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Filing # 180999984 E-Filed 09/01/2023 01:15:05 PM
FLORIDA PAIN AND WELLNESS CENTERS IN THE COUNTY COURT OF THE 11TH
INC a/a/o LIDIA TREVINO , JUDICIAL CIRCUIT, IN AND FOR MIAMI-
DADE COUNTY, FLORIDA
Plaintiff,
vs.
CASE NO: 2023-106608-SP-25
PROGRESSIVE AMERICAN INSURANCE
COMPANY ,
FLORIDA BAR NO.: 15918
Defendant.
/
STATE OF FLORIDA
TO EACH SHERIFF OF SAID STATE:
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YOU ARE COMMANDED to serve this summons and a copy of the Complaint, Request for
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Admissions, Notice of Interrogatories, Request to Produce, and a letter requesting deposition(s), in this
action on Defendant:
PROGRESSIVE AMERICAN INSURANCE COMPANY
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c/o FLORIDA CHIEF FINANCIAL OFFICER AS RA
SERVICE OF PROCESS SECTION
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200 EAST GAINES STREET
TALLAHASSEE, FLORIDA 32399
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Each Defendant is required to serve written defense(s) to the Complaint on Plaintiff’s Attorney, to wit:
Gregory J. Blackburn, Esq.
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Address: c/o Reifkind, Thompson & Rudzinski, LLP.
3333 W. Commercial Blvd., Ste. 200B
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Ft. Lauderdale, FL 33309
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within 20 days after service of this summons on that defendant, exclusive of the day of service, and to file
the original of the defenses without the clerk of his Court either before service on Plaintiff’s attorney or
immediately thereafter. If a defendant fails to do so, a default will be entered against that defendant for
the relief demanded in the Complaint.
A copy of a Complaint, Plaintiff’s First Request for Admissions to Defendant, Plaintiff’s First
Interrogatories to Defendant, Request for Production, and first request for deposition(s), shall be served
with this summons.
JUAN FERNANDEZ-BARQUIN,
CLERK OF THE COURT AND
COMPTROLLER, MIAMI-DADE COUNTY
By
Date: __________________
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Filing # 186297180 E-Filed 11/16/2023 02:22:48 PM
IN THE COUNTY COURT OF THE 11TH
JUDICIAL CIRCUIT, IN AND FOR
MIAMI-DADE COUNTY, FLORIDA
FLORIDA PAIN AND WELLNESS
CENTERS INC a/a/o LIDIA TREVINO,
Plaintiff,
vs.
CASE NO: 2023-106608-SP-25 (CC 06)
PROGRESSIVE AMERICAN CIVIL DIVISION
INSURANCE
COMPANY,
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Defendant.
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NOTICE OF FILING DECLARATION AND CERTIFICATION OF BUSINESS
RECORDS IN SUPPORT OF DEFENDANT’S
MOTION TO DISMISS AND/OR TRANSFER VENUE
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The Defendant, PROGRESSIVE AMERICAN INSURANCE COMPANY, by and
through the undersigned attorney, hereby gives Notice of Filing of the attached Declaration and
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Certification of Business Records in Support of Defendant’s Motion to Dismiss and/or Transfer
Venue.
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CERTIFICATE OF SERVICE
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I HEREBY CERTIFY that a true and correct copy of the above and foregoing has been
furnished via E-Mail on November 16, 2023 to Gregory J. Blackburn, Esq., Reifkind, Thompson
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& Rudzinski, LLP, Attorney for Plaintiff, Florida Pain and Wellness Centers Inc aao Lidia
Trevino, PipService@rtrlaw.com;pipscheduling@rtrlaw.com, (954) 370-5152/(954) 370-1992
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(F).
Progressive PIP House Counsel
Attorneys for Defendant
4030 Crescent Park Drive, Suite 100
Riverview, FL 33578
(813) 775-4768 (Asst.)/(813) 371-3991 (Direct)
Fax: (866) 516-8617
SERVICE DESIGNATIONS:
Primary: Soutchay_S_Xayasone@progressive.com
Secondary TampaPIPHC1@progressive.com
By:
SOUTCHAY S XAYASONE, ESQUIRE
Florida Bar No. 52961
“Salaried Employees of Progressive Casualty Insurance Company”
206740369
IN THE COUNTY COURT OF THE 11TH
JUDICIAL CIRCUIT, IN AND FOR
MIAMI-DADE COUNTY, FLORIDA
FLORIDA PAIN AND WELLNESS
CENTERS INC a/a/o LIDIA TREVINO,
Plaintiff,
vs.
CASE NO: 2023-106608-SP-25 (CC 06)
PROGRESSIVE AMERICAN CIVIL DIVISION
INSURANCE
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COMPANY,
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Defendant.
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DECLARATION OF ADJUSTER IN SUPPORT OF DEFENDANT’S
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MOTION TO DISMISS AND/OR TRANSFER VENUE
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1. My name is HECTOR VAZQUEZ and I am a Litigation Specialist/Claims Adjuster
with PROGRESSIVE AMERICAN INSURANCE COMPANY (hereinafter PROGRESSIVE). I
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have personal knowledge of all of the facts contained herein, and I am over 18 years of age and I
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am competent to testify.
2. I am the Claims Adjuster assigned to the above-referenced case (Claim Number:
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206740369), I have been responsible for handling the claim file relative to this lawsuit and in that
regard, I presently am the custodian of the claim file.
3. I hereby certify that the documents attached to this Declaration and Certification
are true and accurate and are kept in the regular course of business activity. I have personal
knowledge of the documents attached and I have a business duty to furnish the information
contained herein. Further, I hereby certify that the documents attached to this Declaration and
Certification are true, correct, and authentic copies of records that were made at or near the time
by, or from information transmitted by, a person with knowledge, and kept in the course of
regularly conducted business activity and it was the regular practice of Progressive’ s business
activity to make such records.
4. LIDIA TREVINO was covered under a PIP policy of insurance issued by
PROGRESSIVE (Policy Number 17919672). This policy was in full force an effect on the date
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of the alleged accident 3/31/2020.
5. The correct Progressive entity is Progressive American Insurance Company as
noted the subject policy as evidenced by the Declarations of Coverages page and Subject Policy,
including all endorsements and amendments, are attached hereto as Exhibit “A.”
6. I have reviewed the subject claim file. The investigating police department for the
alleged accident is in or near Seminole County. The witnesses listed on the police report as well
as the claimant live in or near Seminole County. See Police Report, attached as Exhibit “B.”
7. In addition, medical services provided to the claimant by the Plaintiff appeared to
have been provided in or near Seminole and/or Orange County. See Plaintiff’s HCFA form,
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attached as Composite Exhibit “C.”
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8. I have reviewed the exhibits attached to Defendant’s Motion and do hereby attest
that all are true and correct copies of the originals which are kept in the ordinary course of
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Defendant’s business.
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9. The Claimant did not update the policy address to reflect an address other than that
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on the policy declaration page, police report, or HCFA’ s.
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UNDER PENALTIES OF PERJURY, I declare that I have read the foregoing
Declaration and Certification of Business Records in Support of Defendant’ s Motion to
Dismiss/Transfer Venue, as well as all attached Exhibits, and that the facts stated in
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these pages are true. Executed on __11/03/2023 _______________________________.
