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HomeMy WebLinkAbout08-2662Peter J. Speaker, Esquire /. D. 42834 THOMAS, THOMAS & HAFER, LLP 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 255-7644 pspeaker@tthlaw.com Attorneys for Plaintiff PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY, Plaintiff V. DANIEL GEYER AND CYNTHIA GEYER, Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA NO. D%- 46(p Eivit ("' CIVIL ACTION - LAW JURY TRIAL DEMANDED NOTICE YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice are served, by entering a written appearance personally or by attorney and filing in writing with the Court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the Court without further notice for any money claimed in the Complaint or for any other claim or relief requested. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS NOTICE TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET HELP. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 717-249-3166 800-990-9108 NOTICIA LE HAN DEMANDO A USTED EN LA CORTE. Si usted quiere defenderse de estas demandas expuestas en las paginas siguientes, usted tien viente (20) dias de plaza al partir de la fecha de la demanda y la notificacion. Usted debe presentar una apariencia excrita o en persona o por abogado y archivar en la corte en forma escrita sus defensas o sus objeciones a las demandas en contra de tomara medidas y puede entrar una Orden contra usted sin previo aviso o notificacion y por cualquier queja o alivio que es pedido en la peticion de demanda. Usted puede perder dinero o sus propiedades o otros derechos impotantes para usted. LLEVE ESTA DEMANDA A UN ABOGADO IMMEDIATEMENTE. SI NO TIENE ABOGADO O SI NO TIENE EL DINERO SUFICIENTE DE PAGAR TAL SERVICIO, VAYA EN PERSONA O LLAME POR TELEFONE A LA OFICINA CUYA DIRECCION SE ENCUENTRA ESCRITA ABAJO PARA AVERIGUAR DONDE SE PUEDE CONSEGUIR ASISTENCIA LEGAL. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 717-249-3166 800-990-9108 Date: THOMAS, THOMAS & HAFER, LLP Peter J. Speaker, Esquire pspeaker@tthlaw.com I.D. 42834 305 North Front Street P. O. Box 999 Harrisburg, PA 17108 (717) 255-7644 2 Peter J. Speaker, Esquire /. D. 42834 THOMAS, THOMAS & HAFER, LLP 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 255-7644 pspeaker@tthlaw.com PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY, Plaintiff Attorneys for Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA NO. OP- a?GG ?. Cc v %c, v. DANIEL GEYER AND CYNTHIA GEYER, Defendants CIVIL ACTION - LAW JURY TRIAL DEMANDED COMPLAINT FOR DECLARATORY JUDGMENT The Plaintiff, Pennsylvania National Mutual Casualty Insurance Company ("Penn National"), by its attorneys, Thomas, Thomas & Hafer, LLP, files this Complaint against the Defendants. 1. Penn National is an insurance company organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal place of business at 2 North Second Street, Harrisburg, Pennsylvania. 2. The Defendant, Daniel Geyer ("Mr. Geyer"), is an adult individual who, on information and belief, resides at 29 Gutshall Road, Shippensburg, Cumberland County, Pennsylvania. 3 3. Defendant Cynthia Geyer ("Mrs. Geyer"), is an adult individual who, on information and belief, resides at 29 Gutshall Road, Shippensburg, Cumberland County, Pennsylvania. 4. This action for declaratory judgment is brought by Penn National pursuant to 42 Pa.C.S.A. §7532. 5. This action for declaratory judgment is instituted by Penn National to determine its rights and responsibilities under an insurance policy issued by it to the Defendants. 6. Penn National issued automobile Policy No. 129 0013168 (the "Policy") to Defendants which was in effect from July 14, 2006, to January 14, 2007. A true and correct copy of the Policy is attached hereto as "Exhibit A." 7. A controversy exists between the parties concerning their respective rights and liabilities under the Policy. 8. The Geyers have made an underinsured motorist ("UIM") claim under the Policy. 9. The Geyers claim arises out of injuries sustained by Mr. Geyer on July 30, 2006, while in the parking lot of the Dollar General store in Shippensburg, Cumberland County, Pennsylvania. 10. On July 30, 2006, Mr. Geyer and Mrs. Geyer drove to the Dollar General store, riding on a 1987 Suzuki Intruder (the "motorcycle") they owned. 11. The motorcycle is not listed as an insured vehicle on the Policy in question but rather was insured under a policy issued to Geyer by Progressive Northern Insurance Co., for which Mr. Geyer had rejected UIM coverage. 4 12. Upon arriving at the Dollar General store, Mr. Geyer, who was driving the motorcycle, stopped the vehicle in the parking lot in front of the Dollar General store, leaving the keys in the ignition. 13. Mrs. Geyer dismounted the motorcycle and entered the Dollar General store to buy several items. 14. While Mrs. Geyer was in the Dollar General store, Mr. Geyer waited by the motorcycle for her to return. 15. A short time later, Mrs. Geyer exited the Dollar General store and rejoined her husband at the motorcycle. 16. Upon arriving back at the motorcycle, Mrs. Geyer began to put her purchases in the motorcycle's saddlebags. 17. As she was doing this, Mr. Geyer was standing next to the motorcycle, wearing his helmet, waiting for her to complete the storing of her purchases so that they could continue their trip on the motorcycle. 18. At that time, a vehicle driven by Amanda Breon backed out of a parking space, struck Mr. Geyer and knocked him down. 19. As a result of the injuries suffered in this accident, Geyer has filed a claim for UIM benefits under the Policy. 20. A dispute exists between the parties as to whether Defendant Geyer is entitled to coverage under the UIM provisions of the Policy with respect to the claim arising out of the July 30, 2006, accident. 21. Penn National avers that coverage does not exist under the UIM provisions of the Policy for the claim submitted by Defendant Geyer. 5 22. Penn National has investigated Defendant Geyer's claim subject to reservations of rights as set forth in the letter attached hereto as "Exhibit B." 23. The Policy provides that, under certain conditions, compensatory damages will be paid to "an insured" who is legally entitled to recover from the owner or operator of an "underinsured motor vehicle" because of "bodily injury." 24. The Policy excludes UIM coverage for bodily injury sustained when "an insured" is "occupying" a vehicle owned by an insured that is not insured under the Policy. 25. The Policy defines "occupying" as meaning "in, upon, getting in, on, out or off." 26. Under the Policy and applicable law, Mr. Geyer was "occupying" the motorcycle at the time of the accident. 27. The motorcycle ridden by the Geyers on July 30, 2006, is not insured under the Policy. 28. As such, at the time of the accident, Geyer was occupying a vehicle he owned which was not insured under the Policy and, therefore, coverage does not exist under the Policy for Geyer's claim. 6 WHEREFORE, Plaintiff Pennsylvania National Mutual Casualty Insurance Company, respectfully requests the Court to enter judgment in this favor and issue a declaratory judgment that Defendants Daniel and Cynthia Geyer are not entitled to coverage under the Penn National Insurance Company Policy with respect to the claim submitted, together with such other relief as the Court may deem appropriate. Respectfy"bmitted, THOMAS, TFJOMAS,O FJOER, LLP J. Spe &,/Esquire ker hlaw.com Date: q lad 0? 569028.1 I.D. 4283/ 305 North Front Street P. O. Box 999 Harrisburg, PA 17108 (717) 255-7644 7 VERIFICATION I, J05HUA 4L-t-(?Z , verify that the statements made in the foregoing document are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. §4904 relating to unswom falsification to authorities. ?xti?b?t ? Ad-; .,o (&OPOA)3d s3ia3s 00006, All PENN NATIONAL INSURANCE Pennsylvania National Mutual Casualty Insurance Company P.O. Box 2361 • Harrisburg, PA 17105 17Q nninisR DECLARATIONS (f/ PENN NATIONAL RENEWAL OF POLICY 129 0013168 INSURANCE e PREFERRED ADVANTAGE AUTO POL ICY RENEWAL DECLARATION POLICY NUMBER FR ?'OLICY PERIODT0 COVERAGE IS PROVIDED IN THE AGENCY P 129 0013168 07/14/06 01/14/07 PA NATIONAL MUTUAL CAS INS CO 1210124 00 NAMED INSURED AND ADDRESS AGENT GEYER DANIEL & CYNTHIA J P FOGELSANGER INS Y 29 GUTSHALL RD P 0 BOX 68 SHIPPENSBURG PA 17257 SHIPPENSBURG PA 17257 VEHICLES COVERED UNIT ST TER YR MAKE-DESCRIPTION SERIAL NUMBER SYM CLASS LIMIT CHG DATE 001 PA 027 02 TYTA TMA LTDSR5 5TEHN72N32Z023264 18 887220 07114106 002 PA 027 06 TYTA COROLLA CE 2T1BR3OE96C580259 15 887220 07/14/06 INSURANCE IS PROVIDED WHERE A PREMIUM IS SHOWN FOR THE COVERAGE REFER TO ENCLOSED FORM 70-2738 FOR INFORMATION CONCERNING COVERAGE FOR DAMAGE TO RENTAL VEHICLES. COVERAGE LIMITS OF LIABILITY PREMIUMS FULL TORT OPTION APPLIES UNIT 1 2 BODILY INJURY $100,000 EACH PERSON $300,000 EACH ACCIDENT 32.00 32.00 PROPERTY DAMAGE $100,000 PER ACCIDENT 47.00 47.D0 UNINSURED MOTORIST COVERAGE BODILY INJURY $ 25,000 EACH PERSON $ 50,000 EACH ACCIDENT STACKING APPLIES 19.00 19.00 UNDERINSURED MOTORIST COVERAGE BODILY INJURY $ 25,000 EACH PERSON $ 50,000 EACH ACCIDENT STACKING APPLIES 15.00 15.00 OTHER THAN COLLISION $50 DEDUCTIBLE. 37.00 43.00 COLLISION $500 DEDUCTIBLE 113.00 128.00 FIRST PARTY BENEFITS 13.00 13.00 MEDICAL EXPENSE BENEFIT UP TO $5,000 INCL INCL TOTAL BY UNIT 276.00 297.00 THIS IS TO CERTIFY TOTAL TERM PREMIUM $573. DO THAT THIS IS A TRUE 8 CORRECT C Y. gk?a Q?LLV_p ey 129 0013168 DECLARATIONS PENN NATIONAL RENEWAL OF POLICY 129 0013168 INSURANCE PREFERRED ADVA NTAGE AUTO POL ICY RENEWAL D=CLARATION POLICY NUMBER Pno?-o CY PER 0 TO COVERAGE IS PROVIDED IN THE AGENCY P 129 0013168 07/14/06 01/14/07 PA NATIONAL MUTUAL CAS INS CO 1210124 00 NAMED INSURED AND ADDRESS AGENT GEYER DANIEL 8 CYNTHIA J P FOGELSANGER INS Y 29 GUTSHALL RD P 0 BOX 68 SHIPPENSBURG PA 17257 SHIPPENSBURG PA 17257 THIS POLICY DOES NOT PROVIDE FIRST PARTY BENEFITS COVERAGE FOR: WORK LOSS BENEFIT FUNERAL EXPENSE BENEFIT ACCIDENTAL DEATH BENEFIT EXTRAORDINARY MEDICAL EXPENSE COV ERAGE ANTI-LOCK BRAKING DISCOUNT APPLIES TO UNIT(S) 1,2 15% ANTI-THEFT DISCOUNT APPLIES T O UNIT(S) 1 DUAL PASSIVE RESTRAINT CREDIT AP PLIES TO UNIT(S) 1,2 SAFE DRIVER DISCOUNT APPLIES A 10% CREDIT APPLIES SINCE YOU HAV E AN ACTIVE HOMEOWNERS P OLICY WITH OUR COMPANY DRIVER ID DRIVER NAME LICENSE NUMBER BIRTH DATE 01 DANIEL P GEYER 18314629 10/23/58 02 CYNTHIA A GEYER 19508093 09/29/61 APPLICABLE FORMS FORM # DATE UNIT FORM # DATE UNIT FORM # DATE UNIT FORM # DATE UNIT 70-30540204 ALL 70-31390498 ALL PPOO010698 ALL 70-30480106 * ALL 70-448 01/99 ALL ILD9100702 ALL 70-1672 ALL ACORD50 * ALL 70-16861085 ALL 70-26590790 ALL PPOS381298 ALL 70-27380699 ALL 70-1512 ALL 70-31690199 ALL 70-32080106 * ALL PP13011299 ALL 70-32820601 ALL 70-33410205 ALL 70-33540106 * ALL 70-26580790 001 PP03050886 001 70-31290802 001 70-31310802 001 PP05510694 001 70-26580790 002 PP03050886 002 70-31290802 002 70-31310802 002 PP05510694 002 129 0013168 DECLARATIONS PMN NATIONAL RENEWAL OF POLICY 129 0013168 e INSURANCE PREFERRED ADVANTAGE AUTO POLICY RENEWAL DECLARATION POLICY NUMBER F oIXoLI Y ERIoorO COVERAGE IS PROVIDED IN THE AGENCY P 129 0013168 07/14/06 1 01/14/07 PA NATIONAL MUTUAL CAS INS CO 1210124 00 NAMED INSURED AND ADDRESS AGENT GEYER DANIEL & CYNTHIA J P FOGELSANGER INS Y 29 GUTSHALL RD P 0 BOX 68 SHIPPENSBURG PA 17257 SHIPPENSBURG PA 17257 LOSS PAYEE FOR UNIT #001 LOSS PAYEE FOR UNIT #002 TOYOTA FINANCIAL SERVICES PATRIOT FCU PO BOX 9490 PO BOX 778 CEDAR RAPIDS IA 52409 CHAMBERSBURG PA 17201 AN TI FRAUD NOTICE ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE IN FORMATION OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS SUCH PERSON TO CRIMINAL AND CIVIL PENALTIES, 05/30/06 PROCESS DATE POLIC-Y PERIOD 12:01 AM STANDARD 11ML PENN NAnONAL . INSURANCE Paaa wia NaNoW LWuW OmWly Nmmm C-p" PA. On Mi • MaMIR, PA 17107 ACCOUNT CREDIT - AUTOMOBILE A 10% credit has been applied to your Auto Policy since you also have an active Pennsylvania National Mutual Casualty Insurance Company Homeowners Policy. This discount will remain on your Auto Policy as long as your Homeowners Policy remains active. If your Homeowners Policy is canceled or non-renewed, the credit will be removed upon the next renewal. Form 70-3054 (Rev. 02/04) PENN NATIONAL e INSURANCE P.O. Box 2361 HaffWx rg, PA 17105.2361 YOUR PERSONAL AUTO POLICY QUICK REFERENCE DECLARATIONS PAGE Your Name and Address Your Auto or Trailer Endorsements Policy Period Coverage and Amounts of Insurance Beginning On Page AGREEMENT i DEFINITIONS 1 PART A - LIABILITY COVERAGE 2 Insuring Agreement Out of State Coverage Supplementary Payments Financial Responsibility Exclusions Other Insurance Limit of Liability PART B - MEDICAL PAYMENTS COVERAGE A Insuring Agreement Limit of Liability Exclusions Other insurance PART C - UNINSURED MOTORISTS COVERAGE 5 Insuring Agreement Other Insurance Exclusions Arbitration Limit of Liability PART D - COVERAGE FOR DAMAGE TO YOUR AUTO 7 Insuring Agreement Payment of Loss Transportation Expenses No Benefit to Baiiee Exclusions Other Sources of Recovery Limit of Liability Appraisal PART E - DUTIES AFTER AN ACCIDENT OR LOSS 10 PART F - GENERAL PROVISIONS 11 Bankruptcy Policy Period and Territory Changes Termination Fraud Transfer of Your Interest in this Policy Legal Action Against Us Two or More Auto Policies Our Right to Recover Payment Form 70-448 (Rev. 0 1199) PENN NATIONAL t uRANGE P.O. Sox 2361 Harrisburg, PA 17105-2361 PENNSYLVANIA MOTOR VEHICLE FINANCIAL RESPONSIBILITY LAW OPTION SELECTION SHEET Indicate the coverages you want on your policy in the blocks below, sign in the space provided and give this form to your agent. You must select a "Tort Option". Contact your agent for the appropriate form.' LIABILITY LEWTS Single Limits Split Limits (Bodily Injury and Property Damage) Bodily Injury Property Damage ? $ 35,000 ? $ 15,000/$ 30,000 ? $ 5,000 ? $ 50,000 ? $ 20,0001$ 40,000 ? $ 10,000 Ds 75,000 ? $ 25,000/$ 50,000 ? $ 20,000 ? $ 100,000 ? $ 50,0003 100,000 ? $ 25,000 ? $ 200,000 ? $ 100,000/$ 200,000 ? $ 50,000 ? $ 300,000 ? $ 100,0004 300,000 ? $ 100,000 ? $ 500,000 ? $ 250,0001$ 500,000 ? $ 250,000• UNINSURED MOTORIST COVERAGE UNDERINS URED MOTORIST COVERAGE Single Limits Bodily Injury Split Limits Bodily Injury Single Limits Bodily Injury Split Limits Bodily Injury ? $ 35,000 ? $ 15,0001$ 30,000 ? $ 35,000 ? $ 15,0001$ 30,000 ? $ 50,000 ? $ 20,0001$ 40,000 ? $ 50,000 ? $ 20,000/$ 40,000 ? $ 75,000 ? $ 25,000/$ 50,000 ? $ 75,000 ? $ 25,000/$ 50,000 ? $ 100,000 ? $ 50,0001$ 100,000 ? $ 100,000 ? $ 50,0001$ 100,1100 ? $ 200,000 ? $ 100,000/$ 200,000 ? $ 200,000 ? $ 100,0001$ 200,000 0$300,000 ? $ 100,0001$ 300,000 ? $ 300,000 ? $ 100,0004 300,000 ? $ 500,000 ? $ 250,000/$ 500,000 ? $ 500,000 ? $ 250,000/$ 500,000 If you want to re Oct coverage or stacking contact your agent for l If you want,to reject coverage or stacking contact your agent for the appropriate form orin the ro Hate f BASIC FIRST PARTY BENEFITS . COVERAGE LIMITS OPTIONS Medical Work Loss Benefit Funeral Accidental Benefit Monthly/Maximnm Expense Benefit Death Benefit ? $ ' 5,000 (BASIC) ? Coverage Rejected 0 Coverage Rejected ? Coverage Rejected ? $ 10,000 L] 1,000/ 5,000 ? 1,500 ? 5,000 ? $ 25,000 ? 1,000/15,000 ? 2,500 ? 10,000 ? $ 50,000 ? 1,500/25,000 ? 25,000 ? $ 100,000 ? 2,500/50,000 COMBINATION FIRST PARTY BENEFITS COVERAGE OPTION TMs coverage is a combination of benefits. Do not complete this section if you. have elected to purchase any of the above options. Option Total Benefits Limit Funeral Expense Benefit Accidental Death Benefit ? $ 50,000 2,500 10,000 ? $ 100,000 2,500 10,000 ? $ 177,500 2,500 25,000 ? $ 277,500 2,500 25,000 EXTRAORDINARY MEDICAL BENEFITS COVERAGE LIMITS OPTION Single Limits (Medical and Rehabilitation) ? $ 100,000 ? $ 500,000 ? I reject Extraordinary Medical Benefits Coverage ? $ 300,000 ? $ 1,000,000 YOUR SIGNATURE ACKNOWLEDGES THAT YOU HAVE READ AND UNDERSTAND THE TERMS AND CONDITIONS OF THE IMPORTANT NOTICES FOUND ON THE REVERSE SIDE OF THIS FORM . _ ........ . . .. ._...?__-. -_ NAMED INSURED (Please Print) TELEPHONE NUMBER POLICY NUMBER EFFECTIVE DATE INSURED SIGNATURE DATE SIGNED SPOUSE/CO-OWNER SIGNATURE DATE SIGNED Form. 70-1512 (Rev. 04/04) 1 st Copy - Policyholder 2nd Copy - Company 3rd Copy - Agency IMPORTANT NOTICE Insurance companies operating in the Commonwealth of Pennsylvania are required by law to make available for purchase the following benefits for you, your spouse or other relatives or minors in your custody, or in the custody of your relatives, residing in your household, occupants of your motor vehicle or persons struck by your motor vehicle. (1) Medical Benefits up to at least $100,000. (1.1) Extraordinary medical benefits, from $100,000 to $ 1,100,000 which may be offered in increments of$ 100,000. (2). Income loss benefits, up to at least $2,500 per month up to a maximum benefit of at least $50,000. (3) Accidental death benefits, up to at least $25,000- (4) F.uneral benefits, $2,500-. . . (5) As an.alternative to paragraphs (l);'(2), (3); and (4), a combination benefit, up to at least 3177,500 of benefits in the aggregate or benefits payable up to th e.years from the date of the accident, whichever occurs first, subject-to a. limit on . accidental death benefit of up to $25,000 and a limit on funeral benefit of $2,500, provided that nothing contained in this r subsection shall be construed. to-limit, reduce, modify-or change the provisrdns-of:section .1715(d) (relating to the availability -of adequate .1imi (6) Uninsured, undefirisured and bodily injury'liaisility coverage up to at least S 00,000. because of injury to onti person in anyone accident and up to' at least $300;00'0 because of injury to.two or -more.persons in any one accident or,.:at the option of the insurer, up to, at least $300;000 to a single limit for these coverages; except for policies insured under the . Assigned Risk Plan. Also at least $5,000 !for damage to property of others in any one :acciiierit Additionally, Insurers may offer.higher benefit levels than those enumerated above as well as additional benefits. However, an insured may -elect-to purchase lower beriefitlevels than those enumerated above. Your signature_4) this notice or'your payment of any renewal premium evidences your actual knowledge and understanding of the.availabiiity ofthese benefits and limits as well as A ie. benefits and lim is you have selected. . If you have any questions or.you do not •understand all of the various options available to you, contact your agent or'. '.company: Ifyou :do not understand any of the-proviewns, contained in this notice,•contactyour agent. or company before you sign IMPORTANT NOTICE OF OPTIONAL IDISCOIINTS If your car has passive seat belts oran airbag, oryou are 55 and have completed a motor vehicle driver improvement. course, y, g. y p y ? Y .. y.? . g y Y. ma 'be:eli" ible to.16*6r our rem'ium:-. Contact your ent if oubelieve' ou"are e1i'ible'fo'r"an°o°ffhese cre3ifs . PENN NA-nONAL INSURANCE Pennsylvania National Malual Casually insurance Company Penn National Security Insurance Company Founders Insurance Company NOTICE OF INSURANCE INFORMATION PRACTICES Your Privacy is Our Concern When you apply for any type of insurance you disclose a certain amount of information about yourself to us Law regulates the collection, use, and disclosure of such information. In addition, Pennsylvania National Mutual Casualty Insurance Company, Penn National Security Insurance Company and Founders Insurance Company (collectively, "Penn National Insurance") recognize the confidentiality expectations of our applicants and policyholders. We also expect our independent agents to follow the same policy regarding the confidentiality of your information in their business practices. Therefore, it is the policy of Penn National Insurance and its independent agents to. • Collect only information necessary or relevant to our business. • Make a reasonable effort that information we act upon is accurate, relevant, timely and complete. • Use only legitimate means to collect information. • Make non-public personal financial information available externally only to respond to legitimate business needs, to regulatory or other government authorities, or as otherwise permitted by law. • Limit employees' access to only those who have a business reason for knowing such information and are trained in the proper handling of personal information. We are providing you with the following summary of the kinds of information that Penn National Insurance or its agents may collect, what is done with information after it is collected, and how you can find out about information, if any, we have