YOUR PERSONAL AUTO POLICY QUICK REFERENCE

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2 PERSONAL AUTO PP R YOUR PERSONAL AUTO POLICY QUICK REFERENCE DECLARATIONS PAGE YOUR NAME AND ADDRESS YOUR AUTO OR TRAILER POLICY PERIOD COVERAGES AND AMOUNTS OF INSURANCE SECTION PAGE NUMBER Agreement 1 Definitions 1 Part A Liability Coverage 2 Insuring Agreement Supplementary Payments Exclusions Limit of Liability Out of State Coverage Financial Responsibility Other Insurance Part B Medical Payments Coverage 4 Insuring Agreement Exclusions Limit of Liability Other Insurance Part C Uninsured Motorists Coverage 6 Insuring Agreement Exclusions Limit of Liability Other Insurance Arbitration Part D Coverage For Damage To Your Auto 8 Insuring Agreement Transportation Expenses Exclusions Limit of Liability Payment of Loss No Benefit To Bailee Other Sources of Recovery Appraisal PP R ISO Properties, Inc., 2006 Page 1 of 2

3 Part E Duties After An Accident Or Loss 11 General Duties Additional Duties For Uninsured Motorists Coverage Additional Duties For Coverage For Damage To Your Auto Part F General Provisions 11 Bankruptcy Changes Fraud Legal Action Against Us Our Right To Recover Payment Policy Period And Territory Termination Transfer Of Your Interest In This Policy Two Or More Auto Policies Page 2 of 2 ISO Properties, Inc., 2006 PP R

4 [PERSONAL AUTO POLICY] DECLARATIONS [Policy Number] [Previous Policy Number] [COMPANY NAME] Policy Period: 12:01 A M Standard Time From: To: [Years] Named insured and mailing address (Number. Street. Apartment. Town or City. County. State. Zip Code.) Description of Auto(s) or Trailer(s) Auto Year Trade Name Model VIN Sym Age The Auto(s) or Trailer(s) described in this policy is principally garaged at the above address unless otherwise stated. (Number. Street. Apartment. Town or City. County. State. Zip Code.) Coverage is provided where a premium and a limit of liability is shown for the coverage Coverages Limit of Liability Premium A. Liability: Bodily Injury $ each person $ $ $ $ each accident $ $ $ Property Damage $ each accident $ $ $ B. Medical Payments $ each person $ $ $ C. Uninsured Motorists $ each person $ $ $ $ each accident $ $ $ D. Damage To Your Auto 1. Collision Loss ACV minus $ Deductible $ $ $ 2. Other Than Collision Loss ACV minus $ Deductible $ $ $ [Towing and Labor Costs] [$ each disablement] [$ $ $ ] (ACV means Actual Cash Value) Endorsements made part of this Policy at time of issue: Loss Payee: Endorsement Premium $ Total Premium $ (Name and Address) [This policy shall not be valid unless countersigned by our authorized agent.] [Countersignature Date] [Agency at] [ (Agent) ] [ (Company Officer) ] [Title] ISO Properties, Inc., 2000

5 POLICY NUMBER: PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FULL COLLISION COVERAGE MASSACHUSETTS SCHEDULE Description Of Vehicle $ $ $ Premium For Full Collision Coverage With respect to the coverage provided by this endorsement, the provisions of the policy apply unless modified by this endorsement. The following is added to Paragraph A. of the Insuring Agreement of Part D: We will pay under Collision Coverage for loss to "your covered auto" or any "non-owned auto" without a deductible. We will pay only if: 1. A specific premium charge for Full Collision Coverage is shown in the Schedule or in the Declarations; and 2. The operator of "your covered auto" or any "nonowned auto" was not more than 50% of the cause of the accident from which the damage arose. We will consider the operator of "your covered auto" or any "non-owned auto" to be not more than 50% of the cause of the accident from which the damage arose if: 1. The operator of "your covered auto" or any "nonowned auto" is entitled to recover in a legal action against another identified person. In this case, the operator of "your covered auto" or any "non-owned auto" must preserve our rights against the identified person or his or her insurer; 2. "Your covered auto" or any "non-owned auto" was legally parked and the loss or damage is the result of impact with another auto owned by another identified person; 3. "Your covered auto" or any "non-owned auto" was struck in the rear by another auto moving in the same direction owned by another identified person; or 4. The operator of the other auto causing loss or damage to "your covered auto" or any "non-owned auto" as a result of the operation of that auto at the time of the accident has been convicted of: a. Operating the auto under the influence of alcohol or a narcotic drug; b. Driving the wrong way on a one-way street; or c. Operating at an excessive speed. However, this Paragraph (4.) does not apply if the operator of "your covered auto" or any "non-owned auto" is convicted of any of the violations described in a., b. or c. above as a result of the operation of "your covered auto" or any "nonowned auto" at the time of the accident. Paragraphs 2., 3. and 4. apply regardless of any right of the operator of "your covered auto" or any "non-owned auto" to recover damages from another person in a legal action for loss or damage. This endorsement must be attached to the Change Endorsement when issued after the policy is written. PP Insurance Services Office, Inc., 2009 Page 1 of 1

