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HomeMy WebLinkAbout13-2293 . Supreme C, ennsylvania COu>fi 0 M leas For Prothonotary Use Only: , d Docket No: T ST'I C�� ran County 13 -JA ClvliTerm The information collected on this form is used solely for court administration purposes. This form does not supplement or replace the filing and service of pleadings or other papers as required by law or rules of court. Commencement of Action: S El Complaint 0 Writ of Summons ® Petition 0 Transfer from Another Jurisdiction E Declaration of Taking � C Lead Plaintiff's Name: Lead Defendant's Name: T Jesse Baker Erie Insurance Exchange t I Are money damages requested? J Yes [3 No Dollar Amount Requested: ®within arbitration limits O (check one) Eloutside arbitration limits N Is this a Class Action Suit? ® Yes M No Is this an MDJAppeal? ® Yes El No j A Name of Plaintiff /Appellant's Attorney: Zachary D. Campbell, Esquire ® Check here if you have no attorney (are a Self- Represented [Pro Sel Litigant) Nature of the Case Place an "X" to the left of the ONE case category that most accurately describes your PRIMARY CASE. If you are making more than one type of claim, check the one that you consider most important. TORT (do not include Mass Tort) CONTRACT (do not include Judgments) CIVIL APPEALS Intentional Ci Buyer Plaintiff Administrative Agencies rl Malicious Prosecution l3 Debt Collection: Credit Card M Board of Assessment ® Motor Vehicle ® Debt Collection: Other © Board of Elections Nuisance Dept. of Transportation ® Premises Liability B Statutory Appeal: Other S ® Product Liability (does not include E mass tort) � Employment Dispute: ® Slander/Libel/ Defamation Discrimination ` C M Other: ® Employment Dispute: Other ® Zoning Board f T ® Other: I ' [E Other: MASS TORT f ® Asbestos ! N [3 Tobacco I [3 Toxic Tort - DES i © Toxic Tort - Implant REAL PROPERTY MISCELLANEOUS Toxic Waste ® Other: 13 Ejectment 0 Common Law /Statutory Arbitration B ® Eminent Domain /Condemnation ® Declaratory Judgment © Ground Rent [3 Mandamus © Landlord /Tenant Dispute ® Non- Domestic Relations El Mortgage Foreclosure: Residential Restraining Order PROFESSIONAL LIABLITY 0 Mortgage Foreclosure: Commercial Quo Warranto f M Dental Partition ©Replevin ® Legal ® Quiet Title ® Other: ® Medical © Other: F-71 Other Professional: Updated 1 /1/2011 Zachary D. Campbell, Esquire Attorney I.D. No. 93177 Metzger, Wickersham, Knauss & Erb, PC 3211 North Front Street P.O. Box 5300 Attorneys for Plaintiff Harrisburg, PA 17110 -0300 (717) 238 -8187 JESSE BAKER, : IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. I3 aag3 00i i ( (e, m ERIE INSURANCE EXCHANGE, ERIE INSURANCE COMPANY; ERIE INSURANCE PROPERTY & CASUALTY COMPANY; ERIE INDEMNITY COMPANY; AND Abft ERIE INSURANCE GROUP, Defendant JURY TRIAL DEMANDED ~' ( : a M me€ NOTICE TO DEFEND - TO: Defendants YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the following pages, you must take action within Twenty (20) days after this Complaint and Notice are served, by entering a written appearance personally or by attorney and filing in writing with the Court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the Court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiffs. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. Cumberland County Lawyer Referral Service O 32 S. Bedford Street b 3 . , ? Ply Carlisle, PA 17013 (800) 990 -9108 e# 6q(057 514049 -1 0 NOTICIA LE HAN DEMANDADO A USTED EN LA CORTE. Si usted quiere defenderse de estas demandas expuestas en las paginas siguientes, usted tiene viente (20) dias de plazo al partir de la fecha de la demanda y la notificacion. Usted debe presentar una apariencia escrita o en persona o por abogado y archivar en la corte en forma escrita sus defensas o sus objeciones a las demandas en contra de su persona. Sea avisado que si usted no se defiende, la corte tomara medidas y puede entrar una orden contra usted sin previo aviso a notificacion y por cualquier queja o alivio que es pedido en la peticion de demanda. Usted puede perder dinero o sus propiedades o otros derechos importantes para usted. LLEVE ESTA DEMANDA A UN ABODAGO IMMEDIATAMENTE. SI NO TIENE ABOGADO O SI NO TIENE EL DINERO SUFICIENTE DE PAGAR TAL SERVICIO, VAYA EN PERSONA O LLAME POR TELEFONO A LA OFICINA CUYA DIRECCION SE ENCUENTRA ESCRITA ABAJO PARA AVERIGUAR DONDE SE PUEDE CONSEGUIR ASISTENCIA LEGAL. Cumberland County Lawyer Referral Service 32 S. Bedford Street Carlisle, PA 17013 (800) 990 -9108 514049 -1 Zachary D. Campbell Attorney I.D. No. 93177 Metzger, Wickersham, Knauss & Erb, PC 3211 North Front Street P.O. Box 5300 Attorneys for Plaintiff Harrisburg, PA 17110 -0300 (717) 238 -8187 JESSE BAKER, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. ERIE INSURANCE EXCHANGE, ERIE INSURANCE COMPANY; ERIE INSURANCE PROPERTY & CASUALTY COMPANY; ERIE INDEMNITY COMPANY; AND ERIE INSURANCE GROUP Defendant JURY TRIAL DEMANDED COMPLAINT AND NOW, comes the Plaintiff, Jesse Baker, by and through his counsel, Metzger, Wickersham, Knauss & Erb, P.C., and avers as follows: FACTS APPLICABLE TO ALL COUNTS 1. Plaintiff, Jesse Baker, is an adult individual currently residing at 239 Walnut Dale Road, Shippensburg, Cumberland County, Pennsylvania, 17257. 2. Defendant, Erie Insurance Exchange, is a corporation with offices for the transaction of business located at 100 Erie Insurance Place, Erie, Erie County, Pennsylvania, 16530. Defendant is licensed and authorized to conduct business as an insurer in the Commonwealth of Pennsylvania. 514049 -1 3. Defendant, Erie Insurance Company, is a corporation with offices for the transaction of business located at 100 Erie Insurance Place, Erie, Erie County, Pennsylvania, 16530. Defendant is licensed and authorized to conduct business as an insurer in the Commonwealth of Pennsylvania. 4. Defendant, Erie Insurance Property & Casualty Company, is a Pennsylvania business corporation with offices for the transaction of business located at 100 Erie Insurance Place, Erie, Erie County, Pennsylvania, 16530. Defendant is licensed and authorized to conduct business as an insurer in the Commonwealth of Pennsylvania. 5. Defendant, Erie Indemnity Company, is a Pennsylvania business corporation with offices for the transaction of business located at 100 Erie Insurance Place, Erie, Erie County, Pennsylvania, 16530. Defendant is licensed and authorized to conduct business as an insurer in the Commonwealth of Pennsylvania. 6. Defendant, Erie Insurance Group, is a Pennsylvania business corporation with offices for the transaction of business located at 100 Erie Insurance Place, Erie, Erie County, Pennsylvania, 16530. Defendant is licensed and authorized to conduct business as an insurer in the Commonwealth of Pennsylvania. 7. All Erie Defendants are collectively referred to herein as "Erie ". 8. At all times material hereto, Plaintiff, Jesse Baker, resided with his mother, Rebecca S. McGuire and step- father, Daniel T. McGuire, who were named insureds under an automobile insurance policy issued by Defendant, Erie, insurance policy number Q04 0410548 H (hereinafter referred to as "the Policy "). A true and correct copy of the Auto Policy Declarations sheet is attached hereto as Exhibit "A." A true and correct copy of the Policy is attached hereto as Exhibit "B." 514049 -1 9. On or about October 8, 2010, at approximately 8:15 p.m., Plaintiff Jesse Baker was a second row, right side passenger in a 1997 Plymouth Voyager driven by Kelsey Negley, which was owned by Sherry Lautsbaugh. 10. At the aforesaid date and place, Ms. Negley and four passengers were traveling South on Whitmer Road, Southampton Road, Cumberland County, Pennsylvania. While traveling through a curve, Ms. Negley lost control of the Voyager, traveled off the roadway and impacted a tree, causing traumatic injuries to Plaintiff Jesse Baker. 11. The injuries sustained by Plaintiff, Jesse Baker, in the aforementioned motor vehicle accident include, but are not limited to, the following: a. Facial /scalp lacerations and abrasions; b. Loss of consciousness and amnesia; C. Scarring; d. Head injury; e. Cervical spine injury; f. Right frontal scalp hematoma; g. Comminuted fracture of the nasal bone; h. Fractures of both medial, anterior and posterior maxillary sinus walls; i. Fractures of the medial and lateral pterygoid plates bilaterally; j. Fracture of the floor of the left orbit; k. Fracture of the right lamina papyracea; 1. Headaches; m. Mouth/teeth injuries; n. Sinus problems; o. Anxiety; p. Post - traumatic stress; q. Insomnia; r. Loss of appetite. 12. Due to the injuries that Plaintiff, Jesse Baker, received in the October 8, 2010 motor vehicle accident, Plaintiff underwent medical treatment including, but not limited to, an open reduction - internal fixation of palate fracture and open reduction of nasal fracture operation 514049 -1 which involved cutting open Plaintiff s face to expose his skull. Bone saws were used to cut the bone and hardware was used to fixate the fractured areas of his face. 13. Plaintiff was also diagnosed with post- traumatic stress disorder as a result of the accident. 14. The damages sustained by the Plaintiff, Jesse Baker, in the aforesaid motor vehicle accident include, but are not limited to, the following: a. Plaintiff, Jesse Baker, has suffered and will continue to suffer great physical pain, discomfort, distress, suffering, inconvenience, embarrassment, humiliation, and mental anguish; b. Plaintiff, Jesse Baker, has suffered and will continue to suffer loss of his ability to enjoy the pleasures of life and limitations in his pursuit of his daily activities all to his great loss and detriment; C. Plaintiff, Jesse Baker, has been and will be required to spend money for medication attention, medical treatment, hospitalization, surgery, rehabilitation, medical supplies, and other medically necessary items; d. Plaintiff, Jesse Baker, has been and will be required to spend money for incidental costs and expenses and losses to include, but not limited to, past and future medicine costs and medical appliances, and travel to and from medical appointments; e. Plaintiff, Jesse Baker, has suffered and will continue to suffer loss of household services and other economic damages; f. Plaintiff, Jesse Baker, has suffered and will continue to suffer permanent scarring and /or disfigurement; g. Plaintiff, Jesse Baker, has been and will be deprived of his earnings; 514049 -1 h. Plaintiff Jesse Baker's earning capacity has been reduced and permanently impaired; and i. Plaintiff Jesse Baker's general health, strength, and vitality have been impaired. 15. At the time of the collision, the tortfeasor driver of the vehicle, Kelsey Negley, was issued a motor vehicle insurance policy through Nationwide Insurance with bodily injury liability limits in the amount of $25,000.00 per person/$ 50,000.00 per accident. 16. At the time of the collision, the tortfeasor owner(s) of the vehicle, Sherry Lautsbaugh and Deron Lautsbaugh, was issued a motor vehicle insurance policy through Nationwide Insurance with a total liability limit of $300,000.00 maximum per person, and/or a maximum of $300,000.00 per accident. 17. Nationwide tendered their limits under both the Negley policy and the Lautsbaugh policy, to be divided among the three injured passengers as follows: Lautsbaugh policy Negley policy Total Settlement Jesse Baker $155,500.00 $25,000.00 $180,500.00 Jonathan Diaz $ 22,500.00 $ 22,500.00 Jordan Meals $122,000.00 $25,000.00 $147,000.00 18. The Defendants herein, Erie, consented to the settlement of the claims against Kelsey Negley and Sherry and Deron Lautsbaugh for payment of the available liability insurance limits and waived the subrogation rights against those parties. See, Exhibit "C" attached hereto. 19. Plaintiff, Jesse Baker, was an underinsured motorist because the combined liability coverage through the Kelsey policy and the Lautsbaugh policy of $180,500.00 paid to Plaintiff was less than Plaintiff's damages. 514049 -1 20. Plaintiff's mother, Rebecca S. McGuire, and Plaintiff's step- father, Daniel T. McGuire, elected to purchase underinsured motorist coverage with the Defendant, Erie. 21. Rebecca S. Mcguire and Daniel T. McGuire elected bodily injury limits under their policy of $250,000.00 per person/$ 500,000.00 per accident. However, they chose to execute documentation lowering their underinsured limits of $100,000.00 per person/$300,000.00 per accident. 22. Said coverage was in full force and effect on October 8, 2010. 23. The above referenced Policy with Defendant, Erie, provided for underinsured motorist coverage, which became applicable to the Plaintiff, Jesse Baker, since the combined liability coverages of $180,500.00, which was paid to the Plaintiff, was inadequate to compensate the Plaintiff for injuries, loses and damages he suffered as a result of the motor vehicle accident. 24. Plaintiff's mother and step- father elected to purchase underinsured motorist coverage with the Defendant, Erie, and as a result of their election of this coverage, they paid and Defendant accepted, additional increased premium payments. 25. After settlement of the liability claims under the two Nationwide policies, a demand for payment of the available underinsured motorist coverage was made to the Defendant, Erie. 26. The Defendant, Erie, has refused to make payment of the available limits of the underinsured motorist coverage and instead has extended an offer of $10,000.00 to settle Plaintiff Jesse Baker's claim. 27. At all times relevant hereto, Plaintiff's mother and step- father fully complied with the terms and conditions of the Policy with Defendant, Erie, and all terms and conditions 514049 -1 precedent and subsequent to their right, and any relative residing with them at the time, to recover under the Policy. 28. Plaintiff, Jesse Baker's mother and step- father chose the full tort option under the Erie policy. Therefore, Plaintiff remains eligible to claim compensation for non - economic loss and economic loss in this collision pursuant to applicable tort law. COUNT I — BREACH OF CONTRACT PLAINTIFF, JESSE BAKER, v. DEFENDANT, ERIE INSURANCE EXCHANGE 29. Paragraphs 1 through 28 are incorporated herein by reference as if fully set forth. 30. Plaintiff Jesse Baker's medical records clearly establish that he suffered significant personal injuries as a direct result of the motor vehicle accident on October 8, 2010. 31. Plaintiff, Jesse Baker, has fully complied with all of the terms, conditions and duties required under the Policy with Defendant, Erie Insurance Exchange. 32. Defendant, Erie Insurance Exchange, either individually and /or jointly and severally, has failed to timely, objectively and reasonably evaluate Plaintiff Jesse Baker's claim. 33. Defendant, Erie Insurance Exchange, either individually and /or jointly and severally, has failed to promptly offer payment of the reasonable and fair value of the underinsured motorist claim to the Plaintiff, Jesse Baker. 34. Defendant, Erie Insurance Exchange, either individually and /or jointly and severally, failed to reasonably investigate Plaintiff Jesse Baker's claim, inasmuch as a thorough and proper inquiry would have revealed that the Plaintiff sustained injuries, damages and losses which reasonable compensation would have required an offer of the available limits. 514049 -1 35. Defendant, Erie Insurance Exchange, either individually and /or jointly and severally, owes a fiduciary, contractual and statutory obligation to investigate, evaluate and negotiate the underinsured motorist claim in good faith and to arrive at a prompt, fair and equitable settlement as the insurer of Plaintiff, Jesse Baker. 36. For the reasons set forth above, Defendant, Erie Insurance Exchange, either individually and /or jointly and severally, has violated and /or breached its obligation under the Policy. WHEREFORE, the Plaintiff, Jesse Baker, seeks damages from Defendant, Erie Insurance Exchange, either individually and/or jointly and severally, in an amount in excess of the compulsory arbitration limits of Cumberland County, exclusive of interest and costs. . COUNT II — BREACH OF CONTRACT PLAINTIFF, JESSE BAKER, v. DEFENDANT, ERIE INSURANCE COMPANY 37. Paragraphs 1 through 36 are incorporated herein by reference as if fully set forth. 38. Plaintiff Jesse Baker's medical records clearly establish that he suffered significant personal injuries as a direct result of the motor vehicle accident on October 8, 2010. 39. Plaintiff, Jesse Baker, has fully complied with all of the terms, conditions and duties required under the Policy with Defendant, Erie Insurance Company. 40. Defendant, Erie Insurance Company, either individually and /or jointly and severally, has failed to timely, objectively and reasonably evaluate Plaintiff Jesse Baker's claim. 514049 -1 41. Defendant, Erie Insurance Company, either individually and /or jointly and severally, has failed to promptly offer payment of the reasonable and fair value of the underinsured motorist claim to the Plaintiff, Jesse Baker. 42. Defendant, Erie Insurance Company, either individually and /or jointly and severally, failed to reasonably investigate Plaintiff Jesse Baker's claim, inasmuch as a thorough and proper inquiry would have revealed that the Plaintiff sustained injuries, damages and losses which reasonable compensation would have required an offer of the available limits. 43. Defendant, Erie Insurance Company, either individually and /or jointly and severally, owes a fiduciary, contractual and statutory obligation to investigate, evaluate and negotiate the underinsured motorist claim in good faith and to arrive at a prompt, fair and equitable settlement as the insurer of Plaintiff, Jesse Baker. 44. For the reasons set forth above, Defendant, Erie Insurance Company, either individually and /or jointly and severally, has violated and /or breached its obligation under the Policy. WHEREFORE, the Plaintiff, Jesse Baker, seeks damages from Defendant, Erie Insurance Company, either individually and /or jointly and severally, in an amount in excess of the compulsory arbitration limits of Cumberland County, exclusive of interest and costs. COUNT III — BREACH OF CONTRACT PLAINTIFF, JESSE BAKER, v. DEFENDANT, ERIE INSURANCE PROPERTY & CASUALTY COMPANY 45. Paragraphs 1 through 44 are incorporated herein by reference as if fully set forth. 46. Plaintiff Jesse Baker's medical records clearly establish that he suffered significant personal injuries as a direct result of the motor vehicle accident on October 8, 2010. 514049 -1 47. Plaintiff, Jesse Baker, has fully complied with all of the terms, conditions and duties required under the Policy with Defendant, Erie Insurance Property & Casualty Company. 48. Defendant, Erie Insurance Property & Casualty Company, either individually and /or jointly and severally, has failed to timely, objectively and reasonably evaluate Plaintiff Jesse Baker's claim. 49. Defendant, Erie Insurance Property & Casualty Company, either individually and /or jointly and severally, has failed to promptly offer payment of the reasonable and fair value of the underinsured motorist claim to the Plaintiff, Jesse Baker. 50. Defendant, Erie Insurance Property & Casualty Company, either individually and /or jointly and severally, failed to reasonably investigate Plaintiff Jesse Baker's claim, inasmuch as a thorough and proper inquiry would have revealed that the Plaintiff sustained injuries, damages and losses which reasonable compensation would have required an offer of the available limits. 51. Defendant, Erie Insurance Property & Casualty Company, either individually and /or jointly and severally, owes a fiduciary, contractual and statutory obligation to investigate, evaluate and negotiate the underinsured motorist claim in good faith and to arrive at a prompt, fair and equitable settlement as the insurer of Plaintiff, Jesse Baker. 52. For the reasons set forth above, Defendant, Erie Insurance Property & Casualty Company, either individually and /or jointly and severally, has violated and /or breached its obligation under the Policy. WHEREFORE, the Plaintiff, Jesse Baker, seeks damages from Defendant, Erie Insurance Property & Casualty Company, either individually and/or jointly and severally, in an amount in 514049 -1 ! i excess of the compulsory arbitration limits of Cumberland County, exclusive of interest and costs. COUNT IV — BREACH OF CONTRACT PLAINTIFF, JESSE BAKER, v. DEFENDANT, ERIE INDEMNITY COMPANY 53. Paragraphs 1 through 52 are incorporated herein by reference as if fully set forth. 54. Plaintiff Jesse Baker's medical records clearly establish that he suffered significant personal injuries as a direct result of the motor vehicle accident on October 8, 2010. 55. Plaintiff, Jesse Baker, has fully complied with all of the terms, conditions and duties required under the Policy with Defendant, Erie Indemnity Company. 56. Defendant, Erie Indemnity Company, either individually and /or jointly and severally, has failed to timely, objectively and reasonably evaluate Plaintiff Jesse Baker's claim. 57. Defendant, Erie Indemnity Company, either individually and /or jointly and severally, has failed to promptly offer payment of the reasonable and fair value of the underinsured motorist claim to the Plaintiff, Jesse Baker. 58. Defendant, Erie Indemnity Company, either individually and /or jointly and severally, failed to reasonably investigate Plaintiff Jesse Baker's claim, inasmuch as a thorough and proper inquiry would have revealed that the Plaintiff sustained injuries, damages and losses which reasonable compensation would have required an offer of the available limits. 59. Defendant, Erie Indemnity Company, either individually and /or jointly and severally, owes a fiduciary, contractual and statutory obligation to investigate, evaluate and negotiate the underinsured motorist claim in good faith and to arrive at a prompt, fair and equitable settlement as the insurer of Plaintiff, Jesse Baker. 