HomeMy WebLinkAbout04-2849IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
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BARRY E. CALHOUN, and
TAMMY CALOUN,
Plaintiffs
NO: ny_..r2(9CIVIL TERM
V.
CIVIL ACTION - EQUITY
PRUDENTIAL GENERAL INSURANCE
COMPANY t/b/a. PRUDENTIAL
FINANCIAL, and LIBERTY MUTUAL
GROUP,
Defendants
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NOTICE TO DEFEND
TO: DEFENDANTS Prudential General Insurance Co., Ud/b/a, Prudential Financial and
Liberty Mutual Group:
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 of for any other claim or relief requested by the
Plaintiff. You may lose money or property or other rights important to you.
YOU SHOULD TAKE THIS PAPER 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 LEGAL HELP.
Cumberland County Bar Association
2 Liberty Avenue
Carlisle, PA 17013
(717) 249-3166
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
•****ssssss*ss*sss**ssssssss***sss*ssss***s**ssssss*s**ss***sssss***ss*s
BARRY E. CALHOUN, and
TAMMY CALOUN,
Plaintiffs
V.
NO: 04-2Lv4?CIVIL TERM
CIVIL ACTION - EQUITY
PRUDENTIAL GENERAL INSURANCE
COMPANY t/b/a. PRUDENTIAL
FINANCIAL, and LIBERTY MUTUAL
GROUP,
Defendants
•*ss*s*ss*sssss*sss****sssssss*s*sss**ssssss*s**s***ss*?ssssss***s***s*s
ACTION FOR DECLARATORY JUDGMENT
42 Pa.C.S.A. 7531, et seq.
1. The Plaintiffs, Barry E. Calhoun and Tammy Calhoun, husband and wife,
reside at 2011 Back Rd., Halifax, Dauphin County, Pennsylvania,
17032 - 9691.
2. Defendant, Prudential General Insurance Company, also known as
Prudential Financial, is a corporation and insurance company with a
principal place of business at PO Box 977, Horsham, in Montgomery
County, Pennsylvania, 19044. The aforesaid Defendant / Insurer
maintains its home office at 23 Main St., Holmdel, New Jersey, 07733.
3. Defendant Liberty Mutual Group is a corporation and insurance company
with a principal place of business at 5021 Louise Drive,
Mechanicsburg, in Cumberland County, Pennsylvania, 17055. The
aforesaid Defendant / Insurer maintains its home office at 175 Berkeley
Street, Boston, Massachusetts, 02116.
4. Defendants regularly conduct business and insurance transactions within
and pertaining to Cumberland County, Pennsylvania, including use and
possession of an insurance office, and including the issuance of
insurance contracts designed to insure persons and property within
Cumberland County, Pennsylvania, thereby purposefully availing itself
of the privilege of conducting activities within the forum of Cumberland
County, Pennsylvania.
5. Pursuant to a "Pennsylvania Car Policy" insurance contract issued by the
Defendants, policy number "288A121714", the Defendants agreed to
provide motor vehicle coverage to the Plaintiffs for two (2) specified
vehicles pursuant to the terms, provisions, and conditions set forth in
said insurance policy and as outlined in the accompanying
Declarations Page. (See, said Pennsylvania Car Policy and
Declarations Page attached hereto as Exhibit A and incorporated
herein by reference thereto).
6. At all times material hereto, the Plaintiffs paid the required insurance
premiums and were the named insureds on the aforesaid car
insurance policy issued by the Defendants for said motor vehicle
insurance coverage; said insurance policy remained in effect relative to
the time periods herein.
2
7. Among other items of motor vehicle insurance coverage required to be
placed on Plaintiffs' vehicles as a matter of state law, said Plaintiffs
paid separate and specific insurance premiums to obtain otherwise
optional Uninsured Motorists and Underinsured Motorists coverage.
(See, Declarations Page attached hereto).
8. On July 21, 2003, Plaintiff Barry E. Calhoun sustained severe injuries to
his low back and spine as a result of a motor vehicle accident which
occurred during the course of his employment as a Pennsylvania State
Trooper. Specifically, said injuries were sustained when said Plaintiffs
patrol car was struck on the passenger's side by a Sports Utility
Vehicle as he was responding to an active domestic dispute call.
9. The Sports Utility Vehicle that struck Plaintiff Barry E. Calhoun on July 21,
2003 was insured by Nationwide Mutual Insurance Company pursuant
to a car policy issued to an adult individual named Dawn Wilson-Oliver;
said Nationwide insured's declaration sheet confirmed insurance
coverage policy limits of $15,000.00 bodily injury liability limit.
10. The aforesaid tortfeasor has offered said $15,000.00 bodily injury liability
limits. Said coverage is inadequate to answer for the damages
sustained by the Plaintiffs who therefore demand that Defendants
honor its contractual provisions regarding Underinsured Motorists
coverage.
3
11. With respect to his receipt of indemnity benefits, medical benefits, and
Heart and Lung payments made to him following the July 21, 2003
motor vehicle accident, the Plaintiff Barry E. Calhoun has received
correspondence dated May 10, 2004 from his employer's workers'
compensation carrier (CompServices, Inc.) which references a
subrogation lien totaling $13,008.26. (See a copy of said May 10,
2004 letter attached hereto as Exhibit B and incorporated herein by
reference thereto).
12. The Plaintiffs have demanded that the Defendants honor the contractual
obligations vis-A-vis the aforesaid car insurance policy provisions
concerning the Uninsured Motorist and Underinsured Motorist
coverage(s).
13. Pursuant to correspondence dated February 25, 2004, the Defendants
advised Plaintiffs' counsel that Plaintiffs were not afforded
Underinsured Motorist coverage for the July 21, 2003 accident.
Defendants' letter advised that said insurance coverage was excluded
under its "Non-Owned Motor Vehicles" terms. (See a copy of said
February 25, 2004 letter attached hereto as Exhibit C and incorporated
herein by reference thereto).
14. Defendants' letter dated February 25, 2004 specified that Underinsured
Motorist losses would not be paid for Non-Owned Motor Vehicles
pursuant to Part 5, Section 3 which states: "We will not pay for bodily
injury sustained while using or occupying a non-owned motor
vehicle or trailer not insured under this Part, that is furnished or made
available for regular use by you or a household resident..."
(emphasis in original - see attached copy at page 2 of Exhibit C).
4
15. Defendants' letter dated February 25, 2004 also stated: "A favorable
enforcement of the policy's exclusion for this circumstance is contained
in recent PA Supreme Court decisions". Thereafter, citations were
made by Defendants to Burstein v. Prudential Property and Casualty
Insurance Company, 809 A.2d 204 (Pa. 2002) and Prudential Property
and Casualty Insurance Company v. Gisler, 806 A.2d 854 (Pa. 2002).
16. In reply to Defendants' denial of coverage for Underinsured Motorist
benefits, Plaintiffs counsel forwarded correspondence dated May 6,
2004 to Defendants' casualty analyst. Said letter from Plaintiffs'
counsel explained, inter alia, that the Defendants' reliance upon said
court decisions was erroneous inasmuch as Plaintiff Barry E.
Calhoun's patrol car was not a regularly used, non-owned motor
vehicle. Said letter further explained that said Plaintiff was not utilizing
a "regularly used" police vehicle at the time of the accident, that the
vehicle assigned to said Plaintiff on that date had never been
previously used by him, and that said Plaintiff was never furnished with
the same vehicle for his various assignments as a Pennsylvania State
Trooper. (See a copy of said May 6, 2004 letter attached hereto as
Exhibit D and incorporated herein by reference thereto).
17. Thereafter, Defendants' casualty analyst replied with a letter dated May
11, 2004 which reiterated the Defendants' position that the Plaintiffs
Underinsured Motorist coverage did not apply to the accident on July
21, 2003. (See a copy of said May 11, 2004 letter attached hereto as
Exhibit E and incorporated herein by reference thereto).
5
18. Despite multiple demands, Defendants refuse and continue to refuse to
indemnify or otherwise reimburse the Plaintiffs for Underinsured
Motorist coverage applicable to the motor vehicle accident on July 21,
2003.
19. In refusing to indemnify the Plaintiffs for said sum, Defendants have
denied coverage on an erroneous theory and/or position that
contradicts the pertinent statutory provisions and judicial interpretations
thereof.
20. Other than said theory and said reasons set forth hereinabove, the
Defendants have not set forth any other theory or any other reasons
for its refusal to indemnify the Plaintiffs for said sum.
21. Counsel for the Plaintiffs and the Defendants have exchanged
correspondence wherein each has set forth their respective clients'
positions on whether said sum must be paid under the car insurance
policy at issue.
22. The Plaintiffs suffered and continue to suffer economic harm, monetary
loss, and are otherwise aggrieved as a result of the Defendants' failure
to honor its contractual obligations under the car insurance policy.
6
23. The Defendants' denial and continuing denial of its responsibility to
indemnify or otherwise reimburse the Plaintiffs for payment of said
Underinsured Motorist benefits, despite the Plaintiffs' repeated
demands for same, presents a real and actual controversy wherein
litigation remains inevitable such that there exists a direct, substantial,
and present interest in having the provisions of the Plaintiffs' car
insurance policy construed whereby the instant parties' rights, status,
and legal obligations may be declared.
WHEREFORE, the Plaintiffs seek a declaratory judgment and final decree
against the Defendants as follows:
(a) This Honorable Court adjudicate and declare that the
Plaintiffs' car insurance policy includes Underinsured
Motorist coverage applicable to the motor vehicle accident
on July 21, 2003.
(b) This Honorable Court adjudicate and declare that Plaintiff
Barry E. Calhoun was not utilizing a "regularly used" police
vehicle at the time of the accident, that the vehicle
assigned to said Plaintiff on that date had never been
previously used by him, and that said Plaintiff was never
furnished with the same vehicle for his various
assignments as a Pennsylvania State Trooper.
7
(c) The Plaintiffs recover costs of litigation and attorneys fees
attendant to this controversy and civil action.
(d) For such other and further relief as This Honorable Court
may deem just and equitable. // 5 - /vt//
are
Submitted,
OFFICES
By: Ron Turo, Esquire
28 South Pitt Street
Carlisle, PA 17013
(717) 245-9688
Attorney for Plaintiffs
Pa. Supreme Ct. ID No.: 34334
8
PENNSYLVANIA CAR POLICY
PARTS 1, 3, 4, 5, 6, & 7
t'
PENNSYLVANIA CAR
POLICY
Prudential Property and Casualty Insurance Company
Prudential General Insurance Company
Corporate Office
23 Main Street, Holmdel, NJ 07733
PAC 186 PA Ed. 11)00
X809.
This is not a crrtpiete and valid contract without a oroperiv compietea Declarations.
Prudential Property and Casualty Insurance Company
Secretary
Prudential General Insurance Company
/-'0.,.4 I? c??9.>J.fl c .•
Secretary
President
President
- 2 -
Pennsylvania Car Policy Parts 1, 3, 4, 5, 6, & 7
PAC 186 PA Ed. 11100
TABLE OF COi4TENiTS
-ginning On
'age
DEFINITIONS
GENERAL PROVISIONS
(These provisions are applicable to
all parts of the policy)
This Policy is A Contract
Agreements Between You And Us
_ Declarations
Policy Area
Restrictions of Coverage
Policy Period
Policies Effective Prior to 9/20/91 -
Lifetime Renewal At Age 65
Concealment or Fraud
Termination
Premium Payment
Policy Changes
Endorsements
Additional Operators
Non-stacking of Coverage Limits
Punitive Damage
Assignment
Bankruptcy
Out-Of-State Coverage
Your Duties After An Accident or. Loss
Full Tort Alternative
Limited Tort Alternative
PART 1- LIABILITY - IF YOU INJURE OTHERS OR
DAMAGE THEIR PROPERTY WITH A CAR
Our Obligations To You
Your Obligations To Us
What Cars Are Covered
Who Is Insured
Losses We Will Not Pay For
How We Will Settle A Claim
4 PART 2 - MEDICAL PAYMENTS
DOES NOT APPLY IN PENNSYLVANIA
3euinnii
?age
5 PART 3 - COLLISION & COMPREHENSIVE - IF Y(
CAR IS DAMAGED OR STOLEN
Our Obligations To You
5 Your Obligations To Us
5 What Cars Are Coverec
5 Losses We Will Not Fa; For
5 How We Will Settle A Claim
PART 4 - UNINSURED MOTORISTS - IF YOU ARI
BY A MOTOR VEHICLE THAT IS UNINSURED
Our Obligations To You
Your Obligations To Us
What Cars Are Coverea
4Vho is insured
Losses We Will Not Pay For
How We Will Settle A Claim
5
5
PART 5 - UNDERINSURED MOTORISTS - IF YOL
HIT BY A MOTOR VEHICLE THAT IS UNDERINSI
Our Obligations To You
Your Obligations To Us
What Cars Are Covered
Who Is Insured
Losses We Will Not Pay For
How We Will Settle A Claim
5
6
6
6
6
6
6
6
6
6
7
7
7
7
7
PART 6 - FIRST PARTY BENEFITS
Definitions
Exclusions
PART 7 - ADDED FIRST PARTY BENEFITS
8
8
9
9
9
10
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AM
DEFINITIONS
The words defined below are used throughout the
policy. rhey are printed in bold type and the
definitions shown next to them apply. Exceptions are
note, under individual policy parts.
BODILY INJURY
Bodily injury means accidentally sustained physical
injury and that person's resulting illness, disease or
death.
CAR
A car is a private passenger automobile, station
wagon, jeep-type, van with four (4) wheels which is
designed for use mainly on public roads. A pickup
truck with four (4) or six (6) wheels and a gross vehicle
weight of less than 10,000 pounds which is designed
for use mainly on public roads is also a car. The car
must be required to be registered and licensed by the
laws of your state.
DIMINUTION OF VALUE
--Diminution of value means the actual or perceived
ross in market or resale value which results from a
loss.
HOUSEHOLD RESIDENT
A "household resident" is someone who lives in your
household. A household resident includes a resident
relative.
INSURED
Insured means the person or persons as described in
"Who is insured" ur:der each policy part.
LIVES OR LIVING
For the purpose of this policy, lives or living means
that place where people have their true, fixed,
permanent home and principal establishment, to
which whenever they are absent, they have the
intention of returning.
MOTOR VEHICLE
A motor vehicle is a self-propelled land vehicle which
is required to be registered and licensed by the laws
of your state for use on public roads.
NAMED INSURED
Throughout this policy, you and your refer to the
named insured shown in your Declarations; and your
spouse if a resident of the same household.
If the spouse ceases to be a household resident
during the policy period, 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 an insured; or
3. the end of the policy period.
NON-OWNED CAR
A non-owned car is a car which is not owned by,
registered in the name of, or furnished or available for
regular use by you or a household resident.
NON-OWNED MOTOR VEHICLE
A non-owned motor vehicle is a motor vehicle v,
is not owned by, registered in the name of, or
turnisheri or available for recuiar use t ,v you or z
household resident.
OCCUPY, OCCUPIED, OR OCCUPYING
Occupy, occupied, or occupying means in, on, g
into, out of or off.
OWNERSHIP
Ownership of a car means:
1, holding legal title to the car; or
2. having legal possession of the car that is st
to a written security agreement with an origir
term of six (6) months or more; or
3. having legal possession of the car that is le
to that person under a written agreement for
continuous period of six i6) months or more.
PROPERTY DAMAGE
Property damage means damage to physical prc
including loss of its use.
RESIDENT RELATIVE
A resident relative is someone who lives in your
household and is related to you by blood, marrii
adoption or is a ward or foster child.
SERIOUS INJURY
Serious injury means a personal injury resulting
death, serious impairment of bodily function or
permanent serious disfigurement.
TRAILER
Trailer means a vehicle designed to be towed or
public roads by a car.
USE, USED OR USING
Use, used or using means the car or motor vehi(
being operated in a manner consistent with the
purpose for which it was designed.
WE, US, OR OUR
We, us. or our means the company shown on yc
Declarations.
YOU OR YOUR
Throughout this policy, you and your refer to thi
named insured shown in your Declarations; and
spouse if a resident of the same household.
If the spouse ceases to be a household resident
during the policy period, the spouse will be
considered you and your under this policy but o
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 t
spouse as an insured; or
3. the end of the policy period.
- 4 -
GENERAL PROVISIONS
A. THE POUCY IS A CONTRACT
This policy is a contract between you and us. When
we refer to the policy, we mean this Booklet, your
mosT rcr3nt Declara. _as ,nd ;awr indorsements.
B. AGREEMENTS BETWEEN U AND US
In exchange for premium paid, we agree to pay for
losses as covered in this policy.
By accepting this policy, you agree that the
statements on your application are true and correct.
