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**** CASE NUMBER: 502024CA004205XXXAMB Div: AN ****
Filing # 197695196 E-Filed 05/06/2024 02:30:49 PM
IN THE CIRCUIT COURT OF THE
FIFTEENTH JUDICIAL CIRCUIT
IN AND FOR PALM BEACH
COUNTY, FLORIDA
GEICO GENERAL INSURANCE
COMPANY, CASE NO.:
Plaintiff,
v.
ANDREW STEVEN HENRY,
CES PIZZA, INC., and
LAKENDRICK WALLER,
Defendants.
_________________________________/
COMPLAINT FOR DECLARATORY RELIEF
Plaintiff, GEICO GENERAL INSURANCE COMPANY (“GEICO”), through
undersigned counsel, files this Complaint for Declaratory Relief and sues Defendants,
ANDREW STEVEN HENRY (“HENRY”), CES PIZZA, INC. (“CES”), and LAKENDRICK
WALLER (“WALLER”), and demands a jury trial of all issues so triable as of right, stating:
JURISDICTION, PARTIES, AND VENUE
1. This is a suit for declaratory relief pursuant to Section 86.011, Florida Statutes.
2. This action arises out of a motor vehicle accident allegedly occurring on
December 9, 2022, in Palm Beach County, Florida, while HENRY was operating a motor vehicle
in the course and scope of the business of CES, and relates to a policy of insurance issued by
GEICO to named insured, HENRY, for which WALLER, HENRY, and CES have made
demands for coverage for the subject accident.
FILED: PALM BEACH COUNTY, FL, JOSEPH ABRUZZO, CLERK, 05/06/2024 02:30:49 PM
3. An actual controversy exists among the parties regarding the issue of coverage
under the subject insurance policy and the rights and obligations, if any, of the parties arising
from the insurance policy.
4. At all material times, GEICO was licensed and doing business in Palm Beach
County, Florida.
5. At all material times, HENRY was a resident of Palm Beach County, Florida.
6. At all material times, CES was licensed and doing business in Palm Beach
County, Florida.
7. At all material times, WALLER was a resident of Palm Beach County, Florida.
8. Venue is proper in Palm Beach County, Florida, as the policy of insurance at issue
in this action was issued for delivery and delivered in Palm Beach County, Florida, and the
subject accident allegedly occurred in Palm Beach County, Florida.
FACTUAL ALLEGATIONS
9. GEICO issued Florida Family Automobile Insurance Policy number 6047-44-64-
45 to HENRY at 13824 Yarmouth Drive, Apartment A, Wellington, Florida 33414, for the
policy period of June 26, 2022 through December 26, 2022 (“the Policy”). The Policy insured a
2009 Hyundai, VIN 5NPET46C69H504039, and carried, among other coverages, Bodily Injury
Liability coverage with limits of $10,000 each person and $20,000 each occurrence and Property
Damage Liability coverage of $10,000 each occurrence. (A true and correct certified copy of the
subject Policy is attached as Exhibit A).
10. The Policy states in pertinent part:
SECTION I – LIABILITY COVERAGES
Bodily Injury Liability And Property Damage Liability
Your Protection Against Claims From Others
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***
LOSSES WE WILL PAY FOR YOU
Under Section I, we will pay damages which an insured becomes legally
obligated to pay because of:
1. Bodily injury, sustained by a person, and
2. Damage to or destruction of property,
arising out of the ownership, maintenance of use of the owned auto or a non-
owned auto.
DUTY TO DEFEND
We will defend any suit for damages payable under the terms of this policy. We
may investigate and settle any claim or suit. We have no duty to investigate or
defend any claims which are not covered under the terms of this policy.
Our duty to defend ends when the limits of liability for bodily injury liability have
been exhausted by payments of judgments or settlements.
***
EXCLUSIONS
Section I does not apply to any claim or suit for damage if one or more of the
following exclusions listed below applies:
***
2. We do not cover bodily injury or property damage arising out of
the ownership, maintenance, or use of any vehicle or trailer while:
(a) being used to carry persons or property for compensation or
a fee, including but not limited to the delivery of food or
any other products.
(Ex. A 9-11).
11. On December 9, 2022, HENRY operated his 2009 Hyundai while in the course
and scope of his employment with CES to deliver pizza to a customer for compensation or a fee.
12. While en route to deliver a pizza to a CES customer, HENRY’s vehicle collided
with the vehicle owned and operated by WALLER, allegedly causing bodily injury to WALLER.
13. WALLER subsequently filed a lawsuit against HENRY and CES in the Fifteenth
Judicial Circuit Court in and for Palm Beach County, Florida, styled as Lakendrick Waller v.
