Preview
16-2023-CA-006648-XXXX-MA Div: CV-D
Filing # 169473526 E-Filed 03/23/2023 12:32:52 PM
IN THE CIRCUIT COURT OF THE
FOURTH JUDICIAL CIRCUIT, IN AND
FOR DUVAL COUNTY, FLORIDA
Case No.:
Division:
VANESSA SINGLETON,
Plaintiff,
Vv.
ZEREEDA V. LEWIS,
KEVIN K. LEWIS and DIRECT
GENERAL INSURANCE COMPANY,
Defendants.
/
COMPLAINT FOR DAMAGES AND DEMAND FOR JURY TRIAL
Plaintiff, VANESSA SINGLETON, by and through undersigned counsel, hereby
sues the Defendants, ZEREEDA V. LEWIS, KEVIN K. LEWIS and DIRECT GENERAL
INSURANCE COMPANY, alleges as follows:
JURISDICTION AND PARTIES
1 This is an action for damages in excess of $50,000, exclusive of attorney's
fees and costs.
2 At all times material hereto, the Plaintiff, VANESSA SINGLETON, was a
resident of Duval County, Florida, is over the age of 18, and is otherwise sui juris.
3 At all times material hereto, the Defendant, ZEREEDA V. LEWIS, was a
resident of Columbia County, Florida, is over the age of 18, and is otherwise sui juris.
4. At all times material hereto, the Defendant, KEVIN K. LEWIS, was a
resident of Columbia County, Florida, is over the age of 18, and is otherwise sui juris.
ACCEPTED: DUVAL COUNTY, JODY PHILLIPS, CLERK, 03/28/2023 03:08:08 PM
5 At all times material hereto, the Defendant, DIRECT GENERAL
INSURANCE COMPANY, hereinafter referred to as DIRECT GENERAL, was and is a
foreign corporation, for profit, authorized to do and doing business in the State of Florida,
including in Jacksonville (Duval County), Florida.
6 On or about February 19, 2023, the Plaintiff, VANESSA SINGLETON, was
the driver of a 2018 Toyota Rav4 motor vehicle and traveling northbound on State Road
115 (Southside Boulevard) in Jacksonville (Duval County), Florida.
7 On or about February 19, 2023, Defendant, ZEREEDA V. LEWIS, was the
driver of a 2020 Chrysler 300 motor vehicle, which was co-owned by Defendant, KEVIN
K. LEWIS, and she was traveling southbound on State Road 115 (Southside Boulevard)
in Jacksonville (Duval County), Florida.
COUNT | — NEGLIGENCE CLAIM AGAINST ZEREEDA V. LEWIS
8 The Plaintiff, VANESSA SINGLETON, hereby readopts and re-alleges the
allegations contained in paragraphs one (1) through seven (7), as if fully set forth herein.
9 On or about February 19, 2023, Defendant, ZEREEDA V. LEWIS,
negligently operated and maintained the 3 Chrysler 300, owned by Defendants,
ZEREEDA V. LEWIS and KEVIN K. LEWIS, so that it collided Plaintiffs vehicle.
10. On or about February 19, 2023, after becoming intoxicated/impaired from
alcoholic beverages, the Defendant, ZEREEDA V. LEWIS, violated the right of way of the
Plaintiff, VANESSA SINGLETON, and thereby the Defendant, ZEREEDA V. LEWIS
caused the crash.
175 That as a direct and proximate result of the negligence of Defendant,
ZEREEDA V. LEWIS, the Plaintiff, VANESSA SINGLETON, suffered severe bodily injury
and resulting pain and suffering, disability, scarring, disfigurement, mental anguish, loss
for the capacity for the enjoyment of life, expense of hospitalization, medical and nursing
care and treatment, loss of earnings, the loss of the capacity to earn money and
aggravation of previously existing condition(s). The losses are either permanent or
continuing and the Plaintiff will suffer these losses in the future.
WHEREFORE, the Plaintiff, VANESSA SINGLETON, hereby demands judgment
for compensatory damages from the Defendant, ZEREEDA V. LEWIS, and further
demands trial by jury on all issues so triable and any other relief this Honorable Court
deems just and proper.
COUNT Ii— CLAIM AGAINST KEVIN K. LEWIS
DANGEROUS INSTRUMENTALITY DOCTRINE
12. Plaintiff, VANESSA SINGLETON, hereby readopts and realleges each of
the allegations contained within paragraphs one (1) through seven (7) and paragraphs
nine (9) and ten (10) as if fully set forth herein.
13. On or about, February 19, 2023, Defendant ZEREEDA V. LEWIS,
negligently operated and maintained the 2020 Chrysler 300, co-owned by Defendant,
KEVIN K. LEWIS, so that it collided Plaintiffs vehicle.
14. At all times material hereto, the vehicle driven by Defendant, ZEREEDA V.
LEWIS, was co-owned by Defendant, KEVIN K. LEWIS.
15. At all times material hereto, Defendant, ZEREEDA V. LEWIS, was operating
said 2020 Chrysler 300 with the consent of the Defendant, KEVIN K. LEWIS.
16. Accordingly, at all times material hereto, the Defendant, KEVIN K. LEWIS,
is vicariously liable, under the Dangerous Instrumentality Doctrine for the negligence of
Defendant, ZEREEDA V. LEWIS, in the operation and maintenance of said vehicle.
1%. That as a direct and proximate result of the negligence of Defendant,
ZEREEDA V. LEWIS, as previously alleged, for which the Defendant, KEVIN K. LEWIS,
is liable, the Plaintiff, VANESSA SINGLETON, suffered severe bodily injury and resulting
pain and suffering, disability, scarring, disfigurement, mental anguish, loss for the capacity
for the enjoyment of life, expense of hospitalization, medical and nursing care and
treatment, loss of earnings, the loss of the capacity to earn money and aggravation of
previously existing condition(s). The losses are either permanent or continuing and the
Plaintiff will suffer these losses in the future.
WHEREFORE, the Plaintiff, VANESSA SINGLETON, hereby demands
compensatory damages from the Defendant, KEVIN K. LEWIS, and further demands trial
by jury on all issues so triable and any other relief this Honorable Court deems just and
proper.
COUNT Ill - VANESSA SINGLETON’s UNDERINSURED MOTORIST CLAIM
AGAINST DIRECT GENERAL INSURANCE COMPANY
18. The Plaintiff, VANESSA SINGLETON, hereby readopts and realleges each
of the allegations contained within paragraphs one (1) through seven (7), paragraphs nine
(9) and ten (10) and paragraphs thirteen (13) through sixteen (16) as if fully set forth
herein.
19. Defendant, DIRECT GENERAL, issued a policy of automobile insurance to
the Plaintiff, VANESSA SINGLETON, being policy number 2014119486 that was in effect
on February 19, 2023. A copy of the Declarations Page providing coverage of said
insurance policy is attached hereto as “Exhibit A,” and by this reference made a part
hereof. The Defendant is in possession of copies of such policy.
20. That the aforementioned underlying policy of insurance provides uninsured
and underinsured motorist protection in the amount of $10,000 per person and $20,000
per incident. The policy provides $10,000 in available uninsured / underinsured motorist
protection coverage to the Plaintiff, VANESSA SINGLETON.
21. On or about, February 19, 2023, Defendant ZEREEDA V. LEWIS,
negligently operated and maintained the 2020 Chrysler 300, co-owned by Defendants,
ZEREEDA V. LEWIS and KEVIN K. LEWIS, so that it collided with Plaintiffs vehicle.
22. At all times material hereto, Defendant ZEREEDA V. LEWIS was operating
said vehicle with the consent of Defendant KEVIN K. LEWIS who was the co-owner of
the 2020 Chrysler 300 driven by ZEREEDA V. LEWIS.
23. The active negligence of ZEREEDA V. LEWIS was the sole cause of the
aforementioned February 19, 2023, car crash in which the Plaintiff, VANESSA
SINGLETON, was injured.
24. Defendant, KEVIN K. LEWIS, is vicariously liable for the negligence of
Defendant, ZEREEDA V. LEWIS, in the operation and maintenance of the vehicle she
was driving, at all times material hereto, under the dangerous instrumentality doctrine.
25. At the time and place of the aforementioned car crash, the Defendants,
ZEREEDA V. LEWIS and KEVIN K. LEWIS, were underinsured.
26. That as a result of the owner and operator of the vehicle that caused the
subject crash being uninsured/underinsured, the Defendant, DIRECT GENERAL,
pursuant to the terms of the subject policy and Florida law, stands in the shoes of the
tortfeasor, ZEREEDA V. LEWIS, and the co-owner(s) of the vehicle, KEVIN K. LEWIS.
