Preview
FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 AM INDEX NO. 607464/2024
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/30/2024
EXHIBIT “A”
FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 AM
Form_SCTNID_CTGRY.NY12216489_DECPAGE
INDEX NO. 607464/2024
NYSCEF DOC. NO. 2
968223106 N IC94549 INS DECPAGE E POLWHITEFONT TZTRHQJQKQ2TUIOQWLO77KTVPH0002 RPUID TRACWHITEFONT
RECEIVED NYSCEF: 04/30/2024
PROGRESSIVE
P.O. BOX 31260
TAMPA, FL 33631
Policy Number: 968223106
Underwritten by:
Progressive Advanced Insurance Co
Valued customer since 2023
FABIENNE MIRAT-SEIDE
Date of Mailing: April 3, 2023
348 RUGBY AVE
ROCHESTER, NY 14619 Policy Period: Apr 3, 2023 - Oct 3, 2023
Page 1 of 2
progressive.com
Online Service
Make payments, check billing activity, update
Auto Insurance policy information or check status of a claim.
1-800-776-4737
Coverage Summary For customer service and claims service,
24 hours a day, 7 days a week.
This is your Declarations Page
Your coverage began on April 3, 2023 at the later of 12:01 a.m. or the effective time shown on your application. This policy period
ends on October 3, 2023 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).
SEE ENCLOSURE FOR SUPPLEMENTAL SPOUSAL LIABILITY INSURANCE NOTICE
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
Fabienne Mirat-seide
Age: 25 Gender: Female
Marital status: Single
Additional information: Named insured
Form 6489 NY (12/21)
4
Continued
FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 AM INDEX NO. 607464/2024
NYSCEF DOC. NO. 2
968223106 N IC94549 INS DECPAGE E POLWHITEFONT TZTRHQJQKQ2TUIOQWLO77KTVPH0002 RPUID TRACWHITEFONT
RECEIVED NYSCEF: 04/30/2024
Policy Number: 968223106
Fabienne Mirat-seide
Page 2 of 2
Outline of coverage
2011 FORD FOCUS 4 DOOR SEDAN
VIN: 1FAHP3FN6BW194512
Garaging ZIP Code: 14619
Primary use of the vehicle: Pleasure/Personal
Annual miles: 0 - 3,999
Length of vehicle ownership when policy started or vehicle added: 5 years or more
Limits Deductible Premium
………………………………………………………………………………………………………………………………………………………..
Liability To Others $332
Bodily Injury Liability $25,000 each person/$50,000 each accident
Including Supplemental Spousal Liability
Property Damage Liability $10,000 each accident
………………………………………………………………………………………………………………………………………………………..
Mandatory Personal Injury Protection $50,000 each person $0 75
………………………………………………………………………………………………………………………………………………………..
Aggregate No-Fault Benefits Available $50,000
Death Benefit $2,000
Maximum Monthly Work Loss $2,000
Other Reasonable & Necessary Expenses (per day) $25
………………………………………………………………………………………………………………………………………………………..
Supplementary Uninsured/Underinsured Motorist $25,000 each person/$50,000 each accident 10
………………………………………………………………………………………………………………………………………………………..
Subtotal policy premium $417.00
………………………………………………………………………………………………………………………………………………………..
Motor vehicle law enforcement fee 5.00
………………………………………………………………………………………………………………………………………………………..
Total 6 month policy premium and fees $422.00
Premium discounts
Description Amount Description Amount
……………………………………………………………………………………………………………………………………………………….
Five-Year Accident Free $16 Electronic Funds Transfer (EFT) $14
Online Signature - First Policy Period Only $26 Home Owner $7
Continuous Insurance: Platinum $10 Paperless $8
Anti-Lock Brakes/Passive Restraint $3
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.
New York Motor Vehicle Law 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 4B tier.
Form 6489 NY (12/21)
FILED: NASSAU 9611D
COUNTY INDEX NO. 607464/2024
NY 0717 CLERK 04/30/2024 11:54 A
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/30/2024
NEW YORK
AUTO POLICY
Form 9611D NY (07/17)
version 2.0
INDEX NO. 607464/2024
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NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/30/2024
INDEX NO. 607464/2024
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NYSCEF DOC. NO. 2 CONTENTS
RECEIVED NYSCEF: 04/30/2024
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—DAMAGE TO 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
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AutoDOC.
