Personal Automobile Endorsement 11-02-2023

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59511 (6-22)

01-0764-00
IEUTER INSURANCE GROUP INC
PO BOX 552
MIDLAND MI 48640

Agency phone: (989) 835-6701

11-06-2023 AUTO-OWNERS INSURANCE COMPANY

You can view your policy, pay your bill, or change your
paperless options at any time online at www.auto-owners.com.

ADDITIONAL WAYS TO PAY YOUR BILL


Pay Online
www.auto-owners.com Pay by Mail
Pay My Bill AUTO-OWNERS INSURANCE
SCOTT & KOLLEEN SMITH PO BOX 740312
500 SYLVAN LN Pay by Phone CINCINNATI, OH 45274-0312
MIDLAND MI 48640-7316 1-800-288-8740

RE: Policy 41-205-904-00 Billing Account 018602237

Thank you for selecting Auto-Owners Insurance Group to serve your insurance needs! Feel free to contact your
independent Auto-Owners agent with questions you may have. If you have questions your agent is unable to
answer, please contact us at 517.323.1200.

Auto-Owners and its affiliate companies offer a full complement of policies, each of which has its own eligibility
requirements, coverages and rates. In addition, Auto-Owners also offers many billing options. Please take this
opportunity to review your insurance needs with your Auto-Owners agent, and discuss which company, program, and
billing option may be most appropriate for you.

Auto-Owners Insurance Company was formed in 1916. Our A++ (Superior) rating by A.M. Best Company signifies that we
have the financial strength to provide the insurance protection you need. The Auto-Owners Insurance Group is comprised
of six property and casualty companies and a life insurance company.

Serving Our Policyholders and Agents Since 1916


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 59519 (5-18)Z

ESSENTIAL INSURANCE NOTICE TO POLICYHOLDER

Dear Policyholder:

Michigan Statute (MCL 500.2112) requires us to notify you that the following information is available and will be provided
to you upon your request:

A description of the specific rating classifications by which the rates and premiums for your policy have been deter-
mined.

A general explanation of the extent to which rates or premiums vary among policyholders on the basis of the rating
classifications used by us.

Sources and reasonable procedure by which you can obtain from us additional information sufficient for you to calcu-
late and confirm the accuracy of your specific premium.

Relevant information regarding your rights under MCLA 500.2113 and 500.2114 to appeal the application of our rating
plan in determining your premium, to obtain documentation from us regarding the determination of the rate, to appeal
the application of our underwriting rules to you, to request an informal conference with us, and to file with the
commissioner a complaint as an aggrieved person.

A description of all of our underwriting rules based upon insurance eligibility points and a description of all of the un-
derwriting rules of our affiliates based on insurance eligibility points.

Please take this opportunity to review your insurance needs with your Auto-Owners Insurance agent and to determine
if you are eligible for insurance from any of Auto-Owners Insurance's affiliate companies or under a different rating
plan that would provide you with a more favorable premium.

To request any of the above information please contact Auto-Owners Insurance Company at (800) 346-0346, extension
52362, or click "Contact Us" on www.auto-owners.com.

Thank you.

59519 (5-18)Z Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 69630 (5-18)

*** IMPORTANT NOTICE ***


PURCHASE PRICE GUARANTEE COVERAGE LIMITATION AND OFFER

Good News! We are now offering Purchase Price Guarantee coverage.

Our Limit of Liability for total loss or damage of a new automobile has changed. Previously, your policy provided that, at
our option, we would replace a newly purchased private passenger automobile with a new one of equal value or pay you
your original purchase price. To invoke this settlement provision, your previous policy required that total loss or damage
occur:

Within 90 days of the purchase date with no mileage restrictions; or


180 days/10,000 miles, 270 days/20,000 miles or 360 days/30,000 miles depending on the coverage that was
previously applying to your policy.

The Purchase Price Guarantee Coverage option is now available to add to a newly purchased vehicle rated on your policy
that was originally titled to you. Coverage will provide the purchase price of the insured vehicle, less any applicable
deductible, and will be applicable until the first renewal after the vehicle purchase date is 2 years in the past.

If you choose not to purchase this new coverage, your policy coverage will be limited. We will pay the original purchase
price of a newly purchased vehicle, less any applicable deductible, in the event of a total loss or damage to your
automobile. However, the total loss or damage must now occur within 90 days of the purchase date.

This notice is for informational purposes only. Your policy contains the specific terms and conditions of coverage.

Please contact your independent Auto-Owners Insurance agent if you would like to purchase this option. Thank you for
choosing Auto-Owners Insurance, the SAFE.SOUND.SECURE.® choice for all your insurance needs!

69630 (5-18) Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 79177 (7-06)Z

IMPORTANT NOTICE

Dear Policyholder:

One or more items are insured on a Stated Amount Basis. In accordance with your policy's provisions, losses will be
settled on the actual cash value of the item at the time of loss, subject to a maximum payment of the Stated Amount as
indicated by "SA" in the Declarations. In no event will we pay more than the Stated Amount shown for the loss of or
damage to the item(s). Requesting coverage on a Stated Amount basis does not guarantee payment in that amount
should a claim occur. Please refer to Sec. III, 4.a. of the Automobile Coverage Form for coverage details.

Please review your Declarations for those item(s) you have insured on a Stated Amount basis
and advise your Auto-Owners agency of any change in value.
This notice is for informational purposes. Your policy contains the specific terms and conditions of coverage.

If you have any questions regarding this policy or this notice, please contact your Auto-Owners agency.

79177 (7-06)Z Page 1 of 1


Issued 11-06-2023

INSURANCE COMPANY
6101 ANACAPRI BLVD., LANSING, MI 48917-3999
AGENCY IEUTER INSURANCE GROUP INC Endorsement Effective 11-02-2023
01-0764-00 MKT TERR 102 (989) 835-6701 POLICY NUMBER 41-205-904-00
INSURED SCOTT & KOLLEEN SMITH Company Use 06-16-MI-9710

Company POLICY TERM


ADDRESS 500 SYLVAN LN Bill 12:01 a.m. 12:01 a.m.
to
MIDLAND MI 48640-7316 10-12-2023 10-12-2024

AUTOMOBILE POLICY
DESCRIPTION OF CHANGES EFFECTIVE 11-02-2023
(See Declarations Attached)

ADDED ITEM 0004 2010 PALOMINO PUMA VIN:4X4TPUB2XAP025733

TERM ALL ITEMS


TOTAL POLICY PREMIUM $1,976.93 $85.92
PAID IN FULL DISCOUNT APPLIES
(THIS IS NOT A BILL) Additional
Page 1 99982 (1-14)
Issued 11-06-2023
Policyholder since 1997
INSURANCE COMPANY AUTOMOBILE POLICY DECLARATIONS
6101 ANACAPRI BLVD., LANSING, MI 48917-3999
AGENCY IEUTER INSURANCE GROUP INC Endorsement Effective 11-02-2023
01-0764-00 MKT TERR 102 (989) 835-6701 POLICY NUMBER 41-205-904-00
INSURED SCOTT & KOLLEEN SMITH Company Use 06-16-MI-9710

Company POLICY TERM


ADDRESS 500 SYLVAN LN Bill 12:01 a.m. 12:01 a.m.
to
MIDLAND MI 48640-7316 10-12-2023 10-12-2024
This policy is amended in consideration of the additional or return premium shown below. This Declarations voids and replaces all previously issued
Declarations bearing the same policy number and premium term.

Discount applies for affiliation with: MI EDUCATION ASSOCIATION (MEA).


Please notify your agent at (989) 835-6701 if you are no longer a member of this group.

TERM ALL ITEMS


TOTAL POLICY PREMIUM $1,976.93 $85.92
PAID IN FULL DISCOUNT APPLIES
(THIS IS NOT A BILL) Additional
DESCRIPTION OF ITEM INSURED

Personal Injury Protection Coverages and Limit Selections

COVERAGES LIMITS
Allowable Expenses (Medical) Unlimited person Excess
Work Loss $ 6,811* person Excess
Replacement Services $ 20/day person
Survivor's Benefits $ 6,811* person
*For any 30 day period and the limit is subject to any changes established under the Michigan Insurance Code for accident occurring
on or after the date of change.

Accidental Death Benefit Endorsement

COVERAGES LIMITS PREMIUM CHANGE


Accidental Death Benefit $20,000 per eligible person Included
TOTAL Included
150
Page 2 99982 (1-14)
AUTO-OWNERS INS. CO. Issued 11-06-2023
AGENCY IEUTER INSURANCE GROUP INC Company POLICY NUMBER 41-205-904-00
01-0764-00 MKT TERR 102 Bill Company Use 06-16-MI-9710
INSURED SCOTT & KOLLEEN SMITH Term 10-12-2023 to 10-12-2024

DESCRIPTION OF ITEM INSURED

1. 2018 NISS ROGUE


VIN: JN8AT2MV9JW343700
Endorsement
COVERAGES LIMITS PREMIUM CHANGE
Combined Liability $ 510,000 occurrence $105.56
Residual Uninsured Motorist $ 500,000 person/$ 500,000 occurrence 8.77
Underinsured Motorist $ 500,000 person/$ 500,000 occurrence 32.19
Special Tort Liability $ 3,000 4.62
Property Protection $1Million occurrence 13.78
Personal Injury Protection See coverage and limit selections
Allowable Expenses (Medical) 93.48
Work Loss 2.66
Replacement Services 2.38
Survivor's Benefits 2.99
MCCA Unlimited ** 74.00
MCCA Deficit ** 48.00
MATPA ** 1.00
MACP ** 43.00
Comprehensive Actual Cash Value - $ 100 deductible 222.54
Collision - Regular Actual Cash Value - $ 500 deductible 324.83
Road Trouble Service All reasonable costs** 7.54
TOTAL $987.34
No Charge
Interested Parties:
Lienholder: DOW CHEMICAL EMPLOYEES CREDIT UNION, 600 E LYON RD, MIDLAND, MI 48640-5396
Additional Forms For This Item: 69434 (12-15)Z 99552 (08-20) 19942 (11-21) 99457 (07-20) 79253 (11-21) 79275 (06-92)Z
99301 (11-21) 99305 (11-21) 69611 (04-18) 79536 (07-94)Z 79539 (03-99)Z 79939 (01-12)Z 79299 (03-99)Z 89023 (07-06)Z
89024 (07-06)Z 89060 (10-13)Z 69557 (11-18)Z 69514 (08-21)

ITEM DETAILS: Automobile driven for pleasure/commute 0-14 use by a 58 year old operator.
Cost Symbol: 26-3B-28-1B-60.
Household Composition Rating applies.
10% Anti-Theft Device Discount applies.
5% ABS Discount applies.
Multi-Car Discount applies.
Premier Credit applies.
35% Air Bag Discount applies.
**See form 69514 (8-21)
Garaging Address: 500 SYLVAN LN, MIDLAND, MI 48640-7316
Rate Effective Date 05-26-2023

150
Page 3 99982 (1-14)
AUTO-OWNERS INS. CO. Issued 11-06-2023
AGENCY IEUTER INSURANCE GROUP INC Company POLICY NUMBER 41-205-904-00
01-0764-00 MKT TERR 102 Bill Company Use 06-16-MI-9710
INSURED SCOTT & KOLLEEN SMITH Term 10-12-2023 to 10-12-2024

DESCRIPTION OF ITEM INSURED

2. 2018 FORD F150


VIN: 1FTEW1EG2JFD16398
Endorsement
COVERAGES LIMITS PREMIUM CHANGE
Combined Liability $ 510,000 occurrence $108.73
Residual Uninsured Motorist $ 500,000 person/$ 500,000 occurrence 8.77
Underinsured Motorist $ 500,000 person/$ 500,000 occurrence 32.19
Special Tort Liability $ 3,000 4.15
Property Protection $1Million occurrence 14.19
Personal Injury Protection See coverage and limit selections
Allowable Expenses (Medical) 67.99
Work Loss 1.93
Replacement Services 1.73
Survivor's Benefits 2.17
MCCA Unlimited ** 74.00
MCCA Deficit ** 48.00
MATPA ** 1.00
MACP ** 43.00
Comprehensive Actual Cash Value - $ 100 deductible 203.14
Collision - Regular Actual Cash Value - $ 500 deductible 260.03
Road Trouble Service All reasonable costs** 6.82
TOTAL $877.84
No Charge
Interested Parties:
Lienholder: DOW CHEMICAL EMPLOYEES CREDIT UNION, ISAOA ATIMA, PO BOX 1649, MIDLAND, MI 48641-1649
Additional Forms For This Item: 69434 (12-15)Z 99552 (08-20) 19942 (11-21) 99457 (07-20) 79253 (11-21) 79275 (06-92)Z
99301 (11-21) 99305 (11-21) 69611 (04-18) 79536 (07-94)Z 79539 (03-99)Z 79939 (01-12)Z 79299 (03-99)Z 89023 (07-06)Z
89024 (07-06)Z 89060 (10-13)Z 69557 (11-18)Z 69514 (08-21)

ITEM DETAILS: Automobile driven for pleasure/commute 0-14 use by a 58 year old operator.
Cost Symbol: 37-9B-21-SB-66.
Household Composition Rating applies.
10% Anti-Theft Device Discount applies.
5% ABS Discount applies.
Multi-Car Discount applies.
Premier Credit applies.
35% Air Bag Discount applies.
**See form 69514 (8-21)
Garaging Address: 500 SYLVAN LN, MIDLAND, MI 48640-7316
Rate Effective Date 05-26-2023

150
Page 4 99982 (1-14)
AUTO-OWNERS INS. CO. Issued 11-06-2023
AGENCY IEUTER INSURANCE GROUP INC Company POLICY NUMBER 41-205-904-00
01-0764-00 MKT TERR 102 Bill Company Use 06-16-MI-9710
INSURED SCOTT & KOLLEEN SMITH Term 10-12-2023 to 10-12-2024

DESCRIPTION OF ITEM INSURED

3. 2021 82IN X14FT ALUMINUM SPL


VIN: 5LEB1UE15M1215327
COVERAGES LIMITS PREMIUM CHANGE
Comprehensive ACV not to exceed $ 3,000 (SA) $10.32
$ 100 ded
Collision - Broad ACV not to exceed $ 3,000 (SA) 10.32
$ 500 ded
Road Trouble Service $100** Included
TOTAL $20.64
No Charge
Interested Parties: None

Additional Forms For This Item: 69434 (12-15)Z 79204 (06-92)Z 79939 (01-12)Z 89023 (07-06)Z 89024 (07-06)Z 69602 (11-20)

Stated Amount (SA) - See Important Notice 79177 (07-06).


**See form 69602 (11-20)
Garaging Address: 500 SYLVAN LN, MIDLAND, MI 48640-7316
Rate Effective Date 05-26-2023
Utility Trailer

150

4. 2010 PALOMINO PUMA SPL


VIN: 4X4TPUB2XAP025733
Item Added
COVERAGES LIMITS PREMIUM CHANGE
Comprehensive ACV not to exceed $ 10,000 (SA) $62.69 $59.12
$ 100 ded
Collision - Broad ACV not to exceed $ 10,000 (SA) 14.14 13.33
$ 500 ded
Road Trouble Service All reasonable costs** 14.28 13.47
Vacation Emergency Expense $250 per day/$ 750 each occurrence Included
Vacation Liability $ 10,000 occurrence Included
Contents ACV not to exceed $ 2,000 $ 100 ded Included
TOTAL $91.11 $85.92
Additional
Interested Parties: None

Additional Forms For This Item: 69434 (12-15)Z 79204 (06-92)Z 79939 (01-12)Z 89023 (07-06)Z 89024 (07-06)Z 69351 (11-20)

ITEM DETAILS: Travel Trailer (Conventional, 26 feet), Pleasure < 30 Days.


Stated Amount (SA) - See Important Notice 79177 (07-06).
**See form 69351 (11-20)
Garaging Address: 500 SYLVAN LN, MIDLAND, MI 48640-7316
Rate Effective Date 05-26-2023

150
Page 5 99982 (1-14)
AUTO-OWNERS INS. CO. Issued 11-06-2023
AGENCY IEUTER INSURANCE GROUP INC Company POLICY NUMBER 41-205-904-00
01-0764-00 MKT TERR 102 Bill Company Use 06-16-MI-9710
INSURED SCOTT & KOLLEEN SMITH Term 10-12-2023 to 10-12-2024

DESCRIPTION OF ITEM INSURED

TERM ALL ITEMS


TOTAL POLICY PREMIUM $1,976.93 $85.92
PAID IN FULL DISCOUNT APPLIES
(THIS IS NOT A BILL) Additional

The Paid In Full Discount does not apply to fixed fees or statutory charges.

Forms That Apply To All Items: 79001 (03-99)Z 79701 (05-17)Z 99501 (11-21) 69405 (01-16)Z 69271 (05-14)Z 89058 (04-07)Z
89281 (04-10)Z 89125 (11-14)Z 99803 (07-16)Z 69396 (09-15)Z 99633 (08-22) 69716 (09-19) 69630 (05-18)

Policy Rate Code 0002


Premium assumes no youthful operator(s).
Property Discount.
Auto/Umbrella Multi-policy discount.
Loss History Rating 2D applies; 0/2
Paid In Full Discount Applies.
Payment History Discount Applies.

Driver List

Listed below are the persons currently listed on a vehicle insured on this policy.

SMITH, SCOTT Age 58


SMITH, KOLLEEN Age 58

**Michigan Catastrophic Claims Association (MCCA) provides coverage for Personal Injury Protection for an automobile accident victim when costs exceed
the threshold per MCL 500.3104(2) and they have chosen unlimited Allowable Expenses (Medical). There are two types of the MCCA charges. MCCA
Deficit will apply for all vehicles. MCCA Unlimited will apply for all vehicles to which unlimited Personal Injury Protection Allowable Expenses (Medical)
could be provided. Michigan Automobile Theft Prevention Authority (MATPA) oversees automobile theft prevention programs per MCL 500.6107. The
Michigan Assigned Claims Plan (MACP) provides coverage for automobile accident victims who are entitled to claim Personal Injury Protection benefits but
do not have applicable personal protection insurance per MCL 500.3172. MCCA, MATPA and MACP are programs established by the State of Michigan.
Automobile
Insurance Policy
POLICY NON-ASSESSABLE
This policy is non-assessable. Subject to the provisions of General Condition 2. CHANGES and any audit provisions of
any coverage provided, the premium stated in the Declarations is the only premium you will be asked to pay.

PARTICIPATING
You will be entitled to an equitable participation in Company funds in excess of the amount required to pay expenses and
all the losses or claims or other policy obligations incurred, together with the reserve and surplus funds required or
permitted by law. A distribution will be made only in accordance with the decision of our Board of Directors acting under
the insurance laws and under our charter.

NOTICE OF MEMBERSHIP AND ANNUAL MEETING


Because we are a mutual company, this policy makes you a member of the Auto-Owners Insurance Company. You are
entitled to vote, in person or by proxy, at all meetings. Our annual policyholder's meetings are held at our home office at
Lansing, Michigan on the second Monday in May in each year at 10:00 A.M.

In witness whereof, we, the Auto-Owners Insurance Company, have caused this policy to be issued and to be duly signed
by our President and Secretary.

Secretary President

79023 (7-12)
Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 79001 (3-99)Z

This policy is a legal contract between you and us. Your policy includes the Declarations, any listed forms and any form
issued to endorse the policy. The policy contains all agreements existing between you and us or any of our agents.

READ YOUR POLICY CAREFULLY. This cover sheet provides only a brief outline of some of the important features of
your policy. The policy itself sets forth, in detail, the rights and obligations of both you and your insurance company. IT
IS THEREFORE IMPORTANT THAT YOU READ YOUR POLICY.

A QUICK GUIDE TO YOUR POLICY

The DECLARATIONS contain: YOUR NAME


POLICY TERM
YOUR AUTOMOBILE
COVERAGES
LIMITS OF LIABILITY
ENDORSEMENTS THAT APPLY

YOU WILL FIND ON PAGE

INSURING AGREEMENT 1
SECTION I - DEFINITIONS 1
SECTION II - LIABILITY COVERAGE 2
1. COVERAGE 2
2. EXCLUSIONS 3
3. COVERAGE EXTENSIONS 4
4. LIMIT OF LIABILITY 5
5. FINANCIAL RESPONSIBILITY AND COMPULSORY 5
INSURANCE LAWS
6. OTHER INSURANCE 6
SECTION III - DAMAGE TO YOUR AUTOMOBILE 6
1. COVERAGES 6
2. EXCLUSIONS 7
3. COVERAGE EXTENSIONS 8
4. LIMIT OF LIABILITY 9
SECTION IV - INDIVIDUAL NAMED INSURED 10
1. LIABILITY COVERAGE 10
2. DAMAGE TO YOUR AUTOMOBILE 10
SECTION V - WHAT YOU MUST DO AFTER AN ACCIDENT OR LOSS 11
1. NOTIFY US PROMPTLY 11
2. ASSIST AND COOPERATE 11
3. PRESERVE OUR RIGHT TO RECOVER PAYMENTS 11
SECTION VI - GENERAL CONDITIONS 11
1. POLICY PERIOD AND TERRITORY 11
2. CHANGES 11
3. FRAUD 12
4. LEGAL ACTION AGAINST US 12
5. SEVERABILITY 12
6. DUPLICATION OF COVERAGE 12
7. ASSIGNMENT 12
Agency Code 01-0764-00 Policy Number 41-205-904-00

INSURING AGREEMENT

The attached Declarations describe the automobile(s) we insure and the Coverages and Limits of Liability for which you
have paid a premium. We agree to insure the described automobile(s) for those Coverages and Limits of Liability sub-
ject to the terms and conditions of this policy. In return you must pay the premium and comply with all the terms and
conditions of this policy.

