Auto medical payments coverage is subject to a number of exclusions


Motorcycle Exclusion

This medical payments exclusion precludes coverage for any injury sustained while occupying a motorized vehicle having less than four wheels. Technically, this exclusion would therefore also apply to other motor vehicles with less than four wheels, if such vehicles come within a given policy's definition of motor vehicle. Potentially, this could include snowmobiles and scooters that have become popular in recent years.

This is a provision in which insurers' policies often vary. Because of this potential variation, you should check to see what your policy does or does not cover if you have such an exposure. Nonetheless, if you own motorcycles or other such vehicles, a policy that is specifically applicable to such vehicles should apply first.

Public or Livery Conveyance Exclusion

This medical payments exclusion precludes coverage for bodily injury to an insured arising out of the transport of goods or persons for hire, with the exception of shared expense carpools. The reasons for this exclusion are the same as discussed with respect to the similar auto liability coverage exclusion. Persons engaged in such businesses need to purchase appropriate commercial policies.

Use of Vehicle as Residence or Premises Exclusion

This medical payments exclusion precludes coverage for bodily injury to an insured sustained while occupying any vehicle located for use as a residence or premises. The intent of this exclusion is to apply, for example, when a motor home or trailer is being used as a primary residence or an office or business premises.

When the primary or exclusive use of such a vehicle is as a residence or premises, it is more properly the subject of a variant of homeowners policy whose medical payments coverage should apply in such circumstances. This is again an example of an exclusion intended to avoid duplicative and overlapping coverage when another type of policy is intended to apply to the particular kind of risk presented.

Workers Compensation Exclusion

This auto medical payments exclusion precludes coverage for bodily injury to an insured occurring in the course of employment if workers compensation benefits are required to be provided or are available to cover that bodily injury in question.

An issue that may arise is whether the workers compensation exclusion precludes coverage when the injured party has not sought or received workers compensation benefits. The view of most states' courts is that the entitlement to workers compensation benefits is the controlling question, and the exclusion applies even if workers compensation benefits were neither sought nor received by the injured person.

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Note: This article was sent to us by: Walt Bielfield at 10072010

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