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Alice owns a car and has a valid auto insurance policy that includes Personal Injury Protection (PIP) coverage. Bob, Alice’s boyfriend, doesn’t own a car but is a named insured on his parents’ auto insurance policy, which also includes PIP coverage. One day, Alice and Bob head off to a nearby restaurant with Bob driving Alice’s vehicle. While they are driving, Bob is involved in an at-fault accident with another vehicle. Alice, Bob, and the driver of the other vehicle sustain minor injuries in the accident

Since both Alice and Bob are insured individuals covered by PIP through their respective auto insurance policies, they can each access PIP benefits to cover their medical expenses and lost wages resulting from the accident. Alice will file a PIP claim with her insurance company and Bob will file a claim with his parents insurance company. The driver of the other vehicle will also file a PIP claim with their insurance company. It doesn’t matter who was driving or which vehicle they were in at the time of the accident; PIP benefits follow the insured individual.

Alice and Bob have immunity for the other driver’s injuries up to $10,000. Because Alice’s vehicle is insured; both Alice, the owner, and Bob, the driver, have immunity for up to $10,000 of the other driver’s injuries.

So, while both Alice and Bob can access PIP benefits regardless of the vehicle they were in, tort immunity protections primarily apply to the vehicles and their associated individuals involved in the accident.

Alice owns a car and does not have it currently insured. Bob, Alice’s boyfriend, doesn’t own a car but is a named insured on his parents’ auto insurance policy, which also includes PIP coverage. One day, Alice and Bob head off to a nearby restaurant with Bob driving Alice’s vehicle. While they are driving, Bob is involved in an at-fault accident with another vehicle. Alice, Bob, and the driver of the other vehicle sustain minor injuries in the accident.

Because Alice did not carry PIP coverage on her vehicle: she, as the owner; and Bob, as the driver; are both responsible for the other driver’s injuries including any pain and suffering, lost wages, and other injury related claims he can file. Both Alice and Bob are subject to loss of their driver license, and for Alice her car’s registration.

Alice owns a car and has a valid auto insurance policy that includes Personal Injury Protection (PIP) coverage with a $0 deductible. Bob, Alice’s boyfriend, doesn’t own a car but is a named insured on his parents’ auto insurance policy, which also includes PIP coverage. One day, Alice and Bob head off to a nearby restaurant with Bob driving Alice’s vehicle. While they are driving, Bob is involved in an at-fault accident with another vehicle. Alice, Bob, and the driver of the other vehicle sustain minor injuries in the accident. Alice files a PIP claim with her own insurance company.

Alice’s injuries total $8,000; and she will be paid $6,400 by her insurance company. Calculated as:

[$8,000 – $0] X 80% = $6,400

If, Alice had a $500 PIP deductible her claims payment would be $6,000.

[$8,000 – $1,000] X 80% = $6,000

And if she had a $1,000 PIP deductible her claims payment would be $5,600.

[$8,000 – $1,000] X 80% = $5,600

Alice Shirley, a Florida resident, is driving her car when she’s involved in an accident caused by another driver. As a result, Alice suffers $8,000 in injuries. Fortunately, Alice has Personal Injury Protection coverage as part of her auto insurance policy. Since the accident occurred in Florida, Alice is covered by her PIP insurance. Therefore, Alice’s PIP coverage will pay for her medical expenses and other related costs up to her $10,000 policy limit.

Now image that Alice Shirley, a Florida resident, is visiting her friend in Georgia. While riding in her friend’s car, they are involved in an accident that causes Alice to suffer $8,000 in injuries. Unfortunately, Alice’s injuries are not covered by her PIP coverage. Florida PIP coverage extends to the insured when they are outside of the state of Florida only when the insured is in their own vehicle or in a vehicle owned by a resident relative.

Alice Shirley, a Florida resident, is driving her car when she’s involved in an accident caused by another driver. Alice is accompanied by Betty, her mother who lives with her now on a permanent basis. As a result, Alice suffers $8,000 in injuries and Betty suffers $5,000 in injuries. Fortunately, Alice has Personal Injury Protection coverage with a $0 deductible s as part of her auto insurance policy. Since the accident occurred in Florida, Alice is covered by her PIP coverage; and Betty, her residing relative is also covered by Alice’s PIP coverage. Therefore, Alice’s PIP coverage will pay up to the $10,000 policy limit for both Alice’s and Betty’s medical expenses and other related costs on an individual basis; that is, up to $10,000 for each injured person.