SECTION I - DEFINITIONS

To understand this policy, you must understand the meaning of the following words. These words appear in bold face
type whenever used in this policy and endorsements attached to this policy.

1. Automobile means a private passenger automo- contract or agreement is made before the bod-
bile, a truck, truck tractor, trailer, farm implement ily injury or property damage occurs. Tort li-
or other land motor vehicle. ability means liability that would be imposed by
law in the absence of any contract or agree-
2. Bodily injury means physical injury, sickness or dis- ment.
ease sustained by a person including resulting death
of that person. An insured contract does not include that part of
any contract or agreement:
3. Equipment means an apparatus or device perma-
nently attached to or installed in your automobile. a. that pertains to the loan, lease or rental of an
Equipment includes an apparatus or device speci- automobile to you; or
fically for use with your automobile.
b. that holds a person or organization engaged in
4. Farm implement means motorized self-propelled the business of transporting property for hire
farm machinery. harmless for your use of your automobile over
a route or territory that person or organization is
5. Insured contract means: authorized to serve by public authority.

a. a lease of premises; 6. Occurrence means an accident that results in bod-


ily injury or property damage and includes, as one
b. a sidetrack agreement; occurrence, all continuous or repeated exposure to
substantially the same generally harmful conditions.
c. an easement or license agreement in connec-
tion with vehicle or pedestrian private railroad 7. Private passenger automobile means:
crossings at grade;
a. a passenger or station wagon type automobile
d. any other easement agreement, except in con- with four or more wheels;
nection with construction or demolition opera-
tions on or within 50 feet of a railroad; b. pickup or van type automobile with a gross
weight of 15,000 pounds or less which is not
e. an indemnification of a municipality as required used in the business of carrying passengers for
by ordinance, except in connection with work for hire; or
a municipality; or
c. a motorhome.
f. that part of any other contract or agreement
pertaining to your business under which you 8. Property damage means damage to or destruction
assume the tort liability of another to pay dam- of tangible property including resulting loss of use of
ages because of bodily injury or property that property.
damage to a third person or organization, if the

79001 (3-99)Z Page 1 of 12


Agency Code 01-0764-00 Policy Number 41-205-904-00

9. Relative means a person who resides with you and 12. You or your means the first named insured shown
who is related to you by blood, marriage or adop- in the Declarations and if an individual, your spouse
tion. Relative includes a ward or foster child who who resides in the same household.
resides with you.
13. Your automobile means the automobile described
10. Suit means a civil court proceeding in which dam- in the Declarations.
ages because of bodily injury or property damage
to which this insurance applies are alleged. 14. We, us or our means the Company providing this in-
surance.
11. Trailer means a vehicle which is designed to be
connected to and towed by an automobile.

SECTION II - LIABILITY COVERAGE

1. COVERAGE or provided for any other automobile (that


is not a trailer) extends:
a. Liability Coverage - Bodily Injury and
Property Damage (a) to any trailer connected to or acciden-
tally disconnected from such automo-
We will pay damages for bodily injury and bile. This coverage includes the trailer
property damage for which you become legally owner.
responsible because of or arising out of the
ownership, maintenance or use of your auto- (b) to any non-motorized farm machine or
mobile (that is not a trailer) as an automobile. farm wagon while connected to or acci-
We will pay such damages: dentally disconnected from such auto-
mobile. This coverage includes the
(1) on your behalf; non-motorized farm machine or farm
wagon owner. No coverage applies to
(2) on behalf of any relative using your auto- the operation or to the loading or un-
mobile (that is not a trailer); loading of the non-motorized farm ma-
chine or the farm wagon.
(3) on behalf of any person using your auto-
mobile (that is not a trailer) with your per- (2) The Liability Coverage provided by this poli-
mission or that of a relative; and cy for your automobile (that is not a trailer)
also extends to any trailer not maintained or
(4) on behalf of any person or organization le- used for commercial purposes:
gally responsible for the use of your auto-
mobile (that is not a trailer) when used by (a) which is owned by you.
you, a relative, or with your permission or
that of a relative. (b) which is owned by a relative who also
owns an automobile (that is not a
We will settle or defend, as we consider appro- trailer) scheduled in the Declarations.
priate, any claim or suit for damages covered by
this policy. We will do this at our expense, us- (c) which is owned by a relative who does
ing attorneys of our choice. This agreement to not own an automobile other than the
settle or defend claims or suits ends when we trailer.
have paid the limit of our liability.
(d) which is not owned by an individual de-
b. Trailers scribed in (a), (b) or (c) above while the
trailer is in the care, custody or control
(1) The Liability Coverage provided by this poli- of such individual.
cy for your automobile (that is not a trailer)

79001 (3-99)Z Page 2 of 12


Agency Code 01-0764-00 Policy Number 41-205-904-00

Coverage is extended only when such 2. EXCLUSIONS


trailer:
Liability Coverage does not apply:
(a) is not connected to an automobile.
This coverage applies to only your lia- a. to any person for bodily injury or property
bility or your relative's liability arising damage arising out of or resulting from an inten-
from the ownership or use of the trailer. tional act of that person.

(b) is connected to an automobile (that is b. to any person operating or employed by an au-


not a trailer) for which Liability Cover- tomobile garage, repair shop, sales agency,
age is not provided by this policy. This service station or public parking place. This ex-
coverage applies to only your liability or clusion does not apply to:
your relative's liability arising from use
of the trailer by a person or organiza- (1) you;
tion other than you or your relative. No
coverage applies to the owner or opera- (2) a relative; or
tor of the automobile or to the owner of
a trailer described in (d) above. (3) any person associated with or employed by
you;
c. Other Automobiles Covered
while using your automobile in such business.
The Liability Coverage provided for your auto-
mobile also applies to certain other automo- c. to any automobile while used as a public or liv-
biles. It applies: ery conveyance. This exclusion does not apply
to car pooling on a share the expense basis.
(1) to an automobile you do not own which is
temporarily used as a substitute for your d. to any automobile while:
automobile. Your automobile must be out
of use because of breakdown, repair, servic- (1) preparing for;
ing, loss or destruction. The owner of the
substitute automobile is not covered. (2) practicing for; or

(2) to an automobile of the same type which (3) participating in;


you acquire after the inception date of the
current policy term if: any prearranged racing, speed or demolition
contest.
(a) it replaces your automobile. You must
report the replacement automobile to e. to any person or organization with respect to the
us no later than the expiration date of loading or unloading of your automobile. We
the policy term during which the auto- will cover you or your employee or a lessee or
mobile was acquired; or borrower of your automobile or that person's
employee.
(b) it is an additional automobile and we in-
sure all automobiles you already own f. to any person or organization (or that person's
provided you: or organization's agents, employees or contrac-
tors) subject to the security requirements of any
1) report the additional automobiles to motor carrier law or regulation because of trans-
us within 30 days of delivery; and porting property for you or for others. This ex-
clusion does not apply to you.
2) pay any required additional premi-
ums. g. to liability which is assumed under any contract
or agreement. This exclusion does not apply to
This extension does not apply if you have such liability for damages that you:
other liability insurance that applies to the
automobile you acquire. (1) assumed under a contract or agreement
that is an insured contract;

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Agency Code 01-0764-00 Policy Number 41-205-904-00

(2) would have in the absence of a contract or (2) to any obligation to share damages with or
agreement; or repay another who must pay damages be-
cause of the injury.
(3) assumed in a private passenger automo-
bile lease or rental agreement, provided This exclusion does not apply to liability you
you are an individual. have assumed under an insured contract.

h. to any person or organization for damage to n. to bodily injury or property damage for which
property that person or organization is trans- insurance is available under any nuclear energy
porting. This exclusion does not apply to liability liability policy. This exclusion applies even if the
you have assumed under a sidetrack agree- nuclear energy liability policy limits of liability are
ment. exhausted.

i. to any person or organization for damage to o. to bodily injury or property damage for which
property or an automobile owned by, rented to financial responsibility or liability insurance is re-
or in the care, custody or control of that person quired to be maintained under the Atomic En-
or organization. ergy Act of 1954, as amended, or for which gov-
ernmental indemnity is available.
j. to any expenses that would be payable under
any workers compensation law, unemployment p. to liability for bodily injury or property damage
compensation or disability benefits law or under caused by war, whether declared or not de-
any similar law. clared, insurrection or any of their consequen-
ces whether or not assumed under a contract or
k. to any person not employed by you for bodily agreement.
injury to an employee who is injured on the job
except: 3. COVERAGE EXTENSIONS

(1) bodily injury to a domestic employee when In addition to our limit of liability, we will also pay:
workers compensation benefits are not re-
quired or available; or a. premiums on appeal bonds in any suit we de-
fend. We will not apply for or furnish such
(2) when such liability is assumed by you under bonds.
an insured contract.
b. premiums on bonds to release attachments, but
l. to your employee for claims brought against him only for bond amounts that do not exceed the
or her by another of your employees injured on applicable limit of liability. We will not apply for
the job. or furnish such bonds.

m. to any person or organization for bodily injury c. premiums on bail bonds required because of an
to: accident or related traffic law violation, involving
your automobile during the policy period. We
(1) an employee of that person or organization; will not apply for or furnish such bonds. Our
or maximum payment is $250 per occurrence.

(2) a spouse, child, parent, brother or sister of d. interest on damages owed by you because of a
the employee which results from the injury judgment in a suit we defend and accruing:
to the employee;
(1) after the judgment, and until we pay, offer or
when that injury arises out of and in the course deposit in court, the amount for which we
of employment by that person or organization. are liable under this policy; or
This exclusion applies:
(2) before the judgment, where owed by law,
(1) whether a claim is made against such per- but only on that part of the judgment we
son or organization as employer or pay.
otherwise; and

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Agency Code 01-0764-00 Policy Number 41-205-904-00

e. expenses you, a relative or a person using (2) which is connected to an automobile not
your automobile with your permission, incur for covered by this policy;
first aid to others at the time of an occurrence
covered by this policy. shall be the limit of liability applicable to your
automobile. If this policy covers more than one
f. all costs charged against you in a suit we de- of your automobiles, the highest limit of liability
fend and all reasonable expenses incurred at applicable to any one such automobile shall ap-
our request including actual loss of earnings up ply.
to $100 per day.
e. The limit of liability for this coverage may not be
4. LIMIT OF LIABILITY added to the limits for the same or similar cover-
age applying to other automobiles insured by
We will pay damages for bodily injury or property this policy to determine the amount of coverage
damage up to the limit of liability stated in the Decla- available for any one occurrence regardless of
rations for this coverage. Such damages shall be the number of:
paid as follows:
(1) automobiles shown in the Declarations;
a. For bodily injury:
(2) premiums charged in the Declarations or
(1) The limit stated for "each person" is the premiums paid;
amount of coverage and the most we will
pay for all damages because of or arising (3) claims presented or suits brought;
out of bodily injury to one person in any
one occurrence. (4) persons injured; or

(2) The limit stated for "each occurrence" is the (5) automobiles involved in the occurrence.
total amount of coverage and the most we
will pay, subject to a.(1) above, for all dam- 5. FINANCIAL RESPONSIBILITY AND COMPUL-
ages because of or arising out of bodily in- SORY INSURANCE LAWS
jury to two or more persons in any one oc-
currence. While your automobile is subject to laws of another
state or Canada, we will:
b. For property damage, the limit stated is the
amount of coverage and most we will pay for all a. increase the Limit of Liability for Liability Cov-
property damage in any one occurrence. erage to comply with the minimum requirements
of a financial responsibility or compulsory insur-
c. The limit of liability applicable to a trailer, ance law of the jurisdiction where your automo-
non-motorized farm machine or farm wagon bile is being operated; and
which is connected to an automobile covered
by this policy shall be the limit of liability appli- b. afford the minimum amounts for the types of
cable to such automobile. The automobile mandatory coverages required by the jurisdiction
and connected trailer, non-motorized farm where your automobile is being operated.
machine or farm wagon are considered one
automobile and do not increase the limit of This provision does not apply to any limits required
liability. by any law governing motor carriers of property or
passengers.
d. The limit of liability applicable to a trailer cov-
ered by this policy: We will not duplicate payments available under this
or any other insurance for the same elements of
(1) which is not connected to an automobile; or loss.

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Agency Code 01-0764-00 Policy Number 41-205-904-00

6. OTHER INSURANCE excess or contingent, we shall be liable for only


our share. Our share shall be the ratio of the
Except as stated below, the Liability Coverage pro- amount of this insurance to the total amount of
vided by this policy for your automobile shall be pri- all collectible automobile liability insurance.
mary and with regard to any other automobile to
which it applies, coverage shall be excess of any c. Subject to a. and b. above, this coverage shall
other applicable automobile liability insurance. be primary when any trailer is connected to
your automobile (that is not a trailer).
a. When this insurance is primary and there is oth-
er automobile liability insurance which is stated d. Subject to b. above, this coverage shall be
to be applicable on an excess or contingent ba- excess when any trailer is connected to an
sis, our liability shall not be reduced by the exis- automobile (that is not a trailer), except your
tence of such insurance. automobile (that is not a trailer).

b. When both this insurance and other insurance


apply on the same basis, whether primary,

SECTION III - DAMAGE TO YOUR AUTOMOBILE

1. COVERAGES c. Comprehensive Coverage

a. Fire Coverage We will pay for loss of or damage to your auto-


mobile and its equipment from any cause ex-
We will pay for loss of or damage to your auto- cept upset or collision with another object or with
mobile and its equipment caused by: a vehicle to which it is attached.

(1) fire or lightning. We will also pay or:

(2) smoke or smudge because of a sudden, un- (1) glass breakage from any cause including
usual or faulty operation of any fixed heating upset or collision;
equipment where your automobile is
stored. (2) damage caused by missiles or falling ob-
jects; and
(3) windstorm, hail, earthquake, explosion, ex-
ternal discharge or leakage of water. We (3) damage caused by collision with an animal
cover damage resulting from the stranding, or bird.
sinking, burning, collision or derailment of
any equipment being used to transport your When a deductible is indicated in the Declara-
automobile on land or water. We will also tions for this coverage, we will reduce our pay-
pay for general average and salvage char- ment by that amount.
ges for which you may be legally responsi-
ble. d. Collision Coverage

b. Theft Coverage We will pay for loss or damage to your automo-


bile and its equipment caused by accidental
We will pay for loss of or damage to your auto- collision with another object or by accidental up-
mobile and its equipment caused by theft, lar- set.
ceny, robbery or pilferage. We cover your loss
when you are tricked into giving your automo- When a deductible is indicated in the Declara-
bile to another person. tions for this coverage, we will reduce our pay-
ment by that amount. If your automobile is a

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Agency Code 01-0764-00 Policy Number 41-205-904-00

private passenger automobile, the deductible (a) If the automobile replaces your auto-
does not always apply. The deductible shall not mobile, we will apply only those
apply: coverages that apply to the automobile
being replaced. You must report the re-
(1) in a collision with another automobile: placement automobile to us no later
than the expiration date of the policy
(a) we insure and which you do not own, term during which the automobile was
rent or have in your care, custody or acquired.
control; or
(b) If the automobile is an additional
(b) whose owner or operator has been iden- automobile and we insure all automo-
tified; and biles you already own, we will apply
only those coverages which are com-
1) is legally responsible for the entire mon to all of your automobiles we in-
amount of the damage; and sure provided you:

2) is covered by a property damage li- 1) report the additional automobile to


ability policy or bond; us within 30 days after you take
possession; and
but only if the damage exceeds the
deductible amount. 2) pay any required additional pre-
miums.
(2) to your legally parked private passenger
automobile in the event it is accidentally You may, at any time during the first 30
struck by another of your private passen- days after you take possession of the
ger automobiles, provided Collision Cover- automobile, purchase the broadest
age applies to both such automobiles. coverages applicable to any one auto-
mobile scheduled in the Declarations.
e. Road Trouble Service
These extensions do not apply when there is
We will reimburse you up to the amount stated other insurance covering your interest or the in-
in the Declarations for this coverage in any one terest of the owner. However, paragraph f.(1)
emergency: above applies if you are legally liable.

(1) for towing your automobile to the nearest 2. EXCLUSIONS


available garage; and
Fire, Theft, Comprehensive and Collision Coverages
(2) for the cost of labor performed on your au- do not apply to:
tomobile at the place of the emergency.
a. loss of or damage to your automobile because
f. Other Automobiles Covered of confiscation or destruction by any civil or gov-
ernmental authorities because of illegal activities
The Damage To Your Automobile Coverages engaged in by:
provided for your automobile also apply to cer-
tain other automobiles. They apply: (1) you; or

(1) to an automobile you do not own which is (2) a relative.


temporarily used as a substitute for your
automobile. Your automobile must be out This exclusion does not apply to a loss payee's
of use because of breakdown, repair, servic- interest in your automobile.
ing, loss or destruction.
b. loss of or damage to your automobile because
(2) to an automobile of the same type which of or arising out of your intentional act or an in-
you acquire after the inception date of the tentional act committed at your direction or with
current policy term subject to the following: your knowledge. This exclusion does not apply
to a loss payee's interest in your automobile.

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Agency Code 01-0764-00 Policy Number 41-205-904-00

c. conversion, embezzlement or secretion by any l. A citizens-band radio, mobile or cellular tele-


person lawfully having your automobile under a phone, television or other similar device for
sale, lease or similar agreement. sending or receiving communications, including
related items. However, these devices are
d. any automobile while: covered if:

(1) preparing for; (1) standard or optional equipment from the


manufacturer of your automobile for that
(2) practicing for; or make, model and model year;

(3) participating in; (2) permanently installed in the dash or console


opening designed for such equipment; or
any prearranged racing, speed or demolition
contest. (3) described in the Declarations and a premi-
um charged.
e. loss of use, except as provided in Coverage
Extensions. m. a radio, stereo, stereo tape deck, compact disc
player or other similar device designed for the
f. wear and tear, freezing, mechanical or electrical reproduction of sound, including related items.
breakdown, other than burning of wiring, unless However these devices are covered if:
this damage follows and results from other loss
or damage covered by this policy. (1) standard or optional equipment for the
manufacturer of your automobile for that
g. tires, unless the loss or damage is caused by: make, model and model year; or

(1) fire; (2) permanently installed in your automobile.

(2) theft; or Our liability under m.(2) above shall not exceed
$1000 unless a greater amount is shown in the
(3) malicious mischief; or Declarations and a premium charged.

is part of other damage covered by this policy. n. Any device designed or used to detect or locate
radar or any other speed measuring or calculat-
h. a stereo tape or disc player: ing apparatus.

(1) that is not attached to your automobile; o. radioactive contamination.


and
p. loss caused by:
(2) is not receiving its power from your auto-
mobile's electrical system. (1) declared or undeclared war or insurrection;
or
i. stereo tapes, cassettes, discs or cartridges or
related items. (2) explosion of a nuclear weapon or its con-
sequences.
j. any caddy, case or container designed for stor-
ing or carrying stereo tapes, cassettes, discs or 3. COVERAGE EXTENSIONS
cartridges.
a. Trailers
k. unless described in the Declarations and a pre-
mium charged: The Damage To Your Automobile Coverages
provided to your automobile extend to certain
(1) a camper body; or trailers you do not own. The trailer must:

(2) a pickup cover with built-in cooking and (1) be designed for use with a private pas-
sleeping equipment. senger automobile;

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Agency Code 01-0764-00 Policy Number 41-205-904-00

(2) used with your private passenger automo- breaking into the automobile for (2)(c)
bile; and above to apply.

(3) be other than a trailer of the home, office, store, (3) This coverage extension does not apply to:
display, or passenger type.
(a) stereo tapes, cassettes, discs or car-
Our limit of liability for all loss and damage tridges or related items.
under this coverage extension is $500 in any
one occurrence. (b) a citizens-band radio, mobile or cellular
telephone, television or other similar
b. Loss Of Use By Theft device for sending or receiving com-
mnications, including related items.
Under Theft Coverage or Comprehensive Cov-
erage, we will reimburse you for transportation (c) a radio, stereo, stereo tape deck, com-
expenses if your private passenger automo- pact disc player or other similar device
bile is stolen. We will pay up to $20 per day but designed for the reproduction of sound,
not more than $600 in one occurrence. We will including related items.
pay such expenses incurred beginning 48 hours
after you report the theft to us and to the police (d) property used in a business, trade or
and ending when your automobile is returned profession.
to use or we pay for its loss.
(e) money or jewelry.
c. Transportation Cost
(f) any device designed or used to detect
Under the coverages for Damage To Your Auto- or locate radar or any other speed
mobile we will reimburse you for expenses you measuring or calculating apparatus.
incur for transportation from where your auto-
mobile was disabled to your home or intended (g) property specifically insured.
destination. The maximum payment is $25 for
each occurrence. (4) Our limit of liability for all loss or damage
under this coverage extension is $200 in any
d. Personal Property one occurrence.