This policy is issued relying on the accuracy of those
statements. This policy contains all the agreements
that exist between you and us.
You will notify us within 30 days of any change of
address. The policy will then be re-rated based on the
rates and coverages in use for the new address. If the
change in address is from one state to another and
you qualify for coverage with us in the new state, then
we will replace this policy with the policv we use in
-the new state.
-The statements an the application are your
representations and are not warranties.
C. DECLARATIONS
Your Declarations is an important part of this policy. It
lists the named insured and describes the cars this
policy covers. Refer to your Declarations to see which
Parts of the policy apply and what amounts of
insurance you have for each of your cars. You only
have the coverage for which a specific premium
charge is shown for the coverage. You will receive
your Declarations when the policy is first issued, each
time a change is made and at each renewal.
D. POUCY AREA
United States, its territories or possessions, or
Canada.
This policy covers accidents which occur in the United
States of America, its territories or possessions, or
Canada, or while a car is being transported between
these places.
E. RESTRICTIONS OF COVERAGE
1. We do not provide any coverage if your car is not
principally garaged and used in the United States.
2. Mexico - WARNING: READ THIS CAREFULLY!
a) Car accidents in Mexico are subject to the laws of
Mexico only - NOT the laws of the United States of
America. Unlike the United States, the Republic of
Mexico may consider a car accident a criminal offense
as well as a civil matter.
b) THIS COVERAGE MAY NOT BE RECOGNIZED BY
MEXICAN AUTHORITIES AND THE COMPANY MAY
NOT BE ALLOWED TO IMPLEMENT THIS COVERAGE
AT ALL IN MEXICO. YOU SHOULD CONSIDER
PURCHASING CAR COVERAGE FROM A UCENSED
MEXICAN INSURANCE COMPANY BEFORE DRIVING
INTO MEXICO.
c) The coverages for your insured car provided by this
policy are extended to accidents occurring in Mexico
within 25 miles of the United States border. This
extension only applies for infrequent trips into N
that do not exceed ten days at any one time,
d) We will pay losses under Part 3 Collision And
Cumprehenswe in the United States, its territoric
possessions, or Canada, out not in Mexico. If yoi
insured car is dernagea in Mexico, you must rett
to the United States to be repaired. If your insure
must be repaired in Mexico in order to be driven
will not pay more than the amount it would cost
have repairs made at the nearest point in the Un
States. The costs for towing, transportation, stor
and salvage operations of the insured car while
Mexico are not covered under the policy.
F. POLICY PERIOD
This policy covers accidents which occur during
policy period. This period is shown on your
Declarations.
G. POUCIES EFFECTIVE PRIOR TO 9120/91 - UFE
RENEWAL AT AGE 65
For a policy that has an original effective date or
9/20/91, if at any renewal you no longer qualify f
continued coverage as permitted by Pennsylvan
we will offer you similar coverage in one of our
affiliated Companies if you have had car insuran
with us continuously for at least 5 years on the f
anniversary date of this policy (or any renewal o
replacement of it) following your 65th birthday.
However, this agreement does not apply if you f
pay a premium when required, if you are not the
principal operator of a car described on the
Declarations page, or if your driver's license or t.
anyone who lives in your household (or who rec
uses a car insured under this policy) has been
suspended or revoked during the current policy
or within the 12 months prior to the beginning c
current period.
This agreement does not apply if the corrected v
of your better eye or that of any persons living it
household (or any person who regularly uses a i
insured under this policy) is less than 20/70. Nor
it apply if the visual form field of you or these pe
is less than 110 degrees.
This agreement does not apply if you or any per
living in your household (or any person who reg
uses a car insured under this policy) have reache
age of 72 but do not give us, on request, a media
report from a licensed physician stating that you
vision and/or that of these other drivers over age
meets the requirements given above and that, it
doctor's opinion, you and/or they are physically
mentally competent to drive safely. We will not
request these medical reports more than once e,
three years. However, after you or other drivers i
the age of 80, we can request these reports ever
All requested medical reports will be at the com
expense.
This agreement applies only to cars as describes
this policy. This agreement stops as of the effect
date of any other car policy which applies to a ci
described on the Declarations page, but only for
coverages provided by the other car policy.
-5-
*80
H. CONCEALMENT OR FRAUD
This policy is void and there is no coverage for you or
any insured if it has been in effect for less than 60
days and you or any other insured under this policy
has, whether before or after a loss:
a! mtenticnahy concealed or mismiaresented any
material fact or circumstance; or
b) made false statements or engaged in fraudulent
conduct relating to a loss. this insurance or the
application.
1. TERMINATION
1. Cancellation By You - You may cancel this policy at
any time by returning it to us or by notifying us in
writing of the future date on which you want it
canceled. In addition, with our permission, you may
cancel this policy by notifying us over the telephone
of the future date on which you want it canceled. A
premium refund will be sent to you as soon as
practical after we receive your notice of cancellation.
2. Cancellation By Company - If we want to cancel this
policy and it has been in effect for less than 60 days,
we will send a written notice at least 15 days before it
is canceled. If you fail to pay a premium by the date
due, we will send a written notice at least 15 days
before it is canceled.
After this policy has been in effect for 60 days, we will
only cancel it if:
a) you do not pay a premium or premium
installment by the date due. We will send you a
written notice at least 15 days before the policy is
canceled;
b) the driver's license of the named insured is
under suspension or revocation during the policy
period. We will send you written notice at least 15
days before the policy is canceled;
c) the policy was obtained through fraud or
material misrepresentation. We will send you
written notice at least 60 days before the policy is
canceled.
We will mail the cancellation notice to the named
insured at the last address shown on the policy.
We and you agree that a proof of mailing of this
notice is sufficient proof that you were properly
notified. We will keep only the premium for the
time the policy was in effect and we will refund any
balance. Any refund due will be sent to you as
soon as practical. Coverage ends on the date
shown on the written notice, not on the date you
get the premium refund.
3. Nonrenewal By Company - If we decide not to
renew this policy, we will send written notice to the
named insured. We will send the notice at least 60
days before the policy is nonrenewed to the last
address shown on the policy. We and you agree that
the mailing of this notice is proof that you were
properly notified.
4. Nonrenewal By You - When we offer to renew or
continue this policy and you do not accept it,
coverage will stop at the end of the current policy
period. Your failure to pay the renewal premium by
the date due indicates your rejection of our renewal
offer.
5. Automatic Termination - If you obtain other
nsumnce on your cc•: ered car, any similar insu
provided by this poucv will terminate as to that
the effective date of t^e other insurance.
6. Other Termination Provisions - We will comp
t' a laws in your state:
ai requiring a specific notice perioa;
b) requiring a special type of mailing; or
c) imposing restrictions on the reasons for
cancellation or nonrenewai.
J. PREMIUM PAYMENT
Your premium payment must be received by us
office by the due date. If we do not receive the
premium by the date shown on any premium n
sent to you the policy will terminate. If the prem
paid by check or other instrument, and it is not
honored, it will be considered as a failure to pa}
premium.
Changes made to your oolicy during the policy
may result in premium adjustment.
K. POLICY CHANGES
No changes can be made to any part of this poli
except by endorsement issuea by us.
The terms of this policy are automatically chant
conform to the laws of the state in which you lie
We will automatically give you the benefits of ai
extension or broadening of this oolicy. This onh
applies if the change does not require additiona
premium.
L ENDORSEP1iENTS
Endorsements are a part of this policy. They adc
delete, or change parts of the policy. They may I
necessary to conform to the laws of your state e
new programs we have implemented. Only thm
endorsements whose numbers appear on your
Declarations are a part of your oolicy.
M. ADDITIONAL OPERATORS
If during the policy term a person not listed on t
policy begins to drive a car or stops driving a ca
shown on your Declarations, you are required tc
immediately inform us of this change. The
appropriate premium adjustment will be made f
the date the operator status changes during the
period.
N. NON-STACKING OF COVERAGE LIMITS
The limits shown under Your Coverage and Lim
section of Your Declarations is the maximum we
pay for an accident involving you or any other p
insured under this policy. This limit of coverage
applies regardless of the number of policies, ins
insured cars, claims made, or cars involved in th
accident or loss. Coverages on other cars insure
us cannot be added to or stacked on the coverac
the particular car involved.
0. PUNITIVE DAMAGE
We will not pay for damages assessed as puniti%
exemplary or vindictive against an insured.
P. ASSIGNMENT
This policy cannot be assigned to anyone withoi
written approval. But, if the named insured dies,
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policy will proviae the other persons insurea by this
policy and the legal representative of the estate (but
only while acting as such) with the same coverages
until the end of the policy period. Until a legal
representative is appointed, anyone who has proper
custody of the car is covered whiie using it, subject to
the terms of this policy, as if he or she was P. resident
relative.
Q. BANKRUPTCY
If an insured beco- bankrupt or insolvent during
the policy term, it a?.s not affect the Agreements
Between You And Us.
R. OUT-OF-STATE COVERAGE
The limits and coverages of this policy will change to
meet the minimum requirements of the laws while
you are in:
1. another state;
2. a territory or possession of the United States; or
3. Canada.
This applies if the laws require non-residents to
carry higher limits of coverage or coverages other
- than provided by this policy.
S. YOUR DUTIES AFTER AN ACCIDENT OR LOSS
1. General Duties - If any persons insured under this
policy are involved in a car accident or if the car is
stolen or damaged, they or someone acting for them
must promptly contact us. We will want to know how
the accident or loss happened, names and addresses
of people involved, witnesses, and any injury or
damage.
Persons making a claim under this policy must:
a) inform us of the details of the accident or loss in
writing, if requested.
b) cooperate with us in investigating, settling, or
defending any loss or legal action. Cooperation
includes attending hearings and trials, helping in
suing others who are responsible for the accident,
giving evidence, and helping us get witnesses to
attend a trial.
c) immediately send us any notices or legal papers
received by them or their legal representatives in
connection with the accident or loss.
d) be examined by doctors we select, for their
injuries as often as we reasonably.require. We will
pay the cost of such examinations. The
examination must take place within 30 days of our
request.
e) give us written permission to obtain their
medical and other relevant records, within 30 days
of our request.
f) give us written proof of their loss in a form
containing any relevant information we request
within 30 days of our request.
g) give us a statement under oath as often as we
reasonably require and within 30 days of our
request.
h) report a hit and run accident or loss to the police
within 24 hours or as soon as reasonably possible.
0 allow us to inspect the car if we request it.
2. Additional Duties If Your Car Is Damaged Or Stolen
- If your car is damaged or stolen and it is covered
under Part 3, you must protect the car from further
damage. We will pay any reasonable costs you in
doing this. You may be required to snow us the
damaged property before its repair or disposal ar
give us a statement under oath.
If the car is stolen, you must report it to the polic(
us within 24 hours or as soot -s reasonably poss
after discovery of the theft.
3. Settlement/Recovery
a) We will not pay for losses which are settled,
without our written consent.
b) If anyone voluntarily makes any payments,
assumes any obligations or incurs any expens
except for first aid to others at the scene of the
accident, we will not be responsible for
reimbursement.
c) When we pay any person for a ioss under tf
policy, we are entitled to the amount we paid
the proceeds of any settlement or judgment th
person recovers from the responsible party. W
allowed by law, we are also entitled to related
collection expenses for any settlement or
judgment. At our request, persons receiving
payment from us must take any necessary acti
recover the payments we have made. We will
select the attorney and pay all related costs an
fees.
d) When we pay for a loss under this policy, p
rights of recovery from anyone else becomes
up to the amount we have paid. Anyone insur
under this policy must:
1. not interfere with our rights to recover; a
2. do whatever is nec.=F",-y to help us reco
the amount we paid.
T. FULL TORT ALTERNATIVE
Each person who elects the full tort alternative ar
each person who is bound by such election of thf
named insured remains eligible to seek compens
for non-economic loss claimed and economic los
sustained in a motor vehicle accident as the
consequence of the fault of another person.
U. LIMITED TORT ALTERNATIVE
Each person who elects the limited tort alternativ
each person who is bound by such election of th(
named insured is eligible to seek compensation f
economic loss sustained in a motor vehicle accid
the accident is determined to be the fault of anotl
person.
If the injury sustained is serious, as defined unde
Definitions section of this policy, each person boi
by the limited tort alternative is also eligible to se
compensation for non-economic loss from the at
party.
If the injury sustained does not meet the definitio
serious injury, each person bound by the limited
alternative is prohibited from seeking compensat
for non-economic loss unless:
1. the person bound by the limited tort electioi
sustains damages in a motor vehicle accident
result of the fault of another person unless om
the following conditions apply:
a) the person at-fault is convicted, or accep
Accelerated Rehabilitative Disposition (ARE
-7-
*805
drivina under the influence of alcohol or a
controijed substance in that accident; or,
b) the person at-fauit is operating a motor
vehicle registerea in another state; or,
c) the person at-fault intends to injure himself or
another be.soes. clues not include
intentional acts, failure to act or to act with tht
realization that it creates a grave risk of causing
injury if for the purpose of everting bodily injury
to himself or another person; or,
d) the person at-fault has not maintained
financial responsibility as required by law;
2. the person wno is bourc by the limited tort
alternative wui remain eiicible to seek
compensation for non•eccnomic loss for ciain
against a person in the business of designing,
manufacturing, repairing. servicing or otherw
maintaining motor vehicles when the claim ar
cui 6f a detect in such motor vchiclewhjch is
causea by or not currecte:: by an act or omiss
the course of such business, other than a defe
a motor vehicle which is operated by such
business; or,
3. the injury is sustainer %vitile an occupant of
motor vehicle other than a Private passenger
motor vehicle.
PART 1 LIABILITY - IF YOU INJURE OTHERS OR DAMAGE THEIR PROPERTY WITH A CAR
A. OUR OBLIGATIONS TO YOU (PART 1)
1. Liability (Bodily Injury Coverage/Property
Damage Coverage)
If you have these coverages (see your
Declarations), we will pay up to our Limit Of
Liability as described in How We Will Settle A
Claim IPart 1) for bodily injury to others and
property damage that an insured is legally
obligated to pay. The bodily injury and property
damage must:
a) result from an accident involving a car
insured under this Part; and
b) be covered under this Part.
2. Investigation, Settlement And Legal Defense
If other persons claim that you or anyone else
insured under this Part injured them or damaged
their property in a covered accident, we will
provide a defense at our expense by counsel of our
choice. We may conduct any investigation and
settle any claim or suit that we decide is
appropriate.
Our obligation to defend a claim or suit ends when
we have paid the applicable coverage limit for
damages resulting from the accident.
3. Additional Payments
In addition to any amount in the Limit Of Liability
section, we will pay the costs listed below:
a) First Aid
We will pay anyone insured under this Part for
the cost of immediate and necessary first aid to
others at the scene of the accident involving a
car insured under this Part.
b) Bail Bonds
If you or anyone else insured under this Part are
arrested as a result of a covered accident which
results in the violation of a traffic law and must
put up bail, we will pay up to $250 for the cost
of a bail bond. The insured must first get the
bond.
c) Release Of Attachment Bonds
If as a result of an accident an insured's
property is attached by court order, we will
reimburse the premium of a bond obtained to
release that attachment. The amount of the
bond we pay premium for cannot be more
our limit of liability.
d) Court Imposed Interest
If we are obligated to cay the amount of a
judgment that is within our limit of liability
will pay, in addition, :cterest required by th
court on that judgment. Our duty to pay in
ends when we pay, offer to pay or deposit
the court the amount owed under this Part
maximum amount is subject to the Limit 0
Liability - Bodily Injury: Each Person and Li
Of Liability - Bodily Injury: Each Accident u
How We Will Settle A Claim (Part 1).
el Court Costs
If we provide a defense, we will pay an
insured's court costs.
f) Expenses
We will pay reasonable costs connected wi
the defense of you or any other insured inc
at our request, such as travel expenses to t
court. We will pay up to a maximum of $5(
day for actual net wages lost if the insured
to take time off from, work at our request.
g) Appeal Bonds
We will pay the premiums for appeal bond
we decide to appeal the case to a higher cc
We will pay premiums on a bond to releas
property attached in a covered lawsuit, bui
for that portion of the bond up to your coy
limits.
B. YOUR OBLIGATIONS TO US (PART 1)
The following provisions apply in addition to am
duties listed in the General Provisions section.
1. Legal Action Against Us
We may not be sued unless there is full comp
with all the terms of this policy. We may not k
sued for payment under this Part until the
obligation of an insured person to pay is final
determined either by final judgment against t
person or by written agreement of the insurer
person, the claimant, and us. No one will hav
right to make us a party to a lawsuit to detern
the liability of an insured person.
