Preview
FILED: QUEENS COUNTY CLERK 04/12/2024 11:39 AM INDEX NO. 707865/2024
NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 04/12/2024
EXHIBIT A
FILED: QUEENS COUNTY CLERK 04/12/2024
09/28/2021 11:39
09:06 AM INDEX NO. 707865/2024
712310/2021
NYSCEF DOC. NO. 4
19 RECEIVED NYSCEF: 04/12/2024
09/28/2021
EXHIBIT A
FILED: QUEENS COUNTY CLERK 04/12/2024
09/28/2021 11:39
09:06 AM INDEX NO. 707865/2024
712310/2021
NYSCEF DOC. NO. 4
19 RECEIVED NYSCEF: 04/12/2024
09/28/2021
IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
EXCESS COVERED AUTOS LIABILITY AND UNINSURED/UNDERINSURED
MOTORISTS COVERAGE ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
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For purposes of the coverage provided by this endorsement, the following changes apply, and to the
extent allowable under applicable law, supercede any provisions to the contrary:
Covered “autos” are specifically included under all coverage parts shown in the Declarations and any
coverage forms for Uninsured Motorist and/or Underinsured Motorist specific to rides originating in New
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York City regardless of where that covered “auto” is registered or principally garaged.
A. The third paragraph under SECTION II — COVERED AUTOS LIABILITY COVERAGE, A.
Coverage is deleted and replaced with the following:
We have no duty, but maintain the right to defend any “insured” against any “suit”. If we choose
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to participate in the defense of a “suit”, we may investigate and settle any claim or “suit” as we
consider appropriate and will not be obligated to participate in the defense when the Covered
Autos Liability Coverage Limit Of Insurance has been exhausted by payment of defense costs,
judgments or settlements.
B. SECTION II — COVERED AUTOS LIABILITY COVERAGE, C. Limit Of Insurance, is deleted
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and replaced with the following:
Regardless of the number of “insureds”, premiums paid, claims made or vehicles (other than
covered “autos”) involved in the “accident”, the most we will pay for the total of all damages and
“covered pollution cost or expense” combined, resulting from any one “accident” is the Limit of
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Insurance for Liability Coverage shown in the Declarations.
If more than one covered “auto” is involved in the same “accident”, a separate Limit of Insurance
for Liability Coverage shall apply to each covered “auto”.
All “bodily injury” from continuous or repeated exposure to substantially the same conditions will
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be considered as resulting from one “accident”.
No one will be entitled to receive duplicate payments for the same elements of “loss” under this
Coverage Form and any Uninsured Motorists Coverage Endorsement or Underinsured Motorists
Coverage Endorsement attached to this Coverage Part.
C. SECTION IV — BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance
is deleted and replaced with the following:
5. Other Insurance
CA 579 018 0719 Page 1 of 3
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a. Liability coverage provided by this policy shall apply if there is no other valid and
collectible automobile liability insurance available to a covered “livery partner”
that provides at least the Limit of Insurance shown in the Declarations of this
policy. If there is other automobile liability insurance available to a covered
“livery partner” that provides at least the amount of Limit(s) shown in the
Declarations of this policy, then this coverage shall not apply.
b. If a “livery partner” has other automobile liability insurance available which
provides less than the Limit of Insurance shown in the Declarations of this policy,
then this policy shall provide excess coverage and our Limits of Insurance will be
reduced by the amount of that other insurance including any deductibles or self-
insured amounts.
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c. Uninsured and/or Underinsured Motorists Coverage provided by this policy shall
only apply if there is no other valid and collectible Uninsured and/or Underinsured
Motorists Coverage for anyone occupying the covered “auto” that provides at
least the Limit of Insurance for Uninsured and/or Underinsured Motorists
Coverage shown in the Declarations of this policy. If there is Uninsured and/or
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Underinsured Motorists Coverage available to anyone occupying the covered
“auto” which provides at least the Limit of Insurance for Uninsured and/or
Underinsured Motorists Coverage shown in the Declarations of this policy, then
this coverage shall not apply.
d. Notwithstanding any changes in conditions to Other Insurance in any Uninsured
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and/or Underinsured Motorists Coverage form attached to this policy, if
Uninsured and/or Underinsured Motorists Coverage available for anyone
occupying the covered “auto” provides less than Limit of Insurance for Uninsured
and/or Underinsured Motorists Coverage shown in the Declarations of this policy,
then this policy shall provide excess coverage and our Limits of Insurance for
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Uninsured and/or Underinsured Motorists Coverage will be reduced by the
amount of that other insurance including any deductibles or self-insured
amounts.
D. The following exclusions are added to SECTION II — COVERED AUTOS LIABILITY
COVERAGE:
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14. Covered “autos” are specifically excluded under all coverage parts shown in the
Declarations and any coverage forms for Uninsured and/or Underinsured Motorists
Coverage where the ride originated in any jurisdiction except New York City.
15. Any loss, cost or expenses payable under or resulting from the following coverages:
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a. First-party physical damage coverage;
b. No-fault coverage; or
c. Personal injury protection or auto medical payments coverage.
E. The following definitions are added to SECTION V — DEFINITIONS:
“Livery partner” means an individual that is operating a taxicab, limousine, luxury limousine, black
car or other for-hire motor vehicle in connection with the use of the “UberPartner Application” and
that has entered into a contract with the Named Insured.
