MCA 010–MSO COMMERCIAL AUTO
FORM ANALYSIS
This article analyzes
the 11 14 edition of The Mutual Service Office, Inc. (MSO)
Commercial Auto Form.
The coverage form
begins with a statement indicating that the policy includes the declarations,
which must be attached to this form along with any other applicable
endorsements. It then provides a table of contents to help locate the coverage
provided.
The final section of
the introduction explains the definitions of words. If a word is italicized,
its definition can be found in one of the sections:
It also explains that
the word “provisions” is a comprehensive term referring to the entire text of
the insurance contract. It includes agreements, conditions, exclusions, limits,
limitations, and all other terms within the contract.
When a word or phrase is
not specifically defined, it is to be defined by conventional methods while
holding the word in context.
Numerical symbols are
used to describe which autos are covered and what coverages apply. These
symbols are defined in the Symbol Description.
The Business Auto
Declarations should include symbol(s) next to each covered business auto. A
symbol displayed indicates that coverage applies. The symbol clarifies which
types of vehicles are covered.
This symbol provides
the broadest coverage, with no limitations or restrictions. If a vehicle
qualifies as an auto under this coverage form, it is covered, although certain
exclusions and conditions apply. Due to its broad scope of coverage, many
insurers use it cautiously. For example, a company might permit its use for
liability but not for physical damage. When Symbol 1 is used, no other symbols
should be included in the same box.
NOTE: See Common Glossary
Parts II and III for the definition of auto.
|
Example: Mary was unsure which symbol to enter
on the application. To be safe, she entered 1, 2, 3, 4, 5, 6, 7, 8, and 9,
thinking any auto would then be covered. Instead of helping, it caused
confusion. If she had entered only the symbol 1, she could have achieved the
goal without any confusion. |
This symbol means any
auto owned by the named insured is covered, including those acquired after the policy
inception date. Additionally, when this symbol is used with liability coverage,
any owned or non-owned trailer being pulled by an owned vehicle is also
covered.
NOTE: See Common Glossary Parts II and III for
the definition of trailer.
Related Court Case: Only "Owned" Autos of the Insured Covered Under
Business Auto Policy
This symbol means all
private passenger cars owned by the named insured are covered. This includes
any private passenger vehicle acquired after the policy inception date.
NOTE: The term 'private passenger type' is not
defined. Pickup trucks and vans that might be considered private passenger on a
personal lines policy are treated as commercial autos on this policy.
Additionally, there is no coverage for nonowned trailers attached to the
private passenger auto.
This symbol means all
autos not classified as private passenger types are covered if owned by the
named insured. Vehicles acquired after the policy inception date are also
covered. Similar to Symbol 2 above, the liability
coverage extends to nonowned
trailers pulled by this type of owned vehicle.
This symbol means any
auto owned, licensed, or garaged in a state where no-fault coverage is
mandatory is covered for no-fault coverage, but only if that specific auto is
required to have such coverage. Coverage also includes autos acquired after the
policy inception date.
This symbol means any
auto owned and garaged or licensed in a state requiring uninsured motorists coverage is covered. It also includes autos
acquired after the policy inception date.
NOTE: This symbol does not
apply to vehicles licensed or operated in states where the named insured can
formally decline Uninsured Motorists coverage.
Only autos specifically
scheduled and for which a premium charge is made are covered. Similar to Symbol 2 above, the liability coverage provided
is extended to any non-owned trailer pulled by this type of owned vehicle.
NOTE: Please refer to
2.B.–Owned Autos Acquired During the Policy Term below for autos acquired
during the policy period.
This symbol means any
autos the named insured leases, hires, rents, or borrows are covered.
However, this symbol has a significant
limitation. It does not include leased, hired, rented, or borrowed vehicles
owned by an employee, partner, LLC member, or members of any of the preceding
groups’ households.
|
Example: Judy, an employee at When You Call, needed to
respond to a call but her company car was in the garage for repairs. She
chose to use her son’s car since it was a short trip. Unfortunately, Judy ran
a stop sign and collided with another vehicle. The When You Call policy does
not cover this incident due to the family limitation under symbol 8. |
This symbol means autos the named
insured uses in its business but does not own, lease, hire, rent, or borrow are
covered. These vehicles may be owned by an employee, partner, LLC member, or
members of any of the preceding groups’ households. However, coverage applies
only when they are used for the named insured’s business operations or personal
activities.
|
Example: In the
example above, When You Call’s insurance company will respond if Symbol 9 is indicated on the policy because
Judy was using her son’s auto for a business call. |
A. If the following symbols
are indicated on the Declarations:
·
1–Any
Auto
·
2–Owned
Autos Only
·
3–Owned
Private Passenger Autos Only
·
4–Owned
Autos Other Than Private Passenger Autos Only
·
5–Owned
Autos Subject to No-Fault
·
6–Owned
Autos Subject to a Compulsory Uninsured Motorists Law
Then, newly acquired autos of the symbol
type indicated are also covered during the policy period. No notification
requirements apply.
B. When symbol
7–Specifically Described Autos is indicated on the Declarations, any new autos
acquired during the policy period are covered if one of the following
conditions is met:
·
All
autos owned by the named insured are already covered.
·
The
newly purchased vehicle is a replacement for an auto currently scheduled.
·
The
insured must notify the insurance company within 30 days of purchasing a new
vehicle for coverage to apply.
|
Example:
Green’s
commercial auto policy has a symbol 1 for liability coverage and a symbol 7
for physical damage coverage. Seven vehicles are scheduled for physical
damage. When Green buys a new auto and an accident happens, he reports it to
the insurance company for coverage. Scenario 1: The new auto replaced one of the seven scheduled
vehicles. The accident occurred the day after the purchase. Coverage applies for
liability and physical damage. Scenario 2: The new auto did not replace a scheduled auto.
However, all autos owned by Green are scheduled. The accident occurred 35
days after the acquisition. Coverage applies for liability and would have
covered physical damage if he had reported the new purchase. However, since
he did not report the acquisition, physical damage coverage does not apply. |
When liability coverage
for covered autos is chosen, several additional vehicle categories are included
as covered vehicles, but only for liability.
A. If the named insured's
covered, owned auto is temporarily out of service for repair, service,
breakdown, loss, or destruction, a nonowned,
temporary substitute auto is covered, provided the insured uses it with the
owner's permission.
|
Example:
Jason, a piano tuner, uses his van to
visit clients. When his van is at the dealership for service, a client
contacts him with an emergency tuning request at the opera house. Scenario 1: Jason notices his friend’s truck is available, so
he gets in and drives off. When Jason has an accident, there's no coverage
because he didn't get permission to take the
vehicle. Scenario 2: Jason asks Louie to take him to the job, but Louie
simply hands him his keys. When Jason has an accident, liability coverage
applies because Jason’s auto was in for maintenance, and Louie gave him
permission to use it. |
B. Mobile Equipment is
covered while being carried or pulled by a covered auto.
|
Example: Herman is driving a covered tractor-trailer
carrying an asphalt plant. The asphalt plant was not secured properly and
began to sway, eventually toppling over. The liability-related damage caused
by that asphalt plant is covered. |
C. Trailers with a load capacity of 2,000 pounds or less, designed for travel
on public roads, are covered, but only when being pulled by a covered vehicle
auto.
NOTE: A semi-trailer is not
covered.
|
Example:
Precious is headed to a convention for
Bears, Inc., pulling a small trailer that holds the company’s booth and
stuffed bears. Liability symbols are 3, 8, and 9. During a lane change, Precious switches lanes too abruptly, causing the trailer
to collide with the front of a car. Scenario 1: Precious is using her personal pickup truck to tow
the trailer because her company vehicle is too small. The loss is covered by
Bears, Inc.’s commercial auto policy because the towing vehicle is a nonowned
vehicle (9), which qualifies as a covered auto. Scenario 2: Precious is using her personal pickup truck to tow
the trailer because she needs the company’s convention booth to help her son
with his science fair project. The loss isn't covered by Bears, Inc.’s
commercial auto policy because the towing vehicle wasn't being used for
company business at the time, so it doesn't qualify under symbol 9. |
This section of the
policy covers liability only for the autos listed in the Declarations and for
the auto symbol shown. It does not require providing any insurance or services
or paying any expenses beyond what is explicitly covered and insured
in the policy.
A.
The coverage is only for the benefit of insureds. Payment
will be made only up to the limit of liability listed on the Declarations and
explained in Part II D – Special Liability Conditions. The insured must be
found legally responsible for damages caused by an
accident resulting in bodily injury or property damage. The bodily injury or
property damage must also be covered by the policy.
The accident must
result from a covered auto that is maintained, owned, or used by the insured.
Only accidents that occur during the policy period and within the coverage
territory as defined in the Common Conditions are covered.
Related Court Cases:
Road Rage
Triggers Coverage Dispute
What Is A Permissive Use Of A Commercial Vehicle?
B.
When damages are not covered by the policy, the insurance
company has no obligation to pay. Additionally, if damages exceed the limits of
liability specified in Part II D – Special Liability Condition, the insurance
company is not required to pay the excess, even if those damages are covered.
Related Court Case: Legal
Expenses Disputed In Multi-Million Dollar Auto Case
C. Who Is an Insured –
Coverage A
For coverage A, the
term 'insured' means the following:
1. The named insured is an
insured for any covered auto.
2. Anyone authorized to
use a covered auto owned, hired, or borrowed by the named insured is considered
an insured, except for the following exceptions:
Related Court Case: What Is A
Permissive Use Of A
Commercial Vehicle?
a. An owner, or anyone
from whom the named insured borrows or hires a covered auto, as well as their
agents or employees, is not an insured.
Trailers are not
subject to this exception if both of the following apply:
·
Trailer
is attached to a covered auto
·
Covered
auto is owned by the named insured
b. An employee of the
named insured is not considered an insured for a covered auto owned by that
employee or a household member.