27. The Plaintiff, VANESSA SINGLETON, has performed all conditions
precedent under the policy of insurance to recover against the Defendant, DIRECT
GENERAL, and files this action.
28. That as a direct and proximate result of the negligence of the ZEREEDA
SINGLETON, for which the Defendant, DIRECT GENERAL, is liable, the Plaintiff,
VANESSA SINGLETON, suffered severe bodily injury and resulting pain and suffering,
disability, scarring, disfigurement, loss for the capacity for the enjoyment of life, expense
of hospitalization, medical and nursing care and treatment, loss of earnings, loss of ability
to earn money and aggravation of previously existing condition(s). The losses are either
permanent or continuing and the Plaintiff will suffer these losses in the future.
WHEREFORE, the Plaintiff, VANESSA SINGLETON, hereby demands judgment
for compensatory damages from the Defendant, DIRECT GENERAL, trial by jury of all
issues so triable, and other relief as may be just.
WOOD, ATTER & WOLF, P.A.
By: /s/ David A. Wolf
DAVID A. WOLF
Florida Bar No.: 857157
Counsel for the Plaintiff
100 N. Laura Street, Suite 702
Jacksonville, FL 32202
Tel: 904-355-8888/Fax: 904-358-3061
dwolf@woodatter.com
erikac@woodatter.com
Nirect
TLE
PO Box 3199 e Winston Salem, NC 27102-3199 Date: 01/13/2023
Policy Number: 2014119486
Named Insured:
VANESSA T SINGLETON Vanessa T Singleton
5309
Policy Period: 02/26/2023 - 02/26/2024
4885 FLORIDA CLUB CIR
JACKSONVILLE FL 32216-1091 Policy Underwritten By:
Direct General Insurance Company
Agent:
Direct General Insurance Agency Inc-1457
1077 W US Highway 90 Ste 150
Lake City FL 32055
(386) 752-5030
It's time to renew your insurance policy!
We know you have a choice when it comes to your insurance and we appreciate the trust you've placed in us for your
insurance needs. Your renewal offer is enclosed, and we've included some important details below. Please review your
current coverage to confirm your policy still meets your needs and protects your investment. Please do not hesitate to
contact us at (386) 752-5030 with any questions or to discuss your coverage.
IMPORTANT NOTICE: Money received will apply to any outstanding balances first. This renewal will not become
active until all outstanding balances have been paid. Your payment must be received before the effective date of
your renewal offer to assure continuous coverage, otherwise your coverage will expire on 02/26/2023.
Your policy form and coverage endorsements may be viewed by going to our website: www.DirectAuto.com. Click on the
Policy Documents link at the top and enter your Policy Number and Last Name. You will be able to view, print and save
your policy forms. The applicable forms are also listed in the "Forms and Endorsements" section on your Declaration Page.
If you prefer to have copies of these policy documents delivered via U.S. Postal Service at no cost to you, please contact
us at 877-463-4732 or your agent at (386) 752-5030.
Thank you again for choosing Direct Auto Insurance. We appreciate your business!
£ ylavion) * A"
Email: service@directauto.com ¢ Fax: 1-877-849-9022 ¢ Phone: 877-463-4732
Visit us at www.DirectAuto.com
10048 (07012017) 1of1
National General Insurance Group
Privacy Notice
The National General Insurance Group” is giving you this notice to tell you how we may collect and share nonpublic
personal information about you and the accounts you have with a company (or companies) in the National General
Insurance Group. This notice also advises you of your right to keep this information from being shared with affiliates of the
National General Insurance Group** or other business associates (non-affiliates) under certain circumstances and your
right to limit marketing, in some cases.
What Nonpublic Personal Information Do We Collect About You?
We collect non-public personal information about you and the members of your household from the following sources:
° Information we receive from you, such as information on applications or other forms, which may include your
name, address, e-mail address, social security number and driving history.
Information about your transactions with us, our affiliates, or others, such as your account balance and payment
history.
Information we receive from outside sources such as consumer reporting agencies, insurance agencies and state
motor vehicle departments which may provide information on your credit history, credit score, driving and accident
history, or prior insurance coverage in place. Please note that the information obtained from outside sources may
be retained by those outside sources and disclosed to other persons without our knowledge.
Information about your computer hardware and software that may be collected by us if you contact our Website
electronically. This information can include: your IP address, browser type, domain names, access times, and
referring Website addresses. This information is used for the operation of the website, to maintain quality of the
website, and to provide general statistics regarding use of our Website.
If you obtain a life, long-term care or disability product, information we receive from you, medical professionals
who have provided care to you and insurance support organizations regarding your health.
How Do We Protect The Information That We Collect About You and Your Accounts?
To protect the privacy and security of nonpublic personal information we collect about you, we restrict access to the
information to our employees, agents and subcontractors who need this information to provide products and services to
you. We maintain physical, electronic, and procedural safeguards that comply with applicable federal and state laws and
regulations to guard your non-public personal information. We strive to keep our information about you accurate. We
require those individuals to whom we permit access to your customer information to protect it and keep it confidential. You
may review the information we have collected on your account and if you tell us of an error, we will update our records
promptly. If you wish to review or correct personal information on your account, please write to us at the address on your
account statement or other account materials.
Do We Share The Inform in We Collect About You and Your Accounts?
Yes, to provide you with superior service, inform you of product and service opportunities that may be of interest to you, or
for other business purposes, we may share all of the nonpublic personal information we collect about you and your
accounts, as described above, as permitted by law. Our sharing of information about you is subject to Your Rights,
described below. However, we do not sell, rent or lease our customer lists to third parties.
We will disclose your personal information, without notice, only if required to do so by law or in the good faith belief that
such action is necessary to: (a) conform to the edicts of the law or comply with legal process served on us; (b) protect and
defend our rights or property; (c) act under exigent circumstances to protect the personal safety of our customers, or the
public; and (d) to process insurance claims.
For Vermont Residents Only: Based on Vermont law, we do not share nonpublic personal information about you with
affiliates or non-affiliated third parties, other than as permitted by law. We automatically treat your accounts as if you
made the Information Sharing and Affiliate Marketing opt out elections described below.
What Types of Affiliates and Non-affiliated Third Parties Do We Share Information About You With?
Subject to Your Rights, detailed below, we may share nonpublic personal information about you with the following types
of affiliates and non-affiliated third parties:
° Financial service providers, such as, credit card issuers, insurance companies, and insurance agents.
° Non-financial companies, such as credit reporting agencies, manufacturers, motor vehicle dealers, retailers, direct
marketers, telecommunications companies, airlines, management companies, attorneys in fact, and publishers.
Companies that perform marketing services on our behalf or with other institutions with which we have joint
marketing agreements.
Others, such as educational institutions.
06159 (09012019) 10f3
We may also share nonpublic personal information about you with affiliates and non-affiliated third parties, as permitted
by law, including consumer report information, such as information from credit reports and certain application information
that we have received from you and from third parties, such as consumer reporting agencies and insurance support
organizations.
*Reference to the National General Insurance Group in this notice includes the following companies: National General Insurance Company,
‘National General Assurance Company, National General Insurance Online, Inc., Integon Casualty Insurance Company, Integon General Insurance
Corporation, Integon Indemnity Corporation, Integon National Insurance Company, Integon Preferred Insurance Company, New South Insurance
Company, MIC General Insurance Corporation, Home State County Mutual Insurance Company — (Administered by Integon National Insurance
Company, National General Insurance Company, Imperial Fire & Casualty Insurance Company or Integon Indemnity Corporation), National General
Motor Club, Inc., National Health Insurance Company, Agent Alliance Insurance Company, National General Premier Insurance Company, Imperial Fire
& Casuaity Insurance Company, Adirondack Insurance Exchange, Mountain Valley Indemnity Company, New Jersey Skylands Insurance Association,
Century-National Insurance Company, Standard Property and Casualty Insurance Company, Direct Insurance Company, Direct General Insurance
Company, Direct General Insurance Company of Mississippi, Direct National Insurance Company, Direct General Life Insurance Company, Old
American County Mutual Fire Insurance Company (Administered by Direct General Insurance Agency), and National Farmers Union Property and
Casualty Company.
**Affiliates of the National General Insurance Group Include: companies in the National General Insurance Group referenced in this notice, and
companies that now or in the future control, are controlled by, or are under common control with a company in the National General Insurance Group.
Do We Share Information About Former Customers?
Yes, subject to Your Rights - detailed below, we may share all of the nonpublic personal information described above
about our former customers with the same types of affiliates and non-affiliated third parties, as described above, as
permitted by law.
