Root Policy Document2023!12!27

Root Lone Star Insurance Agency
80 E Rich Street
Suite 500
Columbus, OH 43215
support@joinroot.com
(866) 980-9431
General agent for Redpoint County

Mutual Insurance Company
Policy number D6G4T7
Auto insurance policy amended declarations

Your coverage begins on October 17, 2023 at 3:49pm CDT. It expires on April 17, 2024 at 12:01am CDT.
Named insured Vehicles

Khristol Brown 2021 KIA Forte (3KPF24ADXME346888)
12700 Fm 1960 Rd W
Apt 1108
Houston, TX 77065
Coverage premiums, limits and deductibles

The following coverages apply to all listed vehicles unless otherwise noted.
Bodily injury liability $30,000 each person

Premium: $949 $60,000 each accident
Property damage liability $25,000 each accident

Premium: $209
Medical payments DECLINED

Premium: $0
Rental DECLINED
Premium: $0
Personal injury protection DECLINED

Premium: $0
Uninsured/underinsured motorist bodily injury DECLINED

Premium: $0
Uninsured motorist property damage DECLINED

Premium: $0
Form 1923 TX (08-2022) TCM

Comprehensive DECLINED
Premium: $0
Collision DECLINED
Premium: $0
Roadside assistance $100 each incident (up to 3 incidents)
Fees
Motor Vehicle Crime Prevention Authority Fee $2.50
Installment fee $8.00
Policy Changes
Cancellation
Effective from: 11/17/2023 12:00AM
Requested on: 11/17/2023 02:04AM
Your payment includes a $2.50 fee per vehicle per term. This fee helps fund (1) auto burglary, theft, and fraud
prevention, (2) criminal justice efforts, and (3) trauma care and emergency medical services for victims of accidents due
to traffic offenses. By law, this fee funds the Motor Vehicle Crime Prevention Authority.
Policy documents
Your insurance policy and any policy endorsements contain a full explanation of your coverage. These are available for
review in your Root App or you may contact us for a copy. The policy contract is Form 1918 TX (02-2021). You’ll see the
form number at the bottom of the pages in your contract. The contract is modified by Form 1931, which you’ll find
included in your contract.
Form 1923 TX (08-2022) TCM

80 E Rich Street
Suite 500
Columbus, OH 43215
(866) 980-9431
General agent for Redpoint County

Mutual Insurance Company
TEXAS
PERSONAL AUTO
INSURANCE POLICY
Form 1918 TX (02-2021)

PLEASE NOTE
PAY PREMIUMS ON TIME FOR COVERAGE TO APPLY.
READ YOUR WHOLE POLICY:

● Your Policy and its related papers create a legal contract with us.
● The Declarations Page shows you what coverage(s) you have purchased. A coverage limit on the Declarations
Page is for reference only. The limits may be subject to further reduction as set forth in this Policy.
● This Policy and the Declarations Page, and any Endorsements to your policy, set forth and describe the coverage
provided. These documents include definitions, as well as the conditions, exclusions, limitations, and duties for
coverage to apply.
● Read ALL terms of your coverage(s), to understand when coverage applies, what is and is not covered,
and what amount of coverage applies after any and all reductions and limitations are applied.
GIVE US NOTICE OF ANY VEHICLE ACCIDENT OR LOSS (and as further described in this policy as to your DUTIES).
Form 1918 TX (02-2021)

TABLE OF CONTENTS
PERSONAL AUTO INSURANCE POLICY 5

AGREEMENT 5
DEFINITIONS 5
PART A – LIABILITY COVERAGE (BODILY INJURY / PROPERTY DAMAGE) 12

INSURING AGREEMENT 12
SUPPLEMENTAL PAYMENTS 12
ADDITIONAL DEFINITIONS 13
EXCLUSIONS 14
LIMITS OF LIABILITY 16
OUT-OF-STATE COVERAGE 16
FINANCIAL RESPONSIBILITY 17
OTHER INSURANCE OR COVERAGE 17
BANKRUPTCY 17
PART B-I – PERSONAL INJURY PROTECTION COVERAGE (PIP) 17

EXCLUSIONS 19
MEDICAL EXPENSE REVIEW 20
ASSIGNMENT OF BENEFITS 20
PART B-II – MEDICAL PAYMENTS COVERAGE 21

EXCLUSIONS 22
MEDICAL EXPENSE REVIEW 24
ASSIGNMENT OF BENEFITS 25
PART C – UNINSURED (UM) and/or UNDERINSURED MOTORIST (UIM) COVERAGE 25

UNINSURED / UNDERINSURED MOTORIST BODILY INJURY COVERAGE (“UM/UIM BI”) INSURING AGREEMENT 25
UNINSURED / UNDERINSURED MOTORIST PROPERTY DAMAGE COVERAGE (“UM/UIM PD”) INSURING AGREEMENT 25
EXCLUSIONS 27
SETTLEMENT / SUIT / ARBITRATION 31
PART D – PHYSICAL DAMAGE COVERAGES 32

COMPREHENSIVE COVERAGE INSURING AGREEMENT 32
COLLISION COVERAGE INSURING AGREEMENT 33
CHILD SAFETY SEAT COVERAGE 33
RENTAL REIMBURSEMENT 34
EXCLUSIONS 35
SETTLEMENT 38
APPRAISAL 39
Form 1918 TX (02-2021) Page 3 of 53

NO BENEFIT TO BAILEE 39
LOSS PAYEE – LIENHOLDER 39
INSUREDS’ DUTIES AFTER ANY ACCIDENT OR LOSS 40

IMPORTANT WARNING: 40
GIVE PROMPT NOTICE TO US OF ANY AND ALL: 40
GIVE PROMPT NOTICE TO LAW ENFORCEMENT WITHIN 24 HOURS OF ANY ACCIDENTS OR LOSSES THAT INVOLVE: 40
COOPERATE FULLY: 40
CLAIMS SETTLEMENT 42
SETTLING FIRST PARTY CLAIMS 42
SETTLING LIABILITY CLAIMS 43
POLICY LIMITS 43
TWO OR MORE POLICIES OR INSUREDS 43
NON-DUPLICATION 43
POLICY TERMINATION 43
CANCELLATION 43
NON-RENEWAL 45
AUTOMATIC TERMINATION 45
OTHER TERMINATION TERMS 46
JOINT & INDIVIDUAL INTERESTS 46
CHANGE OF POLICY TERMS 46
CHANGE OF POLICY INTERESTS - TRANSFER OR ASSIGNMENT OF YOUR INTEREST 46
POLICY TERMS & CONDITIONS 47

POLICY PERIOD & TERRITORY 47
PREMIUM PAYMENT 47
PROOF OF NOTICE 48
ELECTRONIC TRANSACTION OF INSURANCE 48
COMPLIANCE WITH STATE LAW 48
OUR RIGHTS TO RECOVER PAYMENTS - SUBROGATION & REIMBURSEMENT 49
LEGAL ACTION AGAINST US 50
MISREPRESENTATION / CONCEALMENT / FRAUD 50

OUR RIGHT TO RESCIND & VOID 50
OUR RIGHT TO DENY COVERAGE 51
ROADSIDE ASSISTANCE COVERAGE 51
NAMED EXCLUDED DRIVER 53
SPECIAL PROVISIONS 53
Form 1918 TX (02-2021) Page 4 of 53

PERSONAL AUTO INSURANCE POLICY
AGREEMENT
In return for payment to us of all premiums when due, we agree to insure you subject to the terms, conditions and
limitations of this policy. You and we agree:
1. The Policy is issued:
a. in reliance upon the statements, information and representations in your application, all of which you agree
are true, accurate and complete.
b. on the condition that the initial payment to start this Policy is made to us or our agent. If that initial payment
is made by any non-cash method of payment accepted by us, this Policy is conditioned on that payment
being honored by the financial institution when presented by us.
2. We will provide the coverage shown in the declarations with a premium charge:
a. if that premium, and any fees or charges that may apply, are paid when required for that coverage to apply;
and
b. as described in this Policy, and subject to all terms, conditions, exclusions and limitations of this Policy.
3. This Policy contract:
a. is made up of all the forms that follow:
(1) the application;
(2) the most recently dated declarations;
(3) this Policy;
(4) any endorsements from us; and
(5) any reinstatement application.
no matter how issued by us or our agent, and as if all are physically attached here; and
b. contains all terms and agreements between you and us.
DEFINITIONS
This Definitions section defines many words and phrases used in the Policy. Defined words and phrases are shown in
bold face type.
The words, phrases and meanings set forth below apply:
1. When that word or phrase is used anywhere in the Policy; and
2. Even if the word or phrase is being used in the singular, plural, possessive or active or passive tense.
However, if a coverage Part of the Policy defines the same word or phrase, only the definition of the word or phrase
used in that coverage Part will apply in that Part.
Throughout this Policy:
You and your mean:

1. The named insured(s) shown on the declarations; and
2. If a resident of the same household as the named insured, the named insured's:
a. spouse;
b. a person lawfully married to the named insured but who is not a resident of the named insured’s
household, but only:
(1) if living apart during a period of separation in contemplation of divorce; and
(2) up until the effective date of divorce, dissolution, annulment or other event that officially terminates
Form 1918 TX (02-2021) Page 5 of 53

that marriage; or
c. registered domestic or civil union partner. But, if the named insured is not a person, then you and your do
not include any spouse or registered domestic or civil union partner.
We, us and our mean the insurance company shown on the declarations as being your personal auto insurer.
Also, as used throughout this Policy:
Accident means a sudden and unexpected event.
Actual cash value means the fair market value of stolen or damaged property immediately prior to the accident
or loss.
Application means the process and form(s):

1. We or our agent use to gather data about you and your autos; and
2. Upon which we rely when we issue this Policy and set the premium to be charged.
The application includes, though is not limited to, any process used by us or our agent for you to:
1. Select or reject coverage(s), limits, deductibles and other Policy options;
2. Give us any information we require to issue, rate or service your Policy; or
3. Make representations to us that we rely on to issue the policy and set your premium.
Auto means a private passenger type land motor vehicle that is a four-wheeled automobile, van, pick-up truck or sport
utility vehicle, or dual rear wheel six-wheeled pick-up truck.
Bodily injury means physical bodily harm to a person and sickness, disease or death that results from that bodily
harm.
Business means any job, profession, occupation, employment, trade, commercial or for-profit activity, no matter
whether or not any of these listed activities is full-time or part-time.
Business day means a day of the week other than a Saturday, Sunday, or holiday recognized by the State of Texas.
Cost to repair or replace means the amount, as determined by us, needed to:
1. Repair physical damage to return property to its pre-loss physical condition; or
2. Replace stolen or damaged property.
We will determine this amount based on one of the following methods (at our option):
1. The cost of repair or replacement as agreed upon by you and us;
2. A competitive bid approved by us; or
3. Our written estimate based upon the reasonable prevailing competitive price.
To determine the cost to repair or replace, you agree that parts and equipment of like kind and quality, as allowed by
law, may be new, reconditioned, remanufactured, or used, including, but not limited to:
1. Original equipment manufactured parts or equipment (OEM); and/or
2. Non-original equipment manufactured parts or equipment (after-market or non-OEM).
We may specify the use of parts and equipment that are not OEM (unless prohibited by law). Warranties applicable to
Form 1918 TX (02-2021) Page 6 of 53

parts and equipment that are not OEM may be provided by the manufacturer or distributor of such parts rather than
the manufacturer of the auto.
Crime means any act or omission that is a statutory criminal offense or violation of any state or federal penal code (in
the U.S.A.) no matter whether or not the person is arrested, charged and/or convicted. Crime includes, but is not
limited to, any state or federal felony (in the U.S.A.), and fleeing, eluding or evading law enforcement. Crime does not
include misdemeanor violations of the motor vehicle or traffic code.
Declarations means the most recently dated document from us, sent to the last address shown in our records for this
Policy, and that includes, but it not limited to, the following Policy information:
1. Insured autos;
2. Coverage(s), limits, deductibles and other Policy options selected;
3. Premium(s) to be paid;
4. Policy period and other Policy data; and
5. Our company and agent information.
Depreciation means the decline in value of:

1. Property due to overall wear and tear; and
2. An object’s parts and components over the course of its useful life.
Diminution in value means the perceived or real decrease in market or resale value of property due to an accident,
loss or repair. This includes, but is not limited to, the perceived or real decrease in market or resale value of property
because of alleged tangible or intangible taint or stigma related or due to an accident, loss or repair.
Insured auto means the auto(s) we have agreed to insure, as listed and described on the declarations and including a
newly acquired auto and a temporary substitute vehicle, but not if:
1. That auto is sold, assigned, gifted, title transferred or possession permanently transferred to a person or party
other than you; or
2. You have asked us to remove that auto from this Policy.
Minimum limits means the minimum amounts of liability insurance required to apply to an auto, or its owner or
operator, by the motor vehicle compulsory insurance or financial responsibility laws of the state in which you reside,
as shown in our records as the garaging address for an insured auto. The minimum limit amount is the per person/per
accident limits required by such laws.
If our records show the garaging address for the insured auto(s) is in the State of Texas, then the minimum limits for
this Policy (as the term is used throughout this Policy) are as follows:
1. [$30,000] for all compensatory damages due to all bodily injury to one person arising out of the covered use of
an auto or motor vehicle in any one accident;
2. [$60,000] for all compensatory damages due to all bodily injury to two or more persons arising out of the
covered use of an auto or motor vehicle in any one accident (still subject to the liability limit directly above for
one person); and
3. [$25,000] for the total of all property damages arising out of the covered use of an auto or motor vehicle in any
one accident;
unless amended by law to a different minimum limit which would then apply instead, as required by law.
These minimum per person/per accident limits will apply when the term minimum limits is used in this Policy, even if
the declarations shows a combined single limit (“CSL”).
Form 1918 TX (02-2021) Page 7 of 53

Mold or fungus means, no matter the cause, any form or type of:
1. Mold, mildew or yeast;
2. Fungus or fungi; or
3. Any of the following produced or released by such:
a. mycotoxins, toxins or spores;
b. scents or odors;
c. bacteria or viruses; or
d. any other by-products or organism(s) that result.
Motor vehicle means a motorized self-propelled land vehicle that is designed for use on public roads.
Motor vehicle business means any business related to or involving motor vehicles or trailers including, but not limited to:
1. Selling, leasing or renting;
2. Repairing, servicing or delivering;
3. Loading or unloading;
4. Testing, road testing or test-driving;
5. Storing, parking or valet parking;
6. Towing; or
7. Washing, cleaning or detailing of;
any motor vehicle or trailer.
Named insured means the person(s) or entity set forth on the declarations as the policyholder or designated as “Named
Insured”. If the named insured is not a person, then there is no coverage under this Policy for any relative, spouse or registered
domestic or civil union partner.
Newly acquired auto means an auto newly owned by you during the Policy period, if it:
1. Replaces an insured auto; or
2. Is an added auto;
but only if you pay us any extra premium when due.

Subject to the terms of this definition, the coverage that applies to a newly acquired auto is as follows:
1. If a newly acquired auto replaces an insured auto, it will have the same coverage as the auto replaced as of the date you
acquire the auto.
Except that, you must give us notice of a newly acquired auto replacing an insured auto no later than twenty (20) days
after the date on which you become the owner of that replacement auto if you want to:
a. add any coverage for damage to that auto; or
b. continue existing coverage for damage to that auto after the initial twenty (20) days after the date on which you or
your spouse become the owner of that replacement auto.
2. If a newly acquired auto is an added auto that does not replace an insured auto, as of the date acquired by you, that
added newly acquired auto will have the broadest coverage that applies to any insured auto shown on the declarations
(unless you request otherwise), but only if you give us notice no later than twenty (20) days after the date on which you
or your spouse become the owner of that additional auto.
3. If no insured auto has Physical Damage Coverage, any coverage added for physical damage will apply back to the date of
ownership after:
a. you ask us for that coverage; and
Form 1918 TX (02-2021) Page 8 of 53

b. you have paid any extra premium when due for this coverage.
4. If you want to add any coverage or increase any limits, this will apply back to the date of ownership after:
a. you ask us for that coverage; and
b. you have paid any extra premium when due.
5. If a newly acquired auto is an added auto that does not replace an insured auto, but you do not give us notice within
twenty (20) days from the date you own or possess the auto, or you give us notice but do not pay the extra premium
when due, no insurance will apply under this Policy with respect to the ownership, maintenance or use of that auto
unless and until after:
a. you ask us to insure the added auto;
b. you provide us all information we require to determine:
(1) if the auto is an acceptable insurable risk under our Rules and Guidelines; and
(2) the correct premium to insure it; and
c. you pay the extra premium when due.
A newly acquired auto includes an auto and also includes any pickup, utility vehicle, or van with a gross vehicle weight
of 25,000 pounds or less that is not used for the delivery or transportation of goods, materials, or supplies, other than
samples, unless the:
(1) Delivery of the goods, materials, or supplies is not the primary use for which the vehicle is employed; or
(2) Vehicle is used for farming or ranching.
Non-owned auto means an auto that:

1. Is not:
a. owned by;
b. registered in the name of; or
c. furnished or available for the regular or frequent use of;
you, a relative or a rated driver; and
2. Is being used with permission from the owner or a person in lawful possession of that auto. A non-owned auto does not
include any rented auto or temporary substitute auto.
Nuclear event means and includes any nuclear exposure, reaction, radiation or radioactive contamination, no matter how
caused and/or as a consequence of any of these.
Occupying means in, on or getting in or out.
Original equipment manufactured and OEM mean parts, equipment or items produced and/or installed by:
1. The manufacturer of the vehicle; or
2. A vendor of the manufacturer of the vehicle that the manufacturer intends as part of the vehicle or a manufacturer’s
option when new.
Original equipment means equipment, devices or accessories that are permanently installed:
1. By the original factory manufacturer of the vehicle at the time of its original assembly or fabrication;
2. By the vehicle dealer as an original manufacturer new car option at the time of the vehicle’s original retail sale and
purchase; or
3. To replace an item in paragraph 1 or 2 above in this definition with equipment, devices or accessories with similar
function and value if such item is common to the use of an insured auto as a vehicle, and is not an item of custom
equipment (as that term is defined in Part D).
Own or owner means to have or hold (or the person or entity who has or holds):
Form 1918 TX (02-2021) Page 9 of 53

1. Legal title to the motor vehicle, auto or trailer; or
2. Primary legal possession of the motor vehicle, auto or trailer:
a. that is leased or rented to that person or entity under the terms of a written contract for a continuous period of six
(6) months or more; or
b. subject to a lien or security agreement.
Pedestrian means a person who is not occupying a:
1. Self-propelled or motorized vehicle (other than a wheelchair or a similar low-powered motorized or mechanically
propelled vehicle that is designed for use to assist a person with a physical disability); or
2. Vehicle of any type or a trailer designed to be pulled by a self-propelled or motorized vehicle.
Permanently installed means a part or item is attached by bolts, brackets, screws, paint, adhesive, welding or other means so
that it cannot be unattached without the use of tools or chemicals.
Person means a human being.
Personal vehicle sharing program, also referred to as a peer-to-peer car sharing program, means a legal entity engaged in the
business of, or any other for-profit activity related to, facilitating the sharing of motor vehicles for use by individuals by
connecting vehicle owners or drivers with passengers through the use of prearranged vehicle sharing services by using an
online-enabled or digital application, software, website, system or platform.
Pollutants or hazardous materials means any solid, liquid, gaseous or thermal substance, irritant or contaminant. This
includes, but is not limited to:
1. Smoke, vapor, soot, fumes, acids, alkalis, toxic chemicals, asbestos, lead;
2. Explosive or flammable substances;
3. Any waste material or product (this includes, but is not limited to, materials that may be recycled, reconditioned, or
reclaimed, whether or not known to result in environmental damage);
4. Any harmful biological, pathogenic, poisonous or toxic chemical, liquid, gas or substance; and
5. Pollutants as defined by any law of the United States of America.
Pollutants or hazardous materials does not include:
1. Cleaning products, but only when in amounts for ordinary household use and transported in the original product
container.
2. Products and fluids intended for, and normal to, the use of a motor vehicle, but only when used in the proper and
intended scope of the vehicle’s normal use.
3. Fuel for a motorized vehicle or lawn and yard equipment, but only when being safely transported in a federally approved
container.
Punitive or exemplary damages means all damages (other than compensatory damages) awarded to:
1. Punish or deter conduct; and/or
2. Fine, penalize or impose a statutory penalty due to conduct;
or due to conduct that is malicious, grossly negligent, wanton, willful, fraudulent or unlawful.
This includes, but is not limited to, any:
1. Damages that have been defined by law as punitive damages or exemplary damages (for example, double, treble or
statutory multiple damages); and
2. Costs, attorney fees, other fees or interest awarded because of such damages.
Racing or performance driving means when using, whether as a driver or passenger, an auto, motor vehicle or any other
vehicle to participate in or practice or prepare for any speed contest, race, stunt, demolition, competition, demonstration,
sport rally, exhibition or activity, or timed contest.
Form 1918 TX (02-2021) Page 10 of 53