Andrew Steven Henry and CES Pizza, Inc., Case Number 50-2023-CA-004359. WALLER’s
Complaint includes one count of negligence against HENRY and one count of vicarious liability
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against CES, alleging that HENRY was within the scope of his employment with CES at the
time of the subject accident.
14. GEICO is currently providing a defense to HENRY in the lawsuit filed by
WALLER, subject to a reservation of rights.
COUNT I – DECLARATORY JUDGMENT
15. GEICO re-alleges paragraphs 1-14 above, as if fully set forth herein.
16. There is an actual, present, and existing controversy among the parties to this
lawsuit regarding whether liability insurance coverage, including indemnity and a duty to defend,
is afforded under the Policy for the claims asserted by WALLER against HENRY and CES in
Case No. 50-2023-CA-004359 in the Circuit Court of the Fifteenth Judicial Circuit in and for
Palm Beach County, Florida and the damages allegedly sustained by WALLER.
17. GEICO contends there is no liability coverage available under the Policy for the
damages allegedly sustained by WALLER in the December 9, 2022 accident involving HENRY
because of the exclusion contained in the Policy providing that Section I – Liability Coverages
does not apply to “bodily injury or property damage arising out of the ownership, maintenance,
or use of any vehicle or trailer while being used to carry persons or property for compensation or
a fee, including but not limited to the delivery of food or any other products.” (Ex. A 11).
18. At the time of the accident with WALLER, HENRY was operating his 2009
Hyundai in the course and scope of his employment with CES and in the process of delivering
pizza to a customer for compensation or a fee. Thus, the “Carrying Persons or Property for
Compensation or a Fee” Exclusion applies to preclude coverage under the Policy and GEICO
owes no duty to provide a defense or indemnity to HENRY or CES for the claims made by
WALLER.
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19. In view of the foregoing, GEICO is uncertain as to its legal rights and obligations
under the Policy.
WHEREFORE, GEICO respectfully requests that this Court:
A. Take jurisdiction of this case and determine the rights, duties, and obligations of
the parties under the provisions of the subject insurance policy;
B. Enter an Order declaring that GEICO is entitled to deny Bodily Injury Liability
coverage and Property Damage Liability coverage under Policy number 6047-44-64-45 with
respect to the accident occurring on December 9, 2022, and the claims asserted by WALLER
against HENRY and CES in Case No. 50-2023-CA-004359 in the Circuit Court of the Fifteenth
Judicial Circuit in and for Palm Beach County, Florida, based on a finding that, at the time of
loss, HENRY operated his vehicle to deliver food for compensation or a fee, which is excluded
under Section I of the Policy;
C. Declare that GEICO does not owe a duty to defend the claims asserted by
WALLER against HENRY and CES in Case No. 50-2023-CA-004359 in the Circuit Court of the
Fifteenth Judicial Circuit in and for Palm Beach County, Florida; and further
D. Award GEICO costs and other relief as are justified under the circumstances.
DEMAND FOR JURY TRIAL
GEICO demands trial by jury of all issues so triable as of right.
Respectfully submitted this 6th day of May, 2024.
/s/ Sharon C. Degnan
SHARON C. DEGNAN
Florida Bar No.: 61255
RYAN D. ELIAS
Florida Bar No.: 1015282
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KUBICKI DRAPER
Attorneys for GEICO
201 South Orange Avenue, Suite 475
Orlando, Florida 32801
Telephone: (407) 419-3812
Facsimile: (407) 245-7685
E-Mail: SCD-KD@kubickidraper.com
Attorneys for GEICO
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EXHIBIT A
Certified Copy of GEICO
Policy
1. POLICY_6047446445_COVER_SHEET.PDF
CERTIFIED COVER SHEET
Claim Number: 8708292330000002 Date Of Loss: 12/9/2022
Adjuster: J121
Policyholder: ANDREW STEVEN
HENRY
Policy Number: 6047446445
Policy Term Start Date: 6/26/2022
Company: GEICO General Insurance Company
J. Roman Date Requested: 12/12/2022
Date Processed: 12/16/2022
1
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2. POLICY_6047446445_AFF.PDF
REGION 6 UNDERWRITING RESPONSE TO CLAIMS
REQUEST FOR F.S. 627.4137
COPY OF THE POLICY
The Policy Declarations sheet has been electronically forwarded to Claims for
Claim Number 8708292330000002, Policy Number 6047446445, and issued
to ANDREW STEVEN HENRY based upon records in our computer data in
our files and was in effect on the date of loss 12/09/2022.
The policy contract, amendments and endorsements, also electronically
forwarded to Claims, are standard forms with information particular to Policy
Number 6047446445 and issued to ANDREW STEVEN HENRY and was in
effect the date of loss 12/09/2022.