CA 579 018 0719 Page 2 of 3
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
MWTB 313795 20 Uber USA, LLC 07/01/2020 - 07/01/2021
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“UberPartner Application” means any smartphone application licensed by a subsidiary of Uber
Technologies, Inc. which is utilized by a “livery partner” to receive requests for transportation from
passengers.
F. The NEW YORK SUPPLEMENTARY UNINSURED/UNDERINSURED MOTORISTS
ENDORSEMENT, CA 31 07 is amended by adding the following subparagraph to the definition of
a. Insured in INSURING AGREEMENTS, 1. Definitions:
(5) Any person while occupying a covered “auto”.
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CA 579 018 0719 Page 3 of 3
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
MWTB 313795 20 Uber USA, LLC 07/01/2020 - 07/01/2021
FILED: QUEENS COUNTY CLERK 04/12/2024
05/28/2021 11:39
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COMMERCIAL AUTO
CA 31 07 11 18
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NEW YORK SUPPLEMENTARY
UNINSURED/UNDERINSURED
MOTORISTS ENDORSEMENT
The Declarations are completed as follows for this endorsement:
SUPPLEMENTARY UNINSURED/UNDERINSURED MOTORISTS $ EACH PERSON
(SUM) LIMIT $ 250,000 EACH ACCIDENT
We, the company, agree with you, as the named insured, in return for payment of the premium for this coverage,
to provide Supplementary Uninsured/Underinsured Motorists (SUM) coverage, subject to the following terms and
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conditions:
INSURING AGREEMENTS b. Bodily Injury
1. Definitions The term "bodily injury" means bodily harm,
For purposes of this SUM endorsement, the including sickness, disease or death
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following terms have the following meanings: resulting therefrom.
a. Insured c. Uninsured Motor Vehicle
The unqualified term "insured" means: The term "uninsured motor vehicle" means
a motor vehicle that, through its ownership,
(1) You, as the named insured and, while maintenance or use, results in bodily injury
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residents of the same household, your to an insured, and for which:
spouse and the relatives of either you or
your spouse; (1) No bodily injury liability insurance policy
or bond applies to such motor vehicle
(2) Any person while acting in the scope of (including a vehicle that was stolen,
that person's duties for you, except with operated without the owner's permission
respect to the use and operation by or unregistered) at the time of the
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such person of a motor vehicle not accident; or
covered under this policy, where such
person is: (2) The owner and operator cannot be
identified (including a hit-and-run motor
(a) Your employee and you are a fire vehicle), and which causes bodily injury
department; to an insured by physical contact with
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(b) Your member and you are a fire the insured or with a motor vehicle
company, as defined in General occupied by the insured at the time of
Municipal Law section 100; the accident, provided that:
(c) Your employee and you are an (a) The insured or someone on the
ambulance service, as defined in insured's behalf:
Public Health Law section 3001; or
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(i) Reported the accident within 24
(d) Your member and you are a hours or as soon as reasonably
voluntary ambulance service, as possible to a police, peace or
defined in Public Health Law, section judicial officer or to the
3001; Commissioner of Motor Vehicles;
and
(3) Any other person while occupying:
(ii) Filed with the Company a
(a) A motor vehicle insured for SUM
statement under oath that the
under this policy; or
insured or the insured's legal
(b) Any other motor vehicle while being representative has a cause or
operated by you or your spouse; and causes of action arising out of
(4) Any person, with respect to damages such accident for damages
such person is entitled to recover, against a person or persons
because of bodily injury to which this whose identity is unascertainable,
coverage applies sustained by an and setting forth the facts in
insured under Paragraph (1), (2) or (3) support thereof; and
above.
CA 31 07 11 18 © Insurance Services Office, Inc., 2018 Page 1 of 5
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(b) At the request of the Company, the d. Occupying
insured or the insured's legal The term "occupying" means in, upon,
representative makes available for entering into or exiting from a motor vehicle.
inspection the motor vehicle the
insured was occupying at the time of e. State
the accident; or The term "state" means a state, territory or
(3) There is a bodily injury liability insurance possession of the United States, the District
coverage or bond applicable to such of Columbia or a province of Canada.
motor vehicle at the time of the accident, 2. Damages For Bodily Injury Caused By
but: Uninsured Motor Vehicles
(a) The amount of such insurance We will pay all sums that the insured or the
coverage or bond is less than the insured's legal representative shall be legally
third-party bodily injury liability limit entitled to recover as damages from the owner
of this policy; or or operator of an uninsured motor vehicle
(b) The amount of such insurance because of bodily injury sustained by the
insured, caused by an accident arising out of
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coverage or bond has been reduced,
by payments to other persons injured such uninsured motor vehicle's ownership,
in the accident, to an amount less maintenance or use, subject to the Exclusions,
than the third-party bodily injury Conditions, Limits and other provisions set
liability limit of this policy; or forth in this SUM endorsement.
