# Automobile Medical Payments Insurance Coverage Part

## Schedule

**Designation of Automobiles - Division 1**

- (1) Any owned automobile
- (2) Any hired automobile
- (3) Any non-owned private passenger automobile
- (4) Any automobile described in the schedule and designated "MP"
- (5) Any non-owned automobile

**Designated Person Insured - Division 2**

- [Blank]

**Total Advance Premium:** $ [Incl. In Composite Rate]

## Coverage F - Automobile Medical Payments

The company will pay all reasonable medical expenses incurred within one year from the date of the accident.

### Division 1
- To or for each person who sustains bodily injury, caused by accident, while occupying a designated automobile which is being used by a person for whom bodily injury liability insurance is afforded under this policy with respect to such use.
- To or for each insured who sustains bodily injury, sustained by accident, while occupying or, while a pedestrian, through being struck by a highway vehicle.

### Exclusions
This insurance does not apply:
- To bodily injury to any person or insured while employed or otherwise engaged in duties in connection with an automobile business, if such injury is in whole or in part either payable or required to be provided under any workers' compensation law.
- To bodily injury due to war, whether or not declared, civil disorder, insurrection, rebellion or revolution, or to any act or condition incidental to any of the foregoing.
- Under Division 1, to bodily injury to any employee of the named insured arising out of and in the course of employment by the named insured. However, this exclusion does not apply to any such bodily injury sustained unless such employee was in whole or in part either payable or required to be provided under any workers' compensation law.
- Under Division 2, to bodily injury sustained while occupying a highway vehicle owned by any insured and used for the regular use of such vehicle by any person or organization other than the named insured.

## Additional Definitions

The additional definitions applicable to automobile bodily injury liability insurance also apply to this insurance and when used in reference to this insurance include:

- **"Designated automobile"** means an automobile designated in the schedule includes:
  - An automobile not owned by the named insured while temporarily used as substitute for an owned automobile designated in the schedule.
  - A trailer designed for use as a private passenger automobile, if not being used for the purpose of carrying another type automobile and not a horse trailer, store display or passenger trailer.
- **"Highway vehicle"** means a land motor vehicle or trailer other than:
  - A farm type tractor or other equipment designed for use principally off public roads, while not upon public roads.
  - A vehicle operated on rails or crawler tracks.
  - A vehicle while located for use as a residence or premises.
- **"Medical expense"** means expenses for necessary medical, surgical, x-ray, dental services, including prosthetic devices, and necessary ambulance, hospital, professional nursing and funeral services.
- **"Occupying"** means in or upon or entering into or alighting from.

## Policy Period, Territory

This insurance applies only to accidents which occur during the policy period within the territory described in paragraph (1) or (2) of the definition of "polic territory."

## Additional Conditions

### A. Medical Reports, Proof and Payment of Claim
As soon as practicable the injured person or someone on his behalf shall give the company a written statement of the nature and extent of the injury and shall request from the company's authorized representative to enable the company to obtain medical reports and copies of records. The injured person shall cooperate fully with the company in obtaining such reports and records and as often as the company may reasonably require. The company may pay the injured person or any person or organization rendering the services and such payment shall reduce the amount of which the insured is liable for such expenses. This provision shall not constitute an assignment of liability of any person or, except hereunder, of the company.

### B. Excess Insurance
Except with respect to an owned automobile, the insurance under this division shall be excess insurance over any other valid and collectible automobile medical payments or automobile medical expense insurance available to the insured under any other policy.