QUICK REFERENCE
9 8 0 0 Fredericksburg Road San Antonio, Texas 7 8 2 8 8
Named Insured and Address
FLORIDA AUTO POLICY
Policy PeriodOperators
Description o f Vehicle(s) Coverages, Amounts o f
Insurance and Premiums Endorsements
The automobile insurance contract between the Beginning
on Page
named insured and the company shown on the Declarations page consists o f this policy plus the Declarations page and any applicable
Definitions endorsements. The Quick Reference section
Insuring Agreement outlines essential information contained in the
Bodily Injury Liability Coverage and Declarations and the major parts o f the policy.
Property Damage Liability Coverage Limit o f Liability
Supplementary Payments Exclusions
Out o f State Coverage
Financial Responsibility Required This is a participating policy. You are entitled t o
Other Insurance dividends as may be declared by the company's
Board o f Directors.
Definitions I f this policy is issued by United Services
Insuring Agreement Automobile Association ("USAA"), a reciprocal
Limit o f Liability interinsurance exchange, the following apply:
Application o f Deductible Exclusions
By purchasing this policy you are a member
Other Insurance o f USAA and are subject t o its bylaws.
This is a non-assessable policy. You are liable only f o r the amount o f your premium as
Definitions USAA has a f r e e surplus in compliance with
Insuring Agreement Article 1 9 . 0 3 o f the Texas Insurance Code o f
Medical Payments Coverage 1 9 5 1 , as amended.
Air Bag and Seat Belt Benefits Limit o f Liability
The USAA Board o f Directors may annually
Exclusions allocate a portion o f USAA's surplus t o
Other Insurance Subscriber's Savings Accounts. Amounts
Special Provisions allocated t o such accounts remain a part o f
Arbitration USAA's surplus and may be used as
necessary t o support the operations o f the Association. A member shall have no right t o any balance in the member's account except until following termination o f membership, as provided in the bylaws.
(Quick Reference continued on Page 2)
Definitions Air Bag Insuring Agreement Bankruptcy Limit o f Liability Changes
Exclusions Duties A f t e r an Accident o r Loss Other Insurance Legal Action Against Us
Non-Duplication Mediation
Arbitration Misrepresentation
Non-Duplication o f Payment Our Right t o Recover Payment
Definitions Ownership
Insuring Agreement Policy Period and Territory Comprehensive Coverage Termination
Collision Coverage Transfer o f Your Interest in this Policy
Rental Reimbursement Coverage
Towing and Labor Costs Coverage T w o o r More Auto Policies Limit o f Liability
Payment o f Loss Loss Payable Clause
Waiver o f Collision Deductible Exclusions
Mandatory Pre-Insurance Inspection No Benefit t o Bailee
Other Sources o f Recovery Appraisal
FLORIDA AUTO POLICY
AGREEMENT
In return f o r payment o f the premium and subject t o all the terms o f this policy, w e will provide the coverages and limits o f liability f o r which a premium is shown in the Declarations.
DEFINITIONS
The w o r d s defined below are used throughout I. (referred t o as ) means this policy. They are in when used. physical injury to, destruction o f , o r loss o f
use o f tangible property. A. and r e f e r t o the "named insured"
shown in the Declarations and spouse i f a J. means a resident o f the same household. private passenger auto, pickup, , , o r not B. and r e f e r t o the Company owned by o r a while it
providing this insurance. is used as a temporary replacement f o r when withdrawn f r o m normal C. means the business o f use because o f its breakdown, repair,
altering, customizing, leasing, parking, servicing, loss, o r destruction. repairing, road testing, delivering, selling,
servicing, o r storing vehicles. K means a vehicle designed t o be pulled by a private passenger auto, pickup, , o r D. (referred t o as ) means bodily . It also means a farm harm, sickness, disease, o r death. wagon o r implement while t o w e d by such
vehicles.
E. includes, but
is not limited to: L. means a f o u r - w h e e l e d land m o t o r vehicle o f the van type with a load capacity 1. A competition against other people, o f not more than 2 , 0 0 0 pounds.
vehicles, o r time; o r
M. means:
2. An activity that challenges the speed o r
handling characteristics o f a vehicle o r 1. Any vehicle shown in the Declarations. improves o r demonstrates driving skills,
provided the activity occurs on a track o r 2. Any o f the following types o f vehicles course that is closed f r o m acquired by o r a
non-participants. during the policy period, beginning on the date o r a becomes F. means a person related t o the owner, but only i f no other similar by blood, marriage, o r adoption w h o is a insurance policy provides coverage f o r resident o f household. This includes a such vehicle:
ward o r f o s t e r child.
a. A private passenger auto; G. means the following
motorized vehicles: a motorcycle, moped o r b. A pickup o r ; o r similar type vehicle; m o t o r home; golfcart;
snowmobile; all-terrain vehicle; o r dune c. A not used in buggy. any business o r occupation.
H. means in, on, getting into o r out of.
For such newly acquired vehicles, will 3. Any own. automatically provide the broadest
coverages as are provided f o r any 4. Any . Only vehicle shown in the Declarations. I f those coverages provided f o r the vehicle policy does not provide Comprehensive withdrawn f r o m normal use will be and Collision coverages, will provide extended t o its
each with a $ 2 5 0 deductible. However, . will not provide any coverage f o r
more than 3 0 days after the date o r a becomes the o w n e r o f the vehicle. I f wish t o continue any coverage beyond the 3 0 - d a y period, must request it prior t o the end o f the 3 0 - d a y period.
PART A - LIABILITY COVERAGE
as used in this Part means: will pay compensatory damages f o r o r f o r which any becomes 1. o r any f o r the legally liable because o f an auto accident.
ownership, maintenance, o r use o f any auto will settle o r defend, as consider o r . appropriate, any claim o r suit asking f o r these damages. duty t o settle o r defend ends 2. Any person using . when limit o f liability f o r these coverages has been paid o r tendered. have no duty t o 3. Any other person o r organization, but only defend any suit o r settle any claim f o r o r
with respect t o legal liability imposed on not covered under this policy. them f o r the acts o r omissions o f a person
f o r w h o m coverage is a f f o r d e d in 1. o r 2. above. With respect t o an auto o r
other than , this provision
For sustained by any one person in any one only applies i f the other person o r
auto accident, maximum limit o f liability f o r organization does not o w n o r hire the auto
all resulting damages, including, but not limited to, o r .
all direct, derivative o r consequential damages recoverable by any persons, is the limit o f The following are not under
liability shown in the Declarations f o r "each Part A:
person" f o r Liability. 1. The United States o f America o r any o f its
Subject t o this limit f o r "each person", the limit agencies.
o f liability shown in the Declarations f o r "each accident" f o r Liability is maximum limit o f 2. Any person with respect t o o r
liability f o r all damages f o r resulting f r o m any resulting f r o m the operation o f an auto by
one auto accident. The limit o f liability shown in that person as an employee o f the United
the Declarations f o r "each accident" f o r States Government. This applies only i f the
Liability is maximum limit o f liability f o r all provisions o f Section 2 6 7 9 o f Title 28,
damages t o all property resulting f r o m any one United States Code as amended, require the
auto accident. Attorney General o f the United States t o
defend that person in any civil action which
These limits are the most will pay regardless may be brought f o r the o r
o f the number of:
2. Claims made; 6. Other reasonable expenses incurred at request.
3. Vehicles o r premiums shown in the
Declarations; o r 7. All defense costs incur. 4. Vehicles involved in the auto accident.