NYSCEF RepairsNO................................................................................................41
2 RECEIVED NYSCEF: 04/30/2024
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
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NYSCEF DOC. NO. 2 NEW YORK AUTORECEIVED
POLICY NYSCEF: 04/30/2024
INSURING AGREEMENT
In return for your payment of the premium, we agree to insure you subject to all the
terms, conditions and limitations of this policy. We will insure you for the coverages
and the limits of liability shown on this policy’s declarations page.Your policy consists
of the policy contract, your insurance application, the declarations page, and all en-
dorsements to this policy.
GENERAL DEFINITIONS
The following definitions apply throughout the policy. Defined terms are printed in bold-
face type and have the same meaning whether in the singular, plural, or any other form.
1. “Additional auto” means an auto you become the 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.
2. “Auto” means a land motor vehicle:
a. of the private passenger, pickup body, or cargo van type;
b. designed for operation principally upon public roads;
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.
However, “auto” does not include step-vans, parcel delivery vans, or cargo cutaway
vans or other vans with cabs separate from the cargo area.
3. “Auto business” means the business of selling, leasing, repairing, parking, storing,
servicing, delivering or testing vehicles.
4. “Bodily injury” means bodily harm, sickness, or disease, including death that re-
sults from bodily harm, sickness, or disease.
5. “Covered auto” means:
a. any auto or trailer shown on the declarations page for the coverages ap-
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.
6. “Declarations page” means the document showing your coverages, limits of li-
ability, covered autos, premium, and other policy-related information. The declara-
tions page may also be referred to as the Auto Insurance Coverage Summary.
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7. “Digital
NYSCEF DOC. NO. 2means any system or service
network” offered or
RECEIVED utilized by04/30/2024
NYSCEF: a transpor-
tation network company that enables TNC prearranged trips with transporta-
tion network company drivers.
8. “Occupying” means in, on, entering or exiting.
9. “Property damage” means physical damage to, destruction of, or loss of use of,
tangible property.
10. “Rated resident” means a person residing in the same household as you at the
time of the loss who is not a relative, but only if that person is both:
a. listed in the “Drivers and household residents” section on the declarations
page; and
b. not designated as a “List Only” driver.
11. “Relative” means a person residing in the same household as you, and related to
you by blood, marriage or adoption, and includes a ward, stepchild, or foster child.
Your unmarried dependent children temporarily away from home will qualify as a
relative if they intend to continue to reside in your household.
12. “Replacement auto” means an auto that permanently replaces an auto shown
on the declarations page. A replacement auto will have the same coverage as
the auto it replaces 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 unless you notify us within that 30-day period
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.
13. “Trailer” 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.
14. “Transportation network company” or “TNC” 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
exclusively using a digital network to connect transportation network compa-
ny passengers to transportation network company drivers who provide TNC
prearranged trips.
15. “Transportation network company driver” means an individual who:
a. receives connections to potential passengers and related services from a
transportation network 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.
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16. “Transportation
NYSCEF DOC. NO. 2 network company prearranged
RECEIVED means the04/30/2024
trip”NYSCEF: provision of
transportation by a transportation network company driver to a passenger pro-
vided through the use of a TNC’s digital network:
a. beginning when a transportation network company driver accepts a pas-
senger’s request for a trip through a digital network controlled by a trans-
portation network company;
b. continuing while the transportation network company driver transports the
requesting passenger in a TNC vehicle; and
c. ending when the last requesting passenger departs from the TNC vehicle.
The term “Transportation network company prearranged trip” does not in-
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.
17. “Transportation network company vehicle” or “TNC vehicle” means a vehicle
that is:
a. used by a transportation network company driver to provide a TNC prear-
ranged trip originating within the state of New York; and
b. owned, leased or otherwise authorized for use by the transportation net-
work company driver;
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. any motor vehicle having a seating capacity of more than seven passen-
gers; and
viii. any motor vehicle subject to section three hundred seventy of this chapter.