J. Roman
Underwriting Department
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3. POLICY_6047446445.PDF
GEICO FAMILY AUTOMOBILE POLICY ENDORSEMENT DECLARATIONS
GEICO GENERAL INSURANCE COMPANY THIS IS A DESCRIPTION OF YOUR COVERAGE
ONE GEICO PLAZA, WASHINGTON, D.C. 20047-0001 PLEASE KEEP FOR YOUR RECORDS
TELEPHONE: 1-800-841-7475 Fax: 1-478-744-5710 PAGE 1
POLICY PERIOD FROM 06/26/22 TO: 12/26/22 12:01AM LOCAL TIME AT THE ADDRESS OF THE NAMED
INSURED.
THE INSURED VEHICLE(S) WILL BE REGULARLY GARAGED IN THE TOWN AND STATE SHOWN IN ITEM 1,
EXCEPT AS NOTED IN THE VEHICLE SEGMENT.
POLICY NUMBER: 6047446445 DATE PROCESSED: 12/07/22 CONTRACT TYPE: A30FL
ENDORSEMENT EFFECTIVE: 12/08/22
Item 1: Named Insured and Address
ANDREW STEVEN HENRY
13824 YARMOUTH DR APT A
WELLINGTON FL 33414-2726
CONTRACT AMENDMENTS: ALL VEHICLES – A30FL A54FL A54FLPVS SIGPGCW(07-20)
UNIT ENDORSEMENTS: A239 (VEH 1); A431 (VEH 1)
* * * * * * * * * IMPORTANT MESSAGES * * * * * * * * * *
INSURED COPY
U-31-DP
(1)
Sensitivity: General/Internal 5
GEICO GENERAL INSURANCE COMPANY
POLICY NUMBER: 6047446445 DATE PROCESSED: 12-07-22 PAGE 02
VEHICLE RATED LOCATION CLASS
1 2009 HYUNDAI 5NPET46C69H504039 WELLINGTON FL 33414-2726
COVERAGES LIMITS OR PREMIUMS
Coverage applies where a premium or 0.00 is shown for the vehicle. DEDUCTIBLES VEH 1 VEH VEH
BODILY INJURY LIABILITY
EACH PERSON/EACH OCCURRENCE $10,000/$20,000 118.40
PROPERTY DAMAGE LIABILITY $10,000 64.70
PERSONAL INJURY PROTECTION $1,000 DED 101.10
INSURED AND RESIDENT RELATIVES
ADD'L PERSONAL INJURY PROTECTION 20% MED/25% WL 10.20
INSURED
UNINSURED MOTORIST/NONSTACKED
EACH PERSON/EACH OCCURRENCE $10,000/$20,000 93.60
COMPREHENSIVE $1,000 DED 28.80
COLLISION $1,000 DED 66.10
RENTAL REIMBURSEMENT $30 PER DAY 11.70
$900 MAX
SIX MONTH PREMIUM PER VEHICLE $494.60
LIENHOLDER VEHICLE LIENHOLDER VEHICLE LIENHOLDER VEHICLE
INSURED COPY
U-31-DP
Sensitivity: General/Internal 6
4. A30FL(03-20).PDF
ONE GEICO PLAZA
Washington, D. C. 20076-0001
Telephone: 1-800-841-3000
Florida
Family
Automobile
Insurance
Policy
A30FL (03-20)
7
YOUR POLICY INDEX
Page Page
SECTION I - LIABILITY COVERAGES 3 Exclusions: When The Physical Damage
Your Protection Against Claims From Others Section III Does Not Apply
Definitions Limit Of Liability
Losses We Will Pay For You Other Insurance
Duty to Defend Conditions
Additional Payments We Will Make Under Notice
The Liability Coverages Assistance And Cooperation Of The Insured
Legal Expenses And Court Action Against Us
Costs Bail And Appeal Bonds Insured's Duties In Event Of Loss
First Aid Expenses Appraisal
Exclusions Payment Of Loss
No Benefit To Bailee
Persons Insured: Who Is Covered
Subrogation
Financial Responsibility Laws
Assignment
Out of State Coverage
Limits Of Liability SECTION IV - UNINSURED MOTORISTS COVERAGE 22
Other Insurance Protection For You And Your Passengers For
Conditions Injuries Caused By Uninsured And Hit-And-Run
Notice Motorist
Assistance And Cooperation Of The Insured
Action Against Us SECTION V - GENERAL CONDITIONS 22
Subrogation
The Following Apply To All Coverages In This Policy
SECTION II: PART I - PERSONAL INJURY 7 Territory - Policy Period
PROTECTION AND PART V - AUTOMOBILE Premium
MEDICAL PAYMENTS Payment
Definitions Changes
Payments We Will Make Assignment
Exclusions Cancellation By The Insured
Limits Of Liability; Application Of Deductible; Cancellation By Us
Other Insurance Cancellation By Us Is Limited
Policy Period-Territory Renewal
Conditions Non Renewal
Notice; Action Against The Company; Proof Of Mediation Of Claims
Claim And Medical Reports; Independent Medical Other Insurance
Examinations; Payment Of Claim Withheld; Action Against Us
Examination Under Oath; Reimbursement And Dividend Provision
Subrogation; Special Provision For Rented Or Declarations
Leased Vehicles; Reasonable Belief Of Fraud; Fraud and Misrepresentation
Nonreimbursible Claims; Additional Conditions Examination Under Oath
Additional Personal Injury Protection (Part II) Terms Of Policy Conformed To Statutes
Modification Of Policy Coverages (Part III) Choice of Law
Provisional Premium (Part IV) Disposal Of Vehicle
Automobile Medical Payments Coverage
(Part V) SECTION VI - AMENDMENTS AND ENDORSEMENTS 25
SECTION III – PHYSICAL DAMAGE COVERAGES 18 Special Endorsement
Your Protection For Loss Of Or Damage To Your United States Government Employees
Car
Definitions
Losses We Will Pay
Comprehensive(Excluding Collision)
Collision
Additional Payments We Will Make Under The
Physical Damage Coverage
Car Rental If Your Car Is Stolen
A30FL (03-20)
8
Whenever "he," "his," "him," or "himself" appears in this policy, you may read "she," "her," "hers," or "herself."
