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Filing # 69983770 E-Filed 03/29/2018 11:37:11 AM
IN THE CIRCUIT COURT OF THE 9TH JUDICIAL CIRCUIT IN AND FOR
OSCEOLA COUNTY, FLORIDA
CIVIL DIVISION
CASE NO.:
ANA MROSEK LOPEZ,
Plaintiff,
VS.
PEOPLE'S TRUST INSURANCE COMPANY,
Defendant.
COMPLAINT
COMES NOW the Plaintiffs, ANA MROSEK LOPEZ, by and through their undersigned.
counsel, and sue the Defendant, PEOPLE’S TRUST INSURANCE COMPANY, and would allege
as follows:
GENERAL ALLEGATIONS
1. This is an action for damages greater than the sum of FIFTEEN THOUSAND
DOLLARS ($15,000.00), exclusive of interest, costs and attorney’s fees, and otherwise within the
jurisdictional limits of this Court.
2. At all times material hereto, Defendant, PEOPLE’S TRUST INSURANCE
COMPANY, is a Florida corporation authorized and doing business in OSCEOLA COUNTY,
FLORIDA.
3. At all times material hereto, Plaintiffs, ANA MROSEK LOPEZ, own the
property insured by Defendant located at 147 ACAPULCO DRIVE,
KISSIMMEE, FLORIDA 34743, OSCEOLA COUNTY, FLORIDA.
THE STREMS LAW FIRM, P.A.
2555 Ponce de Leon Blvd., Suite 210, Coral Gables, Florida 33134 - TEL: (786) 430-0882 - FAX: (305) 459-15894. Venue is proper in OSCEOLA County, Florida pursuant to Florida Statute
47.011, because the cause of action upon which these allegations are based accrued in O9CEOLA
County, Florida, and the property at issue is located in OSCEOLA County, Florida.
5. That Plaintiff was insured at the time of loss, on 3/30/2016, under
Defendant’s insurance policy number PFL33730500. A true and correct copy of the insurance
policy is attached hereto as Exhibit “A”. All terms of the Policy are incorporated herein.
6. Plaintiff paid all insurance premiums, performed all post loss conditions,
and performed all conditions precedent. In the alternative, all conditions precedent have been
waived.
7. On or about, 3/30/2016, Plaintiff discovered damage to Plaintiff's insured
property due to a water discharge in the kitchen, caused by a plumbing leak or break, which is a
covered loss under the insurance policy.
8. Defendant acknowledged coverage for the loss as claim number CFL16504962 and
assigned an insurance adjuster to adjust the loss.
9. Plaintiff provided Defendant with a damage estimate for a covered loss.
10. Defendant was given timely notice of the loss and investigated the claim
including inspecting the property and estimating the damage, and was not prejudiced in its
investigation.
11. Defendant acknowledged coverage of the loss, however, rejected the total
amount of damages.
12. After a diligent inspection of the loss, it was obvious that the property
sustained damage greater than the damages acknowledged by the Defendant.
13. To date, there is still a dispute as to scope of repairs and damages.
THE STREMS LAW FIRM, P.A.
2555 Ponce de Leon Blvd., Suite 210, Coral Gables, Florida 33134 - TEL: (786) 430-0882 - FAX: (305) 459-1589COUNT I- BREACH OF CONTRACT
14, Plaintiffs reaver, readopt and reallege the allegations contained in
Paragraphs | through 13 of this Complaint, and as a first cause of action, would further allege:
15. That the policy provides coverage for direct physical loss to the Plaintiff's
property due to water discharge in the kitchen mentioned herein.
16. That the Plaintiff sustained unpaid damages for a covered loss under the
Defendant’s policy of insurance.
17. That the Plaintiff demanded the Defendant honor its contractual obligation
and pay for the unpaid damages to the insured property.
18. That as a result of Defendant’s breach of contract, Plaintiff sustained
damage to the insured property.
19, That Defendant refuses to honor its contractual obligations and pay for the
covered loss.
20. That Plaintiff has further had to retain the undersigned attorney and agreed
to pay him a reasonable fee for which the Defendant is liable under § 627.428.
21. Florida Statute 627.428(1) states:
Upon the rendition of a judgment or decree by any of the courts of this state against
an insurer and in favor of any named or omnibus insured or the named beneficiary
under a policy or contract executed by the insurer, the trial court or, in the event of
an appeal in which the insured or beneficiary prevails, the appellate court shall
adjudge or decree against the insurer and in favor of the insured or beneficiary a
reasonable sum as fees or compensation for the insured’s or beneficiary’s attorney
prosecuting the suit in which the recovery is had.
WHEREFORE, Plaintiffs demand judgment against Defendant, plus costs, prejudgment
interest and attorney’s fees pursuant to Florida Statute § 627.428.
THE STREMS LAW FIRM, P.A.
2555 Ponce de Leon Blvd., Suite 210, Coral Gables, Florida 33134 - TEL: (786) 430-0882 - FAX: (305) 459-1589DEMAND FOR JURY TRIAL
Plaintiff demands a trial by jury of all issues so triable.
DESIGNATION OF E-MAIL ADDRESS PURSUANT TO RULE 2.516
Pursuant to Florida Rule of Judicial Administration 2.516, Plaintiff hereby files its notice
of designation of email address for the purpose of service of all documents required to be served
in this proceeding: pleadings@stremslaw.com
DATED this March 29, 2018.
Respectfully submitted,
STREMS LAW FIRM
Attorney for Plaintiff
941 West Morse Boulevard, Suite 100
Winter Park, FL 32789
Telephone: (786) 430-0882
Direct Line: (321) 307-2878
Facsimile: (305) 459-1589
Primary E-Service: pleadings@stremslaw.com
Secondary E-Service: team9@stremslaw.com
E-mail: hpatterson@stremslaw.com
E-mail: alicia@stremslaw.com
By:
HUNTER PATTERSON, ESQUIRE
FLORIDA BAR NO: 102788
ALICIA PEREZ, ESQUIRE
FLORIDA BAR NO: 91930
THE STREMS LAW FIRM, P.A.
2555 Ponce de Leon Blvd., Suite 210, Coral Gables, Florida 33134 - TEL: (786) 430-0882 - FAX: (305) 459-1589~poos
Earthquake, including land shock waves or tremors before, during or after a volcanic
eruption;
Landslide, mudslide or mudflow;
Mine subsidence or sinkhole; or
Any other earth movement including earth sinking, rising or shifting;
Clay shrinkage or other expansion or contraction of soils or organic materials;
Decay of buried or organic materials; or
Settling, cracking or expansion of foundations;
This Exclusion A.2. applies regardless of whether any of the above, in A.2.a. through
A.2.g. is caused by an act of nature or is otherwise caused.
However, ensuing loss by fire or explosion resulting from any of the above, in A.2.a.
through A.2.g. is covered for ensuing loss only.
This Exclusion 2.does not apply to “Catastrophic Ground Cover Collapse”.
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8.
Water
This means:
a. Flood, surface water, waves, including tidal wave and tsunami, tides, tidal water,
overflow of any body of water, or spray from any of these, all whether or not driven by
wind, including storm surge;
b. Water which:
(1) Backs up through sewers or drains; or
(2) Overflows or is otherwise discharged from a sump, sump pump or related
equipment;
c. Water below the surface of the ground, including water which exerts pressure on, or
seeps, leaks or flows through a building, sidewalk, driveway, patio, foundation,
swimming pool or other structure; or
d. Waterborne material carried or otherwise moved by any of the water referred to in
A.3.a. through A.3.c. of this exclusion.
This Exclusion A.3. applies regardless of whether any of the above, in A.3.a. through
A.3.d. is caused by an act of nature or is otherwise caused.
This Exclusion A.3. applies to, but is not limited to, escape, overflow or discharge, for any
reason, of water or waterborne material from a dam, levee, seawall or any other boundary
or containment system.
However, direct loss by fire, explosion or theft resulting from any of the above, in A.3.a.
through A.3.d. is covered,
Power Failure
Power Failure means the failure of power or other utility service if the failure takes place
off the "residence premises". But if the failure results in a loss, from a Peril Insured Against
on the "residence premises", we will pay for the loss caused by that peril.
Neglect
Neglect means neglect of an "insured" to use all reasonable means to save and preserve
property at and after the time of a loss.
War
War includes the following and any consequence of any of the following:
a. Undeclared war, civil war, insurrection, rebellion or revolution;
b. Warlike act by a military force or military personnel; or
c. Destruction, seizure or use for a military purpose.
Discharge of a nuclear weapon will be deemed a warlike act even if accidental.
Nuclear Hazard
This Exclusion A.7. pertains to Nuclear Hazard to the extent set forth in O. Nuclear Hazard
Clause under Section I — Conditions.
Intentional Loss
Intentional Loss means any loss arising out of any act an "insured" commits or conspires
to commit with the intent to cause a loss.
In the event of such loss, no "insured" is entitled to coverage, even “insureds” who did not
commit or conspire to commit the act causing the loss.
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9.
10.
11.
12.
13.
14,
Governmental Action
Governmental Action means the destruction, confiscation or seizure of property described
in Coverage A, B or C by order of any governmental or public authority.
This exclusion does not apply to such acts ordered by any governmental or public
authority that are taken at the time of a fire to prevent its spread, if the loss caused by fire
would be covered under this policy.
Loss Caused By “Sinkhole”
This exclusion does not apply to the peril of “Catastrophic Ground Cover Collapse.”
“Fungi,” Wet Or Dry Rot, Or Bacteria
a. Means the presence, growth, proliferation, spread or any activity of “fungi,” wet or
dry rot, or bacteria.
b. This Exclusion does not apply:
(1} When “fungi,” wet or dry rot, or bacteria results from fire or lightning; or
(2) To the extent, coverage is provided for in the “Fungi,” Wet or Dry Rot, or Bacteria,
Additional Coverage under SECTION | — PROPERTY COVERAGES with
respect to loss caused by a Peril Insured Against other than fire or lightning.
Direct loss by a Peril Insured Against resulting from “fungi,” wet or dry rot, or bacteria
is covered.
Existing Damage
a. Damages which occurred prior to policy inception regardless of whether such
damages were apparent at the time of the inception of this policy or discovered at
a later date; or
b. Claims for damages arising out of workmanship, repairs or lack of repairs arising
from damage which occurred prior to policy inception. However, any ensuing loss
arising out of workmanship, repairs or lack of repairs, caused by a Peril Insured
Against, to property described under Section I — Property Coverages, is covered
unless the loss is otherwise excluded in the policy.