18. “We,” “us” and “our” mean the underwriting company providing the insurance, as
shown on the declarations page.
19. “You” and “your” mean:
a. a person shown as a named insured on the declarations page; and
b. the spouse of a named insured if residing in the same household at the time
of the loss.
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NYSCEF DOC. NO. 2 PART I—LIABILITYTO OTHERS NYSCEF: 04/30/2024
RECEIVED
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 prejudgment interest awarded against an insured person.
We will settle or defend, as we consider appropriate, any claim for damages covered
by this Part I. This applies even if the claim or suit is groundless or false.
ADDITIONAL DEFINITION
When used in this Part I:
“Insured person” means:
a. you, a relative, or a rated resident with respect to an accident arising out of the
ownership, maintenance or use of a trailer shown on the declarations page or a
covered auto;
b. you or a relative with respect to an accident arising out of the ownership, mainte-
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
e. any “Additional Interest” shown on the declarations page with respect only to its
liability for the acts or omissions of a person described in a., b., or c. above.
ADDITIONAL PAYMENTS
In addition to our limit of liability, we will pay for an insured person:
1. all expenses we incur, and all costs taxed against 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 liability. 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 furnish 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
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6. reasonable
NYSCEF expenses,
DOC. NO. 2 including loss of earnings up to $200
RECEIVED per day,
NYSCEF: incurred at
04/30/2024
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 property 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 does not apply to domestic employees if
benefits are neither paid nor required to be provided under workers’ compensa-
tion, disability benefits, or similar laws;
4. bodily injury or property damage arising out of an accident involving 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 property damage arising out of the ownership, maintenance or
use of any vehicle owned by you or furnished or available for your regular use,
other than a covered auto for which this coverage has been purchased;
10. bodily injury or property 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 property damage sustained while the vehicle is used by a trans-
portation network company driver who is logged onto the transportation net-
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.
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LIMITS OF
NYSCEF LIABILITY
DOC. NO. 2 RECEIVED NYSCEF: 04/30/2024
If your declarations page shows a split limit:
1. the amount shown for “each person” is the most we will pay for all damages due to
bodily injury to one person resulting from any one accident;
2. subject to the “each person” limit, the amount shown for “each accident” is the
most we will pay for all damages due to bodily injury sustained by two or more
persons in any one accident; and
3. the amount shown for “property damage” is the most we will pay for the total of all
property damage resulting from any one accident.
However, if your policy has bodily injury split limits of:
1. $25,000 “each person” and $50,000 “each accident” 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 bodily injury that results in death, and the following ad-
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 results in death, our limit of
liability for bodily injury that results in the death of two or more persons in
any one accident is $100,000; or
2. $50,000 “each person” and $100,000 “each accident” 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 liability, 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 bodily 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 bodily injury
that does not result in death, the limit of liability for all damages due to bodily
injury that does not result in death is $100,000; or
d. for any accident that causes bodily injury that results in the death of two or
more persons, the most we will pay for all damages due to bodily injury that
results in death in any one accident is $100,000, and the limit of liability for all
other bodily injury that does not result in death is:
(i) $50,000 if only one person sustains bodily injury in any one accident; or
(ii) subject to the per person limit, $100,000 for two or more persons sustain-
ing bodily injury in any one accident.
The above Limits of Liability with respect to bodily injury that results in death are
subject to the following reductions:
1. in the event of the death of one person in any accident, our $50,000 limit of liability
will be reduced by any amounts paid to or on behalf of that person under this Part I;
and
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2. in the
NYSCEF eventNO.
DOC. of the2 death of two or more persons in anyNYSCEF:
RECEIVED accident, our $100,000
04/30/2024
limit of liability will be reduced by any amounts paid to or on behalf of those per-
sons under this Part I.
The limits of liability described above for “each person” and for “one person” apply to the
total of all claims made for bodily injury to a person and all claims of others derived
from such bodily injury, including, but not limited to, loss of society, loss of compan-
ionship, loss of services, loss of consortium, and wrongful death.