Signature of Declarant
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Hector Vazquez
Printed Name of Declarant
Pip Litigation Rep Sr.
Title of Declarant
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COMPOSITE EXHIBIT A
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9611A FL 0717
FLORIDA
AUTO POLICY
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Form 9611A FL (07/17)
version 2.0
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CONTENTS
INSURING AGREEMENT.................................................................................. 1
GENERAL DEFINITIONS.................................................................................. 1
PART I—LIABILITY TO OTHERS
Insuring Agreement—Bodily Injury...............................................................3
Insuring Agreement—Property Damage......................................................3
Additional Definition.....................................................................................3
Additional Payments.....................................................................................4
Exclusions....................................................................................................4
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Limits of Liability...........................................................................................6
Financial Responsibility Laws......................................................................7
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Other Insurance...........................................................................................7
Out-of-State Coverage.................................................................................7
PART II(A)—PERSONAL INJURY PROTECTION COVERAGE
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Insuring Agreement...................................................................................... 8
Additional Definitions.................................................................................... 8
Exclusions...................................................................................................10
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Limit of Liability...........................................................................................11
Other Insurance..........................................................................................12
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Conditions...................................................................................................12
Extended Personal Injury Protection Coverage...........................................16
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PART II(B)—MEDICAL PAYMENTS COVERAGE
Insuring Agreement....................................................................................17
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Additional Definitions..................................................................................18
Exclusions..................................................................................................19
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Limits of Liability.........................................................................................20
Unreasonable or Unnecessary Medical Expenses....................................21
Other Insurance.........................................................................................22
PART III—UNINSURED MOTORIST COVERAGE
Insuring Agreement....................................................................................22
Additional Definitions..................................................................................23
Exclusions..................................................................................................24
Limits of Liability.........................................................................................24
Other Insurance.........................................................................................26
Trust Agreement.........................................................................................27
Our Rights to Recover Payment.................................................................27
PART IV—DAMAGE TO A VEHICLE
Insuring Agreement—Collision Coverage..................................................27
Insuring Agreement—Comprehensive Coverage.......................................27
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Insuring Agreement—Full Comprehensive Window Glass Coverage.........28
Insuring Agreement—Additional Custom Parts or
Equipment Coverage..............................................................................28
Insuring Agreement—Rental Reimbursement Coverage............................28
Insuring Agreement—Loan/Lease Payoff Coverage..................................29
Insuring Agreement—Pet Injury Coverage.................................................29
Additional Definitions..................................................................................30
Exclusions..................................................................................................30
Limits of Liability.........................................................................................32
Payment of Loss........................................................................................33
No Benefit to Bailee...................................................................................33
Loss Payable Clause..................................................................................33
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Other Sources of Recovery........................................................................34
Appraisal....................................................................................................34
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PART V—ROADSIDE ASSISTANCE COVERAGE
Insuring Agreement....................................................................................34
Additional Definitions..................................................................................35
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Exclusions..................................................................................................35
Unauthorized Service Provider..................................................................36
Other Insurance.........................................................................................36
PART VII—GENERAL PROVISIONS
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PART VI—DUTIES IN CASE OF AN ACCIDENT OR LOSS............................36
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Policy Period and Territory..........................................................................37
Changes.....................................................................................................37
Duty to Report Changes............................................................................38
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Settlement of Claims..................................................................................38
Terms of Policy Conformed to Statutes......................................................38
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Transfer of Interest.....................................................................................38
Fraud or Misrepresentation........................................................................38
Payment of Premium and Fees..................................................................39
Cancellation...............................................................................................40
Cancellation Refund...................................................................................41
Rate Increases...........................................................................................41
Noncancelable Policy.................................................................................41
Nonrenewal................................................................................................42
Automatic Termination................................................................................42
Legal Action Against Us.............................................................................42
Our Rights to Recover Payment.................................................................43
Joint and Individual Interests......................................................................44
Bankruptcy.................................................................................................44
Mediation...................................................................................................44
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FLORIDA AUTO POLICY
INSURING AGREEMENT
In return for your payment of the premium, we agree to insure you subject to all the
terms, conditions and limitations of this policy. We will insure you for the coverages
and the limits of liability shown on this policy’s declarations page. Your policy consists
of the policy contract, your insurance application, the declarations page, and all en-
dorsements to this policy.
GENERAL DEFINITIONS
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The following definitions apply throughout the policy. Defined terms are printed in bold-
face type and have the same meaning whether in the singular, plural, or any other form.
1. “Additional auto” means an auto you become the actual or beneficial owner of
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during the policy period that does not permanently replace an auto shown on the
declarations page if:
a. you notify us within 30 days of becoming the owner of the additional auto;
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and
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b. you pay any additional premium due.
An additional auto will have the broadest coverage we provide for any auto shown
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on the declarations page. If you ask us to insure an additional auto more than
30 days after you become the actual or beneficial owner, any coverage we provide
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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;
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b. designed for operation principally upon public roads;
c. with at least four wheels; and
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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
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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 appli-
cable to that auto or trailer;
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.
7. “Occupying” means in, on, entering or exiting.
8. “Personal vehicle sharing program” means a system or process, operated by a
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business, organization, network, group, or individual under terms of use pursuant
to a written agreement, that facilitates the sharing of private passenger motor ve-
hicles for use by individuals.
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 either an “Excluded” or a “List Only” driver.
11. “Relative” means a person residing in the same household as you, and related to
you by blood, marriage or adoption, and includes a ward, stepchild, or foster child.
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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
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the declarations page. However, if the auto being replaced had coverage under
Part IV—Damage To A Vehicle, such coverage will apply to the replacement auto
only during the first 30 days after you become the actual or beneficial owner unless
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you notify us within that 30-day period that you want us to extend coverage be-
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yond the initial 30 days. If the auto being replaced did not have coverage under Part
IV—Damage To A Vehicle, such coverage may be added, but the replacement
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auto will have no coverage under Part IV until you notify us of the replacement
auto and ask us to add the coverage.
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13. “Ride-sharing activity” means the use of any vehicle to provide transportation of
persons for any compensation or fee in connection with a transportation network
company from the time a user logs on to, or signs in to, any online-enabled appli-
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cation, software, website or system until the time the user logs out of, or signs off of,
any such online-enabled application, software, website or system, whether or not
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the user has accepted any passenger(s), including the time the user is on the way
to pick up any passenger(s), or is transporting any passenger(s).
14. “Trailer” means a non-motorized trailer, including a farm wagon or farm implement,
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designed to be towed on public roads by an auto:
a. while not being used for commercial purposes;
b. while not being used as an office, store, or for display purposes; or
c. while not being used as a passenger conveyance.
15. “Transportation network company” is an organization, sole proprietor, or any
other entity that provides prearranged transportation services for compensation
using an online-enabled application or platform to connect passengers with drivers
using a personal vehicle. This definition does not include shared-expense carpool-
ing.
16. “We,” “us” and “our” mean the underwriting company providing the insurance, as
shown on the declarations page.
17. “You” and “your” mean:
a. a person shown as a named insured on the declarations page; and
b. the spouse of a named insured if residing in the same household at the time of
the loss.
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PART I—LIABILITY TO OTHERS
INSURING AGREEMENT—BODILY INJURY
If you pay the premium for this coverage, we will pay damages for bodily injury for
which an insured person becomes legally responsible because of an accident.