514049 -1 60. For the reasons set forth above, Defendant, Erie Indemnity Company, either individually and /or jointly and severally, has violated and /or breached its obligation under the Policy. WHEREFORE, the Plaintiff, Jesse Baker, seeks damages from Defendant, Erie Indemnity Company, either individually and /or jointly and severally, in an amount in excess of the compulsory arbitration limits of Cumberland County, exclusive of interest and costs. COUNT V — BREACH OF CONTRACT PLAINTIFF, JESSE BAKER, v. DEFENDANT, ERIE INSURANCE GROUP 61. Paragraphs 1 through 60 are incorporated herein by reference as if fully set forth. 62. Plaintiff Jesse Baker's medical records clearly establish that he suffered significant personal injuries as a direct result of the motor vehicle accident on October 8, 2010. 63. Plaintiff, Jesse Baker, has fully complied with all of the terms, conditions and duties required under the Policy with Defendant, Erie Insurance Group. 64. Defendant, Erie Insurance Group, either individually and /or jointly and severally, has failed to timely, objectively and reasonably evaluate Plaintiff Jesse Baker's claim. 65. Defendant, Erie Insurance Group, either individually and /or jointly and severally, has failed to promptly offer payment of the reasonable and fair value of the underinsured motorist claim to the Plaintiff, Jesse Baker. 66. Defendant, Erie Insurance Group, either individually and /or jointly and severally, failed to reasonably investigate Plaintiff Jesse Baker's claim, inasmuch as a thorough and proper inquiry would have revealed that the Plaintiff sustained injuries, damages and losses which reasonable compensation would have required an offer of the available limits. 514049 -1 67. Defendant, Erie Insurance Group, either individually and /or jointly and severally, owes a fiduciary, contractual and statutory obligation to investigate, evaluate and negotiate the underinsured motorist claim in good faith and to arrive at a prompt, fair and equitable settlement as the insurer of Plaintiff, Jesse Baker. 68. For the reasons set forth above, Defendant, Erie Insurance Group, either individually and /or jointly and severally, has violated and/or breached its obligation under the Policy. WHEREFORE, the Plaintiff, Jesse Baker, seeks damages from Defendant, Erie Insurance Group, either individually and /or jointly and severally, in an amount in excess of the compulsory arbitration limits of Cumberland County, exclusive of interest and costs. METZGER, WICKERSHAM, KNAUSS & ERB, P.C. By: a y D. Campbell, Esquire Attorney I.D. No. 93177 P.O. Box 5300 3211 North Front Street Harrisburg, PA 17110 -0300 (717) 238 -8187 Attorneys for Plaintiff Dated: 7 2 2013 514049 -1 VERIFICATION I, Jesse Baker, hereby certify that the following is correct: The facts set forth in the foregoing Complaint are based upon information which I have furnished to counsel, as well as upon information which has been gathered by counsel and/or others acting on my behalf in this matter. The language of the Complaint is that of counsel and not my own. I have read the Complaint, and to the extent that it is based upon information which I have given to counsel, it is true and correct to the best of my knowledge, information, and belief. To the extent that the content of the Complaint is that of counsel, I have relied upon such counsel in making this Verification. I hereby acknowledge that the facts set forth in the aforesaid Complaint are made subject to the penalties of 18 Pa. C.S.A. §4904 relating to unworn falsification to authorities. Date: Jesse 514049 -1 • • ��-� � BIGRP A EXCHANGE ER NSURANCE Erna bsurance FAMILY AUTO POLICY Group REVISED DECLARATIONS 100 Erie Ins PI Erw, PA 16530 REASON FOR AMENDMENT - MULTIPLE CHANGES AGENT ITEM 2. POUCY PERIOD POLICY NUMBER AA7159 CARL L CRAMER INS. LLC 04/04/10 TO 04/04/11 Q04 0410548 H ffEtA 1. NAMED INSURED AND ADDRESS - ITEM 3. OTHER INTEREST DANIEL T MCGUIRE & AS LISTED BELOW i REBECCA S MCGUIRE 239 WALNUT DALE RD SHIPPENSBURG PA 17257 -9691 AGENT CARL L CRAMER INS. LLC 833 W. KING STREET AGENT PHONE - (717) 530 -8600 SHIPPENSBURG PA 17257 9201 ***************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** • CONGRATULATIONS! A PIONEER EXPERIENCE RATING CREDIT HAS • BEEN APPLIED TO YOUR POLICY PREMIUM. ***************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *********************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * YOUR COLLISION COVERAGE AND DEDUCTIBLE APPLY TO PRIVATE PASSENGER * AUTOS YOU OR A RESIDENT RELATIVE RENT FOR 45 DAYS OR LESS. THIS IS * SUBJECT TO LIMITS, TERMS AND CONDITIONS IN THE POLICY. *********************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ITEM 4. AUTOS COVERED AUTO YR MAKE VIN ST TER PHY LIOTCMCL RATINGCLASS DDP 1 98 HOND PASSPORT 4S6CM58W7W4407549 PA 4F 1110 AlASM FM48 2 03 CHEV SLVR250OHD 1GCGK29U93Z227374 PA 4F H 1108 A3ALM MM40 3 92 MITS 3000GT VR4 JA3XE74CONY018583 PA 4F U P 0813 AlASM FM48 4 97 CHRY SEBRINGLXI 4C3AU52NOVE185176 PA 4F K 0916 AlALM MM40 5 93 NISS NX 1600 JNlEB34CXPU200380 PA 4F 0710 AlALM FM48 6 05 CHRY CROSSFIRE 1C3AN79N95XO44871 PA 4F N H 0209 AlASM MM40 ITEM 5. INSURANCE IS PROVIDED WHERE A PREMIUM, OR INCL, IS SHOWN FOR THE COVERAGE. COVERAGES, LIMITS AND ANNUAL PREMIUMS ARE AS FOLLOWS - M EQUALS THOUSAND $ #1 #2 #3 #4 #5 #6 * * ** *GOOD DRIVER RATES APPLY * * * ** - -- THE FULL TORT OPTION APPLIES TO ALL PRIVATE PASSENGER VEHICLES. --- LIABILITY PROTECTION - BODILY INJURY $250M /PERSON $50OM /ACC 110 160 97 129 125 77 PROPERTY DAMAGE $10OM /ACC 82 121 73. 97 94 59 FIRST PARTY BENEFITS - MEDICAL EXPENSE $IOM 38 52 43 59 47 30 INCOME LOSS $1M /MONTH, $5M MAXIMUM 4 6 6 8 6 4 ACCIDENTAL DEATH $5M 1 2 1 2 2 1 FUNERAL BENEFIT $1.5M 1 1 1 1 1 1 UNINSURED MOTORISTS COVERAGE- BOD INJ $100M /PERSON JMpOM /ACC- UNSTACKED 13 012 14 15 13 12 UNDERINSURED MOTORISTS WVERAGE- BOD 'INJ $100M /PERSON $ /ACC - UNSTACKED 75 69 86 93 75 73 PHYSICAL DAMAGE COVERAGES - COMPREHENSIVE - $50 DED COLLISION - $250 DED 229 214 172 111 OPTIONAL COVERAGES- 295 TRANSP EXPENSES - COLL $20 /DAY, $900 /LOSS 12 TOTAL ANNUAL PREMIUM FOR EACH AUTO TOTAL ANNUAL POLICY PREMIUM $ 3,375 324 756 622 647 363 663 INCLUDED IN TOTAL ANNUAL POLICY PREMIUM IS AN ADDITIONAL AMOUNT CHARGED AS A RESULT OF- CURB WEIGHT TO HORSEPOWER RATIO $ 81 N HWLAGT 03/15/10 MISCELLANEOUS INFORMATI P ITEM 7. EACH AUTO WE INSURE WILL BE PRINCIPALLY GARAGED AT THE ADDRESS SHOWN IN ITEM 1, UNLESS ANOTHER ADDRESS IS SHOWN BELOW. Q04 0410548 CONTINUED ON NEXT PAGE ERIE INSURANCE EXCHANGE FAMILY AUTO POLICY REVISED DECLARATIONS REASON FOR AMENDMENT - MULTIPLE CHANGES AA7159 CARL L CRAMER INS. LLC 04/04/10 TO 04/04/11 Q04 0410548 H DANIEL T MCGUIRE & REBECCA S MCGUIRE 239 WALNUT DALE RD SHIPPENSBURG PA 17257 -9691 ITEM 9. UNLESS A CO -OWNER OR LIENHOLDER IS LISTED BELOW, THE NAMED INSURED IS THE SOLE OWNER OF EACH AUTO WE INSURE. LIENHOLDER FOR AUTO 2 LIENHOLDER FOR AUTO 3 PATRIOT F C U AMERICAN GENERAL, CDC P 0 BOX 778 PO BOX 3893 CHAMBERSBURG PA 17201 -0778 EVANSVILLE IN 47737 -3893 LIENHOLDER FOR AUTO 4 LIENHOLDER FOR AUTO 6 NORTHWEST CONSUMER DISCOUNT CO HUNTINGTON BANK ISAOA 2361 MORSE RD PO BOX 985 COLUMBUS OH 43229 -5856 CAMP HILL PA 17001 -0985 ************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** DRIVER* ST 1 DANIEL T MCGUIRE PA 2 REBECCA S MCGUIRE PA *IF A DRIVER IS NOT A RESIDENT RELATIVE AS DEFINED IN YOUR POLICY, COVERAGES, BENEFITS AND RIGHTS MAY BE LIMITED. REFER TO YOUR POLICY AND ITS ENDORSEMENTS FOR T�, DEFINITIONS, LIMITATIOI* REDUCTIONS, EXCLUSIONS AND CONDITI01W ANY PERSON WHO KNOWINGLY AND WITH INTENT TO INJURE OR DEFRAUD ANY INSURER FILES AN APPLICATION OR CLAIM CONTAINING ANY FALSE, INCOMPLETE OR MISLEADING INFORMATION SHALL, UPON CONVICTION, BE SUBJECT TO IMPRISONMENT FOR UP TO SEVEN YEARS AND PAYMENT OF A FINE OF UP TO $1 5,000. THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA, AS ENACTED BY THE GENERAL ASSEMBLY, ONLY REQUIRE THAT YOU PURCHASE LIABILITY AND FIRST -PARTY MEDICAL BENEFIT COVERAGES. ANY ADDITIONAL COVERAGES OR COVERAGES IN EXCESS OF THE LIMITS REQUIRED BY LAW ARE PROVIDED ONLY AT YOUR REQUEST AS ENHANCEMENTS TO THE BASIC COVERAGES. BELOW ARE ANNUAL PREMIUMS FOR THE MINIMUM REQUIRED COVERAGES AND LIMITS FOR LIMITED TORT. PLEASE NOTE THAT THE LIMITED TORT OPTION MAY NOT BE AVAILABLE ON CERTAIN VEHICLES. # 1 # 2 # 3 # 4 ## 5 # 6 BODILY INJURY $15M /PERSON $30M /ACC 30 44 27 36 34 22 PROPERTY DAMAGE $5M /ACC 73 107 64 86 82 50 FIRST PARTY BENEFITS - MEDICAL EXPENSE $5M 19 24 20 27 21 14 N HWLAGT 03/15/10 INVOICE INFORMATION: DATE DUE PAYMENT DUE 04 -04 -10 375.00 * YOU WILL BE BILLED FOR THE BALANCE IN MONTHLY INSTALLMENTS • • ���' i l -. T Famil A u 0 Insurance Policy Erie I� Insuranc t= �\ WHERE TO LOOK IN YOUR POLICY Page Page AGREEMENT ........ ............................... 2 Loss Payment ........ ............................... 9 No Benefit To Bailee .. ............................... 9 GENERAL POLICY DEFINITIONS :.................... 2 Loss Payable Clause............. . LIABILITY PROTECTION ADDITIONAL COVERAGE Definitions .......... ..................:............ 4 Reimbursement For Coverage In Mexico and Our Promise ......... .........................:..... 4. Other Foreign Countries ............................... 10 Additional Payments .. ............................... 5 Extra Protection When Temporarily Out of State ........... 5 RIGHTS AND DUTIES - GENERAL POLICY CONDITIONS Exclusions - What We Do Not Cover.... _ ................ 5 Definitions ............ .............................10 Limit of Protection ...................... .. 6 Assignment.. _ ... ................... . O ther Insurance ..................... . ............. :.. 6 Bankruptcy of Anyone We Protect............ . Concealment, Fraud or Misrepresentation ......:..........10 PHYSICAL DAMAGE COVERAGES Continuous Policy ......... , . • ... • • • • • , • .. • • • • • • • • . , .10 Definitions ........... .....................:.......:6 Cooperation .......... .............................10 Our Promise - Comprehensive Coverage .................: 7 How Your Policy May Be Changed .......... . Our Promise - Collision Coverage ....................... 7 10 Lawsuits A Us ..... .............................11 Our Promise - Road Service ............................. 7 Our Right To Recover From Others .:......... . Our Promise - Transportation Expenses ...................? ......••..11 ..... .Additional Payments ... ..................:...........7 Priority � ........... 11 Subscribers Agreement .......... 4 . ' ' ' ' ............................ Exclusions -What We Do Not Cover .....................'? Survivors' Coverage ..... .............................11 ' ' ' • ' ' ' ' .......11 Limit of Protection .... ............................... 8 Termination ...... Other Insurance ...... .............................. 9 What To Do When an Accident or Loss Happens ...........12 Appraisal . 9 When and Where This Policy Applies ....................12 Thank you for choosin rie Insurance for your auto insurance needs. This olic p y contains many Xtra Protection Features. Wherever an "X" appears in the margin of this policy, you receive Xtra Protection that is not included in most other auto policies. The protection provided by this policy is in keeping with the single purpose of our Founders which is, "To provide YOU with as near PERFECT PROTECTION, as near PERFECT SERVICE, as is humanly possible, and to do so at the LOWEST POSSIBLE COST." AGREEMENT ERIE INSURANCE EXCHANGE This agreement is made in reliance on the information "you" have given "us" and is subject to all the terms of this policy. In return for "your" timely premium payment, "your" compli- g limitations, policy, w coverage a ance with all of the provisions of this policy, and "your" signing This , exclusions of a "Subscriber's Agreement" with Erie Indemnity Company and waivers, conditions, the "Subscriber's Agreement" applicable constitute the and other Subscribers we agree to provide the coverages entire agreement between "you" and "ug emen you h ave purchased. Your coverages and limits of protec- tion are shown on the "Declarations," which are part of this ERIE INSURANCE COMPANY AND ERIE policy. INSURANCE PROPERTY & CASUALTY "Your" signing the "Subscriber's Agreement," which includes COMPANY a limited power -of- attorney, permits Erie Indemnity Company, In return for "your" timely premium payment and "your" com- as Attorney -in -Fact, to make reciprocal insurance contracts be- pliance with all of the provisions of this policy, "we" agree to tween "you" and other Subscribers and otherwise manage the provide the coverages "you" have purchased. "Your" coverages business of the Erie Insurance Exchange. This power -of- and limits of protection are shown on the "Declarations," which attorney applies only to your insurance business at the Ex- are part of this policy. change and is limited to the purposes described in the "Sub- scriber's Agreement." This agreement is made in reliance on the information "you" have given "us" and is subject to all the terms of this policy. "Your" responsibility as a "Subscriber" is determined by this This policy, with coverage agreements, limitations, exclusions policy and the "Subscriber's Agreement." "You" are liable for and conditions, the "Declarations" and applicable endorsements just the policy premiums charged and are not subject to any and waivers, constitute the entire agreement between "you" and other premium liability under this policy. "us." GENERAL POLICY DEFINITIONS Throughout this policy and its endorsements, the following words and phrases have a special meaning when they appear in bold type and quotations. "You" must notify "us" during the policy period of "your" intention to have this policy apply to an "additional auto" • "Additional auto" or "additional trailer:" or an "additional trailer." If "you" obtain an "additional 1. "Additional auto" means any "private passenger auto" auto" or an "additional trailer" within 30 days prior to the X other than a "replacement auto" that "you" acquire, end of the policy period, "you" have 60 days after acquisi- purchase or lease during the policy period. For coverage tion to notify us. to apply, "we" must insure all "private passenger autos' Should a loss occur involving an "additional auto" or "addi- It own on the date "you" acquire, purchase or lease tional trailer" prior to "your" notifying "us," the additional an "additional auto." vehicle will have the broadest coverage "you" g you have purchased X 2. "Additional trailer" means any "trailer" other than a for any one vehicle listed on the "Declarations." "replacement trailer" that "you" acquire, purchase or If "you" do not have: lease during the policy period. For coverage to apply, "we" must insure all "trailers" "you" own on the date 1. Comprehensive Coverage on any vehicle listed on the "you" acquire, purchase or lease an "additional trailer." "Declarations," then Comprehensive Coverage will ap- "Additional auto" or "additional trailer" does not include ply, subject to a $500 deductible. However, Comprehen- any "auto" or "trailer" that "you" acquire, purchase or lease sive Coverage will end seven days after "you" acquire, X with anyone other than a "relative." Coverage does not ap- purchase or lease the vehicle or when "you" report the ply to an "additional auto" or an "additional trailer" regis- additional vehicle to "us," whichever occurs first. tered to a corporation or other business entity. 2. Collision Coverage on any vehicle listed on the "Decla- rations," then Collision Coverage will apply, subject to a $500 deductible. However, Collision Coverage will end seven days after "you" acquire, purchase or lease the ve- X 2 bicle or when "you" report ditional vehicle to "us," • "Moving van" ► a four or six wheel "motor vehicle," whichever occurs first. such as a compact van or step van, designed mainly to trans- "Anyone we protect" is defined separately under the LIABIL- port household goods. It must be borrowed or rented and ITY PROTECTION Section, RIGHTS AND DUTIES - driven by "you" or a "relative" for personal use. GENERAL POLICY CONDITIONS Section or any applica- • "Occupying" means in, upon, getting into or getting out of ble coverage. Refer to each of these sections or the applicable endorsement for the definition of "anyone we protect" as it • "Owned auto we insure" means any: applies to each coverage. 1. "auto" or "trailer" described on the "Declarations" for • "Auto" means any land "motor vehicle" with at least four the coverages "you" have purchased- wheels except a: 2. "additional auto," or "additional trailer;" or 1. vehicle designed for use principally off public roads; 3. "replacement auto," or "replacement trailer." 2. vehicle operated on rails or crawler treads; • "Private passenger auto' means a four wheel land "motor 3. vehicle located for use as a residence; or vehicle" designed mainly to transport people on public roads. 4. "miscellaneous vehicle." It includes station wagons and the following types of vehicles, even with dual rear wheels, when not used for business pur- "Auto business" means the business of selling, leasing, rent- poses, except farming or ranching: ing, repairing, servicing, cleaning, painting, storing or parking "autos," "trailers" or "miscellaneous vehicles." 1. motor homes; 2. pickups; and • "Auto we insure" means: 3. vans. 1. "owned auto we insure;" • "Relative" means a "reside " "resident of your household who is a: 2. "temporary substitute;" or 3. "nonowned auto." " Nonowned auto" is defined sepa- 1 • person related to "you" by blood, marriage or adoption; or rately under the LIABILITY PROTECTION Section, the 2 • ward or any other person under 21 years old in "your" PHYSICAL DAMAGE COVERAGE Section or any ap- care. plicable coverage. Refer to each of these sections or the • "Replacement auto" or "replacement trailer:" applicable endorsement for the definition of " nonowned auto" as it applies to each coverage. 1. "Replacement auto" means any "private passenger auto" that "you" acquire, purchase or lease within the • "Declarations" means "our" form which shows "your" cover- policy period to replace " " p e an auto described on the Dec- ages, limits of protection, "owned auto we insure," premium larations. charges and other information. 2. "Replacement trailer" means any "trailer" that "you" This form is part of this policy. "Declarations" include forms acquire, purchase or lease within the policy period to re- titled Amended Declarations, Revised Declarations, Duplicate place a "trailer" described on the "Declarations." Declarations, New Declarations, Reinstatement of Coverage, "Replacement auto" or "replacement trailer" does not in- or Continuation Notice. clude any "auto" or "trailer" that "you" acquire, purchase • "Fungi" means any type or form of fungus, including, but not or lease with anyone other than a "relative." Coverage does limited to, molds, mildews, smuts, mushrooms, yeasts and any not apply to "replacement autos" or "replacement trail - mycotoxin, spores, scents, vapors, gases or byproducts pro- ers" registered to a corporation or other business entity. duced, arising out of or released by any type or form of fun- "You" must notify "us" during the policy period of "your" g us. intention to have this policy apply to a "replacement auto" • "Miscellaneous vehicle" means a motorcycle (including a or "replacement trailer." If "you" obtain a "replacement motorcycle with a sidecar), moped, snowmobile, golf cart, all auto" or "replacement trailer" within 30 days prior to the X terrain vehicle and any similar recreational vehicle. It does not end of the policy period, "you" have 60 days after acquisi- include a lawn and garden tractor or mower or similar vehicle. tion to notify "us." • "Motor vehicle" means any vehicle that is self - propelled and Should a loss occur involving a "replacement auto" or "re- is required to be registered under the laws of the state in which placement trailer" prior to "your" notifying "us," the replace - you " reside at the time this policy is issued. "Motor vehicle" ment vehicle will have the broadest coverage "you" have pur- X does not include a vehicle: chased for any one vehicle listed on the "Declarations." 1. propelled solely by human power; If "you" do not have: 2. propelled by electric power obtained from overhead 1. Comprehensive Coverage on any vehicle listed on the wires; "Declarations," then Comprehensive Coverage will apply, 3. operated on rails or crawler treads; subject to a $500 deductible. However, Comprehensive 4. located for use as a residence or premises; or Coverage will end seven days after "you" acquire, pur- X 5. which is a lawn and garden tractor or mower or similar chase or lease the vehicle or when "you" report the re- vehicle. placement vehicle to "us," whichever occurs first. 