This exclusion does not apply in the event of a total loss caused by a Peril Insured
Against.
Constant Or Repeated Seepage Or Leakage of water or steam, or the presence or
condensation of humidity, moisture or vapor; which occurs over a period of 14 or more
days, whether hidden or not.
Accidental Discharge Or Overflow Of Water Or Steam from:
a. Within a plumbing, heating, air conditioning or automatic fire protective sprinkler
system;
b. Within a household appliance for heating water; or
c. Within a household appliance.
This exclusion applies only while the dwelling is “vacant” or “unoccupied” for more than
thirty (30) consecutive days or being constructed; unless you have used reasonable
care to:
a. Shut off the water supply; and
b. Drain the system and appliances of water.
Systems and appliances of water do not include outdoor swimming spas or outdoor
irrigation wells.
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15. Assignee(s) Or Third Parties
We will not be responsible for payment under SECTION | and Il - CONDITIONS, G.
Assignment, to any assignee(s) or third parties for payments on losses that are not
covered under this policy.
16. Criminal Acts
Criminal Activity, meaning any and all criminal acts performed by any insured that
result in damage to your structure or personal property.
17. Hurricane Loss to Aluminum Framed Screened Enclosures, Aluminum Framed
Carports, and Awnings
We do not cover loss to aluminum framed Screened Enclosures, aluminum framed
carports or awnings caused by the peril of a hurricane.
We do not insure for loss to property described in Coverages A and B caused by any of the
following. However, any ensuing loss to property described in Coverages A and B not
precluded by any other provision in this policy is covered.
1. Weather conditions. However, this exclusion only applies if weather conditions contribute
in any way with a cause or event excluded in A. above to produce the loss.
2. Acts or decisions, including the failure to act or decide, of any person, group, organization
or governmental body.
3. Faulty, inadequate or defective:
a. Planning, zoning, development, surveying, siting;
b. Design, specifications, workmanship, repair, construction, renovation, remodeling,
grading, compaction;
c. Materials used in repair, construction, renovation or remodeling; or
d. Maintenance;
of part or all of any property whether on or off the "residence premises".
SECTION | - CONDITIONS
A.
Insurable Interest And Limit Of Liability
Even if more than one person has an insurable interest in the property covered, we will not
be liable in any one loss:
1. To an "insured" for more than the amount of such "insured's" interest at the time of loss;
or
2. For more than the applicable limit of liability.
Deductible
Unless otherwise noted in this policy, the following deductible provision applies:
With respect to any one loss:
1. Subject fo the applicable limit of liability, we will pay only that part of the total of all loss
payable that exceeds the deductible amount shown in the Declarations.
2. If two or more deductibles under this policy apply to the loss, only the highest deductible
amount will apply.
Duties After Loss
In case of a loss to covered property, we have no duty to provide coverage under this policy
if the failure to comply with the following duties is prejudicial to us. These duties must be
performed either by you, an "insured" seeking coverage, or a representative of either:
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4,
Give prompt notice to us or our agent;
Notify the police in case of loss by theft, vandalism or malicious mischief;
Notify the credit card or electronic fund transfer card or access device company in case
of loss as provided for in 6. Credit Card, Electronic Fund Transfer Card Or Access Device,
Forgery And Counterfeit Money under Section | — Additional Coverages;
Notice of Hurricane or Windstorm Claims - If Windstorm coverage is provided in this
policy a claim, “supplemental claim” or “reopened claim’ for loss or damage caused by
hurricane or other windstorm must be given to us in accordance with the terms of this
policy and within three years after the hurricane first made landfall or a windstorm caused
the damage.
This condition concerning time for submission of claim does not affect any limitation for
legal action against us as provided in this policy under the Suit Against Us Condition
including any amendment to that condition
Protect the property from further damage. If repairs to the property are required, you must:
a. Make reasonable and necessary repairs to protect the property; and
b, Keep an accurate record of repair expenses.
Cooperate with us in the investigation of a claim;
Prepare an inventory of damaged personal property showing the quantity, description,
actual cash value and amount of loss. Attach all bills, receipts and related documents that
justify the figures in the inventory;
As often as we reasonably require:
a. Show the damaged property;
b. Provide us with records and documents we request and permit us to make copies;
and
¢. Submit to examination under oath, while not in the presence of another "insured", and
sign the same;
Send to us, within sixty (60) days after our request, your signed, sworn proof of loss which
sets forth, to the best of your knowledge and belief:
a. The time and cause of loss;
b. The interests of all "insureds" and all others in the property involved and all liens on
the property;
c. Other insurance which may cover the loss;
d. Changes in title or occupancy of the property during the term of the policy;
e. Specifications of damaged buildings and detailed repair estimates;
f. The inventory of damaged personal property described in C.7. above;
g. Receipts for additional living expenses incurred and records that support the fair rental
value loss; and
h. Evidence or affidavit that supports a claim under 6. Credit Card, Electronic Fund
Transfer Card Or Access Device, Forgery And Counterfeit Money under Section | —
Additional Coverages, stating the amount and cause of loss.
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D. Loss Settlement
Covered property losses are settled as follows:
1. Property of the following types:
a. Personal property;
b. Awnings, carpeting, household appliances, outdoor antennas and outdoor
equipment, whether or not attached to buildings; and
c. Structures that are not buildings;
at actual cash value at the time of loss but not more than the amount required to repair or
replace.
2. Buildings under Coverage A or B at replacement cost without deduction for
depreciation, subject to the following:
a. If, at the time of loss, the amount of insurance in this policy on the damaged
building is eighty percent (80%) or more of the full replacement cost of the building
immediately before the loss, we will pay the cost to repair or replace, after
application of deductible and without deduction for depreciation, but not more than
the least of the following amounts:
(1) The limit of liability under this policy that applies to the building;
(2) The replacement cost of that part of the building damaged for like construction
and use on the same premises; or
(3} The necessary amount actually spent to repair or replace the damaged building.
b. If, at the time of loss, the amount of insurance in this policy on the damaged building
is less than eighty percent (80%) of the full replacement cost of the building
immediately before the loss, we will pay the greater of the following amounts, but
not more than the limit of liability under this policy that applies to the building:
(1) The actual cash value of that part of the building damaged; or
(2) That proportion of the cost to repair or replace, after application of deductible
and without deduction for depreciation, that part of the building damaged, which
the total amount of insurance in this policy on the damaged building bears to
eighty percent (80%) of the replacement costs of the building.
c. To determine the amount of insurance required to equal eighty percent (80%) of
the full replacement cost of the building immediately before the loss, do not include
the value of:
(1) Excavations, foundations, piers or any supports which are below the
undersurface of the lowest basement floor;
(2) Those supports in (a) above which are below the surface of the ground inside
the foundation walls, if there is no basement; and
(3) Underground flues, pipes, wiring and drains.
d. We will initially pay at least the actual cash value of the incurred loss less any
applicable deductible. We will then pay the necessary amounts actually spent to
repair or replace the damaged building as work is performed and expenses are
incurred. If a total loss of the covered dwelling occurs, we shall pay the replacement
cost coverage without reservation of any depreciation in value, subject to policy
limits.
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Homeowners HO3 — Special Form
e. If the dwelling where loss or damage occurs has been vacant for more than thirty
(30) consecutive days before the loss or damage, we will:
Not pay for any loss or damage caused by any of the following perils, even if they
are Perils Insured Against:
(1) Vandalism;
(2) Sprinkler leakage, when caused by or arising out of the freezing of a fire
protective sprinkler system, unless you have protected the system against
freezing;
{3) Dwelling glass breakage;
{4) Water damage;
(5) Theft; or
(6) Attempted theft.
Dwellings under construction are not considered vacant. In the event the construction
extends greater than sixty (60) days you must notify us.
E. Loss To A Pair Or Set
In case of loss to a pair or set we may elect to:
1. Repair or replace any part to restore the pair or set to its value before the loss; or
2. Pay the difference between actual cash value of the property before and after the loss.
Glass Replacement
Loss for damage to glass caused by a Peril Insured Against will be settled on the basis of
replacement with safety glazing materials when required by ordinance or law.
Mediation
If you and we are engaged in a dispute regarding a claim under this policy, either may
demand a mediation of the loss in accordance with the rules established by the Florida
Department of Financial Services. The results of the mediation are binding only when both
parties agree, in writing, on a settlement and, you have not rescinded the settlement within
three (3) business days after reaching settlement. You may not rescind the settlement after
cashing or depositing the settlement check or draft we provided you.
We will pay the cost of conducting any mediation conference except when you fail to appear
at a conference. That conference will then be rescheduled upon your payment of the costs
of that rescheduled conference. However, if “we” fail to appear at a mediation conference
without good cause, “we” will pay the actual cash expenses you incur in attending the
conference and also pay the total cost for the rescheduled conference.
Other Insurance And Service Agreement
Ifa loss covered by this policy is also covered by:
1. Other insurance, we will pay only the proportion of the loss that the limit of liability that
applies under this policy bears to the total amount of insurance covering the loss; or
2. Aservice agreement, this insurance is excess over any amounts payable under any such
agreement.
Service agreement means a service plan, property restoration plan, home warranty, or other
similar service warranty agreement, even if it is characterized as insurance.
Suit Against Us
No action can be brought unless the policy provisions have been complied with and the action
is started within five (5) years after the date of loss.
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J. Our Option
At our option:
1. For losses settled on an actual cash value basis, we may repair or replace any part of
the damaged property with material or property of like kind and quality.
2. For losses covered under Coverage A — Dwelling, insured for Replacement Cost
Loss Settlement as outlined in SECTION f - CONDITIONS, Loss Settlement, we may
repair the damaged property with material of like kind and quality without deduction for
depreciation.
3. We will provide written notice to you no later than thirty (30) days after our inspection
of the reported loss.
4. You must comply with the duties described in SECTION 1 — CONDITIONS, C. 7 and 8.
5. You must provide access to the property and execute any necessary municipal, county
or other governmental documentation or permits for repairs to be undertaken.
6. You must execute all work authorizations to allow contractors and related parties entry
to the property.
