during the course of employment by that insured -Owns or is operating a vehicle while it's being used as public or livery conveyance (meaning it has been hired out to the general public). A vehicle used in a share-the-expense car pool is not considered a public or livery conveyance. -Is employed or engaged in the business of selling, repairing, servicing, storing, road testing or parking motor vehicles. An exception exists if the vehicle is being used by an insured, a family member, or a partner or employee of these. For example, Mary's son is a mechanic. If he's test-driving Mary's car and crashes it, the exception to the exclusion applies - meaning he has coverage. However, if his co-worker crashes Mary's car, the exception doesn't apply because the co-worker is not related to Mary, nor is he her partner or employee. -Is using a vehicle while employed or engaging in business. However, a coverage giveback applies to private passenger autos, pickups, vans, and owned trailers used with such vehicles. -Is using a vehicle without the reasonable belief that he or she is entitled to drive it. Family members always have a reasonable belief of entitlement to drive a "your covered auto" under this coverage.

PART A: LIABILITY COVERAGE: What is excluded in this policy for the ownership, maintenance, or of a vehicle?

Liability coverage is not provided for the ownership, maintenance or use of: -Vehicles that have fewer than four wheels, such as motorcycles -Vehicles designed mainly for use off public roads, such as snowmobiles or ATVs. An exception applies for off-road vehicles used by an insured in a medical emergency, "trailers," or non-owned golf carts. -Vehicles owned by the insured that are not insured on this policy OR not owned by the insured but are furnished to the insured or available for the insured's regular use, such as a company car -Vehicles owned by a family member that aren't insured by this policy OR not owned but are furnished to a family member or available for the family member's regular use, such as a company car -Vehicles located inside a racing facility for the purpose of competing, practicing, or preparing for a race or speed contest

Define Occupying

Means in, upon, getting in, getting on, getting out, or getting off a vehicle.

PART F: GENERAL PROVISIONS: define the changes

No changes may be made unless they are contained in a written endorsement issued by the insurance company. The insurer may also adjust the policy premium if changes occur that affect information that determines premium rates, such as number or type of vehicles insured, drivers of insured vehicles, the overnight locations of vehicles, and insurance coverages, deductibles, and limits of liability. If the insurer makes a change that broadens coverage under the current edition of the insured's policy, and the change doesn't generate a premium charge, the change automatically applies to the insured's policy.

PART F: GENERAL PROVISIONS: define fraud

No coverage is provided for any insured who commits fraud, makes fraudulent statements, or engages in fraudulent activity with respect to a claim for any accident or loss.

PART F: GENERAL PROVISIONS: define legal action against the insurer

No legal action may be taken against the insurance company by anyone unless he/she has complied fully with the policy. In addition, no one may sue the insurance company until it agrees in writing that the insured has a legal obligation to pay for damages.

What are the Coverage parts of the personal auto policy?

Part A: Liability Coverage Part B: Medical Payments Part C: Uninsured Motorist Part D: Coverage after an accident or loss Part E: Duties after an accident or loss Part F: General Provisions PLUS: Selected Endorsements

PART D: COVERAGE FOR DAMAGE TO YOUR AUTO: What is the inuring agreement?

Part D - Coverage for Damage to Your Auto pays for direct and accidental damage, regardless of fault, subject to the policy's exclusions - and those contained in this coverage part. Covered vehicles are Your Covered Auto and non-owned autos. Part D of the policy is the only section that defines non-owned auto. -A deductible applies and will be the amounts shown on the Declarations for Collision coverage and Other Than Collision coverage, which is also known as comprehensive coverage. The deductibles for Collision and Other Than Collision coverages need not be the same. -If this coverage pays for damage to a non-owned auto, the broadest coverage appearing on the Declarations will apply

Define Property Damage

Physical injury to, destruction of, or loss of use of tangible property.