AGREEMENT
We, the Company named in the declarations attached to this policy, make this agreement with you, the
policyholder. Relying on the information you have furnished and the declarations attached to this policy and if
you pay your premium when due, we will do the following:
SECTION I - LIABILITY COVERAGES
Bodily Injury Liability And Property Damage Liability
Your Protection Against Claims From Others
DEFINITIONS
The words bolded and italicized in Section I of this policy are defined below.
1. Auto business means the business of selling, repairing, renting, leasing, brokering, servicing, storing, transporting
or parking of autos.
2. Bodily injury means bodily injury to a person, caused by accident, including resulting sickness, disease or death.
All claims for damages arising from bodily injury to a person from a single loss shall be considered one bodily
injury.
3. Farm auto means a truck type vehicle with a gross vehicle weight of 15,000 pounds or less, not used for
commercial purposes other than farming.
4. Insured means a person or organization described under PERSONS INSURED.
5. Non-owned auto means a private passenger auto, farm auto, utility auto or trailer not owned by, furnished or
available for regular use of either you or your relative, other than a temporary substitute auto. You or your
relative must be using the non-owned auto or trailer with the permission of, or reasonably believed to be with
the express or implied permission of, the owner. A motor vehicle rented or leased for more than 30 days will be
considered as furnished or available for regular use.
6. Owned auto means:
(a) A vehicle described in this policy for which a premium charge is shown for these coverages;
(b) A trailer owned by you;
(c) A private passenger auto, farm auto or utility auto, ownership of which you acquire during the policy period
or for which you enter into a lease during the policy period for a term of six months or more, if
(i) It replaces an owned auto as defined in (a) above; or
(ii) We insure all private passenger autos, farm autos and utility autos owned by you on the date of the
acquisition, and you ask us to add it to the policy no more than 30 days later;
(d) A temporary substitute auto.
7. Personal vehicle sharing program means a business, organization, network or group facilitating the sharing of
private passenger motor vehicles for use by individuals or businesses pursuant to the terms of a written agreement.
8. Private passenger auto means a four-wheel private passenger, station wagon or jeep-type auto, including a farm
auto or utility auto as defined.
9. Relative means a person related to you by blood, marriage or adoption (including a ward or foster child) who is a
resident of the same household as you.
10. Ride-sharing means the use of any vehicle by any insured in connection with a transportation network
company from the time an insured logs on to or signs in to any computer or digital network, application or platform
that connects or matches driver(s) with passenger(s) until the time an insured logs out of or signs off of any such
network, application or platform, including while en route to pick up passenger(s) and while transporting
passenger(s).
11. Temporary substitute auto means a private passenger auto, farm auto or utility auto or trailer, not owned by
you or your relative, temporarily used with the permission of the owner. This vehicle must be used as a substitute
for the owned auto or trailer when withdrawn from normal use because of its breakdown, repair, servicing, loss or
destruction. This vehicle will no longer qualify as a temporary substitute auto:
(a) Five (5) days after the owned auto is deemed by us to be a total loss, and
(b) We pay the applicable limit of liability under Section III.
12. Trailer means a vehicle designed to be towed by a private passenger auto, farm auto or utility auto. If the
vehicle is being used primarily for business or commercial purposes, it is a trailer only while used with a private
passenger auto, farm auto or utility auto. Trailer also means a farm wagon or farm implement used with a farm
auto.
