7.2 Exclusions and Part E Duties After an Accident

Part D Exclusions

Even where Collision or OTC would otherwise respond, the PAP lists exclusions that bar coverage. Knowing these by category is heavily tested because they distinguish a covered claim from a denial.

Key Part D exclusions:

• Loss to a vehicle used as a public or livery conveyance (taxi/ridesharing for hire) - a transportation-network exception applies in many filed forms.
• Damage due and confined to wear and tear, freezing, mechanical or electrical breakdown, or road damage to tires (unless from a covered theft or other loss).
• Loss from war, nuclear hazard, radioactive contamination, or confiscation by government.
• Loss to electronic equipment that reproduces, receives, or transmits audio/visual/data signals not permanently installed, and the media/accessories for such equipment.
• Loss to a camper body, trailer, or motorhome not shown on the Declarations (with limited new-acquisition windows).
• Loss to non-owned autos used without a reasonable belief of permission.

The custom-equipment and rental-reimbursement traps

The base PAP limits coverage for certain custom furnishings and equipment in a pickup or van and for electronic equipment. To restore coverage, agents add endorsements (discussed in 7.3). Two recurring exam traps:

1. Sound/electronic equipment permanently installed in the dash or console is covered as part of the auto; equipment not permanently installed (radar detectors, portable devices) is excluded.
2. There is no rental-reimbursement built into the base Part D - the insured needs the Transportation Expenses provision (which pays a small daily amount only for theft) or the separate Extended Non-Owned / Rental Reimbursement endorsement.

A vehicle being destroyed by the government as contraband or seized in a drug forfeiture is excluded under the confiscation provision - a favorite distractor.

Part E - Duties After an Accident or Loss

Part E is a condition, not a coverage. It lists the obligations the insured must perform after a loss; failure to comply can void coverage to the extent the insurer is prejudiced. The duties apply to a person seeking coverage under any part of the policy.

General duties owed by any insured seeking coverage:

• We must be notified promptly of how, when, and where the accident or loss happened, including names and addresses of injured persons and witnesses.
• Cooperate with the insurer in the investigation, settlement, or defense of any claim.
• Promptly send copies of any legal papers, notices, or summons received in connection with the accident.
• Submit, as often as reasonably required, to physical exams by physicians the insurer selects and to examinations under oath (EUO).
• Authorize the insurer to obtain medical and other records.

Additional duties tied to specific coverages

Certain duties attach only to particular parts:

Note the two-year statute in many filed editions for UM/UIM arbitration demands and the duty to notify the insurer before settling with a tortfeasor when UIM may apply - settling without consent can forfeit UIM rights (the "consent-to-settle" condition).

Part D Exclusions

Physical-damage coverage carves out predictable losses: wear and tear, freezing, mechanical/electrical breakdown, and road damage to tires (unless from a covered loss); loss to electronic equipment and media beyond stated limits; loss while the auto is used as a public/livery conveyance (ride-share without endorsement); war, nuclear, and radioactive loss; and loss to a non-owned auto used without a reasonable belief of permission.

A frequently tested exclusion is carrying persons or property for a fee — a driver using the personal auto for delivery or ride-share is excluded unless a specific endorsement (such as a ride-share endorsement) is added. Mechanical breakdown is excluded because it is a maintenance cost, not a fortuitous loss.

Part E Duties After an Accident or Loss

Part E lists what the insured must do or coverage may be denied: prompt notice to the insurer (how, when, and where the accident happened, plus names of injured and witnesses); cooperate in investigation, settlement, and defense; send copies of legal papers/suits received; submit to physical exams and examination under oath when reasonably required; authorize medical and other records; and for a physical-damage claim, protect the auto from further loss, allow inspection/appraisal, and notify police in case of theft.

These duties are conditions precedent: an insured who fails to report a theft to the police, or who hides the damaged vehicle from inspection, may forfeit the claim. Expect a scenario asking which duty the insured breached.

Worked Scenario — Livery Exclusion and Duty to Report

Consider a driver who signs up for a food-delivery app and, while making a paid delivery, backs into a parked car and dents her own bumper. The public-or-livery conveyance exclusion applies: Part D physical-damage coverage is denied because the auto was carrying property for a fee, unless she carries a ride-share endorsement. The same exclusion can reach the liability side absent the proper endorsement.

Consequences of Breaching Part E Duties

The Part E duties are conditions precedent to coverage. If the insured fails to give prompt notice, hides the vehicle so the insurer cannot inspect it, refuses an examination under oath, or neglects to report a theft to the police, the insurer may reduce or deny the claim to the extent it was prejudiced. A practical exam scenario describes an insured who repairs and sells the damaged car before the insurer can appraise it — that breaches the duty to allow inspection and can void the physical-damage claim. The lesson: cooperation, prompt notice, and preservation of evidence are not optional courtesies but enforceable policy conditions.