(c) The insurer writing such insurance 3. SUM Coverage Period And Territory
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coverage or bond denies coverage This SUM coverage applies only to accidents
or such insurer is or becomes that occur:
insolvent. a. During the policy period shown in the
The term "uninsured motor vehicle" shall Declarations; and
not include a motor vehicle that is: b. In the United States, its territories or
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(1) Insured under the liability coverage of possessions, or Canada.
this policy; or
EXCLUSIONS
(2) Owned by you, the named insured, or This SUM coverage does not apply to:
your spouse residing in your household;
or 1. Bodily injury to an insured, including care or
loss of services recoverable by an insured, if
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(3) Self-insured within the meaning of the such insured, such insured's legal
financial responsibility law of the state in representatives or any person entitled to
which the motor vehicle is registered, or payment under this coverage, without our
any similar state or federal law, to the written consent, settles any lawsuit against any
extent that the required amount of such person or organization that may be legally
coverage is equal to, or greater than, liable for such injury, care or loss of services,
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the third-party bodily injury liability limits however this provision shall be subject to
of this policy; or Condition 9.;
(4) Owned by the United States of America, 2. Bodily injury to an insured incurred while
Canada, a state, a political subdivision occupying a motor vehicle owned by that
of any such government or an agency of insured, if such motor vehicle is not insured for
any of the foregoing; or
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SUM coverage by the policy under which a
(5) A land motor vehicle or trailer, while claim is made or is not a newly acquired or
located for use as a residence or replacement motor vehicle covered under the
premises and not as a motor vehicle or terms of this policy; or
while operated on rails or crawler- 3. Non-economic loss resulting from bodily injury
treads; or to an insured arising from an accident in New
(6) A farm type vehicle or equipment York State, unless the insured has sustained
designed for use principally off public serious injury as defined in Section 5102(d) of
roads, except while actually upon public the New York Insurance Law.
roads.
Page 2 of 5 © Insurance Services Office, Inc., 2018 CA 31 07 11 18
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4. Bodily injury to an insured incurred while the 4. Notice Of Legal Action
motor vehicle is used by a transportation If the insured or the insured's legal
network company driver who is logged onto a representative brings any lawsuit against any
transportation network company's digital person or organization legally responsible for
network but is not engaged in a transportation the use of a motor vehicle involved in the
network company prearranged trip or while the accident, a copy of the summons and
driver provides a transportation network complaint or other process served in
company prearranged trip pursuant to article connection with the lawsuit shall be forwarded
44-B of the Vehicle and Traffic Law. immediately to us by the insured or the
CONDITIONS insured's legal representative.
1. Policy Provisions 5. SUM Limits And Maximum Payments
None of the Insuring Agreements, Exclusions a. The SUM limit payable under this
or Conditions of the policy shall apply to this endorsement shall be determined as
SUM coverage except: "Duties In The Event Of follows:
Accident, Claim, Suit Or Loss", "Fraud" and (1) If an accident results in bodily injury
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"Ending This Policy" if applicable. excluding death to one or more persons,
2. Notice And Proof Of Claim then we will provide the SUM limit stated
As soon as practicable, the insured or other in the Declarations; or
person making a claim shall give us written (2) If an accident results in the death of one
notice of claim under this SUM coverage. or more persons, then we will provide
the greater of the SUM limit stated in the
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a. As soon as practicable after our written
request, the insured or other person making Declarations or $50,000 for such bodily
claim shall give us written proof of claim, injury resulting in death sustained by
under oath if required, including full one person as the result of any one
particulars of the nature and extent of the accident and, subject to this per person
injuries, treatment and other details we limit, $100,000 for such bodily injury
resulting in death sustained by two or
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need to determine the SUM amount
payable. more persons as the result of any one
accident; or
b. The insured and every other person making
claim hereunder shall, as may reasonably (3) If an accident results in both bodily
be required, submit to examinations under injury to one or more persons and the
oath by any person we name and subscribe death of one or more persons, then we
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the same. Proof of claim shall be made will provide the greater of the SUM limits
upon forms we furnish unless we fail to stated in the Declarations or the limits
furnish such forms within 15 calendar days required by the mandatory uninsured
after receiving notice of claim. motorists (UM) coverage as follows:
3. Medical Reports $25,000 per injured person and, subject
to this per person limit,
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The insured shall submit to physical
examinations by physicians we select when $50,000 to two or more persons injured
and as often as we may reasonably require. as the result of any one accident; and
The insured, or in the event of the insured's $50,000 per person for bodily injury
incapacity, the insured's legal representative resulting in death and, subject to this per
(or in the event of the insured's death, the person limit,
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insured's legal representative or the person or $100,000 to two or more persons for
persons entitled to sue therefor), shall upon bodily injury resulting in death as the
each request from us authorize us to obtain result of any one accident.
copies of relevant medical reports and records.
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b. Regardless of the number of insureds, our 8. Exhaustion Required
maximum payment under this SUM Except as provided in Condition 9., we will pay
endorsement shall be the difference under this SUM coverage only after the limits
between: of liability have been exhausted under all motor
(1) The SUM limit; and vehicle bodily injury liability insurance policies
(2) The motor vehicle bodily injury liability or bonds applicable at the time of the accident
insurance or bond payments received in regard to any one person who may be
by the insured or the insured's legal legally liable for the bodily injury sustained by
representative, from or on behalf of all the insured.