Your Rights:
information Sharing
. If you want a company in the National General Insurance Group not to share nonpublic personal information
about you with affiliates, non-affiliated third parties, or both, you may opt out of Information Sharing. That is,
you may direct the company in the National General Insurance Group not to share information (other than as
permitted by law). Information Sharing permitted by law includes, for example, sharing with companies that work
for a company in the National General Insurance Group to provide the product or services you request and
sharing with affiliates information about our transactions or experiences with you for everyday business purposes.
Your Information Sharing opt out direction will apply to nonpublic personal information, as described above, that
the company in the National General Insurance Group has collected about you and your existing accounts.
Affiliate Marketing
. Federal law gives you the right to limit some but not all marketing from the companies in the National General
Insurance Group and their affiliates. You may limit companies in the National General Insurance Group and their
affiliates from marketing their products or services to you based on nonpublic personal information about you
that they receive from a company in the National General Insurance Group. This information includes
income, account information, credit history, and payment history.
. Your choice to limit Affiliate Marketing will apply to nonpublic information about you and your existing account.
Modifications to our privacy policy
We reserve the right to change our privacy practices in the future, which may include sharing nonpublic personal
information about you with nonaffiliated third parties. Before we do that, we will provide you with a revised privacy notice
and give you the opportunity to opt-out of that type of information sharing.
How to Opt Out of Information Sharing or Limit Affiliate Marketing:
. If you wish to opt out of Information Sharing with affiliates, or with non-affiliated third parties, or with both, or to
limit Affiliate Marketing, other than as permitted by law, please complete the form below and return it to the
following address:
Direct Auto Insurance
PO Box 3199
Winston-Salem, NC 27102-3199
Each time you establish a new account with a company in the National General Insurance Group, you will receive
a privacy notice and an opportunity to opt out of Information Sharing and limit Affiliate Marketing for that account,
as permitted by law.
If you have a joint account with another person, either of you may opt out of Information Sharing or limit Affiliate Marketing
(other than as permitted by law) for both of you.
06159 (08012019) 20f3
ee
| direct my information not be shared with affiliates or with non-affiliated third parties, and to limit Affiliate Marketing, other
than as permitted by law.
Vanessa T Singleton 2014119486
Named Insured Account (Policy) Number:
Signature Date
Note: No action is required if you wish to permit information sharing as described in this notice. If you have already told us
not to share your information on this account, you do not need to tell us again.
06159 (09012019) 3of3
Direct General Insurance Company
PERSONAL INJURY PROTECTION OPTIONS
Vanessa T Singleton 2014119486
Policyholder Policy Number
PERSONAL INJURY PROTECTION (NO-FAULT COVERAGE) - Personal Injury Protection must be provided for any
motor vehicle subject to the Florida Motor Vehicle No-Fault Law. Personal Injury Protection benefits include replacement
services expenses, payment of 80% of medical expenses and 60% of work loss up to $10,000 per person. Personal Injury
Protection benefits also include a $5,000 death benefits which are separate from the limits available for replacement
services expenses, medical benefits and work loss.
The named insured may elect a deductible and to exclude coverage for loss of gross income and loss of earning capacity
(‘lost wages” or “work loss"). These elections apply to the named insured alone, or to the named insured and all
dependent resident relatives. For purposes of these elections, a resident spouse is considered a “Named Insured” and not
a dependent resident relative. A premium reduction will result from these elections.
PERSONAL INJURY PROTECTION DEDUCTIBLE -— By electing a deductible you are responsible to pay that portion of
the medical benefits, work loss and replacement services expenses. If you want a deductible, check the box with the
deductible amount you want. If you want the deductible to apply to you and your spouse, check that box. If you want the
deductible to apply to you and any dependent resident relative, check that box. If you do not check a box in this section,
no deductible will apply to your policy. (Note: PIP Deductibles do not apply to death benefits)
Deductible Amount Named Insured(s) Only Named Insured(s) and
(includes resident spouse) Dependent Resident Relative(s)
oO $0 oO
OG $250 a
O $500 a
& $1,000 oO &
EXCLUSION OF WORK LOSS BENEFITS - If you want to exclude work benefits, check only one box. If you do not
check a box in this section, work loss benefits will not be excluded. The named insured is hereby advised not to elect the
work loss exclusion if the named insured or dependent resident relatives are employed, since lost wages will not be
payable in the event of an accident.
& Exclude Work Loss Benefits for Named Insured(s) Only (includes resident spouse).
Oj Exclude Work Loss Benefits for Named Insured(s) and Dependent Resident Relatives.
Signature Date
10436 (07012019) Page 1 of 4
Direct General Insurance Company
FLORIDA UNINSURED MOTORIST SELECTION/REJECTION FORM
YOU ARE ELECTING NOT TO PURCHASE CERTAIN VALUABLE COVERAGE WHICH
PROTECTS YOU AND YOUR FAMILY OR YOU ARE PURCHASING UNINSURED MOTORIST
LIMITS LESS THAN YOUR BODILY INJURY LIABILITY LIMITS WHEN YOU SIGN THIS FORM.
PLEASE READ CAREFULLY.
Uninsured Motorist Coverage provides for payment of certain benefits for damages caused by an owner or a driver of
uninsured motor vehicles because of Bodily Injury or death resulting therefrom. Such benefits may include payments for
certain medical expenses, lost wages, and pain and suffering, subject to the limitations and conditions of the policy. For
the purpose of this coverage an uninsured motor vehicle may include a motor vehicle as to which the Bodily Injury
coverage limits are less than your damages.
Florida law requires that automobile liability policies include Uninsured Motorist coverage limits equal to the Bodily Injury
Liability limits in your policy unless lower limits are requested or the coverage is rejected entirely. Your selection of lower
limits or rejection of Uninsured Motorist coverage will remain in effect unless you make a written request for higher limits
or a written request for this coverage. Uninsured Motorist limits cannot be greater than the Bodily Injury Liability limits in
your policy.
You have the option to purchase, at a reduced rate, “Non-Stacked Uninsured Motorist Coverage.” Under this type of
coverage, if injury occurs in a vehicle owned or leased by you or any family member who resides with you, this policy will
apply only to the extent of coverage (if any) which applies to that vehicle in this policy. The injured person may not add or
combine the coverage provided as to two or more motor vehicles together to determine the limits of uninsured motorist
insurance coverage available, except as described in subsection one below. "Non-stacked Uninsured Motorist" is also
subject to the following limitations:
4 If the injured person is occupying a motor vehicle not owned by the injured person or a family member who resides
with him/her, the injured person may elect the coverage on the motor vehicle occupied and the highest limits of
coverage afforded for any one vehicle insured by the injured person or any family member who resides with him/her.
Such coverage shall be excess over Uninsured Motorist coverage on the vehicle the injured person is occupying.
If the named insured or family member who resides with him/her is occupying a motor vehicle or motorcycle owned by
the named insured or a family member who resides with him/her, there is no coverage if Uninsured Motorist coverage
was not purchased on this policy for that motor vehicle or motorcycle.
If, at the time of the accident the injured person is not occupying a motor vehicle, he or she is entitled to select any
‘one limit of Uninsured Motorist coverage for any one vehicle afforded by a policy under which he/she is insured.
If you select “Stacked Uninsured Motorist Coverage”, your policy limits for each motor vehicle are added together
(stacked) for all covered injuries. Thus, your policy limits change during the policy term if you increase or decrease the
number of automobiles owned under the policy period.
| understand that my election to purchase or reject stacked or non-stacked Uninsured Motorist Coverage will bind all
insureds, including but not limited to, named insureds, listed drivers, family members and any other persons seeking
insured status under this policy.
New Business Clients: If you do not elect any of the options below, your policy will include Uninsured Motorist
coverage at limits equal to the Bodily Injury Liability limits in your policy and your policy will include stacked
uninsured motorist coverage.
Renewal/Existing Clients: If you have previously purchased or rejected Uninsured Motorist coverage and have
selected “stacked” or “unstacked” uninsured motorist coverage, your current declarations page will reflect those
choices. That selection or rejection will continue to apply to your existing policy and any future renewals or
replacements of such policy which are issued at the same amount of Bodily Injury Liability limits. Your selection
or rejection will not change unless you request such change in writing and pay the appropriate premium for the
changed coverage. However, if you change your Bodily Injury Liability limits, your Uninsured Motorist coverage
limits will equal your revised Bodily Injury Liability limits on a stacking bases unless you complete a new
selection/rejection form.