3 2. Collision Coverage on any listed on the "Decla- • "Subscriber" m *the person(s) who signed the "Sub - rations," then Collision Cove e will apply, subject to a scriber's Agreement." $500 deductible. However, Collision Coverage will end X seven days after "you" acquire, purchase or lease the ve- ' "Subscriber's Agreement" means the agreement, including a hicle or when "you" report the replacement vehicle to limited power -of- attorney, among the Subscribers and the Erie "us," whichever occurs first. Indemnity Company, as Attorney -in -Fact. See the RIGHTS AND DUTIES - GENERAL, POLICY CONDITIONS Section, • "Resident" means a person who physically lives with "you" in SUBSCRIBER'S AGREEMENT. "your" household on a regular basis. "Your" unmarried, une- „ mancipated children attending school full time, living away ' We, us" or our means the Subscribers at Erie Insurance from home, will be considered "residents" of "your" house- Exchange as represented by their common Attorney -in -Fact, hold. Erie Indemnity Company. • "Suit" means a civil proceeding in which damages are alleged • "You," "your" or "Named Insured" means the "Subscriber" because of bodily injury or property damage to which this in- named in Item 1. on the "Declarations" and others named in surance applies. "Suit" includes: Item 1. on the "Declarations." Except under the RIGHTS AND DUTIES - GENERAL, POLICY CONDITIONS Section, 1. an arbitration proceeding; or these words include the spouse of the "Subscriber" named in 2. any other alternative dispute resolution proceeding, Item 1. on the "Declarations," provided the spouse is a "resi. to which anyone we protect' must submit or submit with dent." "our" consent alleging such damages. • "Temporary substitute" means any "auto" or "trailer" which ADDITIONAL ERIE INSURANCE COMPANY AND is a substitute for an "owned auto we insure." The "owned ERIE INSURANCE PROPERTY & CASUALTY auto we insure" must be withdrawn from normal use because COMPANY DEFINITIONS of its breakdown, destruction, loss, repair or servicing. The The following words and phrases have a special meaning in "temporary substitute" cannot be owned by "you" and must policies issued by Erie Insurance Company or Erie Insurance be used with the permission of the owner. P Y Property & Casualty Company when they appear in bold type • "Trailer" means a vehicle designed to be pulled by a "private and quotations. p e t wgh auto," if not for business LBILITY • "We," "us" or "our" means the Erie Insurance Company or the p "private passenger g er au I Erie Insurance Property & Casualty Company, whichever is PROTECTION Section of this policy, "trailer" includes a stated on the "Declarations." farm wagon or farm implement while used with a "private . "You, or "Named Insured" means the person (s) passenger auto. named in Item 1. on the "Declarations." Except in he ADDITIONAL ERIE INSURANCE EXCHANGE RIGHTS AND DUTIES - GENERAL POLICY CONDI- DEFINITIONS TIONS Section, these words include the spouse of the per - The following words and phrases have a special meaning in son(s) named in Item I. on the "Declarations," provided the spouse is a "resident." policies issued by Erie Insurance Exchange when they appear in bold type and quotations. LIABILITY PROTECTION DEFINITIONS 2. while a "relative" is using it, any "private passenger The following words and phrases have a special meaning when auto," "moving van," "trailer" or "te substi- they appear in bold type and quotations in the LIABILITY PRO- tute" not owned or leased by "you" or a "relative." TECTION Section. The operation or other use by "you" or a " relative" must be with • "Anyone we protect" means: the permission of the owner or "you" or the "relative" must rea- sonably believe the permission of the owner exists. 1. you or any relative using an auto we insure;" 2. any person using, or any person or organization legally OUR PROMISE responsible for the use of, an "owned auto we insure." This use must be with "your" permission unless the use Bodily injury Liability Coverage is by a "relative;" and Property Damage Liability Coverage 3. any person or organization legally responsible for the If these coverages are indicated on the "Declarations," "we" use, by "you" or a "relative," of any "nonowned auto." will pay all sums that "anyone we protect" legally must pay as This protection applies only if the person or organization damages caused by an accident covered by this policy. The ac- does not own or hire the vehicle being used. cident must arise out of the ownership, maintenance, use, load- • " Nonowned auto" means: ing or unloading of an "auto we insure." X 1. while "you" are using it, any "auto," "moving van," Damages must involve: "try or "temporary substitute" not owned or leased by or I. bodily injury, meaning physical harm, sickness, disease, or y "you;" resultant death to a person; or 4 2. property damage meaning: • 7. reasonable law#ees up to $50 which "anyone we pro- X a. physical injury to or destruction of tangible property, in- tect" incurs because of arrest, resulting from an accident in- cluding loss of its use; or volving an "auto we insure." b. loss of use of tangible property which is not physically First Aid Expenses injured or destroyed. "We" will pay reasonable expenses for first aid to other persons "We" may investigate or settle any claim or "suit" for damages and animals at the time of an accident involving an "auto we X against anyone we protect," at "our" expense. If "anyone we insure." protect" is sued for damages covered by this policy, "we" will defend, with a lawyer "we" choose, even if the allegations are EXTRA PROTECTION WHEN TEMPORARILY OUT not true. "Our" obligation to pay any claim or judgment or de- OF STATE fend any "suit" ends when "we" have used up "your" limit of protection by paying judgments or settlements or making a de- If "anyone we protect:" posit in court. 1. travels to another state, the District of Columbia, a territory ADDITIONAL PAYMENTS or possession of the United States of America, Puerto Rico or Canada; and Payment for the following is in addition to the limit of protec- 2. as a nonresident becomes subject to a motor vehicle finan- tion shown on the "Declarations." cial responsibility law, compulsory insurance law, or other Claim Expenses similar law that imposes insurance requirements which are "We" will pay: greater than the insurance provided by this policy, then, the Liability Protection under this policy will be increased 1. court costs to defend or settle, as we believe proper, any to the minimum amount of liability coverage required by law. claim or "suit" against "anyone we protect," for damages covered under this section. "Our" payment of the limit of Coverage provided to meet the minimum limits will be in lieu of protection for a settlement, judgment or deposit in court ends the insurance otherwise provided by this policy. "our" duty to pay under this item. The insurance under this provision will be reduced to the extent 2. expenses incurred to investigate and defend or settle, as "we" that there is other valid and collectible insurance under this or believe proper, any claim or "suit" against "anyone we pro- any motor vehicle insurance policy. In no event will any person tect" for damages covered under this section. "Our" pay- be entitled to receive duplicate payments for the same elements ment of the limit of protection for a settlement, judgment or of loss. deposit in court ends "our" duty to pay under this item. 3. post judgment interest, but only that portion of the post- EXCLUSIONS - What We Do Not Cover judgment interest which accrues on that part of the judgment "We" do not cover: that does not exceed the limit of protection on a "suit" "we" defend. "Our" payment, offer in writing, or deposit in court 1. damage caused by "anyone we protect" to property they of that part of the judgment that does not exceed the limit of own or are transporting. protection ends "our" duty to pay any post judgment interest 2. damage caused by "anyone we protect" to property rented that accrues after the date of "our" payment, written offer or to them or in their charge. This exclusion does not apply to deposit. household goods or household premises. X X 4. prejudgment interest or delay damages awarded on that part 3. damages caused intentionally by or at the direction of "any - of any judgment that does not exceed the limit of protection. one we protect." If "we" offer in writing to pay the applicable limit of protec- 4. an "owned auto we insure" while being used in the "auto tion, "we" will not pay any prejudgment interest or delay business." This exclusion does not apply if the "owned auto damages for the period of time after the offer. we insure" is being used by: 5. reasonable expenses "anyone we protect" may incur at a. of or a "resident" of "your" household; or It request to help "us" investigate or defend a claim or b. any partner, agent, or employee of " " X suit. This includes up to $300 a day for actual loss of earn- "your" you or a resident of household. ings, limited to those days "anyone we protect" attends hearings or trials at "our" request. 5. an "owned auto we insure" or a "nonowned auto" while 6. premiums on the following types of bonds, but not for bond used in the business of the United States Government where amounts greater than the limit of protection: the United States Government is responsible under the Federal a. appeal bond in a "suit" "we" defend; Tort Claims Act. (28USCA§ 1346, 2671- 2680). 6. a "nonowned auto:" X b. up to $500 for a bail bond premium required because of an accident or related traffic violation involving an "auto a. while used by "anyone we protect" while employed or we insure;" and otherwise engaged in the "auto business;" c. attachment bond to release property of "anyone we pro- b. while used in connection with any other business or oc- tect" due to an accident or related traffic violation in- cupation of "anyone we protect." This exclusion does volving an "auto we insure." not apply to a "private passenger auto" or "trailer;" "We" have no duty to apply for or furnish such bonds. 5 c. while being operated by soA other than "you" or a If coverage is purcheon a "Split Limits" basis, the "Declara- "relative" even if the "nonown�"d auto" is in the custody ' " y ions will show a PER PERSON and PER ACCIDENT limit or control of "anyone we protect;" for Bodily Injury Liability and a PER ACCIDENT limit for d. furnished or available for the regular use of a "relative" Property Damage Liability. The PER PERSON limit for Bodily while a "relative" is using it. This exclusion does not ap- Injury Liability is the most "We" will pay for all damages arising ply if the vehicle is furnished or available for "your" out of bodily injury to one person in any one accident. The PER regular use; or ACCIDENT limit for Bodily Injury Liability is the most "we" e. furnished or available by a governmental agency or unit: will pay for all damages arising out of bodily injury to all per- t. for "your" use while "you" or a "relative" are using sons resulting from any one accident, subject to the PER PER - it; or SON limit. The PER ACCIDENT limit for Property Damage 2. for a "relative's" use unless, being used by "you." Liability is the most "we" will pay for all property damage 7. bodily injury to employees of "anyone we protect" occur- caused by any one accident. ring in the course of employment. "We" will provide cover- If coverage is purchased on a "Single Limit" basis, the "Decla- age for such an injury to a domestic employee not covered rations" will show a PER ACCIDENT limit for Bodily Injury and not required to be covered by a workers compensation Liability and Property Damage Liability. This is the most "we" lave will pay for all damages arising out of bodily injury and prop - 8. a vehicle "you" acquire during the policy period or any erty damage caused by any one accident. "temporary substitute" for it if there is other applicable in- If an individual's damages derive from, arise out of or otherwise surance. result from bodily injury to another person injured in the acci - 9. an "auto we insure" while hired by or rented to others for a dent or the death of another person killed in the accident, "we" fee or while available for hire by the public. "We" will pro- will pay only for such damages within the PER PERSON limit tect "you" or a "relative" held responsible for damages available to the person injured or killed in the accident. while "occupying" but not driving such a vehicle, if it is a OTHER INSURANCE "nonowned auto." Fee does not include payment received in a car pool or for trips for nonprofit social, educational, or This policy provides primary insurance for any "auto we in- charitable agencies. sure" except a "nonowned auto." The policy's coverage is ex- 10. damages for which there is insurance under a nuclear en- cess over any other collectible insurance on a "nonowned ergy liability insurance policy, even if the limits of protec- auto," up to the limit(s) of protection for one "auto." tion under that policy have been used up. "We" will, however, provide primary insurance for a motor ve- 11. an auto we insure while being used in any prearranged or hicle "you" do not own if it is insured under a policy issued to a organized racing, speed or demolition contest, stunting activity business engaged in selling, leasing, repairing, servicing, deliv- or similar activities, or in practice for any such activities. ering, testing, road testing, parking or storing motor vehicles. 12. punitive or exemplary damages and related defense costs. This applies only if "you" or a "relative" are operating the mo- 13. bodily injury or property damage arising directly or indi- for vehicle and are not the owner, operator, employee or agent rectly, in whole or in part, out of the actual, alleged or of that business. threatened inhalation of, ingestion of, contact with, or dry This insurance will be excess to that of a business engaged in sure to, existence of or presence of an r "fun rot, or bacteria. storing, parking, servicing or repairing airin motor vehicles if an ac- cident occurs while " 14. bodily injury or property damage arising out of the owner- Y our" "owned auto we insure " is under ship, maintenance, use, loading or unloading of a miscel- control of the owner, operator, employee or agent of that busi- laneous vehicle." ness. If other insurance, collectible or not, covers an "auto" rented or LIMIT OF PROTECTION leased for less than one year and it states that coverage is void if there is other available insurance then coverages under this sec - "We" will pay no more than the limit(s) shown on the "Declara- tion are void. tions" for one "auto" in any one accident as explained below. It makes no difference how man Y P ersons "we" P rotect "autos we When there is other insurance applicable to the accident on the insure," claims are made or "autos" are involved in the acci- same basis, "we" will pay "our" share. "Our" share is the pro - dent. portion that "our" limit of protection bears to the total of all applicable limits. An auto and attached trailer are considered one auto "We" will never pay more than the limit of protection. under this coverage. P PHYSICAL DAMAGE COVERAGES DEFINITIONS • " Nonowned auto" means, while "you" or a "rellative" are The following words and phrases have a special meaning when using it, any "private passenger auto," "moving van," X the a ear in bold a and quotations in the PHYSICAL "trailer" or "temporary substitute" not owned or leased by Y pp typ 9 "you" or a "relative." Theo operation or other use b " p y you or a DAMAGE COVERAGES Section. "relative" must be with the permission of the owner or "you" • 'Loss" means direct and accidental damage or direct and acci- or the "relative" must reasonably believe the permission of the dental loss. owner exists. 6 OUR PROMISE - Comprell#e Coverage Payment ends on twy - we" offer settlement or on the day the If Comprehensive Coverage is indicated on the "Declarations," "auto:" ":we" will pay for "loss" to an "auto we insure" and its equip- 1. is replaced; ment not caused by collision or upset. If the "loss" is to an 2. is returned to "you" in usable condition; or "owned auto we insure," "we" will only pay if "you" purchased 3. could reasonably be expected to be repaired, Comprehensive Coverage for the "owned auto we insure." whichever comes first. We will pay for loss less the deductible shown on the "Dec- larations." Comprehensive Coverage includes glass breakage, Transportation Expenses apply whether or not "we" pay for X contact with persons, animals, birds, missiles or falling objects. damages under Comprehensive or Collision Coverage. Should only "your" windshield be damaged, "we" will not apply Transportation Expenses are provided for loss of use to a X the deductible if the windshield is repaired rather than replaced. "nonowned auto" if. OUR PROMISE - Collision Coverage 1. "you" or a "relative" are legally liable for damages to the "nonowned auto;" and If Collision Coverage is indicated on the "Declarations," "we" 2. "we" are provided with actual proof of loss of income. will pay for "loss" to an "auto we insure" and its equipment caused by collision or upset. If the "loss" is to an "owned auto Total payment under Transportation Expenses, including loss of we insure," "we" will only pay if "you" purchased Collision use, will not exceed: Coverage for the "owned auto we insure." "We" will pay for 1. Transportation Expenses - Comprehensive Coverage, $20 loss" less the deductible shown on the Declarations. per day nor total more than $900 per loss unless a higher X "We" will not subtract the deductible if the accident is between limit is shown on the "Declarations." an "auto we insure" and another "auto:" 2. Transportation Expenses - Collision Coverage, the limit 1. insured by the Erie Insurance Group. shown on the "Declarations." X 2. not insured by the Erie Insurance Group, if ADDITIONAL PAYMENTS (No Deductible Applies a. the "loss" to the "auto we insure" is greater than the de- To These Additional Payments) ductible amount; If Comprehensive Coverage and/o Collision Coverage are pur- b. the owner of the other "auto" has been identified; chased, "we" will: c. the owner or operator of the other "auto" is solely liable 1. pay all reasonable expenses necessary your sto- or the "loss;" and ary to return len "auto we insure." d which protects uayone property sponsible for the liability insurance 2. reimburse "you" for travel costs, including meals and lodg- X ing, paid by anyone because "you" were unable to reach OUR PROMISE - Road Service (No Deductible Or your destination after "loss" to an "auto we insure." Pay- Waiting Period Applies) ment will not exceed $75 per person for each "loss." X 3. pay for "loss" to personal effects, including clothes and lug- X If Road Service Coverage is indicated on the "Declarations," gage, that are normally carried by a person, while the per - X "we" will reimburse "you" for reasonable towing and labor costs sonal effects are in or upon an "auto we insure." The fol- required because an "auto we insure" is disabled. Labor must lowing restrictions apply: be done at the site of the disablement. "We" will only pay for a. Personal effects must be owned b " "loss" to an "owned auto we insure" on which "you have ur- you or a relative. Y P b. Money, professional or occupati onal tools or machines, chased Road Service Coverage. sales samples, and merchandise for sale, delivery or ex- hibition are not considered personal effects. OUR PROMISE - Transportation Expenses (No c. Theft losses are covered only if the entire vehicle is stolen. Deductible Or Waiting Period Applies) d. When "loss" results from a collision, there must be If Transportation Expenses - Collision Coverage is indicated on enough damage to the "auto we insure" to require a Col. the "Declarations," "we" will reimburse "you" for transporta- lision "loss" payment by "us." tion expenses that result from a Collision "loss" to an "owned e. Payment for 'loss" to personal effects will not exceed auto we insure" that has a premium shown on the "Declara- $350. "We" will only pay for "loss" not covered by other X tions" for this coverage. insurance. If Comprehensive Coverage is indicated on the "Declarations," 4. pay all expenses necessary to replace a deployed airbag. "we" will reimburse "you" for transportation expenses that re- 5. reimburse "you" up to $50 for the cost incurred for lock- X sult from a Comprehensive "loss" to an "owned auto we in- smith services if keys are accidentally locked in an "auto sure" that has a premium shown on the "Declarations" for this we insure." coverage. EXCLUSIONS - What We Do Not Cover Auto rental, bus, or taxi fares are examples of covered Transpor- "We" will not pay for "loss:" X tation Expenses. Payment may start on the day of the 'loss" if 1. confined to or resulting from wear and tear, freezing, me- the "auto" cannot be driven. If drivable, payment may start the chanical or electrical breakdown or failure. "We" will for day "you" leave the "auto" at the garage for repairs. pay damage resulting from a covered "loss." A covered "loss" does not include a "loss" confined to mechanical or 7 electrical failure or body defects d by or resulting from 9. due to any actdition of war, including discharge of any faulty workmanship or negligence "you" or others. nuclear weapon (even if accidental). War (declared or unde- 2. caused intentionally by or at the direction of "you" or a clared) means a state of armed hostile conflict between states "relative." or nations, civil war, insurrection, rebellion or revolution. 3. to any: 10. due to radioactive contamination. 11. to camper bodies unless described on the "Declarations" or a. tape players; replacing one described there. A camper bod b. compact disc players or recorders; P y is a unit de- signed and equipped for use as living quarters to be c. digital video disc players or recorders; mounted on an "auto" with a separate cab. d. video cassette players or recorders; 12. to radar detectors and other equipment designed to give ad- e. electronic navigational systems; vance warning of the operation of a speed - measuring device. f. radios; 13. to tires caused by road damage, such as a blow out or punc - g. two -way mobile radios or telephones; ture, unless it results from another h. scanners; policy. "loss" covered by this i. televisions; and 14. to an "auto we insure" because of destruction or confisca- j. any other similar equipment that records, receives or tion b „ „ transmits audio, visual or data signals. Y governmental or civil authorities if 'you, a rela- tive or a person using an "auto we insure" with "your" This exclusion does not apply to such equipment, its accesso- permission was involved in illegal activities. ries, attachments and antennas if it is perman ently installed. 15. to an "auto we insure" while being used in any prearranged Payment for "loss" to permanently installed equipment will be or organized racing, speed or demolition contest, stunting limited to $1,000. This limit will not apply if the equipment is activity or similar activities, or in practice for any such ac- permanently installed: tivities. 