However, i f a policy provision that would defeat
do not provide Liability Coverage f o r any A.
coverage f o r a claim under this Part is declared
: t o be unenforceable as a violation o f the Florida
M o t o r Vehicle Responsibility Statutes governing
1. W h o intentionally acts o r directs t o cause p r o o f o f financial responsibility, limit o f
o r o r w h o acts o r directs t o liability will be the minimum required by the
cause with reasonable expectation o f Florida M o t o r Vehicle Responsibility Statutes
causing, o r . governing p r o o f o f financial responsibility.
2. For t o property owned o r being transported by a .
In addition t o limit o f liability, will pay on 3. For t o property rented to, used by, behalf o f a : o r in the care o f any . This does not apply t o damage t o a 1. Premiums on appeal bonds and bonds t o residence o r garage.
release attachments in any suit defend.
But will not pay the premium f o r bonds 4. For t o an employee o f that person with a face value over limit o f liability which occurs during the course o f shown in the Declarations. employment. This exclusion (A.4.) does not apply t o a domestic employee unless 2. Prejudgment interest awarded against the workers' compensation benefits are on that part o f the required o r available f o r that domestic judgment pay. I f make an o f f e r t o employee.
pay the applicable limit o f liability, will not
pay any prejudgment interest based on that 5. For that person's liability arising out o f period o f time after the o f f e r . the ownership o r operation o f a vehicle while it is being used t o carry persons 3. Interest accruing, in any suit defend, on f o r a fee. This exclusion (A.5.) does not
that part o f a judgment that does not exceed apply t o a share-the-expense car pool. limit o f liability. duty t o pay interest
ends when o f f e r t o pay that part o f the 6. While employed o r otherwise engaged in judgment that does not exceed limit o f the . This exclusion (A.6.) liability. does not apply t o the ownership,
maintenance, o r use o f
4. Up t o $ 1 0 0 a day f o r loss o f wages because by any , o r o f attendance at hearings o r trials at any partner, agent, o r employee o f
request. o r any .
5. The amount a must pay t o 7. Maintaining o r using any vehicle while that the United States Government because o f person is employed o r otherwise damage t o a government-owned private engaged in any business o r occupation passenger auto, pickup, o r which occurs other than the , farming, while the vehicle is in the care, custody, o r o r ranching.
control o f a . The most
will pay is an amount equal t o one month o f This exclusion (A.7.) does not apply t o the the basic salary o f the at maintenance o r use o f a private the time o f loss. Only Exclusions A.1. and A.8. passenger auto; a pickup o r that
apply. own; o r a used with these
vehicles.
8. Using a vehicle without expressed o r C. There is no coverage f o r f o r which a implied permission. becomes legally responsible
t o pay t o a member o f that 9. For o r f o r which that person is an family residing in that
insured under any nuclear energy liability household. policy. This exclusion (A.9.) applies even i f
that policy is terminated due t o D. There is no coverage f o r liability assumed by exhaustion o f its limit o f liability. any under any contract o r
agreement. 10. For o r occurring while
is rented o r leased t o others.
I f an auto accident t o which this policy applies 11. For punitive o r exemplary damages. occurs in any state o r province other than the one in which is principally B. do not provide Liability Coverage f o r the garaged, policy will provide at least the ownership, maintenance, o r use of: minimum amounts and types o f coverages required by law. However, no one will be entitled 1. Any vehicle that is not t o duplicate payments f o r the same elements o f
unless that vehicle is: loss. a. A f o u r o r six wheel land m o t o r
vehicle designed f o r use on public roads with a rated load capacity o f no
When this policy is certified as future p r o o f o f more than 2 , 0 0 0 pounds;
financial responsibility, this policy shall comply with the law t o the extent required.
b. A moving van f o r personal use;
c. A having at
least f o u r wheels.
I f there is other applicable liability insurance, d. A vehicle used in the business o f will pay only share o f the loss. share is
farming o r ranching; o r the proportion that limit o f liability bears t o the total o f all applicable limits.
e. A vehicle being used in a medical
emergency. With respect t o a vehicle o r a
do not own, any insurance provide Any vehicle, other than
2. t o a shall be excess over:
, that is owned by , o r furnished
o r available f o r regular use. 1. Any other applicable liability insurance, o r 3. Any vehicle, other than 2. Any self-insurance in compliance with a
, that is owned by, o r furnished o r state's financial responsibility law. available f o r the regular use o f , any
. This exclusion (B.3.) However, with respect t o a vehicle leased o r does not apply t o maintenance o r rented by , i f have agreed t o provide use o f such vehicle. primary coverage in a written lease o r rental agreement, the coverage provided by this policy Any vehicle while being operated in, o r in is primary, but only f o r the statutory minimum 4.
practice f o r , any financial responsibility limits required by the . Florida Responsibility Law and the Florida M o t o r
PART B-1 - PERSONAL INJURY PROTECTION COVERAGE
(Referred t o as PIP) does not include the following:A. as used in this Part means:
1. Spinal ultrasound, also known as 1. o r any :
sonography, ultrasonography, and echography;
a. While any ;
o r
2. Surface EMG; b. As a f o r resulting f r o m
an accident occurring within the State 3. Somatosensory Evoked Potential f o r use o f Florida. in the diagnosis o f radiculopathy o r distal nerve entrapment when treating persons 2. Any other person w h o sustains as a sustaining bodily injury covered by
result o f an accident occurring within the personal injury protection benefits; and State o f Florida and involving
: 4. Dermatomal Evoked Potential.
a. While D. means reasonable
; o r expenses f o r surgical,
medical, X - r a y , dental, and rehabilitative b. As a , i f a resident o f services, including prosthetic devices, and Florida, w h o is not an o f a ambulance, hospital, f o r which Security is and nursing services. Such benefits shall also required under the Florida M o t o r include remedial Vehicle No-Fault Law, o r is not treatment and services recognized and entitled t o PIP benefits f r o m the permitted under the laws o f the state f o r an insurer o f the o f such a injured person w h o relies upon spiritual . means through prayer alone f o r healing, in accordance with his o r her religious beliefs; B. as used in this Part means a however, this sentence does not a f f e c t the relative o f any degree by blood, by marriage, determination o f what other services o r o r by adoption, w h o usually makes his o r her procedures are .
home in the same family unit, whether o r not
temporarily living elsewhere. E.
C. r e f e r s t o a medical 1. Means any self-propelled vehicle with service o r supply that a prudent physician f o u r o r more wheels which is o f a type would provide f o r the purpose o f both designed and required t o be licensed preventing, diagnosing, o r treating an illness, f o r use on the highways o f the State o f injury, disease, o r symptom in a manner that Florida and any o r semi-trailer is: designed f o r use with such vehicle.
1. In accordance with generally accepted 2. Does not include a mobile home o r any standards o f medical practice; which is used in mass transit and designed t o transport more 2. Clinically appropriate in terms o f type, than five passengers exclusive o f the frequency, extent, site, and duration, and operator o f the and owned by a municipality, a transit 3. Not primarily f o r the convenience o f the authority, o r a political subdivision o f the patient, physician, o r other health care state. This exception does not apply t o a
provider. used in public school
transportation.