INSURING AGREEMENT—PROPERTY DAMAGE
If you pay the premium for this coverage, we will pay damages for property damage
for which an insured person becomes legally responsible because of an accident.
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Damages for bodily injury and property damage include prejudgment interest award-
ed against an insured person, where owed by law.
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If you pay the premium for Bodily Injury Liability and Property Damage Liability, we will
settle or defend, at our option, any claim for bodily injury or property damage cov-
ered by this Part I. Our duty to settle or defend ends after we have paid the applicable
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limit of liability for the accident that is the basis of the lawsuit. Our duty to settle or de-
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fend does not include any sanctions awarded or assessed against an insured person
due to intentional misrepresentation or concealment committed by that insured person
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during the course of any lawsuit, associated discovery, or other proceedings.
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If you pay the premium for Property Damage Liability only, we will settle or defend, at
our option, any claim for property damage covered by this Part I. Our duty to settle
or defend ends after we have paid the applicable limit of liability for the accident that
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is the basis of the lawsuit. Our duty to settle or defend does not include any sanctions
awarded or assessed against an insured person due to intentional misrepresentation
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or concealment committed by that insured person during the course of any lawsuit,
associated discovery, or other proceedings.
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Satisfaction by an insured person of a judgment for bodily injury or property dam-
age shall not be a condition precedent to the right or duty of us to make payment for
such bodily injury or property damage.
ADDITIONAL DEFINITION
When used in this Part I:
“Insured person” means:
a. you, a relative, or a rated resident with respect to an accident arising out of the
ownership, maintenance or use of an auto or a trailer;
b. any person with respect to an accident arising out of that person’s use of a covered
auto with the permission of you, a relative, or a rated resident;
c. any person or organization with respect only to vicarious liability for the acts or
omissions of a person described in a. or b. above; and
d. any “Additional Interest” shown on the declarations page with respect only to its
liability for the acts or omissions of a person described in a. or b. above.
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ADDITIONAL PAYMENTS
In addition to our limit of liability, we will pay for an insured person:
1. all expenses we incur in the settlement of any claim or in the defense of an insured
person in any lawsuit. This does not include attorney fees or sanctions awarded or
assessed against an insured person unless they were taxed against an insured
because the Company, while providing a defense, rejected an offer of judgment at
or below the applicable limit of liability;
2. interest accruing after entry of judgment, until we have paid, offered to pay, or de-
posited in court, that portion of the judgment which does not exceed our limit of
liability. This does not apply if we have not been given notice of suit or the opportu-
nity to defend an insured person;
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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;
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4. up to $250 for a bail bond required because of an accident resulting in bodily in-
jury or property damage covered under this Part I. We have no duty to apply for
or furnish this bond; and
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5. reasonable expenses, including loss of earnings up to $200 per day, incurred at
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our request.
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EXCLUSIONS—READ THE FOLLOWING EXCLUSIONS CAREFULLY. IF AN EX-
CLUSION APPLIES, COVERAGE WILL NOT BE AFFORDED UNDER THIS PART I.
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Coverage under this Part I, including our duty to defend, will not apply to any insured
person for:
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1. bodily injury or property damage arising out of the ownership, maintenance or
use of any vehicle or trailer while being used:
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a. to carry persons or property for compensation or a fee;
b. for retail or wholesale delivery, including, but not limited to, the pickup, transport
or delivery of magazines, newspapers, mail or food; or
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c. for ride-sharing activity.
This exclusion does not apply to shared-expense car pools;
2. any liability assumed under any contract or agreement by you or a relative;
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’ compensation,
disability benefits, or similar laws;
4. bodily injury or property damage arising out of an accident involving any vehicle
while being maintained or used by a person while employed or engaged in any
auto business. This exclusion does not apply to you, a relative, a rated resident,
or an agent or employee of you, a relative, or a rated resident, when using a
covered auto;
5. bodily injury or property damage arising out of the use of any vehicle, and result-
ing from, or sustained during practice or preparation for:
a. any pre-arranged or organized racing, stunting, speed or demolition contest or
activity by an insured person; or
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b. any driving activity conducted on a permanent or temporary racetrack or race-
course by an insured person;
6. bodily injury or property damage due to a nuclear reaction or radiation;
7. bodily injury or property damage for which insurance:
a. is afforded under a nuclear energy liability insurance contract; or
b. would be afforded under a nuclear energy liability insurance contract but for its
termination upon exhaustion of its limit of liability;
8. any obligation for which the United States Government is liable under the Federal
Tort Claims Act. This exclusion will apply only to the damages that are in excess of
the minimum limits of liability coverage required by the financial responsibility law of
the state of Florida;
9. bodily injury or property damage caused by an intentional act of any insured
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person, or at the direction of any insured person, even if the actual injury or dam-
age is different than that which was intended or expected. With respect to persons
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sustaining bodily injury or property damage who do not also qualify as insured
persons, this exclusion will apply only to the damages that are in excess of the
minimum limits of liability coverage required by the financial responsibility law of the
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state of Florida;
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10. property damage to any property owned by, rented to, being transported by, used
by, or in the charge of that insured person. This exclusion does not apply to a
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rented residence or a rented garage;
11. bodily injury to you or a relative;
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12. bodily injury or property damage arising out of the ownership, maintenance, or
use of any vehicle owned by you or furnished or available for your regular use,
other than a covered auto for which this coverage has been purchased;
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13. bodily injury or property damage arising out of the ownership, maintenance or
use of any vehicle owned by a relative or furnished or available for the regular use
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of a relative, other than a covered auto for which this coverage has been pur-
chased. This exclusion does not apply to your maintenance or use of such vehicle;
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14. bodily injury or property damage arising out of your, a relative’s, or a rated
resident’s use of a vehicle, other than a covered auto, without the permission of
the owner of the vehicle or the person in lawful possession of the vehicle;
15. bodily injury or property damage arising out of the use of a covered auto while
leased or rented to others or given in exchange for any compensation, including
while being used in connection with a personal vehicle sharing program. This
exclusion does not apply to the operation of a covered auto by you, a relative,
or a rated resident, and will only apply to the damages that are in excess of the
minimum limits of liability coverage required by the financial responsibility law of the
state of Florida;
16. punitive or exemplary damages; or
17. bodily injury or property damage caused by, or reasonably expected to result
from, a criminal act or omission, excluding moving traffic violations, of any insured
person. This exclusion applies regardless of whether that insured person is ac-
tually charged with, or convicted of, a crime. With respect to persons sustaining
bodily injury or property damage who do not also qualify as insured persons,
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this exclusion will apply only to the damages that are in excess of the minimum
limits of liability coverage required by the financial responsibility law of the state of
Florida.
LIMITS OF LIABILITY
The limit of liability shown on the declarations page for liability coverage is the most we
will pay regardless of the number of:
1. claims made;
2. covered autos;
3. insured persons;
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4. lawsuits brought;
5. vehicles involved in the accident; or
6. premiums paid.
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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
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bodily injury to one person resulting from any one accident;
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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
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in any one accident; and
3. the amount shown for “property damage” is the most we will pay for the total of all
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property damage resulting from any one accident.
