AUTOMOBILE
LIABILITY COVERAGE
For The
PURMS JOINT SELF-INSURANCE
AGREEMENT
Adopted as of March 30, 1995
Overview of Coverages for PURMS Risk Pools
The Coverages Sections of the SIA set forth the Insuring
Agreements, Exclusions, and other terms and conditions which comprise the
Coverages provided by the Fund for the Members of its Risk Pools and, as
applicable, their Employees under the SIA.�
The current Liability Coverage provided by the Fund for
Members of the Liability Pool includes:�
Commercial General Liability (SIA � III, �CGL�); Public Officials &
Entity Liability (SIA � IV, �PO&E�); Automobile Liability (SIA � V); and
Pollution Liability (� VI). The CGL Coverage was originally adopted on December 20, 1976, has been amended
from time to time, and was unanimously re-adopted by the Members on December 7, 2001.� The PO&E, Automobile and Pollution
Liability Coverages were first adopted effective March 30, 1995. The PO&E Coverage was unanimously
re-adopted by the Members on December
7, 2001.
The current Property Coverage provided by the Fund for
Members of the Property Pool includes:�
General Property Coverage (SIA � X) and Auto Physical Damage Coverage
(SIA � XI). Both of these Property Coverages were originally adopted effective February 27, 1997.
Members of the Property Pool may participate in either or
both Property Coverages (SIA � X and/or � XI).�
Members of the Liability Pool must participate in all Liability
Coverages provided by the Fund (SIA � III - VI).
The current Health & Welfare Coverage provided by the
Fund for the Members of the H&W Pool is set forth in � XIV. The H&W
Coverage was originally adopted on March
16, 2000, effective April
1, 2000, and was amended and restated and unanimously re-adopted by
the Members as of December 7, 2001.
These Coverages, as amended from time to time pursuant to �
I, � 5.2, are specifically incorporated into the Interlocal Agreement and shall
be deemed a part of that Agreement as if fully set forth therein.
�����������
AUTOMOBILE LIABILITY COVERAGE
1.
Definitions for
Automobile Liability Coverage.� The Definitions set forth in the Definitions
Section of the SIA (see, � II) are applicable to the interpretation of
the Coverage provided by this Automobile Liability Coverage Section, except as
may be modified specifically or by implication by the definitions set forth
below which are specific to the Automobile Liability Coverage in this � V.�
1.1
Accident -- with respect
to this Automobile Liability Coverage Section, shall mean an unusual,
unexpected and unforeseen happening, including continuous or repeated exposure
to the same conditions, causing Bodily Injury or Property Damage resulting from
the ownership, maintenance or use of a Covered Vehicle by an Insured. (see
� V, � 2.1).� Multiple Claims arising out
of a single Accident, even if asserted against different Members or their
Employees, shall be deemed to be a single Covered Liability Claim arising from
a Single Accident.
1.2
Auto -- means a land motor vehicle, trailer or
semi-trailer designed for travel on public roads, but does not include Mobile
Equipment, except for the types of "self-propelled" Mobile Equipment
identified in � V, � 1.7(f).
1.3
Covered Vehicle -- shall mean:
(a)
Owned Autos -- which are only those Autos owned by a Member
including owned private passenger autos and Owned Autos other than private
passenger autos, and (including trailers not owned by the Member but attached
to power units the Member does own).�
(b)
Hired Autos -- which means only those Autos that are leased,
hired, rented or borrowed by a Member, or by an Employee for the Member's
account or by the Employee personally, in connection with PUD Business.
(c)
Nonowned Autos -- which means Autos that are not owned, leased,
hired, rented or borrowed by a Member, but that are used in connection with the
Member's Public Utility Operations.�
"Nonowned Autos" includes Autos owned by the Member's Employees
or members of such Employee's households, but only while used in connection
with the Member's PUD Business; subject, however, to the Other Insurance
provisions in � 2.5.
(d)
Other Covered Vehicles -- shall mean:
(1)
Trailers --� which
have a load capacity of 2,000 lbs. or less designed primarily for travel on
public roads.