Racing or performance driving includes any activity listed in this definition above, whether or not that activity is spontaneous,
planned or organized.
Rated driver means a person, other than you or a relative, who:

1. Is a regular user of an insured auto; or
2. Resides in the same household as you;
and who has been disclosed to us and is shown as a driver on the declarations, but who is not any of the following:
1. Designated as “Excluded”;
2. Listed on a named driver exclusion for this Policy; or
3. A driver designated as “List Only” on the declarations.
Registered domestic or civil union partner means a person who resides primarily with the named insured and is legally
recognized as a domestic partner or civil union partner of that named insured as registered under a domestic partner or civil
union law.
Relative means a person related to you by blood, marriage or adoption, including your ward or foster child, who primarily
resides in your household. A relative includes your unmarried and dependent child who has resided in your household but is
temporarily away from your household attending school or in military service who intends to continue to primarily reside in
your household except while attending school or in military service.
Spouse means the person lawfully married to and who resides with the named insured.
Trailer means a non-motorized device designed to be towed by an auto on public roads. This does not include any trailer:
1. Being used as a residence or premises;
2. Used for office, store, commercial or business purposes; or
3. Used to carry or transport persons.
Transportation network company (“TNC”) means an organization or entity, that includes, but is not limited to, a corporation,
limited liability company, partnership, sole proprietor, or any other entity, that provides prearranged transportation services
for compensation using an online-enabled or digital application, software, website, system or platform. The transportation
type services this definition applies to, without limitation, and includes any transport or delivery of persons.
Uncollectible instrument and not honored upon presentment, means a bank or other financial institution does not honor, or
does not recognize, a form of payment. This includes, though is not limited to, a payment where:
1. A check is dishonored or refused due to insufficient funds;
2. A check or transfer is drawn from empty or closed accounts;
3. There is an invalid credit or debit card;
4. Credit card charges are dishonored or refused by the issuing financial institution; or
5. Funds transferred via any electronic means or method are refused, dishonored or rejected;
all of which are deemed nonpayment of premium.
War means and includes war (declared or not), civil war, insurrection, rebellion, revolution or any act by a government force
to respond to or defend against war or threat of attack.
Form 1918 TX (02-2021) Page 11 of 53

PART A - LIABILITY COVERAGE
(BODILY INJURY / PROPERTY DAMAGE)
INSURING AGREEMENT
If the premium for Bodily Injury Liability Coverage and/or Property Damage Liability Coverage has been paid when due, that
coverage(s) shown on the declarations will apply under this Policy and is subject to all Policy terms.
We will pay for:
1. Compensatory damages, subject to the Limits of Liability, that an insured is legally liable for because of:
a. bodily injury to others; and/or
b. property damage (including property damage to a temporary vehicle);
caused by or resulting from an accident that arises out of the ownership, maintenance or use of an auto or vehicle for
which that insured is covered by the terms of this Liability Coverage; and
2. Costs incurred to settle and defend a claim or suit brought against an insured. We will investigate, negotiate and settle or
defend with counsel selected, hired and paid by us. Any payment(s) for defense costs does not to reduce the limit of
liability for the applicable coverage shown on the declarations.
Our duty to settle or defend when our limit of liability has been:
a. exhausted by payment or judgments or settlements; or
b. deposited into a court with jurisdiction.
We have no duty to defend, settle, pay or investigate any claim, lawsuit or judgment not covered under the terms this Policy.
Subject to the Limits of Liability, compensatory damages to which this Liability Coverage applies includes prejudgment interest
awarded against an insured.
SUPPLEMENTAL PAYMENTS
If Bodily Injury Liability Coverage and/or Property Damage Liability Coverage apply to cover damages that arise from an
accident, we also will pay to or on behalf of an insured:
1. Court costs of any suit for damages.
2. Post- judgment interest on all compensatory damages owed by an insured as the result of a judgment until we pay, offer
or deposit in court the amount due under this coverage. We have no duty to make any interest payment if we have not
been given both:
a. notice of suit; and
b. the chance to defend an insured.
3. Premiums or costs for the purchase of bonds:
a. to secure the release of an insured's property attached under a court order in any lawsuit we defend, up to our limit
of liability for the face amount of the bond.
b. required to appeal a decision in a suit for damages that we are defending.
We have no duty to:
a. apply for, furnish, or secure any bonds; or
b. pay premiums for or the cost of any bond in an amount that is greater than our limit of liability.
4. Expenses incurred by an insured at our request. We must be given written proof (that can be verified) of the expenses
incurred.
Form 1918 TX (02-2021) Page 12 of 53

5. If requested by the insured, loss of actual wages or salary (but not other income) incurred by the insured, up to $200 per
day, as a result of attending at our request:
a. the trial of a civil suit; or
b. any related mediation, arbitration, deposition or hearing.
Any supplemental payment by us, as set forth directly above, is separate from and does not reduce the limit of liability that
applies to the covered accident.
ADDITIONAL DEFINITIONS
This Part A Definitions section defines some words and phrases used in Part A. Defined words and phrases are shown in bold
face type. The words, phrases and meanings set forth directly below apply:
1. When that word or phrase is used in Part A; and
Additional named insured means a trust that holds legal title to an insured auto and has been designated by you as an
additional named insured as shown on the declarations.
Insured means:
1. You, relatives, and other rated drivers for the:
a. ownership, maintenance or use of an insured auto or a newly acquired auto.
b. use or operation of a non-owned auto with permission from its owner.
c. use or operation of a temporary vehicle with permission from its owner or the repair facility providing that
temporary vehicle. This also includes a licensed driver who resides in the named insured’s household and who uses a
temporary vehicle with permission from its owner or the repair facility providing that temporary vehicle.
d. use of a trailer while it is being towed by any of these autos or a temporary vehicle.
2. Any other person for the use or operation of an insured auto or a newly acquired auto, with express or implied
permission from you or the person with lawful possession of the vehicle, if that use is within the scope of that permission.
3. For the use of an insured auto, any person, organization or additional named insured that has no other applicable
insurance, but only as to legal liability for acts or omissions of a person who is an insured in clause 1 or 2 above for whom
coverage is afforded under this Liability Coverage. This does not increase our limit of liability, and ends when liability of a
person who is an insured in clause 1 or 2 above has been exhausted.
However, insured does not include:
1. You, relatives, other rated drivers or any other person while any such person is using a motor vehicle other than an
insured auto if that motor vehicle is:
a. owned by;
b. registered to; or
you, a relative or a rated driver.
Property damage means:

1. Physical harm to, or destruction of, tangible real or personal property; and
2. Loss of use that results from that physical harm or destruction.
Repair facility means a person who rebuilds, repairs, or services a motor vehicle for consideration or under a warranty,
service, or maintenance contract.
Form 1918 TX (02-2021) Page 13 of 53

Temporary vehicle includes a motor vehicle that is:
1. Loaned or provided by an automobile repair facility to you, a relative, a rated driver or a licensed driver residing in the
named insured’s household for use while an insured auto is at the repair facility for service, repair, maintenance, or
damage or to obtain an estimate, and the loaned or provided motor vehicle is:
a. in the lawful possession of you, a relative, a rated driver or a licensed driver residing in the named insured’s
household;
b. not owned by you, a relative or any other person residing in your household; and
c. operated by or in the possession of the you, a relative, a rated driver or a licensed driver residing in the named
insured’s household up until the vehicle is returned to the repair facility; and
2. Of one of the following types only:
a. a private passenger automobile; or
b. a pickup, utility vehicle, or van with a gross vehicle weight of 14,000 pounds or less that is not used for the delivery or
transportation of goods, materials, or supplies, other than samples, unless:
(1) the delivery of the goods, materials, or supplies is not the primary use for which the vehicle is employed; or
(2) the vehicle is used for farming or ranching.
EXCLUSIONS
THERE IS NO COVERAGE UNDER PART A FOR, AND WE HAVE NO DUTY TO DEFEND, ANY INSURED:
1. For bodily injury, property damage or any other damages:
a. caused by an intentional act of an insured or at the direction of an insured; or
b. that is or should be reasonably expected to result from an intentional act of an insured; even if that resulting bodily
injury or property damage is:
a. of a different kind or degree than expected or intended; or
b. sustained by a different person(s) than expected or intended.
This does not apply for an insured if that insured has not participated in or consented to the intentional act.
2. For property damage to property owned or being transported by that insured.
3. For property damage to property:
a. rented or leased to; or
b. in the charge or care of;
that insured. This does not apply to damage to a rented residence, a rented private garage or a temporary vehicle.
4. While the insured auto is parked and being used as a living space, residence or premises.
5. For bodily injury to:
a. any employee of an insured during the course of employment. This does not apply to your household employee who
is not covered or not required to be covered under any worker's compensation insurance.
b. a fellow employee while on the job and that arises out of the maintenance or use of any vehicle by another employee
in the employer’s business. This does not apply to you as to bodily injury to a fellow employee.
6. For any obligation of an insured, or that insured’s insurer, under any type of worker’s compensation or disability or
similar law.
Form 1918 TX (02-2021) Page 14 of 53

7. For liability assumed by the insured under a bailment, contract or agreement. This does not apply if and when there is
otherwise covered use of a temporary vehicle under this Part A.
8. While an insured auto is:
a. rented, leased, sub-leased, or given by you, a relative or a rated driver to anyone in exchange for payment or any
form of compensation or value or reimbursement, though this does not apply if you or a relative lend that auto to
another person for reimbursement of operating expenses only;
b. is entrusted to another person or party for the purpose of subleasing, leasing, renting, selling, consignment for sale,
or promoting sale, and is no longer in the possession of you, a relative or a rated driver; or
c. subject to any conditional sale or purchase agreement not declared in this Policy.
This does not apply to you, a relative or a rated driver using or operating an insured auto.
9. For bodily injury, property damage or any other damages for which the United States government may be found liable
under the Federal Tort Claims Act or otherwise.
10. For bodily injury, property damage or any other damages that result from pollutants or hazardous materials, including
any order, demand, claim or suit for testing for, monitoring, cleaning up, removing, treating, neutralizing or remediating
pollutants or hazardous materials or environmental damage.
11. For bodily injury, property damage or any other damages that result from war or any nuclear event.
12. For any type or sort of punitive or exemplary damages.
13. With respect to the ownership, operation, or use of any type of auto, motor vehicle or trailer:
a. while it is being used to carry persons for a fee or for which expense reimbursement is to be paid; this does not apply
to a share-the-expense car pool;
b. while it is being used to carry property for a fee or for business;
However, exclusion 13.b. does not apply to:
(1) vehicles used for farming or ranching;
(2) vehicles not primarily used for delivery or transportation of goods, material, supplies, other than samples; or
(3) a temporary substitute vehicle that is:
i. a private passenger automobile;
ii. a pickup, utility vehicle, or van with a gross vehicle weight of 14,000 pounds or less that is not primarily
used for the delivery or transportation of good, materials, or supplies other than samples; or
iii. used in farming or ranching;
c. while you or a relative is a driver of an auto, motor vehicle or trailer and is logged on to a transportation network
company’s digital network as a transportation network company driver or is engaged in a prearranged drive as
described in Chapter 1954 of the Texas Insurance Code;
d. while it is rented or leased to another; this does not apply if you or a family member lends the auto, motor vehicle or
trailer to another for reimbursement of operating expenses only; or
e. while it is being used, with a personal vehicle sharing program or other similar program that engages in the business
of facilitating the sharing of private passenger motor vehicles.
14. For bodily injury, property damage or any other damages incurred while using any motorized vehicle or device, other
than an insured auto that is insured for this coverage or a newly acquired auto, that is owned by, or furnished or
available for the regular use of, you, a relative or a rated driver.
15. For bodily injury to you, a relative or a rated driver residing in your household. This does not apply to the amount of
otherwise covered damages that is less than or equal to minimum limits.
16. With respect to the ownership, operation, or use of any type of auto, motor vehicle or trailer that is being used for racing
Form 1918 TX (02-2021) Page 15 of 53

or performance driving.
17. Who is operating or using any type of auto or other motor vehicle while committing, aiding, or abetting a felony or
seeking to elude lawful apprehension or arrest by a law enforcement official.
18. For any payment on final conviction of the insured for loss for an insured auto seized by federal state law enforcement
officers as evidence is a case against the insured under Chapter 481, Health and Safety Code, or under the federal
Controlled Substances Act.
LIMITS OF LIABILITY
If purchased, the limit(s) of liability for Bodily Injury Liability Coverage and/or Property Damage Liability Coverage are shown
on the declarations and are subject to the following:
1. For any one covered accident, the limit that applies is the most we will pay no matter the number of:
a. insureds, heirs, survivors or wrongful death beneficiaries;
b. vehicles and/or trailers involved in the accident;
c. claims made;
d. lawsuits filed;
e. autos, trailers, or vehicles covered or shown on the declarations;
f. premiums paid; or
g. policies issued by us to you.
2. Split Limit Liability Coverage
If you bought Liability Coverage with a split limit that sets forth separate limits for Bodily Injury Liability Coverage and
Property Damage Liability Coverage, then for your Liability Coverage:
a. The Bodily Injury limit of liability shown on the declarations that applies “Per Person” is the most we will pay for all
covered damages due to bodily injury sustained by any one person in any one accident.
b. Subject to the limit of liability that applies “Per Person”, the Bodily Injury limit of liability shown on the declarations
that applies “Per Accident” is the most we will pay for all covered damages due to bodily injury sustained by two or
more persons in any one accident. Without changing this “Per Accident” limit, we will apply that limit to provide any
separate “per person” limit required by law for bodily injury liability.
c. The Property Damage limit of liability shown on the declarations is the most we will pay for all covered damages due
to property damage sustained in any one accident.
d. The limit that applies “Per Person” includes all claims, causes of action and lawsuits of others that related to or derive
from the bodily injury of the injured person. When allowed by law, this limit includes, but is not limited to, all claims
and lawsuits for:
(1) Emotional distress or mental anguish as a result of seeing the accident.
(2) Loss of: society, companionship, services, support and/or consortium.
(3) Wrongful death.
3. The limit is not increased in any way if there is a covered accident that involves a trailer attached to and being towed by
an auto or temporary vehicle.
4. If any exclusion, limit of liability or other limitation in this policy is deemed by a court of law with proper jurisdiction to be
in violation of the compulsory insurance or financial responsibility laws of the state where you reside, that exclusion or
limitation shall remain in effect and apply to all damages in excess of the minimum limits required under that compulsory
insurance or financial responsibility law.
OUT-OF-STATE COVERAGE
If an accident covered under this Policy occurs in any state, territory or province within the Policy Territory but other than the
one in which an insured auto is principally garaged (as shown in our records), and that other state, territory or province has a
financial responsibility, compulsory or mandatory insurance or other similar law that requires all owners or operators of an
auto to have:
Form 1918 TX (02-2021) Page 16 of 53

1. Liability insurance with limits of liability for bodily injury or property damage higher than the limits shown on the
declarations, we will provide that required higher limit for Liability Coverage under this Policy. Unless required by law to
do so, we will not provide any Liability Coverage for an accident if the declarations shows you did not buy Liability
Coverage from us on this Policy.
2. Specific types of insurance coverage whenever an auto is driven in that state, territory or province, we will provide the
required minimum amounts and types of coverage so required.
FINANCIAL RESPONSIBILITY
The liability insurance coverage under this Policy is provided in accord with the liability coverage required by, and is subject to,
the Texas Motor Vehicle Safety Responsibility Act, as amended, to the extent required, for bodily injury and property
damage.
When certified by us under any law as proof of future financial responsibility, and while required during the policy period, this
Policy shall comply with such law to the extent required. If we make a payment we would not have made if this Policy had not
been certified as proof of future financial responsibility, we must be reimbursed by you or an insured for that payment and
related costs.
OTHER INSURANCE OR COVERAGE
If there is other similar coverage or source of recovery that applies and is collectible, the following apply subject to all other
terms in this Policy:
1. If any other auto or vehicle liability coverage, bond or self-insurance applies to the same accident:
a. we will not pay more than our share of the damages; and
b. our share is the proportion that the limit of liability of this Policy bears to the total of all auto or vehicle liability
coverage, bond or self-insurance that apply, with the same level of priority, to the accident.
However, if there is other applicable insurance, we shall be entitled to reimbursement of an equal share of the defense
cost and attorney fees in any lawsuit we defend.
This “Other Insurance or Coverage” clause does not create, expand or imply any coverage that does not already exist under
the terms of this Policy.
BANKRUPTCY
The bankruptcy or insolvency of an insured, or that person or party’s estate, shall not relieve us of any obligations under this
Policy.
PART B-I – PERSONAL INJURY PROTECTION COVERAGE (PIP)

INSURING AGREEMENT
We will pay Personal Injury Protection (“PIP) benefits to an insured who sustains bodily injury unless rejected by you in
writing. The PIP benefits described here will apply under this Policy and are subject to all Policy terms and the State of Texas
insurance laws (as amended).
We will pay, without regard to fault and subject to the Limits of Liability and all Policy terms, for the following PIP benefits:
1. Reasonable and necessary medical expenses;
2. Funeral expenses;
3. Income loss;
4. Loss of essential services;
that arise out of bodily injury sustained by an insured as a result of a motor vehicle accident.
We will pay only for the above listed PIP benefits if the expenses and/or losses are incurred:
1. Because of bodily injury sustained by that insured as a result of an accident involving a motor vehicle; and
2. Within three (3) years from the date of the accident.
Form 1918 TX (02-2021) Page 17 of 53

This Part B-I Definitions section defines some words and phrases used in Part B-I. Defined words and phrases are shown in
bold face type. The words, phrases and meanings set forth directly below apply:
1. When that word or phrase is used in Part B-I; and
Funeral expenses means fees, costs or charges incurred or required to be paid for services directly related to the funeral,
burial, cremation and/or internment of the remains of an insured who has died as a result of bodily injury sustained by that
insured as a result of a motor vehicle accident covered by this Part B-I.
Income loss means eighty percent (80%) of actual income lost by the injured insured as the result of a motor vehicle accident
covered by this Part B-I, subject to the following:
1. At the time of the accident, the insured must be:
a. an income or wage producer; or
b. in an occupational status.
2. No more than eighty percent (80%) of income lost from employment, work or other remunerative occupation by an
injured insured as a result of the accident will be paid under this Part, subject to all other limits.
3. Income loss is the difference between the:
a. income that would have been earned if the insured had not been injured; and
b. amount of income actually received from the injured insured’s employment, work or remunerative occupation during
the period of disability.
4. To determine income amounts, one of the following methods will be used:
a. if the income being earned as of the date of the accident is a salary or fixed remuneration, it shall be used in
determining the amount of income which would have been earned; or
b. the average monthly income earned during the twelve (12) month period preceding the accident will be used.
Income loss benefits do not apply after the death of the injured insured.
Insured means:
1. You, relatives and rated drivers:
a. while operating or occupying an auto or motor vehicle designed for use mainly on public roads; or
b. when as a pedestrian is struck or injured by any auto or motor vehicle designed for use mainly on public roads or a
trailer of any type.
2. Any other person while lawfully operating or occupying an insured auto or a newly acquired auto, including a guest
occupant, if doing so with permission from you.
Insured does not include you, relatives or any other person while any such person is using a motor vehicle (other than an
insured auto or a newly acquired auto) if that motor vehicle is:
1. owned by;
2. registered to; or
3. furnished or available for the regular or frequent use of;
you or a relative.
Loss of essential services means necessary and reasonable expenses incurred for essential services ordinarily performed,
without pay, by the injured insured for the care and maintenance of the family or family household.
Loss of essential services benefits:
1. Apply only in the case of an insured who was not an income or wage producer, or not in an occupation status, at the time
Form 1918 TX (02-2021) Page 18 of 53

of the accident.
2. Do not apply to any expense after the death of that insured.
Medical expenses mean reasonable fees, costs or charges incurred or required to be paid for necessary medical treatment,
services, procedures and products provided or prescribed by a licensed health care provider, and within the proper scope of
that provider’s practice, including:
1. Ambulance, hospital, surgical, medical, dental, x-ray, professional nursing, chiropractic, and pharmaceutical services;
2. Physical, occupational, and vocational therapy and rehabilitation;
3. Speech and hearing therapy and rehabilitation; and
4. Medications, prosthetic and orthopedic devices, eyeglasses, hearing aids, and other medical products and supplies.
Medical expenses do not include any fees, costs or charges for:
1. Services that are not necessary for treatment or care of the bodily injury sustained in the accident.
2. Massage therapy not prescribed by a licensed doctor or chiropractor.
3. Treatment, services, procedures and products that are experimental or for research, or not commonly recognized in the
medical profession as a customary treatment for the bodily injury.
EXCLUSIONS
THERE IS NO COVERAGE UNDER PART B-I FOR BODILY INJURY SUSTAINED BY ANY PERSON:
1. If that person’s own conduct contributed to the bodily injury sustained by that person and:
a. was caused intentionally by that person; or
b. occurred while committing a felony or while seeking to elude lawful apprehension or arrest by a law enforcement
official.
2. While occupying or through being struck by any motor vehicle (other than an insured auto that is insured for this coverage
or a newly acquired auto) owned by, or furnished or available for the regular use of, you or a relative.
3. While occupying the insured auto
while you or a relative is a driver of an auto, motor vehicle or trailer and is logged on to a transportation network
described in Chapter 1954 of the Texas Insurance Code.
LIMITS OF LIABILITY
The limit of liability for Personal Injury Protection Coverage (PIP) for any one insured injured in any one accident and is subject
to the following:
1. For any one insured injured in any one covered accident, the limit that applies is the most we will pay no matter the
number of:
c. claims made;
d. lawsuits filed;
e. autos, trailers, or vehicles covered or shown on the declarations; or
f. premiums paid.
an auto or motor vehicle.