If your automobile is a private passenger au- 4. LIMIT OF LIABILITY


tomobile, we will extend the Comprehensive
Coverage and the Collision Coverage that apply a. We will pay no more than the lowest of the
to your automobile to loss of or damage to per- following:
sonal property contained in or on your automo-
bile. This coverage extension is subject to the (1) the actual cash value of stolen or damaged
following: property;

(1) The personal property must be owned by (2) the necessary cost, at local prices, to repair
you, a relative, or your employee. or replace the property or damaged parts
with material of similar kind and quality; or
(2) Comprehensive Coverage is extended only
for loss or damage because of: (3) the Limit of Liability stated in the Declara-
tions.
(a) fire;
b. We will, at our option, replace your automobile
(b) lightning; with a new one of equal value or pay you your
original purchase price if:
(c) theft or attempted theft.
(1) your automobile is a private passenger
Unless the entire automobile is stolen, automobile;
there must be visible signs of someone
(2) you purchased it new;

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Agency Code 01-0764-00 Policy Number 41-205-904-00

(3) we determine the loss or damage can not proportion that the value of a standard automo-
be repaired; and bile bears to the value of your automobile.
This applies only when alteration, remodeling,
(4) the loss or damage occurs within 90 days of conversion or modification affects the amount of
the purchase date. the loss. It does not apply when an additional
premium is charged based on the increased
c. Your automobile may have been altered, re- value.
modeled, converted or modified so that its value
is substantially increased over that of a standard d. If a loss can be paid under either Comprehen-
automobile of the same make and model. In sive or Collision Coverage, payment will be
that case, we will pay only a proportional share made under the coverage that pays you the
of any loss or damage. We will pay the most.

SECTION IV - INDIVIDUAL NAMED INSURED


If the first named insured in the Declarations is an individual and the automobile described in the Declarations is a pri-
vate passenger automobile the following extensions of coverage apply.

1. LIABILITY COVERAGE - BODILY INJURY AND (a) a private passenger automobile; and
PROPERTY DAMAGE
(b) used by you, such relative or the chau-
a. The Liability Coverage provided for your auto- ffeur or household employee of either.
mobile (that is not a trailer) also applies to an
automobile (that is not a trailer) not: (3) you or a relative using an automobile (that
is not a trailer) without a reasonable belief
(1) owned by or furnished or available for regu- of permission to do so.
lar use to you or anyone living with you.
However, we will cover your liability for 2. DAMAGE TO YOUR AUTOMOBILE
your use of an automobile (that is not a
trailer) owned by or furnished for the regular a. The Damage to Your Automobile Coverages
use of a relative. provided for your automobile also apply to an
automobile not:
(2) used in an automobile garage repair shop,
sales agency, service station or public park- (1) owned by or furnished or available for regu-
ing business you own or operate. lar use to you or anyone living with you.

b. We extend this coverage only: (2) used in an automobile garage, repair shop,
sales agency, service station or public park-
(1) to you; ing business you own or operate.

(2) to relatives who do not own an automobile b. We extend this coverage only:
(that is not a trailer); and
(1) to you; and
(3) to anyone legally responsible for the use of
the automobile (that is not a trailer) by the (2) to relatives who do not own an automo-
persons in (1) and (2) above. bile.

c. We do not cover: c. We do not cover an automobile used in your


business or occupation or that of a relative un-
(1) the owner of the automobile (that is not a less it is:
trailer).
(1) a private passenger automobile; and
(2) an automobile used in your business or oc-
cupation or that of a relative, unless it is: (2) used by you, such relative, or the chauf-
feur or household employee of either.

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Agency Code 01-0764-00 Policy Number 41-205-904-00

d. These extensions do not apply when there is interest of the owner. However, they do apply if
other insurance covering your interest or the you are legally liable.

SECTION V - WHAT YOU MUST DO AFTER AN ACCIDENT OR LOSS

1. NOTIFY US PROMPTLY a. You and any person seeking coverage under


this policy must cooperate with us in the investi-
a. You and any person seeking coverage under gation, settlement or defense of any claim or
this policy must notify us promptly as to how, suit. This includes submitting to a statement
when and where the accident happened. We under oath and giving us access to any docu-
must have the names and addresses of any ments which we request.
injured person and of any witnesses. Notice and
documentation of loss must be given if we b. When a claim is made for damage to your auto-
require it. Any loss or damage caused by theft, mobile, you must let us examine the vehicle
larceny, robbery, pilferage or trickery must be before repairs are made or evidence of loss re-
promptly reported to the police. moved.

b. If claim is made or suit is brought against you c. Following damage to your automobile, every
or any person entitled to coverage, we must be reasonable effort must be made to protect the
advised promptly. All papers in connection with vehicle against further loss. We will pay the
claims or suits must be sent to us without de- reasonable expenses incurred to do this.
lay.
3. PRESERVE OUR RIGHT TO RECOVER
c. Under Uninsured Motorist Coverage and/or Un- PAYMENTS
derinsured Motorist Coverage, any person mak-
ing claim must: a. If we make a payment under this policy and the
person to or for whom payment is made has a
(1) give us written notice and documentation of right to recover damages from another, we will
loss; be entitled to that right. That person shall do
everything necessary to transfer that right to us
(2) submit to examinations by physicians we and shall do nothing to prejudice it.
select as often as we require; and
b. The person to or for whom payment is made
(3) authorize us to obtain medical reports and under Uninsured Motorist Coverage and/or Un-
other pertinent records. derinsured Motorist Coverage must hold in trust
for us his rights of recovery against any legally
We must be given copies of the legal papers if liable person. He must do all that is proper to
suit is brought against any person believed to secure such rights and must do nothing to preju-
be legally responsible. dice them. He must take any required action in
his name to recover damages and reimburse us
2. ASSIST AND COOPERATE out of any proceeds to the extent of our pay-
ment.

SECTION VI - GENERAL CONDITIONS

1. POLICY PERIOD AND TERRITORY possessions, Canada or Mexico or between their


ports.
This policy applies only to accidents and losses
which happen during the policy period as shown in 2. CHANGES
the Declarations. They must take place within the
United States of America, its territories or a. This policy contains all the agreements between
you and us or any of our agents relating to this

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Agency Code 01-0764-00 Policy Number 41-205-904-00

insurance. The terms of this policy may not be b. Bankruptcy or insolvency of any person we have
changed except by written endorsement issued agreed to protect will not relieve us of any obli-
by us. gation under the terms of this policy.

b. We may adjust your premium during the policy 5. SEVERABILITY


term because of changes in the factors that
were used to determine such premium. These Except as to our limit of liability, the coverage pro-
factors include but are not limited to: vided by this policy applies separately to each per-
son against whom claim is made or suit is brought.
(1) the principal place of garaging your auto-
mobile; 6. DUPLICATION OF COVERAGE

(2) coverages, limits of liability and deducti- a. If this policy and any other policy or form of cov-
bles; erage provided by us or a company affiliated
with us, provide coverage for the same loss or
(3) the type, make and model of your auto- damage, our maximum limit of liability under all
mobile and its use; the policies or forms of coverage shall not ex-
ceed the highest limit of liability under any single
(4) the operators of your automobile. policy or form of coverage applicable to the loss
or damage.
Premium adjustments will be made at the time
of such changes or when we become aware of b. This condition does not apply to any policy or
the changes, if later. We will use the governing form of coverage issued by us or a company af-
rules and rates in effect on the inception date of filiated with us to specifically provide excess in-
the policy term. surance over this policy.

3. FRAUD 7. ASSIGNMENT

We will not cover any person seeking coverage un- No interest in this policy may be assigned without
der this policy who has made fraudulent statements our written consent. But, if you should die within
or engaged in fraudulent conduct with respect to the policy term, the policy will cover as though
procurement of this policy or to any occurrence for named in the Declarations:
which coverage is sought.
a. your spouse, if you are an individual;
4. LEGAL ACTION AGAINST US
b. your legal representative but only with respect
a. No legal action may be brought against us until to his legal responsibility for the maintenance or
there has been full compliance with all the terms use of your automobile; and
of this policy. Further, under the Liability Cov-
erage no legal action may be brought until we c. any person having proper temporary custody of
agree a person entitled to coverage has an obli- your automobile until a legal representative is
gation to pay or until the amount of that obliga- appointed;
tion has been determined by judgement after
trial. No one has any right under this policy to provided we are given written notice of your death
bring us into any action to determine the liability within 60 days. This requirement does not apply
of any person we have agreed to protect. with regard to your spouse.

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Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 19942 (11-21)

Michigan
PERSONAL INJURY PROTECTION

SECTION I - DEFINITIONS accident with an insured motor vehicle in


The following definitions apply to this endorsement. The Michigan
definitions contained in the policy do not apply to the suffering accidental bodily injury.
coverage provided by this endorsement. 7. Insured motor vehicle means a motor vehicle with
1. Bodily injury means physical injury, sickness or dis- respect to which:
ease, including resulting care, loss of services or a. the bodily injury liability insurance of the policy
death resulting from a motor vehicle accident in- applies and for which a specific premium is
cluding loss of or damage to a person's prosthetic charged; and
device in connection with the bodily injury. b. the named insured is required to maintain secu-
2. Commercial quadricycle means a vehicle to which rity under Chapter 31 of the Michigan Insurance
all of the following apply: Code.
a. The vehicle has fully operative pedals for propul- 8. Motorcycle means a vehicle having a saddle or seat
sion entirely by human power; for the use of the rider, designed to travel on not
b. The vehicle has at least 4 wheels and is oper- more than 3 wheels in contact with the ground,
ated in a manner similar to a bicycle; which is equipped with a motor that exceeds 50
c. The vehicle has at least 6 seats for passengers; cubic centimeters piston displacement. The wheels
d. The vehicle is designed to be occupied by a dri- on any attachment to the vehicle shall not be
ver and powered either by passengers providing considered as wheels in contact with the ground.
pedal power to the drive train of the vehicle or Motorcycle does not include a moped, as defined in
by a motor capable of propelling the vehicle in section 32b of the Michigan vehicle code, Act No.
the absence of human power; 300 of the Public Acts of 1949, being section
e. The vehicle is used for commercial purposes; 257.32b of the Michigan Compiled Laws.
and Motorcycle does not include an ORV.
f. The vehicle is operated by the owner of the 9. Motor vehicle means a vehicle, including a trailer,
vehicle or an employee of the owner of the operated or designed for operation upon a public
vehicle. highway by power other than muscular power which
3. Delivery network platform means any has more than 2 wheels. Motor vehicle does not
online-enabled application used to connect include a motorcycle or a moped, as defined in sec-
customers for purposes of providing the tion 32b of Act No. 300 of the Public Acts of 1949,
prearrangement of deliveries with: being section 257.32b of the Michigan Compiled
a. drivers; or Laws. Motor vehicle does not include a farm trac-
b. local vendors using drivers tor or other implement of husbandry which is not
for compensation. subject to the registration requirements of the Michi-
A delivery network platform does not include a gan vehicle code pursuant to section 216 of the
transportation network company. Michigan vehicle code, Act No. 300 of the Public
4. Digital network means any online-enabled applica- Acts of 1949, being section 257.216 of the Michigan
tion, software, website or system offered or utilized Compiled Laws. Motor vehicle does not include an
by a transportation network company that enables ORV. Motor vehicle does not include a power-
the prearrangement of rides with transportation driven mobility device, a commercial quadricy-
network company drivers. cle or golf carts.
5. Golf cart means a vehicle designed for transporta- 10. Motor vehicle accident means a loss involving the
tion while playing the game of golf. ownership, operation, maintenance, or use of a mo-
6. Injured insured person means: tor vehicle as a motor vehicle regardless of
a. a named insured or relative; or whether the accident also involves the ownership,
b. an operator or passenger of a motorcycle, if the operation, maintenance, or use of a motorcycle as
motorcycle was involved in a motor vehicle a motorcycle.

19942 (11-21) Page 1 of 6


Agency Code 01-0764-00 Policy Number 41-205-904-00

11. Named insured means the person(s) or organiza- requested goods, items or products are no longer
tion(s) identified as an insured in the Declarations. occupying the motor vehicle.
12. Occupying means in or entering into or alighting 17. Prearranged ride means the furnishing of transpor-
from a motor vehicle. tation by a driver to a requesting passenger, begin-
13. ORV means a motor-driven recreation vehicle de- ning when a driver accepts a ride requested by a
signed for off-road use and capable of cross-country passenger through a digital network controlled by a
travel without benefit of road or trail, on or immedi- transportation network company, continuing while
ately over land, snow, ice, marsh, swampland, or the driver transports a requesting passenger and
other natural terrain. ORV includes, but is not lim- ending when the requesting passenger departs from
ited to, a multitrack or multi-wheel drive vehicle, a the motor vehicle.
motorcycle or related 2-wheel, 3-wheel, or 4-wheel 18. Relative means:
vehicle, an amphibious machine, a ground effect air a. The named insured's spouse; and
cushion vehicle, an ATV as defined in section 81101 b. Any other person who is domiciled with the
of the natural resources and environmental protec- named insured and related to either the named
tion act, 1994 PA 451, MCL 324.81101, or other insured or his or her spouse by blood, marriage,
means of transportation deriving motive power from or adoption.
a source other than muscle or wind. ORV does not Relative includes a ward or foster child who is
include a vehicle described in this subdivision that is domiciled with the named insured.
registered for use upon a public highway and has 19. Suit means a civil court proceeding in which dam-
the security described in section 3101 or 3103 in ages because of bodily injury to which this
effect. insurance applies are alleged.
14. Owner means any of the following: 20. Transportation network company means an entity
a. A person renting a motor vehicle or having the that uses a digital network to connect passengers
use of a motor vehicle, under a lease or other- to transportation network company drivers.
wise, for a period that is greater than 30 days. 21. We, us, and our means the Company providing this
b. A person who holds the legal title to a motor insurance.
vehicle or motorcycle, other than a person en-
gaged in the business of leasing motor vehicles SECTION II - PERSONAL INJURY PROTECTION
or motorcycles who is the lessor of a motor 1. COVERAGE
vehicle or motorcycle pursuant to a lease pro- Subject to the provisions of this endorsement and of
viding for the use of the motor vehicle or mo- the policy to which this endorsement is attached, we
torcycle by the lessee for a period that is will pay personal injury protection benefits to or on
greater than 30 days. behalf of an injured insured person for accidental
c. A person who has the immediate right of pos- bodily injury arising out of the ownership,
session of a motor vehicle or motorcycle operation, maintenance, or use of a motor vehicle
under an installment sales contract. as a motor vehicle, subject to the provisions of
d. A person renting a motorcycle or having the Chapter 31 of the Michigan Insurance Code.
use of a motorcycle under a lease for a period Ownership, operation, maintenance, or use of a
that is greater than 30 days, or otherwise for a motor vehicle as a motor vehicle means that the
period that is greater than 30 consecutive days. involvement of the motor vehicle in the bodily
A person who borrows a motorcycle for a pe- injury was directly related to the transportation
riod that is less than 30 consecutive days with function of the motor vehicle.
the consent of the owner is not an owner under Personal injury protection benefits shall consist of:
this subparagraph. a. Allowable expenses, subject to limitations of
15. Power-driven mobility device means a wheelchair Chapter 31 of the Michigan Insurance Code:
or other mobility device powered by a battery, fuel, (1) reasonably necessary products, services
or other engine and designed to be used by an indi- and accommodations incurred for:
vidual with a mobility disability for the purpose of (a) the care;
locomotion. (b) recovery; or
16. Prearranged delivery means any period of time a (c) rehabilitation
driver is logged in to a delivery network platform of the injured insured person. However,
and has accepted a request to transport goods, we do not provide coverage for the medical
items or products through a delivery network use of marijuana or for any expenses
platform and continuing while the driver transports related to the medical use of marijuana.
the goods, items or products and ending when the

19942 (11-21) Page 2 of 6


Agency Code 01-0764-00 Policy Number 41-205-904-00

Charges for a hospital room shall not dependents of a deceased injured insured
exceed reasonable and customary charges person:
for semi-private accommodations unless (a) a deceased injured insured person's
special or intensive care is required. surviving spouse who resided with the
(2) reasonable expenses incurred for the injured insured person at the time of
injured insured person's funeral and burial the injured insured person's death;
if the injured insured person's death is (b) a child of the deceased injured insured
directly caused by injuries sustained in a person while under the age of 18 years
covered motor vehicle accident. or over that age if physically or mentally
b. work loss benefits, subject to limitations of incapacitated from earning, provided the
Chapter 31 of the Michigan Insurance Code, child:
consisting of at least 85% of the actual loss of 1) resided with the deceased injured
income from work the injured insured person insured person; or
would have performed during the first three 2) received support regularly from the
years after the date of the motor vehicle deceased injured insured person
accident if he or she had not been injured. at the time of the deceased injured
Work loss does not include any loss after the insured person's death;
date on which the injured insured person dies. (c) any other person whose specific circum-
c. loss of services for reasonably incurred ex- stances factually support that they were
penses, not to exceed the limit of insurance dependent upon the deceased injured
shown in the Declarations for Replacement insured person.
Services, to obtain ordinary and necessary (3) The dependency of a surviving spouse ends
services to replace those the injured insured upon his or her death or remarriage. The
person would have performed during the first dependency of any other person ends upon
three years after the date of the motor vehicle his or her death and continues only as long
accident not for income but for his or her benefit as the person is:
or the benefit of his or her dependents. Loss of (a) under the age of 18 years;
services does not include any loss after the date (b) physically or mentally incapacitated from
on which the injured insured person dies. earning; or
d. (1) survivor's loss benefits, subject to limitations (c) engaged full time in a formal program of
of Chapter 31 of the Michigan Insurance academic or vocational education or
Code, consisting of: training.
(a) a loss, after the date on which the 2. EXCLUSIONS
deceased injured insured person died, We will not pay personal injury protection benefits
of contributions of tangible things of for:
economic value, not including services, a. bodily injury sustained by an injured insured
that dependents of the deceased person who intentionally caused the injury to
injured insured person would have himself or herself.
received for support during their b. bodily injury if, at the time of the accident, the
dependency upon the deceased injured injured insured person:
insured person during the first three (1) other than the named insured, is entitled to
years after the date of the motor benefits as a named insured in any other
vehicle accident; and insurance policy providing benefits under
(b) expenses reasonably incurred by the Chapter 31 of the Michigan Insurance Code;
dependent, not exceeding $20 per day, (2) is the owner or registrant of a motor vehi-
to obtain ordinary and necessary cle or motorcycle involved in the motor
services to replace those the deceased vehicle accident for which the security re-
injured insured person would have quired by Chapter 31 of the Michigan Insur-
performed during the first three years ance Code was not in effect when the acci-
after the date of the motor vehicle dent occurred;
accident: (3) was willingly operating or willingly using a
1) without any compensation; and motor vehicle or motorcycle that was
2) for the benefit of his or her taken unlawfully, and the injured insured
dependents. person knew or should have known that the
(2) For purposes of the above provision d.(1) motor vehicle or motorcycle was taken
only, the following persons are considered unlawfully;

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Agency Code 01-0764-00 Policy Number 41-205-904-00

(4) is not a resident of Michigan, unless such e. bodily injury sustained while occupying a
injured insured person owned a motor motor vehicle owned or registered by:
vehicle that was registered and insured in (1) the named insured's employer; or
Michigan; or (2) any relative's employer
(5) was operating a motor vehicle or motor- for which Michigan no-fault benefits are in effect.
cycle as to which he or she was named as f. bodily injury sustained by an injured insured
an excluded operator as allowed under sec- person while occupying a motor vehicle
tion 3009(2) of the Michigan Insurance temporarily or permanently located as a
Code. residence or premises.
c. (1) bodily injury arising out of the ownership, g. bodily injury sustained by the named insured
operation, maintenance, or use of a parked while occupying, or through being struck by
motor vehicle unless the: while not occupying, any motor vehicle owned
(a) motor vehicle was parked in such a or registered by the named insured and which
way as to cause unreasonable risk of does not maintain an insurance policy providing
the bodily injury; benefits under Chapter 31 of the Michigan Insur-
(b) bodily injury was a direct result of ance Code.
physical contact with: h. that portion of any benefits which duplicate any
1) equipment permanently mounted on benefits the injured insured person receives or
the motor vehicle while the is entitled to receive under the:
equipment was being operated or (1) laws of any state; or
used; or (2) laws of the federal government.
2) property being lifted onto or lowered i. bodily injury sustained by an injured insured
from the motor vehicle in the person while occupying a motor vehicle
loading or unloading process; or covered by this policy while such motor vehicle
(c) bodily injury was sustained by the involved in the motor vehicle accident is used:
injured insured person while (1) as a public or livery conveyance;
occupying the motor vehicle. (2) to transport persons for compensation or a
(2) No coverage applies for bodily injury fee. This includes a driver who is logged in
described in 2. EXCLUSIONS, c.(1)(a), (b) to a transportation network company's
and (c), if benefits under the Michigan digital network. However, this exclusion
Workers Compensation Law, a similar law of (2) does not apply to a driver who is logged
another state, or a similar federal law are in to a transportation network company's
available to the injured insured person and digital network, has not accepted a
the bodily injury was sustained in the prearranged ride and Limited
course of employment while either: Transportation Network Company Driver
(a) loading, unloading, or doing mechanical Coverage is shown in the Declarations for
work on a motor vehicle unless the such motor vehicle; or
injury arose from the use of another (3) to deliver goods or property for
motor vehicle that was not being compensation or a fee. This includes a
loaded on, unloaded from, or secured to driver who is logged in to a delivery
a motor vehicle as cargo or freight; or network platform. However, this exclusion
(b) entering into or alighting from the motor (3) does not apply to a driver who is logged
vehicle unless: in to a delivery network platform and
1) the bodily injury was sustained Delivery of Goods Coverage is shown in the
while entering or alighting from the Declarations for such driver.
motor vehicle immediately after the However, exclusions i.(1)-(3) do not apply to
motor vehicle became disabled; such motor vehicle:
and (a) used for volunteer or charitable
2) the injury arose from the use or purposes;
operation of another motor vehicle (b) for which reimbursement of normal
that was not being loaded on, operating expenses is received;
unloaded from, or secured to a (c) used for car pooling on a
motor vehicle as cargo or freight. share-the-expense basis; or
d. bodily injury sustained by an injured insured (d) you or a relative are occupying or are
person outside of the United States, its injured by and do not own
territories, and possessions or Canada. at the time of loss or damage.

