Preview
FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 PM INDEX NO. 707776/2024
NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 04/11/2024
"B"
EXHIBIT
FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 PM INDEX NO. 707776/2024
NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 04/11/2024
o°?¼x ?60 PROGRESS/VE
TAMPA, FL33631 DIRECT Auto
Policy Number: 934829543
Underwritten by:
ProgressiveAdvanced InsuranceCo
SYED JAKARIA Valued customersine 2019
87-40165TH ST
Date of Mailing: May 9, 2022
-
JAMICIA, NY 11432 Policy Period: Jun 10, 2022 Dec 10, 2022
Page 1 of 2
progressive.com
Online Service
Make payments, check billing activity, update
policy information or checkstatus of a claim.
1-800-776-4737
Coverage Summary ror customerservie and daims service,
24 hours a day, 7 days a week.
This is your Renewal
Dedarations Page
The coverages, limits and policy period shown apply only if you pay for this policy to renew.
Your coverage begins on June 10, 2022 at 12:01 a.m. This policy expires on December 10, 2022 at 12:01 a.m.
Your insurance policy and any policy endorsements contain a full explanation of your coverage. The policy contract is form 9611D NY
(07/17).
Supplementary Uninsured/Underinsured Motorist: (SUM)
The maximum amount payable under SUM coverage shall be the policy's SUM limits reduced and thus offset by motor
vehicle bodily injury liability insurance policy or bond payments received from, or on behalf of, any negligent party
involved in the accident, as specified in the SUM endorsement.
Drivers and household residents
Gender: Male
Additional information: Named insured
Shohana Syed
Gender: Female
rerm6489NY(05/20) Contin
FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 PM INDEX NO. 707776/2024
NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 04/11/2024
Policy Number: 934829543
SyedJakaria
Page2 of 2
Outline of coverage
2015 TOYOTA RAV4 4 DOOR WAGON
VIN: 2T3BFREV1FW306855
Garaging ZIP Code: 11432
Primary use of the vehide: Commute
Snapshot®
This vehicle is currently enrolled in the Program.
.......................................................................umits
Liability To Others
Bodily Injury Liability $25,000 each person/$50,000 each accident
Including Supplemental Spousal Liability
Property Damage Liability $25,000 each accident
.........................................................................................................................................
Mandatory Personal Injury Protection $50,000 each person
.........................................................................................................................................
Aggregate No-Fault Benefits Available $50,000
Death Benefit $2,000
Maximum Monthly Work Loss $2,000
Other Reasonable & Neessary Expenses (per day) $25
5uppierIeItary Uninsured}Ünderinsured WIo rist [25,000 eac0iperson/550,000 ealacciden
.........................................................................................................................................
Comprehensive Actual Cash Value
. . . ............................................................ . . ... . .. .. ............................................
ReHaf Reim uÏsemen up toj50 ea day/maximum 30 days
iioadsielssisEr
.........................................................................................................................................
Subtotal policy premium
.........................................................................................................................................
Motor vehicle law enforcement fee
.........................................................................................................................................
Total 6 month policy premium and fees
Premium discounts
Desaiption Desaiption
............................................................... .....................................................
Anti-Theft Daytime Running Lamps
Electronic Funds Transfer (EFT) Continuous Insurance: Gold
Paperless Anti-Lock Brakes/Passive Restraint
Snapshot Driving
Premium surcharges
This policy is not surcharged. Surcharges may be applied in the future as outlined in the Rating Information provided in the
Required Information Notice, Form 3072, included in this mailing.
Lienholder information
Vehicle Lienholder
.............................................................................................................................................................................
2015 TOYOTA RAV4 TOYOTA MOTOR CREDIT
2T3BFREV1FW306855 ATLANTA, GA 30348
New York Motor Vehicle I.aw Enforcement Fee
The New York Motor Vehicle Law Enforcement Fee is required by law and is used to fund activities relating to the
detection, prosecution, or reduction of auto thefts.
Policy tier
This policy has been assigned to the 4R tier.