The limit of liability for bodily injury that results in the death of two or more persons
in any one accident includes the total of all claims made for such bodily injury and all
claims of others derived from such bodily injury, including, but not limited to, loss of so-
ciety, loss of companionship, loss of services, loss of consortium, and wrongful death.
If the declarations page shows that “combined single limit” or “CSL” applies, the
amount shown is the most we will pay for the total of all damages resulting from any
one accident. However, without changing this limit of liability, we will comply with any
law that requires us to provide any separate limits.
The limit of liability shown on the declarations page is the most we will pay regardless
of the number of:
1. claims made;
2. covered autos;
3. insured persons;
4. lawsuits brought;
5. vehicles involved in the accident; or
6. premiums paid.
No one is entitled to duplicate payments for the same elements of damages.
Any payment to a person under this Part I will be reduced by any payment to that per-
son under Part III—Uninsured Motorists Coverage.
We will not pay under this Part I any expenses paid or payable under Part II(B)—Medical
Payments Coverage.
An auto and attached trailer are considered one auto. Therefore, the limits of liability
will not be increased for an accident involving an auto that has an attached trailer.
FINANCIAL RESPONSIBILITY LAWS
When we issue this policy as proof of financial responsibility, this policy will comply with
the law to the extent required.
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OTHER INSURANCE
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/30/2024
If there is any other valid and collectible liability insurance or bond that applies to the
accident, we will pay only our share of the damages. Our share is the proportion that
our limit of liability bears to the total of all applicable limits. However, any insurance we
provide for a vehicle or trailer, other than a covered auto, will be excess over any other
valid and collectible insurance, self-insurance, or bond.
OUT-OF-STATE COVERAGE
If an accident to which this Part I applies occurs in any state, territory or possession
of the United States of America or any province or territory of Canada, other than the
one in which a covered auto is principally garaged, and the state, province, territory
or possession has:
1. a financial responsibility or similar law requiring limits of liability for bodily injury
or property damage higher than the limits shown on the declarations page, this
policy will provide the higher limits; or
2. a compulsory insurance or similar law requiring a non-resident to maintain insur-
ance whenever the non-resident uses an auto in that state, province, territory or
possession, this policy will provide the greater of:
a. the required minimum amounts and types of coverage; or
b. the limits of liability under this policy.
PART II(A)—PERSONAL INJURY PROTECTION COVERAGE
MANDATORY PERSONAL INJURY PROTECTION ENDORSEMENT (New York)
The Company agrees with the named insured, as follows:
Section I
Mandatory Personal Injury Protection
The company will pay first-party benefits to reimburse for basic economic loss sus-
tained by an eligible injured person on account of personal injuries caused by an ac-
cident arising out of the use or operation of a motor vehicle or a motorcycle during the
policy period and within the United States of America, its territories or possessions, or
Canada.
First-party Benefits
First-party benefits, other than death benefits, are payments equal to basic economic
loss, reduced by the following:
(a) 20 percent of the eligible injured person’s loss of earnings from work to the extent
that an eligible injured person’s basic economic loss consists of such loss of earn-
ings;
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INDEX NO. 607464/2024
FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 A
(b) amounts
NYSCEF DOC.recovered
NO. 2 or recoverable on account of personal
RECEIVED injury to
NYSCEF: an eligible
04/30/2024
injured person under State or Federal laws providing social security disability or
workers’ compensation benefits, or disability benefits under article 9 of the New
York Workers’ Compensation Law;
(c) the amount of any applicable deductible, provided that such deductible shall apply
to each accident, but only to the total of first-party benefits otherwise payable to
the named insured and any relative as a result of that accident.
Basic Economic Loss
Basic economic loss shall consist of medical expense, work loss, other expense and,
when death occurs, a death benefit as herein provided. Except for such death benefit,
basic economic loss shall not include any loss sustained on account of death. Basic
economic loss of each eligible injured person on account of any single accident shall not
exceed $50,000, except that any death benefit hereunder shall be in addition thereto.