persons that may be legally liable for the 9. Release Or Advance
bodily injury sustained by the insured. a. In accidents involving the insured and one
c. The SUM limit shown on the Declarations is or more negligent parties, if such insured
the amount of coverage for all damages settles with any such party for the available
due to bodily injury in any one accident. limit of the motor vehicle bodily injury
6. Non-Stacking liability coverage of such party, a release
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may be executed with such party after thirty
Regardless of the number of motor vehicles calendar days from our receipt of your
involved, persons covered, claims made, motor written notice to us, unless within this time
vehicles or premiums shown in this policy or period we agree to advance such
premium paid, the limits, whether for UM settlement amounts to the insured in return
coverage or SUM coverage, shall never be for the cooperation of the insured in our
added together or combined for two or more
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lawsuit on behalf of the insured.
motor vehicles to determine the extent of
insurance coverage available to an insured b. We shall have a right to the proceeds of
who was injured in the same accident. any such lawsuit equal to the amount
advanced to the insured and any additional
7. Priority Of Coverage amounts paid under this SUM coverage.
If an insured is entitled to UM coverage or Any excess above those amounts shall be
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SUM coverage under more than one policy, the paid to the insured.
maximum amount such insured may recover c. An insured shall not otherwise settle with
shall not exceed the highest limit of such any negligent party, without our written
coverage for any one motor vehicle under any consent, such that our rights would be
one policy and the following order of priority impaired.
shall apply:
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10. Non-Duplication
a. A policy covering a motor vehicle occupied
by the injured person at the time of the This SUM coverage shall not duplicate any of
accident; the following:
b. A policy covering a motor vehicle not a. Benefits payable under workers'
involved in the accident under which the compensation or other similar laws;
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injured person is a named insured; and b. Non-occupational disability benefits under
c. A policy covering a motor vehicle not New York Workers' Compensation Law
involved in the accident under which the article nine or other similar law;
injured person is an insured other than a c. Any amounts recovered or recoverable
named insured. pursuant to New York Insurance Law article
fifty-one or any similar motor vehicle
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Coverage available under a lower priority
policy applies only to the extent that it exceeds insurance payable without regard to fault;
the coverage of a higher priority policy. d. Any valid or collectible motor vehicle
medical payments insurance; or
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e. Any amounts recovered as bodily injury 12. Subrogation
damages from sources other than motor If we make a payment under this SUM
vehicle bodily injury liability insurance coverage, then we have the right to recover the
policies or bonds. amount of the payment from any person legally
11. Arbitration responsible for the bodily injury or loss of the
a. If any insured makes a claim under this person to whom, or for whose benefit, such
SUM coverage and we do not agree that payment was made to the extent of the
such insured is legally entitled to recover payment. The insured or any person acting on
damages from the owner or operator of an behalf of the insured must do whatever is
uninsured motor vehicle because of bodily necessary to transfer this right of recovery to
injury sustained by the insured, or we do us. Except as permitted by Condition 9., such
not agree as to the amount of payment that person shall do nothing to prejudice this right.
may be owing under this SUM coverage, 13. Payment Of Loss By Company
then, at the option and upon written We shall pay any amount due under this SUM
demand of such insured, the matter or coverage to the insured or, at our option, to a
matters upon which such insured and we
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person authorized by law to receive such
do not agree shall be settled by arbitration, payment or to a person legally entitled to
administered by the American Arbitration recover the damages which the payment
Administration pursuant to procedures represents.
approved by the Superintendent of
Financial Services for this purpose. 14. Action Against Company
No lawsuit shall lie against us unless the
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b. If the maximum amount of SUM coverage
provided by this endorsement equals the insured or the insured's legal representative
amount of coverage required to be provided has first fully complied with all the terms of this
by New York Insurance Law section SUM coverage.
3420(f)(1) and New York Vehicle and 15. Survivor Rights
Traffic Law Article 6 or 8, then such If you or your spouse, if a resident of the same
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disagreement shall be settled by such household, dies, then this SUM endorsement
arbitration procedures upon written demand shall cover:
of either the insured or us. Judgment upon
the award rendered by the arbitrator may a. The survivor as named insured;
be entered in any court having jurisdiction b. The decedent's legal representative as
thereof, and any such insured and we each named insured, but only while acting within
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agree to be bound by any award made by the scope of such representative's duties as
the arbitrator as to this SUM coverage. For such; and
purposes of this Condition, the term
c. Any relative who was an insured at the time
"insured" includes any person authorized to
of such death.
act on behalf of the insured.