Form6489NY(05/20)
FILED: QUEENS 9611D
COUNTY INDEX NO. 707776/2024
NY 0717 CLERK 04/11/2024 12:12 P
NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 04/11/2024
NEW YORK
AUTO POLICY
611D
NY(07/17)
INDEX NO. 707776/2024
FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 P
NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 04/11/2024
INDEX NO. 707776/2024
FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 P
NYSCEF DOC. NO. 4 CONTENTS RECEIVED NYSCEF: 04/11/2024
INSURING AGREEMENT ..................................................................................1
GENERAL DEFINITIONS..................................................................................1
PART I-LIABILITY TO OTHERS
Insuring Agreement......................................................................................4
Additional Definition .....................................................................................4
Additional Payments.....................................................................................4
Exclusions....................................................................................................5
Limits of Liability...........................................................................................6
Financial Responsibility Laws ......................................................................7
Other Insurance ...........................................................................................8
Out-of-State Coverage .................................................................................8
PART II(A)-PERSONAL INJURY PROTECTION COVERAGE
Mandatory Personal Injury Protection Endorsement (New York)..................8
Optional Basic Economic Loss Coverage Endorsement (New York)..........15
Additional Personal Injury Protection Endorsement (New York) .................16
PART II(B)-MEDICAL PAYMENTS COVERAGE
Insuring Agreement....................................................................................19
Additional Definitions..................................................................................20
Exclusions..................................................................................................20
Limits of Liability.........................................................................................21
Unreasonable or Unnecessary Medical Expenses ....................................22
Other Insurance .........................................................................................22
PART III-UNINSURED MOTORISTS COVERAGE
Uninsured Motorists Endorsement.............................................................22
Supplementary Uninsured/Underinsured Motorists Endorsement.............29
PART IV-DAMAGETO A VEHICLE
Insuring Agreement-Collision Coverage ..................................................35
Insuring Agreement-Comprehensive Coverage.......................................35
Insuring Agreement-Additional Custom Parts or Equipment Coverage........36
Insuring Agreement-Rental Reimbursement Coverage............................36
Insuring Agreement-Pet Injury Coverage.................................................37
Additional Definitions..................................................................................37
Exclusions..................................................................................................38
Limits of Liability.........................................................................................39
Waiver of Collision Deductible....................................................................41
Recovery of Stolen or Abandoned Vehicles ...............................................41
Payment of Loss.........................................................................................41
Mandatory Inspection.................................................................................41
i
INDEX NO. 707776/2024
FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 P
NYSCEF Repairs...............................................................................................41
Auto DOC. NO. 4 RECEIVED NYSCEF: 04/11/2024
No Benefit to Bailee ...................................................................................42
Loss Payable Clause..................................................................................42
Other Sources of Recovery........................................................................42
Appraisal ....................................................................................................42
PART V-ROADSIDE ASSISTANCE COVERAGE
Insuring Agreement....................................................................................43
Unauthorized Service Provider...................................................................43
Additional Definitions..................................................................................43
Exclusions..................................................................................................44
Other Insurance .........................................................................................44
PART VI-DUTIES IN CASE OF AN ACCIDENT OR LOSS............................44
PART VII-GENERAL PROVISIONS
Policy Period and Territory..........................................................................46
Changes.....................................................................................................46
Duty to Report Changes ............................................................................47
Settlement of Claims ..................................................................................47
Terms of Policy Conformed to Statutes......................................................47
Transfer of Interest .....................................................................................47
Fraud or Misrepresentation ........................................................................47
Payment of Premium and Fees..................................................................48
Cancellation ...............................................................................................48
Cancellation Refund...................................................................................49
Nonrenewal................................................................................................50
Payment or Performance............................................................................50
Legal Action Against Us..............................................................................50
Our Rights to Recover Payment.................................................................50
Joint and Individual Interests......................................................................51
Bankruptcy.................................................................................................51
RENTAL VEHICLE COVERAGE ENDORSEMENT.........................................51
ii
INDEX NO. 707776/2024
FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 P
NYSCEF DOC. NO. 4 NEWYORK AUTO POLICY
RECEIVED NYSCEF: 04/11/2024
INSURING AGREEMENT
In retum 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 en-
application, the declarations page, and all
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.
auto"
1. "Additional means an auto you become the owner of during the policy pe-
riod that does not permanently replace an auto shown on the declarations page if:
a. we insure all other autos you own;
b. the additional auto is not covered by any other insurance policy;
c. you notify us within 30 days of becoming the owner of the additional auto;
and
d. 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 owner, any coverage we provide will begin at the
time you request coverage.
"Auto"
2. means a land motor vehicle:
a. of the private passenger, pickup body, or cargo van type;
b. designed for operation principally upon public roads;
c. with at least four wheels; and
d. with a gross vehicle weight rating of 12,000 pounds or less, according to the
manufacturer's specifications.
"auto"
However, does not include step-vans, parcel delivery vans, or cargo cutaway
vans or other vans with cabs separate from the cargo area.
business"
3. "Auto means the business of selling, leasing, repairing, parking, storing,
servicing, delivering or testing vehicles.
injury"
4. "Bodily means bodily harm, sickness, or disease, including death that re-
sults from bodily harm, sickness, or disease.
auto"
5. "Covered means:
a. ap-
any auto or trailer shown on the declarations page for the coverages
plicable to that auto or trailer, provided such auto or trailer is predominantly
used for non-business purposes.
b. any additional auto;
c. any replacement auto; or
d. a trailer owned by you.
page"
6. "Declarations 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.
1
FILED: network" INDEX NO. 707776/2024
QUEENS COUNTY CLERK 04/11/2024 12:12 P
7 "Digital
NYSCEF DOC. NO. 4means any system or service offered or
RECEIVED a transpor-
utilized by04/11/2024
NYSCEF:
tation netwok that enables TNC prearranged trips with transporta-
company
tion netwok company drivers.