PART D: COVERAGE FOR DAMAGE TO YOUR AUTO: define other than collision (OTC, Comprehensive)

Provides coverage on an open perils basis, which means all causes of loss other than a collision loss and not excluded in the policy. OTC, or Comprehensive, includes but is not limited to the following causes of loss: -Missiles or falling objects -Fire -Theft or larceny -Explosion or earthquake -Windstorm -Hail, water, or flood, including a flash flood -Malicious mischief or vandalism -Riot or civil commotion -Contact with a bird or an animal -Breakage of glass (If caused by an accident, it may be considered a loss caused by a collision).

Define Rating Factors

Rates and premiums for auto insurance are determined by individual insurance companies using the following factors: For liability coverage, rating factors typically include: age, sex, marital status, driving record, vehicle use, annual mileage, territory of garage, and liability limits selected. Some states may use number of years of driving experience instead of age. -For physical damage coverage, rating factors typically include: all of the above, plus the year, make, and model of the insured vehicle, and the deductible(s) selected

Define Private Passenger Auto

Shall be deemed to be owned by a person if the auto is owned or leased under contract for a continuous period of at least 6 months.

PART F: GENERAL PROVISIONS: What is it?

The General Provisions of the personal auto policy apply to all sections of the policy. They spell out the obligations of both the named insured and the insurance company.

What is the Personal Auto Policy (PAP) about?

The Personal Auto Policy (PAP) is a personal lines policy that provides several types of insurance for loss that results from the non-business use of certain types of motor vehicles. The PAP is designed to cover an individual's or family's personal use of an auto, and is comprised of 6 major parts.

PART A: LIABILITY COVERAGE: Define Split Limit?

The amounts of coverage for bodily injury and property damage are separate. Split limits are expressed using 3 separate limits: a bodily injury (BI) limit per person, a bodily injury (BI) limit per accident, and a separate limit for property damage (PD) per accident. If Part A of a policy is written with limits of 100/300/50, the policy will provide coverage of $100,000 per person for BIwith a maximum BI aggregate limit of $300,000 per accident. Additionally the policy will provide a $50,000 limit for PD per accident.

PART F: GENERAL PROVISIONS: TERMINATION: define non-renewable

The insurer may elect to non-renew a policy; if non-renewing the policy, the insurer must give the insured written notice before the end of the policy period. At least 20 days advance written notice must be provided (some states require 30, 45 or 60 days notice). In most cases, state law requires the insurer to list the reason for non-renewal on the notice. State law prevails.

PART A: LIABILITY COVERAGE: What is the insuring agreement?

The insurer will do the following: -Pay damages for bodily injury or property damage for which any insured becomes legally responsible -Settle or defend any claim or suit asking for such damages -Pay all defense costs it incurs, in addition to the liability limits. The insurer's duty to settle or defend ends when the limit of liability is exhausted.

PART B: MEDICAL PAYMENTS COVERAGE: What is the insuring agreement?

The insurer will pay "or reimburse" reasonable expenses incurred for necessary medical and funeral services caused by an accident, sustained by an insured, and incurred within 3 years of the accident. Unlike Liability Coverage, Medical Payments Coverage does NOT require an insured to be legally responsible for causing injuries.

PART D: COVERAGE FOR DAMAGE TO YOUR AUTO: What are the transportation expenses?

The insurer will pay, without application of a deductible, a maximum of $20 per day, up to $600, for transportation expenses incurred because of a collision or comprehensive loss. If the damaged auto is a non-owned auto, coverage only applies if the insured is legally responsible for the loss. -If the loss is caused by a total theft of the covered auto or a non-owned auto, the insurer will only pay expenses incurred during the period beginning 48 hours after the theft, and ending when the auto is returned to use or the insurer pays for the loss. -If the loss is caused by a peril other than theft of the auto, the insurer will only pay expenses beginning when the auto is withdrawn from use for more than 24 hours.

PART D: COVERAGE FOR DAMAGE TO YOUR AUTO: What is the limit of liability?

