IMAGING CENTER OF WEST PALM BEACH LLC Plaintiff vs. PROGRESSIVE AMERICAN INS CO Defendant, CONO17007966, 06-01-2018_Affidavit in Support of Motion (Fla. Broward Cty. Ct. Jun. 1, 2018) (2024)

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`IN THE COUNTY COURT IN AND FOR
`BROWARD COUNTY, FLORIDA
`
`IMAGING CENTER OF WEST PALM
`BEACH, LLC A/A/O ANABEL HERRERA,
`
`Plaintiff,
`
`Vv.
`
`PROGRESSIVE AMERICAN
`INSURANCE COMPANY,
`
`Defendant.
`
`{
`
`CASE NO: CONO17007966 (73)
`CIVIL DIVISION
`
`AFFIDAVIT OF ADJUSTER, SAMIR D SONL, IN SUPPORT OF
`DEFENDANT’S MOTION FOR FINAL SUMMARY JUDGMENTON NON-
`EMERGENCY MEDICAL CONDITION
`
`BEFORE ME,the undersigned authority, personally appeared SAMIR D SONI, whobeing
`
`first duly sworn, on oath deposes and says, as follows:
`
`
`
`1, Myname is SAMIR D SONIand I amaLitigation Specialist/Claims Adjuster with
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`Progressive American Insurance Company (hereinafter PROGRESSIVE).
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`I have personal
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`knowledge ofall of the facts contained herein, and I am over 18 years of age and I am competent
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`to testify.
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`2.
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`Iam the Claims Adjuster assigned to the above-referenced case (Claim Number:
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`175321707), [have been responsible for handling the claim file relative to this lawsuit and in that
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`regard, I presently am the custodian of the claim file.
`
`3.
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`I hereby certify that the documents attached to this affidavit are true and accurate
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`and are kept in the regular course ofbusiness activity. I have personal knowledgeofthe documents
`
`attached andI have a business duty to furnish the information contained herein. Further, I hereby
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`175321707
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`

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`certify that the documentsattached to this affidavit were madeat or near the time by, or from
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`information transmitted by, a person with knowledge, and keptin the course ofregularly conducted
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`business activity and it was the regular practice of Progressive’s businessactivity to make such
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`records.
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`4,
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`The assignor, Anabel A Herrera, was covered under a PIP policy of insurance
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`issued by PROGRESSIVE(Policy Number 44300146). This policy was in full force an effect on
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`the date of the alleged accident 4/28/2017.
`
`5.
`
`The Declaration Page, Insurance Policy with applicable endorsem*nts are attached
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`hereto as Composite Exhibit “A”, and the documentsare a true, correct andcertified copy of the
`
`original. See Exhibit “A”.
`
`6.
`
`Also, a true and correct copy of the PIP Medical Detail List is attached hereto as
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`Composite Exhibit “B”.
`
`7.
`
`Following the alleged accident
`
`in Plaintiff's Complaint,
`
`the claimant sought
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`treatment from medical providers for injuries allegedly sustained as a result of the accident and the
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`Defendantreceivedbills for reimbursem*nt. Amongthebills received were bills from the Plaintiff
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`for treatment allegedly rendered from 6/21/17.
`
`8.
`
`PROGRESSIVEreviewed and adjusted the bills received in accordance with the
`
`terms of the subject policy and the applicable provisions of the Florida Motor Vehicle No-Fault
`
`Law.
`
`9.
`
`Pursuant to FS 627.736(1)(a)4., reimbursem*nt for services and care provided in
`
`subparagraph 1. or subparagraph 2. is limited to $2500 if a provider listed in subparagraph 2
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`determines that the injured person did not have an emergency medical condition. The medical
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`records did not show that a physician licensed under chapter 458 or chapter 459, a dentist licensed
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`2
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`175321707
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`

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`under chapter 466, a physician assistant licensed under chapter 458 or chapter 459, or an advanced
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`registered nurse practitioner licensed under chapter 464 had determined that the claimant had an
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`emergency medical condition as statutorily required to authorize additional reimbursem*nt.
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`Plaintiff is therefore not entitled to reimbursem*nt above $2500.00. PROGRESSIVE hasalready
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`paid out $2500 in medical benefits, so Plaintiff is not entitled to further benefits.
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`10.
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`To date,the Plaintiffhas failed to provide a determinationthat the claimant suffered
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`from an “emergency medical condition,” and/or has failed to respond to requests for this
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`information.
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`11.
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`The insured/claimantreceived a full $2,500.00 in benefits under the subject policy
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`and no PIP benefits are due and owingto Plaintiff in this action. PROGRESSIVEhassatisfied
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`its contractual obligations to its insured Anabel Herrera in accordance with the subject insurance
`
`policy and Florida No Fault Law.
`
`175321707
`
`

