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CAN A CONFUSING ENDORSEMENT PROVIDE COVERAGE?

CAN A CONFUSING ENDORSEMENT PROVIDE COVERAGE?

CAN A CONFUSING ENDORSEMENT PROVIDE COVERAGE?
January 30
13:05 2018

Darren took Peyton for a ride in his gyrocopter. Unfortunately, the gyrocopter crashed killing both of them. Peyton’s mother sued Darren but Old Republic Insurance Company denied coverage because the gyrocopter was not scheduled on the policy. The mother argued that an attached endorsement containing multiple parts would provide the necessary coverage if only certain parts were considered. She argued that the ambiguity of the endorsement provided coverage for the gyrocopter loss.

Here is how the courts ruled.

Peyton Wilt, a minor, was a passenger on a gyrocopter piloted by Darren Mahler. Both were killed when the aircraft crashed. Wilt’s mother, Lindsey King (King) filed a lawsuit against several parties, including Mahler and Old Republic Insurance Company (Republic).

Republic denied coverage and countered with a motion to declare that they had no coverage obligation as their policy had only a single, fixed wing airplane listed on its policy. Mahler never added the gyrocopter. The original court ruled in favor of the insurer and King appealed.

Upon appeal, King argued that the wording of the Republic policy’s amendatory endorsement which the insurer relied on for denial was ambiguous. The court reviewed the policy and endorsement language. It considered that language in light of King’s point that the five elements of the relevant endorsement should be read and applied separately. Doing so would make the unlisted gyrocopter an eligible aircraft.

The court came to a different conclusion. It held that, using King’s interpretation would strain the language and lead to absurd results. The lower court ruling in favor of Republic was proper. The gyrocopter was not a listed aircraft and, according to the amended policy wording, did not qualify for coverage. The lower court decision was affirmed.

Lindsey King, plaintiff-appellee v. Old Republic Insurance Company, Christopher P. Brupbacher, Dofin Fruits d/b/a Have Gyro Will Travel, and the Succession of Darren Joseph Mahler, defendants-appellants. Court of Appeal of Louisiana, Fourth Circuit. No. 2016-CA-0170 Filed September 7, 2016 Affirmed Westlaw 2016 WL4698248

A little time to report an acquisition

Aircraft policies tend to cover only the aircraft specifically scheduled on a policy. However, many will provide temporary coverage for newly acquired or substitute aircraft in order to give the named insured time to report the acquisition. This coverage must be carefully reviewed though because it is often restricted to similar aircraft. In addition, the time to report is limited.

Read the PF&M Aircraft Insurance Coverage Analysis that includes a discussion of a typical Newly Acquired Aircraft Condition.

This analysis is based on a review of available coverage using several policies as examples. There is no standardized policy but there are similar coverages provided by all carriers.

Insuring Agreements

The insuring agreement establishes the coverage provided by the policy and, naturally, is located at the beginning of the form. The remainder of the policy wording clarifies, expands, or restricts the insuring agreement. Essentially, the insuring agreement states the insurance companies overall obligation for providing coverage based on the insured’s applicable, contractual consideration (paying premium, fulfilling policy provisions, use of qualified pilots, craft maintenance, etc.).

Bodily Injury Excluding Passengers

Usually under this part of the contract, the insurance company obligates itself to pay for the bodily injury that an insured causes to third parties. Naturally, the injury has to be directly related to the ownership, maintenance or use of the insured aircraft.

Example: Samantha has completed her flight, taking clients on an aerial tour of possible sites for construction projects. As she is taxiing to her hangar, she loses her attention and strikes a person who was outside the hangar, inspecting his own plane that was awaiting maintenance work.
Important considerations:

  • How does the policy define bodily injury?
  • Does BI include mental anguish?
  • Does coverage include BI to aircraft passengers?
  • Is the coverage conditional on how the aircraft is being used?
  • Does the coverage apply when an unlisted pilot is operating the aircraft?

Property Damage Liability

This portion of the policy responds to property damage of others that an insured causes. The damage must be related to the ownership, maintenance or use of the insured aircraft.

Passenger Bodily Injury Liability

Usually under this part of the contract, the insurance company obligates itself to pay for the bodily injury that an insured causes to passengers. The injury must be directly related to the ownership, maintenance or use of the insured aircraft.