(2)
Mobile
Equipment� --�
while being carried or towed by a Covered Vehicle.
(3)
Substitute
Autos� -- which means any Auto a Member does not
own, while used with the permission of its owner as a temporary substitute for
a Covered Vehicle a Member does own that is out of service because of
breakdown, repair, servicing, loss or destruction.
1.4
Insured -- for purposes of the Auto Liability Coverage
Section, shall mean any person or organization qualifying as an Insured as
follows:
(a)
The Member,
for any Covered Vehicle;
(b)
Any
Employee, and members of the Employee's household, while using any Covered
Vehicle, other than a Non-Owned Auto, with the Member's express or tacit permission
and in connection with PUD Business,�
except:
(1)
The owner or
anyone else from whom the Member hired or borrowed a Covered Vehicle (provided,
this exception does not apply if the Covered Vehicle is a "trailer"
connected to a "Covered Vehicle" that qualifies as an Owned Auto).
(2)
Anyone other
than a Member's Employees, partners, a lessee or borrower or any of their
employees, while moving property to or from a Covered Vehicle;
(c)
An Employee,
and members of the Employee's household, if the Covered Vehicle is owned by
that Employee or a member of his or her household; provided the Employee is
using the Nonowned Auto with the Member's express or tacit permission and such
use is in connection with PUD Business;
(d)
Any Third
Party, while using a Covered Vehicle with the express permission of a Member or
Employee, but only if such use is in connection with the Member's Public
Utility Operations; and
(e)
Anyone
liable for the conduct of an Insured described above, but only to the extent of
that liability.
1.5
Insured Contract -- shall mean:
(a)
A lease of
premises;
(b)
A sidetrack
agreement;
(c)
Any easement
or license agreement, except in connection with construction or demolition
operations on or within 50 ft. of any railroad real property;
(d)
An
obligation, as required by ordinance, to indemnify a municipality, except in
connection with work for a municipality;
(e)
That part of
any contract or agreement entered into, in connection with a Member's Public
Utility Operations pertaining to the rental or lease, by the Member or by any
of the Member's Employees, of any Auto;�
provided, however, such contract or agreement shall not be considered an
Insured Contract to the extent that it obligates the Member or any of its
Employees to pay for Property Damage to any Auto rented or leased by the Member
or by any of the Member's Employees.
An
"Insured Contract" does not include that part of any contract or
agreement:
(1)
That
indemnifies any person or organization for Bodily Injury or Property Damage arising
out of construction or demolition operations within 50 ft. of any railroad real
property;
(2)
That
pertains to the loan, lease or rental of an Auto to a Member or to any of a
Member's Employees if the Auto is loaned, leased, or rented with a driver; or
(3)
That holds a
person or organization engaged in the business of transporting property by Auto
for hire harmless for a Member's use of a Covered Vehicle over a route or
territory that person or organization is authorized to serve by public
authority.
1.6
Medical Expenses -- All reasonable expenses reasonably incurred
in the treatment of injuries sustained in an Accident for which Uninsured
Vehicle Coverage is provided under � 2.4, including all charges for
hospitalization, doctors' fees, dental fees, charges by treatment centers or
nursing homes, costs of physical therapy, costs of prostheses or other medical
devices, and charges for medications, laboratory and diagnostic procedures, or
other reasonably necessary medical charges.
1.7
Mobile Equipment -- shall mean any of the following types of land
vehicles, including any attached machinery or equipment:
(a)
Bulldozers,
farm machinery, forklifts, and other vehicles designed for use principally off
the public road;
(b)
Vehicles maintained
for use solely on or next to premises owned or rented by a Member;
(c)
Vehicles
that travel on crawler tread;
(d)
Vehicles,
whether self-propelled or not, maintained primarily to provide mobility to
permanently mounted:�
(1)
Power
cranes, shovels, loaders, diggers, or drills; or
(2)
Road
construction or reservicing equipment such as
graders, scrapers or rollers.
