HomeMy WebLinkAbout98-03831
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1\ , 'l'ho VBh:l.a~o Op()n~I:(](l by, tho tort f:BiWOr W/lfJ J.l1fJlI1:t;1Q I)y
!\\;lllnt..i.o 1'11QomnJ\:y 1'IWUrl\l1WJ COmpi1ny (l\aroJ.ni\ft:ar "1Itlnn\:,1.01l) ,
5, 1'1~I,j,n\:J.f: J; NovotnJ. Iwt \::1 ed with the ~or!: l' fJilfJor for the
full polJ.cy limJ.tB of: $50,000 availnbla to tho tortfeaBor,
6, On !:he data Plaintiff: Novotni sustnined injuriea from the
Elbove-ref:erenoecj Qoo:l.qant, \:he Qutoll1obUe wh:\oh pla:l.ntHf: Novot:ni
waa driVing Wqa owned by he~ parenta, Robert nnd Lucarqia Novo!:ni
and Wi1s inaured under i1 motor vehicle :I.nsuranoe pOl:l.oY issued by
prl\qent,j,ql' Property anti Cil/J\lill, ty In/Juranae COll1pql1Y (hereinaf:tel:
IIprUdent.i.alll) I covering two veh.i.oles nnd hnv.i.ng und~rinsured
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mot:Ol~:\.st ooverage in the tlmount of inDO I ADO ,per person,
7, Plaintiff: Novotni received $100,000 in underinsureq
motodst benef.i.ta f:l:Om prudenti.al ns a result: of hei: injur.1.ea
nr.1.sing, from the f.\ccl.dent,
O. On the date Pla:l..nt.i.f:f' Novotn:L austaJ.nl3d .1.n:ludes from the
abo~e-referenoed aoo.1.dent, Plaint.1.ff Novotni was a named .1.nsured
under Ponegil1. motor veh:l.ole J.nf,luranoe poHoytl049 0500 (here.inafter
referred to as the Donegal POl.1.oy), n true and correot dOPy 6f
aal.d ,poHoy .1.s attilohed hereto ilnd Innrkecl ae Iilxh.i.b:l..t II}\II,
,9, 'l'he Donegal poHcy provides underl.naqred motor.1.l3t
aoverage to Ms, Novotn.1. with n single Hm,it of $250/ 000, t, Ms I
Novotil:1. ,. owns a s.1.ngle veh.1.ale I . She J.nsures herse1 f, and th.i.a
"veh.1.ole Ltnc1er the l)onegnl pol iay,
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10, /\1\:l1ol\gh P1n 1.n\: 1. t:r Novo!:.l1:\. pl\rohl.1fJl'lCl 1\H\',lod.1HlI.\l:orl
1I\0\:.odfJ\:. OOV\WQge Hmi.\:fJ. of: $250, \lOD, \)of:e\1(\<ln\: ponefj<ll \H1P pulq
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\.'lfd.n\:.lff Novo!:.n:\. only $1150, ODD f:or l\\lqed,nlJl.lre\l II\CJ\:.Ol':l.fJ\: cloverl1ga
p\1rchnseq under the p0l1ega1Pol1.cy,
l1., 13y le\:\:.er dated l1ebl.'Uf.1ry 11, 1.990, l)one9\11 l:efl.lfJed 1:0
\:ender the $;?50, 000 poU.cy l:l.m:\.\: f.lot l:orth 1n \)onegal poHcy, In
S\1pport of \:.h:l.s refl.lsnl, Ponegal adv1.fJoq Ms, Novotn:l.'fJ oounfJel us
follows I
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We fur\:.her refer YO\1 to the other :l.nsuranae pect:l.on of
the enc10filed under1.ns\1red motol:isl: endorpel11e'llt \1nder the
terms of tho pol:l.cy, Prudo\1tial'fJ $100,000 u\1derlnsured
mot01:il3t paYI11~nt' ~:o your ~U.~n~ recl\1CJefJ the available
covel. age unclel. 01\1. policy t.o $1.5.0,000,
(/\ true and oorrecl:, oopy of I3n1.d fo'ebrum:y 11 ,1990 oorn~fJPondenoe is
attached 11Bl:eto and marlwd nfJfiJxhib:l,t "13"),
12, ~he 1I0ther Inl3urancell section of D0\1ega1'fJ pollcy states
in pertinent part that\
'l'he maximl.\111 reoovery under .all pollciel3 ln the
Seoond priod.ty I3hfll1 not exoeed the amount by
wh:t.chthe highest 1il11itfor anyone vehiole under
any 0116 pollcy :I.n the Second priori\:y exceed's the
l:\.m:l.t appl:l.cable under the pol:\.oy in the 1~:I.rfJ\:
pri.od.\:y,
1.3. In the case of 1\llwein v. Doneq~II1I3Uran~SL"QQ.L,
1141l I?a, SUpal:, 364, 671. 1\,2d 7411, Donegal re1ylng upon 13:1.\\I:1.1ar
pollcy language uttempted \:0 reduce the available coverage to ltfJ
infJured by the amount ho had rece:l.ved 1:1:0111, the tor,tfeul3or'l3
liabillty policy,
ponoga1.' s position provided ita :I.lll3ured wHh
only the difforence between the amount: of the t01'tfeul3or' 8
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ll.AP.iJ..i.\:y CJOV13r<\g8 Hm.1.1: anQ 1:118 !\l1\olln\:' OJ: \:1113 IIl1r.\er:!.nfllll:nnoO
OOVl.WAg8Hm1t; ,
'1'111[1 l:l.nd,\:BQ f:orl1\ of: oovori1913 111 lmown .1.n \:ho
1nqllfl\:ry 11[J "gnp" oOVBn1Ho l\l1rl is oonl:l:\\fll:13el wHh 1I0KOesfj" ooverllg13
\:I1A\: prpv1r:1ep I:he' 1nfJIIl:13q w:l.th \:hq !1ggre91ll:e of \:he <<ppl.i,o/ll)lfl
l.l..fjPU:i. \:y IInel l\nqed.rlfl1.lrnn013 Hm:l.tfJ, 'J'h8 l\llwe;lu COllrl: fonnq\:hAt
POn139fjl' fJ ej:f:ortfj wel:13 :1.mpro[JlJ.t: 1lI1d 1n vlolnUon oj: the Mo\:or
V13hlale FinAna:!.al RefJpons.1.b:l.llty LAW (75 Pa,Ci~,l\, H 1701 8t fJ13~,)
AnQ held thaI: Pl\ .1.s An "oxaeflp" coverAge state,
11\, Doneg!11' 8 Bf:f:01'\:8 to l:edllae L'li'llnt.l. ff: Novotn.l.' fJ
l\ndedn8ured dpve:r<\ge from $;l50, 000 to $150, ODD afJ A rosul\: of,
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Pruc\onl:i<\l' 8 puymenl: of ~1l.00, 000 ar13 imporm1fJfJi)Jle J.n Hght of: tho
~upedo'l: Courl:' fJ 1101d1ng in l\11.wein,
15, Dof:enc\un\:
Done9ul
haa den1er:1
Plu1nl:Hf:
Novotn.l.
und13r1nfJured motod.Elt ooverage under the Donegal Pol:l.ay to t:l1e fUll
l:I.m.l.t8 of the poHoy pUl:ahA/3ed,
16, Pluint:1.f:f Novotn.i.' fl purch/1fle of <\ poHay w1.l:h ponegal und
payment o/: a prel1\.1.UI1\ therBf:Ol:e, enl:itle her to Imded.nsured
motodst aoverage to the fl\11. extent of the poHay pUl'ahused, whl,dh
is $;l50,OOO,
WlIlllnlill!'ORIll, Plu1ntiff Sandl:a M, Novotni requests this HOnol:f\ble
Court to enter judgl1\ent, deellarJ.ng DefendE\l1t Donegnl Mutual
Insuranae Compnny is obligatl;ld .to prov.i.de aoverage under Poliay
N~mber Pl\m 049 05 00 up to the stated l.l.m.l.ts of $260,000 f,or the
injur.1.ea thut Plaintiff Sandra M, Novotni sllsta.l.ned on July, 16,
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:).!l9G, '~n(l gr<ln\:1no <my 131\011 ~\n:ther r1311e~ All \:1]13 CO\lr\: I1\C\Y (l13em
neoef3f3c\l.'Y,
R"' ,eo. ,i~9'P\'i'~~
ral\l-llel,Yy, lTIf3qurl.:e
1 1.1.1<\11 & G13p!1Al-t
21.0 1?lne $tre13t
p,O, Bo~ 006
pqrr1f3burg, pn 1.71.00
(7l.'71~32-1.051
Attorney I,D, R531.48
pC\teql J41.y_!!.., 1.9Q8
At~ornf3Yf3 far p1Q!nt1ff,
l3anqrCl M, l'Ioyotn1
F I \iIOf\ll\,TI,Il\,TI'II\NOvol'll1 \rOfll'l,hI N, T
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NAMIlP ,
tNQUAIlPNOVOTNl pANDR^
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AQIlNTnV~R~Y lNp AQ~NT~ ~ nROK~Rp IN
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flO\!IOYNUM~IlAr^~ p~9B600 PO
AOPNPY N'~Ml'IIlA POPp~O~ 0008 3(
This np\lpe III Paino l\enllo you liS I'f.lqulrep Py Iha PeOnsylvllnl1l Vehlole Opele 'fllle 713 6(10\100 1791,1 (II),
'fha IIIWIl pf Iha Opmmpnwli!lIl1h PI PennllylYl\nlll, !\Ilan!\oleel Py \ha 13eneml Assamllly, only l'equlrl3 \1111\
yoP purphllSe 1I111)llIty I'\nel. flrs\,pllrly medlPIII penl3f1\ ooverf\oes, Any !\PPlllonll.1 oovefl~geS PI'. oPvel'llges In
expells pf Ihe IImlls required py Illw IlfI3 provlpl3P pnly III YO\lr I'eq\.lell\ IIIl enhllnoemenls 10 pl\slo
opverlloefl, ..
Thlllnp\lpe Is 10 provlpl3 ypu .wlllllhe mlnllmlm ooverllqe IImlls find oprrespo~plnp prl3ml~lmS
. ~1 f,i,OPO/$~O,OOO 130tllly Injmy ~IIlPlllty
$5,000 ProperlY Ol'\ml\ge ~llIlllllty
IIntl
$5,000 Flrsl.Pl\rty Mecllolll f3enefl\s
$
,
$
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34,00
27,00
$
'follll $
1~,00.
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73,00
THIS IS NOT YOUR t31\..I..INa NOTIO~, PI..'W~t: Rt:FIlR TO OOVIlA I..I'lTT~R WHloH INo\..u~)as PRt:MIUM
INvoloa FOR AMOUNT PUt:,
.P\..OF.207 (J:cl, 8.~l1) "
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The IIIWs 01 the Oommonwelllth 01 Pennsylvllnla give you Ihe rlghl 10 ohoose either of Ihe following Iwo lorl
op\lonsl '
,A, u\.,lmlteclTort" Option" This lorm of Inlluranoe IImlls your rig hI antl the rights 01 momt:lers 01 your
household 10 seek IInanolal oompensll\lon for Injurlesol.\~18ed t:ly olher drivers, Under Ihle 10 I'm of
InSurllnoB, you l\nd olher hous.ehold memt:lers oovered underlhls polloy mllY Beek reoovery lor 1111
medloal and olher out.Ol.pookel expsnses, t:lul nol lor pAin and suffering or olher nonmonelllry
damagBs unless Ihe Injuries sufferod fall wllhlnlhe dellnl\lon 01 "serious Injury," all sftl lorlhln the
polloy, or unless one 01 several other exoeptlons noted In Ihe polloyapplles,
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13'1' ~Pull 1;,ort" op\lon~ This lorm 01 Insurnnoe allows you to malntl11n an unreslrloted right for yourself and.
,i. olher mamt:lers 01 your household to seall IInanolal oompensallon lor Injuries oaused by olher dtlV. ers,
Under this lorm 01 Insuranoe, you and olher household members ooverod under this polloy mf\y seell
recovery lor all medloal and olher out-ol-pooket expanses and may also seek Ilnanclal oompensatlon
ttlr pain and sullerlng or other nonmonetary damages I'\s a result of Injuries oaused t:ly othor drivers,
II you wish 10 ohl\l1ge the tort option that ourrenlly applies 10 your polloy, you must notlly your agent, t:ltoker
or oompany and tequest and oomplete Ihe appropriate lorm,
P\"OP.200 (Ed, 7.90)
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,g,m,OU 6 0
Thin nollllollllon Inlp II\.Ms(l yo~ of vllrlo~s'~I~oo~nls W111011. mllY P13 IIv!\lI!\pleun~al' Ihla p~.O ~ 31
1, PllaPlve Rt.lalrlllnl pavlpas , If yom lIu\omoplla Is (lqulppa~ wl1l111 fronllll Ofllllh pro\(lpllon
Ilysl(lm whlph req\llre~ np 1I01l0n 01 Ihe vehlole ooolJpllnls llnel oompllea wl\h Sll\n~lH~
1571,~Oa of Ihe Nllllol1l!1 Trllfflo Sl\fely APmlnla\rll\lon, YO\.l mllY pe ell~\ple fpr II ~laQo\.lnl,
Thll IImo\II11 pf ~lIaoo\.ln\ WO\.lI~ pe Plllle~ on .Ih~ llYfllem Inllll\lIe~ In your !\\-!\omoplla I\ncl
will IIPply 10 Ihe Flral PI\r\y !3en(lll\ OoV!lrllge, .
g, An\Hhefl pevlq"'fl ,II your 1\\IIomoplle la aqulppacl WllhllllYlllemwhlohla lIollvlIl",cl lIu\omll\lolllly whlln
Ih!l op!lrlllor Mnl3lhe Ignlllon I\flY 10 IllE1 pH ppSl\lol1 IIncl whlohlll d(lf;llgne~ 10 praV!ln\ unllulhorl~e~ Uae,
you mllY P13 eligible for II ,lIaoounl, Th13 'lI~oo\.lnl Is noll\ppllollPle If Ihe ayalem IlIlha a\l~ndllr~ l~nl\lon
Inter look ayslam provl~ad 1113 IIn I\n\Hhefl cl!lvloa Py Ihe orolnllll ml\nufl\ot\.lrer, Any cl160o\1I11
IIppllOIlPle, wllll\pply to 11113 Oomprehenfllve Qov",mge,' .
a, Mo\or Yehlol13 Prlv",r Imprpv!3men\ 00\lr613' II cllsooun\ Is IIVIIIIIIPI!l1f 1\11 [llIni!'!d Inllurecle lire 66 YOllrs
of IIQe or older IInclhllve S\IPpaesf\.l1ly oompl!lla~ 1\ molor vehlol!'! clrlv!lr Improvam13n\ oourse mllalln~
Iha slllndllrds of Ihe Pepllrtmanl of Trl\l1llporlllllon, Tha dllloounlllppllafl for Ih!l \hra!'! yel\r parlocl .
Immedlf.ll!lly following the auooeBsful oomplallon of Ihe OOurlle, .. .
, PI!lI\Be oonlf.lol ypur IIgenl II you feal you IIreallglple for I\ny of \h!ll\pove cllsoo\.lnIB,.
o e I: U B GO 0 S
,
In Ilclcll\lpn 10 Ihe ~lsoounlsIlBI(ld IIPOVll, olh!lr pr!lmlum Bl\vlng opllons mllY b!lIlVllllllbl!l dapencllng on Iho
poverl\ga ourranlly f.lpplylng 10 IhlB p~lIoy,. .
1, PennaylvAnllllllw no long!lr raqulraB you 10 Of.lrl)' UNINsURi:P MOTORIsTS or UNPi:RINSUF\i:P
MOTORISTs OOYi:RAGj:S, you mllY p!'!lIbla \0 raduoa your premium III .
A, You rsdUoe Ihe IImlla of \IE1blllly I\pplylng 10 elthar or both oovarElgell,
13, You rejeol Ihe "sll\ol\lng" of either or botl1 OOVerllgeB,
Q, You do nol wish 100mI)' elthar or bolh ooverAgas,
2, You may reduce your FIRST PARTY SENi:FITS OOVi:RAGE, The mlnlm\lm madloal expense
ooverage you must oarry Is $5,000, You do nolhl\va 10 oarl)' wag a loss ooverage or lunerlll expansB
ooverage,
S, You may Inorease your OOI.I.ISION deduotlble, Tho higher Ihe daduollbla IIPplylng 10 your vehlolo!!,
Ihe lower the pramlum,
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Plellse oontaol your agenl If you wish mora Informlltlon on any of Ihese options,
PLOF-a09 (Ed,7.90)
~
Any person who knowingly !\I1d with Intenl to Injure or dafraud any Ineuter 11I08 an IIpplloallon or olllhn
oontalnlng any falsa, Inoomplete or miSleading Information shall, upon oonvlollon, bo oubjeol to
Imprisonment for up to seven years and paymenl of a fine 01 up to $16,000, ...' .
Thle nolloe Is being glv~n to you In oompllanae with Aol6 of 1990,
PLOfl-l!19 ed, 6-90
\
IJON!:QA~ MIJT\iAI- IN~URANP';POMPANY
PI-OF 1111\ '
t=~, 1 WU4
I" ,_
't ;il-1
P,mnftvlvftnlp S\jr~hftr\lP Plapl~'\HP ElIAllImllnl
flrplprr~~ Rilling PrOorAm 0 0 083 a
In lIPpprdllnop wllh Pllnnoyly"nlp ~AW, W\I IIrp [lrpyldlno you wllh "n PHplllnnllon 01 o~r Sftlo PrlVllr In'mllnoll
PIAn, ~n~or whloh Vo~r [lolloy hila poon rllllld, IInd 11m [lInn's plloPI Pn YO\H AU\omo\lllll mill In \ho IlYIJf11 of (l
olWOf,pllle 1I00Idllnl(sllln(J1or oonYlollon,
Whllll, Itlll flftfll Prlvllr Inl\lr.ftIWP fll~n?
{,
Thll a"fo Prlyor InQurftnoO PI(l~ (lloroof\or r\lforrod 10 110 aplP) UoOO [lPS\ o~porlono\l ("POI~fll1ls & oonvlollon,,) po Pllrt oflhll
elo\ormlnAllon III YPljrpromi\ml POIl\' Tho syplom dasorlplld Pfllow hila hllan fls\pllllohad lmelor whloh \hoop elrlYllro \llPI hal'o
no polnlo rpoolvtl\llfllowool pramlums. I-Ilollor [lromlumo prll phnrOll(1 for olhar drlyaro PPosd upon Ihll numl10r of [lolnlo
Ihoy hpya, pooumulllllld during Iho oxpllrlanpo [lorlo\l. ThoPl~pllrlllnPll rorlOd 10 Iho I,hroo.yollr Inlorypllllllwopn Iho dillS o(
'hlllnltllll olelm pllymo~I msulllng from nny ono Aopldenl Amllh\! rln\o 0 Iho pppllollllon or 'ho [lropllrllllon ollho ronllwpl.
Prpmlumo for 'ho following pOYOrAoes IIrll \lUllollldl ~IAPlIIlYl Flrsl PlIrty ~onollls pnel OoyerllOo For PlImpOfl To Ypur Aula,
Prlvlng RIlPprd flplnla
QpnvlPllpnll
Pplnlo shplI I1p lIaslgnod for oonYlollons during Ihoe~porlonofl porlod for molar vohlole vlolallons ollho pppllollnl or any
plhor oummlly reolclonl oporalor Po 'ollowSI .'.
(1) Threo polnls IIro psslgnod lor CJonvlqtlon 011
(p) Prlvlng whllo Inloxloaled or undor Iho InflUflnoo 01 drugsl or
(11) FlIllllro 10 slop and raport when Inyolyod In pn aooldenl reoulllng In podlly InjulYl or
(0) Homloldo or pssaullllrlslng oul of Iho operpllon 01 p molar 1'01110101 or
(el) Prlylng whllo IIponso is suopeneled or rovokod.
(Il) Two polnls pre asslgnod for 'ho lIooumu!pllon of polnls undor II Sll\lo Polnl Syslem or II sarlos of 110nvlotlons roqulrlng
the filing of eYldOnoO of flnanolal resppnslblllly undar any Flnsnolol Resppnsll1l1lly l.aw ns 01 Iho eflootlye dlllo of Iho
polloy, . .. . .
(3) One polnlls psslgnod for oonvlotlon pf any olhor mqvlng Irafflo ylolatlon rosulllng Inl
(II) Suspension or reyooallon of en onerator'o 1I00nso, or
(11) Tho filing 01 oYldonoo pI Ilnanolal responsll1l1l1Y undor any Flnanolal Rosponslblllly l.aw requlrod as pf Iho .
offeollYo dlllo of Iho polloy. .
Tha e~porlAnoo Porlod for IIsslonmenl of polnlslor Oonylollono ISI
, "
Tho t:~r.orlonoo pori ad shfJlI tio Ih\llhroo yoars Immodllllely prooodlng Ihfl dolo of appllollllon or tho proparatlon oftho
renOWll, ,
Aooldent SuroharaGa
(1) 8urohorgos for IIooldon!s Ooourlng Prior 10 July 1, 19901
(II) Polnls are asslgnod for oaoh eooldonl thaI ooourrod during Iho oxpol'lonoo porlod,lnyolylng Iho Ilppllollnl or sny
resldonl oporator, whllo oporallng a prlYlllo pllssengor nulo. ono polnl Is asslgnod for oaohllulo acoldenl thaI
rosulln Inl
(I) ~odllY InJulY or doalh rosultlng In II paid olalml or
(II) A psld olalm for damllgo to IIny proporty Inoludlng his or hor owt1ln oxooss of $300.
Page 1 ot 3
PLOP 1119 Ed. 12/94
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M pni! poln! I~ o~~lonlllt for 11'10 ar morn ooolllllnlP durlno 1I11l1l~pllrlonop Pllrlo(1 1'1111011 rllP\11\ In polel
olplmo 11Y IIH1 hW\IrIJr fllr dp!l1POlllO pny proporty 11U\ dP Iwl rllU\111 In 11111 ouolonl11on\ pi poll1\u \melllf (II)
PPoVlI, ..
TI\p I'~porlonoo Porlod pI1plI PlI 1110 Il1mo'yolll 11110rvnlllolwoon 11111 QIIIlI pi Il1l1lnl\llIl ollllm pOYlTlon\ rllolll\ln\l
ffpm ony pno ocolelonl pnel "'0 polo pf IIw IIPpllol111an or 1110 proporot1pn 01 1110 ronowol,
\~)!'Iurol1oroop tpr Aopldpnlp Poo\lrrlnoPn Or Allor July 1,1080: C) a 0 8 :I 4
Pplnl" IIro PPpI~nlld tOl 1I00h liPoid lint for 1'11110111\11 Inpuror ppld llplllhn mllollno 1110 (lrltprlp 110101'1, If 1110 1I00ldonl
InyplYPd II1Pllpplloonl,ll11l npmoQ Ino\lrod, or ony repldlml ppprlllor 1'111110 opemtlno on pulP, ,
(II APpldllnlp ooourrlng pn or !Iller Jllly 1, 1 a9P PilI pafpro July 1 i ,1 OO~I
Pne polnllo poplonad for oooll oooldont for 1'1111011 pn Inouror polQ p plplm clllrlng Iho l1~rl1rll'nOa parloll
~~Mmp . . .
Tlw a~perlanoa pllrlon sl1l1l1 PIl 11111 Il1rllll.ypor Inlervplllalween Il1e dolO of 11111 Inl\lol ololm poymanl reoulllng from pny
pna opoldonl wl1lcl1 mpols Il1e $660 Ihraol1pld, pnd 11111 dPlp of Il1lll1pplloollon or Ihll prapllrpllon of 11111 rpnllwpl,
(II) Aooldpnls ooourrlng on pr I1l1m JUly 1 ,1 OO~I
Ona polnl 10 IIBBlgnael for Iluoh oQoldllnl for 1'1111011 on Inpprer pl\ld l\ ololm Ilurlno IIw o~perlanoa pprlon
01 $760 or mora, .. .
Tl10 p~parlanoa perloel 0111111 pa Il1a thrae.yelll In, larvol pe.lwaan lila, dolO of tile Inlllrll ololm ppymenl reslIllI[10 from IIny
pno 1I0oldenl wl1loh maalo Iha $71\0 Il1rephold, IInel Iha data of the IIppllollllon or Iha preparll\lon of tho renawl\l,
I:lCOBpllQne
The following Aooldenl Burphl\roe p)(o!:PTIGNB apply 10 1100ldente ooourrlno prior to Jply 1, 19801
(1) No polnls I1re asolg[1an for l\ooldenlo Inpurrad Py pnoperator damon~troled 10 pe a named In~urfld pro l\ prlnolpol .
operator pf an aulo Inoured unner 0 oaparate polloYI pnd .'
(~) Nopolnla lira I1soloned for aooldente ocourrlng undar the following olroumolllnOaOI "
(II) AUla lawfully parked (11 the parked vahlolo rolls from the parkacl poplllon Ihl'm IIny suoh 1I00ldenl 10 ohllrgon Ip Ihe
person who parked Iha 01l10)1 \1t '. '
(ti) Tile applicant, ownar or olher reolclpnt !Operator relmPlIrsed ~y, or on behall aI, a peroon who loresponslbla for
the aooldanl qr has judgment ll(Jelnol suoh personl or
(0) Aula Ip slnlOk In Iha roar by another vahlole and Ihe appllollnt or olher repldent operlllor hM nol baen oonyloled
of a moylng Imlflo vlola\lon In oonneollon wl1l1 IhlSlloolclenl1 or .
(d) Gpemtor of Ihe olher aula Inyolved In Ihe aoolnent WPS oonylolad of e moving lrafflo vlola\lon and Ihe l\ppllollnl
or resldenl pperator WaS not oonvlolad of a moving Irafflo vl~la\lon In oonneo\lon wllh Ihe 1I00ldentl or
(e) Auto operl\lor py Ihe applloanl or any rosldent operator is struok by a "hl\.and.run" vahlole, If Ihe aooldenl.ls
reported 10 Ihe proper authority wllhln ~4 hours by tho appllollnl or realQont oparalor: or
If) " Aooldonlslnyolvlng damage by contaol wllh anlmuls or fowll or
"
(0) Aooldenls involving physloal claml1g11, IImllecllp and oaused by flylno grevel, mlssllee, or failing obJeolsl or
(h) Aooldenls ooourrlng when Using auto In response 10 an em~rgonoy 11 Ihe operalqr III Ihe lime of Ihe aooldant was
II paid or volunleer member of ahy Polloe or Fire Department, Flrpt Aid Squad, or any law enforoemant agenoy,
This e~oeplloh does not Inolude /In aooldont ooourrlng after Iha aula ooasop ,10 be used In repponse \0 suoh
emergenoYI or
(I) Aooldents resulllno In en emounl pold on behalf of an Insured under 130slo, Added or ooniblnatlon Flral Par\V
Benefits llovelages only, and Ihe opplloanl or other rasldanlln Ihe oome housBhold was nol. at fault In
oontrlbullng 10 Ihe eoolclent glVlntJ rille 10 Ihe alalm, Ii
paga 2' 01 3
Pl.Oll111a Ed,12/Q4
"
. , \ . .' I
Tl10 lollowlng AGolllt'"' l'lllrolwrup 1:1IP~PTIONS Ilpply 10 acplQPnl6 pcpurrlng on or pllllr Jllly 1, 1119P'
(1) An IIccldllnl lilourrlld lly IIIl oporplor who la cfomonalrp\ud 10 IlP 0 npmpd Illallrpcf or II prlnolppl oppralor of a
1'0111010 InaUlod IIndpr ~ ~opllrlllll polloy la npl pllgll>lp lor slIrohproo, .
(I'!) An Pooldonllnollrrpcl IlY on oporlllor who 16 clpmonalrPlocllO no lonoor rQalclllln Il1p Inauro(j'u hPllBPhold 10
n~1 011011>10 or BurohllrOo, 8 3 I ,
(1l)1 NP p~ln'o Pro lla61gnpd for Iloolllonla ooolmlno undor Iho followlno 0lrollmalanp061 no 0 .,'
(p) Alllo oporolocl lly Iho Ilpplloantor ony roolcll,"1 ppllralor la Q\ruok IlY 0 "I1I1'amj.rlln" vuhlola,lf Iho pooldpnlla
rllpol1ocl 10 tho propllr oulhorlly wl1hln l!4 tlPura lly IIw Ilppllpoll\ or roslclanl oporlllPri pr
(Pl Aooldonto Inyplylnp (lomooo lly ppnlool Wllh onhnola or fpwli pr
(e) Aoelclonla InvolYino phYBleol domooo,lImllocl to omJ oouaoQ hy flying orovol, mlsalloa, or folllno oh)oolol or
(dl Molden'B ooourrlno whon u61no oulo In rosponao Ip pn omoroonoy Illho oporalor!ll tho limo pf Iho pooldonl was
/l paid or yolunloer moml>or of /lny Polloo or Flro Dopal1monl, Flrel Aid Sqllacl, or IIny I/lW onforoomont ooonoy,
Thla oKeppllol1 clooa nol Inolllclo on pooiclonl ooollrrlnp /lltor Ihp Pilla oOl1aoa \0 PIl uoocl In roponao to auoll
omorgonoYI or'
(0) Aooldonle roeulllno In on emounl peino paid on I>ehall alan Ineurod onlY undor Bl\alo, Adcled or Oomlllnpllon Flrel
Parly Bonollle OoyorOooB or undor !Extraordinary Mlldlopl Bonofl1a ooyorogol or
(I) Aooldonte whore Iho Inauror Ie rolml>ureod lly or on I>eholl ol\ho nomlld Ineurod or olhor rOoldont operolor lor
60% or moro of Iho lolel nmollnl 01 tho peld olAlm rooolyod through aubrogollon or from a so\1lAmont or judgmenl
ogplnal tho IndlYlduol rusponell>le for 1110 ooolelAnl, .
Inexperlenoed Operplor
If the prlnolpol operplor of Iho oulo hOB no eurolmroo loi on oooldont, I>llt hAH I>oon 1I00naod loea 1I18n Ihroo Yllare, ono point
Is eSalgnod, .,
Pplnl8. Burohprge Oaloulpllon
,The nurnber of polllta oaslgnocl delormlnoa Iho eurohoroo, Tho lollowlno ehowe Iho surohorgo as 0 poroontego Inorooeo of
Ihe boso promlum, .
Poroentage InoreBQo
ollhe 130810 Promlum
SPIP Ono Mulll'
Feotor Ollr Oar
1 Polnl ,40 40% 211%
2 Polnla ,90 90% 60%
(j Polnla 1,60 1/30% 60%
4 Polnls 2,20 220% 1 16%
'WITH TWO OARS THIS SUROHARGE APPLieS TO eAOH OAR,II' THER!: ARe MORE OARS IT API'l.lI:s .
TO THf> TWO OARS WITH THE HIGHI:BT PREMIUM, USUAl.l. Y THesE ARE TI-n: HIGHEST VALUeD OARB,
, " Theao poroenteoe eurohorgeD ero lIIuslrallvo of the offeot on tho I>aae premium only, Whllo the I>oso promlum la dlfforent
depending upon rellng torrllory,lhe baao promlum does nol yary for other oonelderallons euoh es your oge, aOK or morllol
elatue, Thoreforo, tho dolla" of aurohnrge wllll>e Iho Beme for all drivers wllh oqulvalont oovoraoe In any portlouler lorrllory,
Howovor, tho peroenlage of surohergo whan oompered to your totel promlum, whloh dooe rooognlzo among other thlnge
your ogo, aeK end merlloleleluB, oould yary eomewhet Irom 11m 01>01'0 ollod poroontegee, .. .
You may be eille tll delormlne the point a eBslgned to you by looklno at your polloy, The fronl poga Informellon may Inoludo a
elK.dlglt oode auoh as 01 1 HO, The last dlgll ehowe tho polnle. The zoro Indloetoe no polnte In Ihle ooao,
For mora Inlormellon ebput thOBO aurohargoe, plooae oonloot your agent or oompany,
Page 3 of 3
PLOP' 1110 Ed, 12/94
)
000030
p~RaONA~AUTOPOWOY
AaA~~MF-N1'
,
In mMn (pr p~ymonl pf Iho prllml\lm I1nd S\.lpjool 1(1 oil 1110 lormp pI Ihls ppllpy, wo ~oroo wllh y\'l\.l (10 lollows!
P~FINI1'IONa
A, Thrp\.lohollllh1s pollpy, ~YO\.l" ~nd 'yo\Jr" rllfllrlOI
1, TI1lJ ~nomed Ins\.lrlld' sh\!wn In Iho Pooll1m,
Ilonslllnd
Il, 'Thll spouse If II rosldonl of \l111 Slime hO\lSol1Pld,
13, 'Wo", '\.ls" llnd ~our" rofer Ip Ihe Oompony provlc\'
Ino 1111p In8\.lronOe, '
0, ' Fpr p\.lrposoe pi Ihls pOIIPYb..1I prlYolll poSsengor IYPo
a\.llo shall PS deefl1ed 10 19 owned Py (1. person If
IOI1Slldl
1, Under 0 wrl\llln Ogrollfl1onl 10 Ihlll personi Ilnd
Il, For II opnllnuous period of 01 IlIasl a fl1on\lw,
Olher wordU and phrasflS IIrll doflnlld, They orllln q\.lOlo.
lion marks Whon used,. .
p, 'l3odlly In)\.l!y" moons podlly harm, sloknllss or dls'
Opso, Inoludlng doolh Ihol reeulls,
. 1l,'l3uslnes8" Inpludllslrodll, profllsolon or ooo\.lpa\lon,
p, 'Famlfy fl1empor" moons a person rellllod 10 you by'
plood, msrrlsge or odopllon who Is II resldllnl of your
household, This Inoludes 0 ward or fosler ohlld,
"
Q, ., "Pooupylng" mllonS In, upon,ge\tlng In, on, oUI or
off,
H, "Properly doml1gll" mllons plwslolll InjutY 10, do.
81ruotlon 01 or los8 of use of langllllo properly,
" I, "Trollor" meons 0 vehlole doslgned 10 pe pulled by 0\
1, Prlyole posson\ler autO! or
12, Plokup or van,
II Illso moons 0 fl1fm wogol1 or form Implemenl while
towed py II vohlolo IIsled In 1, or li!, ollove, .,
J. "Your oovered lIulo" meol1SI
i, Arw yehlola shown In Ihe Plloloratlons,
.
12, Any of Ihe followln\l Iypes of Yllhloles on Ihe
I' dole you Peoome Iho ownen
II, e prlyole passenger oulo! or
b, 0 plokup or van Iholl
II
,
Oopyrlgl11, ,lnBUral1oe ServloeB Offloe Ino" 1 gOO
(1) has II ~rpss Vllhlplll WIlIOhl pf Illsp
\110n 10,000 Ipp.! oml
(li!)lp nol \lsod for 111Il dellYllry pr Imns.
pO,r,\pllon of gpo, ds llnd mlllmlllla \.In'
Illss s\.loh USIlIsl
(ll) Inol(:jllnlol 10 your "p\.lolneps"
pf I"PIO IIno, mlllnlalnlno or rll-
pll rlngfurnlllhlnos or oqulp-
mllnll PI
(b) for farmlno or ranol1ll1g,
Thlo proylslol1 (J,li!,) llPpllllS pnly Ifl
0, you aoqulrethll vehlolll during Ihe policy
. Pllrlodl ' .
b, you flsk us to Insurllll wllhln ap d~ys ollar
vou 1l1l00fl1e Ihll OWl1llT1 fwl
0, wllh rospeol 10 II plokup ,or Vim, no OilIer
Inouranoe pollovproyltlll& ooYorll\lll pr
thaI vehlole, '
If the yehlole you aoq\llre raplllolls one shown In
thl! pllcloff.\llpl1o,1I will hllve Ihll&Omll coyorooe
oa Ihll vllhlolo 1\ replooed, YO\.l musl ask ua to
Inaurll II rllplooofl1enl yehlolll wllhln eo days
only If you wlah 10 Ildd or oonllnull Ooyoroge for
DAmllge 10 your Aulo,
, '
II Iho vehlolll you Roq\.llro Is In Ilddl\lon to any
ahown In Ihe Peo!llrollono, It will hove Ihe
htoodest poverpge we now PfQvlclo for IIny ve-
hlole shown In the Deolorotlons,
3, . Any 'Iraller" you pwn,
Any llulo or "Iroller" you do nol own While used
os 0 tomporory sUPslltulo tor Ilny olhar vohlole
dllsorlbod 111 this dalll1ll1on whloh la ou\ 01
normal use peoouae of Ilal. .
a, prookdownl d, losslor
p, ropoln II, dllalruollon,
0, sorvlclng!
