The Mutual Service Office (MSO) is a national service provider for mutual and stock companies, providing statistical reporting, product development, forms, filings, actuarial and other services. This discussion focuses on the Commercial Auto Form MCA 010 11 14 for Pennsylvania. MSO has advised us that their Pennsylvania forms are the best to use for standard coverage discussions.

The form provides liability and physical damage coverage for commercial auto exposures. Vehicles are designated by symbols, and defined terms are found at the end of the policy pages. A separate form, MCA 012 11 14 Commercial Auto Physical Damage Coverage Form is available as well and is discussed in a separate article. Because of the depth of analysis, we are breaking the analysis into segments. This is part 4, covering Part III A – Main Physical Damage Coverages, supplemental coverages, exclusions, limitations and special physical damage coverages.

Topics covered:

 

PART III A – MAIN PHYSICAL DAMAGE COVERAGES

INSURING AGREEMENT

A. We provide insurance for those of the following coverages for which a related limit of liability and related premium charge is shown in the Declarations subject to all applicable provisions.

B. Unless otherwise specifically provided in this policy, this insurance applies only to loss that takes place within the applicable coverage territory (Refer to Common Conditions) during the current policy term.

C. Insuring Agreement Qualification The following Coverages as described below are subject to certain Exclusions and Limitations, including the General Exclusions and Part III D.

ANALYSIS

There are three parts to the physical damage insuring agreement. The first part is the limit agreement, the second part is the agreement to cover a loss as defined in the policy that takes place in the applicable coverage territory during the policy term, in accordance with the Common Conditions in the policy. Lastly, the agreement contains certain exclusions and limitations to coverage as described in the General Exclusions and in Part III D.

COVERAGE F – COMPREHENSIVE

We pay for loss to a covered auto, including its equipment, under Comprehensive Coverage resulting from any cause of loss other than the following:

A. The covered auto's collision with another object.

B. The covered auto's overturn.

C. Causes of loss otherwise excluded or limited in this policy.

ANALYSIS:

Comprehensive coverage pays for loss to a covered auto meeting the policy's definition, including its equipment as a result of any cause except the auto's colliding with any object, the covered auto's overturn, or any other cause of loss that is excluded or limited in the policy. For example, if a covered auto slides off the roadway, collides with a fence and then overturns there will not be coverage for this loss under the Comprehensive coverage. If however, a covered auto is damaged by a bear searching for food, comprehensive coverage will cover this damage.

COVERAGE G – COLLISION

We pay for loss to a covered auto, including its equipment, under Collision Coverage resulting from the following:

A. The covered auto's collision with another object.

B. The covered auto's overturn.

ANALYSIS:

The collision coverage will cover the type of loss not covered in our first example of comprehensive coverage. If a covered auto slides off the roadway, collides with a fence and then overturns this loss would be covered under the Collision coverage.

COVERAGE H – TOWING

We pay for towing and labor expenses incurred when a covered private passenger type auto is disabled. The labor expenses are only for labor performed at the place of disablement.

ANALYSIS:

The towing and labor coverage only applies when a covered auto of the private passenger type is disabled. So if a covered car is in an accident and the car is not driveable, this coverage will pay for its tow and any expenses for labor that is necessary at the place where the car became disabled, such as replacing a blown tire so the car can be driven after an accident.

PART III B – SUPPLEMENTAL COVERAGES

The next section describes a number of supplemental coverages provided based on specific circumstances and to the extent that the coverages are applicable to the main coverages provided under the policy.

SUPPLEMENTAL COVERAGES – ADDITIONAL CONDITIONS

We provide the following Supplemental Coverages as extensions of the main coverages but only when, and then to the extent that, such main coverages apply under this policy.

These Supplemental Coverages are subject to all underlying provisions applicable in this policy, except to the extent specifically modified in Part III B.

ANALYSIS:

The supplemental coverages extend coverages that are already provided under the policy, so if the policy does not already provide that specific coverage then the supplemental coverage will not apply, unless otherwise provided for in Part III B of the policy.

1. CERTAIN ELECTRONIC EQUIPMENT COVERAGE Coverage is extended to the following equipment:

A. Equipment designed solely for the reproduction of sound or video or as a global positioning system (GPS) and accessories used with such equipment, provided such equipment is permanently installed in the covered auto at the time of the loss.