(f)
Vehicles not
described in paragraphs (a) through (d) above that are not self-propelled and
are maintained primarily to provide mobility to permanently attached equipment
of the following types:
(1)
Air
compressors, pumps, and generators, including spraying, welding, building,
cleaning, geophysical exploration, lighting and well servicing equipment; or
(2)
Cherry
pickers and similar devices used to raise or lower workers.
(g)
Vehicles not
described in paragraphs (a) through (d) above maintained primarily for purposes
other than the transportation of persons or cargo.� However, self-propelled vehicles with the following
types of permanently attached equipment are not "Mobile Equipment"
but will be considered "Autos":
(1)
Equipment
designed primarily for snow removal, road maintenance (but not construction or reservicing), or street cleaning;
(2)
Cherry
pickers and similar devices mounted on automobile or truck chassis and used to
raise or lower workers; and
(3)
Air
compressors, pumps and generators, including spraying, welding, building,
cleaning, geophysical exploration, lighting or well servicing equipment.
1.8
Public Utility
Operations -- shall mean the
operations of the Member related to, arising from or associated with the
production, transmission, delivery or furnishing of electricity, gas, water or
sewer service to the public, including the ownership, operation, management or
control of any plant or equipment used in connection therewith.
1.9
PUD Business� --� shall, for purposes of the Auto Coverage
section, mean all activities falling within the definition of Public Utility
Operations which involve the use of a Covered Vehicle, and all business
activities related thereto (like attending seminars, conventions, trade
association meetings, etc.) involving the use of a Covered Vehicle, so long as
the primary purpose for such use is related to such business activities and any
use thereof for personal purposes is incidental to such business use.
1.10
PUD Vehicle -- shall mean any Covered Vehicle operated or
otherwise being used by an Insured,�
regardless of who is actually driving the vehicle, subject, however, to the
Other Insurance provisions in � 2.5. (see � 2.4.1).
1.11
Trailer -- shall include semi-trailer.
1.12
Uninsured Motor Vehicle -- shall include an "underinsured"
motor vehicle and shall mean a motor vehicle with respect to the ownership,
maintenance, or use of which either no bodily injury or liability bond or
insurance policy applies at the time of an Accident, or with respect to which
the sum of the limits of liability under all bodily injury liability bonds and
insurance policies applicable to a person after an Accident is less than the
Uninsured Vehicle Coverage Limit provided for in � V, � 2.4.2, and shall
include, but not be limited to, hit and run motor vehicles and vehicles which
cause an Accident without physical contact where the owner or operator of such
vehicle cannot be located following the Accident after diligent search;
provided, however, that Uninsured Motor Vehicles shall not include vehicles (1)
owned by any governmental unit or agency, (2) designed mainly for use off
public roads while not upon public roads, (3) while located for use as a
residence or premises, or (4) owned or operated by a person or entity
qualifying as a self-insurer under any applicable motor vehicle law.
1.13
Uninsured Vehicle
Coverage -- shall mean the
Liability Coverage provided to Members of the Liability Pool in � 2.4 for
Medical Expenses for any person that, while occupying a PUD Vehicle, sustains
Bodily Injury caused by an Accident with an Uninsured Motor Vehicle.
1.14
Uninsured Vehicle
Coverage Limit -- shall mean the
Liability Coverage Limit and related terms set forth in � 2.2, which is
applicable to the Fund's Uninsured Vehicle Coverage contained in � 2.4.1,
as modified by the terms of the Uninsured Vehicle Coverage Limit contained in �
2.4.2.
2.
Insuring Agreement and
Conditions for Automobile Liability Coverage.� Under its Automobile Liability
Coverage, the Fund provides the following:
2.1
General Automobile
Liability Coverage for Claims Arising out of an Accident. Except as otherwise provided in this � 2
and in � 3 below, or in other sections of the SIA (see, e.g., �
I., � 13.5), and subject to � VII regarding Claims Resolution, the Fund shall
pay on behalf of any Insured all Defense Costs and all Damages such Insured has
or may become legally obligated to pay to a Third-Party resulting from a
Covered Liability Claim for Bodily Injury or Property Damage caused by an
Accident that happens during the Coverage Period.