about you in our records. What kind of information do we collect about you and from whom? Penn National Insurance gets most of our information directly from you. The application you complete, as well as any additional information you provide, generally gives us most of the information we need to know. Sometimes we may contact you by phone or mail to obtain additional information. Depending on the nature of your insurance transaction, we may need additional information about you or other individuals proposed for coverage from outside sources, such as motor vehicle records, loss information reports, credit reports, court records or other public records. For property insurance, we may send someone to inspect your property and verify information about its value and condition. A photo of any property to be insured might be taken. We also might obtain information from third parties, such as other insurance companies or consumer reporting agencies. A consumer report from such an agency may contain information as to credit worthiness, credit standing, credit capacity, character, general reputation, hobbies, occupation, personal characteristics or mode of living. The consumer reporting agency preparing a consumer report for us may keep the information collected about you as permitted by law. What do we do with the information collected about you? Information that has been collected about you will be maintained in either our policy records or in your agent's files. We may review it in evaluating your request for insurance coverage and in determining your rates. We may also refer to and use information in our policy records for purposes related to issuing and servicing insurance policies and settling claims. If coverage is declined, or if the charge for coverage is increased because of information contained in a consumer report we obtained, we will tell you as required by state law and the federal Fair Credit Reporting Act We also give you the name and address of the consumer-reporting agency making the report Should you cease to be one of our policyholders, or after your claim is settled, it is our policy to archive your information for a minimum period of six (6) years. To whom do we disclose information about you? We will not disclose information about you without your written consent unless the disclosure is necessary to conduct our business. By law, we can share information about you without prior permission under certain circumstances to certain people and organizations. For example: Form 70-3282 (Ed 06/01) Page 1 of 2 • Our affiliated insurance companies. • Your agent or broker. • Parties that perform a business, professional or insurance function for-our company,. including our reinsurance companies. • Independent claims adjuster, appraisers, investigators and attorneys in order to investigate, defend or settle a claim involving you. • Businesses that help us with data processing or marketing. • Businesses that conduct statistical or industry research, including actuarial or underwriting studies. Other insurance companies-agents, or consumer reporting agencies in connection with any application,. policy, or.claim involving.you. • Insurance support.organizations that.are.established to.coliect information-for the:.purpose of detecting:and preventing ,insurance crimes or fraudulent claims. Medical care institutions or medical,professionals to verify coverage.or claims-related services. • Insurance regulatory agencies in connection`with-the regulation of our business.. • Law enforcement or other governmental authorities to protect ouriegal interestfor in cases:of suspected fraud or illegal activities.,. . • Authorized persons as ordered by:a subpoena, warrant or other: court 6rder, or as required-bylaw. • Certificateholders or policyholders for providing information regarding the status of an insurance transaction • .-Lienholders, mortgagees,:lessors or other persons shown.on our records as having a legal or .beneficial interest in your policy. We do not otherwise give information about you to peopie or organizations that•would.use the information to contact you about their own products or'services. How do -we protect the. confidentiality of ..information about.;you? .: ... Our company maintains security standards and procedures to prevent unauthorized: apoess_ 9., your information. We limit employee access to personally identifiable information to those with a Eusiness reason' for knowing such information: Penn.National Insurance also, believesin educating our. employees so that they. will understand the --importance of confidentiality,of:.persona( ihf6rmati6n,',and.in,acting apprgp.riately.Jo enforce employee privacy.responsibilities.-Should you cease being a..cus#omer, we uv(I continue to pr A66t your personal information-in this same.manner. How can you..find ..out about information'we have about you? - You have.a right t6 know wharkind of iriformation.we`keep-about you in our files, and-you have a:rightto have reasonable access to the information: We may not°be able to disclose to you certain•types of information collected when evaluating claims or possible lawsuits. In addition, we will not send you any medical information we have received about you from a doctor or other health care provider. Instead, you should contact the doctor. or health care providerdirectly to-obtain the information you seek If applicable, we will give you the name and address of any consumer reporting agency-that prep''ared:a report .about you,.so that .You can contact them for a copy. To submit your request for information, please send your complete name; address,. and policy number. (or type of insurance applied for), to: Penn National Insurance Privacy Inquiries P.O. Box 1543 Harrisburg, PA 17105 -Upon receipt of your request to review yyour.per-sonal information, we will inform you in writing of the nature and substance of locatable and retrievable recorded personal information about you in our files. You may request a copy of this information from us for a reasonable charge to you. If you believe the personal information'we have about you in our records is incomplete or inaccurate, you may.request that we make any necessary corrections to the disputed personal information. We thank you for choosing Penn National Insurance for. your insurance protection We strive to preserve the confidentiality and security of your pr-ivate.information. Our time-honored commitment to.preservitig your privacy continues, as it does in our more traditional means of serving you. We have been in the business of doing just that since 1919. Form 70-3282 (Ed. 06/01) Page -2 of 2 PP 03 05 08 86 LOSS PAYABLE CLAUSE Loss Payee: Loss or damage under this policy shall be paid, as interest may appear, to you and the loss payee shown in the Declarations or in this endorsement. This insurance with respect to the interest of the loss payee, shall not become invalid because of your fraudulent acts or omissions unless the loss results from your conversion, secretion or embezzlement of "your covered auto." However, we reserve the right to cancel the policy as permitted by policy terms and the cancellation shall terminate this agreement as to the loss payee's interest. We will give the same advance notice of cancellation to the loss payee as we give to the named insured shown in the Declarations. When we pay the loss payee we shall, to the extent of payment, be subrogated to the loss payee's rights of recovery. This endorsement must be attached to the Change Endorsement when issued after the policy is written. PP 03 05 08 86 Copyright, Insurance Services Office, Inc., 1986 PENN INSUROar% PII lsttR551' 14ne:• PA 17105 NOTICE TO. NAMED INSUREDS OF YOUR POLICY. NVOICE IS NOT INTENDED TO REFLECT THE ACTUAL E COST OF PURCHAS NGl AI POLICY WITH ONE THIS THE I INTENDED TO PROVIDE YOU WITH THIS INVOICE CE IS MINIMUM LIMITS AND COVERAGES REQUIRED BY LAW- The ws of the Commonwealth of Pennsylvania, as enacted by the General Assembly, only require that you la a medical benefit coverages. Any additional coverages or coverages in purchase liability, and first rovided only at your request as enhancements to basic coverages. excess of the limits required d by law are p A. "LIMITED TORT" OPTION The semiannual premium for basic coverage as required by law under this -limited tort" option is: Unit No.: Coverage Bodily injury $15,000 Each Person $30,000 Each Accident Property Damage $5,000 Each Accident Medical Benefit 65,000 Each Accident POLICY TOTAL TOTAL BY UNIT g, "PULL TORT" OPTION -- coverage as required by law under this "full tort" The semiannual premium for basic option is Coverage Unit No.: Bodily Injury $15,000 Each Person $30,000 Each Accident Property Damage $5,000 Each Accident Medical Benefit $5,000 Each Accident POLICY TOTAL TOTAL BY UNIT Form 70-2658(Ed. 7190) PP 05 51 06 94 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FIRST PARTY BENEFITS COVERAGE - PENNSYLVANIA With respect to coverage provided by this endorsement, the provisions of the policy apply unless modified by the endorsement SCHEDULE BASIC FIRST PARTY BENEFIT BENEFIT LIMIT OF LIABILITY Medical Expenses $5,000 If indicated below or in the Declarations, the following options apply instead of the Basic First Party Benefit: ADDED FIRST PARTY BENEFITS BENEFITS LIMIT OF LIABILITY Medical Expenses $ Work Loss $ -subject to a maximum of $ per month Funeral Expenses $ Accidental Death $ COMBINATION FIRST PARTY BENEFITS BENEFITS LIMIT OF LIABILITY Medical Expenses No specific dollar amount Work Loss No specific dollar amount Funeral Expenses $ 2,500 Accidental Death $ Maximum Limit of Liability For The $ Total of All Combination First Party Benefits NOTE: If Added First Party Benefits or Combination First Party Benefits are not shown as applicable in the Schedule or Declarations, only the Basic First Party Benefit applies. 1. DEFINITIONS The Definitions section is amended as follows A. "The Act' refers to the Pennsylvania Motor Vehicle Financial Responsibility Law. B. The following definitions are replaced: 1. "Bodily injury" means accidental bodily harm to a person and that person's resulting illness, disease or death 2. "Your covered auto" means a "motor vehicle": a. To which Part A of this policy applies and for which a specific premium is charged; and b. For which First Party Benefits Coverage required by the Act is maintained. C. The following definition is added: "Motor vehicle" means a self-propelled vehicle, operated or designed for use upon public roads. However, "motor vehicle" does not include a vehicle operated 1. By muscular power, or 2. On rails or tracks. D. "Insured" as used in this endorsement means: 1. You or any "family member". 2. Any other person while: a. "Occupying" "your covered auto," or b. Not "occupying" a "motor vehicle" if injured as a result of an accident in Pennsylvania involving "your covered auto." If "your covered auto" is parked and unoccupied it is not a "motor vehicle" involved in an accident unless it is parked in a manner which creates an unreasonable risk of injury. PP 05 51 06 94 Copyright, Insurance Services Office, Inc., 1993 Page 1 of 4 PP 05 51 06 94 IL FIRST PARTY BENEFITS COVERAGE INSURING AGREEMENT A. BASIC FIRST PARTY BENEFIT We will pay, in accordance with the Act, the Basic First Party Benefit to or for an "insured" who sustains "bodily injury". The "bodily injury" must be caused by an accident arising out of the maintenance or use of a "motor vehicle." Subject to the limit shown in the Schedule or Declarations, the Basic First Party Benefit consists of: Medica[ expenses. Reasonable and necessary medical expenses incurred for an "Insureds:` (2) A substitute to perform the work a-self-employed "insured" would have performed. However, work loss does not include: a. Loss of expected income or expenses incurred for services performed after the death of an "insured;" or b. Any loss of income, or expenses incurred for services performed, during the first 5 working days the "insured" did not work due to "bodily injury". 3. Funeral expenses. Funeral or burial expenses actually incurred if "bodily injury" causes'an "insured's" death within 24 months from the date of the accident. t, Care;. 2. Recovery; or 3. Rehabilitation. This includes remedial care and treatment . rendered in accordance with a recognized religious method of healing. Medical expenses will be paid if incurred within 18 months from the date of the accident causing "bodily injury." -However, if within 18 months from the date of the accident, it can be determined with reasonable medical probability that additional expenses may be incurred after this period, the 18 month time limit will not apply to the payment of the additional medical. expenses. . B. ADDED FIRST PARTY BFIEFITS If the Schedule or Declarations indicates that Added First Party Benefits apply, we will pay Added First Party Benefits instead of the Basic First Party Benefit to or for an "insured" who sustains "bodily injury". The "bodily injury' must be caused by an accident arising out of the maintenance or use of a "motor vehicle." These benefits are subject to the provisions of the Act Subject to the limits shown in the Schedule or Declarations, Added First Party Benefits consist of the following: t, Medical expenses as described in the Basic First Party Benefit 2. Work Jos& a.. Loss of income. Up to 80% of gross income actually lost by an "insured" as a result of the accident b. Reasonable expenses actually incurred to reduce loss of income by hiring (1) Special -help, thereby enabling an "insured" to work; or 4. Accidental death. A death benefit paid if "bodily in jury" causes the death of you or any "family member" within 24 months from the date of the accident We will pay accidental- death to the executor or administrator of the deceased "Insureds" estate.°lf there is no executor or administrator, "the benefit shall be paid to: a. The deceased 'insured's:' surviving spouse; or - 7 7 b. If there is no surviving spouse, the deceased "insured's" surviving children; or c. If there is no surviving spouse or children, to the deceased "insured's" estate. C. COMBINATION FIRST PARTY BENEFITS If the Schedule or Declarations indicates that Combination First Party Benefits apply, we will pay Combination First Party Benefits instead of the Basic First.Party.Benefit to or for an "insured" who sustains "bodily injury". The "bodily injury" must be caused by an accident arising out of the maintenance or use of a "motor vehicle." These benefits are subject to the provisions of the Act Subject to the limits shown in the Schedule or Declarations, Combination First Party Benefits consist of the following, as described in the Basic First Party Benefit and Added First Party Benefits: t. Medical expenses. 2. Work loss. 3. Funeral expenses. 4. Accidental death. Page 2 of 4 Copyright, Insurance Services Office, inc., 1993 PP 05 51 06 94 PP 05 51 06 94 EXCLUSIONS A. We do not provide First Party Benefits Coverage for "bodily injury" sustained by any "insured": 1. While intentionally causing or attempting to cause "bodily injury" to himself or any other person. We will not pay accidental death on behalf of that "insured". 2. While committing a felony. 3. While seeking to elude lawful apprehension or arrest by a law enforcement official. 4. While maintaining or using a "motor vehicle" knowingly converted by that "insured". This exclusion (A.4.) does not apply to. a. You; or b. Any "family member." 5. Who, at the time of the accident, is. a. The owner of one or more registered "motor vehicles% none of which have in effect the financial responsibility required by the Act, or b. "Occupying" a "motor vehicle" owned by that "insured" for which the financial responsibility required by the Act is not in effect 6. Maintaining or using a "motor vehicle" while located for use as a residence or premises. 7. While "occupying" a: a. Recreational vehicle designed for use off public roads; or b. Motorcycle, moped or similar-type vehicle. B. We do not provide First Party Benefits Coverage for "bodily injury": 1. Sustained by a pedestrian if the accident occurs outside of Pennsylvania This exclusion (B.1.) does not apply to: a. You; or b. Any "family member." 2. Caused by or as a consequence of a. Discharge of a nuclear weapon (even if accidental); b. War (declared or undeclared); c. Civil war; d. Insurrection, or 3. From or as a consequence of the following, whether controlled or uncontrolled or however caused: a. Nuclear reaction; b. Radiation; or c. Radioactive contamination. LIMIT OF LIABILITY A. The limits of liability shown in the Schedule or Declarations for the first party benefits that apply are the most we will pay to or for each "insured" as the result of any one accident, regardless of the number of 1. Claims made; 2. Vehicles or premiums shown in the Declarations; 3. Vehicles involved in the accident; or 4. Insurers providing first party benefits. B. If Combination First Party Benefits are afforded, we will make available at least the minimum limit required by the Act for the Basic First Party Benefit This provision (B.) will not change our maximum limit of liability. C. Any amounts payable under this coverage shall be excess over any amounts: 1. Paid; 2. Payable; or 3. Required to be provided; to an "insured" under any workers' compensation law or similar law. PRIORITIES OF POLICIES A. We will pay first party benefits in accordance with the order of priorities set forth by the Act We will not pay if there is another insurer at a higher level of priority. The First category listed below is the highest level of priority and the Fourth category is the lowest level of priority. The priority order is: First The insurer providing benefits to the "insured" as a named insured Second The insurer providing benefits to the "insured' as a family member who is not a named insured under another policy providing coverage under the Act Third The insurer of the "motor vehicle" which the "insured" is "occupying" at the time of the accident e. Rebellion or revolution. Fourth The insurer of any "motor vehicle" involved in the accident if the "insured" is not PP 05 51 06 94 Copyright, Insurance Services Office, Inc., 1993 Page 3 of 4 PP 05 51 a6 94 a. "Occupying" a "motor vehicle;" and b. Provided first party benefits under any other automobile policy. An unoccupied parked "motor vehicle" is not :,a "motor vehicle" involved in an accident unless it is parked in a manner which creates an unreasonable risk of injury. B. If 2 or more .policies have equal :priority within the highest applicable. priority level: 1. The insurer against whom the claim is first made shall process.and pay the claim as if wholly responsible. The insurer is then -entitled to recover contribution pro rata from any other insurer for the benefits .pal0. and .:the costs of. processing the claim If such contribution is sought among:insurers under the fourth priority, proration shall be based on the number of involved motor vehicles. 2. If we are the insurer against whom the claim is first made, our payment to or for an "insured" wilI*not exceedthe applicable limit of liability for First Party Benefits Coverage shown in the Schedule or Declarations. 3. The maximum recovery under all policies will not exceed the amount-payable under the policy With -the highest limit of liability. NON-DUPLICATION OF BENEFITS No one will be entitled to recover duplicate payments for the some elements of loss under this or any other similar. insurance including self -insurance. III. PART F - GENERAL PROVISIONS Part F is amended as follows: The Our Right to Recover- Payment provision does not apply. This endorsBment must be attached to the Change Endorsement when issued after the policy is written. Page 4 of 4 . Copyright, Insurance Services Office, Inc., 1993 PP 05 51 06 94 PENN NATIONAL INSURANCE P.O. Box 2361 Harrisburg, PA17105-2361 ADVANTAGE DISCOUNT - AUTOMOBILE Congratulations! As a result of the excellent driving records of all operators, your policy has qualified for an Advantage Discount Continued excellent driving habits will ensure that the discount applies to subsequent renewals. Thank you for your continued safe driving practices. Form 70-3139 (Ed 04/98) IL 09 10 07 02 PENNSYLVANIA NOTICE An Insurance Company, its agents, employees, or service contractors acting on its behalf, may provide services to reduce the likelihood of injury, death or loss. These services may include any of the following or related services incident to the application for, issuance, renewal or continuation of, a policy of insurance: 1. Surveys; 2. Consultation or advice, or 3. Inspections. The "Insurance Consultation Services Exemption Act" of Pennsylvania provides that the Insurance Company, its agents, employees or service contractors acting on its behalf, is not liable for damages from injury, death or loss occurring as a result of any act or omission by any person in the furnishing of or the failure to furnish these services. The Act does not apply. t. If the injury, death or loss occurred during the actual performance of the services and was caused by the negligence of the Insurance Company, its agents, employees or service contractors, 2. To, consultation services required to be performed under a written service contract not related to a policy of insurance; or 3. If, any acts or omissions of the Insurance Company, its agents, employees or service contractors are judicially determined to constitute a crime, actual malice, or gross negligence. Instruction to Policy Writers Attach the Pennsylvania Notice to all new and renewal certificates insuring risks located in Pennsylvania IL 09 10 07 02 Copyright, ISO Properties, Inc., 2001 Page 9 of 1 PENN NATIONAL INSURANCE pMpwd? Nr? wua CNWW ham" am" ra.e?