19942 (11-21) Page 4 of 6


Agency Code 01-0764-00 Policy Number 41-205-904-00

j. any loss under SECTION II - PERSONAL b. If the notice of bodily injury has been given or
INJURY PROTECTION, 1. COVERAGE, a.(1) payment has been made under 1. LEGAL
and a.(2) if the Declarations shows: ACTION AGAINST US, a., the action for
(1) Allowable Expenses Exclusion applies to the recovery of personal injury protection benefits
injured insured person; or may be brought at any time within one year after
(2) Allowable Expenses has been declined. the most recent allowable expense, work loss,
k. any loss under SECTION II - PERSONAL loss of service, or survivor's loss has been
INJURY PROTECTION, 1. COVERAGE, b. if incurred. However, the injured insured person
the Declarations shows Work Loss Exclusion may not recover benefits for any portion of the
applies to the injured insured person. loss incurred more than one year before the
3. LIMIT OF LIABILITY date on which the action was brought. A period
a. The Limit of Liability is not increased because of of limitations applicable under this subsection,
the number of: b., to the commencement of an action and the
(1) motor vehicles shown or premiums recovery of benefits is tolled from the date of a
charged in the Declarations; specific claim for payment of benefits until the
(2) claims made or suits brought; date we formally deny the claim. However, this
(3) motor vehicles involved in the occurrence; tolling does not apply if the person claiming
or benefits fails to pursue the claim with reasonable
(4) policies applicable to the loss. diligence.
b. (1) The Limit of Liability for coverage under 2. DUTIES AFTER AN ACCIDENT
SECTION II - PERSONAL INJURY We must be notified promptly of how, when and
PROTECTION, 1. COVERAGE, a.(1) and where the motor vehicle accident happened.
a.(2) shall not exceed the limit shown in the Written notice must be given to us, indicating name
Declarations for Allowable Expenses for any and address of the claimant and indicate in ordinary
one injured insured person in any one language the name of the injured insured person,
occurrence. and the time, place and nature of the injured
(2) The Limit of Liability for funeral or burial insured person's injury. Written notice may be
expenses shall not exceed $2,000 for any given to us or our authorized agent by a person
injured insured person in any one claiming to be entitled to benefits, or by someone on
occurrence, subject to b.(1) above. his or her behalf. We must receive the written notice
4. OTHER INSURANCE within one year of the motor vehicle accident.
When this coverage and any other Personal Injury Notice should include the names and addresses of
Protection coverage applies to a motor vehicle any witnesses.
being used for a prearranged delivery through a A person seeking coverage under this endorse-
delivery network platform and Delivery of Goods ment must:
Coverage is shown in the Declarations, this a. cooperate with us in the investigation or set-
coverage will be excess. tlement of any claim.
b. submit, at our expense and as often as we
SECTION III - CONDITIONS reasonably require, to physical or mental ex-
1. LEGAL ACTION AGAINST US aminations by physicians we select.
No legal action may be brought against us until c. authorize us to obtain:
there has been full compliance with the terms of this (1) medical reports;
endorsement. (2) statements of earnings; and
a. An action for recovery of personal injury protec- (3) other pertinent records.
tion benefits payable in accordance with Chapter d. submit a written proof of claim and as a part of
31 of the Michigan Insurance Code for bodily our investigation we may ask that the person
injury shall not be brought later than one year seeking coverage under this endorsement
after the date of the motor vehicle accident submit to an examination under oath.
causing the bodily injury, unless written notice e. provide full details of the nature and extent of
of the bodily injury has been given to us within any injuries and the treatment received.
one year of the motor vehicle accident causing f. send us a copy of any summons and com-
the bodily injury, or unless we have previously plaint, as soon as practicable, if suit is filed by
made a payment of personal injury protection or on behalf of an injured insured person or his
benefits for the bodily injury. or her surviving dependents against one who
may be liable.

19942 (11-21) Page 5 of 6


Agency Code 01-0764-00 Policy Number 41-205-904-00

3. DUPLICATION OF BENEFITS Insurance Code and if the person required to


No one will be entitled to duplicate payments for the have qualified health coverage is no longer
same elements of loss under this coverage covered by the qualified health coverage, the
regardless of the number of: named insured shall notify us or our authorized
a. motor vehicles covered; or agent that such person is no longer eligible for
b. insurers (including self-insurers) providing secur- the exclusion. Within 30 days after the effective
ity in accordance with: date of the termination of the qualified health
(1) Chapter 31 of the Michigan Insurance Code; coverage, the named insured shall obtain
or appropriate coverage for Allowable Expenses for
(2) any other similar law. such excluded person. If the named insured
If an injured insured person is entitled to recover has not obtained qualified health coverage or
allowable expenses under more than one policy, the coverage for Allowable Expenses within 30
maximum recovery will be the highest dollar limit days, no coverage for Allowable Expenses will
provided under any one of the policies. be provided. An injured insured person may
4. TERMINATION OF QUALIFIED HEALTH be entitled to claim benefits under the Michigan
COVERAGE Assigned Claims Plan in the event a motor
If coverage for Allowable Expenses is: vehicle accident occurs within such 30 days.
a. not maintained as required by part 3107d of However, under no circumstances will coverage
Chapter 31 of the Michigan Insurance Code and for Allowable Expenses be provided under this
such person or persons required to have policy to the person whose qualified health
qualified health coverage cease to have coverage has been terminated.
qualified health coverage, within 30 days after
the effective date of the termination of qualified SECTION IV - CONSTITUTIONALITY
health coverage, the named insured shall The premium for the coverages and the limits of liability
obtain coverage for Allowable Expenses. If the of the policy have been established in reliance upon the
named insured has not obtained qualified provisions of Chapter 31 of the Michigan Insurance
health coverage or coverage for Allowable Code.
Expenses within 30 days, no coverage for In the event a court of competent jurisdiction declares or
Allowable Expenses will be provided. An enters a judgment, the effect of which is to render the
injured insured person may be entitled to claim provisions of such statute invalid or unenforceable in
benefits under the Michigan Assigned Claims whole or in part, we shall have the right to recompute
Plan in the event a motor vehicle accident the premium payable for the policy and revise the limits
occurs within such 30 days. However, under no of liability. In addition, provisions of the policy that have
circumstances will coverage for Allowable been established in reliance upon Chapter 31 of the
Expenses be provided under this policy to the Michigan Insurance Code shall be voidable and shall re-
person whose qualified health coverage has vert to conform to applicable provisions of Chapter 31 at
been terminated. the time of the accident.
b. excluded by SECTION II - PERSONAL INJURY
PROTECTION, 2. EXCLUSIONS, j. as allowed All other policy terms and conditions apply.
in part 3109a of Chapter 31 of the Michigan

19942 (11-21) Page 6 of 6


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 69351 (11-20)

MOTOR HOME / TRAVEL TRAILER / TRUCK CAMPER - PLEASURE USE


Automobile Policy

It is agreed:

1. SECTION I - DEFINITIONS is amended. Vacation Liability Coverage


a. For the purposes of this endorsement only, the a. We shall pay all sums which an insured be-
following definitions are added. comes legally obligated to pay as damages
(1) Aircraft means a conveyance designed or because of or arising out of bodily injury or
used for flight including self-propelled property damage caused by an occurrence
missiles and spacecraft. while your automobile is at a vacation site.
(2) Contents means your personal property or We shall settle or defend, as we consider appro-
personal property of a relative. priate, any claim or suit for damages covered by
(3) Insured means: this policy. We shall do this at our expense,
(a) you; using attorneys of our choice. This agreement
(b) relatives; and to settle or defend claims or suits ends when
(c) any other person under the age of 21 we have paid the limit of our liability.
residing with you who is in your care or b. We do not cover:
the care of a relative. (1) bodily injury or property damage arising
(4) Motor vehicle means a motorized land out of any premises owned, rented or con-
vehicle. Motor vehicle does not include a trolled by any insured which is not a vaca-
recreational vehicle. tion site.
(5) Recreational vehicle means a motorized (2) bodily injury or property damage because
land vehicle designed primarily for of or arising out of the ownership, mainte-
recreational purposes but not designed for nance, use, loading or unloading of any air-
travel on public roads. Recreational craft, motor vehicle, recreational vehicle
vehicle does not include watercraft. or watercraft. This does not apply to your
(6) Truck camper means a slide in unit with automobile parked at a vacation site.
permanently equipped facilities for cooking (3) bodily injury or property damage because
and sleeping that is temporarily attached to of or arising out of:
a pickup truck. (a) the entrustment to any person by any
(7) Vacation site means a temporary location insured; or
other than your primary or permanent (b) the supervision of any person by any
residence that is: insured
(a) owned by you or designated for your with regard to the ownership, maintenance,
sole usage; use, loading or unloading of an aircraft,
(b) occupied by your automobile parked at motor vehicle, recreational vehicle or
such temporary location; and watercraft.
(c) being used for recreational purposes. (4) bodily injury or property damage because
(8) Watercraft means a conveyance capable of of or arising out of the rendering of or failure
being used as a means of transportation on to render professional services.
water. (5) bodily injury or property damage because
b. For purposes of this endorsement only, the of or arising out of business pursuits of an
definition of an automobile is amended to in- insured.
clude a truck camper. (6) bodily injury or property damage reason-
ably expected or intended by the insured.
2. SECTION II - LIABILITY COVERAGE is amended. This exclusion applies even if the bodily in-
The following coverage is added for purposes of this jury or property damage is of a different
endorsement only. kind or degree, or is sustained by a different

69351 (11-20) Page 1 of 5


Agency Code 01-0764-00 Policy Number 41-205-904-00

person or property, than that reasonably (d) vacation sites;


expected or intended. (e) premiums charged; or
(7) bodily injury or property damage caused (f) automobiles shown in the Declarations.
by war, including any undeclared war, civil d. The following condition is added.
war, insurrection, rebellion, revolution, war- Other Insurance - Vacation Liability
like act by a military force or military Coverage
personnel, destruction or seizure or use for (1) This insurance is primary except when (2)
a military purpose, and including any below applies.
consequence of any of these. (2) If there is other valid and collectible insur-
(8) bodily injury because of or arising out of a ance, whether primary, contingent or
communicable disease transmitted by any excess, this insurance is excess over such
insured. insurance. However, if the other insurance
(9) liability assumed under: is specifically written as excess insurance
(a) any oral contract or agreement; or over this policy, the limits of this policy apply
(b) any contract or agreement. first.
(10) bodily injury or property damage for any (3) When other insurance applies on the same
insured under this endorsement who is basis, we shall be liable for only our share.
also an insured under a nuclear energy Our share shall be the ratio of the amount of
liability policy or would be an insured this insurance to the total amount of all col-
except for the exhaustion of the limits of lectible automobile liability insurance.
liability. A nuclear energy liability policy is a
policy issued by American Nuclear 3. SECTION III - DAMAGE TO YOUR AUTOMOBILE
Insurers, Mutual Atomic Energy Liability is amended.
Underwriters, Nuclear Insurance a. 1. COVERAGES is amended for purposes of
Association of Canada or any of their this endorsement only. e. Road Trouble
successors. Service is deleted and replaced by the following
(11) bodily injury to any person if an insured coverage.
has or is required to have a policy providing e. Road Trouble Service
workers compensation, non-occupational When Road Trouble Service is shown in the
disability or occupational disease benefits Declarations for your automobile and:
covering the bodily injury. (1) a dollar amount is shown in the
(12) property damage to property owned by Declarations as applying to Road
any insured. Trouble Service for your automobile
(13) property damage to property occupied or and the towing service representative is
used by any insured or rented to or in the contacted at 1-888-869-2642 or through
care of any insured. the Auto-Owners Mobile app, in any one
c. Our limit of liability shall be as follows: disablement we will pay for:
(1) We shall pay damages for bodily injury (a) towing or transporting your
and property damage up to the limit shown automobile to the nearest repair
in the Declarations under Vacation Liability. facility; and
That limit is the amount of coverage and (b) the cost of labor performed on such
the most we shall pay for all damages automobile at the place of
because of or arising out of all bodily disablement.
injury and all property damage in any one We shall not be liable for more than the
occurrence. limit of liability shown in the Declarations
In no event shall we pay more than the limit for Road Trouble Service under this
of liability for all damages because of or policy in any one disablement involving
arising out of an occurrence which result your automobile. However, if the
from the same set of general towing service representative is not
circumstances. contacted at 1-888-869-2642 or through
(2) The limit of liability is not increased be- the Auto-Owners Mobile app, the most
cause of the number of: we will reimburse you in any one
(a) insureds; disablement is seventy-five dollars ($75)
(b) persons injured; for your automobile.
(c) claims made or suits brought;

69351 (11-20) Page 2 of 5


Agency Code 01-0764-00 Policy Number 41-205-904-00

(2) no dollar amount is shown in the You will be responsible for any
Declarations as the limit applying to charges that exceed the applicable
Road Trouble Service for your limit of one hundred fifty dollars
automobile and the towing service ($150).
representative is contacted at No deductible applies.
1-888-869-2642 or through the b. 2. EXCLUSIONS is amended for purposes of
Auto-Owners Mobile app, in any one this endorsement only. The following exclusions
disablement we will pay for: are added.
(a) towing or transporting such Comprehensive and Collision Coverages do not
automobile to the nearest qualified apply to loss caused by:
service facility or a service facility of (1) water which constantly or repeatedly seeps,
the operator's choice located fifteen leaks or drips for a period of weeks, months
(15) miles or less from the place of or years;
disablement; and (2) gradual deterioration; or
(b) the cost of labor performed on such (3) improper maintenance.
automobile at the place of c. 4. LIMIT OF LIABILITY is amended for
disablement. purposes of this endorsement only.
In the event that such automobile is (1) When Awning Replacement Cost is shown
towed or transported to a service facility, in the Declarations, the following provision is
other than the nearest qualified service added.
facility, located more than fifteen (15) We will pay no more than the lowest of the
miles from the place of disablement, following:
you will be responsible for the additional (1) the full cost incurred to replace the
charges. stolen or damaged awning or cabana
(3) no dollar amount is shown in the with a new one of similar kind and
Declarations as the limit applying to quality;
Road Trouble Service for your (2) the full cost incurred to repair the
automobile and the towing service damaged awning or cabana; or
representative is not contacted at (3) the actual cash value of the stolen or
1-888-869-2642 or through the damaged awning or cabana if such
Auto-Owners Mobile app, in any one awning or cabana is not replaced or
disablement we will reimburse you the repaired.
actual cost up to and including: (2) When Agreed Value (AV) is shown in the
(a) seventy-five dollars ($75) for your Declarations:
automobile (that is not a motor (a) Paragraph a. is deleted and replaced
home). This includes: with the following paragraph.
1) towing or transporting such a. (1) If we determine the loss or
automobile to the service damage to your automobile
facility of the operator's choice; can be repaired, we will pay no
and more than the lowest of the
2) the cost of labor performed on following:
such automobile at the place of (a) the actual cash value of
disablement. stolen or damaged property;
You will be responsible for any or
charges that exceed the applicable (b) the necessary cost, at local
limit of seventy-five dollars ($75). prices, to repair or replace
(b) one hundred fifty dollars ($150) for the property or damaged
your motor home. This includes: parts with material of similar
1) towing or transporting such kind and quality; or
motor home to the service (c) the limit of liability shown in
facility of the operator's choice; the Declarations for Agreed
and Value (AV).
2) the cost of labor performed on (2) If we determine the loss or
such motor home at the place of damage to your automobile
disablement. cannot be repaired, we will pay

69351 (11-20) Page 3 of 5


Agency Code 01-0764-00 Policy Number 41-205-904-00

the limit of liability shown in the damage that occurs while your
Declarations for Agreed Value automobile is rented to others.
(AV) less salvage value if you (3) This insurance shall be primary over any
or the owner elect to retain the other valid and collectible insurance pro-
salvage. No deductible applies. vided by us.
(b) Paragraph c. is deleted. b. Contents
(3) When Total Loss Replacement (1) We shall extend the Comprehensive and
Cost/Purchase Price (TLRC) is shown in the Collision coverages provided by this
Declarations, paragraph b. is deleted and policy to cover contents while such
replaced by the following paragraph. contents are:
b. If we determine the loss or damage to (a) at a location:
your automobile cannot be repaired, 1) owned by you; or
then: 2) designated for your sole usage;
(1) for the current model year and four and
prior model years, we will pay you 3) occupied by your automobile;
the greater of: or
(a) the incurred cost to replace (b) within 25 feet of your automobile
your automobile with a new when not at a location:
one of similar kind and quality; 1) owned by you; or
or 2) designated for your sole usage;
(b) the purchase price stated in the and
Declarations for your 3) occupied by your automobile
automobile. but for no more than 25% of the limit
(2) for the fifth prior model year or shown in the Declarations under
older, we will pay you the purchase Contents. This 25% limitation does not
price stated in the Declarations for apply to contents inside your enclosed
your automobile. trailer.
No deductible applies. (c) in your automobile.
(4) With respect to travel trailers and truck (2) No coverage applies to:
campers only, the following provision is (a) property used in a business, trade
added to paragraph b. or profession;
We will, at our option, replace your (b) merchandise for sale or exhibition;
automobile with a new one of equal value (c) pets or animals;
or pay you your original purchase price if: (d) accounts, bills, currency, deeds,
(1) you purchased it new; money, notes, securities, or other
(2) we determine the loss or damage evidences of debt;
cannot be repaired; and (e) property built into and forming a per-
(3) the loss or damage occurs within 90 manent part of your automobile;
days of the purchase date. (f) contraband or property in the course
d. 3. COVERAGE EXTENSIONS is amended for of illegal transportation or trade; or
purposes of this endorsement only. The property seized or subject to seizure
following coverage extensions are added. by any governmental authority;
a. Vacation Emergency Expense (g) property specifically covered by any
(1) We shall pay you for expenses you other insurance;
incur, up to the limit shown in the Decla- (h) watercraft;
rations for Vacation Emergency Ex- (i) motorized land vehicles. However,
pense, when your automobile is un- coverage does apply to a convey-
inhabitable following loss or damage ance designed primarily to provide
covered by this policy provided your mobility to the handicapped; or
automobile is being used for vacation (j) trailers.
purposes when the loss or damage oc- (3) We do not cover loss or damage caused
curs. You must submit proper receipts directly or indirectly by any of the follow-
for any expenses which will be ing, whether or not any other cause or
reimbursed. happening contributes concurrently or in
(2) The Vacation Emergency Expense any sequence to the loss or damage.
coverage does not apply to loss or

69351 (11-20) Page 4 of 5


Agency Code 01-0764-00 Policy Number 41-205-904-00

(a) Loss to contents caused by break- (4) When Actual Cash Value is shown in
age of eyeglasses, glassware, stat- the Declarations for Contents, we shall
uary, marble, bric-a-brac, porce- pay no more than the lowest of the
lains and similar fragile articles, un- following:
less such loss is coincident with and (a) the actual cash value of the
from the same cause as any other damaged item;
loss covered by this endorsement. (b) the necessary cost to repair the item
This provision, (a), shall not apply to with material of similar kind and
loss caused by: quality; or
1) accidental collision with another (c) the limit of liability shown in the
object or by accidental upset; Declarations under Contents.
2) fire; (5) When Replacement Cost is shown in
3) lightning; or the Declarations under Contents, we
4) theft or attempted theft. Unless shall pay no more than the lowest of the
the entire automobile is stolen, following:
there must be visible signs of (a) the full cost to replace the item with
someone breaking into the a new item:
automobile. 1) identical to the damaged,
(b) Wear and tear, freezing, mechanical destroyed or stolen item; or
or electrical breakdown or failure. 2) of comparable quality when an
(c) As it applies to covered contents identical item is no longer
located outside of your automobile: available;
1) windstorm or hail; (b) the full cost to repair the item; or
2) theft, larceny, robbery, pilferage (c) the limit of liability shown in the
or attempts at any of these; or Declarations under Contents.
3) vandalism or malicious mischief. Coverage is limited to $1,000 per item or
This does not apply to covered group of similar items per occurrence.
contents inside your enclosed When a deductible is shown in the
trailer. Declarations for this coverage, we will
(d) Loss caused by: reduce our payment by that amount.
1) declared or undeclared war or e. The following provision is added.
insurrection; or When more than one deductible applies to the
2) explosion of nuclear weapons or same loss, only the higher of the deductibles
its consequences. shall be applied to the entire loss.
(e) Radioactive contamination.
(f) An action by you or a relative or at All other policy terms and conditions apply.
your direction or the direction of a
relative committed with the intent to
cause loss or damage.