16. resulting directly or indirectly from "fungi," wet or dry rot, a. in the opening of the dash, console, or overhead console, or bacteria, meaning the presence, growth, proliferation, normally used by the auto manufacturer to install such spread or any activity of "fungi," wet or dry rot, or bacteria, equipment; or even if other events or happenings contributed concurrently b. by the auto manufacturer in other locations of the "auto." or in sequence to the "loss." Payment for "loss" to tapes, digital video discs or compact discs 17. due to diminution in value. Diminution in value means any X will be limited to no more than ten tapes, digital video discs or actual or perceived "loss" in market or resale value that re- compact discs in any one "loss." Coverage for theft of tapes, digi- sults from a direct and accidental "loss." Diminution in tal video discs or compact discs will be provided only if the sound value includes any actual or perceived "loss" or reduction in equipment is stolen or the entire "auto" is stolen. market or resale value after an "auto we insure" has been 4. to fax machines, personal computers and peripheral equip- damaged and has been repaired. ment and similar electronic equipment. LIMIT OF PROTECTION 5. to a vehicle "you" acquire during the policy period or any "We" will pay the Actual Cash Value for "loss temporary substitute for it, if there is other applicable insurance. damaged property, but no more than: to stolen or 6. to a "nonowned auto:" 1. what it would cost to repair or replace the property with a. while used in connection with the "auto business;" other of like kind and quality; or b. while used in connection with any other business or oc- 2. the Stated Amount that may be shown on the "Declarations." cupation. This exclusion does not apply to a "private Actual Cash Value reflects fair market value, age and condition passenger auto" or "trailer;" of the property at the time of the "loss." c. while being used by someone other than "you" or a An "auto" and attached "trailer" are considered to be two sepa- "relative" even if the "nonowned auto" is in the custody rate vehicles under these coverages. The limit of protection for or control of "you" or a "relative;" or "loss" to any "trailer" not owned by "you" is $2,000. d. furnished or available for the regular use of "you" or a X "relative." A "private passenger auto," "moving van" An "auto" and its equipment are considered one "auto" under or "trailer" (not including a "temporary substitute ") these coverages including any deductible provision that applies. rented or leased to "you" for a period of more than 45 Equipment means that which is usual or incidental to the use of consecutive days will be considered as furnished or an "auto" as a vehicle. available for the regular use of "you" or a "relative." Equipment includes, but is not limited to: 7. to any "trailer" used as a residence, office, store, display or 1. customized or individually adapted items when built or fit in passenger "trailer." or upon pickups or vans: 8. to any "auto we insure" while hired by or rented to others a. truck caps; for a fee, or while available for hire by the public. Fee does b. bay or custom windows; not include payment received in a car pool or for trips for c. interior wood trim; nonprofit social, educational or charitable agencies. d. special lighting fixtures; and e. window treatments, such as draperies or mini - blinds. 8 2. equipment that allows a handic person to enter, exit or its agreed or appra&alue. There can be no abandonment of operate the vehicle; property to "us." X 3. attached child safety seats; and 4. a camper body if it is: "We" may settle any claim for "loss" with "you" or anyone that a. described on the Declarations' or replaces one de- has a legal interest in the property. scribed there; and For damage to a "nonowned auto," "we" will pay the broadest b. mounted on an "auto." amount available among the coverages "you" purchased under this section. "Loss" to a camper body while not mounted on an "auto" will be paid in accordance with the deductibles purchased on the "You" must assign or transfer to "us" the Certificate of Title for camper body. the "auto" sustaining the "loss" before "we" will make a pay- ment for all or part of the actual cash value for a total "loss" to OTHER INSURANCE an "auto we insure." A total "loss" will be determined in com- pliance with the laws of the state in which "you" reside at the When there is other insurance for "loss" to an "auto we insure," time the policy is issued. This paragraph is not applicable if the except a "nonowned auto," "we" will pay "our" share of "you" choose to retain ownership of the salvage vehicle as part "loss." of the total "loss" settlement. When there is "loss" to a "nonowned auto," "we" will pay the NO BENEFIT TO BAILEE "loss" not covered by other insurance less any applicable de- ductible. When there is other insurance on a "nonowned auto," No bailee will benefit, directly o indirectly, from this insurance. and it states that coverage is void if there is other applicable insurance, then coverages under this section are void. LOSS PAYABLE CLAUSE APPRAISAL This clause applies to the Physical Damage Coverages provided by this policy for the Lienholder named in Item 3. on the "Dec - If "you" and "we" fail to agree on the amount of 'loss," either larations." It protects the Lienholder's financial interest in the party may make written demand for an appraisal. Each party vehicle insured. will select an appraiser and notify the other of the appraiser's identity within 20 days after the demand is received. The ap- Payment for any "loss" under these coverages will be made in praisers will select a competent and impartial umpire. If the ap- accordance with the financial interest the "Named Insured" and praisers are unable to agree upon an umpire within 15 days after the Lienholder, as its interest may appear for specific vehicle(s), both appraisers have been identified, you or we can ask a have in the loss. Payment may be made to the "Named In- judge of a court of record in the state where "you" reside at the sured" and the Lienholder jointly or to either or both separately. time the policy is issued to select an umpire. If separate payments are made, the financial interests of both The appraisers will then set the amount of "loss." If the apprais- will be protected by "us." ers submit a written report of an agreement to "us," the amount When "we" pay the Lienholder for a "loss" for which the "Named agreed upon will be the amount of "loss." If they cannot agree, Insured" is not insured, "we" are entitled to the Lienholder's right they will submit their differences to the umpire. A written award of recovery against the "Named Insured," to the extent of "our" by two will determine the amount of "loss." payment. "Our" recovery will not impair the right of the Lien - Each party will pay the appraiser they choose, and equally bear holder to recover the full amount of its claim. all other expenses of the appraisal. However, if the written de- The Lienholder will, on demand, pay any premium due under mand for appraisal is made by "us," "we" will pay for the rea- this policy for coverages which protect the Lienholder's inter - X sonable cost of "your" appraiser and "your" share of the cost of ests, if the "Named Insured" fails to do so. the umpire. The Lienholder's financial interest will be protected regardless of "We" will not be held to have waived any rights by any act re- the acts or neglect of the "Named Insured," subsequent legal lated to appraisal. encumbrance or any change in ownership of the property. How- ever, this clause does not apply, and "we" will not protect, the LOSS PAYMENT Lienholder's financial interest in any case of fraudulent acts or omissions by the "Named Insured" or anyone representing the At "our" option, "we" will pay the "loss" in money, or repair or "Named Insured ". If "we" cancel or refuse to renew this policy, replace the damaged or stolen property. At any time before the not less than 10 days advance notice of such termination will be "loss" is paid or the property is replaced, "we" may return any mailed to the Lienholder. If this policy is cancelled by the stolen property to "you." "We" will pay the reasonable expense "Named Insured," "we" will mail notice of cancellation to the for its return and for any damage to it. Upon payment of the Lienholder. Mailing notice to the Lienholder's address shown on "loss," "we" have the right to take all or part of the property at the "Declarations" will be sufficient proof of notice. 9 . ADDITICNA'. COVERAGE 0 REIMBURSEMENT FOR COVERAGE IN MEXICO AND OTHER FOREIGN COUNTRIES WARNING: "We" will not be liable for damages or other not apply. Reimbursement will be made ONLY for similar expenses incurred in any foreign country where this policy coverages. Such coverages must apply to an "owned auto we X does not apply. In Mexico, however, Collision Coverage, if insure," used by "you" or a "relative" in the foreign country. purchased, will apply. Reimbursement will not be made to anyone employed, sta- X "We" will reimburse "you" for premium paid for up to 30 tioned in the armed services, or attending school in a foreign days of coverage in a foreign country where this policy does country. RIGHTS AND DUTIES - GENERAL POLICY CONDITIONS "We," "you" and anyone else protected by this policy must do certain things in order for the terms of this policy to apply. DEFINITIONS COOPERATION The following words and phrases have a special meaning when "You" agree to cooperate with "us" by promptly and truthfully they appear in bold type and quotations in the RIGHTS AND- answering all questions about drivers and "autos we insure" DUTIES - GENERAL POLICY CONDITIONS Section. and signing all papers relating to such insurance. • "Anyone we protect" means: 1. "you" and "your" spouse, if a "resident" of "your" HOW YOUR POLICY MAY BE CHANGED household; and 2. persons or organizations defined as "anyone we protect" Changes To Your Policy in the LIABILITY PROTECTION Section or any appli- This policy conforms to the laws of the state in which "you" cable coverage. reside at the time it is issued. If the laws of the state change, this ASSIGNMENT policy will comply with those changes. "We" will give "you" the benefit of any change made by "us" if it does not require Interest in this policy may be transferred only with "our" writ- additional premium. This change will be effective as of the date ten consent. "We" may require evidence that all "Named Insur- "we" implement the change in "your" state. eds" approve the assignment. "You" may change this policy by asking "us." Asking "our" BANKRUPTCY OF ANYONE WE PROTECT Agent is the same as asking "us." "Your" request must contain enough information to identify "you." If "we" agree with "your" Bankruptcy or insolvency of anyone we protect will not re- request, we will then issue a "Declarations." If there is a lieve "us" of "our" obligations. change in the information used to develop the policy premium, "we" may adjust "your" premium during the policy period effec- CONCEALMENT, FRAUD OR MISREPRESENTATION tive as of the date the change occurred. Premium adjustments will Except as modified by law, this entire policy is void if, before or be made using the rules and rates in effect for "our" use. Changes after an accident or loss, "anyone we protect" has intentionally that may result in a premium increase or decrease during the pol- concealed or misrepresented any material fact or circumstance icy period include, but are not limited to: concerning this insurance. 1. change to "your" address; In the event of a fraudulent claim, "we" will not make payment 2• change to the location where the insured vehicle is princi- for the accident or loss. pally garaged; 3. change in "your" marital status; CONTINUOUS POLICY 4. change to the distance "you" drive to or from work or This policy is a continuous policy. It will continue in force until school; cancelled by "you" or terminated by "us" as explained in the Ter- 5 change ]e)in the use of "your" vehicle (i.e., business use of a mination Condition. Each year we will send you a ' Declara- tions" that shows the premium due for the next policy period. 6. addition or deletion of an "auto" or lienholder or another party having a financial interest in "your" vehicle(s); In return for this service, you must mail us written notice 7. addition or deletion of a licensed driver in "your" household prior to the new policy period if "you" want to cancel. If "we" regardless of whether they have their own "auto" and insur- do not receive this notice, this policy remains in force and "you" ance; and must pay "us" the earned premium due for this time. 10 8. changes which modify the app ce or performance of Sylvania corporatiOth its Home Office in Erie, Pennsyl- "your" vehicle with customize quipment. Customized vania, to the following: equipment includes those items or changes that are other ` than what is offered by the auto manufacturer of that specific 1 • "You" agree to pay "your" policy premiums and to ex- model of vehicle or what is added or altered by the auto change with other ERIE Subscribers policies providing in- dealer when the vehicle is new at the time of original sale, surance for any insured loss as stated in those policies. Equipment added to a vehicle to allow a disabled person to 2. "You" appoint "us" as Attorney -in -Fact with the power to: enter, exit or operate the vehicle is not considered custom- a. exchange policies with other ERIE Subscribers; ized equipment. b. take any action necessary for the exchange of such policies; c. issue, change, nonrenew or cancel policies; Your Duty To Notify Us of Changes d. obtain reinsurance; "You" agree to promptly notify "us" if "you" have made any e. collect premiums; material changes, including, but not limited to, those listed f. invest and reinvest funds; above. Changes may result in an increased premium, an adjust- g• receive notices and proofs of loss; ment in the coverage available under this policy, or cancellation h. appear for, compromise, prosecute, defend, adjust and or nonrenewal as permitted by law. settle losses and claims under "your" policies; i. accept service of process on behalf of ERIE as insurer; LAWSUITS AGAINST US and j. manage and conduct the business and affairs of ERIE, its No legal action may be brought against us until there has been affiliates and subsidiaries. This power -of- attorney is lim- full compliance with all the terms of this policy. The legal liabil- ited to the purposes described in this Agreement. ity of anyone we protect must be determined before "we" 3. "You" agree that as compensation for "us:" may be sued. This determination may be made by a court of law or by written agreement of all parties, including "us." No one a. becoming and acting as Attorney -in -Fact; has the right to make "us" a party to a "suit" to determine the b. managing the business and affairs of ERIE; and liability of "anyone we protect." In the event of a medical, in- c. paying general administrative expenses, including sales come or funeral payments claim or a Comprehensive or Colli- commissions, salaries and employee benefits, taxes rent sion loss, no "suit" may be brought against "us" until 30 days depreciation, supplies and data processing, after proof of loss is filed. "we" may retain up to 25% of all premiums written or as- OUR RIGHT TO RECOVER FROM OTHERS sumed by ERIE. The rest of the premiums will be used for losses, loss adjustment expenses, investment expenses, dam - After "we" make a payment under this policy, "we" will have ages, legal expenses, court costs, taxes, assessments, license the right to recover from anyone else held responsible. "Anyone fees, and any other governmental fines and charges, estab- we protect" is required to transfer this right to "us," and do lishment of reserves and surplus, and reinsurance, and may nothing to harm this right. be used for dividends and other purposes "we" decide are to Anyone receiving payment from "us" and from someone else the advantage of the Subscribers. for the same accident or loss will reimburse "us" up to "our" 4. "You" agree to sign and deliver to "us" all papers required to payment. carry out this Agreement. "We" will pay all reasonable expenses "anyone we protect" 5. This Agreement, including the power -of- attorney, will not may incur at "our" request to help "us " recover damages from be affected by "your" subsequent disability or incapacity. anyone else held responsible. This includes up to $300 a day for 6. This Agreement is and will be binding upon "you," "us" and actual loss of earnings, limited to those days "anyone we pro- all executors, administrators, successors and assigns. tect" attends hearings or trials at "our" request. SURVIVORS' COVERAGE PRIORITY If "you" die, the policy will cover: X This insurance will first protect "you," "your" spouse residing 1. "your" spouse if residing in the same household at the time in "your" household and then others "we" protect. of "your" death; SUBSCRIBER'S AGREEMENT 2. anyone having proper custody of an "owned auto we in- sure" until a representative is appointed, but only until the The following applies only to policies issued by Erie Insurance end of the policy period during hich "your" g your death occurs; Exchange. 3. your legal representative, but only while performing du- The Subscriber ("you" or your) agrees with the other Sub- ties as your representative and only until the end of the scribers at ERIE INSURANCE EXCHANGE ( "ERIE "), a Re- policy period during which "your" death occurs; and ciprocal /Inter - Insurance Exchange, and with their Attorney -in- 4 • any "relative" covered under this policy on the date of X Fact, the Erie Indemnity Company ( "we" or "us "), a Penn- "your" death, but only until the end of the policy period dur- ing which "your" death occurs. 11 TERMINATION � 3. provide "us:" 0 Cancellation a. promptly, any papers that relate to the accident or loss; "You" may cancel this policy by mailing or delivering to "our" b• separate, signed, written and /or oral statements contain - Agent or "us" written notice stating at what future date "you" ing all the facts about the claim; and want the cancellation to take effect. "We" may waive these re- c. proof of loss to damaged property. quirements by confirming the date of cancellation to "you" in 4. at "our" request, separately: writing. a. answer all questions about the accident or loss; "We" reserve the right to cancel for " your" noncompliance with b. submit to examinations and statements under oath and g our premium payment plans. We do not waive our right to sign transcripts of the same; cancel, even if "we" have accepted prior late payments. c. assist in making settlement; d. help "us" enforce any right of recovery against anyone X If this policy is cancelled, "we" will return the pro rata unused liable to "anyone we protect;" share of "your" premium. Cancellation will be effective even if e. cooperate with "our" investigations and any lawsuits; we' have not given or offered any return premium. f. attend hearings and trials; Nonrenewal g• assist "us" in securing and giving evidence and in obtain- ing the attendance of witnesses; Should "we" refuse to renew this policy, "we" will do so in h. submit to physical and mental examination by doctors compliance with the laws of the state in which "you" reside. "we" choose as often as "we" reasonably require. "We" "We" will notify "you" before the end of the policy period. will pay for these examinations; Method Of Giving Notice i. sign papers to allow "us" to obtain medical reports, earn- ings statements and copies of records; and "We" may cancel or refuse to renew this policy or any coverage j• allow "us" to inspect and appraise the damaged prope by mailing "you" written notice stating the effective date of before its repair or disposal. g "our" action. Mailing notice to the address shown on the "Dec- 5. not make payments, assume obligations or incur expenses, larations" will be sufficient proof of notice. The policy period except at their own cost. will end on the date and time stated in the notice. 