Preview
Filing # 168997727 E-Filed 03/17/2023 03:51:32 PM 23000546CA
2455 TAMIAMI TRAIL
PORT CHARLOTTE, FL 33952
Ws PROGRESSIVE °
Policy Number: 915708215
Underwritten by:
Progressive American Insurance Co
January 17, 2022
HAROLDJ LAFRANCE
Policy Period: Jan 18, 2022 - Jul 18, 2022
373 ORANGE DR NW
PORT CHARLOTTE, FL 33952 Page 1 of 2
-941-979-8426
CHAPMAN INS GRP LLC
Contact your agent for personalized service.
progressiveagent.com
Auto Insurance Online Service
Make payments, check billing activity, update
Coverage Summary policy information or check status ofa claim.
This is your Declarations Page 1-800-274-4499
To report a claim.
Your coverage has changed
Your coverage begins on January 18, 2022 at 12:01 a.m. This policy expires on July 18, 2022 at 12:01 a.m.
This coverage summary replaces your prior one. Your insurance policy and any policy endorsements contain a full explanation of your
coverage. The policy contract is form 9611A FL (07/17). The contract is modified by forms A261 FL (05/19) and A264 (10/18).
Policy changes effective January 18, 2022
Changes requested or ‘Jan 17, 2022 12:32 p.m.
Requested by: “HAROLDJ LAFRANCE
Premium change
Changes:
-$52.00
"RENAJ LAFRANCE has been removed from the policy.
Drivers and household residents
HAROLD J LAFRANCE
Additional information: Named insured
7
Form 6489 FL (05/21) Continued
Policy Number: 915708215
HAROLD J LAFRANCE
Page2 of 2
Outline of coverage
2015 SUBARU OUTBACK STATION WAGON
VIN: 4S4BSAJC4F3329756
Garaging ZIP Code: 33952
Primary use of the vehicle: Pleasure/Personal
Length of vehicle ownership when policy started or vehicle added: At least 1 month but less than 1 year
Limits Deductible
Peri
Liabili ers,
Bodily I iy Liability $100,000 each person/$300,000 each accident $192
Property Damage Liabil $50,000 each accident 142
Personal Injury Protection/Work Loss Excluded $10,000 $0 58
Deductible applies to Named Insured and Spouse
Uninsured Motorist - Nonstacked $100,000 each person/$300,000 each accident 86
Collision Actual Cash Value $500 116
Roadside Assistance 5
Total
6 month policy premium "$657.00
Premium discounts
Policy
915708215. Five-Year Accident Free, Home Owner, Continuous Insuran Platinum,
Paperless, Paid in Full and Three-Year Safe Driving
Vehicle
2015 SUBARU Anti-Lock Brakes, Driver and Passenger-side Airbag and Passive Anti-theft
OUTBACK Device
Policyholder inquiries
You may call your agent at 1-941-979-8426 to present inquiries or obtain information about coverage, and to obtain
assistance with any complaints.
Agent signature
Maukef2Z,
Company officers
VLG llr
Secretary
Form 6489 FL (05/21)
9611A FL 0717
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FLORIDA
AUTO POLICY
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Form 9611A FL(O7/17)
version 2.0
PROGRESSIVE
AUTO
CONTENTS
INSURING AGREEMENT.............
GENERAL DEFINITIONS
PART I—LIABILITY TO OTHERS
Insuring Agreement—Bodily Injury...
Insuring Agreement—Property Damage .
Additional Definition
Additional Payments.
Exclusions.
Limits of Liabilit
Financial Responsibility Laws .
Other Insurance
Out-of-State Coverage
PART II(A)—PERSONAL INJURY PROTECTION COVERAGE
Insuring Agreement
Additional Definitions.
Exclusions...
Limit of Liability "
Other Insurance 12
Conditions...
Extended Personal Injury Protection Coverage. 16
PART II(B)—MEDICAL PAYMENTS COVERAGE
Insuring Agreement 17
Additional Definition 18
Exclusions. 19
Limits of Liabilit 20
Unreasonable or Unnecessary Medical Expense: 21
Other Insurance .......... 22
PART III—UNINSURED MOTORIST COVERAGE
Insuring Agreement 22
Additional Definition 23
Exclusions. 24
Limits of Liability... 24
Other Insurance 26
Trust Agreement.. 27
Our Rights to Recover Payment....... 27
PART IV—DAMAGE TO A VEHICLE
Insuring Agreement—Collision Coverage ...... 27
Insuring Agreement—Comprehensive Coverage.. 27
i
Insuring Agreement—Full Comprehensive Window Glass Coverage. 28
Insuring Agreement—Additional Custom Parts or
Equipment Coverage... we 28
Insuring Agreement—Rental Reimbt urs ement
Coverage. 28
Insuring Agreement—Loan/Lease Payoff Coverage 29
Insuring Agreement—Pet Injury Coverage. 29
Additional Definition: 30
Exclusions.. 30
Limits of Liabilit 32
Payment of Los: 33
No Benefit to Bailee 33
Loss Payable Claus 33
Other Sources of Recover
Appraisal
PART V—ROADSIDE ASSISTANCE COVERAGE
Insuring Agreement
Additional Definition: 35
Exclusions... 35
Unauthorized Service Provider. 36
Other Insurance 36
PART VI—DUTIES IN CASE OF AN ACCIDENT OR LOSS. 36
PART VII—GENERAL PROVISIONS
Policy Period and Territory. 37
Changes 37
Duty to Report Changes 38
Settlement of Claim 38
Terms of Policy Conformed to Statutes 38
Transfer of Interest... 38
Fraud or Misrepresentatior 38
Payment of Premium and Fee: 39
Cancellation 40
Cancellation Refund 41
Rate Increases..... 41
Noncancelable Policy.. 41
Nonrenewal.. 42
Automatic Termination... 42
Legal Action Against Us. 42
Our Rights to Recover Payment.. 43
Joint and Individual Interests.
Bankruptcy
Mediation ..
ii
FLORIDA AUTO POLICY
INSURING AGREEMENT
In return for your payment of the premium, we agree to insure you subject to all the
terms, conditions and limitations of this policy. We will insure you for the coverages
and the limits of liability shown on this policy's declarations page. Your policy consists
of the policy contract, your insurance application, the declarations page, and all en-
dorsements to this policy.
GENERAL DEFINITIONS
The following definitions apply throughout the policy. Defined terms are printed in bold-
face type and have the same meaning whether in the singular, plural, or any other form.
1
“Additional auto” means an auto you become the actual or beneficial owner of
during the policy period that does not permanently replace an auto shown on the
declarations page if:
a. you notify us within 30 days of becoming the owner of the additional auto;
and
b. you pay any additional premium due.
An additional auto will have the broadest coverage we provide for any auto shown
on the declarations page. If you ask us to insure an additional auto more than
30 days after you become the actual or beneficial owner, any coverage we provide
will begin at the time you request coverage.
“Auto” means a land motor vehicle:
a. of the private passenger, pickup body, or cargo van type;
b. designed for operation principally upon public roads;
Cc. with at least four wheels; and
d. with a gross vehicle weight rating of 12,000 pounds or less, according to the
manufacturer's specifications.
However, “auto” does not include step-vans, parcel delivery vans, or cargo cutaway
vans or other vans with cabs separate from the cargo area.
“Auto business” means the business of selling, leasing, repairing, parking, storing,
servicing, delivering or testing vehicles.
“Bodily injury” means bodily harm, sickness, or disease, including death that re-
sults from bodily harm, sickness, or disease.
“Covered auto” means:
a. any auto or trailer shown on the declarations page for the coverages appli-
cable to that auto or trailer;
b. any additional auto;
c. any replacement auto; or
d. a trailer owned by you.
"De clarations page” means the document showing your coverages, limits of li-
ability, covered autos, premium, and other policy-related information.
The declara-
tions page may also be referred to as the Auto Insurance Coverage Summary.
“Occupying” means in, on, entering or exiting.
“Personal vehicle sharing program” means a system or process, operated by a
1
business, organization, network, group, or individual under terms of use pursuant
to a written agreement, that facilitates the sharing of private passenger motor ve-
hicles for use by individuals.
“Property damage” means physical damage to, destruction of, or loss of use of,
tangible property.
10. “Rated resident’ means a person residing in the same household as you at the
time of the loss who is not arelative, but only if that person is both:
a. listed in the “Drivers and household residents” section on the declarations
page; and
b, not designated as either an “Excluded” or a “List Only” driver.
11 “Relative” means a person residing in the same household as you, and related to
you by blood, marriage or adoption, and includes a ward, stepchild, or foster child.