Alice’s injuries total $8,000; and she will be paid $6,400 by her insurance company. Calculated as:

[$8,000 – $0] X 80% = $6,400

Betty’s injuries total $5,000; and she will be paid $4,000 by her insurance company. Calculated as:

[$5,000 – $0] X 80% = $4,000

Now image that Betty was visiting a friend in Georgia. While riding in the friends car, Betty and her friend are involved in an accident that causes Betty to suffer $5,000 in injuries. Betty’s injuries would not be covered under her daughter’s PIP coverage; she is a residing relative to be sure, but the accident occurred outside of the state of Florida and Betty was not injured while occupying the named insured’s vehicle.

If that same accident had occurred in Georgia and Betty was in Alice’s car then her medical expenses would have been covered by Alice’s PIP coverage.

John Anderson, a Florida resident, is driving his insured motor vehicle on a busy Memorial Day near his favorite Florida beach. John looked down for just a second to change the radio station when he rear-ended another driver at a stoplight. The accident causes significant damage to John’s car and injuries to both John and the other driver, Sarah.

Under Florida’s No-Fault law, John’s Personal Injury Protection (PIP) coverage will initially cover his medical expenses and lost wages (limits apply), regardless of who was at fault in the accident. Therefore, John’s PIP coverage will pay for his medical bills and any lost income while he recovers from his injuries.

However, Sarah, the other driver, suffers from severe whiplash and experiences significant pain and suffering due to the accident. Sarah’s injuries meet one of the PIP exceptions, specifically the “significant and permanent loss of a bodily function.” As a result, Sarah can pursue legal action against John beyond her own PIP coverage limits to seek compensation for her pain, suffering, and other non-economic losses.

In this scenario, although John is initially protected by PIP coverage, Sarah’s injuries meet the threshold for exceptions outlined in Florida’s No-Fault law, allowing her to file a legal claim against John for additional damages beyond what PIP covers.

Vehicles	Eligible
Private passenger autos	Yes
Pickups & Vans with gross vehicle weight under 10,000 pounds	Yes (not used for goods/materials)

Category	Coverage
Vehicle listed in the policy’s Declarations	Yes
Newly acquired autos	Yes
Owned trailers	Yes
Non-owned auto or non-owned trailers used as temporary replacement	Yes

Keep in mind that the coverage for any temporary substitute auto or trailer is for any vehicle described in the definition section of the policy which is out of normal use because of its:

• Breakdown
• Repair
• Servicing
• Loss
• Destruction

Keep in mind that a “your covered auto” does not have coverage for physical damage to these vehicles.

Bert Scott sufre lesiones permanentes debido a un accidente causado por Earnie. Los daños totales de Bert (económicos y no económicos) ascienden a $50,000. Bert está cubierto por el seguro de Protección contra Lesiones Personales (PIP), del cual ya ha recibido el límite completo de $10,000. Además, Bert tiene cobertura contra conductores sin seguro (UM) con un límite de $50,000/$100,000. Earnie, el conductor culpable, tiene un seguro de responsabilidad civil con límites de 10/20/10.

La recuperación de UM de Bert se calcula de la siguiente manera:

Daños totales: $50,000

Menos recuperación de PIP: $10,000

Menos la recuperación de la cobertura del seguro de responsabilidad civil: $10,000

Bert puede cobrar los $30,000 restantes en daños bajo su cobertura para conductores sin seguro.

Bert Scott sustains permanent injuries due to an accident caused by Earnie. Bert’s total damages (economic and non-economic) amount to $250,000. Bert is covered by Personal Injury Protection (PIP) insurance, from which he has already received the full $10,000 limit. Additionally, Bert has stacked Uninsured Motorist (UM) coverage with a limit of $50,000/$100,000, and Bert has two vehicles on his policy. Earnie, the at-fault driver, has liability insurance with limits of 10/20/10.