6. protect "autos we insure" from further damage. "We" will pay reasonable costs to do so. "We" will not pay for loss due WHAT TO DO WHEN AN ACCIDENT OR LOSS to "your" failure to protect an "auto we insure" from further HAPPENS damage after a loss. When there is an accident or loss, "anyone we protect" will: WHEN AND WHERE YOUR POLICY APPLIES 1. notify "us" or "our" Agent in writing as soon as possible stating the: This policy applies to accidents or losses that occur during the policy period in the United States of America, its territories and a. name and policy number of "our" Policyholder; possessions, Puerto Rico, Canada or between their ports. The b. time, place and circumstances of the accident or loss; and policy period is shown on the "Declarations." Unless otherwise c. names and addresses of injured persons and witnesses. specified on the "Declarations," the policy period begins and 2. promptly notify the police in case of theft, ends at 12:01 A.M., Standard Time at the stated address of the "Named Insured." This policy has been signed on "our" behalf in Erie, Pennsylvania, by "our" President and Secretary. If required by law, it has been countersigned on the "Declarations " by "our" Authorized Agent. Secretary President Erie I nsurance " Home Office • 100 Erie Insurance Place • Erie, PA 16530 814.870.2000 Visit our Website at www.erieinsurance.com FAP (Ed. 3/07) OF -8522 12 0 PRIVATE PASSENGER AUTO AFPF01 (Ed. 3/07) OF -4625 ERIE INSURANCE GROUP ERIE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FIRST PARTY BENEFITS ENDORSEMENT -- PENNSYLVANIA This endorsement contains provisions applicable to First Party Benefits Coverage and changes provisions contained in your policy to the extent that the provisions in this endorsement are different from those in your policy. Coverage is provided only if a premium for the specific First Party Benefit selected is shown on the Declarations. DEFINITIONS 2. a ward or any other person under 21 years old in Words and phrases in bold type and quotations are used "your" care; or as defined in this endorsement. If a word or phrase in 3. a minor in the custody of a "relative." bold type and quotations is not defined in this endorse- ment, then the word or phrase is used as otherwise defined OUR PROMISE in the GENERAL POLICY DEFINITIONS section of the policy. As "you" selected in accordance with the Pennsylvania Motor Vehicle Financial Responsibility Law, as "Anyone we protect" means: amended, "we" will pay for: 1. "you;" I. medical expenses, 2. a "relative;" 2. funeral expenses, and/or 3. an individual specifically named on the 3. income loss, "Declarations" for coverage under this First Party Benefits Endorsement, and that person's "relatives;" arising from "bodily injury" to "anyone we protect" due to and an accident resulting from the maintenance or use of a 4. anyone else who sustains "bodily injury" while: "motor vehicle" as a vehicle. "We" will pay these benefits a. "occupying" an "insured motor vehicle," or no matter who is at fault in the accident. b. a nonoccupant of a "motor vehicle" if injured as BENEFITS a result of an accident in Pennsylvania involving an "insured motor vehicle." An unoccupied, Medical Expenses parked "insured motor vehicle" is not a "motor vehicle" involved in an accident unless it was "We" will pay reasonable and necessary charges for: parked in a manner so as to create an unreason- 1. medical treatment, including but not limited to: able risk of injury. a. medical, hospital, surgical, nursing and dental "Bodily injury" or "injury" means accidental bodily harm services; to a person and that person's resulting illness, disease or b. medications medical supplies and death. "Bodily injury" includes mental injury only if it prosthetic arises out of bodily harm sustained in an accident devices; and p covered 'by this endorsement. c. ambulance. "Insured motor vehicle" means a "motor vehicle:" 2. medical and rehabilitative services, including but not limited to: 1. to which the Bodily Injury Liability insurance of this a. medical care; policy applies and for which a specific premium is charged, and b. licensed physical therapy, vocational rehabili- 2. for which "you" maintain First Party Benefits on this tation and occupational therapy; policy as required under the Pennsylvania Motor c. osteopathic,- chiropractic, psychiatric and psy- Vehicle Financial Responsibility Law, as amended. chological services; and "Relative" means a "resident" of "your" household who d. optometric services, speech pathology a is: audiology. 1. a erson related to 3. nonmedical remedial care and treatment rendered in P you by blood, marriage or accordance with a adoption; recognized religious method of healing. 1 Payment of medical expenses a made pursuant to by the, Pennsylvanoraurn Systems Foundation under Section 1797 (a) of the Penns vania Motor Vehicle the Emergency Medical Services Act (P.L.164, No.45), Financial Responsibility Law, and as it may be or a major burn injury patient by a burn facility which amended. meets all the service standards of the American Burn , the amount Of All medical treatment and medical and rehabilitative ser- sual charge payment may not exceed the vices must be provided by or prescribed by a person or facility approved by the Department of Health, the Funeral Expenses equivalent governmental agency responsible for health programs or the accrediting designee of a department or If a premium appears on the "Declarations" agency of the state in which those services are provided. for this cov- era e, "we" will pay directly related to the dune al, burial, cremation or other "We" use Peer Review Organizations (PRO) which have form of disposition of the remains of the deceased person been approved by the Insurance Commissioner to eval- uate whether or not: we protect. The expenses must be incurred as a result of the death of "anyone we protect" and within 24 1. treatment; months from the date of the accident. 2. health care services; Income Loss 3. products; or 4. accommodations; If a premium appears on the "Declarations" for this cov- erage, "we" will pay loss of income meaning 80% of which were provided conform to professional standards gross income actually lost by "anyone we protect." Loss of performance and were reasonable and medically neces- of income includes reasonable expenses actually incurred sary. "We," the injured person or the provider may for hiring: request a reconsideration by the PRO within 30 days of 1. a substitute to perform the work "anyone we protect" the PRO's initial determination. This request for recon- who is self - employed would have performed except sideration as to the reasonableness and necessity of treat- for "bodily injury," or meet must be made pursuant to Section 1797 (b) of the Pennsylvania Motor Vehicle Financial Responsibility 2 special help, thereby enabling a person to work, Law, and as it may be amended. thereby reducing loss of gross income. If "we" refuse payment of a provider's bill and do not challenge it before a PRO within 90 days of receipt, the �We will not pay for: injured person may ask the court to review "our" refusal 1. any loss of income until five full working days have to pay. This 90 day provision does not apply to contin- been lost by "anyone we protect" because of the uing treatment or services. "bodily injury;" Payment of medical expenses will not exceed 110% of 2. loss of expected income for any period following the the: death of "anyone we protect;" or 1. prevailing charge at the 75th percentile; 3. expenses incurred for services performed following 2. applicable fee schedule, the recommended fee or the the death of "anyone we protect." inflation index charge; Accidental Death 3. diagnostic - related groups (DRG) payment; or If a premium appears on the "Declarations" for this cov- 4. fee established by the Insurance Commissioner, erage, "we" will pay for accidental death arising from whichever pertains to the specialty service involved, "bodily injury" to: determined to be applicable in the Commonwealth of 1• "you;" Pennsylvania under the Medicare Program for compa- 2. a "relative;" or rable services at the time the services were rendered, or the provider's usual and customary charge, whichever is 3. an individual specifically named on the less. "Declarations" for coverage under this First Party If a fee, charge or payment has not been calculated under Benefits Endorsement, and that person's "relatives;" the Medicare Program for a particular treatment, accom- due to an accident resulting from the maintenance or use modation, product or service, the amount of the of a "motor vehicle" as a vehicle. "We" will pay this payment may not exceed 80% of the provider's usual benefit no matter who is at fault in the accident. and customary charge. This death benefit will be paid to the executor or admin- If acute care is provided in an acute care facility to a istrator of the deceased's estate should "bodily injury" patient with an immediately life- threatening or urgent cause death within 24 months from the date of the acci- injury by a Level I or Level II trauma center accredited dent. 2 Combination Package c. any other * of "motor vehicle" not required to If a premium appears on the "Declarations" for "CO be registered under Title 75. M- BINATION PACKAGE ", "we" will pay for medical 3. other than "you," a "relative" or an individual specif- expenses, funeral expenses, income loss, and accidental ically named on the "Declarations" for this coverage death as described and limited above. "Our" payment is and that person's "relative," who knowingly steals a limited to $177,500 in the aggregate or to the expenses or "motor vehicle" if the "bodily injury" arises out of the loss incun•ed within three years from the date of the acci- maintenance or use of the stolen vehicle. dent, whichever occurs first. However, within this 4. when the conduct of that person contributed to the $177,500, '.'we" will pay no more than $25,000 for an "bodily injury" sustained by that person, while: accidental death benefit nor $2,500 for funeral expenses. a. intentionally injuring or attempting to inten- Extraordinary Medical Benefits tionally injure himself or another, b. committing a felorly, or If a premium appears on the "Declarations" for this cov- erage, "we" will pay benefits for reasonable and necess c• seeking to elude lawful apprehension or arrest by a law enforcement official. medical expenses in excess of $100,000 arising from "bodily injury" to "anyone we protect." The "injury" 5. not "occupying" a "motor vehicle," other than "you," must be due to an accident resulting from the mainte- a "relative" or an individual specifically named on the nance or use of a "motor vehicle" as a vehicle. "We" will "Declarations" for this coverage and that person's pay these benefits no matter who is at fault in the acci- "relative," if the accident occurs outside the Com- dent. monwealth of Pennsylvania. No benefits will be paid under this coverage until such 6. as a direct result of loading or unloading any "motor medical expenses exceed $100,000. vehicle," except while "occupying" a "motor vehicle." 7. while maintaining or using a "motor vehicle" while Subject to a lifetime aggregate limit of $1,000,000, the located for use as a residence or premises. most "we" will pay on behalf of "anyone we protect" as a 8. due to war, whether or not declared, civil war, result of one accident is $50,000 per year. However, insurrection revolution during the first 18 months of eligibility, "we" will make or rebellion or any accompa- payments in excess of the $50,000 per year limit, subject nying acts or conditions. to the lifetime aggregate limit of $1,000,000. 9. caused by nuclear radioactivity or explosion. 10. arising out of the ownership, maintenance, use, EXCLUSIONS - What We Do Not Cover loading or unloading of a vehicle "anyone we protect" owns "We" will not pay for "bodily injury" sustained by vehicle. at is unregistered and not an "insured motor "anyone we protect:" 11. resulting from the use of any weapon. ]. who is the owner of: a. only one currently registered "motor vehicle" for 12. resulting from assault and/or battery. which Financial Responsibility is not provided; LIMIT OF PROTECTION or b. more than one currently registered "motor "Our" duty to pay benefits to any one person "we" vehicle" if Financial Responsibility is not pro- protect in one accident is restricted to the First Party vided on any of the vehicles. Benefits limits "you" selected as shown on the "Declara- If Financial Responsibility is provided on some cur- bons" for one "insured motor vehicle." r n tly registered "mot v ehicles" and injury o proof ed B will not be increased for any person "we" protect ,� pay "bodily owner while "occupying" or operating an owned by adding together the limits of protection: "motor vehicle" for which Financial Responsibility is 1 • under this policy because there are multiple "motor not provided. vehicles" covered under this policy, or "Financial Responsibility" means the ability to 2. under multiple "motor vehicle" policies covering respond for damages when liable on account of acci- "anyone we protect" for the same loss. dents arising out of the maintenance or use of a "motor vehicle," in compliance with the requirements Any amount payable by "us" for: set forth in 75 Pa. C.S. 1701 et. seq. 1. medical expenses greater than $100 will be excess 2. while "occupying" or being struck by: over any amount paid or payable under Extraor- a. a motorcycle, motor driven cycle, motorized dinary Medical Benefits, and pedalcycle or like type vehicle required to be reg- 2. First Party Benefits will be excess over all benefits istered under Title 75; that "anyone we protect" receives or is entitled to b. a recreational vehicle not intended for highway receive under any workers' compensation law or use; or similar law. 3 PRIORITY OF POLICIES r RIGHTS AND AS GENERAL "We" will pay First Party Benefits in accordance with the CONDITIONS POLICY following order of priority. "We" will not pay if there is another insurer at a higher level of priority even if that The following conditions are added: other insurer has paid its limits. The priority levels shown below are in descending order from highest to MEDICAL REPORTS lowest: - PROOF OF CLAIM As soon as practicable, "anyone we protect," or someone First - The insurer providing benefits to the injured on such person's behalf, wi 11 give "us" written proof of person who is a named insured under its policy. claim, under oath if required, fully describing the nature and extent of "bodily injury, treatment and rehabilitation Second - The insurer providing benefits to the injured received and contemplated and other person as an insured under its policy. information to assist "us" in determining the amount due and payable. Third - The insurer of the "motor vehicle" which the If benefits for income loss are claimed, "an one we injured person is "occupying" at the time of the accident. protect y �� presenting such claim will authorize "us" to obtain details of all earnings paid to such person b Fourth - The insurer providing benefits on any "motor employer or earned since the time of the "inju by an or vehicle" involved in the accident if the injured person was during the year immediately preceding the date of the not "occupying" a "motor vehicle." accident. If two or more policies have equal priority: NONDUPLICATION OF BENEFITS 1. the insurer against which the claim is first made will process and pay the claim as if wholly responsible. No person "we" protect will recover duplicate benefits for The insurer is then entitled to recover contribution the same elements of loss under this or any other similar pro rata from any other insurer for the benefits paid automobile insurance including self - insurance. and the costs of processing the claim. Under the Fourth priority, proration will be based on the The following condition is deleted. number of involved "motor vehicles." 2. the maximum recovery under all policies will not OUR RIGHT TO RECOVER FROM OTHERS exceed the amount payable under the policy with the highest dollar limits of benefits. OTHER PROVISIONS All other provisions of the policy apply. 4 t. ERIE INSURANCE GROUP ,PRIVATE PASSENGER AUTO AFPA03 (Ed. 10/08) OF -6380 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGE ENDORSEMENT -- PENNSYLVANIA GENERAL POLICY DEFINITIONS 1. no more than three days after "we" offer settlement; The following definitions are added under the GENERAL 2. on the day the "auto" is replaced; POLICY DEFINITIONS section: 3. on the day the "auto" is returned to "you" in usable condition; or "Noneconomic loss" means pain and suffering and other 4_ on the day the "auto" could reasonably be expected nonmonetary detriment. to be repaired. "Serious injury" means a personal injury resulting in death, serious impairment of body function or perma- OTHER INSURANCE nent, serious disfigurement. This clause is deleted and replaced by the following: LIABILITY PROTECTION When there is other insurance for "loss" to an "owned OTHER INSURANCE auto we insure," "we" will pay "our" share of the "loss." When there is "loss" to a "nonowned auto " "we" will pay This clause is deleted and replaced by the following: the "loss" not covered by other insurance less any appli- cable deductible. This policy provides primary insurance for any "owned auto we insure." The policy's coverage is excess over any When there is other insurance on a "nonowned auto," other collectible insurance on a "nonowned auto," up to and it states that coverage is void if there is other appli- the limit(s) of protection for one "auto." cable insurance, then coverages under this section are void. "We" will, however, provide primary insurance for a motor vehicle "you" do not own if it is insured under a ADDITIONAL COVERAGE policy issued to a business engaged in selling, leasing, repairing, servicing, delivering, testing, road testing, The following coverage is added. parking or storing motor vehicles. This applies only if "you" or a "relative" are operating the motor vehicle and are not the owner, operator, employee or agent of that PET PROTECTION business. "We" will pay reasonable veterinarian costs incurred for If other insurance, collectible or not, covers an "auto" the necessary treatment of a domestic dog or domestic rented or leased for less than one year and it states that cat which is: coverage is void if there is other available insurance, then 1. owned by "you" or a "relative;" and coverages under this section are void. 2. injured while riding inside an "auto we insure" at the When there is other insurance applicable to the accident time of a covered loss. on the same basis, "we" will pay "our" share. "Our" If such injury results in the death of a domestic dog or share is the proportion that "our" limit of protection bears to the total of all applicable limits. domestic cat, "we" will pay to replace the animal with one of like kind and quality whether or not the animal is "We" will never pay more than the limit of protection. actually replaced. Replacement cost includes the amount associated with the first wellness visit as well as the cost to spay or neuter the animal. Replacement cost does PHYSICAL DAMAGE COVERAGES not include any amounts associated with training. The most "we" will pay for any one animal for any one OUR PROMISE - Transportation Expenses (No covered loss for both veterinarian costs and replacement Deductible Or Waiting Period Applies) costs is $500. If more than one animal is injured or dies as a result of a covered loss, the maximum amount "we" The fourth paragraph is deleted and replaced by the fol- Will pay is $1,000 subject to a maximum payment of lowing: $500 for any one animal for both veterinarian costs and replacement costs. Payment for Transportation Expenses will end as indi- cated below, whichever occurs first: AFPA03 1 N RIGHTS AND DUTIES - JtRAL POLICY tation of a Aal fact, where such concealment, CONDITIONS allegation or misrepresentation was material to acceptance of the risk. CONCEALMENT, FRAUD OR MISREPRESENTATION The effective date of cancellation will never be earlier This condition is deleted and replaced by the following: than: Within the first sixty (60) days this policy is in effect a. 60 days after "we" send it; or , "we" may void this policy in its entirety or deny coverage b. 15 days after "we" send it for nonpayment of if, before or after an accident or loss, "anyone we protect" premium or when the cause of cancellation is has intentionally concealed or misrepresented any mate- license suspension or revocation. rial fact or circumstance concerning this insurance. Nonrenewal After this policy has been f in effect for sixty (60) days, The following is added: "we" may void this policy 1. "anyone we protect" has intentionally concealed or "We" will send this notice at least 60 days in advance of misrepresented any material fact concerning this the end of the policy period. insurance; 2. "we" could not have reasonably discovered the MISCELLANEOUS VEHICLE PROVISIONS concealment or misrepresentation within the first sixty (60) days this policy was in effect; and If a "miscellaneous vehicle" is listed in ITEM 4 on' the 3. the undisclosed information would have caused "us" 'Declarations," the following provisions apply: to refuse to insure the risk. If "we" void this policy after it has been in effect for sixty GENERAL POLICY DEFINITIONS (60) days, coverage under the Liability Protection and the First Party Benefits Endorsement will remain in If a "miscellaneous vehicle" is listed in ITEM 4 on the effect for bodily injury or property damage sustained by 'Declarations," then the GENERAL POLICY DEFI- innocent third parties, provided that such injury or NITIONS are revised as follows: damage is sustained before "we" notify the "Named Insured" that the policy is void. If "we" void this policy Under "Owned auto we insure" the following sub - after it has been in effect for sixty (60) days, coverage paragraphs are added: under the Uninsured/Underinsured Motorists Coverage Endorsement, if purchased and indicated on the "Decla- 4. any "miscellaneous vehicle" described on the "Declara- rations," will remain in effect for bodily injury sustained lions" for the coverages "you" have purchased; or by innocent third parties, provided that such injury or damage is sustained before "we" notify the "Named 5. any "additional miscellaneous vehicle" or "replacement Insured" that the policy is void. miscellaneous vehicle ." "We" may deny coverage for an accident or loss if Under 'Temporary substitute" the following paragraph is "anyone we protect" intentionally conceals or misrepre- added: sents any material fact or circumstance in connection with the presentation or settlement of a claim. Temporary substitute" means any "miscellaneous vehicle" which is a substitute for an owned "miscellaneous In the event of a fraudulent claim, "we" will not make vehicle" described on the "Declarations" which has been payment for the accident or loss. withdrawn from normal use because of a breakdown, destruction, loss, repair or servicing. The "temporary TERMINATION substitute" cannot be owned by "you" and must be used with the permission of the owner. The "temporary sub - Cancellation stitute" must be the same type of "miscellaneous vehicle" The following is added: as shown on the "Declarations." For cancellations mailed during the first 60 days the The following definitions are added.