Texas Personal Automobile Insurance Policy 2020
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CHAPTER 1 A ANNOTATED POLICY NNOT A CONTENTS TED P OLICY CONTENTS .................................................................................................... 1 1-1:1 Texas Personal Auto Policy Agreement ...................................................... 3 1-1:2 Definitions ............................................................................................... 5 1-2 LIABILITY COVERAGE INSURING AGREEMENT .......................... 15 1-2:1 Supplementary Payments ........................................................................ 23 1-2:2 Exclusions .............................................................................................. 24 1-2:3 Limit of Liability .................................................................................... 33 1-2:4 Out of State Coverage ............................................................................ 34 1-2:5 Financial Responsibility Required ........................................................... 35 1-2:6 Other Insurance ..................................................................................... 35 1-3 MEDICAL PAYMENTS COVERAGE .................................................. 37 1-3:1 Insuring Agreement ................................................................................ 37 1-3:2 Exclusions .............................................................................................. 39 1-3:3 Limit of Liability .................................................................................... 41 1-3:4 Other Insurance ..................................................................................... 42 1-3:5 Assignment of Benefits ........................................................................... 42 1-4 PERSONAL INJURY PROTECTION COVERAGE ............................. 42 1-4:1 Insuring Agreement ................................................................................ 43 1-4:2 Exclusions .............................................................................................. 47 1-4:3 Limit of Liability .................................................................................... 48 1-4:4 Other Insurance ..................................................................................... 48 1-4:5 Other Provisions ..................................................................................... 49 1-4:6 Assignment of Benefits ........................................................................... 49 1-5 UNINSURED/UNDERINSURED MOTORISTS ................................ 49 1-5:1 Coverage ................................................................................................ 49 1-5:2 Insuring Agreement ................................................................................ 51 1-5:3 Exclusions .............................................................................................. 68 1-5:4 Limit of Liability .................................................................................... 71 1-5:5 Other Insurance ..................................................................................... 74 1-6 COVERAGE FOR DAMAGE TO YOUR AUTO .................................. 75 1-6:1 Insuring Agreement ................................................................................ 75 1-6:2 Transportation Expenses ......................................................................... 78 1-6:3 Exclusions .............................................................................................. 78 2020 TEXAS PERSONAL AUTOMOBILE INSURANCE POLICY 1 01_annotated_policy.indd 1 7/23/2020 9:46:17 PM CHAPTER 1 ANNOTATED POLICY OLICY P TED A NNOT A 1-6:4 Limit of Liability .................................................................................... 80 1-6:5 Payment of Loss ..................................................................................... 81 1-6:6 No Benefit to Bailee ............................................................................... 81 1-6:7 Other Insurance ..................................................................................... 81 1-6:8 Appraisal ................................................................................................ 81 1-6:9 Specified Causes of Loss ......................................................................... 83 1-6:10 Optional and Limited Specified Causes of Loss (Fire, Theft, Wind) ........ 83 1-7 DUTIES AFTER AN ACCIDENT OR LOSS ....................................... 84 1-7:1 General Duties ....................................................................................... 84 1-7:2 Additional Duties for Uninsured/Underinsured Motorists Coverage ....... 87 1-7:3 Additional Duties for Coverage for Damage to Your Auto ...................... 