`

`FURTHER AFFIANT SAYETH NAUGHT.
`
`Name: SAMIR D SONI
`Litigation Specialist/Claims Adjuster
`
`STATE OF FLORIDA
`
`}
`
`—\*
`couror filblowgl
`,
`The foregoing instrument was acknowledged before methis / q day of NEC
`20 [7 (or has_producedby SAMIR D SONI who is personally kn to me
`
`
`
`as identification) anddid/did not take an oath.
`
`
`
`
`
`NOTARY PUBLIC STATE OF FLORIDA
`
`
`
`Commission Expires/Serial No./Seal
`
`
`
`175321707
`
`

`

`EXHIBIT “A”
`
`

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`CONSOLIDATED INS NAT
`3701 SW 87TH AVE
`MIAMI, FL 33155
`
`LUIS P HERRERA
`1108 NW AVE D APT 4
`BELLE GLADE, FL 33430
`
`Auto Insurance
`Coverage Summary
`This is your Renewal
`Declarations Page
`
`PROGRESSIVE
`
`Policy Number: M0146
`Underwritten by:
`Progressive American Insurance Co
`November 25, 2016
`Policy Period: Dec 27, 2016 - Jun 27, 2017
`Page 1 of 3
`
`1-305-412-2205
`CONSOLIDATED INS NAT
`
`Contact your agentfor personalized service.
`
`progressiveagent.com
`Online Service
`
`Make payments, checkbilling activity, update
`policy information or check status of a claim.
`
`1-800-274-4499
`
`To report a claim.
`
`The coverages, limits and policy period shown apply only if you payforthis policy to renew.
`
`Your coverage begins on December 27, 2016 at 12:01 a.m. This policy expires on June 27, 2017 at 12:01 a.m.
`
`Your insurance policy and any policy endorsem*nts contain a full explanation of your coverage. Thepolicy limits shown for a vehicle
`may not be combined with thelimits for the same coverage on anothervehicle, unless the policy contract or endorsem*nts indicate
`otherwise. The policy contract is form 9611A FL (07/13). The contract is modified by form A139 FL (06/14).
`
`Drivers and resident relatives
`
`Additional information
`
`Anabel A Herrera
`
`Outline of coverage
`2004 LEXUS RX 330 4 DOOR WAGON
`VIN: JTJHA31UX40004014
`
`Garaging ZIP Code: 33430
`Primary use of the vehicle: Commute
`
`Limits
`
`Deductible
`
`Premium
`
`Liability To Others
`Bodily Injury Liability
`Property DamageLiability
`Personal Injury Protection
`Deductible applies to You and DependentRelatives
`
`$10,000 each person/$20,000 each accident
`$10,000 each accident
`
`
`
`Total premium for 2004 LEXUS
`
`Form 6489 FL (03/15)
`
`Continued
`
`