Your unmarried dependent children temporarily away from home will qualify as a
relative if they intend to continue to reside in your household.
12. “Replacement auto” means an auto that permanently replaces an auto shown on
the declarations page. However, if the auto being replaced had coverage under
Part IV—Damage To A Vehicle, such coverage will apply to the replacement auto
only during the first 30 days after you become the actual or beneficial owner unless
you notify us within that 30-day period that you want us to extend coverage be-
yond the initial 30 days. If the auto being replaced did not have coverage under Part
|V—Damage To A Vehicle, such coverage may be added, but the replacement
auto will have no coverage under Part IV until you notify us of the replacement
auto and ask us to add the coverage.
13. “Ride-sharing activity’ means the use of any vehicle to provide transportation of
persons for any compensation or fee in connection with a transportation network
company from the time a user logs on to, or signs in to, any online-enabled appli-
cation, software, website or system until the time the user logs out of, or signs off of,
any such online-enabled application, software, website or system, whether or not
the user has accepted any passenger(s), including the time the user is on the way
to pick up any passenger(s), or is transporting any passenger(s).
14 “Trailer” means a non-motorized trailer, including a farm wagon or farm implement,
designed to be towed on public roads by an auto:
a. while not being used for commercial purposes;
b. while not being used as an office, store, or for display purposes; or
Cc. while not being used as a passenger conveyance.
15. “Transportation network company’ is an organization, sole proprietor, or any
other entity that provides prearranged transportation services for compensation
using an online-enabled application or platform to connect passengers with drivers
using a personal vehicle. This definition does not include shared-expense carpool-
ing.
16. “We,” “us” and “our” mean the underwriting company providing the insurance, as
shown on the declarations page.
17. “You” and “your” mean:
a a person shown as a named insured on the declarations page; and
b. the spouse of a named insured if residing in the same household at the time of
the loss.
PART I—LIABILITY TO OTHERS
INSURING AGREEMENT—BODLLY INJURY
If you pay the premium for this coverage, we will pay damages for bodily injury for
which an insured person becomes legally responsible because of an accident.
INSURING AGREEMENT—PROPERTY DAMAGE
If you pay the premium for this coverage, we will pay damages for property damage
for which an insured person becomes legally responsible because of an accident.
Damages for bodily injury and property damage include prejudgment interest award-
ed against an insured person, where owed by law.
If you pay the premium for Bodily Injury Liability and Property Damage Liability, we will
settle or defend, at our option, any claim for bodily injury or property damage cov-
ered by this Part |. Our duty to settle or defend ends after we have paid the applicable
limit of liability for the accident that is the basis of the lawsuit. Our duty to settle or de-
fend does not include any sanctions awarded or assessed against an insured person
due to intentional misrepresentation or concealment committed by that insured person
during the course of any lawsuit, associated discovery, or other proceedings.
If you pay the premium for Property Damage Liability only, we will settle or defend, at
our option, any claim for property damage covered by this Part |. Our duty to settle
or defend ends after we have paid the applicable limit of liability for the accident that
is the basis of the lawsuit. Our duty to settle or defend does not include any sanctions
awarded or assessed against an insured person due to intentional misrepresentation
or concealment committed by that insured person during the course of any lawsuit,
associated discovery, or other proceedings.
Satisfaction by an insured person of a judgment for bodily injury or property dam-
age shall not be a condition precedent to the right or duty of us to make payment for
such bodily injury or property damage.
ADDITIONAL DEFINITION
When used in this Part I:
“Insured person” means:
a. you, a relative, or a rated resident with respect to an accident arising out of the
ownership, maintenance or use of an auto or a trailer;
b. any person with respect to an accident arising out of that person's use of a covered
auto with the permission of you, a relative, or a rated resident;
Cc. any person or organization with respect only to vicarious liability for the acts or
omissions of a person described in a. or b. above; and
any ‘Additional Interest” shown on the declarations page with respect only to its
liability for the acts or omissions of a person described in a. or b. above.
3
ADDITIONAL PAYMENTS
In addition to our limit of liability, we will pay for an insured person:
1 all expenses we incur in the settlement of any claim or in the defense of an insured
person in any lawsuit. This does not include attorney fees or sanctions awarded or
assessed against an insured person unless they were taxed against an insured
because the Company, while providing a defense, rejected an offer of judgment at
or below the applicable limit of liability;
interest accruing after entry of judgment, until we have paid, offered to pay, or de-
posited in court, that portion of the judgment which does not exceed our limit of
liability. This does not apply if we have not been given notice of suit or the opportu-
nity to defend an insured person;
the premium on any appeal bond or attachment bond required in any lawsuit we
defend. We have no duty to purchase a bond in an amount exceeding our limit of
liability, and we have no duty to apply for or furnish these bonds;
up to $250 for a bail bond required because of an accident resulting in bodily in-
jury or property damage covered under this Part I. We have no duty to apply for
or furnish this bond; and
reasonable expenses, including loss of earnings up to $200 per day, incurred at
our request.
EXCLUSIONS—READ THE FOLLOWING EXCLUSIONS CAREFULLY. IF AN EX-
CLUSION APPLIES, COVERAGE WILL NOT BE AFFORDED UNDERTHIS PART I.
Coverage under this Part I, including our duty to defend, will not apply to any insured
person for:
1
bodily injury or property damage arising out of the ownership, maintenance or
use of any vehicle or trailer while being used:
a. to carry persons or property for compensation or a fee;
b. for retail or wholesale delivery, including, but not limited to, the pickup, transport
or delivery of magazines, newspapers, mail or food; or
Cc. for ride-sharing activity.
This exclusion does not apply to shared-expense car pools;
any liability assumed under any contract or agreement by you or a relative;
bodily injury to an employee of that insured person arising out of or within the
course of employment. This exclusion does not apply to domestic employees if
benefits are neither paid nor required to be provided under workers’ compensation,
disability benefits, or similar laws;
bodily injury or property damage arising out of an accident involving any vehicle
while being maintained or used by a person while employed or engaged in any
auto business. This exclusion does not apply to you, a relative, a rated resident,
or an agent or employee of you, a relative, or a rated resident, when using a
covered auto;
bodily injury or property damage arising out of the use of any vehicle, and result-
ing from, or sustained during practice or preparation for:
a any pre-arranged or organized racing, stunting, speed or demolition contest or
activity by an insured person; or
4
b. any driving activity conducted on a permanent or temporary racetrack or race-
course by an insured person;
bodily injury or property damage due to a nuclear reaction or radiation;
bodily injury or property damage for which insurance:
a, is afforded under a nuclear energy liability insurance contract; or
b. would be afforded under a nuclear energy liability insurance contract but for its
termination upon exhaustion of its limit of liability;
any obligation for which the United States Government is liable under the Federal
Tort Claims Act. This exclusion will apply only to the damages that are in excess of
the minimum limits of liability coverage required by the financial responsibility law of
the state of Florida;
bodily injury or property damage caused by an intentional act of any insured
person, or at the direction of any insured person, even if the actual injury or dam-
age is different than that which was intended or expected. With respect to persons
sustaining bodily injury or property damage who do not also qualify as insured
persons, this exclusion will apply only to the damages that are in excess of the
minimum limits of liability coverage required by the financial responsibility law of the
state of Florida;
10. property damage to any property owned by, rented to, being transported by, used
by, or in the charge of that insured person. This exclusion does not apply to a
rented residence or a rented garage;
11 bodily injury to you or a relative;
12. bodily injury or property damage arising out of the ownership, maintenance, or
use of any vehicle owned by you or furnished or available for your regular use,
other than a covered auto for which this coverage has been purchased;
13. bodily injury or property damage arising out of the ownership, maintenance or
use of any vehicle owned bya relative or furnished or available for the regular use
of a relative, other than a covered auto for which this coverage has been pur-
chased. This exclusion does not apply to your maintenance or use of such vehicle;
14 bodily injury or property damage arising out of your, a relative’s, or a rated
resident’s use of a vehicle, other than a covered auto, without the permission of
the owner of the vehicle or the person in lawful possession of the vehicle;
15. bodily injury or property damage arising out of the use of a covered auto while
leased or rented to others or given in exchange for any compensation, including
while being used in connection with a personal vehicle sharing program. This
exclusion does not apply to the operation of a covered auto by you, a relative,
or a rated resident, and will only apply to the damages that are in excess of the
minimum limits of liability coverage required by the financial responsibility law of the
state of Florida;
16. punitive or exemplary damages; or
17. bodily injury or property damage caused by, or reasonably expected to result
from, a criminal act or omission, excluding moving traffic violations, of any insured
person. This exclusion applies regardless of whether that insured person is ac-
tually charged with, or convicted of, a crime. With respect to persons sustaining
bodily injury or property damage who do not also qualify as insured persons,
5
this exclusion will apply only to the damages that are in excess of the minimum
limits of liability coverage required by the financial responsibility law of the state of
Florida.