F. means a person o r organization w h o insurance. The database will also reflect, holds the legal title t o a and where applicable, (a) the value o f the also includes: actual medical services based on a nonspecialty specific relative value scale 1. A debtor having the right t o possession, f o r the services relative t o other services in the event a is the and, (b) in the case o f new procedures, subject o f a security agreement, and services, o r supplies, a comparison t o commonly-used procedures, services, o r 2. A lessee having the right t o possession, supplies.
in the event a is the
subject o f a lease with option t o J. means, purchase and such lease agreement is f o r with respect t o the period o f disability o f the a period o f six months o r more, and , all expenses reasonably incurred in obtaining f r o m others ordinary 3. A lessee having the right t o possession, and necessary services in lieu o f those that,
in the event a is the but f o r such injury, the
subject o f a lease without option t o would have p e r f o r m e d without income f o r purchase, and such lease agreement is the benefits o f the
f o r a period o f six months o r more, and household. the lease agreement provides that the
lessee shall be responsible f o r securing K. means, with respect t o the insurance. period o f disability o f the
any loss o f gross income and earning G. means a person while not capacity f r o m inability t o w o r k proximately
any self-propelled vehicle. caused by the sustained by the
However, does not H. means any location include any loss after the death o f a
within the municipality where the
is receiving treatment, o r in which the
resides, o r within 1 0 miles L. as used in this Part does by road o f the residence, not include any f o r provided such location is within the county in which security is not required under the which the resides. Florida M o t o r Vehicle No-Fault Law.
I f there is no qualified physician t o conduct the examination in a location
t o the , then will pay, in accordance with the Florida such examination shall be conducted in an M o t o r Vehicle No-Fault Law, t o o r f o r the area o f the closest proximity t o the insured's benefit o f the :
residence.
1. 80% o f , and I. is the amount which will
pay f o r charges made by a licensed hospital, 2. 60% o f and licensed physician, o r other licensed medical
provider f o r services. 3. 100% o f , In determining what is reasonable, w e will and
consider the following:
4. Death benefits o f $5,000, 1. The actual charge;
incurred as a result o f , caused by an accident 2. The charge negotiated with a provider; o r arising out o f the ownership, maintenance, o r use
o f a and sustained by a 3. The charge determined by a statistically .
valid database that is designed t o reflect charges f o r the same o r comparable services o r supplies in cases involving no
will not be liable f o r subsequent PIP benefits i f a unreasonably refuses t o
submit t o a physical o r mental examination, as A. do not provide PIP Coverage f o r required in Part E - General Provisions, Duties sustained by any :
A f t e r An Accident o r Loss.
1. While a o f
Whenever a person making a claim is charged which are the and which is with committing a felony, shall withhold not under this Part; benefits until, at the trial level, the prosecution
makes a formal entry on the record that it will 2. While operating
not prosecute the case against the person, the without express o r implied consent; charge is dismissed, o r the person is acquitted.
3. I f such person's conduct contributed t o his under any o f the following circumstances:
Regardless o f the number o f
a. Causing t o himself intentionally; o r o r , claims made, vehicles o r
premiums shown in the Declarations, o r vehicles
b. While committing a felony; involved in an auto accident, the total aggregate
limit o f PIP benefits available under Florida M o t o r
4. For i f an entry in the Vehicle No-Fault Law, f r o m all sources
Declarations indicates such coverage combined, including this policy, f o r all loss and
does not apply; o r expense incurred by o r on behalf o f any one
person w h o sustains as the result o f one
5. While a accident shall not exceed the amount indicated in
located f o r use as a residence o r the Declarations.
premises. Any amount payable under this insurance (PIP)
B. do not provide PIP Coverage f o r shall be reduced by the amount o f benefits a
sustained by any while has recovered o r is entitled t o
o r when struck by, any vehicle, recover f o r the same elements o f loss under the
other than , that is owned workers' compensation laws o f any state o r the
by o r furnished o r available f o r the regular Federal Government.
use o f , any . This does not apply t o .
The amount o f any deductible stated in the Declarations shall be deducted f r o m the total
I f there is other applicable PIP Coverage, will amount o f , , and
pay only share o f the loss and o f expenses , b e f o r e the
incurred in processing the claim. share is the application o f any percentage limitation incurred
proportion that limit o f liability bears t o the by o r on behalf o f each person t o w h o m the
total o f all applicable limits. deductible applies and w h o sustains as a result
o f any one accident. Such deductible shall not
Notwithstanding any provision o f this coverage apply to:
t o the contrary, i f a person is injured while o r through being struck by, a
1. The death benefit; o r
rented o r leased under a rental o r lease agreement which does not specify otherwise in Any person determined eligible pursuant t o
2.
bold type on the face o f such agreement, the PIP the Florida Crime Compensation Act,
Coverage a f f o r d e d under the lessor's policy shall excluding S.960.28 o f the act.
be primary.
Page 9 o f 2 8 6 - 0 4
PART B-2 - MEDICAL PAYMENTS COVERAGE
1. Consistent with the symptoms, diagnosis, and treatment o f the
A. means a supplemental passive
injury and appropriately documented in restraint system commonly referred t o as an
the medical records; which is originally installed by the
vehicle manufacturer and which, at the time
2. Provided in accordance with recognized o f the accident, had not been made
standards o f care f o r the inoperable through modification, deactivation,
injury at the time the charge is disconnection, switching o f f o r prior
incurred; deployment.
B. means (in order o f priority o f 3. Consistent with published practice payment): guidelines and technology, and assessment standards o f national 1. The surviving spouse i f a resident in the organizations o r multi-disciplinary medical
same household as the deceased at the groups; time o f the accident; o r
4. Not primarily f o r the convenience o f the 2. I f the deceased is an unmarried minor, , his o r her physician,
either o f the surviving parents w h o had hospital, o r other health care provider; legal custody at the time o f the accident;
o r 5. The most appropriate supply o r level o f service that can be safely provided t o the 3. The estate o f the deceased. ; and
C. as used in this Part, B - 2 , 6. Not excessive in terms o f scope, means: duration, o r intensity o f care needed t o provide safe, adequate, and appropriate 1. o r any while diagnosis and treatment.
any auto.
However,
2. Any other person while do not
. include the following:
3. o r any while not 1. Nutritional supplements o r o v e r t h e -a m o t o r vehicle i f injured by: counter drugs;
a. A m o t o r vehicle designed f o r use 2. Experimental services o r supplies, which mainly on public roads; means services o r supplies that
determine have not been accepted by the b. A ; o r majority o f the relevant medical specialty as safe and e f f e c t i v e f o r treatment o f c. A . the condition f o r which its use is
proposed; D.
are those services o r 3. Inpatient services o r supplies provided t o supplies provided o r prescribed by a licensed the when these could hospital, licensed physician, o r other licensed safely have been provided t o the medical provider that, as determined by as an outpatient;
o r someone on behalf, are required t o
identify o r treat caused by an auto 4. Spinal ultrasound, also known as accident and sustained by a sonography, ultrasonography, and
5. Surface EMG;
6. Somatosensory Evoked Potential f o r use A. Medical Payments Coverage. will pay only in the diagnosis o f radiculopathy o r distal the reasonable f e e f o r
nerve entrapment when treating persons and the sustaining bodily injury covered by reasonable expense f o r funeral services personal injury protection benefits; and because o f caused by an auto accident, sustained by a . The medical 7. Dematomal Evoked Potential. services must be rendered within three years o f the date o f the accident unless those E. is the amount, as services are otherwise covered by PIP determined by o r someone on behalf, Coverage, but not payable due t o the which will pay f o r charges made by a co-insurance requirements o f that coverage. licensed hospital, licensed physician, o r other
licensed medical provider f o r A provider o f medical services may charge more than the limits established by this . will pay the lesser of: policy's defined terms, but such additional charges are not covered. o r someone on 1. The actual charge; behalf will review, by audit o r otherwise, claims f o r benefits under this coverage t o 2. The charge negotiated with a provider; determine whether fees and expenses w e r e reasonable and whether treatment was 3. The charge authorized, established, o r medically necessary and appropriate.