The insurer's limit of liability for loss is the lesser of the actual cash value (ACV) of the vehicle or the amount necessary to repair or replace the vehicle with another of like kind and quality. With collision being fairly expensive and is considered to be a named peril coverage, this lesser of ACV rule is more similar to market value. In the event of a total loss, adjustments will be made for depreciation and physical condition when determining the ACV. -If a repair or replacement results in better than like kind or quality, the insurer will not pay for the amount of the betterment. There is a maximum limit of $1,500 for a non-owned trailer and $1,000 for certain electronic equipment.

PART A: LIABILITY COVERAGE: What is the Limit of liability?

The is the maximum limitpaid under Part A- Liability Coverage which is shown on the policy's declarations/ -The limit applies per accident for all bodily injury and property damage arising from that one accident, including damages for care, loss of services, and a death. The limit shown in the Declarations is the most the insurer will pay in any one accident, regardless of the number of: -Insureds -Claims made -Vehicles or premiums shown in the Declarations -Vehicles involved in the accident If the loss is covered under more than one part of the policy, payment will not be duplicated.

PART B: MEDICAL PAYMENTS COVERAGE: define the limit of liability

The limit of liability shown in the Declarations is the maximum the insurer will pay for each person injured in any one accident (Per Person Limit/ Per Accident). This is the most the policy will pay regardless of the number of insureds, claims made, vehicles or premiums shown in the Declarations, or vehicles involved in the accident. If the loss is covered under more than one Part of the policy, payment will not be duplicated.

PART C: UNINSURED MOTORISTS COVERAGE: What is the limit of liability?

The limit of liability shown in the Declarations is the maximum the insurer will pay in any one accident. This is the most the insurer will pay regardless of the number of insureds, claims made, vehicles or premiums shown in the Declarations, or vehicles involved in the accident. If the loss is covered under more than one Part of the policy, payment will not be duplicated.

PART A: LIABILITY COVERAGE: Define Combined Single Limit

The limit of the policy may be applied to bodily injury (BI) and/or property damage (PD). A combined single limit policy has a maximum aggregate per accident, regardless of the type of loss (BI EX: 25/50/25 The Combined Single Limit (CSL) would be the middle and right number combined 50 + 25 = 75 is the CSL.

Define you and your

The named insured listed in the declarations, and the spouse if a resident of the same household. The named insured should always be the person or persons to whom the vehicle is titled and registered, unless it's a leased vehicle.

PART F: GENERAL PROVISIONS: Transfer of your interest in this policy

The named insured may not transfer or assign his/her interest in the policy without the insurer's written consent. However, if the named insured dies, the resident spouse will automatically become the named insured. By the same token, if the named insured dies, his/her legal representative will automatically become the named insured but only with respect to legal responsibility for maintenance or use of any Your Covered Auto. This automatic coverage is provided until the end of the policy period.

PART F: GENERAL PROVISIONS: TERMINATION: Define Automatic termination

The policy automatically terminates if the insured, or a legal representative, fails to accept or pay for a renewal or continuation of the policy. In addition, coverage automatically terminates if the named insured secures other auto insurance on an auto shown on the Declarations.

PART F: GENERAL PROVISIONS: TERMINATION: what is it?

The policy may be terminated by either the named insured or the insurance company.

PART F: GENERAL PROVISIONS: Define Policy period and territory

The policy only provides coverage for accidents and losses that occur during the policy period and within the policy territory. The policy territory is the United States of America, its territories and possessions, Puerto Rico, and Canada, and while being transported between their ports. Mexico is NOT in the policy territory.

What are the requirements to be eligible?

The primary use of eligible vehicles must be personal, although incidental business use is allowed - e.g., making sales calls. Delivery or commercial use of an eligible vehicle renders it ineligible for the personal auto policy and requires it to be insured on a business auto policy.

PART D: COVERAGE FOR DAMAGE TO YOUR AUTO: define collision.