- 8 -
C. WHAT CARS ARE COVERED (PART 11
The following are subject to the Each Person, Each
Accident Limit Of Liability under How We Will Settle A
Claim (Part 1).
1- Cara Described On Your Declarations
This Part covers cars for which a pre.mur,: charge
for these coverages is shown on your Declarations.
2. Replacement Cars
If you acquire ownership of a car to replace a car
covered under this Part, the newly acquired car has
the same coverage as the [car being removed from
the policy. You must notify us of the replacement
within 30 days after you acquire ownership of the
car, for coverage to continue after 30 days.
3. Additional Cars
If you acquire ownership of another car in addition
to those described as covered under this Part, this
Part covers the new car for the first 30 days. The
new car has the same coverage as any of your
other cars insured with us. All your other cars m ust
be insured with us for this Part to cover the
additional car.
You must let us know within 30 days after you
acquire ownership of the new car that you want it
insured under this Part, for coverage to continue
after 30 days.
4. Substitute Cars
If a car covered under this Part breaks down, is
being serviced or repaired, or is stolen or
destroyed, we will cover a car you temporarily
borrow or rent (with the owner's permission) while
your car is being repaired or replaced. This car
cannot be owned by you or a household resident.
The substitute car has the same coverage as the car
that is out of service. We will only pay that part of
the loss that is excess over the amounts payable
under any other insurance which covers the loss.
5. Other Non-Owned Cars
In addition to substitute cars, we will cover a non-
owned car. The owner must give permission to use
it. The non-owned car must be used in the way
intended by the owner. This car must not be
furnished or available for the regular use of you or
a household resident. We will cover a rented car
for a total of 30 days. The non-owned car has the
same coverage as any one of your cars insured
with us. We will only pay that part of the loss that
is excess over the amounts payable under any
other insurance which covers the loss.
6. Trailers, Camper Units, Caps Or Similar Types Of
Cover
We will cover trailers designed to be pulled by a
car while they are attached to a car covered under
this policy. We will cover all camper units, caps or
similar types of cover designed to be mounted on a
car or trailer. When a trailer, camper unit, cap or
similar type of cover is attached to a car it is
considered to be one vehicle. There is no coverage
for a trailer, camper unit, cap or similar type of
cover while used with a car not insured under this
Part. Also, there is no coverage for damage to a
non-owned trailer, camper unit, cap or similar type
-of cover which is attached to a covered car.
D. WHO IS INSURED (PART 1)
1. In Your Car (Includes A Substitute Car)
You and any persons you give permission tc
your car are insured as long as they use it in
way you intended when you gave permissio
2. In A Nor-Owned Car
You and a resident relative are insured while
a non-owned car. The owner must give pern
to use it. It must be used in the way intende(
the owner.
E. LOSSES WE WILL NOT PAY FOR (PART 1)
1. Owned Motor Vehicles
We will not pay for bodily injury or property
damage caused by anyone using a motor ve
or trailer not insured under this Part, owned
or a household resident.
2. Non-Owned Motor Vehicles
We will not pay for bodily injury or property
damage, caused by anyone using a non-own
motor vehicle or trailer not insured under thi
that is furnished or made available for the rei
use by you or a household resident.
3. Motor Vehicles For Hire
We will not pay for bodily injury or property
damage that occurs while a motor vehicle is
used to carry people or property for a fee. Th
does not include using your covered car in a
pool.
4. Racing
We will not pay for bodily injury or property
damage caused by anyone using a motor vet
the motor vehicle was being used in any orgi
racing, speed, demolition or stunt contest or
related activity.
5. Business And Residence
We will not pay for bodily injury or property
damage arising out of the use of a motor veh.
trailer, camper unit, cap or similar type of cov
being used or located for use as a place of
business or as a place of residence.
6. Your Employees
We will not pay for bodily injury to your empl
or an employee of a household resident while
the course of employment. But bodily injury t
domestic employee is covered under this Part
such employee is not covered and does not K
be covered under any workers compensation
disability law or similar law.
7. Fellow Employees
We will not pay for bodily injury caused by an
insured (other than you) to a fellow employee
while the insured is using a motor vehicle in h
her employer's business.
8. Auto Business
We will not pay for bodily injury or property
damage caused by anyone using a non-owne(
motor vehicle in any kind of auto business.
Examples of auto business are: selling, repairi
servicing, storing or parking motor vehicles.
-9-
*Bog
9. War
We wiil not pay for bodily injury or property
damage caused by any act of war, warlike act,
insurrection, rebellion or revolution. Also, we wiil
not pay for a loss caused by discharge of any
nuclear weapon, even r accidental.
10. Nuclear Liability
We will not pay for bodily injury or property
damage caused by anyone who:
a) is an insured under a nuclear energy liability
policy; or
b) would be an insured under a nuclear energy
liability policy but for the exhaustion of its limit
of liability.
11. Criminal Acts
We will not pay for bodily injury or property
damage caused by anyone while committing or
attempting to commit a crime or avoiding arrest.
12. Intentional Injury Or Damage
We will not pay for bodily injury or property
-damage which results from an act:
a) that is intended by an insured to cause harm:
or
b) that an insured could reasonably expect
would cause harm.
This exclusion applies whether or not an
insured intended or expected the results of their
act, so long as the resulting injury or damage
was a natural consequence of the act.
Mental disease, defect or other disorder of the
insured, or the insured being under the
influence of drugs or alcohol shall not bar
application of this exclusion. The intention or
reasonable expectation to cause bodily injury or
property damage shall be determined as though
any such condition of the insured did not exist.
13. Your Property
We will not pay under this Part for any damage to
property owned or being transported by an insured
person. We will not pay under this Part for damage
to property under the care of or rented to you or a
household resident. But we will pay for damage to
a residence or garage rented to you or a resident
relative.
F. HOW WE WILL SETTLE A CLAIM (PART 1)
1. Limit Of Liability - Bodily Injury: Each Person
The limit stated under Liability - Bodily Injury -
Each Person on your Declarations is the maximum
we will pay for ail damages arising out of bodily
injury to one person as a result of any one
accident. Included in Liaoility - Bodily Injury- Ea(
Person, but not as a separate claim or claims, are
all damages sustained by other persons, for
example, loss of services, loss of support, loss o'
consortium ,,rongf, . each, grief, sorrow and
emotional distress..
2. Limit Of Liability - Bodily Injury: Each Accidem
The limit stated under Liability - Bodily Injury -
Each Accident on your Declarations is the
maximum we will pav for all damages arising oL
of bodily injury as a result of any one accident,
subject to the Liability - Bodily Injury - Each Pers
limit.
3. Limit Of Liability - Damage To Property
The limit stated under Liability - Property Damag
Each Accident on your Declarations is the
maximum we will pay for all property damaged
any one accident.
4. Other Insurance - Your Car
If there is other insurance which covers a loss
under this Part, we will pay our share of the loss
Our share is the proportion our limit bears to the
total of all applicable limits. But wewill not pay I
a loss involving anyone using a newly acquired
(additional or replacement), car if you have anoth
insurance policy that covers it.
5. Other Insurance - Non-Owned Car (Includes A
Substitute Car)
In the case of a non-owned car covered under th
Part, we will pay only thos^ damages that are
excess over amounts payable under any other
insurance up to our Each Person, Each Accident
Limit Of Liability.
6. No Duplication Of Benefits
Any damages payable under Part 1 - Liability wil
be reduced by any other coverage of this policy
applicable to the damages so that no person ma,
collect more than once for the same elements of
the damages. No one will be entitled to receive
duplicate payments for the same elements of los
under this policy Part.
7. Financial Responsibility Laws
When this policy is certified as future proof of
financial responsibility, this policy shall comply
with the minimum requirements of your state's
laws.
PART 3 COLLISION AND COMPREHENSIVE - IF YOUR CAR IS DAMAGED OR STOLEN
A. OUR OBLIGATIONS TO YOU (PART 3)
1. Collision Coverage
if you have this coverage (see your Declarations),
we will pay for accidental damage to your insured
car or trailer, including its equipment, if it collides
with another object or if it rolls over.
2. Comprehensive Coverage
If you have this coverage (see your Declarations),
we will pay for any direct and accidental loss of or
damage to your insured car or trailer, including its
equipment, caused by anything other than collis
except as shown under Losses We Will Not Pay 1
(Part 3). Examples of comprehensive coverage
losses are: glass breakage, theft, fire, flood, hail,
earthquake, vandalism and collision with a bird r
animal.
If the car is stolen, we will reimburse you foryour
transportation costs until the car is back in use or ui
we offer to pay for the loss. Transportation costs wi
be covered beginning 48 hours after the theft has
been reported to the police and to us. We
- 10 -
will pay up to S30 a cav for these transportation
costs up to a mtal of $900.
3. Towing And Labor Coverage
If you have this coverage (see your Declarations),
we will nay for towing charges and the cost of
Labor done 'ale scene of a breakdown,. The lim.-
for this coverage is shown on your Declarations.
No deductible applies for this coverage.
4. Rental Car Coverage
If you have this coverage (see your Declarations),
we will reimburse you for the cost of renting a car
if a car you own is out of use for more than 24
hours because of a Collision or Comprehensive
loss. But this coverage does not apply when a car
is stolen and Comprehensive Coverage applies.
We will only pay for actual rental costs for the time
it would normally take to repair or replace the
damaged car up to $30 a day and $900 per incident.
You must promptly notify us of the amount you
spent for rental of the car in the manner and time
we reasonably request.
If you do not rent a car during the time it would
normally take to repair or replace the damaged car,
we will pay you $10 a day up to a total of $300.
B. YOUR OBLIGATIONS TO US (PART 3)
The following provisions apply in addition to any
duties listed in the General Provisions section.
1. Legal Action Against Us
No one insured under this Part may take any legal
action against us until 30 :lays after they have
given us notice of loss and only if all obligations
under this policy have been fulfilled.
C. WHAT CARS ARE COVERED (PART 3)
The following are subject to the Limit Of Liability
under How We Will Settle A Claim (Part 3).
1. Cars Described On Your Declarations
This Part covers cars for which a premium charge
for these ceverages is shown on your Declarations.
2. Replacement Cars
If you acquire ownership of a car to replace a car
covered under this Part, the newly acquired car has
the same conerage as the old car being removed
from the policy. You must notify us of the
replacementvoithin 30 days afteryou acquire
ownership of the car, for coverage to continue after
30 days.
3. Additional Cars
If you acquire ownership of another car in addition
to those desrerioed as covered under this Part, this
Part covers the new car for the first 30 days. The
new car has the broadest coverage as any of your
other cars insured with us. All your other cars must
be insured with us for this Part to cover the
additional ear.
You must let us know within 30 days after you
acquire ownership of the new car that you want it
insured under this Part for coverage to continue
after 30 days
4. Substitute Cars
If a car covered under this Part breaks down, i,
being serviced or repaired. or is stolen or
destroyed, we will cover a car you temporarily
borrow or rent (with the owner's permission) 1
your rar is being repaired or replaced. This cal
cannot be owneJ by ycu or a household resid
The substitute car has the same coverage as ti
that is out of service. We wiii only pay that par
the loss that is excess over the amount payabl
under any other insurance which covers the Ic
5. Other Non-Owned Cars
In addition to substitute cars, we will cover a r
owned car. The owner must give permission t
it. The non-owned car must be used in the we
intended by the owner. This car must not be
furnished or available for the regular use of yc
a household resident. We wiiI cover a rented c
for a total of 30 days. The non-owned car has
same coverage as any one of your cars insurer
with us. We will only pay that part of the loss )
is excess over the amount payable under any
insurance which covers the loss.
D. LOSSES WE WILL NOT PAY FOR (PART 3)
1. Owned Motor Vehicles
We will not pay for damage to or loss of any n
vehicle or trailer not insured under this Part,
owned by you or a household resident.
2. Non-Owned Motor Vehicles
We will not pay for damage to or loss of any n
vehicle or trailer not insured under this Part th
furnished or made available for the regula usr
you or household residents.
3. Motor Vehicles For Hire
We will not pay for damage or loss that occurs
while a motor vehicle is being used to carry pe
or property for a fee. This does not include usi
your covered car in a car pool.
4. Camper Units, Caps Or Similar Types Of Cor
We will not pay for damage to or loss of a cam
unit, cap or similar type of cover, including its
equipment and accessories, unless the owners
or use of the camper unit, cap or similar type c
cover has been reported to us and the requirec
premium has been paid. A camper unit, cap or
similar type of cover is designed to be mounte
a car or trailer.
5. Trailers
We will not pay for damage to or loss of a trail
unless the ownership or use of the trailer has t
reported to us and the required premium has t
paid.
6. Customized Vehicles
We will not pay for damage to or loss of any
customized features unless the value of the
customization has been reported to us and it is
included in the premium which has been paid
this coverage. Customized features include any
furnishings, carpeting, custom installed height
extending roofs, custom paint, custom painted
windows, custom murals, graphics or other
custom applied designs or equipment. This
- 11 -
*Bog
includes items installea at the time of the vehicle's
manufacture or after.
7. Racing
We will not pay for damage to or loss of a motor
vehicle if the motor vehicle was being used in any
organized racing, speed, demolit;on u: s+:c,it
contest or related activity.
8. Business And Residence
We will not pay for damage to or loss of a motor
vehicle, trailer, camper unit, cap or similar type of
cover, being used or located for use as a place of
business or as a place of residence.
9. Auto Business
We will not pay for damage to a car or trailer you
do not own if you are using it in any kind of auto
business. Examples of auto business are: selling,
repairing, servicing, storing or parking cars or
other vehicles.
10. Diminution Of Value
We will not pay for any loss to your car or any non-
owned motor vehicle due to diminution of value as
defined in this policy.
11. War
We will not pay for damage caused by any act of
war, warlike act, insurrection, rebellion or
revolution. Also, we will not pay for a loss caused
by discharge of any nuclear weapon, even if
accidental.
12. Nuclear Contamination
We will not pay for damage from or as a
consequence of the following, whether controlled
or uncontrolled or however caused:
a) nuclear reaction;
b) nuclear radiation; or
c) radioactive contamination.
13. Criminal Acts
We will not pay for damage caused by anyone
while committing or attempting to commit a crime
or avoiding arrest.
14. Intentional Damage
We will not pay for damage which results from an
act:
a) that is intended by an insured to cause harm;
or
b) that an insured could reasonably expect
would cause harm.
This exclusion applies whether or not an
insured intended or expected the results of their
act, so long as the resulting damage was a
natural consequence of the act.
Mental disease, defect or other disorder of the
insured, or the insured's being under the
influence of drugs or alcohol shall not bar
application of this exclusion. The intention or
reasonable expectation to cause property
damage shall be determined as though any
such condition of the insured did not exist.
15. Sound (Receiving, Recording, Reproducing
Transmitting) Equipment
We will not pay for loss to sound equipment w
is not permanently installed. Equipment must t
installed in the dash or console opening specifi
by the manufacturer of the rar, trailer, camper i
cap or similar tyoe,: cover for suchequiomen:
be considered permanently installed.
Loss to compact discs, tapes, records, or other
devices for use with equipment designed for th
reproduction of sound will not oe covered.
16. Wear And Tear
We will not pay for damage which is due and
confined to wear and tear, freezing, or mechani
or electrical breakdown or failure. This does no
apply to damage if your car is stolen.
17. Tires
We will not pay for loss to tires unless the loss
caused by fire, vandalism, malicious mischief,
theft, or unless the loss is caused by an accider
covered under this Part.
18. Additional Living Facility Equipment
We will not pay for damage to or loss of radio c
TV antennas, awnings, cabanas or any equipme
designed to create extra living area while the ce
trailer, camper unit, cap or similar type of coves
set up for living.
19. Personal Property
We will not pay for damage to or loss of persor
property in a car except as provided in the Clotl
and Luggage provision under How We Will Sete
Claim (Part 3).
E. HOW WE WILL SETTLE A CLAIM (PART 3)
1. Limit Of Liability
Our Limit Of Liability will be the least of the:
a) actual cash value (replacement cost less
depreciation) of the damaged or stolen prop
at the time of the loss;
b) amount necessary to repair or replace the
property with parts made by the manufactur
of the vehicle or by other non-original
equipment manufacturer or other sources
unless prohibited by state laws and regulatic
c) amount stated on your Declarations.
A theft loss to permanently installed sound
(receiving, recording, reproducing or
transmitting) equipment is covered up to $1,
Loss to a non-owned trailer when pulled by
car covered under this Part is covered up to
$500. We will only pay the part of a loss caul
by damage to or theft of a non-owned trailer
that is excess over the amount payable uncle
any other insurance which covers the loss.
Our payment will be reduced by any applical
deductible shown on your Declarations. But,
Comprehensive deductible will not apply to
breakage of front windshield glass when the
letter "G" is printed on your Declarations afte
the deductible amount for that car.