Related Court Case: Employee
Injured While Driving To Work Seeks Coverage under
Employer's Policies
c. If the named insured is
a partnership, then a partner of that partnership or a household member is not
regarded as an insured for a covered auto owned by that partner or household
member.
d. If the named insured is
a limited liability company, then a member of that LLC or someone in their
household is not regarded as an insured for a covered auto owned by that person
or a household member.
e. Anyone moving property
to or from a covered auto is not considered an insured during the move.
However, this exception does not apply to the following individuals or
situations, which remain insured:
·
The
named insured’s partners
·
The
named insured’s employees
·
Anyone
from whom the covered auto is being leased or borrowed
·
Employees
of anyone from whom the covered auto is being leased or borrowed
|
Example: Patricia is a carpenter who owns a business-use
pickup truck. She allows her parents to use it for moving household items to
their new home. During the unloading of a chest of drawers, the furniture
starts to tilt and falls, causing serious injuries to their new neighbors’
dog, which was watching. This accident is not covered by Patricia’s
commercial auto insurance because her parents are not insureds. NOTE: If Patricia’s parents were her partners, they
would have remained insureds. |
f.
Anyone using a covered auto for business activities such as
parking, repairing, selling, servicing, or storing vehicles is not considered
an insured. However, this exception does not apply if the business is the named
insured’s.
3. Anyone held liable for
an insured's conduct as described in items 1. and 2. above is also regarded as
an insured, but only to the extent that they are legally responsible for that
insured’s actions.
Related Court Case: Insurer Not
Liable for Driver’s Unauthorized Use of Employer’s Truck
This coverage applies
only when a limit of liability for Medical Payments is listed on the
Declarations.
A. This coverage pays for
reasonable and necessary medical expenses an insured incurs due to an accident.
Payments are limited to the amount specified in the Declarations and detailed
in Part II D – Special Liability Conditions.
·
The
accident must occur during the policy period and within the coverage territory
as defined in the Common Conditions.
·
Payments
are issued only if expenses are incurred and reported to the insurance company
within three years of the accident. Reporting can be done by either the injured
party or the named insured.
·
Medical
payments are not based on liability or fault, and the insurance company does
not admit guilt when making these payments. However, any medical payment must
be for bodily injury that is not excluded or deemed uninsured under this
policy.
|
Example:
Bob Jones
sustains injuries after being hit by a vehicle. He is the named insured on
his commercial auto policy, which provides coverage B. Scenario 1: Bob was walking near his home when the accident
occurred. He is covered for his injuries. Scenario 2: Bob was walking near the pyramids in Egypt when
the accident happened. He is not covered for his injuries. Scenario 3: Bob was riding his bicycle when the accident
occurred. He is not covered because he was neither a pedestrian nor in an
automobile at the time. |
B. The only
covered medical expenses are as follows:
|
·
X-ray services |
·
ambulance |
·
funeral |
|
·
dental services |
·
surgical services |
·
drugs |
|
·
professional nursing |
·
medical services |
·
hospital services |
|
·
surgical supplies |
·
prosthetic devices |
|
C. Who Is an Insured –
Coverage B
Only insureds are
eligible to receive payments under this endorsement. There are three categories
of insureds:
1. The named insured is
considered an insured whenever they are occupying any auto. Additionally, the
named insured is also considered an insured if they are hit by an auto while
walking as a pedestrian.
NOTE: This technically
applies only to an individual named insured. Corporations, associations,
partnerships, and limited liability companies are legal entities and not persons. As a result, they cannot literally occupy a vehicle
or sustain injuries.
2. Family members of the
named insured are insureds only if the named insured is an individual. Each
family member is covered while occupying any auto or while struck by an auto as
a pedestrian.
3.
Any individual not specified in items 1. or 2. above, who
is occupying a covered auto. If a covered auto is out of service and someone
uses a temporary substitute, that person is also an insured. A substitute
vehicle situation occurs when the covered auto has sustained a loss, broken
down, is under repair or service, or has been destroyed.
|
Example: Continuing our example above, Bob Jones is the
named insured on the policy. Scenario 1: Bob’s daughter Carol, who lives at home and
attends college, was walking to class when she was struck by a car. She is
covered. Scenario 2: Carol is driving a car covered under a commercial
auto policy, and she is accompanied by five of her friends. All of them are
covered for injuries when an accident occurs. Scenario 3: John, Bob’s employee, is injured while driving his
personal vehicle. Coverage only applies if John was using that vehicle as a
substitute for a covered auto under Bob’s policy. |
The Commercial Auto
Coverage includes four supplementary coverages. These do not alter or expand
any policy terms, such as the Limits of Liability or applicable Exclusions,
unless explicitly specified.
A. The insurance company
will defend any civil proceeding brought against an insured, but only if the
damages are covered by the insurance provided by this policy. The insurance
company will have sole responsibility for choosing counsel.
To ensure this is
understood, the policy states that the insurance company has no duty to defend
or even to investigate a claim if either or both of the following apply:
·
The
suits or claims are not covered by the policy, or the allegations in a suit are
not covered by the policy.
·
The
applicable limit of liability has been exhausted through payments or
settlements.
B. The investigation and
settlement of claims are entirely within the control of the insurance company.
There is no requirement that the named insured or any insured be consulted
before settlement.
|
Example: A messy car
accident happened, and Jerry is being sued by the other driver. Jerry insists
he did nothing wrong and believes the other driver was entirely at fault. He
looks forward to explaining the events in court. However, his insurance
company decides to settle the case to avoid ongoing
litigation. Jerry still
has the option to pursue his claim against the other driver, but he cannot
prevent his insurer from settling unless he takes control of the case himself
and rejects all coverage and defense from the insurer. |
C. Defense payments are
separate from the liability limit and are covered by the insurance company. The
defense expenses covered include:
1. All expenses the
insurance company incurs.
2. Interest on the entire judgment amount accrued after the judgment is
entered. Once the insurance company pays, offers to pay, or submits its share
of the judgment to the court within its limit of liability, it no longer pays
any interest.
3.
Prejudgment interest when it is awarded against the insured
for the portion of the judgment covered by the insurance company. However, if
the insurer offers to pay their limit of liability, they will not pay any
prejudgment interest for any period after that offer.
4.
All costs charged to the insured, but these costs do not
cover attorney’s fees or expenses taxed against the insured.
5. The cost of appeal
bonds or bonds needed to release attachments in lawsuits filed against the
insured is covered, but only up to the policy limits. The insurance company is
not obligated to provide these bonds.
6. If a bail bond is
required for a covered accident, up to $250 is available to cover its cost. The
bond can be for a traffic law violation, but only if it is connected to the
covered accident. The insurance company is not required to provide any of these
bonds.
7. The insurance company
covers reasonable expenses the insured incurs during any loss-related
investigation or defense. However, compensation for lost earnings is limited to
the actual loss, with a maximum of $250 per day. Expenses are paid only if the
insurance company requests the insured to assist.
When the insurance
company gives written approval, a suit includes the alternative dispute
resolution processes that the insured must or may choose to participate in.
A. When the named insured
assumes liability of others to pay damages under written or oral contracts,
liability coverage extends to include that liability, but only if all of the following conditions are met apply:
·
The
damages pertain to third parties, not to the insured's indemnitee.
·
The
assumption of liability needs to be explicitly stated rather than implied.
·
The
damages are due to bodily injury or property damage.
·
The
bodily injury or property damage is covered under this insurance.
·
The
contracts are made in connection with the named insured’s
business covered under the policy.
·
The
bodily injury or property damage occurs after the contract was executed.
B.
Insured Contracts
Coverage applies only
to the types of contracts (oral or written) outlined below.
1. Obligations mandated by ordinance or law when the contract's purpose is
to indemnify a municipality. This does not relate to actual work contracts for
the requesting municipality. Item 6. below would apply
if the contract is with the municipality.
2. Easements, but does not
include those involving construction or demolition on or within 50 feet of a
railroad. Additionally, the assumption of tort liability for such cases is also
excluded under Paragraph 6.
3. Leases of premises
4. Sidetrack agreements
5.
The section of a contract relating to leasing or renting an
automobile to the named insured or their employees. However, it does not
include the responsibility to pay for property damage to leased or rented
automobiles.
|
Example: Pamela rents a car for a company convention and
signs a rental agreement. After making a wrong turn, she hits a bridge. The
bridge damage is covered by her company’s commercial auto policy, but the
damage to the rental car is not, since responsibility for that damage was
specified in the rental contract. |
6. That part of other
contracts, outside of Paragraphs 1 through 5, in which the named insured
explicitly agrees to assume tort liability with another party.
NOTE: Tort liability arises when
liability is imposed by law due to the absence of a contract.
C.
Contracts Not Insured
This Supplement does
not cover the following contracts, agreements, or parts of contracts.
1. A hold harmless
agreement when given to a party transporting property by auto for hire. It
applies only when the agreement is provided by the named insured and when the
named insured will use a covered auto on a specific route or territory
authorized by a public authority.
2. Any loan, lease, or
rental contract or agreement for the rental, leasing, or borrowing of an auto
with a driver. This pertains to such contracts entered into
by the named insured or its employees.
Trigger Contractual
Coverage Limitations
When MCA 501 appears as an endorsement on the Declarations, this supplement is applicable only to
written contracts submitted to the insurance company within 60 days of signing.
When MCA 502 appears as an endorsement on the Declarations, this supplement applies only to written
contracts.
NOTE: Endorsements MCA 501 and MCA 502 are called Trigger
Endorsements. Instead of attaching an extra piece of paper called MCA 501 or
MCA 502, the wording for that endorsement is built into the policy. This is
unique to MSO policy writing.
Related Article: , MSO Commercial Auto Coverage Trigger Endorsements
Coverage A – Liability
to Others automatically extends to any named insured who is an individual as
follows:
A. If a private
passenger-type auto is owned by the named insured and qualifies as a covered
auto under Coverage A, the following applies:
1. Family members operating owned vehicles are considered
insureds.