B. Such equipment that is removable from a housing unit which is permanently installed in the covered auto at the time of loss, and such equipment is designed to be solely operated in or upon the covered auto by use of the power from the auto's electrical system.

C. Any other electronic equipment that is:

1. Necessary for the normal operation of the covered auto or the monitoring of the covered auto's operating system; or 2. An integral part of the same unit housing any sound reproducing equipment described in the preceding Paragraph A and permanently installed in the opening of the dash or console of the covered auto normally used by the manufacturer for installation of a radio.

ANALYSIS:

The first supplemental coverage is for certain permanently installed equipment, navigational systems such as Onstar and GPS systems, audio equipment such as stereos, and two-way radios, CB radios, and video equipment such as dashboard TVs, DVD players, or monitors. The equipment need not be permanently installed by the auto manufacturer; aftermarket equipment is covered so long as it is permanently installed, as described in paragraph C.2., which could include specialty radios, scanners and DVD equipment.

Permanently installed is not defined in the policy, but its meaning was the subject of a 1978 case decided by a New York supreme court appellate division. In that case, Troncillito v. Farm Family Mutual Insurance Co., 63 A.D.2d 1042 (N.Y.A.D. 1978), the court held that a citizens band radio and a scanner bolted to brackets which in turn were bolted to the underside of the insured's truck were permanently installed to the truck. The insured's testimony that he intended to remove the radio and scanner from the truck if it were sold did not alter the status of the equipment. The important factor, in the eyes of the court, was the insured's intent to keep the equipment installed for as long as he owned the truck. The court relied upon a legal definition of "permanent" which stated that "permanent" does not imply a perpetual installation.

Equipment that is removable from a housing unit which is permanently installed in the covered auto at the time of loss, and powered by the auto's electrical system. A housing unit for electrical components for use in the automobile sector includes a housing part configured to be closed in a sealed manner by a housing cover arrangement. The housing cover arrangement comprises a membrane, at least one ventilation opening, a main cover element comprising a recess, and a cover closure element. This has to do with such things as the vehicle's electrical charging unit, battery, ignition system, computer chips, or spark plugs. With the advent of 5G and increasing technology, it is conceivable that this list could grow.

Equipment necessary for operating or monitoring the operations of the covered auto would include virtually anything needed to run the auto or to monitor its operations such as a fuel or temperature sensor. Since equipment is not defined, it will be given its broadest meaning, but it must be something that keeps the auto in operating order or gauges how to keep the auto operational.

2. FALLING OBJECTS, GLASS BREAKAGE, IMPACT WITH AN ANIMAL / BIRD

If the damaged covered auto is insured for Comprehensive Coverage under this policy, we will pay for the following damage under Comprehensive Coverage:

A. Glass breakage.

B. Loss caused by falling objects or missiles.

C. Loss caused by an impact with an animal or bird.

However, you may elect to have glass breakage that results from a covered auto's collision or overturn settled as a Collision Coverage loss.

ANALYSIS:

This supplemental coverage only applies if the insured has purchased Comprehensive coverage under the policy. If so, the policy will pay for three additional comprehensive coverages:

Glass breakage – this covers replacement of windshields or door glass from any cause, so if a rock flies up from the roadway and puts a crack in the windshield this coverage will pay for the window glass repair or its replacement.

The second coverage is for falling objects or missiles. Hopefully, no one will have a claim for a falling missile damaging their auto, but if so the damage will be covered here. It is more likely that a wayward baseball could damage an auto, or a tree branch may fall on the roof of an auto. So with this coverage, no matter what is falling, if it damages the covered auto, this supplementary coverage will kick in.

Under this supplemental coverage, a loss will be covered if the covered auto comes into contact with an animal or bird causing damage to the auto. While rare, recently a car was damaged by a flying eagle. This loss would be covered if comprehensive coverage was purchased under this form. It is very common for autos to come into contact with animals such as deer, elk, moose or even bears. This type of loss would also be covered by this supplementary coverage.

3. INDIVIDUAL NAMED INSURED COVERAGE

A. If you are an individual, coverage is extended as follows:

1. While any private passenger type auto you own is a covered auto for physical damage coverage, a nonowned auto is also a covered auto for such coverage.