This provision (J,4,) doeo nol Ilpply to Ooyer.
age for Damage to Your Auto. ,
"
4,
Page 1 0111
PP 00011289
PART A '" I..IA~Il..ITY OOVt:!RAQ~
INIlURINQ AQA~~M~NT --- p, ' Olhpr rllllsonplilp llKpllnsos Ino~rrpo
A Will d I I" ~II I III opr r(lq~IlS\, ' () '"'
, 11 W ~pypml\oaB pr "p" y nlllry" pr IprPpllrty "xo'IJIlIPNIl u', 'OB, 3 ~
Ollmpoa' lpr whloh pnr ~lnsllrPtl" paoomas loOplly t"" (
[QsPQnslpla pap~~sa 0 pn PIlIo ppoloa~t, PIII1lP(JPS
11101~rlar.ra'J\ldOmant Intarllsl PWIl, rdllq 1Illlllns\ 11111 A, Wll r10 nol prpvldll!-IIIPIlIIY oovpmOlllpr IIny perpOn!
"Ine~rm ," WII.WIII sal\lp or dpfllnr1, liS WII pons\dur
IIPprpprlf'la, pny olalm or pIIIIIISkl~o Ipf lIlJ.lslllllim. ,1, Whp Inlenllonlllly ollllSlls "poolly Inj~ry" pr
"OPs, In 1I0d,IIIon to oPf IIml' o,IIIpPllllY" WI!, will PIlY ull Ipropprty clumIlOIl,"
dlllensa oosts wll~o~rl O~\ dIllY 10 110111" Ilr tlolond "F" rt" " t rt "
IInds when ollr 11m 101 IIIPllly for Ihls ppveruoo, hus .., Of prpp" y "lImllOe 0 propo y OWnll" or
pIIPn IlKI1A~sllld, II hllv(I np OIlIY Ip dalont1l1ny e~11 polno Irnnsportlld Py \hlll porson, "
1J! slll\le IIIWolplm fo[ ~bodllY f1j~ry, " pr ~proparlY (3, ,Fpr "propllrty dllmpOlllI to properlYI
~lImlloll' nol OIlVPf(ll1 ~nder this ppllpy,
II, r(lntfldlPI
II, Ilns~rlld" AS IIslld In 1I11s Pm! m(lpnal
p, " \lsed pYI or
1 , YP~ pr IIny "fllmlly ml1mppr" lor Ihe ownllrshlp,
mlllnlananoe pr ~sa of IIny a~lo or "Iraller," 0, In Ihp Pllrll ph
II, Any person ~slno "YO~f oOV\lrlld II~IO," Ihpl parson,
(3, For "yo~r opVllrllq 1I~lo," pny pllreon Ilr orOlln. This IIKoluelon (A,B,) nops not apply 10 "prop.
IJI\t1of1P~1 onlr wllh ,respeot tp laoal reeppnsl. llrty dllmlloe" 10 II reslt1anQe or prlvllle Ollraoe,
plllly IQr 1I0ls 0 omleslone of II pereOn for whmn 4, For "P, odlly Inj~ry" 10 Iln emPlo, yall ollhat pllr'
ooyerlloe Is A"ordan IImtpr Ihls Pllrt" Hon durlno the oourpe 01 employmllnt, This IlX'
1\, For Ilny IIl1toor "tmller,' olher Ihlln "your oov. oluelon (A,4,) doos not IIpply to "l1ocllly InJ~ry"
arlld 1I~lo," IIny othllr person or oroAnl~allon 10 a domeello lImployee Imle~s workere' oom.,
P~I only with reppeol to leOll1 roeponslplllly for ponsllllon peneflts lire required or IIvallllPlll for
AoIs or omlselonp 01 you or IIny "1lImlly that t1omesllo employee,
melTlber" fpr whom 1I0verllOe Is alfllrded ~nner
Ihls Part, Thle provlplon (13,4,) afPlles onlY II Iho /3, FOf Ihat person'e IIl1blllty IIrlslng olll of Ihll own.
person or organlJallon doa~ no own or hlrlllha llfshlp or operallon of A yehlQle whle It Ispelno
a~to Ilr "\rallllr," " IIsed as 1\ pupllo or livery onnVeYllnoe, This ex.
ol~elon (A,a,) doee not IIpply \0 a shllte'llle.
eKpenpe ollr pool, ,
6, ,Willie employed or olherwlee Ilnglloen In tha
"puslnees" ofl '
a, eellln01 d, slllrlng! or
p, teplllrlng1 e, pllrklnOI
I), ellrvlolng!
vol/lolee deslgnlld for IIsa tnlllnly on p~bllo
hlg lwaYIl' This Inollldes road lesllno and dllllv.
ery, This axolllelon (A,a,) does nOla?ply to Ihll
ownership, mlllnlellanoe or uell of your ooy.
IIred alllo" pYI '
a, you I
b, any 'farflllY memban" or
0, ahy ~atlnllr, agllnl or employee of you or
any family member," ,
. ,I I ~
-.
, ,
d.'-'
BUPPLPMPNTARVPAVMPNTS
In bdnlllon 10 oui limit 01 liability , we will pay on pehl'lll 01 an
"Insuredl" .
1, Up 10 $260 for tha oosllll bllllponde required
baoause of IInaooldllnt,lnolllt1lng rlllllted tmftlo
law. Vlolallone, The Aooldenl mllat resllll' In
"bodily Injury" or "proparly clemlloe" oovored
underthls polloY,
2, Premiums on appeal bonds and ponds 10 reo
leAse Attllohmenls In any sull we dolend,
il, Intareel"oorulng alter a IUdgment III entered In
any su I we defend, Our duly 10 pay Inlorost
shda when wo ofter 10 pay Ihal part of Ihe IlIdg.
',I lTIenl whlo" dose nol oxpaad our limit olllebllllY
for "lls ooveraoa,
1\, Up 10 $60 a day for loss 01 earnlnge, bul nol
other Inoome1 baceueo 01 allendanoll at
haarlnos or Irlll e al ollr raquesl,
Oopyrlght, Insuranoa Servloes Offloe Ino,,1I100
Page 2 of 11
PP 00 0112 09
'7, MalnlAlnln(l or uslno ony YUIllplll whlllllllPl p~r'
son Is lImp,loyo\l m plllllrwlsa llnOIlOlld Il1pny
Il1uslnose' (Il,t,har lhnn lprmlno or mnohlnol nol
dllsorlpen In ~xo ~olon A.a, Ttllo llKoluslpn
(A,7,) do~e not Apply to Iha ml\lnlol1pnoo pr IISP
Pfal
II, prlvala PlIssan(lor AIlInl
p" plpkup or vlln IhpI YO\l (IWnl or
0, Ilrllllllr" \Jsad with A vohlola dpsprlpa!l In
A, or p, IIbpvo,
Q, \Jslng 1\ Yllhlolll wllhoul II ropsonaplll pallol thllt
Ihol parson Ie antlllllQ 1\1 tlo eo. ,
9, For 'PQ!llly Injury' or "propllny dllmaoo" for
whlph II1AI pereOnl
II, Is IIn Insllrpd ~nQer II n~olnar enemy II.
Ilplllty polloYI pr
p, woulcl pe nn IIlO~reQ under II n\lplenr en.
Ilroy IIl1blllty polloy b~1 lor Its lermlllllllon
\Jppn exhllunllon 01 Its limit olllll\Jlllly,
A nllolllllr enerpy IInplllly polloy Is II pollpy Is.
ellnd Py any 0 1I1a lollowlno or Ihelr suooes.
eorsl" ,
II, Amllrlolln Nilploar Ine~rersl
p, MUlual Alomlo i:neroy ~IIIPlllty lJnclerwrll.
arslor
0, Nuolellr Insurnnbe Assoolallon of olin.
a\la,
13, Wu do not proYlde ~lapllllY OOyerlloe lor Ihe
ownership, malntenllnoe or IIse oil
1, Any molorlzed yehlole hllylno fewer than lour
wheels,
il, Any yehlole, o,hef than "your oovemd auto,'
whlohlsl " ..
p, owned by youl or
b, furnleheQ or nvallaplll for YOllr reglllor use,
(3, Any vehlole, other then "your ooyerod Auto,"
whloh ISI '
II, owned by any "family memben" or
b, lurnlehed or available lot 'he' reglllat lIsa
~ of any ~Iemllymember,"
However,lhle exoluslon (13,3,) dpes not apply to
you while you are melnlalhlng or "ooollpylno"
Any vehlole whloh ISI..
a, owned by a "family memben" or
'.
, '
Oopyrlght, InlluranoeServloas Offloe Ino,,19BB
"
,I
p, hJrnloho~1 or Iwnlllltllnfor tho'
rlI011lllr usa (If 0 "fAmily
mnm!lOr,'
I-IMIT OF I-IAPII-ITY
A, Thpllmlt ollla\llllly nhoWllln Ihp Puolllrpllone for thin
aoyarl1oe Is ollr moxllllllm IImll a{ II11Plllly for All
!lnrnaous rflslllllno IfOm IIIW DnA 111110 OIlO, Idanl',Thls
Is Iho !noS! Wll will PIlY raOllrdlllss of hll n\lmllar of:
" 'InsurAdsl"
~, Qllllms mllQPI 0 0 0 8 B 8
Q, Vehlples Ilr pramlums shown In \1111
PuplamllQnelor "
4, Vahloles Invlllvlld In IIle a\Jto lIooldenl,
"', WA will IIpply \hll Ilmll 01 IIl1plllty 10 provltla IInY
sllpllrlllpllmlln reqlllmd by IlIw lor PodllY IIl)llry'lIntl
property dllmllgll IIn\JIIIlY, Hllweyer, \hle prpylslon
(13,) will npI phllnge ourlotnlllmlt III IIl1plllty,
OUT OF STATIl OOV~AAQr;
IIl1n A\IIO 1I00loent 10 whlal) this pplloy opplleo OoOuro In IIny
etllle or prqylnoa other Ihen the one In Whloh "yo~r ooveren
auto" Is prlnolplllly garll\led, we Wllllnterpfal yo~r polloy Illr
\11111 1I00lclllnl 00 lollowel
A, II Ihe elole pr proYlnoe hilS 1
1, A fll1nnolnl rnsponslblll\Y or slmllllr IlIw
epaollylno lI,rnl\e plllsb IItv for '\Jocl,"Y InJ~ry" or
"property dllmsoe" hloher Ihsn Ih!lllmll ehown
III the peolllrallono\ yo~r polloy Will proYlda Ihll
hl\lher epeolfled 11m t, , '
il, A oornpllleory Insurllnoe or elmllllr IlIw requiring
a nOllresldenl 10 malnlaln InsllfllnoD whenllyar
\llll nonreoldenl IISOS a yehlole In Ihlll etale or
provlnoa, YOllr polloy will provide at lellel Ihe'
rllqlllreQ, mlrlmum emounts llnn Iypes of
ooverage,
p, No one Wlllpa elllltle!l to duplloate pllymente for Ihe
same Blements ofloss, ' ,
I'INANOIAL RaSPONBII'llL1TY
, ,
When Ihls polloy Is oenll/ed as fUlurll proof of
f1nanolal responsibility, this pol/oy shll I oomply with,
Ihe law 10 Ihe e,Xlent requlfed,
OTHaR INSURANce
, II there Is olhor applliiable lIeblllty Inaurenoll we
will pey only our ehare 01 Ihe 10eR, Our ehare Ie
Ihll proportion that' oU11lmll of lIeblllty beare to
the tolal of alt appllollb B limits, However, any
Ineurllnoe Wll proYlde for a yehlole you do nol
own ehell be exoess oyer pnyolher oolleollble
InsllranoD,
I,
Page 30U 1
PP 00 01 1289
1
PART a!'" MI:OIOAI.. PAYMl:NTS coVi:RAGt:!
INIlUAINQ AQAI!~M~NT ..,--,-,. 7, 13llalll,lrllJd whllll 10po\lPylno~ II vohlpln
, , w Iholll 1\ rllllS0l1l11110 I)allnl U1I\1 thAI
A, WIl, will illY rnllsorlllhlll oXllllnlllls 1r1Ourrlltl, lor pllfspnle Ilntlllod IP t1tlSO,
nooasp~ modloal nml hmOfll aOlylOll1l 11111111111I11 of
'~Ilonlly In \IIYI~ U' 131H1lnlnlul whllp 'OPOllflY, Ino" n Vllhlola wllfJnll
III 1IIIIno uspn In \ho "h\lslrlllus~ of IIn
" Palluact tly aOllldonllllmt 'InslIrlld." Thin OXOI\'Slon (0,) t100s no\ np~ly 10
2, l)~slQlnad \ly IIn 'IrW\lro~," ' lotllly Injury" sUntll nod whlln Illopupylno" III
Wo will PIlY IInly Ihllse DXpanSIlQ Inllllrrlllt wllhlli (l II, pf!vnlu pll8sonOllr 1I1111l1
yOmS frllm Iha n~la of Ihlllloolnllnl, h, plok\lp or vlln Ihlll y"u ownl or :;
II, "Insllrlltj' es \lsUtlln Ihle Pllrl mllunSI II, "Irullar" usad wllh II vuhlnlo tfasorlhe(llno
" Yll~ or IIny 'IlImlly m!lmllPrl" 1\, or b, OllOVO, ffi
II, whlla 'oonllpylnOl" or' I), Oll\lslld IlY or 110 II oonsoquonoo oIl c.:
I, liS II portaslrllln whon slr\lok IlYI' II, Illsohllroo 01 p nllolllllr wOllpon (aVlln II
'" , ' Ilooldonllllll
II mplor ye,hlole daelonod for lieD mlllnly on b, Wllr (doolllrod or undeolllrlld)'
p~plIlI roads or II Irllllor of IIny Iyrm, "
2, Any olhor parflon whllo "ooollpylno" "your 0, olvlI Wllrl
oovarlld 111110,' (I. Inswrllollonlor
IlXOI-USIONB 0, roballion or ravolullon,
We do f10t provldo Medioni Pllymante Oovoruoo for ony 10, From or liS II oOnnaqllanoo O[ Iha follllwlno,
person for "bodily Inluryl" whalher oonlrollad or IInoonlro IlItl or however
1, S\lslalnod while "oopupylno" IIny mOlorlJad ouunadl
vehlole hllvlno fewer Ihun four Wheele, a, nllolllPr reaollonl
2, Busll1lned whlle~oooupylng" II "your ooyered b, rlldlllllonlor
IIUlo" whan Ills baing ~sad lie puPllo or lIyery
, oonveYAnoa, This exolll~lon (ll,) doos nol apply 0, redloaollvllllonlllmlnllllon,
10 a uhllre,Ula,expllnsa opr pool, I-tMIT OP "tA13II-ITY
0, Buetlllnad whlla .o'oollpylno" ony vehlola
loolltlld lor IIse os 0 resldDnoe or premleee,
4, Ooourrl~o during Ihe oourse of employment If
workers oompensallon hllneflte ora requlrad
orllvllllublo lor Ihe "bodily In)ury,"
6, I)uslalnad while "oooupylng,. or when slr\lok
by, any yahlole (olher Ihan 'your oovered
euto") whlohlel
II, owned by youl or
b, furnlshod or eyallsblo for your roglllnr uee,
6, Suetlllned whllo 'oooupylng," or when elruok
by, rny yahlole (othar than "your ooyored
lIulo ) whloh lal
a, ownad by any "family memban" Dr
b, furnlshad or ayullpblo lor Ihe reoular lieD
olany "family mambar,. '
Howoyor, thle llxoluslon (6.) doas not apply to
you,
Oopyrlghl, Insuranoo Servloes 01ll001no,,1900
A,
Tha limit of liability ehown In tho OoolDrlltlons for Ihls
ooyerage Is ollr muxlmum limit of lIeblllly for elloh
pafSOn In)lIred In anyone aooldenl, This Is tha most
ws will pay regardleee of the number ofl
1, '"Insuredel"
2, Olalme madel
0, Vehlolee or premlllms shown In Iho
Oeolaratlonslor "
4, Vehloles Involved In the eooldenl,
Any amounle otharwlso pllyabla lor oxponsaa IInder
Ihls oovere{Jo ehllll bo reduoed by eny amollnle paid
or poyable lor Iha eame exponeee unner Part A or
Part 0, . ,
No payment will bo mada unless tha Injured person
or that poreoll'e loglll raprosentlltlYo aorllee In writing
thel any poymont nholl bo IIpplled towerd pny
saUlomenl or ludgmant thlll person rooelvoe under
Part A or Patl C,
a,
0,
Page 4 of 11
PP 00 0112 09
PART 0 ... UNIN6URI:P MOTORIST COVfSRAGI: ,-mT[J1fifff
. p, 1ft or p~qomps Insolvllnl,
/iolYPvllr, '\mln8ur,ad motor vahlolu' dOlls not
no 'Id~ IIny yehlole or Ilq~lpmanll
1, Owned Py or furnlfthad or nVnllllPlo for tha
rooulAr ~eo 01 you or nny Illlmlly membar,"
II, 0, W~Utl or operntllQ lJy II slllHnellfor ,lIndar Any
applolllJla motor yel,lolll Inw, oxoepl /I
self, nfturOr whlohlft Dr paoomeft Insolvllnl,
0, Ownen Py IIny oovernmantlll II nil or 1I0llnoy,
Opar/lle(t on rAils or orAwlar lraadB,
Paslonad mainly lor \lSIl 011 p~pllo roads while
nol on pIIlJllo rOllds, " ,
0, Whllo IDollled for 118e liS a resldenoe of
pramlBas, '
!:xo~ualoNIl
A. We d~ not provide Unlnsllrod Mo\orlels OOVllrllOIl for
"bodily Injllry" s\letAlned lJy IIny persDIlI
1, While ~opo~pylno," or when fltr~pk by" IlI1Y
motor yahlolll owned by yo~ or nny fllmlly
member" whlohle !'lOt Ins~rsp lor this ollyarllgs
IIndar Ihle pollOY, This 1I10ludeo a Irllller of any
type \lead wllh thlll vehlole,
2, If Ihlll pereon or tho leOll1 representallye ee\1lse
the "podlly Injury" ollllm wlllloUt ollr,ooneent,
0, While "oooupylng' 'yollr oovBreP aUlo" whan
II Ie lJolng ueed 08 a pUbllo or lIyery oonyeyonoe,
This exoluslon (A.ll,) doea n\ll apply 10 a
share.tho.expenee oaf pool,
4, Using II yehlolo wllhQul a rlleeonable pellef Ihal
Ihllt pereon Ie entitled to Po so,
13, This ooveflloe ShAll nol apply dlrootly or Indlreotly to
benatllllny Ins\lrer or solf.lnsuror Uhder nny of the
follOWing or elmllar laWI
1, workere' oomponsatlon lawl or
2, dleablllly b'eneflte laW,
0, Wa dp not provine Unlneured Molorlsle
Covernge for p~nltlve or exemplary damages,
LIMIT Or: LIABILITY
A, The IlInll of liability ehown In tho Oeollltlltlone for.lhl8
OClYOrage Ie our msxlmllm limit of lIablllly for all
damaooe rlluulllng Irom ony one aooldont, Thlsle the
mosl we will pay regard lose of the nllmber ofl
PTHIlAINl:IUAANPIl
I, thafa Ie othar ItPP\loIIPlo 1I111q mlldlonl, pnymllnln
nsumnoe Wll will PIlY pn pur s 'aro qllhp losn, Oln shorn
Q thll proportion thlll p\lr Irmlt 01 IIIlPIIlIY Pllllte 10 II,a 1(11/11 01
"
iNIlUAINQAQA~IlMflNT -
A, Wo will PIlY oomponsPlory dllmnoee whloh un
ilnsUfpd" Is laually Ilntllllld to rllopvor ffom \110 pwnur
pr ~parl\tor olAn .,mlnftura(t mOtor vehlole" PPOIIUsll
pI Pot1l1y InjlJryl" ,
1, S\JsllllnatllJyan 'Ins\lracll" IInd
", OAl'soglJy 1II111001PPI\I,
Tha ownor's or ppellllor's IIl1plllly for tho so (lprnaooo
mllal IIrlslI o~,I of Ihe pwnllr~hlp, mnlnlonllnpo or Ufta
of IIlIl 'unlnsura(J mQtor vahlolll,"
Any ludomonlfor nllmlluee lItlslno out pI A s~11
prouOht wllhoul o\lr writ Ian oOl1sant Is not PlnPI110 on
lis,
13,
'Insurop" liS ~sen In Ihle flllrt moans I
1, Yo~orllny l'famllymemlJer,"
2, Any other p~reon 'oooupylno' 'yollr oovare(l
AulD," " , ,
(3, Any pereon lor dllmpoes thlll parson Is ul1lltled
10 reooyer peollusa Ilf "lJodlly InJllry" 10 whloh
thle OOVllrlloe IIpplles ausllllnad by a poreon
dllflorllJed 1111, or 2, IIlJ0ya,
"Un1ns\lred molor 'yehlole" means a IlInd motor
yohlole or\rllllor l;lf any typel . '
1, To whloh no bot1l1y Injury IIl1blllty bond or polloy
IIppllas nl Iho time ollho Qooldent,
2, T, 0 Whloh Q bodily Injury liability bond or polloy
Applies at Ihe time 0 the 1I00ldent, In Ihls oase
lis II mil for bOdilY Injury lIablllly must be less than
Ihe minimum limit fpr bOdily In/ury lIaplllly
speolfled lJy the llnllnolal respone blllly law of
Ihe stala In whloh "your oovered aUlo" Ie
prlnolpnlly gamoed'i
0, Whloh Is a hll and r\ln vehlole whoee oporalor
or owner oannol be Idenllflop and whloh hllel
a, you or any 'fllmlly mernben"
b; a yehlolo whloh 'yolI or any "family
member" are "00oupyln91" or
0, ~your OOyeriln aUlD,.
4, To whloh a bodily InJuryllablllly bond or,polloy
nppllee al the lima of the oool\lenl but thll
bonding or Ineurlng oomponYI
a, denlea ooyerag~1 or
0,
Oopyrlght, InBurance ServlPBB Offloe Ino,,19BB
I
1II1I1Il!'lIIOPPlfI IImlls, rlOWllVllr, f1I1Y In, s~rnnoo wo,
, prov dll wllh nwpllol \0 II vohlolo ypu do npl PWn
phllll 110 axoPSS oVpr I1IW Olhof oollPQllplp P~tll
Ine\JronOII I1rqylrllno pllymol116 lor mllnlonl pr"
hmlltlll f1~PIlI1S\ls,
1\,
Ii,
Pl1gB 6 of 11
PP 00 01 12 09
" I
1, IlnsurIlOPI".....' !, Wtlllll10r "'",1 PP, r~on Is I,P\1ftIlY o,nllllllp ,
10 rnOOVPf pUITInQP~ unt1ur Ihl" Pl1rtl pr
~ Olulms mndOl
, p., As \0 Ihn 1l1TI0\1n\ 01 pUITIlIlIlISI
(), Vllhllllull or prlllfl1l1ms sl1pwn In 1110
poplarllllon~1 or \Ill1l\1r pnr\y mllY muku II wflllllnr10mnnq for
1HIlllrnllon, In Ih ~ ovent, fH'oh purlY will "olaol tIn
,4,' VPl1lolus Invplv!lP In Ihallooldan\. ", fPllrnl\1, r, TI11l \\'/0 IIrllllrll\OfQ will S\lla~l" Il1lftl, II Ihoy
Q, Any IImountQ oll1Prwl~p Pllyulllu for Pllmllolle unrlllr OllnnolllQrno wllhln GO Ollye, allll\lr Ifllly rllRUIIQI 111111
1111s 0, nVllrllM Qhull pa rllP~0llf1lJv 1111 e\,llnSI , "Plllollon 1111 mAda hY II judQII of II oourl "PYlno
" "t. / jlnl"" ollpn,
1 '~Ald PUOIIII~P of \ha Ippdlly Injury" IJY Of on '" l: I III () 0 0 8 4 1
IIhpll pI PUfPOI1S or orO,lInl~ntlPnQ,wl1O mny pn .., ,:po 1 pllrW WI.
, oOlllly rllsponsliJla, TI1IQ InolllPIlS 1111 lI~ms Pllld 1, Pllylhll axpannus 1\ Ino\nslllnq
undar Pllr\ AI Ami
II, !lalU tile oxpnn~lls 01 Ihil Ihlrd IIrpltmlor
il, Puld or, pllynhla POolluQe olll1e "podlly Injury" aqllPlly,
\lndar al1Y pI Iha following pr similAr IIIWI
p, workafS' opmpensllllon IIIWI or 0, \~~~~ill~~II~ PII~~I~~~~~i~ ~mgml'S:~I~~J\~JI~~y~~\1
f .00111 r~las 0 IIIW II" Ip prOoUdllfPllnd evlrlanpe wll
,.0, Any :~Ym~~~II~~~~~~I~: I~~~;~oe will retlupa IIny W11\~~ h~'~~~~~O~oreetlIP,PY IWO of Iha ,llrhltrlllOrQ
amounl 111111 pereon Ie onllllad \0 reoovuf forlho SnllW 1, Whlltlw Ihe 'Ins~re"" In lag ally ~nllllad 10
dlltnlloes IInuar Pllrl A" raoovor dumAoaSlllnd
OTHI!R INSUAAN(JI! 2, Thllllmounl 01 tlamaoeQ. This appll\ls only If Ihe
Iflhera Is oll1ef IIp.Pllppblo elmllllr InSUfllnoa wo will pay only Amo\Jnl does not aKoelld 1I1\llT!lnim~m limit for
o~r "hrfll ollhe lo~s, OUI' ~hpre Is 11111 propofllon Ihat O\lr bodily In,lurY IIl1blllty ~puolflerl \ly 111a flnllnolol
limit 0 1I11IJlllly lJollrQ IP 1110 10t"1 01 All ppplloablo limits, responsl\lIIlIY lAW of \1111 elllte In whlph 'yollr,
Howeyer, Any InQurllno\l we provide wltl1 f!lSpaO\ 10 II povored p~lo" Is prlnolpally garllgpq, If 11111
Vllhlole YO\' do nol own el1l1l1lJe llxonsS over any o\l1or Amounl exollods Ihlll Ilmll, ellhpr Pllrty mRY
oollpplllJle nSllranoe, demand Ihe [IOhl 10 a Ir el, TI1 Q dumlln!l m~s\
, bu mll!la w Il1ln 60 days of Ihe IIrpllflllol'B
ARIIITRATION deolslon, If Ihl~ nemlln~ Is nol mllde, Ih!!
amollnl 01 dllmllgeS agread to by Ihe IIr~Jllralots
A, If we end an "Insured" no nol agrllel will be blndlno,
PART D,;. COVI:RAGE FOR DAMAGE TO YOUR AUTO
INSURING AGRI!IlMIlNT 13, Theft or IlIroenyl 0, Rlol or olvll oommo.
4, J:xp\oslon or \10111'
,A, We will PRY for dlreol IIl1d aool~onlallose 10 "yollr oArlhqupllel 6, Oontllol with bird or
oovered aulo" or MY "non.owned,oulO," Inolut1lno 6, Wlndslorml enlmlll, on
Ihelr equlpmunt, minus any applloab e dndllo\llJle ' 6, Hall, waler or lIoonl 1 O,l3rellkfloe 01 ollles.
shown In Ihe Oeolarn\lons, We will pay for loss to 7, Melloloue mleohlel
'your oovefed auto" ollunod IJYI or vllnrjall~ml .,
1,' Olher Ihan "oolllslon" only IIlhe Decimations If braakage of glass Is oa~sed lJy a ,"(lolllelon," yoU
Indloala Ihal Other Than Oolllslon Ooyeraoe Is 'J'ay eleot JO have II ooneldered Ae II loes lIa\leed by
provldad lor Ihat alllo, oolllslon"
2, 'Oolllslon" only If Ihe Peolllra\lons Indlouto Ihat '0, "Non.ownad QuIp" meone
Oolllelon Oovefnoe Ie prOVided for Ihat Ollto,
IIlhere Is aloes 10 lI, 'non.owned flUID," we will 1, Any prlYlIlll paseengar 01110, plokup, Yen or
pfovlde Iha hroadeet ooyaragu applloalJla 10 any "trailer" nol ownad lJy or furnlehed or IIvallable
"your oovered allto" shown In Ihe Peolora\lone, lor Ih8 regullu uee 01 you or My "family .
" " . " mamber" while In tho ouelody of or being
a, Oolllelon meens Ihe upsel of "y~1Uf ooyered aulo operatod by you or allY "family membar," or
or 8 "non.owned auto" or Ihelr Impaot wllh anolher
vehlole or objaot, 2, Any auto or "trailer" you do not own while ueed
as a lemporary sulJstltule lor "YUllf ooyered
Loss ollusod bv,lhe followlno Is oonslderad olhor than auto" whloh Ie oul 01 normaluee beoauee of ItAI
"00111810111" , ,r
, a, l3rnakdownl p, Losslor
1, Mlssllns or 2, Flrel b, Repaln E, Deslruo\lon
failing objeotel 0, BervlolnOl
oopyrlght, InDUrMoe ServloeD Offloe Ino,,1900
Page tI at 11
PP 00 01 12 89
"
TRAN!lflPRTA'l'IQN ~Xflj:N!l~llln 1I<<llIlIon WII will PIIY,
WI1l1\l\lIIlPPIIP,"I,llon pf dllnllPIllJlo, ~P 10 $1~ par (If.lY, 10 II
m~~m~$~~ ,
1, Trllnsportllllon \l~pUnsllfl \nO~frllq PY yo~i'ln Ihp
Ilvanl pI tha 1011111110'\ of 'yo~f oOYllrll(IIIUlo' ,
This IIPpllas onlY II 1111 Duolllrllllpna InnlplIllI
lhlll Olllllf Thlln Oplllslon povamOlllfl provlrja(t
, orlhllt 11\110,
g, ~ou~ 01 \lua expDnuas for whloh Yo\l pDPome
l~ollllY responell>lB,ln 11111 eYllnl pI \11111 lolllllhalt
0111 "npn,owned lI\llll"' Thlu IIPpllls only II Iha
geolllmllons Ind,1P1I,1 il thlll Plhar Thlln oolllslon
overllQ\I Is prOVided for IIny "Yll~r onymllcl
1I~lolI, \ '
Wa will p"Y only axpensae Inourred cl~rlnQ Iho pOflorll
1, 13PolnnlnQ AO ho~re AHar Ihalhollll1nrl
l!, pnqlno whpn "your' oovafud AIIIO" or Iila '
IInon.owned IIU\O" III !Illumed 10 \iee Ilr wa PIIY
lor lis loss,
IlXOI-UIlIONS We will nol PIIY fon
1, ~oes 11.1 "your oovered A\lto" Ilr 1I11Y
"non.owned lIulo" whloh OQO\HU while II e
lJelno ~sed lie II rUlJlIO or livery oonveyllnoe,
'fhls oxol~slon 1,) does nol applY 10 II
share'lhll.~xpenee om pool,
g, Pllmago n\le and oonflned to!
II, waarlllld loan
IJ, freezlnQl
Q, meohllnlcal or eleolrlonl preakctown or
fllllurelor
ct, road ctllmage 10 IIres, ,
Thle exol~slon (2,) doeD nOlnprly, II the ctllmage
reeulle Irom Iho lolal the I 0 'your oovered
eUlo" or any "non.owned lIulo", '
,
3, Loes nua 10 or aa II oonsequonoe 011
a, rat1lollo\lve oontamlnnllonl
I
p, dlsohnrge of any nlloluar wappon (even If
aooldonllll)l
0, wnr (neolnred or undeolarectll
I d, olvll wen
~
e, Insurreo\lol1lor
I, rebellion or rllyolull.on,
4, LOBS IQ!
a, nny eleo\ronlo oqlllpmenl deelgned for the '
reproduo\lon 01 eound, Inoludlng, but not.
IImllodlol
oopyrlght, Ihsuranoe Servloes Office Ino,,'1988
6,
) , '
(1) 'mrtloD IInq slarllOs!
(gl IlIpll dOP~sl or
(3) opmplIPI ctlup plpYllrs,
I), !lIW Il\lwr alaolron,lo o\llllpmanl
Ihlll rapulvafl or ImnslT\lls /ll1dlo,
YleU1I1 or rjPtll elonuls, Inolunlno,
b~' npl 11m Ipd 101
(1) ol\IJllns Pllml mdlOSI() 0 084 2
(g) lalophpnasl
(\1) Iwo'WIIV mopll!l fActlosl
(4) sOllnnlno mpnltorreoolY\lrSI
(6) ialpvlslnn monitor fflPlllyers!
(11) video oaesella feo()rderel
(71 IIl1dlo onsulll\e rllqprnerel or
(Il) pareonlll oomp~larsl
0, ,III pes, raoorcts, ~lIsos, or olher medlll \IQect
WIlI1 eq~lpmBnl t1aeorlpen In II, or P,l or
n, any olher aooeuuorles usad w1\h
equlpmpnl cteeorllJed In II, or b,
This e~ol~elon (4,) dons not apply 101
e, eqlllpmenl noelonlld solely for, Iho
repronllotlon of sOllnd Ilnd Il~OIlIlSOrlee
\ieed w1\h euoh eqlllprnenl, provided eUQh
equlpmenl 1ft pefmanenlly Inslalled In
','your oov, efed 1111\0" or eny "non.ownlln
auto"IOI'" , '
b, any olhor eleolronlo eq\llpmenl Ihal lei
(1) nooesellry for II\!! normlll operallon
of Iha lIulo or the monllorlng 01 Iha
elllo's operllllng eyelemsl or
(2) an Inlagrlll parI of Ihe same unit
hlluslng IIny eound repronuolng
" equlpmenl desorlbed In II, Ilnd
perrnnnanllY InS\lIl1ed In the opening
of Ihe daeh or oonsole 01 ','yolll'
poyered Iluloll or any "non.ownBd
euto" normally" ueed by Iha
manulaQt~rer for Inelallallon 0 a
radio,
Loee 10 "your oovered aulo" or any
"non.owned all to" due 10 deslruo\lon or
oonfleoa\lon lJy goverhmenllll or olvll authofltles
bOllauee you or IIny "family member" I
0, etlgagod In IIltlgal aotlvllleel or
b, failed 10 oomply wllh Snvlronmen\aj
Proleotlon Agenoy or Department 0
Traneportatlon etandarde,
Page 70111
PP 00 01 1209
, \
This PXolu810n (~,) dllo\l 'nllt APply 10 t II
Inlprnsls 01 l-os8 ffiYllpe 111 "Yll\H poyor (I
!lUlpll,
ll, ~oss to II opml1111 hoqy or "lrnllur"yolI own
whloh Is not sllOwn In IIlll Ppolnrnllol1s, This
PKollIs\pn (ll,) \lO(ls nol ppply Ip 11 Pllmpor holly
Ilr "Irpllof" Yo\1I ,
II, APOlllfP qllflno Iha polloy I1l1rlll(Illlnll
1 ,h, PQk uS III Ins,\lru wllhln 3D dpye PIlUf YOII
, ,I , ' , pooOmll Iha ownar,
7, ~1l8S Ip Any" f1on.ownaq 111110" whon \lsPd 11Y
yo~ or Any ItfAmlly mllmpor" wIlI1Ol" II
reasonlllJle hpllpf IIml yoll III Ihlll "fllmlly
mumlJllrll \If\l enllllau 10 do so,
ll, ~08s101
II, IIwnlngs or ollhllnllA, or
h, oqulpm, enl dllPlonllllto oroll\o Ilddl\lonlll
IlvIno lAo111l1as,
Q, ~oos 10 Ilqulpmenl dllslgnlln or IIsetllor Iho
11elllotlon or loollllon of rlldllr,
10, l-os8 to ony o~sl':lm furnlshlnos pr llq~lpmanl In
or \lppn IIny P\OkUP Of Ylln, O~elom furn\shlnos
III eqlllpmenl noluda but lire nol IImltelllol
II, 8peollll ollrpallng IInlllnsullltlon, I~rnllllro
orbllrsl '
p, IlIollltles lor oOPklng IInd slellplng I
P, halohl.oxlandlno roofs! or
d, ouslom m~;lIls, plllnllnge or olher neollle
or grllphlos, ' .. ,
11, I.oss to IIny "non.ownod AUlD" tJ~lng
mlllntalnell 01' uspd by any person whllo
employed or olherwlse llngagon In the
"business" 011
a, selllngl d, storing, or
b, rllpalrlnOl e, pllrklnOI
0, servlolnm
yehlolos doslgned 10f uee on publlo hlghweys,
This Inoludesload \asllno and dal\vary,
,12, Loss 10 any "non:ownod 111110" being
maintained or used by any peleon Whllo
employen or olherwlee engaged In anY
"lJuQlness" nol desorlbed In exoluelon 11, Thill
exolOslon (12,) doea not apply to tho
mlllhtonanoo or use by you or IIny "family
,rnamber" of II "non.ownlld 111110" whloh Is 0
ptlYllte paslillngar aUlD or "Irallel",
LIMIT OP LlABIL1TV
A, Our limit of lIablll\y for 108s will be Ihe leeser 01 thol
1, Aotuol oaeh Yalua of the etolen 01 dAmaged
propertYI or .
oopyrlghl, lhBural10B SOlvloeB Offloe Ino,,11100
I
il, Amollnl I1I1PllesAry IP fllPlllf or rPplllPII
1110 proplHIV, '
lioWllvur, Ihp mosl wa will PAY Ipr loss 10 pny
'nnn.ownPII 11\/10' whl~h lq u "Imllllr" Is
~~pn,
II" An pdlll~lmllnl for dllPfPpllltlon PIllI I1hyslppl
1I0nnlt,Ipn will IlP /nPdP In da\prrnlnlnp pol~pl opsh
VAIUo 11\ \lIP limp 0 losll,
PAVMI:NT OF 1-01311
Wa mllY ppy lor loss In monav or rllpllll Of IIlplllPO \lIP,
dpn1ll0ocJ or ~lolan prpPllrlr' Wa mlly a\ our \IXpllnSp
rllt\lrn pny slolan pl'opany to 0 0 0 B 4 a
1, VO~!Of " '
p, Tha andrpsa ehown In \Ills polloy,
If we rolurn stolan propll!\y WII will PIlY Ipr \Iny dAmllOll
roslll\lno from II1e Ihell, We mpy kaep 1111 or pllrt of \llP
prpperly IIllIn 1I0r\'lpd or IIppralsed Ylllua,
NO t:lI:NI'lPITTO !'JAIl-ill:
Thle Insllrpnoe shllll not tllroo\ly or Indlroolly lJenelll llny
ollrrler Ilr olher palllla for hlro, '
OTHIaR SOUROIaS OP AIiOOV~RV
If other souroas 01 reo overy III SO ppveflha IIIOQ, we will PIlY
only our ShlllO 01 Ihe losa, Our shllrllls Iha proporllpn thaI
p~r limit of lIalJlllly bellrs tll Iha total 01 pllllPpllollPlallmlls,
r.lowever, IIny Ineuranoe we prpYlde with rllspllol 10 II '
'non.owned 11111011 ehllll lJa exollss OVllr IIny olher
oolleo\lble eOllroll 01 rlloovllry Inollldlng, pul not limited 101
1, Any oovarllge proYIOlld Ily Ihe owner of the .