An amendment is made to the 'Who Is An
Insured' section of the policy, specifically in Item C under Part II A – Main
Liability Coverages. This extension adds family members as insureds for the
named insured's covered private passenger vehicles. Additionally, family
members are also insureds for other vehicles furnished and available for both
the named insured and family members' regular use.
|
Example: John
Smith and Maximus Furniture, Inc. are the named insureds on the policy. John
Smith owns a single private passenger vehicle in his
own name, whereas the remaining nine vehicles are owned by Maximus Furniture,
Inc. Scenario 1: John’s wife is driving John’s
owned vehicle. She is an insured. Scenario 2: John’s resident daughter is
driving a Jeep owned by Maximus Furniture. She is an insured. Scenario
3: John’s ex-wife is driving a van owned by Maximum Furniture. She
is not an insured. |
2. Any nonowned autos are considered covered when used by the
named insured or family members. However, this does not apply in the following
circumstances.
·
The auto is owned by any family member.
·
The auto is furnished to the named
insured or a household family member for regular use.
·
The auto is used by the named insured or a family member involved in parking, repairing,
selling, servicing, or storing autos. This applies only if the named insured or
family member is part of that business.
·
A non-private passenger type vehicle
used by a named insured or family member while working in “any other business
or occupation."
3. The Pollution / Environmental Damage Exclusion specified in
Part II C – Liability Not Insured does not apply to any covered auto classified
as a private passenger type vehicle.
B. The Fellow Employee
exclusion does not apply to the named insured or any family members.
Paragraph D of the Employee, Employment, and Related Injury
Exclusion is removed for bodily injuries to the named insured or any family
member’s fellow employees. With the fellow employee exclusion deleted, coverage
now extends if the named insured or a family member hits one of the named
insured's employees or an employee at any place where they work.
|
Example: Sheila speeds through a corner and accidentally hits Jared, her
coworker, as he is leaving the back of the
restaurant where they work. She has coverage for the injury under her
father’s commercial auto policy because Jared is an employee and she is a
family member. |
This section describes
two key coverage extensions for when an insured is outside the state where the
auto is licensed or garaged and within the coverage territory. These extensions
ensure the insurance aligns with any state-specific laws on financial
responsibility, no-fault, or other compulsory coverage.
The two extensions are
as follows:
A. The limit of insurance
under Coverage A – Liability to Others is automatically adjusted to comply with
the mandatory or financial responsibility limits in the jurisdiction where the
auto is used. However, this extension does not apply to laws regulating motor
carriers, passengers, or property.
|
Example: Felix’s commercial auto
liability limit is $50,000, complying with the state laws where his vehicles are licensed and garaged. One of his
employees crosses into another state and causes an accident. That state’s
minimum liability limit is $75,000. As a result, the coverage available for
the accident increases to $75,000 due to this extension. |
B. The required minimum
coverage amounts and other types of coverage, such as first-party benefits or
no-fault coverage, mandated by the jurisdiction where
the vehicle is operated.
NOTE: A statement in this
section clarifies that the insurance company will not pay multiple times for
the same loss because of these extensions. In other words, it prevents coverage
duplication and prevents damages from being collected more than once.
The insurance company will not cover any
type of costs, damages, expenses, or liability—whether directly or indirectly,
fully or partially—if they are worsened by, caused by, or result from any of
the following exclusions, even if a covered accident contributes concurrently
or sequentially, unless the policy states otherwise.
Damage to property
owned, transported, or in the care, custody, or
control of the insured is not covered unless such liability was assumed in a written
sidetrack agreement.
NOTES:
Related Articles:
AAIS Motor Truck Cargo Legal Liability Forms
ISO Motor Truck Cargo Carriers Coverage Forms
Coverage does not apply
to any bodily injury or property damage due to the insured’s work after it has
been completed or abandoned. Work includes any tasks the insured performs or is
performed for them by others, along with materials, parts, or equipment
supplied for those tasks. It also includes any warranties or claims regarding the fitness, quality, durability, or performance of items
related to the work.
The named insured's
work is considered completed at the earliest time of any one of the following:
If the insured's work
involves service, maintenance, correction, repair, or replacement but is
otherwise finished, it is considered completed.
Damages for bodily
injury or property damage resulting from liability the insured assumed in any
type of contract or agreement (oral, written, or implied) are excluded, with
two exceptions.
A. Workers Compensation and More
Coverage does not apply
to any requirements or obligations that the insured must comply with under laws
such as workers compensation, disability benefits, unemployment compensation,
or similar law.
NOTE: This exclusion prevents
double indemnification for an injury that should be covered by workers compensation or employers
liability coverage.
B. Employment Practices and Employers Liability - Employee
Bodily injury to the
insured's employee due to their employment or while performing job duties is
excluded.
C. Employment Practices and Employers Liability – Employee’s Family
Coverage excludes
bodily injury to the named insured’s employees' brother, child, parent, sister,
or spouse resulting from any injury described in Paragraph B. above.
D. Fellow Employee
Employees are regarded
as insureds under the policy. Therefore, exclusions B. and C. might be bypassed
if an injured employee sues a coworker responsible for the accident. However,
this exclusion prevents the policy from covering such lawsuits. Bodily injury
to a fellow employee of the insured that occurs as a result
of or in the course of that employee’s
employment with the named insured is excluded.
Additionally, the
policy excludes any claims or lawsuits brought by relatives of any fellow
employee seeking retribution due to an insured's actions during employment.
Relatives include, but are not limited to, brothers, sisters, children,
parents, or life partners.
Related Court Case: Bodily Injury to an Employee of an
Insured Arising Out Of or Within the Course of
Employment Exclusion Applied to Injured Employee's Claim
E. Third Party Obligations
Exclusions B., C., and
D. above apply even if there is an obligation to share or repay others for
damages from such injuries.
NOTE: These obligations should be addressed
through Employers Liability Coverage found in the Workers Compensation Coverage
Form or Stop Gap Coverage.
Related Articles:
WC 00 00 00
C–Workers Compensation and Employers Liability Insurance Policy Analysis
Stop
Gap–Employers Liability Coverage
Exclusions B, C, D, and
E apply regardless of who files the suit. They remain in effect even if an
employee sues the insured for reasons other than being an employee of the named
insured.
The only exceptions to
this absolute statement are the following:
·
Liability
assumed in a contract covered under Part II B – Supplemental Coverages – 2.
Contractual Coverage.
·
Domestic
Employees. However, this exception applies only if the domestic employee is not
eligible for workers compensation benefits.
NOTE: Some states do
not classify domestic employees as subject to workers compensation, so this
exception would apply. However, other circumstances might also render the
employee ineligible.
Any bodily injury or
property damage resulting from an insured's intentional harm is not covered.
Similarly, damage caused by an insured knowingly risking harm to property or
people is also excluded.
NOTE: This exclusion aims to
shield insurance companies from covering damages or injuries intentionally
caused by the insured. It serves the public interest by preventing insurance
from being exploited for profit, harming competitors, serving as a tool for revenge,
or causing other deliberate harm.
Related Court Case: Road Rage
Triggers Coverage Dispute
|
Example: Jason is driving the Favorite Flowers Van when he
witnesses a hit-and-run. Fury overtakes him, prompting him to chase the
fleeing vehicle. He chooses to accelerate and ram the car to force it to
stop. The damage incurred is not covered. |
If an explosive that is
made, sold, or transported by the named insured explodes, any bodily injury or
property damage resulting from that explosion is not covered.
This exclusion works in
conjunction with commercial general liability coverage forms to prevent
duplication of coverage and place the event squarely into one coverage form.
Bodily injury or
property damage due to the handling or moving of any property is excluded as
follows:
A. Before the property has
been moved into or onto the covered auto after its acceptance.
B. After the property is
transferred from the covered auto to its final destination.
C.
When the property is moved by mechanical devices not
attached to the covered auto. However, this does not include when the property
is moved by a hand truck. In other words, loading or unloading using conveyors,
mobile carts, forklifts, or other mechanical devices—except for a handcart—is
excluded but may be covered under the commercial general liability coverage
forms.
|
Example: The local school board ordered several pizzas and
other food. Jesse, the driver, delivers the food to the reception area and
waits for Rhonda, the receptionist, to accept the delivery. She confirms the
order is correct and asks if he can help her set up the food since no one
else is available. Jesse agrees, but while assisting, he trips,
sending the pizzas flying, damaging property,
and causing injuries. None of Jesse's damages are covered under the
commercial auto policy because the delivery was considered complete once he
left the food at the reception area. |
A. Bodily injury or
property damage caused by the following equipment, when operated and
permanently attached to an auto, is not covered:
|
·
Air compressors |
·
Sprayers |
·
Lighting |
|
·
Generators |
·
Pumps |
·
Welding equipment |
|
·
Building-cleaning equipment |
·
Geophysical exploration devices |
·
Well servicing equipment |
|
·
Any device used to lower or raise workers, such as a
cherry picker |
|
|
B. This item applies only
if all of the following apply:
·
If
the vehicle qualifies as mobile equipment under the mobile equipment
definition.
·
The
state requires that certain types of mobile equipment be subject to financial
responsibility or compulsory laws.
·
The
equipment is garaged in a state with such laws.
Losses from bodily
injury or property damage caused by mobile equipment while permanently attached
to a vehicle described in A. above are not covered.
NOTE: Coverage for equipment
operations is provided under the ISO CGL Coverage Form. This exclusion avoids overlap with the Commercial Auto and CGL coverage.
Related Article: CG 00 01 and
CG 00 02–Commercial General Liability Forms Analysis
Related Court Case: Business
Auto Insurer Must Reimburse CGL Insurer
The term “pollutants” is defined in Parts II
and III of the Common Glossary. Understanding what pollutants are is crucial
when reviewing this exclusion. This exclusion is divided into several parts to
clearly explain what is excluded.