+•+r?wm,v?mas IMPORTANT NOTICE The laws of the Commonwealth of Pennsylvania give you the right to choose either of the following tort options: A. "Limited Tort" Option The laws of 'the Commonwealth of Pennsylvania give you the right to choose a form of insurance that limits your right and the right of members of your household to seek financial compensation for injuries caused by other drivers. Under this form of insurance, you and other household members covered under this policy may seek recovery for all medical and other out-of-pocket expenses, but not for pain and suffering or other nonmonetary damages unless the injuries suffered fall within the definition of serious injury" as set forth in the policy, or unless one of several other exceptions noted in the policy applies. B. "Pull Tort" Option -- The laws of the Commonwealth of Pennsylvania also give you the right to choose a form of insurance under which you maintain an unrestricted right for you and the members of your household to seek financial compensation for injuries caused by other drivers. Under this form of insurance, you and other household members covered under this policy may seek recovery for all medical and other out-of-pocket expenses and may also seek financial compensation for pain and suffering and other nonmonetary damages as a result of injuries caused by other drivers. If you wish to change the tort option that currently applies to your policy, you must notify your agent, broker or company and request the appropriate form. Form 70-2659 (Ed. 07/90) PENN NATIONAL V? INSURANCE P.O. Box 2261 Haffisburg, PA17105.2361 GOOD NEWS! You may be eligible for a Good Student Discount if the owner or operator is at least 16 through 24 years of age, and a full time high school, college or university student The scholastic records for the immediately preceding school semester need to show that the student has attained one or more of the following. 1. Is in the upper 20% of his/her class scholastically, or maintains a "B" average, or its equivalent If the letter grading system cannot be averaged, then no grade can be below "B". 2. When in a school maintaining a numerical grade, must have at least a 3 in a 4, 3, 2, 1 point system or its equivalent 3. Student is included in a "Dean's List", "Honor Roll" or comparable list indicating scholastic achievement A certified statement from a school official is required annually. Please contact your agent for additional details in regards to this discount. We appreciate your business and are pleased to provide this additional discount Includes copyrighted material of Insurance Services Office, Inc., with its permission Copyright, Insurance Services Office, Inc., 1995 Form 70-3169 (Ed. 01 /99) PENN NATIONAL life INSURANCE Pennsyivania National Mutual Casualty Insurance Company Penn National Security Insurance Company Founders Insurance Company P.O. Box 2257 . Harrisburg, PA 17105 BIG DEAL. Guaranteed repair of chips and small windshield cracks. Even the tiniest chip in your windshield can compromise its structural integrity. Right now that little chip or crack may not seem like a big deal, but if not repaired it can ruin your entire windshield Repairs made by the professionals at Glass Doctor and Harmon AutoGlass restore your windshield's structural integrity and preserve the original factory seal. Repairs are environmentally friendly and help to keep insurance premiums low. In addition, repairs are guaranteed to prevent windshields from cracking further. If the break on your windshield can fit under a dollar bill, chances are we can fix it Repair takes only 30 minutes...wdII even come to you. If you have Other Than Collision coverage on your vehicle, callus today at 1-800-330-3038 fora FREE Repair, your auto Other Than Collision deductible will be waived Don't let a little chip become a big deal GLASSDOCTOR HARMON AUTO. HOME. BUSINESS AUTOGLASS A Glass Doctor Company We fix your panes! Form 70-3341 02/05 PENN NATIONAL INSURANCE P.D. Box 2361 HarrW aT, PA 17105-2461 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. UNINSURED MOTORISTS COVERAGE - PENNSYLVANIA (STACKED) 1. Part C - Uninsured Motorists Coverage is replaced by the following: SCHEDULE Auto Premium Limits 1. $ $ each person $ each accident 2. s $ each person $ each accident 3. $ $ each person $ each accident INSURING AGREEMENT A. We will pay compensatory damages which an "insured" is legally entitled to recover from the owner or, operator of an "uninsured motor vehicle" because of "bodily injury": 1. Sustained by an "insured"; and 2. Caused by an accident C. "Uninsured motor vehicle" means a land motor vehicle or trailer of any type: 1. To which no bodily injury liability bond or policy applies at the time of the accident 2. Which is a hit-and-run vehicle! whose operator or owner cannot be identified and which hits or which causes an accident resulting in "bodily injury" without hitting: The owner's or operators liability for these damages must arise out of the ownership, maintenance or use of the "uninsured motor vehicle". No judgment for damages arising out of a suit brought against the owner or operator of an "uninsured motor vehicle" is binding on us unless we: 1. Received reasonable notice of the pendency of the suit resulting in the judgment, and 2. Had a reasonable opportunity to protect our interests in the suit B. "Insured" as used in this endorsement means: 1. You or any "family member". 2. Any other person "occupying" "your covered auto". 3. Any person for damages that person is entitled to recover because of "bodily injury" to which this coverage applies sustained by a person described in 1. or 2, above. a. You or any "family member"; b. A vehicle which you or any "family member" are "occupying"; or c. "Your covered auto". If there is no contact with the hit-and-run vehicle, the facts of the accident must be proved. 3. To which a bodily injury liability bond or policy applies at the time of the accident, but the bonding or insuring company: a. Denies coverage, or b. Is or. becomes: (1) Insolvent; or (2) Involved in insolvency proceedings. However, "uninsured motor vehicle" does not include any vehicle or equipment: 1. Owned by or furnished for the regular use of you or any "family member". Includes copyrighted material of Insurance Services Office, Inc.,with its permission Copyright, Insurance Services Office, Inc., 1997, 1998, 2002 Form 70-3129 (Rev. 08/02) Page 1 of 3 2. Owned or operated by a self-insurer under any applicable motor vehicle law, except a self-insurer which is or becomes insolvent 3. Operated on rails or crawler treads. 4. Designed mainly for use off public roads while not on public roads. 5. While located for use as a residence or premises. EXCLUSIONS A. We do not provide Uninsured Motorists Coverage for "bodily injury" sustained': 1. By you while "occupying", or when struck by, any motor vehicle you own which is not insured for this coverage under this policy. This includes a trailer of any type used with that vehicle. 2. By a "family member": a. Who owns an auto, while "occupying", or when struck by, any motor vehicle owned by you or any "family member" which is not insured for this coverage under this policy. This includes a trailer of any type used with that vehicle, b. Who does not own an auto, while "occupying", or when struck by, any motor vehicle you own which is insured for this coverage on a primary basis under any other policy. B. We do not provide Uninsured Motorists Coverage for "bodily injury" sustained by any "insured": 1. If that "insured" or the legal representative settles the bodily injury claim without our consent However, this Exclusion (13.1.) does not apply if such settlement does not adversely affect our rights. 2. While "occupying" "your covered auto" when it is being used as a public or livery conveyance. This Exclusion (8.2.) does not apply to a share-the-expense car pool. 3. Using a vehicle without permission of the owner. C. We do not provide Uninsured Motorists Coverage for "noneconomic loss" sustained by any "insured" to whom the limited tort alternative applies, resulting from "bodily injury" caused by an accident involving an "uninsured motor vehicle," unless the "bodily injury" sustained is a "serious injury". This Exclusion (C.) does not apply if that "insured" is injured while "occupying" a motor vehicle insured under a commercial motor vehicle insurance policy. D. This coverage shall not apply directly or indirectly to benefit any insurer or self-insurer under any of the following or similar law. 1. Workers' compensation law; or 2. Disability benefits law. E. We do not provide Uninsured Motorists Coverage for punitive or exemplary damages. LIMIT OF LIABILITY A. If "bodily injury" is sustained in an accident by you or any "family member": 1. Our maximum limit of liability for all damages, including damages for care, loss of services or death, arising out of "bodily injury" sustained b any one person in any such accident is the sum of the limits of liability shown in the Schedule or in the Declarations for each person for Uninsured Motorists Coverage. 2. Subject to the maximum limit for each person described in A.Z. above, our maximum limit of liability for all damages arising out of "bodily injury" resulting from any one accident is the sum of the limits of liability shown in the Schedule or in the Declarations for each accident for Uninsured Motorists Coverage. 3. Subject to the maximum limits of liability set forth in A.1. and A.2. above, the most we will pay for "bodily injury' sustained in such accident by an "insured other -than-you or any "family member" is the . each person or each accident limit of liability shown in the Schedule or in the Declarations applicable to the vehicle that the "insured" was "occupying" at the time of the accident. The maximum limit of liability is the most we will pay regardless of the number o.f" 1. "Insureds"; 2. Claims made; 3. Vehicles or premiums shown in the Schedule or in the Declarations; or 4. Vehicles involved in the accident B. If "bodily injury" is sustained by any "insured" other than you or any "family member" in an accident in which neither you nor any "family member" sustain "bodily injury," the limit of liability shown in the Schedule or in the Declarations for each person for Uninsured Motorists Coverage is our maximum limit of liability for all damages, including damages for care, loss of services or death, arising out of "bodily injury" sustained by any one person in any one accident Subject to this limit for each person, the limit of liability shown in the Schedule or in the Declarations for each accident for Uninsured Motorists Coverage is our maximum limit of liability for all damages for "bodily injury" resulting from any one accident. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Copyright, Insurance Services Office, Inc., 1997, 1998, 2002 Form 70-3129 (Rev. 08102) Page 2 of 3 This is the most we will pay regardless of the number of. 1. "Insureds"; 2. Claims made; 3. Vehicles or premiums shown in the Schedule or in the Declarations, or 4. Vehicles involved in the accident C. The limit of liability under this coverage is reduced by any amount paid to the same person for the same accident under Part A. or Part C. of this policy. D. We will not make a duplicate payment under this coverage for any element of loss for which payment has been made by or on behalf of persons or organizations who may be legally responsible. This includes all payments made to an "insured's" attorney either directly or as part of the payment made to the "insured". E. We will not pay for any element of loss if a person is entitled to receive payment for the same element of loss under any of the following or similar law. 1. Workers' compensation law, or 2. Disability benefits law. OTHER INSURANCE If there is other applicable insurance available under more than one policy or provision of coverage that is similar to the insurance provided under this endorsement The following priorities of recovery apply. First The Uninsured Motorists Coverage applicable to the vehicle the "insured" was "occupying" at the time of the accident Second The policy affording Uninsured Motorists Coverage to the "insured" as a named insured or family member. If two or more policies have equal priority, the insurer against whom the claim is first made shall process and pay the claim as if wholly responsible for all insurers with equal priority. The insurer is thereafter entitled to recover contribution pro rata from any other insurer for the benefits paid and the costs of processing the claim. If we are the insurer against whom the claim is first made, we will pay, subject to the limit of liability shown in the Schedule or in the Declarations for Uninsured Motorists Coverage, after we and all other contributing insurers agree: 1. Whether the "insured" is legally entitled to recover damages from the owner or operator of an "uninsured motor vehicle"; and 2. As to the amount of damages. ARBITRATION A. If we and an "insured" do not agree: 1. Whether that "insured" is legally entitled to recover damages, or 2. As to the amount of the damages which are recoverable by that "insured"; from the owner or operator of an "uninsured motor vehicle" then the matter may be arbitrated However, disputes concerning coverage under this endorsement may not be arbitrated. Either party may make a written demand for arbitration. Arbitration shall be conducted in accordance with the provisions of the Uniform Arbitration Act of 1927. Each party will select an arbitrator. The two arbitrators will select a third. If they cannot agree within 30 days, either may request that selection be made by a judge of a court having jurisdiction. B. Each party will: 1. Pay the expenses it incurs; and 2. Bear the expenses of the third arbitrator equally. C. Unless both parties agree otherwise, arbitration will take place in the county in which the "insured" lives at the time of the accident Local rules of laws as to procedure and evidence will apply. A decision agreed to by two of the arbitrators will be binding. 11. PART F - GENERAL PROVISIONS The following is added to the Two Or More Auto Policies Provision of Part F: TWO OR MORE AUTO POLICIES 1. This provision does not apply to Uninsured Motorists Coverage. 2. No one will be entitled to receive duplicate payments for the same elements of loss under Uninsured Motorists Coverage. This endorsement must be attached to the Change Endorsement when issued after the policy is written. Includes copyrighted material of Insurance Services Office, Inc.,with its permission Copyright, Insurance Services Office, Inc., 1997, 1998, 2002 Form 70-3129 (Rev. 08/02) Page 3 of 3 PERSONALAUTO .. PP 00 01 06 98 PERSONAL AUTO POLICY AGREEMENT In return for payment of the premium and subject to all the terms of this policy, we agree with you as follows: DEFINITIONS A. Throughout this policy, "you" and "your" refer to: 3. Any "trailer" you .own. 1. The "named insured" shown in the Declara- 4: Any auto or "trailer" you do not own while used tions; and as a temporary substitute for any other vehicle The spouse if a resident of the same house- 2 described in this definition which is out of nor- . hold. mal use because of its: If the spouse ceases to be a resident of the same a. Breakdown; household during the policy period or prior to the b. Repair; inception of this policy, the spouse will be consid- c. Servicing; ered "you" and "your" under this policy but only d. Loss; or until the earlier of: 1. The end of 90 days following the spouse's e. Destruction. change of residency; This Provision (J-4.) does not apply to Cover- 2. The effective date of another policy listing the age For Damage To Your Auto. spouse as a named insured; or K.. "Newly acquired auto": 3. The end of the policy period. 1. "Newly acquired auto" means any of the follow- "us" and "our" refer to the Company provid- B. "We" ing types of vehicles you become the owner of , ing this insurance. during the policy period: C. For purposes of this policy, a private passenger a. A private passenger auto; or type auto, pickup or van shall be deemed to be b. A pickup or van, for which no other insur- owned by a person if leased: ance policy provides coverage, that: 1. Under a written agreement to that person; and (1) Has a Gross Vehicle Weight of less 2. For a continuous period of at least 6 months. than 10,000 lbs.; and Other words and phrases are defined. They. are in (2) Is not used for the delivery or transpor- quotation marks when used. tation of goods and materials unless D. "Bodily injury" means bodily harm,, sickness or disease, including death that results. such use is: (a) Incidental to your "business" of in- E: "Business" includes trade, profession or occupa- stalling, maintaining or repairing furnishings or equipment; or tion. (b) For farming or ranching. F. "Family member" means a person related to you " " by blood,. marriage or adoption who is a resident Z. Coverage for a newly acquired auto is pro- of your household. This includes a ward or foster vided as described below. If you ask.us to in- " " child. newly acquired auto after a specified sure a time period described below has elapsed, any G. "Occupying" means In, upon, getting in, on, out or coverage we provide for a; newly acquired off. auto" will begin at the time you request the H. "Property damage" means physical injury to, de- coverage. struction of or loss of use of tangible property. a.. For any coverage provided in this policy 1. "Trailer" means a vehicle designed to be pulled by except Coverage For Damage To Your a: Auto, a "newly acquired auto" will have the 1. Private passenger auto; or broadest coverage we now provide for any vehicle shown in the Declarations. Cover- t. Pickup or van. age begins on the date you become the It also means a farm wagon or farm implement owner. However, for this coverage to apply while towed by a vehicle listed in 1. or 2. above. to a "newly acquired auto" which is in addi- J. "Your covered auto" means: tion to any vehicle shown in the Declara- tions, you must ask us to insure it within 14 1. Any vehicle shown in the Declarations. days after you become the owner. 2. A "newly acquired auto". PP 00 01 06 98 Copyrightjnsurance Services Office, Inc., 1997 Page 1.of 12 If a "newly acquired auto" replaces a vehi- cle shown in the Declarations, coverage is provided for this vehicle without your hav- ing to ask us to insure It. b_. Collision Coverage fora newly acquired..: auto" begins oh-the date you become-th __ ,owner. However, for this coverage to apply, you must ask us.to insure it withln:. (1) 14 days after you become the ownerif` the Declarations indicate that :Collision Coverage applies to at least one auto. In this case,.the "newly:aoquired.auto" will have the broadest coverage we now provide for any auto shown,in the Dec- larations. (2) Four days after you become the owner if the Declarations do not-Indicate that Collision Coverage applies ;to at least one auto. If you comply with. the,.4 clay requirement and a loss 'occurred before you asked us to insure the "newly ac- quired .auto", .a.. Collision:.deducWe of $500,will apply, ;...n c. Other Than Collision Coverage for a "newly acquired auto" begins on the date you be- come the owner. However, for this cover- age to apply, you must ask us to insure it within: (1) 14 days. after you become the-owner if? - the Declarations indicate that Other' Than Collision Coverage applies to at least one auto. In this case, the "newly acquired auto" will have the broadest. -coverage we..now.provide forany auto shown in the Declarations: (2) Four days after you become.the owner if the Declarations do not indicate that Other Than Collision Coverage applies 'to at-least one auto: If you comply with ` the 4"day requirement ;and''"a'loss --oc- curred before you askedus to insure the "'newly acquired auto„, an Other-'Than Collision deductible of $500 will apply. PART A - LIABILITY COVERAGE 1NSU:RING.AGREEMENT SJPPLEMENTARY. PAYMENTS.. We will pay damages for "bodily --injury" or A In addition to our limit of liability, 6 Will pay oh -be- . "property damage'• for which any "insured" be- half-of .an "insu- ed": ;. .comes.l.egally respansible,because.:of an auto ac- ' .y :-Up to $250'for the cost of bail borids required . cident. Damages -.include prejudgment interest because of an accident, including related fraf- awarded against the "insured". We will settle or • ; ficJaw violations.., The :accident-must result in defend; ,as we consider appropriate, any claim or "bodily .injury.'