Example: Wayne, the owner and one of the pilots for “Casual Flyte” Commuter Air Taxi, is sued by a customer who is hurt when Wayne tossed a heavy suitcase to him.

Scenario 1: The customer was still on the plane and fell out when he lost his balance in an attempt to catch the bag.

Scenario 2: The customer was in the airport where Wayne caught up with him with the forgotten bag. The customer falls after losing his balance when attempting to catch the forgotten bag.

Scenario 1 is eligible for coverage while scenario B is not.

Medical Services or Medical Expense Insuring Agreement

The insurance company pays for medical expenses that are incurred due to an accident involving the covered aircraft. Typically, such expenses must be incurred within one year from the date of the accident.

Important considerations:

  1. Who is covered? Passengers, crew, pilot?
  2. How does the policy define medical expenses?

Note: Some policies provide an explanation of covered medical expenses while other forms respond to expenses that are ordinarily considered to be “necessary” or “reasonable.”

Physical Damage to the Aircraft

The insurance company pays for tangible damage to and/or disappearance of the aircraft listed on the Declarations. Coverage is generally provided on an all-risk type basis. Coverage may be offered on a basis of the aircraft being in motion (taxiing, take-off, flight, landing) and not in motion.

Example: A tornado touches down in Middleplace’s Municipal Airport. Hopeless Airlines has one plane that had a wing ripped off and destroyed. Their policy will respond to the loss under the limit for Not In Motion Physical Damage.

Non-Owned Aircraft Liability

The insurance company pays for BI or PD that is connected to an insured’s use or operation of an aircraft that the insured does not own.

Important considerations:

  • Who is considered to be an insured?
  • Does the policy cover only the named insured or does it include the spouse, family members?
  • Does it cover related parties (such as other relatives or, when an insured is a business entity, other members of the business or corporation)?
  • What aircraft is covered? Any aircraft? Aircraft that is similar to the scheduled aircraft?
  • Are there restrictions regarding the types, use and conditions of non-owned aircraft?
  • Is the coverage applicable to commercial, business and pleasure use of the aircraft?

Supplementary Payments

Some insurance companies offer additional items as supplementary payments such as:

  • First-aid
  • Cost of foaming of aircraft
  • Premiums on appeal bonds or bonds to release attachment
  • Search and rescue costs

Naturally these costs would have to be associated with a claim that is eligible for loss under the policy. They are extremely valuable since their use does not reduce the policy’s available coverage limits.

Defense Costs

The insurance company has the right and the duty to defend a bodily injury or property damage suit until the limit of insurance is exhausted by payment to claimants (via judgments or settlements). This means that the insurance company will bear the expense associated with providing a legal defense. Most insurance companies pay these expenses separately, without affecting the policy’s applicable limit of insurance. These expenses can include the attorney’s fees, premiums of court bonds, reasonable expenses of the insured and their employees when testifying or participating in other activities that assist in the defense against a claim.

The cost to defend a lawsuit is extremely high and can quickly use a policy’s liability limit. If the limits are used to pay defense costs and the case is lost, there would be little money left to pay any judgment.

Example: Prinder, a maintenance supervisor at a private airfield, was seriously injured by a piece of metal that fell from the sky. He sued Miguel after learning that Miguel’s plane landed on the field a few minutes after he was struck. Miguel is adamant that he wasn’t responsible for Prinder’s injury. Miguel’s insurer agreed to defend Miguel against Prinder’s lawsuit. After going through many phases, Miguel lost the suit. His defense costs totaled $300,000 and Prinder was awarded $850,000 in damages. Miguel’s aircraft policy limit was $1,000,000.
Loss FeatureAircraft Policy A

Defense costs paid under the insurance limit

Aircraft Policy B

Defense costs paid under supplemental coverage

Liability Ins. Limit$1,000,000$1,000,000
Judgment$850,000$850,000
Defense Costs$300,000$300,000
Total Lawsuit Costs$1,150,000$1,150,000
Total Paid by Insurer$1,000,000$1,150,000
Under the situation as handled by Policy A, Miguel would be left with the financial responsibility of paying the $150,000 of the settlement cost that was not covered by his policy.