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23 PERSONAL AUTO PP s REINSTATEMENT OF INSURANCE The coverages that were suspended are reinstated as of the effective date of this endorsement. This endorsement must be attached to the Change Endorsement when issued after the policy is written. PP Copyright, Insurance Services Office, Inc., 1986 Page 1 of 1

24 FEDERAL EMPLOYEES USING AUTOS IN GOVERNMENT BUSINESS PERSONAL AUTO PP The following are not "insured's" under Part A: 1. The United States of America or any of its agencies. 2. Any person with respect to "bodily injury" or "property damage" resulting from the operation of an auto by that person as an employee of the United States Government. This applies only if the provisions of Section 2679 of Title 28, United States Code as amended, require the Attorney General of the United States to defend that person in any civil action which may be brought for the "bodily injury" or "property damage". This endorsement must be attached to the Change Endorsement when issued after the policy is written. PP Copyright, Insurance Services Office, Inc., 1986, 1992 Page 1 of 1

25 POLICY NUMBER: PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OPTIONAL LIMITS TRANSPORTATION EXPENSES COVERAGE Description Of Your Covered Auto(s) SCHEDULE Limit Per Day For Temporary Transportation Or Loss Of Use Expenses Maximum Limit Of Liability $ Per Day $ $ $ Per Day $ $ $ Per Day $ $ Premium With respect to the coverage provided by this endorsement, the provisions of the policy apply unless modified by the endorsement. OPTIONAL LIMITS TRANSPORTATION EXPENSES COVERAGE When there is a loss to a "your covered auto" described in the Schedule or in the Declarations for which a specific premium charge indicates that Optional Limits Transportation Expenses Coverage is afforded, or to a "non-owned auto": Coverage for Transportation Expenses provided under Part D of this policy is increased to the limits shown in the Schedule or in the Declarations. This endorsement must be attached to the Change Endorsement when issued after the policy is written. PP Copyright, Insurance Services Office, Inc., 1997 Page 1 of 1

26 PERSONAL AUTO PP TOWING AND LABOR COSTS COVERAGE Description of Your Covered Auto SCHEDULE Limit of Towing and Labor Costs Coverage $ $ $ $ $ $ Premium We will pay towing and labor costs incurred each time "your covered auto" or any "non-owned auto" is disabled, up to the amount shown in the Schedule or in the Declarations as applicable to that vehicle. If a "non-owned auto" is disabled, we will provide the broadest towing and labor costs coverage applicable to any "your covered auto" shown in the Schedule or in the Declarations. We will only pay for labor performed at the place of disablement. This endorsement must be attached to the Change Endorsement when issued after the policy is written. PP Copyright, Insurance Services Office, Inc., 1985, 1992 Page 1 of 1