2. Our maximum limit of liability for loss to a nonowned trailer under the preceding Paragraph 1 is $500.

B. Glossary As used in this coverage extension, nonowned auto means any private passenger type auto, pickup or van type truck, or trailer, that is not owned by, or available or furnished for the regular use of, you or a family member while such vehicle is being operated by, or in the custody of, you or a family member.

ANALYSIS:

This supplemental coverage requires an amendment to the Glossary section of the policy to describe a nonowned auto. A nonowned auto is one not owned by, available to, or furnished for, the regular use of an [individual named] insured or family member of a specific auto type to include a private passenger auto, pickup truck, van, or trailer. Coverage will only apply while the vehicle is being operated by or is in the custody of the [individual named] insured or family member.

The coverage provided is for physical damage to the nonowned auto, but only if physical damage coverage is provided for covered autos. The coverage as it applies to trailers is limited to $500.

This is basically physical damage coverage that will extend to a private passenger auto or trailer that is rented, hired, borrowed, or loaned to an individual named insured, as long as that type of auto is otherwise covered for physical damage under the policy.

4. TRANSPORTATION EXPENSE COVERAGE – ADDITIONAL INSURANCE

A. We will pay necessary reasonable transportation expenses that you incur because of the total theft of a covered private passenger type auto that is insured for Comprehensive Coverage under this policy.

B. Our maximum liability per occurrence under this Supplemental Coverage is $600 subject to a maximum $20 per day limit. We pay only for such expenses incurred during the period that begins 48 hours following the theft and ends when the covered auto is either returned to use or we pay for its loss. The described period is not limited by expiration of the policy term.

ANALYSIS:

Again, this supplementary coverage is only available if the policy covers private passenger type autos for Comprehensive Coverage. If so, if the insured's covered private passenger auto is stolen and as a result of the theft the insured has to obtain other transportation, then this will provide the insured with up to $20 each day for such expenses, beginning after a waiting period of 48 hours following the theft. The limit applies for each theft occurrence at a maximum of $600. The coverage will end when the insured's auto is returned to use, or the carrier pays for the loss, whichever comes first, and this time period will not be cut short by the policy's expiration.

5. HIRED AUTO LOSS OF USE COVERAGE – ADDITIONAL INSURANCE

If Physical Damage Coverage is provided for hired autos by this policy:

A. We will pay necessary reasonable expenses for which an insured becomes legally liable to pay for the loss of use of an auto borrowed, hired, leased or rented without a driver under a written contract or agreement. Such loss of use must result from damage caused by a cause of loss not otherwise excluded or limited in this policy.

B. Our maximum liability per occurrence under this Supplemental Coverage is $600 subject to a maximum $20 per day limit. The described period is not limited by expiration of the policy term.

ANALYSIS:

Again, this supplemental coverage will only apply if the insured adds coverage for hired autos. The supplemental coverage will then provide coverage for loss of use when required under a contract or agreement, such as a rental car agreement. Any auto that the named insured leases, hires, rents or borrows is deemed in this instance to be a covered auto owned by the named insured and so, has primary coverage for physical damage. For example, if the named insured rents a car while on his business trip and has an accident, this coverage will cover the rental company's loss of use of their car. The same limits apply as with the transportation expense additional insurance, $20 per day/$600 maximum per occurrence.

PART III C – EXCLUSIONS / LIMITATIONS

Here we find the policy exclusions and limitations that apply to physical damage coverage.

We do not cover the following property or loss except to the extent otherwise specifically provided for in this policy.

1. ELECTRONIC EQUIPMENT, DISKS, TAPES EXCLUSIONS

We do not insure loss to the following:

A. Any electronic equipment, regardless if permanently installed or not, that receives or sends audio, data, or visual signals and is not designed solely for the reproduction of sound. This includes any accessories used with such equipment.

However, this exclusion does not apply to electronic equipment that is permanently installed in the auto or removable from a housing unit which is permanently installed in the covered auto.

Refer to Certain Electronic Equipment Coverage in Supplemental Coverages under Part III B.

B. Cassette tapes, compact disks, or other media devices designed for use with electronic audio, data, or visual equipment.

