HomeMy WebLinkAbout11-4632DONNA MOWRY
V.
INFINITY INSURANCE
Respondent
IN THE COURT OF COMMON PLEA, Ol ,
Of It, . ice..
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CIVIL ACTION -LAW ? -rn
NO: 2011 - m C5
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JURY TRIAL DEMANDED D
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PETITION TO COMPEL ARBITRATION
Petitioner, Donna Mowry, through her undersigned counsel, petitions this Honorable Court under
42 Pa. Cons. Stat. Ann § 7304(a) for an Order compelling arbitration in this matter, and in support
represents as follows:
1. Petitioner, Donna Mowry is a citizen of the Commonwealth of Pennsylvania residing at 168
Amy Drive, Carlisle, Pennsylvania 1701.3.
2. Respondent, Infinity Insurance, is an insurance company duly licensed to do business in the
Commonwealth of Pennsylvania with its principal place of business at 3700 Colonnade
Parkway, Birmingham, Alabama 35243.
3. On or about May 27, 2007, Petitioner was the driver of a vehicle traveling East on the
Harrisburg Pike near the intersection of Harrisburg Pike and South Middlesex Road in
Middlesex Township, Cumberland County, Pennsylvania.
4. Another driver, Matthew Coover, who was traveling North on South Middlesex Road and
was stopped at the traffic light at the intersection South Middlesex Road and Harrisburg
Pike; suddenly, unexpectedly, and failing to yield to oncoming traffic, proceeded into the
intersection of Harrisburg Pike and South Middlesex Road.
5. Due to Mr. Coover's sudden encroachment into the traffic lane, Petitioner was unable to
avoid striking the rear of the Mr. Coover's vehicle.
44
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6. Petitioner reported to her family physician complaining of neck pain and was diagnosed
with a cervical sprain and tinnitus.
7. The accident and resulting injuries to the Petitioner, were solely caused by the negligence of
Matthew Coover.
8. At the time of the accident, Matthew Coover was insured under a policy with Allstate
Property and Casualty Insurance Company, which accepted coverage and to the present
date, remains in litigation.
9. As of the date of filing of this Petition, the Respondent has not provided any sufficient
evidence that the Petitioner is not entitled to UI / UIM motorist coverage.
10. As there is not sufficient coverage available from the tortfeasor, Petitioner has requested
arbitration in accordance with the provisions of her Infinity policy, as set forth in both Part
C - Uninsured Motorist Coverage-Arbitration, and Part D - Underinsured Motorist
Coverage - Arbitration.
WHEREFORE, the Petitioner requests this Court issue a rule upon the Respondent to show cause,
if any it has, why the Respondent should not be submitted to arbitration and thereafter order that the matter
be submitted to arbitration.
Date:
Respectfully submitted,
ROMINGER & ASSOCIATES
Karl E. Rominger, Esquire
155 South Hanover Street
Carlisle, PA 17013
(717) 241 -6070
Supreme Court ID # 81924
Attorney for Plaintiff
DONNA MOWRY
V.
INFINITY INSURANCE
Respondent
IN THE COURT OF COMMON PLEAS OF
f`f 1 fr) T;' I A-k T F N (•i 2Y t*i f"V OUNINTOVI c, n i1Fn
CIVIL ACTION - LAW
NO: 2011 -
JURY TRIAL DEMANDED
CERTIFICATE OF SERVICE
I, Karl E. Rominger, Esquire, attorney for Petitioner, do hereby certify that I this day served a copy
of the within Petition to Compel Arbitration / UM /UIM by USPS First Class Mail, postage prepaid, at
Carlisle, Pennsylvania, addressed as follows:
Infinity Insurance
3700 Colonade Parkway
PO Box 830189
Birmingham, AL 35243-3219
r
Date: S 4?1?
Michael E. Scheib, Esquire
Griffith, Strickler, Lerman, Solymos & Calkins
110 S. Northern Way
York, PA 17402-3737
Respectfully,
Rominger & Associates
Karl E. Rominger, Esquire
155 South Hanover Street
Carlisle, PA 17013
(717) 241 -6070
Supreme Court ID #: 81924
Attorney for Donna Mowry
DONNA MOWRY IN THE COURT OF COMMON PLEAS OF
'irN 90 i''i)1 A *iI.._.flt?'`i i,V i?i'hfk Fi (J v. CIVIL ACTION - LAW
NO: 2011 -
INFINITY INSURANCE JURY TRIAL DEMANDED
Respondent :
ACCEPTANCE OF SERVICE
I, Michael E. Scheib, Esquire, attorney for the Respondent, hereby accept service of Petitioner's
Petition to Compel Arbitration, in the above captioned matter.
Respectfully,
Griffith, Strickler, Lerman, Solymos & Calkins
Date:
Michael B. Scheib, Esquire
110 South Northern Way
York, PA 17402-3737
Phone: (717) 757 - 7602
PAID: 63868
Attorney for Respondent - Infinity Insurance
R.''t. E L1 u r_
'7 Jr PROTHIO?
t?: 11JUN 20 AM 11: 10
C,UHBERLAND
EN!IS.YI.VA 11 A
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
DONNA MOWRY,
Petitioner
V. :
INFINITY INSURANCE,
Respondent
NO. 11-4632 CIVIL TERM
CIVIL ACTION - LAW
JURY TRIAL DEMANDED
RESPONDENT, INFINITY INSURANCE'S ANSWER TO PETITIONER'S
PETITION TO COMPEL ARBITRATION
AND NOW, comes the Respondent, Infinity Insurance, by and through its counsel,
Michael B. Scheib, Esquire, and Griffith, Strickler, Lerman, Solymos & Calkins, and files the
following Answer to Petitioner's Petition to Compel Arbitration, and in support thereof avers as
follows:
1. Admitted.
2. Admitted.
3. Admitted.
4. Admitted in part and denied in part. It is admitted that the vehicles came into
contact with one another. The remaining allegations are denied. After reasonable investigation,
Respondent is without knowledge or information sufficient to form a belief as to the truth of the
allegations set forth in paragraph 4 of Petitioner's Petition, and the same are denied and strict
proof thereof is demanded.
5. Admitted in part and denied in part. It is admitted that the vehicles came into
contact with one another. The remaining allegations are denied. After reasonable investigation,
Respondent is without knowledge or information sufficient to form a belief as to the truth of the
allegations set forth in paragraph 5 of Petitioner's Petition, and the same are denied and strict
proof thereof is demanded.
6. Admitted.
7. Denied. This paragraph states a legal conclusion to which no response is
required.
8. Admitted.
9. Denied. As set forth in the New Matter, Petitioner was provided a copy of the
insurance policy in 2010. Furthermore, the question is not whether "Petitioner is ... entitled to
UI/UIM motorist coverage." The relevant question is whether the policy issued by Infinity
Insurance requires mandatory arbitration.
10. Denied. This paragraph states a legal conclusion to which no response is
required. Furthermore, after reasonable investigation, Respondent is without knowledge or
information sufficient to form a belief as to the truth of the allegations set forth in paragraph 10
of Petitioner's Petition, and the same are denied and strict proof thereof is demanded.
WHEREFORE, Respondent respectfully requests this Court deny the Petitioner's Petition
to Compel Arbitration/UIM/Ul.
NEW MATTER
11. Paragraphs 1 through 10 of Respondent's Answer to Petition to Compel
Arbitration are incorporated herein as though fully set forth at length.
2
12. On or about May 27, 2010, Petitioner, by and through her attorneys, filed a
Petition to Compel Arbitration/UIM/UI in the Court of Common Pleas of Cumberland County,
Pennsylvania. (See Docket No. 10-3451 captioned Donna Mowry v. Infinity Insurance.)
13. On June 18, 2010, Respondent filed an Answer to the Petition. In its Answer,
Respondent stated that Petitioner is not entitled to mandatory arbitration of a claim for UIM/UI
benefits. Rather, the policy provides that the matter "may be arbitrated."
14. The Petitioner's policy expressly requires both parties to agree to arbitration for
an arbitration to occur. (See Exhibit A.)
15. In this case, Respondent does not agree to arbitration.
16. As such, the Petitioner's only recourse is to file suit in the Court of Common
Pleas.
WHEREFORE, Respondent respectfully requests this Court deny the Petitioner's Petition
to Compel Arbitration/UIM/UI.
GRIFFITH, STRICKLER, LERMAN,
SOLYMOS & CALKING'?
Date: June I q , 2011 By:
MICHAEL B. 9CHEIB, ESQ
PA 63868
110 South Northern Way
York, PA 17402-3737
Phone (717) 757-7602
Fax (717) 757-3783
Mscheib2izslsc.com
Attorney for Respondent,
Infinity Insurance
3
VA ).1 NF1 1?
STATEMENT OF CERTIFICATION
State of Alabama
City of Birmingham
County of Jefferson
September 21., 2009
I, Peggy Taggart, Authorized Representative of Leader Preferred Insurance Company, certify the attached
is a complete and accurate copy of the Declaration Page and Policy Jacket for policy number 137-14938-
5413-001 issued to DONNA J. MOWRY. The effective dates of the policy when issued were July 1, 2004
to January 1, 2005. The Declaration Page attached is a from January 1, 2007 to July 1, 2007.
QguT ar
State of Alabama
City of Birmingham
County of Jefferson
September 21, 2009
On this date before me, Joshua Glenn Prather, a Notary Public, personally appeared Peggy Taggart, to me
personally known and being duly sworn affixed her signature to the foregoing document set forth herein.
Qiou?aOtena Prathe
My Commission Expires. November 2, 2011
Infinity Value Added
5205 N. O'Connor Blvd,, Suite 700
Irving, TX 75039
Underwritten by: Leader Preferred insurance Company, 1400 Provident Tower, One E 4th St, Cincinnati, OH 45202
Customer Service: (877) 953-2337 PERSONAL AUTO DECLARATION Claims Service: (800) 334-1661
MOWRY, DONNA.!
116 W BUTLER ST
MOUNT HOLLY SPRINGS PA 17065
# Yr Make -Model Serial Number ComplColl # Driver Name Driver Status
1 04 DODG 1500 1 D7HU18D54S516259 1001500 1 Donna Mowry Active
Active
2 99 DODG INTREPID 2B3HD56J4XH629613 100 / 500
1 FAFPIOPOXW142032 NIA/NIA 2 Edwin Mowry
5 Tyler Mowry Unlicensed
3 99 FORD ESCORT
COVERAGES - LIMITS OF LIABILITY PREMIUMS FOR VEHICLES
THE COVERAGE IS APPLICABLE ONLY IF A PREMIUM IS INDICATED VEH 1 VEH 2 VEH 3
Bodily Injury Liability $100,000 each person $300,000 each accident 26 30
41 20
30
Property Damage Liability $100,000 each accident 41 4
Uninsured Motorist -Slacked $15,000 each person $30,000 each accident 4 4
4 4
Underinsured Motorist . Stacke-315.000 each person $30,000 each accident 4
9 10
Medical 8enefis 55,000 Limit 7
4 5 6
Income Loss S2,500Imonth 550,000 aggregate 52
Comprehensive' 37
98 143
Collision
PREMIUM BY VEHICLE: 221 288 74
TOTAL VEHICLE PREMIUM $ 583.00
POLICY FEES
ENDORSEMENTS MADE A PART OF THIS POLICY: TOTAL POLICY PREMIUM $ 583.00
13752LPE02;13752AE101
IF COLLISION COVERAGE IS PURCHASED, IT DOES APPLY TO A RENTAL VEHICLE USED AS A SUBSTITUTE AUTO.
Additional Payments 520 per day up to $600 per theft for cost of transportation.
POLICY NUMBER: 137-14938-5412-001
POLICY PERIOD: 01/0112007 TO 07/01/2007
Current Policy Period. Policy is effective at the address of
the policy holder as stated herein.
The following coverages and limits apply to each described
vehicle as shown below. Coverages are defined in the policy
and are subject to the terms and conditions contained in the
policy, including amendments and endorsements. No changes
will be effective prior to the time changes are requested.
INSURED COPY
FORM 13752DEC04
Page 1 of 2
AMtNU UPt I t; U-UU11W
ENDORSEMENT: 6-1
Agency information: Please mail all inquiries to:
Jeffrey L Bouder Insurance 8402 (717) 776-4051 Infinity Value Added
19 South High St
Newville, PA 17241
Please fax all inquiries to:
ANY LOSS UNDER PART E IS PAYABLE TO NAMED INSURED AND LOSS PAYEE:
LOSS PAYEE ADDITIONAL INTEREST
Veh # Add€int # Name Veh # Addlint # Name
1 2 Fifth Third Bank
PO Box 598 Amelia OH 45102
Disclosure of the dollar amounts of all surcharges and each discount, as mandated
by Pennsylvania statute or regulation, are listed below:
DISCOUNTS / SURCHARGE DISCLOSURE
DISCOUNTS
Description: Amount: Applies to: Description: Amount: Applies to:
Anti-tltc#t Dc\'ICC Discount 9.89 1.2 PIFli4lulti-CfIG'1'1o]ncowllCl' i 18.7[) NIA
Airbag Discount (2) -17.57 1. 2. 3
Airbag Discount (1) -3.50 2
Passive Resimiut -2.52 3
AAA -15.53 3.1
Marko Factor -16,44 3.1
Limited Toil -216.35 NIA
StJl2CI-IARCFS
Description: Amount: Applies to: I Description: Amount: Applies to:
VIOLATIONS -------
Drv # Violation: Violation Date:
Drv # Violation Violation Date
I Violation PI•CI1141M Surcharge: S 0.00
TOR-r01Y11ON: Limited Tort Page 2 of 2
I/
Infinifiy Value Added
5205 N. O'Connor Blvd., Suite 700
Irving, TX 75039
Underwritten by: Leader Preferred Insurance Company, 1400 Provident Tower, One E 4th St, Cincinnati, OH
45202
Customer Service: (877) 953-2337 Claims Service: (800) 334-1661
Pennsylvania Amendatory Endorsement
...ri.'.. .- -.,g?_ ,..< ?, ..n ;].• ..:yiif:,m::._: :w?:a_FSpc'_°.x'5i ?tfna : =:". .r5ti3S»,+s ...1, ?r.?
_ ,?::?: : ?,x:-=r•:?(?r 'r y?/?? -_ .?.. -?. •? ,Jr1' le•. ;7D:= ` ?a- - ?f•°ir.??ti/?5a=?k3;aate?t=?_:
r3tbl:. il.:a ?-~~-•tifi?...? :. auL:wlt... ,...? «.. L
....•...._r'.-. ::`::?..:.. is^:lt.-v..__...:...ri. .. ._. ..........:.... ...... .....
137-14938-5412-001 07101/2007 12:01 a.m.
if"..:?`+,?.4 '?- ?:.-? `• s?^:Tx;! ??; . r_1:.;;-,.?:3::u",.?:?E'ii--°i4==;L?;r?i•:?:?:,r_
-:.-Nl'111>vtC
Mowry, Donna J _: t
116 W. Butler St. Mowry, Donna
Mount Holly Springs, PA 17065 This policy change incepts at 12;01 a.m. on the Amend Date liste
at the bottom of this form. No changes will be effective prior to tt
Your Pennsylvania Value Added Personal Auto Police is ainaidcd as Follows:
1. Part 13 - first Party Benefits Coverage
A. Exclusions - Part 13 Only
Exclusions S. - Plcasc delete the second Sclltcllec of the exclusion.
11. Parr C, - Uninsured Motorist Coverage
A. E\CILISions - Part C Only
Plcasc delete Exclusion 4. and rcplacc with the following exclusion:
4. For bodily injury SLIStauncd by a driver of the insured an to who is not listed as a driver on the Declarations
Page of this policy of the Insured anlo was m do available for the regular and frcciucni use of that driver.
13. I..iinits of Liability - Part C Only
Add the following slalcmcnl:
Part
As a part of our clainns handling procedures, we may use sofuvare that is designed to evaluatc bodily injury tinder
('- Uninsured Motorist Covcra?,c.
C. Arbitration
Delete this section complctcly.
Ill. Part D - Underinsured Motorist Coverage
A. Exclusions - Part D - Only
Please clefetc Exclusion 4. and replace with the following exclusion:
4. For bodily injury sustained by a driver of the insured auto who is not listed as a driver on the Declarations
Page of this policy oi'the insured auto was made available I'or the regular and frequent use of that driver.
B. 1. imils of Liability - Peu-t D Only
Add the following statement.
Part
As a part orour claims handling procedures, eve may use software that is designed to evaluatc bodily Injury under
tJ - UnderinStlred Motorist Coverage.
Delete this section completely.
Page 1 of 2
INSURED COPY
FORM 13752AE101
AMEND DATE: 01/01/2007
ENDORSEMENT: 6-1
IV Part E _ Coverage for Damaoc to the Insured Auto
A. ExeItIS"sons - Part E Only
Please delete Exclusion 23 from this section.
V.Part F - General Provisions
A. Arbilrali0n rm
the first paragraph of the Arbitration Section and replace with tine follo??