27 PERSONAL AUTO PP LOSS PAYABLE CLAUSE Loss Payee: Loss or damage under this policy shall be paid, as interest may appear, to you and the loss payee shown in the Declarations or in this endorsement. This insurance with respect to the interest of the loss payee, shall not become invalid because of your fraudulent acts or omissions unless the loss results from your conversion, secretion or embezzlement of "your covered auto." However, we reserve the right to cancel the policy as permitted by policy terms and the cancellation shall terminate this agreement as to the loss payee's interest. We will give the same advance notice of cancellation to the loss payee as we give to the named insured shown in the Declarations. When we pay the loss payee we shall, to the extent of payment, be subrogated to the loss payee's rights of recovery. This endorsement must be attached to the Change Endorsement when issued after the policy is written. PP Copyright, Insurance Services Office, Inc., 1986 Page 1 of 1

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31 POLICY NUMBER: PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COVERAGE FOR DAMAGE TO YOUR AUTO (MAXIMUM LIMIT OF LIABILITY) SCHEDULE Description of Vehicle Collision Limit of Liability Other Than Collision Collision Premium Other Than Collision $ Less $ Less $ Ded. $ Ded. $ $ $ Less $ Less $ Ded. $ Ded. $ $ $ Less $ Less $ Ded. $ Ded. $ $ NOTICE The amount shown in the Schedule or in the Declarations is not necessarily the amount you will receive at the time of loss or damage for the described property. PLEASE refer to the Limit of Liability provision below. With respect to the Coverage(s) shown as applicable to a vehicle described in the Schedule or in the Declarations, the Limit of Liability provision in Part D is replaced by the following: LIMIT OF LIABILITY A. Our limit of liability for loss will be the lesser of the: 1. Amount shown in the Schedule or in the Declarations. 2. Actual cash value of the stolen or damaged property; or 3. Amount necessary to repair or replace the property with other property of like kind and quality. Our payment for loss will be reduced by any applicable deductible shown in the Schedule or in the Declarations. If loss to more than one "your covered auto" results from the same "collision", only the highest applicable deductible will apply. B. An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total loss. C. If a repair or replacement results in better than like kind or quality, we will not pay for the amount of the betterment. This endorsement must be attached to the Change Endorsement when issued after the policy is written. PP Copyright, Insurance Services Office, Inc., 1993 Page 1 of 1

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33 PERSONAL AUTO PP CHANGE ENDORSEMENT Attached to and forming part of: Policy No. of the Insured Address (as shown on Policy) (Insurance Co.) Effective Date of Endorsement(s): Term of Policy from: to: Agency By: Endorsement Number(s): Attach Endorsements Below This Line PP Copyright, Insurance Services Office, Inc., 1986 Page 1 of 1

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35 POLICY NUMBER: PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCESS CUSTOM EQUIPMENT COVERAGE SCHEDULE Description Of Vehicle Limit Of Liability Premium $ $ $ $ $ $ With respect to coverage provided by this endorsement, the provisions of the Custom Equipment Exclusion Endorsement apply unless modified by this endorsement. Part D Coverage For Damage To Your Auto is amended as follows with respect to a "non-owned auto" or to "your covered auto" shown in the Schedule or in the Declarations for which Excess Custom Equipment Coverage applies: A. Exclusion 10. is replaced by the following: We will not pay for: 10. Loss to any "custom equipment" in or upon "your covered auto" or any "non-owned auto". This Exclusion (10.) does not apply to "custom equipment" in or upon: a. "Your covered auto" up to the limit for Excess Custom Equipment Coverage shown as applicable to that vehicle in the Schedule or in the Declarations. b. Any "non-owned auto" up to the highest limit for Excess Custom Equipment Coverage shown in the Schedule or in the Declarations. B. The following is added to Paragraph A. of the Limit Of Liability Provision: The most we will pay for loss to any "custom equipment" in or upon: 1. "Your covered auto" is increased from $1,500 to the limit for Excess Custom Equipment Coverage shown as applicable to that vehicle in the Schedule or in the Declarations. 2. Any "non-owned auto" is increased from $1,500 to the highest limit for Excess Custom Equipment Coverage shown in the Schedule or in the Declarations. C. This coverage does not apply to furnishings or equipment that are excluded from coverage under Exclusions 4., 5., 7. or 9. of Part D. This endorsement must be attached to the Change Endorsement when issued after the policy is written. PP Insurance Services Office, Inc., 2008 Page 1 of 1