"non.owned 111110"1 ' ,
2, Any olhar pppllpable physlolll damage
Insllrllnoel '
(l, Any other sou roe 01 rOl1overy upplloalJle 10 the
loae, '
APPRAISAl.
, A, II we pnd you do nol llgfee on Ihe amounl of loee
olther mpy demand lln apprlllaal of Ihe loss, In Ih\s
ovenl, 011011 party will saloot a oompotont IIppr\lloor,
The two ppprnlsere will saleol IIn umpire, The
IIppral&ore will elate RllPuratoly the aotulIl oash Vlllue
IInd the amount of lose, 1I1hey filII to agree,lhoy will
eUbml' thalr dlllerenoGs.to Iha umplro, A deololon
agrelld 10 by any two will ba binding, I:lloh pPrty willi
1. Pay lie ohoeon appralsor! IInd
2, l3aar Iho ll~pensos of Iha appraloplllnd umplro
oqulllly, ,
B, We do nol walYo any of our rlghle und\3r Ihls polloy by
agreeing to an IIpprulaal"
Page 0 of 1 1
pp 00 01 12 Oil
, I \ \
,..... '. '.~-"-- " .,.~---,
.' _ PART ~" PUrll~6 Af.T~R~ AOOIPI:NT OR 1..066, '
WiihIlVP np n\JlY 10 PrtlYldllllPvarpOl1 ijnulIr this polloy 11, olhllr pprllnll~t faopr(I~!O 0 Bif 4
~D\f::' Il1arfl hps p\len 1111 oomrllonoa wllh the Ipllo~lno ti. IMlInll 0 pr\lol III HISS wlwn 'aqlllrad PY
\l~,
A, Wll mllul PI1 I1pllllau promplly pI how, whim Ilnll P A pa'f'son "lllllllno 11'1Insl',rll" 'Ao\orlal"
whllra IIlllllooltlenl or l\ls6 hllPflllnlld, Notloll al1p\llu' . l',' "II! .
!lIsp Inplllda 11m nflmau ann mldrllsuaa olllny Inl~rod OOVarllOll mllSIAlaol
paruons ann 01 IIny wllnossfls, 1, Promrlly nollfy Il1a polloa lIu hl\,pnd,rlln rlrlvor
p, A pllrapn sealllno IIny pOVllrllOO m~ell Is Involvlld,
, '
" ooopllmta wllh ~9 In Ihe Invllslloollon,i!, Pfomr.tly ullntt 116 ooplao 01 Iholp~AI rapare II a
uelllamlml Pf ttafanpo olllny ollllm or eull, sllllls pro~oh\,
II, Promptly sllnd 110 oorloe olllny npllolls or IllOlll' p, A poroon oeplllno Oovamop lllr Ollmage In Yp\lr Allin
PA~flrs rllllalyatlln oonnoptlon willI tile IIPoldenl mllot IIlsql
pr oso, 1, JAIIII rllllsllnflPla oleps aftar losS 10 protllol
(3, ~ulJmll,As often Ao WI1 rllasonlllJly reqlllrll ' YPllr oOYllraU 111110' or flny "nll,.n'IlWnllli Aulp'
find tll11lr llq~lpmanl from f\lr1l111r loBS, WI! will
II, 10 physlolll aXllms, llY P,hyololllne wo pay rallsonllPl1l exponslle Ino\Hrad 10 do Ihls,
oeleot, We will PIlY lor 1I111S11 eXllm,
il. Prol~p\lY no\"y Ihe. pplllla II IIYCMOOVl1flld
p, 10 axpmlnallon llI1dor ,olllh I1nd S\lpsorllJo O\llo' or IIny' non'ownod 11\1\0" 10 Illolllfl, '
the eame,
3, Pllfmlllle 10 Inepool IInd appraise 1110 dllrnlloed
4, AUlhllrl~1l ~o 10 olJtlllni pfQperty ppfore lis repair or tllapoolll,
a, miltlloal reports! and
PART F " ~I:NgRAl.. PROVISIONS
policy PO 01 Ihe dllle we Implement Ihe ohAnoe In YO~f
alllla, This p'lIragmph (0) ttoas nol apply 10 01111noes
Implemanllld wll11 II genoml proorllm revlelon 1111I1
Inoludes poll1 proadanlnou anti reatrlpllone In
ooyarAge, whelllPr Ihlll genaral progrAm reYlulon 10
Implamenlod throllol1lhtroduollon 011
1, A eubeequenl edition 01 yOUf polloYI or,
2, An Amenlilllory I3nnorsamant,
PANKRUPTOY
I3l1nkr~ploy or Ineolvanoy of tha "lnsllret1" 0111111 nol rolleve
\18 olllny olJllgllllono IInder Ihla polloy,
OHANCU1S
A, Thle polloy oonllllne 1111 thAAgreemente lJetween you
a, nd 116, lis Jerm, s mllY not lJe ohAngon or Wlllved
exoept by en oreomanllosuad lJy \Ja,
a; 11 Ihare Ie II ohanga Ip Ihe Infofmlltlon \Jeed 10 devalop
Ihe'polloy premium, We'may adluel YOllr preml~rTl,
Ohangeu durlno tho polloy term thaI may reAlllt In II
, premium Inorellee or t1eorllase Inol\JcJei Pllt are not
limited 10, ohangee 1m '
" The n\Jmporl Iypa otllee olaeolflcatlon of
Inellred vahlo eel
2, Operatorft using Insureu vehloloel
13, The placa 01 pflnclpal garaging of Insllred
vot,'Iolasl . I
4, Oovoraga, deduotlblo or IImlls,
If e uhange resulting from A or B req~lreB a premlllm
adluelment, wa will make tha premlllrn adjllstmllnl In
aocordanoe wllh our manual rulee,
0, If wo make a ohange whloh broadens OOVArllge \Jndor
Ihls edition of YO\Jr polloy wllholll addlllonal preml\Jm
ol1erge, Ihal ohanga Will au\omatloally apply 10 YOllr
oopyrlght, Insuranoe Sarvlbas Offloe Ino,,19!l!l
FRALJP
We cla nol proylde ooVllrago for any "Insurlld" who has
mAde Iraudlllenl statemenls or engllglld In fralldulenl
,00nduol In oonnecllon wllh any ocoltJonl or lOBS for whloh
ooveraga Is eoughl IInnor Ihlo polloy,
l.f~GAI. AOTION AGAINST US
~ No I,egal ao\lon may ba, IJrought agslnsl Uft untlllhere,
I1so been I\JII oOrTlpllanoe wllh el\ IhelormD 0 ,Ihlo
policy, In addlllon, \Jnder Psrt A, no legal po\lon may
be brought IIgalnst \Je \Jnllll '
,. We egreo In writing Ihat Ihe "Inaured" .hllo an
nbllgnllon to PllYI or
2. Tile amount of IhB\ olJllOllllon has Pl1en finally
determlnad by judgmant III\Dr Irllll,
. a, No parson or organl~Bllon llas sny right \Jnder Ihls
polley 10 brlnu liS Into eny Botlon 10 detllrmlna Ihll
liability 01 en "lns\Jred," ,
Page 9 ot 11
PPOO 01 1289
, . i
QIJA AlQt1TTO A~OQVIlA flAYM~" f
A, If Wll mllkp II pllyml1n\ \jndpr this pollpy linn tho
PPllIoh\\HH fO, r Whom pllymonl WIIS rT1l1rlo hl\o 1\ rlol1\
IP rlloavpr nllmllOlls from IInolll\lr wa IIhl1l1 M
lI\lprpO"lllQ to thpI righI, Tlmt poraon almll rJol
" Whlllllypr Is I1POllllllnry Ip IInnl>11I \lo 10 oXlIrolall
our rlOlllslllnd .
11, Nothlno IIflllr Ipas 10 prllju[jlpll tllam,
, '~oI'lIlYaf, Ilur rlohle In Ihls pprllOrllph (A) do nol
, apply IInnor Pllrt P, AOlllnlll llny pllreOn IIlIlno
lIyoUr OPVofon A\llll" Wllh II rUlIsonllPlll lJolle!
111111 thlll perapn la enllllOrllp QO 110, . .
II, II WII mllkll II PPYrnllnl unctarlh's polloy IInd Iho
p'era\1n to or lor WI10m PlIymon /a mllna rlloovore
~lInilloeti lrom IIno\her, Ihll\ pPfaon SI1I1I1\
" Hold In Ir~lI\ lor ~s Ihe proo\lens of tho
roooverylllnd .
il, Relmp~lrlle ~e Ip 1110 eXlanl of ollr pAyment,
flOl-lOY fl~AIOP AND "IlRAITORY
A, This polloy IIppllae only 10 1I00ldenls IInt1 10lleoe
whloh OOOUrl
1, Ourlno Ihll polloy perlotl liS shown In Iha
PaolllrllllonelAnt1
il, Within Iha polloy Illrrllory,
II, . The polloy terrllory Ie
1, The Unlled GlaleQ' of Amerloll, Ita lerrltorlee or
posaesslonsl '
'il, puerto Rlool or
3, Ollnadll,
Thill polloy IIleo applllle to lose 10, or aooldonts
Inyolvlno, "your ooyeren lIulo" while belno
Imnsported petween tholr porta,
TEAMINATloN
A, Canoallallon, This polloy may pe oanoelled during
Ihe PQlloy parlud as follows 1 .
1, The nllmed Insllren shown in the Oeolerallone
mllY oanoel pYI
II, rillumlng Ihla polloy 10 lIel or
P. ~glYlng us nnyanbe wrlllon notloe 01 the
dllta oanoellallon Is 10 lake elloOl, ,
2, Wa may oanoel by mailing 10 the named Insllrad
shown In the Oeolerallons at the addrase ehown
In this polloYI
a, al leaat 10 days nolloo
(1) II oanoellallon Is for nonpayment of
premlumlor
, Oopyrlght, Insuranoe ServloGe DUloe Ino,,1 DBB
I .
(g) II nOlloo Ie mpllon dllrl"g thll'
frill 130 ctAYs Ihle polloY Is In
lllloot pntl Ihlll la nOI II '
rllf1PWIII or oontln~lllllon polloYI pr
P. III 1\llIsl f!0 dllya nolloo IrllIlI 1l111ef Ollsoa,
0, A, ftor ,thin POlloy, III In llllCtol lor 60 dllye, Of II Ihla
<1 ronoWlI1 pr ponllnulltlon polloy, WlI W II ollnQlI1
IlnlYI
0, for nonpllymllnl of premium I or ,
l.l, If your drlVllr's lIoensll or Ihlll b)(' l" R " !3
(1) Imy eJfl,vllr who lIyas 1'11111 yO\j1 or
(11) IIny drlVllr who ofllllomllrlly ~eaS
"yallr oovered A~to 'I
hilS paen S\lllPllndad or raYOklld, This
m~slllllvII pOo~rrodl ,', .
(1) ollrlnolhe polloy perlocll or
(11) slnpe Ihe 111111 f.lnnlversllry of Ihe
orlolnllll effoollV\I OllIe II Ihe polloy
parlod Is other II111n 1 yellrl or
0, II the polloy wpe Ilbtolned Ihrll\lgh mlllerllll
mleropreeenlllllon, "
13, NonreI1I1W"',1f we dllolne nol 10 renew or ppn\lnlle
thlo po loy, wa will mall nO\loe \0 Ihe nllmod Ins~lred
ohown In the Peolarll\lone III t le IId[jrese shown In
Ihls pol py, NO\loe wllllJe mlllled III IPAst ilO dllys
i>elore tha ami of Iha pol/oy porlod, II Iha polloy
period Is olher Ihlln 1 yellr, We will hllve tho rlgl1t not
to renew or oontlnue II only 11\ ellohllnnlvereary DIlts
orlolnlal effaotlve dllte,
C. A\.ItomPllo Tllrmlnllllon,1I we offer 10 ranew or
oonllnlle and YOII or your represenlallve do nol
1I00,epl, Ihls pol/oy wlllllulomlllloally larm nOlll,lI1 \I1\!
ond of the ollrranl pol/oy period, Failure 10 paYJhe
raqulren renewol or oonllnullllon promlum WI,en ue
el1l\1I melln thnt you have not lIooepted our of er,
'II you l,'lbtllln olher Ineuranoe on "yo, ur ooyprad ellto"l
IIny elml/or Inellranoa proYlded by Ihle polluy wll
tarmlnote liS to thlll 011 to on the effeollVB Ollie of the
olher Insuranoa,
0, Olher Termlnallon PrOYIlllonll,
1, II tho law In effeolln your slale al Ihe time thle
polloy Ie Isalled, renewed or oonllnuedl
e, . roqulree 0 longer nolloe period;
b, rpqulree a spaolal form of or prooedure for
olvlng nolloel or
0, modllloe any 01 Ihe staled termlna\lon
roasonsl .
We will oomply with those requlremente,
PllQB 10 of 11
PP 00 011209
l.
"
,,",,'
,
PIl 01 p1 O~ II~
AM~NPM~NT QF PO~IOY PROVltllONS. P~NNaYI-VANIA
P~FIN'TIONfI
Tha Pllflnltlpns QIIPtlpn Is IImpnilad IlQ 101l0w~1
A, PAllnlllpn~, Is rllplllPpq ny Ihp fllllowlnpl
lIYP~f povarlld IIUIO" mPllnSl
1, Any vehlplll ~hown In Ihll PlIPlllrlltiOl1s"
12, Any of thll fpllowlno Iyplls of yahlclas on
Ihll na\1I YOII peQpmll tllll ownllr: 1-,
II, A prlYlIlP pP8Qllnoar IIl1tOi or 00084 7
IJ, A plpk~p or vlln thlll:
(I) Has a Glross Vahlole Welohl
not eHoallQlno Il,POP illS" IIl1q
Is nol prlnolplllly llSaQ In pny
"buelnese" olhar Ihlln fnrrnino
or rllnohlno,
This pfovlelon (12,) npplloll only II:
p, Ypu IIcq~lro the vahlplll durlno tha
polloy parlo(ll
IJ, YOII ask ue 10 Insuro It within (30 dllYS
lifter you beoome \110 owner! and
0, Wllh respllol 10 II plokup or Ylln, no
otller Ineurllnoe polloy provldos
ooyerAge for Ihlll vehlolo,
II \I,a vehlole YolI 1I0qulre repllloes one
ehown In Iho Oaolnrallone, II wlllhllve the
ellmll ooverlloe as tha yehlcle It replllood,
You mUst ask liS 10 Insure a replllooment
yehlole within 30 dllye only II you wleh to
and or oon\lnua Oovemge For Pllmllgo To
Your A~IO,
I,
(II)
i.i I, PO () {I
lI,tha yohlole you aoqlllre Ie In addition to"
anY shown In tha Deolarallona,lIWIII have
, the broadee\ ooverage wo now proYldo for
Ilny velllole ehown In the Deolnratlons,
;"
B,. Any "Irllller" you own,
4, Any oulo or "troller" you do nol own while
lIead os e temporary subslltute lor any
olher yehlolo desotlbed In this definition
whloh 10 oul of normal use baoause of Its:
8. Bteal<downl d, Losslor
b, Rspalr: II, Deetruotlon,
0, Servlolngl
1':1,
This provision (A, 1 doas 110t lIP'
ply Ip OOVllrllpP Fpr Pllmnoo To
YmlrAlllo,
Tha Ipllowlno Is lidded 10 \l1ll Pllflnlllons
SIlOtlOnl '
K, "Nlln,aopnomlo Ipss" maAnll pllln Ilnd
suff(lrlno IIml olher non.monlltllry qalrl.
mllnl,
"/:lerlollslnjuryll mellns IIn Inj~ry resultlno
In dPlllh, sarlp\Js Implllrman\ of ppdy
I~nollon or pprmllnllnl ellrlo\ls nlsIlO\Jre.
mllnl,
\I, 'PART A .I.IA~II-ITY OOVt:lAAQ~
PlltllorllPh A. 01 Ihlllnsurlno Aorellmenl of Pllrt A Is
replaoad py Ihe folloWlno:
INSURINQ AQR~F,Mt:lNT
Wa Will PAY t1~maoas for "P\lqlly InJuryll or'
"property t1l1moge" for whloh Any "Insuradll
lJeoolT1lle leoolly responslllle lJaolluse of IIn
llUlo 1I00lclent, We will settle or defend, liS we
oonslder IIpproprlate, IIny ollllmor e~1t IIsklno
for Ihese t1AmAoeQ, In lIt1dl\lon 10 ollr limit pIli.
IIblllty, we will PIlY all defense oosle wlllnollr,
Our dilly tp eaUle or defend ends W, hen our limit
of lIalJlllly lor Ihle ooyaraoe hAe been eH.
hallellln, We hllVo nu dUlY 10 delenQ any eull or
eettle l\ny ollllm for "bodily In/Ury" or lIproperty
t111ml\ge" nol oovered under I lie polloy,
III, PART t:l . PUTlt:lS AFTIlR AN AOOIOIlNT OR
1.0SS
Pllrt 11 Is replaoed by Ihe followlnOI
OUTIIlS Af'TIlR AN AoolPI3NT OR I-OSS
If an aooldent or loss oooura, tha follOWing muet be
done lorlhe \erme of Ihe polloy 10 apply:
A, Wa mllst ba notified promptly 01 how, whon ann
Where the nooldenl or lose ,happenad, Nolloe
, shollld aleo Inplude the nemes ond addroeses
of any Injured pereons and of any wltneeoee,
e. A petson aeeklno any ooveraga must:
1, Oooperate with us In Ihe Itwesfloo\lon,
eeUlemllnl or defonse of any olalm or slllt,
2. Promptly eend ue ooples of any notloee or '
legal papete tacelved In oonnMllbn Wllh
thllaooldent ot loes.
PP 01 61 00 02
Oopyrlghl, Il1suranoe Servloes 011100, Ino., 1092
Page 1 of (l
0, A person seelllno Unlne\lred Motorlsls Coyor,
pga m~ul Aleol " ,
1, Promptly l10tlly tha polloo IIA hllooncl.nlll
nrlvl!r Is Involvod, "
Il, promPlly.aen,d us ooplos 0111\11 10001 po,
\ 'fl'ors 1I11u\111Ie I>rollohl,
0, A person eel!klno OOYerlloe ~l?r Oomllge To
Your Auto muslllleol .
1, Tllke rellsonoblo elape IIftar IDee to pro.
tllOl "your oOyeretllllllo" , 0 r any "non.
ownen eUlo" and t1llllr equlpmanl from
IlIrther loss, Wa will PIlY rellsonpble IIX. '
panses Inollrred to do Ihls,
Il, Promptly no\lfy the pollooll "your ooyared
lIuto" or any "non.ownod 111110" Ie 9101pn,
3, Parmlt liS 10 Inspeot and opPrlllse tho
ctomnged propal1y before Ite rapolr or dls.
posol,
IV" PART p. GaNaRA~ PROVII:lIONB
Part P Is amended liS followel
A, Tho Tormlnallon proYlslon Is replooed by the
following I
TERMINATION,
000848
\
Il, We mpy ollnopl by mlllllno Ip \llP
nllmpct InS\lrlltl shown In thll
PllolorAtlons PI \llIl i1ddrllsS
shown In Ihlo polloYI
11, Allllnel 15 tlays nO\lop pI
oanollllp\lonl
(1) II np\lollle IIUaptlVIl wllhln Ihll
"ra160 t1I1YP lhle po!loy Is In eft
I(lql nnd this Is nolll rllnllWfll Pf
oon\IIWllllon polloYI
(Il) For nonpllymanl 01 prllml\lml
(3)' If the nrlVllr's Ilollnee of the
nl\mllt1 Ins\lrll(f shown In Ihe
Pllolpfll\lons hilS peen SIlS.
Pllndatl pr reyoked IlIl11r Ihll
llffeo\lvo tlllte If Ihls polloy has
peen In eUeol Illss limn tlnll
yelln or II Ihp polloy has !Jaen
In al/eot lonoer Ihlln ona yellr,
slnoa Ihe los\ IInnlvarsllry of
thl! orlolnal elleo\lva dlllel or
IJ, At lellsl 60 days nolloa II the polley
Wlls,obllllned thro~oh mlllerlol mle.
repreeanto\lon,
Our rloht to oonool Ihl9 polloy Is slllJjeol \0 Ihe
IImlllltlone oonllllnen In the llppllollble
Pennsylvllnlo SlolutllS, .
NonreneWlll, U Wo daeldo not 10 renew or
'oontlnlle Il1ls polloy, we will mall to the nomlld
1I1ellred ehown In tha Oelllnrn\lonp III Ihe
Ilddrees ellOwn In Ihle plllloYI
1, At 1lI1I9t 16 dllYs nO\loa,pafora the end 01
Ihe polloy parlodl
Il, For nonpllymanl of ,iremluml or
b, IIlha drlvar's IIoel1se of Ihe named
Insured el10wn Inlhll Oaolaratlone
hlle belln suspended or revoked
aller 1I111 elleotlve date II Ihls polloy
hlle blllln In elleolless that one yean
or II the policy has be.an In elleol
10noorthal1 one year, slnoo Ihe lasl
onnlvereary of Iho orglnlal effeotlve
date,
"
I
I
I
I
4,
(l, ' a\lpmll, l1e Pll(ln liS' we rPlleonlllJly
rllqulral
A, To pl1Yelonlllxnme lJy physlolnns Wll
snlllol, WI) will pny lor t1l1lQo llXnrnu,
b, To aXllmlnll\lon umlar oath nntl
S\1\lsorlpe the sprne,
AIIlhorl~a \Is to optnll1l '
A, Mpdloul ruporl<<llInd
p, Pillar partlnan! rlloornS,
Elupmllll proof of lo<<s whlln required IlY
liS,
II,
QlIl1pellllllon, Thle polloy may ba oenoelled
durh1g lho polloy period lie followel
1, The namad Insured Ahown lln tho Oeolo.
rllllone may osnoel bYI
a, Rel\ltnlno this polloy to IISI or
b, Glvlno us adYllnoo written nolloe 01
Ihe dete OUl1oollo\lOI1 19 10 teka eft
feol,
2, At leust 50 naye nolloe he fore tho el1d of
the polloy period In all other oases"
HoweVllr, our right to nonrenew this polloy Is
BubJoOI to the IImlla\lolle oontalnod In the
oppllooble Pennaylval1la Statu,tes,
Automallo Termlnallon, II we offer to renew
or oon\lnlJe and you' or your ropreellnlo\lye do
Oopyright, InsurenoD Satvloes Ollloe, Ino" 1992 I'agll 2 01 3
PP 01111 00 Oll
flflO~pUOPIlB '
J.,OQ!3 flAYA!31-1l PI-AU!3t=
-
~ose PIIYIIOI
,
l.oes or ~lImllOll \lI1dar Ihls pollpy shulllJll plllq,llS Inlerllst mny IIppanr, 10 yoU an(1 Ihl11os8 PUYllll shown In Il1ll PllolArlltlpl1s
or In thle on~oraement, This InS~fanOa with feepllol 10 Ihllll1tprllsl of Ihllloss paYlle, eholll101 paoomplnYl\lItlllUolI~se of
YO~f Irn~tllllllntllotG Ilr omlsslpns ~l1ll1ss \ho loes rllsulls Irom ypur Qonverslon, soorllllon or IlmIJll111olT1ont 01 "YOUf
ooveretlllu\o", Howllver, Wll rllSllrye Iha rloht 10 Pllnoallhll plllloy liS pormllllld PV polloy tmms IInr1111ll Psl1Pllllllllon shllll
\IHmlnAIlllhle 1I0rapmlln\!ls 10 11111 loss pllyua's IntllrPsl, We will olvo tho SIlIl111lltlvllnoo notloll of oonosllsllon to Iholoss
pllyee lie Wll OIVOlo Ihll nAmlltllnsuracl shown In the PaolllrUllone,
WI11ln Wll PIIY 11111 lOGs PllYllO wa el1l1l1, 10 Ihll exlenl 01 pllYll1onl, lJe sUprOOIl\ed to Ihplose pllyae's rlol1ts pI fooovpry,
This enr1orSllll1ant must 1JIlllllll0hon 10 thll Ol1onoo t=ndorsament wl10n ISS\lad aftllr Ihe polloy Is wrlltan,
flflOl)O~aBBIl
Qopyrlghl, lilsumiloe Belvloes Olfloe,lno" 1986
000850
"
I ' '" "
,,(.., ,'(I',
,t. , ,
"
\1
"
1'_.
~ " ..
"
" "
, "
"
,
r j.l,
1
II tho 13011IlQ\llp or ppolorAllon~ Indl'
Plllas 111111 AIIIloQ Flrsl Pllrly I3pnlltlls
apply wo will poy Mda(l Flrsl Pl\rly
13011ll1lls Inaloll\1 (If II111l3polo Flrsl PAr\y
l3onollllp or lQr pn "Inaurpd" who SIIS.
IlIlns "pocllly Il1j~ry", Tl10 "Po(llly In'
IIlIY" mllut PO ollllSl1d IlY Iln opol(lpnl
orlulng PilI of tha molntpnonoe or uso of II "mot
lor Vohlnlo", ThoSll hlll1pllls 11m sllPlaol \0 Iha
prpvlslons III tho ApI,
!Ml\apt 10, ,he IImlle shown In Iho I3PI,1I1t111111 or
poo IIrllllone, MIllld Flfst Pllrty l30npllls opn.
sl~1 ollhe followlnOI '
1, Matflpal llxpanBas 110 Qllsorlpll(f In Iha
I3l1slo Flrsl Pllrty l3anotll,
000853
a, WOfk lo~s,
A, ~lIsa of Inoomll, l,Jp 10 PP% 01 groBs
Inopme lIollllllly loet Py 011 "Insllrad"
II~ II result ollhe AOolnunl,
j.l, Rallsol1l1plo axpansae AoI~lIl1y In.
ourrod 10 reduoe loss pf Inllome py
hlrlnOI
(1) 13peollll help, Iherepy enopllng
\In "Insllrod" 10 workl or ..
(ll) A ollbstllUle 10 parfol'm Ihe
work 0 eoll.amployett "In.
, ellred" woulq hllye pllrfprmed,
Howevar, work lous does not II10tudel
a, ~oss of expaole!l 1I100me or ex.
panses Inourred for 811IVloes per.
formlld aller the dalllh of an
"lnsllrlld"I'or
;I, oh [oils Pf trooks,"
p, "Ins\ltod" lis lI~od In this IImlofellmul1l moal1a'
1, Yo~ or IIny "fllmllv mompor",
a, ' Any othllr porson wl1l1oi
p, "Opo\lpylnu" "your oovofpd 11\110" I
or '
II,
. I"
Not "oopupylno" II "motor vlll1lolo"
IIlnj~rlld liS II rll61l11 olAn 1I00ltfonlln
Pennsylvanlo Involvlno "yollr OOy.
eradll\IIP",
II "your poyarpd A\lto" Is 110fklld IIl1d \In-
ooc\lpluQ it 16 n\1t II limo or yehlolll" In.
VolyaQ In tin Aoolnanl unllles II 10 pmkeQ 111
11 monner whloh orall\a6 IIn IInr\lIlBOI1I1PIIl
risk 01 Injury ,
f'IRIlT PARTY III!NI!f'ITS POV~RAGI!
A, I3ABIO FIRST PAR'fY I'l~N~f'IT
INSURINQ AQRIiI!MI!NT
, We wllloav, In 1I000rdnnoo wllh the Aot, Il1e
l3a610 Flrsl Pllrty l3enlltll 10 Of lor an "lnellret1"
who 6uslalna "pot1l1y Injury", The "podlly 111'
, jllry" must pe oallseQ Py an aoolnent mlslno 0111
of Ihe mlllntenanoo or usa of a "molar vehlole",
Bupjeol 10 Iho IImll ehown In the Sohedule or
Pllolarlltlon, tho l3aelo Flrot Parly l3enaflt oon.
elelsol:
Mectloal axpanses, Reasonllblllllnd napeeeary
medloal axpenseSlnOllrfed for on "lneurad's"l
1, Oarol
II, Reooyeryl or
B, Rehubllllatlol1,
1.1, Any loes ollnooma, or expensee In.
ourred lor saIVloee parformen, nur-
Ino Iho lIrsl 6 working dllYo Iho
"Insured" did nol work dlle to "bod.
lIylnjllry",
(I, Funeral expeneDR, Funaral or burial ex.
penees 1I0tllally 1110llrred II "bodily Injllry"
oaueee an "Insumd'e" death wllhln 24
mOl1ll1o from \he dale of Ihu aooldent,
4, Aooldanlal death, A uaalh bonefll paid It
"podlly Injury" oauees Iha dealh of you or
any "Iumlly member" within l!4 monthe
Irom Ihe date of the Moldenl,
We will pay eooldantal death 10 the exeou-
lor or administrator of Ihe deoeased
"Ineured'e" eblala, It thole Is no exeoutor
or admlnletratot, Ihe benefit ahall be paid
tOI :
Oopyrlght, Ineuranoe BeIVjoBs Offloe, Ino" 10na Pege 2 01 4
This Inollldeoremedlal Ollro ond troutment ren.
dered In aooOrdal1011 wllh 0 reoonllnlzad rell-
oloue method of hl1l1l1ng,
Medloal expensee will be pllld Itlnourrild wllhln
10 l'lIonths Irom the nllte 01 the acoldunt oaus.
Ino "bodily Injllry", Howover, It wllhln 10
months from \lIe dele 01 \I1111l001tfont, 11 oan be
detefmlned with reasonabla madloal probability
Ihlll additional oxpenees may blllnoufred lifter
'thl9 parlod,lhe 10 month lime IImll will not apply
10 Iha paymant of Iho additional medloal ox.
pensee,
B, ADDllD FIRST PARTY BENEFITS'
PP 011 111 "02
I "
1\, Tha ownar 01 onll or morl!
rllolst\1rlld "mptor vahh
olas", nono PI Wlllph I1I1Vo In
ollllOlllw Ilnllnollll rll~pon'
~lIlllllY tllq~lfon Py Iha AQtl
or
p, "Oooupylno" 11 "mplor yo,
, hlolo" ownfld Py 1I1llt pllfPpn for
wlllol1 \lw f1nllnpllll rllsponslhlllly rll'
q~lrlld Py Ihe Aot I~ not In Illlaol,
ft. MlllntPlnlng or using A "motPfYIl,
hlolll" wlllla 1001llflcllor ~Sll Il~ II
rasldanoa or prllmlslls,
7, Whllll j'ooo~pYlnolllll
1\, Raorllllllonpl .' vahlolll da,
sloned 10f IIsa nil pllllllo rOlldQl or
~, Motoroyole, moped or Illmllllr.\Vpa
vllhlolll,
'13, We no nol provide Flrsl Party l3enallls Oovor."
aOlllor "podlly Injllry"l
1, B~sllllnad Ily II pedestrllln If IIll1l1ooldent
ooo~rs olltslda of Penl1sylvllnlll, Tills ex.
oluslon (13,1.) doell nol apply 101
II, YO~I or
b, Any "family member",
a, Gllllead Ily or AS II oonsequenoa 011
II, PlsohllfOll, 01 II nuoleflr weapon
(even If 1I00ldentlll)1
b, Wllr (neolorod or undaolllredll
0, Olvll wan
I
1\, Tho QllollllSlld "lI\SUrlHl's': s\uvlvlng
Spo\lsOI of .
p, If lhflr\1 Is np s\lfvlvlno epouso, 1110
daoPllfillcl "Insut\ld'e" 's\lrvlvlno
ohllnfPnlPr ,.. ,.
0, If '"arll II no IllJrvlvlng IlPOUSO or
llhlldrllnl 10 'thll dooollSa(1
"lnS\lfllC1'fi"Psllllp,
0, OOMJ:lINATION FIRST FARTY I3!:NflFITS
Illha !3ohed\lla or Paolllrll\lons Innlpl\las thlll
Opmlllnllllon Flrfit Party I3flnllflls ppply, WP will
PIlY OP, fn\llnlltlon Flrsl PlII1y I3llnll,flls InotoAn 01
\Ill! I3l1slo Flrel Pllrty I3llnelil IQ or lor IIn "In.
fluredll who sUstPlns "Pllolly Injuryll, Tha
"\lotilly InJllry" m~fit PII PA~Slld Ily IIn Ilooltianl
arlslno out 01 Ihe mlllnlllnonpo or Ufill of II "mo. ,
lor yehlole", These penllflls lire s\Jhjoot 10 the
prpvlQlonll of Ihll Aot,
Bulljeot to Ihll IIrnlle ehownln Ih.o Sohodlllo or
Poolllra\lonsj Oomlllnlltllm FlfSI PallY l3eneflls
oonslsl of the followlno, ae desorlllocl In Iha
f:laelo Flfst Party l30nflflls AnQ Addod flrel Party
l3aneflls,
1. MlldloalllXpenal1s,
a, Work loss,
a, Fllneral expansee,
,
,4, Moldantlll delllh,
IlXOI.UBIONS
A". We no not prOVide First Parly l3eneflle Oovor.
age for "podlly Inj~ry" e~stalned Ily l1ny persolll
1, Willie Intenllonlllly olluslng or IIttl1mpllno
10 oause "bodily InjUry" to hlmeelf or any
other pelson, We will nol pay 1I00ldanlel
deoth On behall pf Ihot porson,
2, While oommltllng II lelany,
a, Whlla eeaklng 10 elllde lawflll apprehen. "i
slon or arreat by a low enloroemanlolll'
olal, " '
.1
4, While maintaining or us/no a "motor vehl.
ola" knOWingly oonvortad by that pereon,
This llxolllelon (A,4,) doee nol apply tOI
a, YOUI or
000854
d, Insllrreollonlor
,,' e, Robelllon orrovol\ltlon,
a, From or as, II Olmeeqllenoa 01 tha follow.
lng, whether oontrolled or unoonlrolled or
howevor oaueedl
Il, Nuolaarrellollonl
b, Radllltlonlor
Q, Rodlollotlye Qonlamlnpllon,
I.IMIT ofll.iABIl.ITY
b, Any "family membor",
WI1P, al the time 01 the aooldent, lei '
A. The limits of liability ehown In Ihe Sohe~ule or
Ollolnratlone for tha f1telparty benollle that ap'
ply Pre tho most we will pay to or for eaoh "In~
Silted" as the teslIlI 01 any ona eooldent,
regatdless ollha nllmber 011 " '
Oopyrlght, Iheutanoe Servlooe Olfloo, 1110" 1992 Plllle 3 Dr. 4
II,
PP Dlllll 11 92
. ,
1, Plplln~ mllctol \, '
II, V\lhlolo~ or prllmlllms shpwnln tlw pop,
Iprptlpnsl \ ' I
~, Vlllllpllls Involved In tha IIPlllctonl1 or
1I,Insurllip provldlno flral plllly llano lila,
p, II Qomplnn\lon Flrsl PPr\y I'lunllflls Pro nllorllod,
we will mllka lIvlIlIlIplo nllaflsl tlla mlnlm~ln limit
req~lf\lclllY Ihe APj for Iho ~lIslo Flrsl Pm1Y
l3anaflt, Tills provls pn (13,) Will not olll\l1oe O\lr
mll~lm\Hn limit olllnllllllY,
0, Any hmounls PIlYIIPIIl \lnqllf tll18 Dove mop ehnll
Ila P~O\lSS oyor lIl1V IImOllnlsl
I. Pnltll
II, PlIynblalor
G, Roq\llract 10 pe proYlqadl
to lIn 'ljnsllrlld" ~ndnr !lny workerp' Dampen,
sllllpn IlIw or slmllllr Inw,
flRIORITI~1l OF pOl-lOlaa
A. We will pay first pPrty penellls In 1I000rclllnoo
wllh Iho ornar of priorities sot lor\h Py 1110 AOI,
We will not PIlY If Ihera Is IInolhor Ineurer nt II
hlOllPr laYlI1 01 prlorlly, The Flral oll\egory listen
below Is tho hlohest IllYlll of priority IInd tho
Fourth oalegory Is the lowaallevel of prlorlly,
The prlorl1Y order lal
"
fllrot The Inellrar provlqlno benellle to
the "lnS\lrlld" as a nnmed In.