Delete
u red
Uninsured
I f we and an insured person do not agree whether the insured person is legally person entitled to recover damages, Or if ciCher recoverab Party disagrees as to the amount of damages tMOtoPist Coverage dncnt tile tmaitcrmaybe under Part arbitrated,
Motorist Coverage or Part D Undcrm
and replace
Loss Payable Clause Delete the entire Loss Payable Clause with tlne following:
mage due undcithis policy he iter ?r g i oftle loss YO`_ interest. At
is how nc lobe „
payee if one
At otn discretion nve may pay loss or da e
play also pay Joss, or damage due under this policy acco'din? 111C11ts according to those interests. Ii
Declarations Page at time of loss. \Ve may make separate pay
holdrreloss payee_tlende , or a(lditsonal ii sured for any loss
We will not pay for any loss ed bye aversion, embezz
.acting on Four behalf: in addition pay
where frtuil, misrcprescntation, omission. concealment or intentional damage has been committedy or at t nc
1'son, resident, or rel tive.
direction ofan insured Pc
IC
The loss Payee must notify is of tiny known change of o"1-ncr,hip or ilncrc*,ise in the risk. If it (10c5 nqt, nvlil not be
cntitlc(f to any paynncnt un(Icr this clause.
et(tIle ' loss payee's under the policy. If that is the case, nr'
?c s right to rccovcr the full amount of its
We may pay the loss Pay cc undo} ?t1 nst cot This will not t Ffc g
cla docwllcnts i ? arc pay
arc then subrogated to its it hts , s
im.l'he loss payee muss assign us its intctcst. 'File loss payee must transfer to tts all suppgrtin
the balance due to the loss Payee on tine vehicle.
P aye e be cltitic(i toEcovc ?ge'a'nd benefitst feat r(ihan
C.bvcrage and pttyntcnts to the loss Ptl no event shall in accordance with all
exclusions contained in this policy. In
those applicable to you ()rally insured person. . Ile The (Ieductible amount applicable to losses le onttheloss payee y pion dcr Pa for - Coverage e f for Damage to The
Insured Auto shall be the (Ic(lucubloam
Page 2 of 2
MIMI
Your
Pennsylvania
Value Added
Personal
Auto
Policy
Underwritten by:
LEADER PREFERRED INSURANCE COMPANY
WARNING: 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
material hereto commits a fraudulent
misleading, information concerning any fact
insurance act, which is a crime and subjects such person to criminal and civil
nPnalties. --
Administrative Office: Texas 75039
5205 N. O'Connor Blvd. Suite 700, Irving,
Home office,.
580 Walnut Street, Cincinnati, OH 45202
MEMBER OF
INFINITY PROPERTY & CASUALTY CORPORATION
Form NO. 13752PVA01
INDEX
AGREEMENT (pages2-4)
Policy Agreement
Your Duties in Case of Accident or Loss
Definitions Used Throughout This Policy
PART A - LIABILITY COVERAGE (pages 4 - 6)
Insuring Agreement
Additional Definition
Additional Benefits
Exclusions
Limits of Liability
Federal Tort Claims Act Exclusion
Conformity With State Financial Responsibility Laws
Out of State Insurance
Otherinsurance
PART B- FIRST PARTY BENEFITS COVERAGE
{pages 7 - 9)
Insuring Agreement
Additional Definitions
Basic First Party Benefit
Added First Party Benefits
Combination First Party Benefits
Extraordinary Medical Benefits
Exclusions
Limits of Liability
Priorities of Policies
Non-Duplication of Benefits
General Provisions
PART C - UNINSURED MOTORIST COVERAGE
(pages 9 -13)
Insuring Agreement
Additional Definitions
Exclusions
Limits of Liability
Otherlnsurance
Arbitration
General Provisions
PART D - UNDERINSURED
(pages 13 - 17)
Insuring Agreement
Additional Definitions
Exclusions
Limits of Liability
Other Insurance
Arbitration
General Provisions
MOTORIST COVERAGE
Form No. 13752PVA01
PART E - COVERAGE FOR DAMAGE TO THE
INSURED AUTO (pages 17 - 21)
Insuring Agreement
Additional Definitions
Exclusions
Limits of Liability
Appraisal
Payment of Loss
Proof of Loss
Other Insurance
No Benefit to Bailee
Additional Payments
Car Storage Coverage
Towing and Labor Coverage
Custom or Additional Equipment Coverage
Rental Reimbursement Coverage
PART F - GENERAL PROVISIONS (pages 21 - 25)
Policy Period and Territory
Premium Changes
Coverage Changes
Premium Payment
cancellation and Nonrenewal
Limitations on Agent Authority
Arbitration
Two or More Auto Policies
Suits Against Us
Transfer of Your Interest in This Policy
Bankruptcy
Our Recovery Rights
Loss Payable Clause
Punitive or Exemplary Damages
Terms of Policy Conformed to Statutes
Fraud and Misrepresentation
Pollution Exclusion
Rescission
Structured Settlements
Limited Tort Alternative Information Notice
Excluded Drivers
ACCIDENTAL DEATH BENEFIT ENDORSEMENT
LIMITED COMPREHENSIVE COVERAGE
NAMED DRIVER NON-OWNER COVERAGE
LESSOR LIABILITY ENDORSEMENT
PENNSYLVANIA SURCHARGE DISCLOSURE
STATEMENT
Page 1
POLICY AGREEMENT
This Personal Auto Policy is a binding contract between
you and us. The contract includes the Declarations
Page, endorsements, the application, the Personal Auto
Policy, and all attachments. If you pay your premium
payment, we will insure you subject to the terms of this
pblicy. The Declarations Page shows a premium for
each type of coverage purchased. The selected
coverages in this policy apply only to occurrences while
the policy is in force.
YOUR DUTIES IN CASE OF ACCIDENT OR LOSS
In case of an auto accident or loss, you or any person
claiming coverage under this policy must:
1. Notify us promptly. You or someone for you must
notify us within thirty (30) days, or when practicable.
You must call our claims office during business
hours or our Claims Hotline, available 24 hours a
day, seven days a week. This notice must give the
time, place, and circumstances of the accident or
loss- Such notice must also give the license plate
numbers of the vehicles involved, and the names
and addresses of injured persons and witnesses.
YOUR FAILURE TO PROMPTLY REPORT A LOSS
OR ACCIDENT TO US JEOPARDIZES YOUR
COVERAGE UNDER THIS POLICY.
2. Cooperate with us in any matter concerning a claim
or suit.
3. Submit to physical examination at our expense, by
doctors we select, as often as we may require, and
authorize us to obtain your medical and other
records.
4_ Provide any written proof of loss under an oath that
we require.
5. Not admit any fault, assume any obligation, nor
agree to incur any expense concerning any claim or
accident.
6. Attend hearings and trials as a court or we may
require.
7. Send us promptly any legal papers received to any
claim or suit.
8. Submit to statements or examinations under an oath
and subscribe to the same as we may require.
9_ Allow us to take signed or recorded statements
when and as often as we may require.
We may examine any insured person under an oath,
while not in the presence of any other insured person.
This examination may be about any matter relating to
this insurance or the claim, including an insured person's
books and records. In case of the examination, an
insured person must sign their answers.
A person claiming Uninsured or Underinsured Motorist
Coverage must contact the police within forty-eight (48)
hours, or when practicable after an accident. This applies
if a hit-and-run driver is involved. They must promptly
send us copies of any legal papers in case of a suit.
A person claiming coverage for property damage must
take reasonable steps after the accident to protect the
property from further loss. A person claiming coverage
for loss or damage to the insured auto must do the same.
We will pay reasonable expenses that are incurred for
that protection. In case of any theft or vandalism of the
insured auto, you must promptly file a written report
with the appropriate law enforcement agency. You must
also allow us to inspect and appraise the damaged
property before Its repair or disposal.
A person seeking Extraordinary Medical Benefits
Coverage must submit conclusive proof when required
by us, This proof must show at least $100,000 of
incurred medical expense, This must be because of any
one accident by an insured seeking coverage under
Extraordinary Medical Benefits.
IF YOU FAIL TO COMPLY WITH ANY OR ALL OF THE
LISTED CONDITIONS, WE MAY REFUSE TO EXTEND.
TO YOU ANY PROTECTION UNDER THIS POLICY
FOR THE ACCIDENT OR LOSS.
DEFINITIONS USED THROUGHOUT THIS POLICY
Unless defined differently elsewhere in this policy, the
words and phrases listed below shall have the following
meanings and shall appear in bold print:
1. "Accident" means a sudden, unexpected, and
unintended event causing bodily injury or property
damage, arising out of the ownership, maintenance,
or use of an auto. Coverage under this policy shall
not apply if the insured intended the accident or its
consequences or could have expected them from
the viewpoint of the insured. All bodily injury and
property damage arising out of continuous or
repeated exposure to the same general conditions
shall be considered as arising out of one accident.
2, "Actual cash value" means market value at the time
of the loss based upon vehicle mileage, age,
condition, original optional equipment, and
comparable vehicles available for sale within a
reasonable geographic radius as documented in an
electronic database of publications and dealerships,
less depreciation andlor betterment.
3. "Additional auto" means an auto that you become
the owner of, and that you acquire or purchase
during the policy period. For an auto to qualify as an
additional auto under this policy, we must insure all
autos you own or lease for a term of at least six
months. To qualify as an additional auto under this
policy, any newly acquired auto must be an
acceptable risk to us under our underwriting
guidelines.
4. "Application" means the form entitled Application for
Insurance that contains statements, coverage options,
and agreements that form a part of this policy.
5. "Auto" means a licensed and registered motorized
four-wheel land vehicle of the private passenger
type intended for use on public roads. An auto
includes a pickup, van, or sport utility vehicle, with a
load capacity of 1,500 lbs. or less. Further, such an
auto is not used in any business other than farming
or ranching. An auto does not include motorcycles,
midget cars, golf carts, tractors, or farm machinery.
In addition, an auto does not include any vehicle
operated on rails or crawler treads, or any vehicle
used as a home or premises.
6. "Auto business" means the business of selling,
leasing, repairing, servicing, delivering, testing, road
testing, towing, storing, or parking vehicles or trailers.
Form No. 13752PVA01 Page 2
injury to the body, including 21. "Rental vehicle" means an auto you rent or hire for
"Bodily injury" means inj ment of a term of 14 days or less in one 30-day period while
sickness or disease, resulting in impair such auto is in your custody or is being operated by
physical condition, including death resulting from It, you or a relative. An auto you rent or hire for more
vehicle
which is caused solely by an accident covered than 14 days in one 30-day period
under this policy and occurring white the policy is in regularly available to you. You may rent or hire
force. rental vehicles only from an entity a slicen tate jeddv. to
conduct such business under appl
S. "Business" means trade, profession or occupation.
Business also means courses of employment, job 22. "Replacement auto"means an auto thatyou become
or commercial use of any kind. Business shall not the owner of and that you acquire or purchase
the policy period to replace of an auto
include the use of the Insured auto to carry tools during
and supplies between your home and job site. described on the Declarations Page because of:
a. the ending of your ownership interest in an auto
, or
g, "Crime" means any felony and includes any attempt that is described on the Declarations Page deterioration, or
,
to elude law enforcement personnel. b, total loss mechanical of a listed breakdown auto theft, as shown on the te document you Declarations Page, rendering it permanently
10. "Declarations Page" es ofhcove age you have inoperable, To qualify as a replacement auto selected, the limit for the coverage, the cost for the under this policy, any newly acquired auto must
receive from us listing the e ty typ
be an acceptable risk to us under our
coverage, cy, thibtypeshof coverage for each such underwriting guidelines.
autoby, this and policy, other the information applicable to this policy. 23. "Resident" means a person living in your
11. household, other than you or a relative. You must
list any resident on the application or have them
"Minimum statutory limits means the minimum endorsed on the policy before p loss.
policy limits for vehicle liability coverage required by resulting in death,
the law of the State of Pennsylvania.
24. "Serious injury" means an injury 12, "Non-economic loss" means pain, suffering, and serious impairment of a bodily function, or serious
and permanent disfigurement.
other non-monetary detriment.
25: "State" means the District of Columbia and any state
13. "Non-owned o means erm sauto usd s on ofthebowner of the United States of America.
permission
with the expressss or r implied
and not awned by, furnished, or available for the 26. "Substitute auto" means an auto you use
temporarily while an auto described on the
regular use of you, a relative, or a resident. Anon- Declarations Page is not available for use. Use of
owned auto does not include a substitute auto. the substitute auto must result directly from
means to be in, upon, entering into, or servicing, repair, theft, destruction, or malfunction of
14. "Occupying" the auto described on the Declarations Page. A
exiting from. substitute auto does not include any vehicle that ent
owns
or tha 15. "Owned" mean t hold l of the vehi le that available to you, a resident o a relativet is regularly
vehicle, to have legal possession
is subject to a conditional sale agreement or " means:
any auto insured auto" n the Declarations Page;
mortgage, or to have legal possession of the vehicle 27 "The
that was leased to that person. b. any trailer you own while it is attached to the
insured auto. The Declarations Page must list
any trailer and you must pay a premium for
10. "Owner" means any person who, with respect e a coverage under Part E -Coverage for Damage
vehicle, holds legal tale to the vehicle, has legal to the Insured Auto t this policy.
possession of the vehicle that is subject a
c. a replacement auto. You must notify us within
conditional sale agreement or mortgage, that has legal
person. gal 30 days of your acquisition of the replacement
possession of the vehicle that is leased to th be considered the insured auto.
17. "Premium payment" means the actual receipt of auto for it to The replacement auto will have the broadest
cash funds by us. coverage we now provide for the auto being
damage to replaced only if you notify us within the 30-day
18. tProperty damage" means physical period following the acquisition of the
replacement auto- However, this does not
tangible property, including destruction or toss e its apply to coverage under Part E -- Coverage for
use, which Is caused solely in an accident covered Damage to the Insured Auto. If the auto being
under this policy and occurring while the policy is in replaced has coverage under Part E - Coverage
force. for Damage to the Insured Auto you must notify
19. "Racing" means participating in any race, speed, us within 5 days of the date you become owner
includes pr of the replacement auto or you take physical
demolition, stunt, oreparation for tfine the contest contest or or activity. activity. Racing possession of the replacement auto, whichever
first. You must notify us so to continue
20. "Relative" means any person related to you by blood, comthises es first. coverage t. for the replacement auto. ti the
marriage, or adoption, including a ward a foster under Part r we will add this coverage for the
living, who lives in your household, even if temporarily auto re being placement rautoeplaced does effective not after have coverage
you ask us to
living elsewhere. Relative includes a minor under re so. All insurance for the auto being replaced
list do them your en n dorsed on guardianship thevo lives policy you before a ?i ati losson ooa have ends when you take delivery u the replacement
thust any relati ve on the app ' auto.
.
Page 3
Form No.13752PVAOt
d. an additional auto. You must notify us within 7
days of your acquisition of the additional auto
for it to be considered the insured auto. These
provisions apply only if on the date you acquire
the additional auto, we insure all vehjcles you
own and you ask us to insure the additional
auto within 7 days of the date you acquire it. The
additional auto will have the broadest coverage,
we now provide on your policy only if you notify
us within the 7-day period following the acquisition
of the additional auto. However, this does not
apply to coverage under Part E - Coverage for
Damage to the Insured Auto. If any auto listed
on the Declarations Page has coverage under
Part E - Coverage for Damage to the Insured
Auto you must notify us within 4 days of the date
you become owner of the additional auto or
you take physical possession of the additional
auto, whichever comes first. You must notify us
so to continue coverage under Part E for the
additional auto. If no auto listed on, the
Declarations Page has coverage under Part E,
we will add this coverage for the additional auto
effective after you ask us to do so.
e. a substitute auto. A substitute auto will have
the same coverage as the auto that it temporarily
replaces. For purposes of this policy, any auto
leased by you under a written agreement for a
continuous period of at least six (6) months, we
will consider as owned by you.
28. "Total loss" means:
a. theft of the vehicle if the vehicle is not
recovered within thirty (30) days; or
b. any otherloss to the vehicle that is payable under
Part E - Coverage for Damage to the Insured
Auto, if the cost to repair the damage, when
added to the salvage value, exceeds the actual
cash value of the vehicle at the time of the loss.
29. "Trailer" means a device or vehicle which is not
self-propelled and is designed to be towed by an
auto, Including a farm wagon or farm implement,
and while being towed by an auto. A mobile home,
travel trailer, or any vehicle that can be lived in or is
self-propelled, is not a trailer.
30. "Vehicle" means a surface transportation device used
for conveying goods, passengers, or equipment.
31. "We," "us," and "bur" mean the company shown on
the Declarations Page.
32. "You" and "your' mean the named insured shown
on the Declarations Page and includes your
spouse, if living in the same household.
PART A - LIABILITY COVERAGE
INSURING AGREEMENT
If the Declarations Page shows a premium.charged for
this coverage, we will pay damages for bodily injury
and property damage for which an insured person is
legally liable because of an accident. This shall be up to
the policy limits stated on the Declarations Page. We
will not cover punitive or exemplary damages.
We will settle or defend, as we consider appropriate, any
claim or action that the policy covers. Our duty to settle or
defend ends when our limit of liability for this coverage has
been exhausted by payment of judgment or settlement.