36 PERSONAL AUTO PP ADDITIONAL INSURED LESSOR SCHEDULE Insurance Company Policy Number Effective Date Expiration Date Named Insured Address Additional Insured (Lessor) Description of "your leased auto": Coverages: 1. (a) Single Limit Liability $ each accident or (b) Bodily Injury Liability $ each person $ each accident Property Damage Liability $ each accident 2. No-Fault Coverage $ each person (Enter "X" to indicate Damage to Your Auto Coverage provided) Collision Loss ACV minus $ deductible Other Than Collision Loss ACV minus $ deductible Any liability and any required no-fault coverages afforded by this policy for "your leased auto" also apply to the lessor named in this endorsement as an additional insured. This insurance is subject to the following additional provisions: 1. We will pay damages for which the lessor becomes legally responsible only if the damages arise out of acts or omissions of: (a) you or any "family member", or (b) any other person except the lessor or any employee or agent of the lessor using "your leased auto". 2. "Your leased auto" means: (a) an auto shown in the Declarations or in this endorsement which you lease for a continuous period of at least six months under a written agreement which requires you to provide primary insurance for the lessor, and (b) any substitute or replacement auto furnished by the lessor named in this endorsement. 3. If we terminate this policy, notice will also be mailed to the lessor. 4. The lessor is not responsible for payment of premiums. 5. The designation of the lessor as an additional insured shall not operate to increase our limits of liability. This endorsement must be attached to the Change Endorsement when issued after the policy is written. PP Copyright, Insurance Services Office, Inc., 1986, 1992 Page 1 of 1

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50 POLICY NUMBER: PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PERSONAL INJURY PROTECTION COVERAGE MASSACHUSETTS THE COVERAGE PROVIDED BY THIS ENDORSEMENT DOES NOT INCLUDE PERSONAL INJURY PROTECTION FOR OWNERS, OPERATORS OR GUEST PASSENGERS OF MOTORCYCLES WHO SUFFER BODILY INJURY WHILE OPERATING OR RIDING AS A GUEST UPON SUCH VEHICLES. SCHEDULE Personal Injury Protection Benefits Limit Of Liability Limit For The Total Of All Personal Injury Protection Benefits $ 8,000 per person Personal Injury Protection Coverage Deductible As indicated below or in the Declarations, the total amount of medical and funeral expenses, loss of income and replacement services is subject to a deductible of: $ applicable to either of the following: The "named insured". The "named insured" and any "family member". With respect to the coverage provided by this endorsement, the provisions of the policy apply unless modified by the endorsement. I. Definitions The Definitions section is amended as follows: A. The following definitions are replaced: 1. "Family member" means a person related to the "named insured" by blood, marriage or adoption who is a resident of the "named insured's" household. This includes a ward or foster child. 2. "Occupying" means: a. In or upon; b. Entering into; or c. Alighting from. 3. "Trailer" means any vehicle or object on wheels and having no motive power of its own, but which is drawn by, or used in combination with, a "motor vehicle". Such vehicle does not include: a. A pole dolly or pole dickey; b. A pair of wheels commonly used as an implement for other purposes than transportation; c. A portable, collapsible or separate twowheel tow dolly limited only to the purpose of transporting or towing a registered vehicle; d. Farm machinery or implements when used in connection with the operation of a farm or estate; or e. A vehicle when towed behind a farm tractor and used in connection with the operation of a farm or estate. 4. "Your covered auto" means a "motor vehicle" owned by the "named insured": a. To which the bodily injury liability coverage of this policy applies and for which a specific premium is charged; and b. For which the "named insured" is required by the Massachusetts General Laws to maintain financial responsibility. B. The following definitions are added: 1. "Health benefits plan" means any policy of health, sickness or disability insurance or any contract or agreement of any group, organization, partnership or corporation, other than a government plan. 2. "Motor vehicle" means a: a. Vehicle constructed and designed for propulsion by power other than muscular power including such vehicles when pulled or towed by another motor vehicle; or b. "Trailer". PP Insurance Services Office, Inc., 2009 Page 1 of 5