Medical Expense
Medical expense shall consist of necessary expenses for:
(a) medical, hospital (including services rendered in compliance with article 41 of the
Public Health Law, whether or not such services are rendered directly by a hospi-
tal), surgical, nursing, dental, ambulance, X-ray, prescription drug and prosthetic
services;
(b) psychiatric, physical and occupational therapy
Preview
FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 AM INDEX NO. 607464/2024 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/30/2024 EXHIBIT “A” FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 AM Form_SCTNID_CTGRY.NY12216489_DECPAGE INDEX NO. 607464/2024 NYSCEF DOC. NO. 2 968223106 N IC94549 INS DECPAGE E POLWHITEFONT TZTRHQJQKQ2TUIOQWLO77KTVPH0002 RPUID TRACWHITEFONT RECEIVED NYSCEF: 04/30/2024 PROGRESSIVE P.O. BOX 31260 TAMPA, FL 33631 Policy Number: 968223106 Underwritten by: Progressive Advanced Insurance Co Valued customer since 2023 FABIENNE MIRAT-SEIDE Date of Mailing: April 3, 2023 348 RUGBY AVE ROCHESTER, NY 14619 Policy Period: Apr 3, 2023 - Oct 3, 2023 Page 1 of 2 progressive.com Online Service Make payments, check billing activity, update Auto Insurance policy information or check status of a claim. 1-800-776-4737 Coverage Summary For customer service and claims service, 24 hours a day, 7 days a week. This is your Declarations Page Your coverage began on April 3, 2023 at the later of 12:01 a.m. or the effective time shown on your application. This policy period ends on October 3, 2023 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). SEE ENCLOSURE FOR SUPPLEMENTAL SPOUSAL LIABILITY INSURANCE NOTICE 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 Fabienne Mirat-seide Age: 25 Gender: Female Marital status: Single Additional information: Named insured Form 6489 NY (12/21) 4 Continued FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 AM INDEX NO. 607464/2024 NYSCEF DOC. NO. 2 968223106 N IC94549 INS DECPAGE E POLWHITEFONT TZTRHQJQKQ2TUIOQWLO77KTVPH0002 RPUID TRACWHITEFONT RECEIVED NYSCEF: 04/30/2024 Policy Number: 968223106 Fabienne Mirat-seide Page 2 of 2 Outline of coverage 2011 FORD FOCUS 4 DOOR SEDAN VIN: 1FAHP3FN6BW194512 Garaging ZIP Code: 14619 Primary use of the vehicle: Pleasure/Personal Annual miles: 0 - 3,999 Length of vehicle ownership when policy started or vehicle added: 5 years or more Limits Deductible Premium ……………………………………………………………………………………………………………………………………………………….. Liability To Others $332 Bodily Injury Liability $25,000 each person/$50,000 each accident Including Supplemental Spousal Liability Property Damage Liability $10,000 each accident ……………………………………………………………………………………………………………………………………………………….. Mandatory Personal Injury Protection $50,000 each person $0 75 ……………………………………………………………………………………………………………………………………………………….. Aggregate No-Fault Benefits Available $50,000 Death Benefit $2,000 Maximum Monthly Work Loss $2,000 Other Reasonable & Necessary Expenses (per day) $25 ……………………………………………………………………………………………………………………………………………………….. Supplementary Uninsured/Underinsured Motorist $25,000 each person/$50,000 each accident 10 ……………………………………………………………………………………………………………………………………………………….. Subtotal policy premium $417.00 ……………………………………………………………………………………………………………………………………………………….. Motor vehicle law enforcement fee 5.00 ……………………………………………………………………………………………………………………………………………………….. Total 6 month policy premium and fees $422.00 Premium discounts Description Amount Description Amount ………………………………………………………………………………………………………………………………………………………. Five-Year Accident Free $16 Electronic Funds Transfer (EFT) $14 Online Signature - First Policy Period Only $26 Home Owner $7 Continuous Insurance: Platinum $10 Paperless $8 Anti-Lock Brakes/Passive Restraint $3 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. New York Motor Vehicle Law 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 4B tier. Form 6489 NY (12/21) FILED: NASSAU 9611D COUNTY INDEX NO. 607464/2024 NY 0717 CLERK 04/30/2024 11:54 A NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/30/2024 NEW YORK AUTO POLICY Form 9611D NY (07/17) version 2.0 INDEX NO. 607464/2024 FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 A NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/30/2024 INDEX NO. 607464/2024 FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 A NYSCEF DOC. NO. 2 CONTENTS RECEIVED NYSCEF: 04/30/2024 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—DAMAGE TO 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. 607464/2024 FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 A AutoDOC. NYSCEF RepairsNO................................................................................................41 2 RECEIVED NYSCEF: 04/30/2024 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. 607464/2024 FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 A NYSCEF DOC. NO. 2 NEW YORK AUTORECEIVED POLICY NYSCEF: 04/30/2024 INSURING AGREEMENT In return for your payment of the premium, we agree to insure you subject to all the terms, conditions and limitations of this policy. We will insure you for the coverages and the limits of liability shown on this policy’s declarations page.Your policy consists of the policy contract, your insurance application, the declarations page, and all en- dorsements to this policy. GENERAL DEFINITIONS The following definitions apply throughout the policy. Defined terms are printed in bold- face type and have the same meaning whether in the singular, plural, or any other form. 1. “Additional auto” means an auto you become the 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. 