LIMITS OF LIABILITY
The limit of liability shown on the declarations page for liability coverage is the most we
will pay regardless of the number of:
claims made;
covered autos;
insured persons;
lawsuits brought;
vehicles involved in the accident; or
premiums paid.
If your declarations page shows a split limit:
1 the amount shown for “each person’ is the most we will pay for all damages due to
bodily injury to one person resulting from any one accident;
2. subject to the “each person’ limit, the amount shown for “each accident’ is the most
we will pay for all damages due to bodily injury sustained by two or more persons
in any one accident; and
the amount shown for “property damage’ is the most we will pay for the total of all
property damage resulting from any one accident.
The “each person’ limit of liability applies to the total of all claims made for bodily injury
to a person and all claims of others derived from such bodily injury, including, but not
limited to, emotional injury or mental anguish resulting from the bodily injury of another
or from witnessing the bodily injury to another, loss of society, loss of companionship,
loss of services, loss of consortium, and wrongful death, if recoverable under the ap-
plicable law.
If the declarations page shows that “combined single limit’ or “CSL’ applies, the
amount shown is the most we will pay for the total of all damages resulting from any
one accident. However, without changing this limit of liability, we will comply with any law
that requires us to provide any separate limits.
No one is entitled to duplicate payments for the same elements of damages.
Any payment to a person under this Part | for bodil injury will be reduced by:
1 any payment made to that person for bodily injury under Part III—Uninsured Mo-
torist Coverage; and
2. any amounts that are paid or payable to that person as personal injury protection
benefits.
If multiple auto policies issued by us are in effect for you, we will pay no more than the
highest limit of liability for this coverage available under any one policy.
An auto and attached trailer are considered one auto. Therefore, the limits of liability
will not be increased for an accident involving an auto that has an attached trailer.
FINANCIAL RESPONSIBILITY LAWS
When we certify this policy as proof of financial responsibility, this policy will comply with
the law to the extent required. The insured person must reimburse us if we make a
payment that we would not have made if this policy was not certified as proof of financial
responsibility.
OTHER INSURANCE
If there is any other applicable liability insurance or bond, we will pay only our share of
the damages. Our share is the proportion that our limit of liability bears to the total of all
applicable limits. Any insurance we provide for a vehicle or trailer, other than a covered
auto, will be excess over any other collectible insurance, self-insurance, or bond.
However, when you, a relative, or a rated resident rent or lease an auto, the liability
coverage provided by the lessor's policy shall be primary unless the rental or lease
agreement includes a provision in the form specified in Florida Statute §627.7263, as
amended, stating that the lessee or rentee’s liability insurance and personal injury pro-
tection insurance shall be primary. If the rental or lease agreement includes such a
provision, our duty to pay damages under this Part I, and our duty to defend you, a
relative, or a rated resident under this Part |, shall be primary to any liability coverage
provided by the lessor or owner for operation of that auto by you, a relative, or a rated
resident. We have no duty to defend the lessor or owner of that auto under this Part |.
OUT-OF-STATE COVERAGE
If an accident to which this Part | applies occurs in any state, territory or possession of
the United States of America or any province or territory of Canada, other than the one
in which a covered auto is principally garaged, and the state, province, territory or pos-
session has:
1 a financial responsibility or similar law requiring limits of liability for bodily injury
or property damage higher than the limits shown on the declarations page, this
policy will provide the higher limits; or
a compulsory insurance or similar law requiring a non-resident to maintain insur
ance whenever the non-resident uses an auto in that state, province, territory or
possession, this policy will provide the greater of:
a. the required minimum amounts and types of coverage; or
b. the limits of liability under this policy.
PART II(A)—PERSONAL INJURY PROTECTION COVERAGE
INSURING AGREEMENT
If you pay the premium for this coverage, we will pay benefits that an insured person
is entitled to receive pursuant to the Florida Motor Vehicle No-Fault Law, as amended,
because of bodily injury:
1 caused by an accident;
2. sustained by an insured person; and
3. arising out of the ownership, maintenance or use of a motor vehicle.
Personal Injury Protection Coverage benefits consist of:
1 medical benefits;
2. disability benefits; and
3. death benefits.
ADDITIONAL DEFINITIONS
When used in this Part II(A):
1 “Death benefits” means benefits of $5,000 payable per individual if an insured
person dies because of injury covered under this Part II(A).
2. “Disability benefits” means 60 percent of any work loss per insured person
from inability to work proximately caused by the injury sustained by the insured
person. Disability benefits also include all expenses reasonably incurred in ob-
taining from others ordinary and necessary services in lieu of those services that,
but for the bodily injury, the insured person would have performed without in-
come for the benefit of his or her household.
“Emergency medical condition” means a medical condition manifesting itself by
acute symptoms of sufficient severity, which may include severe pain, such that the
absence of immediate medical attention could reasonably be expected to result in
any of the following:
a. serious jeopardy to patient health;
b, serious impairment to bodily functions; or
Cc. serious dysfunction of any bodily organ or part.
“Insured person” means:
a, you or any resident relative sustaining bodily injury while occupying a mo-
tor vehicle, or when struck by a motor vehicle while not occupying a self-
propelled vehicle;
b, any person sustaining bodily injury while occupying a covered auto; or
Cc. any person, if a resident of Florida, sustaining bodily injury when struck by a
covered auto while not occupying a self-propelled vehicle.
For purposes of this definition, “covered auto” includes an attached trailer or semi-
trailer designed for use with such vehicle.
“Medical benefits” means 80 percent of all reasonable expenses incurred for
medically necessary medical, surgical, x-ray, dental and rehabilitative services,
including prosthetic devices and medically necessary ambulance, hospital and
8
nursing services. All of the following statutory references are to Florida law. Medi-
cal benefits are limited to: 1) services and care received within the initial 14 days
after the motor vehicle accident, or 2) follow-up services and care received beyond
the initial 14 days after the motor vehicle accident if services and care have been
previously received within the initial 14 days after the motor vehicle accident, and
a referral for more services and care has been provided by a statutorily authorized
provider, and the follow-up services and care are consistent with the underlying
medical diagnosis. Medical benefits provide reimbursement for: 1) initial services
and care that are lawfully provided, supervised, ordered, or prescribed by a physi-
cian licensed under chapter 458 or chapter 459, a dentist licensed under chapter
466, or a chiropractic physician licensed under chapter 460 or that are provided in
a hospital or in a facility that owns, or is wholly owned by, a hospital. Initial services
and care may also be provided by a person or entity licensed under part III of chap-
ter 401 which provides emergency transportation and treatment, or 2) upon referral
by a provider described in subparagraph 1), follow-up services and care consistent
with the underlying medical diagnosis rendered pursuant to subparagraph 1) which
may be provided, supervised, ordered, or prescribed only by a physician licensed
under chapter 458 or chapter 459, a chiropractic physician licensed under chapter
460, a dentist licensed under chapter 466, or, to the extent permitted by applicable
law and under the supervision of such physician, osteopathic physician, chiroprac-
tic physician, or dentist, by a physician assistant licensed under chapter 458 or
chapter 459 or an advanced registered nurse practitioner licensed under chapter
464. Follow-up services and care may also be provided by the following persons
or entities: a) hospital or ambulatory surgical center licensed under chapter 395,
b) an entity wholly owned by one or more physicians licensed under chapter 458
or chapter 459, chiropractic physicians licensed under chapter 460, or dentists li-
censed under chapter 466 or by such practitioners and the spouse, parent, child,
or sibling of such practitioners, c) an entity that owns or is wholly owned, directly or
indirectly, by a hospital or hospitals, d) a physical therapist licensed under chapter
486, based upon a referral by a provider described in this subparagraph, e) a health
care clinic licensed under part X of chapter 400 which is accredited by an accredit-
ing organization whose standards incorporate comparable regulations required by
this state, or (i) has a medical director licensed under chapter 458, chapter 459,
or chapter 460; (ii) has been continuously licensed for more than 3 years or is a
publicly traded corporation that issues securities traded on an exchange registered
with the United States Securities and Exchange Commission as a national securi-
ties exchange; and (iii) provides at least four of the following medical specialties: (A)
General medicine, (B) Radiography, (C) Orthopedic medicine, (D) Physical medi-
cine, (E) Physical therapy, (F) Physical rehabilitation, (G) Prescribing or dispensing
outpatient prescription medication, (H) Laboratory services. Medical benefits do
not include massage, as defined in FL. St. 480.033, or acupuncture, as defined in
FL. St. 457.102, regardless of the person, entity or licensee providing the massage
or acupuncture, and a licensed massage therapist or licensed acupuncturist will
not be reimbursed for medical benefits.