51 However, "motor vehicle" does not include: a. Railroad and railway cars; b. Trolley motor or trackless trolleys as defined under Massachusetts law; c. Vehicles running only upon rails or tracks; d. Vehicles used for other purposes than the transportation of property and incapable of being driven at a speed exceeding 12 miles per hour and which are: (1) Used exclusively for the building, repair and maintenance of highways; or (2) Designed especially for use elsewhere than on the travelled part of ways; e. Wheelchairs owned and operated by invalids; f. Vehicles which are operated or guided by a person on foot; or g. Motorized bicycles. 3. "Named insured" means the person named in the Declarations. 4. "Pedestrian" includes persons operating bicycles, tricycles and similar vehicles and persons upon horseback or in vehicles drawn by horses or other draft animals. C. "Insured" as used in this endorsement means: 1. The "named insured" or any "family member": a. While "occupying"; or b. Who is a "pedestrian" struck by; a "motor vehicle". 2. Any other person: a. While "occupying"; or b. Who is a "pedestrian" struck by; "your covered auto". II. Personal Injury Protection Coverage INSURING AGREEMENT A. We will pay, in accordance with the Massachusetts General Laws, personal injury protection benefits to or for an "insured" who sustains "bodily injury". The "bodily injury" must: 1. Be caused by an accident; and 2. Arise out of the ownership, operation, maintenance, control or use of a "motor vehicle" as a vehicle. B. Subject to the limit shown in the Schedule or Declarations, personal injury protection benefits consist of the following: 1. Medical And Funeral Expenses Payment for all reasonable expenses incurred within two years from the date of the accident for necessary: a. Medical, surgical, X-ray and dental services, including prosthetic devices; and b. Ambulance, hospital, professional nursing and funeral services. However, we will only pay up to $2,000 for necessary medical and funeral expenses described in Paragraph II.B.1. above if, and to the extent that such expenses have been or will be compensated, paid or indemnified under any policy of health, sickness or disability insurance or any contract or agreement of any group, organization, partnership or corporation to provide, pay for or reimburse the cost of medical, hospital, dental or other health care services. 2. Loss Of Income Any amounts actually lost by reason of inability to work and earn wages, salary or their equivalent, but not other income, that would otherwise have been earned in the normal course of the injured "insured's" employment. a. If an "insured" is entitled to wages, salary or their equivalent under any program for continuation of such wages, salary or their equivalent, we will pay an amount that, together with any payments due under any program for continuation of wages, salary or their equivalent will provide 75% of the "insured's" average weekly wages or salary or their equivalent for the year immediately preceding the accident. b. If an "insured" is not entitled to wages, salary or their equivalent under any program for continuation of such wages, salary or their equivalent, we will pay 75% of an "insured's" average weekly wages or salary or their equivalent for the year immediately preceding the accident. Page 2 of 5 Insurance Services Office, Inc., 2009 PP

52 3. Replacement Services Reasonable expenses made to others who are not members of the "insured's" household and reasonably incurred in obtaining from those others ordinary and necessary services that the "insured" would have performed: a. Without pay; and b. For the benefit of the "insured" and/or members of the "insured's" household. EXCLUSIONS A. We do not provide Personal Injury Protection Coverage for any "insured" for "bodily injury": 1. Sustained while under the influence of alcohol or a narcotic drug as defined under Massachusetts law. 2. Sustained while committing a felony or seeking to avoid lawful apprehension or arrest by a police officer. 3. Sustained with the specific intent of causing injury or damage to himself, herself or others. 4. Who is entitled to benefits under any workers' compensation law for the same injury. 5. While operating or "occupying" a motorcycle, moped or similar type vehicle. B. We do not provide Personal Injury Protection Coverage for "bodily injury" sustained by: 1. The "named insured" or any "family member" while "occupying", or while a "pedestrian" struck by, any "motor vehicle" other than "your covered auto" for which the security required by the compulsory automobile insurance law of Massachusetts is in effect. 2. Any person, other than: a. The "named insured" or any "family member"; or b. A Massachusetts resident; if the accident occurs outside of Massachusetts. C. We do not provide Personal Injury Protection Coverage for "bodily injury": 1. Due to: a. War (declared or undeclared); b. Civil war; c. Insurrection; d. Rebellion or revolution; or e. Any act or condition incident to any of the foregoing. 2. Resulting from: a. Radioactive; b. Toxic; c. Explosive; or other hazardous properties of nuclear material. LIMIT OF LIABILITY A. The limit of liability shown in the Schedule or in the Declarations for Personal Injury Protection Coverage is our maximum limit of liability for each "insured" injured in any one accident. This is the most we will pay regardless of the number of: 1. "Insureds"; 2. Claims made; 3. "Your covered autos" or premiums shown in the Declarations; or 4. "Your covered autos" involved in the accident. B. We will not make a duplicate payment under this coverage for any element of loss: 1. For which payment has been made by or on behalf of persons or organizations who may be legally responsible; or 2. To the extent that damages for expenses and loss are otherwise recoverable as a personal injury protection benefit in a court judgment or settlement. C. We will not pay for any element of loss if a person is entitled to receive payment for the same element of loss under any disability benefits law or similar law. D. The amount of any deductible shown in the Schedule or Declarations shall be deducted from the total amount of expenses and losses listed in Paragraphs B.1., B.2. and B.3. of the Personal Injury Protection Coverage Insuring Agreement, before the application of any percentage limitation shown in Paragraphs II.B.2.a. and II.B.2.b. Such deductible shall be applicable to: 1. The "named insured"; or PP Insurance Services Office, Inc., 2009 Page 3 of 5