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CA 31 07 11 18 © Insurance Services Office, Inc., 2018 Page 5 of 5
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FILED: QUEENS COUNTY CLERK 04/12/2024 11:39 AM INDEX NO. 707865/2024 NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 04/12/2024 EXHIBIT A FILED: QUEENS COUNTY CLERK 04/12/2024 09/28/2021 11:39 09:06 AM INDEX NO. 707865/2024 712310/2021 NYSCEF DOC. NO. 4 19 RECEIVED NYSCEF: 04/12/2024 09/28/2021 EXHIBIT A FILED: QUEENS COUNTY CLERK 04/12/2024 09/28/2021 11:39 09:06 AM INDEX NO. 707865/2024 712310/2021 NYSCEF DOC. NO. 4 19 RECEIVED NYSCEF: 04/12/2024 09/28/2021 IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCESS COVERED AUTOS LIABILITY AND UNINSURED/UNDERINSURED MOTORISTS COVERAGE ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM AL For purposes of the coverage provided by this endorsement, the following changes apply, and to the extent allowable under applicable law, supercede any provisions to the contrary: Covered “autos” are specifically included under all coverage parts shown in the Declarations and any coverage forms for Uninsured Motorist and/or Underinsured Motorist specific to rides originating in New TI York City regardless of where that covered “auto” is registered or principally garaged. A. The third paragraph under SECTION II — COVERED AUTOS LIABILITY COVERAGE, A. Coverage is deleted and replaced with the following: We have no duty, but maintain the right to defend any “insured” against any “suit”. If we choose EN to participate in the defense of a “suit”, we may investigate and settle any claim or “suit” as we consider appropriate and will not be obligated to participate in the defense when the Covered Autos Liability Coverage Limit Of Insurance has been exhausted by payment of defense costs, judgments or settlements. B. SECTION II — COVERED AUTOS LIABILITY COVERAGE, C. Limit Of Insurance, is deleted ID and replaced with the following: Regardless of the number of “insureds”, premiums paid, claims made or vehicles (other than covered “autos”) involved in the “accident”, the most we will pay for the total of all damages and “covered pollution cost or expense” combined, resulting from any one “accident” is the Limit of NF Insurance for Liability Coverage shown in the Declarations. If more than one covered “auto” is involved in the same “accident”, a separate Limit of Insurance for Liability Coverage shall apply to each covered “auto”. All “bodily injury” from continuous or repeated exposure to substantially the same conditions will CO be considered as resulting from one “accident”. No one will be entitled to receive duplicate payments for the same elements of “loss” under this Coverage Form and any Uninsured Motorists Coverage Endorsement or Underinsured Motorists Coverage Endorsement attached to this Coverage Part. C. SECTION IV — BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance is deleted and replaced with the following: 5. Other Insurance CA 579 018 0719 Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. MWTB 313795 20 Uber USA, LLC 07/01/2020 - 07/01/2021 FILED: QUEENS COUNTY CLERK 04/12/2024 09/28/2021 11:39 09:06 AM INDEX NO. 707865/2024 712310/2021 NYSCEF DOC. NO. 4 19 RECEIVED NYSCEF: 04/12/2024 09/28/2021 a. Liability coverage provided by this policy shall apply if there is no other valid and collectible automobile liability insurance available to a covered “livery partner” that provides at least the Limit of Insurance shown in the Declarations of this policy. If there is other automobile liability insurance available to a covered “livery partner” that provides at least the amount of Limit(s) shown in the Declarations of this policy, then this coverage shall not apply. b. If a “livery partner” has other automobile liability insurance available which provides less than the Limit of Insurance shown in the Declarations of this policy, then this policy shall provide excess coverage and our Limits of Insurance will be reduced by the amount of that other insurance including any deductibles or self- insured amounts. AL c. Uninsured and/or Underinsured Motorists Coverage provided by this policy shall only apply if there is no other valid and collectible Uninsured and/or Underinsured Motorists Coverage for anyone occupying the covered “auto” that provides at least the Limit of Insurance for Uninsured and/or Underinsured Motorists Coverage shown in the Declarations of this policy. If there is Uninsured and/or TI Underinsured Motorists Coverage available to anyone occupying the covered “auto” which provides at least the Limit of Insurance for Uninsured and/or Underinsured Motorists Coverage shown in the Declarations of this policy, then this coverage shall not apply. d. Notwithstanding any changes in conditions to Other Insurance in any Uninsured EN and/or Underinsured Motorists Coverage form attached to this policy, if Uninsured and/or Underinsured Motorists Coverage available for anyone occupying the covered “auto” provides less than Limit of Insurance for Uninsured and/or Underinsured Motorists Coverage shown in the Declarations of this policy, then this policy shall provide excess coverage and our Limits of Insurance for ID Uninsured and/or Underinsured Motorists Coverage will be reduced by the amount of that other insurance including any deductibles or self-insured amounts. D. The following exclusions are added to SECTION II — COVERED AUTOS LIABILITY COVERAGE: NF 14. Covered “autos” are specifically excluded under all coverage parts shown in the Declarations and any coverage forms for Uninsured and/or Underinsured Motorists Coverage where the ride originated in any jurisdiction except New York City. 15. Any loss, cost or expenses payable under or resulting from the following coverages: CO a. First-party physical damage coverage; b. No-fault coverage; or c. Personal injury protection or auto medical payments coverage. E. The following definitions are added to SECTION V — DEFINITIONS: “Livery partner” means an individual that is operating a taxicab, limousine, luxury limousine, black car or other for-hire motor vehicle in connection with the use of the “UberPartner Application” and that has entered into a contract with the Named Insured. CA 579 018 0719 Page 2 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. MWTB 