approved by the Department o f Insurance
under Florida's PIP law; o r will pay under this coverage only i f bills and statements are submitted in accordance 4. The charge determined by a statistically with the billing requirements that are valid database that is designed t o reflect applicable t o claims submitted under PIP charges f o r the same o r comparable Coverage.
services o r supplies in the same o r
similar geographic region. The database B. Air Bag and Seat Belt Benefits. will will also reflect, where applicable, (a) the provide the benefits described only if, at the value o f the actual medical services based time o f the accident, Personal Injury on a nonspecialty specific relative value Protection Coverage was provided by the scale f o r the services relative t o other policy and the f o r w h o m services, and (b) in the case o f new benefits are sought was:
procedures, services, o r supplies, a
comparison t o commonly-used 1. Wearing a ; o r procedures, services, o r supplies.
2. Wearing a and a F. means manual o r automatic safety seat in an automobile in which he was
belts o r seat and shoulder restraints o r a protected by an ; and child restraint device. Both the lap and
shoulder restraints must be w o r n at the time 3. Entitled t o collect benefits f o r medical o f the accident f o r coverage t o apply. I f the expenses incurred as a result o f the is a child, the child restraint accident under the terms o f the policy's device must meet federal m o t o r vehicle Personal Injury Protection Coverage. safety standards and must be one
recommended by its manufacturer as appropriate f o r use by children o f like age and weight. The child must be properly seated and restrained within the device and the device must be attached t o the interior o f the vehicle in accordance with the manufacturer's instructions.
will pay a Death Benefit o f $ 1 5 , 0 0 0 t o
the o f a w h o
dies as the direct result o f sustained in an
do not provide Medical Payments Coverage automobile accident while wearing a
under this Part f o r any f o r : . will pay an Additional Death Benefit
o f $ 1 0 , 0 0 0 t o the o f a
1. Sustained while any vehicle that is w h o dies as a direct result o f
not unless that vehicle is: sustained in an automobile accident while
wearing a and a seat
a. A f o u r o r six wheel land m o t o r vehicle protected by an . In either case, death
designed f o r use on public roads with a must occur within three years o f the date o f
rated load capacity o f no more than the accident.
2 0 0 0 pounds;
b. A moving van f o r personal use; The following provisions represent the most
c. A having at least will pay regardless o f the number o f
f o u r wheels; o r o r , claims made, vehicles
o r premiums shown in the Declarations, o r
d. A vehicle used in the business o f farming vehicles involved in an auto accident.
o r ranching. A. Medical Payments.
2. Sustained while
when it is being used t o carry persons 1. The limit o f liability shown in the
f o r a fee. This does not apply t o a Declarations f o r Medical Payments
share-the-expense car pool. Coverage is the maximum limit o f liability
f o r each injured in any
3. Sustained while any vehicle one accident.
located f o r use as a residence. 2. No one will be entitled t o receive
4. Occurring during the course o f employment duplicate payments f o r the same
i f workers' compensation benefits are elements o f loss under this coverage and
required o r available. Part A o r Part C o f the policy.
Sustained while o r when struck 5.
B. Air Bag and Seat Belt Benefits.
by, any vehicle, other than
that is owned by o r furnished o r 1. The maximum Death Benefit will pay
available f o r regular use. under Air Bag & Seat Belt Benefits is
$ 1 5 , 0 0 0 f o r death o f any one
Sustained while , o r when struck 6.
. The maximum Additional Death
by, any vehicle, other than Benefit will pay f o r death o f any one
that is owned by o r furnished o r is $10,000. These
available f o r the regular use o f any amounts are the most will pay
This does not apply t o . regardless o f the number o f vehicles t o
which this coverage applies, the number
Sustained while a vehicle without 7.
o f coverages o r premiums shown in the
expressed o r implied permission. Declarations, o r any other factor.
Sustained while a vehicle when it 8.
2. No one will be entitled t o duplicate
is being used in the business o r occupation payments f o r the same elements o f loss.
o f a . This does not apply t o sustained while a private passenger auto; a pickup o r own; o r a used with these vehicles.
Caused by o r as a consequence o f war, 9.
insurrection, revolution, nuclear reaction, o r
radioactive contamination. I f and a do not agree:
10. Sustained while 1. On the ;
while it is rented o r leased t o others.
2. That expenses are reasonable; Sustained while a participant in, o r in practice
11.
f o r , any . 3. Whether services o r supplies are ; o r
4. Whether there is coverage under the terms I f there is other applicable auto medical
o f the Insuring Agreement f o r Part B - 2 payments insurance, will pay only share
Medical Payments Coverage, o f the loss. share is the proportion that
limit o f liability bears t o the total o f all applicable
then, that disagreement may be arbitrated, limits. However, any insurance provide with
provided both parties so agree. This arbitration respect t o a vehicle o r a
shall be limited t o the aforementioned issues and do not own, shall be excess over any other
shall not address any other coverage questions. collectible auto insurance providing payments f o r
Any arbitration finding that goes beyond the medical o r funeral expenses.
aforementioned issues shall be voidable by o r the involved in the The Death Benefit and Additional Death Benefit
disagreement. under Air Bag and Seat Belt Benefits will be paid
in addition t o any death benefit payable under the
I f both parties agree t o arbitrate, each party will policy's PIP Coverage.
select an arbitrator, and those t w o arbitrators will select a third. I f the t w o arbitrators cannot I f there are other applicable air bag o r seat belt
agree on a third within 3 0 days, either may death benefits, the maximum limit o f liability
request that selection be made by a judge o f a f o r the death o f any one under
court having jurisdiction. Each party will pay the all such policies shall not exceed $ 1 5 , 0 0 0 f o r
expenses it incurs and bear the expenses o f the the Death Benefit and $ 1 0 , 0 0 0 f o r the Additional
third arbitrator equally. Death Benefit.
Unless both parties agree otherwise, arbitration will take place in the county in which the A. If and every other m o t o r lived at the time o f the vehicle o w n are within the policy accident, and local rules o f law as t o procedure territory referred t o in Part E - General and evidence will apply. A decision agreed t o by Provisions, then coverage under Part B - 2 t w o o r more o f the arbitrators will be binding up Medical Payments Coverage will apply t o t o an amount that, when added t o amounts and any anywhere in the previously paid by does not exceed the limit world. o f liability f o r this coverage.
B. Any coverage under Part B - 2 Medical Payments Coverage, shall pay the portion o f any claim f o r PIP medical expenses which are otherwise covered but not payable due t o the limitation o f 80% o f medical expenses regardless o f whether the full amount o f PIP benefits have been exhausted. However, Medical Payments shall not be payable f o r the amount o f any deductible which has been selected under PIP.
PART C - UNINSURED MOTORISTS COVERAGE
(STACKED) (referred t o as UM Coverage)(1) o r any
(2) A vehicle which o r any A. as used in this Part means:
are o r
1. o r any .