We have no duty to settle or defend any claim or action
that the policy does not cover.
ADDITIONAL DEFINITION USED IN PART A ONLY +
As used in this part, "insured person" means:
1. You, a relative or a resident; or
2. A person using the insured auto with your express
or implied permission and within the scope of your
permission.
As used in this Part "insured person" means with
respect to a non-owned auto or a rental vehicle, you,
a relative or a resident.
ADDITIONAL BENEFITS - PART A ONLY
When we defend an insured person under this Part, we
will provide the following benefits:
1. We will pay costs we incur to investigate the
accident.
2. We will pay costs we incur to arrange for the
settlement of any claim or action.
3. As we deem appropriate, we will defend the Insured
person, hire and pay a lawyer, and pay all defense
costs. We have no duty to defend any claim or
action not covered under this policy.
4. As we deem appropriate, we will pay costs we incur
to investigate and settle any claim or action.
5. We will pay the interest that accrues against an
insured person and before we have offered to pay
or deposited into court sums that are not more than
our limit of liability, on damages awarded in a suit
we defend.
6. We will pay premiums on appeal and attachment
bonds if required in an action we defend. We will
neither apply for nor obtain bonds, nor pay the
premium on any bond that exceeds our limit of
liability.
7. We will pay up to $250 for the cost of all bail bonds for
an insured person resulting from any one accident.
We will not apply for nor obtain any bail bond.
8. We will reimburse an insured person for lost
wages, up to $50 a day, but not other income, when
we ask that insured person to help us investigate
or defend any claim or action.
9. We will reimburse any other reasonable costs an
insured person incurs at our request.
To receive an additional benefit under this section, you
must submit a claim and provide proof of entitlement
thereto.
EXCLUSIONS - PART A ONLY
READ THE FOLLOWING EXCLUSIONS CAREFULLY,
COVERAGE WILL NOT BE AFFORDED UNDER THIS
PART FOR ANY OF THE EXCLUSIONS LISTED
BELOW.
We do not cover:
1. Bodily injury or property damage that results from
nuclear reactions, radiation, or fallout.
2. Bodily injury or property damage covered by a
nuclear energy liability policy, even if the limits of that
policy are exhausted.
Form No. 13752PVA01 Page 4
insured
3 intentionally injury by or at property the direct on of s an is caused
person. Coverage under this Part shall not apply if
the insured either intended the accident or its
consequences or could have expected them from
the viewpoint of the insured.
4. the dimaintenance or property of an auto without from
owner's express or implied permission.
5. Bodily injury or property damage that results from
the maintenance or use of an auto outside the scope
of the owner's express or implied permission.
6. Liability for any bodily in ury or lroperty damage
assumed by or impose on an insured person
under any agreement, contract or bailment.
7. Bodily injury to an insured person's employee that
arises during employment.
Unless coverage is required under workers'
compensation, disability benefits, or similar laws, we
will provide coverage for an insured person's
domestic employee injured in an accident in the
course of employment.
8. Bodily injury to an insured person's co-worker
occurring during employment if such injury arises out
of the insured person's use of a vehicle in any
business.
or course of
9 employmen injury if benefits occurring are during payable the
under a workers' t compensation law or similar law.
10. Bodily injury or rma?nenandamage
e, m or g use a of results a vehic e
while used to transport persons or property for a fee
or compensation. This exclusion does not apply to
shared-expense car pools.
11. Property damage to property owned or being
transported by an insured person.
12. Bodily injury or property damage arising out of the
operation of equipment or machinery not listed on
the Declarations Page.
13. Damage
ge of, except a home or rents,
or has char garage,
including loss of its use.
14. Bodily Injury or property damage resulting from
the ownership, maintenance, or use of any vehicle
other than the insured auto, which is owned by,
furnished or available for the regular use of you, a
relative, or a resident.
15. thBodily e ownership, maintenance damage resulting from
auto by any person who is a regular user of the
insured auto, but is not listed on the Declarations
Page prior to the loss.
This exclusion applies to amounts of coverage
above the minimum statutory limits.
16. insured Bodily injury or property damage aring out of an
of any vehicle other than one with four wheels.
17. Bodily injury or property damage arising out of an
insured person's ownership, maintenance, or use of
any vehicle designed mainly for use off public roads.
18. Bodily injury or property damage resulting from
the ownership, maintenance, or use of a vehicle in
any racing event.
19. Bodily Injury or property damage that is incurred
while the insured auto is leased or rented to others.
20. Bodily injury or property damage resulting from
the use of a vehicle for snow removal.
21. Bodily injury or property damage caused by war
(declared or undeclared), civil war, insurrection,
rebellion, revolution, or riot.
22. Bodily injury or property damage sustained by an
insured person while occupying any vehicle
located for use or used as a residence or premises.
23. Bodily injury or property damage resulting from
the ownership, maintenance, use of a vehicle or a
trailer by a person while in the course and scope of
employment or engaged in any business. This
exclusion includes use of a vehicle for delivery of
goods or services arising out of any business. The
exclusion does not apply if you have declared
"business use" of the insured auto and you have
paid an additional premium.
24. Bodily injury or property damage resulting from an
auto business. However, this exclusion does not
apply to you. This is provided that the bodily Injury
or property damage arises out of auto business
operations conducted by someone other than you, a
relative or resident.
25. Bodily injury or property damage incurred while
any vehicle is used for towing a trailer not designed
for use with that vehicle, and which is owned or
rented by an insured person, and not listed on the
Declarations Page.
from
veproperty hicle by a p eson resulting or p
26 Bodily se not rany or
the u rso s
specifically excluded by endorsement.
27. Bodily injury or property damage arising out of the
ownership, maintenance, use, loading or unloading
of any haulaway, tank truck, or tank trailer when
used with a vehicle that is not listed on the
Declarations Page, which is owned, hired or held
for sale by the insured person.
28. Benefits for bodily injury or property damage that
are payable under the "No Fault Laws" of the
following states: Arkansas, Delaware, Washington,
D.C., Florida, Hawaii, Kansas, Kentucky, Maryland,
Massachusetts, Michigan, Minnesota, New York,
North Dakota, Oregon, Texas, Utah, and Washington.
29. Bodily injury or property damage caused by a
vehicle driven by a person:
a. Under the minimum age to obtain a license to
operate a vehicle in the state in which the
vehicle is licensed,
b. Under fifteen (15) years of age,
c. Who has had their driving privileges rescinded
by either license suspension or revocation or
d. Who does not possess a valid drivers license.
Form No.13752PVAOI Page 5
30. Bodil be ninjury eto the owner of a non-owned d by o driven by an insured person
31. Bodily
he ownership, maintenance, or use of a velhting i le with
a load capacity more than 1,500 pounds.
32. Coverage under this Part does not extend to:
a, any auto or trailer that is rented for any
business purposes; or
b. any auto or trailer that is rented for a period in
excess of 14 consecutive days.
LIMITS OF LIABILITY - PART A ONLY
As to any insured person, the limits of liability shown on
the Declarations Page shall apply. We will pay these
limits of liability as follows:
1. The bodily injury limit for "each person" is the most
we will pay for all damages, including fdamages
derivative claims, resulting bodily injury
sustained by one person in one accident. Derivative
claims include claims for care, loss of services, and
loss of consortium. Damages for derivative claims
will be payable only under the same "each person"
limit of liability as the bodily injury from which they
derive.
2. The bodily will pay for limit all for "each
damages resultng is froh
most we from
bodily injury sustained by more than one person in
one accident. It includes all damages for care,
medical expenses,. loss of services, loss of society,
comfort, companionship, and loss of consortium. In
addition, it includes any other damages in any way
arising out of, or deriving from such bodily injury.
3. The property damage limit for "each accident" is the
most we will pay for all damages to property,
including loss of its use, in one accident.
We will not pay bodily injury or property damage in
any amount exceeding the minimum statutory limits of
the state where the accident occurs arising out of the
use of the insured auto while the Insured person Is in
the commission of a crime.
Regardless of the limits of liability shown on the
Declarations Page or elsewhere in this policy, the limits
for bodily Injury and property damage liability afforded
by this policy to an insured person other than:
you; or
a relative or a resident of your household,
shall not exceed those amounts necessary to satisfy the
minimum statutory limits of the financial responsibility law
of the state in which the bodily injury or property
damage policy was written.
This is the maximum we will pay regardless of the
number of premiums or autos listed on the Declarations
Page, Insured persons, claims, claimants, policies, or
vehicles involved in the accident. Any amount paid or
payable under this coverage to or for an insured person
will be reduced by any payment made to that person
under Part C -- Uninsured Motorist Coverage or Part D -
Underinsured Motorist Coverage of this policy.
An auto and attached trailer are considered one auto.
Therefore, our limits of liability will not be increased for
any accident involving an auto which has an attached
trailer.
FEDERAL TORT CLAIMS ACT EXCLUSION
The following are not insured person(s) under Part A of
the policy:
t. The United States of America or any federal agency.
2. Any person for bodily injury or property damage
resulting from a person acting in the scope of
employment for the United States of America or any
federal agency when the provisions of the Federal
Tort Claims Act apply.
As used herein, "federal agency" means federal agency
as defined in the Federal Tort Claims Act.
CONFORMITY WITH STATE FINANCIAL
RESPONSIBILITY LAWS
When we certify this policy as proof under a state
Financial Responsibility law, it will comply with that law to
the extent of the coverage and limits of liability required
by that law,
You agree to reimburse us for any such payment that
we make under the provisions of this section of the
policy.
OUT OF STATE INSURANCE
We will increase the policy limits to the required
minimum limits of any state that requires a minimum
Financial Responsibility limit for nonresidents. This shall
occur if an insured person is operating an auto in that
state. We will not provide any coverage under the no-
fault law or any other similar law of any other state. No
person is entitled to duplicate payments for the same
element of loss.
OTHER INSURANCE
Coverage for a vehicle not listed on the Declarations
Page shall be excess insurance over any other valid and
collectible insurance. We will pay our proportionate
share of damages and reasonable and necessary
attorney fees and costs as our limit of 'liability bears to
the total of all applicable liability limits. This is if a
primary duty to defend exists under this policy and other
applicable liability insurance exists. Coverage for newly
acquired autos does not apply where there is other valid
and collectible insurance.
However, with respect to a person other than you, a
relative or a resident, using the insured auto with your
express or implied permission and within the scope of
that permission, this coverage shall be excess over any
other valid and collectible insurance available to the user
of the insured auto. Coverage shall be excess
insurance regardless of any provision of any policy
available to the user which makes the other available
insurance excess to any vehicle the user does not own.
If you, a relative or a resident has other insurance
against an accident covered by this Part, the following
applies:
We will not pay a greater proportion of the damages than
the applicable limit of liability stated on the Declarations
Page, bear to the total applicable limits of liability of all
valid and collectible insurance against any such
accident.
Form No. 13752PVA01 Page 6
PART B - FIRST PARTY BENEFITS COVERAGE
INSURING AGREEMENT
We will pay the following First Party Benefits, if shown on
the Declarations Page and a premium has been paid, to
or for an insured person who sustains bodily injury
caused by an accident arising out of the maintenance or
use of a motor vehicle:
1. Medical Benefit;
2. Income Loss Benefit;
3, Funeral Benefit; and
4. Accidental Death Benefit.
ADDITIONAL DEFINITIONS USED IN PART B ONLY
"Insured person" as used in this Part means:
1. You, a relative or any resident; or
2. Any other person:
a. While occupying the insured auto; or not b. W
ashia resu t ofpan acc dent in vehicle
involving the insured auto. If the insured auto
is parked and unoccupied it is not a motor
vehicle involved in an accident unless it was
parked in a manner as to create an
unreasonable risk of injury.
"The insured auto" means a motor vehicle: . To which Liability 1 a specific Coverage
premium e s charged; and und this policy plies
and for which
2. For which you maintain First Party Benefits
Coverage as required Responsbilly the Pennsylvania Motor
Vehicle Financial
BASIC FIRST PARTY BENEr FIT
The Basic First Part y Benefit consists of a Medical
Benefit, The Medical Benefit consists of coverage to
provide for reasonable and necessary medical treatment
and rehabilitative services. Including, but not limited to,
hospital, dental, surgical, psychiatric, psychological,
phcal
nal licensed
osteopathic, ambulance, chiropractic,
and
therapy, nursing services,
occupational therapy, speech pathology and audiology,
optometric services, medication, medical supplies and
prosthetic devices, ail without limitation as to time,
provided that within 18 months from the date of the
accident causing injury, it is ascertainable with
reasonable medical probability that -further expenses may
be incurred as a result of the injury and notice of the
additional expenses is provided to us. Benefits under this
paragraph may include any, non-medical remedial care
and treatment rendered in accordance with a recognized
religious method of healing.
ADDED PARTY BENEFITS
The Added First Party Benefit consists of the following:
Income Loss Benefit - Includes the following:
a. Eighty percent of actual loss of gross income,
b. Reasonable expenses actually incurred for hiring
a substitute to perform self-employment services
thereby mitigating loss of gross income or rnf{or
hiring special help thereby enabling a pe
work and mitigate the loss of gross income.
Form No. 13752PVADI
Income Loss does not include loss of expected
income for any period following the death of an
individual or expenses incurred for services
performed
Loss shall not not the death commence o until five dworrking
days have been lost after the date of the accident.
?. Funeral Benefit - Expenses directly related to the
funeral, burial, cremation, or other form of disposition
of the remains of a deceased individual, incurred as
a result of the death of the individual as a result of
the accident and within 24 months from the date of
the accident.
1 Accidental Death Benefit - A death benefit paid should
bodily injury resulting from a motor vehicle accident
cause death within 24 months from the date of the
accident. The Accidental Death Benefit under this
policy will be paid to the executor or administrator of
the deceased insured person's estate. If there is no
executor or administrator, benefits shall be paid to:
a. The deceased insured person's surviving
spouse; or
b. If there is no surviving spouse, the deceased
insured person's surviving children; or there c. eh cildren, to the deceased insured person's
estate.
COMBINATION FIRST PARTY BENEFITS
If the Declarations Page indicates that Combination
First Party Benefits apply, we will pay, in accordance with
the Pennsylvania Motor Vehicle Financial Responsibility
Law, Combination First Party Benefits instead of the
Basic First Party Benefit to or for an insured person
who sustains bodily injury caused by an accident
arising out of the maintenance or use of a motor vehicle.
Combination First Party Benefits shall be subject to a
maximum total single limit of liability with individual limits
for Accidental Death Benefit up to $25,000 and Funeral
Benefit of $2,500. We will only pay Combination First
Party Benefits for expenses or loss incurred within 3
years from the date of the accident.
EXTRAORDINARY MEDICAL BENEFITS
If Extraordinary Medical Benefits is shown on the
Declarations Page and you have paid a premium for this
coverage, we will pay the Medical Benefit, subject to the
limit of liability shown on the Declarations Page, incurred
by an insured person who sustains bodily injury in
excess of $100,000 which is caused by an accident
arising out of the maintenance or use of a motor vehicle.
Regardless of whether you have purchased the Basic,
Added or Combination First Party Benefit under this
policy, we will pay Extraordinary Medical Benefits
Coverage only after $1.00,000 has been incurred by any
one insured person for medical expenses resulting from
any one accident.
EXCLUSIONS - PART B ONLY
READ THE .
COVERAGE WILLONOT BEXAFFORDED UNDERUTN S
PART FOR ANY OF THE EXCLUSIONS LISTED
BELOW.
We do not provide First Party Benefits for bodily injury
sustained by any person:
1. While intentionally causing or attempting to cause
bodily injury.
Page 7
2. While committing a felony.
3. While seeking to elude lawful apprehension or arrest
by a law enforcement official.
4. While maintaining or using a motor vehicle knowingly
converted by that person. However, this exclusion
does not apply to you while using the insured auto.
5. Who, at the time of the accident:
a. Is the owner of one or more registered motor
vehicles and any of those motor vehicles do not
have in effect the financial responsibility required
by the Pennsylvania Motor Vehicle Financial
Responsibility Law; or
b. Is occupying a motor vehicle owned by that
person for which the financial responsibility
required by the Pennsylvania Motor Vehicle
Financial Responsibility Law is riot in effect.
6. Who is maintaining or using a motor vehicle while
located for use as a residence or premises.
7. Who is injured as a result of conduct within the
course of an auto business. This exclusion does not
apply if the conduct is off the business premises.
8. Who is injured as a pedestrian if the accident
occurs outside of Pennsylvania. This exclusion does
not apply to you, a relative or any resident while
occupying:
a. Any vehicle with more or less than four wheels; or
b. Any vehicle designed mainly for use off public
roads, except in a medical emergency.
9. When caused by or as a consequence of:
a. Discharge of a nuclear weapon;
b. War (declared or undeclared);
c. Insurrection; or
d. Rebellion or revolution.
10. When caused by a nuclear reaction, radiation, or
radioactive contamination.
11- For any loss resulting from the ownership,
maintenance or use of a vehicle when used by an
insured person to carry persons or property for
consideration or fee, including but not limited to retail
or wholesale delivery of magazines, newspapers,
food, or any other product. This exclusion does not
apply to shared-expense car pools.
