June 2007
Summary: Just as a garage coverage form covers liability arising out of automobiles and premises-operations, so can medical payments coverage be arranged for both exposures under a garage policy. Auto medical payments coverage, however, must be added to the policy by one endorsement CA 99 03, and premises-operations medical payments coverage by another, CA 25 05. See Auto Medical Payments Insurance for a discussion of the auto medical payments endorsement. The subject of the present pages is the endorsement for garage locations and operations medical payments coverage, CA 25 05. These pages also cover rating procedures applying to both types of medical payments insurance as written for a garage.
Garage locations and operations medical payments coverage is appropriate for most garage insureds, who by the nature of their business normally have customers on the premises, either shopping for cars or waiting for cars to be repaired. The coverage does not depend on the insured's being legally liable and is purchased with the belief that prompt payment of a person's injuries without a determination of fault can preserve goodwill and possibly even deter a more costly legal action.
Topics covered:
Endorsement
Rating
Proprietors and executive officers
A. Coverage
We will pay reasonable medical and funeral expenses to or for each person who sustains “bodily injury” to which this coverage applies, caused by an “accident” and resulting from:
1. The maintenance or use of the locations shown in the Declarations and that portion of the roads or other accesses that adjoin these locations for garage business.
2. All operations necessary or incidental to a garage business.
We will pay only those expenses incurred for services rendered within one year from the date of the “accident”.
Analysis
The coverage agreement is quite simple. It promises insurance to cover reasonable medical and funeral expenses for persons sustaining accidental bodily injury at the insured's locations or arising out of the insured's operations. The “location” includes “that portion of the roads or other accesses that adjoin these locations for garage business.” Accidental injury arising out of garage operations is covered for med pay regardless of the location (within coverage territory). “Operations” must be “necessary or incidental to a garage business” but any occurrence may be “incidental,” i.e., happening by chance.
The coverage applies to only those expenses that are incurred for services actually rendered within one year from the date of the accident; mere proposed services would not be covered under the terms of this endorsement.
B. Exclusions
This insurance does not apply to:
1. “Bodily injury” resulting from the maintenance or use of any “auto”.
2. “Bodily injury” to a person, whether or not an “employee” of any “insured”, if benefits for the “bodily injury” are payable or must be provided under a workers' compensation or disability benefits law or a similar law.
3. “Bodily injury” arising directly or indirectly out of:
a.War, including undeclared or civil war;
b.Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign, or other authority using military personnel or other agents; or
c.Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these.
4. “Bodily injury” to any “insured”.
Analysis
The first of the four exclusions in the endorsement concerns bodily injury resulting from the maintenance or use of any auto. The policy's definition of auto — “a land motor vehicle, trailer or semitrailer” — means that the coverage for premises-operations exposures does not reach bodily injury arising out of the maintenance or use of even a vehicle such as a forklift or an electric cart. The auto medical payments endorsement is available for response to the exposure to these and other types of “mobile equipment.”
The second exclusion rules out coverage for any person who is covered under a workers compensation or similar law. Even the employee of another concern is not covered here if he is entitled to workers comp or similar benefits. The exclusion underlines the fact that garage locations and operations medical payments coverage is principally for the purpose of covering injuries to customers visiting the named insured's premises.
The third exclusion applies to bodily injury caused by war, declared or not, insurrection, or warlike actions, or the consequences of either. The fourth exclusion applies to bodily injury to any insured.
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