"Occupying"
8. means in, on, entering or exiting.
damage"
9. "Property means physical damage to, destruction of, or loss of use of,
tangible property.
resident"
10. "Rated means a person esiding in the same household as you at the
time of the loss who is not a relative, but only if that person is both:
esidents"
a. listed in the "Drivers and household section on the declarations
page; and
Only"
b. not designated as a "List driver.
"Relative"
11. means a person residing in the same household as you, and elated 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.
auto"
12. "Replacement means an auto that permanently splaces an auto shown
on the declarations page. A replacement auto will have the same coverage as
the auto it splaces if the replacement auto is not covered by any other insurance
policy. However, if the auto being replaced had coverage under Part IV-Damage
To A Vehicle, such coverage will apply to the replacement
auto only during the first
30 days after you become the owner notify us within that 30-day period
unless you
that you want us to extend coverage beyond the initial 30 days. If the auto being
replaced did not have coverage under Part IV-Damage To A Vehicle, such cover-
age 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.
"Trailer"
13. means a non-motorized, non-commercial trailer, including a farm wagon
or farm implement, designed to be towed on public roads by an auto and not be-
ing used:
a. for commercial purposes;
b. as an office, store, or for display purposes; or
c. as a passenger conveyance.
Trailer does not include a mobile home or manufactured home.
company" "TNC"
14. "Transportation netwok or means a person, corporation,
partnership, sole proprietorship, or other entity that is licensed pursuant to Article
44-B of the New York Vehicle and Traffic Law and is operating in New York state
compa-
exclusively using a digital network to connect transportation netwok
ny passengers to transportation netwo& company drivers who provide TNC
prearranged trips.
driver'
15. "Transportation network company means an individual who:
a. receives connections to potential passengers and related services from a
transportation netwo& company in exchange for payment of a fee to the
transportation network company; and
b. uses a TNC vehicle to offer or provide a TNC prearranged trip to trans-
portation network company passengers upon connection through a digital
network controlled by a transportation network company in exchange for
compensation or payment of a fee.
2
INDEX NO. 707776/2024
FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 P
trip"
16. "Transportation
NYSCEF DOC. NO. 4 netwodc company prean·anged
RECEIVED NYSCEF: provision
means the 04/11/2024 of
transportation pro-
by a transportation network company driver to a passenger
vided through the use of a TNC's digital network:
a. beginning when a transportation network company ddver accepts a pas-
senger's request for a trip through a digital network controlled trans-
by a
portation network company;
b. continuing while the transportation network company ddver transports the
requesting passenger in a TNC vehicle; and
c. ending when the last requesting passenger departs from the TNC vehicle.
tdp" in-
The term "Transportation network company prearranged does not
clude transportation provided through any of the following:
a. shared expense carpool or vanpool arrangements, including those as defined
in section one hundred fifty-eight-b of this chapter; and
b. use of a taxicab, livery, luxury limousine, or other for-hire vehicle, as defined in
this chapter, section 19-502 of the administrative code of the city of New York,
or as otherwise defined in local law.
vehicle" vehicle"
12 "Transportation network company or "TNC means a vehicle
that is:
a. prear-
used by a transportation network company driver to provide a TNC
ranged tdp originating within the state of New York; and
b. leased or otherwise for use net-
owned, authorized by the transportation
work company ddver;
c. such term shall not include:
i. a taxicab, as defined in section one hundred forty-eight-a of this chapter
and section 19-502 of the administrative code of the city of New York, or
as otherwise defined in local law;
ii. a livery vehicle, as defined in section one hundred twenty-one-e of this
chapter, or as otherwise defined in local law;
iii. a black car, limousine, or luxury limousine, as defined in section 19-502
of the administrative code of the city of New York, or as otherwise defined
in local law;
iv. a for-hire vehicle, as defined in section 19-502 of the administrative code
of the city of New York, or as otherwise defined in local law;
v. a bus, as defined in section one hundred four of this chapter;
vi. any motor vehicle weighing more than six thousand five hundred pounds
unloaded;
vii. passen-
any motor vehicle having a seating capacity of more than seven
gers; and
viii. any motor vehicle subject to section three hundred seventy of this chapter.
"We," "us" "our'
18. and mean the underwriting company providing the insurance, as
shown on the declarations page.
"You" "your'
19. and 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.
3
INDEX NO. 707776/2024
FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 P
NYSCEF DOC. NO. 4 PART I-LIABILITY TO OTHERS
RECEIVED NYSCEF: 04/11/2024
INSURING AGREEMENT
If you pay the premium for this coverage, we will pay damages, other than punitive or
exemplary damages, for bodily injury and property damage for which an insured
person becomes legally responsible because of an accident.
Damages include pejudgment interest awarded against an insured person.
We will settle or defend, as we consider appropriate, any claim for damages coveæd
by this Part I. This applies even if the claim or suit is groundless or false.
