PSIPersonal Service Insurance Company

1000 River RoadSuite 300

Conshohocken, PA 19428

•New Jersey StandardPersonal Auto Policy

PSIC NJ SPOL (12/11)

POLICY GUIDELINE

Section I. Definitions .........................................................................................................................................1

Section II. Insuring Agreement.........................................................................................................................2

Section III. When and Where Coverage Applies..............................................................................................3

A. When Coverage Applies............................................................................................................................3

B. Where Coverage Applies...........................................................................................................................3

Section IV. Coverages........................................................................................................................................3

A. Liability Coverage......................................................................................................................................3

B. Personal Injury Protection Coverage ........................................................................................................6

C. Uninsured and Underinsured Motorist Coverage....................................................................................17

D. Comprehensive and Collision Coverages – Damage to Your Auto........................................................21

Section V. Duties After An Accident or Loss ................................................................................................27

Section VI. Conditions .....................................................................................................................................28

A. Policy Changes .......................................................................................................................................28

B. Cancellation.............................................................................................................................................28

C. Renewal/Nonrenewal ..............................................................................................................................29

D. Our Right to Recover Payments .............................................................................................................29

E. Suit Against Us ........................................................................................................................................30

F. Change of Interest ...................................................................................................................................30

G. Bankruptcy or Insolvency........................................................................................................................30

H. Past Premium Payment Obligations .......................................................................................................30

I. Limitation on Lawsuit Option ....................................................................................................................30

J. Concealment or Fraud .............................................................................................................................31

K. Loss Payable Clause...............................................................................................................................31

L. Joint Ownership .......................................................................................................................................31

M. Additional Insured-Lessor .......................................................................................................................31

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NEW JERSEY STANDARDPERSONAL AUTO INSURANCE POLICY

SECTION I.Definitions Applicable to All Sections.

We define some words and phrases to shorten the policy. This makes it easier to read and understand.Defined words and phrases are printed in boldface italics. YOU can pick them out easily.

A. Additional Private Passenger Auto means a private passenger auto newly owned by or leased to youin addition to any shown on the policy declarations, if:1. We insure all autos you own, or lease, for a term of at least 6 months;2. No other insurance policy provides coverage for that auto; 3. You pay us any additional premium required when due; and4. The additional private passenger auto is an acceptable risk to us under our underwriting

guidelines.Comprehensive and Collision Coverages for an additional private passenger auto shall not becomeeffective until you notify us and request coverage for the additional private passenger auto. Forcoverages other than Part D, we will provide the broadest coverage we now provide for any auto shownin the declarations to an additional private passenger auto for period of fourteen (14) days after youbecome the owner. We will not provide coverage after this fourteen (14) day period, unless within thisperiod you ask us to insure the additional private passenger auto. If you ask us to insure anadditional private passenger auto after the fourteen (14) day period, any coverage we provide for anadditional private passenger auto will begin at the time you request coverage. If you request coveragenot already provided for any auto shown in the declarations for the additional private passenger auto orincrease your limits, these changes to your policy will not become effective until after you ask us to addthe coverage or increase your limits.

B. Auto means a land motor vehicle with four or more wheels. It does not include:1. Any vehicle while located for use as a dwelling or other premises; or 2. A truck-tractor designed to pull a semi-trailer.

C. Named Insured means the person named as the insured on the policy declarations, and if an individual,named insured includes his or her spouse by marriage or domestic partner by civil union, if the spouseby marriage or domestic partner by civil union, is a resident of the household of the named insured. If thespouse by marriage or domestic partner by civil union ceases to be a resident of the named insured’shousehold, liability coverage will continue for the spouse by marriage or domestic partner by civil union,but only until the earlier of:1. The effective date of another policy listing the spouse or domestic partner as a named insured; or2. The end of the policy period in effect at the time he or she ceased to be a resident of such household.

D. Newly acquired private passenger auto means a replacement private passenger auto or anadditional private passenger auto for which Comprehensive and Collision Coverage is subject to theNew Jersey Mandatory Inspection Provision at Section IV, Coverage D(2) of this policy.

E. Non-owned Auto means an auto not owned by, registered to, leased to, or available or furnished for theregular use of:1. You; 2. Any other person residing in the same household as you;3. Any relative. However, an auto owned by, registered to, leased to, or available or furnished for the regular use of arelative will be considered a non-owned auto for liability arising from your maintenance or use of suchauto. A non-owned auto must be an auto in the lawful possession of the person operating it.

F. Occupying means in, on, entering into, or alighting from.

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G. Private Passenger Auto means a self-propelled auto designed for use principally on public roads andthat is one of the following types: 1. A private passenger or station wagon type automobile; or2. A private passenger pick up or private passenger van that:

a. Has a Gross Vehicle Weight Rating of 10,000 lbs. or less; andb. Is not used for the delivery or transportation of persons or goods and materials unless such use is:

(1) Incidental to your business of installing, maintaining or repairing furnishings or equipment; or(2) For farming or ranching.

A private passenger auto does not include a motorcycle.H. Relative means a person who resides with you in your household, and is related to you by blood,

marriage, civil union, adoption, or is a ward or foster child. I. Replacement Private Passenger Auto means a private passenger auto you become the owner of, if:

1. You acquire the auto during the policy period shown on the declarations page;2. The auto that you acquire replaces one shown on the declarations page;3. No other insurance policy provides coverage for that auto;4. You pay us any additional premium required when due; and5. The replacement auto is an acceptable risk to us under our underwriting guidelines.We will provide the replacement auto with the same coverage as the auto it replaces. You must ask usto insure a replacement auto within three (3) days after you become the owner if you want to continuecoverage under Part D - Comprehensive and Collision Coverages. The three (3) day period includes theday on which the replacement auto is acquired and shall be extended by one day for each Saturday,Sunday, or New Jersey State holiday falling within the three (3) day period. If you ask us to insure areplacement auto after this three day period, any coverage we provide under Part D for a replacementauto will begin at the time you request coverage. If you request coverage not already provided for anyauto shown in the declarations for the replacement auto or increase your limits, it will not becomeeffective until after you ask us to add the coverage or increase your limits.

J. Temporary Substitute Private Passenger Auto means a private passenger auto not owned by you if itreplaces your private passenger auto. Its use has to be with the consent of the owner. Your privatepassenger auto has to be out of use due to its breakdown, repair, servicing, damage, or loss. Atemporary substitute private passenger auto is not considered a non-owned auto.

K. Trailer means a trailer of the utility type or a trailer of the house, or camping type equipped or used asliving quarters. Trailer is limited to a trailer designed for use with a private passenger auto. Farmimplements and farm wagons are considered trailers while pulled by an auto we insure for liability.

L. We, Us, or Our means the company providing this insurance as shown on the policy declarations. M. You or Your means the person or persons named as the insured on the policy declaration and if an

individual, includes his or her spouse by marriage or domestic partner by civil union if the spouse ordomestic partner resides primarily in the same household.

N. The term Your Private Passenger Auto, when it appears in this policy, means a private passenger autothat:1. Is owned by you or is leased for six months or longer to you; 2. Is described on the policy declarations.

SECTION II.Insuring Agreement

This policy is a legal contract between you and us. We agree to insure you according to the terms of thispolicy based on your payment of premium for the coverages you chose. You agree, by the acceptance ofthis policy that: A. Any statements made in conjunction with an application, renewal, or endorsement are your representations

and are true; B. This policy is issued in reliance upon the truth of those representations;

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C. This policy contains all of the agreements between you and us relating to these coverages; D. You will register and principally garage in New Jersey any auto covered by this policy.

SECTION III.When and Where Coverage Applies

A. When Coverage Applies. The coverage you chose applies to accidents and losses that take placeduring the policy period. The policy period is shown on the policy declarations. The policy period beginsand ends at 12:01 A.M. standard time, or the time at which the policy is issued, whichever is later, at theaddress shown on the policy declarations.

B. Where Coverage Applies. The coverage you chose applies: 1. In the United States of America, its territories or possessions, Puerto Rico, or Canada; or 2. While the insured auto is being shipped between their ports.

SECTION IV.Coverages

A. Liability Coverage1. Additional Definitions Applicable to Liability Coverage

a. Bodily Injury means bodily injury, sickness or disease, including death resulting therefrom. b. Property Damage means damage to, or destruction of, tangible property including its loss of use.

2. Coverage a. You have this coverage only if a premium for it appears on the policy declarations. b. We will:

(1) Pay damages that an insured becomes legally liable to pay because of bodily injury to othersand property damage caused by an accident resulting from the ownership, maintenance, oruse of your private passenger auto;

(2) Defend any suit against an insured for such damages with attorneys hired and paid by us. Wewill not defend any suit after we have paid the applicable limit of liability for the accident that isthe basis of the lawsuit;

(3) Have the right to investigate, negotiate, and settle any claim or suit. c. In addition to the limits of liability, we will pay for an insured the costs listed below resulting from

such accident: (1) All defense costs we incur; (2) Interest accruing after a judgment is entered in any suit we defend on behalf of an insured.

Our duty to pay interest ends when we pay, offer, or deposit in court the amount due underthis coverage;

(3) The premiums or costs of bonds:(a) Necessary to secure the release of an insured’s property attached under a court order in

any other suit that we defend on behalf of an insured. The amount of the bond we pay forshall not be more than our limit of liability;

(b) Required to appeal a decision in a suit for damages that we defend on behalf of an insuredif we have not paid our limit of liability that applies to the suit;

(c) Up to $250 for each bail bond needed because of an accident resulting in liability coveredunder this policy or a traffic violation related to such accident. We have no duty to furnishor apply for any bonds.

(4) Expenses incurred by an insured, at our request, for loss of wages or salary up to $50 perday if we ask the insured to attend the trial of a civil suit. We will not pay for loss of otherincome.

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d. Other Autos. The Liability Coverage extends to the use, by an insured, of a newly acquiredprivate passenger auto, a temporary substitute private passenger auto, or a non-ownedauto.

e. Trailer Coverage. The Liability Coverage extends to a trailer while owned by, leased to, or used byyou or your relative.

3. Who Is an Insureda. For your private passenger auto, a newly acquired private passenger auto, or a temporary

substitute private passenger auto, including any trailers attached to such auto, insured means: (1) You; (2) Your relatives; (3) Any other person while using such an auto if its use is with your consent.

b. For a non-owned auto, insured means: (1) You; (2) Your relatives.

4. Limits of Liabilitya. The amount of Bodily Injury Liability Coverage is shown on the policy declarations under Limits of

Liability-Bodily Injury, Each Person, Each Accident. The limit stated for Each Person is themaximum amount of coverage for all damages due to bodily injury to one person in any one autoaccident. “Bodily injury to one person” includes all injury and damages to others, including butnot limited to damages for care, loss of services, or death resulting from this bodily injury. Thelimit stated for Each Accident is the total amount of coverage, subject to the amount shown underEach Person, for all damages due to bodily injury to two or more persons in the same accident. The amount of Property Damage Liability Coverage is shown on the policy declarations underLimits of Liability—Property Damage, Each Accident. The limit stated for Property Damage, EachAccident is the maximum amount of coverage for all property damage resulting from any one autoaccident, regardless of the number of property damage claims presented. We will pay damages forwhich an insured is legally liable up to these bodily injury and property damage limits.

b. The limit of liability is not increased because more than one person or organization may be insured. c. An auto and attached trailer are considered one vehicle. Therefore, the limit is not increased.