C. Equipment designed or used to detect, jam, or locate radar or any other speed measurement devices.

ANALYSIS:

In answer to the questions that might arise in the supplemental coverage for certain electronic equipment, this exclusion identifies items that are not covered, even if attached to or if an accessory for electronic equipment that is covered. Therefore, there is no coverage for items such as headphones, airpods, air buds, phones, tablets, compact disks, audio tapes, and the like. There is also no coverage for jamming apparatuses or any equipment used to detect or measure speed.

2. FARM EQUIPMENT AND TRACTORS EXCLUSION

For any covered auto that is farm equipment, machinery, or a tractor, we do not insure loss to the following:

A. Any other equipment that can be transported by such covered auto. This does not apply to such equipment furnished by its manufacturer as part of the covered auto's delivered price or if such is described in this policy as a covered auto.

B. Stationary equipment that can be powered by the covered auto.

ANALYSIS:

This self-explanatory exclusion precludes coverage for equipment, machinery or tractors used in farming operations, or any equipment that can be transported by same There is an exception for equipment furnished by its manufacturer as part of the covered auto's delivered price, or if added to the policy as a covered auto. For example, if a trailer hitch or bed liner is added to a pickup truck. The last part of the exclusion precludes coverage for non-moving equipment that can be powered by the covered auto.

3. RACING EXCLUSION

We do not insure loss to any covered auto while being used in a prearranged demolition, racing, or speed contest or stunting activity, including preparation or practice for such.

ANALYSIS:

This exclusion is self-explanatory, as racing and stunt vehicles require specialized insurance.

4. WEAR, TEAR AND OTHER SPECIFIED CAUSES OF LOSS EXCLUSIONS

A. We do not insure loss caused by or resulting from any of the following:

1. Wear and tear; corrosion; decay or deterioration; deficiency, error, or omission in design, materials, plans, or workmanship; dry or wet rot; electrical or mechanical breakdown; freezing; fungi, mold, spores, mildew, bacterium, or other natural growth; inherent vice (a customary characteristic of the property); latent defect (an original condition or fault leading to loss); rust. 2. Blowouts, punctures, or other road damage to tires.

B. However, if loss otherwise covered under this insurance:

1. Ensues as a result of a loss described in the preceding Paragraphs A.1 or 2, we insure such resulting loss; or 2. Causes a loss described in the preceding Paragraphs A.1 or 2, we insure such resulting loss.

ANALYSIS:

Paragraph A.1. of this exclusion lists a number of varying and self-descriptive types of conditions that are not fortuitous in nature and therefore are not insurable under the policy. Paragraph A.2. lists tire damages that are not covered by auto insurance in general. Paragraph B. provides an exception to the excluded losses in Paragraph A. for loss that is a result of any of the excluded losses. For example, if a tire blowout results in a covered auto hitting a guardrail, that damage would be covered.

5. DIMINISHED VALUE EXCLUSION

We do not insure any diminution in value to any covered auto.

ANALYSIS:

To understand this exclusion, it is necessary to refer to the definition of diminution in value, which means the actual or perceived reduction in market or resale value that results from a loss. An auto policy pays for the repair or replacement of a covered auto, but sometimes an insured perceives that the value is diminished from its original value before the loss. This is a consequence of loss that is excluded, as it is subjective and also an exact loss in market value cannot be easily and objectively established.

PART III D – SPECIAL PHYSICAL DAMAGE CONDITIONS

This section adds specifically described conditions that apply to physical damage losses under the policy.

1. DUTIES WHEN LOSS / DANGER OF LOSS OCCURS

You, other insureds, and other coverage beneficiaries must do all of the following things:

A. Report the Loss Immediate notify us of any loss. Also, immediately notify the police in case of theft, vandalism, or other violation of law. As soon as possible, give us a description of how, when, and where the loss occurred.

B. Protect Property Protect the covered auto if in imminent danger from a covered cause of loss or, if loss has occurred, from further loss. We cover the reasonable necessary expenses that you incur for such immediate safeguards.

ANALYSIS:

The first two duties of the insured here apply at the time of loss. The insured must first report the loss immediately to the carrier, and if any law has been violated, including theft or vandalism, the police must be notified. While details may not be required at the time of loss, they are required to be provided as soon as possible.

