Which vehicle is covered under Part B - medical payments of the Personal auto policy

Accidental Death & Dismemberment: Covers an insured for accidental death or dismemberment in an automobile accident, regardless of fault. This coverage pays up to the policy limits.

Actual Cash Value (ACV): ACV is the cost to replace a vehicle. Section 626.9743(5), Florida Statutes lists a number of methods or sources which may be used to determine the ACV of a particular pre-owned vehicle, including the cost of two (2) or more comparable vehicles, the retail cost as listed by a motor vehicle industry electronic database or guidebook, or the retail cost using two (2) or more quotations from local automobile dealers. Since the aforementioned methods of determining ACV will produce varying results, the process is subject to a significant degree of subjectivity.

After Market Parts: An after-market part is a replacement for any of the non-mechanical sheet metal or plastic parts which generally constitute the exterior of a motor vehicle, but can include inner and outer panels. They are parts that are not manufactured by the original automobile manufacturer. This is regulated by the Florida Department of Agriculture and Consumer Services, and is referenced in Florida Statute 501.32.

Betterment: An improvement that adds value to the auto. (i.e. a company replaces a five (5)-year old used part with a seven (7)-year life expectancy with a brand new part.)

Cancellation: An automobile policy cancellation is the termination of an insurance policy before its normal termination date. A notice of cancellation must be mailed to the first named insured’s last known address on file and provide at least 45-days advance notice. For a cancellation due to nonpayment of premium, an insurance company is required to issue a 10-day notice of cancellation. The cancellation notices must include the specific reason for the termination of the policy in compliance with F.S. 627.4091. The notice must advise the insured of possible eligibility for coverage in the Florida Joint Underwriting Association (the insurer of last resort).

Comparative Negligence: This means that each party can share in the negligence (fault/liability) that caused the accident.

Customized Equipment: Items added to a vehicle after it has been released from the manufacturer. This equipment can be covered on an automobile policy by endorsement only, which requires the purchase of additional coverage.

Depreciation: A decrease or loss in value because of wear, tear, age, or other causes.

Diminished Value: Diminution in value (DIV), more commonly known as diminished value, describes the theoretical and/or perceived loss of a vehicle’s value resulting from its involvement in a traffic crash, after the collision damage has been repaired. In as much as the value of any vehicle is subject to a significant degree of speculation, opinion, and subjectivity, quantifying such an amount is allusive at best. In addition, Florida Statute does not directly address, or otherwise recognize DIV, nor does it specify any acceptable, or definitive method(s) of calculating it. The burden of proof that DIV exists after proper repairs to a vehicle have been effected, and if it does exist, to what extent, lies with the claimant. Finally, in as much as any potential diminution in value is only realized when the vehicle is sold, it is an amount which continues to decrease with the passing of time.

Examination Under Oath (EUO): Is a part of some claim investigations. If an insurance company finds it necessary to officially document the statements of an individual involved in a particular loss, they may request an EUO. The EUO may be conducted by the insurance company’s attorney and the process could take several hours. If you are subjected to an EUO, you may wish to seek the advice of legal counsel. Refusal to cooperate in an EUO may potentially result in the denial of the claim.

Force Placed Insurance: Coverage placed by a lienholder when the purchaser of a vehicle fails to meet the coverage requirements contained in the loan agreement.
Independent Medical Exam (IME): The insurer has a right to request an independent medical exam. The request for this exam may be for several reasons. It may be used to determine whether the patient has reached maximum medical improvement and to determine the percentage of total or partial disability. An exam may be requested to obtain a second opinion regarding the medical condition or treatment of the patient. The insurer’s request for this exam should not stop payments for PIP benefits until it’s finalized and the report is received by the insurer. However, if the patient refuses the IME, benefits may be terminated. The statutory reference for the IME is included in Section 627.736, Florida Statutes.

Automobile Mediation: A voluntary program that is available to anyone filing a claim with an insurance company for property damage of any dollar amount, or for bodily injuries up to $10,000, which includes injuries covered under PIP. Either party (consumer or insurance company) may request mediation of the claim prior to the institution of litigation or the appraisal process. The insured may have an attorney present but must notify the company in advance.