Bert’s UM recovery is calculated as follows:

Total damages: $250,000

Minus PIP recovery: $10,000

Minus liability insurance coverage recovery: $10,000

Bert can collect $100,000 in damages under his Uninsured Motorists coverage. Bert’s UM coverage is $50,000 per person and it is stacked; basically, he has $50,000 per person + $50,000 per person for a total of $100,000 of Uninsured Motorist coverage. Unfortunately for Bert he only carried $50,000 per person of UM coverage; and thankfully he did his UM coverage stacked so he was able to collect an extra $50,000 of UM coverage.

What if the coverage was different? If Bert Scott sustains permanent injuries due to an accident caused by Earnie. Bert’s total damages (economic and non-economic) amount to $250,000. Bert is covered by Personal Injury Protection (PIP) insurance, from which he has already received the full $10,000 limit. But in this scenario Bert has stacked Uninsured Motorist (UM) coverage with a limit of $100,000/$300,000, and Bert has two vehicles on his policy. Earnie, the at-fault driver, has liability insurance with limits of 10/20/10.

Bert’s UM recovery is calculated as follows:

Total damages: $250,000

Minus PIP recovery: $10,000

Minus liability insurance coverage recovery: $10,000

Bert can collect $200,000 in damages under his Uninsured Motorists coverage. Bert’s UM coverage is $100,000 per person and it is stacked; basically, he has $100,000 per person + $100,000 per person for a total of $100,000 of Uninsured Motorist coverage. Unfortunately for Bert he only carried $100,000 per person of UM coverage; but thankfully he did his UM coverage stacked so he was able to collect an extra $100,000 of UM coverage.

John Bishop, the named insured, is driving to work in his personal car covered by his Personal Auto Policy (PAP). While driving, John realizes he needs to pick up some materials for a home renovation project. He calls his friend, Tom, who agrees to lend him his pickup truck for the afternoon.

The pickup truck lent to John by his friend Tom would be considered a “non-owned auto” under John’s PAP. This is because the pickup truck is not owned by John or furnished for his regular use but is temporarily being used by him.

If instead of borrowing the pickup truck from his friend, John decided to rent a pickup truck from a car rental agency for the same purpose, that rented pickup truck would be considered a “hired auto” under John’s PAP. This is because the pickup truck is not owned by John or furnished for his regular use but is specifically hired by him for a temporary period with a formal rental agreement.

In summary, while both terms refer to vehicles not owned by the insured, “hired autos” are intentionally rented or borrowed for a specific purpose with formal agreements like rentals or leases. “Non-owned autos” are used more incidentally and are not typically vehicles that the insured would use regularly or have formal rental agreements for.

Policy	Perils Insured Against
HO-2	named perils for all Section I Coverages
HO-3	"all-risk" coverage for Coverages A&B and named perils of HO-2 for Coverage C
HO-4	named perils for all Section I Coverages
HO-5	"open" perils coverage for Coverages A, B, & C (broadest form available) - keep in mind that "open perils" and "all risk perils" are the same.
HO-6	named perils coverage
HO-8	first (10) HO-2 named perils + volcanic eruption and catastrophic ground collapse; residence premises theft limited to $10,000 and building glass breakage limited to $100

On September 13, 2008, Hurricane Ike caused significant damage to Elie and Rhonda Nassar’s six acres of property. Their property included barns and outbuildings and over 4000 feet of fencing, including “a white picket fence at the northeast corner of their dwelling, an ornamental iron fence … in front of the dwelling, numerous cross fences, garden fences and pens, and a larger perimeter fence constructed of 2’ x 6’ lumber with wooden posts at eight-foot intervals, on which a welded wire mesh is attached.”

Their insurer valued the damage to their dwelling at $20,090.61 and the damage to their other structures at $70,449.02 but paid up to the policy limits for Coverage B, which in this case was $24,720.

The Nassars, however, believed that their fencing should be considered as part of the dwelling because it was attached to it. The policy does not define “structure,” and their fencing, they pointed out, was attached to their house at four separate points. The insurer, on the other hand, objected that “simply connecting 4,000 feet of fencing to the dwelling by four bolts does not attach the fencing to the dwelling.” Since the policy states that a fence cannot connect the dwelling to other structures, the fence itself must be an “other structure.”

The trial court found in favor of the insurance company. When the Nassars appealed, the court of appeals agreed with the trial court, but with a dissent that argued that the policy was ambiguous and that a decision should therefore have been made in favor of the Nassars. The Supreme Court then heard the case.