(3) 2. Any other person
. d. To which a liability bond o r policy applies at the time o f the accident but 3. Any person f o r damages that person is the bonding o r insuring company entitled t o recover because o f t o denies coverage o r is o r becomes which this coverage applies sustained by insolvent within 4 years after the a person described in 1. o r 2. above. accident.
However, the definition o f 2. does not does not include the Government o f the include any vehicle o r equipment:
United States o f America.
a. Owned by o r furnished o r available
B. . f o r the regular use o f o r any
, unless it is 1. means a land t o which Part A o f the
m o t o r vehicle o r o f any type: policy applies and liability coverage is excluded f o r any person other than a. To which no liability bond o r policy o r any f o r
applies at the time o f the accident. damages sustained in the accident by o r any .
b. To which a liability bond o r policy
b. Operated on rails o r crawler treads. applies at the time o f the accident but
its limit f o r bodily injury liability is not
enough t o pay the full amount the c. Designed mainly f o r use o f f public is legally entitled t o roads while not upon public roads. recover as damages.
d. While located f o r use as a residence c. That is a h i t - a n d - r u n vehicle. This o r premises.
means a m o t o r vehicle whose o w n e r o r operator cannot be identified and that hits o r that causes an accident resulting in without hitting:
Coverage, multiplied by the number o f premiums shown in the Declarations f o r A. will pay compensatory damages which a UM Coverage.
is legally entitled t o recover
f r o m the o w n e r o r operator o f an 3. Subject t o the maximum limits o f liability because o f sustained by a f o r "each person" and "each accident" set
and caused by an auto f o r t h in A.1. and A.2. above, f o r accident. However, will not pay damages sustained in any one accident by a f o r pain, suffering, mental anguish, o r other than o r any inconvenience unless the consists in whole , maximum limit o f o r in part of: liability f o r all resulting damages, including, but not limited to, all direct, derivative, o r consequential damages (1) Significant and permanent loss o f an
recoverable by any persons is the lesser important bodily function;
of: (2) Permanent injury within a reasonable
degree o f medical probability, other than a. The "each person" limit o f liability scarring o r disfigurement; shown in the Declarations applicable t o the vehicle that person was (3) Significant and permanent scarring o r
at the time o f the disfigurement; o r
accident; o r (4) Death.
b. That p r o - r a t a B. The owner's o r operator's liability f o r these share o f the "each accident" limit o f
damages must arise out o f the ownership, liability applicable t o that vehicle. maintenance, o r use o f the
. Any judgment f o r damages arising o r any w h o out o f a suit brought without written sustains in the accident will also be consent is not binding on . entitled t o a p r o - r a t a share o f the "each accident" limit o f liability t o that vehicle. A person's p r o - r a t a share shall be the proportion that that person's damages bears t o the total damages sustained by
all .
A. Accidents involving t o o r any .
B. Accidents not involving t o o r any 1. For sustained by o r any
in any one accident,
maximum limit o f liability f o r all resulting 1. For sustained by any
damages, including, but not limited to, all other than o r any in direct, derivative, o r consequential any one accident, maximum limit o f damages recoverable by any persons, is liability f o r all resulting damages, the limit o f liability shown in the including, but not limited to, all direct, Declarations f o r "each person" f o r UM derivative, o r consequential damages Coverage, multiplied by the number o f recoverable by any persons, is the limit premiums shown in the Declarations f o r o f liability shown in the Declarations f o r UM Coverage. "each person" f o r UM Coverage
applicable t o the vehicle that the
Subject t o the maximum limit f o r "each was at the time o f the 2.
person" set f o r t h in A.1. above, accident. maximum limit o f liability f o r all damages
f o r resulting f r o m any one accident is the limit o f liability shown in the Declarations f o r "each accident" f o r UM
2. Subject t o the maximum limit f o r "each 1. I f that person o r legal representative person" set f o r t h in B.1. above, settles the claim without written maximum limit f o r all damages f o r consent. However, this exclusion (A.1.) resulting f r o m any one accident is the does not apply:
limit o f liability shown in the Declarations
f o r "each accident" f o r UM Coverage a. i f such settlement does not prejudice applicable t o the vehicle that the right t o recover payment; o r
was at the time o f the
accident. b. i f that person o r legal representative provides with advance notice o f C. The limits o f liability described in Paragraphs any proposed settlement as required A. and B., above, are the most w e will pay by Part E - Duties A f t e r An Accident regardless o f the number of: Or Loss.
1. Covered persons; 2. While
when it is being used t o carry persons 2. Claims made; f o r a fee. This exclusion (A.2.) does not
apply t o a share-the-expense car pool. 3. Vehicles o r premiums shown in the
Declarations; o r 3. Using a vehicle without expressed o r implied permission.
4. Vehicles involved in the accident.
4. While is rented o r D. Any amount otherwise payable f o r damages leased t o others.
under UM Coverage shall be reduced by all
sums payable because o f the : 5. While any vehicle when it is being operated in, o r in practice f o r , any 1. Under any workers' compensation, .
disability benefits law, o r similar law; o r
B. UM coverage shall not apply directly o r indirectly t o benefit any insurer o r 2. Under any PIP Coverage, automobile
self-insurer under any o f the following o r medical expense coverage, o r m o t o r
similar law: vehicle liability insurance.
1. worker's compensation law; o r E. Any amount otherwise payable f o r damages
under UM shall be reduced by all sums paid
2. disability benefits law. because o f the by o r on behalf o f
persons o r organizations w h o may be
C. do not provide UM Coverage f o r punitive legally responsible. This includes all sums
o r exemplary damages. under Part A.
I f there is other applicable similar insurance A. do not provide UM Coverage f o r
will pay only share o f the loss. share is sustained by any :
the proportion that limit o f liability bears t o the total o f all applicable limits. However, any insurance provide with respect t o a vehicle o r a do not own, shall be excess over any other collectible insurance.
2. The amount o f damages that the
is legally entitled t o collect f r o m No will be entitled t o receive that owner;
duplicate payments under this coverage f o r the
same elements o f loss which were: then, that disagreement may be arbitrated, provided both parties so agree. This A. Paid because o f the by o r on behalf o f arbitration shall be limited t o the t w o persons o r organizations w h o may be legally aforementioned factual issues and shall not responsible. address any other issues, including but not limited to, coverage questions. Any B. Paid o r payable under any workers' arbitration finding that goes beyond the t w o compensation law o r similar disability aforementioned factual issues shall be
benefits law. voidable by o r a .
C. Paid under another provision o r coverage in B. I f both parties agree t o arbitration, each this policy. party will select an arbitrator, and those t w o arbitrators will select a third. I f the t w o D. Paid under any PIP Coverage o r under any arbitrators cannot agree on a third within 3 0 automobile medical expense coverage. days, either may request that selection be made by a judge o f a court having jurisdiction. Each party will pay the expenses it incurs and bear the expenses o f the third arbitrator equally.
A. I f and a disagree as to:
C. Unless both parties agree otherwise, Whether the is legally
1.
arbitration will take place in the county in entitled t o recover damages f r o m the
which the lived at the time o w n e r o r operator o f an
o f the accident, and local rules o f law as t o o r an
procedure and evidence will apply. A decision ; o r
agreed t o by t w o o f the arbitrators will be binding up t o the coverage limit o f liability.
