If an insured person, or anyone else, wishes to seek coverage under the personal auto policy, he/she must comply with certain duties. Failure to comply with these duties may result in claim denial if the failure to comply with harms the insurance company.
In the event of a covered loss, Persons submitting claims to the insurance company are required to:
Notify the insurer promptly about how, when, and where the accident or loss occurred. In addition, the insurer must be provided with the names and addresses of anyone with injuries or anyone who witnessed the accident or loss.
Cooperate with the investigation and settlement of any claim.
Promptly send to the insurer any copies of notices or legal papers received.
Submit to a physical exam as reasonably required by the insurer.
Authorize the insurer to obtain copies of medical reports and other pertinent records.
Submit a proof of loss when required by the insurer.
When seeking Uninsured Motorists Coverage, the insured must promptly notify the police if a hit-and-run driver is involved and provide legal papers if a lawsuit is filed. An insured making a claim under Part D must protect the property from further damage, notify the police promptly if the vehicle is stolen, and allow the insurer to inspect and appraise the damaged vehicle before its repair or disposal.
Part F – General Provisions
The General Provisions of the personal auto policy apply to all sections of the policy. They spell out the obligations of both the named insured and the insurance company.
Bankruptcy
Bankruptcy or insolvency of an insured does not relieve the insurer of its obligations under the policy. If the insured declares bankruptcy, the insurer must still comply with all obligations of the policy.
Changes
No changes may be made unless they are contained in a written endorsement issued by the insurance company. The insurer may also adjust the policy premium if changes occur that affect information that determines premium rates, such as number or type of vehicles insured, drivers of insured vehicles, the overnight locations of vehicles, and insurance coverages, deductibles, and limits of liability.
If the insurer makes a change that broadens coverage under the current edition of the insured’s policy, and the change doesn’t generate a premium charge, the change automatically applies to the insured’s policy.
Fraud
No coverage is provided for any insured who commits fraud, makes fraudulent statements, or engages in a fraudulent activity with respect to a claim for any accident or loss.
Legal Action Against the Insurer
No legal action may be taken against the insurance company by anyone unless he/she has complied fully with the policy. In addition, no one may sue the insurance company until it agrees in writing that the insured has a legal obligation to pay for damages.
Right to Recover Payment
If the insurance company makes a claim payment, the person on behalf of whom payment was made must assign its rights to recover damages from another party to the insurance company. If a claimant recovers from another party after the insurer has made payment, that claimant must reimburse the insurance company.
Policy Period and Territory
The policy only provides coverage for accidents for accidents and losses that occur during the policy period and within the policy territory. The policy territory is the United States of America, its territories and possessions, Puerto Rico, and Canada, and while being transported between their ports. Mexico is NOT in the policy territory.
Termination
The policy may be terminated by either the named insured or the insurance company.
Cancellation
The named insured may cancel the policy for any reason by either returning it to the insurer or giving the insurer advance written a notice of the date the cancellation is to take effect
During the first 60 days of a new policy, an insurer may cancel the policy for any reason by mailing notice to the named insured shown on the Declarations. Notice of at least 10 days is required for cancellation due to non-payment of premium, and at least 20 days advance written notice for all other reasons
After the policy has been in effect for 60 days, the insurer may cancel only for the following reasons:
Non-payment of premium
The policy was obtained through fraud or material misrepresentation, meaning the application contained false information and, had the insurer been provided with accurate information, would not have issued the policy
Suspension or revocation of the driver’s license of the named insured, any driver who is a household resident of the named insured, any driver who regularly uses a Your Covered Auto
State law will supersede this provision
Non-renewal – The insurer may elect to non-renew a policy; if non-renewing the policy, the insurer must give the insured written notice before the end of the policy period. At least 20 days advance written notice must be provided (some states require 30, 45 or 60 days notice). In most cases, state law requires the insurer to list the reason for non-renewal on the notice. State law prevails.
Automatic Termination – The policy automatically terminates if the insured, or a legal representative, fails to accept or pay for a renewal or continuation of the policy. In addition, coverage automatically terminates if the named insured secures other auto insurance on an auto shown on the Declarations.