7. You must otherwise cooperate with repairs to the property.
8. You are responsible for payment of the deductible stated in your declaration page.
9. Our right to repair or replace, and our decision to do so, is a material part of this contract
and under no circumstances relieves you or us of our mutual duties and obligations
under this contract.
K. Loss Payment
We will adjust all losses with you. We will pay you unless some other person is named in
the policy or is legally entitled to receive payment. Loss will be payable on the earliest of the
following:
1. Twenty (20) days after we receive your proof of loss and we reach written agreement
with you;
2. Sixty (60) days after we receive your proof of loss and:
a. There is an entry of a final judgment; or
b. There is a filing of an appraisal award or a mediation settlement with “us”; or
3. If payment is not denied, within ninety (90) days after we receive notice of an_ initial
claim, “reopened claim,” or “supplemental claim’. However, this provision (K 3.) does
not apply if factors beyond our control reasonably prevents such payment.
Our failure to comply with this paragraph shall not form the sole basis for an action against us
for breach of contract under this policy or for benefits under this policy.
L. Abandonment Of Property
We need not accept any property abandoned by an "insured."
M. Mortgage Clause
The word "mortgagee" includes trustee. Any loss payable under Coverage A or B will be paid
to the mortgagee and you, as interest appears. If there is more than one mortgagee, the
order of payment will be the same as the order of precedence of the mortgages.
If we deny your claim, that denial shall not apply to a valid claim of the mortgagee, if the
mortgagee:
1. Notifies us of any change in ownership, occupancy, or substantial change in risk of which
the mortgagee is aware;
2. Pays any premium due under this policy on demand if you have neglected to pay the
premium; and
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3. Sends to us, within sixty (60) days after our request, a signed, sworn statement of loss
which sets forth, to the best of the mortgagee's knowledge and belief:
a. The time and cause of loss;
b. The interest of the mortgagee and all others in the property involved and all liens on
the property;
c. Other insurance which may cover the loss;
d. Changes in title or occupancy of the property during the term of the policy; and
e, Specifications of damaged buildings and detailed repair estimates.
Policy conditions relating to Suit Against Us and Loss Payment apply to the mortgagee.
If we decide to cancel or not to renew this policy, the mortgagee will be properly notified
at least (ten) 10 days before the date cancellation or nonrenewal takes effect.
If we pay the mortgagee for any loss and deny payment to you:
a. We are subrogated to all the rights of the mortgagee granted under the mortgage on
the property; and
b. At our option, we may pay to the mortgagee the whole principal on the mortgage plus
any accrued interest. In this event, we will receive a full assignment and transfer of
the mortgage and all securities held as collateral to the mortgage debt.
Subrogation will not impair the right of the mortgagee to recover the full amount of the
mortgagee's claim.
N. No Benefit To Bailee
We will not recognize any assignment or grant any coverage that benefits a person or
organization holding, storing or moving property for a fee regardless of any other provision
of this policy.
O. Nuclear Hazard Clause
41. "Nuclear Hazard" means any nuclear reaction, radiation, or radioactive contamination,
all whether controlled or uncontrolled or however caused, or any consequence of any of
these.
2. Loss caused by the nuclear hazard will not be considered loss caused by fire, explosion,
or smoke, whether these perils are specifically named in or otherwise included within
the Perits Insured Against in Section | — Property Coverages.
3. This policy does not apply under Section | — Property Coverages to loss caused directly
or indirectly by nuclear hazard, except that direct loss by fire resulting from the nuclear
hazard is covered.
P. Salvage And Recovered Property
If you or we recover any property for which we have made payment under this policy, you or
we will notify the other of the recovery. At your option, the property will be returned to or
retained by you, or it will become our property. If the recovered property is returned to or
retained by you, the loss payment will be adjusted based on the amount you received for the
covered property.
Q. Volcanic Eruption Period
One or more volcanic eruptions that occur within a 72-hour period will be considered as one
volcanic eruption.
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R. Adjustment To Property Coverage Limits
If your policy is a renewal with us, the limit of liability for Coverage A, Coverage B, Coverage
C, and Coverage D may be adjusted.
Any change in the limits of liability indicated above does not, in any way, represent, warrant,
or guarantee to any person or entity, that:
1. These adjustments will keep pace with inflation; or
2. That the amounts of coverage are adequate to repair or rebuild any specific building or
structure.
SECTION Il - LIABILITY COVERAGES
A. Coverage E - Personal Liability
If a claim is made or a suit is brought against an “insured" for damages because of “bodily
injury" or “property damage" caused by an “occurrence” to which this coverage applies, we
will:
1. Pay up to our limit of liability for the damages for which an “insured” is legally liable.
Damages include prejudgment interest awarded against an "insured": and
2. Provide a defense at our expense by counsel of our choice, even if the suit is groundless,
false or fraudulent. We may investigate and settle any claim or suit that we decide is
appropriate. Our duty to settle or defend ends when our limit of liability for the "occurrence"
has been exhausted by payment of a judgment or settlement.
B. Coverage F - Medical Payments To Others
We will pay the necessary medical expenses that are incurred or medically ascertained within
three years from the date of an accident causing "bodily injury". Medical expenses means
reasonable charges for medical, surgical, x-ray, dental, ambulance, hospital, professional
nursing, prosthetic devices and funeral services. This coverage does not apply to you or
regular residents of your household except “residence employees". As to others, this
coverage applies only:
1. Toa person on the "insured location" with the permission of an "insured"; or
2. Toa person off the “insured location", if the “bodily injury":
a. Arises out of a condition on the “insured location" or the ways immediately adjoining;
b. Is caused by the activities of an "insured";
c. Is caused by a "residence employee" in the course of the "residence employee's”
employment by an "insured".
SECTION Il - EXCLUSIONS
A. Coverage E - Personal Liability And Coverage F — Medical Payments to Others
Do not apply to "bodily injury" or "property damage":
1. Which is expected or intended by the insured,” even if the resulting “bodily injury” or
“property damage” is of a different kind, quality, or degree than initially expected or
intended, or is sustained by a different person, entity, real or personal property, than
initially expected or intended. However this exclusion does not apply to “bodily injury” or
“property damage” resulting from the use of reasonable force by the “insured’ to protect
persons or property
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2. “Bodily injury” or “property damage” arising out of or in connection with a "business"
conducted from the insured location or engaged in by an "insured," whether or not the
“pusiness” is owned or operated by an “insured” or employs an “insured”.
This Exclusion A. 2. applies but is not limited to an act or omission, regardless of its nature
or circumstance, involving a service or duty rendered, promised, owed, or implied to be
provided because of the nature of the “business”.
3. Arising out of the rental or holding for rental of any part of any premises by an "insured."
This exclusion does not apply to the rental or holding for rental of an “insured location”:
a. On an occasional basis if used only as a residence;
b. In part for use only as a residence, unless a single family unit is intended for use by
the occupying family to lodge more than two roomers or boarders; or
c. In part, as an office, school, studio or private garage;
4. Arising out of the rendering of or failure to render professional services;
5. Arising out of a premises;
a. Owned by an “insured”;
b. Rented to an “insured”; or
c. Rented to others by an “insured”;
that is not an “insured location”;
6. Arising out of:
a. The ownership, maintenance, use, loading or unloading of “motor vehicles” or
all other motorized land conveyances, including trailers, owned or operated by or
rented or loaned to an “insured”;
b. The entrustment by an “insured” of a “motor vehicle” or any other motorized land
conveyance, to any person; or
c. Vicarious liability, whether or not statutorily imposed, for the actions of a child or
minor using a conveyance, excluded in paragraph a. or b, above
This exclusion does not apply to:
a. A trailer not towed by or carried on a motorized land conveyance;
b. A motorized land conveyance designed for recreational use off public roads, not
subject to motor vehicle registration and:
(1) Not owned by an “insured”; or
(2) Owned by an “insured” and on an “insured location”;
c. A motorized golf cart when used to play golf on a golf course;
d. A vehicle or conveyance not subject to motor vehicle registration which is:
(1) Used solely to service an “insured's” residence;
(2) Designed for assisting the handicapped; or
(3) In dead storage on an “insured location”;
7. Arising out of:
a. The ownership, maintenance, use, loading or unloading of an excluded “watercraft” or
“personal watercraft” described below;
b. The entrustment by an “insured” of an excluded “watercraft” or “personal watercraft”
described below to any person; or
c. Vicarious liability, whether or not statutorily imposed, for the actions of a child or minor
using an excluded “watercraft” or “personal watercraft’ described below.
Excluded “watercraft” or “personal watercraft” are those that are principally designed to
be propelled by engine power or eleciric motor, or are sailing vessels, whether owned by
or rented to an “insured.”
This exclusion does not apply to “watercraft” or “personal watercraft":
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a. That are not sailing vessels and are powered by:
(1) Inboard or inboard-outdrive engine or motor power of fifty (50) horsepower or
less not owned by an ‘insured’,
{2) Inboard or inboard-outboard engine or motor power of more than fifty (50)
horsepower not owned by or rented to an “insured”;
(3) One or more outboard engines or motors with twenty-five (25) total horsepower
or less; or
(4) One or more outboard engines or motors with more than twenty-five (25) total
horsepower if the outboard engine or motors is not owned by an “insured”;
b, That are sailing vessels, with or without auxiliary power:
(1) Less than twenty-six (26) feet in overall length;
(2) Twenty-six (26) feet or more in overall length, not owned by or rented to an
“insured”;
c. That are stored.
8. Arising out of:
a. The ownership, maintenance, use, loading or unloading of an “aircraft”;
b. The entrustment by an “insured” of an “aircraft” to any person; or
c. Vicarious liability, whether or not statutorily imposed, for the actions of a child, or
minor using an “aircraft.”
9. Caused directly or indirectly by war, including the following and any consequence of any
of the following:
a. Undeclared war, civil war, insurrection, rebellion, or revolution;
b. Warlike act by a military force or military personnel; or
c. Destruction, seizure or use for a military purpose.