69351 (11-20) Page 5 of 5


Agency Code 01-0764-00 Policy Number 41-205-904-00

79253 (11-21)

Michigan
SPECIAL TORT LIABILITY
Automobile Policy

It is agreed:

1. DEFINITIONS items or products are no longer occupying the


For purposes of this endorsement only the following motor vehicle.
definitions apply in addition to those contained in f. Prearranged ride means the furnishing of
SECTION I - DEFINITIONS of the policy. transportation by a driver to a requesting
a. Delivery network platform means any passenger, beginning when a driver accepts a
online-enabled application used to connect ride requested by a passenger through a digital
customers for purposes of providing the network controlled by a transportation
prearrangement of deliveries with: network company, continuing while the driver
(1) drivers; or transports a requesting passenger and ending
(2) local vendors using drivers when the requesting passenger departs from the
for compensation. motor vehicle.
A delivery network platform does not include a g. Transportation network company means an
transportation network company. entity that uses a digital network to connect
b. Digital network means any online-enabled passengers to transportation network company
application, software, website or system offered drivers.
or utilized by a transportation network 2. COVERAGE
company that enables the prearrangement of When Special Tort Liability is shown in the
rides with transportation network company Declarations and a premium charged, we will pay for
drivers. damage to any motor vehicle, caused by a motor
c. Motor vehicle means a vehicle, including a vehicle accident, which you become obligated to
trailer, operated or designed for operation upon pay because of liability imposed upon you under
a public highway by power other than muscular section 3135 of the Michigan Insurance Code. Our
power which has more than 2 wheels. Motor limit of liability for damage to any one motor vehicle
vehicle does not include a motorcycle or a shall not exceed the limit shown in the Declarations
moped, as defined in section 32b of Act No. 300 for Special Tort Liability.
of the Public Acts of 1949, being section 3. EXCLUSIONS
257.32b of the Michigan Compiled Laws. Motor Special Tort Liability does not apply to damages to
vehicle does not include a farm tractor or other any motor vehicle for which you become legally
implement of husbandry that is not subject to the obligated to pay because of liability imposed upon
registration requirements of the Michigan vehicle you while such motor vehicle is used:
code pursuant to section 216 of the Michigan a. (1) as a public or livery conveyance;
vehicle code, Act No. 300 of the Public Acts of (2) to transport persons for compensation or a
1949, being section 257.216 of the Michigan fee. This includes a driver who is logged in
Compiled Laws. to a transportation network company's
d. Personal vehicle sharing program means a digital network. However, this exclusion
legal entity engaged in the business of (2) does not apply to a driver who is logged
facilitating the sharing of a motor vehicle by in to a transportation network company's
individuals under any contract or agreement. digital network, has not accepted a
e. Prearranged delivery means any period of time prearranged ride and Limited
a driver is logged in to a delivery network Transportation Network Company Driver
platform and has accepted a request to Coverage is shown in the Declarations for
transport goods, items or products through a such motor vehicle; or
delivery network platform and continuing while (3) to deliver goods or property for
the driver transports the goods, items or compensation or a fee. This includes a
products and ending when the requested goods, driver who is logged in to a delivery

79253 (11-21) Page 1 of 2


Agency Code 01-0764-00 Policy Number 41-205-904-00

network platform. However, this exclusion b. (1) enrolled in an electronic or written personal
(3) does not apply to a driver who is logged vehicle sharing program; and
in to a delivery network platform and (2) being used in connection with such
Delivery of Goods Coverage is shown in the personal vehicle sharing program.
Declarations for such driver. If you are an individual this exclusion does not
However, exclusions a.(1)-(3) do not apply to apply to you or any relative while using such
such motor vehicle: motor vehicle.
(a) used for volunteer or charitable 4. OTHER INSURANCE
purposes; When this coverage and any other Special Tort
(b) for which reimbursement of normal Liability coverage applies to a motor vehicle being
operating expenses is received; used for a prearranged delivery through a delivery
(c) used for car pooling on a share-the- network platform and Delivery Goods Coverage is
expense basis; or shown in the Declarations, this coverage will be
(d) you or a relative are occupying or excess.
injured by and do not own
at the time of loss or damage. All other policy terms and conditions apply.

79253 (11-21) Page 2 of 2


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 79939 (1-12)Z

SECTION III - DAMAGE TO YOUR AUTOMOBILE AMENDATORY


ENDORSEMENT
Automobile Policy

It is agreed:

1. Under SECTION III - DAMAGE TO YOUR AUTO- (1) glass breakage from any cause includ-
MOBILE, 1. COVERAGES a., b., c. and d. are ing upset or collision;
deleted and replaced by the following: (2) damage caused by missiles or falling
objects; and
1. COVERAGES (3) damage caused by collision with an ani-
mal or bird.
a. Fire Coverage
When a deductible is indicated in the Decla-
We will pay for direct physical damage to rations for this coverage, we will reduce our
your automobile and its equipment payment by that amount.
caused by:
d. Collision Coverage
(1) fire or lightning.
(2) smoke or smudge because of a sudden, We will pay for direct physical damage to
unusual or faulty operation of any fixed your automobile and its equipment caused
heating equipment where your automo- by accidental collision with another object or
bile is stored. by accidental upset.
(3) windstorm, hail, earthquake, explosion,
external discharge or leakage of water. When a deductible is indicated in the Decla-
We cover damage resulting from the rations for this coverage, we will reduce our
stranding, sinking, burning, collision or payment by that amount. If your automo-
derailment of any equipment being used bile is a private passenger automobile,
to transport your automobile on land or the deductible does not always apply. The
water. We will also pay for general deductible shall not apply:
average and salvage charges for which
you may be legally responsible. (1) in a collision with another automobile:

b. Theft Coverage (a) we insure and which you do not


own, rent or have in your care,
We will pay for direct physical loss of or di- custody or control; or
rect physical damage to your automobile (b) whose owner or operator has been
and its equipment caused by theft, larceny, identified; and
robbery or pilferage. We cover your loss
when you are tricked into giving your auto- 1) is legally responsible for the en-
mobile to another person. tire amount of the damage; and
2) is covered by a property
c. Comprehensive Coverage damage liability policy or bond

We will pay for direct physical loss of or di- but only if the damage exceeds the
rect physical damage to your automobile deductible amount.
and its equipment from any cause except
upset or collision with another object or with (2) to your legally parked private passen-
a vehicle to which it is attached. ger automobile in the event it is acci-
dentally struck by another of your pri-
We will also pay for: vate passenger automobiles, provided

79939 (1-12)Z Page 1 of 2


Agency Code 01-0764-00 Policy Number 41-205-904-00

Collision Coverage applies to both such a. loss of or damage to your automobile be-
automobiles. cause of confiscation or destruction by any
civil or governmental authorities because of
2. SECTION III - DAMAGE TO YOUR AUTOMOBILE, illegal activities engaged in by:
2. EXCLUSIONS, is amended as follows:
(1) you; or
a. the following exclusion is added:
(2) a relative.
any real or perceived reduction in market value
of your automobile after it has been repaired b. loss of or damage to your automobile be-
as compared to the real or perceived market cause of or arising out of your intentional
value of your automobile prior to such loss or act or an intentional act committed at your
damage. direction or with your knowledge.

b. exclusions a. and b. are deleted and replaced All other policy terms and conditions apply.
with the following:

79939 (1-12)Z Page 2 of 2


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 89125 (11-14)Z

PET MEDICAL COVERAGE


Automobile Policy

It is agreed:

1. The following definitions are added to SECTION I - (b) anyone living with you who does not own an
DEFINITIONS as they apply to this endorsement automobile; or
only: (5) an automobile not used in an automobile ga-
Pet means a cat or dog owned by you or a relative. rage, repair shop, sales agency, service station,
Pet's replacement cost means the monetary cost or public parking business you own or operate
incurred to replace a pet, that is deceased, with then if a pet is injured, dies or requires necessary or
another cat or dog of similar kind and quality. This veterinary recommended euthanasia as the result of
does not include any cost for: the collision of such automobile, we will pay:
a. veterinary care or services for the new pet; (1) those reasonable and necessary medical ex-
b. training of the new pet; or penses incurred for the:
c. any other expenses incurred (a) care;
after the initial purchase of the new pet. (b) recovery; and
(c) necessary or veterinary recommended
2. The following is added to SECTION III - DAMAGE euthanasia
TO YOUR AUTOMOBILE, 3. COVERAGE of such pet.
EXTENSIONS: (2) the pet's replacement cost if a pet dies or re-
Pet Medical Payments Coverage quires necessary or veterinary recommended
If COLLISION applies to at least one of your auto- euthanasia.
mobiles and a pet is occupying: (3) for the pet's injury. The pet's injury must be
(1) your automobile while being used with your discovered, treated and reported to us within 30
permission or the permission of a relative; days of the occurrence. We will pay only those
(2) an automobile you or a relative does not own medical expenses or the new pet's replace-
which is temporarily used as a substitute for ment cost incurred within one year of the
your automobile. Your automobile must be occurrence.
out of use because of breakdown, repair, ser- We also extend this coverage to you:
vicing, loss or destuction; (1) if you are a partnership or joint venture, your
(3) an automobile which you acquire if: members, your partners and their spouses;
(a) it replaces your automobile. You must re- (2) if you are a limited liability company, your
port the replacement automobile to us no members;
later than: (3) if you are an organization other than a part-
1) the expiration date; or nership, joint venture or limited liability company,
2) 30 days after you take possession if the your executive officers; or
replacement automobile is acquired (4) if you are a trust, your trustees.
less than 30 days prior to the expiration Pet Medical Payments does not apply to injury or
date death of a pet:
of the policy term during which the auto- (1) resulting from or arising out of an intentional act
mobile was acquired. of you or a relative.
(b) it is an additional automobile, provided you: (2) while occupying any automobile:
1) report the additional automobile to us (a) preparing for;
within 30 days after you take posses- (b) practicing for; or
sion; and (c) participating in
2) pay any required additional premiums. any prearranged racing, speed or demolition
(4) an automobile not owned by or furnished or contest.
available for regular use to: (3) resulting from or arising out of war, whether de-
(a) you; or clared or not declared, insurrection or any of the

89125 (11-14)Z Page 1 of 2


Agency Code 01-0764-00 Policy Number 41-205-904-00

consequences. (2) claims made or suits brought; or


(4) while occupying an automobile located for use (3) automobiles involved in the occurrence.
as a residence or premises.
For any one pet, in any one occurrence, we will not If we make a payment under this endorsement and
pay more than $750 or the amount shown in the the person to or for whom payment is made has a
Declarations, whichever is higher, for medical right to recover damages from another, we will be
expenses and the pet's replacement cost entitled to that right. That person shall do everything
combined. necessary to transfer that right to us and shall do
For two or more pets, in any one occurrence, we nothing to prejudice it.
will not pay more than $1500 or the amount shown
in the Declarations, whichever is higher, for all of the At our request you or a relative must authorize us
pet's medical expenses and the pet's replacement to obtain veterinary and other records which pertain
cost combined. to the pet's injury. You must allow the pet, at our
No deductible applies. expense, to be examined by veterinarians we select
The amount we pay shall not be increased be- as often as we may reasonably require.
cause of the number of:
(1) automobiles shown or premiums charged in the All other policy terms and conditions apply.
Declarations;

89125 (11-14)Z Page 2 of 2


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 99301 (11-21)

Michigan
UNINSURED MOTORIST COVERAGE
Automobile Policy

It is agreed:

1. DEFINITIONS when the requesting passenger departs from the


For purposes of this endorsement only the following automobile.
definitions apply in addition to those contained in g. Transportation network company means an
SECTION I - DEFINITIONS of the policy. entity that uses a digital network to connect
a. Delivery network platform means any passengers to transportation network company
online-enabled application used to connect drivers.
customers for purposes of providing the h. Uninsured automobile:
prearrangement of deliveries with: (1) means an automobile:
(1) drivers; or (a) to which no bodily injury liability bond
(2) local vendors using drivers or liability insurance policy applies:
for compensation. 1) at the time of the occurrence; and
A delivery network platform does not include a 2) in at least the minimum amounts
transportation network company. required by the Financial
b. Digital network means any online-enabled Responsibility Law in the state
application, software, website or system offered where your automobile is normally
or utilized by a transportation network garaged.
company that enables the prearrangement of (b) insured by a company that becomes
rides with transportation network company insolvent;
drivers. (c) insured by a company that has issued a
c. Occupying means being in or on an successful written denial of coverage; or
automobile as a passenger or operator, or (d) that is a hit and run automobile. By
being engaged in the immediate acts of this we mean an automobile:
entering, boarding or alighting from an 1) that causes bodily injury by actual
automobile. physical contact with the injured
d. Personal vehicle sharing program means a person or the automobile the
legal entity engaged in the business of injured person is occupying; and
facilitating the sharing of an automobile by 2) whose owner or operator is
individuals under any contract or agreement. unknown.
e. Prearranged delivery means any period of time An occurrence involving a hit and run
a driver is logged in to a delivery network automobile must be reported to the
platform and has accepted a request to police within 24 hours of when it takes
transport goods, items or products through a place.
delivery network platform and continuing while (2) does not include an automobile:
the driver transports the goods, items or (a) owned or leased by, furnished to or
products and ending when the requested goods, available for regular use of you or
items or products are no longer occupying the anyone living with you;
automobile. (b) owned or operated by a self-insurer
f. Prearranged ride means the furnishing of under any automobile law;
transportation by a driver to a requesting (c) owned by any governmental unit or
passenger, beginning when a driver accepts a agency;
ride requested by a passenger through a digital (d) located for use as a residence or
network controlled by a transportation premises;
network company, continuing while the driver (e) that is designed for use primarily off
transports a requesting passenger and ending public roads except while actually on
public roads; or

99301 (11-21) Page 1 of 3


Agency Code 01-0764-00 Policy Number 41-205-904-00

(f) that is an underinsured automobile. An settled by a court having jurisdiction. We will not
underinsured automobile is an be bound by any judgments for damages
automobile to which a bodily injury obtained or settlements made without our
liability bond or liability insurance policy written consent.
applies at the time of the occurrence:
1) in at least the minimum amounts 3. EXCLUSIONS
required by the Financial Uninsured Motorist Coverage does not apply to:
Responsibility Law in the state a. punitive or exemplary damages.
where your automobile is normally b. any person injured while occupying or injured
garaged; and by any automobile which is owned or leased by
2) in which the limits of liability are less such person injured if such automobile:
than the amount of damages the (1) is designed primarily for use on public roads;
injured person is legally entitled to (2) is required to be registered and licensed
recover for bodily injury. prior to its use on public roads; and
(3) is not insured for Uninsured Motorist
2. COVERAGE Coverage by the policy;
a. We will pay compensatory damages, including c. any person who settles a bodily injury claim
but not limited to loss of consortium, any person without our written consent.
is legally entitled to recover from the owner or d. directly or indirectly benefit an insurer or self-
operator of an uninsured automobile because insurer under any workers compensation law or
of bodily injury sustained by an injured person disability benefits law.
while occupying an automobile that is covered e. the extent the same elements of damages are
by SECTION II - LIABILITY COVERAGE of the paid or payable under the Michigan No-Fault
policy. law.
b. This coverage is extended to you, if an f. any person injured while occupying or injured
individual, as follows: by your automobile while such automobile is
(1) We will pay compensatory damages, used:
including but not limited to loss of (1) as a public or livery conveyance;
consortium, you are legally entitled to (2) to transport persons for compensation or a
recover from the owner or operator of an fee. This includes a driver who is logged in
uninsured automobile because of bodily to a transportation network company's
injury you sustain: digital network. However, this exclusion
(a) when you are not occupying an (2) does not apply to a driver who is logged
automobile that is covered by in to a transportation network company's
SECTION II - LIABILITY COVERAGE digital network, has not accepted a
of the policy; or prearranged ride and Limited
(b) while occupying an automobile you do Transportation Network Company Driver
not own which is not covered by Coverage is shown in the Declarations for
SECTION II - LIABILITY COVERAGE such automobile; or
of the policy. (3) to deliver goods or property for
(2) The coverage extended in 2. COVERAGE compensation or a fee. This includes a
b.(1), is also extended to a relative who driver who is logged in to a delivery
does not own an automobile. network platform. However, this exclusion
c. The bodily injury must be accidental and arise (3) does not apply to a driver who is logged
out of the ownership, maintenance or use of the in to a delivery network platform and
uninsured automobile. Delivery of Goods Coverage is shown in the
d. Whether an injured person is legally entitled to Declarations for such driver.
recover compensatory damages, including but However, exclusions f.(1)-(3) do not apply to
not limited to loss of consortium, and the amount such automobile:
of such damages shall be determined by (a) used for volunteer or charitable
agreement between the injured person and us. purposes;
If no agreement can be reached, the injured (b) for which reimbursement of normal
person may file suit against us within the operating expenses is received;
applicable statute of limitations applying to (c) used for car pooling on a share-the-
bodily injury claims in the state in which the expense basis; or
accident occurred in order to have the dispute

99301 (11-21) Page 2 of 3


Agency Code 01-0764-00 Policy Number 41-205-904-00

(d) you or a relative are occupying or are limits which apply. Total damages payable for
injured by and do not own one occurrence shall be considered not to
at the time of loss or damage. exceed the limit of liability of the applicable
g. any person whose injury arises out of the policy that has the highest limit of liability.
ownership, maintenance or use of your The coverage extended to automobiles you do
automobile while: not own will be excess over any other insurance
(1) enrolled in an electronic or written personal available to you.
vehicle sharing program; and b. When this coverage and any other insurance
(2) being used in connection with such applies to an automobile being used for a
personal vehicle sharing program. prearranged delivery through a delivery
If you are an individual this exclusion does not network platform and Delivery of Goods
apply to you or any relative while using such Coverage is shown in the Declarations, this
automobile. coverage will be excess.

4. LIMIT OF LIABILITY 6. CONDITIONS


We will pay compensatory damages, including but For purposes of this endorsement only the following
not limited to loss of consortium, because of bodily conditions apply in addition to those contained in
injury up to the Limit of Liability stated in the SECTION VI - GENERAL CONDITIONS of the
Declarations as follows: policy.
a. The limit stated for "each person" is the amount a. TIME LIMITATION FOR ACTION AGAINST US
of coverage and the most we will pay, subject to Any person seeking Uninsured Motorist
4.b. below, for all compensatory damages, Coverage must:
including but not limited to loss of consortium, (1) present a claim for compensatory damages,
because of or arising out of bodily injury to one including but not limited to loss of
person in any one occurrence. consortium, according to the terms and
b. The limit stated for "each occurrence" is the total conditions of the policy; and
amount of coverage and the most we will pay, (2) conform with any applicable statute of
subject to 4.a. above, for all compensatory limitations applying to bodily injury claims
damages, including but not limited to loss of in the state in which the accident occurred.
consortium, because of or arising out of bodily b. ARBITRATION
injury to two or more persons in any one (1) If we and a person entitled to Uninsured
occurrence. Motorist Coverage under this endorsement
c. The Limit of Liability is not increased because of do not agree:
the number of: (a) that the person is entitled to recover
(1) automobiles shown or premiums charged compensatory damages, including but
in the Declarations; not limited to loss of consortium; or
(2) claims made or suits brought; (b) to the amount of those damages
(3) persons injured; or the matter may be arbitrated provided both
(4) automobiles involved in the occurrence. we and the injured person agree to
d. The amount we pay will be reduced by any arbitration. If so, each party will select an
amounts paid or payable for the same bodily arbitrator. The two arbitrators will select a
injury: third. If they cannot agree within thirty (30)
(1) under SECTION II - LIABILITY days, either may request that a judge of a
COVERAGE of the policy; court having jurisdiction make the selection.
(2) under any workers compensation or similar (2) Each party will pay its own arbitrator and
law; or share equally all other expenses of
(3) by or on behalf of any person or arbitration.
organization who may be legally responsible (3) Arbitration will take place in the county and
for the bodily injury. state in which the person entitled to
coverage lives. Local rules of procedure
5. OTHER UNINSURED MOTORIST INSURANCE and evidence will apply.
a. If there is other Uninsured Motorist Coverage (4) A decision by any two of the arbitrators will
which applies, we will pay our share of the be binding and may be enforced by either
compensatory damages, including but not party in a court of competent jurisdiction.
limited to loss of consortium. Our share will be
the ratio of our limit of liability to the total of all All other policy terms and conditions apply.