. or "property damage".covered suit asking for these damages. 'In'-addition to our under this policy. limit of .li_ability" we: will pay ,all defense costs we Premiums' on 'appeal bonds. and bonds. to 'rr~- incur. fur duty to settle-or defend ends when our lease attachments in any suit we defend: limit of liability for this coverage.-has been ex- hausted by payment of judgments or- settlements. ,. .. • ; . 3.- `Interest accruing.' after a judgment is entered ih ' W -have no duty to defend any,.suit or settle any " " defend. Our duty to pay interest any suit we art -of- the' that a ffer to s n w wh d not or property damage claim for ".bodily injury. p p y e o e s en covered under this policy:` judgment which does not exceed our limit'of li- r; "Insured" as used in this Part means B -ability for this coverage; ." . is or any amily member " for'the ownership, 'You. " " not .:Up to $200 a 'day--for loss of'earriings', but .. other income* because of attendance at ?:hear- ler . ..trai,e i maintenance or use of any auto sir ... _ ings or trials at our request. iy.:person using -"your.covered -auto" 4..,; 2. A - - -- - i .,.-5::.Other reasonable expenses- Incurred at our% 3: For "your covered auto", any person -or otgani- ;. request. -?•.• ??t,.,? h„t nntti,:?nnth-rasnPrY'to legal'resoonsi-. _______________ -- bility for acts or omissions of a' person for whofn coverage is afforded.under this Part. :4. For any auto or'"t?aifer"';'other than "your cov- ered -auto", any 'other person or organization but only with respect°to legal responsibility for ...acts.or omissions of'you or any "family mem- ber" for whom coverage' is afforded under this - Part:; This Provision (8:4.)` applies only if the person or organization does not own or hire the auto-or "trailer": tXI:LU?IVIV? '• A. We •do' not provide Liability Coverage for any, insured", 1. Who intentionally causes "bodily injury" 'or "property damage 2. For "property damage" to property awned or being transported:by,that;"insured".. Page.2 of 12, Copyright, Insurance Senrices.Office, Inc., 1997 PP 00*01 06 98'• 3. For "property damage" to property: . . a. Rented to; b. Used by; or c. In the care of; that "insured". This Exclusion (A.3.) does not apply to "property damage" to a residence,or private garage. 4. For "bodily injury" to an employee of that "insured" during the course of employment. This Exclusion (A.4.) does not apply to "bodily injury" to a domestic employee unless workers' compensation benefits are required or avail- able for that domestic employee. 5. For that "insured's" liability arising out of the ownership or operation of a vehicle while it Is being used as a public or livery conveyance. This Exclusion (A.S.) does not apply. to a share-the-expense car pool. 6. While employed or otherwise engaged in the "business" of: a. Selling; b. Repairing; c. Servicing; d. Storing; or e. Parking; vehicles designed for use mainly on public highways. This includes road testing and deliv- ery. This Exclusion (A4.) does not apply to the ownership, maintenance or use of "your cov- ered auto" by: a. You; b. Any "family member"; or c. Any partner, agent or employee of'you or any "family member". 7. Maintaining or using any vehicle while that ."insured" is employed or otherwise engaged in any "business" (other than farming or ranching) not described in Exclusion A.6. This Exclusion (A.7.) does not apply to the maintenance or use of a: a. Private passenger auto,, b. Pickup or van; or c: "Trailer" used with a vehicle described in a. or b. above., 8. Using a vehicle. without a reasonable . belief that that "insured" is entitled to do so. This Exclusion (A.B.) does not apply to a "family member" using "your covered.auto" which is owned by you. 9. For "bodily injury" or "property damage" for' which that "insured": a. Is an insured under a nuclear energy liabil- ity policy; or b. Would be an insured under a nuclear en- orgy liability policy but for its termination upon exhaustion of its limit of liability. A nuclear energy liability policy is a policy is- sued by any.pf the following or their succes- sors: a. Nuclear Energy Liability Insurance Asso- ciation; b. Mutual Atomic Energy Liability Underwrit- ers; or c. Nuclear Insurance Association of Canada. B. We do not provide Liability Coverage for the own- ership, maintenance or use of: 1. Any vehicle which: a. Has fewer than four wheels; or b. Is designed mainly for use off public roads. This Exclusion (i3.1.) does not apply: a. While such vehicle is being used by -an "insured" in a medical emergency; b. To any "trailer"; or c. To any non-owned golf cart. 2. Any vehicle, other than "your covered auto", which is: a. Owned by you; or b. Furnished or available for your regular use. & Any vehicle, other than "your covered auto", which is: a. Owned by any "family member'';.or b. Furnished or available for the regular use of any "family member". However, this Exclusion .(B.3.) does not apply to you while you are maintaining or "occupying" any vehicle which is: a. Owned by a "family member"; or b. Furnished or available for the regular use of a "family member". 4. Any vehicle, located inside a facility, designed for racing, for the purpose of: a. Competing in; or b. Practicing or preparing for; any prearranged or organized racing or speed contest. PP 00 01 06 98 Copyright, insurance Services Office, Inc., 1997 Page 3 of 12 LIMIT OF LIABILITY A. The limit of liability shown in the Declarations for -; each person for Bodily -Injury.. Liability is our maximum limit of liability for all damages, includ- ing damages for_ care, loss of services-or death, - arising-abrof-"bodil '-injury" -sustained=by-any one -person in. anyone Auto" a'ccident. Subject to this limit for each person, fhe limit of liability' shown in fhp.iDeclarations:for .-each- accident Jor..:Bodiiy In- .,jury Liability -is our-maximum limit of liability. Jor all damages for "bodily injury" resulting from any one ,auto acpidentsi The limit of liability shown' in the Declarations for each accident for Property Damage.Liability,,,ls our maximum limit of liability for ail "pro-perry' dam- age" resulting from any one auto accidert. This 'is the °mosNe' will "pay regardless of_ the numberof: {;• 1. "Insureds"; 2. Claims made; 3. Vehlcles' or premiums shown in the ` Declara- 4. Vehicles Irnvoived•in th`e auto accident.. 9:* No-one;will.<ba.entit:166to receive duplicate pay- ments for'the'satne elements` of loss under this coverage and: - '; 1. Part B or Part,C:ofth_is policy;-,or:;, 2.1-Any ..Underinsured ,Motorists.- .Coverage pro- vided by this pollcy. OUT OF 5TATf* C;UVt=r1AUr_ If an auto accident to which this policy applies occurs in any state or province other than the one In.which "your covered auto" is principally garaged, we will interpret your policy for that accident as follows: A. If the state or province has: 1. A financial responsibility or similar law specify- Ing limits of liability :for "bodlly injury" or "property damage" higher than the limit shown In the Declarations, your. policy -will provide the higher specified.limit. 2. A compulsory insurance or similar law requir- ing a nonresident to maintain insurance when- ever the :nonresident uses a -vehicle in that state or province;. your policy will provide at least the.required_..innimu.m ampunts.and_ty_pes of coverage. , B; No one will be -entitled'Ao,Aduplicate'.payments for the same elements-' loss: - FINANCIAL RESPONSIBILITY r. When this policy is certified as future proof of finan- cial responsibility, this policy shall comply with the law to the extent required. OTHER INSURANCE - ` If there is other applicable liability -insurance we will pay only our share of the loss. Our., share•,is the pro- portion that our limit of liability bears to t.h.e total of all applicable limits. However, any insurance we. provide fdr avehiole yc&do not own shall.be excess over any PART 8 =`MEDICAL PAYMENTS COVERAGE ` ,' 2. Sustained while "occupying" "your, covered INSURING A'GREEIAI NT - , auto" when it is being used as a public or. livery A. We will Pay reasonable, expenses incurred for conveyance. This Exclusion (2.) does not ap- necessary medical aril funeral services because ply to a share-the-expense _car•.pool... of "bodily injury'I,. :. Caused by accident; and 3• Sustained while "occupying" `'any vehicle lo- 1. .cated for use as.,e. residence or.premises: 2: Sustained by an "insured" ; -Occurring dur!hg:the=cdurse of employment if We will pay only ,.those expenses, ,(ncurred for. workers' compensation benefits are required or services rendered within 3 years from the date of available for t eei"bodily injury"" the accident. "' ,. _. 5. Sustained while occupying or when struck B: "'Insured" &Tis'ed in ;this: Partrnebns' ` - -`' by, any vehicle-toth& -than your • covered 1. You or any "family.rriember"• auto") which is: a. vvniie occupyj{;y b, Asa pedestrian w?en;strucK;by,•; a motor vehple, ;designed; for use mainly on public roads or.a trader of any type. 2. Any other person while "occupying" "your cov- ered auto". EXCLUSIONS We do not provide Medical Payments Coverage for any "insured" for "bodily injury": 1. Sustained while "occupying" any motorized vehicle having fewer than four wheels. b. Furnished or available for.your regular use. 6. Sustained while "occupying", or when struck by, any. vehicle (other .than "your covered auto") which, is: a. Owned by any "family member"; -or- b. Furnished or available for the :regular use of any "family member". However, this Exclusion (6.) does not apply to you. Page 4 of 12'.. Copyright, Insurance Services Office, Inc., 1997 • PP 0001 06 98.1 7. Sustained while "occupying" a vehicle without a reasonable belief that-that "insured" -is entl- tied to do so. This Exclusion (7.) does not ap- ply to a "family member" using "your covered auto" which is owned by you. 8. Sustained while "occupying" a vehicle when It is being used in the "business" of an "insured". This Exclusion (8.) does not apply to ''bodily injury" sustained while "occupying"a: a. Private passenger auto; b. Pickup or van that you own; or c. "Trailer" used with. a vehicle described in a. or b. above. 9. Caused by or as a consequence of: a. Discharge of a nuclear weapon (even if accidental); b. War (declared or undeclared); c. Civil war; d. Insurrection; or e. Rebellion or revolution. 10. From or as a consequence of the following, whether controlled or uncontrolled or however caused: a. Nuclear reaction; b. Radiation; or c. Radioactive.contamination. 11. Sustained while "occupying" any vehicle lo- cated inside a facility designed for racing, for the purpose of:.. a. Competing in; or b. Practicing or preparing for, any prearranged or organized racing or speed contest. LIMIT OF LIABILITY A. The limit of liability shown in the Declarations for this coverage is our maximum limit of liability for each person injured in any one accident. This is the most we will pay regardless of the number of: 1. "Insureds"; 2. Claims made; 3. Vehicles or premiums shown in the' Declara- tions; or 4. Vehicles involved in the accident. B. No one will be entitled to receive duplicate pay- ments for the same elements of loss under this coverage and: 1. Part A or Part C of this policy; or 2. Any Underinsured Motorists Coverage pro- vided by this policy. OTHER INSURANCE If there is other applicable auto medical payments insurance we will pay only our share of the loss. Our share is the proportion that our limit of liability bears to the total of all applicable limits. However, any insurance we provide with respect to a vehicle you do not own shall be excess over any other collectible auto insurance ;providing payments for medical. or funeral expenses. PART C- UNINSURED MOTORISTS COVERAGE INSURING AGREEMENT 3. Any person for damages that person is entitled A. We will pay compensatory damages which an to recover because of "bodily injury" to which "insured" is legally entitled to recover from the this coverage applies sustained by a person owner or operator of an "uninsured motor vehicle" described in 1. or 2. above. because of "bodily injury": C. "Uninsured motor vehicle" means a land motor 1. Sustained by an "insured"; and vehicle or trailer of any type: 2. Caused by'an accident. 1. To which no bodily injury liability bond or policy applies at the time of the accident. The owner's or operator's liability for these dam 2. To which a bodily liability bond or ages must arise out of the ownership, mainte- y injury policy nance or use of the "uninsured motor vehicle". applies at the time of the accident. In this case its limit for bodily injury liability must be less Any judgment for damages arising out of a suit than the minimum limit for bodily injury liability brought without our written consent is not binding specified by the financial responsibility law of onus. the state in which "your covered auto" is prin- B. "Insured" as used in this Part means: cipally garaged. 1. You or any "family member", 2. Any 'other person "occupying" "your covered auto PP 00 0106 98 Copyright, insurance Services Office.; Inc.,. 1997. Page 5:of :12 3. Which is a hit-and-run. vehicle.whose..operator or owner,cannot be identified and which; hits: a. You or any "family. member"; b. A vehicle which you or any r!,famiIy_,,ynemw , pying";.or-.. ber'' are 4i ccu c.."Your:covered auto". 4. To whidh-a.bodily injury liability bond or policy applies at -the time ::of- the accident but the bonding or insuring company: a. Denies coverage; or r. b. Is or becomes insolvent,.. However, "uninsured motor vehicle" -does not in- clude any vehicle or equipment; s :1-. Owned: by or furnished or available -for :the . ; regular use ofyou or•any"familymember°;;,; 2. Owned or operated by a self-insurer under.'any applicable, motor vehicle,.-.law, except,.a self- insurer which is or becomes insolvent..i; 3. Owned by any governmental unit or agency. 4. Operated on rails or crawl er:trea. sL :tq ~_. Designed mainly, -for.use off :public;roads:whlle not on.puhlic_roads.-_ 2. Disability benefits law., D. We do not provide Uninsured Motorists Coverage for unitive or ezelnplary damages." LIMIT OF LIABILITY.,_. A- The limit pf debility shown in -the -Declarations for- ..._each;erson for:,fJnin.sured.Motorists Coverage is our maximum limit of :liability for all damages, in- eluding damages for care, loss. of services or death, arising .oUt' of , "bo'di'ly `injury"' sustained by any one person in;-any one accident: Subject to this limit for eat h_.,person, the limit of liability shown in .the Declarations for each accident for ' Uninsured 'Motorists Coverage is- dui 'maximum limit of liability for all damages for "boodily injury" resulting from any one accident.-i. J. This .is the- most'-we- will pay -regardless of the number of: 2. Claims made; c< 3. Vehicles or premiums shown in'-the Declara- tions; or : . _,.4.,, Vehicles involved. in. the accident.;;:. . B:'-No -one will'be entitled to receive duplicate pay- t for the same elements of-loss.,'Under this While located ion. use`as a':iesidence or :poem y' coverage and: . , .. t. B. of this policy; or ,,,s: . °. or -Part A. Part. ?: . ,, .... , , , ,•cr EXCLUSIONS . ` , . 2. `-Any Undennsurod Motorists Coverage pro- A.: We do not provide Uninsured;Motorists:Couerage vided by this policy ,..._. for "bodily. Injury " sustained: .,. .a, `.. We will•?ndt.make:atiuplicate paym, ent;under this G' when 1. By an. "insured" while "occupying", or. .: .:coverage for any element of iQss;.for. which pay- struck, by, any. motor vehicle owned by..<that :. mant has been made by or on behalf, of persons "insured" which is not.insured for.this coverage or organizations who `may'be `legally responsible. under this policy. This includes a trailer. of any -- type-used with-that vehicle.: -c -,-D• We will not..pay,.for ati -element of loss ifi a Person = - : ; ,; is entitled to' receive payment fos;,the, saute.. ele _ --. _ , -2:- By any "family. member" while "occupying ,, or ment of loss under any of the following or 'similar when struck by,,.,any motor vehicle. you own , law::,, ; ,:.... r s 'which is insured. for. this coverage on a.primary ' . ; Workers' compensation1aw, or - 1 - tiasisunder any,Ather policy. . ` We do not.provide Uninsured Motorists Coverage+, 8 , 2. Disability benefits law. . - :''tor "bodily injury" sustained by any "?nsured'?:; OTHER INSURANCE r 1. If that "insured" or the, Legal representative If there is other applicable insurance available under ' settles the""bodil tnjujy". 'lairs without our one or more -policresor provisions of. coverage thais consent: similar to the insurance provided under this Part.of ' 2: While "occupying'your covered auto" when it the'policy This` exclusion_(13.2.) doe's not apply l to - a share4he-expense_: car'pool..` .. Using.;:a,yehicle without, a. reasonable .'belief. that that "insured". is entitled to do' so: This Exclusion (13.3.) does not -apply to a "family member" using "your covered auto": which ;s owned by-you::. C. This coverage shall not apply directly or indirectly; to benefit any insurer or self-insurer under any of the following or similar law: 1. Workers' compensation law; or cies or`p'rovsion.. of coverage M4 equal`but riot' keedd ttie highest"appiicabl'e'tiinit Tot any one vehicle under any insurance providing coverage on either a primary mr.excess basis. 2. Any insurance we provide .with:.;respect to a r? vehicle. you do not own shall. be., excess over any collectible ,insurance providing such cov- erage on a primary basis. Page 6 of 12 Copyright, Insurance-Serv'ices,Office, Inc.,.,1997 PP 00.01 06 98• 3. If the coverage under this policy is provided: a. On a primary basis, we will pay only our share of the loss that must be paid under insurance providing coverage on a primary basis. Our share is the proportion that our limit of liability bears to the total of all ap- plicable limits of liability for coverage pro- vided on a primary basis. b. On an excess basis, we will pay only our share of the loss that must be paid under insurance providing coverage on an excess basis. Our share is the proportion that our limit of liability bears to the total of all ap- plicable limits of liability for coverage pro- vided on an excess basis. ARBITRATION A. If we and an "insured" do not agree: 1. Whether that "insured" is legally entitled to recover damages; or 2. As to the amount of damages which. are re- coverable by that "insured"; from the owner or operator of an "uninsured motor vehicle", then the matter may be arbitrated. How- ever, disputes conceming coverage . under this Part may not be arbitrated, Both parties must agree to arbitration. If so agreed, each party will select an arbitrator. The two arbitrators will select a third. If they cannot agree within 30 days, either may request that se- lection be made by a judge of a court having ju- risdiction. B. Each parry will: 1. Pay the expenses it incurs; and 2. Bear the expenses of the third arbitrator equally. C. Unless both parties agree otherwise, arbitration will take place in the county in which the "insured" lives. Local rules of law as to procedure and evi- dence will apply. A decision agreed to by two of the arbitrators will be binding as to: 1. Whether the "insured" is legally entitled to recover damages; and 2. The amount of damages. This applies only If the amount does not exceed the minimum limit for bodily injury liability specified by the finan- cial responsibility law of the state in which your covered auto is principally garaged. If the amount exceeds that limit, either party may demand the right to a trial. This demand must be made within 60 days of the arbitrators' de- cision. If this demand is not made, the amount of damages agreed to by the arbitrators will be binding. PART D -COVERAGE FOR DAMAGE TO YOUR AUTO INSURING AGREEMENT 5. Windstorm; A.. We will pay for direct and accidental loss to "your 6. Hail, water or flood; covered auto" or any "non-owned auto", including 7. Malicious mischief or vandalism; their equipment, minus any applicable deductible 'shown in the Declarations. If loss to more than g, Riot or civil commotion; one "your covered auto or non-owned auto re- 9. Contact with bird or animal; or sults from the same "collision", only the highest 10, Breakage of glass. applicable deductible will apply. We will pay for doss to "your covered auto' caused by: If breakage of glass is caused by a "collision", you may elect to have it considered a loss caused by 1. Other than "collision" only if the Declarations .. collision" . " indicate that Other Than Collision Coverage is provided for that auto. C. "Non-owned auto" means: 2. "Collision" only if the Declarations indicate that 1. Any private passenger auto, pickup, van or "trailer" not owned by or furnished or available Collision Coverage is provided for that auto. for the regular use of you or any "family mem- If there is a loss to a "non-owned auto", we will _ ber" while in the custody of or being operated provide the broadest coverage applicable to any by you or any "family member"; or "your covered auto" shown in the Declarations. " 2. 