11110 (09012016) 10f2
SELECTION/REJECTION OF UNINSURED MOTORIST COVERAGE
You may select Uninsured Motorist coverage limits up to the Bodily Injury liability limits in your policy or you may reject
Uninsured Motorist coverage entirely. If you do not reject Uninsured Motorist coverage entirely you may select "Stacked
Uninsured Motorist" or "Non-stacked Uninsured Motorist."
Please select one coverage option below and a limit if listed under that option:
o hereby select Stacked Uninsured Motorist coverage in the same limits as my Bodily Injury liability
coverage.
(Note: If you select this option the paragraph regarding “non-stacked uninsured motorist coverage and the
bold statement at the top of page 1 shall not apply.”)
! hereby select Non-stacked Uninsured Motorist coverage in the same limits as my Bodily Injury liability
coverage.
I hereby select Stacked Uninsured Motorist coverage at the limit selected below. (Note: This section
includes an option for Uninsured Motorist coverage limits which are lower than your Bodily Injury liability
limits.)
Uninsured Motorist Coverage Limits Options
(Each Person/Each Accident)
O $10,000 Each Person / $20,000 Each
Accident
| hereby select Non-Stacked Uninsured Motorist coverage at the limit selected below. (Note: This section
includes an option for Uninsured Motorist coverage limits which are lower than your Bodily Injury liability
limits.)
Uninsured Motorist Coverage Limits Options
(Each Person/Each Accident)
O $10,000 Each Person / $20,000 Each
Accident
fel I hereby reject all Uninsured Motorist coverage.
Please contact your agent if you have any questions about this coverage.
| understand and agree that selection of any of the above options applies to my liability insurance policy and any future
renewals or replacements of such policy which are issued at the same Bodily Injury Liability limits. If | decide to select
another option at some future time | must let the Company know in writing.
Vanessa T Singleton 2014119486 / 32216-1091
Named Insured Policy Number/Zip Code
Signature Date
11110 (09012016) 20f2
Direct
ons Date of Notici 1113/2023
PO Box 3199 Winston Salem, NC 27102-3199 Policy Period: 2/26/2023 — 2/26/2024
Agent:
Direct General Insurance Agency Inc
(386) 752-5030
VANESSA T SINGLETON Register online and go paperless! Save money
a and discover your exclusive online benefits at
‘wrww Dinecrauto.com,
GO Papert ESS
This is your renewal bill and your policy documents are enclosed. Your current policy will expire on 02/26/2023 at 12:01 A.M. We are pleased to offer to
renew your policy for another term. Your renewal payment must be received by 2/25/2023 in order to maintain continuous coverage.
[POLICY DETAILS Policy Number Billing Summary]
Personal Auto Policy: 2014119486,
Amount Due:
“Prior Balance Due: (please disregard if already paid)
This may include remaining installments and/or additional premium from your current policy Policy period 02/26/2022-02/26/2023
period. Total Amount Due:
PAYMENT OPTIONS Pay Now!
Pay in Full Save Money! Avoid installment fees by paying your renewal balance in full
Automatic Payments Enrollment required. See reverse side for more information on enrollment.
Installments Due Date: 2/25/2023
Note: If received in our office § days after the due date, a $10.00 late fee will apply
- - Please see reverse side for additional information - -
If mailing, please detach the coupon below and return with your payment, Please mail 7 days in advance.
Payment Coupon Our records show the following:
Personal Auto: 2014119486 Email: vtpayen@hotmail.com
Phone: 347-885-5533
Amount Due 2/25/2023 For automated payments please visit
www.DirectAuto.com or call 877-463-4732
Prior Balance Due: Upon Receipt (please disregard if already paid) If mailing, please make check payable to:
Policy period 02/26/2022-02/26/2023 Direct Auto Insurance
Total Amount Due:
Amount
Enclosed:
DIRECT AUTO INSURANCE
Named Insured: Ch for address nge PO BOX 89431
less enrolim CLEVELAND OH 44101-6431
VANESSA T SINGLETON ‘note your changes
5309 one seside.
4885 FLORIDA CLUB CIR
JACKSONVILLE, FL 32216-1091
020341159486017000000230700000215358
10041 (09012017)
[PAYMENT SCHEDULE
Due Date Scheduled Amount
2/25/2023
3/26/2023
4/26/2023
5/26/2023
6/26/2023
712612023
8/26/2023
9/26/2023
10/26/2023
11/26/2023
12/26/2023
1126/2024
All installments include a $17.51 installment charge.
Please note in accordance with Federal Reserve guidelines we may process your payment electronically via the automated clearing house (ACH).
Enrolling for Automatic Payments
‘Step 1: Make your upcoming payment online at www.DirectAuto.com, by mail or with your agent.
‘Step 2: Complete the Automatic Payments authorization form by phone at 877-463-4732 or contact your agent.
After your Automatic Payments enrollment has been processed on your policy, we will send you an Automatic Payments schedule.
To avoid a cancellation of your coverage, please make sure that your payment is received by the due date. The Company may process a Notice of
Cancellation if payment is not received by the Company on or before the due date. Postmark is not sufficient. If your check is returned by the bank for
insufficient funds or for any other reason, a Notice of Cancellation will be immediately processed.
If you have questions or need assistance with your policy, please call your agent at the phone number listed at the top of your statement or call customer
service at 877-463-4732.
Thank you for choosing Direct Auto Insurance. We appreciate the opportunity to give you the coverage you need and the service you deserve.
Has your address or email changed? Please update your contact information below. ‘10042 (09012017)
Insured First Name Initial Last Name
Street Address or PO Box
City State Zip
Home Phone
- - 1 Garaging Address Change O Mailing Address Change O Both
Email - used for Customer communcation only
Enroll in Electronic Delivery - Would you like to simplify your life and enroll in electronic bills and documents?
OD Yes, I'd like to receive all my bills and documents electronically. Please provide email address above.
Thank you for insuring with us! Here are your identification cards for proof of insurance.
[Birect
Florida Automobile Insurance Identification Card KEEP THIS CARD IN YOUR MOTOR VEHICLE
Direct General Insurance Company Company Number
PO Box 3199 Winston Salem, NC 27102-3199 Report all accidents immediately to: Direct Auto Insurance
02876
Policy Number Effective Date Expiration Date
2014119486 2126/2023 2/26/2024
Toll free at: 800-403-1077
Personal Injury Protection Benefits/ Bodily Injury 9008687
Property Damage Liability Liability AGENCY:
Vanessa T Singleton Direct General Insurance Agency Inc-1457 (386) 752-5030
Tyshawn L Singleton 1077 WUS Highway 80 Ste 150
Lake City, FL. 32055
2018 TOYT RAV4LE 2T3ZFREV4JW478675
Misrepresentation of insurance is a first degree misdemeanor
NOT VALID FOR MORE THAN ONE YEAR FROM EFFECTIVE DATE
MOD: 01 10330 (01012011)
A
Cut On Solid Line — Fold On Dotted Line
1oft
Nirect Policy Number:
2014119486
Date of Notice
01/13/2023 08:54 AM
PO Box 3199 ¢ Winston Salem, NC 27102-3199 Named Insured:
VANESSA T SINGLETON
VANESSA T SINGLETON Policy Period:
02/26/2023 - 02/26/2024
Policy Underwritten by:
Direct General Insurance
Company
24 Hour Claim Reporting: 800-403-1077
For Policy Information: 877-463-4732
www.DirectAuto.com
Your Agent:
Direct General Insurance Agency Inc-1457
1077 W US Highway 80 Ste 150
Lake City FL 32055
(386) 752-5030
FL PERSONAL AUTO DECLARATIONS PAGE
Renewal Effective 02/26/2023 12:01 AM
Drivers and Household Residents
#1 Vanessa T Singleton
Driver Status License # Lic. State Date of Birth Gender Marital Status Driver Pts Yrs. Lic.
Rated Driver XXXXXXXXX7980 FL 08/18/1983 Female Married 0 23
#2 Tyshawn L Singleton
Driver Status License # Lic. State Date of Birth Gender Marital Status Driver Pts Yrs. Lic.
Rated Driver XXXXXXXXX3110 FL 08/31/1979 Male Married 0 27
#3 Amayah A Payen
Driver Status License # Lic. State Date of Birth Gender Marital Status Driver Pts Yrs. Lic.