53 2. The "named insured" and any "family member"; as shown in the Schedule or in the Declarations. OTHER INSURANCE If there is other Personal Injury Protection Insurance, we will pay only our share of the loss. Our share is the proportion that our limit of liability bears to the total of all applicable limits. However, any insurance we provide with respect to a vehicle you do not own, including any vehicle while used as a temporary substitute for "your covered auto", shall be excess over any other collectible Personal Injury Protection Insurance. III. Part E Duties After An Accident Or Loss Part E is amended as follows: A. Duties A. and B.3. are replaced by the following: A. We must be notified as soon as practicable after the accident occurs, and in every case, within at least two years from the date of the accident. Notice must include a written description of the nature and extent of injuries sustained, treatment received and contemplated and such other information as may assist in determining the amount due and payable. B. An "insured": 3. Must submit to physical examinations by physicians we select as often as may be reasonably required and will do all things necessary to enable us to obtain medical reports and other needed information to assist in determining the amounts due. C. The following duty is added: If an "insured" makes a claim for loss of income benefits, that "insured" must authorize us to: 1. Obtain details of all wage or salary payments, or their equivalent, paid to the "insured" by any employer in the year immediately preceding the date of accident, or earned by the "insured"; and 2. Make any reasonable necessary investigation as to whether or not such loss may be reduced as a result of any program calling for the continuance of such wage, salary or earnings during absence from work. IV. Part F General Provisions Part F is amended as follows: A. Paragraph B. of the Policy Period And Territory provision is replaced by the following: Policy Period And Territory B. The policy territory is: 1. The United States of America, its territories or possessions; or 2. Canada. B. The following provisions are added: Prompt Payment Of Claims 1. Upon notification of a disability from a licensed physician, payments for medical expenses described under Section II.B.1. above will begin within 10 days or we will give written notice of our intent not to make such payments, specifying the reasons for the nonpayment. 2. If benefits due and payable remain unpaid for more than 30 days after satisfactory proof of claim is received, any unpaid party shall have a right to commence an action in contract for amounts determined to be due in accordance with this endorsement. Premium Recomputation The premium for this policy has been established in reliance upon the limitations on the right to recover damages contained in the Massachusetts General Laws. If a court of competent jurisdiction: 1. Declares; or 2. Enters a judgment, the effect of which is to render; the provisions of the General Laws invalid or unenforceable, in whole or in part, we shall have the right to: 1. Recompute the policy premium; and 2. At our option, void or amend the provisions of this endorsement. Coordination Of Coverage A. Any amounts payable under Part B of this policy shall be excess over the first $2,000 of medical and funeral expenses paid under the Personal Injury Protection Coverage provided under this policy when: 1. A "health benefits plan" is available to pay benefits; and Page 4 of 5 Insurance Services Office, Inc., 2009 PP