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The “each person” limit of liability applies to the total of all claims made for bodily injury
to a person and all claims of others derived from such bodily injury, including, but not
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limited to, emotional injury or mental anguish resulting from the bodily injury of another
or from witnessing the bodily injury to another, loss of society, loss of companionship,
loss of services, loss of consortium, and wrongful death, if recoverable under the ap-
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plicable law.
If the declarations page shows that “combined single limit” or “CSL” applies, the
amount shown is the most we will pay for the total of all damages resulting from any
one accident. However, without changing this limit of liability, we will comply with any law
that requires us to provide any separate limits.
No one is entitled to duplicate payments for the same elements of damages.
Any payment to a person under this Part I for bodily injury will be reduced by:
1. any payment made to that person for bodily injury under Part III—Uninsured Mo-
torist Coverage; and
2. any amounts that are paid or payable to that person as personal injury protection
benefits.
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If multiple auto policies issued by us are in effect for you, we will pay no more than the
highest limit of liability for this coverage available under any one policy.
An auto and attached trailer are considered one auto. Therefore, the limits of liability
will not be increased for an accident involving an auto that has an attached trailer.
FINANCIAL RESPONSIBILITY LAWS
When we certify this policy as proof of financial responsibility, this policy will comply with
the law to the extent required. The insured person must reimburse us if we make a
payment that we would not have made if this policy was not certified as proof of financial
responsibility.
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OTHER INSURANCE
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If there is any other applicable liability insurance or bond, we will pay only our share of
the damages. Our share is the proportion that our limit of liability bears to the total of all
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applicable limits. Any insurance we provide for a vehicle or trailer, other than a covered
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auto, will be excess over any other collectible insurance, self-insurance, or bond.
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However, when you, a relative, or a rated resident rent or lease an auto, the liability
coverage provided by the lessor’s policy shall be primary unless the rental or lease
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agreement includes a provision in the form specified in Florida Statute §627.7263, as
amended, stating that the lessee or rentee’s liability insurance and personal injury pro-
tection insurance shall be primary. If the rental or lease agreement includes such a
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provision, our duty to pay damages under this Part I, and our duty to defend you, a
relative, or a rated resident under this Part I, shall be primary to any liability coverage
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provided by the lessor or owner for operation of that auto by you, a relative, or a rated
resident. We have no duty to defend the lessor or owner of that auto under this Part I.
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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 pos-
session has:
1. a financial responsibility or similar law requiring limits of liability for bodily injury
or property damage higher than the limits shown on the declarations page, this
policy will provide the higher limits; or
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.
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PART II(A)—PERSONAL INJURY PROTECTION COVERAGE
INSURING AGREEMENT
If you pay the premium for this coverage, we will pay benefits that an insured person
is entitled to receive pursuant to the Florida Motor Vehicle No-Fault Law, as amended,
because of bodily injury:
1. caused by an accident;
2. sustained by an insured person; and
3. arising out of the ownership, maintenance or use of a motor vehicle.
Personal Injury Protection Coverage benefits consist of:
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1. medical benefits;
2. disability benefits; and
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3. death benefits.
ADDITIONAL DEFINITIONS
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When used in this Part II(A):
1. “Death benefits” means benefits of $5,000 payable per individual if an insured
person dies because of injury covered under this Part II(A).
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2. “Disability benefits” means 60 percent of any work loss per insured person
from inability to work proximately caused by the injury sustained by the insured
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person. Disability benefits also include all expenses reasonably incurred in ob-
taining from others ordinary and necessary services in lieu of those services that,
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but for the bodily injury, the insured person would have performed without in-
come for the benefit of his or her household.
3. “Emergency medical condition” means a medical condition manifesting itself by
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acute symptoms of sufficient severity, which may include severe pain, such that the
absence of immediate medical attention could reasonably be expected to result in
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any of the following:
a. serious jeopardy to patient health;
b. serious impairment to bodily functions; or
c. serious dysfunction of any bodily organ or part.
4. “Insured person” means:
a. you or any resident relative sustaining bodily injury while occupying a mo-
tor vehicle, or when struck by a motor vehicle while not occupying a self-
propelled vehicle;
b. any person sustaining bodily injury while occupying a covered auto; or
c. any person, if a resident of Florida, sustaining bodily injury when struck by a
covered auto while not occupying a self-propelled vehicle.
For purposes of this definition, “covered auto” includes an attached trailer or semi-
trailer designed for use with such vehicle.
5. “Medical benefits” means 80 percent of all reasonable expenses incurred for
medically necessary medical, surgical, x-ray, dental and rehabilitative services,
including prosthetic devices and medically necessary ambulance, hospital and
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nursing services. All of the following statutory references are to Florida law. Medi-
cal benefits are limited to: 1) services and care received within the initial 14 days
after the motor vehicle accident, or 2) follow-up services and care received beyond
the initial 14 days after the motor vehicle accident if services and care have been
previously received within the initial 14 days after the motor vehicle accident, and
a referral for more services and care has been provided by a statutorily authorized
provider, and the follow-up services and care are consistent with the underlying
medical diagnosis. Medical benefits provide reimbursement for: 1) initial services
and care that are lawfully provided, supervised, ordered, or prescribed by a physi-
cian licensed under chapter 458 or chapter 459, a dentist licensed under chapter
466, or a chiropractic physician licensed under chapter 460 or that are provided in
a hospital or in a facility that owns, or is wholly owned by, a hospital. Initial services
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and care may also be provided by a person or entity licensed under part III of chap-
ter 401 which provides emergency transportation and treatment, or 2) upon referral
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by a provider described in subparagraph 1), follow-up services and care consistent
with the underlying medical diagnosis rendered pursuant to subparagraph 1) which
may be provided, supervised, ordered, or prescribed only by a physician licensed
under chapter 458 or chapter 459, a chiropractic physician licensed under chapter
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460, a dentist licensed under chapter 466, or, to the extent permitted by applicable
law and under the supervision of such physician, osteopathic physician, chiroprac-
tic physician, or dentist, by a physician assistant licensed under chapter 458 or
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chapter 459 or an advanced registered nurse practitioner licensed under chapter
464. Follow-up services and care may also be provided by the following persons
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or entities: a) hospital or ambulatory surgical center licensed under chapter 395,
b) an entity wholly owned by one or more physicians licensed under chapter 458
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or chapter 459, chiropractic physicians licensed under chapter 460, or dentists li-
censed under chapter 466 or by such practitioners and the spouse, parent, child,
or sibling of such practitioners, c) an entity that owns or is wholly owned, directly or
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indirectly, by a hospital or hospitals, d) a physical therapist licensed under chapter
486, based upon a referral by a provider described in this subparagraph, e) a health
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care clinic licensed under part X of chapter 400 which is accredited by an accredit-
ing organization whose standards incorporate comparable regulations required by
this state, or (i) has a medical director licensed under chapter 458, chapter 459,
or chapter 460; (ii) has been continuously licensed for more than 3 years or is a
publicly traded corporation that issues securities traded on an exchange registered
with the United States Securities and Exchange Commission as a national securi-
ties exchange; and (iii) provides at least four of the following medical specialties: (A)
General medicine, (B) Radiography, (C) Orthopedic medicine, (D) Physical medi-
cine, (E) Physical therapy, (F) Physical rehabilitation, (G) Prescribing or dispensing
outpatient prescription medication, (H) Laboratory services. Medical benefits do
not include massage, as defined in FL. St. 480.033, or acupuncture, as defined in
FL. St. 457.102, regardless of the person, entity or licensee providing the massage
or acupuncture, and a licensed massage therapist or licensed acupuncturist will
not be reimbursed for medical benefits.