ADDITIONAL DEFINITION
When used in this Part I:
person"
"Insured means:
a. you, a relative, or a rated resident with respect to an accident arising out of the
ownership, maintenance or use of a trailer shown on the declarations page or a
covered auto;
b. or a relative with to an accident mainte-
you respect arising out of the ownership,
nance, or use of an auto or trailer with the permission of the owner of the vehicle
or the person in lawful possession of the vehicle;
c. any person with respect to an accident arising out of that person's use of a cov-
ered auto with the permission of you, a relative, or a rated resident;
d. any person or organization with respect only to vicarious liability for the acts or
omissions of a person described in a., b., or c. above; and
Interest"
e. any 'Additional shown on the declarations page with respect only to its
liability for the acts or omissions of a person described in a., b., or c. above.
ADDITIONAL PAYMENTS
In addition to our limit of liabirity,
we will pay for an insured person:
1. all expenses incur, and all costs taxed against
we the insured person, in the
settlement of any claim or defense of any lawsuit;
2. interest accruing after entry of judgment, until we have paid, offered to pay, or
deposited in court, that portion of the judgment which does not exceed our limit
of liabiHty. This does not apply if we have not been given notice of suit or the op-
portunity to defend an insured person;
3. 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 fumish these bonds;
4. up to $250 for a bail bond required because of an accident resulting in bodily
injury or property damage covered under this Part I. We have no duty to apply
for or furnish this bond;
5. expenses incurred by the insured person for first aid to others at the time of the
accident; and
4
INDEX NO. 707776/2024
FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 P
6. reasonable
NYSCEF expenses,
DOC. NO. 4 including loss of earnings up to $200
RECEIVED per day,04/11/2024
NYSCEF: incurred at
our request.
EXCLUSIONS-READ THE FOLLOWING EXCLUSIONS CAREFULLY. IF
AN EXCLUSION APPLIES, COVERAGE WILL NOT BE AFFORDED UNDER
THIS PART I.
Coverage under this Part I, including our duty to defend, will not apply to any insured
person for:
1. bodily injury or pmperty damage arising out of the ownership, maintenance or
use of any vehicle while being used as a public or livery conveyance. This exclu-
sion does not apply to shared-expense car pools;
2. any liability assumed under any contract or agreement by you, a relative, or a
rated resident;
3. bodily injury to an employee of that insured person arising out of or within the
course of employment. This exclusion doesnot apply to domestic employees if
workers' compensa-
benefits are neither paid nor required to be provided under
tion, disability benefits, or similar laws;
4. bodily injury or property damage out of an accident
arising invoMng an auto
or trailer 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;
5. any obligation for which the United States Government is liable under the Federal
Tort Claims Act;
6. bodily injury or property damage caused by an intentional act of that insured
person, or at the direction of that insured person;
7 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;
8. property damage sustained by the spouse of an insured person. However, this
exclusion does
not apply to deny coverage to a spouse if named as a third-party
defendant in a lawsuit brought by his or her spouse against another party;
9. bodily injury or pmperty 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;
10. bodily injury or pmperty damage arising out of the ownership, maintenance or
use of any vehicle owned by a relative or a rated resident or furnished or avail-
able for the regular use of a relative or a rated resident, other than a covered
auto for which this coverage has been purchased. This exclusion does not apply
to your maintenance or use of such vehicle; or
11. bodily injury or pmperty damage sustained while the vehicle is used by a trans-
portation network driver who is logged onto the transportation net-
company
work company's digital network but is not engaged in a transportation net-
work company prearranged trip or while the driver provides a transportation
network company prearranged trip.
5
INDEX NO. 707776/2024
FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 P
LIMITS
NYSCEF OF LIABILITY
DOC. NO. 4 RECEIVED NYSCEF: 04/11/2024
If your declarations page a split limit:
shows
persod'
1. the amount shown for "each is the most we will pay for all damages due to
bodily injury to one person resulting from any one accident;
persod' accident"
2. subject to the "each limit, the amount shown for "each is the
most we will pay for all damages due to bodi7 injury sustained by two or more
persons in any one accident; and
damage"
3. the amount shown for "property is the most we will pay for the total of all
property damage resuting from any one accident.