99301 (11-21) Page 3 of 3


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 99305 (11-21)

Michigan
UNDERINSURED MOTORIST COVERAGE
Automobile Policy

It is agreed:

1. DEFINITIONS when the requesting passenger departs from the


For purposes of this endorsement only the following automobile.
definitions apply in addition to those contained in g. Transportation network company means an
SECTION I - DEFINITIONS of the policy. entity that uses a digital network to connect
a. Delivery network platform means any passengers to transportation network company
online-enabled application used to connect drivers.
customers for purposes of providing the h. Underinsured automobile:
prearrangement of deliveries with: (1) means an automobile to which a bodily
(1) drivers; or injury liability bond or liability insurance
(2) local vendors using drivers policy applies at the time of the occurrence:
for compensation. (a) in at least the minimum amounts
A delivery network platform does not include a required by the Financial Responsibility
transportation network company. Law in the state where your
b. Digital network means any online-enabled automobile is normally garaged; and
application, software, website or system offered (b) in which the limits of liability are less
or utilized by a transportation network than the amount of damages the injured
company that enables the prearrangement of person is legally entitled to recover for
rides with transportation network company bodily injury.
drivers. (2) does not include an automobile:
c. Occupying means being in or on an (a) owned or leased by, furnished to or
automobile as a passenger or operator, or available for regular use of you or
being engaged in the immediate acts of anyone living with you;
entering, boarding or alighting from an (b) owned or operated by a self-insurer
automobile. under any automobile law;
d. Personal vehicle sharing program means a (c) owned by any governmental unit or
legal entity engaged in the business of agency;
facilitating the sharing of an automobile by (d) located for use as a residence or
individuals under any contract or agreement. premises;
e. Prearranged delivery means any period of time (e) that is designed for use primarily off
a driver is logged in to a delivery network public roads except while actually on
platform and has accepted a request to public roads; or
transport goods, items or products through a (f) that is an uninsured automobile.
delivery network platform and continuing while Uninsured automobile means an
the driver transports the goods, items or automobile:
products and ending when the requested goods, 1) to which no bodily injury liability
items or products are no longer occupying the bond or liability insurance policy
automobile. applies:
f. Prearranged ride means the furnishing of a) at the time of the occurrence;
transportation by a driver to a requesting and
passenger, beginning when a driver accepts a b) in at least the minimum
ride requested by a passenger through a digital amounts required by the
network controlled by a transportation Financial Responsibility Law in
network company, continuing while the driver the state where your
transports a requesting passenger and ending automobile is normally
garaged;

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Agency Code 01-0764-00 Policy Number 41-205-904-00

2) insured by a company that becomes settled by a court having jurisdiction. We will not
insolvent; be bound by any judgments for damages
3) insured by a company that has obtained or settlements made without our
issued a successful written denial of written consent.
coverage; or
4) that is a hit and run automobile. By 3. EXCLUSIONS
this we mean an automobile: Underinsured Motorist Coverage does not apply to:
a) that causes bodily injury by a. punitive or exemplary damages.
actual physical contact with the b. any person injured while occupying or injured
injured person or the by any automobile which is owned or leased by
automobile the injured person such person injured if such automobile:
is occupying; and (1) is designed primarily for use on public
b) whose owner or operator is roads;
unknown. (2) is required to be registered and licensed
prior to its use on public roads; and
2. COVERAGE (3) is not insured for Underinsured Motorist
a. We will pay compensatory damages, including Coverage by the policy.
but not limited to loss of consortium, any person c. any person who settles a bodily injury claim
is legally entitled to recover from the owner or without our written consent.
operator of an underinsured automobile d. directly or indirectly benefit an insurer or self-
because of bodily injury sustained by an insurer under any workers compensation law or
injured person while occupying an automobile disability benefits law.
that is covered by SECTION II - LIABILITY e. the extent the same elements of damages are
COVERAGE of the policy. paid or payable under the Michigan No-Fault
b. This coverage is extended to you, if an law.
individual, as follows: f. any person injured while occupying or injured
(1) We will pay compensatory damages, by your automobile while such automobile is
including but not limited to loss of used:
consortium, you are legally entitled to (1) as a public or livery conveyance;
recover from the owner or operator of an (2) to transport persons for compensation or a
underinsured automobile because of fee. This includes a driver who is logged in
bodily injury you sustain: to a transportation network company's
(a) when you are not occupying an digital network. However, this exclusion
automobile that is covered by (2) does not apply to a driver who is logged
SECTION II - LIABILITY COVERAGE in to a transportation network company's
of the policy; or digital network, has not accepted a
(b) while occupying an automobile you do prearranged ride and Limited
not own which is not covered by Transportation Network Company Driver
SECTION II - LIABILITY COVERAGE Coverage is shown in the Declarations for
of the policy. such automobile; or
(2) The coverage extended in 2. COVERAGE (3) to deliver goods or property for
b.(1) is also extended to a relative who compensation or a fee. This includes a
does not own an automobile. driver who is logged in to a delivery
c. The bodily injury must be accidental and arise network platform. However, this exclusion
out of the ownership, maintenance or use of the (3) does not apply to a driver who is logged
underinsured automobile. in to a delivery network platform and
d. Whether an injured person is legally entitled to Delivery of Goods Coverage is shown in the
recover compensatory damages, including but Declarations for such driver.
not limited to loss of consortium, and the However, exclusions f.(1)-(3) do not apply to
amount of such damages shall be determined such automobile:
by agreement between the injured person and (a) used for volunteer or charitable
us. If no agreement can be reached, the injured purposes;
person may file suit against us within the (b) for which reimbursement of normal
applicable statute of limitations applying to operating expenses is received;
bodily injury claims in the state in which the (c) used for car pooling on a
accident occurred in order to have the dispute share-the-expense basis; or

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Agency Code 01-0764-00 Policy Number 41-205-904-00

(d) you or a relative are occupying or exceed the limit of liability of the applicable
injured by and do not own policy that has the highest limit of liability.
at the time of loss or damage. The coverage extended to automobiles you do
g. any person whose injury arises out of the not own will be excess over any other insurance
ownership, maintenance or use of your available to you.
automobile while: b. When this coverage and any other insurance
(1) enrolled in an electronic or written personal applies to an automobile being used for a
vehicle sharing program; and prearranged delivery through a delivery
(2) being used in connection with such network platform and Delivery of Goods
personal vehicle sharing program. Coverage is shown in the Declarations, this
If you are an individual this exclusion does not coverage will be excess.
apply to you or any relative while using such
automobile. 6. CONDITIONS
For purposes of this endorsement only the following
4. LIMIT OF LIABILITY conditions apply in addition to those contained in
a. Our Limit of Liability for Underinsured Motorist SECTION VI - GENERAL CONDITIONS of the
Coverage shall not exceed the lowest of: policy.
(1) the amount by which the Underinsured a. TIME LIMITATION FOR ACTION AGAINST US
Motorist Coverage limits stated in the Any person seeking Underinsured Motorist
Declarations exceed the total limits of all Coverage must:
bodily injury liability bonds and policies (1) present a claim for compensatory damages,
available to the owner or operator of the including but not limited to loss of
underinsured automobile; or consortium, according to the terms and
(2) the amount by which compensatory conditions of the policy; and
damages, including but not limited to loss of (2) conform with any applicable statute of
consortium, because of bodily injury limitations applying to bodily injury claims
exceed the total limits of those bodily injury in the state in which the accident occurred.
liability bonds and policies. b. ARBITRATION
b. The Limit of Liability is not increased because of (1) If we and a person entitled to Underinsured
the number of: Motorist Coverage under this endorsement
(1) automobiles shown or premiums charged do not agree:
in the Declarations; (a) that the person is entitled to recover
(2) claims made or suits brought; compensatory damages, including but
(3) persons injured; or not limited to loss of consortium; or
(4) automobiles involved in the occurrence. (b) to the amount of those damages
c. The amount we pay will be reduced by any the matter may be arbitrated provided both
amounts paid or payable for the same bodily we and the injured person agree to
injury: arbitration. If so, each party will select an
(1) under SECTION II - LIABILITY arbitrator. The two arbitrators will select a
COVERAGE of the policy; third. If they cannot agree within 30 days,
(2) under any workers compensation or similar either may request that a judge of a court
law; or having jurisdiction make the selection.
(3) by or on behalf of any person or (2) Each party will pay its own arbitrator and
organization who may be legally responsible share equally all other expenses of
for the bodily injury. arbitration.
(3) Arbitration will take place in the county and
5. OTHER UNDERINSURED MOTORIST state in which the person entitled to
INSURANCE coverage lives. Local rules of procedure
a. If there is other Underinsured Motorist Coverage and evidence will apply.
which applies, we will pay our share of the (4) A decision by any two of the arbitrators will
compensatory damages, including but not be binding and may be enforced by either
limited to loss of consortium. Our share will be party in a court of competent jurisdiction.
the ratio of our limit of liability to the total of all
limits which apply. Total damages payable for All other policy terms and conditions apply.
one occurrence shall be considered not to

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Agency Code 01-0764-00 Policy Number 41-205-904-00

99501 (11-21)

ACCIDENTAL DEATH BENEFIT


Automobile

It is agreed:

DEFINITIONS and ending when the requesting passenger departs


The following definitions apply in addition to those from the automobile.
contained in SECTION I - DEFINITIONS of the policy. 7. Transportation network company means an entity
1. Delivery network platform means any that uses a digital network to connect passengers
online-enabled application used to connect to transportation network company drivers.
customers for purposes of providing the
prearrangement of deliveries with: COVERAGE
(1) drivers; or We shall pay an accidental death benefit in the event of
(2) local vendors using drivers a death of an eligible person provided:
for compensation. 1. death is the direct result of bodily injury sustained
A delivery network platform does not include a in an accident while occupying a private passenger
transportation network company. automobile or while getting into or out of a private
2. Digital network means any online-enabled passenger automobile; and
application, software, website or system offered or 2. death of the eligible person occurs within 90 days
utilized by a transportation network company that of the date the bodily injury was sustained.
enables the prearrangement of rides with
transportation network company drivers. EXCLUSIONS
3. Eligible person means when the named insured We shall not pay an accidental death benefit if death
shown in the Declarations is: results in any way from:
a. an individual, you or a relative. 1. an accident while occupying or getting into or out of
b. a partnership, your partners and their spouses a private passenger automobile while such
and relatives who reside with them in the same automobile is used:
household. a. as a public or livery conveyance;
c. an organization other than a partnership, your b. to transport persons for compensation or a fee.
officers, as defined in your organization's This includes a driver who is logged in to a
charter, constitution or by-laws and their transportation network company's digital
spouses and relatives who reside with them in network. However, this exclusion b. does not
the same household. apply to a driver who is logged in to a
4. Personal vehicle sharing program means a legal transportation network company's digital
entity engaged in the business of facilitating the network, has not accepted a prearranged ride
sharing of an automobile by individuals under any and Limited Transportation Network Company
contract or agreement. Driver Coverage is shown in the Declarations for
5. Prearranged delivery means any period of time a such automobile; or
driver is logged in to a delivery network platform c. to deliver goods or property for compensation or
and has accepted a request to transport goods, a fee. This includes a driver who is logged in to
items or products through a delivery network a delivery network platform. However, this
platform and continuing while the driver transports exclusion c. does not apply to a driver who is
the goods, items or products and ending when the logged in to a delivery network platform and
requested goods, items or products are no longer Delivery of Goods Coverage is shown in the
occupying the automobile. Declarations for such driver.
6. Prearranged ride means the furnishing of However, exclusions 1.a. - c. do not apply to such
transportation by a driver to a requesting passenger, automobile:
beginning when a driver accepts a ride requested by (1) used for volunteer or charitable purposes;
a passenger through a digital network controlled by (2) for which reimbursement of normal
a transportation network company, continuing operating expenses is received;
while the driver transports a requesting passenger

99501 (11-21) Page 1 of 2


Agency Code 01-0764-00 Policy Number 41-205-904-00

(3) used for car pooling on a share-the-expense 2. The benefit limit for this coverage is not increased
basis; or regardless of the number of:
(4) you or a relative are occupying or injured a. automobiles shown in the Declarations;
by and do not own b. claims presented or suits brought; or
at the time of loss or damage. c. automobiles involved in the accident.
2. the ownership, maintenance or use of your
automobile while: CONDITIONS
a. enrolled in an electronic or written personal 1. We must be furnished with:
vehicle sharing program; and a. a copy of the eligible person's death certificate;
b. being used in connection with such personal and
vehicle sharing program. b. a sworn statement which identifies the person(s)
If you are an individual this exclusion does not apply entitled to the benefit.
to you or any relative while using such automobile. 2. This benefit is primary and shall not be reduced by
or be used to reduce any other coverage or benefit
PAYMENT BENEFITS provided by this policy or a policy issued by us or a
We shall pay the accidental death benefit shown in the Company affiliated with us, except the Accidental
Declarations to the deceased eligible person's Death Benefit of a Homeowners or Mobile
surviving spouse; if none, to surviving children, share Homeowners policy issued by us or a Company
and share alike; if none, to surviving parents, share and affiliated with us.
share alike; if none, to the eligible person's estate.
All other policy terms and conditions apply.
BENEFIT LIMIT
1. We shall pay no more than the accidental death
benefit limit stated in the Declarations for each
eligible person for whom this benefit is payable.

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Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 99552 (8-20)

Michigan
PROPERTY PROTECTION COVERAGE

SECTION I - DEFINITIONS 6. Motor vehicle means a vehicle, including a trailer,


The following definitions apply to this endorsement. The operated or designed for operation upon a public
definitions contained in the policy do not apply to the highway by power other than muscular power which
coverage provided by this endorsement. has more than 2 wheels. Motor vehicle does not
1. Commercial quadricycle means a vehicle to which include a motorcycle or a moped, as defined in
all of the following apply: section 32b of Act No. 300 of the Public Acts of
a. The vehicle has fully operative pedals for 1949, being section 257.32b of the Michigan
propulsion entirely by human power; Compiled Laws. Motor vehicle does not include a
b. The vehicle has at least 4 wheels and is farm tractor or other implement of husbandry which
operated in a manner similar to a bicycle; is not subject to the registration requirements of the
c. The vehicle has at least 6 seats for passengers; Michigan vehicle code pursuant to section 216 of the
d. The vehicle is designed to be occupied by a Michigan vehicle code, Act No. 300 of the Public
driver and powered either by passengers Acts of 1949, being section 257.216 of the Michigan
providing pedal power to the drive train of the Compiled Laws. Motor vehicle does not include an
vehicle or by a motor capable of propelling the ORV. Motor vehicle does not include a
vehicle in the absence of human power; power-driven mobility device, a commercial
e. The vehicle is used for commercial purposes; quadricycle or golf carts.
and 7. Motor vehicle accident means a loss involving the
f. The vehicle is operated by the owner of the ownership, operation, maintenance, or use of a
vehicle or an employee of the owner of the motor vehicle as a motor vehicle regardless of
vehicle. whether the accident also involves the ownership,
2. Digital network means any online-enabled operation, maintenance, or use of a motorcycle as
application, software, website or system offered or a motorcycle.
utilized by a transportation network company that 8. Named insured means the person(s) or
enables the prearrangement of rides with organization(s) identified as an insured in the
transportation network company drivers. Declarations.
3. Golf cart means a vehicle designed for 9. ORV means a motor-driven recreation vehicle
transportation while playing the game of golf. designed for off-road use and capable of
4. Insured motor vehicle means a motor vehicle with cross-country travel without benefit of road or trail,
respect to which: on or immediately over land, snow, ice, marsh,
a. the property damage liability insurance of the swampland, or other natural terrain. ORV includes,
policy applies and for which a specific premium but is not limited to, a multitrack or multi-wheel drive
is charged; and vehicle, a motorcycle or related 2-wheel, 3-wheel,
b. the named insured is required to maintain or 4-wheel vehicle, an amphibious machine, a
security under Chapter 31 of the Michigan ground effect air cushion vehicle, an ATV as defined
Insurance Code. in section 81101 of the natural resources and
5. Motorcycle means a vehicle having a saddle or seat environmental protection act, 1994 PA 451, MCL
for the use of the rider, designed to travel on not 324.81101, or other means of transportation deriving
more than 3 wheels in contact with the ground, motive power from a source other than muscle or
which is equipped with a motor that exceeds 50 wind. ORV does not include a vehicle described in
cubic centimeters piston displacement. The wheels this subdivision that is registered for use upon a
on any attachment to the vehicle shall not be public highway and has the security described in
considered as wheels in contact with the ground. section 3101 or 3103 in effect.
Motorcycle does not include a moped, as defined in 10. Owner means any of the following:
section 32b of the Michigan vehicle code, Act No. a. A person renting a motor vehicle or having the
300 of the Public Acts of 1949, being section use of a motor vehicle, under a lease or
257.32b of the Michigan Compiled Laws. otherwise, for a period that is greater than 30
Motorcycle does not include an ORV. days.

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Agency Code 01-0764-00 Policy Number 41-205-904-00

b. A person who holds the legal title to a motor SECTION II - PROPERTY PROTECTION INSURANCE
vehicle or motorcycle, other than a person 1. COVERAGE
engaged in the business of leasing motor We will pay property protection insurance benefits
vehicles or motorcycles who is the lessor of a for accidental damage to tangible property
motor vehicle or motorcycle pursuant to a consisting of physical injury to or destruction of the
lease providing for the use of the motor vehicle property, including loss of use of the injured or
or motorcycle by the lessee for a period that is destroyed property, which arises out of the
greater than 30 days. ownership, operation, maintenance, or use of:
c. A person who has the immediate right of a. an insured motor vehicle as a motor vehicle;
possession of a motor vehicle or motorcycle or
under an installment sales contract. b. a motor vehicle operated by the named
d. A person renting a motorcycle or having the insured or a relative:
use of a motorcycle under a lease for a period (1) that is not owned by the named insured or
that is greater than 30 days, or otherwise for a a relative;
period that is greater than 30 consecutive days. (2) to which the Property Damage Liability
A person who borrows a motorcycle for a Coverage of the policy applies; and
period that is less than 30 consecutive days with (3) for which the security required by Chapter
the consent of the owner is not an owner under 31 of the Michigan Insurance Code was not
this subparagraph. in effect.
11. Power-driven mobility device means a wheelchair 2. EXCLUSIONS
or other mobility device powered by a battery, fuel, Property protection insurance benefits do not apply
or other engine and designed to be used by an to:
individual with a mobility disability for the purpose of a. damage to vehicles and their contents, including
locomotion. trailers, operated or designed for operation upon
12. Personal vehicle sharing program means a legal a public highway by power other than muscular
entity engaged in the business of facilitating the power. This exclusion does not apply when the
sharing of a motor vehicle by individuals under any vehicle is parked in a manner as not to cause
contract or agreement. unreasonable risk of the damage which
13. Prearranged ride means the furnishing of occurred.
transportation by a driver to a requesting passenger, b. damage to property owned by the named
beginning when a driver accepts a ride requested by insured or a relative, if that person or entity is
a passenger through a digital network controlled by the owner, registrant, or operator of the motor
a transportation network company, continuing vehicle involved in the motor vehicle accident.
while the driver transports a requesting passenger c. property damage arising from motor vehicle
and ending when the requesting passenger departs accidents occurring outside the State of
from the motor vehicle. Michigan.
14. Property damage means damage to tangible d. property damage caused intentionally by the
property including loss of use of such tangible owner of the property.
property. e. property damage to an insured motor vehicle
15. Relative means: or its contents.
a. The named insured's spouse; and f. property damage to any property, while any
b. Any other person who is domiciled with the insured motor vehicle is temporarily or
named insured and related to either the named permanently located as a residence or premises.
insured or his or her spouse by blood, marriage, g. property damage to utility transmission lines,
or adoption. wires, or cables arising from the failure of a
Relative includes a ward or foster child who is municipality, utility company, or cable television
domiciled with the named insured. company to comply with the requirements of
16. Suit means a civil court proceeding in which section 247.186 of the Michigan Compiled Laws.
damages because of property damage to which h. property damage to tangible property that
this insurance applies are alleged. occurs within the course of a business of
17. Transportation network company means an entity repairing, servicing, or otherwise maintaining
that uses a digital network to connect passengers motor vehicles.
to transportation network company drivers. i. property damage to any property, while a
18. We, us, and our means the Company providing this motor vehicle covered by this policy is:
insurance.