`

`2015 CHEVROLET SILVERADO C1500K1500 CREW PICKUP
`VIN: 3GCPCREC9FG286965
`
`Policy Number: Mo 46
`Luis P Herrera
`
`Page2 of 3
`
`Garaging ZIP Code: 33430
`Primary use of the vehicle: Commute
`
`Limits
`Deductible
`Premium
`ie, sepeserncectcecrceeeunesccencrnigercustintseucineacscciscunicacasenccqucinqacisaacinrmanctiacencatian
`Bodily injury Liability
`$10,000 each person/$20,000 each accident
`Property DamageLiability
`$10,000 each accident
`SeisonaljuryBroteciona Cp rT
`Deductible applies to You and Dependent Relatives
`teeaa aseeenrncrcrn cineca<i0,600each 5=rsoni§36,000 each acddent
`Commprchansiyerereare terrence
`Coie ec ceceecencececcnctnccrccacrceacatiaiceacrccactceicrninianiicrcen cin gapactiant
`Forni Rainbarcacee1p10$30 each daylinanimum30dagne
`
`
`
`Total 6 month policy premium
`
`Premium discounts
`
`Policy
`44300146SSFive-YearAccidentFree, HomeOwner, Multi-Car, ContinuousInsurance:
`Platinum, Paperless and Three-Year Safe Driving
`
`Vehicle
`2004LEXUSsti‘; Brakes, Driver andPassenger-sideAirbagandPassiveAnti-Theft
`RX 330
`Device
`
`2015 CHEVROLET
`SILVERADO C1500K1500
`
`Anti-Lock Brakes, Driver and Passenger-side Airbag and Passive Anti-Theft
`Device
`
`Lienholder information
`
`Vehicle
`
`2004 LEXUS RX 330
`
`JTJHA31UX40004014
`
`Lienholder
`
`CAPITAL ONE AUTO FIN
`
`MINNEAPOLIS, MN 55439
`
`2015 CHEVROLET SILVERADO C1500K1500
`
`CHASE AUTO FINANCE
`
`3GCPCRECSFG286965
`
`FT WORTH, TX 76101
`
`Policyholder inquiries
`You may call your agent at 1-305-412-2205 to present inquiries or obtain information about coverage, and to obtain
`assistance with any complaints.
`
`Agent signature
`
`VOweee
`
`Form 6489 FL (03/15)
`
`Continued
`
`

`

`Companyofficers
`
`Secretary
`
`Policy Number: Mo 46
`Luis P Herrera
`
`Page3 of 3
`
`Form 6489 FL (03/15)
`
`

`

`9611A FL 0713
`
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`
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`FLORIDA
`AUTO POLICY
`
`Form 961 1A FL (Q7/13}
`version 1.0
`
`RSI
`eBBoSa8
`Pease ese
`CoesSeteyeee
`LOPES
`wagersert
`‘ways SF a
`
`ywoyayy
`
`PROGRESSIVE
`
`DAIVE ‘Insurance
`
`

`

`CONTENTS
`
`INSURING AGREEMENT. ....0.. cere cee ee eter eee tee eee etteee tena eaaaaaaaaaeneres 1
`
`GENERALDEFINITIONS ........0.... oe. eeceeeseeee cece cette eee eee eee ett eee tana eaaaaaaaaaenerees 1
`
`PART| - LIABILITY TO OTHERS
`Insuring Agreement - Bodily Injury «2.00.0.ee tee e teeter ee eeel 2
`Insuring Agreement- Property Damage..........crannies 2
`Additional Definition .0.... 0. eens t etree etree aetna render eres aaa ne nner aaneneeneeea 3
`Additional Payment.......0... cece tere ee errr eee e nnn enerteertaseteneaeanieed 3
`EXCIUSIONS 0000... etter eee een eee ener ee edge ete n deans eeneeanneeeeneees 4
`Limits of Liability... eee eee e ee eer ee ante r reed ae tne eeenne ten eeenaaeteeeeanaees 5
`Financial Responsibility LAWS 0.00.0... ccccccseeceseeceneeceneeeereaneneanaeeenaeeteneneenees 6
`Other INSUPANCE 020... eee cece cece cece eee ee cee eect eee aa eeteeceaeeeeeeseaaeeetesseeseees 6
`Out-of-State Coverage ....ce arene ieee teeereneeaniael 7
`
`PART IKA) - PERSONAL INJURY PROTECTION COVERAGE
`Insuring AQrEGMeNt...... ee eee ents cert e ete cette entree cena nee eee date teeta ana neeteeed 7
`Additional Definitions... cence cet e eet nete tree canteen ana eeeeee ana neneeraaneeeeneeea 7
`EXCIUSIONS 000... ccc ccc cece cece cnet ence eee nee eee eee ee cee eee dee eee ceeeeseteeeageesaneeeaeaacenseceeneceenees 9
`Extended Personal Injury Protection Coverage 0000.00.00... cece eeneeeeteeeees 10
`Limit of Liability 0000 eee etree rere ere cree nen ereeer nesses cesaeeaaaeeaeaeesaee 10
`Other INSUPANCE ........ececeeeceeeeeeee cence cece cee eect te tee teteeeeee cee ceaaae daa nenenteseeteseeee 11
`CONGITIONS 20... c cece cece cence eee eet eee ene cette cece nese needa eee cneeceeedeeeeeesaeanaeeianedseteseeees 11
`
`PART IK(B) - MEDICAL PAYMENTS COVERAGE
`Insuring AQreeMeNnt0...ee tee ee nee tenet naan eee nne tees anaeeaeeeenees 14
`Additional Definitions.....0... 00. cecee cee eee ee ence teats eestor eeaeeesaeeeeaeaaeseneeeenaees 15
`EXCIUSIONS 000... cece cee c eee etree ener eens date n red ee dada e rede anette teneeaeneeenaaes 15
`Limits of Liability... ieee terete ee eee aad e eect treet eeeeeeeaeaeanaaaaaaneeeees 17
`Unreasonable or Unnecessary Medical Expenses......00.. cee eeeeeeee eee 18
`Other INSUPANCE 0.2... ce eee cet e eee ee cee ee ence ted tee eeeeee cee ceaaaedaaneneeteeeeeeseeee 18
`
`PARTIH - UNINSURED MOTORIST COVERAGE
`Insuring AGreeMeNt......eed deren einen inueeeweseeae 18
`Additional DefinitionS......... 0.0... cccccccccccecec cece esneeeseeeceeeenseesaseeeesseseesnseesnaeeanees 19
`EXCIUSIONS 0.0... .cccccccccceseeecs cece ee ceeece este seueesseeese sean eee eeesseseeeeseusaseeueessnenaeneeunnes 20
`Limits Of Liability... cece nce een eeeer sede e ee eeeeaa eee san esse ne eee eeeneeaneenneneten serene 21
`Other INSUFANGE 00... esc cecee cee eee cen eeeuneeeeceeteenusseeuseeeseseetueeetueuensenaeseeaetenaes 22
`Trust AQrEOMe nt...0c cece ete eter eer eee etree arene ee ened neea ste ananeetee 23
`
`