5. Exclusions-What Is Not CoveredThere is no Liability Coverage for:a. Any person for liability arising out of the ownership or operation of any auto while being used as a

public or livery conveyance. This exclusion (5.a.) does not apply to shared-expense carpools; b. Any person who intentionally causes property damage or bodily injury; c. Any person while using a vehicle without reasonable belief that he or she has the right to do so; d. Any person for property damage to property owned by or being transported by that person;e. Any person for property damage to property rented to, used by, or in the care or custody of that

person. However, coverage applies to a residence or private garage damaged by an auto weinsure;

f. Any person while employed or engaged in any way in the selling, leasing, repairing, servicing,transporting, storing, or parking of land motor vehicles or trailers. This includes road testing anddelivery. For your private passenger auto, a newly acquired private passenger auto, or atemporary private passenger substitute auto, this exclusion (5.f.) does not apply to: (1) You or your relatives; (2) Any partner, agent, or employee of you or any relative.

g. Any person maintaining or using a non-owned auto in any business, occupation, or professionother than farming or ranching and not described in exclusion 5.f. This exclusion (5.g.) does notapply to a private passenger auto or a trailer used with a private passenger auto driven oroccupied by you or your relatives;

h. Any person for bodily injury to any employee of that person arising out of his or her employment.This exclusion (5.h.) does not apply to a household employee who is not covered or required to becovered under any workers’ compensation insurance;

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i. Any person for bodily injury or property damage for which that person would also be coveredunder nuclear energy liability insurance issued by American Nuclear Insurers, Mutual AtomicEnergy Liability Underwriters, Nuclear Insurance Association of Canada, or their successors. Thisexclusion (5.i.) applies even if the limits of that insurance are exhausted;

j. Any person who is a named insured under the terms of a Basic Automobile Insurance Policyissued pursuant to N.J.S.A. 39:6A-3.1. This exclusion (5.j.) does not apply to you if you areoccupying your private passenger auto, a newly acquired private passenger auto, atemporary substitute private passenger auto, or a non-owned auto.

k. Any person for bodily injury or property damage caused by any auto, located inside a facilitydesigned for racing, or for the purpose of practicing, participating in, or preparing for any race,speed contest, or performance contest.

l. Any person for bodily injury or property damage resulting from the use of your privatepassenger auto for snow removal for compensation or a fee.

m. Any person for bodily injury or property damage sustained by an insured while occupying anyvehicle located for use or being used as a residence or premises.

n. Any person for any trailer used for business, occupational, or professional purposes with otherthan a private passenger auto;

o. Any person for any trailer used with an auto that:(1) Is owned by or hired by you; and (2) We do not insure for Liability Coverage.

p. Any person or company which assumes liability under a bailment or other agreement;q. Any person or company with respect to demands for punitive or exemplary damages.

6. If There Is Other Liability Coveragea. Basic Automobile Insurance Policies

This policy provides no Liability Coverage for any person other than you who is a named insuredunder a Basic Automobile Insurance Policy issued pursuant to N.J.S.A. 39:6A-3.1 and N.J.A.C.11:3-3.

b. Other Liability Coverage Available from Other SourcesIf other motor vehicle Liability Coverage applies, we are liable only for our share of the damages.Our share is the percent that the limit of liability of this policy bears to the total of all motor vehicleLiability Coverage applicable to the accident.

c. Other Liability Coverage Including Temporary Substitute Private Passenger Auto, Non-ownedAuto, or TrailerIf a temporary substitute private passenger auto, a non-owned auto, or a trailer designed foruse with a private passenger auto:(1) Has other vehicle Liability Coverage on it; or (2) Is self-insured under any motor vehicle financial responsibility law, motor carrier law, or any

similar law; then Liability Coverage under this policy is excess over such insurance or self-insurance.

d. Newly Acquired Private Passenger AutoThis coverage does not apply if there is other auto Liability Coverage on a newly acquiredprivate passenger auto that is a pickup, panel truck, van, delivery sedan, or utility automobile.

7. Motor Vehicle Compulsory Insurance Law or Financial Responsibility Lawa. Out-of-State-Coverage

If an insured under the Liability Coverage is in another state or Canada and, as a nonresident,becomes subject to higher limits of liability coverage than are shown on the policy declarations asa result of motor vehicle compulsory insurance, financial responsibility, or similar law:(1) This policy will be interpreted to give the liability coverage required by the law; and (2) The liability coverage so given replaces any liability coverage in this policy to the extent

required by the law for the insured’s operation, maintenance, or use of an auto insured underthis policy.

Any coverage so extended shall be reduced to the extent other coverage applies to the accident.

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In no event shall a person collect for the same elements of loss more than once. b. Financial Responsibility Law

When certified under any law as proof of future financial responsibility and while required duringthe policy period, this policy shall comply with such law to the extent required.

B. Personal Injury Protection Coverage1. Personal Injury Protection Coverage

a. Additional Definitions Applicable to Personal Injury Protection Coverage (1) Actual Benefits means those benefits determined to be payable for allowable expenses. (2) Allowable Expenses means medically necessary, reasonable, and customary items of

expense covered by the named insured’s or relative’s health insurance benefit plan(s) or byPersonal Injury Protection Coverage as an eligible charge. The reasonable monetary value ofbenefits provided in the form of services shall be considered as both an allowable expenseand a paid benefit.

(3) Bodily Injury means bodily injury, sickness or disease, including an identified injury or deathresulting therefrom.

(4) Catastrophic Injury Treatment means medically necessary treatment of permanent orsignificant brain injury, spinal cord injury or disfigurement, or other permanent or significantinjuries rendered at a trauma center or acute care hospital immediately following the accidentand until the eligible injured person is stable, no longer requires critical care, and can besafely discharged or transferred to another facility in the judgment of the attending physician.

(5) Clinically Supported means that a health care provider, prior to selecting, performing orordering the administration of a treatment or diagnostic test, has satisfied all of the followingrequirements: (a) Personally examined the eligible injured person to ensure that the proper medical

indications exist to justify ordering the treatment or test; (b) Physically examined the eligible injured person including making an assessment of any

current and/or historical subjective complaints, observations, objective findings, neurologicindications, and physical tests;

(c) Considered any and all previously performed tests that relate to the injury and the results,and which are relevant to the proposed treatment or test;

(d) Recorded and documented these observations, positive and negative findings, andconclusions on the patient’s medical records.

(6) Death benefits means the amount or amounts payable in the event of the death of an eligibleinjured person as determined in subdivision (a) or (b) hereof, as appropriate: (a) If the eligible injured person was an income producer at the time of the accident, an

amount equal to the difference between $5,200 and all income continuation benefitspaid for any loss of income resulting from his or her injury prior to his or her death;

(b) If the eligible injured person ordinarily performed essential services for the care andmaintenance of himself or herself, his or her family, or family household, an amount not toexceed the difference between $4,380 and all essential services benefits paid withrespect to his or her injury prior to death.

(7) Diagnostic Test means a medical service or procedure utilizing biomechanical, neurological,neurodiagnostic, radiological, vascular or any means, other than bioanalysis, intended to assistin establishing a medical, dental, physical therapy, chiropractic or psychological diagnosis, forthe purpose of recommending or developing a course of treatment for the tested patient to beimplemented by the treating practitioner or by the consultant.

(8) Eligible Charges means that portion of the medical expenses incurred for treatment of bodilyinjury that, without considering any deductible or copayment, does not exceed:(a) The percent or dollar amounts specified on the medical fee schedules promulgated by the

New Jersey Department of Banking and Insurance, or the treating health care provider’susual, customary and reasonable charge, whichever is less; or

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(b) The reasonable amount, as determined by us, considering the medical fee schedulespromulgated by the New Jersey Department of Banking and Insurance for similar servicesor equipment in the region where the service or equipment was provided, when an incurredmedical expense is not included on the medical fee schedules promulgated by the NewJersey Department of Banking and Insurance.

(9) Eligible Injured Person means:(a) The named insured or any relative of the named insured, if the named insured or

relative sustains bodily injury:(1) As a result of any accident while occupying, using, entering into, or alighting from a

private passenger auto; or (2) While a pedestrian, caused by a private passenger auto or by an object propelled by

or from a private passenger auto; or (b) Any other person who sustains bodily injury while, with the permission of the named

insured, occupying, using, entering into, or alighting from the insured automobile. (10)Emergency Care means all medically necessary treatment of a traumatic injury or a medical

condition manifesting itself by acute symptoms of sufficient severity such that absence ofimmediate attention could reasonably be expected to result in death, serious impairment tobodily functions, or serious dysfunction of a bodily organ or part. Emergency Care shallinclude all medically necessary care immediately following an automobile accident, including,but not limited to, immediate pre-hospitalization care, transportation to a hospital or traumacenter, emergency room care, surgery, critical and acute care. Emergency Care extendsduring the period of initial hospitalization until the patient is discharged from acute care by theattending physician. Emergency Care shall be presumed when medical care is initiated at ahospital within 120 hours of the accident.

(11)Essential Services Benefits means an amount not exceeding a limit of $12 per day and atotal limit of $4,380 payable to an eligible injured person as reimbursement for paymentsmade to others for substitute essential services of the type actually rendered during his or herlifetime and that he or she would ordinarily have performed not for income but for the care andmaintenance of himself or herself and his or her relatives.

(12)Funeral Expense Benefits means an amount not exceeding $1,000 for reasonable funeral,burial, and cremation expenses incurred.

(13)Health Care Provider means those persons licensed or certified to perform health caretreatment or services compensable as medical expenses and shall include, but not be limited to:(a) A hospital or health care facility that is maintained by a state or any political subdivision; (b) A hospital or health care facility licensed by the Department of Health and Senior Services; (c) Other hospitals or health care facilities designated by the Department of Health and Senior

Services to provide health care services, or other facilities, including facilities forradiological and diagnostic testing, freestanding emergency clinics or offices, and privatetreatment centers;

(d) A nonprofit voluntary visiting nurse organization providing health care services other than ina hospital;

(e) Hospitals or other health care facilities or treatment centers located in other states or nations; (f) Physicians licensed to practice medicine and surgery; (g) Licensed chiropractors; (h) Licensed dentists; (i) Licensed optometrists; (j) Licensed pharmacists; (k) Licensed chiropodists (podiatrists); (l) Registered bio-analytical laboratories; (m)Licensed psychologists; (n) Licensed physical therapists; (o) Certified nurse midwives; (p) Certified nurse practitioners/clinical nurse-specialists;

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(q) Licensed health maintenance organizations; (r) Licensed orthotists and prosthetists; (s) Licensed professional nurses; (t) Providers of other health care services or supplies including durable medical goods.

(14) Identified Injury means those injuries identified by the New Jersey Department of Bankingand Insurance as being subject to medical treatment protocols in accordance with N.J.S.A.39:6A-3.1a and 39:6A-4a.

(15) Income means salary, wages, tips, commissions, fees, and other earnings derived from workor employment.

(16) Income Continuation Benefits means an amount not exceeding a limit of $100 per week anda total limit of $5,200 payable for the loss of income of an eligible injured person who is anincome producer during his or her lifetime, as a result of bodily injury disability. In no caseshall income continuation benefits exceed the net income normally earned during theperiod in which the benefits are payable.

(17) Income Producer means a person who, at the time of the accident, was in an occupationalstatus, earning or producing income. The status of an income producer will cease when therecipient is no longer an income producer for reasons other than bodily injury disability.

(18) Insured Automobile means an automobile with respect to which the named insured isrequired to maintain automobile liability insurance coverage under New Jersey statutes, towhich the liability insurance of this policy applies and for which a specific premium is charged.