, sured,
Seoond The Insurer p,rovldlno penollls 10
Ihe "lnsuret1' es II family momber
who Is not a namod Ineurod under
onolher polloy providing ooyer.
Ilge \lndertho Aot, '
Third The Insurer 01 tho "rnolor yehl.
ole'! whloh Ihe Ilnallred" Is "00.
oupylno" III tha lime of Iho
eooldent.
Th'6lnsurer of eny "motor yehl.
olelllnyolvod In tho aooldant If the
"Insured" Is 11011 '
F04,rth
. ,
p,' ) "oooIlPylno" II "mlltor YO'.
hlolq"il\ncl ,
PI Prllvlqocl flr~t PI\r\y ponqllls
\Jntlpr !my p\h\lr I\ulomolllln
ppllpy,
An ~nooo\Jplllq [Jllrkod "mplor
yohlole" Is npI 11 ' motor vahlol\l"
Invplvod In IInlloplnont \mlllsp Itls
pllrklltlln A mllnnar whloh orfll\les lIn IIn.
rOllsonoplo rink of InJmy,
If II or more pollolaa hllvn llq\11I1 prlorlly wllllln
tha hlghoel lIppllPlIlllo priority IllVlllI
1, Tho Inellror aglllnat whom \ha olalm Is first
mRdo I\holl prooosa IInd pPy Iha olnlm liP
II Wholly raeponslhlo, The Ins~ror Is Ihlln
enlllled 10 reoovor oonlrlp~tlon pro rlllll
from IIny olhllr Insurllr for Ihll l1anoll\8
palt1 IInt1 Ihll 00sl8 of prQoe8slno Iha
ollllm, II elloh ponlrlpu\lon 18 so~gh\
IImong Insllrore \mtler the FoU[th prlllrlty,
pro.rlltlon ehlllllle Illlsed pn Ihe numller
ollnvolvecl mOtor yehlollls, .'
~t II W\l lire Ihe Insllror 1I0fllnst whom Iho
.. ollllrn Is flrel mlldll, our pllymenl 10 or lor
on "ln8I1red" will not o~oellll Ihe IIppllop,
, pie limit olllaplllty lor Flrl\l Party I3flnell\a
Ooyerlloa shown In the 80hadllle or Oeo,
IlIrllllot1s, '
at The moxlm~m reoovery IInder 1111 pollolep
will not exoeect Iho IImounl Pllypllla ~lncter
Ihe policy with Iha hlghllelllmlt of IIl1blllly,
I'
NON,PUfll.loATION OF aaNlaFITS
000855
II,
0,
No llne will po enlllled to reoover t1~pllollle poymenle
for the SlIma olements 01 foes lIndllr Ihls or IIny other
similar Insuronoe Inoludlng eelfolnaurllt1oe, '
III, PART F .lllaNIlRAI. PROVISIONS
Part F Ie omanded liS foII0WSI
Tllo Our RighI To t,oooyer paymenl provlelcn doee
not apply,
"
Thla ondorsemont mllsl bo attaohod to the Ohal1go I:ndoreemont whol1lse~ed ollsr tho polloy Ie written,
liP 06 III 11 92
I,
Oopyrlght, II1~ural1oe Betvloes 011108, Ino" 1 002
11"08,4014
" ,
.
UNINf3URI=P MOTPAI&Tf3 OOYI=AAlll= ~,PI=NN!:IY~YANIA (NPN,f3TAPI(I=P)
, ,\ I '__1' '.
PPP04"110lJ~
O-G-g.g.a,ij.
PpVllrllOll ,. prpvlt:\lIt:\ whllr" II prflmllm1Anr.l IImll 01 IIAPlllly ,. .hown l\"lr Ihp PQV!lrllp!l lln 11111 t1pplArlllllln pPPll,
I, PPI1 0, Unlnsllrllt:l Molorl_I" PpVllrllOG 18 replpped py Itlll Illllowlnlll
aOHPPIJl-fl
UNINIlURflP MOTORISTP OO\lJ;AAQP
Peporlpllon
QI Vehicle
I-Imllol
. I-Inl1ll1IV
Prllmlum
III
.--
III
,
III
III
II
~
III
"
"INaURINQAQR~~Mr:NT
A, We will pRy ocmpenBAlory dRmlloas Whloh IIn "In.
Bur\ld"Is IROIIII~ entitled 10 reoovar Irom the owner or
operAtor 01 An I uninsured molcr vehicle" lleoRuse 01
"bodily InJury" I
1. Sustalnod by Il,n "lnBllred"l
2, Caused by an 1I00ldenl,
Tha ownar'e or operalor'B liability for Ihaso damlloee
muot Arlee oul 01 Ihe ownership, mlllntenanoe or lIeo
01 the "lInln~ured molor vehlole",
,- '.,
"
No judomenl lor demaoea arlelno out 01 II eult brouohl
1I0alnet Ihe owner or oparalof of 1111 "lInlnsllret1 molor
vllhlolo" Is Illnnlnl) on us unless wel "
1, Raoolvod roaeonable notloe of the pendenoy 01
the suit resulllno In Iho jlldomenllllnd
2, Had a reaaoneblo opportunity 10 protool our In.
lareels In Ihe Bull,' ,
~
B,' "Insurod" as ueed In this endorsement,maanBI
3, Any person lor damages that parson Ie entitled
to reooyer beoauee 01 "bodily InMy" 10 whloh
this OOYerage applies sustalnod by a pereon
daaorlbed In 1, or 2, abovo,
0, "UnlnB\lfed mclcr vahlolell meBne II land molor vahl.
ole or Irllllor olllny IYPlll
, "
1, To whloh no podlly Injury IIBPlllty Ilont:\ or polllly
npplles at thellme 01 Iha lIooldonl.
,,2, Whloh Is A hlt'lInd.run vehlole whoee operator
or ownar oannot be Idanlllled ann whloh hlte or
whloh oa~eee I\n aoolelenl reeultlno In "Ilolllly
Injllry" WlthoUI hlttlnOI
a, ,you or Rny "llImlly momllef"l
Il. p yehlolo whloh you or eny "family mam-
berl! lire "oooupylno"l or
0, ,','your oovered 111110",
If Ihere Ie no oonlaol with Ihe hlt.and.run vehl'
ole, tho faote 01 Ihe aooldont mllsl be proved,
If Iho eooldent Wile aile godly ollueed by an IInl.
dentlflad hlt.and.run yahlolll and Iho drlyer [1or
Ihll ownar oan Ile Idantlflbd, Ihe aooldonl mllsl
Iletaported 10 Ihe polloe O( Ilroper govarn.
menIal allthorlly within BO daye rom Ihe date 01
tho aooldont, Notloa ol,\he aooldent must be
given to us wllhln BO days, or lie sOon as praotl.
cable \hereafter,
To whloh a bodily Injllry liability bond or polloy
appllos lit the lime 01 the lIooldonl bul Ihe bond.
Ing or Insuring oompanyl
a, . danlee OOYlltagol or
3,
'1. You or Ilny "Iamlly member" I
2, Any olher person "ooollpylno" "your oovorad
auto",
PPD'04 2110 93
Page 1 /)f 3
, l
Il, I~ or PIlPOmoal
(') Insolvon\i or
(;ill Inyolvpd In Insolvllnoy prooolln/n~~"
Howavllr, "lInlna\lr\lq rnolllf vlll1/olo" dOllS nol In,
pl\)clp flrW V\ll1loll1 pr ll11ulpmonll
" . Qwnecl Py or fumlal10n for Iho rOOlllllr pso pI YOII
or \lny "fllmlly mamller,"
il, Ownpd or pperalaq Py a splHns\lror unclaf any
IIppllollllle mplm val1lolp low, oxollpl u soli.
Ins~rflr wl1loh 10 pr lll/pOmos Insolvunt,
(l, Ownet1lly IIny Ilovflrnmantlll unit or lIoanoy,
4, Operlllaqon rlllls,or prllwler trellds,
6, Pllslonfld mlllnly tor Usa pit p~llllo rOllds whllo
not on pIIPllo rOllds,
13, While looalad fOf ~sef\s II rasl(lanpa or prem.
Isoe,
00085'(
"
'1,
I!XPI-USIONS
A, We do npI provide Unlns~rerJ Molorlsts Oovaroga for
"Ilodlly h1j\lry". aU,otalnad Ily IIny parsonl
" If \11111 person or Ihe la(J1I1 represenlllllYu eeUlue
Il1a Ilonlly Inj~ry olalf]1 wllhou! our wrlllen oon.
senl, Howevar, Ihle aXOlllslon (A,1,) qpee nol
liP ply II suoh seWarnant nOlls not IIdyeroely III.
leolourrlohte, .
/il, ' Willie "ooollpylng" "your oovaretllllllo" when
, II Ie pelng IIsad liS 0 publlq or livery oonyeyanoe,
This exoluslon (A,2,) dooa not IIpply to II shnre.
the.expense ollr pool, "
(3, Uelng II yehlole wllhoul Iha parmlsslon of Il1e
owner,
a, We do nol proYlde Unl~o~racl Molorlole Oovarage lor
"non.eoonomlo lOBS" SUstained by any parson 10
whom tho IIrnlled tort allarnallye applies, roeultlng
from "podlly Injury" o/1l1eon by an aooldent InvolYlno
an "uninsured motor yehlole," IInleae Ihe "bOdily In.
Jury" auslalfled Is a "eerlous Injury,"
.' Thle IIxol~lon (a,) does not IIpplYI
1, If tha owner or oparlltor of the "unlneurad rnotor
" yehlola"I "
a, Is oonvloled, or aoollpls Aooaleraletl
, RehabllltallYD Oleposltlon, for driving un.
der the Influanoe of alool1ol or a oontrollod
SlIbslllnoe In Ihat lIooldanll
b, Ie operating a rnotor yeh/ole roolalerlld In
enolhar stalal or
PPD 04 a1 1093
I
p, Inlands 1\1 Injllr(l hlmspll PI' An;
otlWI' parson, provlqaq tl1l1l \ll11
1t1QlVlduol rlo11s nol Inlpntlonplly
InJ\lrll hlmeolf or lInp\l)llr pllrepn
, " . ' " muraly 11Ooll\jSII his Ill'll or tlllhn\l
to oct la Inlllntlonal or 001111 wlfh
his rllAII~lIl1on Ihul II prllllllls II
orllVII risk pf onualn(J Injury II tha lIot or
pmmleelon of\\!slno tha Inj\lry Ie tor \1)11
purposlI plllvllrtlno'podlly hllrm tll hhl1sll11
or anol/lOr pllrson,
11, II thai parspn Is Injurlld whllll "ooo~pYlnll" II
mOlof valllole Ins~rorJ undar II pomrnerloal mo'
lor val1lpla Insuranoo polloy,
0, This pOVOrllOU sl1l1l1 npl apply Olroo\ly Ilr Indlrllolly to
paneflt Any InSllrllr or solHns\lIl1r undar IIny pI Ihe ,
IplloWlno or similar IIIWI
. " Workars' oompllnuallpn loWI pr '
2, Dlsllblllly penollle IIIW,
D,' We do not prpvlda Unlns~red Molorlsla OOYl1raOe lor
p~nlllve or llKempfllry dllm!Igas,
I.IMIT OF I..IAPII.1TY
A, Tile IImll of IIl1blllly shown In Iha aol1ed~la or In ,Ihe
Peolllrl1t1pne for Unlns~red Motorlsls Ooyarage la our
mllxlmum IImll 01 IIl1blllty for 1111 dllmllges rosullln~
frorn anYone 1I0olnent" 'fhls Is tha moat we will pay
ragart1less 01 Ihe numller ofl
1, "Insuredsl"
d
11, Olalme maclol
ll, Vehlolee or premlllms shown In Ihe Sohedula
or In tho Daolorallonsl or ,,'
4, Vehloles Inyolved In Ihe aooldllnt,
a, Any IImollnte payable for damaoas under Il1ls ooyer.
. age shalllle radllded Py ell allms rll1n beoause of the
"bOdily Injury" by or on behalf 0 pefsons or Or(Jan.
Izallone who rnllY be Illgally reeponslble, This In'
ofudea all sums paid lor Pf1 "Inellred's" a\tomay
ellhllr' dlreolly or aa part 01 tho amount paid 10 Ihe "In,
eured," lIaleo Inoludae all eurne paid lor the aame
darna(Jee undar Part A of Ihls polloy,
0, Any payment IInder this oovllrage will reduoll any
amoul1t Iha\ person Is antlllad to feooyer lor damages
under I=lart A of thle polloy,
D, No one will bll antlUad to teoelvo duplloate payments
for the same elemen\s of lo~s,
OTHllR INSURANOll
If Ihere Ie othor appllopble similar IneuranoD available undet
more than one polloy or provision 01 oOVeragel
Pago 2 01 3
APPI:AI.. RIGHTS
I:lloh Pllrty ehllll have Ihe right to appelll to the oOllrt
havlno jurlenlllllon IIn aWllrd of the arbitrators pro.
YIt1nd the IIppealle baeed upon an error of law, an or,
bllrllllon deolelon Ihat oHoeods the stilted Authority 01
thnllrllltrlltora I1nt1 eny right of IIppelll provided IInder
oommon IlIw arbitration, There shall be no right 01
appeal on queellons of loot regarding Ihe lIablllly of
tha owner or drlyer 01 Ihe "unlnsurod molClr vehlole"
or the amount of dllmlloes determined 10 be I'eooyer.
able from Iho owner or nrlyor of an "uninsured motor
vllhlole," '
II, " PART F. GENERAl.. PROVISIONS
The Polloy Period and Terrlloty proylslon In Part F Is
repllloed by the lollowlngl ,
POI..IOV paRloD
This polloy only opplloa to nooldents !lnd f\ltlses
whloh ooour dllrlng Ihe polloy period aa shown 111 the
Deolaratlons, "
ThP' folloWhiO prlprlll!ls Ilf rllaPVety apply: 0 0 0 8 5 8'
FlnH . Th\l lJnlns~rlJn MOIPllsls Oovllrnoa IIPplf~II' I
, pie to Ihu vphlolp IIW "Insured" Was "0001"
pylng" IIlthll IImll 01 tho pooldenl,
~fl~lpn~ Tha polloy !llfordlno lJnlnsmp(l MOlprlsls
OOYUrAgo to Iha "Insurlld" \IS a namod In.
surlld Of IAmlly mllmpar,
1, Whon thore Is ApplloAPlp Ineurpnoll pvallatlla
untlllr Iho Fire I priority I
p, Thllllmlt of IIPbllllY app,"oIlPIIIIIl tho vahl,
r.fll the "Insllrlld" WAS 'ooo~pYlnO", umler
Ihe flolloy In 11111 Flrsl priority, ehall firs I lIe
IlHhllUsllldlllnd "
b, The mllxlm~m rl100yary undar all pollolllS,
In, tho seoonn prlprlly sl1l\1I not eHoeo,d Ihe
Amo~nt by whloh Ihl! hlohest "mil for IIny
ona yahlole \.H1nar nny Ilna polloY In till!
SAoond priority OHOBllds Ihe IImllAppllplI'
Ille IIntlpr Ihe polloy In Ihll First priority,
2, When thore Ie no I1ppllooblolns~ranoe IIvallapllI
IIndl1r Ihll Flret prlorlly, Ihs mllKlmllm reoovary
undor 1111 polloles In tl1a Saoond priority sllol1 nol
eHp!led Ihe hlol1eslllppllollble limit for IIny ono
vuhloll1 under Ilny one polloy, ,
If two or mllro pollolee hovo eqUlI1 prlorlty,II10 Insllror
119llh1st whom Ihe ollllm Is flrel mllde shllll prooass
Pnd PIlY the ollllm liS If wholly roepOf1slblo for all
Insurere with oqulIl priority, The Ineurer Ie Iherellftar
enlltled 10 rBooyer oontrlbullon pro ralll Irom any
olher Ins~rer for Ihe benaflts Paid and the oosts of
prooeselng Ihe ololm,
If wa lire the Ineurer IIgalnsl whom Ihe olalm Is ftrsl
made, we will PIlY, sUbJeot to Iha limit 01 lIablllly
shown In Iha Sohedufe or In the Doolomtlol1s for
, Unlnsllrod Motorlelll OOYerage, alter we ant1 all othof
oonlrlbullng Insurors ogreel
" Whalher tho "Insured" Is IOOlllly enlllled to reo
cover damaoes Irom the OWnor or operalor of
IIn "unlneured motoryehlole"llInd
il, Ae to Iho omounl of damagee,
,:1,
ARBITRATlbN
A, SEl..l:OTfON OF ARBITRATORS
1/ we and an "Insured" dleogroa whether tho "111'
eurad" Is legally entitled 10 reoovar damaoee from tho
ownar or driver of an "unlnsurod motor yehlolo",or do ,
not IIgreo as to Iho amollnt of darnegae,lllthor parly "
, D,
I
'mllY mak" a Wihll1n damllnn for prIJ!trpllon, '
I:Hol1PI fpr \110 authpfltllls IIncl rlOhl~ SllIllItlln
paroorllphs 13'1 0, Ilntl p, pf thllSP orbltfllllon
proYls1ons, prpltrallpn ahall pa oondHPllI!lln
IIPoprdAnop with \11\.1 prllvlalllrls of Ihll
PllnnaylVpnl1l Unlfprm Arhltrlltlpn Aot, !:pph
pliny will s\lloot Iln Ilrpltralor, Tholwp
IIrllllrlltors will salPPt II Ihlrd. If Ihay ollnnot IIDrIlO
within ~p tlIlYS, olther mpy roq~ast Ihllt sllloolloll pe
mlldp py A Jut10\l III II oP~r\ haVing jurlstllotlon, I:lloh
pa, rty wlllrllY thllllHPllnaoe It In, purn ", nd papr tha llH'
peneos p thllthlrtlllrPllrptpr 11l1\lBIIV, Unfpss polh
Pllrtlaalloree otherwlne, IIrp, Itrllllpl1 will ,pko plllollln
111\1 oP~lIlly In whloh Iha' "Ihs~rlllf" resltles, '
I.IMITATION OF ARI3ITRATOR!:I' AlJTHORITY
The Ilulhorlty Illlhe IIrbltrlltors shllllllo IImltotllo dll'
oldlng thp 1I1l11lllty of thll owner Ill' tlrlvarllf 1111
"unlnsurlld molor vehlolll" And IImount of dllmlloea
rpooyeraple from Iho ownor or ctrlvar of IIn
"unlneuret1 mQtor vel1lole," The IImounl of IIny
pwnrt1 may po up 10 bUI not In eHoesa 01 Iho I..Imlt of
I..llIblllty ehown In Iho Sohad~le Ilr Pllplorllllone for
Unlns~red MotorlalB Qoyeraoe,
0, PIBoOVaRY RIGHTS
I:aoh Pllrty shllll hllye Ihll rlghl 01 full dlscoyory In.
0lunh1g, 1l~1 nolllmlted 10, depositions 01 Any Inyolven
party, roq~psts lor produollol1 of dooumenle suoh ee
empfoymont lInd medlolll reoords, and Ihe rig hI 10
perlorm perlocllc medlool OKllmll1allons on any per,
son milking II ollllm undar Ihle ooyerllge,
':
13,
Thill endorsemenl must be aUaohed to thoOhanga I:ndorsarnont whon Issllad lifter the polloy 10 wrllten,
PPD 04 21 1093
Page 3 of 3
" I
UNPFRIN~URt:P MOTOAlflT~ OOVI=RAQt: . p~NNaYhVANIA (NON.flTAO~I=P)
t. ,. \'{' "~I,
o 0 OS 6 d I , PPP P4 171 P Il~
, '
o!wllrl\~1l11l prpvl~lIc1 wherp p prlJmlum nnclllmll 01 IInpllllV I~ IllloWn for Ihll Pllverpop pn Ihll ~IIQlllrllllrm PI\~Il,
SOH~PUI-F
UNP~RINEl~A~P MOTPRlElTEl POVRAA~R
PllllPrlpllon
01 Val1lplo
I-lmllPI
I-IAlJlilly
'-
,
,
$
INSURING fii:lRIlIlMIlNT
A, WfJ will PIlY oompllnslllory nllmnoes whlph IIn "In.
lI~red"ls laOAlly enllllod 10 reooyer from the ownar or
opem\or ollln "lIndarlnllllred molor vetllole" ba.
OIl~lIe of "lJorlllylnj~lry"1
" 8~ellllned Ily IIn "Ins~rad" I and
II, Ollused by IIn aooldanl,
The owner'lI or oporlllor's 1I1llllllly lor Ihase dllmoglle
m\lollulsa o~t of Ihe' ownership, malntenenoe or \lse
01 Ihe '! \lnnerlns\lran molor yahlola", We will PIlY
under Ihle OOVerllga only lIf\ar the IImlls of 1I111llllly un.
der any appllollllle bo(llly Injury 1I111llllty bonds or poll.
oles haye Ileen axhllueled ~YPllymenl olJlldgmonte
, or selllamllntll, "
No jlldgment for damlloee nrlslng oUI of II ellllllrolloht
IIgolnllllhe owner or oplll'ntor ollln "lIndarlneured
molor vehlola" 1lIIllndlno on ue unless wel
1, Reoelvad reaeonallle nolloe 01 tha pandenoy of
Ihe suit resulting In Iho judgmonll and
\l, Had II reosonnblo opportllnlty 10 proleol our In.
lereets In Ihe e~lt,
a, ,,"lnsuroLi" oe usod In Ihle endorllemen\ mallns!
1. Youorany"famllymembef"l
\l, Any olher parson "oooupylng" "your oovored
auto",
G, Any person for demngee thaI pereon Is enlllled
10, ,reoover beoausa 01 "bodily Injury" 10 whloh
Ihle ooveragll applies sustained by a Pareon
'desorlbed In 1, or 2, ebuye,
PPD 0417 1093
, Pruml\lm
"
$
$~
,
,
0, "\.Inclerlnll~rerl molor vnl1lole" mellnsn Innd molor
val1lole or Irnller of IIny type 10 WI1I11h a Ilodlly Injury II.
1I1lllllY poncl or pollpy IIppllas III Il1e lime ollhe 11001,
donI llul Ihe IIrno~n\ pllln for "podlly InJ~lry" unrler 111111
Ilomj or polloY 10 an "Ins~ran" Is nol eno~gh 10PllY
illS lullnmollnl\ha "Ineuran" Is lagally antlllad 10 re.,
oover 1111 dllmnOes,
However, "~nderlnsLlrad mplor vehlolll" does nlllln.
olude IIny vahlole or aqulpman\l
1, Ownad Ily or 1\lrnlllhed for Il1e reoular uso of YOII
or My "fllmlly membar,"
,2, For wl1loh IIl1blllly ooverage .Ie prOVided under '
Pari A ofthls polloy, '
3, Owned Ily IIny goyarnmanllll IInll or IIgenoy,
4, Operllted on rllllll or mewler\reads"
6, Deelgned mainly lor IIse off pullllo roods while
not on pUbllo rOllde,
0, While looaled for use liS e resldenoa or premo
Inee,
EXO~USIONB
A, We do nol proylda Underlnsllred Motorlets Ooverage
for" bodily InJury" sUlItalnad by any pereonl
1, If Ihal person or the legal repreeentatlve setllee
Ihe bodily Injury olalm wllhoul our wrltlen Don.
senl,
,
2, While "oooupylng" "your oovered auto" when
It Is being used as 0 publlo or livery oonvayllnoll,
Thle eMoluslon (A,\l,) dons nol apply 10 a ehare. .
Ihe.eMpense oar pool,'
PlIge 1 of 3
" l I " .,1 ,
~, !Jslng P VPh1p11) wlll1p~t Il1p parml~slon ~11I1ll ~.'T'lIIl1mll olllAPllltY ehllll P\I rer1~ppq P~ 1111:
owner. ) pum~ pplt1 P, 1l0pusa Ill, Iha"por1l1y InJ~ry' Ily
( n n ~ 6 1 !/r on pahllll 01 pprsonp or prOpl1l~p\lons who
R, Wp qp not provlr1O IJnt1prlns~r(ld Molorlsts Oovpr~'ob' i 1; mllY pp IlIlllllly rllsponplpla, Tills Inol~\1I1s pll
for IInpn,pponpmlp 108s" pUstlllnacl py IIny pllfSOn 10 . sumo pAid for pn "lne~rllt1'sll f.I\\orl1\1Y llllhor
wl10m Ihll Iimllor1lprt III111rl1I11IVll IIppllas, ros\lllln\l nlr\lo\lvpr "s pprt 01 II1\1l1mo\lIl\ plllQ Ip \ho ,
Irpm "P,Ot1I1Y, Injury" PI\,~SlId py PI1A, oolden,I Invplvlno "Insured." ,h AISP,ll1olUQOP 1111 Q,~ms P"pld for
IIn "unclarlnslnod mlltor vpl1lplll," unloQs 1I1ll "llOqlly Il1a BlImp dpmlloas ~nqor PArt A ol\l1ls ppllpy,
Inj~ry" ~~P\IIII1Pqls II "sorlo~s Inj\lry," ' ,
0, Any pllyment unt10r Ihls Qovornoa will rod\JPI1 onY
Thill e~01~810n (~,) doo" nplllPPIYI IImO\m\ Ihl\l parson 1811n\l\llld 10 rllPover for 111118Amll
1,. If tho Ilwnor or oporAtor 01 Iho l'undllrlns\Hed nlltnlloee undar p\lr\ A of Ihls pplloy,
molor yphlpla"l. .' p, No onll will pe pn\ltlacl 10 rllPplYIl q~PIlPlllo pllymlln\s '
II, la oonvlolet1, or popepls Aopalllrllllld IIlr\111l ellmlllllomef1\S 01lPS8,
Rllhlllllllllltlye Plsposl\lpn, fpr tlrlvlno un. OTHI:lR INIlURANO~
d\lr Il1lllnflUllnoll of 111001101 pr p oonlrollod ,
e~llelllnoe In Il1l1t IIpolnllnll
Il, Is op\1rIl\lno II molor yohlola rOolQtflrod In
IInotl1pr IllplolPr
0, Inlenr11l 10 Inl~rll him sell Of pnolhar per.
lion, prllvlded Ihplll1e InnlvldulIl does nol
Inlen\lonally Injure hlmspll or IInolhar per.
son mil rilly Ileollllee I1le polor lallure 10
aol I~ Inlentlonpl or lfonll wlll1l1ls rllllll~II'
\Ion 11111111 oreallle 11 Orllve risk of oll~elno
Injllry IIlhe 1I0\or ommleelol1 ol\~eln\J the
n IIry IA lor Ihll p~rpoae of iwertlng I>odlly
harm 10 I1lmsell or Another person,
Il, II Ihlll parson Is Injured whllll "oppupylno" n
molor Yphlple InsUrfld unnor II pommerloal mo.
loryehlpla Ine\Jrllnpe plllloy, .
0, This ooverll\Jo ehAIl nOl, IIpply dlreotly or Indlreotly 10
bpl10flt IIny Ins~rer or sallolnsurer IIndor any of Ihe
followlno or slmllllr IlIwl
1, WaLkers' oompenes\lon IIlWI or
2, .. Dlpablllly benefltalnw, '
PI ,We do not provide IJndllrlnsurod Molmlslo Ooverage
for punl\lva or lI~omplary dameges,' .
, . i\
.' LIMIT OF LIABILITY
A, Tl1a IImll olllallllllY shown In IheSohedllle or In Iho
Dllolllratlq,ns for Underlnsured Molorlste Ooyeraoe Ie
our ma~lmum lImll 01 lInblllty for all damagas resultlno
ffom eny one aooldent, Thle Ie Ihe mosl wo will pay
rogardless of the number 011
1'; "Insllredel"
Il,
Olelms medel
G, Vohlollls or premiums ahown In Iho Sohodllle
or In Ihe O~olllra\lonsl ot
1\, Vehloles Inyolyed in tho nooldenl,
PPD 0417 10 93
It Ihprp Is olhllr PPpllOAlllo slmllllr.lnsurnnoa AVllllnllle \lnder
morlllhlln onll polloy pr pfovlslon of Ooverl\Oll1
The lollowlno ptlorlllas 01 reoovllry IIpplYI
First The \Jnnarlnll\Jfed Molorlsl8 OOverllOIl np.
, p,ltoable 10 Ihll yohlole \ha IlnS\lred" was
'ooollPyl110" al Iha lime ~I Ihe Aoplnenl,
aecond Thll pollpy IIffordlng Unnerll1eurod Molorlslp
Ooverega III Ihe "Ins~red" as II nllmad In.
surod or fllmlly mllmllar,
1, Whel1 Ihare Ie Appllollble Insurllnoe eVllllllble
unt1ar\he First prlllrltYI .
II, The IImll of IIl1blllly IIpp,lIoabla 10 Ihe vehl.
!lIe the "Inauflld" Wll8 'oooupYlno"1 under
II1Il polloy In Ihll f;lrel priority, ahall Irst pe
o~hllllstedlann
,
b, Tha ma~lmum reooyery under all pollollls
In the Saoond prlllflty s111111 nole~oeed the
emollnlllY whloh the hlghos\ IImll for IIny
one vahlole under any ona policy In Il1e
Seoonn priority eKoeads lhe limit IIpplloa,
plo ~nder Iho polloy In Iha Flrs\ priority,
2, Whon thu(o la no Ilpplloabla Insuranoe nVIIIIIIl)le
under Iha Flrel prlorlly,lhe mexlmum teoOVllry
under all polloles In Ihe Seoond priority Shall nol
e~oeed Iha hlghllst appliCAble IImll for MY one
,,' vahlola undet anyone polloy, ,
, If two or more polloles l1ave equal ptlofltyllhe Il1eurer
noalnel whom Iho claim Is fltst made sholl process
and pay Iho olslm ae If wholly responsible lor all
Ineurore with equal ptlotlty, The Insuror Isll1eteafter
enlllled to teooveroontrlblltlon pro tllta Irom any
otl1etlnsuter lor the benoflts 01 prooe~slng Il1e olnlm,
II We are Ihelneurer nglllnot whom Iha olalm Is flrat
madp, we Will pay, subjoot 10 Ihe limit' of liability
shown In Ihe Schedule or 111 tile Oaolara\lone for
Page 2 ot3
I '
,.
Pnnllflns\1rlld MplorlslQ Oovarp~p, "liar wo Ilf\oylh 8 rOll
olhpr opntrlPllllno Inallrprq 1I0rpPI11\ up,",
" Whpth\lr 1I1p"lnallrpdll Is 1001llly llnllllod \0 r~J I I,'
IlPvpr ~lIml\opa, Irpm IIw pwnpr Dr Ilpornlpr pf
pn"lIn~llrlnSllfPrl motpr yohlolo" Ilmd
II, As Ip Ihe Ilmo~nl 01 ~pmoooa,
ARI3I'fAATION
A, f.j1=I-1=OTION OF AR!3I'fRATQRl3
II wo nnn 'IIn IIlns\IrP~" rllslloreo wholllllr lI'a "In.
s~fen" la Ipunlly ontltlaq '0 rpPoVllr rlllmPQPs Iwm lhe
oWnllf,pr driver pIAn lI\lnqprlnsllrlltl molor Ylll1lplll"
Pf do nol RorpPIIS Ip Ihllnmpl1nl 01 dllmllope, ollhor
pllrty mpy mRklln wrlllen qamllnd for I1rl1l1mllon, 1=x,'
Oil pI Iprlhlu,\u\hoflllllS \lnd rlohts ellltaQ In pnrll'
grllpha 13" 0, Anll p, of Ihllse IIrhllrnllon proYlslone,
I\rllllrnllon shllll Pll ponrlullllld In 1I000rtlllnoa wllh 1I111 .
provlalona III 1110 PlInnaylyonlll Unllp'rm Arpllrnllon
Aol, , ~lIllh pllrty wlllslIlollI IIn Ilrllllrlllor, The Iwo
nrpl\rptllrs will selellt nlhlrtl, ,II Il1l1Y Ollnno\ 1I0ree
wllhln ao doye, ellher mllY raqullnl th\ll nalllollon Ile
mane Py II j~noe 01 a oOllrl hnvlno jllrladlo\Ion, 1=lIoh
pprly will r"y Ihll expeneae IIlnoufii IInrl Pllllr Ihe ex.
pensea 0 Ihe Ihlrll IIrhllrnlof lIq~nIlY, Unlllaa Ilolh
pllrtles ngree oll1l1rwlse, n,rllllrnllon wlllll1ka pllloa In
'he oounly In wl1loh Ihll "Ins~rad':rnsldee,
13, I-IMITATION OF AR!3ITRATOriS' AUTHORITY
'1'1111 aUlhorllY pf Ihllllrlll\rlllore ohllll bo IImlllld 10 dlh
pldlno Ihe 1I111llllty 'of Ihe, owner or nrlyar of on
. "underlneured molor yehlole" Ilnd nmollnl of dnm.
IIgos rooovorllllle Irom Ilia owner or driver 01 nn
"lIndorlneured molor vehlllle," Tile pmollnt 01 any
IIwprd'mllY be up 10 Illlt not In oxooea of the ,Llmll 01
Liability shown In Iha Sohodule or Qeolnrollone for
Undeflnsurod Molofls,\e Ooverllgo,
0, DISOOV1=RY RIGHTS
t=lIllh party ehllll hpyO the rlgl11 of filII dlsooyery In.
oludlng, bul noll1mllad 10, depoelllone of any Involved
party, raqullets for pfoduatlon 01 dooumonls suol1 os
employrnant and madloal reoords, and the rloht to
perform porlodlo madlQnl axarnlnallone on IIny por'
elln mnklng n olaUn IIndor thle ooverage, '
~
)
APPF-AL Rl~HTS
, ,
I'loph Pllrty oholl haV\l Ihe rloht Ip npranl 10
1I11lllP\lrt I1l1vlnQ j\lrlsltlollon 1111 1I\'!lIrl pf th\1
nrpllfnlors provlQnQ 1110 nppanl Is IlllsOQ
uppn nn Ilrrof pllllW, I1n nrllllrnllpn dllplslon
11111\ llxppaqe Il1p stlllaq lI\l\l1prlly 01 ll1a
prpllflllorQ I1nd IIny fl0l11 of Ilppap\ proVIQlld
~nQor pommon law IIrpllrllllpn, Tl1erll shpll
De no rlol11 of IlPPOI1' on 4\1psllpna of fllol fP'
Ollrdlno Ihp IInlllllly of Ihe pwnllr pr qrlVllr 01
1110 "unqprlneuran mlllor VOl1lplll" pr Ihl!
PfnP\1Il1 of dllmllOeS nolarmlnaQ Ip Ilo rlloOVPflllllo
Irom Ihe ownpr or qrlvpr ollln 1I\lIltlPflns\1retlmlllor
vel1lple,"
ADDITIONAl- PUTY
A pPfson QPllklno Umlprlnsurerl Mplorlsls OovprllQll
mllsl alsp prornplly nollfy, linin writing 011\ lenlllllve
se\lIl1manl palwelln Iho 'Insurlltl" IIntl 1I1l1Ins~r\lrol
Ihll "I1nderlnsllret1 motor vehlple", Prior to nny
sel\lomanl with \tIll \Innerln~lIrlld molorlsl or 'he
Insuror of Il1e "llnderlnallra~ molor ve!1lola", IIlB "In'
e~fotl'l must rllolllva our wrltlan oonssnl 10 f1nollJe
IIny slIohllelllamenl,
QIlNIlRAI- PROVISIONfl
Pllrl F Ie amencled liS followel
A, Thlllollowlno Is lidded 10 Ihe OUf Rlol1\ To Reoover .
Pllymllnt provlslolll
OUR RIGI:lT TO RIlOOVIlR PAYMaNT
Our rlghte do nol apply IIndor Pllrllgrllph A, wllh reo
spaol 10 L1nderlna~ran Molorlsls Ooverllga If Wel
1, 'Hllve peen given prom pI wrl\len nolloe of a Ian'
lallye all\\Iernont between an "Inallrlld" IInd Ihe
Insllror 01 an "underlnsllred mo\orvohlolo"llInd
2, Have given Iha "Ineured" Ilur wrl\lon oonsont 10
sollie Il1e podlly Injury olslm,
~,. The Polloy porlod and Territory pfoylelon Is replaoed
by the followlngl
POLICY panlOD
Thle polloy only appllos 10 1I000ldenls end'loseee
whloh ooour d~rlng the polloy period os shown In Ihe
Oalllarll\lona,
This endoresmenl muel be IIl1aohed to Iho Ohange Endoreamenl when Iseued eft~r Ihe polloy Ie wrllten,
PPD 04111093
page 3 of 3
,I ' " .1'
DONEGAL MUTUAL INSURANCE COMPANY
NAM~P
INIlUA~P tlOVP'l'tl J lll\tlPRA
"OI-IQYNUM!l~R fl\J!l 0~9PBPOOO
000860
AQPNT 1l11\ilRl-iY 1 till MlJ!lwrll ~ IlRPI\J!lRIl J N
AQ~NOYNUMIIPA OOO~~OP ,
IMPORTANT NOTIO~
InllllrlmCIl ccmpllnlllll Clpllrllllno In thllOQmmonwlll1llh olPllnnQvlvllnll1l1rllrllqlllrllQ PV IlIw 10 mllkQ ,
IIVIIIIII13le fpr pllrc:1hl1l1e Ihe fpllowlno Pllnflfllll fpr Vl;l\.l, VOllr IIpPlllle PI' pther rellltlvell or mhlPrllln VP\~r
IlllllltpclV PI' In Ihe ClllnOQV of VilliI' relllllvelll, realQlno In vpur hp\l!lellpIQ, Ooc~lpllnlll pf VP\lI' mQIPI' Vllhl.