Excluded Driver FL 03/05/2003 Female Single 0 3
Insured Personal Auto(s) and Schedule of Coverages
#1 2018 TOYT RAV4 LE VIN: 2T3ZFREV4JW478675-7G1430
Usage: Pleasure/Commute
Garaging Location: 322161091
Loss Payee Address
Alive Credit Union PO Box 924493, Fort Worth, TX 76124
Coverages Provided Limits/Deductibles Premium
Bodily Injury $10,000 Each Person / $20,000 Each Accident $273.00
Property Damage $10,000 Each Accident $236.00
Uninsured Motorist Bodily Injury - Nonstacked $10,000 Each Person / $20,000 Each Accident $195.00
Personal Injury Protection $10,000 , $1,000 Deductible Per Occurrence - $697.00
Named Insured and Resident Relatives,
Preview
16-2023-CA-006648-XXXX-MA Div: CV-D Filing # 169473526 E-Filed 03/23/2023 12:32:52 PM IN THE CIRCUIT COURT OF THE FOURTH JUDICIAL CIRCUIT, IN AND FOR DUVAL COUNTY, FLORIDA Case No.: Division: VANESSA SINGLETON, Plaintiff, Vv. ZEREEDA V. LEWIS, KEVIN K. LEWIS and DIRECT GENERAL INSURANCE COMPANY, Defendants. / COMPLAINT FOR DAMAGES AND DEMAND FOR JURY TRIAL Plaintiff, VANESSA SINGLETON, by and through undersigned counsel, hereby sues the Defendants, ZEREEDA V. LEWIS, KEVIN K. LEWIS and DIRECT GENERAL INSURANCE COMPANY, alleges as follows: JURISDICTION AND PARTIES 1 This is an action for damages in excess of $50,000, exclusive of attorney's fees and costs. 2 At all times material hereto, the Plaintiff, VANESSA SINGLETON, was a resident of Duval County, Florida, is over the age of 18, and is otherwise sui juris. 3 At all times material hereto, the Defendant, ZEREEDA V. LEWIS, was a resident of Columbia County, Florida, is over the age of 18, and is otherwise sui juris. 4. At all times material hereto, the Defendant, KEVIN K. LEWIS, was a resident of Columbia County, Florida, is over the age of 18, and is otherwise sui juris. ACCEPTED: DUVAL COUNTY, JODY PHILLIPS, CLERK, 03/28/2023 03:08:08 PM 5 At all times material hereto, the Defendant, DIRECT GENERAL INSURANCE COMPANY, hereinafter referred to as DIRECT GENERAL, was and is a foreign corporation, for profit, authorized to do and doing business in the State of Florida, including in Jacksonville (Duval County), Florida. 6 On or about February 19, 2023, the Plaintiff, VANESSA SINGLETON, was the driver of a 2018 Toyota Rav4 motor vehicle and traveling northbound on State Road 115 (Southside Boulevard) in Jacksonville (Duval County), Florida. 7 On or about February 19, 2023, Defendant, ZEREEDA V. LEWIS, was the driver of a 2020 Chrysler 300 motor vehicle, which was co-owned by Defendant, KEVIN K. LEWIS, and she was traveling southbound on State Road 115 (Southside Boulevard) in Jacksonville (Duval County), Florida. COUNT | — NEGLIGENCE CLAIM AGAINST ZEREEDA V. LEWIS 8 The Plaintiff, VANESSA SINGLETON, hereby readopts and re-alleges the allegations contained in paragraphs one (1) through seven (7), as if fully set forth herein. 9 On or about February 19, 2023, Defendant, ZEREEDA V. LEWIS, negligently operated and maintained the 3 Chrysler 300, owned by Defendants, ZEREEDA V. LEWIS and KEVIN K. LEWIS, so that it collided Plaintiffs vehicle. 10. On or about February 19, 2023, after becoming intoxicated/impaired from alcoholic beverages, the Defendant, ZEREEDA V. LEWIS, violated the right of way of the Plaintiff, VANESSA SINGLETON, and thereby the Defendant, ZEREEDA V. LEWIS caused the crash. 175 That as a direct and proximate result of the negligence of Defendant, ZEREEDA V. LEWIS, the Plaintiff, VANESSA SINGLETON, suffered severe bodily injury and resulting pain and suffering, disability, scarring, disfigurement, mental anguish, loss for the capacity for the enjoyment of life, expense of hospitalization, medical and nursing care and treatment, loss of earnings, the loss of the capacity to earn money and aggravation of previously existing condition(s). The losses are either permanent or continuing and the Plaintiff will suffer these losses in the future. WHEREFORE, the Plaintiff, VANESSA SINGLETON, hereby demands judgment for compensatory damages from the Defendant, ZEREEDA V. LEWIS, and further demands trial by jury on all issues so triable and any other relief this Honorable Court deems just and proper. COUNT Ii— CLAIM AGAINST KEVIN K. LEWIS DANGEROUS INSTRUMENTALITY DOCTRINE 12. Plaintiff, VANESSA SINGLETON, hereby readopts and realleges each of the allegations contained within paragraphs one (1) through seven (7) and paragraphs nine (9) and ten (10) as if fully set forth herein. 13. On or about, February 19, 2023, Defendant ZEREEDA V. LEWIS, negligently operated and maintained the 2020 Chrysler 300, co-owned by Defendant, KEVIN K. LEWIS, so that it collided Plaintiffs vehicle. 14. At all times material hereto, the vehicle driven by Defendant, ZEREEDA V. LEWIS, was co-owned by Defendant, KEVIN K. LEWIS. 15. At all times material hereto, Defendant, ZEREEDA V. LEWIS, was operating said 2020 Chrysler 300 with the consent of the Defendant, KEVIN K. LEWIS. 16. Accordingly, at all times material hereto, the Defendant, KEVIN K. LEWIS, is vicariously liable, under the Dangerous Instrumentality Doctrine for the negligence of Defendant, ZEREEDA V. LEWIS, in the operation and maintenance of said vehicle. 1%. That as a direct and proximate result of the negligence of Defendant, ZEREEDA V. LEWIS, as previously alleged, for which the Defendant, KEVIN K. LEWIS, is liable, the Plaintiff, VANESSA SINGLETON, suffered severe bodily injury and resulting pain and suffering, disability, scarring, disfigurement, mental anguish, loss for the capacity for the enjoyment of life, expense of hospitalization, medical and nursing care and treatment, loss of earnings, the loss of the capacity to earn money and aggravation of previously existing condition(s). The losses are either permanent or continuing and the Plaintiff will suffer these losses in the future. WHEREFORE, the Plaintiff, VANESSA SINGLETON, hereby demands compensatory damages from the Defendant, KEVIN K. LEWIS, and further demands trial by jury on all issues so triable and any other relief this Honorable Court deems just and proper. COUNT Ill - VANESSA SINGLETON’s UNDERINSURED MOTORIST CLAIM AGAINST DIRECT GENERAL INSURANCE COMPANY 18. The Plaintiff, VANESSA SINGLETON, hereby readopts and realleges each of the allegations contained within paragraphs one (1) through seven (7), paragraphs nine (9) and ten (10) and paragraphs thirteen (13) through sixteen (16) as if fully set forth herein. 19. Defendant, DIRECT GENERAL, issued a policy of automobile insurance to the Plaintiff, VANESSA SINGLETON, being policy number 2014119486 that was in effect on February 19, 2023. A copy of the Declarations Page providing coverage of said insurance policy is attached hereto as “Exhibit A,” and by this reference made a part hereof. The Defendant is in possession of copies of such policy. 20. That the aforementioned underlying policy of insurance provides uninsured and underinsured motorist protection in the amount of $10,000 per person and $20,000 per incident. The policy provides $10,000 in available uninsured / underinsured motorist protection coverage to the Plaintiff, VANESSA SINGLETON. 21. On or about, February 19, 2023, Defendant ZEREEDA V. LEWIS, negligently operated and maintained the 2020 Chrysler 300, co-owned by Defendants, ZEREEDA V. LEWIS and KEVIN K. LEWIS, so that it collided with Plaintiffs vehicle. 22. At all times material hereto, Defendant ZEREEDA V. LEWIS was operating said vehicle with the consent of Defendant KEVIN K. LEWIS who was the co-owner of the 2020 Chrysler 300 driven by ZEREEDA V. LEWIS. 23. The active negligence of ZEREEDA V. LEWIS was the sole cause of the aforementioned February 19, 2023, car crash in which the Plaintiff, VANESSA SINGLETON, was injured. 24. Defendant, KEVIN K. LEWIS, is vicariously liable for the negligence of Defendant, ZEREEDA V. LEWIS, in the operation and maintenance of the vehicle she was driving, at all times material hereto, under the dangerous instrumentality doctrine. 25. At the time and place of the aforementioned car crash, the Defendants, ZEREEDA V. LEWIS and KEVIN K. LEWIS, were underinsured. 26. That as a result of the owner and operator of the vehicle that caused the subject crash being uninsured/underinsured, the Defendant, DIRECT GENERAL, pursuant to the terms of the subject policy and Florida law, stands in the shoes of the tortfeasor, ZEREEDA V. LEWIS, and the co-owner(s) of the vehicle, KEVIN K. LEWIS. 27. The Plaintiff, VANESSA SINGLETON, has performed all conditions precedent under the policy of insurance to recover against the Defendant, DIRECT GENERAL, and files this action. 