(19)Medical Expense Benefits means the reasonable and necessary expenses for:(a) Treatment or services rendered by a provider, including medical, surgical, rehabilitative,

and diagnostic services and hospital expenses; (b) Ambulance services or other transportation; (c) Medication; (d) Clinically supported necessary non-medical expenses that are prescribed by a treating

medical provider for a permanent or significant brain, spinal cord, or disfiguring injury.Necessary non-medical expense means charges for: (1) Products and devices, not exclusively used for medical purposes or as durable medical

equipment, such as any vehicles, durable goods, equipment, appurtenances,improvements to real or personal property, fixtures;

(2) Services and activities such as recreational activities, trips, and leisure activities. Medical expense benefits include any non-medical remedial treatment rendered inaccordance with a recognized religious method of healing. Medical expense benefits aresubject to the limitations set forth in the policy and as approved by the Commissioner ofBanking and Insurance.

(20)Medically necessary or medical necessity means that the medical treatment or diagnostictest is consistent with the clinically supported symptoms, diagnosis, or indications of theinjured person, and:(a) The treatment is the most appropriate standard or level of service that is in accordance with

standards of good practice and standard professional treatment protocols, as such protocolsmay be recognized or designated by the Commissioner of Banking and Insurance;

(b) The treatment of the injury is not primarily for the convenience of the injured person orprovider;

(c) Does not include unnecessary or inappropriate testing or treatment; (d) Does not include testing or treatment that is considered by the medical community to be

experimental; and (e) Does not include testing or treatment that is strictly palliative (treating the symptoms of a

condition rather than the condition itself). (21)Named insured means the person named as the insured on the policy declarations, and if an

individual, named insured includes his or her spouse by marriage or domestic partner by civilunion, if the spouse by marriage or domestic partner by civil union, is a resident of the

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household of the named insured. If the spouse by marriage or domestic partner by civil unionceases to be a resident of the named insured’s household, Personal Injury Protection willcontinue for the spouse until the end of the policy period in effect at the time he or she ceasedto be a resident of such household.

(22)Pedestrian means any person who is not occupying, entering into, or alighting from a vehiclepropelled by other than muscular power and designed primarily for use on highways, rails, andtracks.

b. Insuring Agreement(1) You have this coverage only if a premium for it appears on the policy declarations. (2) We will pay Personal Injury Protection Coverage Benefits consisting of:

(a) Medical expense benefits, (b) Income continuation benefits, (c) Essential services benefits, (d) Death benefits, (e) Funeral expense benefits, with respect to bodily injury sustained by an eligible injured person, caused by an accidentand arising out of the ownership, maintenance, or use, including loading or unloading, of aprivate passenger auto as an automobile.

c. Limits of Liability—(1) Medical Expense Benefits

(a) Limit The following per person, per accident limit of liability for medical expense benefits applies:(1) For the named insured and relatives, who are not named insureds under another

policy, the limit is shown on the declarations. However, for catastrophic injurytreatment, the available limit of coverage will be an amount not to exceed $250,000.

(2) For all other eligible injured persons, the limit is shown on the declarations. However,for catastrophic injury treatment, the available limit of coverage will be an amount notto exceed $250,000.

(3) Under no circumstances will more than $250,000 in medical expense benefits be paidfor any one person for any accident involving catastrophic injury treatment.

(b) Limitation Set by Medical Fee Schedule Payments of medical expense benefits shall not exceed the applicable amount set forthin any medical fee schedule promulgated by the New Jersey Department of Banking andInsurance for specific injuries or services. If a claimed eligible charge is not included onthe medical fee schedule, payment will be determined by us, on a reasonable basis,considering the medical fee schedules for similar services or equipment in the regionwhere the service or equipment was provided.

(c) Copayment Our payment of medical expense benefits is subject to a per accident copayment of 20%for the amount between the applicable deductible and $5,000.

(d) DeductibleThe amount shown in the medical expense benefits deductible section on the policydeclarations is the deductible amount that applies to medical expense benefits payable tothe named insured and relatives, who are not named insureds under another policy.

(e) Primary Health Insurance Option (1) If the policy declarations indicate that the Primary Health Insurance Option has been elected:

a) Any health insurance coverage or benefits applying to the named insured andrelatives shall be the primary coverage for medical expense benefits for allowableexpenses. Personal Injury Protection Coverage will apply as secondary coverage formedical expense benefits that remain uncovered. An explanation of benefitpayment calculations when Personal Injury Protection Coverage is secondary isgiven below in the Coordination of Benefits provision.

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b) However, if it is determined that the health insurance certified by the named insured,or another comparable plan, was not in effect at the time of the accident then:1) The terms and conditions applicable if the Primary Health Insurance Option had

not been elected on the policy declarations will apply; 2) An additional $750 deductible per accident will apply to the medical expense

benefits; 3) We will be entitled to recover as additional premium the total amount of any

reduction applied to the premium for the policy period in which the accidentoccurred, due to the insured’s election of the Primary Health Insurance Option.

(2) If the policy declarations indicate that the Primary Health Insurance Option has notbeen elected to provide primary coverage, Personal Injury Protection Coverage shall bethe primary coverage for medical expense benefits payable to the named insuredand relatives, who are not named insureds under another policy.

(3) Health Insurance includes individual, blanket, or group accident insurance; medical orsurgical reimbursement plans; health care services provided by a health maintenanceorganization; a state-sanctioned flexible spending account, or any coverage or benefitsprovided under any federal or state program.

(4) Coordination of Benefitsa) When this coverage applies as primary, we will pay medical expense benefits

without reduction for amounts collected from health insurance coverage. b) When this coverage applies as secondary, we will pay actual benefits to be

calculated as follows: 1) We will first determine the amount of eligible charges which would have been

paid under this coverage after application of the deductible and copaymentrequirements, if this coverage applied as primary.

2) If the allowable expenses that remain unpaid by the health insurance thatapplies as primary are less than the benefits calculated in 1) above, we will payactual benefits equal to the allowable expenses that remain unpaid, withoutreducing the remaining allowable expenses by the deductible or copaymentamounts of Personal Injury Protection Coverage. In determining the allowable expenses that remain unpaid, we shall notconsider any amount for items of expense which exceed the dollar or percentamounts recognized by the medical fee schedules promulgated by the NewJersey Department of Banking and Insurance.

3) If the allowable expenses that remain unpaid by the health insurance thatapplies as primary are greater than the amount calculated in 1) above, withoutreducing the remaining allowable expenses by the deductible or copaymentamounts of this coverage, we will pay the amount calculated in 1) above.

c) The total amount of medical expense benefits for the named insured or anyrelative per accident shall not exceed the maximum amount payable for medicalexpense benefits under this policy.

(2) Income Continuation Benefits The applicable limit on income continuation benefits applies separately to each full regularand customary workweek of an eligible injured person. We will prorate the limit of liabilityshown in the policy declarations for weekly income continuation benefits for any period ofbodily injury disability shorter than one week.

(3) Medical Expense Benefits Only Option If the policy declarations indicate that the Medical Expense Benefits Only Option has beenelected, there is no coverage for the named insured and relatives for any benefit provided byPersonal Injury Protection Coverage except medical expense benefits.

(4) Reduction of Personal Injury Protection Coverage Benefits

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Any amount payable by us as Personal Injury Protection Coverage benefits with respect tobodily injury shall be reduced by all amounts: (a) Paid, payable, or required to be provided under any workers’ compensation or employees’

temporary disability law; or (b) Paid, payable, or required to be provided under Medicare provided under federal law; or (c) Actually paid as benefits provided under federal law to active and retired military personnel.

d. Exclusions (1) Personal Injury Protection Coverage does not apply:

(a) To bodily injury to a person whose conduct contributed to the injury in any of the followingways: (1) While committing a high misdemeanor or felony or seeking to avoid lawful

apprehension or arrest by a police officer; or (2) While acting with specific intent to cause injury or damage to himself or others.

(b) To bodily injury to the named insured or any relative of the named insured sustainedwhile occupying, using, entering into or alighting from a private passenger auto which isnot an insured automobile under this policy, if he or she is required to maintain automobileliability insurance coverage with respect to that automobile under New Jersey statutes.

(c) To bodily injury to any person who at the time of the accident:(1) Was the owner or registrant of a private passenger auto registered or principally

garaged in New Jersey that was being operated without Personal Injury ProtectionCoverage; or

(2) Was operating or occupying a private passenger auto without the permission of theowner or other named insured.

(d) To bodily injury to any person who is not occupying an insured automobile if theaccident occurs outside of New Jersey. This exclusion ((1)(d)) does not apply to:(1) the named insured; or (2) a relative of the named insured; or (3) a resident of New Jersey.

(e) To bodily injury arising out of ownership, maintenance, or use, including loading orunloading, of any vehicle while located for use as a residence or premises other than fortransitory recreational purposes.

(f) To bodily injury due to war, whether or not declared, civil war, insurrection, rebellion, orrevolution, or to any act or condition incident to any of the foregoing.

(g) To bodily injury resulting from the radioactive, toxic, explosive, or other hazardousproperties of nuclear material.

(h) To bodily injury to any person who is entitled to New Jersey Personal Injury protectionCoverage as a named insured or relative under the terms of any other policy. Thisexclusion ((1)(h)) does not apply to the named insured under this policy.

(i) To bodily injury to any relative who is entitled to New Jersey Personal Injury ProtectionCoverage as a named insured under the terms of another policy.

(j) To bodily injury to any person who is a named insured under the terms of a StandardAutomobile Insurance Policy issued pursuant to N.J.S.A. 39:6A-3 and 39:6A-4.

(2) We do not provide Personal Injury Protection Coverage with respect to those diagnostic testsprohibited by the New Jersey Department of Banking and Insurance or by statute or regulation.

e. Mandated Medical Expense Conditions (1) Voluntary Networks

(a) Upon receiving notification of bodily injury covered under this policy, we will makeavailable to the named insured and the treating health care provider information aboutour approved voluntary network providers.

(b) If an eligible injured person does not use a voluntary network provider, we will impose acopayment not to exceed 30% of the eligible charges.

(2) Care Paths for Identified Injuries

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(a) The New Jersey Department of Banking and Insurance has established standard coursesof medically necessary treatment including diagnostic tests for identified injuries thatare reimbursable as medical expense benefits. The standard treatments and practicesare based on the diagnosed injury and are known as Care Paths. Care Paths do not applyto treatment administered during emergency care.

(b) We will advise an eligible injured person of the Care Path requirements established bythe New Jersey Department of Banking and Insurance upon receiving notice of a bodilyinjury covered under this policy.

(c) Within the Care Path, certain treatments and diagnostic tests are subject to the DecisionPoint Review Plan and pre-certification requirements. The administration of any test listedin N.J.A.C. 11:3-4.5(b) 1-10 also require decision point review, regardless of the diagnosis.

(d) Medical care provided to persons injured in auto accidents that is consistent with the CarePaths will be reimbursable by the Personal Injury Protection Coverage medical expensebenefits. Medical care that deviates from these Care Paths will not be reimbursable exceptby reason of specific medical necessity based upon adequate clinically supportedfindings in the particular case. Medical treatments, diagnostic tests, or durable medicalequipment that are not medically necessary will not be reimbursable through PersonalInjury Protection Coverage.

(3) Decision Point Review Plan and Pre-Certification The following Decision Point Review Plan and pre-certification requirements are applicableonly after the tenth day following the accident, and do not apply to treatment administered inemergency care.(a) Upon receipt of notice of bodily injury covered under this policy, we will make available to

the eligible injured person our Decision Point Review Plan and pre-certificationrequirements, if any.

(b) If the eligible injured person or an eligible injured person’s health care providerrequests either:(i) A decision point review; or (ii) Pre-certification of certain diagnostic tests, specific proposed treatment, non-medical

expenses, or durable medical equipment; then we will provide a written authorization, denial, or request for more informationwithin 3 business days.

(c) We must be provided with the appropriate clinically supported findings, that the adminis-tration of a test allowable by the New Jersey Department of Banking and Insurance,proposed treatments, non-medical expenses, or durable medical equipment is medicallynecessary.

(d) During our review of the information required in paragraph (3) (c) above, we may:(1) Approve the proposed treatment, test, non-medical expenses, or durable medical

equipment; (2) Request further information; (3) Schedule a physical examination of the injured person in accordance with (g) below

where the notice and supporting materials and other medical records, if requested, arenot sufficient to authorize or deny reimbursement of further treatment, diagnostic testsor durable medical equipment; and/or

(4) Deny reimbursement of further treatment, diagnostic tests, non-medical expense, ordurable medical equipment pursuant to N.J.A.C. 11:3-4.7(b).

(e) After consideration of the further information and/or physical examination, we will thenauthorize or deny reimbursement for the treatment, tests, non-medical expense, or durablemedical equipment. Our authorization or denial will be based on medical necessity andwill not encourage over or under utilization of benefits.

(f) Any denial of decision point review or pre-certification requests based on medicalnecessity will be the determination of a physician. If the treatment is prescribed by adentist, any denial will be determined by a dentist.

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(g) Physical Examination (1) We will notify the eligible injured person or his or her designee if a physical

examination is required for reimbursement of further treatment, diagnostic tests, ordurable medical equipment.

(2) The medical examination will be: a) Scheduled within seven calendar days of receipt of the notice described above

unless the eligible injured person agrees to extend the time period; b) Conducted by a health care provider similar to the treating health care provider; c) Conducted at a location reasonably convenient to the eligible injured person.

(3) Upon our request, the treating health care provider or the eligible injured person willprovide medical records and other pertinent information to the health care providerconducting the medical examination. The requested records will be provided no laterthan the time of the examination.

(4) We may deny reimbursement of further treatment, testing or use of durable medicalequipment for an eligible injured person’s repeated unexcused failure to appear for aphysical examination required by us in accordance with our plan.

(5) We will notify the eligible injured person, his or her designee, and the treatinghealthcare provider whether reimbursement for further treatment, diagnostic tests, ordurable medical equipment is authorized as promptly as possible but no later thanthree business days after the examination. A copy of the healthcare provider’s report,if prepared, is available upon request.

(h) Penalty If the eligible injured person or healthcare provider fails to: (1) Request a decision point review or pre-certification where required; or (2) Provide clinically supported findings that support the treatment, diagnostic tests or

durable medical equipment;we will impose an additional copayment applicable to eligible charges for medicallynecessary diagnostic tests, treatments, surgery, durable medical goods, and non-medical expenses that were provided between the time notification to us was requiredand the time that proper notification is made and we have an opportunity to respond inaccordance with our Decision Point Review Plan.The copayment will be 25% when the request or findings are provided 30 to 59 days afterthe accident. The copayment will be 50% when the request or findings are provided 60or more days after the accident. We will not impose the additional copayment wherewe received the required notice but failed to act in accordance with the Decision PointReview Plan to request further information, to modify or deny reimbursement of furthertreatment, diagnostic tests, or durable medical equipment.

f. Conditions (1) Notice

In the event of an accident, written notice containing both particulars sufficient to identify theeligible injured person, and reasonably obtainable information respecting the time, place, andcircumstances of the accident shall be given by or on behalf of each eligible injured personto us within 29 days following the accident. If any eligible injured person, his or her legal representative, or survivors shall institute legalaction to recover damages for injury against a person or organization who is or may be liablein tort therefore, a copy of the summons and complaint or other process served in connectionwith such legal action shall be forwarded to us promptly by such eligible injured person, hisor her legal representative, or his or her survivors.

(2) Medical Reports; Proof of Claim Within 29 days following the accident, the eligible injured person or someone on his or herbehalf shall give to us written proof of claim, including full particulars of the nature and extentof the injuries and treatment received and contemplated, and such other information as may

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assist us in determining the amount due and payable. The eligible injured person shall, atour request, submit a timely PIP Application. The eligible injured person shall submit tophysical examination by physicians when and as often as we may reasonably require and acopy of the medical report will be forwarded to such eligible injured person if requested.

(3) Penalty If an eligible injured person fails to provide us with notice, proof of claim and otherreasonably obtainable information regarding an injury or claim, we may impose an additionalcopayment as a penalty. The additional copayment shall be an amount no greater than: (a) 10 percent when notification is received 21 to 30 days after the commencement of

treatment; (b) 25 percent when notification is received 31 to 60 days after the commencement of

treatment; (c) 50 percent when notification is received 61 to 120 days after the commencement of

treatment;(d) 76 percent when notification is received 121 to 160 days after the commencement of

treatment; and (e) 100 percent when notification is received 161 or more days after the commencement of

treatment.Such copayment will reduce the amounts reimbursed for eligible charges that are incurredafter notification to us is required and until we receive notification. Any reduction in the amount of reimbursement in eligible charges shall be in addition toany other deductible or copayment requirement.

(4) Multiple Policies Applicable to One Accident; Non-duplication of Benefits; Priority of ComplyingPolicies This policy provides no Personal Injury Protection Coverage Benefits for a person who is anamed insured under a Basic Automobile Insurance Policy issued pursuant to N.J.S.A. 39:6A-3.1 and N.J.A.C. 11:3-3.Regardless of the number of automobiles insured for Personal Injury Protection Coveragepursuant to Section 4 of the New Jersey Automobile Reparation Reform Act, or the number ofinsurers or policies affording such coverage, there should be no duplication of payment ofPersonal Injury Protection Coverage benefits and the aggregate maximum amount payableunder this and all applicable policies with respect to bodily injury to any one person as theresult of any one accident shall not exceed the applicable amount or limits specified in Section4 of said Act. Personal Injury Protection Coverage applies on a primary basis to bodily injury to the namedinsured and his or her relative and on a secondary basis to all other eligible injuredpersons. Similarly, the Personal Injury Protection Coverage provided by other complyingpolicies applies on a primary basis to bodily injury to those persons who are namedinsureds under such policies and their relatives. If an eligible injured person to whomPersonal Injury Protection Coverage applies on a secondary basis has other Personal InjuryProtection Coverage under another complying policy applicable to his or her bodily injury ona primary basis, all claims for Personal Injury Protection Coverage benefits shall first be madeagainst the insurer issuing the other complying policy. No Personal Injury Protection Coverage benefits shall be due and payable under PersonalInjury Protection Coverage unless the other insurer fails to pay such benefits by reason ofinsolvency and we have been given written notice by the claimant of such failure. “Complying Policy” means a policy of automobile liability insurance maintained pursuant to therequirements of Section 3 of the New Jersey Automobile Reparation Reform Act and providingPersonal Injury Protection Coverage as approved by the Department of Banking and Insurance. The eligible injured person shall not collect under more than one policy. If an eligible injuredperson under this policy qualifies for payments under other policies providing Personal InjuryProtection Coverage benefits, the insurer paying benefits to such person shall be entitled to

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recover from each of the other insurers an equitable pro rata share of the benefits paid. Thepro rata share is the proportion that the insurer’s liability bears to the total of all applicablelimits. Any deductible amounts applicable shall be taken into consideration in determining eachinsurer’s pro rata share.

(5) Reimbursement and Trust Agreement Subject to any applicable limitations set forth In the New Jersey Automobile Reparation ReformAct, in the event of any payment to any person under Personal Injury Protection Coverage:(a) We shall be entitled to the extent of such payment to the proceeds of any settlement or

judgment that may result from the exercise of any rights of recovery of such person againstany person or organization legally responsible for the bodily injury because of which suchpayment is made; and we shall have a lien to the extent of such payment. Notice of ourlien may be given to the person or organization causing such bodily injury, his or herproducer of record, his or her insurer, or a court having jurisdiction in the matter;

(b) Such person shall hold in trust for our benefit all rights of recovery that he or she shallhave against such other person or organization because of such bodily injury;

(c) Such person shall do whatever is proper to secure and shall do nothing after loss toprejudice such rights;

(d) Such person shall execute and deliver to us such instruments and papers as may be appropriateto secure the rights and obligations of such person and us established by this provision.

(6) Payment of Personal Injury Protection Coverage Benefits Medical expense benefits may be paid at our option to the eligible injured person or theperson or organization furnishing the products or services for which such benefits are due.These benefits shall not be assignable except to providers of service benefits who comply withthe Care Paths, pre-certification and decision point review requirements of this policy. The firstrecourse for disputes regarding payment of Personal Injury Protection Coverage for assigneesof benefits shall be the procedure specified in paragraph 3 of this Section. In the event of the death of an eligible injured person, any amounts payable, but unpaid priorto death, for medical expense benefits are payable to the eligible injured person’s estate. Benefits payable under subdivision (a) of the definition of death benefits are payable to theeligible injured person’s surviving spouse by marriage or domestic partner by civil union, or ifthere is no surviving spouse by marriage or domestic partner by civil union, to his or hersurviving children, or if there are no surviving spouse or surviving children, to the eligibleinjured person’s estate. Benefits payable under subdivision (b) of the definition of deathbenefits are payable to the person who has incurred the expense of providing essential services. Funeral expenses benefits are payable to the eligible injured person’s estate.

(7) Our Right to Apply for Employee Benefits If an eligible injured person has not applied for workers’ compensation or employees’temporary disability benefits, we may immediately apply directly to the provider of suchbenefits paid under this coverage.

(8) Proof of Health Benefits Plan Coverage If you have elected the Medical Expense Benefits-As-Secondary option, you must provideproof that you and your relatives are insured by health insurance coverage or benefits in amanner and to an extent approved by the New Jersey Department of Banking and Insurance.

g. Policy Period; Territory Personal Injury Protection Coverage applies only to accidents that occur during the policy periodand anywhere in the world.

2. Extended Medical Expense Benefits Coverage a. Definitions

The definitions under Personal Injury Protection Coverage apply to Extended Medical ExpensesBenefits Coverage, and under Extended Medical Expense Benefits Coverage. (1) Highway Vehicle means a land motor vehicle or trailer other than:

(a) A private passenger auto;

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(b) A farm type tractor or other equipment designed for use principally off public roads, whilenot upon public roads;

(c) A vehicle operated on rails or crawler-treads; or (d) A vehicle while located for use as a residence or premises.

(2) Insured Person means:(a) The named insured or any relative of the named insured, if the named insured or

relative sustains bodily injury:(1) While occupying, using, entering into, or alighting from a highway vehicle; or(2) While a pedestrian, caused by a highway vehicle;

(b) Any other person who sustains bodily injury while occupying a highway vehicle (otherthan a motorcycle or a vehicle while being used as a public or livery conveyance) if suchhighway vehicle is being operated by the named insured or a relative of the namedinsured or any other person using such highway vehicle with the permission of thenamed insured;

b. Insuring Agreement (1) You have this coverage only if a premium for it appears on the policy declarations. (2) We will pay medical expense benefits not to exceed the total aggregate amount stated on

the policy declarations with respect to bodily injury sustained by an insured person, causedby an accident occurring during the policy period anywhere in the world and arising out of theownership, maintenance, or use, including loading and unloading, of an insured automobileor of a highway vehicle not owned by or furnished or available for the regular use of thenamed insured or any relative of the named insured.

c. Limit of Liability The limit of our liability under Extended Medical Expense Benefits for each person entitled tobenefits who sustains bodily injury in any one accident shall not exceed the amount shown in theExtended Medical Expense Limit section on the policy declarations. No eligible injured person will recover duplicate benefits for the same elements of loss underPersonal Injury Protection Coverage.

d. Exclusions (1) Extended Medical Expense Benefits Coverage is subject to all of the exclusions applicable to

Personal Injury Protection Coverage except that the word “person” in exclusion 1.d.(1)(c) isreplaced by the word “pedestrian”.

(2) The following exclusions also apply to Extended Medical Expense Benefits Coverage: (a) Extended Medical Expense Benefits Coverage does not apply to any insured who would be

entitled to benefits under Personal Injury Protection Coverage except for the application ofthe medical fee schedule promulgated by the New Jersey Department of Banking andInsurance.

(b) Extended Medical Expense Benefits Coverage does not apply to any person, other thanthe named insured or a relative of the named insured or a resident of New Jersey, if theaccident occurs outside of New Jersey.

e. Conditions Conditions (1), (2), (5), and (8) of Personal Injury Protection Coverage apply to Extended MedicalExpense Benefits Coverage, substituting the term insured person for eligible injured personwherever it appears therein. The following additional condition applies under Extended MedicalExpense Benefits Coverage: Other Insurance or Benefits Extended Medical Expense Benefits Coverage does not apply to loss or expense with respect towhich an insured person is entitled to benefits under any Medicare provided under federal law, anyworkers’ compensation law, or under Section 4 of the New Jersey Reparation Reform Act. Extended Medical Expense Benefits Coverage does not apply to loss or expense to the extent thatbenefits are payable or are required to be provided therefore under any other automobile no-faultlaw or under any other automobile medical payments insurance.

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Extended Medical Expense Benefits Coverage does not apply to amounts not paid under the NewJersey No-Fault Law because of the application of the deductible or the copayment stated in theLimit of Liability provision for Personal Injury Protection Coverage.

3. Dispute Resolution The New Jersey Department of Banking and Insurance established procedures for the resolution ofdisputes concerning the payment of medical expense and other benefits provided by Personal InjuryProtection Coverage. A request for dispute resolution for Personal Injury Protection Coverage may be submitted by theinjured party, the insured, a provider of service benefits who is an assignee of Personal InjuryProtection Coverage benefits, or the insurer in accordance with New Jersey Law. The request fordispute resolution may include a request for review by a medical review organization.

4. Added Personal Injury Protection Coverage The amount indicated for Income Continuation Benefits, Essential Services Benefits and FuneralExpense Benefits includes the benefits payable under the Personal Injury Protection Coverage. a. The weekly and total limits applicable to income continuation benefits as stated in the policy

declarations are amended by substituting therefore, respectively, the amounts shown in the policydeclarations for income continuation benefits under Added Personal Injury Protection Coverage.

b. The per day and total limits applicable to essential services benefits as stated in the policydeclarations are amended by substituting therefore, respectively, the amounts shown in the policydeclarations for essential services benefits under Added Personal Injury Protection Coverage.

c. The limit applicable to funeral expense benefits as stated in the policy declarations is amendedby substituting therefore the amount shown in the policy declarations for funeral expensebenefits under Added Personal Injury Protection Coverage.

d. The income continuation benefits and essential services benefits shall cease upon the deathof the eligible injured person and shall not operate to increase the amount of any death benefitspayable under the Section IV.B. Personal Injury Protection Coverage of the policy.

e. We will pay an added death benefit of $10,000 to the surviving spouse by marriage or domesticpartner by civil union; or if there is no surviving spouse by marriage or domestic partner by civilunion, to the surviving children; or if there is no surviving spouse by marriage, domestic partner bycivil union or surviving children, to the estate of the person insured for Added Personal InjuryProtection Coverage if his or her death results from bodily injury for which Personal InjuryProtection Benefit Coverage is payable and occurs within 2 years of the accident.

f. Subject to the limits of liability shown in the policy declarations, we shall not be liable for more than75% of weekly income in excess of $100, provided however, that after $5,200 has been paid asincome continuation benefits at the rate specified in the Section IV.B. Personal Injury ProtectionCoverage of the policy, we shall not be liable for more than 75% of weekly income thereafter.

C. Uninsured and Underinsured Motorist Coverage1. Additional Definitions Applicable to Uninsured and Underinsured Motorist Coverage

a. Bodily Injury means bodily injury, sickness or disease, including death resulting therefrom. b. Underinsured Motor Vehicle means:

(1) For you and any insured who is not insured as a named insured, spouse by marriage ordomestic partner by civil union or relative under any policy providing Uninsured andUnderinsured Motorist Coverage: a land motor vehicle or trailer, the ownership, maintenance, or use of which is insured orbonded for bodily injury and property damage liability at the time of the accident, but thelimits of liability are less than the limits you carry for Uninsured and Underinsured MotoristCoverage under this policy.

(2) For any insured who is insured as a named insured, spouse by marriage, domestic partner bycivil union, or relative under any other policy providing Uninsured and Underinsured MotoristCoverage: a land motor vehicle or trailer, the ownership, maintenance, or use of which is insured or

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bonded for bodily injury and property damage liability at the time of the accident, but thelimits of liability are less than the highest applicable limit of liability under any other policyproviding Uninsured and Underinsured Motorist Coverage to that insured as a named insured,spouse by marriage, domestic partner by civil union, or relative.

An underinsured motor vehicle does not include: (1) An uninsured motor vehicle; (2) A land motor vehicle or trailer that is owned by, or leased to, or furnished for the regular use of:

(a) You; or (b) Any relative; or(c) A resident of your household;

(3) A land motor vehicle or trailer:(a) Owned or operated by a self-insurer under any motor vehicle financial responsibility law,

motor carrier law, or any similar law; (b) Owned by any government or any of its political subdivisions or agencies; (c) Designed for use mainly off public roads except while on public roads; (d) Used as a residence or stationary structure; (e) Operated on rails or crawler treads.

c. Uninsured Motor Vehicle means: (1) A land motor vehicle or trailer, the ownership, operation, maintenance, or use of which is:

(a) Not insured or bonded for bodily injury and property damage liability at the time of theaccident; or

(b) Insured or bonded for bodily injury and property damage liability at the time of theaccident, but the insuring company denies coverage or is or becomes insolvent, or theCommissioner of Banking and Insurance has undertaken control of the insurer forpurposes of liquidation; or

(2) With respect to bodily injury, a hit-and-run land motor vehicle whose owner and driverremains unknown and:(a) That strikes the insured or the vehicle the insured is occupying and causes bodily injury

to an insured; or (b) That causes bodily injury to the insured without striking the insured or the vehicle the

insured is occupying. If there is no physical contact with the hit-and run vehicle, the factsof the accident must be corroborated by:(1) An accident report completed by a law enforcement agency; or(2) An affidavit attesting to the truth of the facts of the accident signed by any eyewitness

other than the owner or operator of the vehicle which you, an insured driver, or anyfamily member were occupying at the time of the accident.

(3) An auto covered by a New Jersey Special Automobile Insurance Policy.An uninsured motor vehicle does not include:(1) An underinsured motor vehicle;(2) A land motor vehicle or trailer that is owned by, or leased to, or furnished for the regular use of:

(a) You; or (b) Any relative; or (c) A resident of your household;

(3) A land motor vehicle or trailer: (a) Owned or operated by a self-insurer under any motor vehicle financial responsibility law,

motor carrier law, or any similar law; (b) Owned by any government or any of its political subdivisions or agencies;(c) Designed for use mainly off public roads except while on public roads; (d) Used as a residence or stationary structure; (e) Operated on rails or treads; (f) Insured under the terms of a Basic Automobile Insurance Policy issued pursuant to N.J.S.A

39:6A-3.1 and N.J.A.C. 11:3-3

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2. Coverage a. You have this coverage only if a premium for it is shown on the policy declarations. b. We will pay damages for bodily injury or property damage an insured person

is legally entitled to collect from the owner or operator of an uninsured motor vehicle orunderinsured motor vehicle because of: (1) Bodily injury sustained by an insured person, (2) Damage to or destruction of:

(a) Your private passenger auto or your owned trailer; (b) A newly acquired private passenger auto; (c) A temporary substitute private passenger auto; or (d) Property owned by:

(1) You or any relative while in: a) Your private passenger auto or your owned trailer; b) A newly acquired private passenger auto; c) A temporary substitute private passenger auto; or

(2) Any other insured while in your private passenger auto, a newly acquired privatepassenger auto, or temporary substitute private passenger auto.

The bodily injury or property damage must be caused by an accident arising out of theownership, maintenance, or use of an uninsured motor vehicle or underinsured motor vehicle.This coverage does not apply to the first $500 of the total amount of all property damage as theresult of any one accident.

c. We will pay any amount due: (1) To the insured; (2) To a parent or guardian if the insured is a minor; (3) To the surviving spouse by marriage; (4) To the surviving domestic partner by civil union; (5) At our option, to a person authorized by law to receive such payment.

d. We are not bound by any judgment against any person or organization resulting from any suitbrought without our written consent.

e. Any amount payable under this coverage shall be reduced by any outstanding premium that isowed by you to us for this policy.

3. Who Is An Insured The following are insureds: a. You; b. Your relatives; c. Any other person while occupying your private passenger auto, a temporary substitute

private passenger auto, a newly acquired private passenger auto or a trailer attached to suchauto. Such vehicle has to be used with your consent.

d. Any person entitled to recover damages because of bodily injury to an insured under paragraphsa. through c. above.

4. Determining Liability and Damages a. Two questions must be decided by agreement between the insured and us:

(1) Is the insured legally entitled to collect damages from the owner or driver of the uninsuredmotor vehicle or underinsured motor vehicle?

(2) If so, in what amount? b. If there is no agreement, these questions shall be decided by arbitration upon written request of

the insured or us. Each party shall select a competent and impartial arbitrator. These two shallselect a third arbitrator. If unable to agree on the third one within 30 days either party may requesta judge of a court of record in the county in which the arbitration is pending to select a third one.

c. The cost of the arbitrator and any expert witness shall be paid by the party who hired them. Thecost of the third arbitrator and other expenses of arbitration shall be shared equally by both parties.

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d. The arbitration shall take place in the county in which the insured resides unless the parties agreeto another place. Local rules of law as to procedure and evidence will apply.

e. The written decision of any two arbitrators as to the questions specified in paragraph 4.a. aboveshall be binding on each party unless the amount of damages awarded exceeds the minimum limitof liability specified by the financial responsibility law of New Jersey. If the amount of damagesexceeds that limit, either party may, within 60 days of the arbitrators’ decision, demand a trial. Ifthe demand is not made, the decision of the arbitrators is binding on each party.