A.
Coverage excludes any bodily
injury or property damage caused by pollutants, including discharge, dispersal,
seepage, migration, release, leakage, or escape. It also does not cover bodily
injury or property damage resulting from related environmental issues. This
exclusion applies whether the event actually occurs or
if the bodily injury or damage is based on a threat or allegation that such an
event has occurred.
This exclusion is applicable regardless of the
location or manner in which the event occurs.
However, there are some exceptions to this
exclusion, so the following items specify where and when coverage is excluded.
1.
No
coverage applies when the pollutants or the property that contains the
pollutants are:
a.
handled,
transported, towed, or moved into, onto, or from the covered auto.
b.
in
transit, the insured may be providing the transit, or others may provide the
transit on behalf of the insured.
c.
in or
upon the covered auto while being treated, processed, stored, or disposed of.
2.
No
coverage applies before the pollutants or property containing the pollutants is
moved from the place where the insured accepts it, with the intent to move it
into or onto the covered auto.
NOTE: This is similar to Exclusion 7. – Handling or Movement of Property
exclusion.
3.
No
coverage applies after the pollutants or the property containing the pollutants
are moved from the covered auto to the final location where the insured is
disposing of, delivering, or abandoning the pollutant or the property
containing the pollutant.
|
Example: Kenny is transporting hot tar from
one job site to another. He makes a
sudden stop to avoid hitting a bunny, and the chain holding the hot tar
breaks, causing the tar to fly into the nearby pond. The property damage to
the pond due to the introduction of the tar pollutant is not covered. |
B.
Exceptions
Paragraph A of the
exclusion does not apply to exhaust, fumes, fluids,
fuels, lubricants, or similar pollutants that are necessary for or result from
the normal electrical, hydraulic, or mechanical operation of a covered auto or
its parts, provided that both of the following apply:
1.
The pollutants must have been within an auto part designed
by the manufacturer to hold, store, receive, or dispose of the pollutants prior
to the accident.
2. The bodily injury or
property damage was not due to the operation of any of the following items permanently
attached to an auto:
|
·
Pumps |
·
Generators |
·
Sprayers |
|
·
Lighting |
·
Air compressors |
·
Welding equipment |
|
·
Building cleaning equipment |
·
Well servicing equipment |
|
|
·
Any device used to lower or raise workers, such as a
cherry picker |
·
Geophysical exploration devices |
|
Items A. 2. and A. 3.
within this exclusion do not apply when an accident occurs away from an
insured’s owned, leased, or rented premises and involves pollutants not on or
upon a covered auto. For this exception to apply, both of the following
conditions must be met:
1.
Pollutants
or any property containing them are damaged, overturned, or upset due to the
maintenance, operation, or use of a covered auto.
2.
The
release, dispersal, emission, escape, flow, leakage, migration, or seepage of
pollutants directly results from such damage, overturn, or upset as described
in item 1. above.
|
Example: Peter was backing into position at the warehouse
when his truck suddenly lurched. It hit the loading dock, causing the item he
was supposed to receive to discharge and release pollutants. Since this
incident happened before the pollutants were loaded onto Peter’s truck and
resulted from his accident, his commercial auto policy will cover the
pollution event. |
C.
Cleanup-related Expenses
Cost, expense, liability, or loss due to any
of the following is excluded:
1.
Demands,
directives, orders, or requests from any source to any insured for actions
related to pollutants, such as cleanup, containment, detoxification,
monitoring, neutralization, removal, testing, or treatment.
2.
Governmental
authorities bringing suit or claims seeking actual
damages or reimbursement for costs related to accessing or managing pollutants.
Such actions could include cleanup, containment, detoxification, monitoring,
neutralization, removal, testing, and treatment.
Section C. does not apply to pollution costs
or expenses due to accidents covered in Paragraph B. of this exclusion.
An important condition follows. The
cleanup-related expense is only covered if the same accident caused the bodily
injury or property damage.
No
coverage applies to bodily injury or property damage caused by the following
circumstances:
|
Example: When the casket was loaded into the hearse, the
latch was not securely fastened. As Patrick, the driver, turns the corner,
the latch releases, opening the door. Patrick does not realize the door has
opened, but the family behind him notices. They see the casket gradually
emerge. Fortunately, Patrick is warned and pulls over. The family then sues
the funeral home for the trauma caused when the latch failed. The Commercial Auto
policy will not cover the claim, but a funeral director’s
professional liability policy will most likely cover a loss of this type. |
This exclusion applies
only to prearranged contests and their preparation or practice. Bodily injury
or property damage related to such demolition, racing, speed contests, or stunt
activities is not covered.
This exclusion applies
only to covered autos used as either a mobile showroom or a store.
This is an auto policy,
not a general liability policy; therefore, there is no coverage for injury or
damage caused by items the insured sells, manufactures, rents, or distributes
once those items are no longer in the insured's possession.
Bodily injury or
property damage from any of the following is not covered if it occurs after the
delivery of a liquid product has been completed:
A delivery is
considered complete even if corrections are required due to a
misdelivery.
NOTE: This means that if bodily injury or property damage occurs during
delivery, coverage applies. However, once the product is delivered, there is no
coverage. Misdelivery of a product should be covered under the Commercial
General Liability coverage form.
|
Example: Klutzy Floyd delivered fuel oil to several
different customers: Scenario 1: The address was 5853 Main St, but he became
confused and delivered the product to 5853 Mainville St. Both addresses had
receptacles, but 5853 no longer had a fuel tank, and the oil filled the
basement. Because the property damage occurred
during the delivery, it is covered. Scenario 2: Floyd struggled to pour the fuel oil into what he
believed was the correct container, but it turned out to be the kitchen waste
oil receptacle. Although the oil owner didn’t notice at first, the issue became
apparent later. Since the damage occurred after the delivery, it is not covered. Scenario 3: Floyd was confused and believed he was delivering
diesel fuel, but he was actually delivering fuel
oil. The damage to tractors caused by receiving fuel oil instead of diesel is
not covered, because it happened after the delivery. |
NOTE: The previous 13 exclusions also apply to Coverage B-
Medical Payments. The following exclusions are specific only to Medical
Payments.
Coverage does not apply to any insured
who sustains bodily injury while working for a business that sells, repairs,
services, or parks autos, unless it is the insured's own business.
Medical expenses are not covered for
bodily injury sustained by the named insured or a family member while either in
a vehicle or as a pedestrian when struck by a vehicle not covered under this
policy, and meets either of the following criteria:
NOTE: These
exclusions attempt to eliminate duplicate coverage and primary versus excess
claims handling situations.
|
Example: Percy bought his own car
and is carrying only the minimum liability limits. His father, Kelly, insures
all his company vehicles under his Commercial Auto policy. Kelly pulls out of
the garage just as Percy pulls in, injuring both Kelly and Percy. Neither has
medical payments coverage under Kelly’s commercial auto policy. |
Medical
expenses are not covered for bodily injury to an insured while occupying a
vehicle not being used as an auto, but rather as premises.
NOTE: This
exclusion could raise concern. The terms “located” and “premises” are not
clearly defined, and the point at which a vehicle “locates” and becomes a
"premises" is unclear.
|
Example: Paul
is donating blood at a bloodmobile. He faints upon standing and hits his
head. Although he has medical payments coverage as an insured individual, it
does not apply because the vehicle he was injured in was being used as a premises, not as an auto. |
Medical expenses are not covered for
bodily injury to anyone using a vehicle unless that person reasonably believes
they have the right to do so.
A. Medical expenses related to medical services the named
insured, the named insured’s employees, or those contracted by the named
insured to provide are not covered. This exclusion applies even to first aid provided
at the time of an accident.
B. Medical expenses related to any bodily injury otherwise excluded under this policy.
The duties listed below
must be carried out by the named insured, other insureds, and anyone else who
benefits from this insurance.
A. If a claim occurs or is
likely to occur, the insured must notify the insurance company immediately. The
notification should include all of the following
details:
·
Provide
the named insured.
·
How,
when, and where the accident or injury occurred.
·
Circumstances
surrounding the accident or injury.
·
Names
and addresses of any injured persons or
witnesses.
o
This
is especially important if known.
B. The insurance company
expects to receive all bills, documents, notices, papers, and court summons
promptly when related to a suit or claim. This requirement also extends to
medical expense claims.
C. Cooperate with the
insurance company during the investigation, settlement, or defense of a claim
or suit. This includes offering assistance while the insurance company is
handling a case, such as:
·
Attending
hearings and trials.
·
Providing
evidence.
·
Support
the insurance company in asserting rights of contribution or seeking indemnity
from third parties.
·
Assist
in securing witnesses to testify and supply information and records when
needed.
D. When asked, be prepared
to undergo an examination, including swearing an oath if required.
·
The
insurance company may also request the named insured's signature and a formal
declaration.
·
If
multiple people need to be examined, they can be examined individually.
·
Any
examination could be recorded on video.
E. No commitment can be
made as to whether or what the insurance company will pay unless the insurance
company has granted written permission in advance. Similarly, no obligations
are to be made or expenses incurred on behalf of the
insurance company unless the insurance company has granted written permission.
Payments, obligations,
and expenses made without permission of the insurance company are the
responsibility of the named insured.
F. When the claim is for Medical Payments –
Coverage B, beneficiaries must:
·
Submit
a written proof of claim. This can be required under
oath.
·
Provide
authorizations allowing the insurance company to access medical records or
other relevant information.
·
Claimants
must consent to examination by a physician appointed by the insurer whenever
requested.
·
The
requests should be reasonable, and the insurance company is required to cover
all examination costs.
Failure to perform the
duties described in A. through F. above may result in serious consequences,
including the voiding of all coverage.
NOTE: Although the related
court case below does not involve commercial auto, it illustrates what can
happen to a party that fails to comply with such provisions.