However, if your policy has bodi7 injury split limits of:
persod' accident"
1. $25,000 "each and $50,000 "each for coverage under this Part I,
as shown on the declarations page, then the split limits set forth in the paragraph
above shall not apply to bodi7 that resuts in death, and the following ad-
injury
ditional coverage will apply in the event of bodily injury that results in death, to the
extent required by New York law:
a. our limit of liability for damages due to bodily injury that results in the death
of one person in any one accident is $50,000; or
b. if two or more persons sustain bodily injury that resuts in death, our limit of
liability for bodi7 injury that results in the death of two or more persons in
any one accident is $100,000; or
persod' accident"
2. $50,000 "each and $100,000 "each for coverage under this Part
I, as shown on the declarations page, then the split limits set forth in the para-
graphs above for bodily injury shall not apply, and our limit of liabirrty, to the extent
required by New York law, will be as follows:
a. for any accident that causes bodily injury that results in the death of one
person, the most we will pay for all damages due to bodily injury that results
in death is $50,000;
b. if only one person sustains bodi7 injury that does not result in death, the limit
of liability for damages due to bodily injury to the one person is $50,000;
c. subject to the per person limit, if two or more persons sustain bodi7 in
Preview
FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 PM INDEX NO. 707776/2024 NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 04/11/2024 "B" EXHIBIT FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 PM INDEX NO. 707776/2024 NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 04/11/2024 o°?¼x ?60 PROGRESS/VE TAMPA, FL33631 DIRECT Auto Policy Number: 934829543 Underwritten by: ProgressiveAdvanced InsuranceCo SYED JAKARIA Valued customersine 2019 87-40165TH ST Date of Mailing: May 9, 2022 - JAMICIA, NY 11432 Policy Period: Jun 10, 2022 Dec 10, 2022 Page 1 of 2 progressive.com Online Service Make payments, check billing activity, update policy information or checkstatus of a claim. 1-800-776-4737 Coverage Summary ror customerservie and daims service, 24 hours a day, 7 days a week. This is your Renewal Dedarations Page The coverages, limits and policy period shown apply only if you pay for this policy to renew. Your coverage begins on June 10, 2022 at 12:01 a.m. This policy expires on December 10, 2022 at 12:01 a.m. Your insurance policy and any policy endorsements contain a full explanation of your coverage. The policy contract is form 9611D NY (07/17). Supplementary Uninsured/Underinsured Motorist: (SUM) The maximum amount payable under SUM coverage shall be the policy's SUM limits reduced and thus offset by motor vehicle bodily injury liability insurance policy or bond payments received from, or on behalf of, any negligent party involved in the accident, as specified in the SUM endorsement. Drivers and household residents Gender: Male Additional information: Named insured Shohana Syed Gender: Female rerm6489NY(05/20) Contin FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 PM INDEX NO. 707776/2024 NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 04/11/2024 Policy Number: 934829543 SyedJakaria Page2 of 2 Outline of coverage 2015 TOYOTA RAV4 4 DOOR WAGON VIN: 2T3BFREV1FW306855 Garaging ZIP Code: 11432 Primary use of the vehide: Commute Snapshot® This vehicle is currently enrolled in the Program. .......................................................................umits Liability To Others Bodily Injury Liability $25,000 each person/$50,000 each accident Including Supplemental Spousal Liability Property Damage Liability $25,000 each accident ......................................................................................................................................... Mandatory Personal Injury Protection $50,000 each person ......................................................................................................................................... Aggregate No-Fault Benefits Available $50,000 Death Benefit $2,000 Maximum Monthly Work Loss $2,000 Other Reasonable & Neessary Expenses (per day) $25 5uppierIeItary Uninsured}Ünderinsured WIo rist [25,000 eac0iperson/550,000 ealacciden ......................................................................................................................................... Comprehensive Actual Cash Value . . . ............................................................ . . ... . .. .. ............................................ ReHaf Reim uÏsemen up toj50 ea day/maximum 30 days iioadsielssisEr ......................................................................................................................................... Subtotal policy premium ......................................................................................................................................... Motor vehicle law enforcement fee ......................................................................................................................................... Total 6 month policy premium and fees Premium discounts Desaiption Desaiption ............................................................... ..................................................... Anti-Theft Daytime Running Lamps Electronic Funds Transfer (EFT) Continuous Insurance: Gold Paperless Anti-Lock Brakes/Passive Restraint Snapshot Driving Premium surcharges This policy is not surcharged. Surcharges may be applied in the future as outlined in the Rating Information provided in the Required Information Notice, Form 3072, included in this mailing. Lienholder information Vehicle Lienholder ............................................................................................................................................................................. 