“Medically necessary’ refers to a medical service or supply that a prudent physi-
cian would provide for the purpose of preventing, diagnosing, or treating an illness,
9
injury, disease, or symptom in a manner that is:
a, in accordance with generally accepted standards of medical practice;
b. clinically appropriate in terms of type, frequency, extent, site, and duration; and
Cc. not primarily for the convenience of the patient, physician, or other health care
provider.
“Motor vehicle” means any self-propelled vehicle with four or more wheels which
is of a type both designed and required to be licensed for use on the highways of
the State of Florida and any trailer or semi-trailer designed for use with such vehi-
cle. A motor vehicle does not include a mobile home or any motor vehicle which
is used in mass transit, other than public school transportation, and designed to
transport more than five passengers exclusive of the operator of the motor vehicle
and which is owned by a municipality, a transit authority, or a political subdivision of
the state.
“Owner” means a person who holds the legal title to a motor vehicle, or, in the
event a motor vehicle is the subject of a security agreement or lease with an op-
tion to purchase with the debtor or lessee having the right to possession, then the
debtor or lessee shall be deemed the owner.
“Resident relative” means a relative of any degree by blood or by marriage, or who
is adopted, a foster child, or a ward of the state, and who usually makes his or her
home in the same family unit, whether or not temporarily living elsewhere.
10. “Work loss” means loss of gross income and loss of earning capacity.
EXCLUSIONS—READ THE FOLLOWING EXCLUSIONS CAREFULLY. IF AN EX-
CLUSION APPLIES, COVERAGE WILL NOT BE AFFORDED UNDER THIS PART
IMA).
Coverage under this Part II(A) does not apply to bodily injury:
1 sustained by you or a resident relative while occupying another motor vehicle
owned by you and not insured under this policy;
2 sustained by any person operating a covered auto without your express or im-
plied consent;
3. to any injured person, if such person's conduct contributed to his or her bodily
injury under any of the following circumstances:
a, causing bodily injury to himself or herself intentionally; or
b. sustaining bodily injury while committing a felony. However, whenever an in-
sured is charged with such conduct, the required 30-day payment provision
shall be held in abeyance, and the insurer shall withhold payment of any per
sonal injury protection benefits pending the outcome of the case at the trial
level. If the charge is nolle prossed or dismissed or the insured is acquitted, the
30-day payment provision shall run from the date the insurer is notified of such
action;
sustained by any person, other than you, if such person is the owner of a motor
vehicle with respect to which security is required under the Florida Motor Vehicle
No-Fault Law, as amended;
sustained by any person, other than you or a resident relative, who is entitled to
personal injury protection benefits from the insurer or owner of a motor vehicle
that is not a covered auto under this policy;
10
sustained by any person while occupying a motor vehicle while located for use
as a residence or premises;
with respect to work loss, if such bodily injury is sustained by you, and if anamed
insured has elected to exclude work loss for either you, or your dependent resi-
dent relatives, as indicated on the declarations page;
with respect to work loss, if such bodily injury is sustained by a dependent resi-
dent relative, and if a named insured has elected to exclude work loss for you and
dependent resident relatives, as indicated on the declarations page; or
sustained by any person while occupying a covered auto while it is being used
for ride-sharing activity.
LIMIT OF LIABILITY
The limit of liability shown on the declarations page for Personal Injury Protection is
the most we will pay for each insured person injured in any one accident, regardless
of the number of:
claims made;
covered autos;
insured persons;
lawsuits brought;
vehicles involved in the accident; or
premiums paid.
If no emergency medical condition exists or no determination has been made, the
maximum reimbursement for medical benefits and disability benefits is limited to
$2,500. If an emergency medical condition exists, the insured is eligible to receive
up to $10,000 in medical benefits and isability benefits. That determination can
affirmatively be made only by a physician or physician assistant licensed under chapter
458 or 459, a dentist licensed under chapter 466, or an advanced registered nurse
practitioner licensed under chapter 464, and further can be made only if no physician
or physician assistant licensed under chapter 458 or 459, no chiropractic physician li-
censed under chapter 460, no dentist licensed under chapter 466, no advanced reg-
istered nurse practitioner licensed under chapter 464, no physical therapist licensed
under chapter 486, and no person or entity licensed under part IIl of chapter 401 who
provides emergency transportation and treatment has determined that the injured per-
son did not have an emergency medical condition. This provision is applicable to
all claims without regard to the identity, or status, of the entity seeking reimbursement,
including those claims submitted by government entities possessing a statutory right to
present claims under this Part II(A).
Benefits received under any workers’ compensation law shall be credited against the
benefits provided under this Part II(A). Any deductible elected by a named insured un-
der Personal Injury Protection Coverage applies to those persons indicated as subject
to a deductible on the declarations page. Any deductible that applies to the named
insured shall apply to all persons listed as a named insured on the declarations page
and any spouse of a named insured. When a deductible applies, the deductible will
be applied to 100 percent of the expenses and losses covered under Personal Injury
Protection Coverage. A separate $5,000 benefit limit is reserved exclusively for death
benefits. However, the deductible shall not be applied to reduce death benefits.
1
Personal Injury Protection Coverage is primary to the Medical Payments Coverage un-
der Part II(B).
OTHER INSURANCE
If there is other applicable personal injury protection coverage for the same injury to
any one insured person, the most the insured person may recover is the maximum
amount payable for personal injury protection benefits under the Florida Motor Vehicle
No-Fault Law, as amended. If there is other applicable personal injury protection cov-
erage, and we make a payment under this Part II(A), we are entitled to recover from
each of the other insurers an equitable pro rata share of the benefits paid and expenses
incurred in processing the claim.
If an insured person sustains bodily injury while occupying, or through being struck
by, a motor vehicle which is rented or leased, the liability coverage and the personal
injury protection coverage provided by the lessor’s policy shall be primary unless the
rental or lease agreement includes a provision which specifies that the valid and collect-
ible liability insurance and personal injury protection insurance of any authorized rental
or leasing driver is primary for the limits of liability and personal injury protection cover-
age required by §§ 324.021(7) and 627.736, Florida Statutes.
CONDITIONS
In addition to the duties set forth in Part VI of this policy and the provisions set forth in
Part VII of this policy, the following conditions apply to coverage afforded under this Part
WA).
Policy Period and Territory. The coverage under this Part II(A) applies only to acci-
dents which occur during the policy period:
1 in the State of Florida; and
2. with respect to you or a resident relative, while occupying a covered auto out-
side the State of Florida but within the United States of America, its territories or
possessions, or Canada; and
with respect to you, while occupying a motor vehicle owned by a resident rela-
tive, and for which security is maintained under the Florida Motor Vehicle No-Fault
Law, as amended, outside the State of Florida but within the United States of Amer-
ica, its territories or possessions, or Canada.
Duties in Case of an Accident or Loss. As a condition precedent to obtaining Per
sonal Injury Protection Coverage, a person must:
1 cooperate with us in any matter concerning a claim or lawsuit;
2. provide any written proof of loss we may reasonably require;
3. allow us to take signed and recorded statements, including sworn statements and
examinations under oath, which we may conduct outside the presence of you or
any other person claiming coverage, and answer all reasonable questions we may
ask and provide any documents, records, or other tangible items that we request,
when, where, and as often as we may reasonably require; and
authorize us to obtain medical and other records.
12
Examination under Oath. An insured seeking benefits must comply with the terms of
the policy, which include, but are not limited to, submitting to an examination under oath
The scope of questioning during the examination under oath is limited to relevant infor
mation or information that could reasonably be expected to lead to relevant information.
Compliance with this paragraph is a condition precedent to receiving benefits.
Refusal to Submit to Medical Examination. If a person making a claim under this
Part II(A) unreasonably refuses to submit to or fails to appear at a medical examination
required by us, we shall not be liable for further payments under this Part II(A).A refusal
to submit to or failure to appear at two examinations raises a rebuttable presumption
that the refusal or failure was unreasonable.