The upset of the covered vehicle or a non-owned auto, or its impact with another vehicle or object, such as a tree. Collision is the single named peril in the policy.

PART C: UNINSURED MOTORIST COVERAGE: Define the underinsured motorists coverage (UIM)

This coverage is slightly different from Uninsured Motorists Coverage, and may be required by state statutes as part of the Uninsured Motorists Coverage. In other states, coverage is optional or added by endorsement. Underinsured motorists coverage protects the insured against drivers who do have auto liability insurance, but whose coverage limits are inadequate or insufficient to respond to claims. The coverage pays only up to the amount that exceeds the limit of liability of the at-fault party.

Define Joint ownership coverage endorsement (PP 03 34)

This endorsement amends the definition of "you" and "your" to refer to 2 or more individuals, other than husband and wife, who reside in the same household, or to non-resident relatives who jointly own the insured vehicle. -Non-Resident Relatives - 2 or more persons related by blood, marriage, or adoption who reside in separate households. This includes a ward or foster child.

Define Miscellaneous type vehicle endorsement (PP 03 23)

This endorsement changes the policy by adding a definition for "miscellaneous type vehicle," which means a motor home, motorcycle, or other similar type vehicle, ATV, dune buggy, or golf cart. In addition, to the definitions section of the policy, the endorsement amends "your covered auto" and "newly acquired auto" to include any "miscellaneous type vehicle" shown on the endorsement. The definition generally does not include snowmobiles. In some jurisdictions it will cover snow mobiles. Various exclusions under Parts A, B, and D are also amended to remove exclusions for damage to, and injuries arising out of, vehicles having fewer than 4 wheels and vehicles designed mainly for off-road use. The endorsement excludes coverage for any non-owned vehicles, other than a temporary substitute vehicle.

Define optional limits transportation expenses coverage

This endorsement is used when the insured wishes to increase the limits of liability for transportation expenses that are provided in the personal auto policy ($20 per day, $600 maximum). The vehicle is described on the schedule along with the increased daily limit and the increased maximum limit. The endorsement does NOT change or broaden the insurance that is provided for Transportation Expenses in Part D - Coverage for Damage to your Auto.

Define Limited Mexico Coverage

This endorsement provides coverage on an excess basis and only for losses and accidents that occur in Mexico and within 25 miles of the U.S. border. In addition, coverage only applies if the insured's visit to Mexico is of 10 or fewer days duration. -Coverage only applies if existing liability insurance is in place, and was issued by a licensed Mexican insurance company. No coverage is provided for anyone who is a citizen or resident of Mexico.

Defined named non-owner coverage for a named individual

This endorsement provides liability, medical payments, and uninsured motorists coverage for individuals who do not own vehicles, but often borrow or rent autos. The endorsement is also designed for individuals who need to prove financial responsibility. Definitions are amended by this endorsement, which also amends certain exclusions. Part D - Coverage for Damage to your Auto is NOT provided by this endorsement. -The endorsement covers only the person named in the endorsement; a spouse and family members may be included if that option is selected on the endorsement. The endorsement provides only Liability, Medical Payments, and Uninsured Motorists Coverages.

Define towing and labor costs coverage endorsement (PP 03 03)

This endorsement provides payment, at the designated amount, for towing to a garage or for labor performed at the site of disablement. The coverage applies per occurrence and to either a Your Covered Auto or the insured's use of a non-owned auto. The Basic coverage limit is $25-$50 for combined towing and labor costs per occurrence. Higher limits are available.

Define coverage for audio, visual, and data equipment and tapes, records, discs, and other media endorsement

This endorsement will pay for direct and accidental loss to any electronic equipment that receives or transmits audio, visual, or data signals and is not designed solely for the reproduction of sound. Coverage applies only if the equipment is permanently installed in the auto, or removable from a housing unit which is permanently installed in the auto, and designed to be operated solely by the auto's electrical system. -The endorsement will also pay for direct and accidental loss to any accessories used with such equipment including tapes, records, discs, or other media if they are the property of the named insured or a family member, and are in the covered auto at the time of the loss.