2. “Auto” means a land motor vehicle: a. of the private passenger, pickup body, or cargo van type; b. designed for operation principally upon public roads; 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. However, “auto” does not include step-vans, parcel delivery vans, or cargo cutaway vans or other vans with cabs separate from the cargo area. 3. “Auto business” means the business of selling, leasing, repairing, parking, storing, servicing, delivering or testing vehicles. 4. “Bodily injury” means bodily harm, sickness, or disease, including death that re- sults from bodily harm, sickness, or disease. 5. “Covered auto” means: a. any auto or trailer shown on the declarations page for the coverages ap- 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. 6. “Declarations page” means the document showing your coverages, limits of li- ability, covered autos, premium, and other policy-related information. The declara- tions page may also be referred to as the Auto Insurance Coverage Summary. 1 INDEX NO. 607464/2024 FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 A 7. “Digital NYSCEF DOC. NO. 2means any system or service network” offered or RECEIVED utilized by04/30/2024 NYSCEF: a transpor- tation network company that enables TNC prearranged trips with transporta- tion network company drivers. 8. “Occupying” means in, on, entering or exiting. 9. “Property damage” means physical damage to, destruction of, or loss of use of, tangible property. 10. “Rated resident” means a person residing in the same household as you at the time of the loss who is not a relative, but only if that person is both: a. listed in the “Drivers and household residents” section on the declarations page; and b. not designated as a “List Only” driver. 11. “Relative” means a person residing in the same household as you, and related to you by blood, marriage or adoption, and includes a ward, stepchild, or foster child. Your unmarried dependent children temporarily away from home will qualify as a relative if they intend to continue to reside in your household. 12. “Replacement auto” means an auto that permanently replaces an auto shown on the declarations page. A replacement auto will have the same coverage as the auto it replaces 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 unless you notify us within that 30-day period 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. 13. “Trailer” 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. 14. “Transportation network company” or “TNC” 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 exclusively using a digital network to connect transportation network compa- ny passengers to transportation network company drivers who provide TNC prearranged trips. 15. “Transportation network company driver” means an individual who: a. receives connections to potential passengers and related services from a transportation network 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. 607464/2024 FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 A 16. “Transportation NYSCEF DOC. NO. 2 network company prearranged RECEIVED means the04/30/2024 trip”NYSCEF: provision of transportation by a transportation network company driver to a passenger pro- vided through the use of a TNC’s digital network: a. beginning when a transportation network company driver accepts a pas- senger’s request for a trip through a digital network controlled by a trans- portation network company; b. continuing while the transportation network company driver transports the requesting passenger in a TNC vehicle; and c. ending when the last requesting passenger departs from the TNC vehicle. The term “Transportation network company prearranged trip” does not in- 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. 17. “Transportation network company vehicle” or “TNC vehicle” means a vehicle that is: a. used by a transportation network company driver to provide a TNC prear- ranged trip originating within the state of New York; and b. owned, leased or otherwise authorized for use by the transportation net- work company driver; 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. any motor vehicle having a seating capacity of more than seven passen- gers; and viii. any motor vehicle subject to section three hundred seventy of this chapter. 