'Any auto or "trailer" you do not own while used B. "Collision" means the upset of "your covered auto as a temporary substitute for "your covered „ or a non-owned auto or their impact with another auto" which is out of normal use because of its: vehicle or objet#. . . a. Breakdown; Loss caused by the following is considered other than "collision". b. Repair;. 1. Missiles or. falling objects; ..c. Servicing; 2. Fire; d. Loss; or 3. Theft or larceny; e. Destruction. 4. Explosion or earthquake; PP 00 01 06 98 Copyright, Insurance Services Office, Inc., 1997 Page 7 of 12 TRANSPORTATIOWEXPENSES . A. In addition, we will pay, without application of a deductible, up to a maximum of $600 for: j.-Temporary transportation expenses. not. ex- . yo - ceeding $20 per day incurred by , .u' ..Jr) the event ofa loss to "your covered, auto' 'We'-will - pay for such expenses if the loss is caused by: a. Other 'than'"collision" .' only if the Declara- tions indicate that _ Other Than Collision Coverage is provided for that auto.. . b. "Collision" only if .the-Declarations.indicate that-Collision Coverage is provided for,.Ihat auto.; 2. 'Expenses for which =you. become, legally'--re- sponsible in the;event.of loss to 61hon-owned auto", We will pay fpr;sugh pxpenses if the.loss Is caused by: a. Qtbei.. than. "_collision"•:_only, if :the ,D.eclara- tions. indicate that .Other. Than Collision -.Coverage is provided for,any "your covered auto",r .... b. "Collision" only if -the Declarations1hdicate that, Collision1'C'overage -is, provided Tor any ' "your covered auto".: • `However, .the.:'niost we Will.'payfor .any ex- penses for loss' of;use ?s $20 per day,. B. If the loss is caused by: 1. A total theft of "your covered auto" or a "non- awned auto".,-we will pay only expenses._10- _. . curved during the.period:, a. Beginning 48 hours after the theft; .and . ,. b. Ending when your covered .auto or.-the "non-owned. auto" is, returned ,to use or we pay for its loss: 2. Other than theft of a "your covered auto" or a "non-owned'auto",'we will pay only expenses beginning when the auto is withdrawn from use for more than 24 hours. C. Our payment will be limited to. that period of time reasonably required to repair or replace the "your covered auto" or the "non-owned auto". EXCLUSIONS We will not pay for: auto" which occurs while it is being used as a public or livery conveyance. This Exclusion .(1.) does not apply to a share-the-expense':car pool.. . 2. Damage due and confined to: a. Wear and tear; b. Freezing; c. Mechanical or electrical breakdown or failure; or d. Road damage to tires. This Exclusion (2) does not apply if the dam- age results from the total theft of. "your cov- ered auto" or any' non-owned auto". 3: 'Loss due to or as a.consequence of: a._ Radioactive contamination;. b. Discharge_.of any,.nuclear weapon (even if accidental); c. War (declared or undeclared); d-. Civil war; e:.Insurrection; or. L Rebellion or revolution. : 4. Loss to any electronic equipment designed for the reproduction of sound and any accessories used with such equipment. This includes'bL1Uis not limited.to; :a. Radios.and.stereos, , - b. Tape decks; or ..C..Compact !disc-players.. This Exclusion (4:) -does not apply' to equip- i ment designed -.solely for the :reproduction of sound and accessories!us-ed with. such•lequlp- ,ment, provided: ::r •. . a. The equipmenis permanently installed in "your covered auto" or any "non-owned auto"; or b. The equipment is: (1) Removable from -a- housing unit which is - _ permanently installed in -the -auto;-- -- -- (2) Designed to be' -solely operated'by use of the power, f-. oQ - the auto's electrical system; and-.,.., (3) In or upon "your covered' auto" 'or 'any "non-owned auto" at-the time of loss 5. 'Loss to .any electronic equipment that receives or•transmits audia;, visual,.or. data signals and any accessories" used with, suuc. equipment. This includes but is.not limited to:. a. Citizens band'radios; b. Telephones; x.. -c.=Two-way mobile-radios; - - - d. Scanning monitor receivers; , f. Video cassette, recorders,. g. Audio cassette recorders; or h. Personal computers.'; This Exclusion (5.) does not apply to: a. Any electronic' equipment that is necessary for the normal operation of the auto or, the monitoring of the auto's operating systems; or Rage 8 of 12 Copyright, Insurance Services Office, Inc., 1997 PP 00 01 06 98 b. A permanently installed telephone designed to be operated by use of the power from the auto's electrical system and any acces- sories used with the telephone. 6. Loss to tapes, records, discs or other media used with equipment described in Exclusions 4. and 5. 7. A total loss to "your covered auto" or any "non- owned auto" due to destruction or confiscation by governmental or civil authorities. This Exclusion (7.) does not apply to the inter- ests of Loss Payees in "your covered auto". 8. Loss to: a. A "trailer", camper body, or motor home, which is not shown in the Declarations; or b. Facilities or equipment used with such "trailer", camper body or motor home. Fa- cilities or equipment Include but are not limited to: (1) Cooking, dining, plumbing or refrigera-.- tion facilities; (2) Awnings or cabanas; or (3) Any other facilities or equipment used with a "trailer", camper body, or motor home. This Exclusion (8.) does not apply to a: a. "Trailer", and its facilities or equipment, which you do not own; or .-b. "Trailer", camper body, or the facilities or equipment in or attached to the "trailer" or camper body, which you: (1) Acquire during the policy period; and (2) Ask us to insure within 14 days.after you become the owner. 9.. Loss to any "non-owned auto" when used by you or any "family member" without a reason- able ,belief that you or that "family member" are entitled to do so. 10.. Loss to equipment designed or used for the detection or location of radar or laser. 11. Loss to any custom furnishings or equipment in or upon any pickup or van. Custom furnishings or equipment include but are not limited to: a. Special carpeting or insulation; . b. Furniture or bars; c. Height-extending roofs; or d. Custom murals, paintings or other decals or graphics. This Exclusion (11.) does not apply to a cap, cover or bedliner in or upon any "your covered auto" which is a pickup. 12. Loss to any "non-owned auto being. main- tained or used by any person while employed or otherwise engaged in the "business" of: a. Selling; b. Repairing; c. Servicing; d. Storing; or e. Parking; vehicles designed for use on public highways. This includes road testing and delivery. . 13. Loss to "your covered auto" or any "non-owned auto", located inside a facility, designed for racing, for the purpose of: a. Competing in; or b. Practicing or preparing for; any prearranged or organized racing or speed . contest. 14. Loss to, or loss of use of, a "non-owned auto" rented by: a. You; or b. Any "family member"; if a rental vehicle company is precluded from recovering such loss or loss of. use, from you or that "family member", pursuant to the pro- visions of any applicable rental agreement or state law.. LIMIT OF LIABILITY A. Our limit of liability for loss will be the lesser of the: 1. Actual cash. value of the stolen or damaged property; or 2. Amount necessary to repair or 'replace the property with other property of like kind and quality. However, the most we will pay for loss to: 1. Any "non-owned auto" which is a trailer is $500. 2. Equipment designed solely for the reproduc- tion of .sound, including any accessories used with such equipment, which is.installed in loca- tions not used by the auto manufacturer for installation of such equipment or accessories, is $1,000. B. An adjustment for depreciation and. physical condition will be made in determining actual cash value in the event of a total loss. C. If a repair or replacement results in better than like kind or quality, we will not pay for the amount of the betterment. PP 00 01 00 98 Copyright; Insurance.Services Office,.lnc., 1097 Page 9 of 12 - PAYMENT OF LOSS " We may pay for loss ,in money or repair or -replace the damaged or stolen property. We may, at our expense, return any stolen property to: - - - - 1.- You;-or- - - - - - - ------ 2. - - - 2. The address shown in this policy. If we return stolen property we will pay ;for -any dam- age resulting from the theft. We may keep all or part of the property at. an agreed or appraised value. If we pay for Joss in money,. our: payment 'will include the applicable sales .tax for the, damaged.or stolen property:. NO BENEFIT TO BAILEE . This insurance shall not directly or indirectly benefit any carrier or other_ _bailee for hire.. OTHER SOURCES OF RECOVERY .:; If Other sources of recovery alSO'cover the.lo..ss, we will pay only our share of the loss. Our share is the proportion that our limit of liability bears to'the total of all applicable limits. However, any insurance we provide with respect to a "non-owned,,-auto" shall be excess over any other collectible, source of recovery including, but not limited to :1. Any coverage provided by the owner of the "non-owned :auto"; 2. Any other applicable physical damage insur- ance; ._'3,. App other soiree of TQcov9_7 'App loss: APPRAISAL A.: if we and you,do:not agree on the amount .of loss, either may demand an appraisal .of the. Ioss. In this event, each party,will select a competent ap- praiser. The two appraisers will select-an.umpire. The appraisers will state separately `the• actual cash value and the amount of loss. If .they-fall to .agree, they will:.su_bmil their differences to the umpire. A decision agreed' by any .two will be binding. Each party wi_11, 1. Pay its chosen appraiser; and -2.-Bear the-expenses.of the.appraisal and umpire equally. B.:;We do not waive any. of odr rights under -this pol- icy by agreeing to an appraisal.: - L , . PART:Er-DUTIES AFTER AN ACCIDENT We have' no `duty"to provide,coverage- under this b. Other.pprtirient records.- olicy unless there has been full compliance with the 5. Submit a proof of-loss-When required by us. p following duties: C. A person seeking Uninsured Motorists"Coverage We must be notified .promptiy;of -how,-when. ands: A. ,must also; ,. : _ ,, where the accident or loss happened. Notice ld also Include the names and addresses of h 1, promptly notify the police if` shit-and-run ou s any injured persons and'of-any witnesses,,;;. driver is involved-! :-. . ' ' seekin any coverage a must. , ;. A person B papers if egaf 2. Promptly send us,copies of the , , .., 1.. Cooperate. with., Lis ,in the :investigation;settle- a suit is brought. erson seeking `Coverage"For Damage To Your D. A ment or defense of any claim or suit. p ptly. send ;us copies of any notices' `or 2. Pro legal papers ropeiyed in connection kith the also: ` i .. Auto must` ?: 1. Take` reasonable steps after foss i i-, protect " ;' " accident or lass. • .,. non-owned auto or any your covered auto and'th'eir equipmerft from `further loss. We' ill 3. Submit, as often ps we.reasonably require: ,. pay reasonable expenses in'cufreci to do this. a.:!To phYsical,exams:.by physicians we, select. ti 2. Promptly .notify the pol.icg-if''yaur,_ covered -; - We•will-pay,fdr:these-exams.- -- "` auto° tir'any "non-owned auto" is stolen. b. To examination under oath and subscribe 3 Permit 'us 'to inspect and. _appraise'..the dam- `-thee aged property before its repair or disposal. 4. Authorize us to obtain: _ ?F... a. Medical reports; and Page 10 of12 Copyright, Insurance Services Office, Inc., 1997 PP 00 01 06 99 ' PART F-GENERAL PROVISIONS . BANKRUPTCY OUR RIGHT TO RECOVER PAYMENT Bankruptcy or insolvency of the "insured" shall not A. If we make a payment under this policy and the relieve us of any obligations under this policy. person to or for whom payment was made has a CHANGES right to recover damages from another we shall be A. This policy contains all the agreements between subrogated to that right. That person shall do: you and us. Its terms may not be changed or 1. Whatever is necessary to enable us to exer- waived except by endorsement issued by us. cise our rights; and B. If there is a change to the information used to 2. Nothing after loss to prejudice them. develop the policy premium, we may adjust your However, our rights in this Paragraph (A.) do not premium. Changes during the policy term that apply under Part D, against any person using may result in a premium increase or decrease in- "your covered auto" with a reasonable belief that clude, but are not limited to, changes in: .. , that person Is entitled to do so, 1. The number, type or use classification of in- B. If we make a payment under this policy and the sured vehicles; person to or for whom payment is made recovers 2. Operators using insured vehicles; damages from another, that person shall: 3. The place of principal garaging of insured 1. Hold in trust for us the proceeds of the recov- vehicles; ery; and 4. Coverage, deductible or limits. 2. Reimburse us to the extent of our payment. If a change resulting from A. or B. requires a pre- POLICY PERIOD AND TERRITORY mium adjustment, we will make the premium adjust- A. This policy applies only to accidents and losses ment in accordance with our manual rules. which occur: C. If we make a change which broadens coverage 1. During the policy period as shown in the Decla- under this edition of your policy without additional rations; and premium charge, that change will automatically 2. Within the policy territory apply to your policy as of the date we implement . the change in your state. This - Paragraph (C.) B. The policy territory is: does not apply to changes implemented with a 1. The United States of America, its territories or general program revision that includes both possessions; broadenings and restrictions in coverage, whether , 2. Puerto Rico; or that general program revision is implemented through introduction of: 3. Canada. 1. A subsequent edition of your policy; or This policy also applies to loss to, or accidents in- 2. An Amendatory Endorsement:.. volving, "your covered auto" while being trans- FRAUD ported between their ports. We do not provide coverage for any "insured" who . TERMINATION ' A Cancellation has made fraudulent statements or engaged in . fraudulent conduct in connection with any accident or This policy may be cancelled during the policy loss for which coverage Is sought under this policy. period as follows: LEGAL ACTION AGAINST US 1.7he named insured shown in the Declarations A. No legal action may be brought against us until may cancel by: there has been full compliance with all the terms a... Returning this policy to us; or of this policy. In addition, under Part A, no legal b. Giving us 'advance written notice of the action may be brought against us until: date cancellation Is to take effect. 1. We agree in writing that the "insured" has an obligation to pay; or 2. We may cancel by mailing to the named in- sured shown in the Declarations at the address 2. The amount of that obligation has been finally shown in this policy: determined by judgment after trial. a. At least 10 days notice: B. No person or organization has any right under this policy to bring us into any action to determine the (1) If cancellation is for nonpayment of liability of an "insured". premium; or PP 00 01 Q6 98 Copyright, Insurance. Services. Office, Iric., 1997 Page 11 of 112 . (2) If notice is mailed during the first ;60 i hi if you obtain. other insurance on "your covered insurance provided by this pol- any similar auto" s s days this policy is in effect and..1 a renewal or continuation.pol{cy; or: not• . , icy will terminate as to that auto on the. effective . .b. At least:2Q.days notice in all other cases. date of the other insurance. Other Termination Provisions D - - - - After-thisjpolicy. .is -in.e##ect for_60-days,_.or l.f- a renewaLor continuation policy., we will i thi . .-. --..: 1. We may deliver any notice instead of moiling. fi-, ' s s r be suf Proof of mailing of any notice shall it cancelmonly: . bient-proof of.notice. a. For nonpayment of premium;,or. ; 2. If this policy is cancelled, you may be entitled b. If your driver's license or that of: to a premium refund. If so, we will send you (1) Any driver who lives with-you; or the refund. The premium refund, if any, will be (2) Any--driver who customarily uses' "your „ computed according to our manuals.-However, making or offering to make the refund is not a covered auto ; :. , has.Seen suspended-or..revoked, !'his must of cancellation. condition :., ctive date of cancellation stated in the ff Th have occurred: e e e 3. notice shall become the end of ,the policy pe- ` " During the poicy period; of . .. (.:1a riod. . (2) :Since-the last anniversary of the original TRANSFER OF YOUR INTEREST IN THIS POLICY effective. date if the policy. period is oth6(6an l' year; or V Your rights' and duties under this policy -may not be assigned without our written consent However, c.;,lf the ,policy was.obtAimed through material if a named insured shown in.the Declarations dies, rriisrepresen#ation: coverage will be provided for: ;. B. Nonrenewal ;1? The surviving spouse.•if resident •in, the. same; if"we'decide'not to renew o?'continue this „policy, household at the time of death.. -Coverage ap- we will mail notice to the named insured shown in • ., plies to the spouse as. if a• named insured. ' <"the Declarations at the address shown.'•in'this pol- _..... .,-. :shown in the Declarations And ... icy. Notice will be mailed at least 20 days before 2. The legal representative of the deceased .per- the end of the policy period: Subject to this. notice son as if a named insured shown in the 1Decla- requirement, if the policy period js;;: rations. This applies only, with respect to the 1. Less than 6 months, we wil{•havp the right.not ... representative's legal :responsibility to maintain 'or ' continue ;this .;policy. ^every 6 "' to' renew or use "your covered auto". . months,' beginning 6 months after its ongmal g; Coverage will only be provided until the end of the effective date. policy period. 2. 6 months or longer, but less tharibne year,Fwe TWO OR MORE AUTO POLICIES ` ,; . ; an!ii? have the right not to renew pr continue this policy period: policy at the end,ofahe If this policy and ariy other auto insurance policy ' , ` accident, the issued to you- by us apply to the same not to 3. 1 year or longer, we :will ,have'the -right maximum limit of our liability under all the policies renew or continue this policy at.each.anniver= shall not exceed the highest applicable limit of liability,, sary of its original effective date, under any one policy, , ,. C. Automatic Termination if we offer to renew or continue And you pr,.your representative do not accept, .-this policy Oil '.autornaticaliy terminate at the' end of the current ;,. policy period. Failure to pay the required r newel ??r:;., or continuation: premium when due shall . mean ,. ..