If there is other similar auto or motor vehicle personal injury protection coverage or source of recovery, the following apply
subject to all other terms in this Policy:
Form 1918 TX (02-2021) Page 19 of 53

1. If any other auto or vehicle coverage, bond or self-insurance applies to the same accident:
a. we will not pay more than our share of the damages, expenses or loss; and
b. our share is the proportion that the limit of liability of this Policy bears to the total of all auto or vehicle coverage,
bond or self-insurance that apply, with the same level of priority, to the accident.
2. However:
a. for a motor vehicle accident arising out of the insured occupying or using any motor vehicle, other than an insured
auto or a newly acquired auto, if that other auto or motor vehicle is insured with personal injury protection or
medical payments coverage or similar coverage under a policy of insurance, bond or self-insurance, any coverage
provided under this Policy shall be excess.
b. Personal Injury Protection benefits under this Policy shall be primary to any Part B-II Medical Payments Coverage
under this Policy.
MEDICAL EXPENSE REVIEW
To determine if medical expenses are reasonable and necessary for both the diagnosis and treatment of the insured’s bodily
injury, we have the right to:
1. Review each medical expense and other expenses; and
2. Pay only those expenses that are found by us to be covered, reasonable and necessary. The insured will not be
responsible for payment of any reduction applied by us. If a medical provider disputes an amount paid by us, we will be
responsible for resolving such disputes.
Our review may include the use independent sources of information and services of our choice. This includes, but is not
limited to:
1. Physical exams performed by state licensed health care providers we select and pay for, as often as we reasonably
request;
2. Review of medical files reasonably related to the loss, including but not limited to records, reports, notes, clinical
observations, and test results, all of which the insured must make available to us;
3. Published sources of medical expense information and fee schedules;
4. Computer databases and software; and/or
5. Use of third-party cost containment and utilization review providers to identify excessive or inappropriate treatments and
expenses.
We have no obligation to pay for any medical expense, or portion thereof, that:
1. Is not reasonable or not necessary for the diagnosis or treatment of the insured’s bodily injury.
2. Is for treatment of bodily injury that is not the result of the covered accident.
3. Results from a service, treatment, procedure and/or product that is not provided and prescribed by a licensed health care
provider acting within the proper scope of that license.
4. Is provided by any provider who is not licensed where the treatment, service or care was rendered, where such provider
is required by law to be licensed to render, provide or perform the treatment, service or care.
ASSIGNMENT OF BENEFITS
If the insured gives us a written and signed assignment of benefits for medical expenses that are payable under this coverage:
1. We will pay for those medical expenses directly to the health care provider; and
2. If we do this, we have no further obligation to pay those same benefits to an insured or to any other person or party.
Form 1918 TX (02-2021) Page 20 of 53

PART B-II - MEDICAL PAYMENTS COVERAGE
INSURING AGREEMENT
If the premium for Medical Payments Coverage has been paid when due, that coverage(s) shown on the declarations will
apply under this Policy and is subject to all Policy terms.
We will pay, subject to the Limits of Liability, for:
1. The usual and customary charge incurred for reasonable and necessary medical expenses incurred by an insured; and
2. Funeral expenses incurred on behalf of an insured;
that arise out of bodily injury sustained by an insured as a result of a motor vehicle accident.
We will pay only for:

1. Those expenses incurred for services furnished within one (1) years from the date of the accident; and
2. Funeral expenses incurred due to death of an insured if it:
a. occurs within ninety (90) days of the accident; and
b. is a direct result of the bodily injury from the accident without any other cause.
Payment after death of an insured shall be made:

1. To the surviving spouse or registered domestic or civil union partner; or
2. If there is no surviving spouse or registered domestic or civil union partner, to a parent or guardian or the deceased
insured's estate as we deem most reasonable.
This Part B-II Definitions section defines some words and phrases used in Part B-II. Defined words and phrases are shown in
bold face type. The words, phrases and meanings set forth directly below apply:
1. When that word or phrase is used in Part B-II; and
Funeral expenses means fees, costs or charges incurred or required to be paid for services directly related to the funeral,
burial, cremation and/or internment of the remains of an insured who has died as a result of bodily injury sustained by that
insured as a result of a motor vehicle accident covered by this Part B-II.
Insured means:
1. You, relatives and rated drivers:
a. While operating or occupying; or
b. When as a pedestrian is struck by;
any auto or motor vehicle designed for use mainly on public roads; and
2. Any other person while occupying an insured auto with permission from you.
Insured does not include:
1. You, relatives or any other person while any such person is using a motor vehicle other than an insured auto if that
motor vehicle is:
a. owned by;
b. registered to; or
Form 1918 TX (02-2021) Page 21 of 53

you or a relative.
Medical expenses mean reasonable fees, costs or charges incurred or required to be paid for necessary medical treatment,
services, procedures and products provided or prescribed by a licensed health care provider, and within the proper scope of
that provider’s practice, including:
1. Ambulance, hospital, surgical, medical, dental, x-ray, professional nursing, chiropractic, and pharmaceutical services;
2. Physical, occupational, and vocational therapy and rehabilitation;
3. Speech and hearing therapy and rehabilitation; and
4. Medications, prosthetic and orthopedic devices, eyeglasses, hearing aids, and other medical products and supplies.
Medical expenses do not include any fees, costs or charges for:
1. Services that are not necessary for treatment or care of the bodily injury sustained in the accident.
2. Massage therapy not prescribed by a licensed doctor or chiropractor.
3. Treatment, services, procedures and products that are experimental or for research, or not commonly recognized in the
medical profession as a customary treatment for the bodily injury.
Usual and customary charge means the fees, costs or charges we determine that represents a common and typical charge for
services in the geographical area in which the service is rendered. We may determine the usual and customary charge by
using independent sources of our choice.
EXCLUSIONS
THERE IS NO COVERAGE UNDER PART B-II FOR BODILY INJURY:
1. Caused and sustained by an insured due to the intentional act of that insured or at the direction of that insured.
2. To the extent worker’s compensation benefits are required to be paid or are payable.
3. Sustained while using or occupying any motorcycle, moped or any other similar motorized vehicle which has less than
four (4) wheels.
4. Sustained while occupying or using a vehicle without permission to do so from the owner of the vehicle. This does not
apply to you, relatives or rated drivers when occupying an insured auto insured for this coverage or a newly acquired
auto.
5. Sustained while occupying or using an insured auto or a newly acquired auto when that auto is:
another person for reimbursement of operating expenses only;
b. entrusted to another person or party for the purpose of subleasing, leasing, renting or selling and is no longer in the
possession of you, a relative or a rated driver; or
c. subject to any conditional sale or purchase agreement not declared in this Policy.
6. That results from pollutants or hazardous materials being transported by an insured.
7. That results from war or any nuclear event.
8. That results from the ownership, operation, or use of any type of auto, motor vehicle or trailer:
a. as a public or livery conveyance; or
b. for any transport or delivery of persons, property, food or goods for compensation or a fee, or in the course of any
similar for-profit activity. For example, this exclusion applies, but it not limited to:
(1) the pickup, carrying and drop off of persons, property, food or goods;
(2) any transport or delivery of food, packages, parcels or other property.
Form 1918 TX (02-2021) Page 22 of 53

This exclusion 8. does not apply to:
a. a share-the-expense car pool;
b. use for a charitable or volunteer purpose; or

c. for bodily injury to an insured when a passenger who is not operating a motor vehicle.
9. Sustained while occupying or using a motor vehicle in any business of an insured except a business of the insured we
approved and for which you have paid a business use surcharge on this Policy. This exclusion does not apply for bodily
injury sustained while occupying or using:
a. a private passenger auto;
b. a pickup or van that you own; or
c. a trailer using a vehicle described in 9.a. or 9.b. above.
10. Sustained while using or being struck by any motorized vehicle or device (other than an insured auto that is insured for this
coverage or a newly acquired auto) owned by, or furnished or available for the regular use of, you, a relative or a rated
driver.
11. Sustained while occupying or using any type of auto, motor vehicle or other motorized device for racing or performance
driving.
12. Sustained by an insured while that insured is committing, aiding, or abetting a felony or seeking to elude lawful
apprehension or arrest by a law enforcement official.
13. Caused by, or arising out of the actual, alleged or threatened presence, growth, proliferation or spread of mold or fungus,
without regard to the factors causing or contributing to its growth.
However, this exclusion does not apply to fungus or mold from an accidental direct covered physical loss.
14. Sustained by an insured while occupying the insured auto:
described in Chapter 1954 of the Texas Insurance Code; or
d. while it is being used with a personal vehicle sharing program or other similar program that engages in the business
LIMITS OF LIABILITY
If purchased, the limit of liability for Medical Payments Coverage is shown on the declarations for any one insured and is
subject to the following:
Form 1918 TX (02-2021) Page 23 of 53

1. For any one insured injured in any one covered accident, the limit that applies is the most we will pay no matter the
number of:
c. claims made;
d. lawsuits filed;
an auto or motor vehicle.
3. The limit of liability for the aggregate of all medical expenses and funeral expenses, combined, is the Medical Payments
Coverage limit shown on the declarations.

If there is other similar coverage or source of recovery, the following apply subject to all other terms in this Policy:
1. If any other auto or vehicle coverage, bond or self-insurance applies to the same accident:
a. we will not pay more than our share of the damages, expenses or loss; and
b. our share is the proportion that the limit of liability of this Policy bears to the total of all auto or vehicle coverage,
bond or self-insurance that apply, with the same level of priority, to the accident.
2. However:
a. For a motor vehicle accident arising out of the insured occupying or using a non-owned auto, if that auto is insured
with medical payments coverage or similar coverage under a policy of insurance, bond or self-insurance, any
coverage provided under this Policy shall be excess.
b. Insurance provided under this Part B-II coverage will be excess over any benefits the insured is eligible to receive
under any motor vehicle personal injury protection (including, but not limited to, coverage under Part B-I of this
Policy) or other similar type of no-fault insurance.
MEDICAL EXPENSE REVIEW
To determine if medical expenses are reasonable and necessary for both the diagnosis and treatment of the insured’s bodily
injury, we have the right to:
1. Review each medical expense and other expenses; and
2. Pay only those expenses that are found by us to be covered, reasonable and necessary. The insured will not be
responsible for payment of any reduction applied by us. If a medical provider disputes an amount paid by us, we will be
responsible for resolving such disputes.
Our review may include the use independent sources of information and services of our choice. This includes, but is not
limited to:
1. Physical exams performed by state licensed health care providers we select and pay for, as often as we reasonably
request;
2. Review of medical files reasonably related to the loss, including, but not limited to, records, reports, notes, clinical
observations, and test results, all of which the insured must make available to us;
3. Published sources of medical expense information and fee schedules;
Form 1918 TX (02-2021) Page 24 of 53

4. Computer databases and software; and/or
5. Use of third-party cost containment and utilization review providers to identify excessive or inappropriate treatments and
expenses.
We have no obligation to pay for any medical expense, or portion thereof, that:
1. Is not reasonable or not necessary for the diagnosis or treatment of the insured’s bodily injury.
2. Is for treatment of bodily injury that is not the result of the covered accident.
3. Results from a service, treatment, procedure and/or product that is not provided and prescribed by licensed health care
provider acting within the proper scope of that license.
4. Is provided by any provider who is not licensed where the treatment, service or care was rendered, where such provider
is required by law to be licensed to render, provide or perform the treatment, service or care.
ASSIGNMENT OF BENEFITS
If the insured gives us a written and signed assignment of benefits for medical expenses that are payable under this coverage:
1. We will pay for those medical expenses directly to the health care provider; and
2. If we do this, we have no further obligation to pay those same benefits to an insured or to any other person or party.
PART C – UNINSURED (UM) and/or UNDERINSURED MOTORIST (UIM)

COVERAGE
UNINSURED / UNDERINSURED MOTORIST BODILY INJURY COVERAGE (“UM/UIM BI”)

INSURING AGREEMENT
We will provide Uninsured/Underinsured Motorist Bodily Injury Coverage (“UM/UIM BI”) benefits to an insured who sustains
bodily injury unless rejected by you in writing.
We will pay for compensatory damages, subject to the Limits of Liability, that an insured is legally entitled to collect from the
owner or driver of an uninsured motor vehicle or underinsured motor vehicle because of bodily injury:
1. Sustained by that insured;
2. Due to a motor vehicle accident; and
3. That is causally connected to and arises out of the ownership, maintenance, or use of that uninsured motor vehicle or
underinsured motor vehicle.
UNINSURED / UNDERINSURED MOTORIST PROPERTY DAMAGE COVERAGE (“UM/UIM

PD”) INSURING AGREEMENT
We will provide Uninsured/Underinsured Motorist Property Damage Coverage (“UM/UIM PD”) benefits to an insured who
sustains bodily injury unless rejected by you in writing.
We will pay for compensatory damages, subject to the Limits of Liability, for property damage that an insured is legally
entitled to collect from the owner or driver of an uninsured motor vehicle or underinsured motor vehicle due to a motor
vehicle accident. The property damage must be:
1. Caused by a motor vehicle accident; and
2. Causally connected to and arise out of the ownership, maintenance, or use of that uninsured motor vehicle or
underinsured motor vehicle.
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This Part C Definitions section defines some words and phrases used in Part C. Defined words and phrases are shown in bold
1. When that word or phrase is used in Part C; and
Insured means:
1. You, relatives and rated drivers.
2. Any other person for the use or operation of an insured auto or a newly acquired auto, with express or implied
permission from you or the person with lawful possession of the vehicle, if that use is within the scope of that permission.
3. Any person who is entitled to recover damages covered by this Part C because of bodily injury sustained by a person
described in this definition directly above.
However, insured does not include:
1. You, relatives, other rated drivers or any other person while any such person is occupying or using a motorized vehicle or
device (other than an insured auto or a newly acquired auto for which Part C applies as shown on the declarations) if
that vehicle or device is:
a. owned by;
b. registered in the name of; or
you or a relative.
Property damage means physical injury to or destruction of:

1. An insured auto or a newly acquired auto and including its loss of use.
2. Items of tangible personal property owned by:
a. an insured, if that property is in that insured auto (or that newly acquired auto) at the time of the accident.
b. you, a relative or a rated driver, if that property is in any auto being operated by you, a relative or a rated driver (but
not including an auto owned by, or furnished or available for the regular use of, you, a relative or a rated driver if
that auto is not an insured auto or newly acquired auto).
If a child safety seat or restraint system is damaged, or its integrity compromised, while in the auto and due to an
accident covered under this Part C, then subject to the limit of liability shown on the declarations, we will pay to replace
that child safety seat or restraint system with one of like kind and quality.
Underinsured motor vehicle means a motor vehicle to which one or more liability bond or policies applies at the time of the
accident, but the sum of the limits of liability for liability coverage:
1. Is not enough to pay the full amount the insured is legally entitled to recover for compensatory damages for bodily injury
or property damage; or
2. Has been reduced by payment of claims to other persons injured in the accident to an amount which is not enough to pay
the full amount the insured is legally entitled to recover for compensatory damages for bodily injury or property damage.
An underinsured motor vehicle does not include any vehicle or equipment:
1. Shown on the declarations or covered under the Liability Coverage on this Policy;
2. Owned by, furnished to or available for the regular use of you or a relative;
3. Designed for use mainly off public roads except while on public roads;
4. Operated on rails or crawler treads;
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5. While located as a residence or premises; or
6. Owned by any governmental unit or agency.
This definition does not apply if:
1. the operator of the vehicle is uninsured; and
2. There is no statute imposing liability for damage because of bodily injury or property damage on the governmental body for
an amount not less than the limit of liability for this coverage.
If there is a dispute about whether a vehicle is an underinsured motor vehicle, the burden of proof is on us.
Uninsured motor vehicle means a motor vehicle that is:

1. Not insured or bonded for liability at the time of the accident;
2. Insured or bonded for liability at the time of the accident, but the insuring or bonding company:
a. denies coverage; or
b. is or becomes insolvent;
3. Insured or bonded for liability at the time of the accident, but the limits of liability are less than the required minimum
limits; or
4. A hit-and-run motor vehicle for which the owner or driver is unknown and cannot be identified, and that hit-and-run motor
vehicle causes bodily injury to an insured or property damage by actually physically striking or hitting the insured or the
insured auto (or newly acquired auto).
If there is a dispute about whether a vehicle is an uninsured motor vehicle, the burden of proof is on us.
An uninsured motor vehicle does not include any vehicle or equipment:
1. Shown on the declarations or covered under the Liability Coverage on this Policy, unless at the time of the accident that
insured auto is being operated by an uninsured thief who causes:
a. bodily injury to you, a relative or a rated driver; or
b. property damage;
2. Owned by, furnished to or available for the regular use of you or a relative;
3. Designed for use mainly off public roads except while on public roads;
4. Operated on rails or crawler treads;
5. While located for as a residence or premises;
6. Owned by any governmental unit or agency
However, this does not apply if:
a. the operator of the vehicle is uninsured; and
b. there is no statute imposing liability for damage because of bodily injury or property damage on the governmental
body for an amount not less than the limit of liability for this coverage; or
7. Owned or operated by a self-insurer under any financial responsibility, motor vehicle or similar law, except a self-insurer
that is or becomes insolvent.
EXCLUSIONS
THERE IS NO COVERAGE UNDER PART C:
1. For bodily injury sustained by an insured or property damage, or both, resulting from the intentional acts of the insured.
2. To the extent worker’s compensation benefits are required to be paid or are payable.
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3. If the insured, or the insured’s legal representative, settles the claim and harms our rights or interests by so acting.
4. For bodily injury sustained by an insured or property damage:
a. while using or occupying a motorized vehicle or device (other than an insured auto or a newly acquired auto) if the
vehicle or device is owned by, or furnished or available for the regular use of, you or a relative.
b. while occupying or using a vehicle without permission from the owner or the person with lawful possession of the
vehicle to do so from the owner of the vehicle. This does not apply to you, relatives or rated drivers when occupying
an insured auto insured for this coverage or a newly acquired auto.
5. To the extent it benefits, directly or indirectly, any:
a. worker’s compensation or disability benefits insurer or self-insurer under any such or similar law;
b. governmental unit or agency; or
c. insurer or self-insurer of property.
6. While an insured auto is:
another person for reimbursement of operating expenses only; or
b. is entrusted to another person or party for the purpose of subleasing, leasing, renting or selling and is no longer in
the possession of you, a relative or a rated driver.
7. For bodily injury, property damage or any other damages that result from war or any nuclear event.
8. For any type or sort of punitive or exemplary damages.
9. For bodily injury sustained or property damage while using any type of auto, motor vehicle or trailer:
a. as a public or livery conveyance; or
similar for-profit activity. For example, this exclusion applies but it not limited to:

a. a share-the-expense car pool;
b. use for a charitable or volunteer purpose; or
c. for bodily injury to an insured when a passenger who is not operating a motor vehicle.
10. For bodily injury sustained by any person engaged in any way in a motor vehicle business at the time of the accident.
This exclusion does not apply to the ownership, maintenance or use of the insured auto by you, a relative; any rated
driver, or any partner, agent or employee of you, any relative; or any rated driver.
11. For bodily injury or property damage sustained by an insured who is operating or using any type of auto or other motor
vehicle for racing or performance driving.
12. For bodily injury or property damage sustained when the insured auto:
a. is being used to carry persons for a fee or for which expense reimbursement is to be paid; this does not apply to a
share-the-expense car pool;
b. is being used to carry property for a fee or for business.
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c. or you or a relative is a driver of an auto, motor vehicle or trailer and is logged on to a transportation network
d. is being used with a personal vehicle sharing program or other similar program that engages in the business of
facilitating the sharing of private passenger motor vehicles.
LIMITS OF LIABILITY
If purchased, the limit(s) of liability for Uninsured / Underinsured Motorist Coverage are shown on the declarations and are
subject to the following:
1. For any one covered accident, the limit that applies is the most we will pay no matter the number of:
c. claims made;
d. lawsuits filed;
2. Split Limit UM/UIM Coverage
If you bought coverage with a split limit that sets forth separate limits for bodily injury and property damage, then for
your UM/UIM Coverage:
a. The limit of liability shown on the declarations that applies “Per Person” is the most we will pay for all covered
damages due to bodily injury sustained by any one person in any one accident.
b. Subject to the limit of liability that applies “Per Person”, the limit of liability shown on the declarations “Per Accident”
is the most we will pay for all covered damages due to bodily injury sustained by two or more persons in any one
accident. Without changing this “Per Accident” limit, we will apply that limit to provide any separate “per person”
limit required by law for bodily injury liability.
c. The limit that applies “Per Person” includes all claims, causes of action and lawsuits of others that relate to or derive
from the bodily injury of the injured person. When allowed by law, this limit includes, but is not limited to, all claims
and lawsuits for:
(1) Emotional distress or mental anguish as a result of seeing the accident.
(2) Loss of: society, companionship, services, support and/or consortium.
(3) Wrongful death.
d. The limit of liability shown on the declarations for UM/UIM “property damage” or “PD” is the most we will pay under
Part C for all covered damages due to property damage sustained in any one accident, and also subject to the
following:
(1) our payment will not include, and you are responsible for (when applicable), the amount of:
(a) the Texas statutory UM / UIM PD deductible of $250.
(b) the salvage value if you or the owner retains salvage.
(2) PERMISSION TO RELEASE VEHICLE: This Policy allows us to act as your agent to move the insured auto (or a newly
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acquired auto) to a secure, storage free inspection facility in the event an insured auto is non-drivable and
incurring storage and/or any additional accident expenses. We will notify you before the auto is to be moved.
any vehicle.
4. The total damages an insured is legally entitled to recover because of the accident shall be reduced by any amount paid
or to be paid because of bodily injury or property damage (as applicable):
a. by or on behalf of any persons or parties that may be legally responsible, including, but not limited to:
(1) all sums paid under Part A of this policy; and
(2) if an underinsured motor vehicle causes the accident, the total limits of all liability bonds and policies covering
the liable party, as if such liability policies and bonds were exhausted, when an insured enters into a settlement
where those liability bonds or policies that apply to or for use of the underinsured motor vehicle have not been
exhausted by payment of judgments or settlements to the insured, unless either:
(a) we advance payment to the insured in an amount equal to the tentative settlement with the insurer of the
underinsured motor vehicle; or
(b) that lesser amount settled for was solely because the full liability limits were reduced by multiple claims
being paid to other persons injured in the same accident;
b. under Part B-I (PIP) or Part B-II (Medical Payments Coverage) of this Policy, or under any other personal injury
protection or no-fault coverage of any other motor vehicle policy;
c. under any workers’ compensation law, disability benefits law, or similar laws;
d. under Part D for property damage; and
e. from any other source of recovery, including, but not limited to, any other insurance policy.
If there is other similar uninsured and/or underinsured motorist coverage or source of recovery, the following apply subject to
all other terms in this Policy:
1. If the insured sustains bodily injury:
a. As a pedestrian and other similar UM/UIM coverage issued by us or any other insurer applies, we are liable only for
our share. Our share is that proportion of the damages that the limit of liability of this coverage bears to the total of
all such UM/UIM coverage that applies to the accident.
b. While occupying an insured auto, and that insured auto is shown on the declarations page of another policy issued
by us or any other insurer providing UM/UIM coverage, we are liable only for our share. Our share is that proportion
of the damages that the limit of liability of this coverage bears to the total of all such UM/UIM coverage that applies
to the accident.
c. While occupying a vehicle not shown on the declarations of this Policy, coverage under this policy applies as excess
to any other UM/UIM that applies to the vehicle as primary coverage.
2. As to property damage, if there is other similar coverage or source of recovery for property damage and/or any damages
arising from that property damage, then we are liable only for our share. Our share is that proportion of the property
damage that the limit of liability of this coverage bears to the total of all such UM/UIM coverage that applies to the
property damage with the same level of priority.
3. If coverage under more than one policy issued by us or any other insurer applies as excess, we are liable only for our
share. Our share is that proportion of the damages that the highest limit of liability of any policy issued by us bears to the
total of all UM/UIM coverage applicable as excess to the accident.
Notwithstanding the above, for any property damage, or covered damages that result, to which both UM/UIM PD and any
collision coverage, under either this Policy or any other policy, apply in any one accident, you are entitled to:
1. Choose one of those coverages, if applicable, to cover that property damage or loss; or
2. Recover under both of those coverages, if applicable to cover that property damage or loss, but only if neither coverage
alone is sufficient to pay the damages or loss from that accident. If recovering under both coverages, you:
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a. shall designate one coverage as the primary coverage;
b. must exhaust that primary coverage before any recovery can be made under the coverage you designate as
secondary; and
c. will be responsible for the higher deductible amount under one of those coverages, but you are not responsible for
both deductible amounts under each coverage in any one accident.
In no event may any recovery under any of the coverages or policies be for more than the actual amount of damages or loss.
SETTLEMENT / SUIT / ARBITRATION

1. We will not make a payment under Part C to or for an insured if it is determined that the owner or driver of an uninsured
motor vehicle or underinsured motor vehicle has liability insurance, self-insurance or bond that applies until at least one
of the following events occurs:
a. we and the insured reach a written settlement agreement;
b. after the limits of liability under all liability insurance, self-insurance and/or bonds that apply have been exhausted by
payment of judgments or settlements; or
c. we have been given:
(1) at least thirty (30) days prior written notice of a settlement offer between the insured and insurer, owner or
driver of an uninsured motor vehicle or underinsured motor vehicle; and
(2) a reasonable chance to advance payment to the insured in an amount equal to that settlement offer to protect
our rights.
2. If we and an insured cannot agree as to either:
a. Fault: Is the insured legally entitled to collect damages from the owner or driver of an uninsured motor vehicle or
b. Amount of damages: The amount of compensatory damages the insured is legally entitled to recover;
then upon mutual agreement in writing between us and the insured, arbitration may be used to resolve that
disagreement. If we and an insured cannot agree to resolve the dispute by arbitration, the insured has the right to file a
lawsuit within two years and one day from the date that the cause of action first accrues.
3. If there is mutual agreement to arbitrate, then the following terms apply as to that arbitration (unless agreed otherwise in
writing by the parties):
a. The parties agree that each party will select an arbitrator. The two arbitrators will select a third. If the two arbitrators
cannot agree on a third arbitrator within 45 days, then either party may request that the arbitration be submitted to
the American Arbitration Association, or on joint application by the insured and us, the third arbitrator may be
appointed by a court having jurisdiction.
b. Each party will pay the costs and fees of its attorneys and arbitrator, and any other expenses it incurs. The costs and
fees of the third arbitrator will be shared equally. The cost of expert witnesses shall be paid by the party who hired
them.
c. The arbitration shall take place in the county in which you reside unless the parties agree to another place.
d. The local court rules as to procedure and evidence will apply.
e. A decision agreed to by two of the arbitrators will be binding as to:
(1) whether the insured is legally entitled to recover damages from the owner or driver of an uninsured motor vehicle
or underinsured motor vehicle; and
(2) the amount of covered damages sustained by that insured.
f. The arbitrators have no authority to:
(1) award any amount:
(a) in excess of the limit of liability;
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(b) as punitive or exemplary damages; or
(c) for interest, costs or fees; or
(2) decide any:
(a) coverage or policy issue; or
(b) issues or resolve any dispute as to anything other than the legal liability and damages as set forth above; or
(3) consolidate claims or disputes in arbitration without the mutual consent of the parties.
g. No party shall be entitled to arbitrate any claims or disputes in a representative capacity or as a member of a class.
4. If the insured and the person or party legally liable for the insured's bodily injury or property damage reach a settlement
agreement to pay the insured such person's limits of liability, the insured must submit the agreement to us in writing for
our approval prior to final execution of such settlement agreement if:
a. the settlement would not fully satisfy the insured’s claim for bodily injury and/or property damage; and
b. an uninsured motor vehicle or underinsured motor vehicle claim has been or will be made against us.
5. The insured may file suit against us and the legally liable person if, within thirty (30) days after our receipt of the
settlement agreement, we do not:
a. approve the settlement;
b. waive our rights of recovery against the person or party legally liable for the bodily injury and/or
property damage;
c. authorize the signing of a full release; or
d. agree to arbitrate the uninsured motor vehicle or underinsured motor vehicle claim. The suit shall decide if the
insured is legally entitled to collect damages and if so, how much.
6. Except as provided above:
a. we are not bound by any judgment against any person or party obtained without our written consent; and
b. the insured shall not enter into any settlement with any person or party legally liable for the insured’s bodily injury or
property damage without our written consent if the settlement agreement precludes our right of recovery against
such person or party.
PART D – PHYSICAL DAMAGE COVERAGES
COMPREHENSIVE COVERAGE INSURING AGREEMENT

If the premium for Comprehensive Coverage is paid when due, that coverage shown on the declarations will apply under this
Policy and is subject to all Policy terms.
We will pay for a comprehensive loss to the following autos, including original equipment:
1. An insured auto.
2. A newly acquired auto.
If Comprehensive Coverage applies to a loss, we will also:
1. Pay the reasonable charges for necessary towing for which you become legally liable because of an insured auto or a
newly acquired auto being transported after a loss. We will not pay more than the average towing charge in the
geographic area where the loss occurred.
2. Repay you for temporary transportation costs incurred if an insured auto is stolen in its entirety, subject to the following
limitations. We will pay up to $20 per day, subject to a maximum of $600 per loss, for the period that:
a. begins forty-eight (48) hours after you tell us and the police of the theft; and
b. ends when an insured auto is returned to use or seventy-two (72) hours after we offer to pay for the
comprehensive loss.
Transportation costs will not be paid under this clause if a higher limit for Rental Reimbursement Coverage applies.
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We must be given written proof (that can be verified) of the costs you incurred.
COLLISION COVERAGE INSURING AGREEMENT
If the premium for Collision Coverage is paid when due, that coverage shown on the declarations will apply under this Policy
and is subject to all Policy terms.
We will pay for loss caused by impact with any object or person, or overturning or upset, to:
1. An insured auto.
2. A newly acquired auto.
If Collision Coverage applies to a loss, we will also pay the reasonable charges for necessary towing for which you become
legally liable because of an insured auto or a newly acquired auto being transported after a loss. We will not pay more than
the average towing charge in the geographic area where the loss occurred. We must be given written proof (that can be
verified) of the costs you incurred.
CHILD SAFETY SEAT COVERAGE
If there is a covered loss under either Collision Coverage or Comprehensive Coverage, and a child safety seat or restraint
system was damaged, or its integrity compromised, due to that loss, then subject to the limit of liability shown on the
declarations, we will pay to replace it with a car seat of like kind and quality. That seat or system must have been attached in
the auto at the time of the covered loss. No deductible applies to this coverage.
This Part D Definitions section defines some words and phrases used in Part D. Defined words and phrases are shown in bold
1. When that word or phrase is used in Part D; and
Comprehensive means all perils other than loss caused by collision, impact with any object or person, or overturning or upset.
A comprehensive type loss is caused by but not limited to:
1. Missiles;
2. Falling or thrown objects;
3. Fire or explosion (unless caused by a collision);
4. Theft or larceny;
5. Earthquake;
6. Windstorm or hail;
7. Water or flood;
8. Vandalism or malicious mischief;
9. Riot or civil commotion;
10. Contact with bird or animal; or
11. Breakage of glass (unless caused by a collision).
Custom equipment means equipment, parts, devices, accessories, enhancements and/or changes to an auto or vehicle that:
1. Are not original equipment;
2. Add to, or alter, performance, function or appearance; and
3. Are permanently installed.
Custom equipment includes, but is not limited to:
1. Additional or customized furnishings or equipment such as:
a. custom wheels, seats, paint, decals, graphics, striping, chrome and/or murals;
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b. tires that are not the size specified by the manufacturer;
c. ground effects, after-market lights, custom grilles, louvers, side pipes, hood scoops, spoilers and front end protectors;
d. modified suspension, engines, carburetor or exhaust systems;
e. campers (bodies, slide-ons, shells, conversions) and height-extending roofs;
f. special carpeting, furniture, or bars;
g. facilities or equipment for refrigerating and sleeping;
h. winches, roll bars and running boards;
i. equipment to make a vehicle handicap accessible;
j. pickup truck caps, covers, bed liners; and
k. tool bench/boxes;
but not including equipment for cooking.
2. Electronic equipment designed for use in a vehicle and that reproduces, receives or transmits audio, visual, digital or data
signals such as:
a. radios, stereos, tape deck players, compact disc systems and satellite radio systems;
b. video entertainment systems, DVD or video players and televisions;
c. GPS and navigation systems;
d. emergency and roadside assistance detection and/or communication devices;
e. internet access systems;
f. personal computers;
g. mobile cellular and other telephones; and
h. two-way mobile radios, citizen band radios, and scanners.
Loss means sudden and direct physical damage. Loss does not mean or include any diminution in value.
Windshield is the front window glass panel of an auto. A windshield does not include side, roof or back windows.
RENTAL REIMBURSEMENT
If Rental Reimbursement coverage is shown for an insured auto on the declarations, we will pay the rental charges, up to the
daily (per day) limit shown for this coverage on the declarations, for up to thirty (30) days, for a temporary substitute auto
rented from an auto rental agency or auto repair shop while that insured auto or a newly acquired auto is inoperable or
being repaired due to a covered comprehensive loss or collision loss.
“Rental charges” as used in this Rental Reimbursement option are limited to:
1. The daily rental rate;
2. Mileage charges; and
3. Related taxes; and
does not include any insurance, tolls, fuel, GPS, car seats or other optional equipment or accessories offered or available with
the temporary substitute auto.
The Rental Reimbursement coverage:
1. Begins:
a. when an insured auto or a newly acquired auto is inoperable due to a loss covered under Comprehensive Coverage
or Collision Coverage; or
b. if an insured auto or a newly acquired auto can run, when you leave an insured auto at the shop for agreed repairs;
and
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2. Ends:
a. when an insured auto or a newly acquired auto has been repaired, returned to you, or replaced; or
b. seventy-two (72) hours after we offer a cash settlement for a total loss.
We must be given written proof (that can be verified) of the rental costs you have incurred if we are not paying the rental
agency or garage directly.
Rental Reimbursement does not apply to a recreational rental or business rental, and is limited to a temporary substitute auto
used as described above in connection with a covered comprehensive loss or collision loss.
No deductible applies to this Rental Reimbursement coverage.
EXCLUSIONS
THERE IS NO COVERAGE UNDER PART D OF ANY KIND, FOR OR RELATED TO:
1. Loss or damage to any type or sort of auto or trailer when that loss or damage:
a. is caused intentionally by or at the direction of you, a relative or a rated driver, or the owner of the property; or
b. should be reasonably expected to result from an intentional act by you, a relative or a rated driver, even if the loss
that results is not of the same kind or degree that was intended to be caused.
This exclusion does not apply to an innocent co-insured’s legal interest in property if the:
a. innocent co-insured did not cooperate in or contribute to the cause of the loss;
b. loss arose out of an act of domestic violence or abuse; and
c. person who caused the loss is criminally prosecuted for the act causing the loss.
2. Loss or damage to any type or sort of auto:
a. due and related only to:
(1) rust or corrosion;
(2) wear and tear;
(3) deterioration,
(4) freezing;
(5) wet or dry rot;
(6) mechanical or electrical breakdown; or
(7) road damage to tires. This exclusion does not apply:
(a) if the damage results from a total theft to which Comprehensive Coverage under this Policy applies.
(b) to damage to tires covered by Emergency Road Service Coverage (if purchased).
b. due and related only to:
(1) prior loss or damage;
(2) the lack of routine and/or proper maintenance; or
(3) manufacturer's defects or faulty materials or parts.
3. Loss or damage while the auto is being used:
a. as a public or livery conveyance.
similar for-profit activity. For example, this exclusion applies, but it not limited to:
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(1) a share-the-expense car pool; or
(2) use for a charitable or volunteer purpose.

4. Loss or damage to an insured auto or any newly acquired auto if it is:
form of compensation or value or reimbursement, though this does not apply if you or a relative temporarily lend
that auto to another person for reimbursement of operating expenses only; or
b. is entrusted to another person or party for the purpose of subleasing, leasing, renting or selling and is no longer in
the possession of you, a relative or a rated driver.
5. Loss or damage to any non-owned auto used by you, a relative or a rated driver without permission to do so from its
owner, including any temporary substitute auto.
6. Loss or damage caused by, or arising out of the actual, alleged or threatened presence, growth, proliferation or spread of,
mold or fungus, without regard to the factors causing or contributing to its growth, or for any testing or remediation of
mold or fungus. This exclusion does not apply if the mold or fungus are the direct result of a covered loss that is payable
under Comprehensive Coverage or Collision Coverage.
7. Loss or damage that results from pollutants or hazardous materials.
8. Loss or damage that results from war or any nuclear event.
9. Loss or damage to any:
a. items of personal property (including, but not limited to, video devices, streaming devices, internet devices, compact
discs, tapes, citizens band radio, ham radio, mobile phones, iPads, tablets, power or charging cords for electronic
devices, devices wholly or partially designed to prevent radar detection or circumvent any other law enforcement
detection measures, clothing and tools). This does not apply to permanently installed OEM electronic devices.
b. item that is not permanently installed unless expressly covered under the terms set forth under this Part D.
c. portion of any custom equipment in excess of the limit that applies to custom equipment.
d. child safety seat to which Child Safety Seat Coverage applies.
10. Loss or damage to parts solely used for the purpose of racing or performance driving.
11. Loss or damage that occurs to an insured auto while it is being used for racing or performance driving. This does not
apply if the insured auto is being operated by a thief.
12. Loss or damage that occurs while you, a relative or a rated driver is committing, aiding, or abetting a felony with that
auto or seeking to elude lawful apprehension or arrest by a law enforcement official in or with that auto.
13. Conversion, embezzlement or secretion of any auto.
14. Any seizure by federal or state law enforcement as evidence in a case against the named insured under Chapter 481, Health
and Safety Code, or under the federal Controlled Substances Act (21 U.S.C. Section 801 et seq.).
15. Repossession by any party acting on behalf of the owner of an insured auto or newly acquired auto.
16. Diminution in value.
17. Loss of use damages except those permitted when the insured auto is stolen.
18. Loss or damage to any auto rented by you, a relative or a rated driver if the company renting that auto is not entitled to
recover for the loss under the terms of the rental agreement or under law.
19. For any loss, towing, transportation or salvage of any insured auto that occurs within the Republic of Mexico.
20. Loss or damage to a insured auto:
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(2) vehicles not primarily used for delivery or transportation of goods, material, supplies, other than samples;
or
d. while it is being used with a personal vehicle sharing program or other similar program that engages in the business
LIMITS OF LIABILITY
The limit of our liability for any covered loss shall not be more than the lowest of the:
1. Actual cash value of the damaged or stolen property at the time of the loss; or
2. Cost to repair or replace.
The limit of our liability for a covered loss to custom equipment will not be more than $1,000. Coverage for custom
equipment will not cause our limit of liability for the loss to be increased to an amount greater than the actual cash value of
the auto, including all its custom equipment.
Our payment for any loss will not include, and you are responsible for, the amount of:
1. Any deductible that applies as shown on the declarations. However, if the loss:
a. is to more than one auto or trailer covered by this Part D resulting from the same collision, only the highest
applicable deductible will apply.
b. is the result of more than one accident or loss, a separate deductible shall apply to each accident or loss.
2. Depreciation and betterment if the repair or replacement results in better property or in a better part because you or a
relative have failed to:
a. repair or replace damaged property or parts after a prior loss (i.e., prior unrepaired damage) unless the same labor,
parts, and materials would be used for the current loss; or
b. properly maintain that property.
Adjustment and reductions from payment by us related to depreciation and betterment will be with regard to:
a. market value;
b. the useful life of a part; or
c. improvement of the condition of the auto considering wear and tear and damage that existed prior to the loss that
had not been repaired.
Our adjustment to the amount payable by us due to betterment or depreciation on parts replaced includes, but is not
limited to:
Form 1918 TX (02-2021) Page 37 of 53

a. batteries;
b. tires;
c. engines;
d. transmissions; and
e. any other parts that wear out over time or have a finite useful life or duration typically shorter than the life of the
auto as a whole. This does not include external crash parts, wheels, windshields, or other glass.
3. The salvage value if you or the owner retains salvage.
If coverage under this Part D applies to a non-owned auto, then the:
1. Broadest Comprehensive Coverage or Collision Coverage that applies to any one insured auto shown on the declarations
will apply; and
2. Highest deductible that applies to any one insured auto shown on the declarations will apply.
If you agree to have a windshield repaired at our expense after a loss, no deductible will be applied.
Under this Part D, we have no duty to cover or pay for any:
1. Diminution in value.
2. Storage costs in excess of the storage we reasonably determine is the average or customary charge for such storage in the
geographic area.
SETTLEMENT
To settle a covered comprehensive loss and/or collision loss:
1. We may pay (as limited by the Limits of Liability section above):
a. the actual cash value; or
b. the cost to repair or replace the damaged or stolen property.
2. We may make any such payment directly to:
a. you, the owner of the property, or the loss payee/lienholder (if any is designated); or
b. a repair facility with your prior consent.
3. You or the owner must transfer the title of property to us at or before the time of payment if we make a payment for theft
or total loss of that property. This does not apply if you or the owner are keeping the salvage.
4. We may:
a. at our expense, return any stolen property to you, to the address shown on the declarations, or to any other owner.
If we return stolen property, we will pay for covered damage resulting from the theft.
b. keep all or part of the property at an agreed or appraised value, but there shall be no abandonment of property to us.
5. We have no duty to keep or preserve salvage.

If any other insurance or source(s) of recovery covers the loss, we will pay only our share of the loss. Our share is determined
by adding the limits of this insurance to the limits of all other insurance or source(s) of recovery that apply on the same level
of priority and calculating the percentage of the total that our limits represent, and apply that percentage to the amount of
the covered loss.
However:
1. Any coverage we provide on or with respect to a temporary substitute auto is excess to all other insurance and self-
insurance except where we are required by statute to provide this coverage to such vehicle on a primary basis.
2. For any loss or property damage to which both collision coverage, under this Policy or any other policy, and any UM/UIM
PD coverage apply in any one accident, you are entitled to:
Form 1918 TX (02-2021) Page 38 of 53

a. choose one of those coverages, if applicable, to cover that loss or property damage; or
b. recover under both of those coverages, if applicable to cover that loss or property damage, but only if neither
coverage alone is sufficient to pay the damages or loss from that accident. If recovering under both coverages, you:
(1) shall designate one coverage as the primary coverage;
(2) must exhaust that primary coverage before any recovery can be made under the coverage you designate as
secondary; and
(3) will be responsible for the higher deductible amount under one of those coverages, but you are not responsible
for both deductible amounts under each coverage in any one accident.
In no event may any recovery under any of the coverages or policies be for more than the actual amount of damages or loss.
APPRAISAL
Appraisal is an option to determine the amount of a loss as follows:
1. Either we or you may request an appraisal of the loss if we and you do not agree on the amount of that loss.
2. In the event of a request for appraisal, each party will select a competent and impartial appraiser. The two appraisers will
select an umpire.
3. The appraisers will state separately the actual cash value and the amount of loss. If the appraisers fail to agree, they will
submit their differences to the umpire. A decision agreed to by any two of these persons will be binding.
4. The appraisers and umpire have authority only to decide the amount of the loss. They have no authority to:
a. decide any coverage or policy issues under the Policy; or
b. award any fees, interest or costs.
5. Each party will:
a. pay its chosen appraiser; and
b. bear equally the expenses of the umpire and the costs of appraisal.
6. No rights are waived under this Policy by agreeing to an appraisal.
NO BENEFIT TO BAILEE
This Policy, and the coverages under it, shall not directly or indirectly benefit any carrier or other bailee for hire.
LOSS PAYEE – LIENHOLDER

If a “loss payee” or lienholder is designated and shown on the declarations, then a covered loss to an insured auto or a newly
acquired auto under this Policy will be paid according to your interest and that of any such loss payee or lienholder. At our
option, we may make separate payments according to those interests.
If the loss payee or lienholder makes a claim under this Policy, the loss payee or lienholder:
1. Must abide by all terms and conditions of this Policy; and
2. Has no greater rights than you to receive any payment.
If we pay the loss payee, to the extent of the payment, we shall be subrogated to the loss payee’s rights of recovery.
We may void, cancel or terminate this Policy according to its terms and any such act shall also void, cancel or terminate this
agreement as to any loss payee’s interest. We will give notice as required by law.
If we pay a repair shop directly for repair of a loss with your consent, we have no duty to the loss payee or lienholder with
respect to that loss.
Form 1918 TX (02-2021) Page 39 of 53

INSUREDS’ DUTIES AFTER ANY ACCIDENT OR LOSS
IMPORTANT WARNING:
A partial or total denial of some or all coverage under this Policy may result if there is any failure to:
1. Give us and/or law enforcement notice; and/or
2. Cooperate and/or perform any duty listed below or elsewhere in the Policy.
GIVE PROMPT NOTICE TO US OF ANY AND ALL:
1. Accident or loss. We, or our authorized agent, must be given notice immediately or as soon as practicable after any accident
or loss as to the fact it took place, and the time, place and date of its happening. As soon as known or as soon as practicable
after known, also give us these details:
a. all names and other relevant information of who was involved in the accident or loss. This also includes, but is not
limited to, witness, injury and loss information such as names, addresses and telephone numbers of any witnesses
and/or injured persons;
b. license plate information of vehicles involved or vehicle descriptions;
c. all known driver license information of persons involved;
d. any law enforcement action taken;
e. driving conditions; and
f. any other relevant information.
2. Claim or lawsuit. We must be given prompt and timely notice of any:
a. claim being brought; or
b. lawsuit that has been or is being filed;
that may affect this Policy and the benefits and rights under it. Copies of all notices, summons and/or other legal papers
and process, either sent or received, in connection with any accident or loss also must be given to us.
3. PIP claim(s) under Part B-I. In addition to the notice requirements set forth above, a person seeking benefits under PIP
must promptly give us:
a. written proof of loss as to any claim for benefits under PIP as soon as reasonably possible, but no later than six (6)
months after the date of the accident; and
b. reasonable medical proof of:
(1) the bodily injury to the injured insured causing loss of income or essential services; and/or
(2) an alleged recurrence of bodily injury for which an original claim for benefits was made under Part B-I (PIP) if a
lapse occurs in the period of total disability or in the medical treatment of an insured who:
(a) has already received PIP benefits under Part B-I of this Policy; and
(b) subsequently claims additional benefits based on the alleged recurrence.
GIVE PROMPT NOTICE TO LAW ENFORCEMENT WITHIN 24 HOURS OF ANY ACCIDENTS
OR LOSSES THAT INVOLVE:
1. Vandalism or theft;
2. Hit-and-run vehicles; or
3. Unidentified at-fault drivers.
Complete an official report to a law enforcement agency with jurisdiction within twenty-four (24) hours or as soon as
practicable.
COOPERATE FULLY:
You, relatives, rated drivers, insureds under this Policy and any other person or party seeking coverage from this Policy (or
Form 1918 TX (02-2021) Page 40 of 53

any such person’s or party’s legal representative) must:
1. Fully cooperate in all matters with us, provide information to us and do whatever other duties are needed to settle any
and all claims.
2. Not prejudice our rights in any way, not admit fault, not assume any obligation to other persons or parties, nor incur any
expenses (other than first aid to others and/or or reasonable expenses to protect property insured from further damage
or loss).
3. Give us proof of loss or claim, and under oath, if required by us.
4. Make a statement under oath or take an examination under oath (“EUO”). Such statement or EUO will be:
a. at a reasonable location of our choice;
b. conducted by us, or our representative, as often as reasonably required;
c. outside the presence of any witness, person or party making a claim due to the same accident or loss, or any other
person except for:
(1) that person’s legal counsel; and/or
(2) a parent or guardian if the person making the statement is a minor or deemed incompetent by law; and
d. recorded, by video and/or audio and/or court reporter, as we choose.
5. Cooperate with us to investigate, settle and/or defend any claim, arbitration, mediation, appraisal or lawsuit, and help us
as needed to:
a. make settlements;
b. get, or authorize us to get or secure evidence;
c. give evidence;
d. obtain the attendance of witnesses at hearings, depositions and trial; and
e. conduct arbitration, mediation, appraisal or lawsuits.
6. Give us as often as we reasonably request:
a. current and prior accident, loss, bodily injury and treatment information reasonably related to the loss or damage
asserted; and
b. written authorization to obtain any such information we find is relevant or may lead to relevant information.
7. Take physical and/or mental exams, to be done at our expense by licensed health care providers we choose, as often as
we may reasonably require.
8. Give us, and allow us to get, written, recorded and video statements, including statements under oath, as often as we
reasonably required, outside of the presence of any witness, person or entity making a claim due to the same accident or
loss, or any other person other than that person’s:
a. legal counsel; and/or
b. parent or guardian if the person making the statement is a minor or deemed incompetent by law.
9. Give us, and allow us to get with written authorization to be given to us, any and all relevant records and/or documents
(or copies thereof) including, but not limited to:
a. medical records and reports, including current reports, notes and tests results, records of prior medical history and
treatment, therapy records, and counseling records when reasonably related to the accident, loss, bodily injury,
property damage or damages asserted;
b. credit and financial records;
c. photographs;
d. telephone, including cellular, text messaging and all other telephonic communication records, including billing
records;
e. employment, income and/or wage information;
f. current and prior insurance claim and medical records reasonably related to the loss or damage asserted; and
g. other records, receipts and/or invoices deemed by us to be relevant to investigate or settle a claim.
Form 1918 TX (02-2021) Page 41 of 53

Tax records and/or tax returns will not be required to be provided to us unless the claim involves a claim for loss of profits
or income.
10. Take reasonable steps after damage to or loss of property to:
a. protect all property insured from further damage or loss. We will repay reasonable expenses incurred to protect that
property;
b. preserve, to the extent feasible, any and all damaged property (including, but not limited to, parts removed from an
insured auto) for inspection and testing; and
c. prevent costs when not necessary including, but not limited to, storage fees, impound fees, and parking fees.
11. Allow us to inspect and/or take pictures or video of:
a. any auto or vehicle being used at the time of, or that was involved in, an accident or loss.
b. all damage to or loss to property so it can be appraised before repair, replacement or disposal.
12. Allow or authorize us to get any information on any data, video device, maintenance or event recorder device installed or
used in an auto, as we deem relevant to the facts of the accident or loss. This may include information on, but is not
limited to, any on-board computer, global positioning system (“GPS”) or data recorder.
CLAIMS SETTLEMENT
1. When making a claim, any person or party seeking coverage from this Policy (or any such person’s or party’s legal
representative) must:
a. cooperate and comply with all applicable notice requirements, duties and terms set forth in this Policy; and
b. assist us to settle any and all claims.
2. To adjust claims and determine amounts to be paid under this Policy, we may use:
a. estimating, appraisal or injury evaluation records, systems or tools;
b. records, systems or tools that may be developed by us or by third parties; and/or
c. information that may include and come from, but is not limited to, published resources, medical fee schedules,
and/or computer software, databases, and specialized technology.
SETTLING FIRST PARTY CLAIMS

As required by Texas law, the claims standards set forth here below will apply in any first party claim made by, and to be paid
to, you, relatives, persons insured under this Policy or a named beneficiary:
1. Not later than fifteen (15) days after the date we receive written notice of a claim that reasonably apprises us of the facts
relating to the claim, we will:
a. acknowledge receipt of the claim. If our acknowledgment of receipt of a claim is not made in writing, we will make
and keep a record of the date, manner, and content of the acknowledgment;
b. begin any investigation of the claim; and
c. request from the claimant all items, statements, and forms we reasonably believe will be needed to settle the claim.
We may request additional, relevant information during the investigation of the claim.
2. After the date we receive all information required by us to secure final proof of loss, we shall notify a claimant in writing
of our decision to accept or reject a claim within either:
a. fifteen (15) business days; or
b. thirty (30) days if we reasonably believe the accident or loss resulted from arson.
If the claim is denied or rejected, the reasons for the decision will be given to the claimant in writing.
If we are unable to accept or reject a claim within the time periods set forth here, then within those same time periods,
we shall:
a. notify the claimant of the reasons why we need additional time; and
b. request, in writing, any specific additional information we reasonably believe is necessary to make a decision.
Within forty-five (45) days of the date we give the notice described here pertaining to additional time and information to
Form 1918 TX (02-2021) Page 42 of 53

settle a claim, we then will accept or reject the claim.
3. We will pay the claim, or any part of the claim, not later than the fifth (5th) business day after the date:
a. of the written notice that we have accepted the claim, or a part of the claim; or
b. the claimant performs any act deemed necessary as a condition of claim payment.
4. In the event of a weather-related catastrophe or major natural disaster, as defined by the Texas Commissioner of
Insurance, the claim-handling time periods and deadlines described above will be extended for an additional fifteen (15)
days.
5. As to Part B-I (PIP), if PIP benefits are covered and due under this Policy, those covered benefits will be paid:
a. no later than thirty (30) days after the date we receive satisfactory proof of claim; and
b. periodically as claims for those PIP benefits arise, but not more frequently than once every two (2) weeks.
SETTLING LIABILITY CLAIMS
If we make an offer to settle a claim against an insured covered under Part A - Liability Coverage, we will notify that insured,
in writing, no later than:
1. Ten (10) days after the date we make an initial offer to settle a liability claim against the insured under Part A; and
2. Thirty (30) days after the date a liability claim against the insured under Part A is settled.
POLICY LIMITS
TWO OR MORE POLICIES OR INSUREDS
If this Policy and any other auto or motor vehicle insurance policy issued to you by us apply to the same accident, damage or
loss:
1. Our limit of liability under all those policies shall not exceed the highest limit of liability for the coverage that applies
under any one of those policies.
2. The limit of liability may not be added, combined or stacked with similar coverage under any other auto or motor vehicle
policy issued by us (or any insurers that have common ownership or affiliation with us) to you.
Our limit of liability under this Policy is not increased in any way if more than one person or party is shown as the named
insured on the declarations
NON-DUPLICATION
No person or party is entitled to receive duplicate payments from us for the same elements of damages, expense or loss
already paid or to be payable:
1. Under any coverage or Part of this Policy; or
2. By any other insurance (whether or not issued by us, any insurers that have common ownership or affiliation with us or
any other insurer) or any other source of recovery.
CANCELLATION
Cancellation or cancel means the Policy will end or be terminated during the current Policy period and before the end of the
Policy period as follows:
1. CANCELLATION BY NAMED INSURED
A named insured shown on the declarations may decide to cancel this Policy during the Policy period. To be effective, this
shall be done by:
Form 1918 TX (02-2021) Page 43 of 53

a. giving us, or our authorized agent, advance written notice stating a future date and time when the when the named
insured is requesting the Policy to be cancelled;
b. returning this Policy to us; or
c. by any other means agreed to by both the named insured and us.
Cancellation by any one named insured shall be binding as to all named insureds and all others who would be insured
under this policy.
2. CANCELLATION BY US
We may decide to cancel this Policy during the Policy period, as allowed by law, as follows:
a. We may cancel this Policy for any reason allowed by law:
(1) when this Policy has been in effect for less than sixty (60) days; or
(2) at each twelve (12) month anniversary of the policy’s original effective date.
b. When this Policy has been in effect for sixty (60) days or more, or if this is a renewal or continuation policy, and we
are not otherwise cancelling on the anniversary of the Policy’s original effective date, we may cancel only for one or
more of the following reasons listed here. For a cancellation by us that is not issued during the during the first fifty-
nine (59) days of the first Policy period nor done upon an anniversary of the Policy’s original effective date, we may
cancel for one or more of the following reasons:
(1) nonpayment of premium when due;
(2) you, a relative, a rated driver or a person insured under this Policy submits a fraudulent claim under this Policy;
(3) your driver license or motor vehicle registration, or that of any driver who:
(a) lives with you; or
(b) customarily uses an insured auto;
has been suspended or revoked during the 36 months preceding the effective date of this Policy or any renewal
date thereof, unless that person is a named excluded driver; or
(4) if the Texas Department of Insurance determines continuation of this Policy would result in a violation of the
Texas Insurance Code or any other law governing the business of insurance in the State of Texas.
The above listed cancellation reasons do not apply and do not limit our right to cancel the Policy when this Policy has
been in effect for less than sixty (60) days or at any twelve (12) month anniversary of the Policy’s original effective
date.
c. If we decide to cancel this Policy, we will send cancel notice to the first named insured shown on the declarations at
the last address shown in our records. This notice will be sent at least:
(1) ten (10) days before the effective date of cancellation if:
(a) cancellation is for nonpayment of premium when due; or
(b) the cancel notice is sent during the first fifty-nine (59) days of the first Policy period;
(2) twenty (20) days before the effective date of cancellation in all other cases, except that we will give thirty (30)
days prior notice if this Policy is to be cancelled on any twelve (12) month anniversary of the policy's original
effective date.
This policy will end at the earliest effective date and time shown in any cancel notice.
d. We will not cancel this Policy because the named insured is an elected official.
3. RETURN OF PREMIUM UPON CANCELLATION
If this Policy is cancelled, any unearned premium will be:
a. refunded and calculated on a pro rata daily basis; and
b. returned to the named insured within a reasonable period of time.
Form 1918 TX (02-2021) Page 44 of 53