0111 PI' perfjona IItrllck PV VPllr motpr vllhlollll "
(1) Me(:llolll penllflt~, up tO,lIllellllt 5100,000,
(1,1) ~KlrllPrQlnllrv meQIQlI1 penllflls, frpm 5100,000 tp $1,100,000 whlQh m!lV PII offoreQ In Inore.
mlmla 01 $1 ~o,ooo, .
,. ,.
(a) tnopme loas penElllla, up to 1I111lllat sa,600 per month up to II mm<lmum Pfmlillll of 1I110llet
$60,000,' " '
, (3) AOQIQllntl11 clellth penelllll, up 10 IIllelllll $26,000,
(4) Funerlll penllfltll, $2,600,
(6) All !In nllernlltlve to pllmorllptlll (1lt(a),(3) IIncl (4),11 oomplnlltlon penelll, up to IIllellllt $111t600
of penelltllln thllllggreOllte or bllnelltll PIWIIPIIl up to throe vellrll Irom the dllle 01 the 1I00lclent,
whlohever oooura flrllt,lIl1pleot tp IIl1mll on 1I0oldonllll dellth penellt 01 up to $26,000 IInd II limit on
fune, 1'111 bllnllllt of $2,600, prpvlded th,,1 notllln" oontlllnlld In thlllsublleotlon shall be, oonstruetl tCl
limit, reduoe, modlfv or ohllnge the provisions 01 slloUpn '1716(cl) (rellltlngto aVllllllblll\V of ade.
qUllte IImlls), ' ' "
(6) Unlnaured, underlnaurod Ilnd bodllv InJurv IIl1blllW ooverllge \lP to lit least $100,000 peollllse
, of Injury to ono peraon In IInv one 1I00ldant IInel up to lit lellat 5300,000 beoauall 01 Injury to twp or
I' mpre pllraonsln any pne aooldent or, lit the option 01 the Inaurer, up to lit lellst $300,000 In a single
limit lor these ooverllges, oKollpl for pollolllslssued under thll Asolgned Alak Plan, Also, lit IClast
S6,000 for dllmnge to property of others In any one 1I00ldent,
AddltlonallV, InS~lrers mav oller high Ill' benefit levels than those enumerated above liS well as acldl.
tlonlll benellta. However, IIn lf1sured mllV eleot to purohllae lower benefit levela than thaae enumer.
IIteclabove" .". ..
, ' i' t
Your signature on this notloe or your pllvment of anv renewlIl promlum evldenoea your aotulIl knQw,
ledge and underelandlt\g of the Ilvllllllblllty of these beneflls and IImlle as Well as the benefits and 11m.
lIs you hllVe aeleoted. "
II you have any queallons or you do not underatnnd 1111 ofthe varloua optlono available to you, oontaot
your ngent or oompanv, .
II you do not underatllndllnv 01 the provisions oonlnlned In thla notloe, oontaot your agent or oom~
panv pelore you sI91',. " .' .':
'1-'
"
"
PLOP 173 (Ed. 7/00)
".j
.'
, I
I
,
,
, ,
NAM~P
INIlURf:P tlQvo'.\'IH IlAtlPRII
I
AQ~NTIlY\ilRyY HH'l IIG\ilN'NI ,. nR01\\ilR~ Hl
"
PPI-IPYNUMII~Rrll\il 04~1l60P 0+
AQ~NPYNUMf:lJ;A 0005~07
00087 I
Thill no\lop111 bolnp senl 10 you ~s requlreQ by 111\3 Pennaylvllnl~ Vel1lol\3 QOQP TI\le 75 6eo\lon , 7~', 1 (II),
, ,
The IIIWs ollhe Qommonwellllh 01 Pennaylvanla, lis en~oled by Ihe (3eno[1\1 AaaElmply, only rElqulre Ihlll
you P,Ulohlllle IIl\bllllY IInd Ilrlll',I wly medlolll ~'Qnefll ooven~gea, Any IIQQI\lonl\l,ooVerllg\lll or Qoverlloes In
eXoeS!l 01 Ihl3 IImlls requlreQ by IlIw lue provldeQ only al your rpquelllllll enhl\lloem!lnlll 10 Pl\lllo
, Ooverl\pes,
Thill no\loe Is 10 provide YOII wllh\lw minimum ooverage IImlls and oorrpspondlng premlumll
'$15,000/$60,000 130dlly Injury I-IIIP\lIIY
, $5,000 ProperlY Pl\maoe ~lapllllY
I\IlQ .
$6,000 FlrsW!lrlY Medlol\ll3eneflls
$
$
$
ToI!l1 $
30,00
:24,00
12,00
66,00
THIS IS NOT YOUR r31\..\..ING NOTIO~,Pl-aASJ:! RISFaA TO oovan \..aTTJ:!A WHloH INOLUoaS PRaMIUM
INVOloapoRAMOUNTDUa, , .. ..
PI-OF.~07 (ad, 8.0')
__l'"""__'~ " _ ..".' ",,-., .~__t_'~'''''_'''''''''.'''''.''_'''''''''''t.._,..,...,.._.___
.fiQIlQ.!iQ~
The lawe 01 Ihe Oommonweallh of Pennsylvania give you Ihe rlohllo ohoose ellher 01 Ihe 101l0Wlng Iwo 10r,1
op\lonsl
A. "Limited 1'ort" Option.. Tills lorm of Insuranoe ,lImlls yollr rlghl and Ihe rlghls 01 members of your
household 10 seellllnanolal ot1mpenal\\lon lor Injy\lee oaullad by olher drivers, Un~er Ihls,lorm 01
Insuranoe, you andolher household mambers !;loVe red Under Ihlll polloy may seell reoovery,lor all .
medloal ,and olher oul-ol-pookel expanses, bul nol lor pain and sUffering or olher nonmonetl\ry
damages unless Ihe lnjurlqs suffered Jail wllhltllhe deflnlllon 01 "serious .IrJury," aB sel forth In Ihe
polloy, or unless one 01 several olher e)(oepllons noted In Ihe polloy applies, " . I
B,"1=1I1\ Tllrt" Option" This lorm 01 Insuranoe allows you 10 malnlaln an unreBlrloted rlohl loryoureelf af1d ' !, '
othet members of your houllllhold 10 seek flnanolal oompensallon lor Injuries oaused by othar drivers, '
Under IhlB lorm of lf1suranOe, you and other household members oovered under this pQlloy may seell
reoovery lor all medloal and other out-of-pockel e)(panlles and may alBa seek flnanolal oompllnsallon
lor pain and sullerlno or clher nonmonetary damages aB a resull of.lnjurles o,ausod by other drlvetB,
If you wish 10 ohange the tort opUon Ihal ourrlilnUy applies 10 your polloy, you muel nollly your agent, broker
or oompany and request and oomplele Ihllllpproprlale form" ; , ,
1'1-01=-200 (Sd, 7.90)
This nolllloll\lof1lslo l\~lvIsp YO~I QI vllrloull c1lspo\1nls whloh ml\Y pa IIVlIlIl\pl!l \1nc1ar \Ills polloy,
1, . PIIBlllve R!lslr!llnl p!lvloep , If Yom 1I\II~Hnopll!llp pq\1IPP~c1 wl\lll1 Ironllll PHIIlh P[OIIlPllon
. IlYBlflm whl!?h r!lqulrps np IIpllon pf Ih!l v!lhlplt:l pOPupllnle !Inti oQmpllell wllh S\lwlf\rd
, f.l'71 ,!lOP ot Ihfl' NI\\lonlll Trllftlo Sl\fely Aclmlnlslrllllon, you may pe allulplP for 1\ dllloo\1n\,
,Th~ pmoUnl 01 dlllooun\ would Pll ballecl on Ihe !\ysll3m Inslall!lclln your au\omoplIl3 !Inti
wlllllpplylp Ihll Flrlll PprlY Bt:lneIl\Ooverllua,' ,
!l, f\nMhefl PPVIOOB, II your 1I\1lornoplI!l11l eq\1lppecl wllh lI11yslllmwhlph ISllpllvlIlPr:llIUlomllllollllywhfln,
Ihp operll\llr Illmp Ihlllunlllcln key 10 Ihe I'll pOlllllOI1 IInr:l whlllh III r:lPBlunl1r:1 to pravpn\ ~Hll1\Hhprl~pd UPfl,
YOll mil, y b,e ollUllJlp tor II dlaoo~n\, The dlaoounlla nO\,IIPPIIOIIPIPII IhflllYlllem Is thp S\lImll\rcllunlllon
Inlerl90k syslpm provldad 1111 I\n anlHhall clevloe Py Iha orulnlll\ mllnufIlP\Urt:lr, Any dllloounl
IIppllollP\e, wlllllpply 10 Iha apmprphanlllVe aoVerllgll, .
13, Molor Vfll1lolp Prlvo[ Improvpmllnl OoUl'llP 'II cllsoounllsllvlIlIlIPIB If 1111 nllmed Insuredp lire f.lf.l ypllrll
01 1I0ll or older IInr:l hllve lluooPsllfully POmpllllt:ldll maIoI' Vflhlole driver Improvllmllnl opurllll mllt:ltlnu
Ihe Illlwlludll ollhu Pflpllrltnenl 01 Trllnspprlllllpn. The dlaopunlllpplles lor Ihe Ih[t:le yPllr pllrlor:l
Immedllltely 10llpWlnu Ihp a\lPoPllllful oompllltlon of \l1f3 oourse.
PIBPsP oonlllol YO\1r lIuenllf you lelll you lire ellglpl!lfor IIny of Ih!lllbove dlsoQunls,
~~~
c..P
r-
oo
Cl
C>
~
In IIdr:lltlon 10 Ihll r:llspounlsllllled IIIJ0ve, olher premium llavlng optlonll mllY P!l evallllbleelepllndlnQ on Ihe
OOVllrllQe ourrenlly IIpplylno 10 Ihls polloy, .
"
1, pennaylvl\nla law no longer requlrt:le you 10 oarry UNINfjURJ:D MOTORISTS or UNPt:RINsURt:D
MOTORISTS OP'lgRI\G~S, YO\t m~y pl.ll\ble 10 [er.luoe your premium III '
A. you rpduoe Ihe ,lImlta 01 1I1\I:1111ty I\pplylng 10 ellher or polh oover!lgea.
B. You [eleollhe "slaolllng" 01 !lither or polh ooverages, '
0, you do not wlah 10 oarry ellhe[ or bOlh ooveragee, "
" - II
2, You may [eeluoe yom FIRST PARTY BaNaFlTs OOVaRAGt:, The minimum medlolll expense
ooverage you mual oarry Ie $5,000, You db nol have 10 ollrry Wage loss ooverage or luneral expef1se
ooverage,
3, You ml\Y Inorease your, OOI..I..ISION deduollble, The higher the deduollple appiYlng 10 your vehloles,
thO lowerlhe premium, .' , . , ,
Pleaae oonlaol your agenlll you wlah more Inlormallon on any 01 these opllons,
PLOp.200 (l3d,1.00) ,
I',
~
t!o
Any peraon who knowingly and with Inl!lnllo Injure or defraud any Inourerfllos an appllua\lun or olalm
oonll:llnlng any laleB, Inoompleto or mlaleadlng Inforrnallon ehall, upon oonvlo\loh, pe lIubjeol 10
Imprlaonment for up to aeven Yeara and paymenl of a fine 01 up 10 $15,000,
This nolloe Is being given 10 you In oompliano!l wllh Aol6 01 11l1l0,
PLOP.210 Ed, 6-00)
,
,
" '
,
(
PONF~AI- MUTlJAI- IN!3UAANOF POMflANY
PI-OF 1111\
FQ, Orl/a~
, .
. pann~ylvpnlll s\lIllhllrOll PI~lllp~\If' Illlllomanl
'.' Pralarrall ~PI1"1I progmm () 008 177
".
In ppoordllnOIl wlll1 PIll1neylvonlll ~lIW, wa IlfO provldln\! yP~ wllh on llxplonll\lon of our ~III11 Prlvflr In~\H~nOll
Pllln, unllllr whlph yolH polloV l111s Ilolln rptlld, Ilnd Il1fll1lpn'. allool Oil your 1I~lpmQlllla rptllln Ilw aVllnl 0111
Ill1or\llllllllll ppoldlln\(0)pnd1pr oonvlotlpn, '.
WI1"i'I~ Ihll ~1I111 Prlvar 111"urllnOa PIli"?
Tha BIIIIl Pflvef Ine~rpnoo Pllln (hllrallf\or rllforroll 10 liS llPIP) 1I0~P posl oMl1arlono\l (pPoldanlo P. oonvlollono) ao pllrt of Ihp
dPI!lrmln,lIl1on of ,yo~r p,romlllm oosl, Tho oyotom dlloorlplld pelow hilS peon oe\opllohll,1I IInder whloh Il10ell d,flvllr8 Ihlll hllVIl
no points raoolYo Iha 10wlloI pfomlllmo, Hloher promlumo pnl ol1l1rood for p\hm rlrlvers Pllolld \Ippn 11111 numqer of polnlo
IhllY hllVe,II0QwnlllllleO tl~rlno Il1e oMporlonoo porlod, Tile axporlanoa rerl"ft Is Ih,alhrl!e,yepf inlo,lVlIl palWllon Ihll tllllll pf
Ihlllnlllal olalm pllymanl raolllllno from \lny onllllooldonl omt Ihll,dll\e Q Iha IIpplloallpn or Il1a pfppprnllon of Iha rllnawol,
Prllml~ms lor thl! tpllllWlnll oPVllrllOllO lUll oflopledll-llIPIII\y, Flrol Pllrty l3anof1to Ilnd OOverllOlll'pr Ppmllgo To YO\lr AulP,
Prlvlng Aaoord PQII111l
Oonvlollonll
Poln\s 011011 pa IIsslgnlld for oonvlollons d\lrlnglhll experlonoo parlod lor motor vehlole ylolllllono of Iho IIPpllollnl or IIny
Illhar ollrrllnlly rlleltlenlllperlllorllO fQllowol ' '
(1) Thrall polnle IIrllllseloned for oonvlollon of!
(II) , Prlvlno wl1l1o Inloxlpllled or, ~ntlor Ihe Influanpe III dr~osllIr
(p) pplI~re 10 atop pnd report whan Involved In an aooltlonl reo~l\lno In bodily Injllryl Qr
(0) Homlolda orllullu,lIl1rlolno oul 01 Ihn opllrotlon 01 II motor vehlolel or
(d) Prlvl110 whll~ lIoensllls suopended or reyoken,
, '
(Il) Two polnls ore lIeolgnad for Iho Ilpollmulllllon 01 polnte untlar II BIllIe Polnl Byo\om or II sarles 01 oonYlollone roq~lrlno
Ihe filing 01 eYldanoo of Ilnlll10lal reeponelbllllY under ony Flnllnolal Raeponslblllly ~ow liS of the ofloollve t1alo 01 the
polloy,
(e) Ono poln\ Is IIselgned for oonvlotlon of ony other movlno Irlllflo vlolallon realllllng 1m
(lI)suopenslon or reyooallon 01 en oporalor's lIoonoo, or
(Il) Tha fllln\! 01 evldenoo of Ilnanolal roeponalblllly undor eny Flnonolal RosponslbllllY LlI\'I rllq~lred liS of Ihe
IIflao\lye dale oflhe polloy, ' ,.
Tha exporlenoe Perlotl for aeelgnmllnl 01 polnle lor Oonvlollone 101
Tho eXperlenoe period sholl ba Ihe Ihrlle years Immedlo\ely prlloedlng Iho dole of IIpplloallon or Il1e praparll\lon of Ihe
ranowal, ' " ,
Acaldant \!urohargol
(i) Surohargee lor Aooldenle ooallrlno Prlorto July 1, 1 D~OI
(a) Polnls are' lIIlulgneO for llooh aooldenl Ihal ooourred during the experlonoe, parlod,lnyolvlng Ihe lIpplloanl or al1y
resident opetator, whllo operating a private pessengar alllo, One polnl 10 assigned loroaoh pulo IIcoltlen\ Iha\
reeulte Inl
(I) Bodily Injury or dealh rlleultlng In a paid olalml or
(II) A Ilald claltn lor damage 10 any property Including hie ot her own 1t1 eMoeBe of $300,
"
Pagrl1 of 4
Pl.Or: 111 a Ed, 06/95
L' I,
(p) pnlll point tl8 III se1onO,tll?'f two or mOl'" noolt1on!~ rld\lrlnO Ihll IlI~Plllrllllnop pprlptl WillIan rIP\SIIII In I Pll(ltl) O':'.l
pill rns pV I 111 nfi~mr or ~llmll~o 10 IInv propnrlY ,,11\ 0 npl rIlQ\I\ n I III llulonmonl Il po n Q \1111 (Ir II ......
PIlIlVIl, 00
Cl
'T'lll'l=Kp~rlon~1l porlatl eholl hA tha Ihfllll'yallr Inlarvlll halWllan \l1a dlllo 01 \t1llInl\11I1 olplm pnYlTlllnl rDnllltlno 0
trpm llny IlnIlIlPolrh'll1\ Ilnd Ihll tlll\a 01 Iha pppllpll\tpn or 11111 propllrllllon III thll rall\lwpl, 9
(~) l'Mol1prllDe tor Aooltlonle POllllrrlno On Or AlIflr ~uly 1,10001
Polnle pro IIssl\lnorl tor 1lIlOhIlPolcllll1llor"Wl1loh,pn InS\lrflr plllrl U plnlm mllo\tno Iho Of Iter III polow, It Il1auollldllnl
Involvetl \tlll pppllollnt, Ihe nllmod Infi~raq,pr IInv roelrjpnt PpPfP\or Wllllo oppfp\lnO lIn 11\110,
(p) Aooldonla ollPllrrlna on or Allar ~\llv 1', 1000 pul pofOfe ~ulV 1, 10Dtll
(I) ,Pnll point III IIsslanpq fOf auoh pooltlen\ lor wl1loh pn InS\lrpr plllrJ II ollllm lluflno Iha IIKparlpnop pllrlotl 01 .
'6~0 pr more, ' '
(II) One polnl 18 IIsQlonatl Illr Iwo Dr morp pooldonls dlHln\l 11111 PKpoflanoll p\lrlotf whlpl1 r\lsult In pIIIQ pllllme Py
\l1a Insuror tor IlpllllIOP 10 pnv proparlV PilI liD not rOfilllt In \l1p psslpnmanl 01 polnllllll1clpr (I) Ilpove,
Tll0 aKpllrlonpo porlptf shollllp tha Ihree.yallr Intllrvlllllo\waan tha dlllo of Il1a InitiAl ollllm pllvmllnl rasulllno Irom pny
onp flool~llnl wl1loh mllllls Ihp $600 llirpuholcl, flnd II1P dllle of Il1e IIppllollllon or II111 propPra\tpn 01 Iho rllnaWll\,
(Ill Aooldpnle ooourrlno on or fllter J~IV 1,1 DOll 1
(I) Ona poln\ 10 llssloneq Ipl' olloh llooldenl for wl1lol1lln Insllrer pllltlll ollllm d~rlno 111& axparlllnPll pafloll of
$760 or moro,
(II) Onll poln\ Ie IIssl0ned for two or Illoro Aoolcllln\S n\lrlno tha eKPorlenoD perlotl whlol1 rOfiult In pllld ollllmQ \ly
Il1a Insurer for dOlflllOa 10 IInv proparty P~I do nol reeult In Ihll IIsnlonmlln\ of polnl" undor (I) 1I1l0Yll,
Tha llxPllrlanoe parlon ehllllllo Iha IIlrlla,yaaf Inlorvpl pelwoen Iho dple III Il1alnl\t1l1 ollllm pllymenl rea\ll\tnp frllm IlnY
one pool donI whloh meals Iha $760 \hresholtl, and Ihe nlllo 01 tl10 ppplloptlon or Ihll prepllrl\\lon of 11111 ranowpl,
tllcOllpllDnll,
The followlno ADolnent Surohllr\la gxogPTIDNflllpply to Aooltlllnle ooourrlno prior 10 July 1,19901
(1) No fJDlnlfi IIro IIsaloned for 1I00lden\e Inourrad by IIn oparlltor demonstrated 10 pa II namod Ineured ot.1l prlnolplIl
operator 01 an alllo Ina~retlllntlar II eepprllle polloYlllnd "
(il) No rJOlnte lire 1I0slpnat1 for aooldants ooollrrlnu lIndar the followlno olrDumalanoaal
,. ,.
(A) Aulo Ipw!Ully parkad (If the parklld vohlole rolfe Irom Ihe parked poalllon Ihen IIny euohpooldant Ie ahpr\led 10 Iho
pereonwhDpllrkotlU1alIulo)lor " " '
(Il) The applloanl, Dwner or IIlhar roeldonl operelor relmbursad by, or on Ilahalf 01,11 poraon who hI respDnslble for
Ihe pooldent or haa judgment agalnat euoh personl Dr ' ,
(0) Au\o Is etruak In the rear Ily IInother vohlole ond Ihe applloant or Dther reeldenl oparalor hilS nollloon oonYloled
of n moYlng Iralllo vlolallon In aonneollan Wl\h Ihls lIooldenll or .' ' .' ,
(d) Dpatator 01 Ihe other auto Inyolvlld In tho naoldent WaB oonyloled of A moving trafflo vlolallon ontlthe uppllopn\
Dr resident operalor Was nol oDnylDled of a moving trlllflo Ylolallon In aDnneoUon with Ihe pooldentl or
~
(0) Auto operplot by tha applloant or any'reeldonl opofator Is atruak bV II, "hl\'llnd,runll vuhlole, If the aooltlenlla
repot\od 10 the pfoper authority within 114hours by Iha applloenl or resident Dperator! or
(I) Anoldanta Inyolylng dplllege by abhlaot with enlmals Dr fowll or
(0) Aooldants InyolYll10 phvaloal dllmllga,lImltod 10 end oaueatl bV llylng grayul, mlssllas., or Iplllng Db)eotsl or
(h) Aaoldente oooutrlng when uelng auto In reaponee 10 pn elllerOllnov If the'DpefatDr et Iha limo DI Ihe aoolnenl WPB
, n paid Dr volllnteer membur of any polloa or Flrll Departmant, Flral Aid Squed, or any law enlorDemant pgenoy,
Page 2 ot 4
PI..Op 111 a Ed, 05/95
.
This IIx~lIpllpn IlP\ls nol 'nol~dll !In 1I0~1\lont poollfrlno pft!lr 111\ll\~lo Pllpaps III pa IIseclln r\lsponsp Ip
s~oh IlmerounoYI Ilr , ' ., 0 8 I
(I) Aoplqants rllsllllln\lln An ,,,nolln\ pulll pn puhlllf 01 AnlnellrPd \lnllllr I3l1slp, Addpt1l1r Oomplnllllon RrR 7 U
Pllrty l3onull\ft PPVllraOIlS Ilnfy, IInd 1110 IIppllonnl or plhpr r\lul\lpnt In Ihu sllmo hOllsehol!J wPs npI III
Ip\.11111) Pllnlrlplllln\l Ip Iha popldpnl olvlno rlBII Illlhll 01nlJ)1,
thp fpllowlno Aoolllant SurollllrDa f:l<Ot:PTIONS IIPply 10 flolll\lpnls Doourrlno on or IIl1ur ~uly 1 I 100PI
(1) An lIPllldent Inp~rr\lq Py Iln IIp\lrllt\1r who Ie llomonstrlltuQ 10 PIIII nllmulllnsllrad Qr II prinolplIl Ilparlllof pI II
vllhlollllnSllr\lQ ~ndar 11 supmn\11 polloY Is not pIIOlblulpr. ftllrotlllrlla, '
(il) An IIpol\lenl Ino~rrPQ hy IIn opPrIIlor who Is dpmonelrlllpd 10 nn Illnour rusldp In Ihulnsllron'a ho~aAhold Is nol fllf\llplu
',: for lI\.1rohllrop, .
(3) Nil polnls ArO IIseloned fllr 1l001t1unls ooo~rflno IIm111r 11111 101l0wln(I olroumslllnpasl
,....,
"(II) A\llo PPllrlltod Py Ihi<lIlPpllollnt or IIny rasldan\ Qperlllm la elr~ok py II "hll,untl'rlm" Yllhlolu, If IhulIPlllnent Is
, :';.' fllporte\l III Ihe pfOpar AUlhllrllY wllhln 114 hOllrs IlY Ihe nppllollnl or rllaldurll opemlPr! or"
(Il) Aopldants Inyolvln\l t1l1mllOP py oonlllot wllh IlnlmAla or fowli or
,,(0) Aoolqllnls Inyolvlno phyalolll ~llImlloe,llmlled 10 linn OAIISlld Py f1ylnp Orllvul, mlssllaa, or IAllln\l opjaotsl or
(d) Aooldunts Iloollrrlno whlln Ualno IIl1to In rnsponell 10 nn emeroenpy If tha oparlltnr 11\ Ihe IImu of \hllllooldllnl WIIS
A I1pld or volllnlpar memller pI Ilny Pollpu or Flru Oepll11mefll, Flrel Aid 13q~II\l, or pny IlIw enforoamunl lIoenPy,
This Il~oaptlon doee not In'pl~dlllln lIPolnunl ooo\lrrlno IIl10r Iha 1I\l!0 oellaue 10 pe Ulleclln reponea 10 SUol1
IlmaropnoYI or
(e) Aoolnan\s ree~llInoln nn nmollnt belno PIIIII on Illlhlllf ollln InQUrad only under l3aslo, AdQecl or Opmlllnnllon Flrel
PArty l3enaflta OOVllrlloeS or under !:xtraordlm\ry Menlpal Benefits ooyoraoal or '
(I) Aooldants whore Ihe Insllrer Is ralmll~rsed Py or on Ilehlllf of Ihe nllmed Insured or othur roslnent operlllor lor
RO% or mrHIl of IhA tntRI pmount nlthll PIlIrJ ololm reoAlvnt1throlll1h subrogation or from II eolllament or IlInOmunl
1I0fllnsl Ihulndlvldllal responsible for Iha 1I00idenl,
.
Il1eKperlonoeQ OperAtor
II thu prlnolpal operl\lor 01 the IIUlo hlle no eurohoroa lor IIn 1I00ldenl, bill haa peen IIoensed lose Ihlln Ihree YOllrs, one poln\
Is Assloned, ' , .
Polnl & Surohllrge Oaloulallon
The number 01 points IIssl0net1 delermlnes Ihe sllrol1llroe, The following ahowe the ellrol1llroe ae II peroentlloe Inoreaell 01
Ihe bese promlum, ' ,
Peroentage Inorol\8o
olthe PaBlo Premium
SDIP One Mulll' Mill""
Fllotor Ollr Oor Oar
1 Point ' ,1\0 1\0% ,1!5% 1\00/0 ,
· I! Polnte ,00 90% (100/0 000/.
t) Polnte 1,50 1500/0 000/0 1500/0
4 Polnte 2,I!0 I!I!O% 1150/0 21!00/0
· WITI~ 1WO OARS THIS SUROHARGI: APp~ll:a TO I:AOH OAR, IF THI:RI: ARI: MORe OARS IT APP~II:S TO 'THe
1WO OARS WITH THI: HIGHI:ST PReMIUM, ,U8U~~~ Y THI:SI: ARI: THI: HIGHI:ST VA~ueD OARS,
"THIS SUROHARGI: APP~les WHI:N A SING~e OAR RISI< 18 RI:OEIVING POINTS DI:Vll~OPI:D UNDER SDIP AND
THE MUL TI.OAR DISOOUNT RU~r: PI:RTAINING TO MU~ TI~~E PO~IOII:S IN THE SAME HOUSI:HO~D APP~lgS,
Pogo 3 of 4
PLOP 1110 Ed, 06/06
.
,
( ,:
, Pflll1 ~1 1l~03
AM~NPMJ:NT PF,flol-10Y PRPVI~IONf.l, PI=NNl:IY~VANI" 0 0 Q 8 81
p~rINITIPNIl " This prpYlslon (4,) dops npI liP' '
plY III (Jpvarnoo Fllr PI1IT1UOII To '
Thll Poflnlllol1s ~IlP\lon Is IImlmdod liS follows1,,' Ypur AlJ\I>,
.'
A. Poflnlllpn ~"Uopll1olln Ily \Il1ll01l0Wl1101 ..,:~. II, Thll tollowlno \s odOOQ 10 Il1l1 PllllnlllOI1B
,.... slIPIlr>nl
K, "Non.lloonpmlo loss" mllllnB poln !Inti
1I~II\1rlnQ !lnet 1l1t\lIr non.monalllry notrl.
mant,
,I., "Sllrlolls InIIHY" mOllhs nn Inlllry roaulllno
In t1ellth, sorlous implllrmonl of I>ody
lunollol1 or pllrmllnllnl sllrlo~a olsfl~~ro'
manl,
, ,
I,
lIypur opvarad 111110" maunsl
1, Any vahlolu QllOwn In Iho PlIolllrlllluns,
II, Anv 01 Ihe followlno typas pf vohlolos on
Ihll dllte yOIl paoeme \hll pwnon
Il, A prlvlIlll p!leallnoar lI\llOI or
/), A plokup or vpn Ihllll
(I) Hlle n ~roBs VPhlolll Woloht
nllt oxpoonlno Il,OPO Ills,! ancl
(11) Is noi prlnolppllV !JseQ In any
"Iluslness" otl1or Il1en fllrmll10
0, rllnol1lno,
Tl1ls provision (II.) IIpplles only Ifl
Il, You 1I0q~lre 11111 vahlole nUl'lnp ,Ihe
polloy porlodl ..
p, You ask us 10 Insufall wllhln (30 daye
altar yoU 1l000mllll1a ownen lind,
0" WIII1 raepeol 10 e plokup or van, no
olher Ins~lrnnoa polloV provldos
ooVoraga far Ihlll yehlole, "
, If Ihe yohlolll yo~ aoqulre replpoae one
shown in Iho Peolarnllons, It will hllve Iho
same ooverage lie Ihe yehlole It raplaopd,
You musl!lek us 10 Ineurllll replBonmonl
yohlol!! within (30 dllya only II you Wleh 10
"dd 01' oonllnue OOyerllge For Pamage To
YOllrAllto,
If Ihe yehlolll you aoqlllfe Ie In andltlon 10
. llny ehown In the Qeolamtlone,lt will hllye
tho broadesl ooverage WEl now provldo for
llny yehlole ahown In tha Deolamtlone, ,
":.:t, Any "troller" YOII own;
4, Any llllto or "Ifllllof" you do nol OW" while
used liS l1\emporary sullstllUle lor llny
olher vllhlola dasorlbeclln Ihls dellnltlon
whlohle out of normal use beoPllse 01 lIe 1
1\, Breakdown! d, Lossl br
p, ' RePllln e, Destruollon,
0, Borvlolngl
II, . PART A .I-IAf:\II.1TY POVIiAAQIi
PlIrllornph A. 01 Iha Inallrlnp AorfJllmanl 01 P!lrt A In
rllplnoet1lly Ihe tollowlnOI .
INSURINQ AQRI!I!MI!NT
Wo will PIlY dllmagae lor "podllV Inj\lry" or
"propfJrty damage" lor whloh any "Insurenll
Ilooomos legllllv rosponelbla bepPII~ll of an
lIulo lIooldant, Wll will oellla or cleland, as we
oonslder IIpproprllllo, ony 1I1111m or slllt Ilaklng
1m thF.\B~ IIRmeoeS"ln lldt1ll1on 10 o~r limit of II.
IIblflty, wa will PIlY 1111 delonse oosls Wo Inour,
Our dulY 10 sallie or delend ends wl1en p~r limit
1;11 IIl1blll\y for Ihls oovoroOIl has I>elln ex.
hausllld, We l1Bye no dulY 10 dafend IIny eull or
eellle any ollllm for "bo(jlly InJ~ry" or "property
naml\ge" nol ooveren undar Ihle polloy, ,
111,' PAR'T Ii . OUTIIlS AFTIlR AN AoolOIiNT OR
LOBB
Pert I! Is replaoed llV Ihe tollowlnOI
OUTII!S AFTI!R AN AOOIOI!NT OR LOBB
If an aooldenl or loss oOQurs, iho lollowlng musl Ile
dona lor Ihe lermB 01 Ihe polloy 10 applYI
A, We muet ba notified prUll1ptly 01 how, when ond
, Whore Iha aooldent or loss hnppaned, Nolloo
ehould also Inolude Iha names and addresses
olany InJ~r(Jd pareona IlIld uf nny witnesses.
~, A person soaking any oovaraoe musl:
1, Oooperate wllh us In Ihe InvoslIgatlon,
settlement or defense 01 any olalm or 8ull,
2, Promptlv Bend US oopl08 of any nolloes or
legal papere reoelvod In oonnaollon with
Ihe aooldent ur loee,
PI' 01 81 09 03
Oopyrlgh\\ Insuranoe Servloee Offloe, Ino" 1 9lm
Pl\ge 1 01,3
l
rl, Wn ITlI1Y onl1oqlllY mnlllno III \Iw!
nllmnd Il1s\lrod ahow" In II1n
Paolllrn\lons pI Iho IIddroQU
ullPwn In \hls polloyl
II, AI Illllat HI dllYa I1P\ll1ll 01
ppnplllla\lpn:
(1) II notloll 1ft pflQo\lva wllhln II1P
flrpl 110 dllYs II1ls polloy Ip In ph
!pol IInd Il1lp Is not II r\lnawp\ pr
1l0n\lmJllllon pllllllyi
(II) For nQnpllymllnt 01 prpml~nH
(3) II Ihe drlvllr'a 1I0ensll of Ihll
nllml!d Insllrlld ehown In 11111
PIIOlllrllllons 'I111S bOlln s\lQ'
panded or rflvqkDd 1If1l1r 11111 '
IlflllPllvo dll\a if Ihls pllllcy hila
poan In eflllo\ IlIsP Ihlln onll
yourj or II 11111 policY hilS ll11an
In af elll lonoer III un 0"11 yellr,
elnoo Ihll IlIsI llnnlverellry 01
Ihe IIrlolnlll olleollve dlllOI or
II, AI lellsl aD dllYS no\lpe if Iho ppllPy
WIIS obllllnon Il1m~gh mnlerllll mlp.
reprllsantllllon,
Our rlol11 10 Ollnoel Ihls pollPY Is suhjeo\ 10 II1a
IImltllllone oontlllnlld In Ihe eppllollble
pennaylVllnl1l SIlllulea, ..
Nomenllwal, II we Qllolde nol Ip ronaw or
oonllnue Ihls polloy, we will mlllllo Ihe numed
Insurod al10wn In 1110 Peolnrllllons lit Iha
addrees fll10wn In Il1le polloyl
1. Alleaet 16 dllye nolloe Ilafore Ihe end 01
11111 policy parlodl
II, For nonpaymanl of premium! or
" II, IIlho drlvar's lIoanee of Ihe named
InSUfed shown In Ihe Poolllrllllone
hns been auspendad or revokan
IIl1ar Ille efleollve dllle if Illls polloy
has been In ellaol leas 111 at one yellrl
or II Ihe polloy hue, he en In ofleot
longar Ihan one year I slnoo Ihe lasl
IInnlvareary of 1110 orolnlal alleotlVe
dllto,
2, AI loost aq days nolloa boforll Iha end of "
Ihe po\loy parlod In all olhar cases,
,
However, our rlghl 10 nonronew Ihls policy Is '
eubjeot 10 Ihe IImltllllona oontolnad In Ihe
epp\loablo Panneylvonla Statutes, "
AUlomatlo Termination, II Wll olfllr 10 renaW
or oon\lnllo and YOII or your roproeenla\lvo do
Oopyrlghl, Insuranoo Servloas Olfloe, Ino" 19M Plue 2 01 tl
( \
IlS Illlnn 'ns WII rPIIQonnhly
,
~, au\lmlt,
ra\wlrpl
, ,', (\ I,' II II, Tp physloul oMllmpllY phys\olnl1s wn
Qolpol. Wo will PIIY lor Ihnsllll~lIln",
II, To PKllmlnnllQn IIndor' onlh IIm\
s\lpsorl\lp 111\1 Bllmn,
~I MlhoflJll us 10 p\l\nln;
ll, MlldlplIl roppr\slnnn
II, otl1l1r portlnlll1l rlloorns,
II, Ilupmlt II prllof 01 loss wl1an rllq~lrod Py
~s,
0, A paraon aaeklnu \Jnlneurad Molorlsle Oover.