- .:: _• ----n,.,-na„a-„r,1•?rrnfiitA('J-ot7r-effE . Page 12 of 12--Copyright;oinsuranbe Services Office, Inc., 1997 PP 00 01 06 98 PENNSYLVANIA FINANCIAL RESPONSIBILITY NOTICE PENN NATIONAL INSURANCE r?anMnnh Neioid ?Wlur cutltlly Imdnwu cenam PA Bc[5851 • Huftlia, PA 17105 IMPORTANT NOTICE regarding your Financial Responsibility Insurance Identification Card. The Pennsylvania National Mutual Casualty Insurance Company is required by Pennsylvania law to send you an I.D. card. The card shows that an insurance policy has been issued for the vehicle(s) described satisfying the financial responsibility requirements of the law. If you lose the card, contact your insurance company or agent for a replacement The I.D. card information may be used for vehicle registration and replacing license plates. If your liability insurance policy is not in effect, the I.D. card is no longer valid. You are required to maintain financial responsibility on your vehicle. It is against Pennsylvania law to use the I.D. card fraudulently such as using the card as proof of financial responsibility after the insurance policy is terminated Form,70-1672 PERSONAL AUTO PP 03 38 12 98 LIMITED TORT ALTERNATIVE INFORMATION NOTICE - PENNSYLVANIA Each person who elects the limited tort alternative remains eligible to seek compensation for economic loss sustained in a motor vehicle accident as the consequence of the fault of another person pursuant to applicable tort law. Unless the injury sustained is a serious injury, each person who is bound by the limited tort election shall be precluded from maintaining an action for noneconomic loss, except that A. An individual otherwise bound by the limited tort election who sustains damages in a motor B. vehicle accident as the consequence of the fault of another person may recover damages as if the individual damaged had elected the full tort alternative whenever the person at fault 1. Is convicted, or accepts Accelerated Rehabilitative Deposition for driving under the influence of alcohol or a controlled substance in that accident, 2. Is operating a motor vehicle registered in another state; 3. Intends to injure himself or another person, provided that an individual does not intentionally injure himself or another person merely because his act or failure to act is intentional or done with his realization that it creates a grave risk of causing injury if the act or omission causing the injury is for the purpose of averting bodily harm to himself or another person; or 4. Has not maintained financial responsibility as required by the Pennsylvania Motor Vehicle Financial Responsibility Law. provided that nothing in Paragraphs 1. through 4. shall affect the limitation of a person, precluded from maintaining an action for noneconomic damages under the limited tort alternative, to recover noneconomic damages under Uninsured Motorists Coverage or Underinsured Motorists Coverage. An individual otherwise bound by the limited tort election shall retain full tort rights with respect to claims against a person in the business of designing, manufacturing, repairing, servicing or otherwise maintaining motor vehicles arising out of a defect in such motor vehicle which is caused by or not corrected by an act or omission in the course of such business, other than a defect in a motor vehicle which is operated by such business. C. An individual otherwise bound by the limited tort election shall retain full tort rights if injured while an occupant of a motor vehicle other than a private passenger motor vehicle. PP 03 38 12 98 Copyright, Insurance Services Office, Inc., 1998 PENN NATIONAL INSURANCE P.O. BoX 2381 Harrisburg, PA 17105-2381 GOOD NEWS FIRST ACCIDENT FORGIVENESS Penn National will not increase your policy premium after the occurrence of the first at-fault chargeable accident The First Accident Forgiveness program requirements and guidelines are listed below. • We will waive the premium increase (surcharge) for the first at-fault chargeable accident provided the policy meets the following criteria > The accident did not result in a payment of Bodily Injury damages in excess of $10,000; or > There have been no chargeable moving violations in the past three years, unless the chargeable violation (other than a major violation) is in connection with the chargeable accident; or > There have been no other at--fault accidents in the previous five years. • The waiver will continue to apply for the duration of the three year experience period. • The policy will not be eligible for another surcharge waiver in the event that a future at-fault chargeable accident occurs within five years from the date of the forgiven accident This rule applies, even if the driver responsible for the first accident is removed from the policy. • Policies receiving the benefit of First Accident Forgiveness will be eligible again for forgiveness provided the policy has been at-fault accident free for five years from the date of the forgiven accident • First Accident Forgiveness will not affect our right to cancel or non-renew your policy should we decide such action is necessary. 70-3208 (Rev. 01 /06) PENN NATIONAL INSURANCE P.O. Box 2361 HwMurg, PA 17105.236361 PENNSYLVANIA SURCHARGE DISCLOSURE STATEMENT In accordance with Pennsylvania Law, we are providing you with an explanation of our Safe Driver Insurance Plan, under which your policy has been rated, and the plan's effect on your automobile rate in the event of a chargeable accident(s) and/or conviction. What is the Safe Driver Insurance Plan? The Safe Driver Insurance Plan (hereafter referred to as SDIP) uses past experience (accidents & convictions) as part of the determination of your premium cost The system described below has been established under which those drivers that have no points receive the lowest premiums. Higher premiums are charged for other drivers based upon the number of points they have accumulated during the experience period The experience period is the three-year interval between the date of the initial claim payment resulting from any one accident and the date of the application or the preparation of the renewal. Premiums for the following coverages are affected: Liability, First Party Benefits and Coverage For Damage to Your Auto. A. Convictions Points shall be assigned for convictions during the experience period for motor vehicle violations of the applicant or any other currently resident operator as follows: (1) Three. points are assigned for conviction of: (a) Driving while intoxicated or under the influence of drugs; or (b) Failure to stop and report when involved in an accident resulting in bodily injury, or (c) Homicide or assault arising out of the operation of a motor vehicle, or (d) Driving while license is suspended or revoked. (2) Two points are . assigned for the accumulation of points under a State Point System or a series of convictions requiring the filing of evidence of financial responsibility under any Financial Responsibility Law as of the effective date of the policy. (3) One point is assigned for conviction of any other moving violation resulting in: (a) Suspension or revocation of an operator's license, or (b) The filing of evidence of financial responsibility under any Financial Responsibility Law required as of the effective date of the policy. The Experience Period for assignment of points for convictions is. The Experience Period shall be the three years immediately preceding the date of application or the preparation of the renewal. Includes copyrighted material of Insurance Services Office, Inc.. with its permission. Copyright, Insurance Services Office, Inc., 1997 Form 70-3354 (Ed. 01/06) Page 1 of 3 F B, Accident Surcharges (1) One point is assigned for each accident for which an insurer paid a claim during the experience period, if the paid claim meets or exceeds the applicable dollar amount threshold described below, and if the accident involved the applicant, the named insured, or any resident operator while operating an auto. (2) The applicable threshold is determined by the accident date, as follows: Dollar Threshold I Applies to these Accidents: $ 950 I `Applies to accidents which occurred before July 1, 2002- $1,050 I Applies to accidents which occurred on or after July 1, 2002, but before July 1, 2005. S 1,150 f Applies to accidents occurring on or after July '1, 2005. (3) The experience period. shall be the three-year interval between the date of the initial claim payment resulting from any. one accident which meets the applicable dollar threshold,-and the-date of the application or the preparation of the renewal. g(4) First Accident Forgiveness (a) For renewals effective prior to July 1, 2D06, we will waive the surcharge for the first at-fault chargeable accident provided there have not been any at-fault accidents in the previous five,years. (b) For new business effective on and after January 1, 2006, and renewals effective on and after July 1, 2006, we will waive the surcharge for the first at-fault-chargeable accident provided the policy rneets the following criteria t) The accident did not result in a payment of Bodily Injury damages in excess of $10,000; or 2) There have been no moving violations in the past three years, unless the violation (other than a major violation) is in connection with the accident Major violations are defined in Subparagraph a. of Section B.I. above, and also includes speeding in- excess of 25 mph; or 3) There have been no other at-fault accidents in the previous five years. (c) The waiver will continue to apply for the duration of the experience period. (d) The policy will not be -eligible for another surcharge waiver in the event of a future at-fault chargeable . accident, even if the driver responsible for the first accident is removed from the policy. C. Exceptions 1. An accident incurred by an operator who is demonstrated to be a named insured or a principal operator of a vehicle insured under a separate policy is not eligible for surcharge. - . 2. An accident incurred by an operator who is demonstrated to no longer reside in the insureds household is not eligible for surcharge. 3. No points are assigned for accidents occurring under the following circumstances: a, Auto operated by the applicant or any resident operator is struck by a "hit-and--run" vehicle, if the accident is reported to the proper authority within 24 hours by the applicant or resident operator; or h, Accidents involving damage by contact with animals or fowl; or Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 Form 70-3354 (Ed. 01106) Page 2 of 3 c. Accidents involving physical damage, limited to and caused by flying gravel, missiles, or falling objects; or d. Accidents occurring when using auto in response to an emergency if the operator at the time of the accident was a paid or volunteer member of any Police or Fire Department, First Aid Squad, or any law enforcement agency. This exception does not include an accident occurring after the auto ceases to be used in response to such emergency; or e. Accidents resulting in an amount being paid on behalf of an insured only under Basic, Added or Combination First Party Benefits coverage or under Extraordinary Medical Benefits coverage; or f. Accidents where the insurer is reimbursed by or on behalf of the named insured or other resident operator for 60% or more of the total amount of the paid claim received through subrogation or from a settlement or judgment against the individual responsible for the accident g. Auto lawfully parked (if the parked vehicle rolls from the parked position then any such accident is charged to the person who parked the auto); or It Auto is struck in the rear by another vehicle and the applicant or other resident operator has not been convicted of a moving violation in connection with the accident; or i. Operator of the other auto involved in the accident was convicted of a moving traffic violation and the applicant or resident operator was not convicted or a moving traffic violation in connection with the accident Point and Surcharge Calculation The Number of points assigned determines the surcharge. The following shows the surcharge as a percentage increase of the base premium. Percentage Increase of the Base Premium SDIP One Multi* Factor Car Car 0 Points - .10 - 10% - 30% 1 Point + 40 + 40% - 5% 2 Points + 90 + 90% + 25% 3 Points + 1.50 +150% + 55% 4 Points +2.20 +220% + 90% *WITH TWO CARS THIS SURCHARGE APPLIES TO EACH CAR. IF THERE ARE MORE CARS IT APPLIES TO THE TWO CARS WITH THE HIGHEST PREMIUM. USUALLY THESE ARE THE HIGHEST VALUED CARS. These percentage surcharges are illustrative of the effect on the base premium only. While the base premium is different depending upon rating territory, the base premium does not vary for other considerations such as your age, sex or marital status. Therefore, the dollars of surcharge will be the same for all drivers with equivalent when compared to premium, which does recognize among other things your age, sex and maritastatus could vary somewhat from the above cited percentages. You may be able to determine the points assigned to you by looking at your policy. The front page information may include a six digit code such as 8871-10. The last digit shows the points. The zero indicates no points in this case. For more information about these surcharges, please contact your agent Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 Page 3 Of 3 Form 70-3354 (Ed. 01 /06) PENN NATIoNAL o INSURANCE P.O. Box 2361 F eWwrg, PA 17105.2391 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. UNDERINSURED MOTORISTS COVERAGE - PENNSYLVANIA (STACKED) With respect to the coverage provided by this endorsement, the provisions of the policy apply unless modified by the endorsement SCHEDULE Limits Auto Premium S $ S $ S S INSURING AGREEMENT A. We will pay compensatory damages which an "insured" is legally entitled to recover from the owner or operator of an "underinsured motor vehicle" because of "bodily injury": 1. Sustained by an "insured; and 2. Caused by an accident The owner's or operator's liability for these damages must arise out of the ownership, maintenance or use of the "underinsured motor vehicle". We will pay under this coverage only if 1. or 2. below applies: 1. The limits of liability under any Ibo ?dily injury liability bonds or policies app "underinsured motor vehicle" have been exhausted by payment of judgments or settlements; or 2. A tentative settlement has been made between an "insured" and the insurer of the "underinsured motor vehicle" and we. a. Have been given prompt written notice of such tentative settlement; and b. Advance payment to the "insured" in an amount equal to the tentative settlement within 30 days after receipt of notif ication. No judgment for damages arising out of a suit brought against the owner or operator of an "underinsured motor vehicle" is binding on us unless we: 1. Received reasonable notice of the pendency of the suit resulting in the judgment; and 2. Had a reasonable opportunity to protect our interests in the suit B. "Insured" as used in this endorsement means: Each person $ Each Accident Each person $ Each Accident Each person $ Each Accident 1. You or any "family member". 2. Any other person "occupying" "your covered auto". 3. Any person for damages that person is entitled to recover because of sustained injury" to which this coverage applies by a person described in 1. or 2. above, C. "Underinsured motor vehicle" means a land motor vehicle or trailer of any type to which a bodily injury liability bond or policy applies at the time of the accident but the amount paid for "bodily injury" under that bond or policy to an "insured" is not enough to pay the full amount the "insured" is legally entitled to recover as damages. However, "underinsured motor vehicle" does not include any vehicle or equipment 1. For which liability coverage is provided under Part A of this policy. 2. Operated on rails or crawler treads. 3. Designed mainly for use off public roads whsle not on public road 4. While located for use as a residence or premises. EXCLUSIONS A. We do not provide Underinsured Motorists Coverage for "bodily injury" sustained 1. By you while "occupying", or when struck by, any motor vehicle you own which is not insured for this coverage under this policy. This includes a trailer of any type used with that vehicle. 2. By a "family member": Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Copyright, Insurance Services Office, Inc., 1997, 1998, 2002 Form 70-3131 (Rev. 08/02) Page 1 of 3 a. Who owns an auto, while "occupying", or when struck by, any motor vehicle owned by you or any "family member" which is not insured for this coverage under this policy. This includes a trailer of any type used with that vehicle. b. Who does not own an auto, while "occupying", or when struck by,, any motor vehicle you own which is insured for this coverage on a,primary basis under any other policy. B. We do not provide Underinsured Motorists Coverage for "bodily injury" sustained by any "insured": 1. While "occuPYingif '1your covered auto" when it is being used as a public or livery conveyance. This Exclusion (B.9.) does not apply to a share-the-expense car pool 2. Using a vehicle without permission of the owner. C. We do not provide Underinsured Motorists Coverage for "noneconomic loss" sustained by any "insured" to. whom the limited tort alternative applies, resulting from "bodily injury" caused by an accident involving an "underinsured motor vehicle" unless the "bodily injury" sustained is a seriousinjury. This Exclusion (C.) does not apply if that "insured" is injured while occupying" a motor vehicle insured under a commercial . motor vehicle insurance-policy. D. This coverage shall not apply directly or indirectly to benefit any insurer:or self-insurer under any of the following or similar law: 1. Workers' compensation1aw; or 2. Disability benefits law. E. Coverage for We do not provide Underinsured Motorists LIMIT OF LIABILITY k If "bodily injury" is sustained in an accident by you or any "family member": 1. Our maximum limit of liability for all damages, including damages for care, loss of services or death, arising out of "bodily injury" sustained by any one person in any such accident is the sum of the limits of liability shown in the Schedule or in the Declarations for each person for Underinsured Motorists Coverage. 2. Subject to the maximum limit for each person described in A.I. above, our maximum limit of liability for all damages arising out of "bodily injury" resulting from any one accident is the sum of the limits of liability shown in the Schedule or in the Declarations for each accident for U d nsured Motorists Coverage. 3. Subject to the maximum limits of liability set forth in A.1 and A.2. above, the most we will pay for "bodily injury" sustained in such accident by an "insured" other than you or any "family member" Is the each person or each accident limit of liability shown in the Schedule or in the Declarations applicable to the vehicle that the "insured" was "occupying".at the time of the accident The maximum limit of liability is the most we will pay regardless of the number of: 1. "Insureds"; 2. Claims made; 3. Vehicles or premiums shown in the Schedule or in the Declarations; or 4. Vehicles involved in the accident B. If "bodily injury is sustained by any "-insured" other than you or any "family member" in, an accident in which neither you nor any "family member" sustain "bodily injury ", the limit of liability shown in the Schedule or. -in the Declarations for each.person for Underinsured Motorists Coverage is our maximum, limit of liability for all damages, including damages for care, loss of services or death, arising out of "bodily injury" sustained by any one person in any one accident Sub ject to this limit for each person, the limit of liability shown in the Schedule or in the Declarations for each accident for Underinsured -Motorists Coverage is our maximum limit of liability for all damages for "bodily injury', resulting from any one accident. This is the most we. will pay regardless of the number of: 1. "insureds".; 2. Claims made,. 