2015 TOYOTA RAV4 TOYOTA MOTOR CREDIT 2T3BFREV1FW306855 ATLANTA, GA 30348 New York Motor Vehicle I.aw Enforcement Fee The New York Motor Vehicle Law Enforcement Fee is required by law and is used to fund activities relating to the detection, prosecution, or reduction of auto thefts. Policy tier This policy has been assigned to the 4R tier. Form6489NY(05/20) FILED: QUEENS 9611D COUNTY INDEX NO. 707776/2024 NY 0717 CLERK 04/11/2024 12:12 P NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 04/11/2024 NEW YORK AUTO POLICY 611D NY(07/17) INDEX NO. 707776/2024 FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 P NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 04/11/2024 INDEX NO. 707776/2024 FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 P NYSCEF DOC. NO. 4 CONTENTS RECEIVED NYSCEF: 04/11/2024 INSURING AGREEMENT ..................................................................................1 GENERAL DEFINITIONS..................................................................................1 PART I-LIABILITY TO OTHERS Insuring Agreement......................................................................................4 Additional Definition .....................................................................................4 Additional Payments.....................................................................................4 Exclusions....................................................................................................5 Limits of Liability...........................................................................................6 Financial Responsibility Laws ......................................................................7 Other Insurance ...........................................................................................8 Out-of-State Coverage .................................................................................8 PART II(A)-PERSONAL INJURY PROTECTION COVERAGE Mandatory Personal Injury Protection Endorsement (New York)..................8 Optional Basic Economic Loss Coverage Endorsement (New York)..........15 Additional Personal Injury Protection Endorsement (New York) .................16 PART II(B)-MEDICAL PAYMENTS COVERAGE Insuring Agreement....................................................................................19 Additional Definitions..................................................................................20 Exclusions..................................................................................................20 Limits of Liability.........................................................................................21 Unreasonable or Unnecessary Medical Expenses ....................................22 Other Insurance .........................................................................................22 PART III-UNINSURED MOTORISTS COVERAGE Uninsured Motorists Endorsement.............................................................22 Supplementary Uninsured/Underinsured Motorists Endorsement.............29 PART IV-DAMAGETO A VEHICLE Insuring Agreement-Collision Coverage ..................................................35 Insuring Agreement-Comprehensive Coverage.......................................35 Insuring Agreement-Additional Custom Parts or Equipment Coverage........36 Insuring Agreement-Rental Reimbursement Coverage............................36 Insuring Agreement-Pet Injury Coverage.................................................37 Additional Definitions..................................................................................37 Exclusions..................................................................................................38 Limits of Liability.........................................................................................39 Waiver of Collision Deductible....................................................................41 Recovery of Stolen or Abandoned Vehicles ...............................................41 Payment of Loss.........................................................................................41 Mandatory Inspection.................................................................................41 i INDEX NO. 707776/2024 FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 P NYSCEF Repairs...............................................................................................41 Auto DOC. NO. 4 RECEIVED NYSCEF: 04/11/2024 No Benefit to Bailee ...................................................................................42 Loss Payable Clause..................................................................................42 Other Sources of Recovery........................................................................42 Appraisal ....................................................................................................42 PART V-ROADSIDE ASSISTANCE COVERAGE Insuring Agreement....................................................................................43 Unauthorized Service Provider...................................................................43 Additional Definitions..................................................................................43 Exclusions..................................................................................................44 Other Insurance .........................................................................................44 PART VI-DUTIES IN CASE OF AN ACCIDENT OR LOSS............................44 PART VII-GENERAL PROVISIONS Policy Period and Territory..........................................................................46 Changes.....................................................................................................46 Duty to Report Changes ............................................................................47 Settlement of Claims ..................................................................................47 Terms of Policy Conformed to Statutes......................................................47 Transfer of Interest .....................................................................................47 Fraud or Misrepresentation ........................................................................47 Payment of Premium and Fees..................................................................48 Cancellation ...............................................................................................48 Cancellation Refund...................................................................................49 Nonrenewal................................................................................................50 Payment or Performance............................................................................50 Legal Action Against Us..............................................................................50 Our Rights to Recover Payment.................................................................50 Joint and Individual Interests......................................................................51 Bankruptcy.................................................................................................51 RENTAL VEHICLE COVERAGE ENDORSEMENT.........................................51 ii INDEX NO. 707776/2024 FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 P NYSCEF DOC. NO. 4 NEWYORK AUTO POLICY RECEIVED NYSCEF: 04/11/2024 INSURING AGREEMENT In retum 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 en- application, the declarations page, and all 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. auto" 1. "Additional means an auto you become the owner of during the policy pe- riod that does not permanently replace an auto shown on the declarations page if: a. we insure all other autos you own; b. the additional auto is not covered by any other insurance policy; c. you notify us within 30 days of becoming the owner of the additional auto; and d. 