Related Court Case: Insured's
Failure to Cooperate Relieved Carrier of Its Obligation to Pay Claim
The
most the
insurance company will pay for all damages from a single covered accident is specified in paragraphs A, B, and C that follow. These
limits apply regardless of how many insureds, covered vehicles, involved
vehicles, premiums paid, or claims filed. Once these limits are reached through
settlements or judgments, the insurance company's obligations for that accident
are fully satisfied.
The most to be paid
under Coverage A is the Accident Limit shown on the Declarations. This is the
maximum amount payable in a single accident.
NOTE: Since there is
no aggregate limit, the Accident Limit listed on the Declarations applies to each separate incident. This means the available coverage
resets for each new incident, including the second, third, and subsequent
accidents.
The maximum amount
payable to a person in a single accident under Coverage B is the Per Person
Limit shown on the Declarations. This is the most that will be paid for any one person in a single accident. This means that if
multiple people are injured in a single accident and are eligible to receive
payment, each has access to their own per person limit.
The limits apply
individually to each consecutive 12-month period unless a standard 12-month
policy period is endorsed to extend the policy period.
The policy period
begins on the date specified in the Declarations.
1. A policy is issued as a
standard 12-month policy term
Policy limits apply to
the 12-month policy term.
2. A policy is issued for
more than 12 months, for example, a 27-month policy term
This is a policy issued with a term
period greater than 12 months at its original issue. Since this policy period cannot
complete a full 3 consecutive 12-month periods, the final 3 months of the
policy period will have its own policy limit.
|
Example: Here’s
how the policy limits apply when a policy is originally issued for more than
12 months. We’ll use the 27-month
policy period: ·
The first 12 months
of the policy period receives its own policy limit; ·
The second 12 months
of the policy period receives its own policy limit; and, ·
The remaining 3
months of the 27-month policy period receives its own policy limit. There are essentially three separate policy limits that
will apply. |
·
A policy is originally issued for
12 months but extended at renewal by an endorsement
This policy is issued
for a standard 12-month term, but upon renewal, the policy period is extended
beyond the 12-month period through an endorsement. This is similar
to how a short-term policy would function.
o
The
original 12-month policy period has a dedicated policy limit.
o
Subsequently,
both the renewal 12-month period and the 3-month extension period made by
endorsement share a single policy limit. This is due to the extension period
being added by endorsement rather than being part of the original policy period
when the policy was issued.
NOTE: The policy refers to a
terminal period. A terminal period is the final
duration of a policy, which can last from one day to several years before
coverage ends.
Under this policy and
any additional Uninsured or Underinsured Motorists Coverage, no individual is
allowed to receive duplicate payments for the same elements of damages, expenses, or losses.
A. The coverage under this
policy applies individually to each insured and each named insured. This means
if multiple insureds and named insureds are involved in a single legal action,
the insurance company will treat each one as if they were the only party named
in that action.
Exceptions apply in the
following situations:
·
Except
for the limits of liability as described in Paragraph 2. – Limits of Liability;
and,
·
Any
duties and/or rights stated to apply specifically to the first named insured
apply only to that first named insured and not to any other.
B. If the insured becomes
bankrupt, the insurance company is required to continue all obligations under
the policy.
A. The insurance company
provides coverage only if a limit of liability and premium is specified on the
Declarations. All coverage is subject to the terms and conditions outlined in
the policy.
B.
Coverage applies only to losses occurring within the
designated coverage territory and during the policy period, unless specified
otherwise in the policy. For more information, refer to Common Conditions –
Part III–6.–Coverage Territory.
|
Example: Jeremy was driving his company’s
car when he was in an accident. The policy term was 8/1/2025-8/1/2026. The
mailing address is in Cambridge, Massachusetts. Scenario 1: Jeremy hit a bridge on 8/1/2026 at 11:30 PM while
in California. The policy does not cover the accident because the loss
occurred on 8/2/2026 at 2:30 AM at the mailing address listed on the
Declarations. Scenario 2: Jeremy was on a side trip to Mexico when he hit an
abutment. The policy does not cover the accident because Mexico is outside
the coverage territory. |
C. Insuring Agreement
Qualification
The coverages listed below are subject
to specific exclusions and limitations, including the General Exclusions and
Part III D—Special Physical Damage Conditions.
NOTE: There are no General Exclusions, but
there are Common Exclusions – Parts II and III, with Part III being specifically
noted in this section.
Coverage F - Comprehensive
Coverage
Coverage applies to any
source of damage to a covered auto and its equipment, except when the damage
results from a collision with another object, an overturn, or a cause of loss
excluded or limited by the policy.
NOTE: See Part III –
Supplemental Coverages Section—2. Falling Objects, Glass Breakage, Impact with
an Animal/Bird, for additional information concerning impact with an animal or
bird.
Coverage G - Collision
Coverage
This coverage is very
specific. The only covered losses are those caused by the covered auto
colliding with another object or overturning.
NOTE: Another object could be
another vehicle, a person, a tree, a building, a sign, etc.
Coverage H - Towing
This coverage applies
only to private passenger-type autos.
Towing and labor costs when a covered
private passenger auto becomes disabled are covered. Only labor performed at
the disablement site is paid; costs after the vehicle is towed to the repair
shop are not covered.
|
Example: Patricia is driving her auto for Masquerading
Clowns. Her vehicle suddenly stops running, so she calls for help. Scenario 1: The tow truck driver who responds to the problem in
Patricia’s SUV is also a mechanic. He inspects the engine, identifies a
simple problem, and fixes it. All associated costs are covered, up to the
limit of liability on the Declarations. Scenario 2: The tow truck driver who responds to the problem
with Patricia’s 2-ton truck is a mechanic. He inspects the engine, identifies
a simple issue, and fixes it. There is no coverage because a 2-ton truck is
not classified as a private passenger-type auto. |
The insurance
company provides the following Supplemental Coverages as extensions of the main
coverages, but only when and to the extent the main coverages apply. They do
not change or waive any policy provisions unless explicitly stated and remain
subject to all underlying policy terms unless specifically changed by this
section.
Coverage is extended to
the following equipment:
NOTE: This is
significant because of how electronic equipment is excluded under Part III C –
Exclusions/Limitations. As a result, this should be considered more as an
exception to that exclusion rather than genuine additional coverage.
A.
Equipment installed permanently in
the vehicle. This includes devices solely designed for video, sound
reproduction, or GPS. Accessories used with any of this equipment are also
covered, provided they are installed permanently.
B.
Removable equipment with a permanently installed housing
unit is covered. It must be designed only for video, sound, or GPS purposes.
Accessories used with such equipment are also included if they are stored
within the same permanently installed housing unit. Additionally, the equipment
must draw power from the vehicle's electrical system.
C.
Other electronic equipment that meets either of the
following criteria is covered:
·
Essential for the vehicle's operation or for
monitoring its operating system.
·
An essential part of the same unit that houses any
sound-reproducing equipment described in the preceding Paragraph A and is
permanently installed in the vehicle's dashboard or console opening, typically
used by the manufacturer for radio installation.
|
Example: Cornelius has customized his Kia Soul by
installing speakers in the back to use it as a sound system for advertising
events. In the event of an accident, insurance coverage includes the
permanently installed upgraded sound system. However, the speakers and other
equipment in the rear are not covered since they are not permanently
installed. |
This item applies only when
Comprehensive Coverage applies to the damaged covered auto.
The insurer pays the
following losses under Comprehensive coverage:
A. Glass breakage
B. A loss resulting from
an object or missile falling on the covered auto.
C. A loss that occurs when
an animal or bird hits the covered auto.
When glass breakage is
part of a collision loss or an overturn, the insured may elect to have the loss
paid under either collision or comprehensive coverage.
NOTE: This item explains the coverage
details. The three loss types discussed might be termed collisions because an
object hits the vehicle. This distinction is crucial because of the differences
in deductibles and coverage. When collision coverage is included, its
deductible is typically much higher than the comprehensive deductible.
Sometimes, comprehensive coverage may be the only physical damage coverage on
the vehicle.
A. This coverage is
automatically available to any named insured who is an individual.
1. Physical damage coverage for nonowned private passenger autos is included when
physical damage coverage is provided for owned private passenger autos.
2. The most paid for loss to a nonowned trailer is $500.
B. Glossary
The term
"nonowned auto" in this supplemental extension refers to any private
passenger type auto, pickup, van, or trailer that is not owned by, available
to, or used regularly by the named insured or a family member. This includes
situations in which the vehicle is operated by or in the custody of the named
insured or a family member.
|
Example: Pat borrowed a friend’s trailer to pick up mulch
for landscaping the outside of his office building.
He didn’t handle the trailer well and ended up smashing it against a wall. Up
to $500 is available to pay for the damage to that trailer. |
A. This is a conditional
extension. It applies only if all the following conditions are met.
·
The
covered auto is a private passenger type.
·
Comprehensive
coverage is provided for the covered auto.
·
The
entire covered auto is stolen.
B. When all the above
conditions are met, temporary transportation costs of up to $20 per day are
covered up to a maximum of $600.
The time
period for coverage begins 48 hours after the theft and ends at the
earliest of the following:
·
The
covered auto is returned and is available for use.
·
The
insurance company pays for the loss of the covered auto
The expiration of the
policy period does not impact coverage under this item.
This is a conditional
extension. It applies only if all the following conditions are met:
A. Hired Auto Physical
Damage coverage applies when:
·
An
insured borrowed, leased, rented, or hired a vehicle using a written contract
or agreement.
·
The
contract makes the insured legally liable for damage to the rented vehicle.
·
The
vehicle rental does not include a driver.
·
The
loss of use is the result of damage covered under the policy provisions.
B. A maximum of $20 per day is available for the
loss of use of a rented vehicle. The supplemental coverage is limited to $600.
The period of time is not limited by the policy's
expiration.
NOTE: Symbol
8 or 1 must appear beside Comprehensive and Collision on the Declarations for
coverage to apply.