Who Is An Insured

The following are all considered insureds under the policy:

  1. The named insured
  2. Any person using or riding in the aircraft with permission
  3. Any person or organization legally responsible for the aircraft; provided they do not fit in any of the following groups:
  • An employee who injures a fellow employee
  • Un-named student pilots
  • Any person who has paid to use the aircraft
  • Persons who are not employees of the insured but are employees of repair facilities, flying schools, airports, and similar services

Exclusions

Exclusions must be studied carefully in order to understand their impact on policy coverage. Some exclusions will apply to the entire policy while others are specific to the insuring agreement. A unique aspect of the policy is that some exclusions may apply only when the aircraft is in flight. The exclusions below are typically found in an aircraft insurance policy.

  1. Criminal Acts – There is no coverage when the aircraft is used for an unlawful or criminal purpose. There is normally a requirement that the insured or someone with authority in the insured’s operation be aware of the unlawful use.

Example: Katie, an employee of Global Real Estate, was granted permission to have the company’s pilot fly their Cessna 182 on a trip to Jamaica. While taking off for the trip back home, the pilot lost control of the plane and ran off the runway, damaging several buildings and injuring the buildings’ occupants.

The official reason for the trip was to pick up two clients who were looking for commercial real estate. As it turns out, Katie was also bringing back 10 kilos of cocaine and used the Global plane in order to avoid customs. In this case, the bodily injury and property damage claims arising form the crash would be covered, because the insured, Global Real Estate, was not aware of Katie’s criminal act.

  1. Intentional injury – If an injury or action is the result of an insured’s deliberate action, the policy will not respond to any related loss. There is one exception. Coverage still applies if the intentional action was taken to prevent dangerous interference with aircraft operation.

Example: Paul has completed his final check on his T-6 and starts to enter the cockpit. Suddenly, a woman pushes him out of the way and attempts to start up the plane’s engine. Paul wrestles with her and throws her out of the cockpit. The intruder loses her balance and slams onto the floor, unconscious. Paul calls the police and she is removed from his plane. Several weeks later, Paul receives a legal notice. The woman is suing Paul for the injuries she suffered during their scuffle. Paul’s insurer advises him that it will defend him. His intentional acts occurred while he was protecting the aircraft.

  1. Assumption of Liability – If an insured accepts responsibility for injuries or damage under a contract, coverage for those injuries or damages is excluded UNLESS the contract is with a governmental authority and for the purpose of airport operations.
  2. Certain In-flight Activities – The policy prohibits coverage for losses that occur when the aircraft is in flight under the following circumstances:
  3. Pilot is not listed on the declarations or pilot endorsement

Related Court Case: Unauthorized Pilot Voids Aircraft Coverage

  1. Pilot is listed but is not approved by current FAA regulations
  2. Aircraft does not have FAA Standard Airworthiness Certificate

Related Court Case: Airworthiness Certificate Exclusion Applied Despite Insured’s Lack of Knowledge

  1. If a special permit or waiver is required by the FAA but the waiver or permit has NOT been secured.
  2. A student pilot not under the supervision of a certified flight instructor
  3. A student pilot with a passenger other than a certified flight instructor

Related Court Case: Student Pilot Endorsement Violation Negated Coverage

  1. Nuclear and radioactive activity – All related losses are excluded.
  2. War and terrorism – All related losses are excluded.
  3. Noise, sonic boom, pollution, electrical/electromagnet interference, interference of property use – All such causes of loss are excluded except when it is created by an actual crash, collision of the aircraft or in flight emergency.
  4. Miscellaneous activities – The policy excludes damage or injury that results from using the insured aircraft for the following (this is not a comprehensive list):
advertisingtowingphotographyhunting
herdingsurveillanceflight instructionsky diving
parachutingclosed course racingoff shore business

Note: If an insured is involved in unusual flight activities, the application must thoroughly document the aircraft use in order for any aviation carrier to evaluate and, if applicable, price the risk, and endorsement coverage.

  1. Workers Compensation and Employer Liability situations – Aviation policies exclude losses that should be handled by WC and/or EPLI coverage. The exclusion extends to actions brought by family members of an employee.
  2. Property damage to items owned, held by or controlled by an insured – No coverage exists for damage or loss of items that belongs to or is controlled by an insured with the exception of limited protection for loss involving either of the following:
  • Passenger carry-on items
  • Hangars that are leased or rented by an insured
  1. Other Loss or Damage to the owned aircraft – Other items that damage an insured’s aircraft (or create a loss in value), but which are barred from coverage include:
  2. Embezzlement, repossession or conversion of the aircraft through the use of bailment, lease or similar encumbrances whether they are lawful or unlawful
  3. Wear and tear and deterioration losses. Mechanical, engine, hydraulic structural pneumatic and electrical failures are not covered if they remain confined to the failure.
  4. Loss to engines and power units due to heat or temperature from operation of the engine unless caused by another covered loss
  5. Depreciation
  6. Governmental taking or detaining of the aircraft for any use – peace or war, lawful or unlawful

This is a representative, rather than an exhaustive, list of actual exclusions found in the reviewed policies. A given policy’s actual exclusions must be carefully evaluated in order to determine the scope of coverage.

