SELECTION AND/OR REJECTION OF UNINSURED MOTORISTS COVERAGE
(Maryland)
According to Maryland law, every insurer of a motor vehicle must offer Uninsured Motorists Coverage in limits at least equal to those required by Title 17 of the Transportation Article, or $30,000 for the bodily injury and/or death of any one person and up to $60,000 for the bodily injury and/or death of any two or more persons, as well as $15,000 for the damage and/or destruction of property, all including interests and costs.
In accordance with the above laws, I choose the following Uninsured Motorists Coverage option, despite any information to the contrary in my application for insurance:
(Please select one option below, and mark the applicable item “X”):
I hereby SELECT Uninsured Motorists Coverage in the amount of $30,000 per person and $60,000 per accident for bodily injury and/or death, as well as $15,000 for the damage and/or destruction of property.
I hereby SELECT Uninsured Motorists Coverage in the amount of $50,000 per person and $100,000 per accident for bodily injury and/or death, as well as $15,000 for the damage and/or destruction of property.
I hereby SELECT Uninsured Motorists Coverage in a combined single limit of $75,000 per accident for bodily injury and/or death, as well as for the damage and/or destruction of property.
POLICIES INSURING BUSES AND TAXICABS: According to Maryland law, buses and/or taxicabs are not considered “motor vehicles,” and therefore Uninsured Motorists Coverage may be rejected on policies insuring such vehicles. A bus is a vehicle designed to carry more than ten passengers, as well as any other vehicle designed and used to carry people for compensation; a taxicab is a vehicle for hire designed to carry seven or fewer individuals, including the driver, and used to accept or solicit passengers for transportation between points along highways in the State of Maryland at the passengers’ request.
In accordance with the above information, I choose the following option, despite any information to the contrary in my application for insurance:
(Please mark the applicable item “X”):
I hereby REJECT Uninsured Motorists Coverage in its entirety for my policy covering one or more buses and/or taxicabs, as defined above.
PLEASE READ BEFORE SIGNING
I hereby acknowledge that:
(1)I understand the difference between the options available to me.
(2)The selection I make here, where applicable, will be binding on me and all insureds under my Policy and will be in effect for every extension, reinstatement, substitution, amendment, alteration, modification, transfer, replacement or renewal of my Policy, unless I request, in writing, a different option.
(3)Regardless of the number of vehicles involved, whether insured or not, persons covered, claims made, premiums paid or the number of premiums shown on the policy, in no event shall the limit of liability for 2 or more vehicles or 2 or more policies be added together, combined or stacked to determine the limits of insurance coverage available to injured persons.
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NAMED INSURED (Print) SIGNATURE
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TITLE (If corporation or other business entity) DATE
MD-LIC-UM-1 (01/11) Page 1 of 1