313795 20 Uber USA, LLC 07/01/2020 - 07/01/2021 FILED: QUEENS COUNTY CLERK 04/12/2024 09/28/2021 11:39 09:06 AM INDEX NO. 707865/2024 712310/2021 NYSCEF DOC. NO. 4 19 RECEIVED NYSCEF: 04/12/2024 09/28/2021 “UberPartner Application” means any smartphone application licensed by a subsidiary of Uber Technologies, Inc. which is utilized by a “livery partner” to receive requests for transportation from passengers. F. The NEW YORK SUPPLEMENTARY UNINSURED/UNDERINSURED MOTORISTS ENDORSEMENT, CA 31 07 is amended by adding the following subparagraph to the definition of a. Insured in INSURING AGREEMENTS, 1. Definitions: (5) Any person while occupying a covered “auto”. AL TI EN ID NF CO CA 579 018 0719 Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. MWTB 313795 20 Uber USA, LLC 07/01/2020 - 07/01/2021 FILED: QUEENS COUNTY CLERK 04/12/2024 05/28/2021 11:39 09/28/2021 11:04 AM 09:06 INDEX NO. 707865/2024 712310/2021 NYSCEF DOC. NO. 4 2 19 RECEIVED NYSCEF: 04/12/2024 05/28/2021 09/28/2021 COMMERCIAL AUTO CA 31 07 11 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEW YORK SUPPLEMENTARY UNINSURED/UNDERINSURED MOTORISTS ENDORSEMENT The Declarations are completed as follows for this endorsement: SUPPLEMENTARY UNINSURED/UNDERINSURED MOTORISTS $ EACH PERSON (SUM) LIMIT $ 250,000 EACH ACCIDENT We, the company, agree with you, as the named insured, in return for payment of the premium for this coverage, to provide Supplementary Uninsured/Underinsured Motorists (SUM) coverage, subject to the following terms and AL conditions: INSURING AGREEMENTS b. Bodily Injury 1. Definitions The term "bodily injury" means bodily harm, For purposes of this SUM endorsement, the including sickness, disease or death TI following terms have the following meanings: resulting therefrom. a. Insured c. Uninsured Motor Vehicle The unqualified term "insured" means: The term "uninsured motor vehicle" means a motor vehicle that, through its ownership, (1) You, as the named insured and, while maintenance or use, results in bodily injury EN residents of the same household, your to an insured, and for which: spouse and the relatives of either you or your spouse; (1) No bodily injury liability insurance policy or bond applies to such motor vehicle (2) Any person while acting in the scope of (including a vehicle that was stolen, that person's duties for you, except with operated without the owner's permission respect to the use and operation by or unregistered) at the time of the ID such person of a motor vehicle not accident; or covered under this policy, where such person is: (2) The owner and operator cannot be identified (including a hit-and-run motor (a) Your employee and you are a fire vehicle), and which causes bodily injury department; to an insured by physical contact with NF (b) Your member and you are a fire the insured or with a motor vehicle company, as defined in General occupied by the insured at the time of Municipal Law section 100; the accident, provided that: (c) Your employee and you are an (a) The insured or someone on the ambulance service, as defined in insured's behalf: Public Health Law section 3001; or CO (i) Reported the accident within 24 (d) Your member and you are a hours or as soon as reasonably voluntary ambulance service, as possible to a police, peace or defined in Public Health Law, section judicial officer or to the 3001; Commissioner of Motor Vehicles; and (3) Any other person while occupying: (ii) Filed with the Company a (a) A motor vehicle insured for SUM statement under oath that the under this policy; or insured or the insured's legal (b) Any other motor vehicle while being representative has a cause or operated by you or your spouse; and causes of action arising out of (4) Any person, with respect to damages such accident for damages such person is entitled to recover, against a person or persons because of bodily injury to which this whose identity is unascertainable, coverage applies sustained by an and setting forth the facts in insured under Paragraph (1), (2) or (3) support thereof; and above. CA 31 07 11 18 © Insurance Services Office, Inc., 2018 Page 1 of 5 MWTB 313795 20 Uber USA, LLC 07/01/2020 - 07/01/2021 FILED: QUEENS COUNTY CLERK 04/12/2024 05/28/2021 11:39 09/28/2021 11:04 AM 09:06 INDEX NO. 707865/2024 712310/2021 NYSCEF DOC. NO. 4 2 19 RECEIVED NYSCEF: 04/12/2024 05/28/2021 09/28/2021 (b) At the request of the Company, the d. Occupying insured or the insured's legal The term "occupying" means in, upon, representative makes available for entering into or exiting from a motor vehicle. inspection the motor vehicle the insured was occupying at the time of e. State the accident; or The term "state" means a state, territory or (3) There is a bodily injury liability insurance possession of the United States, the District coverage or bond applicable to such of Columbia or a province of Canada. motor vehicle at the time of the accident, 2. Damages For Bodily Injury Caused By but: Uninsured Motor Vehicles (a) The amount of such insurance We will pay all sums that the insured or the coverage or bond is less than the insured's legal representative shall be legally third-party bodily injury liability limit entitled to recover as damages from the owner of this policy; or or operator of an uninsured motor vehicle (b) The amount of such insurance because of bodily injury sustained by the insured, caused by an accident arising out of AL coverage or bond has been reduced, by payments to other persons injured such uninsured motor vehicle's ownership, in the accident, to an amount less maintenance or use, subject to the Exclusions, than the third-party bodily injury Conditions, Limits and other provisions set liability limit of this policy; or forth in this SUM endorsement. (c) The insurer writing such insurance 3. SUM Coverage Period And Territory TI coverage or bond denies coverage This SUM coverage applies only to accidents or such insurer is or becomes that occur: insolvent. a. During the policy period shown in the The term "uninsured motor vehicle" shall Declarations; and not include a motor vehicle that is: b. In the United States, its territories or EN (1) Insured under the liability coverage of possessions, or Canada. this policy; or EXCLUSIONS (2) Owned by you, the named insured, or This SUM