The next duty of the insured is to protect the covered auto from any imminent danger or from further loss. For example, if the insured must have a company move their auto from impending flood waters the policy will cover the necessary expenses incurred by the insured to have the auto moved to the nearest safe location. These covered expenses are only when there is an immediate need for such safeguarding or loss prevention.

C. Cooperation on the Loss As often as we may reasonably request / require:

1. Allow us to examine and inspect the covered auto and any records proving the loss before its repair or disposition. 2. Submit to examination and provide statements under oath and sign and swear to such. If more than one person is examined, we reserve the right to make such examination of each person out of the presence of the others. We also reserve the right to video record any examinations. 3. Otherwise cooperate with us in the investigation / settlement of the claim.

ANALYSIS:

The last duty listed applies once the loss has been reported, but it is no less important than the other two duties. There are three things the insurer requires the insured to be cooperative in, as often as requested by the insurer. All three items are necessary for the thorough review and determination of the insured's submitted claim. First is the insured's cooperation in permitting the carrier to inspect the covered auto and to examine any records to prove the loss, before the auto can be repaired or disposed of. Next, the insured must submit to examinations and provide statements under oath attested to by their signature, even to the point of having the examinations video-recorded if requested. These examinations may be conducted individually outside the presence of others. Throughout the investigation and settlement of the claim, the insured must cooperate in each step of the process. This can be especially difficult when there are many insureds listed or there are multiple claims to be handled, so it is important that the insured understands the necessity and extent of their required cooperation.

Failure to comply with these (or other conditions) can alter or void our obligations under this policy.

ANALYSIS:

This last paragraph of the insured's duties carries with it the importance of cooperating with the carrier in all aspects of the policy, and the potential consequences of not doing so. All of these conditions apply in addition to other conditions of the policy; as such if the insured fails in their compliance with any condition then the carrier may alter or void coverage under the policy.

2. HOW LOSSES ARE SETTLED

A. Limit of Liability

1. Coverages F & G Our maximum liability for loss in one accident is the least of the following amounts:

a. The actual cash value of the damaged or stolen property at the time of loss; b. The cost of repairing or restoring the damaged property with like materials of comparable quality; or c. The cost to replace the damaged or stolen property with like property of comparable quality.

2. Coverage H Our maximum liability for incurred costs for any one disablement is the limit shown in the Declarations.

B. Deductible We are liable for loss to each covered auto only when the loss is in excess of the Deductible amount shown in the Declarations, and then only on the amount of loss less the deductible amount. The Deductible does not apply under Comprehensive Coverage to any loss caused by fire or lightning.

ANALYSIS:

The second part of the specific physical damage conditions begins with how the losses will be settled in regards to the limit of liability and the deductible application.

With respect to Coverages F & G, payment for a covered accident or theft will be at the lesser of either the actual cash value, the cost of repair or restoration of damaged property with similar materials of comparable quality, or the replacement of damaged or stolen property with comparable property. This is typical of all standard physical damage policies.

With respect to Coverage H, payment will be no greater than the limit shown in the Declarations for any one disablement.

The Deductible does not apply under Comprehensive to fire or lightning losses.

C. Appraisal

1. If you and we do not agree on the amount of the loss either one can require that the value of the items in dispute be set by appraisal. Within 30 days of receipt of a written demand for appraisal, each party is to select a competent and disinterested appraiser. Each party is to then notify the other of the appraiser selected. 2. The two appraisers are to select a competent and disinterested umpire. If the appraisers are unable to agree upon an umpire within fifteen days, you or we may petition a judge of a Court of Record to select an umpire. 3. The appraisers are to reach a mutual agreement on the value of the items in dispute. If the appraisers fail to agree within a reasonable time, they are to submit their differences to the umpire. Written agreement signed by any two of these three persons constitutes settlement on the items in dispute. 4. Each appraiser is paid by the party selecting the appraiser. All other expenses of the appraisal are paid equally by you and us. 5. If we agree to appraisal, we specifically retain our right to deny the claim.

ANALYSIS:

This next section of the physical damage conditions describes the appraisal process in event the insured and insurer cannot agree on the amount of the loss settlement. The dissenting party must demand the appraisal within 30 days, at which time the parties are to select appraisers and notify the other party of the selected appraiser. The appraisers then select an umpire, but if they cannot agree on an umpire within 15 days, then either party may petition the court judge to select an umpire. It will be up to the appraisers to reach agreement on the disputed item value; if they cannot agree within a reasonable time it will be up to the umpire to decide. The settlement will be signed and agreed upon by any two of the three persons, such as the umpire and one of the appraisers. Each appraiser will be paid by the party who selected them, but other expenses of the appraisal process will be split between the insurer and the insured. If the insurer agrees to appraisal, they still retain the right to deny the claim. For example, if during the appraisal process the insurer learns that the insured materially represented the claim, the insurer may alter or deny coverage.

D. Our Liability and Satisfaction of Your Loss If the maximum liability payable by us on a loss, as determined in this policy, does not fully satisfy your loss, than you must either seek insurance that may be provided by others for the difference or otherwise absorb the unsatisfied portion of the loss yourself.

E. Our Options in Settling Losses

1. We may pay for the loss in money. 2. We may repair or replace all or any part of the damaged or stolen property as provided for in this policy, or take all or any part of such property at a mutually agreed, or appraised, value. 3. If any stolen property is recovered, we may return the stolen property, at our expense. We will also pay for any damage that results to the stolen property from the theft. 4. We may settle the claim with you, any loss payee named in this policy, or others legally entitled to receive payment. If the claim applies to property of others, we have the right to adjust the loss with the owners of the property. Satisfaction of their claim is also satisfaction of your claim as to such property.

ANALYSIS:

Paragraph D of the specific physical damage conditions sets forth the insurer's obligations when, after payment of the loss under the terms of the policy, the insured is left with paying part of the loss. In this case, the insured has two options: 1. To go after someone else's insurance; or 2. To absorb the remainder of the loss. This can happen for example when an insured is involved in an at-fault accident with a Jaguar and the insured does not carry a high enough physical damage limit to cover the other party's damaged Jaguar.

Paragraph E lists the manner in which the insurer may pay losses, the first of which is money. When property is damaged or stolen, the insurer may opt to repair or replace the property or take it at its agreed or appraised value. If stolen property is recovered, the insurer may return the property to the insured without cost to the insured, plus if there is any damage from the theft the insurer will pay for such damage. Lastly, if the insurer settles the claim with the insured but there are any loss payees or others legally entitled to payment, the insurer has the right to settle the loss directly with the property owner. If settled with the owner, this will serve to satisfy the insured's claim to that property.

3. LOSS PAYABLE

A. We will pay you and the loss payee named in this policy, to the extent of their interest, for loss to a covered auto. However if loss results from conversion, embezzlement, or secretion on your part, this insurance will not cover the interest of the loss payee.

B. If we cancel this policy, such cancellation ends this agreement with respect to the loss payee's interest. We will mail or send to the loss payee the same advance notice of cancellation we send to the first named insured.

C. If we make any payments to the loss payee, we will obtain such loss payee's right of recovery against any other party.

4. NO BENEFIT TO BAILEE This insurance does not apply to the benefit of any others having custody of covered property. Any assignment to such persons or organizations has no standing under this policy.

ANALYSIS:

The final two specific physical damage conditions address loss payables and others having custody of covered property. Loss payables are paid directly to the extent of their interest in the covered auto, unless the loss results from the insured's conversion, embezzlement or secretion, in which case the policy will not pay the loss payee's interest in the auto. Payments made to the loss payee grants the insurer that loss payee's right of recovery against any other party. If the insurer cancels the policy, the loss payee will be mailed or sent the same advance notice of cancellation as is sent to the insured.

There can be no assignment of benefits under the policy. Just because someone may have custody of covered property doesn't mean they have any rights to benefits under the policy; the policy is an agreement between the insurer and the insured only.

Christine G. Barlow, CPCU

Christine G. Barlow, CPCU

Christine G. Barlow, CPCU, is Executive Editor of FC&S Expert Coverage Interpretation, a division of National Underwriter Company and ALM. Christine has over thirty years’ experience in the insurance industry, beginning as a claims adjuster then working as an underwriter and underwriting supervisor handling personal lines. Christine regularly presents and moderates webinars on a variety of topics and is an experienced presenter.  

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