Conditions

The conditions in a policy outline the responsibilities of both the insurance company and the insured. It is an area that commonly triggers disputes between the insurer and the carrier.

Action Against the Insurance Company – No action can be brought by the insured against the insurance company until the insured has met all conditions required by the insurance policy. There are time limits and requirements that differ by policy but, overall, the insured has a fairly short time frame to sue the insurance company.

Note: State laws and court decisions frequently affect this provision and insurer actions are adjusted accordingly.

Appraisal – This provision may be invoked when the company and the insured don’t agree on the amount of the loss. Each party must select its own qualified appraiser. The two appraisers then select an umpire. The appraisers then submit their opinion of the actual cash value and the amount of the loss. If they don’t reach agreement, they submit this information to the umpire. An agreement by any two persons is binding on both parties.

The company and the insured have to pay for the expenses of their own appraiser, as well as equally share the expenses of the umpire. No other insurer rights are affected by their agreeing to an appraisal. For instance, if another party has some responsibility for the loss, the insurer, after paying the appraised amount of loss, may still subrogate the claim.

Assignment – Policies cannot be assigned by the insured due to a covered aircraft’s sale. The insurance company must be consulted and provide consent before any assignment takes place EXCEPT for the death or bankruptcy of the insured. In death or bankruptcy there is 60 days coverage for the legal representative.

Assistance and Cooperation – The insured is expected to work with the insurance company during all claim proceedings. This could mean testifying, helping with witnesses and participating in examinations. The insured does not have the right to volunteer payments on behalf of the insurance company.

Note: An insured may risk making out of pocket payments without expectations of being re-paid by the insurer. However, this may not be wise if the payment is construed as an admission of liability.

Automatic Reinstatement – At the time of loss to the applicable aircraft, the amount of coverage is reduced with respect to any subsequent losses until the aircraft’s value has been restored due to completed repairs. This provision applies both to eligible and ineligible losses.

Bankruptcy or Insolvency – The insured’s bankruptcy or insolvency does not affect the insurance company’s obligations under this insurance policy.

Cancellation – The insured can cancel at any time. When the insurer wishes to cancel coverage, it must provide notice at least 30 days in advance except for non-payment when only 10 days is required.

Changes – The policy can only be changed by written endorsements. In other words, a policy can only be modified in writing, meaning that any change has to occur with the carrier’s permission.

Declaration – Acceptance of the policy by the insured means that the information that appears in the policy’s declarations is true and the insurance company may rely on that information’s accuracy. Further, that information is deemed to be a part of this insurance contract.

Fraud and Misrepresentation – The policy is void if the insured misrepresents significant information. This is a vital condition since aircraft applications are very detailed and most of the information is important in evaluating a submission. While no standard application exists, an insured must is still obligated to carefully read each question and to respond truthfully and accurately.

Inspections and Audit – The insurance company has the right to inspect the aircraft and records that pertain to the aircraft during the policy period and up to a year afterwards.

More than one aircraft – If there is more than one aircraft on a policy, the policy applies to each one separately.

More than one insured – If there is more than one insured, each is covered as though they are the only insured except that any payment is subject to the policy’s insurance limits. This means that each insured is treated by the carrier uniquely in defense and discovery with no preference. However, at the time of settlement, the only limits available are the single set of limits in the policy.

Notice of occurrence, claim or suit – The insured must notify the insurance company of an occurrence that could lead to a claim. The notice must be given as soon as practicable. If a claim or suit is brought, the insured must immediately send the information to the insurance company.

Other Insurance – If there is more than one policy on the aircraft then all policies are expected to participate in a loss. The participation is based on the relationship of the limit to the policy to the aggregate limit available. Policies purchased as excess policies are not considered in the aggregate limit. Also coverage for non-owned aircraft is excess over any other available insurance.