Discharge of a nuclear weapon will be deemed a warlike act even if accidental;
10. Which arises out of the transmission of a communicable disease by an “insured”;
11. Arising out of sexual molestation, corporal punishment or physical or mental abuse;
12. Arising out of the use, sale, manufacture, delivery, transfer or possession by any
person of a Controlled Substance(s) as defined by the Federal Food and Drug Law at
21 U.S.C.A. Sections 811 and 812. Controlled Substances include but are not limited to
cocaine, LSD, marijuana and all narcotic drugs. However, this exclusion does not apply
to the legitimate use of prescription drugs by a person following the orders of a
licensed healthcare provider;
143. Arising out of the actions, conduct, or behavior of any animal owned or kept by an
“insured,” whether or not the “bodily injury” or “property damage” occurs on an “insured
location” or any other location;
14. Arising out of or resulting from the use of diving boards on an “insured location’;
15. Arising out of or resulting from the use of a pool slide on an “insured location’;
16. Arising out of or resulting from an unprotected swimming pool or spa.
An unprotected swimming pool or spa is defined as un-walled, unfenced or uncovered.
17. Arising out of or resulting from the use of an empty swimming pool;
18. Arising out of or resulting from the use of a skateboard or bicycle ramp;
19. Arising out of or resulting from criminal activity, meaning any and all criminal acts
performed by any “insured” regardless of whether the consequences of those acts were
intended or anticipated;
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20. Arising out of or resulting from:
a. The ingestion of paint that has lead in it;
b. The ingestion of paint that has lead compounds in it;
c. The inhalation of paint that has lead in it;
d. The inhalation of paint that has lead compounds in it;
e. Radon, or any other substance that emits radiation;
f. In any manner (including liability imposed by law) from the discharge, disposal,
release, or escape of:
(1) Vapors or fumes;
(2) Gas or oil;
(3) Toxic chemicals, liquid, or gas;
(4) Waste materials; and
(5) Irritants, contaminants or pollutants.
21. Arising out of:
a. The ownership, maintenance, use, loading or unloading of a “hovercraft”;
b. The entrustment by an "insured" of a “hovercraft” to any person; or
c. Vicarious liability, whether or not statutorily imposed, for the actions of a child, or minor
using a “hovercraft.”
22. Arising out of:
a. The ownership, maintenance, use, loading or unloading of a “drone”;
b. The entrustment by an "insured" of a “drone” to any person; or
c. Vicarious liability, whether or not statutorily imposed, for the actions of a child, or
minor using a “drone.”
23. “Bodily injury” or “property damage” arising out of assault or batiery, when committed by
or at the direction of an “insured.”
Exclusions 5, 6, 7, 8, 21 and 22 do not apply to “bodily injury” to a “residence employee” or
“property damage” of the “residence employee's” property, arising out of and in the course of
the "residence employee’s” employment by an “insured”.
B. Coverage E — Personal Liability, does not apply to:
1. Liability:
a. For any loss assessment charged against you as a member of an association,
corporation or community of property owners;
b. Under any contract or agreement. However, this exclusion does not apply to written
contracts:
(1) That directly relate to the ownership, maintenance, or use of an “insured
location"; or
(2) Where the liability of others is assumed by the "insured" prior to an "occurrence";
unless excluded in a. above or elsewhere in this policy.
2. “Property damage" to property owned by the "insured";
3. "Property damage” to property rented to, occupied, or used by or in the care of the
“insured.” This exclusion does not apply to "property damage" caused by fire, smoke, or
explosion;
4, “Bodily injury" to any person eligible to receive any benefits voluntarily provided or
required to be provided by an “insured” under any:
a. Workers' compensation law;
b. Non-occupational disability law; or
c. Occupational disease law;
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5.
6.
“Bodily injury” or “property damage” for which an “insured” under this policy:
a. Is also an “insured” under a nuclear energy liability policy issued by the:
(1) Nuclear Energy Liability Insurance Association;
(2) Mutual Atomic Energy Liability Underwriters;
(3) Nuclear Insurance Association of Canada;
or any of their successors; or
b. Would be an “insured” under such a policy but for the exhaustion of its limit of
liability; or
“Bodily injury” to you or an “insured” as defined under Definition 7. a. or b.
C. Coverage F — Medical Payments To Others, does not apply to “bodily injury”:
1.
4.
To a “residence employee" if the "bodily injury’:
a. Occurs off the "insured location"; and
b. Does not arise out of or in the course of the "residence employee's" employment by
in "insured".
To any person eligible to receive benefits voluntarily provided or required to be provided
under any:
a. Workers’ compensation law;
b. Non-occupational disability law; or
c. Occupational disease law;
From any:
a. Nuclear reaction;
b. Nuclear radiation; or
c. Radioactive contamination;
all whether controlled or uncontrolled or however caused; or
d. Any consequence of any of these.
To any person, other than a "residence employee" of an “insured,” regularly residing
on any part of the “insured location”.
D. “Personal Injury”, this insurance does not apply to “Persona! Injury” arising out of or caused
by one or more of the following offenses:
1.
2.
3.
Caused by or at the direction of an “insured” with the knowledge that the act would violate
the rights of another and would inflict “personal injury’;
Arising out of oral or written publication of material, if done by or at the direction of an
“insured” with knowledge of its falsity;
Arising out of oral or written publication of material whose first publication took place before
the beginning of the policy period;
Arising out of a criminal act committed by or at the direction of an “insured”;
Arising out of liability assumed by an “insured” under any contract or agreement except any
indemnity obligation assumed by an “insured” under a written contract directly relating to
the ownership, maintenance, or use of the premises;
Sustained by any person as a result of an offense directly or indirectly related to the
employment of this person by an “insured”;
Arising out of or in connection with a “business” conducted from an “insured location”
or engaged in by an “insured,” whether or not the “business” is owned or operated by an
“insured” or employs an “insured”. This exclusion applies but is not limited to an act or
omission, regardless of its nature or circumstance, involving a service or duty rendered,
promised, owned or implied to be provided because of the nature of the “business”;
Arising out of false arrest, detention, or imprisonment;
Arising out of malicious prosecution;
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10.
11.
12.
13.
Arising out of the wrongful eviction from, wrongful entry into, or invasion of the right of
private occupancy of a room, dwelling or premises that a person occupies, committed by
or on behalf of its owner, landlord, or lessor;
Arising out of oral or written publication of material that slanders or libels a person or
organization or disparages a person’s or organization's goods, products or services;
{invasion of privacy, trespassing, harassment, stalking, or spying resulting from the
ownership or use of a “drone” by an “insured”;
Electronic aggression including but not limited to harassment or bullying committed by
means of any electronic forum, including but not limited to a blog, an electronic bulletin
board, an electronic chat room, a gripe site, a social networking site, a web site, a web
blog, email, instant messaging, or text messaging; or
14, Arising out of oral or written publication of material that violates a person’s right of privacy.
SECTION Il —- ADDITIONAL COVERAGES
We cover the following in addition to the limits of liability:
A. Claim Expenses We pay:
1.
2.
3.
Expenses we incur and costs taxed against an "insured" in any suit we defend;
Premiums on bonds required in a suit we defend, but not for bond amounts more than
the limit of liability for Coverage E. We need not apply for or furnish any bond;
Reasonable expenses incurred by an “insured” at our request, including actual loss of
earnings (but not loss of other income) up to $250 per day, for assisting us in the
investigation or defense of a claim or suit; and
Interest on the entire judgment, which accrues after entry of the judgment and before
we pay or tender, or deposit in court that part of the judgment, which does not exceed
the limit of liability that applies.
First Aid Expenses
We will pay expenses for first aid to others incurred by an "insured" for "bodily injury"
covered under this policy. We will not pay for first aid to you or any other “insured.”
Cc. Damage To Property Of Others
We will pay, at replacement cost, up to $500 per “occurrence” for "property damage" to
property of others caused by an “insured.”
We will not pay for "property damage":
1.
PYN
s
To the extent of any amount recoverable under Section | —- Property Coverages of this
policy;
Caused intentionally by an "insured" who is thirteen (13) years of age or older;
To property owned by an "insured";
To property owned by or rented to a tenant of an "insured" or a resident in your household;
or
Arising out of:
a. A "business" engaged in by an "insured";
b. Any act or omission in connection with a premises owned, rented or controlled by
an "insured," other than the "insured location"; or
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¢. The ownership, maintenance, or use of “aircraft,” “drone,” “watercraft,” “personal
watercraft” or “motor vehicle” or all other motorized land conveyances.
This Exclusion 5.¢. does not apply to “motor vehicles” that:
(1) Is designed for recreational use off public roads;
(2) Is not owned by an “insured”; and
(3) At the time of the “occurrence”, is not required by law, or regulations issued by a
government agency, to have been registered for it to be used on public roads or
property.
D. Loss Assessment
We will pay up to $1,000 for your share of loss assessment charged during the policy period
against you by a corporation or association of property owners, when the assessment is
made as a result of:
1. "Bodily injury" or “property damage" not excluded under Section II — Liability Coverages
of this policy; or
2. Liability for an act of a director, officer or trustee in the capacity as a director, officer or
trustee, provided:
a. The director, officer, or trustee is elected by the members of a corporation or
association of property owners; and
b. The director, officer, or trustee serves without deriving any income from the
exercise of duties which are solely on behalf of a corporation or association of
property owners.
This coverage applies only to loss assessments charged against you as owner or tenant
of the "residence premises."
We do not cover loss assessments charged against you or a corporation or association of
property owners by any governmental body.
This coverage is excess over any insurance collectible under any policy or policies covering
the corporation or association of property owners.
Regardless of the number of assessments, the limit of $1,000 is the most we will pay for loss
arising out of:
1. One accident, including continuous or repeated exposure to substantially the same
general harmful condition; or
2. A covered act of a director, officer, or trustee. An act involving more than one director,
officer, or trustee is considered to be a single act.
The following do not apply to this coverage:
1. Section Il — Coverage E — Personal Liability Exclusion B. 1. a.; and
2, Condition A. Policy Period, under Sections | and II — Conditions.