88 1-8 GENERAL PROVISIONS .................................................................... 88 1-8:1 Bankruptcy ............................................................................................. 88 1-8:2 Changes.................................................................................................. 89 1-8:3 Legal Action Against Us ......................................................................... 90 1-8:4 Our Right to Recover Payment ............................................................... 90 1-8:5 Policy Period and Territory ..................................................................... 91 1-8:6 Termination ........................................................................................... 92 1-8:7 Transfer of Your Interest in this Policy .................................................... 96 1-8:8 Two or More Auto Policies ..................................................................... 97 1-9 ADDITIONAL COVERAGES AND PROVISIONS ............................. 98 1-9:1 Towing and Labor Costs Coverage ......................................................... 98 1-9:2 Rental Reimbursement Coverage ............................................................ 98 1-9:3 530A. Loss Payable Clause — Modified ................................................ 98 2 2020 TEXAS PERSONAL AUTOMOBILE INSURANCE POLICY 01_annotated_policy.indd 2 7/23/2020 9:46:17 PM CHAPTER 1 A ANNOTATED POLICY NNOT A 1-1:1 Texas Personal Auto Policy TED P OLICY 1-1:1 TEXAS PERSONAL AUTO estoppel) The authors recommend a thorough POLICY 1, 2 AGREEMENT reading of both of these cases if the issue of In return for payment 3, 4, 5 of the premium 6 “coverage by estoppel” is raised. Dempsey v. ACCC Ins. Co., No. 05-16-01502-CV, 2018 Tex. 7 8 and subject to all the terms of this policy App. LEXIS 3172 (Tex. App.—Dallas May 4, 9, 10, 11, 12, 13 we agree with you as follows: 2018) (citing the 1988 Texas Supreme Court case McGuire stating that waiver and estoppel may operate to avoid a forfeiture of a policy, but they have consistently been denied operative PRACTICE TIP force to change, re-write and enlarge the risks Make sure that you are covered by a policy. In other words, waiver and dealing with a policy issued estoppel cannot create a new and different in Texas before you make contract with respect to risks covered by the any assumptions! The fact policy. Texas Farmers Ins. Co. v. McGuire, 744 that an accident happened S.W.2d 601, 602-03 (Tex. 1988)). in Texas doesn’t mean you 2. The Policy: Texas law requires that motor will be dealing with a Texas vehicle operators demonstrate their financial responsibility if they are to be permitted policy. to drive on the public roads of the State of Texas. Tex. Transp. Code Ann. § 601.051 1. Before we even look at the policy (West 1999). Compliance typically involves itself . If you think that there is no such the purchase of a liability insurance policy in thing as coverage by estoppel, you may wish the format set forth herein. § 601.071.088; to review Ulico Casualty Company v. Allied Birnbaum v. Alliance of American Insurers, Pilots Association which may or may not 994 S.W.2d 766 (Tex. App.—Austin 1999, pet. resolve the issue. In that commercial case, denied) abrogated on other grounds by In re the Texas Supreme Court held “if an insurer’s Bass, 113 S.W.3d 735 (Tex. 2003); Office of actions prejudice its insured, the insurer may Pub. Ins. Counsel v. Texas Auto. Ins. Plan, 860 be estopped from denying benefits that would S.W.2d 231, 233 (Tex. App.—Austin 1993, be payable under its policy as if the risk had writ denied). been covered, but the doctrines of waiver 3. It’s a Contract: Insurance policies are and estoppel cannot be used to re-write the contracts and are governed by the rules of contract of insurance and provide coverage for construction applicable to contracts. Barnett risks not insured.” Ulico Cas. Co. v. Allied Pilots v. Aetna Life Ins., Co., 723 S.W.2d 663 (Tex. Ass’n, 262 S.W.3d 773 (Tex. 2008), see also 1987). Ambiguities are resolved in favor of Farmers Texas Cty. Mut. Ins. Co. v. Wilkinson, coverage. Puckett v. U.S. Fire Ins. Co., 678 601 S.W.2d 520, 521 (Tex. App.—Austin 1980, S.W.2d 936 (Tex. 1984); Ranger Ins. v. Bowie, writ ref’d n.r.e.) (stating that on the one hand, 574 S.W.2d 540 (Tex. 1978). (Note that this there is no such thing as coverage by estoppel; does not mean that every dispute is going to on the other hand, an insurer can waive all be resolved in favor of coverage.) An insurer’s policy defenses, including non-coverage, by wrongful failure to pay each type of benefit certain actions—in other words, coverage by under the policy can give rise to a separate 2020 TEXAS PERSONAL AUTOMOBILE INSURANCE POLICY 3 01_annotated_policy.indd