12. While occupying any vehicle located inside a
facility designed for racing, for the purpose of
competing in or practicing or preparing for any
prearranged or organized racing, speed, demolition
or stunting activity.
LIMITS OF LIABILITY - PART B ONLY _
The limits shown on the Declarations Page for the First
Party Benefits that apply are the most we will pay to or
for each insured person as the result of any one
accident. This is the most we will pay regardless of the
number of claims made, vehicles or premiums shown
on the Declarations Page, vehicles involved in the
accident, lawsuits brought, or insurers providing First
Party Benefits,
The limit of liability shown on the Declarations Page for
Extraordinary Medical Benefits is the most we will pay for
Medical Benefits to or for each Insured person as the
result of any one accident, subject to an annual limit of
$50,000 for each insured person. However, the annual
limit of $50,000 for each insured person does not apply
to medical expense incurred within 18 months from the
date the insured person incurs $100,000 of medical
expense as a result of the accident. This is the most we
will pay regardless of the number of claims made,
vehicles or premiums shown on the Declarations Page,
vehicles involved in the accident, or insurers providing
First Party Benefits.
Any amounts payable under Extraordinary Medical
Benefits shall apply over and above any amounts
available to an insured person for medical expense
under Basic, Added or Combination First Party Benefits
provided in accordance with the Pennsylvania Motor
Vehicle Responsibility Law.
If an insured person who is eligible for Extraordinary
Medical Benefits is also eligible for benefits under the
Catastrophic Loss Trust Fund, the total recovery under
Extraordinary Medical Benefits and Catastrophic Loss
Trust Fund combined shall not exceed $1,000,000.
However, the total amount payable under Extraordinary
Medical Benefits shall not exceed the amount shown on
the Declarations Page.
PRIORITIES OF POLICIES
We will pay First Party Benefits in accordance with the
order or priorities set forth by the Pennsylvania Motor
Vehicle Financial Responsibility Law. We will not pay if
there is another insurer at a higher level of priority. The
First category listed below is the highest level of priority
and the Fourth category listed below is the lowest level of
priority. The priority order is:
First: The insurer providing benefits to the Insured
person as a named insured.
Second: The insurer providing benefits to the insured
person as a relative or a resident 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
insured person is occupying at the time of
the accident.
Fourth: The insurer providing benefits on any motor
vehicle involved in the accident if the
insured person is:
1. Not occupying a motor vehicle, and
2. Not provided First Party Benefits under any other
automobile policy.
In this priority, an unoccupied, parked motor vehicle is
not a motor vehicle involved in an accident unless it was
parked in a manner as to create an unreasonable risk of
injury.
if two or more policies have equal priority within the
highest applicable priority level:
The insurer against whom the claim is first made
shall process and pay the claim as if wholly
responsible. The insurer is thereafter entitled to
recover contribution pro rata from any other insurer
for the benefits paid and the costs of processing the
claim. If contribution is sought among insurers
responsible under the Fourth priority, proration shall
be based on the number of involved motor vehicles.
Form No. 13752P\IA01 Page 8
2. If we are the insurer against whom the claim is first
made, our payment to or for an insured person will
Declarat on liability Page First
not exceed the Party Benefits shownllonbthe limit
3. The maximum recovery under all policies will not
exceed the amount payable under the policy with
highest dollar limits of benefits.
NON-DUPLICATION OF BENEFITS
No one will be entitled to recover duplicate payments for
the same elements of loss under this or any other similar
automobile insurance including self-insurance.
Any amount payable under Extraordinary Medical
Benefits shall be excess over any amount paid, payable
or required to be provided under any workers'
compensation law or similar law.
GENERAL PROVISIONS
Part F is amended as follows:
The OUR RECOVERY RIGHTS provision does not apply
to First Party Benefits.
PART C - UNINSURED MOTORIST COVERAGE
INSURING AGREEMENT
Subject to the limits of liability, if you pay a premium for
Uninsured Motorist Coverage, we will pay damages,
other than punitive or exemplary damages, which an
insured person is legally entitled to recover from the
owner or operator of an uninsured motor vehicle
because of bodily injury:
1_ Sustained by an insured person; and
2. Caused by an accident.
The owner's or operator's liability for these damages
must arise out of the ownership, maintenance or use of
the uninsured motor vehicle.
No judgment for damages arising out of a suit brought
against the owner or operator of an uninsured motor
vehicle is binding on us unless we:
Received reasonable notice of the filing of the suit
resulting in the judgment; and
Had a reasonable opportunity to protect our interest
in the suit.
ADDITIONAL DEFINITIONS USED IN PART C ONLY
"Insured person" as used in this Part means:
1. You, a relative or any resident;
2. Any other person occupying the insured auto with
the permission of the owner; or
3. Any person for damages that person is entitled to
recover because of bodily injury to which this
coverage applies sustained by a person described in
1. or 2. above.
"Uninsured motor vehicle" means a land motor vehicle
or trailer of any type:
Form No. 13752PVA41
1. To which no Bodily Injury Liability bond or policy
applies at the time of the accident.
2. Which is a hit-and-run whose operator or owner
cannot be identified and which hits, or causes an
accident resulting in bodily injury without hitting:
a. You, a relative or any resident;
b. A motor vehicle which you, a relative or any
resident are occupying; or
c. The insured auto.
If there Is no contact with the hit-and-run motor
vehicle, the facts of the accident must be proved.
3. Which is an unidentified motor vehicle that causes
an accident resulting in injury provided the accident
is reported to the police or proper governmental
authority within 48 hours, or as soon thereafter as is
practical; and you or your legal representative notify
us within 30 days, or as soon as practical thereafter,
that you have a legal action arising out of the
accident.
4. To
applies c at theme of the Injury Liability but the bonding
or insuring company:
a. Denies coverage; or
b. Is or becomes:
L Insolvent; or
ii. Involved in insolvency proceedings.
However, uninsured motor vehicle does not include
any vehicle or equipment:
1. Owned by, leased or furnished for the regular use of
you or any insured person.
2. Owned or operated by a self-insurer under any
applicable motor vehicle law.
3. Owned by any governmental unit or agency.
4. Operated on rails or crawler treads.
5. Designed mainly for use off public roads while not on
public roads.
6. While located for use as a residence or premises.
7. Which qualifies as the insured auto under this
policy.
EXCLUSIONS - PART C ONLY
READ THE FOLLOWING EXCLUSIONS CAREFULLY.
COVERAGE ANY N B AFFORDED UNDER LISTED
PART FOR NY OF THE EXXC D
BELOW.
We do not provide Uninsured Motorist Coverage:
For bodily Injury sustained by any person:
a. If that person or their legal representative settles
the bodily injury claim without our consent.
b. For any loss resulting from the ownership,
maintenance or use of a vehicle when used by
an insured person to carry persons or property
for consideration or fee, including but not limited
to retail or wholesale delivery of magazines,
newspapers, food, or any other product. This
exclusion does not apply to shared-expense car
pools.
c. Using a vehicle without permission of the owner
to use the vehicle, or using the vehicle outside
of the scope of permission of the owner.
Page 9
Occupying the insured auto while it is being
operated by someone without the permission of
the owner, or is using the insured auto outside
of the scope of permission of the owner.
2. For non-economic loss sustained by any person to
whom the Limited Tort Alternative applies, resulting
from bodily injury caused by an accident involving
an uninsured motor vehicle, unless the bodily
injury sustained is a serious injury. This exclusion
does not apply:
a. If the owner or operator of the uninsured motor
vehicle:
I. Is convicted, or accepts Accelerated
Rehabilitative Disposition, for driving under
the influence of alcohol or a controlled
substance in that accident;
ii. Is operating a motor vehicle registered in
another state; or
iii. Intends to injure himself or another person,
provided
person
tionally injure himself or another anothere not
intentionally
merely because his act or failure to act is
intentional or done with his realization that it
creates a grave risk of injury if the act or
omission causing the injury is for the
purpose of averting bodily harm to himself or
another person.
b. If that person is injured while occupying a motor
vehicle insured under a commercial motor
vehicle insurance policy.
3., For damage caused intentionally by or at the
direction of an insured person,
4. For loss to the insured auto when made available
for the regular or frequent use of a driver not listed
on the Declarations Page of this policy.
5. For bodily injury or property damage resulting
from the ownership, maintenance, or use of:
a. Any veh icle with more or less than four wheels;
b. Any vehicle designed mainly for use off public
roads, except In a medical emergency;
c. Any vehicle, other than the insured auto, which
is owned by you or available for your regular
use; or
d. Any vehicle, other than the insured auto, which
is owned by a relative, a resident, or regularly
used by a relative or a resident or members of
their immediate families.
6. For property damage, sustained by any person while
occupying or when struck by any motor vehicle
owned by you, a relative or any resident which is
not insured for this coverage under this policy.
7. For property damage to a trailer of any type, any
motor vehicle owned by you to which Collision
Coverage applies under this policy, or any other
vehicle to the extent that there is valid thand
at
collectible Collision Coverage applicable
damage under any other policy.
8. For punitive or exemplary damages awarded as a
punishment or deterrent.
9. For any loss sustained while a vehicle is used to
transport nursery or school children, migrant workers,
or hotellmotel guests. This exclusion does not apply
to your children or children engaged in a car pool
arrangement with you.
10. While the insured auto is used in, or in preparation
for, any race, speed or performance contest, or while
the insured auto is located inside a facility designed
for such events.
11. To benefit any insurer or self-insurer under any of
the following or similar law:
a. Workers' compensation law; or
b. Disability benefits law.
LIMITS OF LIABILITY - PART C ONLY
STACKED UNINSURED MOTORIST COVERAGE
if Stacked Uninsured Motorist Coverage is shown on the
Declarations Page, the following provisions apply:
1. Except as provided in paragraph 2., the limit of
liability shown on the Declarations Page for
Uninsured Motorist Coverage is our maximum limit
of liability for all damages resulting from any one
accident. This is the most we will pay regardless of
the number of:
a. Insured persons;
b. Claims made;
c. Vehicles or premiums shown on the
Declarations Page; or
d. Vehicles involved in the accident.
2. If bodily injury is sustained in an accident by you,
a relative or any resident, our maximum limit of
liability for all damages in any such accident is the
sum of the limits of liability for Uninsured Motorist
Coverage shown on the Declarations Page
applicable to "each vehicle" on the policy. Subject to
this maximum limit of liability for all damages, the
most we will pay for bodily injury sustained by an
insured person other than you, a relative or any
resident is the limit of liability shown on the
Declarations Page applicable to the vehicle the
insured person was occupying at the time of the
accident. This is the most we will pay regardless of
the number of:
a. Insured persons;
b. Claims made;
c. Vehicles or premiums shown on the
Declarations Page; or
d. Vehicles involved in the accident.
3. Any amounts otherwise payable for damages under
this coverage shall be reduced by all sums paid
because of the bodily injury by or on behalf of
persons or organizations that may be legally
responsible. This includes all sums paid under Part
A and Part D of this policy.
4. Any payment under this coverage shall be reduced
by any amount that person is entitled to recover
under Part A or Part D of this policy.
5. No one will be entitled to receive duplicate payments
for the same elements of loss.
6. If an insured person and an uninsured motorist are
jointly to recover liable damages augnder both Part A and Part tC of
this policy.
7. If an uninsured motorist and an underinsured
motorist are jointly liable for damages, no person
shall be entitled to recover damages under both Part
C and Part D of this policy.
Form No. 13752PVA01 Page 10
UNSTACKED UNINSURED MOTORIST COVERAGE
If Unstacked Uninsured Motorist Coverage 'is own on
the Declarations Page, the following provisions apply;
1 elimit of botrist Coverage Is l our i maxmau
for Uninsured M m
limit of liability for all damages resulting from any one
accident. This is the most we will pay regardless of
the number of:
a. Insured persons;
b. Claims made;
c. Vehicles or premiums shown on the
Declarations Page; or
d. Vehicles involved in the accident.
2. Any amounts otherwise payable for damages under
this coverage shall be reduced by all sums paid
because of the bodily injury by or on behalf of
persons or organizations that may be legally
responsible. This includes all sums paid under Part
A and Part D of this policy.
3. Any payment under this coverage shall be reduced
by any amount that person is entitled to recover
under Part A or Part D of this policy.
4. No one will be entitled to receive duplicate payments
for the same elements of loss.
5. If an insured person and an uninsured motorist are
jointly liable for damages, no person shall be entitled
to recover damages under both Part A and Part C of
this policy.
6. If an uninsured motorist and an underinsured
motorist are jointly liable for damages, no person
shall be entitled to recover damages under both Part
C and Part D of this policy.
SPLIT STACKED UNINSURED MOTORIST
COVERAGE. LIMITS
if split Stacked Uninsured Motorist coverage limits
owing
shown on the Declarations Page,
provisions apply:
1. If bodily injury is sustained in an accident by you,
a relative or any resident:
a. Our maximum limit of liability for all damages,
including damages for care, loss of services, or
death, arising out of bodily injury sustained by
any one person in any such accident is the sum
of the limits shown on the Declarations Page for
"each person" for Uninsured Motorist Coverage
applicable to each vehicle on the policy.
b. Subject to the maximum limit for "each person"
described in 1.a. above, our maximum limit of
liability for all damages arising out of bodily
injury resulting from any one accident is the
sum of the limits of liability shown on the
Declarations Page for "each accident" for
Uninsured Motorist Coverage applicable to each
vehicle on the policy.
c. Subject to the maximum limits of liability set forth
in 1 _a. and 1.b. above, the most we will pay for
bodily injury sustained in such accident by an
insured person other than you, a relative or
any resident is the "each person" or "each
accident" limit of liability shown on the
Declarations Page applicable to the vehicle
that the insured person was occupying at the
time of the accident.
Form No. 13752PVA01
The maximum limit of liability is the most we will
pay regardless of the number of:
i. Insured persons;
ii. Claims made;
iii. Vehicles or premiums shown on the
Declarations Page; or
iv. Vehicles involved in the accident.
if bodily injury is sustained by any insured person
other than you, a relative or any resident in an
accident in which neither you nor a relative nor any
resident sustains bodily injury, the limit of liability
shown on the Declarations Page for "each person"
for Uninsured Motorist Coverage is our maximum
limit of liability for all damages, including damages
for care, loss of services, or death, arising out of
bodily injury sustained by any one person in any
one accident. Subject to this limit for "each person,"
the limit of liability shown on the Declarations Page
for "each accident" for Uninsured Motorist Coverage
is our maximum limit of liability for all damages for
bodily injury resulting from any one accident.
This is the most we will pay regardless of the
number of:
a. Insured persons;
b. Claims made;
c. Vehicles or premiums shown on the
Declarations Page; or
d. Vehicles involved in the accident.
3. Any amounts otherwise payable for damages under
this coverage shall be reduced by all sums paid
because of the bodily injury by or on behalf of
persons or organizations that may be legally
responsible. This includes all sums paid under Part
A and Part D of this policy-
4. Any payment under this coverage shall be reduced
by any amount -that person is entitled to recover
under Part A or Part D of this policy.
5. No one will be entitled to receive duplicate payments
for the same elements of loss.
6. If an insured person and an uninsured motorist are
jointly liable for damages, no person shall be entitled
to recover damages under both Part A and Part C of
this policy.
7. If an uninsured motorist and an underinsured
motorist are jointly liable for damages, no person
shall be entitled to recover damages under both Part
C and Part D of this policy.
SPLIT UNSTACKED UNINSURED MOTORIST
COVERAGE LIMITS g
are Split heUDecla Declarations Motorist the afole limits
lowing
provisions apply:
1. The limit of liability shown on the Declarations Page
for e"each Uninsured y for otorist damag
our maximum limit oliability es,
including damages for care, loss of services, or
death, arising out of bodily injury sustained by any
one person in any one accident. Subject to this limit
for "each person," the limit of liability shown on the
Declarations Page for "each accident" for
Uninsured Motorist Coverage is our maximum limit
of liability for all damages for bodily injury resulting
from any one accident. This is the most we will pay
regardless of the number of:
Page 11
insured persons;
Claims made;
Vehicles or premiums shown on the
Declarations Page; or
Vehicles involved in the accident.
2. Any amounts otherwise payable for damages under
this coverage shall be reduced by all' sums paid
because of the bodily injury by or on behalf of
persons or organizations that may be legally
responsible. This includes all sums paid under Part
A and Part D of this policy.
3. Any payment under this coverage shall be reduced
by any amount that person is entitled to recover
under Part A or Part D of this policy.
4. No one will be entitled to receive duplicate payments
for the same elements of loss.
5. If an insured person and an uninsured motorist are
jointly liable for damages, no person shall be entitled
to recover damages under both Part A and Part C of
this policy.
6. If an uninsured motorist and an underinsured
motorist are jointly liable for damages, no person
shall be entitled to recover damages under both Part
C and Part D of this policy.
OTHER INSURANCE - PART C ONLY
STACKED UNINSURED MOTORIST COVERAGE
If Stacked Uninsured Motorist Coverage is shown on the
Declarations Page, the following provisions apply:
If there is other applicable similar insurance available
under more than one policy or provision of coverage, the
following priorities of recovery apply:
First: The Uninsured Motorist Coverage applicable
to the vehicle the insured person was
occupying at the time of the accident.