• policy is in effect, the effective date of cancellation will Additional miscellaneous vehicle" means a "miscellaneous never be earlier than 15 days after "we" send it. vehicle" other than a "replacement miscellaneous vehicle" which "you" acquire, purchase or lease during the policy For cancellations mailed after the first 60 days the policy period. For coverage to apply, "we" must insure all is in effect, "we" will cancel only for one or more reasons owned miscellaneous vehicles" of the same type on the permitted by state law, including the following reasons: date "you" acquire an "additional miscellaneous vehicle." 1. nonpayment of premium; We will not automatically cover an "additional miscel- laneous vehicle when we do not already insure a "mis- 2. "your" driver's license or motor vehicle registration cellaneous vehicle" of the same type owned by "you." has been under suspension or revocation during the policy period; or "Additional miscellaneous vehicle" does not include an "miscellaneous vehicle" that y 3. concealment of a material fact, making a material lease with anyone other than a "relative." Coverage does or allegation contrary to fact, or making a misrepresen- AFPA03 2 not apply to an "additional r�'1 1'P Y laneous vehicle" regis- "You" must notify during the tered to a corporation or other , siness entity. intention to have this policy g Policy period of "your" P y apply to a "replacement`mis- cellaneous vehicle." If "you" obtain a "replacement mis- "You" must notify "us," during the policy period, of cellaneous vehicle" within 30 days prior to the end of the "your" intention to have this policy apply to the "addi- policy period, "you" have 60 days after acquisition to tional miscellaneous vehicle." If "you" obtain an "addi- notify "us." tional miscellaneous vehicle" within 30 days prior to the end of the policy period, "you" have 60 days after acqui- Should a loss occur involving a "replacement miscella - sition to notify "us." neous vehicle" prior to „ P "your' notifying us," the replace - Should a loss occur involving an "additional miscella- C OV t miscellaneous vehicle" will have the broadest neous vehicle" prior to "your" notifying "us," the "addi- on the "D clarations.'pchased for any one vehicle listed tional miscellaneous - •vehicle "..will have the broadest You" do not have: coverage "you have purchased for any` one vehicle listed L :Comprehensive Coverage on any vehicle listed on the "Declar'ations," then Comprehensi "ve Coverage on the "Declarations." If "you" do not have: I. Comprehensive Coverage" on any vehicle listed on will apply; subject to _,a $500 deductible. However, the "Declarations," then Comprehensive Covera a .Comprehensive coverage will end seven days after will apply, subject to a $500 deductible. However, You acquire, purchase or lease the vehicle or when Comprehensive coverage will end seven days after to us," report whichever oc!urs first. miscellaneous vehicle" you acquire, purchase or lease the vehicle or when "you" report the "additional miscellaneous vehicle" to 2• Collision Coverage on any vehicle listed on the "us," whichever occurs first. "Declarations," then Collision Coverage , will appl subject ..to a -$500 . deductible. However,. Collin' 2. Collision , Coverage on any vehicle listed on the "Declarations," then Collision Coverage will apply, Coverage will end seven days after "you" acquire, on the "replacemen g PP Y . purchase or lease the vehicle or when "you" `report subject to' a $500 deductible. However, Collisit miscel .laneous vehicle" to. "us," Coverage" will end seven . days after you' acquire, whichever occurs first. purchase or lease the vehicle or when "you" ; report the "additional miscellaneous vehicle" to 'us," which- ever occurs first. LIABILITY PROTECTION "Replacement miscellaneous vehicle" means a "miscella- EXCLUSIONS What We Do Not Cover neous vehicle': that "you" acquire, purchase or lease within the policy period .to replace a "miscellaneous Exclusion 14: does not o I vehicle" of the same type described on the "Declarations." listed in ITEM 4 on the D clarations.scellaneous vehicle" "Replacement miscellaneous vehicle" does not include a "miscellaneous vehicle" that "you" acquire, purchase or lease with anyone other than a "relative." Coverage does OTHER PROVISIONS not apply to a "replacement miscellaneous vehicle" regis- tered to a corporation or other business entity. All :other provisions of the policy apply. AFPA03 3 * PRIVATE PASSENGER AUTO AFPU01 (Ed. 03107) OF-8805 qs � ERIE INSURANCE GROUP ERIE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. UNINSURED/UNDERINSURED MOTORISTS COVERAGE ENDORSEMENT -- PENNSYLVANIA This endorsement contains provisions applicable to Uninsuredl Underinsured Motorists Bodily Injury Coverage and changes provisions contained in your policy to the extent that the provisions in this endorsement are different from those in your policy. DEFINITIONS "First Party Benefits" means Pennsylvania motor vehicle insurance first party benefits (medical benefit, income Words and phrases in bold type and quotations are used loss benefit, funeral benefit, accidental death benefit, as defined in this endorsement. If a word or phrase in combination benefit) in accordance with the bold type and quotations is not defined in this endorse- Pennsylvania Motor Vehicle Financial Responsibility ment, then the word or phrase is defined in the Law. GENERAL POLICY DEFINITIONS section of the policy. "Nonowned auto" means, while "you" or a "relative" are using it, any "private passenger auto," "moving van," "Anyone we protect" means: "trailer," or "temporary substitute" not owned or leased 1. "you" and any "relative;" by "you" or a "relative." The operation or other use by "you" or a "relative" must be with the permission of the 2. anyone else, while "occupying" any "owned auto we owner, or "you" or the "relative" must reasonably believe insure" other than: the permission of the owner exists. a. one while hired by or rented to others for a fee, "uninsured motor vehicle" means: or while available for hire by the public. Fee. does not include payment received in a car pool 1. a "motor vehicle" for which there is no liability bond or for trips for nonprofit social, educational or or insurance or self-insurance at the time of the acci- charitable agencies; or dent; b. one being used without the permission of the 2. a "motor vehicle" for which the insuring company owner; denies coverage or is or becomes insolvent; or 3. anyone else who is entitled to recover damages 3, a hit-and-run "motor vehicle" which causes "you" because of bodily injury to any person protected by bodily injury. The identity of the driver and owner this coverage; and " t accident he hit-and-run be vehicle mustthe unknown. The reported police or other 4. anyone else while occupying a "nonowned auto proper governmental authority within 24 hours or as other than: soon as possible. "You" must notify "us" as soon as a. one "you" are using that is owned or leased by possible. another "resident" of "your" household; An b. one furnished or available for the regular use of "uninsured motor vehicle" does not include: "you" or any "resident" of "your" household; 1. "motor vehicles" insured for Liability Protection c. one being operated by anyone other than "you" under this policy; or a "relative;" 1 "motor vehicles" that are owned, leased, or operated d. one while hired by or rented to others for a fee, by a self-insurer within the meaning of the financial responsibility laws, motor carrier laws or similar or while available for hire by the public. Fee laws, unless the self-insurer becomes insolvent; does not include payment received in a car pool or for trips for nonprofit social, educational or 3. "motor vehicles" designed for use mainly off public charitable agencies; or roads; or e. one being used without the permission of the 4. "motor vehicles" owned, leased, or rented by, fur- owner. nished to or available for the use of "You" or a "rela- tive." "Extraordinary Medical Benefits Coverage" means cov- erage for injury arising out of the maintenance or use of "Underinsured motor vehicle" means a "motor vehicle" for a "motor vehicle" for which medical treatment and which the limits of available liability bonds or insurance rehabilitative services exceed $100,000. 1 or self-insurance at the time J& accident are insuffi- 2. health care AS; cient to pay losses and damages. 3. products; or An "underinsured motor vehicle" does not include: 4. accommodations; 1. "motor vehicles" insured for Liability Protection h whic were provided conform to under this policy; or p professional standards of performance and were medically necessary and eco- 2. "motor vehicles" designed for use mainly off public nomically provided, may be used by us. The injured roads. person may request a reconsideration by the PRO within 30 days of the PRO's initial determination. OUR PROMISE If "we" refuse payment of a provider's bill and do not If Uninsured Motorists Coverage is indicated on the challenge it before a PRO within 90 days of receipt (90 "Declarations," "we" will pay damages for bodily injury day provision does not apply to continuing treatment or that the law entitles "anyone we protect" or the legal rep- services), the injured person may ask the court to review resentative of "anyone we protect" to recover from the "our" refusal to pay. owner or operator of an "uninsured motor vehicle." If Underinsured Motorists Coverage is indicated on the "d'i'e" will not be bound by a judgment against the owner "Declarations," "we" will pay damages for bodily injury or operator of the "uninsured motor vehicle" or that the law entitles "anyone we protect" or the legal rep- underinsured motor vehicle" on issues of liability or resentative of "anyone we protect" to recover from the amount of damages unless it is obtained with "our" owner or operator of an "underinsured motor vehicle." written consent. Damages must result from a motor vehicle accident EXCLUSIONS - What We Do Not Cover arising out of the ownership or use of the "uninsured motor vehicle" or "underinsured motor vehicle" as a This insurance does not apply to: motor vehicle and involve bodily injury,to "anyone we 1 damages sustained by "anyone we protect" if he, she protect. Bodily injury means physical harm, sickness, or a legal representative settled with anyone who disease or resultant death to a person. may be liable for the damages, without "our" written Payment of medical expenses will not exceed 110% of consent. the: 2. the benefit of any workers' compensation or disa- bility benefits carrier or anyone qualifying as a self- 1. prevailing charge at the 75th percentile; insurer under a workers' compensation, disability 1 applicable fee schedule, the recommended fee or the benefits or similar taw. inflation index charge; 3. damages sustained by "anyone we protect" while 3. diagnostic-related groups (DRG)payment; or "occupying" or being struck by a "motor vehicle" 4. fee established by the Insurance Commissioner, owned or leased by "you" or a "relative," but not insured for Uninsured or Underinsured Motorists whichever pertains to the specialty service involved, Coverage under this policy. determined to be applicable in the Commonwealth of 4. damages sustained by "anyone we protect" while Pennsylvania under the Medicare Program for compa- "occupying" or being struck by a "miscellaneous rable services at the time the services were rendered, or vehicle" owned or leased by "you" or a "relative," but the provider's usual and customary charge, whichever is not insured for Uninsured or Underinsured Motor- less. ists Coverage under this policy. If a fee, charge or payment has not been calculated under 5. punitive or exemplary damages and related defense the Medicare program for a particular treatment, accom- costs. modation, product or service the amount of the payment 6. noneconomic damages sustained in a "motor vehicle" may not exceed 80% of the provider's usual and cus- accident by "anyone we protect" unless such person tomary charge. sustained "serious injury." If acute care is provided in an acute care facility to a Exclusion 6. applies only when the LIMITED TORT patient with an immediately life-threatening or urgent option is selected. injury by a Level I or Level II trauma center accredited 7. bodily injury sustained by "anyone we protect" by the Pennsylvania Trauma Systems Foundation under resulting from the use of any weapon. the Emergency Medical Services Act (P.L.164, No. 45), g bodily injury sustained by "anyone we protect" or to a major burn injury patient by a bum facility resulting from assault and/or battery. which meets all the service standards of the American Burn Association, the amount of payment may not 9. bodily injury sustained by "anyone we protect" while exceed the usual and customary charge, involved in committing a crime. Peer Review Organizations (PRO), which have been 10. bodily injury to "you" or a "resident" using a non- owned "motor vehicle" or a nonowned "miscellaneous approved by the Insurance Commissioner to evaluate vehicle" which is regularly used by "you" or a "resi- whether or not: dent," but not insured for Uninsured or 1. treatment; Underinsured Motorists Coverage under this policy. 2 LIMIT OF PROTECTION Unstacked Covens Limitations of Payment If Unstacked Uninsured Motorists and/or Unstacked Underinsured Motorists Coverage is purchased, "we" will If coverage is purchased on a "Split Limits" basis, the pay no more than the Uninsured or Underinsured "Declarations" will show a PER PERSON and PER Motorists Coverage limits shown on the "Declarations" ACCIDENT limit for Uninsured and/or Underinsured for the "auto" involved in the accident, regardless of the Motorists Bodily Injury. The PER PERSON limit for number of persons "we protect," "autos we insure," pre- Bodily Injury for one "auto" is the most "we" will pay for miums paid, claims made or "autos" involved in the acci- damages arising out of bodily injury or death to one dent. If none of the "autos" are involved in the accident, person in any one accident. The PER ACCIDENT the highest limit of Uninsured or Underinsured Motor- limit for Bodily Injury for one "auto" is the most "we" ists Coverage applicable to any one "auto" will apply. will pay for damages arising out of bodily injury or death to all persons resulting from any one accident, subject to Reductions the PER PERSON limit. The amount of damages paid or payable under this If coverage is purchased on a "Single Limit" basis, the Uninsured or Underinsured Motorists Coverages will be "Declarations" will show a PER ACCIDENT limit for reduced by: Uninsured and/or Underinsured Motorists Bodily Injury. 1. the amounts paid or payable by or for those liable The PER ACCIDENT limit for one "auto" is the most for bodily injury to "anyone we protect." "we" will pay for all damages arising out of bodily injury resulting from any one accident. 2. the amounts paid or payable to "anyone we protect" under the Liability Protection of this policy. Uninsured/Underinsured Motorists Coverage is not pro- vided for any "trailer," whether or not the "trailer" is Payment under these coverages to or for "anyone we attached to another "motor vehicle" or "miscellaneous protect" will reduce the amount of damages they may be vehicle." No separate limit of protection for Uninsured/ entitled to recover from those protected under the Underinsured Motorists Coverage is available for a Liability Protection of this policy. "trailer," whether attached or unattached to a "motor vehicle" or "miscellaneous vehicle." A person who recovers damages under Uninsured Uninsured/Underinsured Motorists Coverage does not Motorists Coverage cannot recover damages under apply to a "miscellaneous vehicle" owned or leased by Underinsured Motorists Coverage for the same accident. "you" or a "relative" unless the "miscellaneous vehicle" is listed on the "Declarations" and a premium is shown for In any action for damages for Uninsured Motorists bene- this coverage. fits or Underinsured Motorists benefits arising out of the maintenance or use of a "motor vehicle," a person who is No one will be entitled to receive duplicate payments for eligible to receive benefits under "First Party Benefits" the same elements of loss. If an individual's damages coverages shall be precluded from recovering the amount derive from, arise out of, or otherwise result from bodily of injury to another person injured in the accident or the 1 required benefits paid or payable under "First Party death of another person killed in the accident, "we" will Benefits;" and pay only for such damages within the PER PERSON limit available to the person injured or killed in the acci- 2. medical and rehabilitation expenses which were paid dent. or are payable under "Extraordinary Medical Bene- fits Coverage," if purchased. Stacked Coverage OTHER INSURANCE If Stacked Uninsured Motorists and/or Stacked Underinsured Motorists Coverage is purchased and the If other similar insurance applies to the accident, "we" injured person is "you" or a "relative," "we" will pay no will pay "our" share of the loss, subject to the other more than the applicable sum of the Uninsured or terms and conditions of the policy and this endorsement. Underinsured Motorists Coverage limits shown on the "Our" share will be the proportion the limit of protection "Declarations." of this insurance bears to the total Limit of Liability of all applicable insurance. If the injured person is other than "you" or a "relative," "we" will pay no more than the applicable Uninsured or For bodily injury to "anyone we protect" while "occu- Underinsured Motorists Coverage limits shown on the pying" a "motor vehicle" "you" do not own, "we" will pay "Declarations" for the "auto" involved in the accident, the amount of the loss up to the applicable limit(s) regardless of the number of persons "we" protect, "autos shown on the "Declarations," less the amount paid or we insure," premiums paid, claims made or "autos" payable by other insurance. involved in the accident. If none of the "autos" are involved in the accident, the highest limit of Uninsured When the accident involves "underinsured motor or Underinsured Motorists Coverage applicable to any vehicles," "we" will not pay until all other forms of insur- one "auto" will apply. ance under all bodily injury liability bonds and insurance policies and self-insurance plans applicable at the time of the accident have been exhausted by payment of their limits or have been resolved by settlement or by final resolution of the court. 3 PAY6'ENT OF LOSS a. repay "us* of any damages recovered from When multiple policies apply, payment shall be made in the legally liable party; the following order of priority: b. take any action necessary to recover 1. A policy covering the '"motor vehicle" the injured made under this coverage, through a ayments person is "occupying" at the time of the accident chosen by "us;" and g lawyer 2. A policy covering a "motor vehicle" not involved in C. repay "us" from an the accident with respect to which the injured person or lawyers' fees "we" paid in the action. Y recovery for expenses, costs is an insured. If two or more policies have equal RIGHTS AND DUTIES - GENERAL POLICY against which the claim is first made shall process sand CONDITIONS pay the claim as if wholly responsible. Thereafter, the LAWSUITS AGAINST US insurer is entitled to recover a pro rata contribution from any other insurer for the benefits paid and claims costs This condition is deleted and replaced by the following. incurred. If "we" are the insurer against which the claim is first made, "we" will not pay more than "our" Limit of Protection. ��you�� must comply with the terms of the policy before " At "our" option, "we" will pay: you" may sue "us." Suit must be brought in a court of competent jurisdic- 1. "anyone we protect;" tion in the county and state of "your" legal domicile at 2. the surviving spouse; the time of the accident. 3. the legal representative; or WHAT TO DO WHEN AN ACCIDENT OR LOSS 4. anyone legally entitled to recover. HAPPENS TRUST AGREEMENT The following is added.- 1. When "we" owe payment to anyone under this cov- If claimants or their representatives bring action for erage, they will: damages, copies of suit a. hold in trust for "us" all rights of recovery once. Papers must be sent to "us" at against the other party; b. whatever is required to secure these rights, In an action against "us," "we" may require "anyone we and do nothing to harm them; and protect" to join with "us to bring those "we" allege to be a liable into the action as party defendants. c. sign and deliver to "us" all relevant papers. 2. When "we" pay anyone under this coverage, they OTHER PROVISIONS will: All other provisions of the policy apply. 