$)/ 3DJHRI 3ROLF\1XPEHU
9
13. Transportation network company means an entity, company or organization facilitating and/or providing
transportation services using a computer or digital network, application or platform to connect or match
passengers with drivers for compensation or a fee.
14. Utility auto means a vehicle, other than a farm auto, with a gross vehicle weight of 15,000 pounds or less of the
pick-up body, van or panel truck type not used for commercial purposes.
15. War means armed conflict between nations, whether or not declared, civil war, insurrection, rebellion or revolution.
16. You and your means only the individual(s) named in the Declarations as Named Insured and his or her
spouse if a resident of the same household.
You and your does not include any individual(s) named in the Declarations Page as:
(a) Additional Drivers;
(b) Additional Driver; or
(c) any other individual(s).
LOSSES WE WILL PAY FOR YOU
Under Section I, we will pay damages which an insured becomes legally obligated to pay because of:
1. Bodily injury, sustained by a person, and
2. Damage to or destruction of property,
arising out of the ownership, maintenance or use of the owned auto or a non-owned auto .
DUTY TO DEFEND
We will defend any suit for damages payable under the terms of this policy. We may investigate and settle any claim or
suit. We have no duty to investigate or defend any claims which are not covered under the terms of this policy.
Our duty to defend ends when the limits of liability for bodily injury liability have been exhausted by payments of
judgments or settlements.
ADDITIONAL PAYMENTS WE WILL MAKE UNDER THE LIABILITY COVERAGES
1. Investigative costs for services we specifically request for an insured. We do not pay for fees or costs assessed
against an insured pursuant to statute, court order, court rule or otherwise.
2. Legal services provided by an attorney we retain to represent an insured and any other legal services we retain to
represent an insured.
3. We only pay post-judgment interest that begins to accrue after the entry of a final judgment against an insured,
subject to all of the following:
(a) We only pay post-judgment interest on that part of the judgment that is against an insured and only for those
damages that are covered under this Section; and
(b) We only pay post-judgment interest calculated on that part of the judgment against an insured that is within the
applicable limit of liability under this Section. If the applicable limit of liability under this Section has been reduced
by payment(s) of any other liability claims or judgments, we only pay post-judgment interest calculated on that
part of the remaining applicable limit of liability under this Section; and
(c) We only pay post-judgment interest calculated up until the time we pay, offer to pay, or deposit in court the
remaining applicable limit of liability under this Section; and
(d) We do not pay post-judgment interest if we have not been given notice of suit or the opportunity to defend the
insured.
4. We pay the premiums for appeal bonds in a suit we appeal or the premiums for bonds to release attachments,
subject to all of the following:
(a) The amount bonded shall not exceed the applicable limit of liability under this Section. If the applicable limit of
liability under this Section has been reduced by payment(s) of any other liability claims or judgments, the amount
bonded shall not exceed the remaining applicable limit of liability under this Section; and
(b) The amount bonded shall only be for those damages that are covered under this Section; and
(c) We do not pay premiums for bonds if we pay, offer to pay, or deposit in court the remaining applicable limit of
liability under this Section; and
(d) We have no duty to apply for or furnish these bonds.
5. We will upon request by an insured, provide reimbursement for the following items:
(a) An insured's loss of earnings up to $200 a day for each day an insured attends hearings and trials at our
request.
(b) An insured's reasonable expenses for travel, meals and lodging, to attend hearings and trials at our request.
(c) Premiums for bail bonds paid by an insured due to traffic law violations arising out of the use of an owned auto,
not to exceed $250 per bail bond. We have no duty to apply for or furnish these bonds.
(d) An insured's reasonable costs up to $500 incurred when that insured provides and renders first aid to others at
the time of an accident involving an owned auto or non-owned auto .
(e) An insured's other reasonable costs incurred at our request. This does not include fees or costs assessed
against an insured pursuant to statute, court order, court rule or otherwise.
$)/ 3DJHRI 3ROLF\1XPEHU
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EXCLUSIONS
Section I does not apply to any claim or suit for damage if one or more of the following exclusions listed below applies:
1. We do not cover any bodily injury to any insured or any member of an insured's family residing in the insured's
household.
This exclusion does not apply if you or your relative is injured as a passenger in a motor vehicle insured under this
policy while that vehicle is being driven by a person who is neither you nor your relative.
2. We do not cover bodily injury or property damage arising out of the ownership, maintenance, or use of any vehicle
or trailer while:
(a) being used to carry persons or property for compensation or a fee, including but not limited to the delivery of
food or any other products; or
(b) being used for ride-sharing.
However, this exclusion does not apply to ordinary car pools. An ordinary car pool is one where:
(i) An insured receives no payment for using a vehicle for a car pool ride; or
(ii) An insured receives only reimbursement for expenses for using a vehicle for a car pool ride, the
reimbursement an insured receives for providing the car pool ride does not exceed the reasonable cost of
gas and depreciation for the distance traveled, and the reimbursement received by an insured is not
required to be reported for income tax purposes.