Second: The policy affording Uninsured Motorist
Coverage, to the insured person as a
named insured, a relative or a resident.
If two or more policies have equal priority, the insurer
against whom the claim is first made shall process and
pay the claim. as if wholly responsible for all insurers with
equal priority.: The insurer is thereafter entitled to recover
contribution pro rata , from any other insurer for the
benefits paid and the costs of processing the claim.
UNSTACKED UNINSURED MOTORIST COVERAGE
If Unstacked Uninsured Motorist Coverage is shown on
the Declarations Page, the following provisions apply:
If there is other applicable similar insurance available
under more than one policy or provision of coverage, the
following priorities of recovery apply:
First: The Uninsured Motorist Coverage applicable
to the vehicle the insured person was
occupying at the time of the accident.
Second: The policy affording Uninsured Motorist
Coverage to the insured person as a
named insured, a relative or a resident.
When there is applicable insurance available under
the First priority:
a. The limit of liability applicable to the vehicle the
insured person was occupying, under the
policy in the first priority, shall first be
exhausted; and
b. The maximum recovery under all policies in the
Second priority shall not exceed the amount by
which the highest limit for any one vehicle under
anyone policy in the Second priority exceeds the
limit applicable under the policy in the First priority.
When there is no applicable insurance available
under the First priority, the maximum recovery under
all policies in the Second priority shall not exceed the
highest applicable limit for any one vehicle under
any one policy.
If two or more policies have equal priority, the insurer
against whom the claim is first made shall process and
pay the claim as if wholly responsible for all insurers with
equal priority. The insurer is thereafter entitled to
recover contribution pro rata from any other insurer for
the benefits paid and the costs of processing the claim.
SPLIT STACKED UNINSURED MOTORIST
COVERAGE LIMITS
if Split Stacked Uninsured Motorist Coverage is shown on
the Declarations Page, the following provisions apply:
If there is other applicable similar insurance available
under more than one policy or provision of coverage, the
following priorities of recovery apply:
First: The Uninsured Motorist Coverage applicable
to the vehicle the insured person was
occupying at the time of the accident.
Second: The policy affording Uninsured Motorist
Coverage to the insured person as a
named insured, a relative or a resident.
If two or more policies have equal priority, the insurer
against whom the claim is first made shall process and
pay the claim as if wholly responsible for all insurers with
equal priority.
The insurer is thereafter entitled to recover contribution
pro rata from any other insurer for the benefits paid and
the costs of processing the claim.
SPLIT UNSTACKED UNINSURED MOTORIST LIMITS
If Split Unstacked Uninsured Motorist is shown on the
Declarations Page, the following provisions apply:
If there is other applicable similar insurance available
under more than one policy or provision of coverage, the
following priorities of recovery apply:
First: The Uninsured Motorist Coverage applicable
to the vehicle the insured person was
occupying at the time of the accident.
Second: The policy affording Uninsured Motorist
Coverage to the insured person as a
named insured, a relative or a resident.
When there is applicable insurance available under
the First priority:
a. The limit of liability applicable to the vehicle the
insured person was occupying, under the
policy in the First priority, shall first be
exhausted; and
Form No. 13752PVAOI Page 19
b. The maximum recovery under all policies in the
Second priority shall not exceed the amount by
which the highest limit for any one vehicle under
any one policy in the Second priority exceeds the
limit applicable under the policy in the First priority.
2. When there is no applicable insurance available
under the First priority, the maximum recovery under
all policies in the Second priority shall not exceed the
highest applicable limit for any one vehicle under
any one policy.
If two or more policies have equal priority, the insurer
against whom the claim is first made shall process and
pay the claim as if wholly responsible for all insurers with
equal priority. The insurer is thereafter entitled to recover
contriution t paid and the costs of processing the claim. from an othr insurer for the
ARBITRATION y_?
If we and an insured person do not agree whether the
insured person is legally entitled to recover damages
amount of
under the
the damages, either party may make a writ n demand
for arbitration,
Arbitration shall be conducted in accordance with the
provisions of the Pennsylvania Arbitration Act of 1927.
Each party will select an arbitrator. The two arbitrators
will select a third. If they cannot agree within 30 days,
either may request selection be made by a judge of a
court having jurisdiction.
the expenses party of the thi d t incurs and arbitrator
equally.
Unless both parties agree otherwise, arbitration will take
place in the county in which the insured person lives.
LocI urules of nless the arbitrators agree on evidence will
rules. Each
apply
party shall have the right of full discovery.
Unless both parties agree otherwise, the arbitrators shall
have no authority to determine issues related to
coverage under this Part, including, but not limited to,
stacking or non-stacking of coverage, waivers of
coverage, residency, statutes of limitations, or whether a
person qualifies as an insured person.
A written decision agreed to by two of the arbitrators will
be binding as to whether the insured person is legally
entitled to recover damages and the amount of
damages, sUb'ect to the terms of this policy. The
arbitrators shall have no authority to award an amount in
excess of the limit of liability stated on the Declarations
Page. The arbitrators shall have no authority to
determine coverage under the policy.
As a part of our claims handling procedures, we may
use software that is designed to evaluate bodily injury
under Part C - Uninsured Motorist Coverage.
GENERAL- PROVISIONS
The following is added to the Two or More Auto Policies
provision in Part F:
TWO OR MORE AUTO POLICIES
This provision does not apply to Stacked Uninsured
Motorist Coverage.
2. No one will be entitled to receive duplicate payments
for the same elements of loss under Uninsured
Motorist Coverage.
PART D - UNDERINSURED MOTORIST
COVERAGE
INSURING AGREEMENT
We will pay damages, other than punitive or exemplary
damages, which the insured person is legally entitled to
recover r the owner or operator of an underinsured
motor vehicle because of bodily injury sustained by an
insured person and caused by an accident.
The owner's or operator's liability for these damages
must arise out of the ownership, maintenance or use of
the underinsured motor vehicle. We will pay under
this coverage only after the limits of liability under all
applicable Bodily Injury Liability bonds or policies have
been exhausted by payment of" judgments or
settlements.
No judgment for damages arising out of a suit brought
against the owner or operator of an underinsured
motor vehicle is binding on us unless we:
1. Received reasonable notice of the filing of the suit
resulting in the judgment; and
2. Had a reasonable opportunity to protect our interests
in the suit.
ADDITIONAL DEFINITIONS USED IN PART D ONLY
"Insured person" as used in this Part means:
1. You, a relative or any resident;
2. Any other person occupying the insured auto with
the permission of the owner; or
3. Any person for damages that person is entitled to
recover because of bodily injury to which this
coverage applies sustained by a person described in
1. or 2. above.
"Underinsured motor vehicle" means a land motor
vehicle or trailer of any type to which a Bodily Injury
Liability bond or policy applies at the time of the accident
but the amount paid for bodily injury under that bond or
policy to an insured person is not enough to pay the
amount the insured person is legally entitled to recover
as damages.
However, underinsured motor vehicle does not
include any vehicle or equipment:
1. Owned by, leased or furnished for the regular use of
you or any insured person.
2. Owned by any governmental unit or agency.
3. Operated on rails or crawler treads.
4. Designed mainly for use off public roads while not on
public roads.
5. While located for use as a residence or premises.
6. Which qualifies as the insured auto underthis policy.
Form No.13752PVA01 Page 13
EXCLUSIONS - PART D ONLY
READ THE FOLLOWING EXCLUSIONS CAREFULLY.
COVERAGE WILL NOT BE AFFORDED UNDER THIS
PART FOR ANY OF THE EXCLUSIONS LISTED
BELOW.
We do not provide Underinsured Motorist Coverage:
1. For bodily injury sustained by any person:
a. If that person or their legal representative settles
the bodily injury claim without our consent.
b. For any loss resulting from the ownership,
maintenance or use of a vehicle when used by
an Insured person to carry persons or property
for consideration or fee, including but not limited
to retail or wholesale delivery of magazines,
newspapers, food, or any other product. This
exclusion does not apply to shared-expense car
pools.
c. Using a vehicle without permission of the owner
to use the vehicle, or using the vehicle outside
of the scope of permission of the owner.
d. Occupying the insured auto while it is being
operated by someone without the permission of
the owner, or using the insured auto outside of
the scope of permission of the owner.
2. For non-economic loss sustained by any person to
whom the Limited Tort Alternative applies, resulting
from bodily injury caused by an accident involving
an underinsured motor vehicle unless the bodily
injury sustained is a serious injury. This exclusion
does not apply:
a. If the owner or operator of the underinsured
motor vehicle:
i. Is convicted, or accepts Accelerated
Rehabilitative Disposition, for driving under
the influence of alcohol or a controlled
substance in that accident;
ii. Is operating a motor vehicle registered in
another state; or
iii. Intends to injure himself or another person,
provided that the individual does not
intentionally injure himself or another person
merely because his act or failure to act is
intentional or done with his realization that it
creates a grave risk of injury if the act or
omission causing the injury is for the
purpose of averting bodily harm to himself or
another person.
b. If that person is injured while occupying a motor
vehicle insured under a commercial motor
vehicle insurance policy-
3. For damage caused intentionally by or at the
direction of an insured person.
4. For loss to the insured auto when made available
for the regular or frequent use of a driver not listed
on the Declarations Page of this policy.
5. For bodily injury or property damage resulting
from the ownership, maintenance, or use of:
a. Any vehicle with more or less than four wheels:
b. Any vehicle designed mainly for use off public
roads, except in a medical emergency;
c. Any vehicle, other than the insured auto, which
is owned by you or available for your regular
use; or
d. Any vehicle, other than the insured auto, which
is owned by a relative or a resident, or regularly
used by a relative or a resident or members of
their immediate families.
6. For property damage sustained by any person while
occupying or when struck by any motor vehicle
owned by you, a relative or any resident which Is
not insured for this coverage under this policy.
7. For property damage to a trailer of any type, any
motor vehicle owned by you to which Collision
Coverage applies under this policy, or any other
motor vehicle to the extent that there is valid and
collectible Collision Coverage applicable to that
damage under any other policy.
8. For punitive or exemplary damages awarded as a
punishment or deterrent.
9. For any loss sustained while a vehicle is used to
transport nursery or school children, migrant
workers, or hotel/motel guests. This exclusion does
not apply to your children or children engaged in a
car pool arrangement with you.
10. While the insured auto is used in, or in preparation
for, any race, speed or performance contest, or while
the insured auto is located inside a facility designed
for such events.
11, To benefit any insurer or self-insurer under any of
the following or similar law:
a. Workers' compensation law; or
b. Disability benefits law.
LIMITS OF LIABILITY - PART D ONLY
STACKED UNDERINSURED MOTORIST COVERAGE
If Stacked Underinsured Motorist Coverage is shown on
the Declarations Page, the following provisions apply:
1. Except as provided in paragraph 2. the limit of liability
shown on the Declarations Page for Underinsured
Motorist Coverage is our maximum limit of liability for
all damages resulting from any one accident. This is
the most we will pay regardless of the number of:
a. Insured persons;
b. Claims made;
c. Vehicles or premiums shown on the
Declarations Page; or
d. Vehicles involved in the accident.
2. If bodily injury is sustained in an accident by you, a
relative or any resident, our maximum limit of liability
for all damages in any such accident is the sum of the
limits of liability for Underinsured Motorist Coverage
shown on the Declarations Page applicable to "each
vehicle" on the policy. Subject to this maximum limit
of liability for all damages, the most we will pay for
bodily injury sustained by an insured person other
than you, a relative or any resident is the limit of
liability shown on the Declarations Page applicable
to the vehicle the insured person was occupying
at the time of the accident, This is the most we will
pay regardless of the number of:
a. Insured persons;
b. Claims made;
c. Vehicles or premiums shown on the
Declarations Page; or
d. Vehicles involved in the accident.
3. Any amounts otherwise payable for damages under
this coverage shall be reduced by all sums paid
because of the bodily injury by or on behalf of
persons or organizations that may be legally
responsible. This includes all sums paid under Part
A and Part C of this policy.
Form No. 13752PVA01 Page 14
4. Any payment under this coverage shall be reduced
by any amount that person is entitled to recover
under Part A or Part C of this policy.
5. No one will be entitled to receive duplicate payments
for the same elements of loss.
U. If an insured person and an underinsured motorist
are jointly liable for damages, no person shall be
entitled to recover damages under both Part A and
Part D of this policy.
7. If an uninsured motorist and an underinsured
motorist are jointly liable for damages, no person
shall be entitled to recover damages under both Part
C and Part D of this policy.
UNSTACKED UNDERINSURED MOTORIST
COVERAGE
If Unstacked Underinsured Motorist Coverage is shown
on the Declarations Page, the following provisions apply.-
1 . The limit of liability shown on the Declarations Page
for Underinsured Motorist Coverage is our maximum
limit of liability for all damages resulting from any one
accident. This is the most we will pay regardless of
the number of:
a. Insured persons;
b. Claims made;
c. Vehicles or premiums shown on the
Declarations Page; or
d. Vehicles involved in the accident.
2. Any amounts otherwise payable for damages under
this coverage shall be reduced by all sums paid
because of the bodily injury by or on behalf of
persons or organizations that may be legally
responsible. This includes all sums paid under Part
A and Part C of this policy.
3. Any payment under this coverage shall be reduced
by any amount that person is entitled to recover
under Part A or Part C of this policy.
4. No one will be entitled to receive duplicate payments
for the same elements of loss.
5. If an insured person and an underinsured motorist
are jointly liable for damages, no person shall be
entitled to recover damages under both Part A and
Part D of this policy.
6. If an uninsured motorist and an underinsured
motorist are jointly liable for damages, no person
shall be entitled to recover damages under both Part
C and Part D of this policy.
SPLIT STACKED UNDERINSURED MOTORIST
COVERAGE LIMITS
If Split Stacked Underinsured Motorist Coverage limits
are shown on the Declarations Page, the following
provisions apply:
1. If bodily injury is sustained in an accident by you,
a relative or any resident:
a. Our maximum limit of liability for all damages,
including damages for care, loss of services, or
death, arising out of bodily injury sustained
by any one person in any such accident is the
sum of the limits of liability shown on the
Declarations Page for "each person" for
Underinsured Motorist Coverage applicable to
"each vehicle" on the policy.
b. Subject to the maximum limit for each person
described in 1.a. above, our maximum limit of
liability for all damages arising out of bodily
injury resulting from any one accident is the
sum of the limits of liability shown on the
Declarations Page for "each accident" for
Underinsured Motorist Coverage applicable to
"each vehicle" on the policy.
c. Subject to the maximum limits of liability set forth
in 1.a. and 1.b. above, the most we will pay for
bodily injury sustained in such accident by an
insured person other than you, a relative or
any resident is the "each person" or "each
accident" limit of liability shown on the
Declarations Page applicable to the vehicle
that the Insured person was occupying: at the
time of the accident.
The maximum limit of liability is the most we will
pay regardless of the number of:
1. Insured persons;
ii. Claims made;
iii. Vehicles or premiums shown on the
Declarations Page; or
iv. Vehicles involved in the accident.
If bodily injury is sustained by any insured person
other than you, a relative or any resident in an
accident in which neither you nor any relative nor
any resident sustains bodily injury, the limit of
liability shown on the Declarations Page for "each
person" for Underinsured Motorist Coverage is our
maximum limit of liability for all damages, including
damages for care, loss of services, or death,
arising out of bodily injury sustained by any one
person in any one accident. Subject to this limit
for "each person," the limit of liability shown on
the Declarations Page for "each accident" for
Underinsured Motorist Coverage is our maximum
limit of liability for all damages for bodily injury
resulting from any one accident. This is the most
we will pay regardless of the number of;
a. Insured persons;
b. Claims made;
c. Vehicles or premiums shown on the
Declarations Page: or
d. Vehicles involved in the accident.
3. Any amounts otherwise payable for damages under
this coverage shall be reduced by all sums paid
because of the bodily Injury by or -on behalf of
persons or organizations who may be legally
responsible. This includes all sums paid under Part
A and Part C of this policy.
4. Any payment under this coverage shall be reduced
by any amount that person is entitled to recover
under Part A or Part C of this policy.
5. No one will be entitled to receive duplicate payments
for the same elements of loss.
6. If an insured person and an underinsured motorist
are jointly liable for damages, no person shall be
entitled to recover damages under both Part A and
Part D of this policy.
7. If an uninsured motorist and an underinsured
motorist are jointly liable for damages, no person
shall be entitled to recover damages under both Part
C and Part D of this policy.
Form No. 13752PVA01 Page 15
SPLIT UNSTACKED UNDERINSURED MOTORIST
COVERAGE LIMITS
If Split Unstacked Underinsured Motorist Coverage limits
are shown on the Declarations Page, the following
provisions apply;
1. The limit of liability shown on the Declarations Page
for "each person" for Underinsured Motorist
Coverage is our maximum limit of liability for all
damages, including damages for care, loss of
services, or death, arising out of bodily injury
sustained by any one person in any one accident.