PART D - PHYSICAL DAMAGE COVERAGE
w i n d o w glass is caused by a
may elect t o have it considered a A. the amount that it caused by .
would cost, at the time o f , t o buy a
comparable vehicle. As applied t o C. means the , a comparable vehicle is one following while in o r upon
o f the same make, model, model year, body : type, and options with substantially similar
mileage and physical condition. 1. Any item usual and incidental t o the use o f a m o t o r vehicle as a m o t o r vehicle. B. means the impact with an object
and includes upset o f a vehicle. caused 2. Any device o r instrument f o r transmitting, by the following is covered under recording, receiving, o r reproducing data, Comprehensive Coverage and is not sound, o r pictures that is capable o f considered fire; missiles o r falling being operated by p o w e r f r o m the objects; hail, water o r flood; malicious electrical system o f , mischief o r vandalism; theft o r larceny; riot including:
o r civil commotion; explosion o r earthquake;
contact with bird o r animal; windstorm; o r a. Cassettes, compact discs, and other breakage o f w i n d o w glass. I f breakage o f media f o r use with any such device
o r instrument; and
b. Antennas and other accessories f o r 2. A . I f there is a use with any such device o r t o a , will provide instrument. the broadest coverage shown in the
Declarations. D. means direct and accidental damage t o
the operational safety, function, o r appearance o f , o r theft o f ,
o r that
A. Comprehensive Coverage (excluding are not permanently installed in
). . includes a total loss, but
does not include any damage other than the
1. Physical damage. will pay f o r cost t o . does not
caused by other than t o include any loss o f use, o r diminution in value
, and that would remain after
that are not permanently o f the damaged o r stolen
installed in minus any property.
applicable deductible shown in the Declarations.
E. means any private passenger auto, , pickup, , o r
will pay under Comprehensive not owned by, o r
Coverage f o r the cost o f repairing o r furnished o r available f o r the regular use o f ,
replacing the damaged windshield on o r any . This applies
without a deductible. only when such vehicle is in the custody o f
will pay only i f the Declarations indicates o r being operated by o r a
that Comprehensive Coverage applies.
. A does not
include a o r
2. Transportation expenses. will also any o f the following vehicles used in any
pay: business o r occupation other than farming o r
ranching - pickup, , o r
a. Up t o $15 a day, t o a maximum o f .
$450, f o r transportation expenses incurred by . This applies only in F. means restoring the
the event o f a total theft o f damaged property t o its pre-accident
. will pay only operational safety, function, and appearance.
transportation expenses incurred However, may at option
during the period beginning 4 8 hours with parts o f like kind and quality,
after the theft and ending when including used o r non-OEM parts (non-OEM
is returned t o use or, i f parts are those produced by someone other
not recovered o r not repairable, when than the original equipment manufacturer).
pay f o r its loss. does not include:
b. I f Increased Rental Reimbursement A return t o the pre-accident market value
1.
Coverage is afforded, limits f o r o f the property; o r
transportation expenses are increased up t o $30 per day t o a maximum o f 2. Restoration, alteration, o r replacement o f
$900. undamaged property, unless such is
needed f o r the operational safety o f the
B. Collision Coverage. will pay f o r vehicle.
caused by t o
and that are not
G. as used in this Part
permanently installed in , includes:
minus any applicable deductible shown in the Declarations.
1. permanently
C. Rental Reimbursement Coverage and it would be greater than Increased Rental Reimbursement Coverage its minus its salvage value
. (for other than total theft). after the
1. will reimburse f o r expenses B. For a other than a total loss t o incur t o rent a substitute f o r , limit o f liability under
. These coverages apply Comprehensive and Collision Coverages is only if: the amount necessary t o
the damaged o r stolen property without a. is withdrawn deduction f o r depreciation.
f r o m use f o r more than 2 4 hours due
t o a , other than a total theft, t o C. For t o
that auto; and that are not permanently installed in , limits o f liability are described below. These limits are separate b. The is covered under
f r o m the limits available f o r a t o Comprehensive Coverage o r caused
: by , and the cause o f is
not otherwise excluded under Part D
1. For cassettes, compact discs, and o f this policy.
other media as described in Definition C.2.a, without deduction f o r depreciation, 2. will reimburse only f o r that
limit o f liability is the lesser of: period o f time reasonably required t o
. I f
a. The amount necessary t o determine is a
such damaged o r stolen total loss, the rental period will end when
property; o r pay f o r its loss.
b. $250. D. Towing and Labor Costs Coverage. will
pay the reasonable costs incur f o r one
2. For t o all other o f the following each time
that are not permanently is disabled:
installed in , without deduction f o r depreciation, limit o f 1. Mechanical labor up t o one hour at the
liability is the lesser of: place o f breakdown.
a. The amount necessary t o 2. Towing, t o the nearest place where
such damaged o r stolen necessary repairs can be made during
; o r regular business hours, i f the vehicle will
not run o r is stranded on o r immediately
b. The o f
next t o a public road.
. 3. Delivery o f gas to, o r a change o f tire on
D. Under Rental Reimbursement Coverage, the disabled vehicle. However, do not
limit o f liability is $15 a day, t o a maximum o f pay f o r the cost o f these items.
$450. Under Increased Rental Reimbursement Coverage, limit o f liability is $30 a day, t o a maximum o f $900.
E. Under Towing and Labor Costs Coverage, A. For a total loss t o , limit o f liability is the reasonable price f o r the
limit o f liability under Comprehensive and covered service. Collision Coverages is its
will declare t o be a total loss if, in judgment, the cost t o
may pay f o r in money, o r will not pay for: the damaged o r stolen property.
may, at expense, return any stolen property 1. t o which occurs t o o r t o the address shown in the while it is used t o carry persons f o r a fee. Declarations. I f return stolen property, This does not apply t o a share-the-expense will pay f o r any damage resulting f r o m the theft. car pool.
may keep all o r part o f the damaged o r stolen property and pay an agreed o r
2. Damage due and confined t o wear and tear, appraised value f o r it. cannot be required t o
freezing, o r road damage t o tires. This does assume the ownership o f damaged property.
not apply i f the damage results f r o m the total may settle a claim either with o r with the
theft o f This exclusion o w n e r o f the property.
(2.) does not apply t o Towing and Labor Costs Coverage.
3. Damage due and confined t o mechanical o r o r damage under this policy will be paid, as electrical breakdown o r failure, including such interest may appear, t o the named insured and damage resulting f r o m negligent servicing o r the loss payee shown in the Declarations. This repair o f o r its insurance, with respect t o the interest o f the equipment. will pay f o r ensuing damage loss payee, will not become invalid because o f only t o the extent the damage occurs outside fraudulent acts o r omissions unless the o f the major component (such as results f r o m conversion, secretion, o r transmission/transaxle, electrical system, embezzlement o f . may engine including cooling and lubrication cancel the policy as permitted by policy terms thereof, air conditioning, computer, and the cancellation will terminate this agreement suspension, braking, drive assembly, and as t o the loss payee's interest. will give the steering) in which the initial mechanical o r same advance notice o f cancellation t o the loss electrical breakdown o r failure occurs.
payee as give t o the named insured shown in
the Declarations. When pay the loss payee This exclusion (3.) does not apply i f the will, t o the extent o f payment, be subrogated damage results f r o m the total theft o f t o the loss payee's rights o f recovery. , and it does not apply t o
Towing and Labor Costs Coverage.
4. due t o o r as a consequence o f war, insurrection, revolution, nuclear reaction, o r will not apply the deductible t o caused radioactive contamination.
by with another vehicle i f all o f these
conditions are met: 5. t o a camper body o r o w n which is not shown in the Declarations. This 1. The t o is greater does not apply t o one acquire during the than the deductible amount; and policy period and ask t o insure within 3 0
days after become the owner. 2. The o w n e r and driver o f the other vehicle
are identified; and 6. t o any o r
when used by 3. The o w n e r o r driver o f the other vehicle has any person without a reasonable belief that
a liability policy covering the ; and that person is entitled t o do so.