coverage does not apply to: your spouse residing in your household; or 1. Bodily injury to an insured, including care or loss of services recoverable by an insured, if ID (3) Self-insured within the meaning of the such insured, such insured's legal financial responsibility law of the state in representatives or any person entitled to which the motor vehicle is registered, or payment under this coverage, without our any similar state or federal law, to the written consent, settles any lawsuit against any extent that the required amount of such person or organization that may be legally coverage is equal to, or greater than, liable for such injury, care or loss of services, NF the third-party bodily injury liability limits however this provision shall be subject to of this policy; or Condition 9.; (4) Owned by the United States of America, 2. Bodily injury to an insured incurred while Canada, a state, a political subdivision occupying a motor vehicle owned by that of any such government or an agency of insured, if such motor vehicle is not insured for any of the foregoing; or CO SUM coverage by the policy under which a (5) A land motor vehicle or trailer, while claim is made or is not a newly acquired or located for use as a residence or replacement motor vehicle covered under the premises and not as a motor vehicle or terms of this policy; or while operated on rails or crawler- 3. Non-economic loss resulting from bodily injury treads; or to an insured arising from an accident in New (6) A farm type vehicle or equipment York State, unless the insured has sustained designed for use principally off public serious injury as defined in Section 5102(d) of roads, except while actually upon public the New York Insurance Law. roads. Page 2 of 5 © Insurance Services Office, Inc., 2018 CA 31 07 11 18 MWTB 313795 20 Uber USA, LLC 07/01/2020 - 07/01/2021 FILED: QUEENS COUNTY CLERK 04/12/2024 05/28/2021 11:39 09/28/2021 11:04 AM 09:06 INDEX NO. 707865/2024 712310/2021 NYSCEF DOC. NO. 4 2 19 RECEIVED NYSCEF: 04/12/2024 05/28/2021 09/28/2021 4. Bodily injury to an insured incurred while the 4. Notice Of Legal Action motor vehicle is used by a transportation If the insured or the insured's legal network company driver who is logged onto a representative brings any lawsuit against any transportation network company's digital person or organization legally responsible for network but is not engaged in a transportation the use of a motor vehicle involved in the network company prearranged trip or while the accident, a copy of the summons and driver provides a transportation network complaint or other process served in company prearranged trip pursuant to article connection with the lawsuit shall be forwarded 44-B of the Vehicle and Traffic Law. immediately to us by the insured or the CONDITIONS insured's legal representative. 1. Policy Provisions 5. SUM Limits And Maximum Payments None of the Insuring Agreements, Exclusions a. The SUM limit payable under this or Conditions of the policy shall apply to this endorsement shall be determined as SUM coverage except: "Duties In The Event Of follows: Accident, Claim, Suit Or Loss", "Fraud" and (1) If an accident results in bodily injury AL "Ending This Policy" if applicable. excluding death to one or more persons, 2. Notice And Proof Of Claim then we will provide the SUM limit stated As soon as practicable, the insured or other in the Declarations; or person making a claim shall give us written (2) If an accident results in the death of one notice of claim under this SUM coverage. or more persons, then we will provide the greater of the SUM limit stated in the TI a. As soon as practicable after our written request, the insured or other person making Declarations or $50,000 for such bodily claim shall give us written proof of claim, injury resulting in death sustained by under oath if required, including full one person as the result of any one particulars of the nature and extent of the accident and, subject to this per person injuries, treatment and other details we limit, $100,000 for such bodily injury resulting in death sustained by two or EN need to determine the SUM amount payable. more persons as the result of any one accident; or b. The insured and every other person making claim hereunder shall, as may reasonably (3) If an accident results in both bodily be required, submit to examinations under injury to one or more persons and the oath by any person we name and subscribe death of one or more persons, then we ID the same. Proof of claim shall be made will provide the greater of the SUM limits upon forms we furnish unless we fail to stated in the Declarations or the limits furnish such forms within 15 calendar days required by the mandatory uninsured after receiving notice of claim. motorists (UM) coverage as follows: 3. Medical Reports $25,000 per injured person and, subject to this per person limit, NF The insured shall submit to physical examinations by physicians we select when $50,000 to two or more persons injured and as often as we may reasonably require. as the result of any one accident; and The insured, or in the event of the insured's $50,000 per person for bodily injury incapacity, the insured's legal representative resulting in death and, subject to this per (or in the event of the insured's death, the person limit, CO insured's legal representative or the person or $100,000 to two or more persons for persons entitled to sue therefor), shall upon bodily injury resulting in death as the each request from us authorize us to obtain result of any one accident. copies of relevant medical reports and records. CA 31 07 11 18 © Insurance Services Office, Inc., 2018 Page 3 of 5 MWTB 313795 20 Uber USA, LLC 07/01/2020 - 07/01/2021 FILED: QUEENS COUNTY CLERK 04/12/2024 05/28/2021 11:39 09/28/2021 11:04 AM 09:06 INDEX NO. 707865/2024 712310/2021 NYSCEF DOC. NO. 4 2 19 RECEIVED NYSCEF: 04/12/2024 05/28/2021 09/28/2021 b. Regardless of the number of insureds, our 8. Exhaustion Required maximum payment under this SUM Except as provided in Condition 9., we will pay endorsement shall be the difference under this SUM coverage only after the limits between: of liability have been exhausted under all motor (1) The SUM limit; and vehicle bodily injury liability insurance policies (2) The