Right of Reimbursement from Owner or Insurer of Commercial Motor Vehicle. If
we make a payment under this Part II(A) to any person sustaining bodily injury while
occupying a commercial motor vehicle, as defined under the Florida Motor Vehicle
No-Fault Law, as amended, or when struck by a commercial motor vehicle while not
occupying a self-propelled vehicle, we shall have a right of reimbursement, to the ex-
tent of our payment, against the owner of the commercial motor vehicle or the owner’s
insurer. This right of reimbursement shall not apply from the owners or registrants of
motor vehicles being used as taxicabs.
Unreasonable or Unnecessary Medical Benefits. If an insured person incur
Preview
Filing # 168997727 E-Filed 03/17/2023 03:51:32 PM 23000546CA 2455 TAMIAMI TRAIL PORT CHARLOTTE, FL 33952 Ws PROGRESSIVE ° Policy Number: 915708215 Underwritten by: Progressive American Insurance Co January 17, 2022 HAROLDJ LAFRANCE Policy Period: Jan 18, 2022 - Jul 18, 2022 373 ORANGE DR NW PORT CHARLOTTE, FL 33952 Page 1 of 2 -941-979-8426 CHAPMAN INS GRP LLC Contact your agent for personalized service. progressiveagent.com Auto Insurance Online Service Make payments, check billing activity, update Coverage Summary policy information or check status ofa claim. This is your Declarations Page 1-800-274-4499 To report a claim. Your coverage has changed Your coverage begins on January 18, 2022 at 12:01 a.m. This policy expires on July 18, 2022 at 12:01 a.m. This coverage summary replaces your prior one. Your insurance policy and any policy endorsements contain a full explanation of your coverage. The policy contract is form 9611A FL (07/17). The contract is modified by forms A261 FL (05/19) and A264 (10/18). Policy changes effective January 18, 2022 Changes requested or ‘Jan 17, 2022 12:32 p.m. Requested by: “HAROLDJ LAFRANCE Premium change Changes: -$52.00 "RENAJ LAFRANCE has been removed from the policy. Drivers and household residents HAROLD J LAFRANCE Additional information: Named insured 7 Form 6489 FL (05/21) Continued Policy Number: 915708215 HAROLD J LAFRANCE Page2 of 2 Outline of coverage 2015 SUBARU OUTBACK STATION WAGON VIN: 4S4BSAJC4F3329756 Garaging ZIP Code: 33952 Primary use of the vehicle: Pleasure/Personal Length of vehicle ownership when policy started or vehicle added: At least 1 month but less than 1 year Limits Deductible Peri Liabili ers, Bodily I iy Liability $100,000 each person/$300,000 each accident $192 Property Damage Liabil $50,000 each accident 142 Personal Injury Protection/Work Loss Excluded $10,000 $0 58 Deductible applies to Named Insured and Spouse Uninsured Motorist - Nonstacked $100,000 each person/$300,000 each accident 86 Collision Actual Cash Value $500 116 Roadside Assistance 5 Total 6 month policy premium "$657.00 Premium discounts Policy 915708215. Five-Year Accident Free, Home Owner, Continuous Insuran Platinum, Paperless, Paid in Full and Three-Year Safe Driving Vehicle 2015 SUBARU Anti-Lock Brakes, Driver and Passenger-side Airbag and Passive Anti-theft OUTBACK Device Policyholder inquiries You may call your agent at 1-941-979-8426 to present inquiries or obtain information about coverage, and to obtain assistance with any complaints. Agent signature Maukef2Z, Company officers VLG llr Secretary Form 6489 FL (05/21) 9611A FL 0717 Ul l UMNO FLORIDA AUTO POLICY Pe 7p fs} a ae a oe x ey ay ae33 Tas ae ee oenkey ey ae Toy ee oe aeParas 7p 7 SSSI Eee Pea 7a Pay En ¥ as Er a See roe Srahra28 rat 7 Sh Soh 7Oep §ae ee Safe Ro ff ens on BT,SPST IPSSSo 2 Sete PSP SeFas rae Payee Be POS DS Beene SU: y Sans ae Satake Soo Sy aeae ew ere Form 9611A FL(O7/17) version 2.0 PROGRESSIVE AUTO CONTENTS INSURING AGREEMENT............. GENERAL DEFINITIONS PART I—LIABILITY TO OTHERS Insuring Agreement—Bodily Injury... Insuring Agreement—Property Damage . Additional Definition Additional Payments. Exclusions. Limits of Liabilit Financial Responsibility Laws . Other Insurance Out-of-State Coverage PART II(A)—PERSONAL INJURY PROTECTION COVERAGE Insuring Agreement Additional Definitions. Exclusions... Limit of Liability " Other Insurance 12 Conditions... Extended Personal Injury Protection Coverage. 16 PART II(B)—MEDICAL PAYMENTS COVERAGE Insuring Agreement 17 Additional Definition 18 Exclusions. 19 Limits of Liabilit 20 Unreasonable or Unnecessary Medical Expense: 21 Other Insurance .......... 22 PART III—UNINSURED MOTORIST COVERAGE Insuring Agreement 22 Additional Definition 23 Exclusions. 24 Limits of Liability... 24 Other Insurance 26 Trust Agreement.. 27 Our Rights to Recover Payment....... 27 PART IV—DAMAGE TO A VEHICLE Insuring Agreement—Collision Coverage ...... 27 Insuring Agreement—Comprehensive Coverage.. 27 i Insuring Agreement—Full Comprehensive Window Glass Coverage. 28 Insuring Agreement—Additional Custom Parts or Equipment Coverage... we 28 Insuring Agreement—Rental Reimbt urs ement Coverage. 28 Insuring Agreement—Loan/Lease Payoff Coverage 29 Insuring Agreement—Pet Injury Coverage. 29 Additional Definition: 30 Exclusions.. 30 Limits of Liabilit 32 Payment of Los: 33 No Benefit to Bailee 33 Loss Payable Claus 33 Other Sources of Recover Appraisal PART V—ROADSIDE ASSISTANCE COVERAGE Insuring Agreement Additional Definition: 35 Exclusions... 35 Unauthorized Service Provider. 36 Other Insurance 36 PART VI—DUTIES IN CASE OF AN ACCIDENT OR LOSS. 36 PART VII—GENERAL PROVISIONS Policy Period and Territory. 37 Changes 37 Duty to Report Changes 38 Settlement of Claim 38 Terms of Policy Conformed to Statutes 38 Transfer of Interest... 38 Fraud or Misrepresentatior 38 Payment of Premium and Fee: 39 Cancellation 40 Cancellation Refund 41 Rate Increases..... 41 Noncancelable Policy.. 41 Nonrenewal.. 42 Automatic Termination... 42 Legal Action Against Us. 42 Our Rights to Recover Payment.. 43 Joint and Individual Interests. Bankruptcy Mediation .. ii FLORIDA AUTO POLICY INSURING AGREEMENT In return for your payment of the premium, we agree to insure you subject to all the terms, conditions and limitations of this policy. We will insure you for the coverages and the limits of liability shown on this policy's declarations page. Your policy consists of the policy contract, your insurance application, the declarations page, and all en- dorsements to this policy. GENERAL DEFINITIONS The following definitions apply throughout the policy. Defined terms are printed in bold- face type and have the same meaning whether in the singular, plural, or any other form. 1 “Additional auto” means an auto you become the actual or beneficial owner of during the policy period that does not permanently replace an auto shown on the declarations page if: a. you notify us within 30 days of becoming the owner of the additional auto; and b. you pay any additional premium due. An additional auto will have the broadest coverage we provide for any auto shown on the declarations page. If you ask us to insure an additional auto more than 30 days after you become the actual or beneficial owner, any coverage we provide will begin at the time you request coverage. “Auto” means a land motor vehicle: a. of the private passenger, pickup body, or cargo van type; b. designed for operation principally upon public roads; Cc. with at least four wheels; and d. with a gross vehicle weight rating of 12,000 pounds or less, according to the manufacturer's specifications. However, “auto” does not include step-vans, parcel delivery vans, or cargo cutaway vans or other vans with cabs separate from the cargo area. “Auto business” means the business of selling, leasing, repairing, parking, storing, servicing, delivering or testing vehicles. “Bodily injury” means bodily harm, sickness, or disease, including death that re- sults from bodily harm, sickness, or disease. “Covered auto” means: a. any auto or trailer shown on the declarations page for the coverages appli- cable to that auto or trailer; b. any additional auto; c. any replacement auto; or d. a trailer owned by you. "De clarations page” means the document showing your coverages, limits of li- ability, covered autos, premium, and other policy-related information. The declara- tions page may also be referred to as the Auto Insurance Coverage Summary. “Occupying” means in, on, entering or exiting. “Personal vehicle sharing program” means a system or process, operated by a 1 business, organization, network, group, or individual under terms of use pursuant to a written agreement, that facilitates the sharing of private passenger motor ve- hicles for use by individuals. “Property damage” means physical damage to, destruction of, or loss of use of, tangible property. 10. “Rated resident’ means a person residing in the same household as you at the time of the loss who is not arelative, but only if that person is both: a. listed in the “Drivers and household residents” section on the declarations page; and b, not designated as either an “Excluded” or a “List Only” driver. 11 “Relative” means a person residing in the same household as you, and related to you by blood, marriage or adoption, and includes a ward, stepchild, or foster child. Your unmarried dependent children temporarily away from home will qualify as a relative if they intend to continue to reside in your household. 12. “Replacement auto” means an auto that permanently replaces an auto shown on the declarations page. However, if the auto being replaced had coverage under Part IV—Damage To A Vehicle, such coverage will apply to the replacement auto only during the first 30 days after you become the actual or beneficial owner unless you notify us within that 30-day period that you want us to extend coverage be- yond the initial 30 days. If the auto being replaced did not have coverage under Part |V—Damage To A Vehicle, such coverage may be added, but the replacement auto will have no coverage under Part IV until you notify us of the replacement auto and ask us to add the coverage. 13. “Ride-sharing activity’ means the use of any vehicle to provide transportation of persons for any compensation or fee in connection with a transportation network company from the time a user logs on to, or signs in to, any online-enabled appli- cation, software, website or system until the time the user logs out of, or signs off of, any such online-enabled application, software, website or system, whether or not the user has accepted any passenger(s), including the time the user is on the way to pick up any passenger(s), or is transporting any passenger(s). 