Coverage does not apply to the property or loss described in this section
unless explicitly stated in the policy.
The following property is
not covered:
A. Any type of electronic
equipment capable of receiving, reproducing,
or transmitting audio, visual, or data
signals. This exclusion also
applies to any accessories used with such equipment.
However, equipment permanently installed in a covered auto, or with a
permanently installed housing unit, is covered. See Part III B - Supplemental
Coverage – 1. Certain Electronic Equipment provides some coverage.
B. Cassette tapes, CDs,
and similar media devices intended for use with audio, visual, or data
electronic equipment.
C. Devices used to measure
speed, such as radar and laser, as well as tools for jamming, detecting,
evading, or interfering with these speed-measuring devices.
This exclusion applies only
to farm equipment, machinery, or tractors covered by the policy. There is no
coverage for losses to any of the following.
A. Any equipment
that can be transported by the covered auto.
There are two
exceptions:
·
Equipment
included in the covered auto’s delivered price.
·
Equipment
specifically described as a covered auto.
B. Equipment that is
stationary but capable of being powered by the covered auto.
|
Example: Evelyn owns a tractor used for land maintenance
around her large warehouse complex. Recently, she acquired different types of
equipment that can be attached to the tractor. The tractor is a covered auto,
but the equipment is not because it was not purchased with the tractor and is
not described as a covered auto. |
This exclusion applies only to
prearranged contests and to the preparation or practice for them. Damage
resulting from demolition, racing, speed contests, or stunt activities is not
covered.
|
Example: Evelyn loves driving her tractor and often works
on it to boost its performance. She frequently joins other tractor
enthusiasts for discussions. Some propose a tractor pull contest, and Evelyn
eagerly signs up. During practice for the tractor pull, Evelyn loses her
grip, sending the tractor into a ditch and causing damage. Since the damage
occurred during practice for the competition, it is not covered. |
A. Coverage does not apply
to loss or damage caused by any of the following:
|
·
Corrosion ·
Freezing |
·
Decay or deterioration ·
Inherent vice |
|
·
Rust |
·
Latent defect |
|
·
Wear and tear |
·
Dry or wet rot |
|
·
Electrical or mechanical breakdown |
·
Tire blowouts, punctures, or other road damage to tires |
|
·
Deficiencies, errors, or omissions in design, materials,
plans, or workmanship |
·
Natural growth such as fungi, mold, spores, mildew,
bacterium and other similar growth |
B. This exclusion has two
exceptions:
·
If
a covered loss is the result of any items described in A. above, that
resulting loss is covered.
·
If
an otherwise covered loss causes any of the items described in A. above,
the resulting loss from that otherwise excluded loss is then covered.
Loss of a covered
auto's value because it was involved in an accident is not covered. Diminution in
value is a defined term in Common Glossary – Parts II and III.
The duties listed below
must be carried out by the named insured, other insureds, and any others who
benefit from this coverage.
A. Report the Loss
The insured must immediately
notify the insurance company of any loss. When a loss involves a violation of
the law, such as theft or vandalism, the policy must be notified immediately.
Also, provide details
about when the loss occurred, the location of the loss, and a description of the
accident as soon as possible.
B. Protect Property
The covered
auto must be protected if a covered cause of loss appears imminent. After a
covered loss, the auto should also be safeguarded from additional damage. The
insurance company will cover reasonable expenses required to prevent further
harm to the auto.
|
Example: Perry
recently bought a new car and is very eager to keep it undamaged. To that
end, he takes several precautions. Scenario
1:
He has no garage, so he must park in his driveway. His neighbor has a tree
from which limbs have been known to fall. Would the insurance company pay for
an arborist to trim the limbs? Scenario
2:
He hears that a hailstorm is on its way, but has no
garage in which to pull the car. Would the insurance company cover the cost
of overnight parking in a parking garage? Scenario 3: A hurricane
is predicted, and evacuation is ordered. Would the insurance company pay his
costs to evacuate, including his hotel and meals, while he is away? |
C. Cooperation on the Loss
The insurance company
may request or require the following items as often as they find necessary,
provided it is reasonable.
·
The
insurance company must be able to inspect the damaged vehicle and gather
details about the loss prior to repairing or disposing of it.
·
All
parties are required to agree to be examined under oath and sign any statement
of answers if requested by the insurance company.
o
If
multiple individuals need to be examined, the insurance company may choose to
conduct their examinations separately from others.
o
Videos
might be recorded during the examinations.
·
Cooperation
is required during the insurance company's investigation or settlement of the
claim.
Failure to cooperate
could lead to severe consequences, including the potential voiding of coverage.
NOTE: While the following
case does not involve commercial auto, it demonstrates what can happen to a
party that fails to comply with such provisions.
Related Court Case: Insured's
Failure to Cooperate Relieved Carrier of Its Obligation to Pay Claim
A. Limit of Liability
1. Coverage F- Comprehensive & Coverage G - Collision Coverages
The most paid for all loss or damage to a single covered auto damaged or
stolen is the least of:
·
The
actual cash value of the property,
which is determined as of the date of the loss,
not the date of adjustment.
·
The
cost to repairing or restoring the property with items
of similar kind and quality.
·
The
cost to replace the property with items of similar kind and quality.
|
Example: Patrick and the Less Than Cooperative Insurance
Company have been at odds over coverage. After nearly 18 months, Less Than
Cooperative finally concedes that Patrick is right about the coverage he
should receive. However, a new dispute arises because the adjuster insists on
paying the actual cash value as of the settlement date. Patrick counters that
the actual cash value is based on the loss date, not the adjustment date. |
2. Coverage H – Towing
The most paid in a single disablement is the limit specified on the
Declarations.
B. Deductible
The insurance company
covers the cost to repair, restore, or replace each covered vehicle's damaged
or stolen property, less the deductible specified on the Declarations.
If a covered auto includes comprehensive
coverage, there is no deductible for losses due to fire or lightning.
|
Example: Wildfires are spreading rapidly across the area,
forcing Jalousies, Inc. to abandon its shop. The evacuation order is issued while
all company vehicles remain on-site. Employees are focused on evacuating
their families, and cannot be concerned with moving the vehicles. As the fires pass through, all the vehicles
are destroyed. Fortunately, they are covered, and no deductible applies. |
C. Appraisal
1. If the insurance
company and the named insured cannot agree on the loss amount, either party can
request an appraisal. Once a written demand is made, each side must, within 30
days, select a qualified appraiser and inform the other party.
2. The two appraisers must
select a disinterested and qualified umpire within 15 days. If they do not,
either party may ask a judge of a court of record to appoint the umpire.
3. The appraisers are to
reach a mutually acceptable agreement on any disputed values. If they cannot
reach an agreement, they refer their disagreements to
the umpire. When two of the three agree, the decision is final and binding for
all parties.
4. The insurance company
and the named insured are each responsible for paying their own appraiser's
costs, and they must share the expenses for the umpire and any other
appraisal-related costs.
Related Court Case: Insurer Must
Accept Decision of Its Approved Umpire
5. Even if the insurance
company participates and consents to the appraisal process, it still has the
right to deny the claim.
D. Our Liability and Satisfaction of Your Loss
This policy's coverage
may not fully cover a loss. If that happens, the named insured is responsible
for securing additional insurance available to cover the gap or pay the
difference themselves using other available means.
E. Our Options in Settling Losses
The insurance company
decides how to settle a physical damage loss and may choose from the following
options:
1.
Compensate with money for the loss.
2.
Pay for repairing or replacing damaged or stolen property,
or to take all or part of it at an agreed or appraised value.
3.
Return stolen property if recovered, at the insurance
company's expense. The insurance company will also cover any damage to the
property resulting from the theft.
4.
Any settlement will be made with the named insured, loss
payees, or anyone else legally entitled to payment. If property of others is
involved, the insurance company may settle the claim directly with that party.
Once the claim is settled with the other party, it will also satisfy the named
insured's claim for that property.
A. The named insured and the applicable loss payee listed on
the policy are paid based on their specific interest in the property for any covered
loss. No payment will be made to the loss payee when the covered loss is due to
conversion, embezzlement, or secretion but only when the named insured is the
one who performs any of these actions.
NOTE: “Secretion"
is when the insured intentionally hides insured property to deny the loss payee
access or recovery. It’s similar to conversion and
embezzlement—deliberate, dishonest acts.
B.
The loss payee will be notified
in the same way as the first-named insured if the insurance company cancels the
policy. Once the policy is canceled, the insurance company's obligation to the
loss payee ends on the cancellation date.
|
Example: Punctual
Insurance issues a cancellation notice to Smith
Paving, Inc. Despite Ned Money, Inc. being listed on the declarations as the
loss payable, it does not receive the required notice. Two days after the cancellation takes effect, three
of Smith Paving’s vehicles are stolen. When Ned Money files a claim, Punctual
must cover the loss because Ned Money was never sent
the required cancellation notice. However, if Punctual can prove that Smith Paving converted the cars, it may be able to avoid paying for
this loss. |
C. When the insurance company makes a payment to a loss payee, the loss
payee is required to transfer their recovery rights for that loss to the
insurance company.
If a party with custody
of covered property requires an assignment of coverage from the insured, the
insurance company does not acknowledge that assignment, regardless of other
provisions in this coverage form. This policy does not benefit any party with
custody of the covered property.
The exclusions listed
in this section are in addition to the Exclusions located in Part II and Part
III. They are absolute, meaning the insurance company will not cover any damage,
expense, liability, or loss. These exclusions apply
even if the damage or loss is directly or indirectly caused or worsened by the
exclusions, including if they are partly responsible. They also apply if the
exclusions are involved in the sequence of events or occur simultaneously with
a covered loss or accident, which would otherwise be covered if not for these
exclusions.
NOTE: Government/Legal/War
and Nuclear/Radioactive are exclusions applying to both Parts II and III.