`

`PARTIV - DAMAGE TO A VEHICLE
`Insuring Agreement - Collision Coverage ....... 0. ceeeceeeee eee ere eer eeeeeeneeeeee 23
`Insuring Agreement - Comprehensive Coverage 0... ceecscesceeteeesteeeees 23
`Insuring Agreement- Pet Injury Coverage ......... eee eeeceeenereeeetseeeetereateeees 24
`Insuring Agreement- Full Comprehensive Window Glass Coverage........ 25
`Insuring Agreement - Additional Custom Parts or Equipment Coverage...... 25
`Insuring Agreement- Rental Reimbursem*nt Coverage.............ccc:seseeceees 25
`Insuring Agreement - Loan/Lease Payoff Coverage ............... eee 26
`Additional Definitions... eee eee ree ice een nee ena eee naeteeaeaaesaaneeesnee 26
`EXCIUSIONS 000... ete eee eee eee ee etre centre te edad eee n deans eeneeanneeeenee 27
`Limits of Liability...rir eer nreraeieieneneeee 28
`Payment of LOSS... cece eee re ee eer ere a deer et edna tebe eenae den teenanenneetanee 30
`No Benefit to Bailee oo... ected etter eee nn ete te ee ane den teenaneteeeeanae 30
`LOSS Payable ClauUSC..........cccccccccccsseseseeceeeeeeeessseeeseeesuseseseesueeseeseenanaseneeanse 30
`Other Sources Of RECOVESY 000... cc ce eee eee errr ere eer tienen nereereeeereeeea 30
`ADPraiSal0...Ere err e en E Cn nr enn e rete eteeneteeeaenenae 30
`
`PART V - ROADSIDE ASSISTANCE COVERAGE
`Insuring AQrEGMeNt...... eee etter eee e ee ee nee ee a rete tenet tet eananeetes 31
`Additional Definitions... ence cere eect te eter cant ee ener tees ana tenes saaneeeetee 31
`EXCIUSIONS .00... ccc ccc cece eee cne eee eee ee eee eee cence teen nec a ne tee cesses eeeeaeeecaereeaeaeeenaeeeeneneen 31
`Unauthorized Service Provider... 2.00. ...cccccc ccc ceecee cece ee eeeeeeeeeneeeeesesaaeeeeeeeanes 32
`Other INSUPANCE 00... cece teeter e eee rere eter e tase eda nedee naan tetenaedaes 32
`
`PARTVI - DUTIES IN CASE OF AN ACCIDENTOR LOSS.........00 eee 32
`
`PARTVil - GENERAL PROVISIONS
`Policy Period and Territory......0.00000.0 cece tec eater eee e ne tnneeeneeaeneeennes 33
`CNANGES.... eee cee cere cece eee renee tree rere eter ee nnn tree eres eeeeeee cea gaennnteneereeenteeete 33
`Duty to Report Changes .00.. i cc cc ee etre crete eee tettneetteaaaaeaseaeemeraeeteeeees 34
`Settlement of Claims ............. ccc eee c eee ee cee tee tee ee tere tee setae anne daa neneeteeeeerenee 34
`Terms of Policy Conformed to Statutes 2.2.0.0... ceceeeeee eee eee cae eeeteneeneneeees 35
`Transfer of Interest ...0. eee eee eee eee e eee ee reenter e eet ne state aaa neetee 35
`Fraud or Misrepresentation .......... cece eee eeecennee erent ene cee eee aneeeeeeeeeeeeeenae 35
`Payment of Premium and Fees.....0.000..0 cee teeter ee eee tee ete en rane 36
`Cancellation 2... cece eee cte eee cee eee eee eee eee tee serena ete tee cede nedesgeaaaneeseaeaaes 36
`Cancellation RefUN«0.0... cece eee c eee e cae tenet tee eete renee see eeu nae ninneneeteneereeeee 37
`Rate INCrEASES 0... ieee eee etter ceeds ee eee ee tne ee ree tert state aaa neeees 38
`Noncancelable Policy .........c. cece cece cence cree ee enter ee eneeeetees saad teenaeeteneranae 38
`Nonrenewall 0.0.0... eect eee caer eet ee ae retro ae ener ean eee et eae deer eenne een tet anata neeanee 38
`Automatic Termination ...... 00... cece eeneeee tees e ne een eee aa eee seen eet eee anne tneesanaenetee 39
`Legal Action Against US...ee eee teeter nena a ete tee ne teeeeana 39
`Our Rights to Recover PayMent......... cece eres e errr eens a ea eeeteneereeeneteete 39
`Joint and Individual Interests .......0.0c eee e eee reece etree eee ana teens teanaeeeeee 40
`Bankruptcy ..00.0er re reeeereeent eae neennaeeenneeees 40
`Mediation . 0.0... cece eee e ee eter ee ener t en errr ee ttre dee a tnd e tended teenaeenneeranae 41
`
`