Return premium – If the insured cancels, the return is based on a short rate table but if the insurance company cancels the return premium is based on prorate tables. If a plane is a total loss, the insurance company is not required to refund any remaining premium.

Rights of Recovery – The insured must agree to give the insurance company full rights of recovery and do nothing to hurt (prejudice) the insurance company’s ability to exercise those rights and will help the insurance company exercise those rights.

Example: Mabel and her Cessna 150 were insured by Acme Airsurers when she had her plane serviced by Tempe Air Garage. A Tempe employee accidentally nicked a hydraulic line on Mabel’s Cessna 150, causing a leak that went unnoticed when the plane was returned. A few days later, when she tried to take off, the plane lifted slightly off the ground, stuttered and then crashed. The plane seriously damaged the main building of an FBO and the plane was demolished. Acme paid the losses to the FBO. After an investigation determined Tempe’s error, Acme assumed Mabel’s recovery rights and sued Tempe Air Garage. She cooperated with the insurer and the company received reimbursement from the garage and repair firm.

Territory – The territory is the United States, Canada and Mexico and the airspace while en route between the mentioned countries. Some policies include the U.S. territories and possessions, the Bahamas and West Indies. The policy’s territory definition should be carefully reviewed in order to understand the areas within which aviation losses are eligible for coverage.

When an insured regularly travels outside Canada, Mexico or the United States, consideration should be made to purchasing a policy just for that country through a representative licensed to operate in that country.

United States Navy and Air Force Insurance Requirements – If the insurer providing aviation coverage is required to issue a certificate of insurance per the U.S. Navy or the U.S. Air Force, this policy is changed. Specifically, the relevant provisions of this policy are automatically replaced by those required under either OPNAV Form 3770 (Navy) or Regulation 55-20 (Air Force). This results in the complete incorporation of those provisions, rendering this policy to be in applicable Navy or Air Force compliance.

Note: Essentially, these regulations contain unique stipulations with regard to defining aircraft, aircraft use and use of military aircraft facilities by non-military personnel.

Valuation – If the aircraft loss is total, the insurance company pays the limit shown on the declaration or summary page. However, if the loss is partial, the loss is settled based on who repairs the plane. If the insured repairs it – cost of like kind or quality material plus the straight time rate wages plus an amount for supervisory and overhead is paid. If someone other than the insured makes the repairs, the net cost to the insured is paid.

Note: Where is the plane repaired? Normally it must be repaired at the loss site or at the aircraft’s home airport. The insurance company pays the cost of transportation for the aircraft and the parts. The insurer has the discretion of finding the most economical method to handle the move. The insured has the right to choose another place for repair or another mode of transportation, but then will have to pay the additional cost.

When parts are replaced or the entire plane is replaced, the insurance company has the right to all salvage. However, retaining salvage is the carrier’s choice. An insurer is not obligated to accept salvage.

Limits Of Liability

The liability limits are per occurrence. There is no aggregate limit. This means that the policy’s limit is available to each separate eligible occurrence. The Declarations states the occurrence limit is the maximum liability payment for any single occurrence. The definition of occurrence includes any series of related events. For instance, if a single accident started a chain reaction, all injuries and damages would be considered a single occurrence and subject to the occurrence limit.

The policy can have a per person or a per passenger limit. This is a restriction of coverage. It means that the maximum coverage available for a single person or passenger is limited to the per person or passenger limit. The per person limit is more restrictive than the per passenger limit since it includes the passengers and any other person who might bring suit.

The Medical Expense Limit is a separate coverage and limit that operates independently of the policy’s occurrence and the per person limit.

Example: While Clint was landing his plane, he slightly tilted the wings and crashed into a small office/hangar. His passenger was thrown around the cockpit and a maintenance person who had been working in the building was seriously injured. The property damage loss was $50,000 for the building and its contents. The passenger suffered back injuries and lacerations and filed suit for $200,000. The groundskeeper broke a leg and arm and lost 60 days of work. He sued Clint for $300,000. Clint had a policy with $1,000,000 per occurrence limit. The policy included a per person limit of $100,000. This means that his policy pays no more than $100,000 for the passenger’s claim and no more than $100,000 for the maintenance person’s claim. The maximum payment is therefore $250,000 (two injuries plus the property damage). Clint is responsible for the remaining $300,000 injury amounts. If Clint’s policy had the per passenger limit instead of the person limit, insurance company would have paid $50,000 plus $100,000 plus $300,000 or a total $450,000. In the later instance, Clint would continue to be responsible for the passenger’s remaining $100,000.

