Insurance ATV Policy

INSURANCE ATV POLICY

Policy Identification

Insured / Applicant Information

ATV Vehicle Details

Policy Period and Premium

Effective Policy Period: From to .

Coverages Selected

Select coverages and specify limits and deductibles where required. Coverage applies only as stated in this policy and subject to all terms, conditions and exclusions.

Liability — Bodily Injury and Property Damage. Limit per person: ; Limit per occurrence:

Collision — Damage to insured ATV resulting from collision. Deductible:

Comprehensive — Theft, vandalism, fire and non-collision perils. Deductible:

Medical Payments — Medical expense coverage for insured and passengers. Limit:

Uninsured/Underinsured Motorist — Limits:

Endorsements and Additional Coverages

Attach endorsements applicable to this policy. Indicate selected endorsements below:

Roadside Assistance

Rental Reimbursement

Custom Parts and Equipment Coverage — Limit:

Exclusions and Limitations

This policy does not provide coverage for loss or liability arising from:

• Use of the ATV for commercial hire, races, timed competitions or organized contests unless specifically endorsed;
• Operation by a person under the influence of alcohol or controlled substances as determined by jurisdictional law;
• Intentional acts, willful misconduct, or use of the ATV in the commission of a felony;
• Non-compliance with manufacturer safety or modification advisories that materially contribute to a loss;
• Damage to tires caused by braking, road punctures, cuts or regular wear unless the tire damage is a result of a covered total loss.

The insurer retains all rights of subrogation, and payments made under this policy are subject to recovery from responsible third parties. Coverage is subject to proof of loss, cooperation with investigations, and the conditions set forth in this policy.

Designated Beneficiary (for medical payments / accidental death)

Policy Conditions and Applicant Certifications

The undersigned applicant represents that all statements made in this application are true and complete to the best of the applicant's knowledge. Material misrepresentation or omission in the application or in any claim may result in denial of coverage, rescission of the policy, or reduction of benefits pursuant to the terms of this policy and applicable law.

Applicant agrees to: (a) permit inspection of the insured ATV upon request; (b) notify the insurer promptly of any material change in the operation, ownership, or storage of the ATV; (c) cooperate with investigations and claims handling and provide proof of loss and documentation as required. All premiums are earned pro rata unless otherwise stated in the policy. Cancellation and nonrenewal provisions will be governed by the terms of the policy and applicable law.

Acknowledgment and Signature

I certify under penalty of perjury and pursuant to the terms of this application that the information contained herein is true, accurate and complete. I understand that coverage, limits, exclusions and conditions are governed by the policy document and endorsements issued by the insurer. I authorize the insurer to obtain and share underwriting and claims information as permitted by law.

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