`

`FLORIDA AUTO POLICY
`
`INSURING AGREEMENT
`
`In return for your payment of the premium, we agree to insure you subjectto all
`the terms, conditions, and limitations of this policy. We will insure you for the cov-
`erages and the limits of liability shown on this policy’s declarations page. Your
`policy consists of the policy contract, your insurance application, the declarations
`page, and all endorsem*ntsto this policy.
`
`GENERAL DEFINITIONS
`
`The following definitions apply throughout the policy. Defined terms are printed in bold-
`face type and have the same meaning whetherin the singular, plural, or any other form.
`1.
`“Additional auto” means an auto you becomethe actual or beneficial owner
`of during the policy period that does not permanently replace an auto shown
`on the declarations page if:
`a. we insure all other autos you own;
`b.
`the additional auto is not covered by any other insurance policy;
`c.
`younotify us within 30 days of becoming the ownerof the additional auto; and
`d. you pay any additional premium due.
`An additional auto will have the broadest coverage weprovide for any auto
`shown on the declarations page. If you ask us to insure an additional auto
`more than 30 days after you become the actual or beneficial owner, any
`coverage we provide will begin at the time you request coverage.
`“Auto” means a land motor vehicle:
`a.
`of the private passenger, pickup body, or cargo van type;
`b. designed for operation principally upon public roads;
`c. with at least four wheels; and
`d. with a gross vehicle weight rating of 12,000 pounds or less, according to
`the manufacturer’s specifications.
`However, “auto” does notinclude step-vans, parcel delivery vans, or cargo cut-
`away vans or other vans with cabs separate from the cargo area.
`“Auto business” meansthe businessofselling, leasing, repairing, parking,
`storing, servicing, delivering, or testing vehicles.
`“Bodily injury” means bodily harm, sickness, or disease, including death that
`results from bodily harm, sickness, or disease.
`“Covered auto” means:
`a.
`any auto or trailer shown on the declarations pagefor the coverages
`applicable to that auto or trailer;
`any additional auto;
`b.
`any replacementauto; or
`c.
`a trailer owned by you.
`d.
`“Declarations page” means the document showing your coverages,limits of
`liability, covered autos, premium, and other policy-related information. The
`declarations page may also be referred to as the Auto insurance Coverage
`Summary.
`
`