3. Vehicles or premiums shown in the Schedule or in the Declarations; or 4. Vehicles involved in the accident C. The limit of liability under this coverage is reduced by any amount paid to the same person for the same accident under Part A. or Part C. of this policy. D. We will not make a duplicate payment under this coverage for any element of loss for which payment has been made by or on behalf of persons or organizations who may be legally responsible. E. We will not pay for any element of loss if a person is entitled to receive payment for the same element of loss under any of the following or similar law: 1. Workers' compensation law; or 2. Disability benefits law. to eri Includes copyrighted material of Insurance Services Office, inc.,with its permission. Copyright, Insurance Services Office, inc., 1997, 1998, 2002 Form 70-3131 (Rev. 08/02) Page 2 of 3 bTHER INSURANCE if there is other applicable insurance available under more than one policy or provision of C. coverage that is similar to the insurance provided by this endorsement: The following priorities of recovery apply. First The Underinsured Motorists Coverage applicable to the vehicle the "insured" was "occupying" at the time of the accident. Second The policy affording Underinsured Motorists Coverage to the "insured" as a named insured or family member. If two or more policies have equal priority, the insurer against whom the claim is first made shall process and pay the claim as if wholly responsible for all insurers with equal priority. The insurer is thereafter entitled to recover contribution pro rata from any other insurer for the benef its paid and the costs of processing the claim if we are the insurer against whom the claim is first made, we will pay, subject to the limit of liability shown in the Schedule or in the Declarations for Underinsured Motorists Coverage, after we and all other contributing insurers agree: 1. Whether the "insured" is legally entitled to recover damages from the owner or operator of an "underinsured motor vehicle"; and 2. As to the amount of damages. ARBITRATION A. If we and an "insured" do not agree: 1. Whether that "insured" is legally entitled to recover damages, or 2. As to the amount of the damages which are recoverable by that "insured"; from the owner or operator of an "underinsured motor vehicle" then the matter may be arbitrated. However, disputes concerning coverage under this endorsement may not be arbitrated. Either party may make a written demand for arbitration. Arbitration shall be conducted in accordance with the provisions of the Uniform Arbitration Act of 1927. Each party will select an arbitrator. The two arbitrators will select a third if they cannot agree within 30 days, either may request that selection be made by a judge of a court having jurisdiction. B. Each party will: 1. Pay the expenses it incurs; and 2. Bear the expenses of the third arbitrator equally. Unless both parties agree otherwise, arbitration will take place in the county in which the "insured" lives at the time of the accident. Local rules of laws as to procedure and evidence will apply. A decision agreed to by two of the arbitrators will be binding. ADDITIONAL DUTIES A person seeking Underinsured Motorists coverage must also promptly. 1. Send us copies of the legal papers if a suit is brought; and 2. Notify us in writing of a tentative settlement between the "insured" and the insurer of the "underinsured motor vehicle" and allow us 30 days to advance payment to that "insured" in an amount equal to the tentative settlement to preserve our rights against the insurer, owner or operator of such "underinsured motor vehicle". PART F - GENERAL PROVISIONS Part F is amended as follow: A. The following is added to the Our Right To Recover Payment Provision: OUR RIGHT TO RECOVER PAYMENT Our rights do not apply under Paragraph A. with respect to Underinsured Motorists Coverage if we: 1. Have been given prompt written notice of a tentative settlement between an "insured" and the insurer of an "underinsured motor vehicle"; and 2. Fail to advance payment to the "insured" in an amount equal to the tentative settlement within 30 days after receipt of notification. If we advance payment to the "insured" in an amount equal to the tentative settlement within 30 days after receipt of notification: 1. That payment will be separate from any amount the "insured" is entitled to recover under the provisions of Underinsured Motorists Coverage; and 2. We also have a right to recover the advanced payment. B. The following is added to the Two Or More Auto Policies Provision: TWO OR MORE AUTO POLICIES 1. This provision does not apply to Underinsured Motorists Coverage. 2. No one will be entitled to receive duplicate payments for the same elements of loss under Underinsured Motorists Coverage. This endorsement must be attached to the Change Endorsement when issued after the policy is written. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Copyright, Insurance Services Office, Inc., 1997, 1998, 2002 Form 70-3131 (Rev. 08/02) Page 3 of 3 PENN NATIONAL o INSURANCE P.O. Box 2361 Harrisburg, PA 17105-2361 AMENDMENT OF POLICY PROVISIONS - PENNSYLVANIA 1. DEFINITIONS The Definitions section is amended as follows- A. Section K.1. of the definition of "Newly acquired auto" is replaced by the following: 1. Newly acquired auto" means any of the following types of vehicles you become the owner of during the policy period: a. A private passenger auto; or b. A pickup or van, for which no other insurance policy provides coverage, that B. Paragraph 1. of the Supplementary Payments Provision is replaced by the following: 1. Up to $300 for the cost of bail bonds required because of an accident, including related traffic law violations. The accident must result in "bodily injury" or "property damage" covered under the policy. C. The following is added to the Supplementary Payments Provision: SUPPLEMENTARY PAYMENTS In addition to our limit of liability we will pay on behalf of an "insured"; (1) Has a Gross Vehicle Weight not exceeding 12,500 lbs.; and (2) Is not principally used in any "business" other than farming or ranching. B. The following is added to the Definitions section: L. "Noneconomic loss" means pain and suffering and other nonmonetary detriment M. "Serious injury" means an injury resulting in death, serious impairment of body function or permanent serious disfigurement 11. PART A - LIABILITY COVERAGE A. Paragraph A. of the Insuring Agreement is replaced by the following: INSURING AGREEMENT We will pay damages for "bodily injury" or "property damage" for which any "insured" becomes legally responsible because of an auto accident We will settle or defend, as we consider appropriate, any claim or suit asking for these damages. In addition to our limit of liability, we will pay all defense costs we incur. Our duty to settle or defend ends when our limit of liability for this coverage has been exhausted by payment of judgments or settlements. We have no duty to defend any suit or settle any claim for "bodily injury" or "property damage" not covered under this policy. Prejudgment interest. awarded against the "insured" on the part of the judgment we pay. Any prejudgment interest awarded against the insured is subject to the applicable Pennsylvania Rules of Civil Procedure. Paragraph A.S. of the Exclusions of Part A. is replaced by the following: EXCLUSIONS 8. Using a vehicle without permission of the owner. Paragraph B. of the Limit of Liability section of Part A. is replaced by the following LIMIT OF LIABILITY B. This coverage is reduced by any amount paid to the same person for the same accident under Part A. or Part C. of the policy. Ill. PART B - MEDICAL PAYMENT COVERAGE Paragraph 7. of the Exclusions of Part B. is replaced by the following: EXCLUSIONS 7. Sustained. while "occupying" a vehicle without permission of the owner. IV. PART C - UNINSURED MOTORIST COVERAGE Paragraph B.3. of the Exclusions of Part C. is replaced by the following. includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 Form 70-3048 (Rev. 01 /06) Page 1 of 5 EXCLUSIONS 3. Using a vehicle without permission of the owner. Paragraph S. of-the Limit of Liability of Part C. is replaced by the following: LIMIT OF LIABILITY This coverage is reduced by any amount paid to the same person for the same accident under Part A. or Part C. of the policy. V. PART D - COVERAGE FOR DAMAGE TO YOUR AUTO Paragraph 9. of the Exclusions of Part D. is replaced by the.. following: . . EXCLUSIONS 9, Loss to,any ".non-owned auto" when used by you or any ,family member" without permission of the owner. VI.PART E .- DUTIES AFTER AN ACCIDENT ; OR LOSS Part E. is replaced_by the following DUTIES AFTER AN ACCIDEN'T' OR LOSS If an accident or loss,oecurs; the following•must be done for the terms of the policy to apply A. We must be notified promptly of how, when and where the accident or foss happened. Notice should also include the names and addresses of any injured persons and of any witnesses. B. A person seeking any coverage must: 1. Cooperate with us in the investigation, settlement or defense of any claim or suit 2. Promptly send us copies of any notices or legal papers received in connection with the accident-or loss. 3. Submit, as often as we reasonably require: a. To physical exams by physicians we select We will pay for these exams. b. To examination under oath and subscribe-the same. ., a. Authorize us to'obtain: a. Medical reports, and b. Other pertinent records. 5. Submit a proof of loss when required by us. C. A person seeking Uninsured Motorists Coverage must also: 1. Promptly notify the police if a hit-and-run driver is involved . 2. Promptly send us copies of the legal papers if -a suit is brought D. A person seeking Coverage For-Damage To Your Auto must also: 1. Take reasonable steps after loss to protect "your ..covered :auto" or any 'non-owned auto" and their equipment from further loss. We will pay reasonable expenses incurred to do this. 2. Promptly notify the police if "your covered auto" or any "non-owned auto" is stolen: 3. Permit us to 'inspect and appraise the damaged property before its repair or disposal. VII. PART F - GENERAL PROVISIONS Part F. is amended as•follows: A. The Our Rights To Recover Payment "provision is amended-as follows: OUR RIGHT TO RECOVER 'PAYMENT The last paragraph under A. is replaced by the following: However, our rights in this paragraph (A.) do not apply under Part D. against any person using "your covered auto" with permission of the owner. B. Paragraph B. of the Our Right To Recover Payment provision is replaced by the following: If we make a payment under this policy, and the person to or for whom payment is made recovers damages from another, that person shall: includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 page 2 of 5 Form 70-3048 {Rev. 01 /06} 1. Hold in trust for us the proceeds of the recovery, and 2. Reimburse us to the extent of our payment less reasonable attorneys' fees, costs and expenses incurred by that person in collecting our share of the recovery. C. The Termination Provision is replaced by the following: TERMINATION 1. Cancellation. This policy may be cancelled during the policy period as follows a. The named insured shown on the Declarations may cancel by. (1) Returning this policy to us; or (2) Giving us advance written notice of the date cancellation is to take effect b. We may cancel by mailing to the named insured shown in the Declarations at the address shown in this policy. (1) At least 15 days notice of cancellation: (a) If notice is effective within the first 60 days this policy is in effect and this is not a renewal or continuation policy; (b) For nonpayment of premium; (c) If the driver's license of the named insured shown in the Declarations has been suspended or revoked after the effective date if this policy has been in effect less than one year; or if the policy has been in effect longer than one year, since the last anniversary of the original effective date; or (2) At least 60 days notice if the policy was obtained through material misrepresentation. Our right to cancel this policy is subject to the limitations contained in the applicable Pennsylvania Statutes. 2. Nonrenewal. If we decide not to renew or continue this policy, we will mail to the named insured shown in the Declarations at the address shown in this policy: a. At least 15 days notice before the end of the policy period: (1) For nonpayment of premium; or (2) if the driver's license of the named insured shown in the Declarations has been suspended or revoked after the effective date if this policy has been in effect less than one year, or if the policy has been in effect longer than one year, since the last anniversary or the original effective date. b. At least 60 days notice before the end of the policy period in all other cases. However, our right to nonrenew this policy is subject to the limitations contained in the applicable Pennsylvania Statutes. 3. Automatic Termination. If we offer to renew or continue and you or your representative do not accept, this policy will automatically terminate at the end of the current policy period Failure to pay the required renewal or continuation premium when due shall mean that you have not accepted our offer. 4. Other Termination Provisions. a. We may deliver any notice instead of mailing it Proof of mailing of any notice shall be sufficient proof of notice. b. If this policy is cancelled, you may be entitled to a premium refund If so, we will send you the refund The premium refund, if any, will be computed according to our manuals. However, making or offering to make the refund is not a condition of cancellation. c. The effective date of cancellation stated in the notice shall become the end of the policy period Includes copyrighted material of Insurance Services Office, Inc., with its permission Copyright, Insurance Services Office, Inc., 1997 Form 70-3048 (Rev. 01 /06) Page 3 of 5 D. The following provision is added; CONSTITUTIONALITY CLAUSE The premium for, and the coverages of, this policy has been established in reliance upon the provisions of the Pennsylvania Motor Vehicle Financial Responsibility Law. In the event a court, from which there is no appeal, declares.or enters a judgment the effect of which is to render the provisions of such statute invalid or unenforceable in whole or in. part, we will have the right to recompute the premium"payable for the policy and void or amend the provisions of the policy, subject to the approval of the Insurance Commissioner. Vf1l:' JOINT ;OWNERSHIP COVERAGE ENDORSEMENT If the -Joint Ownershi Coverage Endorsement is attached to this.policy, the provisions of the policy and the Joint Ownership Coverage Endorsement apply except as follows: A. $6btion K.'i. of. the definition "Newly acquiredauto" of the Personal Auto Policy is replaced by tie following: 1, "Newly acquired. auto" means any of the followinglypes`•of vehicies'you become the owner of during the policy period: a. A.private passenger auto; or b. A pickup or van, for which no other insurance policy provides coverage, that (1) Has a Gross Vehicle Weight not exceeding 12,500 lbs.; and (2) Is not principally used in any "business" other than farming or ranching. a. Paragraph A. of the Definitions Section of the Joint Ownership Coverage Endorsement is replaced by the following: A. For the purpose of the coverage provided by this endorsement, "you" and "your" refer to two or more: t. Individuals, other than husband and wife, residing in the same household; or 2. "Non-resident relatives"; who, jointly own: 1. A private passenger auto; or 2. A pickup or van that a. Has a Gross •Vehicie.;Weight not exceeding 12,500 lbs.; and b. is..not principally used in any "business" other than -farming or ranching. IX. MISCELLANEOUS TYPE VEHICLE ENDORSEMENT If the Miscellaneous Type Vehicle Endorsement is.attached to this policy,.-the provisions of the Miscellaneous Type Vehicle Endorsement apply except as follows: Paragraph C. `of the. Definitions 'Section is replaced by the following: C. Paragraph 1. of the definition of "Newly acquired auto" is replaced by the following: 1. "Newly acquired auto" means any of the following types of vehicles you become the owner of during the policy.period: a. A private passenger auto; b. A pickup or van, for which no other insurance policy provides coverage, that (1) Has a Gross Vehicle Weight not exceeding 12,500 Ibs.; and (2) is not principally used in any "business" other than farming or ranching. c. Any "miscellaneous type vehicle" of the same type shown in the Schedule or in the Declarations. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1387 Form 70-3048 (Rev. 01/06) Page 4 of 5 o X. NAMED NON-OWNER COVERAGE ENDORSEMENT If the Named Non-Owner Coverage Endorsement is attached to this policy, the provisions of the Named Non-Owner Coverage Endorsement apply except as follows: Paragraph D. of the Definitions Section is replaced by the following D. The definition of "newly acquired auto" is replaced by the following: "Newly acquired auto" means any of the following types of vehicles on the date you become the owner: a. A private passenger auto; or b. A pickup or van that (1) Has a Gross Vehicle Weight Rating not exceeding 12,500 lbs.; and (2) Is not principally used in any "business" other than farming or ranching. This provision applies only: a. If you acquire the vehicle during the policy period; and b. For 14 days after you become the owner. This insurance does not apply if other insurance applies with respect to newly acquired vehicles. XI.LIMITED MEXICO COVERAGE ENDORSEMENT If the Limited Mexico Coverage Endorsement is attached to this policy, the provisions of the Endorsement apply except as follows: Paragraph B. of the Definitions Section is replaced by the following: B. Paragraph 1. of the definition of "newly acquired auto" is replaced with the following: 1. "Newly acquired auto" means an of the following types of vehicles you become the owner of during the policy period, and the vehicle is principally garaged and used in the United States: a. A private passenger auto; or b. A pickup or van that (1) Has a Gross Vehicle Weight Rating not exceeding 12,500 lbs.; and (2) is not principally used in any "business" other than farming or ranching. This endorsement must be attached to the Change Endorsement when issued after the policy is written. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 Form 70-3048 (Rev. 01 /06) Page 5 of 5 PMN NATIONAL INSURANCE want wrww rcaww0yw0womCeafm Pasaxmi - WMsbam PA 17103 IMPORTANT NOTICE TO PENNSYLVANIA POLICYHOLDERS COVERAGE FOR RENTAL VEHICLES THIS DOCUMENT DOES NOT PROVIDE COVERAGE, AND IT DOES NOT REPLACE ANY PROVISIONS IN YOUR POLICY. READ YOUR POLICY AND THE "DECLARATIONS PAGE" FOR COMPLETE COVERAGE INFORMATION. IF ANYTHING IN THIS DOCUMENT CONFLICTS WITH YOUR POLICY, THE PROVISIONS OF THE POLICY PREVAIL IF YOUR POLICY DOES NOT PROVIDE COLLISION COVERAGE, YOU DO NOT HAVE COVERAGE FOR DAMAGE TO A RENTAL VEHICLE. MOST RENTAL CAR COMPANIES OFFER "COLLISION DAMAGE WAVER" INSURANCE WHEN YOU RENT A CAR. MANY INSUREDS ARE UNSURE IF THEY SHOULD PURCHASE THE COVERAGE FROM THE RENTAL CAR COMPANY OR IF DAMAGE TO THEIR RENTAL CAR WOULD BE COVERED UNDER THE COLLISION PORTION OF THEIR AUTO INSURANCE POLICY. COLLISION MEANS THE UPSET OF YOUR COVERED AUTO OR ITS IMPACT WITH ANOTHER VEHICLE OR OBJECT. IT DOES NOT INCLUDE FALLING OBJECTS, FIRE, THEFT, WINDSTORM, VANDALISM, HAIL, WATER OR FLOOD. OUR POLICYHOLDERS NORMALLY RENT CARS UNDER TWO CIRCUMSTANCES - THEY ARE ON VACATION OR, THEY RENT A CAR AS A TEMPORARY SUBSTITUTE WHILE THEIR CAR IS OUT OF SERVICE IF YOU RENT A CAR WHILE YOU ARE ON VACATION OR IF YOU RENT A CAR WHILE YOUR CAR 1S OUT OF SERVICE. IF YOUR POLICY PROVIDES COLLISION INSURANCE ON AT LEAST ONE CAR, AS LONG AS THAT COVERAGE REMAINS IN EFFECT, YOUR POLICY WOULD PROVIDE COLLISION INSURANCE EQUAL TO THE BROADEST COLLISION INSURANCE PROVIDED ON A CAR ON YOUR POLICY. FOR EXAMPLE, IF YOU HAVE THREE CARS COVERED FOR COLLISION INSURANCE, TWO WITH $250 DEDUCTIBLE AND ONE WITH A $200 DEDUCTIBLE, THE $200 DEDUCTIBLE WOULD APPLY TOWARD THE RENTAL CAR PLEASE CONTACT YOUR AGENT IF YOU NEED TO RENT A CAR UNDER CIRCUMSTANCES OTHER THAN THOSE OUTLINED ABOVE OR, IF YOU HAVE ANY QUESTIONS. Form 70-2738 (Rev. 06/99) PERSONAL AUTO PP 13 01 12 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COVERAGE FOR DAMAGE TO YOUR AUTO EXCLUSION ENDORSEMENT With respect to the coverage provided by this endorsement, the provisions of the policy apply unless modified by the endorsement 1. Definitions 11. Part D - Coverage For Damage To Your The following definition is added: Auto "Diminution in value" means the actual or The following exclusion is added: perceived loss in market or resale value which We will not pay for results from a direct and accidental loss. Loss to "your covered auto" or any "non-owned auto" due to "diminution in value". This endorsement must be attached to the Change Endorsement when issued after the policy is written PP 13 01 12 99 Copyright, Insurance Services Office, Inc., 1999 Page 1 of 1 MUTUAL POLICY CONDITIONS This is non-assessable. The policyholder is a member of the company. The member shall participate to the extent and upon the conditions fixed and determined by the Board of Directors in accordance with the law, in the distribution of dividends so fixed and determined. ANNUAL MEETING The insured is hereby notified that by virtue of this policy, he is a member of the Pennsylvania National Mutual casualty Insurance Company. The insured is entitled to vote either in person or by proxy at any and all meetings of said company. The Annual Meeting of the company is held at its Home office in Harrisburg, Pennsylvania, on the second Monday of April in each year, at 10:00 A.M. The inclusion of this notice in the policy shall be notice to the member of the Annual Meeting. The PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY of Harrisburg, Pennsylvania has caused this policy to be signed by its president and a secretary and countersigned by a duly authorized representative of the company. 