4. The driver o f is not 7. t o equipment designed o r used t o legally responsible, in any way, f o r causing o r evade o r avoid the enforcement o f m o t o r contributing t o the . vehicle laws.
8. t o any arising out o f its use by o r a
while employed o r otherwise engaged in This insurance shall not directly o r indirectly operations. benefit any carrier o r other bailee f o r hire. 9. t o while it is
rented o r leased t o others.
I f other sources o f recovery also cover the 10. t o any vehicle while it is being operated
will pay only share o f the in, o r in practice f o r , any
share is the proportion that limit o f .
liability bears t o the total o f all applicable limits. However, any insurance provide with respect 11. resulting from:
t o a o r
will be excess over any a. The acquisition o f a stolen vehicle;
other collectible source o f recovery including, but not limited to:
b. Any legal o r governmental action t o return a vehicle t o its legal owner; o r
1. Any coverage provided by the o w n e r o f the o r
c. Any confiscation o r seizure o f a vehicle by governmental authorities.
2. Any other applicable physical damage This exclusion (11.) does not apply t o
insurance. innocent purchasers o f stolen vehicles f o r
value under circumstances that would not
3. Any other source o f recovery applicable t o cause a reasonable person t o be suspicious
the o f the sales transaction o r the validity o f the
title.
This provision does not apply t o Towing and Labor Costs Coverage.
12. resulting f r o m use in any illicit o r prohibited trade o r transportation where o r any is a willing participant.
I f and do not agree on the amount o f 13. Any arising out o f any act committed: , either may demand an appraisal. In this event, each party will select a competent a. By o r at the direction o f o r any appraiser. The t w o appraisers will select an ; and umpire. The appraisers will state separately the
and the amount o f . b. With the intent t o cause a .
I f they fail t o agree, they will submit their differences t o the umpire. A decision agreed t o by any t w o will be binding. Each party will pay its have the right t o inspect any private chosen appraiser and share the expenses o f the passenger m o t o r vehicle which insure o r umpire equally. Neither nor waive any o f intend t o insure f o r Physical Damage Coverage rights under this policy by agreeing t o an under this policy. This right applies only in appraisal.
accordance with Florida Statute 627.744.
When require an inspection must cooperate and make the vehicle available f o r the inspection.
PART E - GENERAL PROVISIONS
5. Addition o r deletion o f an operator. I f an air bag in deploys f o r
6. Change, addition, o r deletion o f any any reason, will pay without deductible t o
coverage o r limits. replace it.
C. will make any calculations o r adjustments o f premium using the applicable rules, rates, and f o r m s as o f the e f f e c t i v e date o f Bankruptcy o r insolvency o f the the change.
, as defined in this policy, shall not relieve
o f any obligations under this policy. D. I f make a change which broadens coverage under this edition o f policy without additional premium charge, that change will automatically apply t o
insurance as o f the date implement that A. The premium is based on information
change in location. This paragraph does have received f r o m and other sources.
not apply t o changes implemented with a agree t o cooperate with in
revision that includes both broadenings and determining i f this information is c o r r e c t and
restrictions in coverage. Otherwise, this complete. agree that i f this information
policy includes all o f the agreements changes, o r is incorrect o r incomplete,
between and . Its terms may not be may adjust premiums accordingly
changed o r waived except by endorsement during the policy period.
issued by . B. If, during the policy period, the risk exposure
changes f o r any o f the following reasons, the necessary premium adjustments will be
made e f f e c t i v e the date o f change in A. must be notified promptly o f how, when, exposure. agree t o give notice o f and where an accident o r loss happened. such exposure changes as soon as is Notice should also include the names and reasonably possible: addresses o f any injured persons and o f any
witnesses. 1. Change in location where any vehicle is
garaged. B. A person seeking any coverage must:
2. Change, addition, o r deletion relating t o 1. Cooperate with in the investigation, the description, equipment, purchase settlement, o r defense o f any claim o r date, registration, cost, usage, miles suit.
driven annually, o r operators o f any
vehicle. 2. Promptly send copies o f any notices o r legal papers received in connection 3. Replacement, deletion, o r addition o f any with a suit, accident, o r loss.
vehicle. must request coverage f o r a
newly acquired vehicle within 3 0 days 3. Submit, as o f t e n as reasonably f r o m the date the vehicle is acquired i f require:
wish t o continue any coverage. See
DEFINITIONS - . a. To physical exams by physicians select. will pay f o r these exams. 4. Change, addition, o r deletion relating t o
the date o f birth, marital status, o r driving b. To examination under oath. The record o f any operator. examination must be signed.
4. Authorize t o obtain medical reports D. A person seeking coverage under Part C -and other pertinent records. UM Coverage must also comply with the
following: 5. Submit a p r o o f o f loss when required by
1. I f the and the o w n e r o r operator o f the
legally liable f o r the
6. Promptly notify the police i f a reach a settlement h i t - a n d - r u n driver is involved. agreement t o pay the
such person's limits o f liability, the C. A person seeking coverage under Part B - 1 must submit the
Personal Injury Protection Coverage must agreement t o in writing f o r also: approval prior t o final execution o f such
settlement agreement if: 1. As soon as practicable, give t o
written p r o o f o f claim, under oath i f a. The settlement would not fully satisfy required, which may include full the claim f o r particulars o f the nature and extent o f and
the injuries and treatment received and
contemplated, and such other information b. An claim as may assist in determining the has been o r will be made against . amount due and payable.
2. The may file suit against 2. Submit t o mental examinations by and the legally liable person if, within physicians select at expense 3 0 days after receipt o f the when and as o f t e n as may reasonably settlement agreement do not:
require. Mental exams o r physical exams
as required by in B.3.a. above will be a. Approve the settlement; scheduled in a location reasonably
accessible t o such person, and a copy o f b. Waive rights o f recovery against the medical r e p o r t shall be f o r w a r d e d t o the person o r organization legally such person i f requested. Reasonably liable f o r the ;
accessible means any location:
c. Authorize the signing o f a full release; a. Within the municipality where such and
person is receiving treatment o r in
which that person resides; o r d. Agree t o arbitrate the claim. b. Within 1 0 miles by road o f such
person's residence, provided such The suit shall decide i f the
location is within the county in which is legally entitled t o collect that person resides. damages and i f so, the amount.
I f there is no qualified physician t o E. A person seeking coverage under Part D -conduct the examination in a location Physical Damage Coverage must also:
reasonably accessible t o such person,
then the examination shall be conducted 1. Take reasonable steps after loss t o in an area o f the closest proximity t o that protect and its person's residence. equipment f r o m further loss. will pay reasonable expenses incurred t o do this.