An ordinary car pool does not include a car pool established, set up or planned through a transportation
network company.
3. We do not cover any person who intentionally causes bodily injury or property damage.
4. We do not cover bodily injury or property damage that is insured under a nuclear liability policy. This exclusion
applies even if the limits of that policy are exhausted.
5. We do not cover bodily injury or property damage arising from the operation of farm machinery.
6. We do not cover bodily injury to an employee of an insured arising out of and in the course of employment by an
insured. However, bodily injury of a domestic employee of the insured is covered unless benefits are payable or
are required to be provided under a workmen's compensation law.
7. We do not cover bodily injury to a fellow employee of an insured (other than you) injured in the course of his
employment if the bodily injury arises from the use of an auto in the business of his employer, and if benefits
are payable under a workmen's compensation policy.
8. We do not cover an owned auto while used by a person (other than you or a relative or your or your relative's
partner, agent or employee) when he is employed or otherwise engaged in the auto business.
9. We do not cover a non-owned auto while maintained or used by a person while he is employed or otherwise
engaged in any auto business.
10. We do not cover damage:
(a) To property owned, transported, or used by an insured; or
(b) To property rented to or in the charge of an insured. This exclusion 10.(b) does not apply to a residence or
private garage.
11. We do not cover an auto acquired by you during the policy term, if you have purchased other liability insurance for it.
12. We do not cover:
(a) The United States of America or any of its agencies;
(b) Any person, including you, if protection is afforded under the provisions of the Federal Tort Claims Act.
13. We do not cover any liability assumed under any contract or agreement.
14. We do not cover bodily injury or property damage arising out of:
(a) the insured’s participation in and/or preparation for any racing, speed, or demolition contest or stunting activity
of any nature, whether or not prearranged or organized; or
(b) the operation or use of a motor vehicle on a track designed primarily for racing or high speed driving. This does
not apply if the vehicle is being used in connection with an activity other than racing, high speed driving or any
competitive driving.
15. We do not cover punitive or exemplary damages, regardless of any other provision of this policy.
16. We do not cover any person or organization while any owned auto is operated, maintained or used as part of
personal vehicle sharing facilitated by a personal vehicle sharing program. This exclusion does not apply to the
operation of a temporary substitute auto by you or by any other person using the auto with your express or
implied permission.
This exclusion only applies to the portion of the damages that are in excess of the minimum limits of liability
coverage required by the Florida Financial Responsibility Law.
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17. We do not cover damages arising from the ownership, maintenance, use, rental, loading, unloading, entrustment or
supervision of any motorized vehicle that is designed for use principally off public roads that is not registered for use
on public roads. This exclusion does not apply if the motorized vehicle is listed on the declarations page of this policy
and a premium charge is shown for this coverage.
PERSONS INSURED
Who Is Covered
Section I applies to the following as insureds with regard to an owned auto:
1. You;
2. Any other person using the auto with your express or implied permission;
3. Any other person or organization for his or its liability because of acts or omissions of an insured under 1. or
2. above.
Section I applies to the following as insureds with regard to a non-owned auto :
1. You and your relatives when driving the non-owned auto. Such use must be with the permission, or
reasonably believed to be with the express or implied permission, of the owner.
2. A person or organization, not owning or hiring the auto, regarding his or its liability because of acts or
omissions of an insured under 1. above.
The limits of liability stated in the declarations are our maximum obligations regardless of the number of insureds
involved in the occurrence.
FINANCIAL RESPONSIBILITY LAWS
When this policy is certified as proof of compliance with the Florida financial responsibility law for the future, this
liability insurance will comply with the provisions of that law.
OUT OF STATE COVERAGE
When the policy applies to the operation of a motor vehicle outside of your state, we agree to increase these
coverages to the extent required of out-of-state motorists by local, compulsory insurance law. This additional coverage
will be reduced to the extent that you are protected by another insurance policy. No person can be paid more than
once for any item of loss.
LIMITS OF LIABILITY
Regardless of the number of autos or trailers to which this policy applies:
1. The limit of bodily injury liability stated in the declarations as applicable to "each person" is the limit of our liability
for all damages, including damages for care and loss of services, because of bodily injury sustained by one
person as the result of one occurrence.
2. The limit of such liability stated in the declarations as applicable to "each occurrence" is, subject to the above
provision respecting each person, the total limit of our liability for all such damages, including damages for care
and loss of services, because of bodily injury sustained by two or more persons as the result of any one
occurrence.
3. The limit of property damage liability stated in the declarations as applicable to "each occurrence" is the total limit
of our liability for all damages because of damage to or destruction of the property of one or more persons or
organizations, including the loss of use of the property as the result of any one occurrence.