Any refund due will be sent by us to the first named insured shown on the declarations at the last address shown in our
records, and no later than fifteen (15) business days after the effective date of cancellation or termination.
However, the making of, or offering to make, a refund is not a condition of cancellation and does not change the effective
cancel date.
4. Nothing in this “Cancellation” clause shall supersede or waive any of our rights to void or rescind this Policy (as allowed by
law).
NON-RENEWAL
Non-renewal means the Policy will not be continued or renewed at and after the end of the current Policy period as follows:
1. NON-RENEWAL BY NAMED INSURED
If we offer to renew the Policy and we do not receive that premium payment to renew when due:
a. that nonpayment is deemed the named insured’s rejection of our offer to renew the policy; and
b. named insured agrees that the Policy will expire and lapse under its own terms by automatically ending at the end of
the current Policy period.
2. NON-RENEWAL BY US
We may decide not to renew or continue this Policy at the end of any twelve (12) month annual anniversary date of the
original effective date of the Policy for any reason allowed by law. If we decide not to renew or continue this Policy at the
end of any such Policy period:
a. we will send notice to the first named insured shown on the declarations at the last address shown in our records;
and
b. notice will be sent at least thirty (30) days before the end of the Policy period.
However, we will not refuse to renew or continue this Policy on the sole basis of any one of the following reasons:
a. the named insured being an elected official;
b. the age of any person covered by the Policy;
c. claims that involve damage from a weather-related incident that do not involve a collision, including, but not limited
to, hail, flood, tornado, winds, or hurricanes;
d. accidents or claims for damage caused by contact with animals or fowls;
e. accidents or claims for damage caused by flying gravel, missiles, or falling objects, except that upon renewal we may
increase the deductible to the higher of $250 or the next higher available deductible increment in the event of three
(3) losses in any thirty-six (36) month period;
f. claims for towing and labor, except that we may remove any towing and labor coverage or Roadside Assistance
Coverage from your Policy in the event of four (4) such claims in any thirty-six (36) month period or any other greater
amount as set forth under the coverage; or
g. any other accidents or claims in which an insured cannot reasonably be considered to be at- fault, unless there are
two (2) or more such accidents or claims in any twelve (12) month period.
AUTOMATIC TERMINATION
The Cancellation and Nonrenewal terms of this Policy do not apply if:
1. You reject our offer to renew or continue this Policy by not paying the required renewal or continuation premium when
due. In this case, you have allowed the Policy to expire and lapse under its own terms so that it automatically ends at the
end of the current Policy period.
2. An insurable interest no longer exists in the property insured. This occurs when a person or party, other than you, a relative
or a rated driver, becomes the owner of an insured auto. In this case, coverage for that auto will end at the earlier of the
time the:
Form 1918 TX (02-2021) Page 45 of 53

a. new owner obtains possession; or
b. ownership is conveyed to the new owner.
3. You get other motor vehicle insurance on an insured auto or a newly acquired auto. In this case, any similar insurance
provided by this Policy will end, but only as to that auto, on the effective date of the other motor vehicle insurance.
OTHER TERMINATION TERMS

This Policy is neither severable nor divisible. Any cancellation or nonrenewal of the Policy, whatever the reason, will be
effective for all:
1. Autos, trailers and/or any other vehicles to which this Policy may apply; and
2. Persons and parties.
Nothing in this “Policy Termination” clause, or any other part of the Policy, obligates us to renew or continue this Policy, or
waives our rights to void this Policy (as allowed by law).
POLICY CHANGES
JOINT & INDIVIDUAL INTERESTS
When there are two or more named insureds shown on the declarations, one (1) named insured acts for all named insureds
to change or end the Policy. The action of one (1) named insured is binding on all persons and parties under this Policy.
CHANGE OF POLICY TERMS

1. POLICY CHANGES BY YOU
You must promptly, and no later than thirty (30) days after the date of the change, give us or our agent notice of changes
that affect your Policy. These include, but are not limited to, changes to:
a. the number, type, and/or use of autos, motor vehicles or trailers insured under your Policy;
b. the number of relatives or other drivers using the autos, motor vehicles or trailers insured under your Policy;
c. driver license status, driving history or marital status of any person who resides in your household or who regularly
operates an insured auto; and
d. your address and/or the principal place where you garage any of the autos, motor vehicles or trailers insured under
your Policy.
2. POLICY CHANGES BY US
The terms of this Policy contract may be changed or waived only if agreed to, and done in writing, by us. This can be done
by our issuance of a revised declarations, an endorsement or a revised policy. If we make a change to this Policy during
the Policy period that:
a. expands any coverage without an extra premium charge, you will have the expanded coverage if that coverage is in
effect on this Policy when the change occurs. The effective date of a change will be the date we implement that change
in your state.
b. both expands and limits coverage, and is to be implemented with a general program revision, it will be given to you
and effective by way of a new version of your Policy, or an amendatory endorsement, upon renewal.
3. If any change to your Policy requires a premium adjustment or other action, we will:
a. give you notice of the premium or other change; and
b. adjust the premium or take required action, to be effective the date of the change, in accord with our Rules and
Guidelines.
CHANGE OF POLICY INTERESTS - TRANSFER OR ASSIGNMENT OF YOUR INTEREST
You may not transfer or assign any of your interests, rights and/or duties under this Policy except as allowed by the express
terms of this Policy for assignment of benefits under Personal Injury Protection Coverage and Medical Payments Coverage.
Form 1918 TX (02-2021) Page 46 of 53

However, if a named insured shown on the declarations dies during the Policy period, coverage will be provided for:
1. That named insured’s surviving spouse, or registered domestic or civil union partner if that person was residing in the
same household as the named insured at the time of death. Coverage applies to that spouse or registered domestic or
civil union partner as if a named insured shown on the declarations; and
2. Any person with proper custody of an insured auto or a newly acquired auto, until a legal representative is qualified; and
then
3. The legal representative of the deceased named insured, but only with respect to and within the scope of, such
representative’s legal duty to maintain or use an auto or a newly acquired auto.
Coverage shall not apply under this Policy to any auto not owned by the named insured, or the named insured’s spouse or
registered domestic or civil union partner on the date of the death of the named insured.
Any person or party who obtains any interest in the Policy, or its benefits, is subject to all the terms and conditions of the
Policy. Policy notice requirements are met by mailing the notice to the deceased named insured’s last known address in our
records.
POLICY TERMS & CONDITIONS

POLICY PERIOD & TERRITORY
The Policy period and territory is as follows:
1. This Policy applies only during the Policy period which is:
a. is shown on the declarations, as amended, and ends at 12:01 A.M. in the time zone that applies to the address shown
on the declarations; and
b. runs for successive periods shown on the declarations, as amended, if the required renewal premium is paid when
due.
2. This Policy does not apply:
a. outside the Policy period shown on the declarations;
b. during any lapse in coverage under this Policy; or
c. after this Policy has been cancelled or otherwise terminated.
3. If you apply for coverage on the same day the Policy is to start, no coverage shall apply on that first day of the initial Policy
period before the time you apply for coverage and we accept the risk.
4. The Policy territory is:
a. in the United States of America, and its territories and possessions;
b. Canada;
c. Puerto Rico; and
d. while an insured auto is shipped between the ports of the territory described above in 4.a. and 4.b.
This Policy only applies to accidents and loss that take place within this Policy territory.
5. The Policy territory does not include the Republic of Mexico (“Mexico”). It is a crime for a person to operate a motor
vehicle in Mexico without a liability policy issued by an insurer licensed to sell insurance in Mexico. We are not licensed to
sell insurance in Mexico. This insurance will not satisfy the minimum insurance requirements in Mexico. This Policy does
not provide any coverage to any accident, property damage, bodily injury, loss, expense or claim, wherever defined or
referred to in this Policy, that occurs within Mexico or between its ports and the Policy territory.
PREMIUM PAYMENT
As to payment of premium for this Policy:
Form 1918 TX (02-2021) Page 47 of 53

1. All premium, and any fees or charges that apply, must be paid when due for coverage to apply.
2. Coverage and benefits under this Policy are conditioned on our receipt of the full and valid payment of the initial down-
payment of premium. We have the right to void the policy from its inception if the initial down-payment is unpaid or
dishonored for any reason.
3. If an initial premium payment is unpaid or dishonored for any reason, such as being made with an uncollectible
instrument or it is not honored upon presentment, this Policy will be deemed void from its inception. When the policy is
void from its inception, it means:
a. it is as if the Policy never existed; and
b. we will not be liable under this Policy for any coverage, claims, bodily injury, property damage, loss, expenses or
damages which would otherwise be covered if the check, draft, or remittance had been honored upon presentment.
4. If we are required by law to make any payment after we void this Policy, you must pay us for all expenses incurred and
payments made.
5. We reserve the right to restrict the form of payment we will accept.
PROOF OF NOTICE
Proof that we have sent notice is done as follows:
1. Any proof of:
a. mailing notice; or
b. sending or delivering notice;
whether shown by post, electronically or otherwise, shall be sufficient proof of notice, except when state law requires
otherwise.
2. If and when allowed by law:
a. we may send or deliver, by way of electronic devices or other methods, any notice instead of mailing it.
b. sufficient proof of notice includes, but is not limited to, proof of:
(1) mailing, which means evidence that a notice or paper has been presented to the United States Postal Service for
mailing, which may be shown by use of:
(a) any form of certificate of mailing or certificate of bulk mailing issued by the United States Postal Service;
(b) intelligent mail barcode or another similar tracking method used and approved by the United States Postal
Service; or
(c) other credible proof of mailing or sending of actual notice.
(2) delivery directly to you, including delivery via e-mail, phone text, fax or any type of electronic device.
ELECTRONIC TRANSACTION OF INSURANCE
When allowed by law and agreed to by you and us, you and we agree that electronic signatures, notices and forms:
1. May be used to transact this insurance;
2. Will satisfy any legal or other requirement for written signatures, notices or forms; and
3. Shall include, but are not limited to, any assent, acceptance, agreement, election, selection, rejection, notice or form done
as a recorded telephonic signature or assent or sent via e-mail, internet, text message or fax.
When a law requires a signature on any form or document, or letter or document to be notarized, verified or acknowledged or
made under oath, the electronic signatures will satisfy this requirement if the signature of the person authorized to perform
the service of notarizing, verification, or acknowledgment is attached or logically associated with the signature or electronic
signatures of record.
COMPLIANCE WITH STATE LAW

This Policy and all terms within it will be applied in accord with applicable state law.
Form 1918 TX (02-2021) Page 48 of 53

If any of the terms of this Policy:
1. Do not comply with the laws of:
a. the State of Texas, if Texas is listed on the named insured’s application as the resident address, then any term of this
Policy that conflicts with Texas law shall be amended to so conform;
b. the state where this Policy is issued to, that Policy term(s) is amended to comply with the state law that applies.
2. Are found invalid by a court with proper jurisdiction, then that Policy term(s) is amended so that it:
a. does not apply to the portion of the otherwise covered damages or loss that is less than or equal to minimum limits
or minimum amounts of coverage required by law; and
b. continues to apply to the portion of the damages or loss that is greater than minimum limits or minimum amounts of
coverage required by law.
All other Policy terms remain unchanged and in full effect.
OUR RIGHTS TO RECOVER PAYMENTS - SUBROGATION & REIMBURSEMENT
As to subrogation and reimbursement, the following terms apply:
1. Any person or party, to or for whom a payment is made under this Policy, must:
a. cooperate with us by doing whatever is needed to protect our interests and rights to recover our payment if there is
another responsible or at-fault person or party. This cooperation may include, but is not limited to, filing legal papers
and taking action as requested by us to recover our payment; and
b. not do anything after the accident or loss to harm our interests and rights.
2. If a payment is made under this Policy, then to the extent allowed by law and for the amount of that payment made by us
to any person or party:
a. the right of recovery of any such person or party passes to us, and we will be subrogated to all the rights of recovery
that such person or party has against another.
b. any such person or party who recovers loss or damages from a responsible or at-fault person or party, or an insurer of
that person or party, shall hold the proceeds of that recovery in trust for us and reimburse us.
c. which is not actually covered by this Policy but is required by law, then (to the extent allowed by law) you must
reimburse us to the full extent of all damages or loss paid by us as well as our claims adjustment expenses.
3. Our rights to recover do not apply as to a payment made under:
a. Physical Damage Coverage when a person, with the permission of you, a relative or a rated driver, uses an insured
auto or a newly acquired auto.
b. Uninsured / Underinsured Motorist Coverage if we:
(1) have been given prompt written notice of a proposed settlement between an insured and the insurer of an
uninsured motor vehicle or underinsured motor vehicle (as defined in that coverage part); and
(2) fail to make advance payment to that insured in an amount equal to the proposed settlement within thirty (30)
days after receipt of notice of the proposed settlement.
If we make advance payment to the insured in an amount equal to the proposed settlement within those thirty (30)
days after receipt of notice, our rights are retained and the insured must cooperate with us and assist us in
recovering those sums from any and all responsible or at-fault persons or parties.
c. Personal Injury Protection Coverage (PIP) as against any person who has caused or contributed to an accident
resulting in the payment of PIP benefits under this Policy unless, on the date of accident, financial responsibility as
required by the Texas Transportation Code, has not been established for the vehicle involved in the accident and
operated by the person causing or contributing to that accident.
4. Deductible recovery is subject to the following if we pursue recovery from a responsible or at-fault person or party:
a. you agree to allow us to seek recovery of any deductible that may apply, though we:
(1) have no duty to do so; and
Form 1918 TX (02-2021) Page 49 of 53

(2) will give you notice if we do not intend to collect it.
b. as required by Texas law (as amended), we shall:
(1) take action to recover the deductible against the responsible third party not later than the first anniversary of
the date your claim is paid; or
(2) pay the amount of the deductible to you.
Except, we are not required to take action to recover or pay the amount of the deductible if we:
(1) notify you in writing that we do not intend to take further collection actions against the responsible the
responsible third party; and
(2) authorize you to take further collection actions;
not later than the earlier of the first anniversary of the date your claim is paid or the 90th day before the date the
statute of limitations for a negligence action expires.
c. we have the right to compromise or settle the deductible and property damage claims against the responsible or at-
fault person or party for less than the full amount. For those sums, you agree to be bound by the:
(1) settlement agreement entered into by us and that person or party; or
(2) outcome of appraisal or arbitration.
d. if the total recovery is less than the total of our payment and the deductible, we will reduce reimbursement of the
deductible to you based on the proportion that the actual recovery bears to the total of our payment and the
deductible.
LEGAL ACTION AGAINST US

Legal actions are subject to the following:
1. No right to legal action against us exists until all the terms, duties and conditions of this Policy have been met.
2. Any legal action against us for coverage under any Part of this Policy, or any legal action filed against us following an
accident or loss, must be commenced within two (2) years and one (1) day after the date the cause of action first accrues.
3. In addition, as to Liability Coverage:
a. no person or party has any right to bring us into any action to determine the liability of an insured under the Liability
Coverage of this Policy; and
b. no legal action may be brought against us until:
(1) we agree in writing that an insured under Liability Coverage has an obligation to pay for damages due to a
covered accident; or
(2) the amount of that obligation has been finally determined by judgment after trial and appeal (if any).
4. In addition, as to Uninsured / Underinsured Motorist Coverage, any lawsuit against us by any person or party seeking that
coverage must be brought in the county in which the:
a. policyholder or beneficiary bringing the action resided at the time of the accident involving the uninsured or
b. the accident occurred.
5. We have no duty to retain or preserve salvage and/or property for any purpose, including for use as evidence in any civil
or criminal proceeding.
MISREPRESENTATION / CONCEALMENT / FRAUD

OUR RIGHT TO RESCIND & VOID
1. We have the right to rescind and void this Policy from its inception, and will do so, if in the initial application you or your
Form 1918 TX (02-2021) Page 50 of 53

representative:
a. made incorrect or untrue statements or representations to us or our authorized agent as to any material fact;
b. concealed, omitted or misrepresented any material fact; or
c. engaged in fraudulent conduct;
and we can show, at trial, that the fraudulent conduct or the matter misrepresented:
a. was material to the risk; or
b. contributed to the accident or loss on which the Policy became due and payable.
A fact is material if we would not have issued the Policy, would not have agreed to insure the risk or would not have
insured it at the premium initially charged.
2. We also have the right to rescind and void this Policy from its inception, and will do so, if:
a. you or any person who would otherwise be an insured under this Policy made a misrepresentation, including a false
statement, in a proof of loss for a claim or death in connection with any accident or loss for which coverage or
benefits are sought under this Policy; and
b. we can show at trial that such misrepresentation:
(1) was fraudulently made;
(2) misrepresented a fact material to the question of our liability under this Policy; and
(3) misled us and caused us to waive or lose a valid defense to the Policy.
3. If we void or rescind this Policy:
a. the Policy will be void from its inception as if the contract was never formed and the Policy never issued.
b. there is NO coverage for any claims, damages or loss that would have otherwise been covered.
However, our voiding or rescinding of this Policy due to fraud, concealment or misrepresentation will not prevent
coverage under Part A as to an otherwise covered claim for payment to be made to an innocent injured third-party,
but such coverage shall be:
(1) only as required by law for an accident that occurs before we notify the named insured that the policy is void;
and
(2) limited to the amount of damages that is less than or equal to the minimum limits for bodily injury and property
damage to an innocent injured third person or party.
c. you are responsible to repay us for all
amounts we are required by law to pay, and our related expenses, if law requires us to protect any innocent third parties or
requires us to pay any other amount.
OUR RIGHT TO DENY COVERAGE
We will not provide coverage or benefits for any person or party who has:
1. Misrepresented, concealed, omitted or misstated a material fact or circumstance;
2. Engaged in fraudulent conduct; or
3. Aided, abetted or directed any behavior of the type listed in clause 1 or 2 directly above; in connection with this Policy or
any accident, loss or claim under it.
If we assert our rights under this Our Right To Deny Coverage clause, you are responsible to repay us for all amounts we are
required by law to pay, and our related expenses, if law requires us to make payment to protect any innocent third parties or
requires us to pay any other amount.
ROADSIDE ASSISTANCE COVERAGE

If Roadside Assistance Coverage is shown on the declarations, we will pay for our authorized service representative to provide
the following services when necessary due to a covered emergency sustained by an insured auto:
Form 1918 TX (02-2021) Page 51 of 53

1. Towing of a covered disabled auto; and
2. Labor on a covered disabled auto at the place of disablement.
Additional Definitions for Roadside Assistance Coverage
When used in Roadside Assistance Coverage:
1. Covered disabled auto means an insured auto for which this coverage has been purchased that sustains a covered
emergency.
2. Covered emergency means a disablement that is a result of:
a. Mechanical or electrical breakdown;
b. Battery failure;
c. Insufficient supply of fuel, oil, water, or other fluid;
d. Flat tire;
e. Lock-out; or
f. Entrapment in snow, mud, water or sand within 10 feet of a road or highway.
Limits, Exclusions, Conditions and Other Terms for Roadside Assistance Coverage
1. If service is provided by an unauthorized service representative, we must approve the towing or other service before it is
performed and the amount we agree to reimburse shall not exceed the amount we pay for similar services in the
geographic area. An itemized receipt must be received by us within 60 days of the date of any such pre-approved service.
2. Coverage under Roadside Assistance Coverage will not apply to:
a. The cost of purchasing parts, fluid, lubricants, or replacement keys, or the labor to make replacement keys;
b. Installation of products or material not related to the disablement;
c. Labor not related to the disablement;
d. Labor on a covered disabled auto for any time period in excess of 60 minutes per disablement;
e. Towing or storage related to impoundment, abandonment, illegal parking, or other violations of law;
f. Assistance with jacks, levelers, airbags or awnings;
g. Labor or repair work performed at a service station, garage, or repair shop;
h. Auto storage charges;
i. Disablement that occurs on roads not regularly maintained, sand beaches, open fields, or areas designated as not
passable due to construction, weather, or earth movement;
j. Mounting or removing of snow tires or chains;
k. Tire repair;
l. Disablement that results from an intentional or willful act or action by you, a relative, a rated driver or any other
permissive operator of a covered disabled auto;
m. Disablement of any vehicle other than an insured auto shown with this coverage on the declarations;
n. Any insured auto while it is being used in a personal vehicle sharing program; or
o. A trailer.
3. Roadside Assistance Coverage is excess over any other collectible insurance or towing protection coverage.
4. We will not provide service under Roadside Assistance Coverage for more than three (3) occurrences to any insured auto
in any six (6) month period.
Form 1918 TX (02-2021) Page 52 of 53

