# Premises Medical Payments Insurance Coverage Part

## Schedule

| Coverage | Advance Premium |
| --- | --- |
| (a) Premises and operations | $ INCL. |
| (b) Elevators | $ |
| (c) Sports activities | $ INCL. |
| Total Advance Premium | $ INCL. |

**It is agreed that exclusion (c) (5) is void.**

## Coverage E - Premises Medical Payments

The company will pay to or for each person who sustains bodily injury caused by accident all reasonable medical expenses incurred within one year from the date of the accident on account of such injury, provided that such injury arises out of (a) the ownership, maintenance, operation, use, loading or unloading of any elevator unless a premium charge is entered for elevators in the policy with respect to Premises Medical Payments Coverage; (b) arising out of the ownership, maintenance, operation, use, loading or unloading of any automobile or aircraft owned or operated by or rented or loaned to the named insured; (c) arising out of the ownership, maintenance, operation, use, loading or unloading of any watercraft, if the bodily injury occurs away from the insured premises; (d) arising out of and in the course of the transportation of mobile equipment by an automobile owned or operated by or rented or loaned to the named insured.

### Exclusions

This insurance does not apply:

1. To bodily injury:
   1. Arising out of the ownership, maintenance, operation, use, loading or unloading of any automobile or aircraft owned or operated by or rented or loaned to the named insured.
   2. Arising out of operations performed for the named insured by independent contractors other than (i) maintenance and repair of the insured premises or (ii) structural alterations of such premises which do not involve changing the size of or moving buildings or other structures.
   3. Resulting from the selling, serving or giving of any alcoholic beverage (i) in violation of any statute, ordinance or regulation, (ii) to a minor, (iii) to a person under the influence of alcohol, or (iv) of which the named insured contributes the intoxication of any person, but this exclusion (b) (3) applies only if the named insured is a person or organization engaged in the business of manufacturing, distributing, selling or serving alcoholic beverages or is an owner or lessor of premises used for such purposes.
   4. Due to war, whether or not declared, civil war, insurrection, rebellion or revolution, or to any act or condition incident to any of the foregoing.
   5. To bodily injury:
      1. To the named insured, any partner therein, any tenant or other person regularly residing on the insured premises or any employee of any of the foregoing if the bodily injury arises out of and in the course of his employment therewith.
      2. To any other tenant if the bodily injury occurs on that part of the insured premises rented from the named insured or to any employee of such a tenant.

## Composite Rate

If the bodily injury occurs on the tenant's part of the insured premises and arises out of and in the course of his employment for the tenant:

1. To any person while engaged in maintenance and repair of the insured premises or alteration, demolition or new construction at such premises.
2. To any person if any benefits for such bodily injury are payable or required to be provided under any workman's compensation, unemployment compensation or disability benefits law, or under any similar law.
3. To any person practicing, instructing or participating in any physical training, sport, athletic activity or contest unless a premium charge is entered for sport activities in the policy with respect to Premises Medical Payments Coverage.
4. To any physical expenses for services by the named insured, any employee thereof, or any person or organization under contract to the named insured to provide such services.

## Limits of Liability

The limit of liability for Premises Medical Payments Coverage stated in the declarations as applicable to "each person" is the limit of the company's liability for all medical expenses for bodily injury to any one person as the result of any one accident; but subject to the above provision respecting "each person", the total liability of the company under Premises Medical Payments Coverage for all medical expenses necessary to two or more persons as the result of the same accident shall not exceed the limit of liability stated in the declarations as applicable to "each accident".

When more than one medical payments coverage afforded by this policy applies to the loss, the company shall not be liable for more than the amount of the highest applicable limit of liability.

## Additional Definitions

When used in reference to this insurance including endorsements forming part of the policy:

- "Insured premises" means all premises owned by or rented to the named insured with respect to which the named insured is afforded coverage for bodily injury liability under this policy, and includes the ways immediately adjoining on land.
- "Medical expenses" means expenses for necessary medical, surgical, x-ray and dental services, including prosthetic devices, and necessary ambulance, hospital, professional nursing and funeral services.

## Policy Period: Territory

This insurance applies only to accidents which occur during the policy period within the United States of America, its territories or possessions, or Canada.

## Additional Condition

Medical Reports; Proof and Payment of Claim

As soon as practicable the injured person or someone on his behalf shall give to the company written proof of claim, under oath if required, and shall, after each request from the company, execute authorization to enable the company to obtain medical reports and hospital records. The company may require such examination of physicians selected by the company when and as often as the company may reasonably require. The company may pay the injured person or any person or organization rendering the service, and the payment shall be made without prejudice to the right of the injured person to sue. Such payment shall not constitute an admission of liability of any person or, except hereunder, of the company.