PART D: COVERAGE FOR DAMAGE TO YOUR AUTO: What is the payment of loss?

When paying for losses covered under Part D, the insurer may make payment in cash or by repairing or replacing the stolen or damaged property. If making payment in the form of cash, the insurer will include any sales tax that applies to the stolen or damaged property. -If stolen property is recovered, the insurer has the option of keeping the stolen property (at agreed or appraised value) or returning it to the named insured. If the insurer returns the stolen property, it must pay for any damage that resulted from the theft.

PART C: UNINSURED MOTORISTS COVERAGE: What is the insuring agreement?

Uninsured Motorists Coverage provides insurance to insured persons injured in accidents that are caused by another party. The other party must be legally responsible for bodily injury ONLY to an insured that arises out of the ownership, maintenance, or use of an "uninsured motor vehicle." If the other party is NOT legally responsible (or not at-fault), this coverage doesn't apply. The insurer will pay damages that an insured is legally entitled to recover from the owner or operator of an uninsured motor vehicle because of bodily injury ONLY. Unless the policy specifically states that Uninsured Motorist Physical Damage (UMPD) is also provided, this section of the policy only applies to bodily injury damages.

PART A: LIABILITY COVERAGE: Define out of state coverage

When a "your covered auto" is being driven outside the state in which it is principally garaged (and also within the coverage territory), Part A - Liability Coverage extends to provide coverage as required by the financial responsibility or compulsory insurance laws of that state or Canadian province. For example, if the insured's policy doesn't provide Personal Injury Protection (PIP) coverage and the state in which the vehicle is being driven requires it, the insured's personal auto policy will provide PIP coverage at required limits while the insured is in that state.

PART A: LIABILITY COVERAGE: Define financial respondsibility

When the policy is certified as future proof of financial responsibility, the policy shall comply with the law to the extent required.

PART B: MEDICAL PAYMENTS COVERAGE: Although legal liability on the part of an insured is not required for Medical Payments Coverage to apply, when is the bodily injury sustained by the insured not covered?

bodily injury sustained by an insured is NOT covered under the following circumstances when an insured: -Is occupying a vehicle with fewer than 4 wheels -Is occupying a vehicle being used as a public or livery conveyance. A share-the-expense car pool is NOT public or livery conveyance. -Is occupying any vehicle that is located for use as a residence or premises—for example living in one's car or a permanently located motor home or trailer used as a residence -Sustains bodily injury in the course of employment and Workers' Compensation benefits are either required or available -Is occupying or struck by a vehicle owned by the insured that is not a "your covered auto" and is either owned by the insured OR furnished to the insured or available for the insured's regular use, such as a company car -Is occupying or struck by a vehicle owned by a family member that is not a "your covered auto" and is either owned by a family member OR furnished to a family member or available for the family member's regular use, such as a company car Is using a vehicle without having a reasonable belief that he/she is entitled to drive the car -Is using a vehicle while engaged in business; however, a coverage giveback applies to private passenger autos, pickups, vans, and owned trailers used with such vehicles. This exclusion applies to the business use of trucks and other commercial vehicles. -Injuries sustained because of, or as a result of, any type of war or nuclear hazard or action -Injuries sustained when occupying a vehicle located inside a racing facility for the purpose of competing, practicing, or preparing for a race or speed contest


Related study sets

22.2 Complete the sentences using will ('ll). Choose from the following:

View Set

TExES Science of Teaching Reading (STR) (293) V3

View Set

Biology Practice Exam 1 + Need to Study

View Set

Chapter 6: Reporting and Analyzing Inventory

View Set

Information Systems - Applications

View Set

6-Optic Disc Swelling (Papilledema and Other Causes)

View Set

PrepU Chapter 31: Assessment and Management of Patients With Hypertension

View Set