2.2
Liability Coverage
Limit. The Fund shall not
be obligated to pay an amount in excess of the Liability Coverage Limit
established by the Board for one or more Covered Liability Claims arising out
of any one Accident, irrespective of the number of Members or Employees who may
be liable therefor; provided, however, that all Defense Costs incurred in
connection with a Covered Liability Claim shall be included within the
Liability Coverage Limit; and provided further, that if coverage for Defense
Costs under the applicable Excess Liability Policy with respect to a particular
Covered Liability Claim does not begin at the point the Fund has paid the total
amount of its Liability Coverage Limit, including Defense Costs, and if the
amount of Defense Costs and Incurred Liability resulting from the Covered
Liability Claim exceed the Liability Coverage Limit, then the Board may, for
Sufficient Cause and by Super-Majority Vote, increase the Liability Coverage
Limit for such Claim in an amount within its discretion, up to a maximum of
$500,000 of additional Coverage for the Claim, including Defense Costs.� The Fund's Liability Coverage Limit,
effective January 1, 1996, is $1,000,000, less the amount of the Deductible
determined by the Board as provided in � 2.3; provided, however, that the Board
may increase or decrease the Liability Coverage Limit from time to time by Super-Majority Vote, and any such change shall
thereafter be reflected� as provided in �
I, � 5.7, and in � V, � 2.2 of revised Operational Rules.� Any such change in the amount of the
Liability Coverage Limit shall not apply to any Claim arising from an Accident
which took place prior to the effective date of the amendment, except as
permitted in � I., � 5.4.2.2.� The Board
shall attempt to coordinate any changes in the Liability Coverage Limit with
the Attachment Points of any Excess Liability Coverage to prevent or minimize
any gaps in coverage.
2.3
Deductible. All Members shall be required to pay a
Deductible in an amount determined by the Board for each Covered Liability Claim
asserted against a Member and/or its Employees. If more than one Covered
Liability Claim arises out of one Accident, the Member shall be required to pay
only one Deductible for all such Claims. In a Multi-Member Claim, even if
it arises out of a single Accident, each Member against which such Claim is
asserted shall be required to pay a Deductible; provided, however, that the
Member shall pay the Deductible when the Covered Liability Claim is asserted
against both the Member and one or more of its Employees; and, provided
further, that the Employee shall pay the Deductible with respect to a Covered
Liability Claim asserted against the Employee only which does not involve the
Member. The initial Deductible shall equal $250; provided, however, that the Board
may increase or decrease the amount of the Deductible from time to time by
Super-Majority Vote, and any such change shall
thereafter be reflected� as provided in �
I, � 5.7, and in � V, � 2.3 of revised Operational Rules.� A change in the amount of the Deductible
shall not apply to any Liability Claim arising from an Accident which took
place prior to the effective date of the amendment, except as permitted in �
I., � 5.4.2.2.
2.4
Limited
Uninsured/Underinsured Motorist Coverage for Medical Expenses.
2.4.1
Uninsured Vehicle
Coverage.� Subject to the Uninsured Vehicle Liability
Coverage Limit in � 2.4.2 below and the Other Insurance provisions in � 2.5,
the Fund will pay Medical Expenses only which any person occupying a PUD
Vehicle is legally entitled to recover from the owner or operator of an
Uninsured Motor Vehicle for Bodily Injury caused by an Accident; provided,
however, that the Fund shall have no obligation to any person injured in any
such Accident until such time as the limits of liability under all applicable
bodily injury liability bonds or insurance policies (including, but not limited
to, any applicable uninsured or underinsured motorist coverages, worker's
compensation, disability benefits or any coverage which would have been
available but for a waiver entered into by the person injured or his/her
employer) have been exhausted by payment of judgments or settlements.� The liability of the owner or operator of the
Uninsured Motor Vehicle for these Medical Expenses must arise out of the
ownership, maintenance or use of the Uninsured Motor Vehicle.