NAMED EXCLUDED DRIVER
A specifically named driver may be excluded from all coverage under this Policy. This can be done at the request of the named
insured.
If a specifically named driver is excluded:
1. NO coverage is provided under any part of this Policy for any claim arising out of any accident or loss that occurs while that
named excluded driver is operating any motor vehicle.
2. NO coverage will apply to the excluded driver or for any other parties or persons, including, but not limited to, you, relatives
and any rated driver who may be liable vicariously or for negligent entrustment, as to any accident or loss that arises out
of the operation of a motor vehicle by a named excluded driver.
3. You have agreed that the named driver exclusion serves as an express rejection of all:
a. Uninsured / Underinsured Motorist Bodily Injury Coverage;
b. Uninsured / Underinsured Motorist Property Damage Coverage;
c. Personal Injury Protection Coverage; and
d. Medical Payments Coverage;
and any and all other coverage while any vehicle is being operated by any named excluded driver.
4. A named driver exclusion will continue to apply to this Policy and all renewals, reinstatements and replacement policies
unless and until:
a. we get written notice from the named insured ending that driver exclusion; and
b. the extra premium for coverage of that driver has been paid when due.
_________________________________________________________________________
SPECIAL PROVISIONS
This Company is licensed to operate under Chapter 912, Texas Insurance Code, and such statutes shall apply to and form a
part of this policy the same as written or printed upon, attached or appended hereto.
This policy is issued subject to the constitution and bylaws and all amendments hereto of the company, which shall form a
part of the policy.
MUTUALS – MEMBERSHIP AND VOTING NOTICE – The insured is notified that by virtue of this policy, he is a member of the
Redpoint County Mutual Insurance Company and is entitled to vote either in person or by proxy at any and all meetings of
said Company. The Annual Meetings are held in its Home Office in Austin, Texas, on the first Tuesday of March in each year,
at 10:00 o’clock A.M.
MUTUALS – PARTICIPATION CLAUSE WITHOUT CONTINGIENT LIABILITY – No Contingent Liability: This policy is non-
assessable. The policy holder is a member of the Company and shall participate, to the extent and upon the conditions fixed
and determined by the Board of Directors in accordance with the provisions of the law, in the distribution of dividends so
fixed and determined.
In Witness Whereof, the Company has caused this policy to be executed and attested.
________________________________________
Christopher A. McClellan, President & Secretary
Form 1918 TX (02-2021) Page 53 of 53

IMPORTANT NOTICE AVISO IMPORTANTE
To obtain information or make a complaint: Para obtener informacion o para someter

una queja:
You may call our toll-free telephone number Usted puede llamar al numero de telefono
for information or to make a complaint at: gratis para informacion o para someter una
queja al:
866-980-9431 866-980-9431
You may contact the Texas Department of Puede comunicarse con el Departamento
Insurance to obtain information on de Seguros de Texas para obtener
companies, coverages, rights or complaints informacion acerca de companias,
at: coberturas, derechos o quejas al:
1-800-252-3439 1-800-252-3439
You may write the Texas Department of Puede escribir al Departamento de Seguros
Insurance: de Texas:
P. O. Box 149104 P. O. Box 149104

Austin, TX 78714-9104 Austin, TX 78714-9104
Fax: (512) 490-1007 Fax: (512) 490-1007
Web: www.tdi.texas.gov Web: www.tdi.texas.gov
E-mail: ConsumerProtection@tdi.texas.gov E-mail: ConsumerProtection@tdi.texas.gov
PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS O

Should you have a dispute concerning your RECLAMOS:
premium or about a claim you should Si tiene una disputa concerniente a su
contact the agent or the company first. If the prima o a un reclamo, debe comunicarse
dispute is not resolved, you may contact the con el agente o la compania primero. Si no
Texas Department of Insurance. se resuelve la disputa, puede entonces
comunicarse con el departamento (TDI).
ATTACH THIS NOTICE TO YOUR UNA ESTE AVISO A SU POLIZA:

POLICY: Este aviso es solo para proposito de
This notice is for information only and does informacion y no se convierte en parte o
not become a part or condition of the condicion del document adjunto.
attached document.
Form 03, Texas, August 2017

28 TAC Section 5.9970(b)
CONSUMER BILL OF RIGHTS

Personal Automobile Insurance
What is the Bill of Rights?

It is a basic outline of important rights you have under Texas law. Insurance companies must give you this Bill
of Rights with your policy. It is important to read and understand your policy.
The Bill of Rights is not:

• A complete list of all your rights,
• Part of your policy, or
• A list of everything that you are responsible for.
Questions about these rights?

• If you are not sure about anything in your policy, ask your agent or insurance company.
• If you have questions or a complaint, contact the Texas Department of Insurance (TDI) at:
Phone: 1-800-252-3439
Email: ConsumerProtection@tdi.texas.gov
Website: www.tdi.texas.gov/consumer
Mail: Consumer Protection MC 111-1A
P.O. Box 149091
Austin, TX 78714-9101
• To learn more about insurance, visit www.opic.texas.gov or call the Office of Public Insurance Counsel
(OPIC) at 1-877-611-6742.
AVISO: Este documento es un resumen de sus derechos como asegurado. Tiene derecho a llamar a su
compañía de seguros y obtener una copia de estos derechos en español. Además, puede ser que su compañía
de seguros tenga disponible una versión de su póliza en español.
1920 TX 02-2022 Table of Contents

Where to Get Information ........................................................................................................... 2
1. Your insurance company ................................................................................................................................. 3
2. Your declarations page .................................................................................................................................... 3
3. The Texas Department of Insurance (TDI). .................................................................................................... 3
4. Resources for shopping for insurance. ............................................................................................................ 3
What You Should Know When You File a Claim..................................................................... 3

5. Choice of repair shop and replacement parts .................................................................................................. 3
6. Auto repair notice requirements ...................................................................................................................... 3
7. Deadlines for processing claims and payments ............................................................................................... 3
8. Written explanation of claim denial ................................................................................................................ 4
9. Information not required for processing your claim ....................................................................................... 4
10. Reasonable investigation ................................................................................................................................. 4
11. Deductible recovery ........................................................................................................................................ 4
12. Notice of liability claim settlement ................................................................................................................. 4
Who to Contact for Claim Disagreements ................................................................................. 4

13. Claim disagreements ....................................................................................................................................... 4
What You Should Know about Renewal, Cancellation, and Nonrenewal ............................. 4
14. Offer of uninsured/underinsured motorist and personal injury protection coverages ..................................... 5
15. Insurance company cancellation of personal automobile policies .................................................................. 5
16. Notice of cancellation ...................................................................................................................................... 5
17. Your right to cancel ......................................................................................................................................... 5
18. Refund of premium ......................................................................................................................................... 5
19. Limits on using claims history to change premium ......................................................................................... 5
20. Timing of nonrenewal. ..................................................................................................................................... 5
21. Notice of nonrenewal. ..................................................................................................................................... 6
22. Not-at-fault claims ........................................................................................................................................... 6
23. Limit on using credit information to nonrenew your policy. .......................................................................... 6
24. Limit on using age to nonrenew your policy ................................................................................................... 6
25. Protections from discrimination ...................................................................................................................... 6
26. Right to ask questions...................................................................................................................................... 6
27. Notice of a “material change” to your policy .................................................................................................. 6
28. Written explanation of cancellation or nonrenewal ........................................................................................ 7
Where to Get Information

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1920 TX 02-2022
1. Your insurance company. When you get a copy of your policy you will also get an “Important Notice”
from the company. The notice explains how to contact your company and how to file a complaint. You
may request a complete copy of your policy from your company at any time.
2. Your declarations page. The declarations page, also called the “dec page,” shows: (a) the name and address
of your insurance company, (b) the dates your policy is in effect, (c) the insured vehicles and drivers, (d) any
excluded drivers, (e) the amounts and types of coverage, and (f) your deductibles.
3. The Texas Department of Insurance (TDI). You have the right to call TDI for free at 1-800-252-3439 for
information and help with a complaint against an insurer. You can also find information on the TDI website
at www.tdi.texas.gov.
4. Resources for shopping for insurance. The Office of Public Insurance Counsel (OPIC) and TDI
developed www.HelpInsure.com to help you compare rates and coverages for different insurance
companies. OPIC also has an online tool to help you compare policies. You can find this policy comparison
tool at www.opic.texas.gov.
What You Should Know When You File a Claim

5. Choice of repair shop and replacement parts. You have the right to choose the repair shop and parts for
your vehicle. An insurance company may not specify the brand, type, kind, age, vendor, supplier, or
condition of parts or products used to repair your auto, but they are not required to pay more than a
reasonable amount.
6. Auto repair notice requirements. The insurance company must provide you a document about your rights
regarding auto repairs as follows:
• Claims submitted by telephone: Written notice within 3 business days or verbal notice during the
call, followed by written notice within 15 business days;
• Claims submitted in person: Written notice at the time you present your vehicle to an
insurer, an insurance adjuster, or other person in connection with a claim for repair; or
• Claims submitted in writing (including email and fax): Written notice must be provided within
3 business days of the insurance company receiving notice of the claim.
7. Deadlines for processing claims and payments. When you file a claim on your own policy, the insurance
company must meet these deadlines:
• Within 15 days after you file a claim: The company must let you know they received your claim.
The company must also start their investigation and ask you for any other information they need.
• Within 15 business days after they get all the information they need: The company must approve
or deny your claim in writing. They can extend this deadline up to 45 days from the date they: (a) let
you know they need more time and (b) tell you why.
• Within 5 business days after they let you know your claim is approved: The company must pay
the claim.
Note: TDI can extend these deadlines by 15 more days if there is a weather-related catastrophe.
3
1920 TX 02-2022
If your company fails to meet these deadlines, you may be able to collect the claim amount, interest, and
attorney’s fees.
8. Written explanation of claim denial. Your insurance company must tell you in writing why your claim or
part of your claim was denied.
9. Information not required for processing your claim. Your insurance company can only ask for
information reasonably needed for their claim investigation. However, they cannot ask for your federal
income tax returns unless: (a) they get a court order or (b) your claim involves a fire loss, loss of profits, or
lost income.
10. Reasonable investigation. Your insurance company cannot refuse to pay your claim without a reasonable
investigation of the claim. You should keep records of all claim communications (including notes from
phone calls) and other claim documentation (including damage estimates and receipts).
11. Deductible recovery. If another person may be liable for the damage to your auto and you (a) filed a claim,
and (b) paid or owe a deductible on your own policy, then your insurance company must:
• Take action to recover your deductible no later than 1 year from when your claim is paid; or
• Refund your deductible; or
• Notify you that they will not take action and allow you to try to collect your money (a) within 1 year
from that date your claim is paid, or (b) at least 90 days before the statute of limitations expires
(whichever date comes first).
12. Notice of liability claim settlement. Liability means you are responsible for other people’s injuries or
damage to their property. Your insurance company must let you know in writing:
• About the first offer to settle a claim against you within 10 days after the offer is made.
• About any claim settled against you within 30 days after the date of the settlement.
Who to Contact for Claim Disagreements

13. Claim disagreements. You can dispute the amount of your claim payment or what is covered under your
policy. You can:
• Contact your insurance company.
• Contact the repair person or shop.
• Contact an attorney to advise you of your rights under the law. The State Bar of Texas can help you
find an attorney.
• Pay a qualified appraiser to examine the damage to your property.
• File a complaint with TDI.
What You Should Know about Renewal, Cancellation, and Nonrenewal

Renewal means that your insurance company is extending your policy for another term.
Cancellation means that, before the end of the policy period, the insurance company:
4
1920 TX 02-2022
• Terminates the policy;
• Gives you less coverage or limits your coverage; or
• Refuses to give additional coverage that you are entitled to under the policy.
“Refusal to renew” and “nonrenewal” are terms that mean your coverage ends at the end of the policy
period. The policy period is shown on the declarations page of your policy.
14. Offer of uninsured/underinsured motorist and personal injury protection coverages. Insurance
companies must offer you Uninsured/Underinsured Motorist (UM/UIM) and Personal Injury Protection
(PIP) coverage on a new policy. If you decline them, it must be in writing. The company is not required to
reoffer these coverages upon renewal, but you may request them at any time.
15. Insurance company cancellation of personal automobile policies. If your policy has been in effect for
60 days or more, your company can only cancel your policy if:
• You don’t pay your premium when it is due;
• You file a fraudulent claim;
• TDI decides that keeping the policy violates the law;
• Your driver’s license or vehicle registration is suspended or revoked (unless you agree to exclude
coverage for yourself as a driver under the policy); or
• Any driver who lives with you, or who usually drives a vehicle covered by the policy, has their
driver’s license or vehicle registration suspended or revoked (unless you agree to exclude coverage
for that person as a driver under the policy).
16. Notice of cancellation. If your insurance company cancels your policy, they must let you know by mail at
least 10 days before the effective date of the cancellation. Check your policy because your company may
give you more than 10 days' notice.
17. Your right to cancel. You can cancel your policy at any time and get a refund of the unused premium.
18. Refund of premium. If you or your insurance company cancel your policy before it ends, the company
must refund any unused premium.
• If the company cancels, they have 15 business days from the day they cancel your policy.
• If you ask to cancel your policy, the company has 15 business days from the day you want the
policy to end.
You must let your company know you want the refund sent to you. If not, they may refund the remaining
premium by giving you a premium credit on the same policy.
19. Limits on using claims history to change premium. Your insurance company can’t change your premium
solely because of a claim you file that is not paid or payable under your policy.
20. Timing of nonrenewal. Your insurance company must renew your policy until it has been in effect for 1
year. If your policy is renewed, your company must continue to renew your policy until the yearly
anniversary of the original effective date.
For example, if your six-month policy was originally effective on January 1, 2050, your company must
renew your policy until January 1, 2051. After that, your company may only refuse to renew your policy on
the original effective date (in this example, January 1) of any future year.
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1920 TX 02-2022
21. Notice of nonrenewal. Your insurance company must send you a notice that they are not renewing your
policy. They must let you know at least 30 days before your policy expires, or you can require them to
renew your policy.
22. Not-at-fault claims. Your insurance company cannot refuse to renew your policy solely because of any
one of the following:
• Claims involving damage from a weather-related incident that do not involve a collision, like
damage from hail, wind, or flood.
• Accidents or claims involving damage by contact with animals.
• Accidents or claims involving damage caused by flying gravel, missiles, or other flying objects.
However, if you have 3 of these claims in a three-year period, the company may increase your
deductible on your next annual renewal date.
• Towing and labor claims. However, once you have made 4 of these claims in a three-year period, the
company may remove this coverage from your policy on your next annual renewal date.
• Any other accident or claim that cannot reasonably be considered your fault, unless you have 2 of
these claims or accidents in a one-year period.
23. Limit on using credit information to nonrenew your policy. An insurance company cannot refuse to
renew your policy solely because of your credit.
24. Limit on using age to nonrenew your policy. An insurance company cannot refuse to renew your policy
based solely on the age of any person covered by the policy. Your company also cannot require you to
exclude a family member from coverage solely because they reached driving age.
25. Protections from discrimination. An insurance company cannot refuse to insure you; limit the coverage
you buy; refuse to renew your policy; or charge you a different rate based on your race, color, creed,
country of origin, or religion.
26. Right to ask questions. You can ask your insurance company a question about your policy. They cannot
use your questions to deny, nonrenew, or cancel your coverage. Your questions also cannot be used to
determine your premium.
For example, you may ask:
• General questions about your policy;
• Questions about the company’s claims filing process; and
• Questions about whether the policy will cover a loss, unless the question is about damage: (a) that
occurred and (b) that results in an investigation or claim.
27. Notice of a “material change” to your policy. If your insurance company does not want to cancel or
nonrenew your policy, but wants to make certain material changes, then they must explain the changes in
writing at least 30 days before the annual renewal date. Material changes include:
• Giving you less coverage;
• Changing a condition of coverage; or
• Changing what you are required to do.
Instead of a notice of “material change” a company may choose to not renew your existing policy. If so, the
company has to send a nonrenewal letter, but may still offer you a different policy.
6
1920 TX 02-2022
Note: A company cannot reduce coverage during the policy period unless you ask for the change. If you
ask for the change, the company does not have to send you a notice.
28. Written explanation of cancellation or nonrenewal. You can ask your insurance company to tell you in
writing the reasons for their decision to cancel or not renew your policy. The company must explain in
detail why they cancelled or nonrenewed your policy.
7
1920 TX 02-2022
WHAT DOES ROOT, INC.
FACTS DO WITH YOUR PERSONAL INFORMATION?
Why? Financial companies choose how they share your personal information. Federal law gives
consumers the right to limit some but not all sharing. Federal law also requires us to tell
you how we collect, share, and protect your personal information. Please read this notice
carefully to understand what we do.
What? The types of personal information we collect and share depend on the product or service
you have with us. This information can include:
◼ Drivers License and income

◼ Credit-based insurance scores and insurance claim history
◼ Transaction or loss history
How? All financial companies need to share customer’s personal information to run their
everyday business. In the section below, we list the reasons financial companies can
share their customer’s personal information; the reasons Root chooses to share; and
whether you can limit this sharing.
Does Root Insurance

Reasons we can share your personal information Can you limit this sharing?
share?
For our everyday business purposes — YES NO

such as to process your transactions, maintain your
account(s), respond to court orders and legal
investigations, or report to credit bureaus
For our marketing purposes — YES NO

to offer our products and services to you
For joint marketing with other financial companies YES NO
For our affiliates’ everyday business purposes— YES NO

information about your transactions and experiences
For our affiliates’ everyday business purposes— YES YES

information about your creditworthiness
For our affiliates to market to you YES NO
For nonaffiliates to market to you NO NO
To limit our ◼ Email us at: privacy@joinroot.com

sharing Please note:
If you are a new customer, we can begin sharing your information 30 days from the date
we sent this notice. When you are no longer our customer, we continue to share your
information as described in this notice.
However, you can contact us at any time to limit our sharing.
Questions Call 1-866-980-9431 or go to www.joinroot.com
Who we are
18 20 CW 02-2022
Who is providing this notice? Root Insurance Company, Root Insurance Agency, LLC, Root
Scout, LLC, Root Property & Casualty Company, Root Lone
Star Insurance Agency, and Redpoint Insurance Group, LLC
which are all either affiliates that operate under the Root, Inc.
umbrella or business partners.
What we do
How does Root Insurance protect my personal To protect your personal information from unauthorized access
information? and use, we use security measures that comply with federal law.
These measures include computer safeguards and secured files
and buildings.
We restrict access only to those employees and personnel who

need to provide you with products or services
How does Root Insurance collect my personal We collect your personal information, for example, when you
information?
◼ Apply for insurance or pay insurance premiums
◼ File an insurance claim or tell us where to send money
◼ Give us your contact information
We also collect your personal information from others such as

credit bureaus, affiliates, or other companies
Why can’t I limit all sharing? Federal law gives you the right to limit only
◼ sharing for affiliates’ everyday business purposes—

information about your creditworthiness
◼ affiliates from using your information to market to you
◼ sharing for nonaffiliates to market to you
State laws and individual companies may give you additional

rights to limit sharing.
What happens when I limit sharing for an Your choices will apply for everyone on your account.
account I hold jointly with someone else?
Definitions
Affiliates Companies related by common ownership or control. They can
be financial and nonfinancial companies.
Nonaffiliates Companies not related by common ownership or control. They

can be financial and nonfinancial companies.
◼ Non-affiliates we can share with include: insurance

companies, direct marketing companies, data analytics
companies, and companies who help deliver our advertising
to you.
18 20 CW 02-2022
Joint marketing A formal agreement between nonaffiliated financial companies
that together market financial products or services to you.
◼ Our joint marketing partners may include insurance

licensees.
Other important information

For CA Customers: We will not share your personal information with companies outside of the Root Insurance family of
companies, except for our everyday business purposes, for marketing our products and services to you, or with your
consent.
For insurance customers in only AZ, CT, GA, IL, MT, NV, NM, ND, OH, OR, and VA: The term “Information” means
information we collect during an insurance transaction. We will not use your medical information for marketing purposes
without your consent. We may share your Information with nonaffiliates without your prior authorization as permitted or
required by law. We may share your Information with insurance regulatory authorities, law enforcement, and consumer
reporting agencies. Information we obtain from a report prepared by an insurance-support organization may be retained
by that insurance-support organization and disclosed to others.
18 20 CW 02-2022
80 E Rich St Ste 500
Columbus, OH 43215
www.root.com
General Agent for

Redpoint County Mutual Insurance Company
Amendatory Endorsement – Fees

Texas
This endorsement is attached to and changes the Policy.
The following is added to your Policy:
Fees
We reserve the right to charge the following fees:
● Policy Fee – A fee to initiate and/or renew the Policy;