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Agency Code 01-0764-00 Policy Number 41-205-904-00

(1) used to transport persons or property for claiming to be entitled to benefits, or by someone on
compensation or a fee; his or her behalf. We must receive the written notice
(2) hired by or rented to others for within one year of the motor vehicle accident.
compensation or a fee; Notice should include the names and addresses of
(3) available for hire by the public for any witnesses.
compensation or a fee; or A person seeking coverage under this endorsement
(4) being used by a driver who is logged in to a must:
transportation network company's digital a. cooperate with us in the investigation or
network. settlement of any claim.
This exclusion i.(1)-(4) does not apply: b. submit a written proof of claim and as a part of
(a) to car pooling on a share the expense our investigation we may ask that the person
basis; seeking coverage under this endorsement
(b) while using a motor vehicle for submit to an examination under oath.
volunteer or charitable purposes or for c. take reasonable steps after a loss, at our
which reimbursement for normal expense, to protect the damaged property. Any
operating expenses is received; or loss due to failure to protect the property will not
(c) when Limited Transportation Network be paid under this insurance.
Company Driver Coverage is shown in d. permit us to inspect and appraise the damaged
the Declarations for such motor vehicle property before its repair or disposal.
and the driver has not accepted a e. submit proof of the loss when required by us.
prearranged ride. 3. DUPLICATION OF BENEFITS
j. property damage arising out of the ownership, No one will be entitled to duplicate payments for the
operation, maintenance or use of a motor same elements of loss under this coverage
vehicle which occurs while: regardless of the number of:
(1) enrolled in an electronic or written personal a. motor vehicles covered; or
vehicle sharing program; and b. insurers (including self-insurers) providing
(2) being used in connection with such security in accordance with:
personal vehicle sharing program. (1) Chapter 31 of the Michigan Insurance Code;
If a named insured is an individual this or
exclusion does not apply to the named insured (2) any other similar law.
or a relative while using such motor vehicle. 4. DEFENSE OF SUITS
3. LIMIT OF LIABILITY a. If suit is filed or claim is made arising out of the
Our Limit of Liability for damages to all tangible ownership, maintenance, or use of a motor
property, including loss of use, arising from any one vehicle as a motor vehicle which results in
motor vehicle accident shall not exceed damage to tangible property for which the
$1,000,000. In no event shall we pay more than owner, registrant, or operator has no liability
the: under section 3135 of Chapter 31 of the
a. reasonable repair costs for damaged property; Michigan Insurance Code and involves the use:
or (1) of an insured motor vehicle; or
b. replacement cost less depreciation for damaged (2) by the named insured or relative of any
property. other motor vehicle and the use of that
motor vehicle would otherwise be covered
SECTION III - CONDITIONS under the property damage liability
1. LEGAL ACTION AGAINST US insurance of this policy
No legal action may be brought against us until we will defend the named insured, relative,
there has been full compliance with the terms of this owner, or operator of the insured motor
endorsement. vehicle or the named insured or relative
An action for property protection insurance benefits operating any other motor vehicle at our
shall not be commenced later than one year after expense.
the accident. b. This condition does not apply to:
2. DUTIES AFTER AN ACCIDENT (1) damage intentionally caused to property.
We must be notified promptly of how, when and Even though a person knows that harm to
where the motor vehicle accident happened. persons or property is substantially certain
Written notice must be given to us, indicating name to be caused by his or her act or omission,
and address of the claimant. Written notice may be the person does not cause or suffer such
given to us or our authorized agent by a person harm intentionally if he or she acts or

99552 (8-20) Page 3 of 4


Agency Code 01-0764-00 Policy Number 41-205-904-00

refrains from acting for the purpose of provisions of Chapter 31 of the Michigan Insurance
averting injury to any person, including Code.
himself or herself, or for the purpose of In the event a court of competent jurisdiction declares or
averting damage to tangible property; or enters a judgment, the effect of which is to render the
(2) damage to property owned by the named provisions of such statute invalid or unenforceable in
insured or a relative, if that person is the whole or in part, we shall have the right to recompute
owner, registrant, or operator of the motor the premium payable for the policy and revise the limits
vehicle involved in the motor vehicle of liability. In addition, provisions of the policy that have
accident; or been established in reliance upon Chapter 31 of the
(3) damage to an insured motor vehicle or its Michigan Insurance Code shall be voidable and shall
contents. revert to conform to applicable provisions of Chapter 31
at the time of the accident.
SECTION IV - CONSTITUTIONALITY
The premium for the coverages and the limits of liability All other policy terms and conditions apply.
of the policy have been established in reliance upon the

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Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 99633 (8-22)

DELIVERY OF GOODS AND LIMITED TRANSPORTATION NETWORK


COMPANY DRIVER COVERAGE
Automobile Policy

It is agreed:

1. DEFINITIONS 2. SECTION II - LIABILITY COVERAGE is amended.


The following definitions apply in addition to those a. 2. EXCLUSIONS, c. is deleted and replaced by
contained in SECTION I - DEFINITIONS of the the following exclusion.
policy. c. to any person who is operating an
a. Delivery network company means an entity automobile while such automobile is used:
that uses a delivery network platform to (1) as a public or livery conveyance;
connect consumers with the delivery of goods, (2) to transport persons for compensation
items or products. or a fee. This includes a driver who is
b. Delivery network platform means any logged in to a transportation network
online-enabled application used to connect company's digital network. However,
customers for purposes of providing the this exclusion c.(2) does not apply to a
prearrangement of deliveries with: driver who is logged in to a
(1) drivers; or transportation network company's
(2) local vendors using drivers digital network, has not accepted a
for compensation. prearranged ride and Limited
A delivery network platform does not include a Transportation Network Company Driver
transportation network company. Coverage is shown in the Declarations
c. Digital network means any online-enabled ap- for such automobile; or
plication, software, website or system offered or (3) to deliver goods or property for
utilized by a transportation network company compensation or a fee. This includes a
that enables the prearrangement of rides with driver who is logged in to a delivery
transportation network company drivers. network platform. However, this
d. Prearranged delivery means any period of time exclusion c.(3) does not apply to a
a driver is logged in to a delivery network driver who is logged in to a delivery
platform and has accepted a request to network platform and Delivery of
transport goods, items or products through a Goods Coverage is shown in the
delivery network platform and continuing while Declarations for such driver.
the driver transports the goods, items or However, exclusions c.(1)-(3) do not apply
products and ending when the requested goods, to such automobile:
items or products are no longer occupying the (a) used for volunteer or charitable
automobile. purposes;
e. Prearranged ride means the furnishing of trans- (b) for which reimbursement of normal
portation by a driver to a requesting passenger, operating expenses is received; or
beginning when a driver accepts a ride re- (c) used for car pooling on a share-the-
quested by a passenger through a digital net- expense basis
work controlled by a transportation network at the time of loss or damage.
company, continuing while the driver transports b. The following provision is added to 6. OTHER
a requesting passenger and ending when the INSURANCE.
requesting passenger departs from the When this coverage and any other insurance
automobile. applies to an automobile being used for a
f. Transportation network company means an prearranged delivery through a delivery
entity that uses a digital network to connect network platform and Delivery of Goods
passengers to transportation network company Coverage is shown in the Declarations, this
drivers. coverage will be excess.

99633 (8-22) Page 1 of 2


Agency Code 01-0764-00 Policy Number 41-205-904-00

3. SECTION III - DAMAGE TO YOUR AUTOMOBILE, (c) used for car pooling on a share-the-
is amended. expense basis
a. Under 2. EXCLUSIONS, the following exclusion at the time of loss or damage.
is added: b. Under 3. COVERAGE EXTENSIONS, the fol-
any automobile while used: lowing extension is added:
(1) as a public or livery conveyance; Excess Comprehensive and Collision
(2) to transport persons for compensation or a Coverage
fee. This includes a driver who is logged in (1) We will extend the Comprehensive and
to a transportation network company's Collision Coverage that apply to your
digital network. However, this exclusion automobile and its equipment when
a.(2) does not apply to a driver who is Limited Transportation Network Company
logged in to a transportation network Driver Coverage is shown in the
company's digital network, has not Declarations for such automobile while a
accepted a prearranged ride and Limited driver is logged in to a transportation
Transportation Network Company Driver network company's digital network and
Coverage is shown in the Declarations for has accepted a prearranged ride.
such automobile; or (2) We will extend the Comprehensive and
(3) to deliver goods or property for Collision Coverage that apply to your
compensation or a fee. This includes a automobile and its equipment when
driver who is logged in to a delivery Delivery of Goods Coverage is shown in the
network platform. However, this exclusion Declarations for the driver that is logged in
a.(3) does not apply to a driver who is to a delivery network platform and has
logged in to a delivery network platform accepted a prearranged delivery.
and Delivery of Goods Coverage is shown in The coverage afforded by this extension shall be
the Declarations for such driver. excess of any other physical damage coverage
This exclusion a.(3) does not apply while provided by a transportation network
such automobile is being used to deliver company or a delivery network company.
mail for the United States Postal Service as However, when such other physical damage
a rural postal carrier. coverage is subject to a deductible greater than
However, exclusions a.(1)-(3) do not apply to the deductible which applies to this coverage,
such automobile: we will pay the difference between the two
(a) used for volunteer or charitable deductibles.
purposes;
(b) for which reimbursement of normal All other policy terms and conditions apply.
operating expenses is received; or

99633 (8-22) Page 2 of 2


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 69405 (1-16)Z

PRESERVE OUR RIGHT TO RECOVER PAYMENTS


Automobile Policy

It is agreed:

SECTION V – WHAT YOU MUST DO AFTER AN prorated between you and us based on the interest of
ACCIDENT OR LOSS, 3. PRESERVE OUR RIGHT TO each in the loss. This condition only applies if we pay
RECOVER PAYMENTS is amended. The following for a loss and then payment is made by those respon-
condition is added. sible for the loss.
If the claim paid is less than the agreed loss because of
any deductible or other limiting terms, the recovery is All other policy terms and conditions apply.

69405 (1-16)Z Page 1 of 1

Auto-Owners Insurance Company 69716 (9-19)

FINANCIAL RESPONSIBILITY AND COMPULSORY INSURANCE


LAWS AMENDATORY
Automobile Policy

It is agreed:

SECTION II – LIABILITY COVERAGE is amended. 5. b. provide the minimum amounts and types of
FINANCIAL RESPONSIBILITY AND COMPULSORY other coverages, such as no-fault, required of
INSURANCE LAWS is deleted and replaced by the out-of-state vehicles by the jurisdiction where
following provision. your automobile is being used.
5. FINANCIAL RESPONSIBILITY AND This provision does not apply to any limits required by
COMPULSORY INSURANCE LAWS any law governing motor carriers of property or
While your automobile is subject to the laws of passengers.
another state or Canada, we will: We will not duplicate payments available under this or
a. increase the limit of liability for bodily injury or any other insurance for the same elements of loss.
property damage to comply with the minimum
requirements of a financial responsibility or All other policy terms and conditions apply.
compulsory insurance law of the jurisdiction
where your automobile is being operated; and

69716 (9-19) Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 79275 (6-92)Z

Michigan
PROPERTY DAMAGE LIABILITY LIMITATION

It is agreed:

SECTION II - LIABILITY COVERAGE does not apply to property damage for which you become legally responsible
because of or arising out of the ownership, maintenance, or use of your automobile as an automobile within the State
of Michigan

As used in this endorsement, automobile means a vehicle, including a trailer, operated or designed for operation upon a
public highway by power other than muscular power which has more than 2 wheels. Automobile does not include a
motorcycle or a moped, as defined in section 32b of Act No. 300 of the Public Acts of 1949, being section 257.32b of the
Michigan Compiled Laws. Automobile does not include a farm tractor or other implement of husbandry that is not sub-
ject to the registration requirements of the Michigan vehicle code pursuant to section 216 of the Michigan vehicle code,
Act No. 300 of the Public Acts of 1949, being section 257.216 of the Michigan Compiled Laws.

All other policy terms and conditions apply.

79275 (6-92)Z Page 1 of 1

Auto-Owners Insurance Company 89023 (7-06)Z

AIR BAG REPLACEMENT COVERAGE ENDORSEMENT


Automobile Policy

It is agreed:

Under SECTION III - DAMAGE TO YOUR AUTOMOBILE, 3. COVERAGE EXTENSIONS, the following coverage
extension is added:

Air Bag Replacement Coverage

If your automobile is a private passenger automobile, we will extend the Comprehensive Coverage that applies to
your automobile for the replacement of the air bag when it inflates without your automobile having been involved in a
Comprehensive or Collision loss.

All other policy terms and conditions apply.

89023 (7-06)Z Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 89058 (4-07)Z

AMENDATORY ENDORSEMENT
SECTION II - LIABILITY COVERAGE
Automobile Policy

It is agreed:

Under SECTION II - LIABILITY COVERAGE, 2. EXCLUSIONS, i. is deleted and replaced by the following:

i. to any person or organization for damage to property or an automobile owned by, rented to or in the care, custody or
control of that person or organization. This exclusion does not apply to property damage to a residence or private
garage, caused by a private passenger automobile, when the residence or private garage is rented to or is in the
care, custody or control of that person or organization.

All other policy terms and conditions apply.

89058 (4-07)Z Page 1 of 1

Auto-Owners Insurance Company 69396 (9-15)Z

PERSONAL VEHICLE SHARING PROGRAM EXCLUSION


Automobile Policy

It is agreed:

1. DEFINITIONS If you are an individual this exclusion does not apply


The following definition applies in addition to those to you or any relative while using such automobile.
contained in SECTION I - DEFINITIONS of the 3. SECTION III – DAMAGE TO YOUR AUTOMOBILE,
policy. 2. EXCLUSIONS is amended. The following EX-
Personal vehicle sharing program means a legal CLUSION is added.
entity engaged in the business of facilitating the Loss to your automobile (that is not a trailer) which
sharing of an automobile by individuals. occurs while:
2. SECTION II – LIABILITY COVERAGE, 2. EXCLU- a. enrolled in an electronic or written personal ve-
SIONS is amended. The following EXCLUSION is hicle sharing program agreement; and
added. b. being used in connection with such personal
We do not provide Liability Coverage for the owner- vehicle sharing program.
ship, maintenance or use of your automobile (that If you are an individual this exclusion does not apply
is not a trailer) while: to you or any relative while using such automobile.
a. enrolled in an electronic or written personal ve-
hicle sharing program agreement; and All other policy terms and conditions apply.
b. being used in connection with such personal
vehicle sharing program.

69396 (9-15)Z Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 69434 (12-15)Z

COMMON LOSS DEDUCTIBLE


Automobile Policy

It is agreed:

SECTION III – DAMAGE TO YOUR AUTOMOBILE is covered loss, with your permission, we will use the
amended. The following provision is added. deductible that benefits you the most.
1. If you have a Homeowners or Mobile Homeowners 2. However:
policy with us or a company affiliated with us and a. the covered losses must result from a single
there is a covered loss under your Homeowners or occurrence and you must file a claim on each
Mobile Homeowners policy and: of the covered losses.
a. this policy; or b. the amount of loss under each policy must ex-
b. a relative’s Automobile policy insured with us or ceed the applicable deductible and result in a
a company affiliated with us, that includes the paid loss.
endorsement entitled Common Loss Deductible c. in no event will the amount of such reduction
then, at your option, the automobile deductible exceed the amount of the applicable auto-
applicable to the loss will be reduced by the amount mobile deductible.
of the Homeowners or Mobile Homeowners policy d. this provision only applies to one automobile
deductible. In the event that more than one auto- deductible per household.
mobile deductible provision applies to the same
All other policy terms and conditions apply.

69434 (12-15)Z Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 89024 (7-06)Z

WAIVER OF GLASS DEDUCTIBLE FOR REPAIR


Automobile Policy

It is agreed:

Under SECTION III - DAMAGE TO YOUR AUTOMOBILE, 1. COVERAGES, c. Comprehensive Coverage, the following
provision is added:

A deductible stated in the Declarations for Comprehensive Coverage does not apply to the repair of safety or laminated
glass contained within the windshield, rear window, a door window or any other side window of your automobile,
provided both you and we agree to the repair.

The provisions of this endorsement do not apply to:

(1) any light or any component of any light of your automobile;

(2) sunroofs of any type;

(3) removable roof panels of any type; or

(4) mirrors of any type.

All other policy terms and conditions apply.

89024 (7-06)Z Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 89060 (10-13)Z

LOSS PAYABLE CLAUSE

It is agreed:

Under SECTION III - DAMAGE TO YOUR AUTOMO- a. within 60 days after our request; and
BILE, the following provision is added: b. in a form and manner required in the policy.

LOSS PAYABLE 4. At our option, we may pay the loss payee:

1. Loss or damage under the policy shall be paid to a. the amount of loss or damage; or
the: b. the whole principal due with interest accrued at
the time of settlement. If we make such pay-
a. named insured; and ment, the loss payee shall assign and transfer
b. the loss payee (lienholder) shown in the Decla- the lien to us.
rations as their interest may appear at the time
of such loss or damage. 5. After we make payment to the loss payee under this
agreement, we will have the right to recover, to the
2. We shall notify the loss payee ten (10) days prior to extent of our payment, from anyone held respon-
the effective date of cancellation on this policy. sible. The transfer of such right to recover shall not
impair the loss payee's right to recover the full
3. If the insured fails to render proof of loss within the amount of its claim.
time required in the policy, the loss payee shall
render proof of loss: All other policy terms and conditions apply.

89060 (10-13)Z Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 69271 (5-14)Z

Michigan
ADDITIONAL AND REPLACEMENT AUTOMOBILE COVERAGE
Automobile Policy

It is agreed:

1. Under SECTION II - LIABILITY COVERAGE, 1. your automobile. Your automobile


COVERAGE, c. Other Automobiles Covered is must be out of use because of break-
deleted and replaced by the following: down, repair, servicing, loss or
c. Other Automobiles Covered destruction.
The Liability Coverage provided for your auto- (b) to an automobile which you acquire if:
mobile also applies to certain other auto- 1) it replaces your automobile. You
mobiles. It applies: must report the replacement auto-
(1) to an automobile you do not own which is mobile to us no later than:
temporarily used as a substitute for your a) the expiration date; or
automobile. Your automobile must be out b) 30 days after you take posses-
of use because of breakdown, repair, ser- sion if the replacement auto-
vicing, loss or destruction. The owner of the mobile is acquired less than 30
substitute automobile is not covered. days prior to the expiration date
(2) to an automobile which you acquire if: of the policy term during which the
(a) it replaces your automobile. You must automobile was acquired.
report the replacement automobile to 2) it is an additional automobile, pro-
us no later than: vided you:
1) the expiration date; or a) report the additional auto-
2) 30 days after you take possession if mobile to us within 30 days
the replacement automobile is ac- after you take possession; and
quired less than 30 days prior to the b) pay any required additional
expiration date premiums.
of the policy term during which the auto- (2) When an automobile described by and sub-
mobile was acquired; or ject to the conditions in f.(1)(b) above:
(b) it is an additional automobile, provided (a) is not provided Comprehensive Cover-
you: age, then Comprehensive Coverage
1) report the additional automobile to shall be provided with a $500 deduct-
us within 30 days after you take ible; or
possession; and (b) is not provided Collision Coverage, then
2) pay any required additional Regular Collision Coverage shall be pro-
premiums. vided with a $500 deductible
This extension does not apply if you have for the lesser of:
other liability insurance that applies to the (a) 30 days from the date the automobile
automobile you acquire. was acquired; or
(b) the expiration date of the policy term
2. Under SECTION III - DAMAGE TO YOUR AUTO- during which the automobile was ac-
MOBILE, 1. COVERAGES, f. Other Automobiles quired when such policy term is not
Covered is deleted and replaced by the following: renewed.
f. Other Automobiles Covered These extensions do not apply when there is
(1) The Damage To Your Automobile Cover- other insurance covering your interest or the
ages provided for your automobile also ap- interest of the owner. However, paragraph
ply to certain other automobiles. They f.(1)(a) above applies if you are legally liable.
apply:
(a) to an automobile you do not own which All other policy terms and conditions apply.
is temporarily used as a substitute for

69271 (5-14)Z Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 69514 (8-21)

ROAD TROUBLE SERVICE


Automobile Policy

It is agreed:

SECTION III - DAMAGE TO YOUR AUTOMOBILE, 2. DAMAGE TO YOUR AUTOMOBILE


1. COVERAGES is amended. Paragraph e. Road applies to such automobile.
Trouble Service is deleted and replaced by the In the event that such automobile is towed or
following paragraph. transported to a service facility, other than the
e. Road Trouble Service nearest qualified service facility, located more
(1) When Road Trouble Service is shown in the than fifteen (15) miles from the place of
Declarations for your automobile and the disablement, you will be responsible for the
towing service representative is contacted at additional charges.
1-888-869-2642 or through the Auto-Owners (2) When Road Trouble Service is shown in the
Mobile app, in any one disablement we will: Declarations for your automobile and the
(a) pay for: towing service representative is not contacted at
1) towing or transporting such automobile 1-888-869-2642 or through the Auto-Owners
to the nearest qualified service facility or Mobile app, in any one disablement we will
a service facility of the operator's choice reimburse you the actual cost up to and
located fifteen (15) miles or less from including one hundred dollars ($100) for your
the place of disablement; and automobile or an automobile when coverage
2) the cost of labor performed on such under SECTION IV - INDIVIDUAL NAMED
automobile at the place of disablement. INSURED, 2. DAMAGE TO YOUR
(b) reimburse you for: AUTOMOBILE applies. This includes:
1) towing or transporting an automobile to (a) towing or transporting to the service facility
the nearest qualified service facility or a of the operator's choice; and
service facility of the operator's choice (b) the cost of labor performed at the place of
located fifteen (15) miles or less from disablement.
the place of disablement; and You will be responsible for any charges that
2) the cost of labor performed on an exceed the limit of one hundred dollars ($100).
automobile at the place of disablement No deductible applies.
when coverage under SECTION IV -
INDIVIDUAL NAMED INSURED, All other policy terms and conditions apply.