6. “Medically necessary” refers to a m
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IA L F I C O F U N IA L F I C O F U N Filing # 180999984 E-Filed 09/01/2023 01:15:05 PM FLORIDA PAIN AND WELLNESS CENTERS IN THE COUNTY COURT OF THE 11TH INC a/a/o LIDIA TREVINO , JUDICIAL CIRCUIT, IN AND FOR MIAMI- DADE COUNTY, FLORIDA Plaintiff, vs. CASE NO: 2023-106608-SP-25 PROGRESSIVE AMERICAN INSURANCE COMPANY , FLORIDA BAR NO.: 15918 Defendant. / STATE OF FLORIDA TO EACH SHERIFF OF SAID STATE: L YOU ARE COMMANDED to serve this summons and a copy of the Complaint, Request for IA Admissions, Notice of Interrogatories, Request to Produce, and a letter requesting deposition(s), in this action on Defendant: PROGRESSIVE AMERICAN INSURANCE COMPANY I C c/o FLORIDA CHIEF FINANCIAL OFFICER AS RA SERVICE OF PROCESS SECTION F 200 EAST GAINES STREET TALLAHASSEE, FLORIDA 32399 F Each Defendant is required to serve written defense(s) to the Complaint on Plaintiff’s Attorney, to wit: Gregory J. Blackburn, Esq. O Address: c/o Reifkind, Thompson & Rudzinski, LLP. 3333 W. Commercial Blvd., Ste. 200B N Ft. Lauderdale, FL 33309 U within 20 days after service of this summons on that defendant, exclusive of the day of service, and to file the original of the defenses without the clerk of his Court either before service on Plaintiff’s attorney or immediately thereafter. If a defendant fails to do so, a default will be entered against that defendant for the relief demanded in the Complaint. A copy of a Complaint, Plaintiff’s First Request for Admissions to Defendant, Plaintiff’s First Interrogatories to Defendant, Request for Production, and first request for deposition(s), shall be served with this summons. JUAN FERNANDEZ-BARQUIN, CLERK OF THE COURT AND COMPTROLLER, MIAMI-DADE COUNTY By Date: __________________ 1 Filing # 186297180 E-Filed 11/16/2023 02:22:48 PM IN THE COUNTY COURT OF THE 11TH JUDICIAL CIRCUIT, IN AND FOR MIAMI-DADE COUNTY, FLORIDA FLORIDA PAIN AND WELLNESS CENTERS INC a/a/o LIDIA TREVINO, Plaintiff, vs. CASE NO: 2023-106608-SP-25 (CC 06) PROGRESSIVE AMERICAN CIVIL DIVISION INSURANCE COMPANY, L Defendant. ___________________________________/ IA NOTICE OF FILING DECLARATION AND CERTIFICATION OF BUSINESS RECORDS IN SUPPORT OF DEFENDANT’S MOTION TO DISMISS AND/OR TRANSFER VENUE I C The Defendant, PROGRESSIVE AMERICAN INSURANCE COMPANY, by and through the undersigned attorney, hereby gives Notice of Filing of the attached Declaration and F Certification of Business Records in Support of Defendant’s Motion to Dismiss and/or Transfer Venue. F CERTIFICATE OF SERVICE O I HEREBY CERTIFY that a true and correct copy of the above and foregoing has been furnished via E-Mail on November 16, 2023 to Gregory J. Blackburn, Esq., Reifkind, Thompson N & Rudzinski, LLP, Attorney for Plaintiff, Florida Pain and Wellness Centers Inc aao Lidia Trevino, PipService@rtrlaw.com;pipscheduling@rtrlaw.com, (954) 370-5152/(954) 370-1992 U (F). Progressive PIP House Counsel Attorneys for Defendant 4030 Crescent Park Drive, Suite 100 Riverview, FL 33578 (813) 775-4768 (Asst.)/(813) 371-3991 (Direct) Fax: (866) 516-8617 SERVICE DESIGNATIONS: Primary: Soutchay_S_Xayasone@progressive.com Secondary TampaPIPHC1@progressive.com By: SOUTCHAY S XAYASONE, ESQUIRE Florida Bar No. 52961 “Salaried Employees of Progressive Casualty Insurance Company” 206740369 IN THE COUNTY COURT OF THE 11TH JUDICIAL CIRCUIT, IN AND FOR MIAMI-DADE COUNTY, FLORIDA FLORIDA PAIN AND WELLNESS CENTERS INC a/a/o LIDIA TREVINO, Plaintiff, vs. CASE NO: 2023-106608-SP-25 (CC 06) PROGRESSIVE AMERICAN CIVIL DIVISION INSURANCE L COMPANY, IA Defendant. ___________________________________/ I C DECLARATION OF ADJUSTER IN SUPPORT OF DEFENDANT’S F MOTION TO DISMISS AND/OR TRANSFER VENUE F 1. My name is HECTOR VAZQUEZ and I am a Litigation Specialist/Claims Adjuster with PROGRESSIVE AMERICAN INSURANCE COMPANY (hereinafter PROGRESSIVE). I O have personal knowledge of all of the facts contained herein, and I am over 18 years of age and I N am competent to testify. 2. I am the Claims Adjuster assigned to the above-referenced case (Claim Number: U 206740369), I have been responsible for handling the claim file relative to this lawsuit and in that regard, I presently am the custodian of the claim file. 3. I hereby certify that the documents attached to this Declaration and Certification are true and accurate and are kept in the regular course of business activity. I have personal knowledge of the documents attached and I have a business duty to furnish the information contained herein. Further, I hereby certify that the documents attached to this Declaration and Certification are true, correct, and authentic copies of records that were made at or near the time by, or from information transmitted by, a person with knowledge, and kept in the course of regularly conducted business activity and it was the regular practice of Progressive’ s business activity to make such records. 4. LIDIA TREVINO was covered under a PIP policy of insurance issued by PROGRESSIVE (Policy Number 17919672). This policy was in full force an effect on the date « of the alleged accident 3/31/2020. 5. The correct Progressive entity is Progressive American Insurance Company as noted the subject policy as evidenced by the Declarations of Coverages page and Subject Policy, including all endorsements and amendments, are attached hereto as Exhibit “A.” 6. I have reviewed the subject claim file. The investigating police department for the alleged accident is in or near Seminole County. The witnesses listed on the police report as well as the claimant live in or near Seminole County. See Police Report, attached as Exhibit “B.” 7. In addition, medical services provided to the claimant by the Plaintiff appeared to have been provided in or near Seminole and/or Orange County. See Plaintiff’s HCFA form, L attached as Composite Exhibit “C.” IA 8. I have reviewed the exhibits attached to Defendant’s Motion and do hereby attest that all are true and correct copies of the originals which are kept in the ordinary course of C Defendant’s business. I 9. The Claimant did not update the policy address to reflect an address other than that F on the policy declaration page, police report, or HCFA’ s. O F UNDER PENALTIES OF PERJURY, I declare that I have read the foregoing Declaration and Certification of Business Records in Support of Defendant’ s Motion to Dismiss/Transfer Venue, as well as all attached Exhibits, and that the facts stated in N these pages are true. Executed on __11/03/2023 _______________________________. Signature of Declarant U Hector Vazquez Printed Name of Declarant Pip Litigation Rep Sr. Title of Declarant 2 COMPOSITE EXHIBIT A IAL F I C O F U N IAL F I C O F U N IAL F I C O F U N IAL F I C O F U N IAL F I C O F U N 9611A FL 0717 FLORIDA AUTO POLICY IA L F IC O F U N Form 9611A FL (07/17) version 2.0 IA L F IC O F U N CONTENTS INSURING AGREEMENT.................................................................................. 1 GENERAL DEFINITIONS.................................................................................. 1 PART I—LIABILITY TO OTHERS Insuring Agreement—Bodily Injury...............................................................3 Insuring Agreement—Property Damage......................................................3 Additional Definition.....................................................................................3 Additional Payments.....................................................................................4 Exclusions....................................................................................................4 L Limits of Liability...........................................................................................6 Financial Responsibility Laws......................................................................7 IA Other Insurance...........................................................................................7 Out-of-State Coverage.................................................................................7 PART II(A)—PERSONAL INJURY PROTECTION COVERAGE IC Insuring Agreement...................................................................................... 8 Additional Definitions.................................................................................... 