4 DISCOUNTS - Listed below a auto insurance discounts which may be ale from The ERIE. The discounts which have been applied to your policy are indicated on your Declarations. For additional information on these dis. counts, please contact your Agent. You must notify your Agent if you qualify for any of these discounts and they are not indicated on your Declarations. Accident Prevention Course Discount - Available for a Multi-Car Discount - Available if two or more private three year period if all Named Insureds are age 55 or passenger autos are insured by the ERIE INSURANCE older as of the policy renewal date and have voluntarily GROUP and are owned and used by the Named Insured and successfully completed a Motor Vehicle Accident or a relative residing in the same household. Prevention Course which meets the standards of the State Department of Transportation. The discount will The discount may also apply if the Named Insured has be applied to all motor vehicles on the policy. unlimited personal use of a company-furnished private passenger auto even if that private passenger auto is not Age 55 Or Over Discount - Available if you are age 55 insured by The ERIE or titled to the Named Insured. or over as of your renewal date AND the principal driver of a private passenger auto listed on your Declarations. If "M" appears after the Rating Class in ITEM 4, the auto has received the Multi-Car Discount. Anti-Lock Brakes Discount - Available for autos equipped with anti-lock brakes on all four wheels. Multi-Policy Discount - Available if you have an ERIE Family Auto Policy and an: Anti-Theft Device Discount - Available for autos ERIE HomeProtector or Mobile HomeProtector equipped with anti-theft devices such as: Policy; and/or • security alarms ERIE Life Policy that meets specified criteria, hood locking mechanisms unlocked by a key or elec- tronic device The discount applies on the Family Auto Policy and the = remote monitoring alarms and central base computer HomeProtector or Mobile HomeProtector policies. systems, or Passive Restraints Discount - Available for autos with • etching VIN or serial number on automobile parts. factory-installed passive seat belts or air bags. College Student Discount - Available to reflect the Pay Plan Discount - Available if your policy premium is limited use of an auto if a young, unmarried driver is a paid under one of the following ERIE pay plans. The full-time college student, does not live at home, and does discount applied under Plan A is greater than the dis- not have a vehicle at school. count applied under Plan 13. Driver Training Discount - Available for drivers under • Plan A - entire premium is paid by policy effective age 21 who have successfully completed a driver training date. course which meets the standards of the Pennsylvania • Plan B - one third of the premium is paid by policy Department of Education or other educational agency. effective date. One third of the premium is paid within 30 days after policy effective date. One third 100% Farm Use Discount - Available for autos used of the premium is paid within 64 days after policy exclusively in connection with the operation of a farm effective date. owned or rented by you. You must reside on the farm. The autos cannot be used regularly in connection with To qualify for this discount, choose Plan A or Plan B any other business or occupation. If the fourth digit of prior to your policy effective date. If you choose one of the Rating Class is "F" the auto has received the Farm these payment plans during the policy period, the dis- Discount. count will be applied at your next renewal. If you do not make payments in accordance with the 'terms of the pay plan you selected, you may lose the pay plan dis- count and your premium will be adjusted to reflect quar- terly payments for the remainder of the policy period. 2 Prior Bodily Injury Limits Dint - Available if your Safe Driver Discoioncer Experience Rating Credit Bodily Injury Liability limit was at- least $300,000 per (PERC) - Available if your policy has a good accident: claim/violation history. Variables that determine the dis- count percentage may include the violation history of all • Renewal business - at the beginning of your pre- drivers on the policy, number of years the policy has vious ERIE policy period, been in force and the clairns experience of all drivers on • New business - on the expiring policy with your the policy. previous insurer. Youthful Driver Discount - Available to reflect the Reduced Usage Discount - Available on an auto that limited use of an auto due to the graduated Iicensing will not be driven for at least 90 consecutive days during program. Unmarried drivers under age 21 who reside the policy period. This discount cannot be added with their parents may be eligible for the discount. retroactively. Youthful Driver Longevity Discount (Erie Insurance Exchange) - May be available on a private passenger auto with an unmarried young driver classification. The amount of the discount is determined by the number of years the policy has been continuously in force. NOTICE OF TORT OPTIONS - The laws of the Commonwealth of Pennsylvania give you the right to choose either of the following two tort options. If you wish to change the tort option that currently applies to your policy, please contact your ERIE Agent. "Limited Tart" Option - This form of insurance limits c. intends to injure himself or another person, pro- your rights and the rights of the members of your house- vided that an individual does not intentionally hold to seek financial compensation for injuries caused injure himself or another person merely because by other drivers. Under this form of insurance, you and his act or failure to act is intentional or done other household members covered under this policy may, with his realization that it creates a grave risk of seek recovery for all medical and other out-of-pocket causing injury or the act or omission causing the expenses but not for pain and suffering or other non- injury is for the purpose of averting bodily harm monetary damages unless the injuries suffered fall within to himself or another person; or the definition of "serious injury" as set forth in the policy d. has not maintained financial responsibility as or unless one of several other exceptions noted in the required by the Pennsylvania Motor Vehicle policy applies. Financial Responsibility Law. Each person who elects the limited tort alternative 1 shall retain full tort rights with respect to claims remains eligible to seek compensation for economic loss against a person in the business of designing, manu- sustained in a motor vehicle accident as a consequence of facturing, repairing, servicing or otherwise main- the fault of another person pursuant to applicable tort taining motor vehicles arising out of a defect in such law. Unless the injury sustained is a serious injury, each motor vehicle which is caused by or not corrected by person who is bound by the limited tort election shall be an act or omission in the course of such business, precluded from maintaining an action for any noneco- other than a defect in a motor vehicle which is oper- nomic loss, except that an individual otherwise bound by ated by such business. the limited tort election: 3. shall retain full tort rights if injured while an occu- I.. who sustains damages in a motor vehicle accident as pant of a motor vehicle other than a private pas- a consequence of the fault of another person may senger motor vehicle. recover damages as if the individual damaged had elected the full tort alternative whenever the person "Full Tort" Option - This form of insurance allows you at fault: to maintain an unrestricted right for yourself and other a. is convicted or accepts Accelerated Rehabilitative members of your household to seek financial compen- Disposition (ARD) for driving under the influ- sation for injuries caused by other drivers. Under this ence of alcohol or a controlled substance in that form of insurance, you and other household members covered under this policy may seek recovery for all accident; medical and other out-of-pocket expenses and may also b. is operating a motor vehicle registered in another seek financial compensation for pain and suffering or state; other nonmonetary damages as a result of injuries caused by other drivers. 3 PLEASOTIFY YOUR AGENT WITHIN 60 DO IF YOU: change your address or marital status; • add/delete an auto or lienholder or another party Change the use of your vehicle or the distance you having a financial interest in your vehicle(s); drive to or from work/school; • add/delete a licensed driver in your household, even • change the location where your vehicle is principally if they have their own auto and insurance; garaged; • modify the appearance or performance of your vehicle with customized equipment. This information is needed to properly rate your policy. If there is a change in the information used to develop your policy premium, we may adjust your premium during the policy period effective as of the date the change occurred. ABBREVIATIONS USED IN ITEM 5 OF YOUR DECLARATIONS ACC - ACCIDENT OCC - OCCURRENCE BOD - BODILY PERS - PERSONAL COLL- COLLISION PROP - PROPERTY COMP - COMPREHENSIVE PRSN - PERSON COV- COVERAGE RCV- RECREATIONAL CAMPING VEHICLE DED - DEDUCTIBLE TRANSP - TRANSPORTATION INJ - INJURY WC- WORKERS COMPENSATION M - THOUSAND WK(S) - WEEK(S) MAX - MAXIMUM ABBREVIATIONS FOR DRIVER ATTRIBUTES USED ON YOUR DECLARATIONS AA3- First chargeable accident in a three-year period, CSD - College Student Discount first year the surcharge is on policy DTD - Driver Training Discount AA2 - First chargeable accident in a three-year period, F15- Accident Forgiven Under Feature 15 second year the surcharge is on policy FFN - First Accident Forgiven AA1 - First chargeable accident in a three-year period, IOS - Inexperienced Operator Surcharge third year the surcharge is on policy LSP - License Suspension AB3 - Second chargeable accident in a three-year period, MDT- Mature Driver Training Course-Over Age 55 first year the surcharge is on policy MVL - Moving Violation AB2 - Second chargeable accident in a three-year period, MVR- Motor Vehicle Request second year the surcharge is on policy MV1 - Hit and Run or Leaving the Scene of an Accident AB1 - Second chargeable accident in a three-year period, MV2 - Drag Racing on a Public Highway third year the surcharge is on policy MV3 - Driving under Suspension AC3 - Third chargeable accident in a three-year period, MV4- Attempting to Evade Arrest in a Car first year the surcharge is on policy MV5- Assault with a Car AC2 - Third chargeable accident in a three-year period, MV6- Any Misdemeanor or Felony Involving a Car second year the surcharge is on policy MV7- Driving While Intoxicated AC1 - Third chargeable accident in a three-year period, NSA- Non-surchargeable At-fault Accident third year the surcharge is on policy NSN - Nan-surchargeable Not At-fault Accident ACF - Accident/Chargeable Motor Vehicle Request NVL- Non-chargeable Violation AFY- Accident Free Years PAD- Preassigned Driver APC - Accident Prevention Course YDD - Youthful Driver Discount CLU - Comprehensive Loss Underwriting Exchange 4 Applicant: DAMEL T MCG DIRE& Pape No; 10 Agent: AA7159 CARL L. CRAMER INSURANCE LLC 81nder No: Q98-1101663 RE+QMT FOR LOWER LINT$OF UNINSURED MOTOR$T COVERAGE By signing this torn, 1 am requesting for myself and members of my household uninsured motorist cowage in an amount less then the limits o(rmy bodily injury liability cwwage. I am knowingly and utlur>:arfly rejecting uninsured motorist coverage in an amount equal to my bodily iryury liability limits. Rather,i am requesting the lbllowing amount of uninsured motorist coverage: ;100,000 FAC HP1cRSON :800,000 EACHAOM)ENT FACHAOC1DFNr(Combined Single Limit) Signature of Flrsf Insured Date Applicant DANIEL T MCGUIRE& Page No: 12 Agent: AA7159 CARL L CRAMER INSURANCE LLC 81nder No: CAS-1181663 REgM—T FOR LOWER LIMTS OF UNDERINSURED MOTORIST COVEPAGL By signing this tarn, I am requesting for myself and members d my household underinsured rotorist coverage in an amount lass than the limits of my bodily injury liability coverage. 1 am knowingly and voluntarily rejecting underinsured motorist coverage In an amount equal to my bodily injury 14011ty limits, Rattner, I am requesting the idiowlng amount of underinsured motorist coverage. $100,000 EACH PERSON $300,000 EAOi AC CIDEW EACH ACCIDENT(Combined Single Lim*) Signature of First AWned/ ur d Date Applicant: DANIEL T Agent: AA7159 CARL L.C RAMER INSURANCE LLC UNINSURED COVERAGE LlMITs --y— Q04•041 OU8 By signing this waiver, I am �'------ myself and members of my household limb ich the limits is uninsured co�tOrjsl coverage under — for each motor vehicle insured under the li g der the policy for be reduced to the limits stated in the policy. Instead, the limits off coverage gum be the sum of Ilmits coverage. f understand that m P Cy. I knowingly and voluntarily reject the sta purchasing shall Y premiums will be reduced if I reject this coverage, limits of Signature of First N mod insured �� I d Date Applicant: QANIEL T MCGUIRE& Agent: AA7159 CARL L.CRAMER INSURANCE LLC 004..041p548 UNDERINSURED COVERAGE LIMITS �+ By signing this waiver, I am rejecting stacked limits of underinsured motorist coverage under the policy for myself and members of my household under which the limits of coverage available would be the sum of limits for each motor vehicle Insured under the policy. instead,the limits of coverage that I am purchasing shall be reduced to the limits stated in the policy. I knowingly and voluntarily reject the stacked limits of coverage, I understand that my premiums will be reduced If I reject this coverage. nve a X Aia Signature of FirstNad6d Insured Applicant, DANIEL T MCGUIRE& Page No: 14 Agent; AA7159 CARL L.CRAMER INSURANCE LLC Binder Me: 098-1101663 ---NOTICE OF AVAILABLE BENEFITS AND LIMITS ... IMPORTANT NOTICE Insurance companies operating in the Commonwealth of Pennsyivento are required by law to make available fbr purchase the following benNlts for you,your spouse or other relatives or minor*in your custody or in the custody of your relatives,molding in your household,occupants of your motor vehicle or persons struck by your motor vehicle: (1)Medical Benefits,up to at least$100,00o. (1.1)Extraordinary Medical Benefits;from$100,00D to$1,100,000,which may be offend In increments of 3100,000. (2)Income Lose Benefits,up to at least$2,500 per month up bo a maximum benefit of at least$50.000. (3)Accidental Death Benefits, up to at least 526,000. (4)Funeral Benofibt,$"1,500. (5)An an alternative to paragraphs(1),(2),(3)and(4),a Combination Benefit,up to at least$177,500 of benefits in the aggregate or bensfits payable up to three years from the date of the accident, whichever occurs Oft,subject to a limit on Accidental Death Benefit of up to$4000 and a limit on Funeral Benefit of$2,50 pr Aded that nothing contained In this subsection shall be construed to limit,reduce,modify,or change the provisions of Section 1716(d)(relating to availabifity of adequate Ilmits). is)Uninsured, Undertneured and Bodily Injury L.iabltity cavarage up to at least$100,000 because of injury to one person in any one accident and up to at least 5300,000 because of injury to two or more persons in any one accident or, at the option of the Insurer,up to at least$'300,000 In a single limit for those coverages,except for policies issued under the Assigned Mak Plan. Also,at least$5,000 for damage to property of others in any ono accident. Additionally.insurers may ofhr higher benefit levels titian those enumerated above as well as additional bonsfits. However,an insured may*tact to purchase lower benefit levels than thaw enumerated above. YOUR SIGNATURE ON THIS NOTICE OR YOUR PAYMENT OF ANY ii OVAL PRSAIUM EVIO90ES YOUR ACTUAL KNOWLEDGE AND UNDERSTANDING OF THE AVAILABILITY OF THWE BENEFITS AND LIMBS AS WELL AS THE BENEFITS AND LIMITS YOU HAVE S@,f3CTED. if you have any questions or you do not understand all of the various options available to you,contact your agent or company. N you do not understand any of the provisions contained In this notice,contact your agent or company before you sign. Appticanrs Signature Policy E fective Date y� Date L4 1 t4 W . � i `� \. ��-- .. .. � T Kerry J.Ritchey,CPCU,AIC Erie . Assistant Vice President&Claims Manager Insurance® Branch Office 4901 Louise Drive • Rossmoyne Business Center P.O. Box 2013 • Mechanicsburg,PA 17055-0-7 10 717.795.8200 Toll Free 1.800.382.1304 • Fax 717.795.2315 www.erieinsurance.com September 14, 2012 Zachary Campbell, Esquire Metzger Wickersham, P.C. 3211 North Front Street P.O. Box 5300 Harrisburg, PA 17110-0300 Re: Your Client: Jesse Baker Erie Claim No.: 010171120783 Erie Insured: Daniel & Rebecca McGuire Date of Loss: October 8, 2010 Dear Mr. Campbell: I am in receipt of your letter dated September 11, 2012, wherein you request Erie's consent to settle and waiver of subrogation. Be advised, Erie will waive its subrogation rights versus Deron Lautsbaugh, Sherry Lautsbaugh& Kelsey Negley and consents to the settlement with their carrier Nationwide Insurance in the amount of their $1 80,500.00. However, Erie reserves all rights afforded under policy Q04-0410548. By providing consent to settle, Erie does not waive, invalidate or forfeit any other terms or conditions under said policy. Be advised, Erie's position with regard to excess coverage remains as outlined in my letter dated May 2, 2012. Finally, upon completion of the third party Release I am requesting that you provide me with a copy of the same. If you have any questions please contact me. Sincerely, Douglas G. Kocher Claims Representative (717) 761-7475 The ERIE is Above All in SERVICE' SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson �g4M1t1h bt l�qWI1NbC�?%,tj '0Sheriff ;., t t�(?E�V_7'�1`r 1 Jody S Smith Chief Deputy F ,.'; '' P : Richard W Stewart CUM Solicitor OFrICE OF Tk-,KMtFr P Nif 5}'LW IA' . Jesse Baker vs. Case Number Erie Insurance Exchange (et al.) 2013-2293 SHERIFF'S RETURN OF SERVICE 04/29/2013 Sheriff Ronny R Anderson, being duly sworn according to law, states he made diligent search and inquiry for the within named Defendant to wit: Erie Indemnity Company, but was unable to locate the Defendant in the Sheriffs bailiwick. The Sheriff therefore deputizes the Sheriff of Erie, Pennsylvania to serve the within Complaint& Notice according to law. 04/29/2013 Sheriff Ronny R Anderson, being duly sworn according to law, states he made diligent search and inquiry for the within named Defendant to wit: Erie Insurance Company, but was unable to locate the Defendant in the Sheriffs bailiwick. The Sheriff therefore deputizes the Sheriff of Erie, Pennsylvania to serve the within Complaint& Notice according to law. 04/29/2013 Sheriff Ronny R Anderson, being duly sworn according to law, states he made diligent search and inquiry for the within named Defendant to wit: Erie Insurance Exchange, but was unable to locate the Defendant in the Sheriffs bailiwick. The Sheriff therefore deputizes the Sheriff of Erie, Pennsylvania to serve the within Complaint& Notice according to law. 04/29/2013 Sheriff Ronny R Anderson, being duly sworn according to law, states he made diligent search and inquiry for the within named Defendant to wit: Erie Insurance Property& Casualty Company, but was unable to locate the Defendant in the Sheriffs bailiwick. The Sheriff therefore deputizes the Sheriff of Erie, Pennsylvania to serve the within Complaint& Notice according to law. 04/29/2013 Sheriff Ronny R Anderson, being duly sworn according to law, states he made diligent search and inquiry for the within named Defendant to wit: Erie Insurance Group, but was unable to locate the Defendant in the Sheriffs bailiwick. The Sheriff therefore deputizes the Sheriff of Erie, Pennsylvania to serve the within Complaint&Notice according to law. 05/06/2013 11:00 AM-The requested Complaint& Notice served by the Sheriff of Erie County upon Pauline Minor, Assistant, who accepted for Erie Insurance Group, at 100 Erie Insurance Place, Erie, PA 16530. Robert Merski, Sheriff, Return of Service attached to and made part of the within record. 05/06/2013 11:00 AM -The requested Complaint& Notice served by the Sheriff of Erie County upon Pauline Minor, Assistant, who accepted for Erie Insurance Property&Casualty Company, at 100 Erie Insurance Place, Erie, PA 16530. Robert Merski, Sheriff, Return of Service attached to and made part of the within record. 05/06/2013 11:00 AM -The requested Complaint& Notice served by the Sheriff of Erie County upon Pauline Minor, Assistant, who accepted for Erie Insurance Exchange, at 100 Erie Ins. PI., Erie, PA 16530. Robert Merski, Sheriff, Return of Service attached to and made part of the within record. 05/06/2013 11:00 AM -The requested Complaint& Notice served by the Sheriff of Erie County upon Pauline Minor, Assistant, who accepted for Erie Insurance Company, at 100 Erie Insurance Place, Erie, PA 16530. Robert Merski, Sheriff, Return of Service attached to and made part of the within record. 05/06/2013 11:00 AM -The requested Complaint& Notice served by the Sheriff of Erie County upon Pauline Minor, Assistant, who accepted for Erie Indemnity Company, at 100 Erie Insurance Place, Erie, PA 16530. Robert Merski, Sheriff, Return of Service attached to and made part of the within record. (c)CountySuito Sherd,Teleosof`.Inc. SHERIFF COST: $101.46 SO ANSWERS, x2z May 13, 2013 RoNIV R ANDERSON, SHERIFF (c)CountySuile Shentt,'rehosoft,Inc. ' � SHERIFF'S OFFICE OF ERIE COUNTY B*bMersk! JOHN LOOMIS Sheriff Captain JONHAByRSWY ROGER GUNESCH Chief Deputy lieutenant JESSE BAKER Case Number vs. | 2013-02293M ER|EiNSURANCEGFl{}UP(edoi) | - SHERIFF'S RETURN OF SERVICE 05/06/2013 11:UDAN_DEPUTY MARTy DAVIS, BEING DULY SWORN ACCORDING TO LAW, SERVED THE REQUESTED COMPLAINT&NOTICE BY HANDING A TRUE COPY TO A PERSON REPRESENTING THEMSELVES TDBEPAUL|NEMINOR ASS|8T..WHO ACCEPTED AS"ADULT PERSON |N CHARGE"FOR ERIE INSURANCE COMPANY AT 100 ERIE INSURANCE PLACE, ERIE, PA 16530. MARTY DAVIS, DEPUTY 0506/2013 11:00AM-DEPUTY MARTY DAVIS, BEING DULY SWORN ACCORDING TO LAW, SERVED THE REQUESTED COMPLAINT&NOTICE BY HANDING A TRUE COPY TO A PERSON REPRESENTING THEMSELVES TOBEPAUL|NEMINOR A88|ST.` WHO ACCEPTED A8"ADULT PERSON}N ' CHARGE"FOR ERIE INSURANCE PROPERTY&CASUALTY CO AT 100 ERIE INSURANCE PLACE, ERIE, PA1G53O. MARTY DAVIS, DEPUTY 0506/2013 11:00 AM-DEPUTY MARTY DAVIS, BEING DULY SWORN ACCORDING TO LAW, SERVED THE REQUESTED COMPLAINT&NOTICE BY HANDING A TRUE COPY TO A PERSON REPRESENTING THEMSELVES TO8EPAUL|NEMINOR A8G|ST.. WHO ACCEPTED AG"ADULT PERSON |N CHARGE"FOR ERIE INSURANCE GROUP AT 100 ERIE INSURANCE PLACE, ERIE, PA 16530. MARTY DAVIS, DEPUTY 0506Q013 11:00 AM-DEPUTY MART/DAVIS, BEING DULY SWORN ACCORDING TOLAW, SERVED THE REQUESTED COMPLAINT&NOTICE BY HANDING A TRUE COPY TO A PERSON REPRESENTING THEMSELVES TQBERAUL|NEMINOR A8S|GT..WHO ACCEPTED AG"ADULT PERSON |N CHARGE"FOR ERIE INSURANCE EXCHANGE AT 100 ERIE INSURANCE PLACE, ERIE, PA 16530. —A' DAVIS, DEPUTY 0506/2013 11:00AM-DEPUTY MARTY DAVIS, BEING DULY SWORN ACCORDING TO LAW, SERVED THE REQUESTED COMPLAINT&NOTICE BY HANDING A TRUE COPY TO A PERSON REPRESENTING THEMSELVES TOBERAUL|NEMINOR ASS|ST.