11011 mllst lllsOI
" 'Promp\ly no\lfy tha polloo 1111 hl\'lInlhnm
driver Is Invplvad, '
II, promr"y eand \IS ooplas of tile 100111 pll'
para I II elllt Is IlroUUhl,
P, A pafson Bellklno OoverllOIl For Pllmnge To
Yo~r AulO m~ellllePI
1. Takll rOllsonallle eleps Illlor IpPS 10 pro.
laolllyo~r ooYOr,Od lIulo" or IIny "non.
qwnlltl IIl1to" IInd Ihalr equlpmant from
fUfl~or 10eQ, WlI w1l1 PllY ralleona\llll ox.
panseB In?urred 10 QO Ihle, .
II, Promp\ly nollly tha pollol.1l1 "yollt oovored
aulo" ot any "non.owned lIuto" Is stolen,
G, Perm II us 10 Inspeo\ and apPrlllea Ihe
dllmllged proparly Ilofore lis repair or nls.
poeBI, '
IV. PART P' GIU.ll=I'IAI. PROVISIONS
PIIl1 P Ie amended aB 101l0wBI
f>" The Tormlnatlon provlelon IB roplaood by Iho
loll owing I
Tl!RMINATION
0ln081111110n, This polloy may bo oonoalled
du"rlng Ihe polloy parlod as lollowel
1, Tho named Insured shown on tho Oaoln.
tlltlons mllY ounoel bYI
a, Returnlno IhlB polloy to us! or
"
b, Giving ull advanoa wrl\tan notloo of
Ihe data oanoellll\lon Is 10 laka of.
tecl,
PP 01 61 090tl
N
00
CO
Cl
o
1;1
ff
. , , I' t ' '
" nol ~poapl, Ihip pollpy Will @tom~llpnIlY
10rmlnRIIl PI the llnd of 11111 ollfrlln\ polloy parlod,
Fpll\lrll Ip pllV Ih~ rllqlllrlld rllnllWlI1 or
ppnllll\la\lon promillm wh~n 11"0 ~hllll mlllln
Ihlll YPI1hPVll nOlllooapler1 our pffpr,
" If ypu (1l>llIln olhllr In~lIrPnoo pn IIYOIU poVOfflt1
p"lo", Ilnr fllmllllr Ins\lrllnoll provlollo py Il1lft
. , . I ppllpy wll Illrmlnulo pft 10 Ihlll 1I\l\P on Ihp
f1ff\lollvll 111110 Ilf Iho olhllr Infl\lrllnoo,
Plhllr Tllrmln\1llon Prllvl.II:mS,
1, Wa mn~ dllllVllr Ilny nolloo Instaull pf
mlllllno I, Propf of mlllllno of IIny nolloe
phall Po fl"lfloiol11 prpol of nolloe,
Il, If Ihls pplloy Is p~npellad, YOU mllY pa
Ilnlltlotl In II praml\lm rahmd, If flP, Wll will
flOnq you Ihll ref~nd, Thll premium
rafunn,lf IIny, will pa pomPUler1 epoordlnO
16 our mllnllllls, Howeyer, mnklno or
11110rino 10 mpke Ihe rof\lnd Is nol II
pontllllon of opnpollll\ion,
3, Tho OffllOllYIl dllle 01 ollnoelllltlon elaled 111
tha nolloa el1all baooma Iha enr1 ollhe
polloy period,
II, The fOllowln\l provision Is lIr1dQdl
CONSTITUTIONAI-ITY.OI-AUIlP
Tho promlum lor, end Iha ooverlloes of, Ihle
ftollOY hove \leen llstallllshod In rollllnoe IIpon
he proylelone of Ihe PenneylVMla Molor VI,
Vehlpla Flnllnolpl Res~onellllllY Low, In Iho
evenl II pourl, Irom wh oh Ihllre Ie no appeal,
neolaree or enlerfl 11 Judgmonl Ihe elloot 01
, whlohls 10 rendor Iha Ilrtwlelons of s~ol1 slallllo
Invalln or unenloroeallle In whola or In part,we
will hllva Ihe rl\lhl 10 reoompllle Ihe promlum
pllyllblo for Ihe pollpy end void or IImenr1 Ihe
proylelons 01 Ihe 801l0Y, e~bleol 10 Iha approval
ulthe Insuranoo omlnlssloner,
V, JOINT OWNRRSHIP OOVRRAGP RNPORBR.
MEtJT
If Ihe Jo1nl Ownorehlp Oovorlloe !intloreemonl Is
lI\\ao~ed to this polloy, the provlelons of Iha Joint
Ownllrshlp Coverage !indoreemant apply exoapl ae
101l0wsI ' "
paragraphs A. ond 13,2,b, of Ihe Oaflnltlone saollon
oro roplaoed by the loll OWing I
I ,
Fpr IIW pllrposo 01 Iho opVflrllOo prp, '
vldfltll1Y Il1ls Ilnnorpomllnl, "yollllllnq
"yp~rll rllfpr 1[.1 IWP or mprlli
1, Inqlvln~plu, plhar Il1pn 1111sllllntl
nnr1 Wlfa, rpsltllno in tl1a flllmO
hollolll1olr1lof
1/), IINon,rllflldllnt relellvaslll 00088 :1
WI1l\ lolnlly OWnl
1, A prlvPle pllflsan\lof nlllol or
Il. A plokllp or VIlf1 Ihetl
\1, I-Ies II (:1rODQ Vahlol\l Welal1\ nol
expoadlno P,OPo Ipfl,J And'
\l, Ifl nol prlnolpally Ilfter1 In lIMY
"\lulllnlles" plher Ihlln 'Armlno or
,r!\l1ohl110,
IIYO"r oovered IIUlO" mopnS!
a, Any of tho followlno typaa of vehloles on
the cjple yO\l baoomo the owner!
b, A plokllp or van Ihll\l
(1) 1~lIfl II Grosp Vohlple Welol1l
1101 exooedlno 9,OnO Ille,\llIltl
" (ta) 10 nol prlnolpAlly uoop In Any
"buslnees" olher thlln IlIrmlno
or rllnohlng,
'MIBORl-l-ANfJOUS TYPll VllH10l-Il BNDORBP.
MPNT
If Iha Mlsoellaneoue Typa Vehlola l:ndorllement Ie
at\lIohed 10 ,Ihls polloy, the provisions of ,the
Mlsoellaneoue Typo Vehlole !indorsement opply
exoepl eS followsl
Peraorpph 13,2,j), of Ihe Oeflnlllone seolllln Ie
repleoad Ily Ihe 101l0wlnOl
13. "Vour oo'/ored 111110" meanSI
A.
II,
2. Any of the following Iypee of vehloles on
the dele you beoome the ownar!
"
b. A plokup or ven Ihll\l
(1) Hes a, Grbss Vehlole Wulght
hot exoeedlng 91000 Illa,llInd
(2) la not Pllnolplllly ueed In pny'
"buslnese" olher then larmlng
or ranohlM,
This endorsemont muet bll aUaohed to the Ohpnge Endorsement when leolled nller the polloy Is wrlUen,
PP 01 61 09 93
oopyrlght, InsuraMa Bervlona Office, Ino,. 1993
Page 3 of 3
(,
DONEGAL MUTUAL INSURANCE COMPANY
" 1"
NAMIiP
INPURIiPNOVO~NI aANPRA
PPhlOYNUMl3liR PAlll 049P~0001
" I, 'I'
" ,.'
A~IiNT~rlllR~Y IMa ^Q~NTa & ~ROK.Ra IN
Al:lIiNOY NUMl3liR 000 6~07
IMPPRTANT NOTIO~
Ina\.lrunQI! oomppnlOll opllrPllng In the Oommonwopllh pfponnllylvpnlp pre rpq\.llrecl py Ipw to mpke
f.\vpllpplll for p\.lrOhPll, e Ihe following POntlfllll for YO\.l, YO,\.lr IIpO\.lIlO or olher rOlllllvell or mlnorllln Y,O\.lr
11\.lIlIQcly or In the O\.llllocly 0' yom rf;llpllvOll, roolcllng In YO\.lr hP\.lIlOholcl, ooo\.lpllnlll 1" VO\.lr maIm vehl,
010 pr p'raOnlllllr\.l!lk Py YPIU m,olor vehlolol ,
(1) Mllcll!l1l1 penQfllo, \.lp 10 pt 10PIII $1 oO,aoo.
(1,1) lixlrporcllnpry medlopl penefllll, frpm 5100,00010 $1,100,000 wl,IQh mpy be offered In Inore,
menlo 01$1 00,000, "
(ll) In!lome 101111 pqneflls, up lei 1\1 101101 1ll1l,600 por monll, \.lp 10 a mlll\lm\.lm bonllfll 0' III 101101
$60,000, , ' '
(3) A!lolclontlll clolllh benoflla, \.lP to III 101101 5116,000,
(4) f1unllral penllfllo, $11,600,
(6) Ao an allernllllve to parpgrl\pha (1 ).(11),(3) ancl (4), p oomblnllllon benofll, \.lP to alloaol $1 'f7r600
I;If bonll'II. In Ihl! aggrogpto or benofllll pllyaplo \.lP to Ihreo YOllrll 'rom the dpte 0' thlllloolclllnt,
, whlllhllvllr Or;lOUrO flrllt,lIubjoOl to a limit on aooldentlll dopth pOf1llflt 0' \.lP 10 lllal5,OoO ana allmll on
funorlll pllneflt p' $11,6001 provldlld that nOlhlng oontalned In Ihlll o\.lbllf;lotlon ,.hall be oonolruf~d 10
IImll,roclUoe, mOcllfy or ohllngo tho provlolono 0' seollon 1716(d) (rel~llng 10 avallpblllty 0' ade.
qualo limits), ' ,
(el) Unlnsured,unclorlnsuredancl bodily In!Ury liability ooverllgo up to Ilt Illllst $100,000 boollulie
0' Injury to onll pllrson In IIny onllllooldon ~ncl up 10 I1t Illllllt 1ll300,OOO beollusll 0' Injury 10 two or
moro perllons In IIny one aoolclllnl or,allho opllon 0' tho Inluror, up to at loast $300,000 In alllnglll
limit 'or these OOVllragol, oxoopl for pollolllslBluecl under Ihll Asslgnod Risk Pllln, Also; lit IOllllt
S6,000'or damage to property of olhorllln IIny one aooldllnl.
A(lclltlonllllY1lnsurllrs may ofror higher benoflllovels than those enumerlltlld above 1111 wellasaddl.
tloMI bonof Ill, However, an Insured may elllot to purOhllSlllowor benllflt Illvels than Ihole enumllr.
ated apove; . ,
Your Ilgnature on thlll notloll or your pllymenl of any renllwlll premium 8vldllnOOll your llotual know.
ledge and underatllndlng of Ihe avallllblllty of thllso peneflts and limits al well as the bllneflts and llln.
Itl you hlivullllloted. ' ,
If you have any queltlons or you do not understllnd all of tho various options aVllllllble to you, oontaot
yaur agont or oompany. .,
If you do not understand any of thll provisions oontalned In this notloe, oontaot your agent or oom-
pany boloro you Sign. ". " .' "
000884
Pl.OF 173 (ad. 7/90)
I , ,
"'NPj;RIN~UAFP MOTORI~T~ OPVj;RAGE, Pj;NN~Y!.VANIA (NON,~TAOKj;P)
f'f'PP4 11P~ pa
oovllrll~13I. provl~~n Whl/rll II pr!)mll1m Iln~ 110111 of II II I:lll lIy I. f1hllWn IIl[ Ull1 poVOrll~\1 on 111. q\lolllrllllQn
PIIIl II , ' , ,
With raepllPll1l IhallovamOIl provl~a(lllY Ihl~ ont111r~omllnt, \1111 provl~lon~ pf the pollllY ppply \lnleftS mof.flllll(l by thle
\InQOrsllmllnl,
, ,\,:' SOH~PUI-J;
UNPIlA1NElUR~P MOTORISTIl OOV~AAGI3
PII8o[lpII011 1-10111 pI
01 Vohlolll I-IlIl:llH,Iy
$~
$
$
--,,.-
INElUAINQ AGAEPMRNT
A, We will' ppy ,oomppnalllory f.famll\Jas whlph nn
"Inaured" Is legally entlllpt1 10 raoover from the ownar
Ilr operlllor of IIn "lInderlnsllreq molor Yllhlole"
Ileoll~se of "PPdlly Inl~ry" I
1, S~61~ln,"d I:.y IIn "Insured" I linn
2, Olluslld by an aoolcjent,
The owner's or opsrPtor'e 1I111llllly for Iheee dllmaoee
mllelarlso oul of Iha ownerahlp, mlllnlenpnoe or uee
Of tha "underln~ured mplor vehlple," We will pay
11l1der Ihle ooverllga only IIftllr the limits of IIl1blllty ,
under nny appllonllle bodily In)U,ry lIablllly ponde or
pollolos have been, e~hlllleleQ by, peyment of,
lllnomenls or eetllamant8, However, wa muet be
provldlld wl\h pfompt wfltllln notlflllatlon 01 any
lenlatlye eO\llemanl belwean the "ln8I1to(l" and the
/neurer of tho "underlnsurod r1\OIof yehlple" or IIny
plher party, No eOlllomenl of the "Insllrad'e" bodily
Injllry lIablllly 010101 may be mode wltholll our wrll\an
ooneenl,
No juclomant lor damllgoo arlslno out of a sull brPIIght
agolnstlhe owner or operalor 01 an "undilrln~ured
mptor yohlole" Ie binding on liS unlees WOI
1 \ Rapelyed reaoonable notloe of the pendanoy of
Ih~ suit reSUlting In the judgmllntl and
2, Hnd a reasonable opportul1l1y 10 prolopt out
Interests In the ellll,
IIPD ~4 1702 OB
000881::-
,)
f'n1mll1m
$
$-
$
13, "In~uted" liS ueed In \llle andorSllment mOllnel
, 1, YOII or any "llIrnlly mamllor" I
II, Any olher pereon "oooupyln\J" "your oovered
IIUto," '
~, An)' pArson for d~ma\Jea Ihllt I1Arqnn I, 'mlltl",d
to reooyer beollllee of "Ilonlly Injury" 10 whloh
'hie ooveroge lIPPlle, s auetlllned by a pereon
t1eeorlllad In " or 2, above, '
0, "Under/neured motor vohlole" meane alllnd mQtor
, yelllole or Irllller of any type 10 whloh 0 bot1I1Y Injllry
lIalllllly !.lpnd or Pallpy IIppllee 01 Ihe lime of Ih9
, aooldenl !.lul the lImounl paid for '~bodlly Inj\lry" IIntler
lhllt bont1 or polloy to on "Insured" Is nol enough 10
pay the 1IIIIIImount the "lnsllred"ls le\Jolly entltlad 10
rooovar ae nllmogea,
HOWllver, "lInderlnsured molor Yohlole" does not
InpllldallnY vehlple or equlpmenll
1, Owned by or furnl~hed lorlhe regular lIee 01 you
or any" femlly memper,"
"
2, For whloh lIablllly ooveraoa Ie proYlden IInder
Part A of thle polloy,
3, Owned by nny goyernn'1antal IInlt or agonoy,
4, Operated on ralle or nrllwlor treade,
Ii, Deelgned mlllnly for IIse off pllbllo roade while '
not on publlo roads,
0, Wllllo loollled for uee o~ a resldenoe or
premlsee,
lIage 1 of 4
.I
...
,I
( I )
~, hlMIT A .lION OF AA13ITRA TOR!'l' AWTHORITY 0, PISPOVI:AY Rl\:lliTa
TllfI nlllhqrlly pI 11)0 IIrpllrlllqrs sh~IIIJo IIrnllocl to !:~Pl1 pnrly eholl hnva \1111 rloht 01 fplI (Jle.
n\lol(JIIlO IhllllOplll\y 0111111 ownar or npllrnlor pf flrl oPVDfY Inolp(Jlnp,I>\1! npt IImlllln 10, dllpn~I'
"\jllinp~r\l11 mOlor vel1lolo" IInd nmOllnl 01 dllrnnooB t10ns pf ony InyplYlld Pllt!y, Illqll\1n\B for
f!lpoVllrel1ll1 ffom Ihe pwnpr or opnrlllor of nn prlld~ptlon of '(oallmanln S\lOI1 liS omploy,
"~nlns\jr,od mptpr vahlolll," Thll mnollnl 01 IIny ownrn mOl1ll1nrJ medlonl rooorda, IIn(J \ll11 tlOh\ \0
mllY 1111 up \0 PilI npl In llXPIlQS ollhol.lmll of ~lol1l1l1y , panorm porlodla l1111rllolll aXllmlnlltlons qn
~I1pWn In tha Sohll(Jple or PIIPlnrll\lons for Unlns\lrll,l IIny pllrson milking II pllIlm undllr II1ls pov,
MOlprlnts OpYllrpop, OrllOO,
Thll ntPllrntor~ mllY nol renclot (joolslnne 011' p, APP, !:Ah RI~lm 0 0' 0 8 B ' .
dlslIorellmllll!S pelween IIny pliny milking P ololm, fj
nncl \le tllonrt11no whll\ll\lr the pPl1y Is anlllllld \0 i:lloh Parly ahllll hllYP IhP rlOht 10 IIppeprfo Ihe pO~i1
ooyeraO\l IIn(Jflrthl~pollpy or Ihp IIppllollhlll ~Imlle of hllyI110 JlIrledlotlon on IIwnrd 01 Iho IIrhllrnlors
~lnpllllY 'fpr lhla pOVllflloe, All dlsllorllllmonls provldolha npplllIl Ie l1aee(j \lpon IIn llrror 01 Inw, nn
reonrdlno OOVllrnOll qUBetlons or Iha nprl/Pllble IIrpltrllllon dool~lon \llIIlllxollet1s Ihll Slnl\ltlnlllhorlty
~Imlls III hleblllty lor \I"s oovorngll mllnl po doolded of the nrllllrnlorn antllll1Y rlOht III nppalll proYlded '
by 1110 PIl~rl hllvlno J~rlelflollpn, ~n(Jer Pommon 111I'1 IIrlllltllllpn, TI1erll ehllll pe no rl(llll
of Ilppolll pn qllesll0I111 of fllol rOOllrdlno tholllllllllly of
Ihe owner or opamlor of Ihe "unlns~red motor
vahlQlo" or tho IImo\1f11 of t1l1mllOlle dolermlnlln 10 IlB
reooyamlllp from the ownar or operntor of IIn
"lInIIlS~red motor yahlolo,"
TIlle endoreement must lia al\lIohad Ip Iho Ol1l1nga r:ndorsemllnfwhen Isslllld Ollerthll plllloyls wrll\on,
Oontalns Oppyrlohtad Mllle,rlnl of InBllrllnoo Servloas Offloa,lno" Wllh Ihalr permlselon,
Oopyrlohl,lnB~ranQa Sorvloeeoffloe, Ino" 1904
!; r
;11
"
,!\
~
"
'i
PPD 04 21 02 96
Page 1\ 01 4
1, '''lnftIHPOS''1
\.
000387,
~, Ollllmft mpdtll
11, , VllhlolllS pr prtlmlllms fthown Inlhll SohpUII11l
Ilr In the PeplllrAllonsl or " . "
1\, Vehloleft Invplven In Ihtl npolrJanl,
P, Any nmp\lnts Pllyapltl for t1l1mnope IIntltlr !l1la
OPVfHAOlllll1AII pe rllll~loen py Alle~mQ pllltllleOIlUQll
III 1110 IIpot1l1y InjlJry" Py or pn pehllll of pereons or
prOAnlJnllons WilD mllY pe leOnlly rllsponelllla, Tille
Inpl~rJeQ 1111 ellme plllrJ lor nn "Inft~fetl'e" lI\\ornoy
\lither rJlrllolly Ilr 11ft PArt of Ihe IImp~nl plllrJ 10 Il1tl
"lnslIrlld," Itllfeo Inol~rJeQ 1111 Slime plllrJ ~lf1ner Pllrt A
of tills pollpy,
Q, Np, onll will pa entltlarJ III rllolllve tl~p!lPllle pllymanls
fllf the llllmll alemenlft olloQQ lI~nar IhlQ oovarnoo
IInd IIny other poverllOIl prt;lvldet1 Py Ihls polloy,
p, Wa will nol maka II eluplloate pllvment IInder this
ooverlloe lor nny elemllnt Ilf lose for wl1loh pllymenl
hllft peen mllr1e IlV or on pal1l1l1 01 pereons or
orOllnlJllllone wl10 fnlly pe IllOlllly rllsponelllle,
Il, We will nol pllY lor IIny elllmllnl of lOllS lIa pllreon Is
anlltlan 10 reoelye pllymenl for Ihe slime alamllf1t of
loss ~lIlner IIny of Il1e lollowlno or 1\ elmllar IIIWI
" Any uro\lp or IndlvlnulIl oonlrl\OI or progmm (hilI
proYldee pef19llte lor IIn\' element pi Ins51
/I, Workars' oOf\1penell\lon Iswl or
a, PlslI\.llllty benaflte IIIW,
OTHIlR INsURANoll
,",
II there Ie olher IIppllollllle elmllar Insursnoa IIYl1l1l1llle undor
more Il1an Dna pOIlOY or prDvlslon of ooyarSoel
The lollowlno prlorltloe pf raooyery spplYI
Plr81 Tile Unlneured Mt;l(orlete OoverAoe
eppllooble to Ihe yel1lole thl!, "Insurod" woe
"ooollPylno" lit Ihe time of thallooldenl,
Seoond The polloy effordlno Uninsured Motorists
Ooverage 10 the "Insurncl" liS II nllmod
In8ured or fllmllY member" '
" tvhen Ihere Ie IIppllonble Inellranoa evallllbla
under the Flret Priority I
Q, The limit 01 liability apPlloahlo to tile'
vehlole tl10 "Insllren" Wae "oooupylno,"
under Iho 110IIOY In tile Flret prlorlly, shall
flret be exholletedl ond ' ,
, PPD 04 21 02 90
p, Tl1a ITIllxlrnum rapPVllry \lndlH
1111 PllllOlps In II1P 13lloond prlprlty
shllll np\ IlKPlllld 1I11lllmollnt py
whlol1 11111 hlollOS1 limit for IIny
Dna Vtlhlpla ~nqof IIny Ilnll pph
Ipy in Ihll sllllPntf prlprlty OK.
panels 11111 limit IIppllon\l11l \In\flH
\l1fl polloy In thll First priority,
~, Whon Il1erf3le no Ilppllollllla Ine\lnmoa IIvllllnpll!
IIndar 1I1tl Flret priority, \1111 maKlmllm reoovery
under ", II pollolllll In Il1e seoont1 priority ehnll nol
f3xoalld tl10 hlohaQI IIppllolllllllllmlt for IIny one
vf3l1lol11 IIntfer Ilny Ilnll pnllpy,
II two or morll PllllolllS I1l1ve Ilq~1II1 priority, 1I1fllnsl,lmr
1l01llnol whom Ihtl pllllm 1ft flrol mane shllll prOOtlell
IInd PIlY the ollllm 11ft II Wholly rllsponsl\l11l for 1111
InQ\lrarQ with aqunl pflorlty, Th,alns\lrllr, is, Ihllrllllflllr
anllllad to rllollver pon\rlll~\lon pro rnlll Irom IIny
oll1ar Ineurer lor Ihallenelllo pllltlllnlJ Iha DOllIe of
pflloellelno \l11l ol/.\Im,
II we rHe \lle Ine\lrar Iloalnsl whom Ihtl olalm Ie first
mlldll, we will pay, e\lbjtlol 10 Il1a limit of IIl1blllty
Qhown In the f.lohDd~le Of In Il1a Ptlolnrllllons lor
Unlneurlld Motorlete Oovemoaillllllr we IInd all olhar
ponlrlbutlno IneurlUQ aoreal
1, Wha\lwr Ihe "Ine~red" ie feglllly entllled 10
raoovar dllmaoes from the ownar or operalor Qf
an "lInlnsllred molor yehlolll"llInd
II, As to Ihe amounl of damlloes,
AR13ITRATlON
A. St:l-EOTfON OF ARBITRATORS
If we and en "In~~redll nlQlIgree whather Ihe
"Ineured" Is lag ally enllllad lei reoover dllmllges Irom
,Ihe ownoror operator of an "unlnsllred motor
vehlole" or, t10 not IIgree as 10 tha amounl of
dllmllgee, alther Pllrty may make a wrlllon t1emand
for arbllrallon, Exoept for the aulhorltlee and rlghle
ataled In Ilaragrpphs 13,,0, and p, of Ihese arbllrlltlon
prllylalons, arbltrallon shllll ba oonduotad In
aooordanoe wllh the provision a of Ih9 Penneylvllnla
Uniform Atbllratlon Aot, Eaoh Pa1iy will seleol nn
arbitrator, The two arbllrll(ors will saleol a Ihlrd, If they
oannol agree within 30 duys,althor may rtlqueet thlll
saleollon ba matfo by II Judge of II oourt having
jurledlotlon, Eaoh pllrty WlII,pay tho DXpenetls It Inollrs
and bear the llKptl[1ees of the third arbltrlllor eqllally,
Unless both partloa agree otherwise, arllllrlltlon will
talle plaoo In thaooU[1ty In whloh Ihe "Insured"
resldee,
rlge 3 of 4
i I
....,
n
11, Is or l1appmpsl
(1) Infiolyalll! or
(ll) InvQlvP(lln Insolvnnpy prtlonor1lnOa,
HOWllvor, "\1nlnsurell mtllor VPI11olo" dOlls nol
lnol\lnp IIny Vlll1lol11 Ilr eqlllpmontl
1, Ownllll Py or hunlsl1ecl tor 111\1 rllO\llnr \J6P iif YPII
or ony "fllmlly mllmllllf,"
ll, awnell Il[ oparlltad Py II uaU.lnU\lrIJr ~nr1prl\ny
IIppl\qallle mp\or vllhlolll IIIW, llMOPpl II
fillll,lnsllrer wl1lph Is or !lenomae Insolvllnl,
a, Dwnpn Py IIny govllrnmanllll ~mll or agenny,
4, Operllten lln rlllls or orllwlnr Irllllr1fi.
", Dlls(gnacl mlllnly for uaa off pllllllo ronds whllp
not on publlo rOllds,
e, Whlla loolllan for IISn lie a realr1enoe or
pre.mlsee, ,
~XO~USIONll
A, WI,1 no nol provide Unlnsura(1 Molorlslu Ooveraoa for
"bodily Injllry" ll\lelolneQI .
1, Byypu wl1l111"oooupylng,1I or whon Iltruok Ily,
MV molor vahlole YOII own whloh lfi not Inellred
lor this 1I0verlloa undar tills polloy. Thle
Inolur1lls a Irnller of lIny type lisen wlll1 11101
vahlole, .
()00888
2, aya "hlmlly memller"l
" '
II, Who owns an aUlo, while "oooupylng," or
when slrllok by, IInv motor yehlole owned
by you or any "fllmllY memllor" whloh Is
nol Ineurell far thle oovera08 IInder this
pOlloy, Thllllnoludae e Irllller ofony type
ueed wllh thaI yehlole,
b, Who does not own an auto, Willie
"oooupylng," or whan e\ruok by, IIny
motor vehlole you own whloh Ie Insurad
for Ihle oovllrage on a prlmsry Ilasls under
any othor polloy,
B, We do npt provide Unlneurod Motorlets OQvarage for
"bodily Injury" sustalnad by pny "Inellrod" I '
1, If Ihat "Ineured" or Iha legal roprosanlullvo
s9\lIes tho bodily Injury olalm wllhoUI om Wfllten
ooneel1l. Howeyor, this aMoluslon (a,1 ,) dOBe
not apply If 8110h eetllemant does nol adyereely
n!feot our rlghls,
PIID 04 21 02 tie
)
p, Whllo "Ooo\lpylno'l "yo\lr oOVllrar1
11\110" wlllln II Ie Ilnlng IIseQ liS II puplln
or lIynry (lOnVllyannll, Tills eX,olllSlon
1{3,~,) (fpllS not \Ipply to II fihllrl!!\llII'
aXPllnso opr pool,
;I, Uslno llV\lhlole wlll1Q\lllhe parmlfi'
slQn \1111111 ownOf,
0, We r10 npl provldn \Jnlns~rar1 MotPflste QOVllrlloe for
"non.eoonomlo 1\1l1e" 811ellllnoq Py Ilny IIlnfiurllcl" 10
whom 11111 IImller110rt lIlIllrnollvo Ilpplles, rll~ulllng
Irolll "Ilocllly Inl~ry" olluslld Py IIn llpolnlln\ Involving
IIn "Imlnsurtlcl motor vehlol\l," IInhlafi Ihll "podlly
Inj\lry" suellllnad Is II "sorlolls Injury,'1
Tl1ls PKolllfilon ((3,) cloefi not liP ply I
1, II tha ownllr pr Ilpllrlllor pI Ihp "\lnlnsllflld motor
vehlola"l
p, Is oonvloloQ, or, 1I00aple Aopnlllrlltar1
Rehlllllllllltlve Dlsposlllon, fpr clrlvlno
uncler Ihe Influenoe of 1I100hol or 0
oont[olled a~belannaln Ihlll a(loldpn\i .
\), ',Is operllllng II molor vehlola rpgletllred In
anolher ellllol or
0, Inlande \0 Injure hlnwolf or another
pereon, provlned thll\ IhelnnlvlQulI1 noes
nol Inlentlpnlllly Injure hlmsolf or IInolhef
perean morllly IlOQlluae his 1101 or 11I1I\lre
10 lIoI la Inlenllonl\l or clone wllh his
rllallJallon 111(11 II oreales a Orllve rlek 01
ollllslng Injury II Ihe aot or ommlfielon
oallelng the InJ~ry Is for Ih8 rurposlI pI,
avartlng bodily hllrm 10 hlmsel or Ilnolher
perfion,
2, II Il1a\ "Ins~red" Ie Injuren while "oooupylno" II
molor Vllhlole Insurlld unclnr 0 oommerlol\l
motor vilhlole Inellrllnoe polloy,
D, This OOyerllge sl1all not apply dlreoUy or Indlreolly to
benllllt any Insurer 'or eelf,lnsurer under any of the
loll owing or eltnllar lawl
1, Workera' nompensl\t1on lawl or
2, Dlllablllly bel1ellts hlW,
S, Wa do nol prOVide Unlns\lred Motorlets Obverago for
punlllye or eMornplary damagee,
LIMIT OF LIABILITY
A. The limit of IIl1blllty ehown In Ihe Bohadula or In 1110
DeolllraUons for Unlneured Motorlete Ooyerage Is our
maMlmum IImll of lIoblllly for all t1amagas teeulllno
'from any anD aooldent. This Is the moet we will pay
togardleee of the nllmllot 011
Page 2 of 4
, "
,
\
0.0088U,
, ,
J)ONEGAL MUTUAL INSURANCE COMPANY
AQI!NT IlYlllRJ:<Y I lif' IIQIllIi'l'~"~ nROI~I!lRf) I Ii
, ,
AQI!NOVNUM~I!R OPP6~O?
IMPORTANT NOTlo~
In.~nmpl!, pompRnlea opflrptlng In thl! Oommonwppltl' of pennllylvRnlp IIrll roq\llrpd Py IRW tei mRkp
R, VlIlIpplp for P\ll'ohlUle thl;l folloWing penofltll for VOL', yom IIpO~lIe or pthe, I' mlRllvl;l1l or mlnorllln your
11\.Istody PI' In the o~lItody of YO\lr relptlve., rellldlng In your hOlJllehold, OOQ\lpl1nl. of your motor vehl.
olll or pllrsons .Ir~pk py yo~r molor vehlolel
(1) MpdlplIl benefit., up to III IplllII $100,0110,
(1,1) ~Ktrllordlnllry m!lclloRI ppnefltll, from $100,0011 to 51,100,000 whloh mllY be,offerer;i In Inoro.
monlspfS100,OOO, ,,'
(al Inoome 10Sll blmpfltll, up to pt lelllll SIi!,SOO per month up 10 a muxlm\lm bfmeflt of 1\1 'PRill
$50,000, " , , ,
(3) AOoldental cloRth Pllneflts, \.Ip 10 al 101lllt 5Ii!S,OOO,
(4) Funerl\l benoflts, SIi!,SOO,
(6)Asl\n Illll!rnlltlve to pl\rl1grl\phl'J (tMa),(3) I1nd (1\), il OOmplnRtlon benoflt, up to I1t lOl\lIt $177,600
of poneflts In thlll\ggrogllle or penofltll pRypble up to three YOllrs from tho dl1tp of tho 1I00ldonl,
wnlonever ooours first, sUbjoot to 1111mlt on I\oold!lnttll dORth bllnofll of up to 526,000 I1nd a limit on
funorlll benoflt,of $Ii!,600, provldod thlll nothing oontlllnod In thlsllubllootlon 11111111 be oonstruel'.l to
limit, redLloe, mpdlfy or ohllngo tho provllllonll of 1I00tlon 1716(d) (rellltlng to avalll\plI\tv of ado,
qUl\te limits)" ,
(6) Unlnllur~d, undorlnl'Jurod and podlly Inlurylll\plllly oovorllge u~ to 1\1 101lllt $100,000 POOIlUIIO
of Injury to one porllon In I\ny ono 110olclont I\nd up to I\t 10l\st 5300,000 boolluse of Injury to two or
more porsons In "ny ono I\ooldont or,l\t tho option of the Inlluror, up to I1t lellst 5300,000 In 1\ single "
IImlttor theso ooveragOll' oxoopt for pollolell Issuod undor the ASlIlgned Alsl< Phm, Also, at lOl\st,
$6,000 for dl\ml\ge to proporty of othorsln I\ny one I\ooldont,
Additionally, In~urerll mllY offer hlghar benoflt lovels thal1 thooe enumerl'ted Ilbovo as Well as addl.
tlonal benefltll, Howover, an Insurod may oleot to purohaao lower benefit levola than those onumor.
ated above, ' '
NAMI=P
INPUR~PNQvo~IiI f'IINPRII
flPI-IOVNUMlIllA PAm 049p(iOOO~
, Your slgnl\ture on this notloe or your payment of any renowal promlum evldonces your aotual know'
ledge I\nd understanding of the availability of those benefits and limits all wolllls tho benoflts and 11m.
lIs you havo 1I0leotod. . II . "
IfVou hllve I\ny questions or you do not understand all of the various optlonlll\vallable to VOU, oontaot
your agont or oompany, '
If vou do not understand any of tho provlolons oontalned In thla notice, oontaot your agont or oom-
pany beforo you IIlgn.' , ,
'i'
PLOF 1 '73 (Ed. 7/90)
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ID<O~Ul'l'PI~1l ,
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I A, W\I dp npl provlcje \.!ndprlnS\Jrlld Mptofls\s OoyprllOll
for II\locjllV Ir1j\.lry" e~ellllllllPI
1, l3y yo~ wl1l1a "oooIlPylnu," pr whon ~Irllok IlY,
flny mol~lt yphlola YPII own whlol1ls 1101 Insurod
for Il1ls ooV\lrllOP umtef ll1la plllloy, Tills
Inolllqos II \rollor 01 IIny typo usod wllhlllllt
yahlolll,
~, l3y nlllllmlly mllmpaf"I
II, WilD owne fin 1I\lIP, Willie "oooupylno," or
when slr~ok py, llny mll\pr val1lole pwnod
\IY YO\l pr llny "fl1mlly mllmpor" Will 011 Is
nol Ins~rod ,pr Ihl8 ooverllOIl \lndor Ihls
pOlloY, Tills 11101~doll II 'rllllllr olnny Iypa
\.Isen with IhpI vel1lolo, .
11" WhQ {Joes npl own IIny l1\lIQ,whllll
"pooupylno," or whlln elr\lok \ly, nny
molor valli pia you own whlol1le Ins\lrnd
lor Ihls oovafnoe on prlmllry pflsle under
, nny olhar polloy,
II, Wa do nol pro, vldll Unuorlnsllrad Molorls\s 0, ovamoa
tor "Iloplly Inj\lryll s~slolned Ily IIny "lnsured"l
1, If Ihlll "Insuropll or Ihe laOll1 reprosenlllllva ,
setlle8 Ihe Ilodlly Injllry olalm wllll01l1 ollr wrlllen
oonsenl,' '
It Whllo,"oooupyjno" "yollr ooverod llulO" whan
Ills bolng IIsed as a plJllllo pr IIvory oOnvlly"noe,
,. Tills e~ol~slori (l3,il,) doas nllt apply 10 "
share-Ihe,axponso Ollr pool,
(I, Uslno /I Yohlola wIII10UI 1110 permlaslon 01 tho
owner, '
i'
0, Wa do nol provlda Undarlneured Molorlsle Ooverllgo
" "for "non.ooonomlo lose I' sllslolnad by any "Insurad"
10 whom Ihe IImllen torI IlltemllllVe llppllee, reeulllno
'1rom "Ilodlly Injllry" oaused by an aooltlonl Inyolvlng
.an "lJnderlnsllrod molor Yllhlolo," unlaea Ihe "bodilY
1njllry" suslalned 18 a "serious Injury,"
~.,Is oxoluslon (0,) does nol applyl
1, 'II the ownar or operalor of Il1a "underlneured
,I mlllor vehlola" I
a, Is oonvlolad, or aooopts Aoolllera\ed
Rehallllltlltlve Dleposlllon, for drlylnO
undor the Inllllonoe 01 aloohol or a
oontrollad eubelanoe In thaI aooldanll
b, ~s oporatlng a motor vahlcle raolelored In .