28. That as a direct and proximate result of the negligence of the ZEREEDA SINGLETON, for which the Defendant, DIRECT GENERAL, is liable, the Plaintiff, VANESSA SINGLETON, suffered severe bodily injury and resulting pain and suffering, disability, scarring, disfigurement, loss for the capacity for the enjoyment of life, expense of hospitalization, medical and nursing care and treatment, loss of earnings, loss of ability to earn money and aggravation of previously existing condition(s). The losses are either permanent or continuing and the Plaintiff will suffer these losses in the future. WHEREFORE, the Plaintiff, VANESSA SINGLETON, hereby demands judgment for compensatory damages from the Defendant, DIRECT GENERAL, trial by jury of all issues so triable, and other relief as may be just. WOOD, ATTER & WOLF, P.A. By: /s/ David A. Wolf DAVID A. WOLF Florida Bar No.: 857157 Counsel for the Plaintiff 100 N. Laura Street, Suite 702 Jacksonville, FL 32202 Tel: 904-355-8888/Fax: 904-358-3061 dwolf@woodatter.com erikac@woodatter.com Nirect TLE PO Box 3199 e Winston Salem, NC 27102-3199 Date: 01/13/2023 Policy Number: 2014119486 Named Insured: VANESSA T SINGLETON Vanessa T Singleton 5309 Policy Period: 02/26/2023 - 02/26/2024 4885 FLORIDA CLUB CIR JACKSONVILLE FL 32216-1091 Policy Underwritten By: Direct General Insurance Company Agent: Direct General Insurance Agency Inc-1457 1077 W US Highway 90 Ste 150 Lake City FL 32055 (386) 752-5030 It's time to renew your insurance policy! We know you have a choice when it comes to your insurance and we appreciate the trust you've placed in us for your insurance needs. Your renewal offer is enclosed, and we've included some important details below. Please review your current coverage to confirm your policy still meets your needs and protects your investment. Please do not hesitate to contact us at (386) 752-5030 with any questions or to discuss your coverage. IMPORTANT NOTICE: Money received will apply to any outstanding balances first. This renewal will not become active until all outstanding balances have been paid. Your payment must be received before the effective date of your renewal offer to assure continuous coverage, otherwise your coverage will expire on 02/26/2023. Your policy form and coverage endorsements may be viewed by going to our website: www.DirectAuto.com. Click on the Policy Documents link at the top and enter your Policy Number and Last Name. You will be able to view, print and save your policy forms. The applicable forms are also listed in the "Forms and Endorsements" section on your Declaration Page. If you prefer to have copies of these policy documents delivered via U.S. Postal Service at no cost to you, please contact us at 877-463-4732 or your agent at (386) 752-5030. Thank you again for choosing Direct Auto Insurance. We appreciate your business! £ ylavion) * A" Email: service@directauto.com ¢ Fax: 1-877-849-9022 ¢ Phone: 877-463-4732 Visit us at www.DirectAuto.com 10048 (07012017) 1of1 National General Insurance Group Privacy Notice The National General Insurance Group” is giving you this notice to tell you how we may collect and share nonpublic personal information about you and the accounts you have with a company (or companies) in the National General Insurance Group. This notice also advises you of your right to keep this information from being shared with affiliates of the National General Insurance Group** or other business associates (non-affiliates) under certain circumstances and your right to limit marketing, in some cases. What Nonpublic Personal Information Do We Collect About You? We collect non-public personal information about you and the members of your household from the following sources: ° Information we receive from you, such as information on applications or other forms, which may include your name, address, e-mail address, social security number and driving history. Information about your transactions with us, our affiliates, or others, such as your account balance and payment history. Information we receive from outside sources such as consumer reporting agencies, insurance agencies and state motor vehicle departments which may provide information on your credit history, credit score, driving and accident history, or prior insurance coverage in place. Please note that the information obtained from outside sources may be retained by those outside sources and disclosed to other persons without our knowledge. Information about your computer hardware and software that may be collected by us if you contact our Website electronically. This information can include: your IP address, browser type, domain names, access times, and referring Website addresses. This information is used for the operation of the website, to maintain quality of the website, and to provide general statistics regarding use of our Website. If you obtain a life, long-term care or disability product, information we receive from you, medical professionals who have provided care to you and insurance support organizations regarding your health. How Do We Protect The Information That We Collect About You and Your Accounts? To protect the privacy and security of nonpublic personal information we collect about you, we restrict access to the information to our employees, agents and subcontractors who need this information to provide products and services to you. We maintain physical, electronic, and procedural safeguards that comply with applicable federal and state laws and regulations to guard your non-public personal information. We strive to keep our information about you accurate. We require those individuals to whom we permit access to your customer information to protect it and keep it confidential. You may review the information we have collected on your account and if you tell us of an error, we will update our records promptly. If you wish to review or correct personal information on your account, please write to us at the address on your account statement or other account materials. Do We Share The Inform in We Collect About You and Your Accounts? Yes, to provide you with superior service, inform you of product and service opportunities that may be of interest to you, or for other business purposes, we may share all of the nonpublic personal information we collect about you and your accounts, as described above, as permitted by law. Our sharing of information about you is subject to Your Rights, described below. However, we do not sell, rent or lease our customer lists to third parties. We will disclose your personal information, without notice, only if required to do so by law or in the good faith belief that such action is necessary to: (a) conform to the edicts of the law or comply with legal process served on us; (b) protect and defend our rights or property; (c) act under exigent circumstances to protect the personal safety of our customers, or the public; and (d) to process insurance claims. For Vermont Residents Only: Based on Vermont law, we do not share nonpublic personal information about you with affiliates or non-affiliated third parties, other than as permitted by law. We automatically treat your accounts as if you made the Information Sharing and Affiliate Marketing opt out elections described below. What Types of Affiliates and Non-affiliated Third Parties Do We Share Information About You With? Subject to Your Rights, detailed below, we may share nonpublic personal information about you with the following types of affiliates and non-affiliated third parties: ° Financial service providers, such as, credit card issuers, insurance companies, and insurance agents. ° Non-financial companies, such as credit reporting agencies, manufacturers, motor vehicle dealers, retailers, direct marketers, telecommunications companies, airlines, management companies, attorneys in fact, and publishers. Companies that perform marketing services on our behalf or with other institutions with which we have joint marketing agreements. Others, such as educational institutions. 06159 (09012019) 10f3 We may also share nonpublic personal information about you with affiliates and non-affiliated third parties, as permitted by law, including consumer report information, such as information from credit reports and certain application information that we have received from you and from third parties, such as consumer reporting agencies and insurance support organizations. *Reference to the National General Insurance Group in this notice includes the following companies: National General Insurance Company, ‘National General Assurance Company, National General Insurance Online, Inc., Integon Casualty Insurance Company, Integon General Insurance Corporation, Integon Indemnity Corporation, Integon National Insurance Company, Integon Preferred Insurance Company, New South Insurance Company, MIC General Insurance Corporation, Home State County Mutual Insurance Company — (Administered by Integon National Insurance Company, National General Insurance Company, Imperial Fire & Casualty Insurance Company or Integon Indemnity Corporation), National General Motor Club, Inc., National Health Insurance Company, Agent Alliance Insurance Company, National General Premier Insurance Company, Imperial Fire & Casuaity Insurance Company, Adirondack Insurance Exchange, Mountain Valley Indemnity Company, New Jersey Skylands Insurance Association, Century-National Insurance Company, Standard Property and Casualty Insurance Company, Direct Insurance Company, Direct General Insurance Company, Direct General Insurance Company of Mississippi, Direct National Insurance Company, Direct General Life Insurance Company, Old American County Mutual Fire Insurance Company (Administered by Direct General Insurance Agency), and National Farmers Union Property and Casualty Company. **Affiliates of the National General Insurance Group Include: companies in the National General Insurance Group referenced in this notice, and companies that now or in the future control, are controlled by, or are under common control with a company in the National General Insurance Group. Do We Share Information About Former Customers? Yes, subject to Your Rights - detailed below, we may share all of the nonpublic personal information described above about our former customers with the same types of