Subject to this limit for "each person," the limit of
liability shown on the Declarations Page for "each
accident" for Underinsured Motorist Coverage is our
maximum limit of liability for all damages for bodily
injury resulting from any one accident. This is the
most we will pay regardless of the number of:
a. Insured persons;
b. Claims made;
c. Vehicles or premiums shown on the
Declarations Page; or
d. Vehicles involved in the accident.
2. Any amounts otherwise payable for damages under
this coverage shall be reduced by all sums paid
because of the bodily injury by or on behalf of
persons or organizations that may be legally
responsible. This includes all sums paid under Part
A and Part C of this policy.
3. Any payment under this coverage shall be reduced
by any amount that person is entitled to recover
under Part A or Part C. of this policy.
4. No one will be entitled to receive duplicate payments
for the same elements of loss.
5. If an insured person and an underinsured motorist
are jointly liable for damages, no person shall be
entitled to recover damages under both Part A and
Part D of this policy.
6. If an uninsured motorist and an underinsured
motorist are jointly liable for damages, no person
shall be entitled to recover damages under both Part
C and Part 0 of this policy.
OTHER INSURANCE --FART D ONLY
STACKED UNDERINSURED MOTORIST COVERAGE
If Stacked Underinsured Motorist Coverage is shown on
the Declarations Page, the following provisions apply:
If there is other applicable similar insurance available
under more than one policy or provision of coverage, the
following priorities of recovery apply:
First: The Underinsured Motorist Coverage
applicable to the vehicle the insured
person was occupying at the time of the
accident.
Second: The policy affording Underinsured Motorist
Coverage to the insured person as a
named insured, a relative or a resident.
If two or more policies have equal priority, the insurer
against whom the claim is first made shall process and
pay the claim as if wholly responsible for all insurers with
equal priority. The insurer is thereafter entitled to
recover contribution pro rata from any other insurer for
the benefits paid and the costs of processing the claim.
UNSTACKED UNDERINSURED MOTORIST
COVERAGE
If Unstacked Underinsured Motorist Coverage is shown
on the Declarations Page, the following provisions apply:
If there is other applicable similar insurance available
under more than one policy or provision of coverage, the
following priorities of recovery apply:
First: The Underinsured Motorist Coverage
applicable to the vehicle the insured person
was occupying at the time of the accident.
Second: The policy affording Underinsured Motorist
Coverage to the insured person as a named
insured, a relative or a resident.
1. When there is applicable insurance available under
the First priority:
a. The limit of liability applicable to the vehicle the
insured person was occupying, under the First
priority, shall first be exhausted; and
b. The maximum recovery under all policies in the
Second priority shall not exceed the amount by
which the highest limit for any one vehicle under
any one policy in the Second priority exceeds the
limit applicable under the policy in the First priority.
2. When there is no applicable insurance available
under the First priority, the maximum recovery under
all policies in the Second priority shall not exceed the
highest applicable limit for any one vehicle under
any one policy.
If two or more policies have equal priority, the insurer
against whom the claim is first made shall process and
pay the claim as if wholly responsible for all insurers with
equal priority. The insurer is thereafter entitled to
recover contribution pro rata from any other insurer for
the benefits paid and the costs of processing the claim.
SPLIT STACKED UNDERINSURED MOTORIST
COVERAGE LIMITS
if Split Stacked Underinsured Motorist Coverage limits
are shown on the Declarations Page, the following
provisions apply:
If there is other applicable similar insurance available
under more than one policy or provision of coverage, the
following priorities of recovery apply:
First: The Underinsured Motorist Coverage
applicable to the vehicle the insured
person was occupying at the time of the
accident.
Second: The policy affording Underinsured Motorist
Coverage to the insured person as a
named insured, a relative or a resident.
if two or more policies have equal priority, the insurer
against whom the claim is first made shall process and
pay the claim as If wholly responsible for all insurers with
equal priority- The insurer is thereafter entitled to
recover contribution pro rata from any other insurer for
the benefits paid and the costs of processing the claim.
SPLIT UNSTACKED UNDERINSURED MOTORIST
COVERAGE LIMITS
If Split Unstacked Underinsured Motorist Coverage is
shown on the Declarations Page, the following
provisions apply:
Form No. 13752PVA01 Page 16
If there is other applicable similar insurance available
under more than one policy or provision of coverage, the
following priorities of recovery apply:
First: The Underinsured Motorist Coverage
applicable to the vehicle the insured person
was occupying at the time of the accident.
Second: The policy affording Underinsured Motorist
Coverage to the insured person as a named
insured, a relative or a resident,
1. When there is applicable insurance available under
the First priority:
a. The limit of liability applicable to the vehicle the
insured person was occupying, under the First
priority, shall first be exhausted; and
b. The maximum recovery under all policies in the
Second priority shall not exceed the amount by
which the highest limit for any one vehicle'under
any one policy in the Second priority exceeds the
limit applicable under the policy in the First priority.
2. When there is no applicable insurance available
under the First priority, the maximum recovery under
all policies in the Second priority shall not exceed the
highest applicable limit for any one vehicle under
any one policy.
If two or more policies have equal priority, the insurer
against whom the claim is first made shall process and
pay the claim as if wholly responsible for all insurers with
equal priority. The insurer is thereafter entitled to
recover contribution pro rata from any other insurer for
the benefits paid and the costs of processing the claim.
ARBITRATION
If we and an insured person do not agree whether the
insured person is legally entitled to recover damages
under the applicable liability law or as to the amount of
the damages, either party may make a written demand
for arbitration.
Arbitration shall be conducted in accordance with the
provisions of the Pennsylvania Arbitration Act of 1927.
Each party will select an arbitrator. The two arbitrators
will select a third. If they cannot agree within 30 days,
either may request selection be made by a judge of a
court having jurisdiction. Each party will pay the expense
it incurs and bear the expenses of the third arbitrator
equally.
Unless both parties agree otherwise, arbitration will take
place in the county in which the insured person lives.
Local rules of law as to procedure and evidence will
apply unless the arbitrators agree on other rules, Each
party shall have the right of full discovery.
Unless both parties agree otherwise, the arbitrators shalt
have no authority to determine issues related to
coverage under this Part, including, but not limited to,
stacking or non-stacking of coverage, waivers of
coverage, residency, statutes of limitations, or whether a
person qualifies as an insured person.
A written decision agreed to by two of the arbitrators will
be binding as to whether the insured person is legally
entitled to recover damages and the amount of damages,
subject to the terms of this policy. The arbitrators shall
have no authority to award an amount in excess of the
limit of liability stated on the Declarations Page. The
arbitrators shall have no authority to determine coverage
under the policy.
As a part of our claims handling procedures, we may
use software that is designed to evaluate bodily injury
under Part Q - Underinsured Motorist Coverage.
GENERAL PROVISIONS
The following is added to the Two or More Auto Policies
provision in Part F:
TWO OR MORE AUTO POLICIES
1. This provision does not apply to Underinsured
Motorist Coverage.
2. No one will be entitled to receive duplicate payments
for the same elements of loss under Underinsured
Motorist Coverage.
DART E - COVERAGE FOR DAMAGE
TO THE INSURED AUTO
INSURING AGREEMENT
If the Declarations Page shows a premium charged for
Comprehensive Coverage, we will pay for direct and
accidental comprehensive loss to the insured auto,
less any applicable deductible for each separate loss.
This shall include its factory-installed equipment.
If the Declarations Page shows a premium charged for
Collision Coverage, we will pay for direct and accidental
loss to the insured auto caused by collision, less any
applicable deductible for each separate loss. This shall
include its factory-installed equipment.
ADDITIONAL DEFINITIONS USED IN PART E ONLY
1. "Actual cash value" means market value at the time
of the loss based upon vehicle mileage, age,
condition, original optional equipment, and
comparable vehicles available for sale within a
reasonable geographic radius as documented in an
electronic database of publications and dealerships,
less depreciation and/or betterment.
2. "Aftermarket parts" means replacement auto parts
not made by the original manufacturer of the motor
vehicle or by a manufacturer authorized by the
original manufacturer to use its name or trademark.
3. "Betterment" means a deduction for making an item
better or adding value thereto.
4. "Collision" means loss caused by the insured
auto's upset or overturn, or sudden impact with
another object.
5. "Comprehensive" means loss to the insured auto
caused by an event other than collision.
Comprehensive loss includes, but is not limited to,
loss caused by missiles, falling objects, fire, theft or
larceny. It also includes explosion, earthquake,
volcanic activity, windstorm, hail, water, flood,
malicious mischief or vandalism, riot or civil
commotion, contact with a bird or animal, or
breakage of glass. If breakage of glass results from
collision, you may elect to have it treated as loss
caused by collision.
6. "Custom or additional equipment" means any
equipment that was not installed at the factory or
added as original equipment when the vehicle was
purchased as new.
Form No. 13752PVA01 Page 17
ducted from the
7 Decllarat olns iPagetansum d will b?ehdeis shown on the
loss.
g. "Depreciation" means the loss of value caused by
physical, technological, social, and/or location
deterioration.
9. "Diminution of value' means the difference in the
actual cash value of the insured auto immediately
before and after a loss.
10. "Loss' means sudden, direct, and accidental
damage to, or theft of, the insured auto, including
its original optional equipment, which is permanently
installed at the factory by the vehicle manufacturer or
authorized dealer. Custom or additional
equipment over the maximum limit of $500 under
this Part is covered only if it is declared before the
loss and you pay an additional premium.
Equipment installed or alterations made by
to
conversion facilities
an auto or camper are considered standard or original optional equipment.
11. "The insured auto" shall also mean a rental vehicle
rented from a commercially licensed rental agency,
and while used as a substitute auto for any other
auto described in this policy for which coverage
under this Part is provided. However, coverage
under this Part does not apply:
a. to any auto driven outside the United States of
America;
b. to compensate any party for loss of use or rental
value;
c. to any rental vehicle or trailer used in any
business, including an auto business; or
eany xcess auto of fourteen (14) iconsecutive r calendar
d. in to
days.
EXC U ISL ONS - PART EON -ONLY
READ THE FOLLOWING EXCLUSIONS CAREFULLY.
COVERAGE ANY NOT BE AFFORDED ELISTE
PART FOR NY OF THE EXCLUSIONS D
BELOW.
We do not cover loss:
1. That results from nuclear reactions, radiation, or
fallout.
2 Covered of that pocy ae exhaustlee policy, even if
he limits
3. That results from the ownership, maintenance, or
the insured
use of t
sonsorpr property for at fee or while compensato transport This
exclusion does not apply to shared-expense car
pools.
4. To the insured auto white it is rented or leased to
others.
5. To clothes, tools, or other personal effects.
8. Resulting from the use of any vehicle in any racing
event or off-road recreational activity.
9. To any
ownership of any auto business.
employment br y vehicle
10. Resulting from the ownership, maintenance, or use
of a vehicle or trailer while a person is engaged in
any business activity other than auto business
activities. This exclusion includes use of a vehicle
for delivery of goods or services arising out of any
business. The exclusion does not apply if "business
use" of the insured auto has been declared and
you pay an additional premium.
11. Resulting from the use of the insured auto for snow
removal.
12. Caused by war (declared or undeclared), civil war,
insurrection, rebellion, or revolution.
13. Caused not odescribed r on ythe trailer
Decla ations bPage.
However, coverage does apply to loss to a camper
body or trailer which you acquire during the policy
after
period if
you acquire it and pay any insure requiredi premium s when
due.
14. Resulting from prior loss or damage, manufacturers`
defects, wear and tear, freezing, mechanical or
electrical breakdown or failure, or road damage to
tires. However, coverage does apply if the loss is
the result of other loss covered by this policy.
15. To any modified suspension equipment, modified
engines, modified carburetor systems, or modified
equipment, including but not limited to:
a. Aluminum, magnesium, chrome or alloy wheels:
b. Special wide-tread tires or slicks.
This exclusion does not apply to special equipment
as outlined under Custom or Additional Equipment
Coverage.
16. To winches, utility boxes, or tool boxes.
17. To tapes, compact discs, records, cassettes, or
similar recording or recorded media used with sound
equipment, including any cases or other containers
used in storing or carrying such items.
18
19
6. To property the insured person rents, uses, or has 20
charge of, including loss of its use. This does not
apply to a rental vehicle subject to the definition of
insured auto as used in this Part.
7. To any vehicle other. than one With four
unless specifically listed on the Declarations Page wheels
To custom paint, murals, decals or graphics, special
carpeting or furnishings. To custom sunroofs, moon
roofs, t-bar roofs or height extending roofs, bubble
domes or similar windows. To refrigeration or cooking
equipment and any equipment used for sleeping.
To any electronic equipment, antennas, other
devices used exclusively or primarily to send or
receive audio, visual, or data signals, or to play back
recorded media. This is provided that such equipment
or device is not permanently installed in the dash or
console opening of the insured auto by the vehicle
manufacturer or dealer. It also will not be specified as
original equipment by the vehicle manufacturer.
To sound receiving or transmitting equipment
designed for use as citizen band radios or two-way
mobile radios. Also, televisions not permanently
installed in the insured auto by the vehicle
manufacturer or dealer and specified as original
equipment by the vehicle manufacturer, VCRs,
Page 18
Form No. 13752PVA01
telephones not originally installed by the original
make and model vehicle manufacturer or dealer.
Also, home high fidelity equipment, scanning monitor
receivers, radar or laser detectors. Also, any other
detection equipment. for speed-measuring devices,
or any accessories or antennas to any of these types
of equipment.
21. To TV antennas, awnings, cabanas, or equipment
designed to provide additional living facilities.
22. To the insured auto while in the care, custody, or
control of any person for the purpose of selling the
insured auto.
23. Caused intentionally by, or at the direction of you, a
relative, a resident, or anyone using the insured
-auto with your express or Implied permission and
within the scope of such permission.
24. To the insured auto caused by or resulting from
your acquiring an auto from the seller without legal
titles available to you.
25. To the insured auto while being operated by a
person or persons specifically excluded by
endorsement.
26. To any vehicle that is subject to bailment lease,
conditional sale or consignment agreement not
specifically declared and described in this policy.
27. Caused to the insured auto when it is driven,
operated or used with your express or implied
permission by a person who:
a. is under the minimum age to obtain legal
authority to drive,
b. does not have a valid driver's license, or
c. has had their driving privileges rescinded by
either license suspension or revocation.
28. Caused to the insured auto when it is driven,
operated or used by any person who resides in your
household or has regular use of the insured auto
and such person is not listed or endorsed on the
policy prior to loss.
29. Arising out of or.due to the use of the vehicle for
transportation of any explosive substance,
flammable liquid, or similarly hazardous materials,
except transportation incidental to your ordinary
household activities.
30. Due to confiscation or destruction by governmental
or civil authorities.
31. To paint or discoloration of paint resulting from acid
rain, smoke, smog, chemicals, salt, tree sap, or
animal or bird droppings unless such loss is a direct
result of collision or vandalism.
32_ While the insured auto is used in the commission of
a crime. This exclusion applies only while the
insured auto is being used by you, a relative, a
resident, or anyone with your express or implied
permission.
33. To the insured auto, non-owned auto or trailer for
diminution of value.
34. To any non-owned auto.
35. Caused by the theft or conversion of the insured
auto by a person to whom you have voluntarily
entrusted the insured auto. This exclusion does
not apply when the insured auto is stolen from the
person to whom you loaned the auto, if the theft is
reported to the police within 24 hours of the loss.
36. To any non-dealer or non-factory installed equipment
that mechanically or structurally changes the
insured auto. This change results in an increase in
performance or a change in appearance.
37. To, or for loss of use of, a rental vehicle rented by
you, a relative or a resident if a rental vehicle
company is precluded from recovering such loss or
loss of use, from you, a relative or a resident
pursuant to the provisions of any applicable rental
agreement or state law.
38. To any rental vehicle or substitute auto when used
by you, a relative or a resident without the owner's
express or Implied permission or outside the scope
of the owner's permission.
LIMITS OF LIABILITY - PART E ONLY
Our limits of liability for loss shall not exceed the lesser
of:
1. The actual cash value of the stolen or damaged
property, at the time of loss, which may include an
adjustment for depreciation andlor betterment;
2. The amount necessary to repair or replace the
property to its physical condition at the time of loss
using parts produced by or for the vehicle's
manufacturer or parts from other sources including,
but not limited to, aftermarket parts, as specified in
Payment of Loss - Part E Only; or
3. The amount necessary to repair or replace a trailer
not owned by you, a relative or a resident subject
to a maximum of $500.
Non-excluded custom or additional equipment is
covered subject to a maximum limit of $500. This Is the
maximum limit unless you have reported the value to us
prior to the loss. You must also have then paid a
premium for the Custom or Additional Equipment
coverage as shown on the Declarations Page to apply.
Our limit of liability for this equipment shall be the lesser
of:
1. The actual cash value of the stolen or damaged
property, at the time of loss, which may include an
adjustment for depreciation and/or betterment or,
2. The declared value.
All claims submitted under this Part shall be subject to
the applicable deductibles shown on the Declarations
Page. Any applicable deductible amount and salvage
value, if you retain the salvage, is subtracted from all
toss payments.
We may elect to pay for the cost to repair or replace the
property or part. If so, then our liability does not include
any decrease in the property's value, however measured,
resulting from the loss and/or repair or replacement. If
repair or replacement results in the betterment of the
property or part, we will not pay for the betterment.