8 Exclusions...................................................................................................10 F Limit of Liability...........................................................................................11 Other Insurance..........................................................................................12 F Conditions...................................................................................................12 Extended Personal Injury Protection Coverage...........................................16 O PART II(B)—MEDICAL PAYMENTS COVERAGE Insuring Agreement....................................................................................17 N Additional Definitions..................................................................................18 Exclusions..................................................................................................19 U Limits of Liability.........................................................................................20 Unreasonable or Unnecessary Medical Expenses....................................21 Other Insurance.........................................................................................22 PART III—UNINSURED MOTORIST COVERAGE Insuring Agreement....................................................................................22 Additional Definitions..................................................................................23 Exclusions..................................................................................................24 Limits of Liability.........................................................................................24 Other Insurance.........................................................................................26 Trust Agreement.........................................................................................27 Our Rights to Recover Payment.................................................................27 PART IV—DAMAGE TO A VEHICLE Insuring Agreement—Collision Coverage..................................................27 Insuring Agreement—Comprehensive Coverage.......................................27 i Insuring Agreement—Full Comprehensive Window Glass Coverage.........28 Insuring Agreement—Additional Custom Parts or Equipment Coverage..............................................................................28 Insuring Agreement—Rental Reimbursement Coverage............................28 Insuring Agreement—Loan/Lease Payoff Coverage..................................29 Insuring Agreement—Pet Injury Coverage.................................................29 Additional Definitions..................................................................................30 Exclusions..................................................................................................30 Limits of Liability.........................................................................................32 Payment of Loss........................................................................................33 No Benefit to Bailee...................................................................................33 Loss Payable Clause..................................................................................33 L Other Sources of Recovery........................................................................34 Appraisal....................................................................................................34 IA PART V—ROADSIDE ASSISTANCE COVERAGE Insuring Agreement....................................................................................34 Additional Definitions..................................................................................35 IC Exclusions..................................................................................................35 Unauthorized Service Provider..................................................................36 Other Insurance.........................................................................................36 PART VII—GENERAL PROVISIONS F F PART VI—DUTIES IN CASE OF AN ACCIDENT OR LOSS............................36 O Policy Period and Territory..........................................................................37 Changes.....................................................................................................37 Duty to Report Changes............................................................................38 N Settlement of Claims..................................................................................38 Terms of Policy Conformed to Statutes......................................................38 U Transfer of Interest.....................................................................................38 Fraud or Misrepresentation........................................................................38 Payment of Premium and Fees..................................................................39 Cancellation...............................................................................................40 Cancellation Refund...................................................................................41 Rate Increases...........................................................................................41 Noncancelable Policy.................................................................................41 Nonrenewal................................................................................................42 Automatic Termination................................................................................42 Legal Action Against Us.............................................................................42 Our Rights to Recover Payment.................................................................43 Joint and Individual Interests......................................................................44 Bankruptcy.................................................................................................44 Mediation...................................................................................................44 ii FLORIDA AUTO POLICY INSURING AGREEMENT In return for your payment of the premium, we agree to insure you subject to all the terms, conditions and limitations of this policy. We will insure you for the coverages and the limits of liability shown on this policy’s declarations page. Your policy consists of the policy contract, your insurance application, the declarations page, and all en- dorsements to this policy. GENERAL DEFINITIONS L The following definitions apply throughout the policy. Defined terms are printed in bold- face type and have the same meaning whether in the singular, plural, or any other form. 1. “Additional auto” means an auto you become the actual or beneficial owner of IA during the policy period that does not permanently replace an auto shown on the declarations page if: a. you notify us within 30 days of becoming the owner of the additional auto; C and I b. you pay any additional premium due. An additional auto will have the broadest coverage we provide for any auto shown F on the declarations page. If you ask us to insure an additional auto more than 30 days after you become the actual or beneficial owner, any coverage we provide F 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; O b. designed for operation principally upon public roads; c. with at least four wheels; and N 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 U 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 appli- cable to that auto or trailer; 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. 7. “Occupying” means in, on, entering or exiting. 8. “Personal vehicle sharing program” means a system or process, operated by a 1 business, organization, network, group, or individual under terms of use pursuant to a written agreement, that facilitates the sharing of private passenger motor ve- hicles for use by individuals. 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 either an “Excluded” or a “List Only” driver. 11. “Relative” means a person residing in the same household as you, and related to you by blood, marriage or adoption, and includes a ward, stepchild, or foster child. L 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 IA the declarations page. However, if the auto being replaced had coverage under Part IV—Damage To A Vehicle, such coverage will apply to the replacement auto only during the first 30 days after you become the actual or beneficial owner unless C you notify us within that 30-day period that you want us to extend coverage be- I yond the initial 30 days. If the auto being replaced did not have coverage under Part IV—Damage To A Vehicle, such coverage may be added, but the replacement F auto will have no coverage under Part IV until you notify us of the replacement auto and ask us to add the coverage. F 13. “Ride-sharing activity” means the use of any vehicle to provide transportation of persons for any compensation or fee in connection with a transportation network company from the time a user logs on to, or signs in to, any online-enabled appli- O cation, software, website or system until the time the user logs out of, or signs off of, any such online-enabled application, software, website or system, whether or not N the user has accepted any passenger(s), including the time the user is on the way to pick up any passenger(s), or is transporting any passenger(s). 14. “Trailer” means a non-motorized trailer, including a farm wagon or farm implement, U designed to be towed on public roads by an auto: a. while not being used for commercial purposes; b. while not being used as an office, store, or for display purposes; or c. while not being used as a passenger conveyance. 