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SECTION II - CONDITIONS
A. Limit Of Liability
Our total liability under Coverage E for all damages resulting from any one "occurrence"
will not be more than the limit of liability for Coverage E as shown in the Declarations. This
limit is the same regardless of the
Preview
Filing # 69983770 E-Filed 03/29/2018 11:37:11 AM IN THE CIRCUIT COURT OF THE 9TH JUDICIAL CIRCUIT IN AND FOR OSCEOLA COUNTY, FLORIDA CIVIL DIVISION CASE NO.: ANA MROSEK LOPEZ, Plaintiff, VS. PEOPLE'S TRUST INSURANCE COMPANY, Defendant. COMPLAINT COMES NOW the Plaintiffs, ANA MROSEK LOPEZ, by and through their undersigned. counsel, and sue the Defendant, PEOPLE’S TRUST INSURANCE COMPANY, and would allege as follows: GENERAL ALLEGATIONS 1. This is an action for damages greater than the sum of FIFTEEN THOUSAND DOLLARS ($15,000.00), exclusive of interest, costs and attorney’s fees, and otherwise within the jurisdictional limits of this Court. 2. At all times material hereto, Defendant, PEOPLE’S TRUST INSURANCE COMPANY, is a Florida corporation authorized and doing business in OSCEOLA COUNTY, FLORIDA. 3. At all times material hereto, Plaintiffs, ANA MROSEK LOPEZ, own the property insured by Defendant located at 147 ACAPULCO DRIVE, KISSIMMEE, FLORIDA 34743, OSCEOLA COUNTY, FLORIDA. THE STREMS LAW FIRM, P.A. 2555 Ponce de Leon Blvd., Suite 210, Coral Gables, Florida 33134 - TEL: (786) 430-0882 - FAX: (305) 459-15894. Venue is proper in OSCEOLA County, Florida pursuant to Florida Statute 47.011, because the cause of action upon which these allegations are based accrued in O9CEOLA County, Florida, and the property at issue is located in OSCEOLA County, Florida. 5. That Plaintiff was insured at the time of loss, on 3/30/2016, under Defendant’s insurance policy number PFL33730500. A true and correct copy of the insurance policy is attached hereto as Exhibit “A”. All terms of the Policy are incorporated herein. 6. Plaintiff paid all insurance premiums, performed all post loss conditions, and performed all conditions precedent. In the alternative, all conditions precedent have been waived. 7. On or about, 3/30/2016, Plaintiff discovered damage to Plaintiff's insured property due to a water discharge in the kitchen, caused by a plumbing leak or break, which is a covered loss under the insurance policy. 8. Defendant acknowledged coverage for the loss as claim number CFL16504962 and assigned an insurance adjuster to adjust the loss. 9. Plaintiff provided Defendant with a damage estimate for a covered loss. 10. Defendant was given timely notice of the loss and investigated the claim including inspecting the property and estimating the damage, and was not prejudiced in its investigation. 11. Defendant acknowledged coverage of the loss, however, rejected the total amount of damages. 12. After a diligent inspection of the loss, it was obvious that the property sustained damage greater than the damages acknowledged by the Defendant. 13. To date, there is still a dispute as to scope of repairs and damages. THE STREMS LAW FIRM, P.A. 2555 Ponce de Leon Blvd., Suite 210, Coral Gables, Florida 33134 - TEL: (786) 430-0882 - FAX: (305) 459-1589COUNT I- BREACH OF CONTRACT 14, Plaintiffs reaver, readopt and reallege the allegations contained in Paragraphs | through 13 of this Complaint, and as a first cause of action, would further allege: 15. That the policy provides coverage for direct physical loss to the Plaintiff's property due to water discharge in the kitchen mentioned herein. 16. That the Plaintiff sustained unpaid damages for a covered loss under the Defendant’s policy of insurance. 17. That the Plaintiff demanded the Defendant honor its contractual obligation and pay for the unpaid damages to the insured property. 18. That as a result of Defendant’s breach of contract, Plaintiff sustained damage to the insured property. 19, That Defendant refuses to honor its contractual obligations and pay for the covered loss. 20. That Plaintiff has further had to retain the undersigned attorney and agreed to pay him a reasonable fee for which the Defendant is liable under § 627.428. 21. Florida Statute 627.428(1) states: Upon the rendition of a judgment or decree by any of the courts of this state against an insurer and in favor of any named or omnibus insured or the named beneficiary under a policy or contract executed by the insurer, the trial court or, in the event of an appeal in which the insured or beneficiary prevails, the appellate court shall adjudge or decree against the insurer and in favor of the insured or beneficiary a reasonable sum as fees or compensation for the insured’s or beneficiary’s attorney prosecuting the suit in which the recovery is had. WHEREFORE, Plaintiffs demand judgment against Defendant, plus costs, prejudgment interest and attorney’s fees pursuant to Florida Statute § 627.428. THE STREMS LAW FIRM, P.A. 2555 Ponce de Leon Blvd., Suite 210, Coral Gables, Florida 33134 - TEL: (786) 430-0882 - FAX: (305) 459-1589DEMAND FOR JURY TRIAL Plaintiff demands a trial by jury of all issues so triable. DESIGNATION OF E-MAIL ADDRESS PURSUANT TO RULE 2.516 Pursuant to Florida Rule of Judicial Administration 2.516, Plaintiff hereby files its notice of designation of email address for the purpose of service of all documents required to be served in this proceeding: pleadings@stremslaw.com DATED this March 29, 2018. Respectfully submitted, STREMS LAW FIRM Attorney for Plaintiff 941 West Morse Boulevard, Suite 100 Winter Park, FL 32789 Telephone: (786) 430-0882 Direct Line: (321) 307-2878 Facsimile: (305) 459-1589 Primary E-Service: pleadings@stremslaw.com Secondary E-Service: team9@stremslaw.com E-mail: hpatterson@stremslaw.com E-mail: alicia@stremslaw.com By: HUNTER PATTERSON, ESQUIRE FLORIDA BAR NO: 102788 ALICIA PEREZ, ESQUIRE FLORIDA BAR NO: 91930 THE STREMS LAW FIRM, P.A. 2555 Ponce de Leon Blvd., Suite 210, Coral Gables, Florida 33134 - TEL: (786) 430-0882 - FAX: (305) 459-1589~poos Earthquake, including land shock waves or tremors before, during or after a volcanic eruption; Landslide, mudslide or mudflow; Mine subsidence or sinkhole; or Any other earth movement including earth sinking, rising or shifting; Clay shrinkage or other expansion or contraction of soils or organic materials; Decay of buried or organic materials; or Settling, cracking or expansion of foundations; This Exclusion A.2. applies regardless of whether any of the above, in A.2.a. through A.2.g. is caused by an act of nature or is otherwise caused. However, ensuing loss by fire or explosion resulting from any of the above, in A.2.a. through A.2.g. is covered for ensuing loss only. This Exclusion 2.does not apply to “Catastrophic Ground Cover Collapse”. Page 17 of 38 PTIC PO03 1115 Includes copyrighted material of Insurance Services Office, Inc. with its permission.People’s Trust Insurance Company Homeowners HO3 - Special Form 8. Water This means: a. Flood, surface water, waves, including tidal wave and tsunami, tides, tidal water, overflow of any body of water, or spray from any of these, all whether or not driven by wind, including storm surge; b. Water which: (1) Backs up through sewers or drains; or (2) Overflows or is otherwise discharged from a sump, sump pump or related equipment; c. Water below the surface of the ground, including water which exerts pressure on, or seeps, leaks or flows through a building, sidewalk, driveway, patio, foundation, swimming pool or other structure; or d. Waterborne material carried or otherwise moved by any of the water referred to in A.3.a. through A.3.c. of this exclusion. This Exclusion A.3. applies regardless of whether any of the above, in A.3.a. through A.3.d. is caused by an act of nature or is otherwise caused. This Exclusion A.3. applies to, but is not limited to, escape, overflow or discharge, for any reason, of water or waterborne material from a dam, levee, seawall or any other boundary or containment system. However, direct loss by fire, explosion or theft resulting from any of the above, in A.3.a. through A.3.d. is covered, Power Failure Power Failure means the failure of power or other utility service if the failure takes place off the "residence premises". But if the failure results in a loss, from a Peril Insured Against on the "residence premises", we will pay for the loss caused by that peril. Neglect Neglect means neglect of an "insured" to use all reasonable means to save and preserve property at and after the time of a loss. War War includes the following and any consequence of any of the following: a. Undeclared war, civil war, insurrection, rebellion or revolution; b. Warlike act by a military force or military personnel; or c. Destruction, seizure or use for a military purpose. Discharge of a nuclear weapon will be deemed a warlike act even if accidental. Nuclear Hazard This Exclusion A.7. pertains to Nuclear Hazard to the extent set forth in O. Nuclear Hazard Clause under Section I — Conditions. Intentional Loss Intentional Loss means any loss arising out of any act an "insured" commits or conspires to commit with the intent to cause a loss. In the event of such loss, no "insured" is entitled to coverage, even “insureds” who did not commit or conspire to commit the act causing the loss. Page 18 of 38 PTIC PO03 1115 Includes copyrighted material of Insurance Services Office, Inc. with its permission.People’s Trust Insurance Company Homeowners HO3 - Special Form 9. 10. 11. 12. 13. 14, Governmental Action Governmental Action means the destruction, confiscation or seizure of property described in Coverage A, B or C by order of any governmental or public authority. This exclusion does not apply to such acts ordered by any governmental or public authority that are taken at the time of a fire to prevent its spread, if the loss caused by fire would be covered under this policy. Loss Caused By “Sinkhole” This exclusion does not apply to the peril of “Catastrophic Ground Cover Collapse.” “Fungi,” Wet Or Dry Rot, Or Bacteria a. Means the presence, growth, proliferation, spread or any activity of “fungi,” wet or dry rot, or bacteria. b. This Exclusion does not apply: (1} When “fungi,” wet or dry rot, or bacteria results from fire or lightning; or (2) To the extent, coverage is provided for in the “Fungi,” Wet or Dry Rot, or Bacteria, Additional Coverage under SECTION | — PROPERTY COVERAGES with respect to loss caused by a Peril Insured Against other than fire or lightning. Direct loss by a Peril Insured Against resulting from “fungi,” wet or dry rot, or bacteria is covered. Existing Damage a. Damages which occurred prior to policy inception regardless of whether such damages were apparent at the time of the inception of this policy or discovered at a later date; or b. Claims for damages arising out of workmanship, repairs or lack of repairs arising from damage which occurred prior to policy inception. However, any ensuing loss arising out of workmanship, repairs or lack of repairs, caused by a Peril Insured Against, to property described under Section I — Property Coverages, is covered unless the loss is otherwise excluded in the policy. This exclusion does not apply in the event of a total loss caused by a Peril Insured Against. Constant Or Repeated Seepage Or Leakage of water or steam, or the presence or condensation of humidity, moisture or vapor; which occurs over a period of 14 or more days, whether hidden or not. Accidental Discharge Or Overflow Of Water Or Steam from: a. Within a plumbing, heating, air conditioning or automatic fire protective sprinkler system; b. Within a household appliance for heating water; or c. Within a household appliance. This exclusion applies only while the dwelling is “vacant” or “unoccupied” for more than thirty (30) consecutive days or being constructed; unless you have used reasonable care to: a. Shut off the water supply; and b. Drain the system and appliances of water. Systems and appliances of water do not include outdoor swimming spas or outdoor irrigation wells. Page 19 of 38 PTIC P003 1115 Includes copyrighted material of Insurance Services Office, Inc. with its permission.People’s Trust Insurance Company Homeowners HO3 — Special Form 15. Assignee(s) Or Third Parties We will not be responsible for payment under SECTION | and Il - CONDITIONS, G. Assignment, to any assignee(s) or third parties for payments on losses that are not covered under this policy. 16. Criminal Acts Criminal Activity, meaning any and all criminal acts performed by any insured that result in damage to your structure or personal property. 17. Hurricane Loss to Aluminum Framed Screened Enclosures, Aluminum Framed Carports, and Awnings We do not cover loss to aluminum framed Screened Enclosures, aluminum framed carports or awnings caused by the peril of a hurricane. We do not insure for loss to property described in Coverages A and B caused by any of the following. However, any ensuing loss to property described in Coverages A and B not precluded by any other provision in this policy is covered. 1. Weather conditions. However, this exclusion only applies if weather conditions contribute in any way with a cause or event excluded in A. above to produce the loss. 2. Acts or decisions, including the failure to act or decide, of any person, group, organization or governmental body. 3. Faulty, inadequate or defective: a. Planning, zoning, development, surveying, siting; b. Design, specifications, workmanship, repair, construction, renovation, remodeling, grading, compaction; c. Materials used in repair, construction, renovation or remodeling; or d. Maintenance; of part or all of any property whether on or off the "residence premises". SECTION | - CONDITIONS A. Insurable Interest And Limit Of Liability Even if more than one person has an insurable interest in the property covered, we will not be liable in any one loss: 1. To an "insured" for more than the amount of such "insured's" interest at the time of loss; or 2. For more than the applicable limit of liability. Deductible Unless otherwise noted in this policy, the following deductible provision applies: With respect to any one loss: 1. Subject fo the applicable limit of liability, we will pay only that part of the total of all loss payable that exceeds the deductible amount shown in the Declarations. 2. If two or more deductibles under this policy apply to the loss, only the highest deductible amount will apply. Duties After Loss In case of a loss to covered property, we have no duty to provide coverage under this policy if the failure to comply with the following duties is prejudicial to us. These duties must be performed either by you, an "insured" seeking coverage, or a representative of either: Page 20 of 38 PTIC POO3 1115 Includes copyrighted material of Insurance Services Office, Inc. with its permission.People’s Trust Insurance Company Homeowners HO3 - Special Form 4, Give prompt notice to us or our agent; Notify the police in case of loss by theft, vandalism or malicious mischief; Notify the credit card or electronic fund transfer card or access device company in case of loss as provided for in 6. Credit Card, Electronic Fund Transfer Card Or Access Device, Forgery And Counterfeit Money under Section | — Additional Coverages; Notice of Hurricane or Windstorm Claims - If Windstorm coverage is provided in this policy a claim, “supplemental claim” or “reopened claim’ for loss or damage caused by hurricane or other windstorm must be given to us in accordance with the terms of this policy and within three years after the hurricane first made landfall or a windstorm caused the damage. This condition concerning time for submission of claim does not affect any limitation for legal action against us as provided in this policy under the Suit Against Us Condition including any amendment to that condition Protect the property from further damage. If repairs to the property are required, you must: a. Make reasonable and necessary repairs to protect the property; and b, Keep an accurate record of repair expenses. Cooperate with us in the investigation of a claim; Prepare an inventory of damaged personal property showing the quantity, description, actual cash value and amount of loss. Attach all bills, receipts and related documents that justify the figures in the inventory; As often as we reasonably require: a. Show the damaged property; b. Provide us with records and documents we request and permit us to make copies; and ¢. Submit to examination under oath, while not in the presence of another "insured", and sign the same; Send to us, within sixty (60) days after our request, your signed, sworn proof of loss which sets forth, to the best of your knowledge and belief: a. The time and cause of loss; b. The interests of all "insureds" and all others in the property involved and all liens on the property; c. Other insurance which may cover the loss; d. Changes in title or occupancy of the property during the term of the policy; e. Specifications of damaged buildings and detailed repair estimates; f. The inventory of damaged personal property described in C.7. above; g. Receipts for additional living expenses incurred and records that support the fair rental value loss; and h. Evidence or affidavit that supports a claim under 6. Credit Card, Electronic Fund Transfer Card Or Access Device, Forgery And Counterfeit Money under Section | — Additional Coverages, stating the amount and cause of loss. Page 21 of 38 PTIC PO003 1115 Includes copyrighted material of Insurance Services Office, Inc. with its permission.People’s Trust Insurance Company Homeowners HO3 - Special Form D. Loss Settlement Covered property losses are settled as follows: 1. Property of the following types: a. Personal property; b. Awnings, carpeting, household appliances, outdoor antennas and outdoor equipment, whether or not attached to buildings; and c. Structures that are not buildings; at actual cash value at the time of loss but not more than the amount required to repair or replace. 2. Buildings under Coverage A or B at replacement cost without deduction for depreciation, subject to the following: a. If, at the time of loss, the amount of insurance in this policy on the damaged building is eighty percent (80%) or more of the full replacement cost of the building immediately before the loss, we will pay the cost to repair or replace, after application of deductible and without deduction for depreciation, but not more than the least of the following amounts: (1) The limit of liability under this policy that applies to the building; (2) The replacement cost of that part of the building damaged for like construction and use on the same premises; or (3} The necessary amount actually spent to repair or replace the damaged building. b. If, at the time of loss, the amount of insurance in this policy on the damaged building is less than eighty percent (80%) of the full replacement cost of the building immediately before the loss, we will pay the greater of the following amounts, but not more than the limit of liability under this policy that applies to the building: (1) The actual cash value of that part of the building damaged; or (2) That proportion of the cost to repair or replace, after application of deductible and without deduction for depreciation, that part of the building damaged, which the total amount of insurance in this policy on the damaged building bears to eighty percent (80%) of the replacement costs of the building. c. To determine the amount of insurance required to equal eighty percent (80%) of the full replacement cost of the building immediately before the loss, do not include the value of: (1) Excavations, foundations, piers or any supports which are below the undersurface of the lowest basement floor; (2) Those supports in (a) above which are below the surface of the ground inside the foundation walls, if there is no basement; and (3) Underground flues, pipes, wiring and drains. d. We will initially pay at least the actual cash value of the incurred loss less any applicable deductible. We will then pay the necessary amounts actually spent to repair or replace the damaged building as work is performed and expenses are incurred. If a total loss of the covered dwelling occurs, we shall pay the replacement cost coverage without reservation of any depreciation in value, subject to policy limits. Page 22 of 38 PTIC P003 1115 Includes copyrighted material of Insurance Services Office, Inc. with its permission.People’s Trust Insurance Company Homeowners HO3 — Special Form e. If the dwelling where loss or damage occurs has been vacant for more than thirty (30) consecutive days before the loss or damage, we will: Not pay for any loss or damage caused by any of the following perils, even if they are Perils Insured Against: (1) Vandalism; (2) Sprinkler leakage, when caused by or arising out of the freezing of a fire protective sprinkler system, unless you have protected the system against freezing; {3) Dwelling glass breakage; {4) Water damage; (5) Theft; or (6) Attempted theft. Dwellings under construction are not considered vacant. In the event the construction extends greater than sixty (60) days you must notify us. E. Loss To A Pair Or Set In case of loss to a pair or set we may elect to: 1. Repair or replace any part to restore the pair or set to its value before the loss; or 2. Pay the difference between actual cash value of the property before and after the loss. Glass Replacement Loss for damage to glass caused by a Peril Insured Against will be settled on the basis of replacement with safety glazing materials when required by ordinance or law. Mediation If you and we are engaged in a dispute regarding a claim under this policy, either may demand a mediation of the loss in accordance with the rules established by the Florida Department of Financial Services. The results of the mediation are binding only when both parties agree, in writing, on a settlement and, you have not rescinded the settlement within three (3) business days after reaching settlement. You may not rescind the settlement after cashing or depositing the settlement check or draft we provided you. We will pay the cost of conducting any mediation conference except when you fail to appear at a conference. That conference will then be rescheduled upon your payment of the costs of that rescheduled conference. However, if “we” fail to appear at a mediation conference without good cause, “we” will pay the actual cash expenses you incur in attending the conference and also pay the total cost for the rescheduled conference. Other Insurance And Service Agreement Ifa loss covered by this policy is also covered by: 1. Other insurance, we will pay only the proportion of the loss that the limit of liability that applies under this policy bears to the total amount of insurance covering the loss; or 2. Aservice agreement, this insurance is excess over any amounts payable under any such agreement. Service agreement means a service plan, property restoration plan, home warranty, or other similar service warranty agreement, even if it is characterized as insurance. Suit Against Us No action can be brought unless the policy provisions have been complied with and the action is started within five (5) years after the date of loss. Page 23 of 38 PTIC PO03 1115 Includes copyrighted material of Insurance Services Office, Inc. with its permission.People’s Trust Insurance Company Homeowners HO3 — Special Form J. Our Option At our option: 1. For losses settled on an actual cash value basis, we may repair or replace any part of the damaged property with material or property of like kind and quality. 2. For losses covered under Coverage A — Dwelling, insured for Replacement Cost Loss Settlement as outlined in SECTION f - CONDITIONS, Loss Settlement, we may repair the damaged property with material of like kind and quality without deduction for depreciation. 3. We will provide written notice to you no later than thirty (30) days after our inspection of the reported loss. 4. You must comply with the duties described in SECTION 1 — CONDITIONS, C. 7 and 8. 5. You must provide access to the property and execute any necessary municipal, county or other governmental documentation or permits for repairs to be undertaken. 6. You must execute all work authorizations to allow contractors and related parties entry to the property. 7. You must otherwise cooperate with repairs to the property. 