14 “Trailer” means a non-motorized trailer, including a farm wagon or farm implement, designed to be towed on public roads by an auto: a. while not being used for commercial purposes; b. while not being used as an office, store, or for display purposes; or Cc. while not being used as a passenger conveyance. 15. “Transportation network company’ is an organization, sole proprietor, or any other entity that provides prearranged transportation services for compensation using an online-enabled application or platform to connect passengers with drivers using a personal vehicle. This definition does not include shared-expense carpool- ing. 16. “We,” “us” and “our” mean the underwriting company providing the insurance, as shown on the declarations page. 17. “You” and “your” mean: a a person shown as a named insured on the declarations page; and b. the spouse of a named insured if residing in the same household at the time of the loss. PART I—LIABILITY TO OTHERS INSURING AGREEMENT—BODLLY INJURY If you pay the premium for this coverage, we will pay damages for bodily injury for which an insured person becomes legally responsible because of an accident. INSURING AGREEMENT—PROPERTY DAMAGE If you pay the premium for this coverage, we will pay damages for property damage for which an insured person becomes legally responsible because of an accident. Damages for bodily injury and property damage include prejudgment interest award- ed against an insured person, where owed by law. If you pay the premium for Bodily Injury Liability and Property Damage Liability, we will settle or defend, at our option, any claim for bodily injury or property damage cov- ered by this Part |. Our duty to settle or defend ends after we have paid the applicable limit of liability for the accident that is the basis of the lawsuit. Our duty to settle or de- fend does not include any sanctions awarded or assessed against an insured person due to intentional misrepresentation or concealment committed by that insured person during the course of any lawsuit, associated discovery, or other proceedings. If you pay the premium for Property Damage Liability only, we will settle or defend, at our option, any claim for property damage covered by this Part |. Our duty to settle or defend ends after we have paid the applicable limit of liability for the accident that is the basis of the lawsuit. Our duty to settle or defend does not include any sanctions awarded or assessed against an insured person due to intentional misrepresentation or concealment committed by that insured person during the course of any lawsuit, associated discovery, or other proceedings. Satisfaction by an insured person of a judgment for bodily injury or property dam- age shall not be a condition precedent to the right or duty of us to make payment for such bodily injury or property damage. ADDITIONAL DEFINITION When used in this Part I: “Insured person” means: a. you, a relative, or a rated resident with respect to an accident arising out of the ownership, maintenance or use of an auto or a trailer; b. any person with respect to an accident arising out of that person's use of a covered auto with the permission of you, a relative, or a rated resident; Cc. any person or organization with respect only to vicarious liability for the acts or omissions of a person described in a. or b. above; and any ‘Additional Interest” shown on the declarations page with respect only to its liability for the acts or omissions of a person described in a. or b. above. 3 ADDITIONAL PAYMENTS In addition to our limit of liability, we will pay for an insured person: 1 all expenses we incur in the settlement of any claim or in the defense of an insured person in any lawsuit. This does not include attorney fees or sanctions awarded or assessed against an insured person unless they were taxed against an insured because the Company, while providing a defense, rejected an offer of judgment at or below the applicable limit of liability; interest accruing after entry of judgment, until we have paid, offered to pay, or de- posited in court, that portion of the judgment which does not exceed our limit of liability. This does not apply if we have not been given notice of suit or the opportu- nity to defend an insured person; the premium on any appeal bond or attachment bond required in any lawsuit we defend. We have no duty to purchase a bond in an amount exceeding our limit of liability, and we have no duty to apply for or furnish these bonds; up to $250 for a bail bond required because of an accident resulting in bodily in- jury or property damage covered under this Part I. We have no duty to apply for or furnish this bond; and reasonable expenses, including loss of earnings up to $200 per day, incurred at our request. EXCLUSIONS—READ THE FOLLOWING EXCLUSIONS CAREFULLY. IF AN EX- CLUSION APPLIES, COVERAGE WILL NOT BE AFFORDED UNDERTHIS PART I. Coverage under this Part I, including our duty to defend, will not apply to any insured person for: 1 bodily injury or property damage arising out of the ownership, maintenance or use of any vehicle or trailer while being used: a. to carry persons or property for compensation or a fee; b. for retail or wholesale delivery, including, but not limited to, the pickup, transport or delivery of magazines, newspapers, mail or food; or Cc. for ride-sharing activity. This exclusion does not apply to shared-expense car pools; any liability assumed under any contract or agreement by you or a relative; bodily injury to an employee of that insured person arising out of or within the course of employment. This exclusion does not apply to domestic employees if benefits are neither paid nor required to be provided under workers’ compensation, disability benefits, or similar laws; bodily injury or property damage arising out of an accident involving any vehicle while being maintained or used by a person while employed or engaged in any auto business. This exclusion does not apply to you, a relative, a rated resident, or an agent or employee of you, a relative, or a rated resident, when using a covered auto; bodily injury or property damage arising out of the use of any vehicle, and result- ing from, or sustained during practice or preparation for: a any pre-arranged or organized racing, stunting, speed or demolition contest or activity by an insured person; or 4 b. any driving activity conducted on a permanent or temporary racetrack or race- course by an insured person; bodily injury or property damage due to a nuclear reaction or radiation; bodily injury or property damage for which insurance: a, is afforded under a nuclear energy liability insurance contract; or b. would be afforded under a nuclear energy liability insurance contract but for its termination upon exhaustion of its limit of liability; any obligation for which the United States Government is liable under the Federal Tort Claims Act. This exclusion will apply only to the damages that are in excess of the minimum limits of liability coverage required by the financial responsibility law of the state of Florida; bodily injury or property damage caused by an intentional act of any insured person, or at the direction of any insured person, even if the actual injury or dam- age is different than that which was intended or expected. With respect to persons sustaining bodily injury or property damage who do not also qualify as insured persons, this exclusion will apply only to the damages that are in excess of the minimum limits of liability coverage required by the financial responsibility law of the state of Florida; 10. property damage to any property owned by, rented to, being transported by, used by, or in the charge of that insured person. This exclusion does not apply to a rented residence or a rented garage; 11 bodily injury to you or a relative; 12. bodily injury or property damage arising out of the ownership, maintenance, or use of any vehicle owned by you or furnished or available for your regular use, other than a covered auto for which this coverage has been purchased; 13. bodily injury or property damage arising out of the ownership, maintenance or use of any vehicle owned bya relative or furnished or available for the regular use of a relative, other than a covered auto for which this coverage has been pur- chased. This exclusion does not apply to your maintenance or use of such vehicle; 14 bodily injury or property damage arising out of your, a relative’s, or a rated resident’s use of a vehicle, other than a covered auto, without the permission of the owner of the vehicle or the person in lawful possession of the vehicle; 15. bodily injury or property damage arising out of the use of a covered auto while leased or rented to others or given in exchange for any compensation, including while being used in connection with a personal vehicle sharing program. This exclusion does not apply to the operation of a covered auto by you, a relative, or a rated resident, and will only apply to the damages that are in excess of the minimum limits of liability coverage required by the financial responsibility law of the state of Florida; 16. punitive or exemplary damages; or 17. bodily injury or property damage caused by, or reasonably expected to result from, a criminal act or omission, excluding moving traffic violations, of any insured person. This exclusion applies regardless of whether that insured person is ac- tually charged with, or convicted of, a crime. With respect to persons sustaining bodily injury or property damage who do not also qualify as insured persons, 5 this exclusion will apply only to the damages that are in excess of the minimum limits of liability coverage required by the financial responsibility law of the state of Florida. LIMITS OF LIABILITY The limit of liability shown on the declarations page for liability coverage is the most we will pay regardless of the number of: claims made; covered autos; insured persons; lawsuits brought; vehicles involved in the accident; or premiums paid. If your declarations page shows a split limit: 1 the