However, the specific exclusions are unique to each part. By grouping exclusions
into a single section, it is easier to understand their scope.
A. War and similar military actions are not covered. This
exclusion applies regardless of circumstances, such as a formal declaration of
war. This means civil war, invasion, insurrection, rebellion, revolution, or
power seizures are all excluded. Actions taken to defend against or hinder such
actions are also considered war and are excluded.
Ultimately, there is no coverage for
any loss directly or indirectly related to war or warlike activities.
B. The following actions, known to any insured, are also
excluded:
·
Violation of an ordinance or penal law
committed by an insured or with their consent
·
Statutory fines or liability
·
Punitive or exemplary damages
·
Illegal trade
A. Coverage A – Bodily Injury
and Property Damage are excluded
as follows:
1.
For any insured who is also covered under ANY policy issued as a nuclear
energy liability policy.
NOTE: This means coverage would likely be provided by one
of the following:
·
Nuclear Energy
Liability Insurance Association
·
Mutual Atomic Energy
Liability Underwriters
·
Nuclear Insurance of
Canada
·
A successor carrier
to any of the above
This insured remains not covered, even
after the limits under that nuclear energy policy have been exhausted,
resulting in termination of coverage.
2.
When bodily injury or property damage results from the hazardous
properties of nuclear materials, coverage does not apply with respect to either
of the following:
·
A person or organization is required to
comply with the Atomic Energy Act of 1954 to maintain financial protection or
any amendments.
·
The insured has the right to
compensation from the United States of America or its agencies under any
agreement between them, or would be available if this
policy were not in place.
3.
When it results from the hazardous property of nuclear materials under
the following circumstances:
·
The material is located at an
insured-owned or operated nuclear facility, or it has been discharged or
dispersed from such a facility. This applies even if the insured does not own
or operate the facility, but another party does so on their behalf.
·
The material is contained in spent fuel
or waste that the insured, or others acting on their behalf, have handled in
any way at any time. This includes material that has been disposed of,
possessed, processed, stored, transported, or used by or for the insured.
4.
An insured providing any services or supplies to a nuclear facility, such
as construction, maintenance, operation, planning, or use. However, if the
nuclear facility is in the United States, its territories and possessions, or
in Canada, this exclusion applies only to property damage to that specific
nuclear facility and its property.
B. Coverage B—Medical Payments excludes medical expenses for any
individual or organization injured by the hazardous properties of nuclear
materials. This exclusion applies when the injury occurs from the operation of
a nuclear facility.
C.
Glossary
The following definitions apply to the Nuclear
Energy Exclusions:
1. Hazardous properties
This term includes substances with
radioactive, toxic, or explosive properties.
2. Nuclear facility
This includes the site,
operations, and premises of any of the following:
·
A nuclear reactor
·
Equipment or devices designed or used
for any of the following:
o
separating uranium or plutonium
isotopes through a process of isolation
o
spent fuel utilization or processing
o
waste handling, processing, or
packaging
·
Equipment or devices used for alloying,
fabricating, or processing special nuclear materials, if at any time the total
amount of such materials in the custody of the insured at the location of the
equipment or device, contains:
o
more than 25 grams of plutonium, or
o
more than 25 grams of uranium - 233, or
o
any combination of the two above, or
o
250 grams of uranium - 235.
·
Any structure or place prepared or used
to store or dispose of waste
·
The site location where any of the
above are situated, including all operations and premises used for those
activities.
3. Nuclear material
This refers to source material, special
nuclear material, or by-product material.
4. Nuclear reactor
This is any device designed for or used
to:
·
maintain nuclear fission through a
self-sustaining chain reaction.
·
contain enough fissionable material to
reach critical mass.
NOTE: It does not specify the reactor's size or the amount and
kind of material needed.
5. Property damage
The term property damage is expanded to
also cover all forms of radioactive contamination of property.
6. Source Material, Special Nuclear Material,
and Byproduct Material
These terms are
given their meaning by the Atomic Energy Act of 1954 and any amendments.
7. Spent fuel
This refers to any fuel element or
component used in or exposed to radiation within a nuclear reactor. It can be
either solid or liquid.
8. Waste
This refers to any waste material
meeting the following criteria:
·
Waste resulting from the operation of a
nuclear facility as described in the first two items of the nuclear facility.
·
Waste containing any by-product
material
o
This excludes tailings or waste from
extracting or concentrating uranium or thorium from ore primarily processed for
their original source material.
A. War and similar military actions are not covered. This
exclusion applies regardless of circumstances, such as a formal declaration of
war. This means civil war, invasion, insurrection, rebellion, revolution, or
power seizures are all excluded. Actions taken to defend against or hinder such
actions are also considered war and are excluded.
Ultimately, there is no coverage for
any loss directly or indirectly related to war or warlike activities.
B. The following actions, known to any insured, are also
excluded:
·
Violation of an ordinance or penal law
committed by an insured or with their consent
·
Statutory fines or liability
·
Punitive or exemplary damages
·
Illegal trade illegal
C. Losses involving property considered contraband or involved
in illegal transportation or trade are not covered. Additionally, losses,
confiscations, or seizures resulting from laws or regulations related to the
following are also excluded:
·
Customs
·
Drug
enforcement
·
Quarantine
A.
Nuclear events, occurences, or operations are excluded.
This includes explosions, reactions, radiation, or radioactive contamination.
Fire,
explosion, smoke, and other causes of loss are not part of this exclusion.
B.
Properties of nuclear or radioactive material, whether
natural or manufactured, are excluded if they are injurious, such as:
·
Explosive
·
Radioactive
·
Toxic
·
Other
The following
Conditions apply to Parts II and III of the policy and are in addition to the
Conditions specified in the separate coverage parts.
It is important to
understand that legal action may be taken against the insurance company, but it
is limited by the following conditions:
A. All contractual obligations of the insured must be
fulfilled.
B. The insured’s obligation under this policy has been
determined by a court judgment or a written agreement approved by the insurance
company.
The policy does not grant the named insured any right to
bring the insurance company into legal action against any other insured.
Part III
It is important to
understand that legal action may be taken against the insurance company, but it
is limited by the following conditions:
·
All contractual obligations of the
insured must be fulfilled.
·
The action is initiated within one year
from the date of the loss.
The policy does not grant the named insured any right to
bring the insurance company into legal action against any other insured.
The named insured does not have the option to assign its
interest in the policy to another without the insurance company's written
consent.
The only exception occurs when the named insured is an
individual.
If the insured is an
individual and dies, all rights and responsibilities transfer to a legal
representative. However, this transfer is limited to the period when the
representative is acting in their official capacity or has custody of the named
insured’s property. Outside of this role, the legal representative is not
covered for any actions.
|
Example: John wants out. Tired of
running his company, he accepts a lucrative cash offer from Jack. John
transfers all ownership rights to Jack and leaves town. However, Jack
encounters a problem: he has no insurance coverage because, although John can
relinquish his ownership, he cannot transfer his insurance policies to Jack
or anyone else. As a result, Jack must obtain his own insurance coverage. |
This condition outlines how
cancellations are handled. Although many states mandate the use of a specific
state form instead of this cancellation condition, it serves as a starting
point.
A. General
1. The first named insured is the only entity authorized to
cancel the policy on behalf of the insured. To do so, they need to surrender
the policy or mail a notice to the company agent or the insurance company, and include the cancellation date. The cancellation
request will apply to all other insureds and any interests covered by the
policy.
2. The first named insured receives a return premium if the
policy is cancelled. If the insurance company cancels the policy, the return
premium must be pro rata of the policy premium. However, if the first named
insured requests the cancellation, the return premium may be less than the pro
rata amount. Payment of the return premium is to be made within 30 days of the
cancellation date.
NOTE: The short-rate penalty is not mandatory, but it is a
possibility.
3. Automatic Terminations
·
If the named insured chooses to
purchase insurance from another company and does not pay the premium or
installment on this policy when it is due, this policy will automatically end
once that other insurance takes effect.
·
If the named insured sells a covered
auto, the policy coverage for that vehicle ends immediately once the title is
transferred.
B.
Our Right to Cancel or Terminate
The insurance company's
rights to cancel or terminate the policy are found in the state mandatory
endorsement.
A. Coverage is void in any
case of fraud by the named insured at any time with respect to this insurance.
It is also void if the named insured or any insured at any time intentionally
conceals or misstates important facts related to this insurance. This includes
information the insurance company relied on when issuing the policy.
B. If the insurance
company does not void the policy entirely, it reserves the right to deny
coverage to any insured who committed any voidable offense.
Related Court Case: Does
Driver's Fraud Bar Coverage?
The insurance company
agrees that, in the event of a conflict between statutory requirements and the
terms of this policy, statutory requirements will prevail.
Only accidents and
losses occurring in the coverage territory are covered. The coverage territory includes
the following:
·
The
United States of America and its territories and possessions
·
Puerto
Rico
·
Canada
Coverage also applies
if the covered auto is being transported between any of the coverage
territories.
A.
The insurance
company has the right to make inspections and/or conduct surveys. It then may
also provide reports and recommendations to the named insured.
This right benefits only the insurance
company. Inspections and surveys are not intended as safety checks for third
parties or employees. They should not be viewed as warranties or guarantees
that the named insured meets safety or health codes.
This condition applies to the insurance
company that provides coverage and any rating advisory organization.
The insurance company has the right to review the named
insured's books and records. However, this right applies only to books and
records that relate to this coverage form or premium payment. This right
extends throughout the policy term and for up to three years after. The first
named insured is required to keep the books accurate
and ready to be reviewed.
B. The initial premium paid is an estimated premium based on
the exposures the named insured provided to the insurance company at inception.
The insurance company calculates the final premium based on the actual
exposures. This is usually completed after the end of the policy term.
After calculating the actual exposures,
the estimated premium is deducted. The first named insured is then billed for
any remaining balance or issued a refund if they overpaid.
