1. Forms
2. CA
3. CA-99-03

What the form is

The CA 99 03 Auto Medical Payments Coverage endorsement is used to add medical payments insurance to commercial automobile policies. Standard commercial auto coverage forms, like the Business Auto Coverage Form (CA 00 01), Garage Coverage Form (CA 00 05), and Truckers Coverage Form (CA 00 12), do not automatically include this coverage. This endorsement provides for the payment of reasonable and necessary medical and funeral expenses incurred by an "insured" as a result of bodily injury caused by an accident involving a covered auto. The expenses must be incurred and reported to the insurer within three years of the accident date.

Classes of business it applies to

This endorsement is applicable to a wide range of businesses that utilize vehicles in their operations and wish to provide first-party medical benefits for occupants of those vehicles, regardless of fault. Examples include:

• Businesses with sales fleets whose employees frequently drive company cars.
• Service industry businesses where employees drive to various job sites (e.g., plumbers, electricians, HVAC technicians).
• Companies that transport employees or clients in company-owned vehicles.
• Organizations like schools or non-profits that use vehicles to transport individuals.

For instance, if an employee of a delivery company is injured while driving a company van during a delivery, this coverage could help pay for their medical expenses. Similarly, if a client is injured while being transported in a real estate agency's covered vehicle, this endorsement could apply.

Special considerations

It's crucial to understand who is considered an "insured" under this endorsement. This typically includes the named insured (if an individual), family members of an individual named insured while occupying any auto or as a pedestrian struck by an auto, and any other person while occupying a covered auto. Coverage does not extend to occupants of other vehicles involved in an accident with the insured's covered auto.

• The coverage is generally provided on a per-person, per-accident basis, subject to the limit shown in the declarations.
• There are specific exclusions. For example, coverage may not apply if the injury is sustained while occupying, or when struck by, any vehicle (other than a covered auto) owned by the named insured or any family member, or furnished or available for their regular use.
• This coverage is often considered a no-fault coverage, meaning it pays regardless of who was at fault for the accident.
• In some states, this coverage may interact with Personal Injury Protection (PIP) or other state-mandated medical benefits.

Key information for agents and underwriters

For Agents:

• Clearly explain the benefits and limitations of Auto Medical Payments coverage to clients, ensuring they understand it's an optional add-on to their commercial auto policy.
• Discuss appropriate limits based on the client's needs and potential exposures.
• Identify situations where this coverage would be particularly valuable, such as for businesses that frequently transport non-employees or want to provide an added benefit for their employees.

For Underwriters:

• Assess the exposure based on the type of business, the number of covered autos, vehicle usage (e.g., passenger transport vs. tool transport), and the typical number of occupants.
• Consider the driving records of employees and the overall safety culture of the business.
• Pricing will be influenced by the selected limit of coverage and the assessed risk.
• Be aware of how this coverage interacts with other coverages the insured may have, such as workers' compensation or health insurance, especially concerning who is an "insured" for a business entity versus an individual.