- 12 -
If two or more vehicles owned by you and
insured by us collide, the deductible applies
separately to each vehicle.
If we can pay a loss under either comprehensive
or collision, we will pay under the coverage
where you coiiect the moz?t.
2. Replacement Coverage On Newly Acquired Cars
We will pay the replacement cost of your covered
car if it is stolen or deemed a total loss within 180
days of acquiring ownership of a car not previously
owned and the mileage is under 7,500 original
miles.
3. Clothing And Luggage
Clothing and Luggage that is owned by you or a
household resident are covered for up to $250
while in a car insured for Comprehensive or
Collision coverage under this policy.
This coverage applies to the following losses:
a) a Comprehensive Coverage loss caused by
fire, lightning, flood, falling objects, explosion,
earthquake or the total theft of your covered car:
b) a Collision Coverage loss caused by collision
with another vehicle or object.
No deductible applies to clothing and luggage
coverage under this Part. The $250 limit applies
regardless of how many insured persons incur a
clothing or luggage loss and this coverage
applies as excess over any other collectible
coverage for the same loss.
4. Locksmith Service
We will pay up to $50 for locksmith services if you
lock your keys inside your car. No deductible
applies to this coverage.
5. Loss Of Use
If your car cannot be used because of a covered
collision or comprehensive loss, we will pay up to
a maximum of $200 for the following reasonable
additional expenses incurred as a result of the
covered loss when the loss causes a delay en-
route:
a) commercial transportation expenses,
excluding car rentals, to continue to your
destination;
b) meals, lodging and phone expenses between
the time of the loss and arriving at your
destination.
This coverage only applies if you are more than
50 miles from your closest residence. No
deductible applies to Loss of Use coverage.
6. Trailer, Camper Unit, Cap Or Similar Type Of
Cover Deductibles
A car with a trailer attached to it is considered to be
two separate vehicles and separate deductibles
apply.
A car with a camper unit, cap or similar type of
cover mounted on it is considered to be one car
and only the deductible on the car applies. If the
camper unit, cap or similar type of cover is
unmounted, separate deductibles apply to the car
and the camper unit, cap or similar type of cover.
7. Claim Settlement
We may pay for the loss, c: repair or replace th
damaged or stolen properrv with parts made b)
manufacturer of the vehicle or by other non-
original equipment manufacturer or other sour(
unloss prohibited by state laws and regulations
dt our option, we pay fn, -.ne cost to repair or
replace the property or can, our liability does n
include any diminution of value, however
measured, as a result of the loss, and/or
replacement. If the repair or replacement result:
a betterment of the property or part, you may b
responsible for the amount of the betterment
subject to applicable state laws and regulations
Betterment means an imorovement that adds vi
to the car or part of the car.
If the stolen property is recovered before we he
paid you for it or replaces it, we can return it to
you, along with payment for any damage result
from the theft. If we pay for any property or pay
its replacement, we may retain the property. Bu
you cannot require us to assume ownership of
damaged property. We cav settle the claim eith
with you or with the owner of the property.
If you should decide to use a repair facility
provided by us, we will provide you with a
guarantee for the workmanship on the performE
repairs for as long as you own your car.
8. Appraisal
If there is disagreement over the amount of the
loss, either of us may demand an appraisal with
60 days aft-r you give us written proof of your I
In that case, each of us will select a qualified
appraiser. The two appraisers will select an umr
Each appraiser will then state both the actual ca
value and the amount of the loss. If they disagre
they will submit their differences to the umpire.
decision in writing of anv two of these three
persons will determine the amount of the loss.
Each of us will pay our own appraiser. We will
share equally the other costs of the appraisal an
of the umpire.
9. Other Insurance - Your Car Or Trailer
If there is other insurance which covers damage
or theft of a car or trailer covered under this Pan
we will pay our share of the loss. Our share is th
proportion our limit bears to the total of all
applicable limits.
10. Other Insurance - Non-Owned Car Or Trailer
(Includes A Substitute Car)
In the case of a non-owned car or trailer coverec
under this Part, we will pay only that part of a to
caused by damage to or theft of the car or trailer
that is excess over amounts payable under any
other insurance up to our Limit Of Liability uncle
How We Will Settle A Claim (Part 3).
11. Loss Payee And Additional Interest Clause
Payment for loss of or damage to a car covered
under this Part will be made to the person or
organization shown in your Declarations as the
loss payee or the additional interest. This payme
will be made, up to the amount of the loss, to th
extent that the loss payee or the additional interE
has a financial interest in the car.
- 13 - *809-(
This insurance, covering the interest o' any loss
payee or the additionai interest will not oe
invalidated because of the insured's conversion,
emoezzlement or secretion of the car. Put, we
reserve the right to cancel or non-renew the policy
as aermitted by its terms. The termination notice
will end this agreement with all loss pavees or all
additinnal interests. Notice of termination will be
sent to the loss payee or the additional interest at
the time it is sent to the named insured.
If the insured fails to provide us with a croof of
loss within a reasonable time period, the loss
payee or additional interest shall do so within 60
davs of notice by us. Further, the loss pavee or
additional interest shall be suoject to all Drovisi,
of the policy relating to appraisals, time of
payment, payment of premium and of bringing
suit.
When we pay the loss payee or the additional
interest, we will, tc the exten-, oY payment. ca
subrogated to the loss payee's or 'lie addmonai
interest's rights of recovery. When we make am
payment under this policy, we can make separa
payments to each party at interest, provided we
protect the ownershiD interest of all parties.
PART 4 UNINSURED MOTORISTS -
IF YOU ARE HIT BY A MOTOR VEHICLE THAT IS UNINSURED
A. OUR OBLIGATIONS TO YOU (PART 4)
1. Uninsured Motorists Bodily Injury Coverage
If you have these coverages (see your
Deciarationsl, we will pay up to our Limit Of
Liability for bodily injury as described in How We
Will Settle A Claim (Part 4) when an insured or an
insured's car is struck by an uninsured motor
vehicle or trader. Our payment is basea on the
amount that an insured is legally entitlea to
recover for bodily injury but could not collect from
the owner or operator of the uninsurea motor
vehicle because:
a) The Owner Or Operator Is Not Insured
The owner or operator responsible for the
a:..-:dent has no liability insurance or liability
bond or has coverage in an amount :hat is less
than required by your state's financial
responsibility law.
b) The Coverage Of The Owner Or Operator Is
Denied
The owner or operator responsible for the
accident has liability coverage at the time of the
accident, but the company writing the insurance
or bond denies coverage or is unable to make
payments because of insolvency or bankruptcy.
c) The Accident Is A Hit And Run
The owner and the operator of the motor
vehicle which caused bodily injury by hitting a
person insured under this Part (or by hitting a
car that person was occupying at the time of the
accident) cannot be identified. But actual
physical contact is not required if the details of
the accident given by the injured insured can be
confirmed.
We will pay under this coverage only after the
limits of liability under any bodily injury liability
insurance or any bodily injury liability bonds
applicable to the underinsured motor vehicle
have been exhausted by payment of judgments
or settlements.
B. YOUR OBLIGATIONS TO US (PART 4)
The following provisions apply in addition to any
duties listed in the General Provisions section.
Legal Action Against Us
No one insured under this Part may take any le(
action against us unless all obligations undertf
policy have been fulfilled.
C. WHAT CARS ARE COVERED (PART 4)
The following are sub iect to the Each Person. Each
Accident Limit Of Liability under How We Will Sett
Claim (Part 4).
1. Cars Described On Your Declarations
This Part covers cars for which a premium char
for this coverage is shown on your Declaration.
2. Replacement Cars
If you acquire ownership of a car to replace a ca
covered under this Part, the newly a_couired car
the same coverage as the car being removed fn
the policy. You must notify us of the replaceme
within 30 days after you acquire ownership of t
car, for coverage to continue after 30 days.
3. Additional Cars
If you acquire ownership of another car in addi
to those described as covered under this Fart, t
Part covers the new car for the first 30 days. Th
new car has the same coverage as any of your
other cars insured with us. All your other cars r
be insured with us for this Part to cover the
additional car.
You must let us know within 30 days afteryou
acquire ownership of the new car that you wan
insured under this Part, for coverage to continu
after 30 days.
4. Substitute Cars
if a car covered under this Part breaks down, is
being serviced or repaired, or is stolen or
destroyed, we will cover a car you temporarily
borrow or rent (with the owner's permission) w
your car is being repaired or replaced. This car
cannot be owned by you or a household reside
The substitute car has the same coverage as th
that is out of service. We will only pay that part
the loss that is excess over the amount payable
under any other insurance which covers the Ios
5. Other Non-Owned Cars
In addition to substitute cars, we will cover a n
owned car. The owner must give permission to
it. The non-owned car must be used in the way
- 14 -
intended by the owner. This car must not be
furnished or available for the regular use of you or
a household resident. We will cover a rented car
for a total of 30 days. The non-owned car has the
same coverage as any one of your cars insured
with us. We will only pav that nart of the loss that
is exces_ over the a,i uCCt pay 1_!a ncder anv other
insurance which covers the Ip-s
D. WHO IS INSURED (PART 4)
1. In Your Car (Includes A Substitute Car)
You and any persons you give permission to use
this car are insured as long as they use it in the
way you intended when you gave permission.
2. In A Non-Owned Car
You and a resident relative are insured while using
a non-owned car. The owner must give permission
to use it. It must be used in the way intended by
the owner.
3. Hit By A Motor Vehicle
If you are hit by an uninsured motor vehicle while
- a pedestrian, you are insured. If a resident relative
- is hit by an uninsured motor vehicle while a
pedestrian, that resident relative is insured.
E. LOSSES WE WILL NOT PAY FOR (PART 4)
1. Losses Denied, Excluded Or Exhausted Under
Other Parts
We will not pay for bodily injury if anyone claims a
car covered under this policy is uninsured because
coverage is denied, excluded or exhausted under
another part of this policy.
2. Owned Motor Vehicles
We will not pay for bodily injury caused by anyone
using a motor vehicle or trailer not insured under
this Part, owned by you or a household resident.
3. Non-Owned Motor Vehicles
We will not pay for bodily injury caused by anyone
using a non-owned motor vehicle or trailer not
insured under this Part, that is furnished or made
available for the regular use by you or a household
resident.
4. Motor Vehicles For Hire
We will not pay for bodily injury that occurs while
a motor vehicle is being used to carry people or
property for a fee. This does not include using your
covered car in a car pool. But you and a resident
relative are covered if injured in an accident while a
passenger in a non-owned car being used to carry
people or property for a fee.
5. Land Vehicles
We will not pay for bodily injury if hit by the
following land vehicles:
a) motor vehicles owned or operated by self-
insurers under any financial responsibility law
or similar law;
b) motor vehicles owned by a government
agency in the United States of America or in
Canada;
c) land vehicles operated on crawler-treads or
rails;
d) motor vehicles or equipment designed fo
use mainly off public: roads (unless the attic
happens on a public road);
e) motorcycles or other motorized vehicles t
are not requirea to be licensed and registere
(.unless the accident happens on a public ro;
f) motor vehicles or equipment while used a
residence or premises.
6. Racing
We will not pay for bodily injury caused by any
using a motor vehicle covered under this Part i
motor vehicle was being used in any organizes
racing, speed, demolition or stunt contest or
related activity.
7. Business And Residence
We will not pay for bodily injury arising out of
use of a motor vehicle, trailer, camper unit, caF
similar type of cover, being used or located for
as a place of business or as a place of resident
8. Workers Compensation Or Similar Laws
We will not pay for bodily injury to anyone wh
payment under this Part duplicates benefits
recovered under any worker's compensation la
disability law, or any other similar law. Also, th
coverage shall not apply directly or indirectly ti
benefit any insurer or self-insurer under any
workers compensation law, disability law, or ai
other similar law.
9. Auto Business
We will not pay for bodily injury caused by an}
using a non-owned motor vehicle in any kind c
auto business. Examples of auto business are:
selling, repairing, servicing, storing or parking
motor vehicles.
10. War
We will not pay for bodily injury caused by an)
of war, warlike act, insurrection, rebellion or
revolution. Also, we will not pay for a loss cau,
by discharge of any nuclear weapon, even if
accidental.
11. Nuclear Contamination
We will not pay for bodily injury from or as a
consequence of the following, whether control
or uncontrolled or however caused:
a) nuclear reaction;
b) nuclear radiation; or
c) radioactive contamination.
12. Criminal Acts
We will not pay for bodily injury caused by and
while committing or attempting to commit a ci
or avoiding arrest.
13. Intentional Injury Or Damage
We will not pay for bodily injury which results
an act:
a) that is intended by an insured to cause h
or
b) that an insured could reasonably expect
would cause harm.
This exclusion applies whether or not an
insured intended or expected the results of
- 15 -
*Bog
act so long as the resulting injury or damage
was a natural consequence of the act.
Mental disease, defect or other disorder of the
insured, or the insureds being under the
influence of drugs or alcohol shall not bar
application of this cxcinsion. The intention or
reasonable expectation to cause i,adily injury
shall be determined as though any such
condition of the insured did not exist.
F. HOW WE WILL SETTLE A CLAIM (PART 4)
1. Stacking Of Uninsured Motorists Coverage
Limits
If you have selected this opiion (your Declarations
will indicate stacking applies) then stacking of
coverage under this Part applies to you and a
resident relative insured under this Part. This
means that you or a resident relative can add or
stack the Uninsured Motorists Coverage limits of
other cars insured for this coverage by us upon the
Uninsured Motorists Coverage limits of the car
involved in the accident or loss.
Non-Stacking Of Coverage Limits in the General
Provisions section does not apply.
2. Non-Stacking Of Uninsured Motorists Coverage
Limits
if you have selected this option (your Declarations
will indicate non-stacking applies) then the Non-
Stacking of Coverage Limits provision under this
policy's General Provisions is replaced by the
following. In addition, the Limit of Liability under
Part 4, How We Will Settle A Claim (Part 4) applies
to you and any other person insured under this
Part. This means that if you or any other person
insured under this policy is in an accident:
a) In a car that is insured by this policy - We will
not pay more than the limit of liability for the
particular car involved in the accident.
b) In a car that is not owned by you or a
resident relative or while a pedestrian - You are
entitled to the highest limit of Uninsured
Motorists Coverage available on any one car as
to which you are a named insured or an insured
resident relative. If you choose the coverage
available to you as an insured under this policy
Part, then we will pay those damages that are
excess over amounts payable on the car you
occupy at the time of the accident. If you choose
the coverage available to you as an insured
under another policy, then we will not pay for
damages under this policy Part.
This limit of coverage applies regardless of the
number of policies, insureds, insured cars,
claims made, or cars involved in the accident or
loss. Coverages on other cars insured by us
cannot be added to or stacked on the coverage
of the particular car involved.
3. Limit Of Liability-Bodily Injury: Each Person
The limit stated under Uninsured Motorists - Bodily
Injury - Each Person on your Declarations is the
maximum we will pay for all damages arising out
of bodily injury to one. person as a result of any
one accident. Included in Uninsured Motorists -
Bodily Injury - Each Person, but not as a separate
claim or claims. are aii damages sustained by oth
persons, for example, loss of services, loss of
support, loss of consortium, wrongful death, gne
sorrow and emotional distress.
4. Limit Of Liability-Bodily Injury: Each Accident
-he Irr„t stated under Uninsured Motorists- Bod
!niury - each Accident en your Declarations is the
maximum we will pay for ail damages, subject tc
the Limit Of Liability - Uninsured Motorists - Bodi
Injury - Each Person limit.
Any Medical Payments determined to be payable
under this Part are subject to a maximum payme
for the service provided as established by the
Pennsylvania Motor Vehicle Financial
Responsibility Law.
If a prevailing medical fee, charge or payment he
not been calculated under the Medicare Program
for a treatment, accommodation, product or
service, the amount of our payment will not exce
80% of the medical provider's usual and custom<
charge. Payment for acute care in an accredited
acute care facility or burn foundation will not
exceed the usual and customary charge.
If the peer review program, established by the
Pennsylvania Motor Vehicle Financial
Responsibility Law is utilized, an insured covere
under this Part may request reconsideration of ti
peer review initial determination of the disputed
medical necessity of treatment or services. A
request for reconsideration must be made withir
30 days of the initial determination.
5. Arbitration
If we and an insured do not agree:
a) whether that person is legally entitled to
recover damages resulting from the negligen
of the owner or operator of an uninsured ma
vehicle; or
b) as to the amount of compensatory damag
Either party may make a written demand for
arbitration. In this event, each party will sale(
an arbitrator from the county where the insui
lives. The two arbitrators will select a third
arbitrator from the same county. If they cann
agree within 30 days, either parry may reque.
selection from a judge of a common pleas cc
having jurisdiction where the insured claimir
coverage lives; or by a judge in the Federal
District Court whose jurisdiction includes the
county where the insured claiming coverage
lives.