The billing statement will specify the due date for the additional premium.
Any broadened or
additional coverage offered under a revised version of this coverage form by
the insurance company, which is available at no additional charge,
automatically applies to this policy. It takes effect on the date the coverage
begins in the named insured’s state, even if that date is as much as 45 days
prior to the policy's issuance.
A. This insurance is
primary if the named insured owns the covered auto; otherwise, it acts as
excess over any other collectible insurance. Trailer coverage follows a similar
principle.
B. Coverage A—Liability to Others – Special Condition
1. Liability coverage for
a covered trailer attached to the named insured's covered auto is primary.
However, if the trailer is attached to a motor vehicle the insured does not
own, the coverage becomes excess.
2. This coverage is
primary for liability included under the Contractual Supplemental Coverage.
C. If this insurance and
any other insurance provide coverage on the same basis, whether as excess or
primary, the insurer will only pay its proportional part of the loss or obligation.
This proportion is determined by dividing its applicable limit of liability by
the total insurance limits from all insurers providing
coverage on the same basis.
NOTE: Ratios are determined
based on each company’s limits, expressed as a percentage of the total
available limits. Losses are proportioned among the companies
accordingly.
D. Under Coverage
B—Medical Payments, the sharing of limits discussed in paragraph C above
applies only to collectible auto medical payments coverage.
Related Court Case: Insurer
Obligated To Pay Only Its Pro-Rata Share under
"Other Insurance" Provision
A. The first named insured
is the party responsible for paying all premiums and receives
all return premiums. This includes premium adjustments resulting from audits.
B. If the policy is issued
for a period longer than one year, the premium will be recalculated annually at
each anniversary date, using the rates and premiums effective at that time.
When the insurance
company makes payments for any covered party under this policy, all rights that
party has to seek recovery from others for the loss or
damage caused by the responsible party automatically transfer to the insurance
company up to the amount paid. That party must take all necessary steps
requested by the insurance company to protect their recovery rights and avoid
actions that could jeopardize those rights.
This requirement is not
applicable to Coverage B – Medical Payments.
The policy's start and
end dates are determined by the address listed on the Declarations. The policy
begins at 12:01 AM Standard Time on the start date and expires at 12:01 AM
Standard Time on the end date.
Unless a policy or
coverage is explicitly issued as an umbrella or excess liability, if this
coverage form and any other coverage form or policy issued to the same insured
by the insurance company or any of its affiliates cover the same accident, the
total payment across all coverage limits combined will not exceed the highest
limit of liability in any single coverage form or policy.
The policy issued by the insurance company is an agreement
with the named insured. If the first named insured requests a change, the
insurance company can accept or reject it. Only the first named insured has the
authority to make policy changes. Any endorsement that alters, waives, or
modifies the policy must be attached to the policy.
All agreements between the named insured and the insurance
company are contained in this policy.
Some words and phrases in this policy are specifically
defined for this insurance contract. They appear throughout the policy in
italics. The following provides definitions for these terms.
When used in this
policy, the term accident includes continuous or repeated exposure to the same
condition that results in bodily injury or property damage.
NOTE: The term
"accident" is not specifically defined in this context. Therefore, it
will then typically follow the definition from a widely used dictionary, such
as Merriam-Webster. Merriam-Webster describes "accident" as “an
unforeseen and unplanned event or circumstance, a lack of intention or
necessity, or an unfortunate event resulting especially from carelessness or
ignorance.” This definition would then be expanded to include continuous and
repeated exposure to the same condition causing the injury
or damage.
The insurance company
will consider any or all of the following factors when
determining the actual cash value of property:
|
·
condition |
·
deterioration |
·
obsolescence |
|
·
use |
·
utility |
·
economic value |
|
·
market value |
·
original cost |
|
|
·
cost to repair, replace, or restore – subject to
appropriate depreciation |
·
any other circumstance that could impact the value, as long as it is reasonable. |
|
NOTE: ACV is typically defined as Replacement Cost minus depreciation, but this definition expands the conditions under which ACV is considered.
Auto refers to any land
motor vehicle, trailer, or semitrailer designed for use on public roads. It
does not include mobile equipment but covers land vehicles subject to a state's
financial responsibility or vehicle registration laws. Mobile equipment is
defined later in this section. The applicable state law is based on where the
vehicle is either licensed or principally garaged.
The term bodily injury,
as used in this policy, includes harm to the body, sickness, or disease a
person sustains. Death resulting from bodily injury, sickness, or disease is
also considered bodily injury.
This refers to the reduction in market value that occurs solely due to a
loss, which can be either actual or perceived.
Related Court Case: Value of
Automobile Disputed In Court
When the term employee
is used in this policy, it refers to individuals employed directly by the named
insured and to workers who are leased. However, it does not include temporary
workers or independent contractors.
To be considered a
family member, the person must meet both of the following requirements:
This definition
includes all fungi, such as molds, mildews, spores, algae, protists, rusts, and
organisms that contribute to rot and decay. Organisms similar
to or related to these are also considered fungi.
Toxins and any
compounds, chemicals, substances, mist, or vapor produced by any of the items
in the prior paragraph are considered fungi. The byproducts or waste of any of
those fungi are also considered fungi.
The only exception to
this definition is edible fungi. This indicates that mushrooms and related
edible fungi are excluded from this definition.
Any party qualifying as
an insured under “Who Is An Insured" is
considered an insured.
A worker the named insured hires through a labor-leasing firm to work
in the named insured's business. An agreement between the leasing firm and the
named insured is required.
Temporary workers are
not considered leased workers.
Only direct and
accidental loss or damage qualifies as a loss. Property taken through theft is
also considered a loss.
Mobile equipment is any
of the following types of land vehicles, including any machinery or equipment
attached to it:
A. Vehicles whose only
purpose is to be used at the premises owned or rented by the named insured.
B. Vehicles designed primarily for use off
public roads. Examples include bulldozers, farm machinery, forklifts, and
similar commercial equipment.
C. Any vehicle used
primarily to provide mobility to nonmix-in-transit concrete mixers, power
cranes, shovels, loaders, diggers, drill or road construction, or resurfacing
equipment, provided it is permanently attached to or forms an integral part of
the vehicle.
D. Similar
to
what is described in C., but not included in A., B., or C., these vehicles are
used to transport equipment such as air compressors, pumps, generators, and
tools for spraying, welding, building cleaning, geophysical exploration,
lighting, and well servicing. They also carry devices used to lift or lower
workers. These items must be permanently mounted on the vehicle and cannot be
self-propelled.
E. Any vehicle that
travels on crawler treads.
F. Vehicles maintained primarily
by the insured, not used to transport people or cargo, and not described in
paragraphs A., B., C., D., or E. above.
However, there are
exceptions. Any self-propelled vehicle with the following equipment permanently
attached is considered an auto and not mobile equipment:
·
Vehicles
designed primarily for road maintenance, such as snow
removal or street cleaning, but excludes any road
construction or resurfacing.
·
Vehicles
with air compressors, pumps, and
generators, including spraying, welding, building cleaning, geophysical
exploration, lighting, or well servicing equipment.
·
Devices like cherry pickers and similar equipment used to lift workers, provided they are mounted on an
automobile or truck chassis.
Land vehicles governed
by a state's financial responsibility or vehicle registration laws are
classified as autos, not mobile equipment.
NOTE: Recognizing the
difference between autos and mobile equipment can be challenging. This issue is
the focus of the following court case.
Related Court Case: CGL's
Automobile Exclusion Held to Apply, Regardless of Contention That an Unlicensed
and Unregistered Truck Was Mobile Equipment
NOTE: This is a
crucial term and should be taken very seriously because many coverage disputes
have centered on whether the person was occupying a covered auto at the time of
the accident.
All the following are considered
occupying:
|
·
getting in |
·
getting out of |
·
getting off |
|
·
in |
·
on |
·
upon |
Pollutants are irritants and contaminants that can appear as
solids, liquids, gases, or thermal substances. Examples include smoke, vapor,
soot, fumes, acids, alkalis, or chemicals. Waste is also considered a
pollutant, including items intended for disposal, recycling, reconditioning, or
reclamation.
If the named insured is
an individual, private passenger type vehicles also include any covered auto
owned by the named insured that is a pickup or van-type truck and not used for
business, unless it is for farming or ranching.
Direct physical harm to
tangible property, including the loss of use. The loss of use is considered to
occur at the moment of the physical
injury. For tangible property not physically damaged, any loss of use is also
understood to happen at the time of the relevant accident.
This term refers to a
living organism and is used in the definition of fungi. It causes the
decomposition of physical material.
A temporary worker is
someone furnished to the named insured to replace a permanent employee or
assist in a short-term situation, like work. Leased workers, however, are not
classified as temporary workers.
NOTE: This
definition is important because temporary workers are not classified as
employees. In addition, exclusions applicable to employees do not apply to
temporary workers. As well, temporary workers are not
considered insureds.
The term "trailer" includes semitrailers.
This refers to the Insurance Company providing the coverage and named in
the policy.
These terms refer to
the insureds shown on the Declarations. There could be
multiple named insureds listed. If this is the case, the first insured shown is
known as the first named insured and has additional duties and rights.
These terms also
include the named insured’s spouse, but only if that spouse resides with the
named insured.
NOTE: The definition
specifies only “insured’s spouse.” However, in context, it is
clear that only the spouse of a named insured qualifies as a named
insured.
There are several parts
to this definition.
·
The work or operations carried out by or for the
named insured.
·
Furnished
equipment, parts, or materials used in connection with the work or operations
described in A. above.
·
Warranties
or representations, regardless of when they are made, related to the work,
operations, or the equipment, parts, or materials provided for this work,
covering the following:
o
Durability
o
Fitness
o
Performance
o
Quality
o
Use
·
Instructions
or warnings regarding the work or operations or the equipment, parts, or
materials involved in the insured’s work, whether provided or should have been
provided.