`

`7
`8.
`
`9.
`
`“Occupying” meansin, on, entering, or exiting.
`“Property damage’ meansphysical damageto, destruction of, or loss of use
`of, tangible property.
`“Rated resident’ means a person residing in the same household as you at the
`time of the loss whois not a relative, but only if that person is both:
`a.
`listed in the “Drivers and household residents” section on the declarations
`page; and
`not designated as either an “Excluded”or “List Only”driver.
`b.
`10. “Relative” means a person residing in the same household as you, and
`related to you by blood, marriage, or adoption, and includes a ward, step-
`child, or foster child. Your unmarried dependent children temporarily away
`from home will qualify as a relative if they intend to continue to reside in
`your household.
`11. “Replacement auto” means an auto that permanently replaces an auto
`shown on the declarations page. A replacement auto will have the same
`coverage as the auto it replaces if the replacement auto is not covered by
`any other insurance policy. However, if the auto being replaced had coverage
`under Part IV - Damage To A Vehicle, such coverage will apply to the replace-
`ment auto only during the first 30 days after you become the actual or ben-
`eficial owner unless you notify us within that 30-day period that you want us
`to extend coverage beyond theinitial 30 days. If the auto being replaced did
`not have coverage under Part IV - Damage To A Vehicle, such coverage may
`be added, but the replacementauto will have no coverage under Part [V until
`you notify us of the replacement auto and askus to add the coverage.
`12. “Trailer” means a non-motorized trailer, including a farm wagonor farm imple-
`meni, designed to be towed on public roads by an auto and not being used:
`a.
`for commercial purposes;
`b.
`as an office, store, or for display purposes; or
`c.
`as a passenger conveyance.
`13. “We?“us? and “our” mean the underwriting company providing the insurance, as
`shown on the declarations page.
`14. “You” and “your” mean:
`a. aperson shown as a namedinsured on the declarations page; and
`b.
`the spouse of a named insuredif residing in the same household at the
`time of the loss.
`
`
`PART |- LIABILITY TO OTHERS
`
`INSURING AGREEMENT- BODILY INJURY
`
`If you pay the premium for this coverage, we will pay damagesfor bodily injury
`for which an insured person becomeslegally responsible because of an accident.
`
`INSURING AGREEMENT - PROPERTY DAMAGE
`
`If you pay the premium for this coverage, we will pay damagesfor property damage
`for which an insured person becomeslegally responsible because of an accident.
`
`2
`
`

`

`Damagesfor bodily injury and property damage include prejudgmentinterest
`awarded against an insured person, where owedbylaw.
`
`lf you pay the premium for Bodily Injury Liability and Property DamageLiability, we
`will settle or defend, at our option, any claim for bodily injury or property dam-
`age covered by this Part I. Our duty to settle or defend ends after we have paid the
`applicable limit of liability for the accident that is the basis of the lawsuit.
`
`If you pay the premium for Property Damage Liability only, we will settle or defend,
`at our option, any claim for property damagecovered bythis Part |. Our duty to
`settle or defend ends after we have paid the applicable limit ofliability for the ac-
`cident that is the basis of the lawsuit.
`
`Satisfaction by an insured person of a judgment for bodily injury or property
`damageshall not be a condition precedentto the right or duty of us to make pay-
`mentfor such bodily injury or property damage.
`
`ADDITIONAL DEFINITION
`
`When usedin this Part |:
`“Insured person” means:
`a.
`you, a relative, or a rated resident with respect to an accidentarising out of the
`ownership, maintenance, or use of an autoortrailer;
`any person with respect to an accidentarising out of that person's use of a covered
`auto with the permission of you, a relative, or a rated resident;
`any person or organization with respectonly to vicarious liability for the acts
`or omissions of a person described in a or b above; and
`any Additional Interest shown on the declarations page with respect only to
`its liability for the acts or omissions of a person described in a or b above.
`
`b.
`
`c.
`
`d.
`
`ADDITIONAL PAYMENTS
`
`2.
`
`In addition to our limit of liability, we will pay for an insured person:
`1.
`all expenses weincur in the settlement of any claim or in the defense of an
`insured personin any lawsuit. This does not include attorney fees awarded
`or assessed against an insured person;
`interest accruing after entry of judgment, until we have paid, offered to pay, or
`deposited in court, that portion of the judgment which does not exceed our limit
`ofliability. This does not apply if we have not been given notice of suit or the op-
`portunity to defend an insured person;
`the premium on any appeal bond or attachment bond required in any lawsuit
`we defend. We have no duty to purchase a bond in an amount exceeding our
`limit of liability, and we have no duty to apply for or furnish these bonds;
`up to $250 for a bail bond required because of an accident resulting in bodily
`injury or property damage covered under this Part |. We have no duty to
`apply for or furnish this bond; and
`reasonable expenses,including loss of earnings up to $200 per day, incurred
`at our request.
`
`3.
`
`4.
`
`5.
`
`