2.4.2
Uninsured Vehicle
Liability Coverage Limit.� The Fund shall not be obligated to pay any
amount in excess of the Liability Coverage Limit for Automobile Liability
Coverage contained in � 2.2, and subject to the terms contained therein, for
Medical Expenses resulting from any one Accident, regardless of the number of
persons or entities entitled to Coverage therefor, or the number of Claims
asserted or PUD Vehicles involved in the Accident; provided, however, that the
Uninsured Vehicle Liability Coverage Limit shall be reduced by all sums paid by
or on behalf of any persons or entities who may be legally responsible to the
injured person(s) for Medical Expenses, including, but not limited to, amounts
paid under any workers' compensation law, disability benefits law, insurance
policies (including any applicable health or medical insurance or uninsured or
underinsured motorist coverages), and under any other Coverages of the SIA.� For purposes of determining the amount of
Uninsured Vehicle Coverage available, it shall be conclusively presumed that
any payments to any injured person by any persons or entities potentially
responsible for the Accident or for paying some or all of the Damages arising
out of the Accident shall be deemed to have been applied first to reimbursement
of the injured person's Medical Expenses, and then to pain and suffering or
Property Damage.
2.4.3
Deductible.� Any
person claiming Uninsured Vehicle Coverage under this � 2.5 shall be
subject to a Deductible in the amount provided in � 2.3.
2.4.4
Notice of Suit.� Any
person seeking Uninsured Vehicle Coverage under this � 2.4 must promptly send
to the Fund copies of any notice of suit and all related legal papers in any
suit arising from or involving the Accident.
2.4.5
Phantom Vehicles.� In the
event of an accident caused by a hit and run driver in which there is no
physical contact with the PUD Vehicle, the Fund shall have no obligation to make
any Uninsured Vehicle Coverage payments unless:�
(a) the facts of the Accident can be corroborated by competent evidence
other than the testimony of any person having a Claim for Uninsured Vehicle
Coverage resulting from the Accident; and (b) the Accident was reported to the
appropriate law enforcement agency within 72 hours of the Accident.
2.4.6
No Benefit to Other
Insurers.� The Uninsured Vehicle Coverage shall not
apply directly or indirectly to benefit any insurer or self-insurer, including,
but not limited to, any automobile insurer, uninsured or underinsured motor
vehicle insurer, health or medical insurer, or any insurers or self-insurers
under workers compensation law, disability benefits law, or any similar
law.�
2.4.7
Additional Conditions
and Limitations to Uninsured Vehicle Coverage.� Nothing contained in this
� 2.4 shall be construed to provide Uninsured Vehicle Coverage for any
person operating a PUD Vehicle without a reasonable belief that the person is
entitled to do so, or to provide any such Coverage for any Liability Claims for
Damages, including but not limited to, lost wages, loss of consortium, pain and
suffering, attorney fees or other consequential damages, sustained by any such
person injured while occupying a PUD Vehicle other than for Medical Expenses.
2.4.8
No Member Settlement
Ceiling.� The Member Settlement Ceiling provided for in
� VII, � 6.3 shall not apply to Claims made under this Uninsured Vehicle
Coverage, and no Member shall have authority to settle any such Claim on behalf
of the Fund.
2.4.9
Arbitration for
Disputes Regarding Medical Expenses.� If the Fund and any person making a Claim for
Uninsured Vehicle Coverage are unable to agree regarding whether such person is
legally entitled to recover Medical Expenses hereunder, or regarding the amount
of such Medical Expenses, either party may make a written demand for
arbitration.� In this event, each party
will select an arbitrator.� The two
arbitrators will then select a third arbitrator; provided, however, if the two
arbitrators cannot agree within 30 days to a third arbitrator, either party may
request that selection be made by any judge of any court having
jurisdiction.� The arbitrators shall be
empowered to determine all rules and procedures for the arbitration, subject to
their obligation to resolve the dispute between the parties in a fair,
expeditious, and cost effective manner, and the decision of two of the three
arbitrators shall be binding on the parties.�
Each party will pay all expenses it incurs in the arbitration, including
any fee charged by the arbitrator it selects.�
The expenses of the third arbitrator, and all other common expenses,
shall be borne equally by the parties.�
Unless both parties agree or the arbitrators shall rule otherwise,
arbitration will take place in the county in which the Member that owns the PUD
Vehicle or whose Employee was involved with the PUD Vehicle is located.