5. Limits of Liability a. Bodily Injury

The limit shown on the policy declarations under Uninsured and Underinsured Motorist Coveragefor bodily injury Each Person is the maximum amount of coverage for all damages due to bodilyinjury to one person in any one accident. Bodily Injury to one person includes all injuries anddamages to others resulting from this bodily injury. The limit shown under Uninsured andUnderinsured Motorist Coverage for Each Accident is the maximum amount of coverage subject tothe amount shown under Each Person, for all damages due to bodily injury to two or morepersons in the same accident.

b. Property Damage The limit shown on the policy declarations under Uninsured and Underinsured Motorist Coveragefor Property Damage, Each Accident is the maximum amount of coverage for all propertydamage sustained by all insureds as the result of an accident.

c. However, subject to our maximum limit of liability for this coverage, for an insured other than youthat is insured as a named insured, spouse, domestic partner, or relative under one or morepolicies providing Uninsured and Underinsured Motorist Coverage at a limit of liability less thanour limit of liability, our limit of liability shall not exceed the highest applicable limit under anypolicy providing Uninsured and Underinsured Motorist Coverage to that insured as a namedinsured, spouse, domestic partner, or relative. For an insured other than you or your relative,who is not insured as a named insured, spouse, domestic partner or relative under a policyproviding Uninsured and Underinsured Motorists Coverage, our limit of liability is $15,000 for alldamages due to bodily injury to one person in any one accident and $30,000 for all damages totwo or more persons in the same accident.

d. Any amount payable for economic loss under this coverage shall be reduced by the amount of any:(1) Personal Injury Protection benefits; (2) Additional Personal Injury Protection benefits; paid or payable under this or any other motor vehicle insurance policy.

e. Any amount payable under this coverage as the result of an accident involvingan uninsured motor vehicle shall be reduced by any amount paid to or for the insured:(1) By or for any person or organization who is or may be legally liable for the bodily injury or

property damage; or (2) Under any Comprehensive or Collision Coverage of this policy.

f. Any payment made to a person under this coverage as the result of an accident involving anuninsured motor vehicle shall reduce any amount payable to that person under LiabilityCoverage.

g. Subject to the Limits of Liability set forth in a. through c. above, the most we will pay as the resultof an accident involving an underinsured motor vehicle will be the lesser of:(1) The difference between the applicable limit of liability of this coverage and the amount paid to

the insured in damages by or for any person or organization who may be legally liable for thebodily injury or property damage; or

(2) The amount of damages for bodily injury or property damage sustained by but notrecovered by the insured.

h. The limits of liability are not increased because: (1) More than one person is insured at the time of the accident; (2) More than one auto is insured for this coverage under this policy;

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(3) More than one underinsured motor vehicle is involved in the same accident.i. No injured person will recover duplicate benefits for the same elements of loss under this or any

other uninsured motorists insurance, including approved plans of self-insurance. 6. Exclusions—What Is Not Covered

There is no coverage:a. For any person if that person or the legal representative without our written consent, settles a

claim with the owner or operator of an uninsured motor vehicle or underinsured motor vehiclewho may be liable for the bodily injury or property damage;

b. For damages for pain, suffering, and non-economic damages resulting from bodily injury causedby an accident involving an uninsured motor vehicle, unless the injured person has a legal rightto recover damages for such pain, suffering, and non-economic damages allowed under NewJersey law. The injured person’s legal right to recover non-economic damages allowed under NewJersey Law will be determined by the liability tort limitation, if any, applicable to that person;

c. To the extent it benefits:(1) Any workers’ compensation or disability benefits insurance company; (2) A self-insurer under any workers’ compensation, disability benefits, or similar law; (3) Directly or indirectly any insurer of property;

d. For property damage arising out of ownership, maintenance, or use of a hit-and-run vehicle;e. For any person while using a vehicle without reasonable belief that he or she has a right to do so; f. For punitive or exemplary damages;g. For any person who is a named insured under the terms of a Basic Automobile Insurance Policy

issued pursuant to N.J.S.A. 39:6A-3.1 and N.J.A.C.11:3-3. This exclusion (6.g.) does not apply toyou if you are occupying your private passenger auto, a newly acquired private passengerauto, a temporary substitute private passenger auto, or a non-owned auto.

h. For any relative who is also insured as a relative under the terms of a Basic AutomobileInsurance Policy issued pursuant to N.J.A.C. 39:6A-3.1 and N.J.S.A. 11:3-3. This exclusion (6.h.)does not apply if your relative is occupying your private passenger auto, a newly acquiredprivate passenger auto, or a temporary substitute private passenger auto.

i. For any person occupying a motor vehicle that he or she owns for which he or she has failed tomaintain required insurance coverage under New Jersey statutes and regulations;

j. For bodily injury or property damage to any person occupying an auto while used as a publicor livery conveyance. This exclusion (6.j.) does not apply to shared-expense car pools.

7. If There Is Other Uninsured and/or Underinsured Motorist Coverage a. If the insured sustains bodily injury and other Uninsured and/or Underinsured

Motorists Coverage applies, the total limits of liability under all such coverage shall not exceed thatof the coverage with the highest limit for any one vehicle.

b. However, for an insured other than you that is insured as a named insured, spouse by marriage,domestic partner by civil union, or relative under one or more policies providing Uninsured and/orUnderinsured Motorist Coverage, the total limits of liability under all such Uninsured and/orUnderinsured Motorist Coverage for that insured shall not exceed the highest applicable limitunder any policy providing Uninsured and/or Underinsured Motorist Coverage to that insured as anamed insured, spouse by marriage, domestic partner by civil union, or relative.

c. We are liable only for our share. Our share is that percent of the damages that the limit of liabilityof this coverage bears to the total of all Uninsured and/or Underinsured Motorist Coverageapplicable to the accident.

d. For a non-owned auto this coverage is excess over any other collectible insurance.

D. Comprehensive and Collision Coverages-Damage To Your Auto 1. Additional Definitions Applicable to Comprehensive and Collision Coverages

a. Camper Body means a body designed for use as temporary living quarters and constructed as adetachable unit. A camper unit includes caps, toppers, canopies, and all equipment andaccessories built into and forming a permanent part of the structure.

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b. Collision means:(1) The upset of your private passenger auto or your trailer; or (2) Your private passenger auto or your trailer hit a vehicle or other object; or (3) Your private passenger auto or your trailer was hit by a vehicle or other object.

c. Custom Parts or Equipment means equipment, devices, accessories, enhancements, andchanges, other than those which are original manufacturer installed which:(1) Are permanently installed or attached; and(2) Alter the appearance or performance of a vehicle.This includes any electronic equipment, antennas, and other devices used exclusively to send orreceive audio, visual, or data signals, or to play back recorded media, other than those which areoriginal manufacturer installed, that are permanently installed in your private passenger autousing bolts or brackets, including slide-out brackets.

d. Loss means each direct and accidental loss of or damage to:(1) Your private passenger auto or your owned trailer; or (2) Its equipment that is common to the use of your private passenger auto as a vehicle; or (3) A camper body attached to or removed from your private passenger auto for storage.

2. New Jersey Mandatory Inspection Provision a. We or our authorized representative have the right to inspect any private passenger auto

insured or intended to be insured under this policy before Comprehensive or Collision Coverageshall be effective, with the exception of a new private passenger auto purchased from afranchised automobile dealership when we are provided with the following documents:(1) A copy of the bill of sale which contains a full description of the private passenger auto,

including all options and accessories;(2) A copy of the window sticker or advanced dealer shipping notice (invoice) showing the

itemized options and equipment, the total retail price of the private passenger auto, and anydealer installed option purchased by the customer; or

(3) A vehicles buyer’s order (contract) and/or the dealership invoice to the buyer, including alloptions and accessories.

b. During the term of this policy, coverage for an additional or replacement private passengerauto shall not become effective until you notify us and request coverage for the auto. However,this provision does not apply to a replacement private passenger auto for a period of threedays, including the day on which the auto is acquired, if: (1) The auto is acquired during the policy period; and (2) There was Comprehensive or Collision Coverage on the auto replaced for at least the 12-month

period proceeding the replacement date.The three-day period shall be extended by one day for each Saturday, Sunday, or New JerseyState holiday falling within the three-day period.

c. When an inspection is required by us, you shall cooperate and make the auto available forinspection.

d. The mandatory insurance inspection report, completed by the authorized inspection site represen-tative for your private passenger auto, shall not establish coverage for any equipment that isexcluded by this policy or that should be specifically insured by an endorsement to this policy.

3. Comprehensive Coveragea. You have this coverage only for your private passenger auto or your owned trailer for which a

premium for this coverage appears on the policy declarations. The deductible amount is shown onthe policy declarations for the private passenger auto or trailer to which it applies.

b. We will pay for loss to your private passenger auto or your owned trailer except loss bycollision but only for the amount of each loss in excess of the deductible amount, subject to ourLimit of Liability, and minus any outstanding premium that is owed by you to us for this policy.Breakage of glass, or loss caused by missiles, falling objects, fire, theft, larceny, explosion,earthquake, windstorm, hail, water, flood, malicious mischief or vandalism, riot, or civil commotionis payable under this coverage. Loss due to hitting or being hit by a bird or an animal is payable

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under this coverage. If breakage of glass is caused by a collision, at your option, we may cover itunder Collision Coverage.

c. We will repay you for transportation costs if your private passenger auto is stolen. We will payup to $15 per day for the period that begins 48 hours after the theft up to a maximum of $450. Theperiod ends when your private passenger auto is returned to use or when we offer to pay for itsloss. We will also pay for loss-of-use expenses for which you are legally responsible due to theftof a non-owned auto or a temporary substitute private passenger auto. The most we will payfor loss of use expenses is $15 per day. Payment for these transportation costs and loss-of-useexpenses will not be subject to any deductible. You must provide us with written proof of yourtransportation expenses and loss-of-use expenses.

4. Collision Coverage a. You have this coverage only for your private passenger auto or your owned trailer for which a

premium for this coverage appears on the policy declarations. The deductible amount is shown onthe policy declarations for the private passenger auto or trailer to which it applies.

b. We will pay for loss to your private passenger auto or your owned trailer caused by collisionbut only for the amount of each such loss in excess of the deductible amount, subject to our Limitof Liability and minus any outstanding premium that is owed by you to us for this policy.

5. Coverage for the Use of Other Autos and Owned Trailers a. The same coverages in this section that you have on your private passenger auto extend to a

newly acquired private passenger auto, a temporary substitute private passenger auto, or anon-owned auto. These coverages extend to a non-owned auto while it is driven by or in thecustody of you or your relatives. If you have two or more private passenger autos insured onthis policy, we will provide the broadest coverage applicable to any of your private passengerautos to an additional private passenger auto, a temporary private passenger substituteauto, or a non-owned auto. A replacement private passenger auto will have the samecoverage as the private passenger auto it replaced. This policy will only provide coverage for thereplacement private passenger auto for a period of three days from its delivery to you, afterwhich you must satisfy the requirements of the New Jersey Mandatory Inspection Provision atSection 2 above in order to continue Comprehensive and Collision coverage on yourreplacement private passenger auto. The three-day period shall be extended by one day foreach Saturday, Sunday, or any New Jersey State legal holiday falling within the three-day period.

b. If you acquire a trailer during the policy period, it is covered if you ask us to insure it within 30days after you become the owner. If the trailer you acquire is an additional trailer, we will providethe broadest coverage applicable to any of your private passenger autos or trailers. Areplacement trailer will have the same coverage as the trailer it replaced.

6. Coverage for Owned Camper BodiesYour camper body is covered in accordance with the terms and conditions of paragraphs D.1., D.3.,and D.4. above:a. When it is described on the policy declarations of this policy; b. For the coverages shown as applying to it; c. Subject to any applicable deductible. If you acquire a camper body during the policy period, it is covered if you ask us to insure it within30 days after you become the owner.