Mediation is non-binding and neither the consumer nor the insurance company is legally obligated to accept an offer that they consider unsatisfactory. If a settlement is reached, the consumer has three days in which to change their mind as long as the check has not been cashed.

Both first party claims (claims against your insurance company) and third party claims (claims against the other party's insurance company) are eligible for mediation. The cost of mediation is $100. More information regarding this program is available on our website at: https://www.myfloridacfo.com/Division/Consumers/Mediation/default.htm

Independent Medical Exam (IME): The insurer has a right to request an independent medical exam. The request for this exam may be for several reasons. It may be used to determine whether the patient has reached maximum medical improvement and to determine the percentage of total or partial disability. An exam may be requested to obtain a second opinion regarding the medical condition or treatment of the patient. The insurer’s request for this exam should not stop payments for PIP benefits until it’s finalized and the report is received by the insurer. However, if the patient refuses the IME, benefits may be terminated. The statutory reference for the IME is included in Section 627.736, Florida Statutes.

Non-Renewal: A non-renewal is the conclusion of an insurance policy at its scheduled expiration date, followed by the insurance company’s refusal to renew coverage for a subsequent policy term. A notice of non-renewal must be mailed to the first named insured’s last known address, and provide at least 45 days of advanced notice.

Non-renewal notices must include the specific reason the policy will not be renewed. The statutory reference for the provisions associated with the non-renewal of a policy are included in Section 627.4091, Florida Statutes. The notice must advise the insured of possible eligibility for coverage in the Florida Automobile Joint Underwriting Association (the insurer of last resort).

Pre-Insurance Inspection: Section 627.744, Florida Statutes, requires that in order for a policy to include physical damage (Collision, Comprehensive) coverage, vehicles in the counties of Duval, Palm Beach, Broward, Dade, Orange, Hillsborough and Pinellas must be inspected for existing physical damage. Although Florida law only addresses these counties, it is common for insurers to require inspections of vehicles located in other counties as a precondition to including Physical Damage coverage.

Reservation of Rights: When an insurance company discovers, or identifies a possible claim defense (a reason to deny the claim) during the course of a claim investigation, it is required to notify its insured (policyholder) that it is continuing its investigation under a Reservation of Rights. In some cases, the insurer may suspect a breach of policy conditions by the insured, often involving a failure to cooperate with its claim investigation, or a material misrepresentation. The notice is sent to notify the insured that the insurer may investigate the claim without admitting liability, or waiving any of its rights under the policy.

If an insurer investigates a question of coverage, they must send the insured a Reservation of Rights letter within 30 days after they knew, or should have known of the potential coverage defense. If the insurer fails to do so, they cannot deny coverage based on the coverage defense.

Stacked/Non-Stacked UM: Florida law requires that a company add together, or "stack" Uninsured/ Underinsured (UM) coverage unless otherwise rejected in writing. For example, if an insured has three vehicles, and each has a UM limit of 50/100 ($50,000 per person/$100,000 per accident) those limits are added together, resulting in coverage totaling $150,000 per person/$300,000 per accident. If an insured chooses not to stack their UM Coverage limits (non-stacked), an Uninsured/Underinsured Motorist Rejection form must be completed, and provided to the insurer. Since policy provisions vary by insurance company, you should contact your insurance agent or company to determine whether carrying your UM coverage in a stacked, or non-stacked manner best suits your particular insurance needs. You should also determine the cost difference, if any, between stacked and non-stacked UM. The Florida Statute to reference is 627.727.

Total Loss: A vehicle is a total loss when an insurer pays the policyholder to replace the damaged (or stolen) vehicle with one of like kind and quality. No specific ratio of the damage repair cost, as compared to the vehicle’s actual cash value, is stipulated in Florida law, which determines when a vehicle is deemed a total loss.

The definition of a total loss and requirements of such is addressed in Section 319.30, Florida Statutes. This statute is overseen by the Department of Highway Safety & Motor Vehicles and includes directions for submitting the title of a ”total loss vehicle”.

Which of the following would not be covered under a personal auto policy?

What are the 4 parts of a personal auto policy?

What type of insurance covers each person in on around or under the car for medical expenses in an accident?

Which of the following would you find in the conditions section of an insurance policy?