`

`EXCLUSIONS - READ THE FOLLOWING EXCLUSIONS CAREFULLY. IF AN
`EXCLUSION APPLIES, COVERAGE WILL NOT BE AFFORDED UNDER THIS
`PARTI.
`
`Coverage under this Part I, including our duty to defend, will not apply to any
`insured personfor:
`1.
`bodily injury or property damagearising out of the ownership, maintenance,
`or use of any vehicle or trailer while being used:
`a.
`to carry persons or property for compensation ora fee; or
`b.
`for retail or wholesale delivery, including, but notlimited to, the pickup, transport
`or delivery of magazines, newspapers, mail or food.
`This exclusion does not apply to shared-expense car pools;
`anyliability assumed under any contract or agreementby you, a relative, or a
`rated resident;
`bodily injury to an employee of that insured person arising out of or within
`the course of employment. This exclusion does not apply to domestic em-
`ployees if benefits are neither paid nor required to be provided under work-
`ers’ compensation, disability benefits, or similar laws;
`bodily injury or property damage arising out of an accident involving any
`vehicle while being maintained or used by a person while employed or en-
`gaged in any auto business. This exclusion does not apply to you, a relative,
`a rated resident, or an agent or employee of you, a relative, or a rated resi-
`dent, when using a covered auto;
`bodily injury or property damage resulting from, or sustained during prac-
`tice or preparationfor:
`a.
`any pre-arranged or organized racing, stunting, speed, or demolition con-
`test or activity; or
`any driving activity conducted on a permanentor temporary racetrack or
`racecourse;
`bodily injury or property damage due to a nuclear reaction or radiation;
`bodily injury or property damage for which insurance:
`a.
`is afforded under a nuclear energyliability insurance contract; or
`b. would be afforded under a nuclear energyliability insurance contract but
`for its termination upon exhaustion ofits limit of liability;
`any obligation for which the United States Governmentis liable under the Fed-
`eral Tort Claims Act. This exclusion will apply only to the damagesthat are in
`excess of the minimum limits of liability coverage required by the financial re-
`sponsibility law of the state of Florida;
`bodily injury or property damage causedby an intentional act of any insured
`person, or at the direction of any insured person, even if the actual injury or
`damageis different than that which was intended or expected. This exclusion
`will apply only to the damagesthatare in excess of the minimum limits ofliability
`coverage required by the financial responsibility law of the state of Florida;
`. property damageto any property owned by, rented to, being transported by,
`used by, or in the charge of that insured person. This exclusion does not ap-
`ply to a rented residence or a rented garage;
`
`b.
`
`4
`
`