54 2. The "health benefits plan" includes a provision stating that coverage is secondary to other coverage for health care services. However, if coverage provided under Part B is exhausted, the Personal Injury Protection Coverage under this policy will apply up to the limit for the total of all Personal Injury Protection Benefits shown in the Schedule or in the Declarations. B. Any amounts payable under Part B of this policy shall be excess over the limit for the total of all Personal Injury Protection Benefits shown in the Schedule or in the Declarations when a "health benefits plan" is not available to pay benefits. Renewal Or Continuation Of A Policy Of Health, Sickness Or Disability Insurance Within two years from the date of the accident, we may pay the cost of renewing or continuing a policy of health, sickness or disability insurance to an "insured" who is unwilling or unable to pay such cost. Upon receipt of such payment, the "insured" shall continue that policy of insurance or an equivalent policy in force for the two-year period. Prior to receipt of such payment, the "insured" shall not be compelled to renew or maintain any policy of insurance that is in force. The payment of such cost by us shall not interfere in any way with the "insured's" choice of physician or course of medical treatment. PP Insurance Services Office, Inc., 2009 Page 5 of 5

55 PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIABILITY COVERAGE EXCLUSION ENDORSEMENT LIABILITY COVERAGE The following exclusion is added to Part A, Section A: We do not provide Liability Coverage for any "insured" for "bodily injury" to you or any "family member". This endorsement must be attached to the Change Endorsement when issued after the policy is written. PP Copyright, Insurance Services Office, Inc., 1993 Page 1 of 1

56 POLICY NUMBER: PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MISCELLANEOUS TYPE VEHICLE AMENDMENT (MOTOR HOMES) WARNING THE COVERAGE PROVIDED BY THIS POLICY WITH RESPECT TO A MOTOR HOME THAT YOU OWN: DOES NOT PROVIDE LIABILITY, MEDICAL PAYMENTS OR PHYSICAL DAMAGE COVERAGE WHILE THE MOTOR HOME IS RENTED OR LEASED TO ANY ORGANIZATION, OR ANY PERSON OTHER THAN YOU. YOU MAY PURCHASE THIS COVERAGE FOR AN ADDITIONAL PREMIUM. DOES NOT COVER ANY PHYSICAL DAMAGE LOSS YOU INCUR IF YOUR MOTOR HOME IS FRAUDULENTLY ACQUIRED BY ANY PERSON OR ORGANIZATION WHILE IT IS IN THEIR CARE. With respect to the coverage provided by this endorsement, the provisions of the Miscellaneous Type Vehicle Endorsement apply unless modified by this endorsement. SCHEDULE Coverage is provided where a premium is shown: Motor Home Rental Coverage Premium Veh. 1 Veh. 2 Veh. 3 Liability $ $ $ Medical Payments $ $ $ Coverage for Damage to Your Auto Collision $ $ $ Other Than Collision $ $ $ I. Except with respect to the coverages and motor homes shown in the Schedule or Declarations where a specific premium for Motor Home Rental Coverage is charged, the following additional exclusions apply to any motor home which is "your covered auto". A. Part A Liability Coverage Exclusion We do not provide Liability Coverage for the ownership, maintenance or use of any motor home while rented or leased to any organization, or any "insured" other than you. However, this Exclusion (I.A.) does not apply up to the financial responsibility limits of any compulsory insurance law applicable to the state in which "your covered auto" is principally garaged. B. Part B Medical Payments Coverage Exclusion We do not provide Medical Payments Coverage for any "insured" for "bodily injury" sustained while "occupying" the motor home while it is rented or leased to any organization, or any "insured" other than you. C. Part D Coverage For Damage To Your Auto Exclusion We will not pay for loss to the motor home or its facilities or equipment which occurs while the motor home is rented or leased to any organization, or any person other than you. PP Copyright, Insurance Services Office, Inc., 1997 Page 1 of 2

57 II. The following additional exclusion also applies to any motor home which is "your covered auto" regardless of any other coverage which may be afforded by this endorsement: Part D Coverage For Damage To Your Auto Exclusion We will not pay for loss to the motor home or its facilities or equipment due to fraudulent acquisition by any person or organization, which occurs while the motor home is: a. Rented to; b. Used by; or c. In the care of; that person or organization. This endorsement must be attached to the Change Endorsement when issued after the policy is written. Page 2 of 2 Copyright, Insurance Services Office, Inc., 1997 PP