2. Promptly notify the police i f The Florida Department o f Financial Services will is stolen. appoint a mediator. Each party may reject one mediator whether b e f o r e o r after the other party 3. Permit t o inspect and appraise the has made a rejection. The mediator will notify the damaged property b e f o r e its repair o r parties o f the date, time, and place o f the disposal. mediation conference, which will be held within 4 5 days o f the request f o r mediation. The mediation will be conducted informally and may be held by telephone i f feasible. Participants must have authority t o make a binding decision, A. No legal action may be brought against
and must mediate in good faith. Information and until there has been full compliance with all
disclosures provided during mediation are not the terms o f this policy.
admissible in any subsequent action o r proceeding relating t o the claim o r cause o f In addition, under Part A, no legal action
1.
action giving rise t o the claim. Costs o f the may be brought against until agree
mediator shall be shared equally by each party in writing that the , as
unless the mediator determines a party has not defined in Part A, has an obligation t o
mediated in good faith. pay, o r the amount o f that obligation has
been finally determined by judgment after
I f a person files suit which relates t o facts trial.
already mediated, such facts shall not be mediated again. Only one mediation may be In addition, under Part B - 1 PIP and Part
2.
requested f o r each claim, unless all parties agree B - 2 Medical Payments, i f fail t o deny
t o further mediation. o r pay a claim within 3 0 days o f
receiving adequate p r o o f o f that claim,
The filing o f a request f o r mediation tolls the the will not file suit f o r
applicable time requirements f o r filing suit f o r a those benefits until providing with a
period o f 6 0 days following the conclusion o f written demand f o r payment and giving
the mediation process o r the time prescribed in 1 5 days in which t o respond t o that
the Limitation o f Actions, whichever is later. demand.
B. No person o r organization has any right under this policy t o bring into any action
do not provide coverage f o r any t o determine the liability o f a
, as defined in this policy, w h o has , as defined in this policy.
knowingly concealed o r misrepresented any material f a c t o r circumstance relating t o this insurance:
o r the insured may request mediation o f any 1. A t the time application was made; o r claim f o r personal injury in an amount o f
$ 1 0 , 0 0 0 o r less o r a claim f o r in any amount 2. A t any time during the policy period; o r arising out o f the ownership, operation, use, o r
maintenance o f a m o t o r vehicle prior t o the 3. In connection with the presentation o r institution o f litigation. settlement o f a claim.
Such request shall be filed with the Florida Department o f Financial Services on a f o r m
approved by the department. The request must When a claim, o r part o f a claim, is payable state w h y mediation is being requested and the under more than one provision o f this policy, issue in dispute. will pay the claim only once under this policy.
share in the recovery, will pay share o f the legal expenses. share is that A. I f make a payment under this policy and percent o f the legal expenses that the the person t o o r f o r w h o m payment was amount recover bears t o the total made has a right t o recover damages f r o m recovery. This does not apply t o any amounts another, will be subrogated t o that right. recovered o r recoverable by f r o m any That person shall do whatever is necessary other insurer under any inter-insurer t o enable t o exercise rights, and shall arbitration agreement.
do nothing after loss t o prejudice them.
However, rights in this paragraph do not E. I f make payment f o r a claim under Part apply under Part D - Physical Damage A, and the , as defined in Coverage, against any person using Part A:
with a reasonable belief that
that person is entitled t o do so nor under 1. Failed o r refused t o comply with the Part B - 2 Medical Payments Coverage, Air duties specified in this provision; and Bag and Seat Belt Benefits.
2. Prejudiced defense o f the liability B. I f make a payment under this policy and claim by such failure o r refusal;
the person t o o r f o r w h o m payment was
made recovers damages f r o m another, that then, the shall reimburse person shall hold in trust f o r the t o the extent o f payment and cost o f proceeds o f the recovery and reimburse defense.
t o the extent o f payment. However, this paragraph does not apply t o Part B - 2 Medical Payments Coverage, Air Bag and Seat
Belt Benefits. For purposes o f this policy, a private passenger type auto, pickup, o r is deemed t o be C. rights do not apply under Paragraph A. owned by a person i f leased under a written with respect t o coverage under Part C - UM agreement t o that person f o r a continuous Coverage, Section 2. o f the definition o f period o f at least six months.
, i f :
1. Have been given p r o m p t written notice o f
a tentative settlement between a A. This policy applies only t o accidents and , as defined in Part C, and the losses which occur during the policy period insurer o f an ; as shown in the Declarations and within the and policy territory. The policy territory is the United States o f America (USA), its territories 2. Fail t o advance payment t o such person in and possessions, Puerto Rico, and Canada,
an amount equal t o the tentative including transportation o f
settlement within 3 0 days after receipt o f between any ports o f these locations. notification.
However, PIP benefits under Part B - 1 PIP I f advance payment t o the Coverage apply only t o accidents occurring in an amount equal t o the tentative within the State o f Florida with respect t o settlement within 3 0 days after receipt o f any , as defined in Part B - 1 notification, that payment will be separate PIP, other than o r any . f r o m any amount the is
entitled t o recover under the provisions o f B. The policy territory also includes Mexico, Part C - UM Coverage. However, shall subject t o the following conditions:
have a right t o recover such advance
payment. 1. All coverages a f f o r d e d by the policy, except PIP Coverage, are extended t o D. I f the , as defined in this include coverage during trips into Mexico. policy, recovers f r o m the party at fault and This applies only t o loss o r accident that occurs within 7 5 miles o f the USA border.
6 - 0 4
2. Any liability coverage a f f o r d e d by the b. The named insured transfers policy, except PIP Coverage, is extended ownership o f ; o r t o include the remainder o f Mexico, but
only i f have valid and collectible c. The named insured purchases another liability coverages f r o m a licensed policy covering
Mexican insurance company at the time which was covered under the policy o f loss. Also, f o r this Part t o be being cancelled; o r
effective, the original liability suit f o r
o r must be brought in the USA. d. are a member o f the United States Armed Forces and are called 3. This coverage does not extend: t o o r on active duty outside the United States in an emergency a. To any , as defined situation.
in this policy, w h o does not live in the
USA. 2. may cancel f o r any reason after this policy is in e f f e c t f o r 6 0 days, but the b. To any , as defined e f f e c t i v e date o f cancellation cannot be
in this policy, an auto earlier than the date o f request. which is not principally garaged and
used in the USA. 3. may cancel by mailing a notice t o the named insured shown in the Declarations c. To any auto which is not principally at the address shown in the policy:
garaged and used in the USA.
a. A t least ten days notice i f cancellation 4. The w o r d s "state o r province" as used in is f o r nonpayment o f premium; o r
the Out o f State Coverage provision in
Part A o f the policy do not include a b. A t least 4 5 days notice in all other "state o r province" o f Mexico. cases.
5. Losses payable under Part D o f the policy 4. I f this is a new policy providing PIP and will be paid in the USA. I f the auto must liability coverage, will not cancel be repaired in Mexico, limit o f liability f o r nonpayment o f premium during the will be determined at the nearest point in f i r s t 6 0 days following the date o f the USA where repairs can be made. issuance. However, may cancel i f a check used t o pay is dishonored f o r 6. Any insurance provide will be excess any reason.
over any other similar valid and collectible
insurance. 5. A f t e r this policy is in e f f e c t f o r 6 0 days, o r i f this is a renewal policy, will cancel only:
a. For nonpayment o f premium; A. Cancellation. This policy may be cancelled
during the policy period as follows:
b. For material misrepresentation o r fraud; o r
1. may not cancel a new o r renewal policy providing PIP and liability
coverage during the f i r s t 6 0 days this c. I f driver's license, o r that o f any policy is in e f f e c t unless: driver w h o lives with o r customarily uses , a. has been totally has been suspended o r revoked. This
destroyed so that it is no longer must have occurred: operable on the roads o f Florida; o r
(1) During the policy period o r during the 1 8 0 days immediately preceding its e f f e c t i v e date; o r