`

`11.
`12.
`
`13.
`
`14.
`
`15.
`
`16.
`17.
`
`bodily injury to you or a relative;
`bodily injury or property damagearising out of the ownership, maintenance, or
`use of any vehicle owned by youorfurnished or available for your regular use,
`other than a covered auto for which this coverage has been purchased;
`bodily injury or property damagearising out of the ownership, maintenance,
`or use of any vehicle ownedbya relative or a rated resident or furnished
`or available for the regular use of a relative or a rated resident, other than
`a covered auto for which this coverage has been purchased. This exclusion
`does not apply to your maintenance or use of such vehicle;
`bodily injury or property damagearising out of your,a relative’s, or a rated
`resident’s use of a vehicle, other than a covered auto, without the permis-
`sion of the owner of the vehicle or the person in lawful possession of the ve-
`hicle;
`bodily injury or property damage arising out of the use of a covered auto while
`leased or rented to others or given in exchange for any compensation. This exclu-
`sion does not apply to the operation of a covered auto by you, a relative, or a
`rated resident;
`punitive or exemplary damages; or
`bodily injury or property damage caused by, or reasonably expected to re-
`sult from, a criminal act or omission of any insured person. This exclusion
`applies regardless of whether that insured person is actually charged with,
`or convicted of, a crime. This exciusion will apply only to the damagesthat are
`in excess of the minimum limits ofliability coverage required by the financial
`responsibility law of the state of Florida and does not apply to movingtraffic
`violations.
`
`LIMITS OF LIABILITY
`
`The limit of liability snown on the declarations pageforliability coverage is the most
`we will pay regardless of the numberof:
`claims made;
`covered autos;
`insured persons;
`lawsuits brought;
`vehicles involved in the accident; or
`premiums paid.
`
`OAMa
`
`2.
`
`If your declarations page showsa split limit:
`1.
`the amount shownfor “each person”is the most wewill pay for all damages due
`to bodily injury to one person resulting from any one accident;
`subject to the “each person’limit, the amount shownfor “each accident’ is the
`most we will pay for all damages due to bodily injury sustained by two or more
`persons in any one accident; and
`the amount shownfor “property damage’is the most wewill pay for the total of
`all property damageresulting from any one accident.
`
`

`

`The “each person’limit of liability applies to the total of all claims made for bodily
`injury to a person and all claims of others derived from such bodily injury, in-
`cluding, but not limited to, emotional injury or mental anguish resulting from the
`bodily injury of another or from witnessing the bodily injury to another, loss of
`society, loss of companionship, loss of services, loss of consortium, and wrong-
`ful death, if recoverable under the applicable law.
`
`If the declarations page showsthat “combined single limit” or“CSL’ applies, the
`amount shownis the most wewill pay for the total of all damages resulting from
`any one accident. However, without changingthis limit ofliability, we will comply
`with any law that requires us to provide any separatelimits.
`
`No one is entitled to duplicate payments for the same elements of damages.
`
`Any payment to a person under this Part | for bodily injury will be reduced by:
`any payment madeto that person for bodily injury under PartIll - Uninsured
`Motorist Coverage; and
`any amounts that are paid or payable to that person as personalinjury protec-
`tion benefits.
`
`2.
`
`If multiple auto policies issued by us are in effect for you, we will pay no more than
`the highestlimit of liability for this coverage available under any one policy.
`
`An auto and attached trailer are considered one auto. Therefore, the limits ofliability
`will not be increased for an accident involving an auto that has an attachedtrailer.
`
`FINANCIAL RESPONSIBILITY LAWS
`
`When wecertify this policy as proof of financial responsibility, this policy will com-
`ply with the law to the extent required. The insured person must reimburseusif
`we make a payment that we would not have madeif this policy was notcertified as
`proof of financial responsibility.
`
`OTHER INSURANCE
`
`If there is any other applicable liability insurance or bond, we will pay only our
`share of the damages. Our share is the proportion that our limit of liability bears
`to the total of all applicable limits. Any insurance we provide for a vehicle or
`trailer, other than a covered auto, will be excess over any other collectible insur-
`ance, self-insurance, or bond.
`
`However, when you, a relative, or a rated resident rent or lease an auto, the li-
`ability coverage provided by the lessor’s policy shall be primary unless the rental
`or lease agreementincludes a provision in the form specified in Florida Statute
`§627.7263, as amended, stating that the lessee or rentee’s liability insurance and
`personal injury protection insurance shall be primary.If the rental or lease agree-
`
`6
`
`

`

`ment includes such a provision, our duty to pay damages under this Part |, and
`our duty to defend you, a relative, or a rated resident under this Part |, shall be
`primary to anyliability coverage provided by the lessor or ownerfor operation of
`that auto by you, a relative, or a rated resident. We have no duty to defend the
`lessor or owner of that auto under this Part I.
`
`OUT-OF-STATE COVERAGE
`
`If an accident to which this Part | applies occurs in anystate, territory, or pos-
`session of the United States of America or any province or territory of Canada,
`other than the one in which a covered autois principally garaged, and thestate,
`province, territory, or possession has:
`1.
`a financial responsibility or similar law requiring limits ofliability for bodily injury
`or property damagehigher than the limits shown on the declarations page,
`this policy will provide the higherlimit