affiliates and non-affiliated third parties, as described above, as permitted by law. Your Rights: information Sharing . If you want a company in the National General Insurance Group not to share nonpublic personal information about you with affiliates, non-affiliated third parties, or both, you may opt out of Information Sharing. That is, you may direct the company in the National General Insurance Group not to share information (other than as permitted by law). Information Sharing permitted by law includes, for example, sharing with companies that work for a company in the National General Insurance Group to provide the product or services you request and sharing with affiliates information about our transactions or experiences with you for everyday business purposes. Your Information Sharing opt out direction will apply to nonpublic personal information, as described above, that the company in the National General Insurance Group has collected about you and your existing accounts. Affiliate Marketing . Federal law gives you the right to limit some but not all marketing from the companies in the National General Insurance Group and their affiliates. You may limit companies in the National General Insurance Group and their affiliates from marketing their products or services to you based on nonpublic personal information about you that they receive from a company in the National General Insurance Group. This information includes income, account information, credit history, and payment history. . Your choice to limit Affiliate Marketing will apply to nonpublic information about you and your existing account. Modifications to our privacy policy We reserve the right to change our privacy practices in the future, which may include sharing nonpublic personal information about you with nonaffiliated third parties. Before we do that, we will provide you with a revised privacy notice and give you the opportunity to opt-out of that type of information sharing. How to Opt Out of Information Sharing or Limit Affiliate Marketing: . If you wish to opt out of Information Sharing with affiliates, or with non-affiliated third parties, or with both, or to limit Affiliate Marketing, other than as permitted by law, please complete the form below and return it to the following address: Direct Auto Insurance PO Box 3199 Winston-Salem, NC 27102-3199 Each time you establish a new account with a company in the National General Insurance Group, you will receive a privacy notice and an opportunity to opt out of Information Sharing and limit Affiliate Marketing for that account, as permitted by law. If you have a joint account with another person, either of you may opt out of Information Sharing or limit Affiliate Marketing (other than as permitted by law) for both of you. 06159 (08012019) 20f3 ee | direct my information not be shared with affiliates or with non-affiliated third parties, and to limit Affiliate Marketing, other than as permitted by law. Vanessa T Singleton 2014119486 Named Insured Account (Policy) Number: Signature Date Note: No action is required if you wish to permit information sharing as described in this notice. If you have already told us not to share your information on this account, you do not need to tell us again. 06159 (09012019) 3of3 Direct General Insurance Company PERSONAL INJURY PROTECTION OPTIONS Vanessa T Singleton 2014119486 Policyholder Policy Number PERSONAL INJURY PROTECTION (NO-FAULT COVERAGE) - Personal Injury Protection must be provided for any motor vehicle subject to the Florida Motor Vehicle No-Fault Law. Personal Injury Protection benefits include replacement services expenses, payment of 80% of medical expenses and 60% of work loss up to $10,000 per person. Personal Injury Protection benefits also include a $5,000 death benefits which are separate from the limits available for replacement services expenses, medical benefits and work loss. The named insured may elect a deductible and to exclude coverage for loss of gross income and loss of earning capacity (‘lost wages” or “work loss"). These elections apply to the named insured alone, or to the named insured and all dependent resident relatives. For purposes of these elections, a resident spouse is considered a “Named Insured” and not a dependent resident relative. A premium reduction will result from these elections. PERSONAL INJURY PROTECTION DEDUCTIBLE -— By electing a deductible you are responsible to pay that portion of the medical benefits, work loss and replacement services expenses. If you want a deductible, check the box with the deductible amount you want. If you want the deductible to apply to you and your spouse, check that box. If you want the deductible to apply to you and any dependent resident relative, check that box. If you do not check a box in this section, no deductible will apply to your policy. (Note: PIP Deductibles do not apply to death benefits) Deductible Amount Named Insured(s) Only Named Insured(s) and (includes resident spouse) Dependent Resident Relative(s) oO $0 oO OG $250 a O $500 a & $1,000 oO & EXCLUSION OF WORK LOSS BENEFITS - If you want to exclude work benefits, check only one box. If you do not check a box in this section, work loss benefits will not be excluded. The named insured is hereby advised not to elect the work loss exclusion if the named insured or dependent resident relatives are employed, since lost wages will not be payable in the event of an accident. & Exclude Work Loss Benefits for Named Insured(s) Only (includes resident spouse). Oj Exclude Work Loss Benefits for Named Insured(s) and Dependent Resident Relatives. Signature Date 10436 (07012019) Page 1 of 4 Direct General Insurance Company FLORIDA UNINSURED MOTORIST SELECTION/REJECTION FORM YOU ARE ELECTING NOT TO PURCHASE CERTAIN VALUABLE COVERAGE WHICH PROTECTS YOU AND YOUR FAMILY OR YOU ARE PURCHASING UNINSURED MOTORIST LIMITS LESS THAN YOUR BODILY INJURY LIABILITY LIMITS WHEN YOU SIGN THIS FORM. PLEASE READ CAREFULLY. Uninsured Motorist Coverage provides for payment of certain benefits for damages caused by an owner or a driver of uninsured motor vehicles because of Bodily Injury or death resulting therefrom. Such benefits may include payments for certain medical expenses, lost wages, and pain and suffering, subject to the limitations and conditions of the policy. For the purpose of this coverage an uninsured motor vehicle may include a motor vehicle as to which the Bodily Injury coverage limits are less than your damages. Florida law requires that automobile liability policies include Uninsured Motorist coverage limits equal to the Bodily Injury Liability limits in your policy unless lower limits are requested or the coverage is rejected entirely. Your selection of lower limits or rejection of Uninsured Motorist coverage will remain in effect unless you make a written request for higher limits or a written request for this coverage. Uninsured Motorist limits cannot be greater than the Bodily Injury Liability limits in your policy. You have the option to purchase, at a reduced rate, “Non-Stacked Uninsured Motorist Coverage.” Under this type of coverage, if injury occurs in a vehicle owned or leased by you or any family member who resides with you, this policy will apply only to the extent of coverage (if any) which applies to that vehicle in this policy. The injured person may not add or combine the coverage provided as to two or more motor vehicles together to determine the limits of uninsured motorist insurance coverage available, except as described in subsection one below. "Non-stacked Uninsured Motorist" is also subject to the following limitations: 4 If the injured person is occupying a motor vehicle not owned by the injured person or a family member who resides with him/her, the injured person may elect the coverage on the motor vehicle occupied and the highest limits of coverage afforded for any one vehicle insured by the injured person or any family member who resides with him/her. Such coverage shall be excess over Uninsured Motorist coverage on the vehicle the injured person is occupying. If the named insured or family member who resides with him/her is occupying a motor vehicle or motorcycle owned by the named insured or a family member who resides with him/her, there is no coverage if Uninsured Motorist coverage was not purchased on this policy for that motor vehicle or motorcycle. If, at the time of the accident the injured person is not occupying a motor vehicle, he or she is entitled to select any ‘one limit of Uninsured Motorist coverage for any one vehicle afforded by a policy under which he/she is insured. If you select “Stacked Uninsured Motorist Coverage”, your policy limits for each motor vehicle are added together (stacked) for all covered injuries. Thus, your policy limits change during the policy term if you increase or decrease the number of automobiles owned under the policy period. | understand that my election to purchase or reject stacked or non-stacked Uninsured Motorist Coverage will bind all insureds, including but not limited to, named insureds, listed drivers, family members and any other persons seeking insured status under this policy. New Business Clients: If you do not elect any of the options below, your policy will include Uninsured Motorist coverage at limits equal to the Bodily Injury Liability limits in your policy and your policy will include stacked uninsured motorist coverage. Renewal/Existing