7. Coverage for a Non-owned Trailer or Camper Body a. Any Comprehensive and Collision Coverage in force on your private passenger auto applies to a

non-owned:(1) Trailer, if it is designed for use with a private passenger auto, or (2) Camper body, used by you or your relatives.

b. A non-owned trailer or camper body is one that is not owned by or registered in the name of: (1) You or any relative; (2) Any other person residing in the same household as you or any relative; (3) An employer of you or any relative.

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c. The most we will pay under Comprehensive or Collision Coverage for loss to such non-ownedtrailer or camper body is $500.

8. Coverage for Additional Custom Parts or Equipment CoverageIf you pay a premium for Additional Custom Parts or Equipment Coverage, the Limit of Liability forloss to custom parts or equipment for this additional coverage will be the lowest of: a. The actual cash value of such custom parts or equipment; b. The declared value of such custom parts or equipment; or c. The amount necessary to repair or replace such custom parts or equipment; reduced by the applicable deductible. Coverage for custom parts or equipment shall not cause any Limit of Liability to be increased to anamount in excess of the actual cash value of any stolen or damaged vehicle. Any deductible amountwill apply separately to each loss.

9. Coverage for Emergency Towing and Labor If you pay a premium for Emergency Towing and Labor coverage, we will pay for towing and laborcost incurred by you as a result of the disablement of a covered vehicle or non-owned auto, subjectto the Limit of Liability shown on the declarations page, provided that: a. The labor is performed at the place of disablement; and b. The disablement does not occur at your residence.

10. Coverage for Rental Reimbursement If you pay a premium for Rental Reimbursement Coverage, we will reimburse you according to thelimits stated on the policy declaration for any one (1) accident for rental charges incurred by you whenyou rent a vehicle from a rental agency or vehicle repair shop due to a loss to a covered vehicle, otherthan a total theft, that is payable under this coverage. Rental charges will be reimbursed beginning: a. When the covered vehicle cannot be driven due to a loss; b. If the covered vehicle can be driven, when you deliver the covered vehicle to a vehicle repair shop

for repairs due to the loss;and ending when the covered vehicle has been repaired, replaced, or if the covered vehicle isdeemed by us to be a total loss, forty-eight (48) hours after we make an offer to pay the actual cashvalue of the covered vehicle.

11. Limit of Liability-Comprehensive and Collision Coverages a. The limit of our liability for loss to property or any part of it is the lesser of:

(1) The actual cash value not to exceed $60,000; or (2) The cost of repair or replacement not to exceed $60,000.

b. An adjustment for depreciation and physical condition will be made in determining actual cashvalue in the event of a total loss.

12. Settlement of Loss— Comprehensive and Collision Coverages a. We have the right to settle a loss with you or the owner of the property in one of the following ways:

(1) Pay the agreed upon actual cash value of the property at the time of the loss in exchange forthe damaged property. If the owner and we cannot agree on the actual cash value, either partymay demand appraisal as described in paragraph 12.b. If the owner keeps the damagedproperty, we will deduct its value after the loss from our payment. The damaged propertycannot be abandoned to us.

(2) Pay to: (a) Repair the damaged property or part, or (b) Replace the property or part.If the repair or replacement results in betterment, you must pay for the amount of betterment; or

(3) Return the stolen property and pay for any damage due to the theft. b. Appraisal under item a.(1) above shall be conducted according to the following procedure. Each

party shall select a competent appraiser. These two shall select a third appraiser. The writtendecision of any two appraisers shall be binding. The cost of the appraiser shall be paid by theparty who hired him or her. The cost of the third appraiser and other appraisal expenses shall be

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shared equally by both parties. We do not waive any of our rights by any act relating to appraisal.If you give us your consent, we may move the damaged property, at our expense, to reducestorage costs during the appraisal process. If you do not give us your consent, we will pay onlythe storage cost that would have resulted if we had moved the damaged property.

c. The settlement of loss provision for Comprehensive and Collision Coverages incorporates the limitof liability stated in paragraph 11. above.

d. You must provide us written proof of your rental charges. Duplicate recovery for identical elements of damages is not permitted under this policy.

13. Payment of Loss At our expense, we may return any stolen property to you or to the address shown on thedeclarations page, with payment for any damage resulting from the theft. We may keep all or part ofthe property at the agreed or appraised value. We may settle any loss with you or the owner orlienholder of the property.

14. No Benefit to Bailee These coverages shall not benefit any carrier or other bailee for hire liable for loss.

15. Exclusions-What is not CoveredThere is no coverage for:a. Any auto or trailer used as a public or livery conveyance. This exclusion (15.a.) does not apply to

shared-expense car-pools; b. Any loss to any auto or trailer arising out of or during its use for the transportation of any:

(1) Explosive substance; (2) Flammable liquid; (3) Similar hazardous materials;except transportation incidental to your ordinary household activities;

c. Any customized equipment in or on a pickup, panel truck, van, delivery sedan or utilityautomobile. Customized equipment includes but is not limited to: (1) Television antennas; (2) Cooking and plumbing equipment; (3) Sleeping facilities; (4) Height-extending roofs; (5) Special carpeting and insulation, furniture, or bars; (6) Murals, paintings, or other decals or graphics;

d. Awnings, cabanas, or equipment designed to create additional living facilities; e. Any non-owned auto while being repaired, serviced, or used by any person while that person is

employed or engaged in any way in the selling, leasing, repairing servicing, transporting or storing,or parking of land motor vehicles or trailers including road testing and delivery of such vehicle;

f. Any person maintaining or using a non-owned auto in any business, occupation, or professionother than farming or ranching and not described in exclusion 15.e. This exclusion (15.f.) does notapply to a private passenger auto, or trailer used with a private passenger auto driven,maintained, or occupied by you or your relatives;

g. Any auto or trailer while being operated in any prearranged or organized racing or speed contestor in practice or preparation for any such contest;

h. Loss resulting from the use of your private passenger auto for snow removal for compensationor a fee;

i. Loss to paint or discoloration of paint resulting from acid rain, smog, salt, tree sap, or animal orbird droppings unless such loss is a direct result of an otherwise covered loss;

j. Any sound reproduction system including, but not limited to, radios, stereos, tape decks, orcompact disk players. Coverage under this Section also will not apply to any apparatus oraccessories in or on the auto designed for use with that system. This exclusion (15.j.) does notapply if the sound reproduction system is permanently installed in the auto;

k. Any audio, visual, or data receiving and transmitting equipment including, but not limited to:

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(1) citizens band or two-way mobile radios; (2) telephones; (3) scanning or television monitor receivers; (4) video or audio cassette recorders; or (5) personal computers. (6) This exclusion (15.k.) does not apply if the electronic equipment is necessary for the normal

operation of an auto. Coverage under this Section also will not apply to any apparatus oraccessories designed for use with that equipment;

l. Any tapes, records, discs or other media used with equipment described in exclusions 15.j. and15.k. above for recording or reproducing sound;

m. Any laser or radar detector; n. Loss to any vehicle due to or as a consequence of:

(1) Radioactive contamination;(2) Discharge of any nuclear weapon (even if accidental);(3) War (declared or undeclared);(4) Civil war;(5) Insurrection; or(6) Rebellion or revolution;

o. Loss to any vehicle due to and limited to wear and tear, freezing, and mechanical or electricalbreakdown or failure. This exclusion (15.o.) does not apply when the loss is the result of a theftcovered by this policy;

p. Road damage to tires. This exclusion (15.p.) does not apply if the damage results from the totaltheft of your private passenger auto, temporary substitute private passenger auto, newlyacquired private passenger auto, non-owned auto or any trailer;

q. A total loss to your covered auto or any non-owned auto due to destruction or confiscation bygovernmental or civil authorities. This exclusion (15.q.) does not apply to the interests of LossPayees in your private passenger auto;

r. Any diminution in the value of any auto or trailer after it has been repaired as compared to itsvalue before it was damaged;

s. Loss to your your private passenger auto or any non-owned auto due to or resulting fromintentional acts committed by you, an insured driver, or a family member, or by anyone at yourdirection;

t. Loss to any vehicle intended by, or reasonably expected to result from, a criminal act or omissionof you, a family member, or the owner of a non-owned auto. For purposes of this exclusion,criminal acts or omissions do not include traffic violations;

u. Damage to a covered vehicle prior to inspection by us or our representative as required by NewJersey law.

16. If There Is Other Insurance a. Coverage Available from Other Sources

If other insurance applies to the loss or expenses, we will pay only our share. Our share is thepercent the limit of liability of this policy bears to the total of all coverage that applies.

b. Temporary Substitute Private Passenger Auto, Non-owned Auto, or Trailer. If a temporary substitute private passenger auto, a non-owned auto, or trailer designed foruse with a private passenger auto has other coverage on it, then this coverage is excess.

17. It is agreed that loss covered under Comprehensive and/or Collision coverage under your policy shallbe paid to you and, as its interest may appear, to the loss payee shown above or in the policydeclarations. Coverage for the loss payee, shall not terminate because of your fraudulent acts ormisrepresentations. However, if a loss results from your conversion, secretion or embezzlement ofyour private passenger auto, coverage for the loss payee shall be invalid. If a Named Excluded Driver Endorsement has been issued for this policy, such exclusion applies toany claim of the loss payee for the specified driver and auto.

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If we initiate termination of this coverage, we will give the same advance notice of cancellation to theloss payee as we give to the named insured.When we pay the loss payee for a loss, we are entitled to the loss payee’s right of recovery againstyou to the extent of our payment.

SECTION V.Duties After An Accident Or Loss

If you do not fulfill the following responsibilities, we have no duty to provide coverage under this policy. A. Notice to Us of an Accident or Loss

We must be given notice of the accident or loss as soon as reasonably possible. The notice must give us:1. Your name;2. The names and addresses of all persons involved; 3. The hour, date, place, and facts of the accident or loss; 4. The names and addresses of witnesses.

B. Notice to Us of Claim or Suit We must be given copies of every demand, notice, or claim made and every summons or legal processreceived in connection with the accident or loss as soon as reasonably possible.

C. Duty to Cooperate with Us You and any person seeking coverage shall cooperate with us and, when asked, assist us in:1. Investigating; 2. Defending; 3. Making settlements; 4. Securing and giving evidence; 5. Attending, and getting witnesses to attend, hearings and trials;6. Taking signed or recorded statements, including statements under oath, and answer all reasonable

questions we may ask, as often as we may reasonably require;7. Providing any written proof of loss we may reasonably require.

D. Other Duties Under Personal Injury Protection Coverage The person making claim also shall:1. Give us all the details about the death injury, treatment, and other information we request; 2. Be examined by physicians chosen and paid by us as often as we reasonably may require. A copy of

the report will be sent to the person upon written request. The person, or his or her legal representativeif the person is dead or unable to act, shall authorize us to obtain all medical reports and records;

3. Answer questions under oath when asked by anyone we name, as often as we reasonably ask, andsign copies of the answers;

4. Submit a proof of loss and PIP Application when required by us; 5. Authorize us to obtain medical and other pertinent records.