Each party will:
a) pay the expenses it incurs; and
b) bear the expenses of the third party
equally.
Arbitration will be conducted in the county
where the insured lives. Local rules of
procedure and evidence will apply to the eni
Arbitration process.
We will not arbitrate questions of coverage
law as whether a person making a claim is
covered under the policy, or is excluded unc
the policy. All disputes affecting the scope o
coverage, the amount of coverage, a person
- 16 -
right or eligibility to make a claim, or the
insured's selection of coverage, will be
determined by the court in the county where the
insured lives at the time the demand for
arbitration is made; or a Federal District Court
whose iurisdiction includes the county where
the insured lives.
Following the entry of an arbitration award,
either party may file a petition to vacate or
modify the award in the court in the county
where the arbitration was conducted. The court
may only modify or correct the award where:
a) the arbitrators addressed and resolved
issues not within the scope of their authority
under this policy;
b) the arbitrators were biased in the conduct
of the hearing and the entry of any award;
c) either party was denied appropriate due
process rights to a full and fair hearing;
d) the arbitrators committed an error of law
such that had it been a verdict of a jury the
_ court would have entered a different or other
judgment notwithstanding the verdict.
Arbitration will be conducted in accordance
with the Provisions of the Pennsylvania
Uniform Arbitration Act and the
Pennsylvania Arbitration Act of 1927.
6. Judgment
We will not be bound by any judgment or
agreement against any person or organization
which was obtained without our written consent.
Payments Reduced
Payments for damages for bodily injury will be
reduced by any amounts paid or payable:
a) by persons or organizations who may be
legally responsible; or
b) under any other part of this policy; or
c) by other sources such as workers
compensation, disability or similar laws.
We will pay the difference between the sum of
these amounts and the amount of the loss up to
our Limit Of Liability subject to the Each Person,
Each Accident limits.
2. Other insurance - Your Car
If there is other insurance which covers a loss
under this Part, we will pay our share of the los
Our share is the proportion our limit bears to th
total of all applicable limits. But we will not pay
a loss involving anyore using a newly acquired
(additional or repiace!neni! car it you have anot
insurance policv that covers it.
9. Other Insurance - Non-Owned Car (Includes i
Substitute Car)
In the case of a non-owned car covered under t
Part, we will pay those damages that are excess
over amounts payable under any other insurani
up to our Limit Of Liability subject to the Each
Person, Each Accident limits.
Priorities of Policies. We will pay under this par
accordance with the following order of priontie
We will not pay if there is another insurer at a
higher level of priority. The priority order is:
First: The policy covering a motor vehicle
occupied by the inlurea oerson at the time o
the accident.
Second: The pohcv covering a motor vehicle
involved in the acciaent with respect to whit
the injured person is an insured.
If two or more policies have equal priority:
1. The insurer against which the claim is firs
made under the above priorities shall proces
and pay the claim as if wholly responsible. 1
insurer is thereafter entitled to recover
contribution pro-rata f•cm ary other insurer
the benefits paid and the cost of processing
claim.
2. The maximum recovery under all policies
not exceed the amount payable under the pi
with the highest dollar limits of benefits.
For the purposes of determining priorities, an
unoccupied parked motor vehicle is not a motc
vehicle involved in an accident unless it was
parked in a manner as to create an unreasonab
risk of injury.
PART 5 UNDERINSURED MOTORISTS -
IF YOU ARE HIT BY A MOTOR VEHICLE THAT IS UNDERINSURED
A. OUR OBLIGATIONS TO YOU (PART 5)
1. Underinsured Motorists Bodily Injury Coverage
If you have this coverage (see your Declarations),
we will pay up to our Limit Of Liability for bodily
injury as described in How We Will Settle A Claim
(Part 5) when an insured is struck by an
underinsured motor vehicle. Our payment is based
on the amount that an insured is legally entitled to
recover for bodily injury because:
a) The Owner Or Driver Is Underinsured
The owner or driver responsible for the accident
has bodily injury liability insurance or a bodily
injury liability bond with limits that are less than
the full amount the insured is legally entitled to
recover as damages.
We will pay under this coverage only after tl
limits of liability under any bodily injury liat
insurance or any bodily injury liability bond;
applicable to the underinsured motor vehicl
have been exhausted by payment of judgme
or settlements.
B. YOUR OBLIGATIONS TO US (PART 5)
The following provisions apply in addition to any
duties listed in the General Provisions section.
1. Legal Action Against Us
No one insured under this Part may take any le
action against us unless all obligations under tl
policy have been fulfilled.
- 17 -
*809.
C. WHAT CARS ARE COVERED (PART 5)
The following are subiect to the Each Person. Each
Accident Limit Of Liability under How We Will Settle A
Claim Wart 5).
1. Cars Described On Your Declarations
T tiis Part covers cars for .which a premium charge
for this coverage is snow^. on your Oeaarations
2. Replacement Cars
If you acquire ownership of a car to replace a car
covered under this Part, the newly acquired car has
the same coverage as the car being removed from
the policy. You must notify us of the replacement
within 30 days after you acquire ownership of the
car, for coverage to continue after 30 days.
3. Additional Cars
If you acquire ownership of another car in addition
to those described as covered under this Part, this
Part covers the new car for the first 30 days. The
new car has the same coverage as any of your
other cars insured with us. All your other cars must
be insured with us for this Part to cover the
- additional car.
You must let us know within 30 days after you
acquire ownership of the new car that you want it
insured under this Part, for coverage to continue
after 30 days.
4. Substitute Cars
If a car covered under this Part breaks down, is
being serviced or repaired, or is stolen or
destroyed, we will cover a car you temporarily
borrow or rent (with the owner's permission) while
your car is being repaired or replaced. This car
cannot be owned by you. The substitute car has
the same coverage as the car that is out of service.
We will only pay that part of the loss that is excess
over the amount payable under any other
insurance which covers the loss.
5. Other Non-Owned Cars
fn addition to substitute cars, we will cover a non-
owned car. The owner must give permission to use
it. The non-owned car must be used in the way
intended by the owner. This car must not be
furnished or available for the regular use of you or
a household resident. We will cover a rented car
for a total of 30 days. The non-owned car has the
same coverage as any one of your cars insured
with us. We will only pay that part of the loss that
is excess over the amount payable under any other
insurance which covers the loss.
D. WHO IS INSURED (PART 5)
1. In Your Car (Includes A Substitute Car)
You and any persons you give permission to use
this car are insured as long as they use it in the
way you intended when you gave permission.
2. In A Non-Owned Car
You and a resident relative are insured while using
a non-owned car. The owner must give permission
to use it. It must be used in the way intended by
the owner.
3. Hit By A Motor Vehicle
If you are hit by an
while a pedestrian.
relative is hit by an
while a pedestrian,
underinsures motor vehicle
you are insurea. If a resident
underinsured motor vehicle
that resident relative is insur
E. LOSSES WE WILL N'OT PAY FOR (PART 5)
1. Losses Denied. Excluded Or Exhausted Unde(
Other Parts
We will not pay for bodily injury to anyone who
claims a motor vehicle insured under this policy
underinsured because coverage is denied,
excluded or exhausted under another Part of thi
policy.
2. Owned Motor Vehicles
We will not pay for bodily injury caused by any(
using a motor vehicle or trailer not insured and
this Part, owned by you or a household resident
if the liability coverage of that vehicle is used to
pay any portion of an insured's bodily injury
iiability claim.
3. Non-Owned Motor Vehicles
We will not pay for bodily injury caused by any(
using a non-owned motor vehicle or trailer not
insured under this Part that is furnished or mad
available for the regular use by you or a househ
resident.
4. Motor Vehicles For Hire
We will not pay for bodily injury to anyone usin
motor vehicle which is being used to carry peol
or property for a fee. This does not include usin
your covered car in a car pool. But you or a
resident relative are covered if injured in an
accident while a passenger in a non-owned car
being used to carry people or property for a fee
5. Land Vehiaes
We will not pay for bodily injury to anyone hit t
the following land vehicles:
a) motor vehicles owned or operated by self
insurers under any financial responsibility Is
or similar law;
b) motor vehicles owned by a government
agency in the United States of America or in
Canada;
c) land vehicles operated on crawler-treads (
rails;
d) motor vehicles or equipment designed fo
use mainly off public roads (unless the accic
happens on a public road);
e) motorcycles or other motorized vehicles t
are not required to be licensed and registere
(unless the accident happens on a public rot
or
f) motor vehicles or equipment while locate
use as a residence or premises.
6. Racing
We will not pay for bodily injury to anyone whi
using a motor vehicle covered under this Part i
motor vehicle was being used in any organizec
racing, speed, demolition or stunt contest or
related activity.
- 18 -
7. Business And Residence
We will not pay for bodily injury to anyone arising
out of the use of a motor vehicle, trailer, camper
unit, cap or similar type of cover, being usea or
located for use as a place of business or as a place
of residence.
8. Workers Compensation Or Similar Laws
We will not pay for bodily injury to anyone wnen
payment under this Part duplicates benefits
recovered under any worker's compensation iaw,
disability law, or any other similar law. Also, this
coverage shall not apply directly or indirectly to
benefit any insurer or self-insurer under any
workers compensation law, disability law or any
other similar law.
9. Auto Business
We will not pay for bodily injury caused by anyone
using a non-owned motor vehicle in any kind of
auto business. Examples of auto business are:
selling, repairing, servicing, storing or parking
motor vehicles.
10. War
We will not pay for bodily injury caused by any act
of war, warlike act, insurrection, rebellion or
revolution. Also, we will not pay for a loss caused
by discharge of any nuclear weapon, even if
accidental.
11. Nuclear Contamination
We will not pay for bodily injury from or as a
consequence of the following, whether controlled
or uncontrolled or however caused:
a) nuclear reaction;
b) nuclear radiation; or
c) radioactive contamination.
12. Criminal Acts
We will not pay for bodily injury to anyone while
committing or attempting to commit a crime or
avoiding arrest.
13. Intentional Injury
We will not pay for bodily Injury which results from
an act:
a) that is intended by an insured to cause harm;
or
b) that an insured could reasonably expect
would cause harm.
This exclusion applies whether or not an insured
intended or expected the results of their act, so
long as the resulting injury or damage was a
natural consequence of the act.
Mental disease, defect or other disorder of the
insured, or the insureds being under the influence
of drugs or alcohol shall not bar application of this
exclusion. The intention or reasonable expectation
to cause bodily injury or property damage shall be
determined as though any such condition of the
insured did not exist.
F. HOW WE WILL SETTLE A CLAIM (PART 5)
1. Stacking Of Underinsured Motorists Coverac
Limits
If you have selected this option (your Declaratic
will indicate stacking applies) then stacking of
coverage under this Part applies to you and a
resident relative insured under this Part. This
means that you or a resident relative can add c
stack the Underinsured Motorists Coverage lim
of other cars insured for this coverage by us uF
the Underinsured Motorists Coverage limits of
car involved in the accident or loss.
Non-Stacking of Coverage Limits in the Genera
Provisions does not apply.
2. Non-Stacking Of Underinsured Motorists
Coverage Limits
If you have selected this option (your Declaratil
will indicate non-stacking applies) then the Noi
Stacking of Coverage Limits provision under tl'
policy's General Provisions is replaced by the
following. In addition, the Limit of Liability unc
How We Will Settle A Claim (Part 5), applies to
and any other person insured under this Part.
means that if you or any other person insured
under this policy is in an accident:
a) In a car that is insured by this policy - We
not pay more than the limit of liability for it
particular car involved in the accident.
b) In a car that is not owned by you or a
resident relative or while a pedestrian - you
entitled to the highest limit of Underinsurec
Motorists Coverage available on any one ca
to which you are a named insured or an ins
resident relative. If you choose the coverag
available to you as an insured under this pc
Part, then we will pay those damages that a
excess over amounts payable on the car yo
occupy at the time of the accident. If you ch
the coverage available to you as an insured
under another policy, then we will not pay
damages under this policy Part.
This limit of coverage applies regardless of
number of policies, insureds, insured cars,
claims made, or cars involved in the accide
loss. Coverages on other cars insured by ut
cannot be added to or stacked on the cover
of the particular car involved.
3. Limit Of Liability - Bodily Injury: Each Perso
The limit stated under Underinsured Motorist:
Bodily Injury - Each Person on your Declaratio
the maximum we will pay for all damages, les
amounts recovered for all damages, arising oc
bodily injury to one person as a result of any c
accident. Included in Underinsured Motorists
Bodily Injury - Each person, but not as a separ
claim or claims, are all damages sustained by
persons, for example, loss of services, loss of
support, loss of consortium, wrongful death; c
sorrow and emotional distress.
4. Limit Of Liability-Bodily Injury: Each Accide
The limit stated under Underinsured Motorist:
Bodily Injury - Each Accident on your Declarat
is the maximum we will pay for all damages,
subject to the Limit Of Liability - Underinsurec
- 19 -
*80!
Motorists - Bodiiv Injury - Each Person limit, arising
out of bodily injury as a result of any one accident.
Any Medical Payments determined to be payable
under this Part are subject to a maximum payment
for the service provided as established by the
Pennsylvania Motor Vehicle Financial
Responsibility Law.
If a prevailing medical fee, charge or payment has
not been calculated under the Medicare Program
for a treatment, accommodation, product or
service, the amount of our payment will not exceed
80% of the medical provider's usual and customary
charge. Payment for acute care in an accredited
acute care facility or burn foundation will not
exceed the usual and customary charge.
If the peer review program, established by the
Pennsylvania Motor Vehicle Financial
Responsibility Law is utilized, an insured covered
under this Part may request reconsideration of the
peer review initial determination of the disputed
medical necessity of treatment or services. A
_ request for reconsideration must be made within
= 30 days of the initial determination.
5. Arbitration
If we and an insured do not agree:
a) whether that person is legally entitled to
recover damages resulting from the negligence
of the owner or operator of an underinsured
motor vahicle; or
b) as to the amount of compensatory damages.
Either party may make a written demand for
arbitration. In this event, each party will select
an arbitrator from the county where the insured
lives. The two arbitrators will select a third
arbitrator from the same county. If they cannot
agree within 30 days, either party may request
selection from a judge of a common pleas court
having jurisdiction where the insured claiming
coverage lives; or by a judge in the Federal
District Court whose jurisdiction includes the
county where the insured claiming coverage
lives.
Each party will:
a) pay the expenses it incurs; and
b) bear the expenses of the third party
equally.
Arbitration will be conducted in the county
where the insured lives. Local rules of
procedure and evidence will apply to the entire
Arbitration process.
We will not arbitrate questions of coverage or
law as whether a person. making a claim is
covered under the policy, or is excluded under
the policy. All disputes affecting the scope of
coverage, the amount of coverage, a person's
right or eligibility to make a claim, or the
insureds selection of coverage, will be
determined by the court in the county where the
insured fives at the time the demand for
arbitration is made; or a Federal District Court
whose jurisdiction includes the county where
the ins aced fives.
ollowing the entry of an arbitration award,
either party may file a petition to vacate or
modify the award in the court in the county
where the arbitration was conducted. The cc
may only modify or correct the award where
a) the arbitrators addressed and resolved iss
not within the Scott e of ti,eir authority under
policy;
b) the arbitrators were biased in the conduct
the hearing and the entry of any award;
c) either party was denied appropriate due
process rights to a full and fair hearing;
d) the arbitrators committed an error of law
such that had it been a verdict of a jury the c
would have entered a different or other
judgment notwithstanding the verdict.
Arbitration will be conducted in accordance
the Provisions of the Pennsylvania Uniform
Arbitration Act and the Pennsylvania Arbitre
Act of 1927.
6. Judgment
We will not be bound by any judgment or
agreement against any person or organization
which was obtained without our written conse
Payments Reduced
Payments for damages for bodily injury will be
reduced by any amounts paid or payable:
a) by persons or organizations who may be
legally responsible; or
b) under any other part of this policy under
other part of this policy except Medical
Payments "Part 2"; or
c) by other sources such as workers
compensation, disability or similar laws.
We will pay the difference between the sum of
these amounts and the amount of the loss up
our Limit Of Liability subject to the Each Persc
Each Accident limit.
8. Other Insurance - Your Car
If there is other insurance which covers a loss
under this Part, we will pay our share of the Ic
Our share is the proportion our limit bears to
total of all applicable limits. But we will not pt
a loss involving anyone using a newly acquire
(additional or replacement) car if you have ant
insurance policy that covers it.