Clients: If you have previously purchased or rejected Uninsured Motorist coverage and have selected “stacked” or “unstacked” uninsured motorist coverage, your current declarations page will reflect those choices. That selection or rejection will continue to apply to your existing policy and any future renewals or replacements of such policy which are issued at the same amount of Bodily Injury Liability limits. Your selection or rejection will not change unless you request such change in writing and pay the appropriate premium for the changed coverage. However, if you change your Bodily Injury Liability limits, your Uninsured Motorist coverage limits will equal your revised Bodily Injury Liability limits on a stacking bases unless you complete a new selection/rejection form. 11110 (09012016) 10f2 SELECTION/REJECTION OF UNINSURED MOTORIST COVERAGE You may select Uninsured Motorist coverage limits up to the Bodily Injury liability limits in your policy or you may reject Uninsured Motorist coverage entirely. If you do not reject Uninsured Motorist coverage entirely you may select "Stacked Uninsured Motorist" or "Non-stacked Uninsured Motorist." Please select one coverage option below and a limit if listed under that option: o hereby select Stacked Uninsured Motorist coverage in the same limits as my Bodily Injury liability coverage. (Note: If you select this option the paragraph regarding “non-stacked uninsured motorist coverage and the bold statement at the top of page 1 shall not apply.”) ! hereby select Non-stacked Uninsured Motorist coverage in the same limits as my Bodily Injury liability coverage. I hereby select Stacked Uninsured Motorist coverage at the limit selected below. (Note: This section includes an option for Uninsured Motorist coverage limits which are lower than your Bodily Injury liability limits.) Uninsured Motorist Coverage Limits Options (Each Person/Each Accident) O $10,000 Each Person / $20,000 Each Accident | hereby select Non-Stacked Uninsured Motorist coverage at the limit selected below. (Note: This section includes an option for Uninsured Motorist coverage limits which are lower than your Bodily Injury liability limits.) Uninsured Motorist Coverage Limits Options (Each Person/Each Accident) O $10,000 Each Person / $20,000 Each Accident fel I hereby reject all Uninsured Motorist coverage. Please contact your agent if you have any questions about this coverage. | understand and agree that selection of any of the above options applies to my liability insurance policy and any future renewals or replacements of such policy which are issued at the same Bodily Injury Liability limits. If | decide to select another option at some future time | must let the Company know in writing. Vanessa T Singleton 2014119486 / 32216-1091 Named Insured Policy Number/Zip Code Signature Date 11110 (09012016) 20f2 Direct ons Date of Notici 1113/2023 PO Box 3199 Winston Salem, NC 27102-3199 Policy Period: 2/26/2023 — 2/26/2024 Agent: Direct General Insurance Agency Inc (386) 752-5030 VANESSA T SINGLETON Register online and go paperless! Save money a and discover your exclusive online benefits at ‘wrww Dinecrauto.com, GO Papert ESS This is your renewal bill and your policy documents are enclosed. Your current policy will expire on 02/26/2023 at 12:01 A.M. We are pleased to offer to renew your policy for another term. Your renewal payment must be received by 2/25/2023 in order to maintain continuous coverage. [POLICY DETAILS Policy Number Billing Summary] Personal Auto Policy: 2014119486, Amount Due: “Prior Balance Due: (please disregard if already paid) This may include remaining installments and/or additional premium from your current policy Policy period 02/26/2022-02/26/2023 period. Total Amount Due: PAYMENT OPTIONS Pay Now! Pay in Full Save Money! Avoid installment fees by paying your renewal balance in full Automatic Payments Enrollment required. See reverse side for more information on enrollment. Installments Due Date: 2/25/2023 Note: If received in our office § days after the due date, a $10.00 late fee will apply - - Please see reverse side for additional information - - If mailing, please detach the coupon below and return with your payment, Please mail 7 days in advance. Payment Coupon Our records show the following: Personal Auto: 2014119486 Email: vtpayen@hotmail.com Phone: 347-885-5533 Amount Due 2/25/2023 For automated payments please visit www.DirectAuto.com or call 877-463-4732 Prior Balance Due: Upon Receipt (please disregard if already paid) If mailing, please make check payable to: Policy period 02/26/2022-02/26/2023 Direct Auto Insurance Total Amount Due: Amount Enclosed: DIRECT AUTO INSURANCE Named Insured: Ch for address nge PO BOX 89431 less enrolim CLEVELAND OH 44101-6431 VANESSA T SINGLETON ‘note your changes 5309 one seside. 4885 FLORIDA CLUB CIR JACKSONVILLE, FL 32216-1091 020341159486017000000230700000215358 10041 (09012017) [PAYMENT SCHEDULE Due Date Scheduled Amount 2/25/2023 3/26/2023 4/26/2023 5/26/2023 6/26/2023 712612023 8/26/2023 9/26/2023 10/26/2023 11/26/2023 12/26/2023 1126/2024 All installments include a $17.51 installment charge. Please note in accordance with Federal Reserve guidelines we may process your payment electronically via the automated clearing house (ACH). Enrolling for Automatic Payments ‘Step 1: Make your upcoming payment online at www.DirectAuto.com, by mail or with your agent. ‘Step 2: Complete the Automatic Payments authorization form by phone at 877-463-4732 or contact your agent. After your Automatic Payments enrollment has been processed on your policy, we will send you an Automatic Payments schedule. To avoid a cancellation of your coverage, please make sure that your payment is received by the due date. The Company may process a Notice of Cancellation if payment is not received by the Company on or before the due date. Postmark is not sufficient. If your check is returned by the bank for insufficient funds or for any other reason, a Notice of Cancellation will be immediately processed. If you have questions or need assistance with your policy, please call your agent at the phone number listed at the top of your statement or call customer service at 877-463-4732. Thank you for choosing Direct Auto Insurance. We appreciate the opportunity to give you the coverage you need and the service you deserve. Has your address or email changed? Please update your contact information below. ‘10042 (09012017) Insured First Name Initial Last Name Street Address or PO Box City State Zip Home Phone - - 1 Garaging Address Change O Mailing Address Change O Both Email - used for Customer communcation only Enroll in Electronic Delivery - Would you like to simplify your life and enroll in electronic bills and documents? OD Yes, I'd like to receive all my bills and documents electronically. Please provide email address above. Thank you for insuring with us! Here are your identification cards for proof of insurance. [Birect Florida Automobile Insurance Identification Card KEEP THIS CARD IN YOUR MOTOR VEHICLE Direct General Insurance Company Company Number PO Box 3199 Winston Salem, NC 27102-3199 Report all accidents immediately to: Direct Auto Insurance 02876 Policy Number Effective Date Expiration Date 2014119486 2126/2023 2/26/2024 Toll free at: 800-403-1077 Personal Injury Protection Benefits/ Bodily Injury 9008687 Property Damage Liability Liability AGENCY: Vanessa T Singleton Direct General Insurance Agency Inc-1457 (386) 752-5030 Tyshawn L Singleton 1077 WUS Highway 80 Ste 150 Lake City, FL. 32055 2018 TOYT RAV4LE 2T3ZFREV4JW478675 Misrepresentation of insurance is a first degree misdemeanor NOT VALID FOR MORE THAN ONE YEAR FROM EFFECTIVE DATE MOD: 01 10330 (01012011) A Cut On Solid Line — Fold On Dotted Line 1oft Nirect Policy Number: 2014119486 Date of Notice 01/13/2023 08:54 AM PO Box 3199 ¢ Winston Salem, NC 27102-3199 Named Insured: VANESSA T SINGLETON VANESSA T SINGLETON Policy Period: 02/26/2023 - 02/26/2024 Policy Underwritten by: Direct General Insurance Company 24 Hour Claim Reporting: 800-403-1077 For Policy Information: 877-463-4732 www.DirectAuto.com Your Agent: Direct General Insurance Agency Inc-1457 1077 W US Highway 80 Ste 150 Lake City FL 32055 (386) 752-5030 FL PERSONAL AUTO DECLARATIONS PAGE Renewal Effective 02/26/2023 12:01 AM Drivers and Household Residents #1 Vanessa T Singleton Driver Status License # Lic. State Date of Birth Gender Marital Status Driver Pts Yrs. Lic. Rated Driver XXXXXXXXX7980 FL 08/18/1983 Female Married 0 23 #2 Tyshawn L Singleton Driver Status License # Lic. State Date of Birth Gender Marital Status Driver Pts Yrs. Lic. Rated Driver XXXXXXXXX3110 FL 08/31/1979 Male Married 0 27 #3 Amayah A Payen Driver Status License # Lic. State Date of Birth Gender Marital Status Driver Pts Yrs. Lic. Excluded Driver FL 03/05/2003 Female Single 0 3 Insured Personal Auto(s) and Schedule of Coverages #1 2018 TOYT RAV4 LE VIN: 2T3ZFREV4JW478675-7G1430 Usage: Pleasure/Commute Garaging Location: 322161091 Loss Payee Address Alive Credit Union PO Box 924493, Fort Worth, TX 76124 Coverages Provided Limits/Deductibles Premium Bodily Injury $10,000 Each Person / $20,000 Each Accident $273.00 Property Damage $10,000 Each Accident $236.00 Uninsured Motorist Bodily Injury - Nonstacked $10,000 Each Person / $20,000 Each Accident $195.00 Personal Injury Protection $10,000 , $1,000 Deductible Per Occurrence - $697.00 Named Insured and Resident Relatives,