motor vehicle bodily injury liability or bonds applicable at the time of the accident insurance or bond payments received in regard to any one person who may be by the insured or the insured's legal legally liable for the bodily injury sustained by representative, from or on behalf of all the insured. persons that may be legally liable for the 9. Release Or Advance bodily injury sustained by the insured. a. In accidents involving the insured and one c. The SUM limit shown on the Declarations is or more negligent parties, if such insured the amount of coverage for all damages settles with any such party for the available due to bodily injury in any one accident. limit of the motor vehicle bodily injury 6. Non-Stacking liability coverage of such party, a release AL may be executed with such party after thirty Regardless of the number of motor vehicles calendar days from our receipt of your involved, persons covered, claims made, motor written notice to us, unless within this time vehicles or premiums shown in this policy or period we agree to advance such premium paid, the limits, whether for UM settlement amounts to the insured in return coverage or SUM coverage, shall never be for the cooperation of the insured in our added together or combined for two or more TI lawsuit on behalf of the insured. motor vehicles to determine the extent of insurance coverage available to an insured b. We shall have a right to the proceeds of who was injured in the same accident. any such lawsuit equal to the amount advanced to the insured and any additional 7. Priority Of Coverage amounts paid under this SUM coverage. If an insured is entitled to UM coverage or Any excess above those amounts shall be EN SUM coverage under more than one policy, the paid to the insured. maximum amount such insured may recover c. An insured shall not otherwise settle with shall not exceed the highest limit of such any negligent party, without our written coverage for any one motor vehicle under any consent, such that our rights would be one policy and the following order of priority impaired. shall apply: ID 10. Non-Duplication a. A policy covering a motor vehicle occupied by the injured person at the time of the This SUM coverage shall not duplicate any of accident; the following: b. A policy covering a motor vehicle not a. Benefits payable under workers' involved in the accident under which the compensation or other similar laws; NF injured person is a named insured; and b. Non-occupational disability benefits under c. A policy covering a motor vehicle not New York Workers' Compensation Law involved in the accident under which the article nine or other similar law; injured person is an insured other than a c. Any amounts recovered or recoverable named insured. pursuant to New York Insurance Law article fifty-one or any similar motor vehicle CO Coverage available under a lower priority policy applies only to the extent that it exceeds insurance payable without regard to fault; the coverage of a higher priority policy. d. Any valid or collectible motor vehicle medical payments insurance; or Page 4 of 5 © Insurance Services Office, Inc., 2018 CA 31 07 11 18 MWTB 313795 20 Uber USA, LLC 07/01/2020 - 07/01/2021 FILED: QUEENS COUNTY CLERK 04/12/2024 05/28/2021 11:39 09/28/2021 11:04 AM 09:06 INDEX NO. 707865/2024 712310/2021 NYSCEF DOC. NO. 4 2 19 RECEIVED NYSCEF: 04/12/2024 05/28/2021 09/28/2021 e. Any amounts recovered as bodily injury 12. Subrogation damages from sources other than motor If we make a payment under this SUM vehicle bodily injury liability insurance coverage, then we have the right to recover the policies or bonds. amount of the payment from any person legally 11. Arbitration responsible for the bodily injury or loss of the a. If any insured makes a claim under this person to whom, or for whose benefit, such SUM coverage and we do not agree that payment was made to the extent of the such insured is legally entitled to recover payment. The insured or any person acting on damages from the owner or operator of an behalf of the insured must do whatever is uninsured motor vehicle because of bodily necessary to transfer this right of recovery to injury sustained by the insured, or we do us. Except as permitted by Condition 9., such not agree as to the amount of payment that person shall do nothing to prejudice this right. may be owing under this SUM coverage, 13. Payment Of Loss By Company then, at the option and upon written We shall pay any amount due under this SUM demand of such insured, the matter or coverage to the insured or, at our option, to a matters upon which such insured and we AL person authorized by law to receive such do not agree shall be settled by arbitration, payment or to a person legally entitled to administered by the American Arbitration recover the damages which the payment Administration pursuant to procedures represents. approved by the Superintendent of Financial Services for this purpose. 14. Action Against Company No lawsuit shall lie against us unless the TI b. If the maximum amount of SUM coverage provided by this endorsement equals the insured or the insured's legal representative amount of coverage required to be provided has first fully complied with all the terms of this by New York Insurance Law section SUM coverage. 3420(f)(1) and New York Vehicle and 15. Survivor Rights Traffic Law Article 6 or 8, then such If you or your spouse, if a resident of the same EN disagreement shall be settled by such household, dies, then this SUM endorsement arbitration procedures upon written demand shall cover: of either the insured or us. Judgment upon the award rendered by the arbitrator may a. The survivor as named insured; be entered in any court having jurisdiction b. The decedent's legal representative as thereof, and any such insured and we each named insured, but only while acting within ID agree to be bound by any award made by the scope of such representative's duties as the arbitrator as to this SUM coverage. For such; and purposes of this Condition, the term c. Any relative who was an insured at the time "insured" includes any person authorized to of such death. act on behalf of the insured. NF CO CA 31 07 11 18 © Insurance Services Office, Inc., 2018 Page 5 of 5 MWTB 313795 20 Uber USA, LLC 07/01/2020 - 07/01/2021