9. Other Insurance - Non-Owned Car (Include:
Substitute Carl
In the case of a non-owned car covered under
Part, we will pay those damages that are exce
over amounts payable under any other insura
up to our Each Person, Each Accident Limit O
Liability under How We Will Settle A Claim.
Priorities of Policies. We will pay under this p.
accordance with the following order of priorit
We will not pay if there is another insurer at a
higher level of priority. The priority order is:
First: The policy covering a motor vehicle
occupied by the injured person at the time
the accident.
- 20 -
Secona: The policy covering a motor vehicle not
involved in the occident with respect to which
the injured person is an insured.
If two or more policies have equal priority:
a) The insurer against which the claim is first
made under the ;?oove priorities snail process
and pay the eiairn as if wholly responsible. The
insurer is thereafter entitled to recover
contribution pro-rata from any other insurer for
PART 6 - FIRST PARTY BENEFITS
If you have paid for this coverage (see your
Declarations), we will pay first party benefits for
medical expenses and if purchased for:
a. income loss, and
b. funeral expenses
for bodily injury to an eligible person resulting from
the maintenance or use of a motor vehicle as a
vehicle.
-7::Also, the Company will pay death benefits arising
from bodily injury to the named insured or resident
relative resulting from the maintenance or use of a
motor vehicle as a vehicle.
Only the benefits shown as applicable by dollar
amount on your Declarations apply.
In accordance with the Pennsylvania Motor Vehicle
Financial Responsibility Law, eligible Medical
Expenses which result from a car accident covered
under this Part will he paid up to our Limit Of Liability
for this coverage subject to a maximum of the current
available and prevailing charge for the service
provided as established by the Pennsylvania Motor
Vehicle Financial Responsibility Law.
If a prevailing Medical fee, charge or payment has not
been calculated under the Medicare Program for a
treatment, accommodation, product or service, the
amount of our payment will not exceed 80% of the
Medical provider's usual and customary charges for
the service in the provider's geographical region.
Payment for acute care if any accredited acute care
facility or bum foundation will not exceed the usual
and customary charge.
If the peer review program, established by the
Pennsylvania Motor Vehicle Financial Responsibility
Law, is utilized, an insured covered under this Part
may request reconsideration of the peer review initial
determination of the disputed medical necessity of
treatment orservices, within 30 days of such
determination,
DEFINITIONS
The following definitions apply only under Parts 6 and
7 of this Policy.
"Death benefits" means a benefit paid because of the
death of the named insured or resident relative as a
result of injury sustained in a motor vehicle accident if
death occurs within 24 months from the date of
accident. The death benefits shall be paid to the
administrator or executor of the insured's estate.
"Eligible person" means:
(a) the named insured or any resident relative; and
-ne benefits paid and the cost of processing t
:aim.
n; The maximum recovery under all policies
-,ot exceed the amount payable under the po
with the highest dollar limits of benefits.
%r the purposes of determining priorities ar
unoccupied parked motor vehicle is not a motor
vehicle invoived in an accident unless it was
parked in a manner as to create an unreasonabei
risk of injury.
(b) any other person who sustains bodily injury
;1) while occupying the insured motor vehicl
or
(2) while a non-occupant of a motor vehicle,
injured as a result of an accident in
Pennsylvania involving the insured motor
vehicle. An unoccupied insured motor vehicl
not a motor vehicle involved in an accident
unless it was parked in a manner as to cause
unreasonable risk of injury.
"Funeral expenses" means reasonable exoenses
incurred directly related to funeral, burial, crematic
or other disposition of the remains of the decease(
eligible person. The expenses must be incurred as
result of the death of the eligible person and withi
months from the date of accident.
"Income loss" means eighty (80) percent of gross
income actually lost by an eligible person. Income
loss includes reasonable expenses actually ineisrre
for hiring:
(a) a substitute to perform the work a self-
employed eligible person would have perform(
except for the bodily injury; or
(b) special help, thereby enabling a person to v
thereby reducing loss of gross income.
"Income loss" does not include:
(a) loss of expected income for any period
following the death of an eligible person; or
(b) expenses incurred for services performe
following the death of an eligible person; or
(c) any loss of income during the first five
working days the eligible person did not we
after the accident because of the bodily inju
"insured motor vehicle" means a motor vehicle:
(a) to which the bodily injury liability insurance
the policy applies; and
(b) by which the named insured maintains first
party benefits coverage as required under
Pennsylvania Motor Vehicle Financial
Responsibility Law.
"Medical expenses" means reasonable and neces.
charges for:
(a) medical treatment, including but not limite
(1) medical, hospital, surgical, nursing and
dental services;
(2) medications, medical supplies and pros
devices; and
(3) ambulance.
- 21 -
*80!
b) medical and rehabilitative services. including
but not limited to:
(1) medical care;
(2) licensed physical therapy, vocational
rehabilitation and occupational therapy;
3) osteopathic, chiropractic, psy-i ie'ric: ,nd
psychological services; and
(4) optometric services, speech pathology and
audiology.
(c) non-medical remedial care and treatment
rendered in accordance with a recognized religious
or licensed method of healing.
All medical treatment and medical and rehabilitative
services must be provided by or prescribed by a
person or facility approved by the Department of
Health, the equivalent governmental agency
responsible for health programs or the accrediting
designee of a department or agency of the state in
which those services are provided.
Payment of medical expenses after 18 months from
the date of accident causing bodily injury shall be
made only if it was ascertainable with reasonable
medical probability within 18 months from the date of
accident that further expenses would be incurred as a
result of the bodily injury.
EXCLUSIONS
This coverage does not apply to bodily injury to:
Persons Who Don't Have Their Own Cars Insured.
(a) any person who is the owner of a currently
registered motor vehicle for which financial
responsibility has not been provided, even if that
person is occupying or struck by a motor vehicle
by which financial responsibility is provided;
Repair, Servicing, Etc.
(b) any person resulting from the conduct of the
business of repairing, servicing, or otherwise
maintaining motor vehicles if the bodily injury
arises out of that business unless the conduct
occurs off the business premises;
Loading and Unloading.
(c) sustained by any person as a direct result of
loading or unloading a motor vehicle;
Motorcycles.
(d) any person while occupying a motorcycle,
motor-driven cycle, motorized pedacycle or like
type vehicle required to be registered under Title
75, or a recreational vehicle not intended for
highway use;
Non-Authorized Users.
(e) any person other than the named insured or any
relative, while maintaining or using a motor
vehicle without reasonable belief that he is legally
entitled to do so;
Non-Occupants in Other States.
(f) any person not occupying a motor vehicle other
than the named insured or any relative, if the
accident occurs outside the Commonwealth of
Pennsylvania;
Parked Camper Vehicles. Etc.
(g) any person while maintaining or using a mot
vehicle while locatea for use as a residence or
premises;
War, Riot, Etc.
(h) anv person due to war, wheih?r or riot decia
civil war, msurrection, revolution or rebellion or
any accompanying acts of conditions;
Nuclear Accidents.
(i) any person causea by nuclear radioactivity of
explosion;
Intentional Injury.
(j) any person who intentionally injures or atten
to intentionally injure himself or another; and
Felony or Eluding Arrest.
(k) any person who injures himself or another
while committing a felony or eluding lawful
apprehension or arrest by a law enforcement
official,
Policy Period/Territory
This coverage applies only to accidents which occ
during the policy penoo and within the United Sta
of America, its territories and possessions or Cana
Limits of Liability
The limits of liability apply regardless of the numb
of persons insured, policies or plans of self-insura
applicable, claims made, insured motor vehicles e
motor vehicles involved in the accident. The
Company's maximum limits of liability for medica
expenses, income loss, funeral expenses and deal
benefits with respect to bodily injury to any one
eligible person in any one motor vehicle accident
shown on your Declarations.
Any amount payable by the Company under first 1
benefits shall be excess overall benefits an eligibl
person receives or is entitled to receive under any
workers compensation law or similar laws.
Conditions
A. Action Against Company. No action shall lie
against the Company on the part of any eligible
person unless such person has fully complied wit
the terms of this coverage.
B. Notice. If an accident occurs, written notice
adequately identifying the eligible person and
reasonably accessible facts concerning the time, i
and circumstances of the accident shall be given ;
soon as practicable by or on behalf of each eligibl
person to the Company or any of its authorized
agents.
C. Medical Reports,- Proof of Claim. As soon as
practicable the eligible person, or someone on hi,
behalf, shall give the Company written proof of cl
under oath if required, fully describing the nature
extent of bodily injury, treatment and rehabilitatic
received and contemplated and other informatior
assist the Company in determining the amount d
and payable.
Proof of claim shall be made upon forms furnishi
the Company unless the Company fails to supply
forms within 15 days after receiving notice of clai
-22^
The eligible person shall submit to mental and
physical examinations by physicians selected by the
Company when and as often as the Company may
reasonably require. The Company will pay the costs of
such examinations.
The eligible perse : tor, :it the event of such person's
incapacity or death, his legal representatives ;nal::f
the Company requests, sign papers to enable the
Company to obtain medical reports and copies of
records. A copy of such medical report will be
forwarded to such eligible person upon his written
request.
If benefits for income loss are claimed, the eligible
person presenting such claim shall authorize the
Company to obtain details of all earnings paid to him
by an employer or earned by him since the time of the
injury or during the year immediately preceding the
date of the accident.
D. Priorities of Policies We will pay first party, benefits
in accordance with the following order of priorities.
We will not pay if there is another insurer at a higher
-level of priority. The priority order is:
= First: The insurer providing benefits to the eligible
person as a named insured.
Second: The insurer providing benefits to the
eligible person as a relative who is not a named
insured under another policy providing coverage
under the Pennsylvania Motor Vehicle Financial
Responsibility Law.
Third: The insurer of the motor vehicle which the
eligible person is occupying at the time of the
accident.
Fourth: The insurer providing benefits on any
motor vehicle involved in the accident if the
eligible person:
(a) is not occupying a motor vehicle, and
(b) is not provided coverage under any other
policy.
If two or more policies have equal priority
PART 7 • ADDED FIRST PARTY BENEFITS
If you have paid for this coverage (see your
Declarations) we agree that amounts payable for
bodily injury to an eligible person under the "Limits of
Liability" provision of the Pennsylvania First Party
Benefits Coverage endorsement is changed as stated
below.
The Company's maximum limits of liability for
medical expenses, income loss, funeral expenses and
death benefits with respect to bodily injury to any one
eligible person in any one motor vehicle accident
shall not exceed the lessor of:
(a) $177,500 in the aggregate; or
(b) benefits payable for expenses incurred up to
three years from the accident.
These limits of liability are subject to specified limits
for death benefits as follows:
(a) The maximum amount payable for death
benefits shall not exceed $25,000.
These limits of liability apply regardless of the
number of persons insured, policies or plans of self
1. The insurer against which the claim is first
made shall process and pay the claim as if
wholly responsible.
2. The maximum recovery under all policieswi
nofexceed the amount payable under the polio
with the highest dollar limits of benefits.
For the purpose of determining priorities, an
unoccupied parkea motor vehicle is not a mot
vehicle. involved in an accident unless it was
parked in a manner as to create an
unreasonable risk of injury.
E. Indemnity. The Company has the right of indemni
against any person who:
1. has converted a motor vehicle;
2. committed a felony;
3. eluded lawful apprehension or arrest by a law
enforcement official; or
4. intentionally injured himself or another person
This right of indemnity is for first party benefits
paid for:
1. the loss caused by the conduct of that persc
2. the cost of processing the claims for such
benefits; and
3. the cost of enforcing this right of indemnity
(including reasonable attorney's fees).
F. Non-Duplication of Benefits- Other Insurance. No
eligible person shall recover duplicate benefits for tl
same elements of loss under this or any similar
automobile insurance including self-insurance.
G. Customary Charges for rreatment The amounts
will pay to a person or institution providing treatme
accommodations, products or services to an eligible
person for an injury covered by medical expense
benefits shall not exceed the amount the person or
institution customarily charges for like treatment,
accommodations, products and services in cases
involving no insurance.
insurance applicable, claims made, insured motor
vehicles or motor vehicles involved in the accident.
In accordance with the Pennsylvania Motor Vehicle
Financial Responsibility Law, eligible medical
expenses which result from a car accident covered
under this Part will be paid up to our Limit of Liabil
for this coverage subject to a maximum of the curr
allowable and prevailing charge for the service
provided as established by the Pennsylvania Motoi
Vehicle Financial Responsibility Law.
If a prevailing Medical fee, charge or payment has
been calculated under the Medicare Program for a
treatment, accommodation, product or service, the
amount of our payment will not exceed 80% of the
Medical provider's usual and customary charges fc
the service in the provider's geographical region.
Payment for acute care in any accredited acute can
facility or burn foundation will not exceed the usue
and customary charge.
If the peer review program, established by the
Pennsylvania Motor Vehicle Financial Responsibili
-23-
*809-
Law, is utilized, an insured covered under this Part Fourth: The insurer providing benefits on any
may request rec nsideration of the peer review initial motor vehicle involved in the accident if the
determination of the disputed medical necessity of eligible person:
treatment or services, within 30 days of such (a) is not occupying a motor vehicle, and
determination.. (b) is not provided coverage under any oth(
D. Priarifi s orFo/ices We will pay first party benefits policy.
in accordance with the fr llovwing order of priorities.
We wui nut pay if there is another insurer at a higher if two or more policies have equai orionw:
level of priority. The priority order is: The insurer against which the claim is fir
gam
First: The insurer providing benefits to the eligible made shall process and pay the claim as if
wholly responsible,
person as a named insured. 2. The maximum recovery under all policie,
Second: The insurer providing benefits to the not exceed the amount payable under the l:
eligible person as a relative who is not a named with the highest dollar limits of benefits.
insured under another policy providing coverage For the purpose of determining priorities
an
under the Pennsylvania Motor Vehicle Financial
Responsibility Law. ,
unoccupied parked motor vehicle is not a motor
vehicle involved in an accident unless it was parts
Third: The insurer of the motor vehicle which the a manner as to create an unreasonable risk of inj
eligible person is occupying at the time of the
accident.
- 24 -
PAC 226 PA Ed. 11101
Pennsylvania Special Stete Provisions
the following changes apply to your policy, PAC 186 PA Ed. 11100.
PART 4 - VNINSURFD F.10TORISTS 4. LOSSES WE WILL NOT PAY FOR - t ;c following it;:als -ir
revised:
(Page 21)
2. Owned Motor Vehicles
We will not pay for bodily injury sustained while using or occupying a motor vehicle or trailer nc
insured under this Part, owned by you or a household resident.
3. Non-Owned Motor Vehicles
We will not pay for bodily injury sustained while using or occupying a non-owned motor vehicle
or trailer not insured under this Part, that is furnished or made available for regular use by you
or a household resident.
5. Land Vehicles
We will not pay for bodily injury if hit by the following land vehicles:
a) motor vehicles owned or operated by self-insurers under any financial responsibility law c
similar law;
b) motor vehicles owned by a government agency in the United States of America or in
Canada;
c) land vehicles operated on crawler-treads or rails;
di motor vehicles or equipment designed for use mainly off public roads (unless the acciden
happens on a public road);
e) motorcycles or other motorized vehicles that are not required to be licensed and registers
(unless the accident happen; on a public road);
0 motor vehicles or equipment while used as a residence or premises, or to service a
residence
premises.
6. Racing
We will not pay for bodily injury sustained while using or occupying a motor vehicle covered
under this Part if the motor vehicle was being used in any organized racing, speed, demolition
or stunt contest or related activity.
9. Auto Business
We will not pay for bodily injury sustained while using a non-owned motor vehicle in any kind
auto business. Examples of auto business are: selling, repairing, servicing, storing or parking
motor vehicles.
(PAGE 22)
12. Criminal Acts
We will not pay for bodily injury sustained while committing or attempting to commit a felon
or avoiding arrest.
PART 5- UNDERINSURED MOTORISTS- 5. E. LOSSES WE WILL NOT PAY FOR- the following items
are revised:
(Page 26)
2. Owned Motor Vehicles
We will not pay for bodily injury sustained while using or occupying a motor vehicle or trailer
insured under this Part, owned by you or a household resident, or if the liability coverage of
that vehicle is used to pay any portion of an insured's bodily injury liability claim.
- 35 - *Bog-
3. Non-Owned Motor Vehicles
We will not pay for bodily injury sustained while using or occupying a non-owned motor vehicle
or trailer not insured under this Part, that is furnished or made available for regular use by yon
or a household resident.