Deductibles

Any aircraft physical damage is subject to deductibles that differ according to circumstances surrounding a given loss. The applicable amounts are:

  1. Not-In-Motion Deductible – This amount applies whenever the aircraft is not moving.
  2. In-Motion Deductible – This applies when the aircraft is intentionally moving either on the ground or in flight.
  3. In-Flight Deductible – This applies when the aircraft is intentionally in flight.

Typically the required in-flight deductible is the greatest amount, while the not-in-motion deductible is the least.

The deductibles apply independently based on the actual loss.

Substitute, Replacement and Newly Acquired Aircraft

If the insured uses a substitute aircraft for an insured craft that is out of commission, the policy provides protection. The insured has liability and medical expense coverage while using the substitute, but the maximum payout for any occurrence can not exceed what would have been paid if the primary aircraft was in operation. This is a critical consideration if the substitute craft has a significantly higher value than the insured craft.

If the insured purchases a new aircraft to replace a scheduled aircraft, there is automatic coverage provided the insurance company is notified within 30 days of the purchase and premium payment is made. The coverage is the same as on the scheduled aircraft.

If the insured purchases an additional aircraft, there is automatic coverage provided the insurance company currently insures all of the insured’s owned aircraft. The insured must notify the insurance company within 30 days of the acquisition. The coverage is the same as another aircraft with similar passenger capacity. The physical damage limit is the actual amount the insured paid for the aircraft.

Related Court Case: “Reporting Form Dispute Decided In Insured’s Favor”

Definitions

Typically, a policy will have a number of terms with a special meaning. Actual defined terms can vary by insurer, but the following are items that are likely to appear:

  • Aircraft
  • Bodily Injury
  • Charter
  • Commercial
  • Disappearance
  • Federal Aviation Administration
  • In Flight
  • In Motion
  • Instruction and Rental
  • Insured
  • Medical Expense
  • Occurrence
  • Partial Loss
  • Passenger
  • Physical Damage
  • Premises
  • Pleasure and Business
  • Premises
  • Property Damage
  • Total Loss

Related Article: Glossary of Aviation Terms – helpful in better understanding underwriting or claims information involving aircraft

Endorsements

Common endorsements that are used to modify aviation coverage are in the categories of additional exclusions (such as for terrorism, pollution), clarifications (such as pilot requirements) and amendatory (such as cancellation information).

Related Article: Aircraft And Aviation Insurance Available Endorsements

Flying blind?

Newly acquired, replacement, or substitute unit coverage is a part of many other types of coverage. The ISO Personal Lines auto policy provides an excellent example of how complicated newly acquired vehicle coverage can be. It is particularly important to note that the number of days coverage applies, the types of vehicles that will be covered, and the actual coverage provided can vary significantly.

Review an analysis of the ISO Personal Auto Newly Acquired Auto definition.

(July, 2016)

DEFINITIONS

  1. “Newly acquired auto”
  2. This term applies to a private passenger auto, pickup, or van that any insured obtains possession of during the policy period (but after the policy period’s inception date). However, van and pickup eligibility is subject to a weight and a use restriction. Pickups and vans are ineligible as covered autos if they are used for business activities. The policy makes an exception for incidental business use as part of a repair or maintenance business. It also allows covered auto status for such vehicles that are used on a farm or ranch business. Though not specifically referenced, SUVs are treated as private passenger autos and are subject to the following weight restriction.

In order to be eligible, a pickup or van has to have a maximum Gross Vehicle Weight Rating of 10,000 lbs or less.

Example: Joe Karluver has a PAP with a policy period of February 10, 2015 to August 10, 2015 and it covers a ‘14 Taurus. Given this information, which of the following qualifies as a “newly acquired auto”?

  • An ‘11 Chrysler Joe bought on 03/16/15 – qualifies
  • A ‘10 Chevy 2-ton truck Joe bought on 06/10/15 – doesn’t qualify
  • A ‘12 Buick which Joe’s grandfather left to him in a will on 07/20/15 – qualifies
  • An ‘08 Chevy pickup that Joe gets by trading a boat and trailer to his neighbor on 05/03/15 – qualifies
  • An ‘09 Chevy pickup that Joe gets by trading a boat and trailer to his neighbor on 05/03/15 AND the pickup is hired out to a couple of businesses for making deliveries – doesn’t qualify
  • A ’10 Explorer that Joe bought on 02/02/15, but doesn’t list on his new policy – doesn’t qualify.

