Personal Auto Policy Definitions & Part A

Back to: TelaClaims Adjuster I – Insurance Basics for Adjusting a Claim

Definitions

Your Covered Auto – If a vehicle meets any of the following four definitions, it is a “your covered auto.”

• Any vehicle shown in the Declarations
• A newly acquired auto
• Any trailer that the insured owns
• Any auto or “trailer” the named insured doesn’t own while being used as a temporary substitute for any other vehicle described in this definition, which is out of the normal use because of:
  • Breakdown
  • Repair
  • Servicing
  • Loss
  • Destruction

Newly Acquired Auto – Any of the following types of vehicles for which the insured becomes the owner during the policy period:

• A private passenger auto
• A pickup or van, for which no other insurance policy provides coverage if the auto:
  • Has a gross vehicle weight of less than 10,000 pounds.
  • Is not used for delivery or transportation of goods and materials, unless such use is incidental to the insured’s business of installing, maintaining, or repairing furnishings or equipment. For example, if the insured is a plumber; he may use his pickup or van for the transportation of his tools.
• For all coverages EXCEPT Part D – Coverage for Damage to your Auto, coverage begins on the date the named insured becomes the owner.
  • If newly acquired auto is an additional vehicle, insured must report to the insurer within 14 days.
  • A replacement auto for another with all coverages except collision and comprehensive (other than collision) is covered for liability and medical payments for the remainder of the policy period, even if the insured does not report the replacement.
• Under Part D, Coverage for Damage to your Auto automatic coverage begins on the date the named insured becomes the legal owner of the vehicle.
  • The insured must report the newly acquired auto to the insurer for coverage to continue. If the insured doesn’t report as required, coverage ends after either 4 or 14 days.
  • If the Declarations page indicates that either Collision or Other than Collision coverage applies to at least one vehicle, the insured has 14 days to report for either coverage to apply. Automatic coverage ends after 14 days if the insured doesn’t report.
  • If the Declarations page indicates that NO Collision or Other than Collision coverage applies to at least one vehicle, the insured has 4 days to report for coverage to apply. Automatic coverage ends after 4 days if the insured doesn’t report.

PIP Terms:
(most commonly used terms and their meaning)
Insd= Insured
N/I= Named Insured I/V= Insured Vehicle
VOP= Vehicle on Policy
Clmnt= Claimant
O/V= Other Vehicle
O/P= Other Party
DOL= Date of Loss
U/W= Underwriting
AP= Additional Premium
DNOP= Driver Not Listed on Policy
VNOP= Vehicle Not Listed on Policy
AOB= Assignment of Benefits
D&A= Disclosure and Acknowledgment Form
IOT= Initiation of Treatment
IME= Independent Medical Examination
EUO= Examination Under Oath
S/S= Sworn Statement
R/S= Reschedule and/or Recorded Statement
C/O= Cut-off
Attny= Attorney
Adj= Adjuster
MVR= Motor Vehicle Run (Driving Records)
PIP Log= Log that is maintained by the PIP adjuster. This log contains information regarding medical bills: this log should specify when (date) bill was paid or denied, the original amount of the bill, bill amount after applied to the fee schedule, bill amount after applied to 80%, bill amount after applied to deductible. Each individual will have their own separate PIP log.
EOB= Explanation of Benefits
H/H= Household
MM= Material Misrepresentation
P/R= Police Report
LOR= Letter of Representation

Auto Policy Coverage Terms:   

Check with your insurance company’s underwriting department if you have any questions with regard to the policy coverage’s.

PD= Property Damage (This coverage covers vehicles or property that the policyholder damages)
BI= Bodily Injury (This covers other persons that are injured, not those listed in the policy or resident relatives of those listed in the policy)
PIP= Personal Injury Protection (This covers injuries to the policyholder, listed drivers and resident relatives of the policyholder)
UM= Uninsured Motorists
COMP= Comprehensive
COLL= Collision
COMP/COLL= (This covers damage to the vehicle listed on the policy)
Note: COMP/COLL coverage can’t be purchased separately. If an individual has COMP, automatically know they also have COLL.

Personal Auto Policy Part A – Liability Coverage                                                   

• Pay damages for bodily injury or property damage for which any insured becomes legally responsible.
• Settle or defend any claim or suit asking for such damages.
• Pay all defense costs it incurs, in addition to the liability limits. The insurer’s duty to settle or defend ends when the limit of liability is exhausted.

• The named insured or any family member for the ownership, maintenance, or use of any auto.
• Any person using the covered auto with permission.
• A person or organization, for “your covered auto,” if legally responsible for an insured.

• If a bail bond is required because of an accident, the policy will pay up to $250 for the cost of the bail bond so long as the accident resulted in a covered bodily injury or property damage claim.
• If defending a suit, the insurer will pay premiums on appeal bonds and bonds to release attachments.
• Any interest that accumulates after a judgment has been entered will also be paid by the insurer if it defends a suit.
• The policy pays up to $200 a day for loss of earnings because the insurer requests attendance at hearings or trials. This does not include loss of other earnings.
• The policy will also pay for reasonable expenses incurred at the insurer’s request. This does NOT include traffic fines.

• Intentionally causes bodily injury or property damage.
• Causes property damage to property he or she owns or is transporting.
• Causes property damage to property rented to, used by, or in the care of that insured. An exception exists for damage to a residence or private garage – this is the care, custody, or control exclusion.
• Is responsible for causing bodily injury to an employee (of that insured) during the course of employment by that insured.
• Owns or is operating a vehicle while it’s being used as public or livery conveyance (meaning it has been hired out to the general public). A vehicle used in a share-the-expense car pool is not considered a public or livery conveyance.
• Is employed or engaged in the business of selling, repairing, servicing, storing, road testing or parking motor vehicles. An exception exists if the vehicle is being used by an insured, a family member, or a partner or employee of these. For example, Mary’s son is a mechanic. If he’s test-driving Mary’s car and crashes it, the exception to the exclusion applies – meaning he has coverage. However, if his co-worker crashes Mary’s car, the exception doesn’t apply because the co-worker is not related to Mary, nor is he her partner or employee.
• Is using a vehicle while employed or engaging in business. However, a coverage giveback applies to private passenger autos, pickups, vans, and owned trailers used with such vehicles.
• Is using a vehicle without the reasonable belief that he or she is entitled to drive it. Family members always have a reasonable belief of entitlement to drive a “your covered auto” under this coverage.

• Vehicles that have fewer than four wheels, such as motorcycles
• Vehicles designed mainly for use off public roads, such as snowmobiles or ATVs. An exception applies for off-road vehicles used by an insured in a medical emergency, “trailers,” or non-owned golf carts
• Vehicles owned by the insured that are not insured on this policy OR not owned by the insured but are furnished to the insured or available for the insured’s regular use, such as a company car
• Vehicles owned by a family member that isn’t insured by this policy OR not owned but are furnished to a family member or available for the family member’s regular use, such as a company car
• Vehicles located inside a racing facility for the purpose of competing, practicing, or preparing for a race or speed contest

• Insureds
• Claims made
• Vehicles or premiums shown in the Declarations
• Vehicles involved in the accident