5. Land! Vehicles
We :vlil not pay for oodily injury if hit by the following land vehicles:
a) motor vehicles owned or operated by self-insurers under any financial responsibility law c
similar law;
b) motor vehicles owned by a government agency in the United States of America or in
Canada;
c) land vehicles operated on crawler-treads or rails;
d) motor vehicles or equipment designed for use mainly off public roads (unless the accident
happens on a public road);
e) motorcycles or other motorized vehicles that are not required to be licensed and registerei
(unless the accident happens on a public road);
f) motor vehicles or equipment while used as a residence or premises, or to service a
residence premises.
_ 6. Racing
We will not pay for bodily injury sustained while using or occupying a motor vehicle covered
under this Part if the motor vehicle was being used in any organized racing, speed, demolition
or stunt contest or related activity.
9. Auto Business
We will not pay for bodily injury sustained while using a non-owned motor vehicle in any kind o
auto business. Examples of auto business are: selling, repairing, servicing, storing or parking
motor vehicles.
(Page 27)
12. Criminal Acts
We will not pay for bodily injury sustained while committing or attempting to commit a felony
or avoiding arrest.
PAC 204 (Ed. 4186)
Non-Owned Motor Home And Truck/Van Campers Coverage
If you have paid for this coverage (see the Declarations), the non-owned vehicle shown on the Dec-
larations that comes with this endorsement has the coverages shown on the Declarations.
All provisions and exclusions of your policy apply for the period shown on the Declarations except
as follows.
Throughout the policy when reference is made to a car, it is specifically limited to the vehicle
shown on the Declarations.
- 36 -
03/05/2004 07:56
Prudential
Financial
P. O. Box 429
Hinsdale, rL 60522
Client Services
1-900.437-5556
Claims
1.800.437-3535
Named Insured
and P.O. Address
PSP TROOP H HHG,PR.17112 4 92452165
Prudential General
Insurance Company
Roger L. Desjadon
President
II???d??a9YY'' NO..190 P02
1IIm19 MIN11111IIIpI1
Policy Number: 28 BA121714
Agency Data: 690160 3 W SH 010
Calhoun Barry E b Tammy
2011 Back Rd
Halifax, PA 17032-9691
December 10, 2003
Dear Policyholder:
On behalf of Prudential, I. want to thank you for giving us the opportunity to provide
your Car insurance.
By insuring with us, you have purchased more than protection and security. You've
also gained access to a strong team of Prudential professionals dedicated to
providing you with world class service. We hope you've been pleased with our service,
and we look forward to continuing our relationship.
Your renewal package is enclosed and contains:
Your renewal Declarations Page
A Payment Notice
Your insurance Identification Card(s)
A Privacy Policy
Please refer to the back of this page for other important policy information and any
coverage changes which may have occurred since your last :olicy period. We've also
included Information about certain discounts available in your area. Remember, your
representative is always available to discuss additional discount3 and savings
opportunities.
Prudential is committed to providing you with financial solutions for a lifetime o?
needs. If you require additional advice or information on policy discounts, please
contact your representative.
We appreciate the trust you have placed in Prudential, and look forward to serving
your insurance needs.
Sincerely,
President and CEO
3000000 MAO PAGE 01
288A121i'?
03/05!2004 07:56 PSP TROOP H HBG,PR.17112 4 92452165
NO. 190
Providing you with excellent service and a policy that works for you is very
important to us. Please take some time to review the following information and
materials enclosed in your renewal package. Please keep this package in a safe,
accessible place for easy future reference.
COVERAGE CHANGES and/or ADDITIONAL POLICY INFORMATION
Please note that your policy's premium has been calculated based on a variety of
factors and may include payment history, years of driving experience, credit history.
incidents not subject to the Safe Driver Insurance Plan (such as non-surchargeable
incidents) and Comprehensive losses (excluding glass and towing losses).
The laws of the Commonwealth of Pennsylvania, as enacted by the General Assembly,
give you the right to choose either of the following two tort options:
A. "Limited Tort" Option - This form of insurance limits your right
and the rights of other 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. "Full Tort" Option - This form of insurance allows you to maintain
an unrestricted right for yourself and other 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 ccmpansietlan for
pain and suffering or other nonmonetary damages as a result of
injuries caused by other drivers.
Also, the laws of the Commonwealth of Pennsylvania only require that you purchase
liability and first party medical benefit coverages. Any additional coverage or
coverages in excess of the limits required by law are provided only at your request
as enhancements to the basic coverages. The minimum coverages are:
- Bodily Injury
Each Person $15,000
Each Accident $30,000
- Property Damage $ 5,000
- First Party
Medical Benefits $ 5.000
If you choose these minimum coverages and the "Limited Tort" option, your premium fe
your upcoming renewal term will be $135. If you choose the minimum coverages and thi
"Full Tort" option, your premium will be $162. These premiums reflect any changes
that will become effective with this renewal. Your current tort option is shown in
70^0000 MAO PAGE 02 288A121?1z
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111111I111111ANI NIN1111
the Important Messages section on the reverse side of the Declarations page.
We'd like to be sure that you take advantage of discounts we offer when policyholders
maintain other policies with use.
If either you or a member of your immediate family, who reside in your household,
owns an individual life insurance or annuity policy issued by Prudential, you may
also qualify for our Companion Product Discount - Life/Annuity. We regret that group
life insurance policies provided by your place of employment or an association do not
qualify.
Please take a few minutes to review the enclosed Declarations Page under the heading
"Discounts, Credits, and Additional Charges Applied to your Premium" for an important
message about these discounts. If you feel you qualify for either or both and they
are not mentioned on your Declarations page, please contact a Customer Service
Specialist.
If you are planning a trip to Canada and will be driving while in Canada, please note
that Canadian law requires you to carry a Canada Non-Resident Inter-Province Motor
Vehicle Liability Insurance Card as proof of insurance. We'll be happy to provide
this card to you upon your request. Simply contact us at the toll-free number shown
on your Declarations Page, and a Service Specialist will assist you.
Please note, the company must receive your premium payment in our office by the due
date on each payment notice for coverage to continue. If your check, electronic
remittance, or monthly Pru-Matic withdrawal is not received in our office by the due
date, or is returned by the bank for insufficient funds, your policy will terminate
due to non-payment of premium.
IF YOU HAVE QUESTIONS, NEED ADDITIONAL SERVICE, OR NEED TO REPORT A CLAIM
For policy changes or billing questions, our Service Specialists are available to
assist you at the Customer Service number shown at the too of tnia latter.
If you need to report a claim, please call (800) 437-3535• Since accident; can happer
at any time, we are available 24 hours a day, seven days a week.
To access our Telecommunications Device for the Deaf (TOO), speech and hearing
impaired customers with TOO terminals may call 1-800-552-0994 for policy service anc
1-800-327-0196 to report a claim.
0000000 RA0
?_, PAfiE 03 288A12171-`
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03/65,/2004 07:56 PSP TROOP H HBa,PR.17112 -? 92452165
ME7.190 DE
Prudential '1'111 111111 101 111
Financial
prudential General Insurance Company
PAGE Iof4
Your Car Policy Renewal Declarations
Cars Covered By Your Policy
Car Year & Make Model Body Type Identification Number
1" 2000GMC Sonoma Pickup 1GTDT19W7Y8130070
2 2002 Honda Ace Ex(SE Sedan 4D IHGCG66832A101671
The car(s) described above are principally kept (garaged) at the above address unless otherwise stated in
Important Messages.
Licensed Operatoe(s) Resident in Your Household
Now Surcharge Points Date of Birth
I Calhoun Barry E 00 11118/68
2 Calhoun Tammy 00 10113n0
PO Box 429
Hinsdale b 60522
Calhoun Barry E & Tammy
2011 Back Rd
Halifax PA 17032-9691
Named Insured: Calhoun Barry E & Tammy
Policy Number: 28 BA121714
Policy Period: Jan. 12, 2004 to Jul. 12, 2004
12:01 am, at place of garaging
Customer Service Office: (800) 437-5556
To report a claim, please call: (800) 437-3535
Your local Prudential office: (717) 975-8150
R. FARA13AUGH CLU CHFC LUTCF CMFC MSFS CLI
If any licensed driver in household is not listed, please call the Customer Service Office provided above.
k
??? n? R1? l10Y
03/05/004 07:56 PSP TROOP H HBG,PR.17112 4 92452165
NO. 190 Doi
PAGE 2of4
Policy Number: 28 BA121714
Discounts, Credits, And Surcharges Applied To Your Premium
Discounts & Credits
Anti-Theft Device Discount
Deluxe Package Discount
Multi-Car Discount
Safety Device Discount
We appreciate your Prudential Companion Home, Life,
and/or Annuity business- Our maximum Companion Product
Discount has been applied to this policy
Important Message(s) That Apply To Your Policy
First Party Benefits includes:
Medical Expenses S 5,000
First Party Benefits provided without Funeral Benefits
Applies to
Car(s) 1, 2
Your policy
Your policy
Car(s) 1, 2
Your policy
IF THIS POLICY PROVIDES COLLISION COVERAGE FOR ANY VEHICLE, THAT COLLISION
COVERAGE ALSO EXTENDS TO VEHICLES RENTED, UP TO A MAXIMUM OF 30 DAYS.
Full Tort applies to all cars listed on the Policy-
IMPORTANT: Your policy premium may have changed due to rating by
make and model of your car. Please check the vehicle description shown.
Your policy is free of any acciderrt, conviction or inexperienced driver surcharge.
Stacking of Uninsured Mownsts coverage, described in Part 4(Umusured
Motorists) of your policy, applies to all cars listed an the policy.
Stacking of Underiusured Motorists coverage, described in Part 5(Under nsured
Motorists) of your policy, applies to all cars listed on the policy.
P
PAC 681 ED. 1198
03/05!2004 07:56
Prudential
Financial
PSP TROOP H HBG,PR.17112 4 92452165 N6.190
I N IllYf 1191111111111'p lit 11111
PAGE 3 of 4
Policy Number: 28 SA121714
Listed below and within "Important Messages" are your policy coverages, limits, and premiums. If a premium
charge does not appear, that coverage is not provided.
Your Coverage And Limits
Premiums
d' .asp Limits Car 1 Car 2
93/05/2004 07:56
Q,W Prudential
Financial
PSP TROOP H HBG,PR.17112 i 92452165
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IHIII1111N111011111111111II III
PAGE 3 of 4
Policy Number: 28 SA121714
Listed below and within "Important Messages" are your policy coverages, limits, and premiums. If a premium
charge does not appear, that coverage is not provided.
Your Coverage And Limits
Coverage Limits
Liability - Bodily Injury
Each Person $100,000
Each Accident $300,000
Liability - Property Damage
Each Accident $25,000
Uninsured Motorists -
Bodily Nary
Each Person $100,000
Each Accident $300,000
Underinsured Motorists -
Bodily Injury
Each Person $100,000
Each Accident $300,000
First Party Benefits
Collision
Deductible -Car 1 $ 500
Deductible -Car 2 $ 500
Comprehensive (G=FR Wnshld Glass Cov)
Deductible -Car I $ 50-G
Deductible - Car 2 $ 100-G
Towing - Each Occurrence $50
Total Premium Per Car
Premiums
Car 1 Car 2
$ 49 $ 44
S 31 $ 27
$ 13 $ 18
S 17 $ 24
$ 12 -$ 11
S 64
$ 83
$ 42
5 ?3
S 2
$ 230
TOTAL POLICY PREMIUM'
$ 247
$477
Premium amount includes applicable discounts, credits, and surcharge!
PAC i81 ED. 1198
low
O3/05/.2004 07:56 PSP TROOP H HEG,PR.17112 4 92452165
N0. 190
PAGE 4 of
Policy Number: 28 8AI21714
Your Policy Forms & Endorsements
Your policy is made up of your most recent Declarations and the forms and endorsements listed below. Forms
and endorsements being made part of your policy with this transaction are provided in separate booklets or are
indexed and reproduced on pages which follow:
Mandatory Policy Forms and Endorsements
Pennsylvania Car Policy Parts 1,3,4,3,6 and 7
Pennsylvania Special State Provisions
Optional Endorsements
None
Lienholder/Loss Payee Information
Car
1 Pennsylvania St Ecu PO Box 67013 Harrisburg PA
2 Psecu PO Box 67013 Harrisburg PA
PAC 186/PAEd. 11/00
PAC 226 PA Ed. 11/01
rrerritory Rating Class
Symbol Code
098 H 811320
098 F 811120
PAC 681 511. 1/98
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IIINII 1k,1 11I 111 N1011111
ACCIDENT SURCHARGE FORGIVENESS PROGRAM
Dear Policyholder
We value our loyal customers and their good driving experience. To express our appreciation, we are offering an
Accident Surcharge Forgiveness program.
If you are involved in an accident that results in a policy surcharge, the surcharge for the first surchargeable
accident will be waived if:
You have been continuously insured through a Prudential Car Policy, excluding Residual Market Plans (e.g.,
Assigned Risk Plans), for five years prior to the date of this accident; and
There are no other surchargeable accidents with a date of loss within that five year period.
You should be aware that, although the surcharge for the first surchargeable accident may be waived, in many
states, the accident may affect your eligibility for other discounts.
We will be glad to provide you with details on this program. Please contact us at the Customer Service number
shown on your Policy Declarations page.
PAC 4007 Ed. 6071N5
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PAC 9 PA (Ed. 4/03)
Car Rating Information Form (PRUGEN)
The premium you pay for your automobile ipsurance depends upon many factors. Many of these factors are
reflected in the six digit Class Code that is assigned to each vehicle on your policy. (The Class Code for each
vehicle is shown on the last page of your policy Declarations.)
This form provides a brief explanation of the Class Codes and other considerations that play a role in
determining your policy premium.
Rate Class Code Explanation (Sample Code is 854610)
The first digit (the 8 above) of the Rate Class is always 7 or 8. It shows the number of miles your car is driven in
a year.
Number 7 meane: Your car is driven under 7500 miles a year. Number 8 means: Your car is driven 7500 or more
miles a year.
2nd digit Ithe 5 above) Driver Class
No Youthful Driver
1 All other
2 Principal Senior Driver Age 65-74
4 Principal Driver Age 55-59
5 Principal Driver Age 60-64
7 Principal Driver Age 75 or over
8 Principal Driver Age 50-64 without
youthful driver
Youthful Driver
4&7 Unmarried Driver not owner or principal
driver
5&8 Unmarried Driver owner or principal driver
0&6 Married Driver
3rd digit (the 4 above) Driver Class
1 No Youthful: Driver
Youthful Driver
2 Age under 21, without Driver Training
3 Age under 21,with Driver Training
4 Age 21-24
5th digit (the 1 above) - Car Typo;Multipie Car
1 Only One Car Insured
2 More Than One Car Insured
4th digit (the 6 above) Use Class
No Youthful Driver
1 Pleasure
2 Work under 100 MilesAveek
3 Work, 100 or more Miles/wesk
4 Business Use
5 Farm Use
Youthful Driver
6 Pleasure, including Work, under 100
Miles/week, or Farm Use, without Good
Student Discount
8 Work, 100 or more Miles/weakr or
Business Use, without Good Student
Discount
7 Pleasure, including Work, under 100 Miles/
week, or Farm Use, with Good Student
Discount
9 Work, 100 or more Mil"ANeek, er
Business Us3, with Good Student DiscvC?'
8th digit (the 0 above) - Safe Driver Plan
The percentage of premium change is displayed compared to our base classification (i.e., Adult, principa:
driver, under age 50, carlis used for pleasure and driven 7,500 or more miles annually).
Multi-Car
Single Car
All Class Rated All Class Rated Multi-Car
Paints
Cove Coverages, excluding Comprehensive
O No Points rages
0 Comprehensive cmiu l
1 One Point
+10 -20
-10 -10
2 Two Points +25 0
3 Throe Points
45
+45 +5 +15
4FourPoints
+80 +25 x+35
5 Five Points
+120 +60
6 Six Points
+170 +100 *70
7 Seven Points
+230
+ +150 .010
8 Eight Points + +210 +160
9 Nine Points
*100 will be added to th
op
e
4 +280
+380 --220
-2v:
pert e
n
Ige for 9 poi nts for each point beyond 9 points. .35C
2 -
03/05!2004 07:56 PSP TROOP H HBG,PA.17112 i 92452165
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Safe Driver Insurance Plan Data
1. Studies have shown that, as a group, drivers who have been involved in accidents or who have motor vehicle
convictions are more likely to have future accidents than drivers without accidents or convictions. Our Safe
Driver Insurance Plan reflects this.
2. Points are assigned for convictions and accidents occurring within the experience period for the applicant or
any resident driver as follows:
A. Car Convictions
(1) Six points are assigned for each conviction of:
a. Driving while intoxicated or under the influence of drugs.
b. Failure to stop and report when involved in an accident resulting in bodily injury.
c. Homicide or assault arising out of the operation of a motor vehicle.
d. Driving during a period while the license is suspended or revoked.
e. Reckless driving.