.anolhor elalol or
PPO 04 17 OR 98
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P, InlplI\~s 10 InJllro I1lmsoll or nn.
1~~w\I~~lsg~~rri~~I~;\~~\mh~~~
o ~ (I B n l II I
InjlltU hlmeu pr llnot lIlr pefspn
mllrllly IlePIlUso Ills IlpI pr lnllurp
10 nolls Inlllntlonpl or nOn" with
hla rp"II~lIlIon Ihlllll orlllllllS II
OfOVP flak of Prl\IRlng InlIHY II \hll
110\ or pmmlsslon olluslng \1111
Inlury Is lpr \I'll pllrpOS\l pf Ilvor\- ,
I,no hocllly twm t\l hlms\l1I pr IIn.
olhllr pOfslln, '
\l, II Ihlll"lns~rolj" 10 InJufan whllflllPoolIPylno" II
mplpr vahlplo InsllrPlj ~ndllr II opmmllrlolll
motor Vllhlole Ins\Jrnnoa pollllY, '
p, This oov,erlloll shllll nol IIpply dlreotly or Indlrllotly 10 '
bllnell\ IIny Insllrllr or sellolnsllrllr IInPllr IIny 01 Ihe
following or similar lawl
1, WorkefS' oomppnsp\lon loW; or
~, Plellplllly Ilonefllll low,
Il, ,We do nol provl(le Undllrlnsufad MptorlelB Ooverlloe
fOf punitive or axamplary QnmlloeS,
I-IMIT Q~ I-IAIIII-ITY
A, The lIinll Ilf 1I111llllly shown In tha Bohllnllle or In Ihe
peolflratlone for Unnerlneurod Motorlels Oovarlloe Is
our moxlmum IImll of 1I11lll1lly lor all domllgoc rocul\lno
Irom IIny ona lIooldent, This Is \ho moel wa will PIlY
reOllrdless of tha n~mb~r ofl
1, "lneUrade" I
,
\l, Olnlms modal
G, Vehicles, or premlllms ~hown In Iha Bohed~le
or In Iho Oeolarlltlona; or '
4, Vllhlolae Involved Inlhollooldonl,
13, lfhollml\ 01 liability sholl be reduoed by all eums paid' t
. booaullo ollho "bodily Injury" by or on Ilehalf pf ~ ~
4>Drsone or organlza\lonn who 'ffiIlY Ila lag~IIY .
.,tlBponel\lle, Thle inoludoD'1I11 eums paid for an OJ
~'Insuradls" Illlomoy ellher dlreotly or ae part of Ihe \vI
fllmounl paid to Ihe "Ineurad," 1\ also Inoludee 1111
nume paid undar Pllrt A 01 Ihlo polloy,
0, No one will bo al1t1t1ed 10 reoelve dlJplloll\e paymenls
for Iho Slime elements of IIlBS undor this ooverage
IInd any olher coyerllgo proylded by \hle polloy,
<' .,
0, '., We Will nol make a duplloate payment under Ihls
ooyarege for ,any elemonl olloes for whloh payment
hes bean made by or on behalf of pereone or
organizations who may Ilo leglllly reeponelble, '
Page Ii! of 4
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~, WP will not P\lY l{lr IIny plampn\ ollpe~ 1111 porfiPn Ie
anllllllq IP rlloplVII pllympnl lor \1111 pllnw elamonl of
lo~s ~ntlor IIny of \1111 foll{lwln~ or 1\ ~Imllar IAWI
1,An,y grPII, p pr l,nnlvl~\JII, I opnlmo\ or PrtlO, rAm Ihnt
pr(lvldo~ panallts lor flny olamlln\ pllposl
II, W~rkllrs'Qompansll\lonloWI pr '0 ~ ~
3, Ploo\llllly Pllnllflts Inw. \) G G
OTHI;A INSIJRANOI;
If \l1l1rlllsPlllllr nppllollllle plmllor Ins~mnpo nVIIIIII\Jla \lI1qar
mOfll 1I1An onll PlllloY or provlslpn of ooYarllg~1
TllIllollpwlno prlorltlep pf rlloovery IIpplYI
Flrl!1 Ttw Undorlnsuratl Molotlsle Oovefl\go
npplloll\Jlo IP Ihe vahlolo Ihll "Insurod" wns
"oooupylno" pI lilll lima 01 tile nooldonl,
S800nl1 The pollpy IItfordln\l Untlorlnpurotl Mo\orlele
OOYllroOIl 10 Iho "Inawacl" Ap II nllmen
Insuratl or IlImlly mem\Jer,
1, Wilen thare Is IIppllolllllo InS\ltllnoe IIvIIIIII\Jla
unqer Iha Flrel priority I
II, Tho limit IIf 1I11\JllllY IIppllOll~lo \0 Ihe
vehlolll Iho "Insllrodll WlIo lIoopupylng,"
\tntler Ihe polloy In th~ first priority, phlllt
Ilrol PO exhllupledlllnd
Il. Tha ma~lmum reoovery unt10r 1111 polloles
In Iha Seoontl priority ehall not e~oeed Ihe
IImount \Jy whloh Ihe illgheel limit lor IIny
ona Vllhlole undor IIny onll policy In Ihe
Saoant! priority eKoeeds the, limit
eppllollblo unner Iho polloy In tile Flrsl
priority" ,
II: When Ihefals no applloabla InellrPnoe aYlllla\Jlo
under the Flrsl priority, Ihe maxlmllm reoovery
, under 1111 polloloo In lile Seoond priority ehall nol
, exooed Iha hlghesl applloo\Jle limit lor ony onll
YOhlole under anyone polloy,
II two or more polio lee haye equal prlorlty,lhe Insuror
agalnel whom Iha ollllm Ie IIrel mllde ehall prooeee
lint! pay Ihe olalm as If Wholly roeponelble lor 011,
Insur~re with oqual priority, Thelnellrer 10 Iheroefter ,
enlllled to rOOOVllr oonlrlllullon pro rola Irom any
olhar Insllrer for Iha Ilenoflle IInd Ihe ooets 01
prooooelng Ihoolalm,
If we are the Ineurer oOlllne\ whom the olalm Is flrel
made, we will pay, subjeol to Iho limit 01 liability
shown In Ihe Sohenula or In the Deolllrn\lone lor
Underlnsllred Motorists Ooyoraoe, after we andllll
othor oontrlbullno Inllllrars IIgfoel
pro 04 1'7 02 9B
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1,
Who\l1or Iha"lnsIH\lt1" Is 1000lly anli<
II0q 10 rpooVllr qllmOOos Irom Ihp ow'
mH or opllrator of on "undurlns\lrllll
mQlor yphlole" 1 ond
Aa 10 tha IImounl 01 dllmoOIlS,
II,
ARI'IITRATION
A. S~I.I:OTION OF ARI3ITRA TORf\
II WII IIntl on "lnSllrod" tllSlIoroa wliolhor Iho
"Ins~retl"la leoally Ilnllllod In rllOPvor tlnmoooe Ifom
\1m ownqr or pperlllor of IIn "\lnt1oflnpurorl mol{lr
vphlolll" pr nn [101 1I0rflll liS 10 tha pmo~n\ pI
dl\mIlOIlP, IIlIhllr' pllrtV mny mllko n wflllsn qllmllnq
for IIrllllrnll\ln, f:!~oap\ for Ihe nulIl(Jrltlll~ ond rlllilts
sllllen In parPorllPhP 13., 0, Ilntl p, ollhasll orpllrPllon
provisions, IIrpltrllllpn fth~1I PIl 1I0ndllOlll~ In
aooord~npe with \lw provlelonp pf fha Pannsy!vlmlll
Uniform Arllllrnllon Aot, F.lloh Pllr\y will saleol IIn
IIfllltrlllorl Tha IWo IItpllrlllore will eelflO\ II Ihlftl, If tl1flY
ollnnolllorfle within ~o dllYs, flllhal' rnlly ruqllllsl \l1PI
saleollon Po mlltlll Py n I~dgfl pf a oour\ hllvlng
j~rlscllollon, ~lIoh Plll1Y, Will PIlY IIle e~pllnBsB IIlno~rs
IInd pellr IIw Il~pens~p of Ihe Ihlrd IIrpllrnlor equlllly,
Unleee \Jolh p~rlles lIurlle olharwlee, Ilrllllrnllpn will
tllke pllloe In Ihe oounty In whloh Iha "Ins~rlln"
roaldea,
II, ~IMITATION OF ARI3ITRATORS' AUTHOR!TY
Tho nUlhorlly (If Ihe IIr\Jllrlltora shllll Illl IImlllld to
deol~t1ng the 1I111llllly ollhe owner or opsrnlor (1f IIn
"undarlnsurecl molor vehlolell Ilnd IImount of
dllmllges rllOOYflrllble from tha owner or operPlor pI
IIn "underlnp~red molor Yllhlole," The IlmOllnt of nny
~Wllrd mllyba lip 10 PilI nol In e~oees of Iha I-Imll of
I-Ialllllly shown In Ihe Sohedula or Paolarnllone lor
Undllrlnallrad Motorlsls Ooyerall~,
The ~rbllrotore may nor fonder deolslons on
, t1lsagreemante beMeAn ~ny party milking a olalm
IInd lIa regarding whalher Ihe party Is anlltled 10
oovar~oe IInder Ihle polloy or Ihe epplloablo Llmlls of
LI~\JllI\y for Il1le ooverage, All dlsngreemente
rlloardlng oovarage quee\lons Of Ihe epplloable
1.lmlls of Llalllllly for this oOVllrllge musl be deolded
by Ihe oOllfll1aYlno )lIrlsdlollon,
0, DISOOVERY RIGHTS
I:aoh pllrty shall hAva Ihe rloht 01 full dlsoovery
Inolllt1lno, bill not IImllad 10, depoelllons 01 any
Inyolyed parlY, tequosts for prod~ollon 01 doollmente
auoh ae employment and madl6hl reoorda, and the
tlOh\ 10 par!otm patlodlo medloal e~amlnallons on
any porson making a olelm unner Ihls ooYstllge,
PallB 3 of 4
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NAM!!P r
m~UA~PNPVPW"I ~^NPRA
A~!!NT~Y~R~Y IN~ ^Q~NT~ . PROK~R~ IN
PPI-IPYNU,MI3~Al'wn 04~B5pO O~
A~~NPYNUMI3!!R0005~07
0008nB
Thlll110Upe Is PI'llng senl 10 yo\1l\S rpq\1lreq Pv Ihp Pel1l1llvlVllnl1l Vahlolp Oode 'fllla,76 8eolloI117111, 1 (II),
'fhl'l IIIWs ollha Oommonwallllh 01 Pal1nsylvanlll, IUl enllole~1 py Iha13pnerlll Aallemply, only req\llre Ihlll
YO\1 pmoh/lse 1I111llllly I\I1d IlrllH'Jllrlv medlollll)enf,lfl\ poVerl\gell, Any IIdqlUOnlll, oovarllga, s or OOVllrflllllllln,
axoaaa of Ihe IImllo rllq\1lrad by IlIw ara provld",d only III your rllq\lasl liS cmhl\noemanls 10. PlIlllo
PPveragell;
This nolloe Is 10 provlqa YIlU wllh Ihf,lm/nlmu!11 ooverllflallmlls nf1d oorreaponeUng prel11l\1ma
$16,000/$[30,000 130dllY Injury I.lal:lllllY $ 30.00
,.,r---
$f,i,000 Propel"\Y Pllmllge 1.IIIIllllly $ ~4. 00
,
Anel
$6,000 FlrsH~III"\Y Medlol\ll3enefl\s $ ~2.00
---
TollIl $ 66.00
,THIS IS NOT YOlJR 131\..I.IN(i NOTloa, p\..aAB.a Rt:P13R TO oovaR \..13rr13R WI110H INO\..UPJ:l$ J1RaMIUM
INVOI013 POA AMOUNT,PUt:.
PI.OP.1201 (ad, 11.01)
The lawa 01 Ihe Oommonwealth 01 Pennaylvanla give you the right 10 ohoose either 01 the following Iwo 11111
opUona! ' ',. ' .' '.
A. "Limited Tt:;lrt" Optlon.r Thla 10rl11 01 lf1aUrall0e IImlla your rlghl and Ihe rights 01 members 01 your,
household 10 aeek IlnanolAI oompensallon lor Injurlea olluaed by olher drlve[a, Under thla lorm 01
lf1suranoe, you and olher houaehold membera oovered under Ihla polloy mllY Beek reoovery lor all
medloAI Ilnd olher lIut.ol-pooket expenses, bul nol lor pllln Ilnd klUfferlng or other nonmonetary
dllmages unless Ihe InJu[les sullered lall within Ihe definition 01 "serious Injury," aa sel 10l"\h In the
policy, or unlesa one 01 several olher exoepllons noted In Ihe polloy applies, .
a, "Pull Tort" Opllon- This lorm of Insuranoe allows you 10 malnlaln an unreslrloled right lor yourself and
olhe~ member!! 01 your household 10 aElek flnanolal oompef1al\lIon lor Injuries oaused by olher drlvera,
Under Ihls lorm 01 Insuranoe,you and olher houaehold members oovered under Ihla polloy may seek
reoovery lor all medlolll and other out'ol-pookel expensea and mar also seell flnMOIl\1 oompensl\lIon
lor pain and SUffering or other nonmonelary damages as a resull 0 InJurh3s oauaed by olher drivers,
II you wlah 10 ohange Ihe Ion opllon Ihat ourrenlly applies 10 your polloy, you must notify your agent, broker
, or oompany and request and oomplete the approprlale lorm, .
Pl.OP-20D (Eld. 7-00)
L
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Baau sa,
, '" ' ',' '" "" , 0 0 0 S fY
Thill npllflpl\\lon III III l\qvlllrj Yll\J pf VArlo\Js qlsoP\Jnls whlph mllY ~III1VIIIII\~la \Jnpl'lr Ihls pollpy,
1, FIIIllllvll Alllllrlllnl PaVlpes, II YOIJr lI\Jlomoplla Is pqIJlpparl wl\l1l1lrpnll\l orlll;h prplao\lon "
IIYIl\pm whloh req\Jlrell np f.lp\lpn llf\llP VPl1lQle oOP\lPllnls Iwl pomplles wl\h ~llInqllrp
1m ,~pa 01 Ihl3 Nl\llpf11\1 Tmfflll SlIfllly Aclmlnlslmllon, YO~I ml\Y pe ellgl~le lor II qlljoo\tnl.
'Th!lllmolJnl pI rllllooun\ WO~llcl Pll PIIlIarl of1 Ihe syslem Inl;llI II a ('1 In yoU[ lIulpmoplle Anp
wllll\pply 10 Ihe Flrlll F!Ir\Y f:l!lnefll OOVerl\ge,
~, An\l.lhllfl p!lvloes , II your A~I\omo~II11ls equlppecl wllh 1\ syslem whloh Is l\ollVllleq 1\\.l\omIlIlQl\lIy when
Ihe oPllrl\lor l\.lrnlllhlllgnlllon Iley 10 Ihe off poslllon IInel Which Is pelllgneel Ip preVllnl \.lnl\\Jlhorl~llcl IJIl!l,
YO\J ml\Y Ile !:lllgl~le 10, r 1\ qlspoUn,l, T,he elllloo\Jn, I II; nolllppllpaple If Ihll I;yslflm,Is Ihll !lll\nell\[ellgnlllqn
Inlllrlooll ayslllm provlclllel liS IIn AnlHhllfl qeVlpll Ily tile o[(1lnll\l ml\nUIAOI\1rllr, Any dlsoo\Jf11
IIPpllol\pla, wllll\pply to Iht.'l comprahllnlllve OOVllrllga, '
a. Molor Vehlolll Prlvar Imprpvamenl Oourl;t.'l , II ellspo~ml Is IWI\II 1\ pi t.'lII All nAmlld Inlll1raela ftfl'l55 yellra
olllga O[ olper I\nel hl\ve a\.loQt.'lssl\.llly oompleted II molar vehlole prlver Improvement oP\.lrse meellng
Ihll Slllncll\rPa pI Iha PPPI\r1ment 01 Tmnspor1l\llon, The qlsoo~1I11 l\ppllllll lo[ Ihe Ihree Yl3l\r perloel
Irnmeelllllely following Ihe Il\looaaslul oomplallon of the oourse, ' '
PI~llse 00f111101 YO\.lr I\genlll Yo\.! leel YO\.lllre eligible lor IIny of Ihlll\Pove dlsoounls,
,QI!:1JllleB U a G a a B
.
,
In l\dplt!on lolhe plsoo\.lnls IIsleellloove, olher prl3ml\.lm lIavlng opllons ml\Y oe IIvallllblt.'l pt.'lpendlng on Ihe
OOVt.'lrl\ge ourrently I\pplYlng 10 Ihls polloy,
, !.
1, PennsylvaniA law no longer requires you 10 ollrry \.JNIN!;lUAgp MOTORISTS or, UNPgRINsUAgp
MOTORI!;lTs aovgRA~i:s, You mllY he I1l1le to [eduoe your preml~m If: '
, A. You repuolllhe IIml\s of liability applying 10 either or bOlh ooverAges.
13, You reJeot Ihe IIstlloklng" 01 ellher or both ooverages,
0, You po nol wll;h 10 oarry tillthel' or bolh ooverAges.
Il. You mlly [eduoe yoU[ FIRST PARTY.l3gN!:FITS OOV!:RAG!:, The minimum medloal expense '
ooverage you must oArry Is $6,000, YO\.l po not have 10 oarry wage loss ooverage or fUneflll expense
ooverage, "
3, You nw Inorease your OOL.L.ISION deduollble, The higher the deduollble Applying \0 your vehloles,
the lower Ihe premium, .', ,
Please oontaot your agef1t II you wlsll more Inlormallon on any 01 Ihose options,
PI.ONIOO (Ep,7.00)
I
UD
Any person who tlnowlngly and with Intenlto Injure or delraud any Insurer files an appiloallon or olalm
oonlalnlng any falSe, Inoomplete or misleading Informallon shall. upon oonvlotlon, b\l llUbJeol 10
Imprlsof1mrmt for up 10 seV(ln years and paymenl 01 a fine 01 up 10 $15,000,
Thill notloe 18 belrlg given 10 you In oompllanoe with Aol 601 1 gOO,
PI.OF,210 (Ed, 6-00)
"
PPNF~Ak MUTUAl. INSURANPF OOMPANY
PlInn~ylvMIII S\.lrol1nrp~ Plaoltls\.lrfl ~llIlomllnl
Prlllllrro(j flllllna Proorflrn
j " ,
In pooorollnOll with Ppnneylvnnln kllW, WII ma provlqlno yqU wltl1l1n axplpnallon pf \lpr alllll Prlvllr Ina\.lrlWlll
"llIn, \lnqllr w, hlllh VIM polloy hflspaan rlltad, IInd 1I1l1 pllln's pflllo! on YO\tr pUlomollllll rlllllln 1I1f1l1Vant of II
phllroeflPllllloolclpnHM findlor opnvlollpn,
Whllllllll111 Bille Prlvllr Ina\.lrpnoe "llIn? 0 0 0 8 8 8
Thll flllf\l PrlVllr Insurllnoo Pllln (I111rllllllllr referred Ip liS flDIP) ~Sas past eKpllrlonue (f1oolnents /II ponvlollonS) liS flPrt of 11111
detllrmlnatlon of yo~r premlllm post, Thll syslam naeorll1otl pillow hilS Pllfln lIstllhllslla(l under Whloh Ihoee "rlvars 1l111t hflVll
no points raolllye Iha loweet premiums, Hloher premiums pfll otwoa" for pther drlYore Ilpeed uPQn Iha n~ml)ar 01 Plllnls
Ihay hllvlllloo~mplntlld (jprlno \l1Il aKparlenoe pllrlon, The eKperlanoo period Ie Iha !hroe.yellr InlllrYlI1 pelWllen the dllta III
Ihlllnllllll ollllm pllymllnt rlls~llIn(l Irom pny one nool(lllnl IIncllllll dlllll 01 Iha lIppllollllon or Iho prllpllrlllllln of tha rllnawpl,
Pramlums for thll lollowlno ooyarlloes nralllloolenl klfll11llly, Flrsl Pn~y [:lanallts linn Ooverpoo For PllmllQa To YOPf A~lp,
Prll/lna A.oorcl ~'J1lnls
OPlwlolltlna
Polnla shlllllle assigned for oonvlotlons dljrlno thp exparlenoo Pllrlod for motor vehlole YlolaUone of Ihe IIppllonnt or IIny
othar ollrrllnUy rasldent operAtor f1S followel .
(1) Thrall polntllaro IIseloned foroonvlotlpn 011
(a) DrlYlng while IntoKlollten or ~nt1Dr the Inllullnoe of nruOel or
(Il) 11111111ro 10 Slop IInd rllport when Inyolvad In an lIooldant reelllllno In bonlly In)lIryl or
,,(0) Homlolde or IIssfllllt IIrlelno o~t of Ihe oparllllon of II motor vllhlrlol or .
(d) Driving whllelloenee Ie ellspended or reyokod,
(2), Two polnle lire IIsBloned for tho Ilooumlllollon of polnle under II State Point System or II eerlee of oonYlotlons raq~lrlng
Ihe filing of ovldenoe of flnanolol responelblllly undar IInv Flnllnollll ReeponslbllllY ~aw ae of Ihe efleollya dllle of Ihe
pOlloy,
, ,
(3) One polnlla lie signed for oonvloUon olllny olher moving trafflo vlolllllon resulllno IIlI
(II) 811spenlllon or reYooallon of IIn oporalor'e 1I011nse, Of
(p) The filing of evldll110a of f1npnollll responelbllllY IInner any Flnflnollll Raeponelblllty ~IIW roqulred liS of Ihe
elleollve t1ate of the polloV' . ,
The i=i<perlanoe Period for lIeslgnmonl of polnte for OonYlollone ISI
Tha Exparlenoe Porlod sholl be Ihe \hrao yellrs Imll1enlalllly preoedlno tha nate 01 appUoatlon or Ihe preparllllon of Ihe
rllnewal. ,
PI.OF 11111
FQ, 1 l!/f/4
Aooldent Iiuroherglls
(1) Surohargoe for Aooldanls Ooollrlng Prior to July 1, 19901
,(a) Points are assigned lor olloh 1I0oldenl that ooollrred dllrlng tha oKperlenoeporlod,lnvolvlng Iho epplloanl or any
, resldont Oporlltor, while oparollno II privata paosengor auto, Dna point Is ao~lgl1ed lor IlIlOh lIulo oooldent Ihal
rosultsllll
(I) Bodily Injllry or deeth reellltlng In u paid olalml or
, (II) A paid otalm for damage 10 any proparty InollldlnO his or har own In eKoeeB 01 $300,
Page 1 of 3
PLOP 111a Ed,12/94
., , '."
, ,
'l' " ) ,
(p) Qr)ll polnl Is peelono~ fpr'IWP Ilr morll popldonls rl~rlno thofl~porlonpo poript1 wl110h rfls\Jltln p\lltl
plplm~ pV 1110 Il1e~for lor dllmllOo 10 III1Y \1fPparW \llO do 1101 flls~ltln Iho paslOnmal11 III polnla ~l1dor (0)
IIPIlVP, '
Tl1a l=xpflrlonoe Parlocl ahall pa Ihll IIlrPP.VIIPr' IntofVpl patWPPI1 tlw tlplp pI Ihelnllllll ollllm plIvmonl rllalllll110
Ifpm III1Y PI1Pllopltlllnl IInd Iha dolll 01 Ihp IIpplloollon pf,IIW proPllrllllon of Ihll rlTe'tllg 8 U
(12) f3l1fohllroes 'Of Aoold\lnts Doo\Jrrlno On Or Allm ~\lIV 1, 19901
pplnls lire paslonad lor olloh 1I0olr!pnl lor whlohlln InQ~rpr pold II ollllm ma\ltlno lIl\l prlterla palow, II 111\1 1I001cl\lnl
Invplved Ih\lnppllollnl, Ihlt nomed 11111\Jr{l(I, pr nnv raSIQIII1t oporlllor whlla oporntln~ IIn !lIllO,
(I)' Apoldanlll PPo\Jrrlno pn or /111m ,'~IV 1, 1 990 1l~1 p\llore ~ulV 1,109(31
Onll pplnt Is IIslIlonod for allohllOQlltllnt far whloh IIn Inellrar pllld II ollllm durlno 111\1 oxpnrlenpe porlod
of ~~~o or morp, ' ,
T, hp expe, flal1pa period Sh,lIl1 P,o II1a Ihrae,vollr Inlmval hOIWllon the dlll\l 01 Ihe Inllllll Pllllm, PIIY, mont r\lsulllno frpm IInv
one nooldanl whlph me\lts Ih\l $~60 Ihr\lshold,lmlt tha clPla pi Iho IIppllollllon or Ihe prapllffJllonol tha reneWIII, '
(II) Aoolnan\s opourrlno on or 1If\llr ,IIIIV 1, 1 (19(31
Ono plllnllQ IIQslon\ld for onoh 1I0oldont for whlohlln Ine\lrar pllld II ollllm d~rlno the exparlllnpa peflorl
of $760 or more, '
Thfl \l~parlanoa perlpQ shlllllla Ihe Ihrflo,yellr Inlarvnl halwean "'ll dllle of 1118 Initial ol,lIlm PIIY, menl reeullll10 from IInv
, one nooldant whloh meets tho $7~0 Ihreeholt1,llnd Ihe dllle 01 Ihe IIppllQlltlon or Ihe preparation of Ihe ronnwlIl,
JlKIll1PlloI18
Tha lollowlno Aool~ent S\Jrol1llfoe g)(O!:PTIONSllpply to IIpoldents ooourrlng pflor\o ,July 1,1 (I90i "
(1) No polnle IIrll Ilesloned for Ilooldenls InourreQ by on oparlllor damonelrolod 10 be a nllmlltilns~req Ilr II prlnolpal
operlltor 01 on 111110 Inellrad unlter II eepllrole polloVI anti "
, '
(il) No polnla IIro lIeelonen lor 1I00ldpnle ooourrlno IInOOf Ihe followlno olroums\lInoElel
f " ' " ,
(Ill AUlD IlIwlullV parkad (II tha pllrkod vohlole rolla from Iha pllrken poslllol1 Ihen nnv auoh aoold\lnt III oharoad 10 Iho
person Who pllrked Iho a~loll or , ,
(bl The epplloonl, ownOf CIr other reel dent opemlor relrnb~rgetl by, or on bahllll of, a pareon who Is reaponslblolor
thfl aoolnenl or has I~doment Roalnst e\loh porsonl or
(0) A~Io Is etrllok In tha rallr Ily anolhor vahlola ant1 Ihe applloant or other reeldenl operlllor hilS nol boen oonvlotad
01 a moylno tmfllo Ylolo\lon In oonneotlon with Ihls aooldanll or ' '
(d) Oparalorof Ihe olhor aulo Inyolyad In Ihe aooldonlwas oonyloled of II mOVing lrafflo Ylolpllbn IInd Ihe opplloanl
or rasldent opefelol' was nol oonvlolod of a moYlno trafflo vlolallon In oonnaollon with Ihe aooldanll or
(el Aulo opernlorPY Iha applloonl or any residant operlltor Is alnJok by a "hlt.and.rlln" yahlole,lIlha llooldQnt Is
reponed to Iha I?ropor aUlhorlly wllhln l!4 hOllfe by Ihe IIpplloant or resldenl opamton or '
(I) Aooldente Involving damage by oonloo, wllh animals or fowll Of
,
(g) AOQldente InvolYlng phyeloal damage,lImltad 10 and ollusod by f1ylno orayel, mleellee, or 1IIIIIno oblaol91 or
(h) Aooldents oeollrrlng Whan IIslno aUlD In responee to Iln emarllanoy If Ihe operator lit Ihe lime ollhe aooldenl was
o ppld or vblllntear mambefof any Polloe or Flro Oapntlment, Flret Aid Squod, or any law anloroamenl aoenol',
This oMoopllon doas nollnolllde on aooldent ooourrlng olter Ihe 01110 ooaaas 10 be uead In raepol'\ee 10 ouoh
emetgonoYI or
(I) Aooldents resulllng In on amounl paid on bohall of an Inellred IIndor l3aslo, Added or Oomblnallon Flret POllY
Beneflla oovorogas only, ann tho IIpplloenl Of olher reeldant In Iha Dame household wae nol at fault In
oontrlbutlng to tho M~ldont giving rise to Iha ololm, "
i
Pago 2 01 3
PL,OP 1111\ Ed, 12/94
, ,
I 1 ft.,'!, ('\
( . ,." I
IJNIN~URRP MPTPAI13T6 OOVRRA~R' PRNNSYI.vANIA (NON,aTAOKRP)
PPP 114 P1 II~ 1111
"
-
POVllfll\l1l '" PfllVldll11 whafe II pfemlllrn nmll1mlllll IIp\:lllltV IlIl\hown I!)f Il1e oovefnlle IIn 11111 dawlllfllllon
Pllllll,
WIII1 rllsllool 10 Iha ooVarllOa prpvlcted Py Ihla Ilndorean,anl, \110 pfovlalonp pf Iha pollpy IIpply \lnl!lss mpqlllet1 Py this
endprSllmant,
I, PII!t P, Unln.llrlln MoIOflsl8 PflVllrll\le III fllpllltl!ll1 ~y Iho Illllowlnlll
1l0HPPUI-~ 0 009 0 1
UNINSUAIiP MOTOAIST!! OOVPRAQ~
pel\tlflplllln
QIVlll1ll1le
~Imllol
1-11l\:llllly
Pfeml\lm
~--
$
$
$,.......
$
$
,
S
"
"'" \'0
3, Any poruon lor damageB that pereon Ie entitled
to reoovet beoaueB of "podlly Injury" 10 whloh
Ihls ooyerago appllee slletelnad by a poteon
doeorlbed In 1,_ or 2, aboyo,
"PD 04 21 02 e8
,p, "Unlnaured motor Va hi ole" meene Il IlInd molor
yehlole or Irllller of IIny type I
1, To whloh no bonlly Inj~ry IIl1blllty Iloncl or polloy
Ilpplles pt Ihe lime of Ihe Ilooldanli"
II, Whltlhls II hlt'and.rlln V,ehlolo whoee operlllor
or owner ollnnot Ila Ictenllllen Ilnd whloh hllll or
whloh tlllusee en ~ooldanl feB\llllng In "Ilodlly,
Injury" without 111111nOl
II, YUII or Ilny "family memller" I
11, fl vehlole' whloh YOII or IIny ."famlty
member" ere "oooupylnO"1 Dr
0, "your ooyerad lIuto,'"
If II1llre Ie no oonlaot with \lle I1It.and.run
yehlole, Ihe leotB of Ihe aooldenl mUBt be
proved, '
If the aooldllnt was IIl1egadlY oauBed by an
unldentllled hlt.and,run yahlola Ilnd the
operetor nor the owner,olln be Identified, Ihe
lIooldent muat be feportad to the polltle or
proper goyernmontal IIlIthorlty within IlO daya
Irom the date of Ihe eooldent, Nolloe of the
oooldent must be glyen 10 UII within ~o daya, or
oe eoon all preotl91lbla tI\oreafler,
ll, . To whloh a bodily Injury Uablllly bond ot polloy
pppllas at the time of Iha aooldent bul Iha
bondl~g or Inautlng oompanYI ,.
a, denlee boyatagel or
INSUAING AGRIiPMt=NT
A, WI) will PIlY oompanslltory (jampgos whloh IIn
"Insured" Ie laOlllly entllled tQ reoover from the owner
or operator 01 Iln "unlnll~red motor vahlole" beOIlUSll
of "Ilodily Injllry" I
1, B\lstlllnllr1lly'lln "lne~lrlld"l
2, Douaed Ily IlIlllooldent,
The own!lr's or operlllor's IIl1blllty lor thalle damaoee p.
muet arlee 0111 of Il1e ownership, mnlntenonoll or IIse
of tho" unlnsurod motor yehlole,"
No jlldomonl for damages ariSing out of Il sUllllroughl
Ilgalnst the owner or operalor ollln "\lnlnAUred motor' "
yehlola" Is binding on us unleeB wel
1, Reo!llved reasonable notloe 01 the pendenoy of
. Ihe suit reeultlng In the judomanll and
2, Had Ii reasonllble opportllnlty to protllol ollr
Interllele In the e~lI,
~
a, "Insured" liB uelld In this endoreemenl meanel
1. You orllny "lamlly membaf"l
2, Any other per"on "oooupylng" "your ooyered
auto," "
Page 1 01"
NOVO'l'tH ~lINP1Vt
clo Ro~mR~'NOVO'l'Nl
~ rlllTROW PR
~qHlINIC~aURQ p~
1701i5
aVIllR~Y IN~ lI~mNT~ , aRoKIllR~ IN
5~5 N l~'l'H ~'l'RmIllT
p 0 poX 5~1i
~IllMOVNIll FlI 17043
~HIc~ma COVIllRIllP
PNI T aT TIllR VR HAKm 11 N amRI 1I~ NtJNlllllR ~YM c~lI~a ~'l' 11M CHo PlI
001 PlI 0~7 93 o):.PSMOPlf.\ll 931i753 103WHHTliflP341i~~0 07 QBlinO . Olinli!
,
INSURlINClI1 III flROVIPlilP WHIllRlil 1\ flRmt41UM HI ElHOWN ron 'l'Hlil COVliJRlIO\!l
COVIllRI\OIll ~IMITS or ~ll111I~XTY flRlilMIUMS
, UNI T 1
f..lHI'l'1ll0 TOR~OPTION 1\Pp):.Ims TO THIS flO~ICY , YIllS
I
, Apr.IT Ll^nI~ITY LIMITS flp0309 04Bli
BOPILY lNJURY LI1\aILITY
~260,000 Jilllcn PIllRElON ~600,000 lill\CH I\CCIP1l11lT 6~.00
pp,opmR~Y DlIMAOID LIABILITY
~lOO,OOO mACH ACCIPIllNT 26,00
UIlIllsunlllP MOTORIST aOPILY INJURY
PIllR PlilnsoN $250,000 pmn lICCIPIllNT $600,000
(NO ElT1\C1U NO or COVIllR1\GIll) 26 tOO
UNDIllRINSURmo MOTORIST nOOILY INJURY
pmR PIllRSON' ~~50, 000 pmR lICCIOlllllT $600,000
(NO ST"clU NO or COVIilRIIOIil) ,
,/.00
MmOICIIL mXPIllNsm,covmRAom $100,000
OTHmR THAll COLLISIOIl LOSS Lmss $100 OIllPUCTIDLIil
COLLISION LOSS Lmss $200 OIDOUCTIBLIll
,
26,00
16,00
71l.00
~
A~~ Pf1Illdon\
CONTINumo ON Rlllvmnsm SIOIll
RIllFmR TO FINlIL PAOIll FOn DILLINO NOTIcm
I P~'R (9/00)
I
!. 04/10/96
~
, ,
"
Donaonlls Pllrsonlll Auto Pplloy was raollnlly revlsad, IInt1 YO!H onoloson ranaWlI1 pollpy maY opnlaln ellVllrll1 of
Ihe ohllnoes, 131l10\V Ie a S\lmmnry 01 \hu ohllnoos mllPll, .
NO ODvr:RAm: IS PROVIDf:D 13Y THIS SUMMARY, YOU I3HOU~D Rr:VIr:W YOUR POI-IOY AND Pr:OI-ARATIDNa
PA~r: FOR OOMPI.r:Tl: INFORMATION ON PPVl:RA~l: PRDVIDl:D, IF THi:Rl: 113 ANY ODNF~IOT 13r:TWr:r:N THt:
PO~IOY AND THIS SUMMARY, THI! PROVISIONS OF TH~ POI-laY sHAI-\. ApPI- y,
Thll following amlors\lmanls oonlaln eeVllrlll ohllnOllsl
PPD 0417 O;lIlB. Undeflnsltrllt1 Molorlels Oovarngu. Panneylvanlll (Non.alll, Oklld)
PpD 04 111 O;lIlB. Uncleflns~rat1 Motorists Qoyerlloe . Pennsylvanlll (Ellaoklld)
PpD 04;11 OllllB .\Jnlns~rut1 Mlllorlsls Oovemoa . Pellnsylvllnlll (Non.Slnoked)
ppD 04113 O;lIlB. Unlnsllrell Molorlsls Oovllrnoe. Pllnneylvllnlll (Blllokat1l ,.