E. Other Duties Under Uninsured and Underinsured Motorists Coverage The person making claim also shall:1. Give us all the details about the death, injury, treatment, and other information that we request; 2. Be examined by physicians chosen and paid by us as often as we reasonably may require. A copy of

the report will be sent to the person upon written request. The person, or his or her legal represen-tative if the person is dead or unable to act, shall authorize us to obtain all medical reports andrecords;

3. Answer questions under oath when asked by anyone we name, as often as we reasonably ask, andsign copies of the answers;

4. Promptly report a hit-and-run accident to us and to the police or the Commissioner of Motor Vehicles; 5. Send us at once a copy of all suit papers if the person sues the party liable for the accident for

damages;

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6. If making the claim due to an accident involving an underinsured motor vehicle:a. Give us prompt notice if a tentative settlement is offered by the insurer of the underinsured

motor vehicle; and b. Allow us 30 days to advance payment to the insured person in an amount equal to the tentative

settlement; 7. Submit a proof of loss when required by us; 8. Authorize us to obtain medical and other pertinent records.

F. Other Duties Under Comprehensive and/or Collision CoveragesWhen there is a loss, you or the owner of the property also shall:1. Make a prompt report to the police when the loss is the result of theft or larceny; 2. Protect the damaged auto and/or trailer and equipment. We will pay reasonable expense incurred to

do it; 3. Allow us to inspect and appraise the damaged property; 4. Provide all records, receipts, and invoices and authorize us to obtain pertinent records;5. Answer questions under oath when asked by anyone we name, as often as we reasonably ask, and

sign copies of the answers; 6. Submitted proof of loss when required by us;7. Allow us to inspect and appraise the damaged property prior to its repair or disposal.

SECTION VI.Conditions

A. Policy Changes 1. Premium Changes

a. The premium for this policy is based on information we have received from you or other sources.You agree:(1) That if any of this information material to the development of the policy premium is incorrect,

incomplete, or changed, we may adjust the premium accordingly during the policy period; (2) To cooperate with us in determining if this information is correct and complete, and to advise

us of changes in this information. b. Any adjustments of your premium will be made using the rules in effect at the time of the change. c. Premium adjustment may be made as the result of a change in:

(1) Autos insured by the policy, including changes in use; (2) Drivers (including newly licensed relatives) or driver’s marital status; (3) Coverages or coverage limits; (4) Rating territory; (5) Eligibility for discounts or other premium credits.

2. Policy Terms The terms of this policy may be changed or waived only by: a. An endorsement issued by us; or b. The revision of this policy form to give broader coverage without an extra charge. If any coverage

you carry is changed to give broader coverage, we will give you the broader coverage without theissuance of a new policy as of the date we make the change effective.

B. Cancellation 1. How You May Cancel

The named insured may cancel this policy by notifying us in writing of the date to cancel, which mustbe later than the date he or she mails or delivers the notification to us. We may waive theserequirements by confirming the date and time of cancellation to the named insured in writing.

2. How and When We May Cancel a. We may cancel this policy by written notice mailed to the named insured shown in the

declarations at the address shown in this policy and to the producer of record.

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b. We may cancel this policy for fraud or if the insured knowingly provides materially false ormisleading information in connection with any application for insurance, renewal of insurance, orclaim for benefits under an insurance policy.

c. The notice will be mailed to you at least: (1) 10 days before the cancellation date, if notice is mailed during the first 60 days this policy is in

effect and if this is not a renewal policy; (2) 15 days, but no more than 30 days, before the cancellation date if the cancellation is for

nonpayment of premium; (3) 20 days before the cancellation date for any other reason. The effective date of cancellation stated in the notice shall become the end of the policy period.

3. If you get an insurance policy that provides any coverage for your private passenger auto that issimilar to any coverages provided by this policy, we will cancel the similar coverages on this policyupon our receipt of proper notice. We will cancel such coverages effective on the effective date of theother insurance policy.

4. Return of Unearned Premium If this policy is cancelled, you may be entitled to a refund of unearned premium. Any premium refundwill be computed according to our manuals. Delay in the return of unearned premium does not effectthe cancellation.

C. Renewal/Nonrenewal 1. How and When We May Renew This Policy

a. We will mail an offer to renew this policy at least 45 days, but not more than 60 days, prior to theexpiration date of this policy to the named insured shown in the declarations at the addressshown in this policy and to the producer of record.

b. The notice will specify the renewal premium and payment options. c. Failure to pay the required renewal premium when due shall mean that you have not accepted

our offer. d. If you do not accept our offer, this policy will automatically terminate at the end of the current

policy period. e. If your renewal payment is justifiably dishonored by a financial institution, no coverage shall be

provided by us after the expiration of this policy. 2. How and When We May Nonrenew This Policy

We will not renew this policy if you cease to be a qualified applicant as defined in our manuals. Wewill mail or deliver to the named insured shown in the declarations at the address shown in this policyand to the producer of record a notice of nonrenewal of this policy 60 days prior to the expiration dateof this policy.

D. Our Right to Recover Payments 1. Uninsured and Underinsured Motorist Coverage

a. If the bodily injury or property damage results from an accident involving an uninsured motorvehicle:(1) We are subrogated to the extent of our payments to the proceeds of any settlement the injured

person recovers from any party liable for the bodily injury or property damage; (2) If the person to or for whom we have made payment has not recovered from the party at fault,

he or she shall:(a) Keep these rights in trust for us; (b) Execute any legal papers we need; (c) When we ask, take action through our representative to recover our payments. We are to be repaid our payments, costs, and fees of collection out of any recovery.

b. If the bodily injury or property damage results from an accident involving an underinsuredmotor vehicle to the extent of our payment:(1) We have subrogation rights; (2) The insured shall assign to us any judgment obtained by the insured against the parties liable

for the bodily injury or property damage.

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If the insured has not recovered from the parties at fault, he or she shall:(1) Keep these rights in trust for us; (2) Execute any legal papers we need; (3) When we ask, take action through our representative to recover our payment.We are to be repaid our payments, costs and fees of collection out of any recovery.

If we are notified of a tentative settlement offer from the insurer of an underinsured motor vehicle toan insured claimant, we may advance a payment equal to such settlement offer to the insuredclaimant. Such payment will be separate from any payment under Uninsured or UnderinsuredMotorists Coverage and will be subject to our rights to recover payments. We lose our rights torecover payments if we fail to advance such payment to the insured claimant within 30 days after weare notified of the settlement offer.

2. All Other Coveragesa. For all other coverages, the right of recovery of any party we pay passes to us. Such party shall:

(1) Not hurt our rights to recover; (2) Help us get our money back. However, our rights to recover under Comprehensive and Collision Coverages do not apply to anyperson while using an auto or trailer with your consent.

b. We are to be repaid our payments out of the proceeds of any settlement the injured personrecovers from any legally responsible party.

E. Suit Against Us 1. There is no right of action against us under any coverage until all the terms of this policy have been

met. In addition, there is no right of action against us under the Property Damage Liability Coverageuntil:a. We agree in writing that the insured has an obligation to pay; or b. The amount of damages an insured is legally liable to pay has been finally determined by

judgment after trial. 2. This policy does not provide any right to a person or organization to bring a cause of action against us

under any coverage to determine an insured’s liability. F. Change Of Interest

1. No assignment of interest in this policy is effective unless we consent in writing. However, if the policy-holder named on the policy declarations dies, for the remainder of the current policy period we willprotect as named insured:a. The surviving spouse by marriage or domestic partner by civil union, if residing primarily with the

named insured at the time of death; b. The legal representative of the deceased policyholder while acting within the scope of his or her duties.

2. Our notice requirements are met by mailing any notices to the deceased named insured’s last knownaddress.

G. Bankruptcy Or Insolvency Bankruptcy or insolvency of the insured or his or her estate shall not relieve us of our obligations underthis policy.

H. Past Premium Payment Obligations We may deduct from your deposit premium any unpaid premium owed to us by you for a prior policyissued by us. Any deduction from the deposit premium made in accordance with the foregoing may beapplied to the unpaid premium balance for such prior policy and you will be billed for any requiredadditional deposit premium or a cancellation notice will be issued.

I. Limitation On Lawsuit Option You and any relatives, who are not named insureds under another policy, may not maintain a suit fortort liability for non-economic loss for an accident arising out of the maintenance, operation, or use,including loading or unloading, of an auto to which N.J.S.A. Section 39:6A-8 applies, unless you or suchrelative has sustained a bodily injury that results in death; dismemberment; significant disfigurement orsignificant scarring; displaced fractures; loss of a fetus; or a permanent injury within a reasonable degreeof medical probability, other than scarring or disfigurement.

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J. Concealment or Fraud Your policy was issued in reliance upon the information you provided on your insurance application andthe coverage selection form. We will not provide coverage and may void this policy if you: 1. Made incorrect statements or representations to us with regard to any material fact or circumstance;2. Concealed or misrepresented any material fact or circumstance; or3. Engaged in fraudulent conduct;At the time of application or at the time of renewal. This means that we will not be liable for any claims ordamages that would otherwise be covered.However, if we void this policy, this shall not affect coverage:1. Under Part A - Liability Coverage up to the minimum limit mandated by the motor vehicle financial

responsibility law of New Jersey; or2. Under Part B - Personal Injury Protection Coverage for any injured person who has not knowingly

concealed or misrepresented any material fact or circumstance;For claims or damages arising from an accident that occurs before we notify the named insured thatthe policy is void. This means that we will not be liable for any claims or damages except asindicated in 1. and 2. above, nor will we be responsible for any amounts in excess of the minimumrequired limits of liability coverage.We may deny coverage for an accident or loss, for which coverage is sought under this policy, if you or aperson seeking coverage has knowingly concealed or misrepresented any material fact or circumstance,or engaged in fraudulent conduct, in connection with the presentation or settlement of a claim.

K. Loss Payable ClauseLoss or damage under this policy shall be paid, as interest may appear, to you and the loss payee shownin the declarations. This insurance with respect to the interest of the loss payee, shall not become invalidbecause of your fraudulent acts or omissions unless the loss results from your conversion, secretion orembezzlement of your covered auto. However, we reserve the right to cancel the policy as permitted bypolicy terms and the cancellation shall terminate this agreement as to the loss payee’s interest. We willgive the same advance notice of cancellation to the loss payee as we give to the named insured shownin the declarations. When we pay the loss payee we shall, to the extent of payment, be subrogated to theloss payee’s rights of recovery.

L. Joint Ownership If applicable, it is agreed that your policy is changed as follows: I. Section I. Definitions Applicable To All Sections

The following definition is changed to read as follows: You or Your means the persons named as insureds on the policy declarations.

II. Section IV. A-Liability Coverage If the persons named as insureds on the policy declarations do not reside primarily in the samehousehold, Liability Coverage is changed as follows: A. Section IV.A.2d is changed to read:

d. Other AutosThe Liability Coverage extends to the use, by an insured, of a newly acquired privatepassenger auto, or a temporary substitute private passenger auto.

B. Section A.3. is changed to read: 3. Who Is an Insured

For your private passenger auto, a newly acquired private passenger auto, or atemporary substitute private passenger auto, insured means:a. You; b. Your relatives; c. Any other person while using such an auto if its use is with your consent;

M. Additional Insured-Lessor It is agreed that for the auto specified in the policy declarations as having an additional insured–lessor,your policy is changed as follows:

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I. Liability Coverage The lessor identified in the declarations is an insured for the specified auto or a temporary substitutevehicle for such auto furnished by the lessor. However, this coverage only applies for acts andomissions of you, your relatives and any other person, except such lessor and his employees andagents, using such auto with your consent. This endorsement does not increase our Limit of Liability.

II. Cancellation We will give the same advance notice of cancellation to the lessor as we give to the named insured.

In Witness Whereof, the Company has caused this policy to be executed and attested.

Bruce Arneson, President William Lockhorn, Chairman

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PSIC NJ SPOL (12/11)