amount shown for “each person’ is the most we will pay for all damages due to bodily injury to one person resulting from any one accident; 2. subject to the “each person’ limit, the amount shown for “each accident’ is the most we will pay for all damages due to bodily injury sustained by two or more persons in any one accident; and the amount shown for “property damage’ is the most we will pay for the total of all property damage resulting from any one accident. The “each person’ limit of liability applies to the total of all claims made for bodily injury to a person and all claims of others derived from such bodily injury, including, but not limited to, emotional injury or mental anguish resulting from the bodily injury of another or from witnessing the bodily injury to another, loss of society, loss of companionship, loss of services, loss of consortium, and wrongful death, if recoverable under the ap- plicable law. If the declarations page shows that “combined single limit’ or “CSL’ applies, the amount shown is the most we will pay for the total of all damages resulting from any one accident. However, without changing this limit of liability, we will comply with any law that requires us to provide any separate limits. No one is entitled to duplicate payments for the same elements of damages. Any payment to a person under this Part | for bodil injury will be reduced by: 1 any payment made to that person for bodily injury under Part III—Uninsured Mo- torist Coverage; and 2. any amounts that are paid or payable to that person as personal injury protection benefits. If multiple auto policies issued by us are in effect for you, we will pay no more than the highest limit of liability for this coverage available under any one policy. An auto and attached trailer are considered one auto. Therefore, the limits of liability will not be increased for an accident involving an auto that has an attached trailer. FINANCIAL RESPONSIBILITY LAWS When we certify this policy as proof of financial responsibility, this policy will comply with the law to the extent required. The insured person must reimburse us if we make a payment that we would not have made if this policy was not certified as proof of financial responsibility. OTHER INSURANCE If there is any other applicable liability insurance or bond, we will pay only our share of the damages. Our share is the proportion that our limit of liability bears to the total of all applicable limits. Any insurance we provide for a vehicle or trailer, other than a covered auto, will be excess over any other collectible insurance, self-insurance, or bond. However, when you, a relative, or a rated resident rent or lease an auto, the liability coverage provided by the lessor's policy shall be primary unless the rental or lease agreement includes a provision in the form specified in Florida Statute §627.7263, as amended, stating that the lessee or rentee’s liability insurance and personal injury pro- tection insurance shall be primary. If the rental or lease agreement includes such a provision, our duty to pay damages under this Part I, and our duty to defend you, a relative, or a rated resident under this Part |, shall be primary to any liability coverage provided by the lessor or owner for operation of that auto by you, a relative, or a rated resident. We have no duty to defend the lessor or owner of that auto under this Part |. OUT-OF-STATE COVERAGE If an accident to which this Part | applies occurs in any state, territory or possession of the United States of America or any province or territory of Canada, other than the one in which a covered auto is principally garaged, and the state, province, territory or pos- session has: 1 a financial responsibility or similar law requiring limits of liability for bodily injury or property damage higher than the limits shown on the declarations page, this policy will provide the higher limits; or a compulsory insurance or similar law requiring a non-resident to maintain insur ance whenever the non-resident uses an auto in that state, province, territory or possession, this policy will provide the greater of: a. the required minimum amounts and types of coverage; or b. the limits of liability under this policy. PART II(A)—PERSONAL INJURY PROTECTION COVERAGE INSURING AGREEMENT If you pay the premium for this coverage, we will pay benefits that an insured person is entitled to receive pursuant to the Florida Motor Vehicle No-Fault Law, as amended, because of bodily injury: 1 caused by an accident; 2. sustained by an insured person; and 3. arising out of the ownership, maintenance or use of a motor vehicle. Personal Injury Protection Coverage benefits consist of: 1 medical benefits; 2. disability benefits; and 3. death benefits. ADDITIONAL DEFINITIONS When used in this Part II(A): 1 “Death benefits” means benefits of $5,000 payable per individual if an insured person dies because of injury covered under this Part II(A). 2. “Disability benefits” means 60 percent of any work loss per insured person from inability to work proximately caused by the injury sustained by the insured person. Disability benefits also include all expenses reasonably incurred in ob- taining from others ordinary and necessary services in lieu of those services that, but for the bodily injury, the insured person would have performed without in- come for the benefit of his or her household. “Emergency medical condition” means a medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following: a. serious jeopardy to patient health; b, serious impairment to bodily functions; or Cc. serious dysfunction of any bodily organ or part. “Insured person” means: a, you or any resident relative sustaining bodily injury while occupying a mo- tor vehicle, or when struck by a motor vehicle while not occupying a self- propelled vehicle; b, any person sustaining bodily injury while occupying a covered auto; or Cc. any person, if a resident of Florida, sustaining bodily injury when struck by a covered auto while not occupying a self-propelled vehicle. For purposes of this definition, “covered auto” includes an attached trailer or semi- trailer designed for use with such vehicle. “Medical benefits” means 80 percent of all reasonable expenses incurred for medically necessary medical, surgical, x-ray, dental and rehabilitative services, including prosthetic devices and medically necessary ambulance, hospital and 8 nursing services. All of the following statutory references are to Florida law. Medi- cal benefits are limited to: 1) services and care received within the initial 14 days after the motor vehicle accident, or 2) follow-up services and care received beyond the initial 14 days after the motor vehicle accident if services and care have been previously received within the initial 14 days after the motor vehicle accident, and a referral for more services and care has been provided by a statutorily authorized provider, and the follow-up services and care are consistent with the underlying medical diagnosis. Medical benefits provide reimbursement for: 1) initial services and care that are lawfully provided, supervised, ordered, or prescribed by a physi- cian licensed under chapter 458 or chapter 459, a dentist licensed under chapter 466, or a chiropractic physician licensed under chapter 460 or that are provided in a hospital or in a facility that owns, or is wholly owned by, a hospital. Initial services and care may also be provided by a person or entity licensed under part III of chap- ter 401 which provides emergency transportation and treatment, or 2) upon referral by a provider described in subparagraph 1), follow-up services and care consistent with the underlying medical diagnosis rendered pursuant to subparagraph 1) which may be provided, supervised, ordered, or prescribed only by a physician licensed under chapter 458 or chapter 459, a chiropractic physician licensed under chapter 460, a dentist licensed under chapter 466, or, to the extent permitted by applicable law and under the supervision of such physician, osteopathic physician, chiroprac- tic physician, or dentist, by a physician assistant licensed under chapter 458 or chapter 459 or an advanced registered nurse practitioner licensed under chapter 464. Follow-up services and care may also be provided by the following persons or entities: a) hospital or ambulatory surgical center licensed under chapter 395, b) an entity wholly owned by one or more physicians licensed under chapter 458 or chapter 459, chiropractic physicians licensed under chapter 460, or dentists li- censed under chapter 466 or by such practitioners and the spouse, parent, child, or sibling of such practitioners, c) an entity that owns or is wholly owned, directly or indirectly, by a hospital or hospitals, d) a physical therapist licensed under chapter 486, based upon a referral by a provider described in this subparagraph, e) a health care clinic licensed under part X of chapter 400 which is accredited by an accredit- ing organization whose standards incorporate comparable regulations required by this state, or (i) has a medical director licensed under chapter 458, chapter 459, or chapter 460; (ii) has been continuously licensed for more than 3 years or is a publicly traded corporation that issues securities traded on an exchange registered with the United States Securities and Exchange Commission as a national securi- ties exchange; and (iii) provides at least four of the following medical specialties: (A) General medicine, (B) Radiography, (C) Orthopedic medicine, (D) Physical medi- cine, (E) Physical therapy, (F) Physical rehabilitation, (G) Prescribing or dispensing outpatient prescription medication, (H) Laboratory services. Medical benefits do not include massage, as defined in FL. St. 480.033, or acupuncture, as defined in FL. St. 457.102, regardless of the person, entity or licensee providing the massage or acupuncture, and a licensed massage therapist or licensed acupuncturist will not be reimbursed for medical benefits. “Medically necessary’ refers to a medical service or supply that a prudent physi- cian would provide for the purpose of preventing, diagnosing, or treating an illness, 9 injury, disease, or symptom in a manner that is: a, in accordance with generally accepted standards of medical practice; b. clinically appropriate in terms of type, frequency, extent, site, and duration; and Cc. not primarily for the convenience of the patient, physician, or other health care provider. “Motor vehicle” means any self-propelled vehicle with four or more wheels which is of a type both designed and required to be licensed for use on the highways of the State of Florida and any trailer or semi-trailer designed for use with such vehi- cle. A motor vehicle does not include a mobile home or any motor vehicle which is used in mass transit, other than public school transportation, and designed to transport more than five passengers exclusive of the operator of the motor vehicle and which is owned by a municipality, a transit authority, or a political subdivision of the state. “Owner” means a person who holds the legal title to a motor vehicle, or, in the event a motor vehicle is the subject of a security agreement or lease with an op- tion to purchase with the debtor or lessee having the right to possession, then the debtor or lessee shall be deemed the owner. “Resident relative” means a relative of any degree by blood or by marriage, or who is adopted, a foster child, or a ward of the state, and who usually makes his or her home in the same family unit, whether or not temporarily living elsewhere. 