Form No.13752PVA01 Page 19
Coverage under this Part may apply to a vehicle you do
not own. If so, then our liability is limited to the highest
actual cash value of the auto described on the
Declarations Page for which coverage under this Part
has been purchased.
More than one auto shown on the Declarations Page
may be insured under this Part of the policy. If so, then
our limit of liability shall not exceed the actual cash
value of the highest-valued auto shown on the
Declarations Page.
Loss to the insured auto may also be payable under
the Liability Coverage of another policy issued by us. If
so, then we will pay for such damage or loss only once,
either under this policy or under the Liability section of
the other policy.
Sound reproducing equipment and component parts
shall be subject to a maximum limit of $1,000. This shall
be in total when permanently installed by a factory or
dealer as original equipment in the dash or console
opening of the insured auto.
APPRAISAL - PART E ONLY
You or we may demand appraisal of the toss. Both
parties will be bound by the results of the appraisal. Each
party will appoint and pay a competent disinterested
appraiser and will equally share other appraisal expenses.
Each appraiser will state separately the actual cash
value and the amount of loss, If the appraisers fail to
agree, they will select an umpire and submit their
differences to the umpire. If the appraisers cannot agree
on an umpire, either may request that a judge of a court
having jurisdiction make selection. An award in writing by
any two of these three will determine the amount payable,
subject to the terms of this policy, Attorney fees shall not
be regarded as appraisal expenses. We do not waive any
rights by agreeing to an appraisal.
PAYMENT OF LOSS - PART E ONLY
We may pay for the loss in money, or repair or replace
the damaged or stolen property. If the insured auto is
older than two model years from the date of loss, we
may repair the insured auto using either aftermarket
parts or recycled used parts, whichever is deemed to
be less expensive by us, and with a deduction for
depreciation andlor betterment. We may, at any time
before the loss is paid or the property is replaced, return
at our expense any property either to you or to the
address shown on the Declarations Page, with payment
for any resulting damage. We may keep all or part of the
property at the agreed or appraised value. You do not
have the right to abandon salvage to us. We may settle
any claim for loss either with you, or with the owner of
the property. Payment for loss is required only if you
have fully complied with the terms of this policy.
PROOF OF LOSS
You must file written proof of loss within 60 days from
the date we request it or there will be no coverage under
this Part.
OTHER INSURANCE - PART E ONLY
If other insurance applies to a toss covered under this
Part, we will pay only our share of the loss, Our share
is the prorated amount of our limit of liability compared to
all available limits of liability.
Insurance afforded under this Part of the policy for an
auto you do not own will be excess over any other
applicable coverage or insurance.
NO BENEFIT TO BAILEE
This coverage shall not directly or indirectly benefit any
person, organization, group, or other bailee caring for or
handling property for a fee or compensation.
ADDITIONAL PAYMENTS
If there is a theft of the insured auto, we will pay up to
the limits shown on the Declarations Page, for the cost
of transportation incurred by you, This coverage begins
48 hours after you notify the police of the theft- The
coverage period ends when the auto is returned to use
or when we pay for the loss. We will not pay for the cost
of transportation incurred by an insured person if there is
a theft only of a trailer.
CAR STORAGE COVERAGE
We will pay up to a reasonable and customary daily rate
for the cost of storage of the insured auto in the event
of a loss to the insured auto for which coverage is
provided under this Part. We will pay no more than $400
total for the cost of storage of the insured auto under
this section.
TOWING AND LABOR COVERAGE
If the Declarations Page shows a specific premium
charged for Towing and Labor Coverage, we will pay up
to the limits shown on the Declarations Page for towing
and labor costs incurred each time the insured auto is
disabled. This does not include its running out of gas.
We will cover labor, not including emergency locksmith
repair, only if performed at the place of disablement,
You agree to provide us with proof of incurred towing
and labor charges. This proof must be in the form of
verifiable receipts.
CUSTOM OR ADDITIONAL EQUIPMENT COVERAGE
If the Declarations Page shows a specific premium
charged for Custom or Additional Equipment
Coverage, we will pay for direct and accidental loss to
additional equipment. You must have identified the
additional equipment to us before the loss and such
equipment must be permanently attached to the insured
auto. Our limit of liability for loss to additional
equipment shall not exceed the lesser of:
The actual cash value of the stolen or damaged
property at the time of loss which may include an
adjustment for depreciation and/or betterment,
The amount necessary to repair or replace the
property as specified in Payment of Loss - Part E
Only, or
The declared value of the identified equipment as
shown on the Declarations Page.
The amount referenced above will be reduced by the
applicable deductible as listed on the Declarations
Page.
Our limit of liability for Custom or Additional
Equipment Coverage under this Part shall not exceed
the limit shown on the Declarations Page.
Form No. 13752PVA01 Page 20
We do not cover loss to any of the following types of
equipment unless declared, approved, and an additional
premium is charged for Custom or Additional
Equipment Coverage:
1. Awnings, cabanas, campers, custom enclosures, or
any other equipment designed to provide additional
living facilities.
2. Any equipment or alteration not permanently installed
at the factory by the original make and model vehicle
manufacturer or authorized dealer and considered
standard or original optional equipment for such
vehicle. Equipment installed or alterations made at
a conversion facility to an auto or camper is not
considered standard or original optional equipment
installed by the vehicle manufacturer.
3. Nonstandard chrome, alloy, aluminum, or magnesium
wheels.
4. Custom wide-tread tires and racing slicks.
5. Custom chroming or gold plating, two-tone or custom
paintwork, or custom interior work.
6. Captains or swivel chairs or tables.
7. Sun roof, moon roof, T-bar roof, or landau roof, if not
permanently installed by the original make and model
vehicle manufacturer or the authorized representative
of the vehicle manufacturer.
8. Bubble dome, bubble window, or any deluxe roof
treatment.
9. Satellite navigational devices if not permanently
installed by the original make and model vehicle
manufacturer or the authorized representative of the
vehicle manufacturer.
10. Any "ground effects" package or "continental kit."
11. Telephones permanently installed by the original
make and model vehicle manufacturer.
RENTAL REIMBURSEMENT COVERAGE
If the Declarations Page shows a specific premium
charged for Rental Reimbursement Coverage, we
agree to pay you for any reasonable and necessary
transportation expense incurred. This payment shall not
be more than the limit shown on the Declarations Page
for the loss of use of the insured auto because of
damage covered under Part E to the insured auto. The
limit shown on the Declarations Page shall be payable
for a maximum of thirty (30) days.
1. This endorsement does not apply to theft of the
insured auto since Additional Payments Coverage
is provided under Part E - Coverage for Damage to
the Insured Auto.
2. The insured auto means the vehicle described on
the Declarations Page and for which specific
premium is charged for this coverage.
3. The Insured auto must be continuously withdrawn
from normal use for more than twenty-four (24) hours.
4. We will reimburse you for rental only for the length of
time required to repair or replace the insured auto
as quickly and reasonably as possible.
This endorsement is subject to such exclusions,
conditions, and other terms of the policy which are
applicable to Part E for damage to the insured auto.
PART F - GENERAL PROVISIONS
POLICY PERIOD AND TERRITORY
This policy shall become effective on the date and time
shown on the Declarations Page at the address shown
on the Declarations Page. The policy will expire on the
date and time specified on the Declarations Page at the
address shown on the Declarations Page, unless
terminated sooner.
This policy applies only to accidents and losses that
occur during the policy period shown on the Declarations
Page and within the United States of America.
If you owe us any premium on your expired or expiring
policy, these funds must be paid before your policy will
be renewed by us. Any payment sent by you will first be
used to pay any balance owed on the expired or expiring
policy. Any remainder of such payment will then be
applied to the renewal premium.
PREMIUM CHANGES
The premium for this policy is based on information we
have received from you and other sources.
You agree:
1. That if you provide incorrect or incomplete
information, we may adjust the premium accordingly
during the policy period. We may also adjust the
premium if any information material to calculating the
policy premium changes.
2. To cooperate with us in determining if this
information is correct and complete. You must also
advise us of changes in this information within 14
days of the change.
3. That the return premium will be calculated based on
the correct premium, if this policy is canceled.
Any adjustment of your premium will be made using the
rules in effect at the time of the change.
Premium adjustment may be made as the result of a
change in:
1. Any auto insured by the policy including changes in
use.
2. Drivers, driver's age, or driver's marital status;
3. Coverages or coverage limits.
4. Rating territory.
5. Eligibility for discounts or other premium credits
6. Any other rating criteria permitted bylaw
COVERAGE CHANGES
We may revise your policy coverages to provide more
protection without additional premium charge. If we do
this and you have the coverage, which we change, your
policy will automatically provide the additional coverage.
This shall be as of the date the revision is effective in
your state. Otherwise, this policy, the application, the
endorsements, the Declarations Page and all
attachments contain all of the coverage agreements
between you and us. Its terms may not be changed or
waived except by an endorsement issued by us.
Form No. 13752PVA01 Page 21
PREMIUM PAYMENT
Premium payment means the actual receipt of cash
funds by us. We provide coverage for each policy term
only on condition that the initial premium payment and
subsequent installment payments for that policy term are
paid. You have not paid the initial premium or any
installment payment if you give us a check or a credit
card or an electronic funds transfer that is not honored at
first presentation by the financial institution upon which it
is drawn.
You have not paid the initial down payment premium if
you give us a check or a credit card or an electronic
funds transfer that is not honored at first presentation by
the financial institution upon which it is drawn. In that
event, this policy shall be void from the inception of the
policy term and no coverage will exist, regardless of
whether the policy has been issued.
You may receive a cancellation notice from us,
referencing either a regular installment payment or a
renewal down payment, and informing you that your
premium payment to us was returned unpaid. You
then must provide a replacement payment to us by
means of either a cashiers check or money order.
When you then make such payment, in a timely manner,
by the due date noted on the cancellation notice, your
policy will remain active and in force.
CANCELLATION AND NONRENEWAL
We will not cancel, non-renew or discontinue your policy
solely because of the age, race, color, religion, sex,
national origin or ancestry of anyone who is an insured.
You may cancel this policy by returning it to an authorized
agent or us. You also may cancel by advising us in
writing at a future date as to when the cancellation is to
be effective.
If this policy has been in effect 59 days or less and is not
a continuation or renewal policy, we may cancel for any
reason. We will mail notice to you at the address shown
on the Declarations Page at least fifteen (15) days
before the effective date of the cancellation. We may
also deliver the notice at least fifteen (15) days before
the effective date of the cancellation.
If this policy has been in effect sixty (60) days or more or
is a continuation or renewal policy, we may cancel only:
1. With at least 15 days' notice of cancellation;
a. For nonpayment of premium.
b. If the named insured's driver's license has been
suspended or revoked after the effective date.
This applies if this policy has been in effect less
than one year. If the policy has been in effect
longer than one year, since the last anniversary
of the original effective date.
2. With at least 60 days' notice if the policy was
obtained through material misrepresentation.
We will mail to you at the address shown on the
Declarations Page or deliver to you notice of non-
renewal if we decide not to renew or continue this policy:
1. With at least 15 days' notice before the end of the
policy period:
a. For nonpayment of premium; or
b. If the named insured's driver's license has been
suspended or revoked after the effective date.
This applies if this policy has been in effect less
than one year. If the policy has been in effect
longer than one year, since the last anniversary
of the original effective date,
With at least 60 days' notice before the end of the
policy period in all other cases,
Proof of mailing is proof of notice. Mailing is equivalent
to delivery.
Upon cancellation, you may be entitled to a premium
refund, If so, we will send it to you. However, our offer
of a refund is not a condition of cancellation. If you
cancel, the refund will be computed in accordance with
the customary short rate procedure. If we cancel, the
refund will be computed on a pro-rata, basis. The
effective date of cancellation stated in a notice is the end
of the policy period.
This policy will automatically terminate at the end of the
current policy period if you or your representative do not
accept our offer to renew or continue it. Your failure to
pay the required continuation or renewal premium when
due means that you have declined our offer.
ATIONS ON AGENT AUTHORITY
The authorized agent who obtained this policy for you
has limited authority to act in transacting business with
you on this policy. Your policy is governed by our
guidelines, our rules, applicable laws, and regulations. If
the authorized agent makes any statements or
assurances to you concerning your policy, such
statements or assurances are also governed by our
guidelines, our rules, applicable laws, and regulations.
The authorized agent who obtained this policy for you
does not possess any apparent, implied, or actual
authority to act on our behalf after the expiration,
cancellation, or nonrenewal of your policy with us. Any
representations made by the authorized agent after a
notice of termination has been initiated, by either you or
us, will apply only if we provide prior written approval.
v
ARBITRATION
If we and an insured person do not agree whether that
insured person is legally entitled to recover damages, or
if either party disagrees as to the amount of damages
that are recoverable by the insured under Part B - First
Party Benefits Coverage then the matter may be
arbitrated.
Both parties must agree to arbitration. If so agreed, each
party will select an arbitrator. The two arbitrators will select
a third arbitrator. If they cannot agree on a third arbitrator
within 30 days, either may appear in a court of jurisdiction
to request that the judge appoint a third arbitrator.
Each party will pay the expenses it incurs and bear the
expenses of the third arbitrator equally. Unless both
parties agree otherwise, the arbitration is to take place in
the county in which the insured resides.
Either party may dispute the arbitration award by
demanding the right to a trial. A demand for trial must be
made within 60 days of the decision by the board of
arbitrators. If the demand for trial is not made within the
time period, the amount of damages agreed to by the
arbitrators would be binding, subject to the limits shown
on the Declarations Page. The arbitrators shall have no
authority to determine coverage under the policy.
Form No. 13752PVADI Page 22
TWO OR MORE AUTO POLICIES
This policy and any other auto insurance policy issued to
you by us may apply to the same accident. If that is the
case, the maximum limit of our liability under all the
policies shall not exceed the highest applicable limit of
liability under any one policy, even though separate
premiums have been paid.
SUITS AGAINST US
We may not be sued unless there is full compliance with
all terms of this policy. We may not be sued under Part
A of this policy until the obligation of an insured to pay is
finally determined either by judgment against the insured
or by written agreement of the insured, the claimant, and
us. No one shall have any right to make us a party to a
suit to determine the liability of an insured, Any lawsuit
brought against us under this policy must be commenced
within 1 (one) year.
TRANSFER OF YOUR INTEREST IN THIS POLICY
Interest in this policy may not be assigned or transferred
without our written consent. However, if you die, coverage
will be provided until the end of the policy period for:
Any person specifically named as an operator on the
Declarations Page.
2. The legal representative of the deceased person
while acting within the scope of his or her duties as a
legal representative.
If the insured auto is sold, coverage will terminate as to
that auto when the buyer takes possession of the auto
and will not transfer to the new owner.
BANKRUPTCY
An insured person's bankruptcy or insolvency will not
relieve us of any obligation under this policy.
OUR RECOVERY RIGHTS
We may make a payment under this policy and the
person receiving payment is entitled to recover from
another. We are then entitled to those same rights of
recovery to the extent of our payment. You and anyone
we cover must sign and deliver to us any legal papers
relating to that recovery. You and anyone we cover
must do whatever else is necessary to help us exercise
our rights. You and anyone we cover must do nothing
after a loss to harm our rights.
A person who has been paid by us under this policy may
also recover from another. That person shall then hold
the amount recovered in trust for us. It then shall be
reimbursed to us to the extent of our payment. This is
provided that the person to or on behalf of whom such
payment is made is fully compensated for their loss.
If an insured person or organization receives recovery
from a responsible party without our written consent, the
organization or insured person's right to payment under
any affected coverage of this policy will no longer exist.
LOSS PAYABLE CLAUSE
We will pay loss or damage due under this policy
according to your interest. We will also pay loss or
damage due under this policy according the interest of
the loss payee if one is shown on the Declarations
Page. We may make separate payments according to
those interests-
We will pay the loss payee for a loss under this policy
although you have violated the terms of the policy. You
have violated the terms of the policy by something that
you have done or failed to do. However, we will not pay
for any loss caused by conversion, embezzlement,
secretion, fraud or omissions by you or anyone acting on
your behalf.
We may cancel this policy according to its terms. We will
protect the loss payee's interest for ten (10) days after
we mail them notice that the policy has terminated, for
any reason. We may pay the loss payee for any loss or
damage suffered during that ten (10) day period. In that
event, we have the right to recover the amount of any
such payment from you.
If you fail to give proof of loss within the time allowed, .
the loss payee may protect its interest by filing a proof of
loss within thirty (30) days after that time.
The loss payee must notify us of any known change of
ownership or increase in the risk. If it does not, it will not
be entitled to any payment under this protection.
We may pay the loss payee under the terms of this
protection for a loss not covered under the policy. If that
is the case, we are then subrogated to its rights against
you. This will not affect the loss payee's right to recover
the full amount of its claim. The loss payee must assign
us its interest. The loss payee must transfer to us all
supporting documents if we pay the balance due to the
loss payee on the vehicle.
The deductible amount applicable to losses payable to
the loss payee under Part E - Coverage for Damage to
the insured auto shall be the deductible amount shown
on the Declarations Page for this coverage.