I, Q~NI!RA~ RI!VIIlION
, Thu Illa(Hn stlltllmanl fpr 1111 of thll DntlO, rsamen\e IIs\IIP IIbOYII hilS pOlin revlslld In ordllr 10 makall olellr Ihlll wllh
'respool 10 oOVllrnoe provide" py tha Ilntlorsllmanls, Ihu polloy provlslpns IIpply ,\!ll1!!.W! modified Ily Ihe
endofeemenle,
II; INBURINQ AQRI!I!MI!NT
. Undef Ihe EP~lInt1 PPP 0419 02 9B, parllorllph tWO of the Inellrlng Agroemenlle rllvlsod 10 slale Ihat
lha Oomp~ovltlacr Will) prompt wrlllen nollllolltlon of any lenlllllve satllemenl be\Wean Ihll
'Insured' IInd Ihe Insurer of the "llllQerlne\lred motor vehlola" Of IIny olher party, Also11t Is ollrlfled Ihal no
salllemenl of nn "Ins~red's" Ilodlly njury liability ollllm mey ba made wltholll tha Oompllny s wrltllln ooneenl,
III, 13XOI-UIlIONS
. For oil lha ennnrsamants listed, sever'" relurllnpee Ie p(.' eoo In the r:xnluslons hllve Ilaen ohangad to now
releronoe "Ineufed,"
II Aleo, for /llIllndorsements listen I unt1er the r:xolllslons Seollon, new exoluelone have baen lidded, The new,
oxoluslons dlr,allow oOyeragll IInaor tho L1nlneurlld Molorlets Oovarnoe or Ullderlnsured Molorlsls Ooveraoe for
"bodily InJury' sllstalned byl .. '
. 11 named In8~red while oooupylno, or when elrllok by, hie or hor own vahlole when It Is nol Insured for this
ooyerage,
. any family mempar while oooupylng, or whlln elruok Ily any vehlole owned by Ihe named Ine~red or any lamlly
member who Ie the oWller 01 an auto and doea not Inslire the I\uto IInder Ihls polloy,
. eny family member thaI doee not own an auto, While ooollpylng or when etr\lok by any molor vehlole owned by
the nemed Insurlld, 1111\1 Is Ineured for Unlneured (or Underlnellred) Molorlele Ooyefaga under IIny other
polloy, "
, . IV, , LIMIT Of' ~IAaILITY
II For alllha ennorsamente IISllld, IIndor lhe Limit of ~Iablllty seollon, language has been amended In ordor 10 olarlfy
the non.dllpllollllon of benellls provls onel elso a speolflo worker'e oompensatlon non.duplloellon 01 benellle
provision Ie Inlroduoed, '
V, ARBITRATION
. For all Ihe endorellmente IIstad, under Llmllallon of Arbltratore' AIIlhorlty, langllago has be on added In order to ',I
olarlfy Ihlll erbltratore may nol make deolelons on disagreements on oovel'aoe questions or the applloable limite
olllablllty or the ooyernge, Theee dlsaoreamente "1l1st be deolded by the oourt haylno Jurlsdlollon,
VI, G13NERAL PROVISIONS
. For all Ihe endoreamente IIstod, the General ProYlslone eeotlon hae baen amonded to remove the exoepllons to
the polloy'a polloy period and territory provision" .
(
, ,
000906
Pt:RBPNA~ AUTP PP~IOY
IMPPRTANTNOTIOt: A130UT OHANQt=s IN "PIJR PP~'OY
pI=NNSYl-VANIA
Donegal MutuallnsllrUfloe Oompany
PLOP .434 (l:d, 6/96)
,\
H, Adml\lull. II>' WilY or 1III'Ihul' IInHIWl', Ihu Ponul1l1l MIII\1I11 Polloy ("llw Polluy") IH
mllnl1Pl'utl PAH. C)i\lJ HSoo,
I), Thu pl'ovlHlol1H or 1110 polltl)' Hpolll; Ihl' Ihtll11HtllwH, lIy WilY or 1\II'Ihol' IInHIWl', Iho
PolltlY'H InHlul'hlHlIrod 11111101'IHI (\JIM) 111\11101' $250,000 IH propol'ly IllI\1,10tlllo IlInllllllon \1y tIJe
Olhol' InH\II'III1OO provlHlonH Ill' tlw Polloy,
10, ponlod IIH Hllllod, IIIH IItllnlllo(llhllllJonoglll MlllulIl hllH pllld PllIll1tll'f$ISO,OOO
InlJlM 11owrngo llI1dul' Iho Itll'l11H ol'lho Polloy, Ily WilY 01'1111'11191' III1HWOI', IhlH IHOW mll1iIl11\1I11
11111011111 10 Whltlll 1'llIlnlllT IH 01111110'1 \lnllol' Iho GtlWI' 1I1H\II'lIIWll provlHlonH 111'1110 pollc)'
1'0HII'IIlllng Inllll'pollo)' Hhwklng,
11, bonllglll M\lI\lIII'H Fuhnllll'y 4, 1l)I)H 11l\l01' III PIIlII1II1T HpllllkH 1\11' IIHoll', fl)' wn)' Ill'
I\II'tlWI' IInHIYIll', It IH IIdl11l\llld 1IIIIIIJIllwglll.I'Ill\IHIld 1011l11dol' $2S0,OOO to PllllntHT, fl)' 'I'll)' or
I\lrllwl'l\llHWOI', I'lillnlln'H \JIM IImllH undlll' thll Polloy 'I'llI'll 1l1\I1(nIHlolllll $1 so,ooo hOl1l1UHO or
tho $100,000 VIM pnynwllt II1l1do hy Pl'lII\llnOIlIPl'opOl'lynnd CnHunlty InH\U'lInllll COl11pllny
("PnldIlIlOhl"),
12, 'I'lw pl'uvlHlonH ul'tho lJonoglll MUlllnl P'\lIoy HllOnk 1'01' tllol11HlllvoH,
13, '1'1", IlVOl'lllllnlH or Pnrngmpll 13 nro lJ(lnllhIHllln~ ot: IIIII' Ip whloh 110 1Iff1l'lllntlvo
rOHponHIl IH roqll\l'Ild, In Ihll Ilvonl \hOHIlIlVllI'llWnIH nro dlllll110d fholllnlln nnhu'll, tllllY 1I1'1l d"lll"d,
By wny ql' 1\11'11101' III1HWllr; Ilw IlnHllol' AII\VIlIIl v, IJonobllll MUlunllnHlll'nnll1l Con~, 448 I'll,
,
8UPOI', 3M, em ^,2d 744 (11)%) IH Il1nppllollhllllu \hoHlllhoIH, Allwoll1 donltonl)' wllh thlllHHuo
'"
ol'wholhol' VIM OOVOl'lIgo 1I11'011llHylvIII11l1 11m)' ho phwldod 01111 "gnp" hnHIH WI'HUH nn "01\OOHH"
hllHIH l'olIlOW 10 II 101'\1'01lHOI"H IInhllll~ IlIllIIH, A1b~ dOOH nol oonll'olln II OIlHO dOllllng with tho
2
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1.:>,0, Box 11116
Hard,!3burg, F1\ 1'7,1.00
('l1.'7) 232-~,051
A\:.l:orney I,D, 6531GO
1\l:l:orneYf3 for Plain\:.iff,
l3anqra M, NoVol:ni
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IN 'l'lllil COlJH'I' Ol~ cOMMON PI"lilMJ Ol~
ClJMBIilHbllND COlJN'l'Y, PlilNNSYTNlINI(\
No, 90-3031
S1\NPH1\ M I NOVO'I'N I,
Plrl:!,nl: j I~ J~ /pe\:ll:,lonor
PONIWl\I, MIl'l'lll\l, TNB\JHlI(\jCJI,J
COMl'lINY I
Do I' enclnn \: / Hl~ oponclolll:
CIVIl, 110'1'1:01'1 - r,lIW
illUtllL..'J'J2:J!.I:IQ\i....QlillIDll
.IUlD NOW, l:hio
clrw 01'
I 1999',' f\
'{tile i/3 hereby J.psueq upon l:he Pe l'en(~f\nl:/Hesponc1enl: 1:0 phpw aE1l\pe
why
l~ule rel:l\l"nable
clays atter perviae,
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TN 'I'IIHI COUR'!' ai" cOMMoN pr"lill\l3 01"
Cl1MI31illU,I\ND cOIlN'I'Y, pmNNl3yr,NlIl'lll\
No, 91\-3031.
1l1lNPI~1\ M, NOVo'rNI,
P1Ain~iff/Pp~i~ionor
PONIiJOl\T" MU'I'UlIr, IN/3\JRI\NClil
COMpI\NY,
, Defenqanl:/l~o"ponc\ent:
CIVIL ACTION - LI\W
Qlill!lIR
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AND WOW, t:hi" di~Y OfYI'J..{bl ' 1!l!l9,
l?un:JUant: ~o tho attaohed MoUon t:ocolllpel il: i" herepy ordoroc;j that:
ROf3pOnQont l'floponc1 to l'otitionor'i3 li'j,rf.lt Requoot fOl: ProQuo\:ion of
poaUIll~n\:13 and Thingo ,and Firo\: /3et, of Interrogatorioo 'wi\:hiri aD
, 5'-1"1'''' .\
dayo of \:he da\:eot thio order,
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BY '1'Im GOUR'l',
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OIlMUltllH,l\NP ()OllN'I'Y, PH1NN13YINANTA
No, !J(l<lll n
f.JI\NPlll\ M, NOVO'I'N T , "
plaintiCC!Petitioner
DONIilGl\l, MU'l'lll\l, I NfJllllllNClil
COf\WANY, ,
pefen~ftnt!RepPondent
Clvn, f\C~'I'ION - l.,AW
MOTION TO aOMvmu
I\ND NOW, oomep '['.he Pel:i,I:;\.Onel:, fJftn~r<1 M, Noyotni, py l\l1d
through her attorneys, KillJ<1n & Gephart and does hereby
respectfully reprepentthe followingl
1, On i\l\gIHlt 21, 1990, the petHioner qled pla:\,ntiff:' 13
First l<equest for production oj: Doouments and '1'1'1:\,ngf.l Dll:eoted to
,the pefen~l'1nt
m~hibil: IIAII)
(<1 copy of: Whioh ia att<1ched hereto and ma~~ed as
I' ' ,
and First fJet of: Interrogatories f:orAnawar by the
Defendant (a oopy of wh:l.ch il3 at'tl10hed hereto C\nd marl~ed ,as m~hibit'
11)311) ,
2, On october 2, 19913, counsel f:0l: the Petitioner :r.ec~ived
correspondence f:rom Donegal Mutual Insuranoe company indicating
that the responael3 were f:orthooming,
(A oopy of said letter ia
attached hereto and mElrl~ed al3 mxhibit "C"),
3, Pet:\.tioner hal3 yet .to reoeive rel3ponsel3 to the dil3covery
documenta served upon Def:Emdant in Auguat oj: 1990,
11 , '1'he Petitioner requirel3 rel3pon13e13 to thel3e dil300very
requel3tl3 in order to prol3ecute thil3 matter to n oonolul3ion,
WIUIRBFORE, the Petitioner respectfully requel3ts this Honorable
Court to enter an Order requiring the Respondent to respond to
Petitioner'S discovery requests.
I'
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illiap & Gap" ~
,110 PipCl 13t:l'eoL
P,o, llox B06
llm:dl'lbllrg I PA lnOB
(7l'7l ,l3;3-1051
ADl'U JJL 1\t: \;orney I,D, 115 3lil B
P~I;eq, , I ;l'999
At: l;o!:peyl'l for Pe\;it;j,oner
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pref.!on\:w11op tho notlon oOCJ\\J:l:qd, <\ pl:i\\:emon\: <\13 \:0' whl3t:her
mlnut~p, noten, momorAnda or othor reo~rdp oxlot wlth reapect to
the aotion, nnd identi~lontion of tho per Bon or pornopp presently,
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\Wy1,ng popf.ll3ppion, ol\ptody 0]: oon\;ro1 of fJIWll docl1lnan\:p,
3, When Ul3ed wJ.\:h l:el3poct to A c1001\ment, \:\10 \:l3rm
rl3fl31:S to 1:1113 !wovipion of \:he fol1.0wina informAtion I
(n)
(p)
(0)
,( d)
(13)
(f)
(g)
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(h)
'l'he dAI:e of ~he dO~l\.\menl: I
The titl.e of~ the lloo\lmept I
I\ny iQentHy1,ng number on the doo\\ment I
I\ny lQentifying depignation for the document I
iI desodptlon of t:.h<;l daclument,l
'l'he supjeot' matter of \:he dOOl,\ment I
The pame, title, addresf.l and telephone number
of each person who wrote, pigned, prepared,
diotatsQ ,partioipated in preparntion of,
orented, ~nitia+ed or otherw1,pe had any
funotion reppeotingpreparation of the
dpc\\ment or review of the qooumentl
'rhe name, title, ac\dreps anc\ telephone number
of each addrespee on the document as well as
the snme fo~ each person reoeiving a copy of
the documentrl I ,
,
(i) 'l'hEl pl'esent looation of the dooument and the
name 'and address of the" custodian of the
docUl11ent I
(j)
an original, the
of the custodian of
If a' document is not
looation, name and' <lddl'ess
the origin<lll and
(ld AnY othe,r del3ignation neoessary to identify
the document fo;l.' purposes of obtaining a oopy
thereof.
B, 'l'he term "doouments" when uaed herein shall \nea'n <\11
written, typed, pr1ntecl, reoo1:ded or graphic matter of every type
and desoription, however and by whomever prepared, prodUC1ed, repro-
dl.\oOd, d:l.f.If.1emint\ted or \\\"r10, in mw forl1\, now qr f:0I:n18rly in I:ho
pOf.l1380f.liop, oUf.ltody, or oont~ol of the PArty \:0 whom thio ~oquef.lt
ia Addref.lfJed, 1\:1l off. ioonJ, C\\Jon\:p, o\l1ployeol3 And C\\:\:or!1eYI3, or Any
of: I:hem, inalucling, bl.\t pol: HmH:od \:0 10t\:orf.l, rJOl:rof.lponclopoe,
l:olegl:C\l1\f.I, IlIeI110I:l\l1da, l:eoOl:ds, l1\ipll\:OI3 of: nll typea of: moetings,
qon\:I.'<\otp, supoon\:rE\otl'l, ;:Igreo\11on\:f.I, inl:rC\ And intorof:f:ioe oommuni-
oe.l:iol1f.1, pu:r.ahal30 orderfJ, requirll,U,Onf.l, p1f\l)l3, f.Itl\dl,of.l, f.I111I1m<\:r.:\,ol3/
nlHIlysos, ref.lul\:a of invef.lU,gC\\:ionf.l, I:OVieWfl, \)llUedna, PI.'Opof,lC\lf.l,
ef.l\:imatof.l, nppre.if.lalp, reoommendation13, oritiquea, \:rip rePortf.l,
engineering dC\lou:LEltl.onf.l, pilla of materJ.Alf.l, c1rclw~ngf.l, r*e\:ohop,
pll.\eprint13, ohArts, incl10ea, notioef.l, d~C\rief.l, pookf.l, d'f.Ik
oEllendar13, appointment poolef.l, mef.l13agea, inf.ltrl\cu'onf.l, worle A13/3ign-
ments, noteI'!, notepoole8,' tC\pe reool.'dingf.l, , PElI:tJ;Al ,or oomplete'
reportf.l of t~lephone oonverf.lEltions, photographf.l, alid~~, pub~~o
f.ItEltementf.l, neWf.lPaper or other mediA releaaef.l, pl.\plio and
governl1\ental filings,opiniona, And any other writ,ingl3, cl:!:'awingf.l or
,
reoordl,nga , If: f.my document waf.l, put iI'!' no longer, ,in \:he
poas8sf.lion of: the ,pArty to whdm thif.l Request if.l, addresf.led or
f.Iubjeot to f.Il\oh party'f.1 control, identify the dooument,
0, When Uf.led herein, the term IIperf.lonll shall mean any indi-
vidual, partnership, joint venture, firm, ~f.lsociation, oorporAtion
or pl\siness or C\ny governmontEll or legEll entity,
D, When l\f.led herein, the term lIoommUn:l.oat:l.onll'f.lhal:\. mean any'
and all trC\nsmis~ions"of information, the inform~tion tranf.lmittsd,
the pl."odesS by whioh the information is tranf.l\11itted and the term
I'
f.lhall expressly be. inclusive of all
oommunications,
wdtten and
oral,
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Ii). Vlhen Ql3ect l)erflip, \:]10 terl1\o IIreln\:~ to", IIroli'\t:Lnu \:011 or
"in relAtion \:0" rclllRll moun c)onutltutj.no, reflead.ng, repl;o-
f.I8p\:ino,
13qpportin9, oontr~diotino,
l;o!:oJ:l:inu to,
I3t.U d.pg,
def.lorib~.119, 1'(300):'(\1.1'10, no\:ing, ompody1.no, apntaining, men\::1.on~.ng,
f.Itucty1.ng, UnAlyzi\1g, qipa\.\sl3ing, evallla\::L.ng, or relevunt to, 1\13
;lnq;lrJi'\ted, the term neocJf;!I3<1dly inolqdes informution which :1.13 in
opposition to <113 well AO in pupport of the pos:Ltion(l3) unq claim(s)
of the PU1;tY to whom the Request il3 adQressed,.
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When Ul3ed herein, the term "refleat" PhAll meClI1 empody,
contuin, reoorq, note, refer to, relate to, del3cribo, pe reieVi'\nt
tor state or ment:l.on,
0, When Ul3edhel:ein, the term l1'laintiffl3" I3hall l;efer to
Sandri'\ Novotni, 1'laint:l.ff herein,
H, When uped herein, the term IIDefendantll shull refer to
,.
DefendClnt Donegd Mutual l;nI3U1'AnOe c?1l1pany,
II. ~eneral !nl3truction~
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.. A. Whenever a l;eqU13l3t fOl" documents ia' frAmed in the
conjunctive, it ahall also pe tA~en in the disjunctive and vice
versa,
13, Whenever a request fOl; documents is framQd in the
l3ingular, it I3hall be ta~en in the plural, .nd vice versa,
C, The use of Any tense of .ny verb shall be,considered also
to include within its meaning all other tenses of..the verb 130 used,
I D. All Qoaumetlts produced shall be segregated and idt;lntif;\.ed
,.
by the pAl;agraphs to which they a1'e pdmarily l'esponsive, Where'
required by A particular paragraph of this Request, doouments
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'f~iljj;{;;i?~\:~fl\'\ir:':~i:K' ':'lii~ll~clt~,~~~A~g~H" A'R' !l' 'r', " ",'
',\~'t}tJ:\~tt\~__:wwrl(\:\;,.,- - J1, ~H:'!i~:"t,M;~.~"- '1, - T - i_"
i.\'~t:if;:'rq\l}j;{,~{d(liJ;'l>'-"~. i_-/;';j:'-_-~..\R t1lt111 ,nnnT' ,
rrlp::N,-~~t'-l:Wff4\(f_':,N~~,,~- _','-.:_L~,_!_;,t{p, "O~'~.-9- - , "
'_'_',':';_._. .':,"'-_\1",' 'J -!'1"':';1(!." -'_ .'." "'_ 'L'_ - .'. ,"'- '-:'- .'
:\,:,::g:i<"'~,~~llWl'l\-lR~,Il~NN13V\-V~N\" 171cll,'PQ\I~ , " I ""
I" " ,,', ,,"I ',l' ;1IiI(f'~"""1lllIUII11llil1llllilltlN"'1\I\l~Ti.t\<llI."'I\'il>\\t\liflrll.\\~~"lUI_~iI,*
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IN 'l'tUti CO\Jl\'l' aI" COMMON PLEAS OL~
C\JMI31DIU,f\NP COllN'l'Y, I'IUNN~Yl.vI\N:rA
No, 90-3031
~flNPll1\ M, NDVO'l'NI,
1'1/1J.n\::L.l:';
I)ONIU01\I~MU'l'Ui\l1 :rN~llIU\NCtti
COMI'1\NY, ,
pef:enrlan\:
CIvn, l\C'l'JON _ I,,1\W
Qlill1ll.R~l~ OOUR'~
1\ND NOW, thip
c~ay of
, :\.999, J.t if>
herepy ordered Bnd deorsed thAtl
:\., Def.endant shall pay qonnl'lsl feel'l \:0 1'1A:l.nt;\.ff I 1'1 attorney
in the amoun\: of $1,000,
;.1, Df;lfsndan\: l'lball prov:L.de d:L.saovery responl'lS/'l ylHh:L.n ten
(10) dAYl'lof l'lervice of thJ.s order,
13y t:he Court I
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SI\NDHI\ M, NOVO'l'NI,
P1A1.nt:.if: I:
IN 'l'lm r.OUW1' Ol~ cOMMoN PI"li)l\,9 ol~
C\JMBlilIU,I\NP COUN'l'Y I PlilNN,9YTN1\NI1\
V,
No, 90-3031.
DONIDG1\I, MU'l'Ul\I, INSUHI\NCIil
COMPANY,
Defenc1f\nt
CIVIL ACTION _ LAW
MQ\UQILEQ.lLW\NOTIQN/i '
AND NOW, 1:111.1> L- d<1y of 41((j'II....j- ,1999, oomel3 the
P1Aint:l.ff, SandrA M, Novotni, by anQ through hsr attorneys, ~il1ian
& C1ephAri: AnQ does rel>pectfully replCel>snt the t:ollowJ.ng,l
1, The Compluint for DeclArAtory JUdgment WAS initiated on
July 8, :\.998,
2, on A1I9UsI: 21, 1998 the Pet.i.tionelC l3erved Pla.i.ntiff II)
Firl>t !~(~quel>t 1:01' Production of Documents' <1I1d 'l'hings D:lreateQ to
"
the, DefelidElnt: ,a\ld First ,get oJ: InterrogAtoriep J:or Answer by
Defendant upon the Defendant.
3, On October 2, 1990 oOlltlsel for the 1'etitioner rece.i.ved
aorrespondence from DonegAl Mutual Inl>lIl:ance Company indicating
t:hat l'eSpOnsel> were forthcoming I
(A copy of said letter 1.s
fltt:achec:1 hereto and malC!ted <11'1 Elxl1l.bit "A"),
4, Due to befend<1nt's refusal to plCovide lCesponses to the
afo\:eSAid c:1:Lsdovery l:equesta, on Apdl 29, 1999 the Plal.ntiff 1:J.leQ'
a Moti.on to Compel seeldng thl,s Honorable Court to enter an ol'der
,requi.lCing Defendant to comply with the aforesaid dil3,oovery
requests, .
S, 0\1 May 1\, 1999, th1fJ llonol'l~l)le COln'\: o\'l\:erod qn ,01:t101:
reqnir:\.ng peJ:o\1Qrm\: (:0 reppont1 \:0 \:ho 1~:L.J:I'i\: HO'luel3\: for 1'1:011\10\:10\)
of Dooumenta and ~hingB and Pirst Set ~f Interrogatoriea with1n aD
QaYP oJ: pervioe of thip Ordor, (A DOpy of paid ordor 1a attAo~ed
heruto and mArl~ed as mxhib1.t "8"),
6, on MoW S, ).~99, this 001117\:"" Orde1: WClB fOl:WA1;Qed \:0
ooqnpal for the DefendAnt vi~ regulAr mail And fa~, ,(A true and
oorrecl: copy oJ: 131,'1<:1 Clon:oF.Jpondenoo :LP att;<lchl3d hereto and ,\na1;1~eCl
aB IU~hibit "CII) ,
7, To dAte, Plaintiff has received abpolutely no response to
its Q1scovery requepts,
O. plA:l.nt:l, ff hal3 l.ncurred signif :I.Ct1nt at torney I s feElS :Ln :I.tp
.'
continuing effort to compel Defendant to rOl3pond to the aforel3a:l.d
Clisc~vel'y roquestp And 1.p seeJdng An Award of counsel foes 01:
$1.,000,
9, PUrsuant t~ Pa, R, C, P, Rule 11 0), 9, tj1e court, if A party
fails to answer 1.nterr09Atories and requests for doouments, may
iaBue an award of <lttornoy's fees and may restrict an offenCling
,
party from presenting evidenoe to support dofenpes,
WHj;JRJJ11?ORIU, the 'petitl.oner respeotfully requests this Honorable
Court to find the RosponQont, Donegal Mutual Insurance CompAny in
oontempt of its Ol;der of May 11, 1999 a\1d to ente1; a furtl;.er order,
(1.) Clireotingthe Respondent to pay PlaintiJ:fls counsel fees
in the amount of $1.,0001
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1l1l\IlC:f PIAl,: 11\7) 211oS~JI
Il.M,'l1.: 1\~,lI~~N'nrl'll\ollh corn
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.c..c.l "
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DOI,II'Pn\ll:
111m wrlllng 10 ollnOn11 0111' 1010pho\)0'eol1versn\10\) 011 OO\OhOI' I; IIJIJH, lll1dlon\od \0
)'011 Il1ul wo hud dmn rospousos 10 YOl\I' dlsoovery roqlIOH\S uS wollus doo\lmol1ls p\lllod hilI thnt I
1\9111101\ \0 1'i1Vlow Ihem hothre Onn\lzh1l.llhom, YOlI woro kll1d onol\gh 10 glvo liS u1\ oxtm to\)
duys 01' so und I will hnvo \110 rospollsos \0 )'011 wlthl1\ thnl tlmo 11'111110, IlIndorslul1ll Ihllt YO\l
muy 1\ood SO\)10 uddlllo1\ul limo to rcspol1d to 0111' dlsoovery IIl1d, of OI1lIl'SO, I Will 1'0111\'11 tho 611I110
.oo\lrlosy, .
Wo wlllulso prooood wllh Iho proposed Htlplllu\lolI of Fllots whloh wo IlIlkod ul1o\ll US
wcllus uWllY pf moving Ihls ouso Ibl'Wnl'd,
Plouso ollllmo If YO\I huvc 1\ny q\losllol161
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, Vory tl'\lI)' YO\lrs,
;'ii!lc'l-'/ f, iL d~l/,,' (7) ,
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::(%'I">';"~I.I:"L~,I~~I.~N ~ @!;Pl;lAR1'\'" , '..,,~,.DI Gl"N,.','A'. ,.," ',' ,," I,' ,,' .,' ,IC'"
\,'i'~b/;,IF!:)I":JV":" :'\1:":1.;., ~,\U'~~~,n'ffl " ". '\JA\.... ~'... ...,. CI\IlTIFIIt~'CprY l .. ".'.'\ "~'
'\l,',i""lr.\h.,I.."\,,,I,r,p~OHu, ." ", "r St'D "
i::'~;'li':!:::~~",~:\~~~~~\,r~I'IN~Y~Vf,l'lt~ t7'Pl!'~!lllq. ",!, ", . ' , '~~,'~i ." ~" 2U~~.',
~''''l/IW),.a~~\jI.I\''~Wj'''''')'''''''''''''.'''''"'U''.\1I''''''''~''''''U'''''f'",'''''''''\ ....." ,l1r'.'~_WilM_lfllf
fJl\NPI~1\ M, NOVO'J'NI,'
plAInt: J. f f
IN 'J'l\lil COUl,'!' m' COMMON 1?1"mAS 0[.'
CllMIl\ilIU'l\ND CO\JN'J'Y, PliINNsYJN1\NH\
v,
No, 9U-3U31
PONlilO1\I. MlJ'J'llAJ., INslll~I\NClil
cOMPI\NY,
I)efendunt:
CIVIL 1\cTION - LAW
WorUR OlP aOURI~
AND NOW, thJ.s
dl'\Y ()f
, 1:999, l.t ip
hel:epy ordered and dem:eed tha\:,
1, l)ofendAnt I3hl1ll Pf1y',rJollr1l301 fee!3 \:0 PlaJ.ntJ.H '13 <lttl1l7ney
in the <lmOllnt of $1,000,
2, Defendant J.13 reqtd,red to respond to PlflJ.ntH f I fol dJ.saovery
reqlle!3ts withJ.n twenty (20) days of the s~rvi6e of this order or,be
precluded from l'a:Ll3J.ng any facts in supp'ort of ita posJ.tJ.on that
P1ClintJ.ff ip not entitled to $260,000 in underinl3ur<lnce coverage as
l3et: for~h J.n tho declaratJ.on pu~e of her Donegal InsuranQ8 policy,
13y,the Court,
---'
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001 III 13 f.d, Co;: I:ho Do l:enrli111t , rUroGl:ly by \'.IlIl Court,
1 n i.lelrU I: 101),
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'1'\)o Cpl\l:I:'fl On10r WllfI f01:Vmnlm1 1:0 AI',tornoy Hobm:1: lil, I<elly,
l:h1p Order WiH3 fi\~ed 1:0 AI: I:ol:1I0Y Hobrn'l: \il, l<olly on Al\rJupt 2G,
1999, ^ I:nle and aOl,'\:oot ooPY of rJOlTOfJpondence in IItl:aohml hereto
and 1l\Al:I~eQ 1.18 I;:~hib.i.t II n, II
3, lilven:l.C 1\ttorneY Kelly did not reoe1ve thiA Courtlp Dreier
until 1\ugnsl: 2G, 1999/ in exoess of 20 doyp hAve pnnsed sinoe the
entry DC th:l.s Court'p Order,
WllmJUWOlUil, PlnintHf respectfully reCjl1eutp I:h:Ls llonorable
Court to ma~e its Rule Abuolute Bnd to enter an Order requiring (1)
the peCendanl: to pay Plainl:1Cf I a oalmsel fees in the amount oC
$1,0001 anQ (2) the Defendant is required to reupond to plaintifC'a
diaoovery requests W:l.thin twenty (20) daya of the ,servioe of this
order or be preoluded from rais:l.ng tiny facts in au~port of its
,.
pC1sidon that Plai,nt1.f:f is not entitled to $250,000 1n
underinsurance ooverage as set forth in the deolaration page of her
Donegal Inaurance policy,
DAtedl September n, 1999
Respeotfully submitted,
a '-/L-
J, 'aul 'lelVy, m q\ :L.:t:e
A" "Ol'ne I,D, 11531 0
~dley A, Schut. e', msquire
ttorney I,D, 117595~
Killian & Gephart
210 P:L.ne street
p, 0, Box OOG
Harr:l.sburg, PA17100
(71.7) 232-1ll51
~
Att~1~1eys for Plaintiff
2
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l:oqlloPt:nc\ flhO'\\ld Hot: bo' Ul'inlt:od rot\ln\ilblo wll:hin (.0 dilyn of
fJlJl:ylrJ(), (1\ (Jopy 01' wdc1 Hlllo J.n att:i\CIhed hOl:lJ\',O nnd II1nr)w<1 <lfJ
1,:xh.1bl\: "0"),
1\, /'11'1 il rOI1\\l\: of Donnunl: Mllt:Uill 1nflul'iIl'1ClO OOlllpilny 1 fJ fnll\\rtl
t:o renponrj, Plil:ln\::IJ'f I':lled a Rulo I\bpolul:o on /3optom\,>or (l0, 1999,
(1\ oopy of' Pillet H\,lle /'Ibtlolllte :Is [,l\:t:ilahed heret:o ilncl II1nrlwcl AI3
lilxhlbi\: 111)11),
!i, On Sop\:smbel: 21, 1999, thlfl Court: entclrod 1m Orc1or wh.i.oh
fltated "upon oonsic1erntlon 01' Plnintlfl"s Mot.i.on I'or Sanctions and
Motion to Mu!\:e IWle Absolute, the RIIl:o lSf,lllod upon th.i.fJ Court on
l\ugUf.l\; ;.n, 1999 113 i'lbfJolute i'lnd Pli'lJ.nt:L.ff '13 Mol:ion I'or Si'lnot.i.onlJ .i.s
granted to the extent: that Def:enc1ftnt :L,s c1.i.1;ec\:ed to proy:I.Qe
cl:l.l3covery rel3polHles, wil:hotlt objept:L.ons, to Pl:alntHf's q,j,poovery
requestp Whioh were tho eubjoat of: Plaintif:f:1s Motion w:l.thin 30
d<lYs of the clute of ,th1s Order I II (/'I copy of fJu.i.d OrQer .i.s
attached horeto,and markocl an llixhibit "lli") ,
6, Tn exoess of: 30 di'lYf3 have pasfled fJ1nce tho entry 01' th.i.s
Court I s Order and st,Ul 1?laintlt:f hOle rece1ved no, response from the
Donegal Mutual InBUri'lnCe Company, Pla1ntif:f belioves thi'lt tibsent
rel.i.ef: from this Court 1t wIll be v1rtllillly 1mposs:L,ble f01:
1'la:l.ntiff to proceed with l.ts Ci'lAO 1n chief:,
71 Tile ~~titione]: }lua incurred aigllifiaollt attorneyl~ fees
.i.n its ongoing offorts, to obti'lln reeponf3ea to lta d:l.scovery
reqllestfJ,
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Ii, On May 1\, 1.999, \;hill 110\101;C\ble CJoql'\: r,Jl1\:GI:od an ol:der,
reqylring DefendAnt to respond to th~ rirl3t Req\.\Bpt for Production
of Doouments and ~~:Lngp anQ PirDt Set of Interrogutorien with1.n 20
dClYs of pervioe of thiD Order, (A copy of saiQ Order is Pttaohed
he1'etO anQ lOudted as mxhil)H: 111311),
6, On Mtly 5, 1.999, this Court I n Orclflr w<\s forwardeq to
aounse~ for the DefentlAnt via regulm; ma:ll anq fax, (fI. trt!e anQ
correot copy of saiQ oo~reppondence is attaoheQ hereto AnQ 1l1Ar~ed
CIS JjJxhi)):L,~; IIClI) ,
"I I '1'0 date, Pla;\,n\:ifJ: has received absolqtely nO l;espOnsa to
its d:l.l3covery requests,
B, Plaintiff. hl~13 incurred s1.gni,f:l.oAnt attorneY'13 fl1el3 ini,ts
continuing effort to oompel Defendant to responQ to the aforesaid
discovery requests and is' seeldng an nW<lrQ of oounsel fees of
$1,000,
9, Pursuant to Pa,R,C,P, Rule 1\019, the Co~rt, if a PArty
f<\ils to anl3war interrogatories and requests for ~ocuments, may
issue an, aWal;Q of, uttorney 113 fees and muy restrict an offending
pArty from presenting evidence to ~Upport defenses,
\'lltmRffil<'ORITI/ \:he Petitionel" l;espeotl:ully requestfj this 1-lonorAPle
COU1't to find. \:he. Respondent, Donegal Mutual InStl1'anoe company in
contempt of ita Order of May 1\, 1.999 and to enter a further OrQ8rl
,
(1.) direoting the Rel3pondent tQpay Plaintiff's oo~nselfees
in the tlmount of $1.,POO,
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IN Tim CotlRT OF cOMMON PI,EAS OF
c\JlY1111~l\I-^NP COUNTY, 1111l'lNSYT~YAN\A
,CIV1LACTION -.. LAW
SAND1{A M; NOYOT1Nl, I
,. Ph\lnllff
PONHClAl- Ml.l'nJAL
lNflOI{ANC1J,
COMPANY,
Pcfcndnnl I
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ORl}llit OF CCl\lBX
ANP NOW, thlH 't-.\iJ~lny of AIIBI\SI, t 999, Ilpol\ ponsldpl'Mh:1I1 of Plnlntl ff'6
Motion 1'01' Snnetlons, n Rille Is hereby Issuod upon Defendnnt 10 show OI\USO why tlw
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I'cllefrc(juoBled shouhl not be grnnted,
IU.lLB RETURNA131.B wl\hln 20 dnys ol'servlec,
BY THE COURT,
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.Tesley Ole~b\ . /1 \
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21 B Pine Streot "
P,O. BoX BB6
Hllrl'lsbui:g, P ^ 17108
Attorney for Pln\ntll'f
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Robert H, Kell)', Jr" Esq, .
305 Not'th Front Street
Hllrl'lsburg, P ^ 171 OB.1 003
Allol'ne)' ('01' Del'endnnl
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TRUll Copy FROM RECORD
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and lha soal of snld Court at Corlls10, pa,
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of \:\1e w:I.I;hln clolJl\l1\on!:llp,m I:lIo l'nllnw,j,nrJ by dopofl:l,tll\o II ClOpI' 01:
flame in tlHJ ull:l.l:pd S\:r\l:orJ 11mB, pOfll:lln(~ pl.'oprd,cl, <1c1clroJJfJod un
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Robert ill, KollY, Jr" msqulrp
DUAne, Mo~ri~ . "~ck~cher
305 North~rDnt Street
,'Hqrripb\.\rgl PA 17100-1003
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Killian ~ Gephart
~l8 P:l.ne .l3treet
):',0, Box 006
Harrisburg, fA l7l00
(71.7) 232-l051
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Tl1\l Honornblp J, WPRlp)'Olpf. Jf,
C\lmbflflpnrl Oounty Court pfCpllll110n Plp!lft
One QourthollHll :;qUllfll"
CilrllRlp, PA 170' 3
REI lSovotnl.!JloneeaLMlltllllllnJ.ur.!ln'ILC,nmllllny.
No. 98-31131 ' "
Our Irllll No,l 11881-01
Dlmr Judgu alul':
As I lndllllltlld tp " memher Qf your slllff this morning, Altpmey Kelly nnd T have
rllsolved the Issues relntlng to the Motion for Snnctlons whloh hlld huen flied In Ute ubovo-
cnptioned Iw\lpn, The helU'lng which hl\d beun schedulel\ regl\rl\lllg this mntler fl1r (otlllY,
Frl.c\IlY, DoeomjJcr 17. \ 999 lit 3100 P,In, will thurefafc not be "ClleS~lII'Y,
'111lmk )'011 for your oonslderntlon ofUI\a mflttcr,
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00: Sandra Novatnl
Rubert E, Klllly, Jr,. BRqlllre
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