However, even if an additional car, pickup or van clears the vehicle type, vehicle use and date of acquisition hurdles, there are other requirements. Paragraph K.2. covers the issue of when to report an additional vehicle to the insurance company. The timing of reporting the vehicle has a direct impact upon coverage.

Note: The required reporting period varies according to the type of coverage involved and whether the vehicle is a replacement.

  1. 2. The coverage that is available for newly acquired autos depends on the type of coverage provided by the PAP. However, in order for coverage to apply beyond the automatically provided coverage, the insured must report the newly acquired auto within the applicable time period. If not reported as required, there is no coverage on the auto between the time of automatic coverage and the date the formal request is made.
  2. a. All coverages other than Coverage D-Coverage for Damage to Your Auto.

The insured has to report a new auto no later than 14 days from its acquisition. During those 14 days, the coverage is equal to the broadest coverage existing for an auto that appears on the policy declarations. If   the new vehicle replaces a vehicle that is listed on the policy, the replacement does not have to be reported.

The issue of a vehicle replacing a vehicle already described and covered by a PAP  is an area that could use clearer policy wording. The implication is that a vehicle would have to be reported by the renewing term because, once the policy renews, the replacing vehicle loses its status as a newly acquired auto. However, since the policy states “If a ’newly acquired auto’ replaces a vehicle shown in the Declarations, coverage is provided for this vehicle without your having to ask us to insure it,” a case may be made that the insured has no obligation to EVER report the vehicle. While there are other portions of the policy which would support an implicit requirement that a vehicle should be reported, it would help matters if the policy specifically stated that such a vehicle would have to be reported at the time of the policy’s next renewal after acquisition.

  • anewly acquired ADDITIONAL car qualifies for coverage if it is reported to the insurer within 14 days of the date it is acquired. Within that timeframe, the vehicle is covered for the broadest level of coverage (i.e., highest insurance limits, etc.) that is written under the policy. If the vehicle is never reported, it is not eligible for any coverage after 14 days. If the vehicle is reported after 14 days, coverage applies on the date it is reported.
Example: Dill E. Dally’s PAP covers a ‘04 Mercury, has a policy period of April 15, 2015 to October 15, 2015, and it has the following coverages:
Bodily Injury$100,000/$300,000
Property Damage$100,000
Medical Payments$10,000
Uninsured Motorist$25,000/$50,000
Bodily Injury$100,000/$300,000
Scenario 1: On September 3, 2015, Dill buys a ‘10 Ford Ranger. On September 16, Dill collides with another car when he ignores a stop sign. He causes $22,000 in injuries to the other driver, $4,500 in damages to the other driver’s car and $6,700 in damages to his Ranger. Dill reports the accident to his insurance company on September 18 and that is the same day that the insurance company learns of the new car. Under these circumstances, the soonest that ANY coverage can apply to the Ford is on September 18. Even though the loss occurred within the first 14 days, the car was not reported in time.
Scenario 2: On September 3, 2015, Dill buys a ‘10 Ford Ranger. On September 16, Dill collides with another car when he ignores a stop sign. He causes $22,000 in injuries to the other driver, $4,500 in damages to the other driver’s car and $6,700 in damages to his Ranger. Dill reports the accident to his insurance company on September 17 and that is the same day that the insurance company learns of the new car. Under these circumstances, the loss would be eligible for coverage, but only for the injury to the other driver and the damage to the other driver’s car.

A little suggestion

ISO offers a Special Auto policy that varies from the standard policy discussed above. It is more restrictive in coverage in many ways, including the newly acquired vehicle definition. While they may look very similar, there is a very significant difference between the two.

Compare the following analysis and the one provided above to see the gap created by moving a client from the standard to the special ISO auto policy.

(November, 2017)

DEFINITIONS

  1. “Newly acquired auto”
  2. 1. Any private passenger auto, pickup, or van that any insured obtains possession of during the policy period (but after the policy period’s inception date) qualifies as a newly acquired auto. However, van and pickup eligibility is subject to a weight and a use restriction. Pickups and vans are ineligible as covered autos if they are used for business activities.