(2) Two points are assigned for a conviction of any of the following;
a. Improper passing on a hill.
b. Leaving the scene of an accident involving property damage only.
c. Exceeding maximum speed limit by 16 or more miles per hour.
d. Failure to stop for a school bus with flashing lights.
(3) One point is assigned for any other conviction for a moving traffic violation.
NOTE: Under (2) or (3) above, points are only assigned for the second or subsequent conviction under
statute 75-1535.
B. Car Accidents
(1) Occurring on or after 7/1/02:
a. New Business*
Two points are assigned for each at-fault accident involving the applicant or any resident driver of a car
resulting in payment(s) on your behalf by an insurance company of $1,050 or more for damage to:
the car driven; and/or
other property.
b. Renewal Business*"
Two points are assigned for each accioant involving the insured or arty resident driver of the car, as of
the date the company has made payment(s) during the experience period of $1,050 or more for damage
to:
- the car driven; and/or
- other property.
(2) Occurring on or after July 1, 1999 but before July 1, 2002:
a. New Business*
Two points are assigned for each at-fault accident involving the applicant or any resident drvar of a car
resulting in payment(s) on your behalf by an insurance company of $950 or more for damage to:
the car driven; and/or
other property
b. Renewal Business"*
Two points are assigned for each accident involving the insured or any resident driver of the car, as of
the date the company has made payment(s) during the experience period of $950 or more damage to:
- the car driven; and/or
- other property
*New Business means the accident occurred prior to being insured with Prudential.
**Renewal Business means the accident occurred while insured with Prudential.
Accident Surcharge Forgiveness
No point(s) will be assigned to the firq surchargeable accident if the named insured has been
continuously insured under a Prudgrj0?tl Car Policy, excluding Residual Market Plans (e.g., Assigned Risk
Plans), for the five years prior to the, dfta of loss and there were no other surchargeable accidents that had
a date of loss within that five year I I
C. Exceptions
No point is assigned for an accident uncIft4above if the accident occurred under one of the following
circumstances:
(1) Lawfully Parked: Car of applicant pr other resident driver was lawfully parked. A car rolling frog- a
perked position is not lawfully perked, but is caused by the operation of the last driver.
(2) Not-At-Fault: Applicant or other resident driver is less than 50% at-fault for the accident.
- 3 -
03/05/2004 '07:56 PSP TRODP H HBG,PR.17112 4 92432165
ND. 190
iiiiiBimllll lullili ills
liberty*
Mutual.
NOTICE'OF PRIVACY POLICY
Liberty Mutual" values you as a customer and takes your personal privacy seriously. When you apply for
insurance, you disclose information about yourself or members of your family. This notice tells you how we
treat the information we collect about you.
1. INFORMATION WE MAY COLLECT
We collect information about you from:
- Applications or other forms you complete;
Your business dealings with us and other companies;
Your employer or association for Liberty Mutual Group products;
- Consumer reporting agencies, Motor Vehicle Departments, inspection services, the Medical Information
Bureau and medical providers; and,
- Visits to our Liberty Mutual website.
2. TYPES OF INFORMATION WE MAY DISCLOSE
We may disclose the following about you:
- Information from your application or other forms, such as your name, address, vehicle and driver
information;
- Information about your transactions with us, our affiliates or others, such as your insurance coverages,
payment history, and certain claims information; and,
- Information we receive from third parties, such as your motor vehicle records and claims history.
3. TO WHOM
MAY BE DISCLOSED
We do not disclose personal information about you to anyone unless allowed by law. We are allowed by law
to provide information to:
- A third party that performs services for us, such as claims investigations, inspections, and appraisals;
- Our affiliated companies and reinsurers;
- Insurance regulators and reporting agencies;
- State Motor Vehicle Departments to obtain a report of any accidents or convictions;
- Law enforcement agencies or other government authorities to report suspected illegal activities;
- A person or organization conducting insurance actuarial or research studies which are subject to
appropriate confidentiality agreements;
- Companies that provide marketing services on our behalf, or as part of a joint marketing agreement with
banks, credit unions, and affinity partners, or providers of annuity and financial products and services
offered through us;to our customers, which are subject to appropriate confidentiality agreements, and
- As otherwise permitted by law.
4. NOW WE PROTECT INFORMATION
We maintain physical, electronic, and procedural safeguards to protect your nonpublic personal information.
These safeguards comply with applicable laws. We retain your information for as long as required by law or
regulation. The only employees or agents who have access to your information are those who must have it to
provide products or services to you. We do not sell your information to mass marketing or telemarketing
companies.
This privacy notice is provided m behalf ofibe Mewing Lai" Mutual cerepwi a and affdiatn that provide pmoaal a tomobile, bomeoptre., life iaxw=m-
amerity sod &McW praduc? sod cervices: Liberty Mutual twrame Coo4my, libertyAfirmal Fire is u a Company. Liberty Inmrmree Cwpmafim L\f
Imuarlce Curpmmian, The rust Liberty fwrmrs C-p-MM liberty bmaxice Conipsay of Ammw% Liberty Nard west Imunocs Corporwom Lbuty bit
Anuome Convasy cf eneeq Liberty Life Seeuriiie LLC. flbmty County Mutual fnmrance Company (Toss ouly). and liberty, Lloyds of Tem Innaaace
Caotyany. Prudential PrepatV and Casualty to maregg t Cempeey. Prudential Coa marcial insurance Compugv PrudmtW General huurnwe Cmopmy.
OCD W" Ed. 1 ba3
JT
03/05/2004 07:56 PSP TROOP H HEG,Pq,17112 92452169
Nd. 1130
IN 1 11101311M MtI1111110
Prudential
Financial Renewal Payment Notice
Prudential General Insurance Company Automobile
www.pmdential.com
Please send payments to:
Prudential Account Processing Center
P.O. Box 856139
Louisville, KY 40285-6139
Calhoun Barry E & Tammy
2011 Back Rd
Halifax PA 17032-9691
Notice Date: December 10, 2003
Insureds Nance: Calhoun Barry E & Tammy
Policy Number: 28SA121714
Policy Period: Jan 12, 2004 - Jul 12, 2004
Customer Service Office: (800) 437-5556
To report a claim, please call: (800) 437-3535
Your Prudential Representative: (717) 975-8150
R FARABAUGH CLU CHFC LUTCF CMFC MSFS CL
Billing Summary
Premium
Current balance
Paying Your Bill
$477.00 You may make a full payment, or choose an installment
$477.00 payment plan at this Um Paying one of the installment
amounts automatically enrolls you in that payment plan for
future installments. Policy changes may affect future
amounts and dates.
Duce Date
January 12, 2004 Full payment
January 12, 2004 2 payment plan
March 12, 2004 2nd payment
January 12, 2004 4 payment plan.
February 17, 2004 2nd payn=1
$5.00 service charge included in uhf z :rs_'.
Amaat
54-- -,,
1mPottant Messages
' Save money by eliminating service charges. It's easy, Choose Pru-Matic and have month right from your bank account. you can also select a monthly billing date that your makes seaufor r? tam
a . he
See the ttad of am notice for add =MWC
d.
s+a?.........-..
03/05%2004 07:56 PSP TROOP H HBS,PR.17112 4'32452165
My. 190
Policy Number. 28SA121714
Additional Important Messages
out how by calling 1-800-437-5556 today.
The company must receive your premium payment in our office by the due date for coverage to continue.
If your check or electronic remittance is not received in our office by the due date, or is returned by the hank
for insufficient funds, your policy will terminate.
If you have a touch-tone telephone, you can reach us 24 hours a day, 7 days a week through our automated response unit.
You can obtain policy information such as billing status, payment history, policy coverage, and request duplicate policy
documents by calling the Customer Service Office Number listed on the front of this notice.
Your premium may be different from the premium for your last policy period. This bill reflects
our current Company rate adjustment as well as any coverage changes you may have requested.
Congratulationst Your policy qualifies you for our Deluxe Package Discount. This means
you are now paying 10°A less than those who do not quality. Policyholders have received a
10% discount if they are insuring at least two vehicles with us, carrying at least 1001300125
Liability limits, and carry both Comprehensive and Collision coverages co, at least one vetucle.
If you did not purchase optional Rental Car Coverage and you have collision or
comprehensive coverage on your policy, you may wish to amend your policy to include
it. Rental Car Coverage covers the cost of renting a car if a car you own is
out of use for more than 24 hours because of a Collision or Comprehensive loss.
But this coverage does not apply when a car is stolen and Comprehensive Coverage applies.
If you would like to add Rental Car Coverage to your policy, please contact your
Prudential Representative or our Prudential Customer Service Specalists regarding
the details and cost
Prudential W Financial
Turo Law Offices
28 South Pitt Street
Carlisle, PA 17013
RE: Our Insured: Barry E. & Tammy Calhoun
Your Client: Barry E. Calhoun
Our Claim Number: 46YO3937-12-065
Date of Loss: 7/21/03
Attention: Ron Turo, Esquire
Dear Mr Turo:
Prudential General Insurance Company
PO Box 977, Horsham, PA 19044
Tel 25-658-5752 Fax 215-658-5720
February 25, 2004
We have reviewed the facts surrounding this loss and must advise you that your client's
policy does not afford him Underinsured Motorist coverage for this accident.
Your client was injured while in the course of his employment as a Pennsylvania State
Police Officer while using a "regularly used" police vehicle. This vehicle is not a listed
vehicle on our policy nor does the vehicle qualify for coverage as a non-owned vehicle.
We are denying this claim because the vehicle involved in this loss was not a covered
vehicle under THE PENNSYLVANIA CAR POLICY. The covered vehicles are listed on
page 25.
"C. WHAT CARS ARE COVERED (PART 5)...
t. Cars Described On Your Declarations...
2. Replacement Cars...
3. Additional Cars...
4. Substitute Cars.
5. Other Non-Owned Cars"...
In addition to the above there is a specific exclusion in the policy's Pennsylvania Special
State Provisions PAC 226 PA Ed. 11/01.
"PART 5- UNDERINSURED MOTORISTS- 5. E. LOSSES WE WILLNOT PAY-the
following items are revised:...
3. Non-Owned Motor Vehicles
We will not pay for bodily injury sustained while using or occupying a non-owned
motor vehicle or trailer not insured under this Part, that is furnished or made
available for regular use by you or a household resident."...
A favorable enforcement of the policy's exclusions for this circumstance is contained in
recent PA Supreme Court decisions (see Burstein v PRUPAC Ins Co. 809 A.2d 204 Pa.
2002, Gisler v PRUAPC, No. 31 EAL 2001, 2002 PA LEXIS 1853, Pa. Sept. 5, 2002).
Sincerely,
Sandra Fiore
Casualty Analyst
Turo Law Offices
RON TURD, Esquire
ROBERT J, MULDERIG, Esquire
GALEN R. WALTZ, Esquire
JAMES M. ROBINSON, Esquire
DANIEL D. WORLEY, Esquire
JAMES G. GAULT, Esquire
NANCY A. PRESCOTT, Esquire
May 6, 2004
Sandra Fiore ?'LE
Prudential General Insurance Company
P.O. Box 977
Horsham, PA 19044
Re: Your Insured: Barry E. & Tammie Calhoun
My clients: Barry E. & Tammie Calhoun
Your Claim Number: 46YO3937-12065
Date of Loss: July 21, 2003
Dear Ms. Fiore:
www.TuroLaw.com
28 South Pitt Street
Carlisle, Pennsylvania 17013
(717) 245-9688
(800) 562-9778
Fax (717) 245-2165
COPY
Thank you for your letter of February 25, 2004. We have now had an opportunity to research
the issue under which you have denied coverage to Barry Calhoun for the accident that arose on July
21, 2003 when Trooper Calhoun was operating a State Police patrol vehicle and was seriously injured
through the negligence of a third party. The Torfeasor's Insurance company, NationWide, has
tendered its $15,000.00 limit and we have filed a claim for underinsured motorist coverage through
Trooper Calhoun's personal policy. You have denied the claim based on your reading of the policy as
well as the Supreme Court Case of Burstein.
Trooper Calhoun was not utilizing a "regularly used" police vehicle at the time of the accident.
In fact the vehicle assigned that day to Trooper Calhoun had never been previously been used by
him. The Burstein case discusses the public policy of requiring a motorist to insure a "regularly used"
employer owned vehicle when that vehicle is assigned to that employee in the course of his or her
duties. This is akin to a "company owned vehicle" provided to the motorist for use by the motorist and
in furtherance of the employer's business. In such a situation Burstein contemplates that the motorist
can obtain uninsured and underinsured coverage either through his family policy or through the
employer. In the situation Trooper Calhoun found himself he was totally incapable of providing such
additional coverage as he was never assigned the same vehicle and consequently could not, in fact,
insure the entire State Police fleet. The Public Policy of Burstein is clear however it does not provide
an exclusion to Prudential in this circumstance. Trooper Calhoun was not utilizing a "regularly used"
vehicle and consequently the exclusion does not apply.
I renew our request for benefits and ask for your consent to settle so that we may obtain the
first $15,000.00 from the Tortfeasor. If you are unable or unwilling to accept this claim we plan to
Page 2
5/6/04
litigate this matter against you. If you do reject the claim I still would anticipate receiving consent to
settle while reserving your right to litigate the issue.
I look forward to receiving your consent to settle, you acceptance of this claim and your
adjuster contact so that we can begin to discus the underinsured value of this claim.
Sincerely,
RON TURO, ESQUIRE
RonTuro@TuroLaw.com
RT/jah
c.c. Barry Calhoun
Prudential
Financial
P.O. Box 977
Horsham, PA 19044-0977
800-634-1523
Prudential General Insurance Company
May 11, 2004
Ron Turo, Esq.
28 South Pitt Street
Carlisle, PA 17013-
Claim Number:
Date of Loss:
Insured:
Claimant:
Policy Number:
Dear Sir:
46Y03937-E-12-065
JuLy 21, 2003
Barry E & Tammy Calhoun
Barry E. Calhoun
288A121714
I am in receipt of your correspondence of May 6, 2004.
Our position is that since your client's DIM coverage does not apply to
this loss, then a consent to settle is not required.
Thank you for your cooperation.
If you have any questions, you're welcome to call me at (800) 634-1523,
ext. 5752, between 7:00 a.m. and.5:00 p.m. Eastern time, Monday, Tuesday,
Wednesday and Thursday. I can also be contacted by Fax or my Internet
email address. Both are provided below for your convenience.
' ncerel ,
Sandra Fiore
Claims Representative
Fax: (215) 658-5720
email: sandra.fiore@llibertymutual.com
THE STATE OF PENNSYLVANIA REQUIRES THE FOLLOWING STATEMENT BE PROVIDED.
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 INFORMATION 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.
I I
vi
SHERIFF'S RETURN - REGULAR
CASE NO: 2004-02849 P
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
CALHOUN BARRY E ET AL
VS
PRUDENTIAL GENERAL INSURANCE
SHAWN HARRISON
, Sheriff or Deputy Sheriff of
Cumberland County,Pennsylvania, who being duly sworn according to law,
says, the within COMPLAINT - EQUITY was served upon
LIBERTY MUTUAL GROUP the
DEFENDANT , at 1549:00 HOURS, on the 24th day of June 2004
at 5021 LOUISE DRIVE
MECHANICSBURG, PA 17 055 by handing to
BERNADETTE BALINT, P ERSONAL SALES ASST, ADULT IN CHARGE
a true and attested copy of COMPLAINT - EQUITY together with
and at the same time directing Her attention to the contents thereof.
Sheriff's Costs: So Answers:
Docketing 18.00
Service 8.28
Affidavit .00
Surcharge 10.00 R. Thomas Kline
.00
36.28 06/28/2004
RON TURO
Sworn and Subscribed to before By: t
P
me this '7 day of ep
y Sheriff
- A.D.
'1u , i
A,
P o honotary & p tw.
Curtis R. Long
Prothonotary
office of the Protbonotarp
Cumberlanb Countp
Renee K. Simpson
Deputy Prothonotary
John E. Slike
Solicitor
n14 - .2-e ? .r(_ CIVIL TERM
ORDER OF TERMINATION OF COURT CASES
AND NOW THIS 5TH DAY OF NOVEMBER 2007 AFTER MAILING NOTICE OF
INTENTION TO PROCEED AND RECEIVING NO RESPONSE - THE ABOVE
CASE IS HEREBY TERMINATED WITH PREJUDICE IN ACCORDANCE WITH PA
R C P 230.2.
BY THE COURT,
CURTIS R. LONG
PROTHONOTARY
One Courthouse Square - Carlisle, Pennsylvania 17013 - (717) 240-6195 - Fax (717) 240-6573