Other Termination Provisions
Proof of mailing of any notice constitutes sufficient proof of notice
If the policy is canceled, the insured may be entitled to a premium refund. If so, the insurer will send the refund
The effective date of cancellation stated in the notice will become the end of the policy period
Transfer of Your Interest in This Policy
The named insured may not transfer or assign his/her interest in the policy without the insurer’s written consent. However, if the named insured dies, the resident spouse will automatically become the named insured. By the same token, if the named insured dies, his/her legal representative will automatically become the named insured but only with respect to legal responsibility for maintenance or use of any Your Covered Auto. This automatic coverage is provided until the end of the policy period.
Two or More Auto Policies
If two or more policies issued by the same insurer apply to the same accident, the maximum limit of liability that will be paid will not exceed the policy with the highest limit.
Selected Endorsements
Extended Non-Owned Coverage for a Named Individual (PP 03 06)
This endorsement provides coverage by removing or altering some of the Personal Auto Policy’s exclusions or limitations. It also covers non-owned autos furnished or available for the insured’s regular use.
The endorsement provides excess liability coverage, for the individual named on the endorsement and for the business use of a commercial type vehicle that the named insured does not own. It can be used to provide excess liability coverage for the use of a vehicle as a public or livery conveyance.
An extra premium charge applies for liability and medical payments purchased by this endorsement.
Towing and Labor Costs Coverage Endorsement (PP 03 03)
This endorsement provides payment, at the designated amount, for towing to a garage or for labor performed at the site of disablement. The coverage applies per occurrence and to either a Your Covered Auto or the insured’s use of a non-owned auto.
Miscellaneous Type Vehicle Endorsement (PP 03 23)
This endorsement changes the policy by adding a definition for “miscellaneous type vehicle,” which means a motorhome, motorcycle, or another similar type vehicle, ATV, dune buggy, or golf cart. In addition, to the definitions section of the policy, the endorsement amends “your covered auto” and “newly acquired auto” to include any “miscellaneous type vehicle” shown on the endorsement. The definition does not include snowmobiles.
Various exclusions under Parts A, B, and D are also amended to remove exclusions for damage to, and injuries arising out of, vehicles having fewer than 4 wheels and vehicles designed mainly for off-road use. The endorsement excludes coverage for any non-owned vehicles, other than a temporary substitute vehicle.
Named Non-owner Coverage for a Named Individual
This endorsement provides liability, medical payments, and uninsured motorists coverage for individuals who do not own vehicles, but often borrow or rent autos. The endorsement is also designed for individuals who need to prove financial responsibility. Definitions are amended by this endorsement, which also amends certain exclusions. Part D – Coverage for Damage to your Auto is NOT provided by this endorsement.
The endorsement covers only the person named in the endorsement; a spouse and family members may be included if that option is selected on the endorsement. The endorsement provides only Liability, Medical Payments, and Uninsured Motorists Coverages.
Excess Electronic Equipment Coverage
This endorsement provides coverage for electronic equipment that is permanently installed in the vehicle in a location not used by the auto manufacturer. Coverage increases the policy limit from $1,000 to the amount shown on the endorsement. It Includes $200 of coverage for tapes, records, discs, and other media used with covered excess electronic equipment.
Limited Mexico Coverage
This endorsement provides coverage on an excess basis and only for losses and accidents that occur in Mexico and within 25 miles of the U.S. border. In addition, coverage only applies if the insured’s visit to Mexico is of 10 or fewer days duration.
Coverage only applies if existing liability insurance is in place, and was issued by a licensed Mexican insurance company. No coverage is provided for anyone who is a citizen or resident of Mexico.
Optional Limits Transportation Expenses Coverage
This endorsement is used when the insured wishes to increase the limits of liability for transportation expenses that are provided in the personal auto policy ($20 per day, $600 maximum). The vehicle is described on the schedule along with the increased daily limit and the increased maximum limit. The endorsement does NOT change or broaden the insurance that is provided for Transportation Expenses in Part D – Coverage for Damage to your Auto.
Joint Ownership Coverage Endorsement (PP 03 34)
This endorsement amends the definition of “you” and “your” to refer to 2 or more individuals, other than husband and wife, who reside in the same household, or to non-resident relatives who jointly own the insured vehicle.
Non-resident relatives – 2 or more persons related by blood, marriage, or adoption who reside in separate households. This includes a ward or foster child.
https://tela3.wpengine.com/wp-content/uploads/2018/08/logo.png00Christian Ramirezhttps://tela3.wpengine.com/wp-content/uploads/2018/08/logo.pngChristian Ramirez2018-07-19 13:30:012018-10-10 10:10:12Personal Auto Policy Part E, F & Endorsements