PUNITIVE OR EXEMPLARY DAMAGES
This insurance shall not apply to punitive or exemplary
damages. We will not provide any defense of punitive or
exemplary damages sought under any Part of this policy.
We will not pay for any claim, settlement, judgment, or
other award of punitive or exemplary damages under any
Part of this policy.
TERMS OF POLICY CONFORMED TO STATUTES
Terms of this policy that conflict with the statutes of the
state in which we issue this policy are amended to
conform to such statutes.
FRAUD AND MISREPRESENTATION
We do not provide coverage for any insured person who
has made false or fraudulent representations or
statements or engaged in fraudulent conduct in obtaining
or maintaining coverage, or concerning any accident or
loss for which coverage is sought under this policy.
If we are not permitted to void this policy, any first-party
claims will be reduced by the amount of any additional
premium owed to us. Any payments made by us as the
result of your fraud or misrepresentation may be
recovered from you or from any payments due or made
to you under any first party coverage provided by this
policy.
POLLUTION EXCLUSION
As used in this Exclusion,"Pollutants" include but are not
limited to any solid, liquid, gaseous, or thermal substance,
irritant, or contaminant including but not limited to smoke,
Form No. 13752PVA01 Page 23
vapor, soot, fumes, acids, alkalis, toxic chemicals, and
waste. Waste includes but is not limited to materials that
may be recycled, reconditioned, or reclaimed, whether or
not known to contain pollutants or result in
environmental damage.
It is agreed that this insurance does not provide
coverage for bodily injury or property damage arising
out of, or resulting from, the intentional or unintentional,
actual, alleged, or threatened discharge, release,
dispersal, seepage, or escape of pollutants contained in
any property:
1. Transported by, towed by, loaded into, or unloaded
from the insured auto,
2. Otherwise in the course of transit,
Stored, disposed of, treated, or processed in or upon
the insured auto. This exclusion does not apply if:
a. The pollutants are emitted directly from an auto
part designed by its manufacturer to hold, store,
receive, or dispose of such pollutants,
b. The bodily injury or property damage does not
arise out of the operation of any equipment or
device mounted on an auto chassis or used to
raise or lower workers, and
c_ The bodily injury or property damage does not
arise out of the operation of any air
compressors, pumps, and generators, including
spraying, welding, building cleaning, geophysical
exploration, lighting, or well servicing equipment.
Containing the pollutants before or after the
pollutants are moved from the place of acceptance,
delivery, disposal, or abandonment, for movement
into, onto, or from the insured auto. This exclusion
does not apply if:
a. The pollutants or any property in which they are
contained are upset, overturned, or damaged as
a result of the maintenance or use of the
insured auto, or
b. The discharge, dispersal, release, or escape of
the pollutants is caused directly by such upset,
overturn, or damage.
It Is agreed that this insurance does. not provide
coverage for any toss, cost, liability, or expense arising
out of any judicial, administrative, or other governmental
order, direction, or request that you test for, monitor,
clean up, remove, contain, treat, detoxify, or neutralize
pollutants or environmental damage.
RESCISSION
In the first 59 days of this policy;
We retain the right to void this policy from Its beginning if
we receive a down payment that is returned unpaid for
any reason. Coverage under this policy is contingent
upon us receiving full, final and complete payment of the
down payment of the premium. We will not cover losses
of any kind that occur after the inception of the policy if
your down payment is returned unpaid.
We reserve the right to void this policy from its beginning
if we determine that you have provided incomplete,
inaccurate or false information in your application.
STRUCTURED 5ETTLEMENTS
Any insured and we may make an agreement that is
mutually satisfactory as respects to timing and amounts
of payments under Extraordinary Medical Benefits. This
shall be when it is apparent that payment of medical
expense benefits in the form of a structured settlement
will be both cost-effective to us and in the best interest of
an insured. This may include annuities or other long-
term payment arrangements.
LIMITED TORT ALTERNATIVE INFORMATION
NOTICE
You have the right to elect a form of insurance, which
limits your right, and the rights of members of your
household to seek financial compensation for injuries
caused by other drivers. Each person who elects the
"limited tort alternative" remains eligible to seek
compensation for economic loss sustained in a motor
vehicle accident, as the consequence of the fault of
another person pursuant to applicable tort law. Unless
the injury sustained is a serious injury, each person
who is bound by the limited tort election shall be
precluded from maintaining an action for non-economic
loss, except that:
An individual otherwise bound by the limited tort
election that sustains damages in a motor vehicle
accident as the consequence of the fault of another
person may recover damages as if the individual
damaged had elected the full tort alternative
whenever the person at fault:
a. Is convicted or accepts Accelerated
Rehabilitative Disposition for driving under the
influence of alcohol or a controlled substance in
that accident;
b. Is operating a motor vehicle registered in
another state;
c. Intends to injure himself or another person. This
is provided that an individual does not
intentionally injure himself or another person
merely because his act or failure to act is
intentional or done with his realization that it
creates a grave risk of causing injury if the act or
omission causing the injury is for the purpose of
averting bodily harm to himself or another
person; or
d. Has not maintained financial responsibility as
required by the Pennsylvania Motor Vehicle
Financial Responsibility Law. Provided that
nothing herein shall affect the limitation of a
person, precluded from maintaining an action for
non-economic damages under the limited tort
alternative, to recover non-economic damages
under Uninsured Motorist Coverage or
Underinsured Motorist Coverage.
2. An individual, otherwise bound by the limited tort
election, shall retain full tort rights with respect to
claims arising out of a defect in a motor vehicle.
Such defect shall be caused by or not corrected by
an act or omission of a person in the business of
designing, manufacturing, repairing, servicing, or
otherwise maintaining motor vehicles. The defect
shall arise in the course of such business, other
than a defect in a motor vehicle that is operated in
such business.
3. An individual otherwise bound by the limited tort
election shalt retain full tort rights if -injured while
occupying a motor vehicle other than a private
passenger motor vehicle.
Form No. 13752PVA01 Page 24
EXCLUDED DRIVERS
If you have asked us to exclude any person from
coverage under this policy, then we will not provide
coverage for any claim arising from an accident or loss
involving a covered vehicle that occurs while it is being
operated by the excluded person. This Includes any
claim for damages made against you, a relative or any
other persons or organization that is vicariously liable for
an accident arising out of the operation of the insured
auto or non-owned auto by the excluded driver.
This policy is signed on behalf of Leader Preferred
Insurance Company by our, President and Secretary,
and is countersigned on the Declarations Page, if
necessary, by our authorized representative.
Tommy J. Stone
President
Samuel J. Simon
Secretary
Form No. 13752PVA01
Page 25
The following endorsement applies only if
L Form Number 13752ADB01 appears on your
Declarations Page
ACCIDENTAL DEATH BENEFIT ENDORSEMENT
INSURING AGREEMENT
We agree with you, in return for your premium
payment and subject to all of the provisions of this
endorsement and to all of the provisions and definitions
of the policy as modified herein, as follows:
We will pay the limit of liability shown on the
Declarations Page in the event of death of an insured
person that results directly and solely from bodily injury
caused by an accident involving a vehicle.
ADDITIONAL DEFINITIONS
As used in this endorsement (all other definitions in the
policy remain as written):
"Insured person" means you, a relative or resident.
"Vehicle" means a motor vehicle having more than three
load-bearing wheels, of a kind required to be registered
under the laws of the state and relating to motor vehicles
designed primarily for operation upon the public streets,
roads and highways, and driven by power other than
muscular power, and includes a trailer drawn by or
attached to such a motor vehicle.
EXCLUSIONS
We do not provide Accidental Death Benefits for any
person who sustains an:
1. Accidental death while occupying a motorcycle,
moped, motorized bicycle or similar two-wheeled
vehicle, or all-terrain motorized vehicle having two,
three, or four wheels.
2. Accidental death while occupying the insured auto
when it is being used to carry persons or property for
a fee, including rental of the Insured auto to others.
This exclusion does not apply to a shared expense
car pool.
3. Accidental death while occupying any vehicle used
as a residence or premises.
4. Accidental death while operating any vehicle other
than the insured auto, which is owned by or
furnished or available for regular use of any insured
person.
5. Accidental death while occupying a vehicle without
the express or implied permission of the owner.
6. Accidental death while occupying a vehicle when it
is being used in the business of an insured person.
7. Accidental death while occupying a vehicle when it
is being used in any auto business.
8. Accidental death caused by the discharge of a
nuclear weapon (even if accidental), war (declared or
undeclared), civil war, insurrection, rebellion or
revolution or any consequence of any of these.
9. Accidental death from any nuclear reaction, radiation
or radioactive contamination, all whether controlled
or uncontrolled or however caused, or any
consequence of any of these.
10. Accidental death while the motor vehicle is used for
racing.
11. Accidental death where the accident occurs and
arises out of the use of a motor vehicle while the
insured person is in the commission of a crime.
LIMIT OF LIABILITY
Regardless of the number of insured persons, policies
or bonds applicable, claims made or the insured autos
to which this coverage applies, the limit of our liability
under Accidental Death Benefit Coverage Is the limit of
liability shown on the Declarations Page per insured
person.
GENERAL PROVISIONS
Part F of the policy applies to this coverage.
The following endorsement applies only if
Form Number 13752LCC01 appears on your
Declarations Page
LIMITED COMPREHENSIVE COVERAGE
In consideration for a premium discount to your
Comprehensive premium, it is agreed that the policy is
amended as follows:
Amendment 1
The definition of "Comprehensive" is deleted and
replaced by the following:
"Comprehensive" means only loss caused by fire, theft
or breakage of glass. If breakage of glass results from
collision, you may elect to have it treated as a loss
caused by collision.
Amendment 2
The following definition is used in this Part only:
"Theft' means the unlawful taking of the insured auto in
its entirety during a single incident.
Amendment 3
Coverage under this policy does not apply to theft of
parts or equipment, unless the entire vehicle has been
stolen.
The following endorsement applies only if
E Form Number 13752NOE01 appears on your
Declarations Page
NAMED DRIVER NON-OWNER COVERAGE
INSURING AGREEMENT
If you purchase a Named Driver Non-owner policy, it is
agreed that the policy is amended as follows.
AMENDMENT 1
The Liability Coverage Insuring Agreement used in Part
A - Liability Coverage is deleted in its entirety and
replaced by the following:
We will pay damages except for punitive or exemplary
damages, for which an insured person is legally liable
because of bodily injury or property damage resulting
from the use of your insured auto.. The bodily injury
or property damage must not be expected nor intended
from the standpoint of the insured person.
We will defend any suit or settle any claim for damages,
as we think appropriate. We will not defend or settle
after our limit of liability has been paid. We have no duty
to defend any suit or settle any claim for bodily injury or
property damage not covered under this policy.
NDMENT 2
The following definitions replace those found in the
section titled Definitions Used Throughout this Policy:
"You' and "your" mean only the individual person named
as the insured on the Declarations Page.
"Your insured auto" means any non-owned auto or
trailer provided that you have the express permission of
the owner to use the auto or trailer. No coverage shall
apply for you while operating an auto owned by you, a
resident, or a relative of the household in which you
reside.
AMENDMENT 3
As used throughout this policy, "insured person" means
you. No person shall be considered an insured person
if that person uses an auto without having the express
permission of the owner.
AMENDMENT 4
The Other Insurance provision in Part A-Liability Coverage
is deleted in its entirety and replaced by the following:
OTHERINSURANCE
The insurance provided by this Part is excess over any
other collectible auto liability insurance.
AMENDMENT 5
No coverage applies under Part E - Coverage for
Damage to the Insured Auto of this policy.
Form No. 13752PVA01 Page 26
AMENDMENT 6 -
Exclusion number 14 in Part A -- Liability Coverage is
deleted in its entirety.
AMENDMENT 7
The terms and conditions of this endorsement and state
statutes also apply to Part C - Uninsured Motorist
Coverage and Part D - Underinsured Motorist Coverage
of this policy.
The following endorsement applies only if
Form Number 13752LLE01 appears on your
Declarations Page
LESSOR LIABILITY ENDORSEMENT
In exchange for your increased premium, this
endorsement has been added to your insurance policy.
The provisions in this endorsement are effective only
while the insured auto is leased by you, for a period of
at least six (6) months, as documented by a standard
form lease agreement with expressly stated insurance
coverage requirements.
During the term of this policy, the limits of coverage for
damages you become legally obligated to pay, as
defined by your policy, shall be those limits listed on
your Declarations Page.
The endorsement provides the following additional
liability coverage for your lessor:
Bodily Injury: $100,000 per person
$300,000 per accident
Property Damage: $50,000 per accident
This additional coverage will apply to damages your
lessor becomes legally obligated to pay that arise from
and are legally related to a loss covered under your
policy.
The coverage provided by this endorsement is in addition
to that listed on your Declarations Page and is available
only to indemnify your lessor pursuant to the terms listed
herein.
The provision of the coverages in this endorsement shall
in no event increase our limits of liability for any
damages you become legally obligated to pay, pursuant
to the terms of your policy.
If we terminate this policy, notice will also be mailed to
the lessor.
The lessor is not responsible for payment of premiums.
PENNSYLVANIA SURCHARGE DISCLOSURE
STATEMENT
In compliance with 75 Pennsylvania Consolidated
Statutes Section 1793(b), we provide this surcharge
disclosure plan to explain our system of driving record
points. This statement provides an overview; more
detailed information is available on request.
Driving record points are assigned to operators for
chargeable accidents and violations. All accidents and
violations occurring in the 35-month period prior to policy
inception are considered in developing a driver's policy
premium. If a driver is added midterm, accidents and
violations will be charged for the entire 35-month period
prior to the driver being added to the policy.
Point surcharges follow the driver. To determine if the
accident or violation took place in the chargeable period,
we use the accident date instead of the conviction date.
We charge for accidents and a violation occurring while a
driver is operating a private passenger automobile,
commercial vehicle, motorcycle, or recreational vehicle.
Accidents. We assess a surcharge of approximately
30% for each at-fault accident charged to an operator.
Accidents are chargeable if, as a result of the accident,
the insurer incurs at feast $1,150 in losses in excess of
any deductible for personal injury or damage to property,
including the insured person's property.
Each accumulation of $1,150 in aggregate losses from
incidents not otherwise charged represents an at-fault
accident, if the insured can demonstrate that any of the
facts of loss described in 31 Pennsylvania Code Section
67.33 (non-chargeable accidents) apply to an accident,
the accident will not be charged to the operator.
Minor Violations. We assess a surcharge of
approximately 15% for the second and each subsequent
conviction of routine traffic infractions like speeding or
failure to yield. Most of these infractions are listed in 75
Pennsylvania Consolidated Statutes Section 1535,
Major Violations. We assess a surcharge of
approximately 45% for each conviction of a violation,
which suggests the presence of a materially Increased
risk in a motorist. Such major violations include
vehicular homicide, leaving the scene of an accident
involving death or injury, or fleeing a police officer.
Driving While Intoxicated, We assess a surcharge of
approximately 15% for each Driving While Intoxicated
conviction under 75 Pennsylvania Consolidated Statutes
Section 3731 (Driving under the influence of alcohol or
controlled substance), notice of acceptance of
Accelerated Rehabilitative Disposition under 75
Pennsylvania Consolidated Statutes Section 1534, or
similar infraction.
Form No. 13752PVA01 Page 27
r
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
DONNA MOWRY,
Plaintiff
V.
INFINITY INSURANCE,
Defendant
NO. 11-4632 CIVIL TERM
CIVIL ACTION - LAW
JURY TRIAL DEMANDED
CERTIFICATE OF SERVICE
AND NOW, this ,"7+y,? day of June, 2011, I, Michael B. Scheib, Esquire, a member of
the firm of Griffith, Strickler, Lerman, Solymos & Calkins, hereby certify that I have this date
served a copy of the Respondent, Infinity Insurance's Answer to Petitioner's Petition to Compel
Arbitration, by United States Mail, postage prepaid, addressed to the party or attorney of record
as follows:
Karl E. Rominger, Esquire
Rominger & Associates
155 South Hanover Street
Carlisle, PA 17013
(Attorney for Plaintiff)
GRIFFITH, STRICKLER, LERMAN,
SOLYMOS & CALKINS „
By:
MICHAEL B. SCFLEM,
PA 63868
110 South Northern Way
York, PA 17402-3737
Phone (717) 757-7602
Fax (717) 757-3783
Mscheib pslsc.com
Attorney for Respondent,
Infinity Insurance
CA'Al.
DONNA MOWRY, IN THE COURT OF COMMON PLEAS OF
Petitioner CUMBERLAND COUNTY, PENNSYLVANIA
vs. CIVIL ACTION - LAW
NO. 11-4632 CIVIL r -;
INFINITY INSURANC -M
E'
Respondent JURY TRIAL DEMANDED
IN RE: PETITION TO COMPEL ARBITRATION
Na
ORDER -
AND NOW, this q' day of October, 2011, the Prothonotary is ordered and
directed to list this matter for the regular session of Argument Court to be held on December 16,
2011.
? Karl E. Rominger, Esquire
For the Petitioner
? Michael B. Scheib, Esquire
For the Respondent
:rlm
Npies
Mai
1"Nif
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BY THE COURT,