8. You are responsible for payment of the deductible stated in your declaration page. 9. Our right to repair or replace, and our decision to do so, is a material part of this contract and under no circumstances relieves you or us of our mutual duties and obligations under this contract. K. Loss Payment We will adjust all losses with you. We will pay you unless some other person is named in the policy or is legally entitled to receive payment. Loss will be payable on the earliest of the following: 1. Twenty (20) days after we receive your proof of loss and we reach written agreement with you; 2. Sixty (60) days after we receive your proof of loss and: a. There is an entry of a final judgment; or b. There is a filing of an appraisal award or a mediation settlement with “us”; or 3. If payment is not denied, within ninety (90) days after we receive notice of an_ initial claim, “reopened claim,” or “supplemental claim’. However, this provision (K 3.) does not apply if factors beyond our control reasonably prevents such payment. Our failure to comply with this paragraph shall not form the sole basis for an action against us for breach of contract under this policy or for benefits under this policy. L. Abandonment Of Property We need not accept any property abandoned by an "insured." M. Mortgage Clause The word "mortgagee" includes trustee. Any loss payable under Coverage A or B will be paid to the mortgagee and you, as interest appears. If there is more than one mortgagee, the order of payment will be the same as the order of precedence of the mortgages. If we deny your claim, that denial shall not apply to a valid claim of the mortgagee, if the mortgagee: 1. Notifies us of any change in ownership, occupancy, or substantial change in risk of which the mortgagee is aware; 2. Pays any premium due under this policy on demand if you have neglected to pay the premium; and Page 24 of 38 PTIC P0O3 1115 Includes copyrighted material of Insurance Services Office, Inc. with its permission,People’s Trust Insurance Company Homeowners HO3 — Special Form 3. Sends to us, within sixty (60) days after our request, a signed, sworn statement of loss which sets forth, to the best of the mortgagee's knowledge and belief: a. The time and cause of loss; b. The interest of the mortgagee and all others in the property involved and all liens on the property; c. Other insurance which may cover the loss; d. Changes in title or occupancy of the property during the term of the policy; and e, Specifications of damaged buildings and detailed repair estimates. Policy conditions relating to Suit Against Us and Loss Payment apply to the mortgagee. If we decide to cancel or not to renew this policy, the mortgagee will be properly notified at least (ten) 10 days before the date cancellation or nonrenewal takes effect. If we pay the mortgagee for any loss and deny payment to you: a. We are subrogated to all the rights of the mortgagee granted under the mortgage on the property; and b. At our option, we may pay to the mortgagee the whole principal on the mortgage plus any accrued interest. In this event, we will receive a full assignment and transfer of the mortgage and all securities held as collateral to the mortgage debt. Subrogation will not impair the right of the mortgagee to recover the full amount of the mortgagee's claim. N. No Benefit To Bailee We will not recognize any assignment or grant any coverage that benefits a person or organization holding, storing or moving property for a fee regardless of any other provision of this policy. O. Nuclear Hazard Clause 41. "Nuclear Hazard" means any nuclear reaction, radiation, or radioactive contamination, all whether controlled or uncontrolled or however caused, or any consequence of any of these. 2. Loss caused by the nuclear hazard will not be considered loss caused by fire, explosion, or smoke, whether these perils are specifically named in or otherwise included within the Perits Insured Against in Section | — Property Coverages. 3. This policy does not apply under Section | — Property Coverages to loss caused directly or indirectly by nuclear hazard, except that direct loss by fire resulting from the nuclear hazard is covered. P. Salvage And Recovered Property If you or we recover any property for which we have made payment under this policy, you or we will notify the other of the recovery. At your option, the property will be returned to or retained by you, or it will become our property. If the recovered property is returned to or retained by you, the loss payment will be adjusted based on the amount you received for the covered property. Q. Volcanic Eruption Period One or more volcanic eruptions that occur within a 72-hour period will be considered as one volcanic eruption. Page 25 of 38 PTIC P0O3 1115 Includes copyrighted material of Insurance Services Office, Inc. with its permission.People’s Trust Insurance Company Homeowners HO3 - Special Form R. Adjustment To Property Coverage Limits If your policy is a renewal with us, the limit of liability for Coverage A, Coverage B, Coverage C, and Coverage D may be adjusted. Any change in the limits of liability indicated above does not, in any way, represent, warrant, or guarantee to any person or entity, that: 1. These adjustments will keep pace with inflation; or 2. That the amounts of coverage are adequate to repair or rebuild any specific building or structure. SECTION Il - LIABILITY COVERAGES A. Coverage E - Personal Liability If a claim is made or a suit is brought against an “insured" for damages because of “bodily injury" or “property damage" caused by an “occurrence” to which this coverage applies, we will: 1. Pay up to our limit of liability for the damages for which an “insured” is legally liable. Damages include prejudgment interest awarded against an "insured": and 2. Provide a defense at our expense by counsel of our choice, even if the suit is groundless, false or fraudulent. We may investigate and settle any claim or suit that we decide is appropriate. Our duty to settle or defend ends when our limit of liability for the "occurrence" has been exhausted by payment of a judgment or settlement. B. Coverage F - Medical Payments To Others We will pay the necessary medical expenses that are incurred or medically ascertained within three years from the date of an accident causing "bodily injury". Medical expenses means reasonable charges for medical, surgical, x-ray, dental, ambulance, hospital, professional nursing, prosthetic devices and funeral services. This coverage does not apply to you or regular residents of your household except “residence employees". As to others, this coverage applies only: 1. Toa person on the "insured location" with the permission of an "insured"; or 2. Toa person off the “insured location", if the “bodily injury": a. Arises out of a condition on the “insured location" or the ways immediately adjoining; b. Is caused by the activities of an "insured"; c. Is caused by a "residence employee" in the course of the "residence employee's” employment by an "insured". SECTION Il - EXCLUSIONS A. Coverage E - Personal Liability And Coverage F — Medical Payments to Others Do not apply to "bodily injury" or "property damage": 1. Which is expected or intended by the insured,” even if the resulting “bodily injury” or “property damage” is of a different kind, quality, or degree than initially expected or intended, or is sustained by a different person, entity, real or personal property, than initially expected or intended. However this exclusion does not apply to “bodily injury” or “property damage” resulting from the use of reasonable force by the “insured’ to protect persons or property Page 26 of 38 PTIC P003 1115 Includes copyrighted material of Insurance Services Office, Inc. with its permission.People’s Trust Insurance Company Homeowners HO3 — Special Form 2. “Bodily injury” or “property damage” arising out of or in connection with a "business" conducted from the insured location or engaged in by an "insured," whether or not the “pusiness” is owned or operated by an “insured” or employs an “insured”. This Exclusion A. 2. applies but is not limited to an act or omission, regardless of its nature or circumstance, involving a service or duty rendered, promised, owed, or implied to be provided because of the nature of the “business”. 3. Arising out of the rental or holding for rental of any part of any premises by an "insured." This exclusion does not apply to the rental or holding for rental of an “insured location”: a. On an occasional basis if used only as a residence; b. In part for use only as a residence, unless a single family unit is intended for use by the occupying family to lodge more than two roomers or boarders; or c. In part, as an office, school, studio or private garage; 4. Arising out of the rendering of or failure to render professional services; 5. Arising out of a premises; a. Owned by an “insured”; b. Rented to an “insured”; or c. Rented to others by an “insured”; that is not an “insured location”; 6. Arising out of: a. The ownership, maintenance, use, loading or unloading of “motor vehicles” or all other motorized land conveyances, including trailers, owned or operated by or rented or loaned to an “insured”; b. The entrustment by an “insured” of a “motor vehicle” or any other motorized land conveyance, to any person; or c. Vicarious liability, whether or not statutorily imposed, for the actions of a child or minor using a conveyance, excluded in paragraph a. or b, above This exclusion does not apply to: a. A trailer not towed by or carried on a motorized land conveyance; b. A motorized land conveyance designed for recreational use off public roads, not subject to motor vehicle registration and: (1) Not owned by an “insured”; or (2) Owned by an “insured” and on an “insured location”; c. A motorized golf cart when used to play golf on a golf course; d. A vehicle or conveyance not subject to motor vehicle registration which is: (1) Used solely to service an “insured's” residence; (2) Designed for assisting the handicapped; or (3) In dead storage on an “insured location”; 7. Arising out of: a. The ownership, maintenance, use, loading or unloading of an excluded “watercraft” or “personal watercraft” described below; b. The entrustment by an “insured” of an excluded “watercraft” or “personal watercraft” described below to any person; or c. Vicarious liability, whether or not statutorily imposed, for the actions of a child or minor using an excluded “watercraft” or “personal watercraft’ described below. Excluded “watercraft” or “personal watercraft” are those that are principally designed to be propelled by engine power or eleciric motor, or are sailing vessels, whether owned by or rented to an “insured.” This exclusion does not apply to “watercraft” or “personal watercraft": Page 27 of 38 PTIC P0O3 1115 Inctudes copyrighted material of Insurance Services Office, Inc. with its permission.People’s Trust Insurance Company Homeowners HO3 - Special Form a. That are not sailing vessels and are powered by: (1) Inboard or inboard-outdrive engine or motor power of fifty (50) horsepower or less not owned by an ‘insured’, {2) Inboard or inboard-outboard engine or motor power of more than fifty (50) horsepower not owned by or rented to an “insured”; (3) One or more outboard engines or motors with twenty-five (25) total horsepower or less; or (4) One or more outboard engines or motors with more than twenty-five (25) total horsepower if the outboard engine or motors is not owned by an “insured”; b, That are sailing vessels, with or without auxiliary power: (1) Less than twenty-six (26) feet in overall length; (2) Twenty-six (26) feet or more in overall length, not owned by or rented to an “insured”; c. That are stored. 8. Arising out of: a. The ownership, maintenance, use, loading or unloading of an “aircraft”; b. The entrustment by an “insured” of an “aircraft” to any person; or c. Vicarious liability, whether or not statutorily imposed, for the actions of a child, or minor using an “aircraft.” 