Part E: Duties After an Accident or Loss
CRITICAL: Failure to Perform These Duties Can VOID Your Coverage!
These aren't suggestions - they're requirements. If you don't follow them, the insurer may deny your claim.
General Duties (Apply to ALL Claims)
Give Notice Promptly
Notify the insurer as soon as reasonably possible of how, when, and where the accident or loss happened.
Cooperate with Investigation
Cooperate with the insurer in the investigation, settlement, or defense of any claim or suit.
Provide Documentation
Provide copies of any legal papers if you or a family member is sued.
Submit to Examinations
Submit to physical examinations by physicians chosen by the insurer when the insurer requires and at insurer's expense.
Authorize Medical Records Release
Authorize the insurer to obtain medical reports and other pertinent records.
Submit Proof of Loss
Submit proof of loss when required by the insurer.
Additional Duties for Uninsured Motorist (Part C) Claims
Promptly notify police if hit-and-run driver involved
Promptly send copies of legal papers if suit is brought
Additional Duties for Physical Damage (Part D) Claims
Take reasonable steps to protect the vehicle from further loss
Promptly notify police if theft is involved
Permit inspection and appraisal of the damaged property
Part F: General Provisions
These provisions apply to the entire policy and govern how it operates.
Bankruptcy
Bankruptcy or insolvency of the covered person will NOT relieve the insurer of its obligations under the policy.
Even if you go bankrupt, the insurer still has to pay valid claims.
Changes
The policy and endorsements contain all agreements between you and the insurer.
No changes can be made except by endorsement issued by the insurer.
Fraud
Coverage will NOT apply to any covered person who makes fraudulent statements or engages in fraudulent conduct relating to any accident or loss.
Lie about your claim = lose your coverage!
Legal Action Against Us
No legal action may be brought against the insurer until all terms and conditions of the policy have been fully complied with.
Under liability coverage, no one has the right to make the insurer a party to a lawsuit to determine liability of the insured.
Our Right to Recover Payment (Subrogation)
If the insurer makes a payment under the policy, it obtains the right to recover that amount from the at-fault party.
- + The insured must help the insurer recover the payment
- + The insured must do nothing to prejudice these rights
- + If the insured recovers from the at-fault party without the insurer's consent, the insured must hold those funds in trust for the insurer
Policy Period and Territory
The policy applies only to accidents and losses that occur:
- + During the policy period shown in the declarations
- + Within the policy territory
Policy Territory Includes:
- + The United States, its territories and possessions
- + Puerto Rico
- + Canada
Termination (Cancellation)
Insured Can Cancel:
By returning the policy or giving written notice of the date cancellation is to take effect.
Insurer Can Cancel:
By mailing notice to the named insured at the last known address.
First 60 Days:
At least 10 days notice
Can cancel for any reason
After 60 Days:
At least 20 days notice
Only for specific reasons (nonpayment, fraud, license revoked, etc.)
Nonrenewal:
If insurer decides not to renew: at least 20 days notice before the end of the policy period.
Transfer of Your Interest
The policy does NOT automatically transfer if you sell your car!
Cannot Transfer Without Consent:
Your interest in the policy cannot be assigned or transferred without the insurer's written consent.
Exception: Death of Named Insured
If the named insured dies, coverage will be provided for:
- + The surviving spouse if a resident of the same household
- + The legal representative of the deceased (for covered auto only)
- + Any person having proper temporary custody of your covered auto
Two or More Auto Policies
If the policy and any other auto insurance policy issued by the same insurer apply to the same accident:
- + The maximum limit of liability will NOT be increased beyond the highest limit under any ONE policy
- + No duplicate recovery for the same elements of loss
Exam Trap Alerts
10 days vs 20 days: First 60 days = 10 days notice to cancel. After 60 days = 20 days notice.
Fraud voids coverage: Any fraudulent statements = no coverage for that person.
Bankruptcy doesn't void policy: Insurer still has to pay even if insured goes bankrupt.
No transfer without consent: Can't assign policy to new car owner - EXCEPT upon death of named insured.
Territory: US (including territories), Puerto Rico, and Canada only.
Subrogation: Insurer can recover from at-fault party. Insured must NOT do anything to hurt these rights.
Physical exam: Insurer can require you to see their doctor - but they pay for it.