Duties after Loss and General Provisions

Summary: The conditions of the personal auto policy are contained in parts E and F of the policy. The scope of part E is conveyed by its title – "duties after an accident or loss." Part F, entitled "general provisions," is a catchall for such matters as policy period and territory, subrogation rights of the insurer, cancellation provisions, etc. Separate descriptions of the two parts follow.

Topics covered: Insured's duties after an accident or loss

General provisions

Insured's Duties after an Accident or Loss

We have no duty to provide coverage under this policy if the failure to comply with the following duties is prejudicial to us:

A.We must be notified promptly of how, when and where the accident or loss happened. Notice should also include the names and addresses of any injured persons and of any witnesses.

Analysis

The insured's duties after an accident or loss are intended to be conditions precedent for providing coverage under the personal auto policy. In other words, the intent of the PAP has always been to require, after a loss, compliance with the duties section prior to implementing the insuring agreements.

ISO changed the lead-in sentence to include prejudice language. When making the change, ISO stated that "the general rule appears to be that if the 'duties' provision contains the language that makes the 'duties' a condition precedent to the performance by the insurer of its obligations under the policy, the insurer can deny coverage because of failure to comply with such 'duties' only if said failure is prejudicial to the insurer."

The first duty after an accident or loss is that of promptly notifying the company of the particulars of the accident: "how, when and where" the accident occurred and the names and addresses of any persons injured in the accident or witnessing it.