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 owner, any coverage we provide will begin at the time you request coverage. "Auto" 2. means a land motor vehicle: a. of the private passenger, pickup body, or cargo van type; b. designed for operation principally upon public roads; c. with at least four wheels; and d. with a gross vehicle weight rating of 12,000 pounds or less, according to the manufacturer's specifications. "auto" However, does not include step-vans, parcel delivery vans, or cargo cutaway vans or other vans with cabs separate from the cargo area. business" 3. "Auto means the business of selling, leasing, repairing, parking, storing, servicing, delivering or testing vehicles. injury" 4. "Bodily means bodily harm, sickness, or disease, including death that re- sults from bodily harm, sickness, or disease. auto" 5. "Covered means: a. ap- any auto or trailer shown on the declarations page for the coverages plicable to that auto or trailer, provided such auto or trailer is predominantly used for non-business purposes. b. any additional auto; c. any replacement auto; or d. a trailer owned by you. page" 6. "Declarations 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. 1 FILED: network" INDEX NO. 707776/2024 QUEENS COUNTY CLERK 04/11/2024 12:12 P 7 "Digital NYSCEF DOC. NO. 4means any system or service offered or RECEIVED a transpor- utilized by04/11/2024 NYSCEF: tation netwok that enables TNC prearranged trips with transporta- company tion netwok company drivers. "Occupying" 8. means in, on, entering or exiting. damage" 9. "Property means physical damage to, destruction of, or loss of use of, tangible property. resident" 10. "Rated means a person esiding in the same household as you at the time of the loss who is not a relative, but only if that person is both: esidents" a. listed in the "Drivers and household section on the declarations page; and Only" b. not designated as a "List driver. "Relative" 11. means a person residing in the same household as you, and elated 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. auto" 12. "Replacement means an auto that permanently splaces an auto shown on the declarations page. A replacement auto will have the same coverage as the auto it splaces if the replacement auto is not covered by any other insurance policy. However, if the auto being replaced had coverage under Part IV-Damage To A Vehicle, such coverage will apply to the replacement auto only during the first 30 days after you become the owner notify us within that 30-day period unless you that you want us to extend coverage beyond the initial 30 days. If the auto being replaced did not have coverage under Part IV-Damage To A Vehicle, such cover- age 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. "Trailer" 13. means a non-motorized, non-commercial trailer, including a farm wagon or farm implement, designed to be towed on public roads by an auto and not be- ing used: a. for commercial purposes; b. as an office, store, or for display purposes; or c. as a passenger conveyance. Trailer does not include a mobile home or manufactured home. company" "TNC" 14. "Transportation netwok or means a person, corporation, partnership, sole proprietorship, or other entity that is licensed pursuant to Article 44-B of the New York Vehicle and Traffic Law and is operating in New York state compa- exclusively using a digital network to connect transportation netwok ny passengers to transportation netwo& company drivers who provide TNC prearranged trips. driver' 15. "Transportation network company means an individual who: a. receives connections to potential passengers and related services from a transportation netwo& company in exchange for payment of a fee to the transportation network company; and b. uses a TNC vehicle to offer or provide a TNC prearranged trip to trans- portation network company passengers upon connection through a digital network controlled by a transportation network company in exchange for compensation or payment of a fee. 2 INDEX NO. 707776/2024 FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 P trip" 16. "Transportation NYSCEF DOC. NO. 4 netwodc company prean·anged RECEIVED NYSCEF: provision means the 04/11/2024 of transportation pro- by a transportation network company driver to a passenger vided through the use of a TNC's digital network: a. beginning when a transportation network company ddver accepts a pas- senger's request for a trip through a digital network controlled trans- by a portation network company; b. continuing while the transportation network company ddver transports the requesting passenger in a TNC vehicle; and c. ending when the last requesting passenger departs from the TNC vehicle. tdp" in- The term "Transportation network company prearranged does not clude transportation provided through any of the following: a. shared expense carpool or vanpool arrangements, including those as defined in section one hundred fifty-eight-b of this chapter; and b. use of a taxicab, livery, luxury limousine, or other for-hire vehicle, as defined in this chapter, section 19-502 of the administrative code of the city of New York, or as otherwise defined in local law. vehicle" vehicle" 12 "Transportation network company or "TNC means a vehicle that is: a. prear- used by a transportation network company driver to provide a TNC ranged tdp originating within the state of New York; and b. leased or otherwise for use net- owned, authorized by the transportation work company ddver; c. such term shall not include: i. a taxicab, as defined in section one hundred forty-eight-a of this chapter and section 19-502 of the administrative code of the city of New York, or as otherwise defined in local law; ii. a livery vehicle, as defined in section one hundred twenty-one-e of this chapter, or as otherwise defined in local law; iii. a black car, limousine, or luxury limousine, as defined in section 19-502 of the administrative code of the city of New York, or as otherwise defined in local law; iv. a for-hire vehicle, as defined in section 19-502 of the administrative code of the city of New York, or as otherwise defined in local law; v. a bus, as defined in section one hundred four of this chapter; vi. any motor vehicle weighing more than six thousand five hundred pounds unloaded; vii. passen- any motor vehicle having a seating capacity of more than seven gers; and viii. any motor vehicle subject to section three hundred seventy of this chapter. "We," "us" "our' 18. and mean the underwriting company providing the insurance, as shown on the declarations page. "You" "your' 19. and 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. 