69514 (8-21) Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 69557 (11-18)Z

ORIGINAL EQUIPMENT MANUFACTURER PARTS


Automobile Policy

It is agreed:

SECTION III – DAMAGE TO YOUR AUTOMOBILE, 4. repairs may include use of aftermarket,
LIMIT OF LIABILITY is amended. reconditioned or recycled parts.
1. Paragraph a. is deleted for purposes of this endorse- b. Safety equipment will be repaired or replaced
ment only. with new original equipment manufacturer parts
2. The following provision is added. when available.
We will pay no more than the lowest of the following: c. Age means the current calendar year minus the
a. the necessary cost, at local prices, to repair or model year of your automobile stated in the
replace damaged parts with: Declarations.
(1) new original equipment manufacturer parts d. Safety equipment means:
through the age of two years, if reasonably (1) air bag components;
available; or (2) brakes;
(2) material of similar kind and quality after the (3) seat belts;
age of two years; (4) steering components, including tie rods;
b. the actual cash value of stolen or damaged (5) steering racks;
property; or (6) suspension components, both front and
c. the Limit of Liability stated in the Declarations. rear; or
3. For purposes of this endorsement only: (7) tires.
a. When new original equipment manufacturer
parts are specified, but such parts are not All other policy terms and conditions apply.
reasonably available or if you and we agree,

69557 (11-18)Z Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 69602 (11-20)

ROAD TROUBLE SERVICE - TRAILERS


Automobile Policy

It is agreed:

SECTION I - DEFINITIONS is amended. The following or through the Auto-Owners Mobile app, in any
definition is added for purposes of this endorsement one disablement we will pay for:
only. (a) towing or transporting such trailer to the
Your trailer means the trailer described in the nearest qualified service facility or a service
Declarations. facility of the operator's choice located
fifteen (15) miles or less from the place of
SECTION III - DAMAGE TO YOUR AUTOMOBILE, 1. disablement; and
COVERAGES is amended. Paragraph e. Road Trouble (b) the cost of labor performed on such trailer
Service is deleted and replaced by the following at the place of disablement.
paragraph. In the event that such trailer is towed or
e. Road Trouble Service transported to a service facility, other than the
(1) If a dollar amount is shown in the Declarations nearest qualified service facility, located more
as applying to Road Trouble Service for your than fifteen (15) miles from the place of
trailer and the towing service representative is disablement, you will be responsible for the
contacted at 1-888-869-2642 or through the additional charges.
Auto-Owners Mobile app, in any one (3) If no dollar amount is shown in the Declarations
disablement we will pay for: as the limit applying to Road Trouble Service for
(a) towing or transporting your trailer to the your trailer and the towing service
nearest repair facility; and representative is not contacted at
(b) the cost of labor performed on such trailer 1-888-869-2642 or through the Auto-Owners
at the place of disablement. Mobile app, in any one disablement we will
We shall not be liable for more than the Limit of reimburse you the actual cost up to and
Liability shown in the Declarations for Road including seventy-five dollars ($75) for your
Trouble Service under this policy in any one trailer. This includes:
disablement involving your trailer. (a) towing or transporting such trailer to the
However, if the towing service representative is service facility of the operator's choice; and
not contacted at 1-888-869-2642 or through the (b) the cost of labor performed on such trailer
Auto-Owners Mobile app, the most we will at the place of disablement.
reimburse you is seventy-five dollars ($75) in You will be responsible for any charges that
any one disablement. exceed the applicable limit of seventy-five
(2) If no dollar amount is shown in the Declarations dollars ($75).
as the limit applying to Road Trouble Service for No deductible applies.
your trailer and the towing service
representative is contacted at 1-888-869-2642 All other policy terms and conditions apply.

69602 (11-20) Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 69611 (4-18)

CUSTOM EQUIPMENT, FURNISHINGS AND ELECTRONICS COVERAGE


Automobile Policy

It is agreed:

1. SECTION I – DEFINITIONS is amended. Definition (5) property covered under the Personal
3. Equipment is deleted and replaced by the Property Coverage of this policy.
following.
3. Equipment: 2. SECTION III – DAMAGE TO YOUR AUTOMOBILE
a. means: is amended.
(1) an apparatus or device: a. 2. EXCLUSIONS is amended.
(a) attached to or installed in or upon (1) Exclusions i., j. and m. are deleted.
your automobile; or (2) Exclusions k. and l. are deleted and
(b) designed for use with, but detached replaced by the following.
from, your automobile; k. Unless described in the Declarations
(2) custom paint, decals, carpet or similar and a premium charged:
type items; 1) a camper body or truck camper; or
(3) stereo tapes, cassettes, discs or 2) a pickup cover with built-in cooking
cartridges and related items; and sleeping equipment.
(4) any caddy, case or container designed l. A citizens-band radio and a mobile or
for storing or carrying stereo tapes, cellular telephone.
cassettes, discs or cartridges; or However, these devices are covered if
(5) a radio, television or other similar device standard or optional from the
for sending or receiving manufacturer of your automobile for
communications, a stereo, stereo tape that make, model and model year.
deck, compact disc player or other b. 4. LIMIT OF LIABILITY is amended.
similar device designed for the (1) The following provision is added to
reproduction of sound, including related paragraph a.
items. However, the most we will pay for loss or
However, this only applies if such items damage to equipment shall not exceed one
are not standard or optional from the thousand five hundred dollars ($1500) in any
manufacturer of your automobile for one occurrence unless a higher limit is
that make, model and model year and shown in the Declarations under Custom
are receiving power from the electrical Equipment and Electronics.
system of your automobile. (2) Paragraph c. is deleted.
b. does not include:
(1) anything attached to real estate; 3. SECTION VI - GENERAL CONDITIONS,
(2) removable child safety seats; 6. DUPLICATION OF COVERAGE is amended.
(3) a trailer; Paragraph a. does not apply to this coverage only.
(4) property used in a business, trade or
profession; or All other policy terms and conditions apply.

69611 (4-18) Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 79204 (6-92)Z

Michigan
COLLISION COVERAGE AMENDATORY ENDORSEMENT
Automobile Policy

It is agreed:

1. When BROAD COLLISION is shown in the Declarations and a premium charged, the Collision Coverage applying to
your automobile is changed as follows:

a. the deductible amount shown in the Declarations shall not apply if collision damage to your automobile is sus-
tained in an accident; and

b. the operator of your automobile, by his or her action or inaction, was not more than 50% of the cause of the
accident.

2. When LIMITED COLLISION is shown in the Declarations and a premium charged, Collision Coverage applies to your
automobile only;

a. with respect to accidental collision damage to your automobile; provided

b. the operator of your automobile, by his or her action or inaction, was not more than 50% of the cause of the
accident.

If your automobile is damaged while parked in such a way as to not cause unreasonable risk of the damage which
occurs, we shall pay for damage which is not covered by Property Protection Insurance under Section 3121 of the
Michigan Insurance Code.

3. Under BROAD COLLISION and LIMITED COLLISION, the determination;

a. as to whether the operator of your automobile was more than 50% of the cause of the accident; and

b. the amount of the loss;

shall be made by agreement between you and us. If both parties do not agree, either may demand in writing that the
unresolved matter be settled by arbitration.

All other policy terms and conditions apply.

79204 (6-92)Z Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 79299 (3-99)Z

RENTED AUTOMOBILE REPLACEMENT COVERAGE


Automobile Policy

It is agreed:

1. DEFINITIONS

The following definition applies to this endorsement in addition to those contained in SECTION I - DEFINITIONS of
the policy.

Rented automobile means a private passenger automobile or a truck with a registered gross vehicle weight of
26,000 pounds or less, owned by and registered in the name of a person or organization licensed to be engaged in
the business of renting automobiles, without drivers, to others provided the automobile use rate is determined on a
monthly, weekly or daily basis and the rental agreement is for a period of 30 days or less.

2. COVERAGE

The coverage provided by SECTION IV - INDIVIDUAL NAMED INSURED to a rented automobile, rented by you or
a relative who does not own an automobile, shall include the following provision provided your automobile is insur-
ed for both COMPREHENSIVE COVERAGE and COLLISION COVERAGE by the policy.

If, as a result of accidental loss or damage, we and the owner of the rented automobile agree that it is a construc-
tive total loss and the terms of the written rental agreement require the rented automobile be replaced with a new
automobile, we shall replace the rented automobile with a new automobile:

a. of the same make and model; and

b. of the current model year; and

c. with comparable equipment and operating features.

If such automobile is not available, we shall provide a new replacement automobile of comparable type and quality.

This provision applies without regard to fault or negligence on the part of you or your relative.

All other policy terms and conditions apply.

79299 (3-99)Z Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 79536 (7-94)Z

LOSS OF USE - RENTAL FEE REIMBURSEMENT


Automobile Policy

It is agreed:

1. COVERAGE

If your automobile is a private passenger automobile insured for Comprehensive Coverage and Collision Cover-
age by the policy; and

a. those coverages extend to a private passenger automobile you rent from a licensed rental automobile agency;
and

b. that rental automobile sustains loss or damage covered by the policy;

we will reimburse you for payment of the daily or weekly rental fee that would have been paid if the rental auto-
mobile had not sustained loss or damage.

2. CONDITIONS

The following conditions apply in addition to those contained in SECTION VI - GENERAL CONDITIONS of the policy.

a. You must be required by the rental agreement to continue payment of the daily or weekly rental fee when loss or
damage to the rental automobile:

1) prevents rental of that automobile to others; and

2) the loss or damage is covered by the policy.

b. You must report the occurrence that results in the rental automobile being unavailable for use to us as soon as
practicable.

c. We will provide this coverage for a period beginning the day following the occurrence and ending, regardless of
the policy expiration date, at the earliest of the following:

1) the day repairs to the rental automobile are completed;

2) the day we make payment for replacement of the rental automobile; or

3) thirty (30) days after the date coverage begins.

However, coverage will not exceed a period longer than that required to repair or replace the rental automobile,
exercising due diligence and dispatch.

d. You must submit proper receipts to us for all expenses claimed under this coverage.

e. If you are covered by your employer's insurance policy, then the Company writing your employer's insurance
policy has primary responsibility to pay claims arising from the use of the rented vehicle. The coverage provided
by this endorsement shall be excess over any coverage provided by your employer's policy.

All other policy terms and conditions apply.

79536 (7-94)Z Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 79539 (3-99)Z

COMBINED LIMIT OF LIABILITY


Automobile Policy

It is agreed:

Under SECTION II - LIABILITY COVERAGE, 4. LIMIT OF LIABILITY is deleted and replaced by the following:

LIMIT OF LIABILITY

We will pay damages for bodily injury or property damage up to the limit of liability stated in the Declarations for this
coverage. Such damages shall be paid as follows:

a. The limit stated for "each occurrence" is the total amount of coverage and the most we will pay for damages because
of or arising out of all bodily injury and property damages in any one occurrence.

b. Subject to the provisions of a. above, the limit of liability applicable to a trailer, non-motorized farm machine or farm
wagon which is connected to an automobile covered by this policy shall be the limit of liability stated in the
Declarations for this coverage as it applies to such automobile. The automobile and connected trailer, non-
motorized farm machine or farm wagon are considered one automobile and do not increase the limit of liability.

c. The limit of liability applicable to a trailer covered by this policy:

(1) which is not connected to an automobile; or

(2) which is connected to an automobile not covered by this policy;

shall be the limit liability applicable to your automobile. If this policy covers more than one of your
automobiles, the highest limit of liability applicable to any one such automobile shall apply.

d. The limit of liability for this coverage may not be added to the limits for the same or similar coverage applying to other
automobiles insured by this policy to determine the amount of coverage available for any one occurrence regardless
of the number of:

(1) automobiles shown in the Declarations:

(2) premiums charged in the Declarations or premiums paid;

(3) claims presented or suits brought;

(4) persons injured; or

(5) automobiles involved in the occurrence.

All other policy terms and conditions apply.

79539 (3-99)Z Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 79701 (5-17)Z

Michigan
POLICY CANCELLATION AND NONRENEWAL
Automobile Policy

It is agreed:

SECTION VI - GENERAL CONDITIONS is amended. c. We may cancel for any reason conforming to
The following conditions are added. our underwriting rules if this policy has been in
CANCELLATION effect for 55 days or less. We may cancel only
1. You may cancel this policy by notifying us of the for one of the following reasons if this policy has
date on which cancellation is to take effect. been in effect for more than 55 days:
2. a. We may cancel this policy by mailing or deliver- (1) nonpayment of premium; or
ing written notice stating the reason for cancel- (2) the named insured or any other operator,
lation to you at your last address known to us either resident of the same household or
or our authorized agent. who customarily operates an automobile
b. This notice shall be mailed or delivered at least: insured under this policy, has had his or her
(1) 10 days prior to the effective date when can- operator's license suspended during the pol-
cellation is for nonpayment of premium; icy period and the revocation or suspension
(2) 20 days prior to the effective date when can- has become final; or
cellation is for other than nonpayment of (3) that during the 55 days following the date of
premium and this policy has been in effect original issue thereof, the risk is unaccept-
for 55 days or less; or able to us.
(3) 30 days prior to the effective date when can- NONRENEWAL
cellation is for other than nonpayment of If we decide not to renew this policy, we will mail or de-
premium and this policy has been in effect liver written notice stating the reason for nonrenewal to
more than 55 days. you at your last address known to us or our authorized
agent. This notice shall be mailed or delivered at least
30 days prior to the expiration of this policy.

All other policy terms and conditions apply.

79701 (5-17)Z Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 89281 (4-10)Z

Michigan
AMENDATORY OF SECTION IV - INDIVIDUAL NAMED INSURED
Automobile Policy

It is agreed:

1. For this endorsement only, the definition of you or c. We do not cover:


your is superseded by the following definition. (1) the owner of the automobile (that is not
a trailer).
You or your means an individual shown as named (2) an automobile used in the business or
insured in the Declarations and your spouse who occupation of any named insured or that
resides in the same household. Your spouse shall of a relative, unless it is:
be considered a resident of your household when: (a) a private passenger automobile;
a. there is a legitimate marital covenant; and
b. you and your spouse share economic and non- (b) used by you, such relative or the
economic burdens; and chauffeur or household employee of
c. there are legitimate reasons for your spouse to either.
be living in another home or location. (3) you or a relative using an automobile
(that is not a trailer) without a reason-
2. SECTION IV - INDIVIDUAL NAMED INSURED is able belief of permission to do so.
deleted and replaced by the following.
2. DAMAGE TO YOUR AUTOMOBILE
SECTION IV - INDIVIDUAL NAMED INSURED a. The Damage to Your Automobile Cover-
ages provided for your automobile also
The following extensions of coverage apply if a apply to an automobile not:
named insured shown in the Declarations is an (1) owned by or furnished or available for
individual and an automobile described in the regular use to you or anyone living with
Declarations is a private passenger automobile. you.
(2) used in an automobile garage, repair
1. LIABILITY COVERAGE - BODILY INJURY shop, sales agency, service station or
AND PROPERTY DAMAGE public parking business you own or
a. The Liability Coverage provided for your operate.
automobile (that is not a trailer) also ap- b. We extend this coverage only:
plies to an automobile (that is not a trailer) (1) to you; and
not: (2) to relatives:
(1) owned by or furnished or available for (a) who do not own an automobile
regular use to you or anyone living with (that is not a trailer); or
you. However, we will cover your lia- (b) who own an automobile described
bility for your use of an automobile in the Declarations.
(that is not a trailer) owned by or fur- c. We do not cover an automobile used in
nished for the regular use of a relative. your business or occupation or that of a
(2) used in an automobile garage repair relative unless it is:
shop, sales agency, service station or (a) a private passenger automobile; and
public parking business you own or (b) used by you or such relative, or the
operate. chauffeur or household employee of
b. We extend this coverage only: either.
(1) to you; d. These extensions do not apply when there is
(2) to relatives; other insurance covering your interest or the
(a) who do not own an automobile interest of the owner. However, they do
(that is not a trailer); or apply if you are legally liable.
(b) who own an automobile described
in the Declarations; and All other policy terms and conditions apply.
(3) to anyone legally responsible for the use
of the automobile (that is not a trailer)
by the person in b.(1) and b.(2) above.
89281 (4-10)Z Page 1 of 1
Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 99457 (7-20)

Michigan
COORDINATION OF PERSONAL INJURY PROTECTION
Automobile Policy

It is agreed:

Michigan Personal Injury Protection (19942) is amended (2) all available health and accident coverage
for purposes of this endorsement only. The following providers:
provisions are added. (a) determine there is no authorized health
1. SECTION I - DEFINITIONS is amended. The care provider qualified to provide
following definition is added. treatment; and
Health care provider means a person licensed, (b) determine there are no prescribed
certified, or registered under parts 61 to 65 or 161 to guidelines for obtaining treatment from
182 of the Public Health Code, Act No. 368 of the any health care provider; and
Public Acts of 1978, being sections 333.6101 to (c) deny coverage for treatment.
333.6523 and 333.16101 to 333.18237 of the b. WORK LOSS
Michigan Compiled Laws. When the Declarations state Work Loss is
Excess, the work loss benefits provided to the
2. SECTION III - CONDITIONS is amended. The named insured or a relative in accordance with
following conditions are added. Chapter 31 of the Michigan Insurance Code do
a. ALLOWABLE EXPENSES not apply until all work loss benefits available
When the Declarations state Allowable from any health or accident policy or plan have
Expenses is Excess, the medical expense been paid. We will pay work loss benefits only
benefits provided to the named insured or a to the extent they are not eligible for payment by
relative in accordance with Chapter 31 of the any health or accident policy or plan.
Michigan Insurance Code do not apply until
either: 3. The following provision is added.
(1) treatment has been sought and received DEDUCTIBLE
from all sources of health and accident When the Declarations state Allowable Expenses or
coverage available to the named insured or Work Loss are Excess, and there is not applicable
relative in accordance with the prescribed health or accident coverage, a $500 deductible per
guidelines of the health and accident accident shall apply.
coverage providers:
(a) for determination of covered treatment; All other policy terms and conditions apply.
and
(b) for securing covered treatment; and
(c) for payment for covered treatment; or

99457 (7-20) Page 1 of 1


Agency Code 01-0764-00 Policy Number 41-205-904-00

Auto-Owners Insurance Company 99803 (7-16)Z

Michigan
AMENDATORY ENDORSEMENT
Automobile Policy

It is agreed:

1. Under SECTION I - DEFINITIONS, 12. is deleted time specified shall not invalidate any claim
and replaced by the following definition. made by you if it shall be shown not to have
12. You or your means the named insured shown in been reasonably possible to give such notice
the Declarations and if an individual, your within the time specified and that notice was
spouse who resides in the same household. given as soon as was reasonably possible.
If your spouse is not residing in your house- Notice should include the names and addresses
hold, your spouse shall be considered a resi- of any injured person and of any witnesses. No-
dent of your household when: tice and documentation of loss must be given if
a. there is a legitimate marital covenant; we require it. Any loss or damage caused by
b. you and your spouse share economic and theft, larceny, robbery, pilferage or trickery must
noneconomic burdens; and be promptly reported to the police.
c. there are legitimate reasons for your
spouse to be living in another home or loca- 3. Under SECTION VI - GENERAL CONDITIONS, 4.
tion. LEGAL ACTION AGAINST US, paragraph a. is de-
leted and replaced with the following:
2. Under SECTION V - WHAT YOU MUST DO AFTER a. No legal action may be brought against us until
AN ACCIDENT OR LOSS, 1. NOTIFY US there has been full compliance with all the terms
PROMPTLY, paragraph a. is deleted and replaced of this policy. Further, under the Liability Cov-
with the following: erage no legal action may be brought against us
a. You and any person seeking coverage under until a person entitled to coverage has an obliga-
this policy must notify us promptly as to how, tion to pay or until the amount of that obligation
when and where the accident happened. Notice has been determined by judgment after trial.
given by you or on your behalf to any author- No one has any right under this policy to bring
ized agent of ours, with particulars sufficient to us into any action to determine the liability of
identify you, shall be deemed to be notice to us. any person we have agreed to protect.
Failure to give any notice required within the
All other policy terms and conditions apply.

99803 (7-16)Z Page 1 of 1

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