Based on dictionary definitions, it concluded that the fence was a structure, “composed of parts purposefully joined together,” and that it was attached, since it was “fastened to the dwelling either by being cemented to the brick and slab of the house (as the Nassars contend) or by ‘four bolts’ (as the insurance company contends). “Putting everything together and giving words their ordinary meaning in light of their common usage, the Nassars’ fencing is composed of parts purposefully joined together and fastened to the dwelling by bolts or cement…. We conclude that the Nassars’ policy interpretation is reasonable, and the applicable policy language is unambiguous.”

The court went on to note that the fencing did not fall under “other structures,” because the policy says that “other structures” are “set apart from the dwelling by clear space” and the fencing was not.

But, said the insurance company, if a fence attached to the dwelling is considered part of the dwelling and the fence is also attached at the other end to a barn, then the barn would also be attached to the dwelling—and that is exactly what the policy explicitly denies when it defines “other structures” as including “structures connected to the dwelling by only a fence.” Therefore, the fence cannot be included in the dwelling and must be seen as an “other structure” itself.

The court rejected this line of argument. It is true that the barn is not part of the dwelling since it is connected to the dwelling by only a fence. But that does not mean that the fence is not part of the dwelling. The Nassars’ fencing, “a structure clearly attached to their dwelling” so that it should be covered with the dwelling, is not required “to morph into an ‘other structure’ … simply because that same fencing cannot operate to connect other structures to the dwelling.”

But are all 4000 feet of fencing part of the dwelling? That said, the court, stated it was a matter for the trial court to resolve. “A fact finder may determine that only the fencing of the type originally bolted to the dwelling is covered” with the dwelling, whereas the pens and garden fencing and so on are “other structures.” Or perhaps, just as a barn connected to the dwelling by only a fence is an “other structure,” so a section of fence connected to the dwelling by only a section of fence should be considered an “other structure.” “Courts may have to treat fencing as both part of the ‘dwelling’ and ‘other structures’ depending on the circumstances. That is what the policy’s plain language requires.”

The court concluded that the Nassars’ interpretation of the policy was reasonable, and the insurance company’s was not, that there was no ambiguity, and that the trial court and court of appeals had both erred. It reversed the court of appeals’ judgment and remanded the case to the trial court for further proceedings consistent with this opinion.

Mary and John Knight own a house in a quiet suburban neighborhood. One evening, a severe thunderstorm swept through the area, causing a large tree to collapse onto their house, severely damaging the roof and rendering a portion of the house uninhabitable.

As a result of the covered peril (windstorm damage), Mary and John’s residence is deemed unfit for occupancy by local authorities and their insurance company. Fortunately, their ISO Homeowners Insurance policy includes Coverage D – Loss of Use.

Mary and John are forced to temporarily relocate to a nearby hotel while their home is being repaired. The insurance company covers the additional living expenses incurred by Mary and John during this period, such as hotel bills, restaurant meals, and laundry expenses, allowing them to maintain their normal standard of living despite the displacement.

Mary and John also rent out a portion of their home to tenants. Since the rented portion is now uninhabitable due to the storm damage, the insurance company reimburses them for the fair rental value of that space, less any expenses that do not continue while it remains unfit for occupancy. This ensures that Mary and John do not suffer financial loss due to the inability to collect rental income.

If local authorities prohibit Mary and John from accessing their home due to safety concerns stemming from the neighboring damage caused by the windstorm, Coverage D would also apply. The insurance company would cover the additional living expenses and fair rental value for up to two weeks while the civil authority prohibits access to the property.

In this example, Coverage D – Loss of Use provides Mary and John Knight with financial assistance to cover the temporary increase in living expenses and rental income loss incurred as a result of their home being rendered uninhabitable by a covered peril.

Cassie Pfenning, sixteen years old, attended a golf outing with her grandfather. Her grandfather had volunteered to drive a beverage cart at the event. He got the cart but then joined a shorthanded group of golfers and left Pfenning at the cart with her great aunt. About ten minutes later, the great aunt joined another group of golfers, but an employee of the tavern that promoted the event joined Pfenning, who then drove the cart around the golf course while the tavern employee served beverages to the golfers.

