Flashcards in Assignment 2 Deck (117)
How does an auto lx ins policy pay out
on behalf of the insd to the parties who are damaged or injured as a result of negligence of the insd
Who does the auto lx ins policy protect
Who is considered "the insd" on a lx auto policy? (4)
1. named insured
2. family members
3. permissive driver
4. someone who is responsible for the acts of the insd such as an employer who is vicariously liable
When does legal lx generally arise on an auto lx insurance policy
arises from the negligent act associated with the maintenance, use, or ownership of an automobile
bodily injuries (def) (4*)
includes physical harm, sickness, disease or death resulting from the physical harm, sickness, or disease associated with the acciden t
property damage (def)
physical injury to tangible property, including loss of use
How do prejudgment and post judgment interest relate to the settlement amount (2)
1. included in the definition of the damages
2. interest is supplemental and above/beyond the limits of the policy
Auto lx limits may be expressed in what two types of limits?
The insurance company has what duty and right with lx claims?
1. duty to defend the insd
2. right to settle claims in any manner it sees fit
What is the lowest single limit for auto lx in FL?
Do policy limits apply to cost of defense & interest payments?
no, limits only apply to damages
Is auto lx insurance primary, secondary or excess for vehicles owned by the insd? (2)
1. primary for veh owned by the insd
2. excess for veh not owned by the insd
What does PAP stand for?
Personal Auto Policy
Who does PAP provide coverage for? (3)
2. related persons
3. unrelated persons who live together w/insd
Who is PAP not available for? (3)
3. combination of business and individual interests
In PAP, who does "You" and "Yours" refer to?
named insd and residing spouse
In PAP, what does "Business" refer to
trade, profession or occupation
In PAP, who does "Family Member" refer to
relatives and foster children in the household of the named insd
What does "occupying" mean
in, upon,getting in, on, out or off a vehicle
What is the purpose of lx auto coverage?
pay damages to others who are injured or damaged by an insd's negligence, on behalf of the insd
What types of loss are exclusions under auto LX coverage? (5)
1. intentional injury or damage
2. property owned or being transported by the insd
3. injuries to an employee while on the job
4. using the veh w/out reasonable belief of permission
*5. adjuster must read policy to see all exclusions that may apply
What three types of vehs are generally excluded from auto lx policies?
1. veh w/less than 4 wheels
2. those designed mainly for use off public roads
3. veh owned by, or available for regular use of a family member that is not insured
What does PIP pay for? (4)
1. medical bills
2. lost wages
3. replacement services
4. death benefits
What change was made to PIP for FL on 01/01/2013?
those seeking PIP medical benefits must receive initial services and care w/in 14 days after an MVA
Who can provide care that qualifies for PIP medical? (6)
1. licensed physician
2. osteopathic doctor
3. chiropractic physician
5. hospital or facility owned by hospital
6. licensed emergency provider
What happens if an Emergency Medical Condition is not dx?
basic PIP medical benefit of $10K is reduced to $2500
What two types of treatment are now excluded from treatment as of 01/01/2013?
1. massage therapy
What happens if medical care is not rendered w/in 14 days of the DOL in regards to PIP benefits?
no PIP benefits will be available
What % of medical expenses are paid under PIP, and including what types of care? (6)
80% of reasonable med exp including med, surgical, x-x-ray, dental and rehab