18. “We,” “us” and “our” mean the underwriting company providing the insurance, as shown on the declarations page. 19. “You” and “your” mean: a. a person shown as a named insured on the declarations page; and b. the spouse of a named insured if residing in the same household at the time of the loss. 3 INDEX NO. 607464/2024 FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 A NYSCEF DOC. NO. 2 PART I—LIABILITYTO OTHERS NYSCEF: 04/30/2024 RECEIVED 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 prejudgment interest awarded against an insured person. We will settle or defend, as we consider appropriate, any claim for damages covered by this Part I. This applies even if the claim or suit is groundless or false. ADDITIONAL DEFINITION When used in this Part I: “Insured person” means: a. you, a relative, or a rated resident with respect to an accident arising out of the ownership, maintenance or use of a trailer shown on the declarations page or a covered auto; b. you or a relative with respect to an accident arising out of the ownership, mainte- 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 e. any “Additional Interest” shown on the declarations page with respect only to its liability for the acts or omissions of a person described in a., b., or c. above. ADDITIONAL PAYMENTS In addition to our limit of liability, we will pay for an insured person: 1. all expenses we incur, and all costs taxed against 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 liability. 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 furnish 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. 607464/2024 FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 A 6. reasonable NYSCEF expenses, DOC. NO. 2 including loss of earnings up to $200 RECEIVED per day, NYSCEF: incurred at 04/30/2024 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 property 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 does not apply to domestic employees if benefits are neither paid nor required to be provided under workers’ compensa- tion, disability benefits, or similar laws; 4. bodily injury or property damage arising out of an accident involving 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 property damage arising out of the ownership, maintenance or use of any vehicle owned by you or furnished or available for your regular use, other than a covered auto for which this coverage has been purchased; 10. bodily injury or property 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 property damage sustained while the vehicle is used by a trans- portation network company driver who is logged onto the transportation net- 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. 607464/2024 FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 A LIMITS OF NYSCEF LIABILITY DOC. NO. 2 RECEIVED NYSCEF: 04/30/2024 If your declarations page shows a split limit: 1. the amount shown for “each person” is the most we will pay for all damages due to bodily injury to one person resulting from any one accident; 2. subject to the “each person” limit, the amount shown for “each accident” is the most we will pay for all damages due to bodily injury sustained by two or more persons in any one accident; and 3. the amount shown for “property damage” is the most we will pay for the total of all property damage resulting from any one accident. However, if your policy has bodily injury split limits of: 1. $25,000 “each person” and $50,000 “each accident” 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 bodily injury that results in death, and the following ad- 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 results in death, our limit of liability for bodily injury that results in the death of two or more persons in any one accident is $100,000; or 2. $50,000 “each person” and $100,000 “each accident” 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 liability, 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 bodily 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 bodily injury that does not result in death, the limit of liability for all damages due to bodily injury that does not result in death is $100,000; or d. for any accident that causes bodily injury that results in the death of two or more persons, the most we will pay for all damages due to bodily injury that results in death in any one accident is $100,000, and the limit of liability for all other bodily injury that does not result in death is: (i) $50,000 if only one person sustains bodily injury in any one accident; or (ii) subject to the per person limit, $100,000 for two or more persons sustain- ing bodily injury in any one accident. The above Limits of Liability with respect to bodily injury that results in death are subject to the following reductions: 1. in the event of the death of one person in any accident, our $50,000 limit of liability will be reduced by any amounts paid to or on behalf of that person under this Part I; and 6 INDEX NO. 607464/2024 FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 A 2. in the NYSCEF eventNO. DOC. of the2 death of two or more persons in anyNYSCEF: RECEIVED accident, our $100,000 04/30/2024 limit of liability will be reduced by any amounts paid to or on behalf of those per- sons under this Part I. The limits of liability described above for “each person” and for “one person” apply to the total of all claims made for bodily injury to a person and all claims of others derived from such bodily injury, including, but not limited to, loss of society, loss of compan- ionship, loss of services, loss of consortium, and wrongful death. The limit of liability for bodily injury that results in the death of two or more persons in any one accident