2.5
Other Insurance and
Third Party Indemnifications.� If any valid and collectible Other Insurance
or Third Party Indemnifications (hereinafter, "Third Party
Indemnifications" are included within the meaning of "Other
Insurance") are available to the Insured for a Claim the Fund Covers under
its Automobile Liability Coverage in �� 2.1, the Fund's Coverage obligations
are limited as follows:
(a)
This Automobile Liability Coverage provides primary
insurance for any Covered Vehicle that is an Owned Auto.
(b)
This Automobile Liability Coverage is excess over valid
and collectible Other Insurance for any Covered Auto a Member does not own.
(c)
While a Covered Auto which is a Trailer is connected to
another vehicle, the Coverage provided by the Automobile Liability Coverage is:
(1)
Excess while it is connected to a Motor Vehicle the
Member does not own.
(2)
Primary while it is connected to a Covered Vehicle that
is an Owned Auto.
(d)
When the Automobile Liability Coverage and any Other
Insurance covers on the same basis, either primary or excess, the Fund shall be
obligated to pay only its proportionate share based on the ratio of its
Liability Coverage Limit to the total applicable limits of all Other Insurance
covering on the same basis.
2.6
Separation of Insureds
with Respect to Liability Claims Asserted Among Members and Single Liability
Coverage Limit.� Except with respect to Liability Claims
excluded under the Exclusion paragraph of the various Liability Coverage
Sections of the SIA, in the event any Covered Automobile Liability Claim is
asserted by an Insured under the SIA against any other Insured under the SIA,
the Fund will provide Coverage for the Claim for such other Insured against
which the Claim is made in the same manner as if the Claim was being asserted
by a Third Party; provided, however, that when two or more different Members'
Employees are involved in the same Accident, the total of the Fund's Liability
Coverage obligation shall be its Liability Coverage Limit; and provided
further, that no Employee of one Insured shall be construed to be an Employee
of any other Insured, unless at the time of the Accident, there exists a
relationship of master/servant between such Employer and such other Insured.
2.7
Board's Authority to
Establish the Number of Accidents Involved in a Covered Automobile Liability
Claim.� The Board shall have the authority, by
Super-Majority Vote, to establish the number of Accidents involved in
connection with any Covered Automobile Liability Claim and such determination
shall be binding on all Members involved in the Claim; provided, however, that
in making its decision, the Board shall consider the advice of General Counsel
regarding the applicable law; and provided, further, that the Board's failure
to affirmatively establish the number of Accidents with respect to a Covered
Automobile Liability Claim shall result in the Claim being treated as a single
Accident by the Fund; and provided further, that any Dispute with the result of
the Board's Vote� may be submitted to
Arbitration pursuant to � I., � 24.5, and the Arbitrator shall affirm the
Board's decision unless it is contrary to clearly established Washington law.
3.
Exclusions for Automobile
Liability Coverage.
Notwithstanding the provisions of any other section of the SIA, the Fund shall
not provide Defense or Coverage for the types of Claims described in the
"Exclusions" below which shall not be Covered Automobile Liability
Claims.� The subsection headings for the
Exclusions are for ease of reference only and shall have no effect with respect
to the substantive meanings of the Exclusions.
3.1
Personal Use of Covered
Vehicles.� Any Claim arising out of an Insured's use of
a Covered Vehicle, except for an Owned Auto, where the primary purpose of such
use is personal and any use in connection with PUD Business is incidental to
such personal use.� (See,
� 1.9.)
3.2
Expected or Intended
Injury.� Any Claim for Bodily Injury or Property Damage
expected or intended from the standpoint of the Insured.
3.3
Assumed Contractual
Liability.� Any Claim for liability assumed under any
contract or agreement;
(1)
But this
Exclusion does not apply to liability for Damages: