137 Commercial Auto - Coverage_Limits Section
Applicant (first named insured)
*
-----Business Auto Section-------------------------------------------------------
LIABILITY
Select YES or NO for each type of covered auto
Any auto
Select
Yes
No
All owned autos
Select
Yes
No
Owned private passenger autos
Select
Yes
No
Owned autos other than private passenger
Select
Yes
No
Autos specified on schedule
Select
Yes
No
Hired autos
Select
Yes
No
Non-owned autos
Select
Yes
No
Limits of liability
CSL or bodily injury each per
Select
CSL
Bi each per
Limit amount ($)
Bodily injury each accident($)
Property damage($)
PERSONAL INJURY PROTECTION
Select YES or NO for each type of covered auto
All owned autos which require no-fault coverage
Select
Yes
No
Autos specified on schedule
Select
Yes
No
Limits of personal injury protection
Limit per person ($)
Waiver of P.I.P.
Select
Yes
No
ADDITIONAL PERSONAL INJURY PROTECTION
Select YES or NO for each type of covered auto
All owned autos which require no-fault coverage
Select
Yes
No
Autos specified on schedule
Select
Yes
No
Limits of additional personal injury protection
Limit($)
MEDICAL PAYMENTS
Select YES or NO for each type of covered auto
All owned autos
Select
Yes
No
Owned private passenger autos
Select
Yes
No
Owned autos other than private passenger
Select
Yes
No
Autos specified on schedule
Select
Yes
No
Hired autos
Select
Yes
No
Limits of medical payments
Limit each person($)
UNINSURED MOTORIST
Select YES or NO for each type of covered auto
All owned autos
Select
Yes
No
Owned private passenger autos
Select
Yes
No
Owned autos other than private passenger
Select
Yes
No
Owned autos subject to compulsory U.M. law
Select
Yes
No
Autos specified on schedule
Select
Yes
No
Limits of uninsured motorist
CSL or bodily injury each per
Select
CSL
Bi each per
Bodily injury each accident($)
Property damage($)
HIRED/BORROWED LIABILITY
Select
Yes
No
States
Limits of hired/Borrowed liability
Cost of hire ($)
NON-OWNED LIABILITY
Select
Yes
No
States
Limits of non-owned liability
Group type
Select
Employees
Volunteers
Partners
Number of employees
Number of volunteers
Number of partners
OTHER COVERAGES 1
Other coverages
Other covered auto symbols
Other limits
OTHER COVERAGES 2
Other coverages
Other covered auto symbols
Other limits
PHYSICAL DAMAGE
Owned private passenger autos
Select
Yes
No
Autos specified on schedule
Select
Yes
No
Physical damage amount ($)
Comprehensive
All owned autos
Select
Yes
No
Owned private passenger autos
Select
Yes
No
Owned autos other than private passenger
Select
Yes
No
Autos specified on schedule
Select
Yes
No
Hired autos
Select
Yes
No
Specified causes of loss
All owned autos
Select
Yes
No
Owned private passenger autos
Select
Yes
No
Owned autos other than private passenger
Select
Yes
No
Autos specified on schedule
Select
Yes
No
Hired autos
Select
Yes
No
Collision
All owned autos
Select
Yes
No
Owned private passenger autos
Select
Yes
No
Owned autos other than private passenger
Select
Yes
No
Autos specified on schedule
Select
Yes
No
Hired autos
Select
Yes
No
Hired physical damage
States
Number of days
Number of vehicle
Coverage/Deductible
Select
COMP
Spec C of L
Coll
Specify amount ($)
Coverage type
Select
Primary
Secondary
-----Truckers Section------------------------------------------------------------
LIABILITY
Select YES or NO for each type of covered auto
Any auto
Select
Yes
No
Owned autos only
Select
Yes
No
Owned commercial autos only
Select
Yes
No
Specifically described autos
Select
Yes
No
Hired autos only
Select
Yes
No
Non-owned autos only
Select
Yes
No
CSL or bodily injury each per
Select
CSL
Bi each per
Limit ($)
Bodily injury each accident($)
Property damage($)
PERSONAL INJURY PROTECTION
Select YES or NO for each type of covered auto
Autos subject to no fault
Select
Yes
No
Specifically described autos
Select
Yes
No
Limits of personal injury protection truckers
Limit per person ($)
Waiver of P.I.P.
Select
Yes
No
ADDITIONAL PERSONAL INJURY PROTECTION
Select YES or NO for each type of covered auto
Autos subject to no fault
Select
Yes
No
Specifically described autos
Select
Yes
No
Limits of additional personal injury protection truckers
Limit amount($)
MEDICAL PAYMENTS
Select YES or NO for each type of covered auto
Owned autos only
Select
Yes
No
Owned commercial autos only
Select
Yes
No
Specifically described autos
Select
Yes
No
Limits of medical payments truckers
Limit each person($)
UNINSURED MOTORIST
Select YES or NO for each type of covered auto
Owned autos only
Select
Yes
No
Owned commercial autos only
Select
Yes
No
Owned autos subject to a compulsory uninsured motorist law
Select
Yes
No
Specifically described autos
Select
Yes
No
Limits of uninsured motorist truckers
CSL or bodily injury each per
Select
CSL
Bi each per
Limit amount ($)
Bodily injury each accident($)
Property damage($)
NON-TRUCKERS HIRED/BORROWED
Select
Yes
No
States
Cost of hire($)
HIRED/BORROWED LIABILITY
Select
Yes
No
States
Cost of hire($)
NON-OWNED AUTO LIABILITY
Select
Yes
No
States
Limits of non-owned liability
Group type
Select
Employees
Volunteers
Partners
Number of employees
Number of volunteers
Number of partners
OTHER COVERAGES
Other coverages
Other covered auto symbols
Other limits ($)
PHYSICAL DAMAGE
Comprehensive
Owned autos only
Select
Yes
No
Owned commercial autos only
Select
Yes
No
Specifically described autos
Select
Yes
No
Hired autos only
Select
Yes
No
Limits ($)
Deductible ($)
Specified causes of loss
Owned autos only
Select
Yes
No
Owned commercial autos only
Select
Yes
No
Specifically described autos
Select
Yes
No
Hired autos only
Select
Yes
No
Select limits
Select
SCL
F
FT
LSP
Deductible ($)
Collision
Owned autos only
Select
Yes
No
Owned commercial autos only
Select
Yes
No
Specifically described autos
Select
Yes
No
Hired autos only
Select
Yes
No
Limits ($)
Deductible ($)
Towing and labor
Specifically described autos
Select
Yes
No
Limits ($)
Deductible ($)
Trailer interchange
Comprehensive
Trailers in your possession under a trailer interchange agreement
Select
Yes
No
Your trailers in the possession of another trucker under a trailer interchange agreement
Select
Yes
No
Number of trailers
State
Number of days
Radius
Deductible ($)
Specified causes of loss
Trailers in your possession under a trailer interchange agreement
Select
Yes
No
Your trailers in the possession of another trucker under a trailer interchange agreement
Select
Yes
No
Number of trailers
State
Number of days
Radius
Deductible ($)
Collision
Trailers in your possession under a trailer interchange agreement
Select
Yes
No
Your trailers in the possession of another trucker under a trailer interchange agreement
Select
Yes
No
Number of trailers
State
Number of days
Radius
Deductible ($)
Hired physical damage
States
Number of days
Number of vehicles
Coverage type
Select
Primary
Secondary
53 Loveton Circle, Suite 120 • Sparks, MD 21152
Phone • 1.800.926.8085 • 410.472.1620 • Fax • 410.472.1897
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