` WHO ACCEPTED AS"ADULT PERSON (N CHARGE"FOR ERIE INDEMNITY COMPANY AT 100 ERIE INSURANCE PLACE, ERIE, PA 16530. _4ARTY DAVIS, DEPUTY wo�wxu*Sheriff,`��oft,Inc. r L SHERIFF COST: $188.00 SO ANSWERS, May 08, 2013 RS I, SHERIFF -- ,(+����¢y,� ply ypW ,q(� F_ Y �'f V iii= .YS VE' �Y( NOTARIAL SE1a4. �R6ARA D..TURINFR,Nokwy City of Ene,Erie Coun� ion E>�r�es AW MS ----- "------ ------------------- ---------------- --------------------------------- ------- ----- - - ---------- NOTARY Affirmed and subscribed to befor me this day of , �-111-3 .� Plainfiff Attome METZGER WickERSHAM, Pd'BOX 5300, HARR/SBURG, PA 0110 'F (c)CouniySuite SheriR,Teleosoft,Inc. P i. )k46' r"UL 23 15Pg2.. 51 ,UMBt NSYtDdAN Ut " Johnson, Duffie, Stewart&Weidner By: John A. Statler, Esquire I.D. No. 43812 Attorneys for Defendants 320 Market Street P.O. Box 109 Lemoyne, PA 17043-0109 (717) 761-4540 jas @jdsw.com JESSE BAKER, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW ERIE INSURANCE EXCHANGE, ERIE INSURANCE COMPANY, NO. 13-2293 CIVIL TERM ERIE INSURANCE PROPERTY & CASUALTY COMPANY, ERIE INDEMNITY COMPANY and ERIE INSURANCE GROUP, JURY OF 12 PERSONS DEMANDED Defendants PRAECIPE FOR ENTRY OF APPEARANCE TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Please enter the appearance of John A. Statler, Esquire, of Johnson, Duffie, Stewart & Weidner, P.C. as counsel for the Defendants in the above-captioned case. JOHN-SO FIE, WART &WEIDNER By: John A. Statler, Es ' e Attorney I.D. No. 43812 301 Market Street P.O. Box 109 Lemoyne, PA 17043-0109 Telephone (717) 761-4540 Attorneys for Defendants DATE: 557281 22740-3116 CERTIFICATE OF SERVICE HEREBY CERTIFY that I served a true and correct copy of the foregoing Praecipe for Entry of Appearance upon all parties or counsel of record by depositing a copy of same in the United States Mail at Lemoyne, Pennsylvania, with first-class postage prepaid on the , q day of W 2013, addressed to the following: Zachary D. Campbell, Esquire Metzger, Wickersham, Knauss & Erb, P.C. 3211 North Front Street P.O. Box 5300 Harrisburg, PA 17110-0300 JOHNSON, DUFFIE, STEWART & WEIDNER By: John A. Statler, it Attorney I.D. No. 43812 301 Market Street P.O. Box 109 Lemoyne, PA 17043-0109 Telephone (717) 761-4540 Attorneys for Defendants ED r O9. THE PROTHOINOTAR"( 2013 MAY 21 AM 11: 25 Johnson, Duffie,Stewart&Welidne!" By: John A. Statler, Esquire UMBERLAND COUNTY I.D. No. 43812 PENNSYLVANIA Attorneys for Defendants 320 Market Street P.O. Box 109 Lemoyne, PA 17043-0109 (717) 761-4540 jas@jdsw.com JESSE BAKER, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW ERIE INSURANCE EXCHANGE, ERIE INSURANCE COMPANY, NO. 13-2293 CIVIL TERM ERIE INSURANCE PROPERTY & CASUALTY COMPANY, ERIE INDEMNITY COMPANY and ERIE INSURANCE GROUP, JURY OF 12 PERSONS DEMANDED Defendants STIPULATION AND NOW, come the parties to the above cast, by and through their respective counsel, who hereby agree and stipulate as follows: 1. The proper Defendant in this case is Erie Insurance Exchange. 2, Defendants Erie Insurance Company, Erie Insurance Property & Casualty Company, Erie Indemnity Company and Erie Insurance Group are dismissed from this case. 3. Counts 11 through V of the Plaintiffs' Complaint, paragraphs 37-68 are dismissed. 4. The caption of this case should be reformed to read as follows: JESSE BAKER, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW NO. 13-2293 CIVIL TERM ERIE INSURANCE EXCHANGE, Defendant JURY OF 12 PERSONS STIPULATED AND AGREED: METZGER, WICKERSHAM, KNAUSS & ERB, P.C. By: tac;hary D. Campbell, Esquire Attorney I.D. No. 93177 3211 North Front Street P.O. Box 5300 Harrisburg, PA 17110-0300 Telephone: (717) 238-8187 Attorneys for Plaintiff JO NSON, DUFFIE, STEWART &WEIDNER By: John A. Statler, ui e Attorney I.D. No. 43812 301 Market Street P.O. Box 109 Lemoyne, PA 17043-0109 Telephone (717) 761-4540 Attorneys for Defendant DATE: � Z�`— � 3 557291 22740-3116 CERTIFICATE OF SERVICE HEREBY CERTIFY that I served a true and correct copy of the foregoing Stipulation upon all parties or counsel of record by depositing a copy of same in the United States Mail at Lemoyne, Pennsylvania, with first-class postage prepaid on the d' day of 2013, addressed to the following: Zachary D. Campbell, Esquire Metzger, Wickersham, Knauss & Erb, P.C. 3211 North Front Street P.O. Box 5300 Harrisburg, PA 17110-0300 JOHNSO D 1E, STEWART &WEIDNER By: John A. Statler, Esquire Attorney I.D. No. 43812 301 Market Street P.O. Box 109 Lemoyne, PA 17043-0109 Telephone (717) 761-4540 Attorneys for Defendants JESSE BAKER, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW ERIE INSURANCE EXCHANGE, ERIE INSURANCE COMPANY, NO, 13-2293 CIVIL TERM ERIE INSURANCE PROPERTY & CASUALTY COMPANY, ERIE INDEMNITY COMPANY and ERIE INSURANCE GROUP, JURY OF 12 PERSONS DEMANDED Defendants ORDER AND NOW, this A-3 day of VMIO, upon Stipulation of the parties, it is HEREBY ORDERED THAT: 1 The proper Defendant in this case is Erie Insurance Exchange. 2. Defendants Erie Insurance Company, Erie Insurance Property & Casualty Company, Erie Indemnity Company and Erie Insurance Group are dismissed from this case, 3. Counts 11 through V of the Plaintiffs' Complaint, paragraphs 37-68 are dismissed. 4. The caption of this case should be reformed to read as follows: JESSE BAKER, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW NO. 13-2293 CIVIL TERM ERIE INSURANCE EXCHANGE, Defendant JURY OF 12 PERSONS BY THE COMRT7� Gc� Ir's /7&1*trXk C-3 —J J. raw ,�/e�.+�-�/� • 7,1 r-.00_O F F 10 C { PROTHONOTARY IN �l j<< .,t,.N --T AM ESQ 22 CUMBERLAND COUNTY PENNSYLVANIA Johnson, Duffie, Stewart&Weidner By: John A. Statler, Esquire l.D. No. 43812 Attorneys for Defendant 320 Market Street P.O. Box 109 Lemoyne, PA 17043-0109 (717) 761-4540 jas @jdsw.com JESSE BAKER, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA v. : CIVIL ACTION - LAW : NO. 13-2293 CIVIL TERM ERIE INSURANCE EXCHANGE, Defendant : JURY OF 12 PERSONS DEMANDED NOTICE TO PLEAD TO: JESSE BAKER, Plaintiff c/o ZACHARY D. CAMPBELL, ESQUIRE Metzgar, Wickersham, Knauss & Erb, P.C. 3211 North Front Street P.O. Box 5300 Harrisburg, PA 17110-0300 Attorney for Plaintiff YOU ARE REQUIRED to plead to the within Answer With New Matter within 20 days of service hereof or a default judgment may be entered against you. JOH ON, i • IE, STrt ART &WEIDNER By: John A. Statier, squire Attorney I.D. No. 43812 301 Market Street P.O. Box 109 Lemoyne, PA 17043-0109 Telephone (717) 761-4540 Attorneys for Defendant Erie Insurance Exchange DATE Johnson, Duffie, Stewart&Weidner By: John A. Statler, Esquire I.D. No. 43812 Attorneys for Defendant 320 Market Street P.O. Box 109 Lemoyne, PA 17043-0109 (717)761-4540 jas @jdsw.com JESSE BAKER, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA v. : CIVIL ACTION - LAW : NO. 13-2293 CIVIL TERM ERIE INSURANCE EXCHANGE, Defendant : JURY OF 12 PERSONS DEMANDED ANSWER OF DEFENDANT ERIE INSURANCE EXCHANGE TO PLAINTIFF'S COMPLAINT INCLUDING NEW MATTER AND NOW, comes Defendant Erie Insurance Exchange, by its attorneys, Johnson, Duffie, Stewart & Weidner, P.C. who file the following Answer and New Matter in response to the Plaintiff's Complaint in this case: 1. Admitted on information and belief. 2. Denied as stated, Defendant Erie Insurance Exchange is a reciprocal insurance company licensed and authorized to conduct business in the Commonwealth of Pennsylvania. It is admitted that Erie Insurance Exchange has a business office located at 100 Erie Insurance Place, Erie, Pennsylvania16530. 3-7. The averments in these paragraphs have been dismissed by Stipulation of the parties. 8. Admitted on information and belief. 9. Admitted on information and belief. 10. It is admitted that on October 8, 2010, Plaintiff Jesse Baker was injured while riding as a passenger in a vehicle driven by Kelsey Negley and owned by Sherry Lautsbaugh. 11. It is admitted that Plaintiff Jesse Baker sustained injuries in the October 8, 2010 motor vehicle accident. By way of further answer, Defendant is without information sufficient to form a belief as to the truth or falsity of the averments concerning the nature and extent of all of the Plaintiff's injuries, losses and damages and, therefore, denies the same and demands strict proof at time of trial if deemed material. 12. It is admitted that as a result of injuries sustained in the October 8, 2010 motor vehicle accident, Plaintiff Jesse Baker underwent medical treatment including an open reduction—internal fixation of a palate fracture and open reduction of a nasal fracture procedure. By way of further answer, Defendant is without information sufficient to form a belief as to the truth or falsity of the remaining averments in this paragraph and, therefore, denies the same and demands strict proof at time of trial if deemed material. 13. Admitted. 14. Denied. After reasonable investigation, Defendant is without information sufficient to form a belief as to the truth or falsity of the averments concerning the nature and extent of the injuries, losses and damages allegedly suffered by Jesse Baker as a result of the motor vehicle accident of October 8, 2010, including, but not limited to those damages averred in subparagraphs a-i, and, therefore, denies the same and demands strict proof at time of trial if deemed material. 15. Admitted. 16. Admitted. 17. Admitted. 18. Admitted. 19. Denied. It is specifically denied that Plaintiff Jesse Baker was an underinsured motorist. 20. Admitted. 21. Admitted. 22. Admitted. 23. It is admitted that the Erie policy provided for underinsured motorist insurance coverage that was applicable to Jesse Baker at the time of the October 8, 2010 accident. It is further admitted that if it is determined that Jesse Baker's damages from the subject accident exceed the sum of $180,500.00, he would be entitled to underinsured motorist benefits from Erie. 24. Admitted. 25. Admitted. 26. Admitted. 27. Admitted that the Plaintiff's parents have complied, to date, with all of the terms and conditions of the policy. 28. Admitted. COUNT I — BREACH OF CONTRACT Jesse Baker v. Erie Insurance Exchange 29. Defendant incorporates by reference its answers to the averments in paragraphs 1 through 28 of the Plaintiff's Complaint as if set forth at length. 30. Admitted. 31. Admitted. 32. Denied. It is specifically denied that Erie Insurance Exchange, either individually and/or jointly and severally, has failed to timely, objectively and reasonably evaluate Plaintiff Jesse Baker's claim. 33. Denied. It is specifically denied that Defendant Erie Insurance Exchange, either individually and/or jointly and severally, has failed to promptly offer payment of the reasonable and fair value of the underinsured motorist claim to the Plaintiff, Jesse Baker. 34. Denied. It is specifically denied that Erie Insurance Exchange, either individually and/or jointly and severally, failed to reasonably investigate Plaintiff Jesse Baker's claim, and denied that a more thorough and proper inquiry would have revealed that the Plaintiff sustained injuries, damages and losses which reasonable compensation would have required an offer of the available limits. 35. The averments in this paragraph constitute conclusions of law to which no response is required. In the event a response is deemed to be required, it is specifically denied that Defendant Erie Insurance Exchange, either individually and/or jointly and severally, owes a fiduciary obligation to the Plaintiff in this case. By way of further answer, it is admitted that Erie Insurance Exchange owes a contractual and statutory obligation to investigate, evaluate and negotiate the underinsured motorist claim in good faith and to arrive at a prompt, fair and equitable settlement as the insurer of Plaintiff Jesse Baker. 36. The averments in this paragraph constitute conclusions of law to which no response is required. In the event a response is deemed to be required, it is specifically denied that Defendant Erie Insurance Exchange, either individually and/or jointly and severally, has violated and/or breached its obligation under the policy. WHEREFORE, Defendant Erie Insurance Exchange respectfully requests that Count I of the Plaintiff's Complaint be dismissed and that judgment be entered in favor of Defendant Erie Insurance Exchange and against the Plaintiff in this case. NEW MATTER By way of additional answer and reply, Defendant Erie Insurance Exchange raises the following New Matters: 37. The Plaintiffs' claims are barred in whole or in part and/or are limited by the provisions of the Pennsylvania Motor Vehicle Financial Responsibility Law, 75 Pa. C.S.A. §1701, et seq. and especially by §1722 of that law. 38. Discovery may reveal that the Plaintiff has failed to mitigate some of his damages. 39. Discovery may reveal that some or all of the Plaintiff's injuries or medical conditions pre-existed the date of the subject accident and were not caused or aggravated by the accident. 40. Discovery may reveal that some of the Plaintiff's injuries or conditions were caused or aggravated by events that occurred subsequent to the date of the subject accident. 41. To the extent that the Plaintiff has been paid or will be paid for some or all of his damages, then claims for those damages are barred both by the defense of payment and by §1722 of the Pennsylvania Motor Vehicle Financial Responsibility Law, 75 Pa. C.S.A. §1722. 42. Erie Insurance Exchange is entitled to a credit setoff for the $180,500.00 in liability settlement funds paid by Nationwide Insurance under both the Negley and Lautsbaugh policies. 43. If it is determined that the total value of Jesse Baker's damages from the October 8, 2010 accident do not exceed $180,500.00, then Jesse Baker would not be entitled to any underinsured motorist insurance benefits or payments from Erie Insurance Exchange. WHEREFORE, Defendant Erie Insurance Exchange respectfully requests that judgment be entered in its favor and against the Plaintiff in this case. JOHNSON, DUFFIE, STEWART &WEIDNER By: John A. Statle , Esq_uir- Attorney I.D. No. 43812 301 Market Street P.O. Box 109 Lemoyne, PA 17043-0109 Telephone (717) 761-4540 Attorneys for Defendant Erie Insurance Exchange 2 DATE: — ( J 558644 22740-3116 VERIFICATION I, boLIL3 alter , hereby acknowledge that Erie Insurance Exchange is the Defendant in this action and that I am authorized to make this verification on its behalf; that I have read the foregoing Answer of Defendant Erie Insurance Exchange to Plaintiff's Complaint Including New Matter; and that the facts stated therein are true and correct to the best of my knowledge, information and belief. I understand that any false statements herein are made subject to penalties of 18 Pa. C. S. Section 4904, relating to unsworn falsification to authorities. ERIE INSURANCE EXCHANGE By: - DATE: (p/WC CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing Answer of Defendant Erie Insurance Exchange to Plaintiff's Complaint Including New Matter upon all parties or counsel of record by depositing a copy of same in the United States Mail at Lemoyne, Pennsylvania, with first-class postage prepaid on the day of Vlil e , 2013, addressed to the following: Zachary D. Campbell, Esquire Metzger, Wickersham, Knauss & Erb, P.C. 3211 North Front Street P.O. Box 5300 Harrisburg, PA 17110-0300 JOHNSON, DUFFIE, STEWART & WEIDNER By: John A. Statler, • e Attorney I.D. No. 43812 301 Market Street P.O. Box 109 Lemoyne, PA 17043-0109 Telephone (717) 761-4540 Attorneys for Defendants 0 - OF THE TA 24 PH 1: 23 pEENNRLANj) couj�!-v S YLVANIA Zachary D. Campbell. Attorney I.D. No. 93177 Metzger, Wickersham, Knauss & Erb, PC 3211 North Front Street P.O. Box 5300 Attorneys for Plaintiff Harrisburg, PA 17110-0300 (717)238-8187 JESSE BAKER, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY,PENNSYLVANIA V. NO. 13-2293 CIVIL TERM ERIE INSURANCE EXCHANGE, Defendant JURY TRIAL DEMANDED PLAINTIFF'S REPLY TO DEFENDANT'S ANSWER WITH NEW MATTER 37. The averments contained in paragraph 37 of Defendant's New Matter are denied as conclusions of law to which no reply is required. If a reply is required, the averments are specifically denied and denied pursuant to Pa.R.C.P. No. 1029(e), By way of further reply, Plaintiff is not barred by any provision of the Pennsylvania Motor Vehicle Financial Responsibility Law, including under §1722. 38, Conclusions of law, no reply required. If a reply is required,the averments are specifically denied and denied pursuant to Pa. R.C.P. No. 1029(e). By way of further reply, Plaintiff, Jesse Baker, has sought the necessary medical treatment and Plaintiff has mitigated his damages the best he could. 526993-1 e 39. Conclusions of law, no reply required. If a reply is required,the averments are specifically denied and denied pursuant to Pa.R.C.P. No. 1029(e). By way of further reply, Defendant has not identified any of Plaintiffs injuries or medical conditions that pre-existed the within accident and Plaintiff cannot more specifically reply. Plaintiff is entitled to recover for the injuries and damages set forth in the Complaint filed in this action which is incorporated herein by reference. Plaintiff will provide the required proof of his injuries and damages. 40. Conclusions of law, no reply required. If a reply is required, the averments are specifically denied and denied pursuant to Pa.R.C.P. No. 1029(e). By way of further reply, Defendant has not identified any subsequent accident, illness, condition, injury or event which caused or contributed to Plaintiffs injuries and damages and Plaintiff cannot more specifically reply. 41. The averments contained in paragraph 41 of Defendant's New Matter are denied as conclusions of law to which no reply is required. If a reply is required, the averments are specifically denied and denied pursuant to Pa.R.C.P. No. 1029(e). By way of further reply, Plaintiff is not barred by any provision of the Pennsylvania Motor Vehicle Financial Responsibility Law, including under §1722. 42. Denied. It is specifically denied that Erie Insurance Exchange is entitled to a credit setoff for the $180,500.00 in liability settlement funds paid by Nationwide Insurance under both the Negley and Lautsbaugh policies. 43. Denied. It is specifically denied that if it is determined that the total value of Jesse Baker's damages from the October 8, 2010 accident do not exceed $180,500.00, then Jesse Baker would not be entitled to any underinsured motorist insurance benefits or payments from Erie Insurance Exchange. 526993-1 4 WHEREFORE, Plaintiff Jesse Baker respectfully requests that Defendant, Erie Insurance Exchange's New Matter be dismissed and that judgment be entered in Plaintiff's favor and against Defendant as requested in the Complaint filed in this action. METZGER, WICKERSHAM, KNAUSS & ERB, P.C. Zac . Campbell, Esquire Attorney I.D. No. 93177 3211 North Front Street Harrisburg, PA 17110 (717) 238-8187 (717) 234-9478 (Fax) zdc @mwke.com Date: �i 2� , 2013 526993-1 JUN-21-2013 09:07A FRON:PHOTO THIS 7172642325 TO:2349478 P.2 VERIFICATION I,Jesse Baker,hereby certify that the following is correct: The facts set forth in the foregoing Reply to New Matter are based upon information which I have furnished to counsel, as well as upon information which has been gathered by counsel and/or others acting on my behalf in this matter. The language of the Reply to New Matter is that of counsel and not my own. I have read the Reply to New Matter, and to the extent that it is based upon information which I have given to counsel, it is true and correct to the best of my knowledge, information,and belief. To the extent that the content of the Reply to New Matter is that of counsel, I have relied upon such counsel in making this Verification. I hereby acknowledge that the facts set forth in the aforesaid Reply to New Matter are made subject to the penalties of 18 Pa. C.S.A. §4904 relating to unswom falsification to authorities. Date: , ao 13 01.123 16JI14/ Jesse Baker 526993-1 CERTIFICATE OF SERVICE I, Zachary D. Campbell, Esquire, of the law firm of Metzger, Wickersham, Knauss & Erb, P.C., hereby certify that I served a true and correct copy of Plaintiff's Reply to Answer With New Matter with reference to the foregoing action by first class mail, postage prepaid, this 2-0/lay of 5 VA , 2013 on the following: Defendant, Erie Insurance Exchange c/o John A. Statler, Esquire Johnson, Duffie, Stewart& Weidner 301 Market Street P. O. Box 109 Lemoyne, PA 17043-0109 METZGER, WICKERSHAM, KNAUSS & ERB, P.C. Zac a D. Campbell, Esquire 526993-1 r ILE0--0F F lE s I HE PR0TH0NO IAR,y�, 2013 SEP 26 AM 11: 3 7 CUMBERLAND COUNTY PENNSYLVANIA Zachary D. Campbell Attorney I.D. No. 93177 Metzger, Wickersham, Knauss &Erb, PC 3211 North Front Street P.O. Box 5300 Attorneys for Plaintiff Harrisburg, PA 17110-0300 (717) 238-8187 JESSE BAKER, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 13-2293 CIVIL TERM ERIE INSURANCE EXCHANGE, Defendant JURY TRIAL DEMANDED PRAECIPE TO SETTLE, DISCONTINUE AND END TO THE PROTHONOTARY: Kindly mark the above matter settled, discontinued and ended. METZGER, WICKERSHAM, KNAUSS & ERB, P.C. Zach . Campbell, Esquire Attorney I.D. No. 93177 3211 North Front Street Harrisburg, PA 17110 (717) 238-8187 (717) 234-9478 (Fax) zdc @mwke.com Date: 9 �� , 2013 535660-1 CERTIFICATE OF SERVICE I, Zachary D. Campbell, Esquire, of the law firm of Metzger, Wickersham, Knauss & Erb, P.C., hereby certify that I served a true and correct copy of a Praecipe to Settle, Discontinue and End with reference to the foregoing action by first class mail, postage prepaid, this �� day of —�r)L ,2013 on the following: Defendant, Erie Insurance Exchange c/o John A. Statler, Esquire Johnson, Duffie, Stewart& Weidner 301 Market Street P. O. Box 109 Lemoyne, PA 17043-0109 METZGER, WICKERSHAM, KNAUSS &ERB, P.C. Zac D. Campbell, Esquire 535660-1