● Installment Payment Fee – A fee to make a payment plan available to you. The installment payment fee
may also include a fee charged with the policy down payment;
● Late Payment Fee – A fee if your payment is not paid by the due date;
● Reinstatement Fee – A fee if this Policy is terminated but we agree to reinstate it. This fee will be added
to the unpaid, earned premium amount required to reinstate the Policy and will only be charged once per
reinstatement;
● Rewrite Fee – A fee if this Policy is terminated but we agree to rewrite it. This fee will be added to the
down payment amount required to write the Policy and will only be charged once per rewrite; and
● Any other fee(s) that is filed and/or approved where required by the state department of insurance or
other applicable regulator.
The above fees are not refundable, unless required by applicable state law. All fees will be administered in
accordance with the terms and conditions filed and/or approved where required by the state department of
insurance or other applicable regulator. Fees will be deducted first from any payment received from you.
Nothing herein contained shall be held to vary, alter, waive, or extend any of the terms, limits of liability,
conditions, or exclusions in this endorsement or the Policy to which this endorsement is attached other than as
stated above.
Form 1931 TX (08-2022) 1

Redpoint
80 E Rich Street
Suite 500
Columbus, OH 43215
Notice of Adverse Action

Dear Khristol Brown,
Thank you for choosing Redpoint for your insurance needs.
We’re writing to let you know that an adverse action has been taken. As part of our standard process,
we secure third-party reports from consumer reporting agencies. State law and the Federal Fair Credit
Reporting Act require that we provide this notice.
At Root, we pride ourselves on fairness and transparency, and we want to help you better understand
the information we use and why the adverse action has been taken.
The following adverse action was taken:
The rate we have assigned to your car insurance policy is not our lowest rate. Root determined your
rate using various consumer reports, which may be different from the models most carriers use.
The adverse action was taken for the following reason:
We provided you a less favorable rating classification due, in part, to information we evaluated from
your Prior Insurance, and Credit report.
Khristol Brown
LexisNexis Risk Solutions Consumer Center - Prior Insurance Report
Policy
End Date: 2019-04-29
Start Date: 2019-02-03
Company Name: PROGRESSIVE GROUPS
Policy
End Date: 2022-10-31
Company Name: ESURANCE INS CO
Policy
End Date: 2022-12-13
Please read the next page for more information Page 1 of 3
Form 1930, revised 2021-08

Company Name: PROGRESSIVE GROUPS
Policy
End Date: 2023-06-02
Company Name: HOME STATE COUNTY MU
TransUnion Consumer Solutions - Credit Report

Negative item
Credit Score: 359
Negative item
Code GAO: ,Age is 26-30 and average number of months accounts on file is 30 to 59.
Optimum value is age 30 or less and average number of months accounts on file is 141 or
more.
Negative item
Code D25: There are 6 third party collections. Optimum value is no collections.
Negative item
Code S09: There are 10 or more inquiries. Optimum value is no inquiries.
Negative item
Code DH0: There are no accounts. Optimum value is no delinquency and the maximum
credit card utilization over last 12 months is > 0% and <1%.
What you can do:
The Fair Credit Reporting Act states that you are entitled to a free copy of your consumer report
within sixty (60) days of receiving this letter. You have to make a request to the applicable consumer
reporting agency (listed below). If you want to dispute the accuracy or completeness of any
information included in your report, you will need to contact the consumer reporting agency directly.
It’s important to know that the consumer reporting agency did not make any decisions about
premium, rating or underwriting. They will not be able to explain your policy premium or the reason
for the adverse action.
Consumer reporting agencies:
LexisNexis Risk Solutions Consumer Center TransUnion Consumer Solutions

P.O. Box 105108 P.O. Box 2000
Atlanta, GA 30348-5018 Chester, PA 19016-2000
(888) 497-0011 (800) 916-8800
Please read the next page for more information Page 2 of 3

Redpoint - Notice of Adverse Action Page 3 of 3
Underwritten by
Redpoint County Mutual Insurance Company
Root Lone Star Insurance Agency, MGA
80 E Rich Street Suite 500
Columbus, OH 43215
www.joinroot.com
E-Delivery Terms and Conditions

Revised: August 11, 2022
Please read these Terms and Conditions carefully. By voluntarily opting-in to

electronic delivery of notices and documents, you are affirmatively consenting to
these terms and conditions. If you disagree with these terms and conditions, do not
continue.
These Terms and Conditions may change from time to time and all updates will be emailed to
you, and it is your responsibility to review this information. When we do change these Terms
and Conditions, we may also revise the “Revised” date and may notify you or post a message
on the Website and/or through the Service.
Hardware Requirements: You will need to be able to access the Internet and have access to an
Android or iOS smartphone.
Software Requirements: You will need to have iOS version 13.0 and above or Android version
5.0 and above.
We will inform you of any changes to these hardware and software requirements. You will need
to review the new requirements and contact us should we make changes to the hardware or
software requirements for the e-delivery option such that you may no longer be capable of
accessing or retaining your electronic insurance documents and wish to opt out of e-delivery. In
this event, opting out of e-delivery will not impose any additional fees, though it may affect your
total premium.
You are responsible to inform us of any changes to your email address, as well as keeping your
You are responsible to inform us of any changes to your email address, as well as keeping your
email address active and capable of receiving new emails. Your email address can be updated
in the Root App, on Root's website, or by contacting us at support@joinroot.com or toll-free at
(866) 980-9431. We are not responsible for issues due to emails sent to inactive or out-of-date
email addresses, unless we are solely negligent for using an incorrect address.
Your consent to these terms and conditions, confirms that you are consenting to receive all
policies, endorsements, notices and/or documents from us electronically, including notice of
nonrenewal and cancellation. However, there may be some documents that we continue to
send via mail due to legal or technological constraints. You do have the right to request any of
these documents in paper by contacting us at:
Email: support@joinroot.com
Toll-free telephone: (866) 980-9431
Web: www.joinroot.com
You will not be charged a fee to receive any of these documents in paper. You can access your
documents to retain any notices sent electronically for your own records by tapping the policy
tab in the app and tapping “Policy Document.”
You may continue to receive delivery of the policy and all notices in hard copy; receive delivery
of the policy electronically, but receive all notices in hard copy; or receive delivery of the policy
and all notices electronically. You can manage these options, including opting-out of e-delivery,
by contacting us at support@joinroot.com or toll-free at 866-980-9431.
State Specific Provisions:
For Kentucky and Tennessee Policyholders:

By consenting to this E-Delivery Terms and Conditions, you, the policyholder, elect to allow for
policies, notices and communications to be sent to the electronic mail address provided by you
and you should be aware that this election operates as consent by you for all notices to be sent
electronically, including notice of nonrenewal and cancellation. Therefore, you, the
policyholder, should be diligent in updating the electronic mail address provided to us in the
event that the address should change.
For Georgia Policyholders:

I AGREE TO RECEIVE ALL MAILINGS AND COMMUNICATIONS ELECTRONICALLY. SUCH
ELECTRONIC MAILING OR COMMUNICATIONS MAY EVEN INCLUDE CANCELLATION OR
NONRENEWAL NOTICES.
Khristol Brown
First Named Insured

I verify and confirm that I have read and agree to the document(s) above, that I own
or lease the vehicle(s) on this policy, and that I am the Named Insured on this policy
and authorized to make the selections of coverage.
I understand that this constitutes a legal signature confirming that I acknowledge

and agree to the above Affirmation Statement.
Acknowledged at: 2023-10-17 20:48:52 UTC
Acknowledged by: Khristol Brown, e57a4ca8-8b66-400d-bcb1-e5def70e7917

Underwritten by Redpoint County Mutual Insurance Company
Important Notice
Root Lone Star Insurance Agency, MGA for Redpoint County Mutual Insurance Company
reserves the right to cancel this policy at any time in accordance with our underwriting
guidelines.
In the event this occurs, you will be notified of the cancellation as required by your state laws
and regulations.
If you have any questions, please contact Customer Service at support@joinroot.com.


Use of Credit Information Disclosure

We will obtain and use credit information on you or any other member(s) of your household as
a part of the insurance credit scoring process.
If you have questions regarding this disclosure, contact Root at (866) 980-9431 or
support@joinroot.com. For information or other questions, contact the Texas Department of
Insurance at 1 (800) 578-4677 or PO Box 149104, MC 104-PC, Austin, Texas 78714.
Section 559.053 of the Texas Insurance Code requires an insurer or its agents to disclose to its
customers whether credit information will be obtained on the applicant or insured or on any
other member(s) of the applicant's or insured's household and used as part of the insurance
credit scoring process.
If credit information is obtained or used on the applicant or insured, or on any member of the
applicant's or insured's household, the insurer shall disclose to the applicant the name of each
person on whom credit information was obtained or used and how each person's credit
information was used to underwrite or rate the policy. An insurer may provide this information
with this disclosure or in a separate notice.
Adverse effect means an action taken by an insurer in connection with the underwriting of
insurance for a consumer that results in the denial of coverage, the cancellation or nonrenewal
of coverage, or the offer to and acceptance by a consumer of a policy form, premium rate, or
deductible other than the policy form, premium rate, or deductible for which the consumer
specifically applied.
Credit information is any credit related information derived from a credit report itself, or
provided in an application for personal insurance. The term does not include information that is
not credit-related, regardless of whether the information is contained in a credit report or in an
application for insurance coverage or is used to compute a credit score.
Credit score or insurance score is a number or rating derived from a mathematical formula,
computer application, model, or other process that is based on credit information and used to
predict the future insurance loss exposure of a consumer.
SUMMARY OF CONSUMER PROTECTIONS CONTAINED IN

CHAPTER 559
PROHIBITED
Includes USE
copyrighted OF CREDIT
material of InsuranceINFORMATION.
Services Office, Inc., with its permission
PROHIBITED USE OF CREDIT INFORMATION.
An insurer may not:
(1) use a credit score that is computed using factors that constitute unfair discrimination;
(2) deny, cancel, or nonrenew a policy of personal insurance solely on the basis of credit
information without consideration of any other applicable underwriting factor independent of
credit information; or
(3) take an action that results in an adverse effect against a consumer because the consumer
does not have a credit card account without consideration of any other applicable factor
independent of credit information.
An insurer may not consider an absence of credit information or an inability to determine credit
information for an applicant for insurance coverage or insured as a factor in underwriting or
rating an insurance policy unless the insurer:
(1) has statistical, actuarial, or reasonable underwriting information that: (A) is reasonably
related to actual or anticipated loss experience; and (B) shows that the absence of credit
information could result in actual or anticipated loss differences;
(2) treats the consumer as if the applicant for insurance coverage or insured had neutral credit
information, as defined by the insurer; or
(3) excludes the use of credit information as a factor in underwriting and uses only other
underwriting criteria.
NEGATIVE FACTORS.
An insurer may not use any of the following as a negative factor in any credit scoring
methodology or in reviewing credit information to underwrite or rate a policy of personal
insurance:
(1) a credit inquiry that is not initiated by the consumer;
(2) an inquiry relating to insurance coverage, if so identified on a consumer's credit report; or
(3) a collection account with a medical industry code, if so identified on the consumer's credit
report.
Multiple lender inquiries made within 30 days of a prior inquiry, if coded by the consumer
reporting agency on the consumer's credit report as from the home mortgage or motor vehicle
lending industry, shall be considered by an insurer as only one inquiry.
EFFECT
Includes OF EXTRAORDINARY
copyrighted material of Insurance EVENTS.
Services Office, Inc., with its permission
EFFECT OF EXTRAORDINARY EVENTS.
An insurer shall, on written request from an applicant for insurance coverage or an insured,
provide reasonable exceptions to the insurer's rates, rating classifications, or underwriting rules
for a consumer whose credit information has been directly influenced by a catastrophic illness
or injury, by the death of a spouse, child, or parent, by temporary loss of employment, by
divorce, or by identity theft. In such a case, the insurer may consider only credit information not
affected by the event or shall assign a neutral credit score.
An insurer may also consider granting an exception to an applicant for insurance coverage or
an insured for an extraordinary event not listed in this section. An insurer is not out of
compliance with any law or rule relating to underwriting, rating, or rate filing as a result of
granting an exception under this article.
NOTICE OF ACTION RESULTING IN ADVERSE EFFECT.
If an insurer takes an action resulting in an adverse effect with respect to an applicant for
insurance coverage or insured based in whole or in part on information contained in a credit
report, the insurer must provide to the applicant or insured within 30 days certain information
regarding how an applicant or insured may verify and dispute information contained in a credit
report.
DISPUTE RESOLUTION; ERROR CORRECTION.
If it is determined through the dispute resolution process established under Section 611(a)(5),
Fair Credit Reporting Act (15 U.S.C. Section 1681i), as amended, that the credit information of a
current insured was inaccurate or incomplete or could not be verified and the insurer receives
notice of that determination from the consumer reporting agency or from the insured, the
insurer shall re-underwrite and re-rate the insured not later than the 30th day after the date of
receipt of the notice.
After re-underwriting or re-rating the insured, the insurer shall make any adjustments necessary
within 30 days, consistent with the insurer's underwriting and rating guidelines. If an insurer
determines that the insured has overpaid premium, the insurer shall credit the amount of
overpayment. The insurer shall compute the overpayment back to the shorter of the last 12
months of coverage; or the actual policy period.
Includes copyrighted material of Insurance Services Office, Inc., with its permission

Named Insured: Khristol Brown

Policy Number: D6G4T7
PERSONAL INJURY PROTECTION COVERAGE

REJECTION FORM
As required by Section 1952.152 of the Texas Insurance Code, I have been given the
opportunity to purchase Personal Injury Protection Coverage.
☒ I hereby reject Personal Injury Protection Coverage. I understand that this

rejection also applies to all future renewals, reinstatements or replacements of my
automobile insurance policy. I also understand that I may have this coverage added
to my policy at any future date.
Applicant Signature: Khristol Brown
Authorized On: 10/17/2023


RCM.PIPR.2016
RCM.PIPR.2016
Named Insured: Khristol Brown

Policy Number: D6G4T7
Texas Uninsured/Underinsured Motorists Coverage

Selection/Rejection
Texas law permits you to make certain decisions regarding Uninsured/Underinsured Motorists
Coverage. This document briefly describes this coverage and the options available.
You should read this document carefully and contact us if you have any questions regarding
Uninsured/Underinsured Motorists Coverage and your options with respect to this coverage.
This document includes general descriptions of coverage. However, no coverage is provided

by this document. You should read your policy and review your Declarations Page(s) and/or
Schedule(s) for complete information on the coverages you are provided.
UNINSURED/UNDERINSURED MOTORISTS COVERAGE
Uninsured/Underinsured Motorists Coverage provides insurance protection to an insured for

compensatory damages which the insured is legally entitled to recover from the owner or
operator of an uninsured/underinsured motor vehicle because of bodily injury or property
damage caused by an automobile accident. Also included are damages due to bodily injury or
property damage that result from an automobile accident with a hit-and-run vehicle whose
owner or operator cannot be identified.
Unless rejected, Uninsured/Underinsured Motorists Coverage will be afforded at limits at least

equal to split limits of $30,000 for each person, subject to $60,000 for each accident with
respect to bodily injury, and $25,000 with respect to property damage.
Rejection of Uninsured/Underinsured Motorist Coverage
KB I reject Uninsured/Underinsured Motorist Coverage
Form 10, Texas, June 2019


Form 10, Texas, June 2019

Root Lone Star Insurance
Agency
80 E Rich Street Suite 500
Columbus, OH 43215
(866) 980-9431
Application for Insurance General agent for Redpoint

County Mutual Insurance
Policy Number: D6G4T7 Company
Driver Information
Name: Khristol Brown Mailing Address:
Named Insured? Yes 12700 Fm 1960 Rd W Apt 1108
Date of Birth: **/**/1997 Houston, TX 77065
Homeowner? No Driver’s License State: TX
Marital Status: Single Driver’s License Number: *****383
Vehicle Information
Year, Make, and Model: 2021 KIA Forte VIN: 3KPF24ADXME346888
Garaging Address1: 12700 Fm 1960 Rd W Garaging Address2: Apt 1108
Garaging City: Houston Garaging State: TX
Garaging Address ZIP Code: 77065
Coverage Information
Coverage limits and deductibles
The following coverages apply to all listed vehicles unless otherwise noted.
Bodily injury liability $30,000 each person

$60,000 each accident
Property damage liability $25,000 each accident
Medical payments DECLINED
Rental DECLINED
Form 101, October 2019

Personal injury protection DECLINED
Uninsured/underinsured motorist bodily injury DECLINED
Uninsured motorist property damage DECLINED
Comprehensive DECLINED
Collision DECLINED
Roadside assistance $100 each incident (up to 3 incidents)
Any person who with intent to defraud or knowing that he or she is facilitating a fraud against an insurer, submits an
application or files a claim containing a false or deceptive statement is guilty of insurance fraud.
Your insurance policy and any policy endorsements contain a full explanation of your coverage.
I verify and confirm that I have read and agree to the document(s) above,
that I own or lease the vehicle(s) on this policy, and that I am the Named
Insured on this policy and authorized to make the selections of coverage.
I understand that this constitutes a legal signature confirming that I
acknowledge and agree to the above Affirmation Statement.
Acknowledged by: Khristol Brown, e57a4ca8-8b66-400d-bcb1-

e5def70e7917
Form 101, October 2019

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Root Lone Star Insurance Agency

General agent for Redpoint County

Policy number D6G4T7

Auto insurance policy amended declarations

Named insured Vehicles

Coverage premiums, limits and deductibles

Bodily injury liability $30,000 each person

Property damage liability $25,000 each accident

Medical payments DECLINED

Personal injury protection DECLINED

Uninsured/underinsured motorist bodily injury DECLINED

Uninsured motorist property damage DECLINED

Form 1923 TX (08-2022) TCM

Roadside assistance $100 each incident (up to 3 incidents)

Form 1923 TX (08-2022) TCM

General agent for Redpoint County

Form 1918 TX (02-2021)

READ YOUR WHOLE POLICY:

Form 1918 TX (02-2021)

PERSONAL AUTO INSURANCE POLICY 5

PART A – LIABILITY COVERAGE (BODILY INJURY / PROPERTY DAMAGE) 12

PART B-I – PERSONAL INJURY PROTECTION COVERAGE (PIP) 17

PART B-II – MEDICAL PAYMENTS COVERAGE 21

PART C – UNINSURED (UM) and/or UNDERINSURED MOTORIST (UIM) COVERAGE 25

PART D – PHYSICAL DAMAGE COVERAGES 32

Form 1918 TX (02-2021) Page 3 of 53

INSUREDS’ DUTIES AFTER ANY ACCIDENT OR LOSS 40

POLICY TERMS & CONDITIONS 47

MISREPRESENTATION / CONCEALMENT / FRAUD 50

ROADSIDE ASSISTANCE COVERAGE 51

NAMED EXCLUDED DRIVER 53

Form 1918 TX (02-2021) Page 4 of 53

You and your mean:

Form 1918 TX (02-2021) Page 5 of 53

Also, as used throughout this Policy:

Accident means a sudden and unexpected event.

Application means the process and form(s):

Form 1918 TX (02-2021) Page 6 of 53

Depreciation means the decline in value of:

Form 1918 TX (02-2021) Page 7 of 53

but only if you pay us any extra premium when due.

Form 1918 TX (02-2021) Page 8 of 53

Non-owned auto means an auto that:

Occupying means in, on or getting in or out.

Form 1918 TX (02-2021) Page 9 of 53

Person means a human being.

Form 1918 TX (02-2021) Page 10 of 53

Rated driver means a person, other than you or a relative, who:

Form 1918 TX (02-2021) Page 11 of 53

Form 1918 TX (02-2021) Page 12 of 53

Property damage means:

Form 1918 TX (02-2021) Page 13 of 53

Form 1918 TX (02-2021) Page 14 of 53

Form 1918 TX (02-2021) Page 15 of 53

Form 1918 TX (02-2021) Page 16 of 53

PART B-I – PERSONAL INJURY PROTECTION COVERAGE (PIP)

Form 1918 TX (02-2021) Page 17 of 53

Form 1918 TX (02-2021) Page 18 of 53

OTHER INSURANCE OR COVERAGE

Form 1918 TX (02-2021) Page 19 of 53

Form 1918 TX (02-2021) Page 20 of 53

We will pay only for:

Payment after death of an insured shall be made:

Form 1918 TX (02-2021) Page 21 of 53