15. “Transportation network company” is an organization, sole proprietor, or any other entity that provides prearranged transportation services for compensation using an online-enabled application or platform to connect passengers with drivers using a personal vehicle. This definition does not include shared-expense carpool- ing. 16. “We,” “us” and “our” mean the underwriting company providing the insurance, as shown on the declarations page. 17. “You” and “your” mean: a. a person shown as a named insured on the declarations page; and b. the spouse of a named insured if residing in the same household at the time of the loss. 2 PART I—LIABILITY TO OTHERS INSURING AGREEMENT—BODILY INJURY If you pay the premium for this coverage, we will pay damages for bodily injury for which an insured person becomes legally responsible because of an accident. INSURING AGREEMENT—PROPERTY DAMAGE If you pay the premium for this coverage, we will pay damages for property damage for which an insured person becomes legally responsible because of an accident. L Damages for bodily injury and property damage include prejudgment interest award- ed against an insured person, where owed by law. IA If you pay the premium for Bodily Injury Liability and Property Damage Liability, we will settle or defend, at our option, any claim for bodily injury or property damage cov- ered by this Part I. Our duty to settle or defend ends after we have paid the applicable C limit of liability for the accident that is the basis of the lawsuit. Our duty to settle or de- I fend does not include any sanctions awarded or assessed against an insured person due to intentional misrepresentation or concealment committed by that insured person F during the course of any lawsuit, associated discovery, or other proceedings. F If you pay the premium for Property Damage Liability only, we will settle or defend, at our option, any claim for property damage covered by this Part I. Our duty to settle or defend ends after we have paid the applicable limit of liability for the accident that O is the basis of the lawsuit. Our duty to settle or defend does not include any sanctions awarded or assessed against an insured person due to intentional misrepresentation N or concealment committed by that insured person during the course of any lawsuit, associated discovery, or other proceedings. U Satisfaction by an insured person of a judgment for bodily injury or property dam- age shall not be a condition precedent to the right or duty of us to make payment for such bodily injury or property damage. ADDITIONAL DEFINITION When used in this Part I: “Insured person” means: a. you, a relative, or a rated resident with respect to an accident arising out of the ownership, maintenance or use of an auto or a trailer; b. any person with respect to an accident arising out of that person’s use of a covered auto with the permission of you, a relative, or a rated resident; c. any person or organization with respect only to vicarious liability for the acts or omissions of a person described in a. or b. above; and d. any “Additional Interest” shown on the declarations page with respect only to its liability for the acts or omissions of a person described in a. or b. above. 3 ADDITIONAL PAYMENTS In addition to our limit of liability, we will pay for an insured person: 1. all expenses we incur in the settlement of any claim or in the defense of an insured person in any lawsuit. This does not include attorney fees or sanctions awarded or assessed against an insured person unless they were taxed against an insured because the Company, while providing a defense, rejected an offer of judgment at or below the applicable limit of liability; 2. interest accruing after entry of judgment, until we have paid, offered to pay, or de- posited in court, that portion of the judgment which does not exceed our limit of liability. This does not apply if we have not been given notice of suit or the opportu- nity to defend an insured person; L 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; IA 4. up to $250 for a bail bond required because of an accident resulting in bodily in- jury or property damage covered under this Part I. We have no duty to apply for or furnish this bond; and C 5. reasonable expenses, including loss of earnings up to $200 per day, incurred at I our request. F EXCLUSIONS—READ THE FOLLOWING EXCLUSIONS CAREFULLY. IF AN EX- CLUSION APPLIES, COVERAGE WILL NOT BE AFFORDED UNDER THIS PART I. F Coverage under this Part I, including our duty to defend, will not apply to any insured person for: O 1. bodily injury or property damage arising out of the ownership, maintenance or use of any vehicle or trailer while being used: N a. to carry persons or property for compensation or a fee; b. for retail or wholesale delivery, including, but not limited to, the pickup, transport or delivery of magazines, newspapers, mail or food; or U c. for ride-sharing activity. This exclusion does not apply to shared-expense car pools; 2. any liability assumed under any contract or agreement by you or a relative; 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’ compensation, disability benefits, or similar laws; 4. bodily injury or property damage arising out of an accident involving any vehicle while being maintained or used by a person while employed or engaged in any auto business. This exclusion does not apply to you, a relative, a rated resident, or an agent or employee of you, a relative, or a rated resident, when using a covered auto; 5. bodily injury or property damage arising out of the use of any vehicle, and result- ing from, or sustained during practice or preparation for: a. any pre-arranged or organized racing, stunting, speed or demolition contest or activity by an insured person; or 4 b. any driving activity conducted on a permanent or temporary racetrack or race- course by an insured person; 6. bodily injury or property damage due to a nuclear reaction or radiation; 7. bodily injury or property damage for which insurance: a. is afforded under a nuclear energy liability insurance contract; or b. would be afforded under a nuclear energy liability insurance contract but for its termination upon exhaustion of its limit of liability; 8. any obligation for which the United States Government is liable under the Federal Tort Claims Act. This exclusion will apply only to the damages that are in excess of the minimum limits of liability coverage required by the financial responsibility law of the state of Florida; 9. bodily injury or property damage caused by an intentional act of any insured L person, or at the direction of any insured person, even if the actual injury or dam- age is different than that which was intended or expected. With respect to persons IA sustaining bodily injury or property damage who do not also qualify as insured persons, this exclusion will apply only to the damages that are in excess of the minimum limits of liability coverage required by the financial responsibility law of the C state of Florida; I 10. property damage to any property owned by, rented to, being transported by, used by, or in the charge of that insured person. This exclusion does not apply to a F rented residence or a rented garage; 11. bodily injury to you or a relative; F 12. bodily injury or property damage arising out of the ownership, maintenance, or use of any vehicle owned by you or furnished or available for your regular use, other than a covered auto for which this coverage has been purchased; O 13. bodily injury or property damage arising out of the ownership, maintenance or use of any vehicle owned by a relative or furnished or available for the regular use N of a relative, other than a covered auto for which this coverage has been pur- chased. This exclusion does not apply to your maintenance or use of such vehicle; U 14. bodily injury or property damage arising out of your, a relative’s, or a rated resident’s use of a vehicle, other than a covered auto, without the permission of the owner of the vehicle or the person in lawful possession of the vehicle; 15. bodily injury or property damage arising out of the use of a covered auto while leased or rented to others or given in exchange for any compensation, including while being used in connection with a personal vehicle sharing program. This exclusion does not apply to the operation of a covered auto by you, a relative, or a rated resident, and will only apply to the damages that are in excess of the minimum limits of liability coverage required by the financial responsibility law of the state of Florida; 16. punitive or exemplary damages; or 17. bodily injury or property damage caused by, or reasonably expected to result from, a criminal act or omission, excluding moving traffic violations, of any insured person. This exclusion applies regardless of whether that insured person is ac- tually charged with, or convicted of, a crime. With respect to persons sustaining bodily injury or property damage who do not also qualify as insured persons, 5 this exclusion will apply only to the damages that are in excess of the minimum limits of liability coverage required by the financial responsibility law of the state of Florida. LIMITS OF LIABILITY The limit of liability shown on the declarations page for liability coverage is the most we will pay regardless of the number of: 1. claims made; 2. covered autos; 3. insured persons; L 4. lawsuits brought; 5. vehicles involved in the accident; or 6. premiums paid. IA 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 C bodily injury to one person resulting from any one accident; I 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 F in any one accident; and 3. the amount shown for “property damage” is the most we will pay for the total of all F property damage resulting from any one accident. O The “each person” limit of liability applies to the total of all claims made for bodily injury to a person and all claims of others derived from such bodily injury, including, but not N limited to, emotional injury or mental anguish resulting from the bodily injury of another or from witnessing the bodily injury to another, loss of society, loss of companionship, loss of services, loss of consortium, and wrongful death, if recoverable under the ap- U plicable law. If the declarations page shows that “combined single limit” or “CSL” applies, the amount shown is the most we will pay for the total of all damages resulting from any one accident. However, without changing this limit of liability, we will comply with any law that requires us to provide any separate limits. No one is entitled to duplicate payments for the same elements of damages. Any payment to a person under this Part I for bodily injury will be reduced by: 1. any payment made to that person for bodily injury under Part III—Uninsured Mo- torist Coverage; and 2. any amounts that are paid or payable to that person as personal injury protection benefits. 6 If multiple auto policies issued by us are in effect for you, we will pay no more than the highest limit of liability for this coverage available under any one policy. An auto and attached trailer are considered one auto. Therefore, the limits of liability will not be increased for an accident involving an auto that has an attached trailer. FINANCIAL RESPONSIBILITY LAWS When we certify this policy as proof of financial responsibility, this policy will comply with the law to the extent required. The insured person must reimburse us if we make a payment that we would not have made if this policy was not certified as proof of financial responsibility. L OTHER INSURANCE IA If there is any other applicable liability insurance or bond, we will pay only our share of the damages. Our share is the proportion that our limit of liability bears to the total of all C applicable limits. Any insurance we provide for a vehicle or trailer, other than a covered I auto, will be excess over any other collectible insurance, self-insurance, or bond. F However, when you, a relative, or a rated resident rent or lease an auto, the liability coverage provided by the lessor’s policy shall be primary unless the rental or lease F agreement includes a provision in the form specified in Florida Statute §627.7263, as amended, stating that the lessee or rentee’s liability insurance and personal injury pro- tection insurance shall be primary. If the rental or lease agreement includes such a O provision, our duty to pay damages under this Part I, and our duty to defend you, a relative, or a rated resident under this Part I, shall be primary to any liability coverage N provided by the lessor or owner for operation of that auto by you, a relative, or a rated resident. We have no duty to defend the lessor or owner of that auto under this Part I. U 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 pos- session has: 1. a financial responsibility or similar law requiring limits of liability for bodily injury or property damage higher than the limits shown on the declarations page, this policy will provide the higher limits; or 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. 7 PART II(A)—PERSONAL INJURY PROTECTION COVERAGE INSURING AGREEMENT If you pay the premium for this coverage, we will pay benefits that an insured person is entitled to receive pursuant to the Florida Motor Vehicle No-Fault Law, as amended, because of bodily injury: 1. caused by an accident; 2. sustained by an insured person; and 3. arising out of the ownership, maintenance or use of a motor vehicle. Personal Injury Protection Coverage benefits consist of: L 1. medical benefits; 2. disability benefits; and IA 3. death benefits. ADDITIONAL DEFINITIONS IC When used in this Part II(A): 1. “Death benefits” means benefits of $5,000 payable per individual if an insured person dies because of injury covered under this Part II(A). F 2. “Disability benefits” means 60 percent of any work loss per insured person from inability to work proximately caused by the injury sustained by the insured F person. Disability benefits also include all expenses reasonably incurred in ob- taining from others ordinary and necessary services in lieu of those services that, O but for the bodily injury, the insured person would have performed without in- come for the benefit of his or her household. 3. “Emergency medical condition” means a medical condition manifesting itself by N acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in U any of the following: a. serious jeopardy to patient health; b. serious impairment to bodily functions; or c. serious dysfunction of any bodily organ or part. 4. “Insured person” means: a. you or any resident relative sustaining bodily injury while occupying a mo- tor vehicle, or when struck by a motor vehicle while not occupying a self- propelled vehicle; b. any person sustaining bodily injury while occupying a covered auto; or c. any person, if a resident of Florida, sustaining bodily injury when struck by a covered auto while not occupying a self-propelled vehicle. For purposes of this definition, “covered auto” includes an attached trailer or semi- trailer designed for use with such vehicle. 5. “Medical benefits” means 80 percent of all reasonable expenses incurred for medically necessary medical, surgical, x-ray, dental and rehabilitative services, including prosthetic devices and medically necessary ambulance, hospital and 8 nursing services. All of the following statutory references are to Florida law. Medi- cal benefits are limited to: 1) services and care received within the initial 14 days after the motor vehicle accident, or 2) follow-up services and care received beyond the initial 14 days after the motor vehicle accident if services and care have been previously received within the initial 14 days after the motor vehicle accident, and a referral for more services and care has been provided by a statutorily authorized provider, and the follow-up services and care are consistent with the underlying medical diagnosis. Medical benefits provide reimbursement for: 1) initial services and care that are lawfully provided, supervised, ordered, or prescribed by a physi- cian licensed under chapter 458 or chapter 459, a dentist licensed under chapter 466, or a chiropractic physician licensed under chapter 460 or that are provided in a hospital or in a facility that owns, or is wholly owned by, a hospital. Initial services L and care may also be provided by a person or entity licensed under part III of chap- ter 401 which provides emergency transportation and treatment, or 2) upon referral IA by a provider described in subparagraph 1), follow-up services and care consistent with the underlying medical diagnosis rendered pursuant to subparagraph 1) which may be provided, supervised, ordered, or prescribed only by a physician licensed under chapter 458 or chapter 459, a chiropractic physician licensed under chapter IC 460, a dentist licensed under chapter 466, or, to the extent permitted by applicable law and under the supervision of such physician, osteopathic physician, chiroprac- tic physician, or dentist, by a physician assistant licensed under chapter 458 or F chapter 459 or an advanced registered nurse practitioner licensed under chapter 464. Follow-up services and care may also be provided by the following persons F or entities: a) hospital or ambulatory surgical center licensed under chapter 395, b) an entity wholly owned by one or more physicians licensed under chapter 458 O or chapter 459, chiropractic physicians licensed under chapter 460, or dentists li- censed under chapter 466 or by such practitioners and the spouse, parent, child, or sibling of such practitioners, c) an entity that owns or is wholly owned, directly or N indirectly, by a hospital or hospitals, d) a physical therapist licensed under chapter 486, based upon a referral by a provider described in this subparagraph, e) a health U care clinic licensed under part X of chapter 400 which is accredited by an accredit- ing organization whose standards incorporate comparable regulations required by this state, or (i) has a medical director licensed under chapter 458, chapter 459, or chapter 460; (ii) has been continuously licensed for more than 3 years or is a publicly traded corporation that issues securities traded on an exchange registered with the United States Securities and Exchange Commission as a national securi- ties exchange; and (iii) provides at least four of the following medical specialties: (A) General medicine, (B) Radiography, (C) Orthopedic medicine, (D) Physical medi- cine, (E) Physical therapy, (F) Physical rehabilitation, (G) Prescribing or dispensing outpatient prescription medication, (H) Laboratory services. Medical benefits do not include massage, as defined in FL. St. 480.033, or acupuncture, as defined in FL. St. 457.102, regardless of the person, entity or licensee providing the massage or acupuncture, and a licensed massage therapist or licensed acupuncturist will not be reimbursed for medical benefits. 6. “Medically necessary” refers to a m