9"\&0tu C. OW-9-- SECRETARY PRESIDENT ??????T I? .. S31&3S 00006, November 8, 2006 CERTIFIED MAIL RETURN RECEIPT REQUESTED 7003 3110 0002 8162 1096 AND REGULAR US MAIL RESERVATION OF RIGHTS Costopoulos, Foster & Fields Attn: David J. Foster 831 Market Street Lemoyne, PA 17043-0222 Claim No: 02757652 Insured: Daniel & Cynthia Geyer Policy No: 1290013168 Claimant: Daniel Geyer Date of Loss: July 30, 2006 Dear Mr. Foster: Penn National Insurance acknowledges receipt of the above referenced claim. On or about August 8, 2006 Penn National Insurance received notice of this matter from J P Fogelsanger Insurance by way of a submitted loss notice. Your letter of representation was received by Melissa Adkins, the medical payments adjuster, on or about August 23, 2006; and on or about October 9, 2006 we spoke by phone regarding a potential underinsured motorist claim. As of this date, the information and/or documents in our possession concerning this matter consist of the following: Acord loss notice, a certified copy of the Geyer's personal automobile policy 1290013168 effective 07/14/2006 - 01/14/2007, a copy of Shippensburg Borough police report SP-2006-3793, and correspondence between your office and Penn National Insurance. Based upon the foregoing, Penn National Insurance understands that this matter involves an underinsured motorist claim filed by Daniel Geyer against the personal automobile policy of Daniel and Cynthia Geyer. The claim arises out of injuries sustained by Mr. Geyer on July 30, 2006 while in the parking lot of the Dollar General Store in Shippensburg, PA. It is our understanding that Mr. Geyer was struck by a vehicle backing out of a parking space. We understand that Daniel Geyer is submitting this claim for coverage under the personal automobile policy issued by Perm National Insurance pursuant to Policy No. 1290013168 for the Policy Period of July 14, 2006 - January 14, 2007. In view of the foregoing, Penn National Insurance will afford coverage and provide a defense for this claim pursuant to the subject general liability policy; however, it does so subject to a reservation of rights under the following policy provisions. PERSONAL AUTO POLICY AGREEMENT In return for payment of the premium and subject to all the terms of this policy, we agree with you as follows: DEFINITIONS A. Throughout this policy, "you" and "your" refer to: 1. The "named insured" shown in the Declarations; and 2. The spouse if a resident of the same household. If the spouse ceases to be a resident of the same household during the policy period or prior to the inception of this policy, the spouse will be considered "you" and "your" under this policy but only until the earlier of: 1. The end of 90 days following the spouse's change of residency; 2. The effective date of another policy listing the spouse as a named insured; or 3. The end of the policy period. B. "We", "us" and "our" refer to the Company providing this insurance. D. "Bodily injury" means bodily harm, sickness or disease, including death that results. F. "Family member" means a person related to you by blood, marriage or adoption who is a resident of your household. This includes a ward or foster child. G. "Occupying" means in, upon, getting in, on, out or off. This policy is endorsed with Form 70-3131 (rev. 08/02), UNDERINSURED MOTORISTS COVERAGE - PENNSYLVANIA (STACKED), which reads in part as follows: With respect to the coverage provided by this endorsement, the provisions of the policy apply unless modified by endorsement. INSURING AGREEMENT A. We will pay compensatory damages which an "insured" is legally entitled to recover from the owner or operator of an "underinsured motor vehicle" because of "bodily injury": 1. Sustained by an "insured"; and 2. Caused by an accident. The owner's or operator's liability for these damages must arise of the ownership must arise out of the ownership, maintenance or use of the "underinsured motor vehicle". We will pay under this coverage only if 1. or 2. below applies: 1. The limits of liability under any bodily injury liability bonds or policies applicable to the "underinsured motor vehicle" have been exhausted by payment of judgments or settlements; or 2. A tentative settlement has been made between an "insured" and the insurer of the "underinsured motor vehicle" and we: a. Have been given prompt written notice of such tentative settlement, and b. Advance payment to the "insured" in an amount equal to the tentative settlement within 30 days after receipt of notification. No judgment for damages arising out of a suit brought against the owner or operator of an "underinsured motor vehicle" is biding on us unless we: 1. Received reasonable notice of the pendency of the suit resulting in the judgment; and 2. Had a reasonable opportunity to protect our interests in the suit. B. "Insured" as used in this endorsement means: 1. You or any "family member". 2. Any other person "occupying" "your covered auto". 3. Any person for damages that person is entitled to recover because of "bodily injury" to which this coverage applies sustained by a person described in 1. or 2. above. C. "Underinsured motor vehicle" means a land motor vehicle or trailer of any type to which a bodily injury liability bond or policy applies at the time of the accident but the amount paid for "bodily injury" under that bond or policy to an "insured" is not enough to pay the full amount the "insured" is legally entitled to recover as damages. However, "underinsured motor vehicle" does not include any vehicle or equipment: 1. For which liability is coverage is provided under Part A. of this policy 2. Operated on rails or crawler treads. 3. Designed mainly for use off public roads while not on public road. 4. While located for use as a residence or premises. EXCLUSIONS A. We do not provide Underinsured Motorists Coverage for "bodily injury" sustained: 1. By you while "occupying", or when struck by, any motor vehicle you own which is not insured for this coverage under this policy. This includes a trailer of any type used with that vehicle. 2. By a "family member": a. Who owns an auto, while "occupying", or when struck by, any motor vehicle owned by your or any "family member" which is not insured for this coverage under this policy. This includes a trailer of any type used with that vehicle. b. Who does not own an auto, while "occupying", or when struck by, any motor vehicle you own which is insured for this coverage on a primary basis under any other policy. OTHER INSURANCE If there is other applicable insurance available under more than one policy or provision of coverage that is similar to the insurance provided by this endorsement: The following priorities of recovery apply: First The Underinsured Motorists Coverage applicable to the vehicle the "insured" was "occupying" at the time of the accident. Second The policy affording Underinsured Motorists Coverage to the "insured" as a named insured or family member. If two or more policies have equal priority, the insurer against whom the claim is first made shall process and pay the claim as if wholly responsible for all insurers with equal priority. The insurer is thereafter entitled to recover contribution pro rata from any other insurer for the benefits paid and the costs of processing the claim. If we are the insurer against whom the claim is first made, we will pay, subject to the limit of liability shown in the Schedule or in the Declarations for Underinsured Motors Coverage, after we and all other contributing insurers agree: 1. Whether the "insured" is legally entitled to recover damages from the owner or operator of an "underinsured motor vehicle"; and 2. As to the amount of damages. We are reserving our right to deny coverage based on the policy language listed earlier in this letter. Legitimate issues exist as to whether coverage is provided under this policy as the Shippensburg Borough police report SP-2006-3793 indicates that Mr. Geyer was standing next to his motor cycle in a parking stall when he was struck by a vehicle. There is no motorcycle scheduled under the Geyer's personal automobile policy 1290013168, effective 07/14/2006 through 01/14/2007. This policy excludes underinsured motorist coverage for bodily injury sustained when occupying a vehicle that is not insured on the policy. Further this policy defines occupying as in, upon, getting in, on, out or off. As there is potential that Mr. Geyer was occupying a vehicle not insured under this policy, there is potential that underinsured motorist coverage may be excluded for this loss. As mentioned immediately above, issues exist as to whether the subject policy affords coverage for underinsured motorist coverage. Penn National hereby reserves any and all of its rights to modify or amend its coverage position and assert any defenses and disclaimers based upon any of the policy provisions, definitions, conditions or exclusions, whether or not specifically mentioned herein. Please be advised that Penn National Insurance reserves any and all of its rights under any of the provisions, definitions, conditions or exclusions contained in any insurance policy issued by Penn National Insurance to Daniel and Cynthia Geyer. Furthermore, upon the discovery of any other facts or issues relating to coverage of this matter, Penn National reserves its rights to modify or amend its coverage position and assert any defenses based upon any of the policy provisions, definitions, conditions or exclusions, whether or not specifically mentioned herein. Please be advised that this is not a denial of coverage, but rather to inform Daniel and Cynthia Geyer, and their attorney David Foster, of potential coverage issues. Any actions taken by Penn National Insurance in the investigation of this matter, or in negotiating for a compromise settlement, or in making any settlement, or in defending this claim, or in any other way acting or failing to act, shall not constitute an admission of liability or an admission of coverage. Furthermore, any actions taken by Penn National Insurance in connection with this matter are not to be deemed a waiver of any of its rights to disclaim liability or coverage under the insurance policy issued by Penn National Insurance to Daniel and Cynthia Geyer bearing Policy No. 1290013168 for the policy period July 14, 2006 through January 14, 2007. Please contact this writer upon receipt of this letter so that we may begin our investigation. In addition, please do not hesitate to contact us in the event either you or your insurance broker has any questions or comments regarding this matter. Sincerely, PENN NATIONAL INSURANCE Josh Heller Claim Representative cc: File J P Folgelsanger Insurance 00 CP b r.,7 ? t ORIGINAL Costopoulos, Foster & Fields By: David J. Foster, Esquire Attorney I.D. No.: 23151 831 Market Street/P.O. Box 222 Lemoyne, PA 17043-0222 Phone: 717.761.2121 Fax: 717.761.4031 Email: djonfoster(cD-aol.com PENNSYLVANIA NATIONAL MUTUAL : CASUALTY INSURANCE COMPANY, : Plaintiff, V. DANIEL GEYER AND CYNTHIA GEYER, : Defendants. Attorney for Defendants IN THE COURT OF COMMON PLEAS, CUMBERLAND COUNTY, PENNA. No. 08-2662 Civil Term CIVIL ACTION - LAW JURY TRIAL DEMANDED DEFENDANTS' ANSWER TO COMPLAINT FOR DECLARATORY JUDGMENT AND NOW, comes the Defendants, Daniel Geyer and Cynthia Geyer, by and through their counsel, David J. Foster, Esquire, COSTOPOULOS, FOSTER & FIELDS, and respectfully responds as follows: 1. Admitted. 2. Admitted. 3. Admitted. 4. Admitted. 5. Admitted. 6. Admitted. 7. Admitted. 8. Admitted. -1- ham, 9. Admitted. 10. Admitted. 11. Admitted. 12. Admitted. 13. Admitted as stated. By way of further information, Mr. Geyer also dismounted the motorcycle. 14. Denied as stated. Admitted that while Mrs. Geyer was in the Dollar General store, Mr. Geyer waited for her return. However, Mr. Geyer was in no way in contact with the motorcycle during this time, and was at least four to five feet away from the motorcycle at all times; he spent his time watching his mother's residence, which he could see from his position in the parking lot, in and effort to determine if she was home. 15. Denied as stated. It is admitted that Mrs. Geyer exited the Dollar General store and returned to the motorcycle; however, she did not "rejoin" Mr. Geyer, who continued to look up at his mother's residence windows, standing four to five feet away from the motorcycle. 16. Admitted as stated. By way of further information, Mr. Geyer did not participate in placing any of the materials in the motorcycle's saddlebags, but rather, continued to watch his mother's residence from his position in the parking lot, four to five feet away from the motorcycle. 17. Denied as stated. Mr. Geyer was not standing next to the motorcycle, as he was at least four to five feet from it; at this point in time he was unsure as to whether he would continue the trip on the motorcycle or visit his mother, who he continued to -2- r look for by looking at her residence. 18. Admitted. 19. Admitted. 20. Admitted. 21. Admitted. 22. Admitted. 23. No answer required as this is a statement of law. 24. No answer required as this is a statement of law. 25. Admitted. 26. Denied as a statement of law. However, denied also because, as defined by the policy, Mr. Geyer was not "occupying" the motorcycle at the time of the accident, but rather was standing at least four to five feet away from the motorcycle at all times. 27. Admitted. 28. Denied. Rather, at the time of the accident Daniel Geyer was not occupying the motorcycle (in that he was not "in, upon, getting in, on, out or off") he owned which was not insured under the Policy and, therefore, coverage does exist under the Policy for his claim in the instant action. WHEREFORE, Defendants Daniel Geyer and Cynthia Geyer respectfully request this Honorable Court to enter judgment in their favor and to issue a declaratory judgment that they are entitled to coverage under the Penn National Insurance Company Policy with respect to the claim submitted. -3- Respectfully submitted: David J. Foster, uire PA I.D. No.: 23151 COSTOPOULOS, FOSTER & FIELDS 831 Market Street/P.O. Box 222 Lemoyne, PA 17043-0222 Phone: 717.761.2121 Fax: 717.761.4031 Email: dionfosterCcD-aol.com ATTORNEY FOR DEFENDANTS Date: May 5, 2008. VERIFICATION I, Defendant, Daniel Geyer, verify that the statements made in the foregoing document are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties at 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. ae'.1"o1c, ?. z---I Daniel Geyer DATED: April ._3' Q , 2008. VERIFICATION I, Defendant, Cynthia Geyer, verify that the statements made in the foregoing document are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties at 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Cy is Geyer DATED: April 3-D, 2008. CERTIFICATE OF SERVICE I, Tiffany M. Miller, a secretary for the law offices of Costopoulos, Foster & Fields, hereby certify that on this J` day of May, 2008, a true and correct copy of the foregoing Defendants' Answer to Plaintiff's Complaint for Declaratory Judgment, was served upon all counsel of record by: Hand Delivery X First Class Mail, Postage Pre-Paid Certified Mail, Return Receipt Requested Fax Transmission Overnight Mail at the following address(es) and/or number(s): Peter J. Speaker, Esquire THOMAS, THOMAS & HAFER, LLP 305 North Front P.O. Box 999 Harrisburg, PA 17108 Counsel for Plaintiff Pennsylvania National Mutual Casualty Insurance Company BY: COSTOPOULOS, FOSTER & FIELDS Tiffany M. Miler C-) s PRAECIPE FOR LISTING CASE FOR TRIAL ORIGINAL (Must be typewritten and submitted in duplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY Please list the following case: (Check one) ( ) for JURY trial at the next term of civil court. ( X ) for trial without a jury. ------------------------------------------ CAPTION OF CASE (entire caption must be stated in full) (check one) Pennsylvania National Mutual Casualty Insurance Company ( X) Civil Action - Law ( ) Appeal from Arbitration (other) VS. (Plaintiff) Daniel Geyer and Cynthia Geyer VS. (Defendant) The trial list will be called on and Trials conmence on Pretrials will be held on (Briefs are due 5 days before pretrials. ) (The party listing this case for trial shall provide forthwith a copy of the praecipe to all counsel, pursuant to local Rule 214.1.) No. 2662 Civil 2008 Indicate the attorney who will try case for the party who files this praecipe: David J. Foster, Esq., P.O. Box 222, Lemoyne, PA 17043 Indicate trial counsel for other parties if known: Peter J. Speaker, Esq., 305 N. Front St., Harrisburg, PA 17101 This case is ready for trial. Date: June 18, 2008. Signed: Print Name David J. oster Attorney for: pefPnrlants ?? ? 0 g, W 0 t? J ? a ra --rx s ?.. C... ? -:-_ r+? .- Y _ ?' ?- t?,? ? ?- c:a ; -: ?-- ^, r:? ? ??„ PENNSYLVANIA NATIONAL : IN THE COURT OF COMMON PLEAS OF MUTUAL CASUALTY : CUMBERLAND COUNTY, PENNSYLVANIA INSURANCE COMPANY, Plaintiff V. DANIEL GEYER and CYNTHIA GEYER, Defendants CIVIL ACTION - LAW NO. 08-2662 CIVIL TERM ORDER OF COURT AND NOW, this 8`h day of July, 2008, a pretrial conference in the above matter is scheduled for Thursday, October 2, 2008, at 9:30 a.m., in chambers of the undersigned judge, Cumberland County Courthouse, Carlisle, Pennsylvania. Pretrial memoranda shall be submitted by counsel in accordance with C.C.R.P. 212-4, at least five days prior to the pretrial conference. A NONJURY TRIAL in the above matter is scheduled for Monday, November 3, 2008, at 9:30 a.m., in Courtroom No. 1, Cumberland County Courthouse, Carlisle, Pennsylvania. BY THE COURT, Peter J. Speaker, Esq. 305 N. Front Street Harrisburg, PA 17101 Attorney for Plaintiffs David J. Foster, Esq. P.O. Box 222 Lemoyne, PA 17043 Attorney for Defendants J esley 01W, Jr., J. Court Administrator :rc d1NVATSI N3d AINO) S 9 :6 WV 6- Inn Beez PENNSYLVANIA NATIONAL IN THE COURT OF COMMON PLEAS OF MUTUAL CASUALTY CUMBERLAND COUNTY, PENNSYLVANIA INSURANCE COMPANY, Plaintiff CIVIL ACTION - LAW v DANIEL GEYER AND CYNTHIA GEYER, Defendants NO. 08-2662 CIVIL TERM IN RE: PRETRIAL CONFERENCE A pretrial conference was held in the chambers of Judge Oler on October 2, 2008, in the above-captioned case. Present on behalf of Plaintiff insurance company was Peter J. Speaker, Esquire. Present on behalf of Defendants was David J. Foster, Esquire. This is a declaratory judgment action brought by an insurer. Underlying the action is a claim made by a motorcyclist for uninsured motorist coverage against his car insurer premised upon the position that he was a pedestrian and not an occupier of a vehicle when struck in a parking lot as he stood in the vicinity of his motorcycle. This will be a nonjury trial which is expected to be of a duration of one-half day. By separate Order of Court the trial has been scheduled for Monday, November 3, 2008, at 9:30 a.m. Counsel are requested to submit briefs to the Court on the issues which they perceive to exist in the case at least 5 days prior to commencement of the trial. One issue which may be briefed, unless resolved by agreement of counsel, is whether the insurance company has the burden of proof in this case. t- 75 : ?'? 4 ^^.a L t- 4 ? ? t ` 1 r V , By the Court, J. es ey Ol r r J. /Peter J. Speaker, Esquire 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 For Plaintiff avid J. Foster, Esquire 831 Market Street P.O. Box 222 Lemoyne, PA 17043-0222 For Defendants mae PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY, Plaintiff V. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW DANIEL GEYER and CYNTHIA : GEYER, Defendants NO. 08-2662 CIVIL TERM IN RE: NONJURY TRIAL ORDER OF COURT AND NOW, this 30`h day of October, 2008, upon relation of Peter J. Speaker, Esq., attorney for Plaintiff, that this matter has been settled, the nonjury trial previously scheduled for November 3, 2008, is cancelled. Peter J. Speaker, Esq. 305 North Front Street P.O. Box 999 ZDavid Harrisburg, PA 17108-0999 J. Foster, Esq. 831 Market Street P.O. Box 222 Lemoyne, PA 17043-0222 Attorney for Defendant :rc O'CriesILL ",go BY THE COURT, J. '!"1 , ° 6 E :Z Wd 0 C 100 gooz f viley? t W D;i 0