4. An auto and attached trailer are considered to be one auto.
OTHER INSURANCE
Any insurance we provide for losses arising out of the ownership, maintenance or use of a vehicle you do not own
shall be excess over any other valid and collectible insurance.
If the insured has other applicable insurance against a loss covered by Section I of this policy, we will not owe more
than our pro-rata share of the total coverage available.
CONDITIONS
The following conditions apply to Section I:
1. NOTICE
As soon as possible after an occurrence, written notice must be given to us or our authorized agent stating:
(a) The identity of the insured;
(b) The time, place and details of the occurrence;
(c) The names and addresses of the injured, and of any witnesses; and
(d) The names of the owners and the description and location of any damaged property.
If a claim or suit is brought against an insured, he must promptly send us each demand, notice, summons or other
process received.
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2. ASSISTANCE AND COOPERATION OF THE INSURED
The insured will cooperate and assist us, if requested:
(a) In the investigation of the occurrence;
(b) In making settlements;
(c) In the conduct of suits;
(d) In enforcing any right of contribution or indemnity against any legally responsible person or organization
because of bodily injury or property damage;
(e) At trials and hearings;
(f) In securing and giving evidence; and
(g) By obtaining the attendance of witnesses, when it is within the insured’s ability to do so.
Only at his own cost will the insured make a payment, assume any obligation or incur any cost other than for first
aid to others.
3. ACTION AGAINST US
No suit may be brought against us:
(a) Unless the insured has fully complied with all the policy's terms and conditions, and
(b) Until the amount of the insured's obligation to pay has been finally determined, either:
(i) By a final judgment against the insured after actual trial; or
(ii) By written agreement of the insured, the claimant and us.
A person or organization or the legal representative of either, who secures a judgment or written agreement, may
then sue to recover up to the policy limits.
No person or organization, including the insured, has a right under this policy to make us a defendant in an action to
determine the insured's liability.
Bankruptcy or insolvency of the insured or of his estate will not relieve us of our obligations.
4. SUBROGATION
When payment is made under this policy, we will be subrogated to all the insured's rights of recovery against
others. The insured will help us to enforce these rights. The insured will do nothing after loss to prejudice these
rights.
This means we will have the right to sue for or otherwise recover the loss from anyone else who may be held
responsible.
When a person has been paid damages by us under this policy and also recovers from another, that person shall:
(a) Hold in trust for us the amount recovered; and
(b) Reimburse us to the extent of our payment.
SECTION II: PART I - PERSONAL INJURY PROTECTION AND PART V - AUTOMOBILE MEDICAL PAYMENTS
(Automobile Medical Payments Coverage applies only if a premium amount is shown in the Policy Declarations
for "Medical Payments" coverage)
PART I - PERSONAL INJURY PROTECTION
DEFINITIONS
1. Bodily injury means bodily injury, sickness, or disease to a person, caused by accident, including resulting
sickness, disease or death resulting therefrom. All claims for damages arising from bodily injury to a person from
a single loss shall be considered one bodily injury .
2. Disability benefits means sixty percent (60%) of any loss of gross income and loss of earning capacity per individual
from inability to work proximately caused by the injury sustained by the injured person, plus all expenses reasonably
incurred in obtaining from others ordinary and necessary services in lieu of those that, but for the injury, the injured
person would have performed without income for the benefit of his or her household.
3. Emergency medical condition means a medical condition manifesting itself by acute symptoms of sufficient severity,
which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to
result in any of the following:
(a) Serious jeopardy to patient health;
(b) Serious impairment to bodily functions; or
(c) Serious dysfunction of any bodily organ or part.
4. Entity wholly owned means a proprietorship, group practice, partnership, or corporation that provides health care
services rendered by licensed health care practitioners and in which licensed health care practitioners are the business
owners of all aspects of the business entity, including, but not limited to, being reflected as the business owners on the
title or lease of the physical facility, filing taxes as the business owners, being account holders on the entity's bank
account, being listed as the principals on all incorporation documents required by this state, and having ultimate
authority over all personnel and compensation decisions relating to the entity. However, this definition does not apply to
an entity that is wholly owned, directly or indirectly, by a hospital licensed under Florida Statutes, chapter 395.
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5. Insured means:
(a) You or any relative while occupying a motor vehicle or, while a pedestrian through being struck by a motor
vehicle; or
(b) Any other person while occupying the insured-motor-vehicle or, while a pedestrian, through being struck by the
insured-motor-vehicle.
6. Insured-motor-vehicle means a motor vehicle:
(a) Of which you are the owner, and
(b) With respect to which security is required to be maintained under the Florida Motor Vehicle No-Fault Law, and
(c) For which a premium is charged by us, or which is a trailer, other than a mobile home, designed for use with a
motor vehicle.