Example: Hannah had her sedan insured under a new SPAP. Two weeks after she received the policy, she bought a used van. It was in a collision less than a week later.

Scenario 1: Hannah bought the van to better handle her personal chores and transporting kids. This vehicle is covered.

Scenario 2: The van was purchased and  used in her start-up leasing company. The van is not eligible for coverage.

The policy makes an exception for incidental business use (as part of a repair or maintenance business). It also allows covered auto status for such vehicles that are used on a farm or ranch business. Though not specifically referenced, SUVs are treated as private passenger autos and therefore are not subject to the following weight restriction.

In order to be eligible, a pickup or van has to have a Gross Vehicle Weight of no more than 10,000 lbs. The use of the term GVW Rating conforms to what is used in the U.S. Government’s vehicle classification manual.

However, even if an additional car, pickup or van clears the vehicle type, vehicle use and date of acquisition hurdles, there are other requirements. Item K.2. coversthe issue of when to report an additional vehicle to the insurance company. The timing of reporting the vehicle has a direct impact upon coverage.

Note: The reporting requirements depend upon the type of coverage involved and whether the vehicle is a replacement.

  1. 2. Coverage for a “newly acquired auto” (but only when it is a replacement) is provided along the basis discussed below. The policy states that, if the insured fails to report a newly acquired auto within the applicable time period requested by the policy, coverage will not begin until the date the late request is made.
  2. The replacement does not have to be reported for liability coverage. The liability coverage that applies to the vehicle being replaced also applies to the replacement vehicle. Reporting is not required.
  3. If the replaced vehicle had Coverage for Damage to Your Auto, the replacement vehicle has the same coverage but only for 14 days. If a report is not provided to the insurance company within 14 days of its acquisition the physical damage coverage ends on the replacement vehicle. If the replaced vehicle did not have Coverage for Damage to Your Auto, the replacement vehicle does not have such coverage either.

Now this is an area that should be clarified by the policy wording. The implication is that a vehicle would have to be reported by the renewing term because, once the policy renews, the replacing vehicle loses its status as a newly acquired auto. However, since the policy states “If a ’newly acquired auto’ replaces a vehicle shown in the Declarations, coverage is provided for this vehicle without your having to ask us to insure it,” a case may be made that the insured has no obligation to EVER report the vehicle. While there are other portions of the policy which would support an implicit requirement that a vehicle should be reported, it would help matters if the policy specifically stated that such a vehicle would have to be reported at the policy’s renewal.

A newly acquired ADDITIONAL car qualifies for coverage ONLY when it is reported to the insurer and that coverage begins upon the date the vehicle is reported. THERE IS NO automatic coverage provided for newly acquired autos that are in addition to the insured autos appearing on the policy.

Example: Dill E. Dally’s SPAP covers a ’13 Mercury and has a policy period of April 15, 2017 to October 15, 2017. It has the following coverage limits
Bodily Injury$100,000/$300,000
Property Damage$100,000
Medical Payments$10,000
Collisionn/a
Other Than Collisionn/a
Uninsured Motorist$25,000/$50,000
On September 3, 2017, Dill buys a second vehicle, a ‘13 Ford Ranger. On September 16, Dill collides with another car when he ignores a stop sign. He causes $22,000 in injuries to the other driver, $4,500 in damages to the other driver’s car and $6,700 in damages to his Ranger. Dill reports the accident to his insurance company on September 18 and that is the same day that the insurance company learns of the new car. Under these circumstances, there is no coverage for either the vehicle or the damage or injuries caused by its use. It is an additional vehicle.

Like the PAP, the SPAP considers pickups and vans eligible vehicles as long as their gross vehicle weight does not exceed 10,000 pounds and they aren’t used commercially. This auto policy is intended to provide coverage for personal exposures. Where the language regarding pickups and vans excludes business use of such vehicles (since commercial policies are available), its approach is reasonable, since it makes exceptions for incidental business use and for farming or ranching. The exceptions recognize the fact that such use is still consistent with what an insurer would consider a personal loss exposure. Another qualifier for providing coverage to pickups or vans is that no other coverage applies. Both owned and non-owned “trailers” are defined as covered autos. Finally, if they’re pulled by an eligible vehicle, farm wagons and implements are also defined as “trailers,” which are eligible for coverage.

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