includes the total of all claims made for such bodily injury and all claims of others derived from such bodily injury, including, but not limited to, loss of so- ciety, loss of companionship, loss of services, loss of consortium, and wrongful death. If the declarations page shows that “combined single limit” or “CSL” applies, the amount shown is the most we will pay for the total of all damages resulting from any one accident. However, without changing this limit of liability, we will comply with any law that requires us to provide any separate limits. The limit of liability shown on the declarations page is the most we will pay regardless of the number of: 1. claims made; 2. covered autos; 3. insured persons; 4. lawsuits brought; 5. vehicles involved in the accident; or 6. premiums paid. No one is entitled to duplicate payments for the same elements of damages. Any payment to a person under this Part I will be reduced by any payment to that per- son under Part III—Uninsured Motorists Coverage. We will not pay under this Part I any expenses paid or payable under Part II(B)—Medical Payments Coverage. An auto and attached trailer are considered one auto. Therefore, the limits of liability will not be increased for an accident involving an auto that has an attached trailer. FINANCIAL RESPONSIBILITY LAWS When we issue this policy as proof of financial responsibility, this policy will comply with the law to the extent required. 7 INDEX NO. 607464/2024 FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 A OTHER INSURANCE NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/30/2024 If there is any other valid and collectible liability insurance or bond that applies to the accident, we will pay only our share of the damages. Our share is the proportion that our limit of liability bears to the total of all applicable limits. However, any insurance we provide for a vehicle or trailer, other than a covered auto, will be excess over any other valid and collectible insurance, self-insurance, or bond. OUT-OF-STATE COVERAGE If an accident to which this Part I applies occurs in any state, territory or possession of the United States of America or any province or territory of Canada, other than the one in which a covered auto is principally garaged, and the state, province, territory or possession has: 1. a financial responsibility or similar law requiring limits of liability for bodily injury or property damage higher than the limits shown on the declarations page, this policy will provide the higher limits; or 2. a compulsory insurance or similar law requiring a non-resident to maintain insur- ance whenever the non-resident uses an auto in that state, province, territory or possession, this policy will provide the greater of: a. the required minimum amounts and types of coverage; or b. the limits of liability under this policy. PART II(A)—PERSONAL INJURY PROTECTION COVERAGE MANDATORY PERSONAL INJURY PROTECTION ENDORSEMENT (New York) The Company agrees with the named insured, as follows: Section I Mandatory Personal Injury Protection The company will pay first-party benefits to reimburse for basic economic loss sus- tained by an eligible injured person on account of personal injuries caused by an ac- cident arising out of the use or operation of a motor vehicle or a motorcycle during the policy period and within the United States of America, its territories or possessions, or Canada. First-party Benefits First-party benefits, other than death benefits, are payments equal to basic economic loss, reduced by the following: (a) 20 percent of the eligible injured person’s loss of earnings from work to the extent that an eligible injured person’s basic economic loss consists of such loss of earn- ings; 8 INDEX NO. 607464/2024 FILED: NASSAU COUNTY CLERK 04/30/2024 11:54 A (b) amounts NYSCEF DOC.recovered NO. 2 or recoverable on account of personal RECEIVED injury to NYSCEF: an eligible 04/30/2024 injured person under State or Federal laws providing social security disability or workers’ compensation benefits, or disability benefits under article 9 of the New York Workers’ Compensation Law; (c) the amount of any applicable deductible, provided that such deductible shall apply to each accident, but only to the total of first-party benefits otherwise payable to the named insured and any relative as a result of that accident. Basic Economic Loss Basic economic loss shall consist of medical expense, work loss, other expense and, when death occurs, a death benefit as herein provided. Except for such death benefit, basic economic loss shall not include any loss sustained on account of death. Basic economic loss of each eligible injured person on account of any single accident shall not exceed $50,000, except that any death benefit hereunder shall be in addition thereto. Medical Expense Medical expense shall consist of necessary expenses for: (a) medical, hospital (including services rendered in compliance with article 41 of the Public Health Law, whether or not such services are rendered directly by a hospi- tal), surgical, nursing, dental, ambulance, X-ray, prescription drug and prosthetic services; (b) psychiatric, physical and occupational therapy