After several such trips around the course, Pfenning was suddenly struck in the mouth by a golf ball. Joseph Lineman, about eighty yards away, had hit the ball. The low drive was straight for the first sixty or seventy yards and then hooked to the left toward the cart. Lineman shouted “fore,” but Pfenning did not hear it. The golfer heard a “yelp” and ran after the ball and found that it had struck Pfenning, who suffered injuries to her mouth, jaw, and teeth.

Pfenning filed a damage action against Lineman among others. The trial court granted summary judgment in favor of all of the defendants, and Pfenning appealed. The court of appeals affirmed the trial court’s judgment. The case came to the Supreme Court, where Pfenning argued again that summary judgment was inappropriate because there were genuine disagreements about the facts.

The golfer, Joseph Lineman, argued that “he could not be held liable under a negligence theory because [Pfenning] was a co-participant in the sporting event, and her injuries resulted from an inherent risk of the sport.” The court recognized that to establish a claim of negligence, a plaintiff must establish that there was (1) a duty owed to the plaintiff by the defendant, (2) a breach of the duty, and (3) an injury proximately caused by the breach of duty.” The court also affirmed that public policy encourages participation in athletic activities and therefore discourages “excessive litigation of claims by persons who suffer injuries from participants’ conduct.”

The court concluded that, “in negligence claims against a participant in a sports activity, if the conduct of such participant is within the range of ordinary behavior of participants in the sport, the conduct is reasonable as a matter of law and does not constitute a breach of duty.” The court recognized, though, that “a participant’s particular conduct may exceed the ambit of such reasonableness as a matter of law if the ‘participant either intentionally caused injury or engaged in [reckless] conduct.’”

In this case, Lineman’s “hitting an errant drive which resulted in [Pfennig’s] injury … is clearly within the range of ordinary behavior of golfers and thus is reasonable as a matter of law and does not establish the element of breach required for a negligence action.” Pfenning argued that golf etiquette required shouting “fore” and that, while Lineman said he said and some others testified that they heard him, Pfenning herself did not hear him. The court recognized that a number of factors could have prevented her hearing Lineman, that yelling “fore” or not doing are both within ordinary golfing behavior, and therefore that “neither the omission nor manner of yelling ‘fore’ can be a proper basis for a claim of negligence in golf ball injury cases.”

The court therefore affirmed the previous courts’ decisions that Lineman was not negligent and therefore was not liable for Pfenning’s injuries.

When Jamie Sierfeld lost her job she moved back into the home of her parents, Curtis and Michele Sierfeld. About four months later, the family dog bit her, causing severe injury to her face that required several surgeries and psychological counseling. She sought compensation from her parents’ insurer both for damages for which, she said, they were liable and for medical expenses.

The insurance policy specifically excluded coverage for damages for an insured, defined to include a resident relative, and for medical expenses for “bodily injury to any insured person or regular resident of the insured premises.” The policy did not define “resident.”

The insurer denied coverage and sought summary judgment from the court on the basis of these exclusions. Jamie argued in response that the policy exclusions were ambiguous because they did not define “resident,” and therefore they must be read in such a way as to provide coverage for her. Alternatively, she said, she should not be considered a resident of her parents’ home because neither she nor her parents intended her to live there long-term. She had, in fact, moved into their house temporarily after losing her job, had planned to start her own business, and had intended to stay only six months—though she ended up staying longer after her injuries.

The trial judge mistakenly thought that the Sierfelds had given up their argument based on ambiguity, and so he focused only on whether Jamie was a resident of her parents’ home. He noted that both Jamie and her parents intended her stay to be temporary but also that “the arrangement was informal, flexible and without any specific duration … no different from any child living as a family member of a parents’ home.” She paid no rent or utility costs. She had meals occasionally with her family, though she purchased her own food because she, unlike her parents, was a vegetarian. He concluded that she “had sufficient connection to the insured premises to be considered a resident member of that household.”

Exception	Coverage
Vehicles in Dead Storage and those used to service the residence	COVERED
Golf Carts at the Insured Location and Golf Course	COVERED
Owned Off-road Recreational Vehicles (RV) at residence premises	COVERED
Non-owned RVs Worldwide	COVERED
Vehicles to Assist the Handicapped	COVERED