9. Caused directly or indirectly by war, including the following and any consequence of any of the following: a. Undeclared war, civil war, insurrection, rebellion, or revolution; b. Warlike act by a military force or military personnel; or c. Destruction, seizure or use for a military purpose. Discharge of a nuclear weapon will be deemed a warlike act even if accidental; 10. Which arises out of the transmission of a communicable disease by an “insured”; 11. Arising out of sexual molestation, corporal punishment or physical or mental abuse; 12. Arising out of the use, sale, manufacture, delivery, transfer or possession by any person of a Controlled Substance(s) as defined by the Federal Food and Drug Law at 21 U.S.C.A. Sections 811 and 812. Controlled Substances include but are not limited to cocaine, LSD, marijuana and all narcotic drugs. However, this exclusion does not apply to the legitimate use of prescription drugs by a person following the orders of a licensed healthcare provider; 143. Arising out of the actions, conduct, or behavior of any animal owned or kept by an “insured,” whether or not the “bodily injury” or “property damage” occurs on an “insured location” or any other location; 14. Arising out of or resulting from the use of diving boards on an “insured location’; 15. Arising out of or resulting from the use of a pool slide on an “insured location’; 16. Arising out of or resulting from an unprotected swimming pool or spa. An unprotected swimming pool or spa is defined as un-walled, unfenced or uncovered. 17. Arising out of or resulting from the use of an empty swimming pool; 18. Arising out of or resulting from the use of a skateboard or bicycle ramp; 19. Arising out of or resulting from criminal activity, meaning any and all criminal acts performed by any “insured” regardless of whether the consequences of those acts were intended or anticipated; Page 28 of 38 PTIC POO3 1115 Includes copyrighted material of Insurance Services Office, Inc. with its permission.People’s Trust Insurance Company Homeowners HO3 - Special Form 20. Arising out of or resulting from: a. The ingestion of paint that has lead in it; b. The ingestion of paint that has lead compounds in it; c. The inhalation of paint that has lead in it; d. The inhalation of paint that has lead compounds in it; e. Radon, or any other substance that emits radiation; f. In any manner (including liability imposed by law) from the discharge, disposal, release, or escape of: (1) Vapors or fumes; (2) Gas or oil; (3) Toxic chemicals, liquid, or gas; (4) Waste materials; and (5) Irritants, contaminants or pollutants. 21. Arising out of: a. The ownership, maintenance, use, loading or unloading of a “hovercraft”; b. The entrustment by an "insured" of a “hovercraft” to any person; or c. Vicarious liability, whether or not statutorily imposed, for the actions of a child, or minor using a “hovercraft.” 22. Arising out of: a. The ownership, maintenance, use, loading or unloading of a “drone”; b. The entrustment by an "insured" of a “drone” to any person; or c. Vicarious liability, whether or not statutorily imposed, for the actions of a child, or minor using a “drone.” 23. “Bodily injury” or “property damage” arising out of assault or batiery, when committed by or at the direction of an “insured.” Exclusions 5, 6, 7, 8, 21 and 22 do not apply to “bodily injury” to a “residence employee” or “property damage” of the “residence employee's” property, arising out of and in the course of the "residence employee’s” employment by an “insured”. B. Coverage E — Personal Liability, does not apply to: 1. Liability: a. For any loss assessment charged against you as a member of an association, corporation or community of property owners; b. Under any contract or agreement. However, this exclusion does not apply to written contracts: (1) That directly relate to the ownership, maintenance, or use of an “insured location"; or (2) Where the liability of others is assumed by the "insured" prior to an "occurrence"; unless excluded in a. above or elsewhere in this policy. 2. “Property damage" to property owned by the "insured"; 3. "Property damage” to property rented to, occupied, or used by or in the care of the “insured.” This exclusion does not apply to "property damage" caused by fire, smoke, or explosion; 4, “Bodily injury" to any person eligible to receive any benefits voluntarily provided or required to be provided by an “insured” under any: a. Workers' compensation law; b. Non-occupational disability law; or c. Occupational disease law; Page 29 of 38 PTIC PO03 1115 Includes copyrighted material of Insurance Services Office, Inc. with its permission.People’s Trust Insurance Company Homeowners HO3 —- Special Form 5. 6. “Bodily injury” or “property damage” for which an “insured” under this policy: a. Is also an “insured” under a nuclear energy liability policy issued by the: (1) Nuclear Energy Liability Insurance Association; (2) Mutual Atomic Energy Liability Underwriters; (3) Nuclear Insurance Association of Canada; or any of their successors; or b. Would be an “insured” under such a policy but for the exhaustion of its limit of liability; or “Bodily injury” to you or an “insured” as defined under Definition 7. a. or b. C. Coverage F — Medical Payments To Others, does not apply to “bodily injury”: 1. 4. To a “residence employee" if the "bodily injury’: a. Occurs off the "insured location"; and b. Does not arise out of or in the course of the "residence employee's" employment by in "insured". To any person eligible to receive benefits voluntarily provided or required to be provided under any: a. Workers’ compensation law; b. Non-occupational disability law; or c. Occupational disease law; From any: a. Nuclear reaction; b. Nuclear radiation; or c. Radioactive contamination; all whether controlled or uncontrolled or however caused; or d. Any consequence of any of these. To any person, other than a "residence employee" of an “insured,” regularly residing on any part of the “insured location”. D. “Personal Injury”, this insurance does not apply to “Persona! Injury” arising out of or caused by one or more of the following offenses: 1. 2. 3. Caused by or at the direction of an “insured” with the knowledge that the act would violate the rights of another and would inflict “personal injury’; Arising out of oral or written publication of material, if done by or at the direction of an “insured” with knowledge of its falsity; Arising out of oral or written publication of material whose first publication took place before the beginning of the policy period; Arising out of a criminal act committed by or at the direction of an “insured”; Arising out of liability assumed by an “insured” under any contract or agreement except any indemnity obligation assumed by an “insured” under a written contract directly relating to the ownership, maintenance, or use of the premises; Sustained by any person as a result of an offense directly or indirectly related to the employment of this person by an “insured”; Arising out of or in connection with a “business” conducted from an “insured location” or engaged in by an “insured,” whether or not the “business” is owned or operated by an “insured” or employs an “insured”. This exclusion applies but is not limited to an act or omission, regardless of its nature or circumstance, involving a service or duty rendered, promised, owned or implied to be provided because of the nature of the “business”; Arising out of false arrest, detention, or imprisonment; Arising out of malicious prosecution; Page 30 of 38 PTIC PQO3 1115 Includes copyrighted material of Insurance Services Office, Inc. with its permission,People’s Trust Insurance Company Homeowners HO3 - Special Form 10. 11. 12. 13. Arising out of the wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies, committed by or on behalf of its owner, landlord, or lessor; Arising out of oral or written publication of material that slanders or libels a person or organization or disparages a person’s or organization's goods, products or services; {invasion of privacy, trespassing, harassment, stalking, or spying resulting from the ownership or use of a “drone” by an “insured”; Electronic aggression including but not limited to harassment or bullying committed by means of any electronic forum, including but not limited to a blog, an electronic bulletin board, an electronic chat room, a gripe site, a social networking site, a web site, a web blog, email, instant messaging, or text messaging; or 14, Arising out of oral or written publication of material that violates a person’s right of privacy. SECTION Il —- ADDITIONAL COVERAGES We cover the following in addition to the limits of liability: A. Claim Expenses We pay: 1. 2. 3. Expenses we incur and costs taxed against an "insured" in any suit we defend; Premiums on bonds required in a suit we defend, but not for bond amounts more than the limit of liability for Coverage E. We need not apply for or furnish any bond; Reasonable expenses incurred by an “insured” at our request, including actual loss of earnings (but not loss of other income) up to $250 per day, for assisting us in the investigation or defense of a claim or suit; and Interest on the entire judgment, which accrues after entry of the judgment and before we pay or tender, or deposit in court that part of the judgment, which does not exceed the limit of liability that applies. First Aid Expenses We will pay expenses for first aid to others incurred by an "insured" for "bodily injury" covered under this policy. We will not pay for first aid to you or any other “insured.” Cc. Damage To Property Of Others We will pay, at replacement cost, up to $500 per “occurrence” for "property damage" to property of others caused by an “insured.” We will not pay for "property damage": 1. PYN s To the extent of any amount recoverable under Section | —- Property Coverages of this policy; Caused intentionally by an "insured" who is thirteen (13) years of age or older; To property owned by an "insured"; To property owned by or rented to a tenant of an "insured" or a resident in your household; or Arising out of: a. A "business" engaged in by an "insured"; b. Any act or omission in connection with a premises owned, rented or controlled by an "insured," other than the "insured location"; or Page 31 of 38 PTIC PO03 1115 Includes copyrighted material of Insurance Services Office, Inc. with its permission.People’s Trust Insurance Company Homeowners HO3 — Special Form ¢. The ownership, maintenance, or use of “aircraft,” “drone,” “watercraft,” “personal watercraft” or “motor vehicle” or all other motorized land conveyances. This Exclusion 5.¢. does not apply to “motor vehicles” that: (1) Is designed for recreational use off public roads; (2) Is not owned by an “insured”; and (3) At the time of the “occurrence”, is not required by law, or regulations issued by a government agency, to have been registered for it to be used on public roads or property. D. Loss Assessment We will pay up to $1,000 for your share of loss assessment charged during the policy period against you by a corporation or association of property owners, when the assessment is made as a result of: 1. "Bodily injury" or “property damage" not excluded under Section II — Liability Coverages of this policy; or 2. Liability for an act of a director, officer or trustee in the capacity as a director, officer or trustee, provided: a. The director, officer, or trustee is elected by the members of a corporation or association of property owners; and b. The director, officer, or trustee serves without deriving any income from the exercise of duties which are solely on behalf of a corporation or association of property owners. This coverage applies only to loss assessments charged against you as owner or tenant of the "residence premises." We do not cover loss assessments charged against you or a corporation or association of property owners by any governmental body. This coverage is excess over any insurance collectible under any policy or policies covering the corporation or association of property owners. Regardless of the number of assessments, the limit of $1,000 is the most we will pay for loss arising out of: 1. One accident, including continuous or repeated exposure to substantially the same general harmful condition; or 2. A covered act of a director, officer, or trustee. An act involving more than one director, officer, or trustee is considered to be a single act. The following do not apply to this coverage: 1. Section Il — Coverage E — Personal Liability Exclusion B. 1. a.; and 2, Condition A. Policy Period, under Sections | and II — Conditions. Page 32 of 38 PTIC POO3 1115 Includes copyrighted materiat of Insurance Services Office, Inc, with its permission.People’s Trust Insurance Company Homeowners HO3 - Special Form SECTION II - CONDITIONS A. Limit Of Liability Our total liability under Coverage E for all damages resulting from any one "occurrence" will not be more than the limit of liability for Coverage E as shown in the Declarations. This limit is the same regardless of the