10. “Work loss” means loss of gross income and loss of earning capacity. EXCLUSIONS—READ THE FOLLOWING EXCLUSIONS CAREFULLY. IF AN EX- CLUSION APPLIES, COVERAGE WILL NOT BE AFFORDED UNDER THIS PART IMA). Coverage under this Part II(A) does not apply to bodily injury: 1 sustained by you or a resident relative while occupying another motor vehicle owned by you and not insured under this policy; 2 sustained by any person operating a covered auto without your express or im- plied consent; 3. to any injured person, if such person's conduct contributed to his or her bodily injury under any of the following circumstances: a, causing bodily injury to himself or herself intentionally; or b. sustaining bodily injury while committing a felony. However, whenever an in- sured is charged with such conduct, the required 30-day payment provision shall be held in abeyance, and the insurer shall withhold payment of any per sonal injury protection benefits pending the outcome of the case at the trial level. If the charge is nolle prossed or dismissed or the insured is acquitted, the 30-day payment provision shall run from the date the insurer is notified of such action; sustained by any person, other than you, if such person is the owner of a motor vehicle with respect to which security is required under the Florida Motor Vehicle No-Fault Law, as amended; sustained by any person, other than you or a resident relative, who is entitled to personal injury protection benefits from the insurer or owner of a motor vehicle that is not a covered auto under this policy; 10 sustained by any person while occupying a motor vehicle while located for use as a residence or premises; with respect to work loss, if such bodily injury is sustained by you, and if anamed insured has elected to exclude work loss for either you, or your dependent resi- dent relatives, as indicated on the declarations page; with respect to work loss, if such bodily injury is sustained by a dependent resi- dent relative, and if a named insured has elected to exclude work loss for you and dependent resident relatives, as indicated on the declarations page; or sustained by any person while occupying a covered auto while it is being used for ride-sharing activity. LIMIT OF LIABILITY The limit of liability shown on the declarations page for Personal Injury Protection is the most we will pay for each insured person injured in any one accident, regardless of the number of: claims made; covered autos; insured persons; lawsuits brought; vehicles involved in the accident; or premiums paid. If no emergency medical condition exists or no determination has been made, the maximum reimbursement for medical benefits and disability benefits is limited to $2,500. If an emergency medical condition exists, the insured is eligible to receive up to $10,000 in medical benefits and isability benefits. That determination can affirmatively be made only by a physician or physician assistant licensed under chapter 458 or 459, a dentist licensed under chapter 466, or an advanced registered nurse practitioner licensed under chapter 464, and further can be made only if no physician or physician assistant licensed under chapter 458 or 459, no chiropractic physician li- censed under chapter 460, no dentist licensed under chapter 466, no advanced reg- istered nurse practitioner licensed under chapter 464, no physical therapist licensed under chapter 486, and no person or entity licensed under part IIl of chapter 401 who provides emergency transportation and treatment has determined that the injured per- son did not have an emergency medical condition. This provision is applicable to all claims without regard to the identity, or status, of the entity seeking reimbursement, including those claims submitted by government entities possessing a statutory right to present claims under this Part II(A). Benefits received under any workers’ compensation law shall be credited against the benefits provided under this Part II(A). Any deductible elected by a named insured un- der Personal Injury Protection Coverage applies to those persons indicated as subject to a deductible on the declarations page. Any deductible that applies to the named insured shall apply to all persons listed as a named insured on the declarations page and any spouse of a named insured. When a deductible applies, the deductible will be applied to 100 percent of the expenses and losses covered under Personal Injury Protection Coverage. A separate $5,000 benefit limit is reserved exclusively for death benefits. However, the deductible shall not be applied to reduce death benefits. 1 Personal Injury Protection Coverage is primary to the Medical Payments Coverage un- der Part II(B). OTHER INSURANCE If there is other applicable personal injury protection coverage for the same injury to any one insured person, the most the insured person may recover is the maximum amount payable for personal injury protection benefits under the Florida Motor Vehicle No-Fault Law, as amended. If there is other applicable personal injury protection cov- erage, and we make a payment under this Part II(A), we are entitled to recover from each of the other insurers an equitable pro rata share of the benefits paid and expenses incurred in processing the claim. If an insured person sustains bodily injury while occupying, or through being struck by, a motor vehicle which is rented or leased, the liability coverage and the personal injury protection coverage provided by the lessor’s policy shall be primary unless the rental or lease agreement includes a provision which specifies that the valid and collect- ible liability insurance and personal injury protection insurance of any authorized rental or leasing driver is primary for the limits of liability and personal injury protection cover- age required by §§ 324.021(7) and 627.736, Florida Statutes. CONDITIONS In addition to the duties set forth in Part VI of this policy and the provisions set forth in Part VII of this policy, the following conditions apply to coverage afforded under this Part WA). Policy Period and Territory. The coverage under this Part II(A) applies only to acci- dents which occur during the policy period: 1 in the State of Florida; and 2. with respect to you or a resident relative, while occupying a covered auto out- side the State of Florida but within the United States of America, its territories or possessions, or Canada; and with respect to you, while occupying a motor vehicle owned by a resident rela- tive, and for which security is maintained under the Florida Motor Vehicle No-Fault Law, as amended, outside the State of Florida but within the United States of Amer- ica, its territories or possessions, or Canada. Duties in Case of an Accident or Loss. As a condition precedent to obtaining Per sonal Injury Protection Coverage, a person must: 1 cooperate with us in any matter concerning a claim or lawsuit; 2. provide any written proof of loss we may reasonably require; 3. allow us to take signed and recorded statements, including sworn statements and examinations under oath, which we may conduct outside the presence of you or any other person claiming coverage, and answer all reasonable questions we may ask and provide any documents, records, or other tangible items that we request, when, where, and as often as we may reasonably require; and authorize us to obtain medical and other records. 12 Examination under Oath. An insured seeking benefits must comply with the terms of the policy, which include, but are not limited to, submitting to an examination under oath The scope of questioning during the examination under oath is limited to relevant infor mation or information that could reasonably be expected to lead to relevant information. Compliance with this paragraph is a condition precedent to receiving benefits. Refusal to Submit to Medical Examination. If a person making a claim under this Part II(A) unreasonably refuses to submit to or fails to appear at a medical examination required by us, we shall not be liable for further payments under this Part II(A).A refusal to submit to or failure to appear at two examinations raises a rebuttable presumption that the refusal or failure was unreasonable. Right of Reimbursement from Owner or Insurer of Commercial Motor Vehicle. If we make a payment under this Part II(A) to any person sustaining bodily injury while occupying a commercial motor vehicle, as defined under the Florida Motor Vehicle No-Fault Law, as amended, or when struck by a commercial motor vehicle while not occupying a self-propelled vehicle, we shall have a right of reimbursement, to the ex- tent of our payment, against the owner of the commercial motor vehicle or the owner’s insurer. This right of reimbursement shall not apply from the owners or registrants of motor vehicles being used as taxicabs. Unreasonable or Unnecessary Medical Benefits. If an insured person incur