7. Medical benefits means all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and
rehabilitative services, including prosthetic devices and medically necessary ambulance, hospital, and nursing
services if the individual receives initial services and care pursuant to paragraph (a) within 14 days after the motor
vehicle accident. The medical benefits provide reimbursement only:
(a) For initial services and care that are lawfully provided, supervised, ordered, or prescribed by a physician licensed
under Florida Statutes, chapter 458 or chapter 459, a dentist licensed under Florida Statutes, chapter 466, a
chiropractic physician licensed under Florida Statutes, chapter 460, or an advanced practice registered nurse
registered under Florida Statutes 464.0123 or that are provided in a hospital or in a facility that owns, or is wholly
owned by, a hospital. Initial services and care may also be provided by a person or entity licensed under part III of
Florida Statutes, chapter 401 which provides emergency transportation and treatment.
(b) Upon referral by a provider described in paragraph (a), for follow up services and care consistent with the
underlying medical diagnosis rendered pursuant to paragraph (a) which may be provided, supervised, ordered, or
prescribed only by a physician licensed under Florida Statutes, chapter 458 or chapter 459, a chiropractic physician
licensed under Florida Statutes, chapter 460, a dentist licensed under Florida Statutes, chapter 466, or an
advanced practice registered nurse registered under Florida Statutes 464.0123, or, to the extent permitted by
applicable law and under the supervision of such physician, osteopathic physician, chiropractic physician, or dentist,
by a physician assistant licensed under Florida Statutes, chapter 458 or chapter 459 or an advanced registered
nurse practitioner licensed under Florida Statutes, chapter 464.
(c) Follow up services and care may also be provided by any of the following persons or entities:
1. A hospital or ambulatory surgical center licensed under Florida Statutes, chapter 395.
2. An entity wholly owned by one or more physicians licensed under Florida Statutes, chapter 458 or chapter
459, chiropractic physicians licensed under Florida Statutes, chapter 460, advanced practice registered
nurses registered under Florida Statutes 464.0123, or dentists licensed under Florida Statutes, chapter 466 or
by such practitioners and the spouse, parent, child, or sibling of such practitioners.
3. An entity that owns or is wholly owned, directly or indirectly, by a hospital or hospitals.
4. A physical therapist licensed under Florida Statutes, under chapter 486, based upon a referral by a provider
described in paragraph (b) under medical benefits.
5. A health care clinic licensed under Florida Statutes, part X of chapter 400 which is accredited by the Joint
Commission on Accreditation of Healthcare Organizations, the American Osteopathic Association, the
Commission on Accreditation of Rehabilitation Facilities, or the Accreditation Association for Ambulatory Health
Care, Inc., or
(a) Has a medical director licensed under Florida Statutes, chapter 458, chapter 459, or chapter 460;
(b) Has been continuously licensed for more than 3 years or is a publicly traded corporation that issues
securities traded on an exchange registered with the United States Securities and Exchange Commission
as a national securities exchange; and
(c) Provides at least four of the following medical specialties:
(i) General medicine.
(ii) Radiography.
(iii) Orthopedic medicine.
(iv) Physical medicine.
(v) Physical therapy.
(vi) Physical rehabilitation.
(vii) Prescribing or dispensing outpatient prescription medication.
(viii) Laboratory services.
Medical benefits do not include massage as defined in Florida Statutes § 480.033 or acupuncture as defined in Florida
Statutes § 457.102, regardless of the person, entity, or licensee providing massage or acupuncture, and a licensed
massage therapist or licensed acupuncturist will not be reimbursed for medical benefits.
8. Medically necessary refers to a medical service or supply that a prudent physician would provide for the purpose of
preventing, diagnosing, or treating an illness, injury, disease, or symptom in a manner that is:
(a) In accordance with generally accepted standards of medical practice;
(b) Clinically appropriate in terms of type, frequency, extent, site, and duration; and
(c) Not primarily for the convenience of the patient, physician, or other health care provider.
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9. Motor vehicle means any self-propelled vehicle of four or more wheels which is of a type both designed and required
to be licensed for use on the highways of Florida and any trailer or semi-trailer designed for use with such vehicle.
A motor vehicle does not include:
(a) Any motor vehicle which is used in mass transit other than public school transportation and designed to transport
more than five passengers exclusive of the operator of the motor vehicle and which is owned by a municipality, a
transit authority, or a political subdivision of the state; or
(b) A mobile home.
10. Occupying means in or upon or entering into or alighting from.
11. Owner means a person or organization who holds the legal title to a motor vehicle, and also includes:
(a) A debtor having the right to possession, in the event a motor vehicle is the subject of a security agreement, and
(b) A lessee having the right to possession, in the event a motor vehicle is the subject of a lease with option to
purchase and such lease agreement is for a period of six months or more, and
(c) A lessee h