3 INDEX NO. 707776/2024 FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 P NYSCEF DOC. NO. 4 PART I-LIABILITY TO OTHERS RECEIVED NYSCEF: 04/11/2024 INSURING AGREEMENT If you pay the premium for this coverage, we will pay damages, other than punitive or exemplary damages, for bodily injury and property damage for which an insured person becomes legally responsible because of an accident. Damages include pejudgment interest awarded against an insured person. We will settle or defend, as we consider appropriate, any claim for damages coveæd by this Part I. This applies even if the claim or suit is groundless or false. ADDITIONAL DEFINITION When used in this Part I: person" "Insured means: a. you, a relative, or a rated resident with respect to an accident arising out of the ownership, maintenance or use of a trailer shown on the declarations page or a covered auto; b. or a relative with to an accident mainte- you respect arising out of the ownership, nance, or use of an auto or trailer with the permission of the owner of the vehicle or the person in lawful possession of the vehicle; c. any person with respect to an accident arising out of that person's use of a cov- ered auto with the permission of you, a relative, or a rated resident; d. any person or organization with respect only to vicarious liability for the acts or omissions of a person described in a., b., or c. above; and Interest" e. any 'Additional shown on the declarations page with respect only to its liability for the acts or omissions of a person described in a., b., or c. above. ADDITIONAL PAYMENTS In addition to our limit of liabirity, we will pay for an insured person: 1. all expenses incur, and all costs taxed against we the insured person, in the settlement of any claim or defense of any lawsuit; 2. interest accruing after entry of judgment, until we have paid, offered to pay, or deposited in court, that portion of the judgment which does not exceed our limit of liabiHty. This does not apply if we have not been given notice of suit or the op- portunity to defend an insured person; 3. 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 fumish these bonds; 4. up to $250 for a bail bond required because of an accident resulting in bodily injury or property damage covered under this Part I. We have no duty to apply for or furnish this bond; 5. expenses incurred by the insured person for first aid to others at the time of the accident; and 4 INDEX NO. 707776/2024 FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 P 6. reasonable NYSCEF expenses, DOC. NO. 4 including loss of earnings up to $200 RECEIVED per day,04/11/2024 NYSCEF: incurred at our request. EXCLUSIONS-READ THE FOLLOWING EXCLUSIONS CAREFULLY. IF AN EXCLUSION APPLIES, COVERAGE WILL NOT BE AFFORDED UNDER THIS PART I. Coverage under this Part I, including our duty to defend, will not apply to any insured person for: 1. bodily injury or pmperty damage arising out of the ownership, maintenance or use of any vehicle while being used as a public or livery conveyance. This exclu- sion does not apply to shared-expense car pools; 2. any liability assumed under any contract or agreement by you, a relative, or a rated resident; 3. bodily injury to an employee of that insured person arising out of or within the course of employment. This exclusion doesnot apply to domestic employees if workers' compensa- benefits are neither paid nor required to be provided under tion, disability benefits, or similar laws; 4. bodily injury or property damage out of an accident arising invoMng an auto or trailer 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; 5. any obligation for which the United States Government is liable under the Federal Tort Claims Act; 6. bodily injury or property damage caused by an intentional act of that insured person, or at the direction of that insured person; 7 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; 8. property damage sustained by the spouse of an insured person. However, this exclusion does not apply to deny coverage to a spouse if named as a third-party defendant in a lawsuit brought by his or her spouse against another party; 9. bodily injury or pmperty 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; 10. bodily injury or pmperty damage arising out of the ownership, maintenance or use of any vehicle owned by a relative or a rated resident or furnished or avail- able for the regular use of a relative or a rated resident, other than a covered auto for which this coverage has been purchased. This exclusion does not apply to your maintenance or use of such vehicle; or 11. bodily injury or pmperty damage sustained while the vehicle is used by a trans- portation network driver who is logged onto the transportation net- company work company's digital network but is not engaged in a transportation net- work company prearranged trip or while the driver provides a transportation network company prearranged trip. 5 INDEX NO. 707776/2024 FILED: QUEENS COUNTY CLERK 04/11/2024 12:12 P LIMITS NYSCEF OF LIABILITY DOC. NO. 4 RECEIVED NYSCEF: 04/11/2024 If your declarations page a split limit: shows persod' 1. the amount shown for "each is the most we will pay for all damages due to bodily injury to one person resulting from any one accident; persod' accident" 2. subject to the "each limit, the amount shown for "each is the most we will pay for all damages due to bodi7 injury sustained by two or more persons in any one accident; and damage" 3. the amount shown for "property is the most we will pay for the total of all property damage resuting from any one accident. However, if your policy has bodi7 injury split limits of: persod' accident" 1. $25,000 "each and $50,000 "each for coverage under this Part I, as shown on the declarations page, then the split limits set forth in the paragraph above shall not apply to bodi7 that resuts in death, and the following ad- injury ditional coverage will apply in the event of bodily injury that results in death, to the extent required by New York law: a. our limit of liability for damages due to bodily injury that results in the death of one person in any one accident is $50,000; or b. if two or more persons sustain bodily injury that resuts in death, our limit of liability for bodi7 injury that results in the death of two or more persons in any one accident is $100,000; or persod' accident" 2. $50,000 "each and $100,000 "each for coverage under this Part I, as shown on the declarations page, then the split limits set forth in the para- graphs above for bodily injury shall not apply, and our limit of liabirrty, to the extent required by New York law, will be as follows: a. for any accident that causes bodily injury that results in the death of one person, the most we will pay for all damages due to bodily injury that results in death is $50,000; b. if only one person sustains bodi7 injury that does not result in death, the limit of liability for damages due to bodily injury to the one person is $50,000; c. subject to the per person limit, if two or more persons sustain bodi7 in