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60 POLICY NUMBER: PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO LOAN/LEASE COVERAGE With respect to the coverage provided by this endorsement, the provisions of the policy apply unless modified by the endorsement. Schedule Description of Your Covered Auto(s) Other Than Collision Additional Premium $ $ $ $ $ $ Collision Additional Premium In the event of a covered total loss to a "your covered auto" shown in the Schedule or in the Declarations for which a specific premium charge indicates that Auto Loan/Lease Coverage applies, we will pay any unpaid amount due on the lease or loan for "your covered auto" less: 1. The amount paid under Part D of the policy; and 2. Any: a. Overdue lease/loan payments at the time of the loss; b. Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; c. Security deposits not refunded by a lessor; d. Costs for extended warranties, Credit Life insurance, Health, Accident or Disability insurance purchased with the loan or lease; and e. Carry-over balances from previous loans or leases. This endorsement must be attached to the Change Endorsement when issued after the policy is written. PP Copyright, Insurance Services Office, Inc., 1993 Page 1 of 1

61 POLICY NUMBER: PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SINGLE UNINSURED MOTORISTS LIMIT SCHEDULE Uninsured Motorists Coverage $ each accident Paragraph A. of the Limit Of Liability Provision in Part C is replaced by the following: LIMIT OF LIABILITY The limit of liability shown in the Schedule or in the Declarations for Uninsured Motorists Coverage is our maximum limit of liability for all damages resulting from any one accident. This is the most we will pay regardless of the number of: 1. "Insureds"; 2. Claims made; 3. Vehicles or premiums shown in the Declarations; or 4. Vehicles involved in the accident. This endorsement must be attached to the Change Endorsement when issued after the policy is written. PP Copyright, Insurance Services Office, Inc., 1997 Page 1 of 1

62 POLICY NUMBER: PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SINGLE UNDERINSURED MOTORISTS LIMIT SCHEDULE Underinsured Motorists Coverage $ each accident Paragraph A. of the Limit Of Liability Provision in the Underinsured Motorists Coverage Endorsement is replaced by the following: LIMIT OF LIABILITY The limit of liability shown in the Schedule or in the Declarations for Underinsured Motorists Coverage is our maximum limit of liability for all damages because of "bodily injury" resulting from any one accident. This is the most we will pay regardless of the number of: 1. "Insureds"; 2. Claims made; 3. Vehicles or premiums shown in the Declarations; or 4. Vehicles involved in the accident. This endorsement must be attached to the Change Endorsement when issued after the Policy is written. PP Copyright, Insurance Services Office, Inc., 1997 Page 1 of 1

63 PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COVERAGE FOR DAMAGE TO YOUR AUTO EXCLUSION ENDORSEMENT With respect to the coverage provided by this endorsement, the provisions of the policy apply unless modified by the endorsement. I. Definitions The following definition is added: "Diminution in value" means the actual or perceived loss in market or resale value which results from a direct and accidental loss. II. Part D Coverage For Damage To Your Auto The following exclusion is added: We will not pay for: Loss to "your covered auto" or any "non-owned auto" due to "diminution in value". This endorsement must be attached to the Change Endorsement when issued after the policy is written. PP Copyright, Insurance Services Office, Inc., 1999 Page 1 of 1

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68 POLICY NUMBER: PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED COLLISION COVERAGE MASSACHUSETTS SCHEDULE Description Of Vehicle $ Limited Collision Coverage Premium $ $ Limited Collision Coverage Deductible: $ With respect to the Limited Collision Coverage provided by this endorsement, the provisions of the Definitions section, Part D Coverage For Damage To Your Auto, Part E Duties After An Accident Or Loss and Part F General Provisions apply unless modified by this endorsement. I. Paragraphs A., B. and C. of the Insuring Agreement in Part D are replaced by the following: A. We will pay for direct and accidental loss to "your covered auto", including its equipment, minus any applicable deductible shown in the Schedule or in the Declarations caused by "collision" only if the Schedule or Declarations indicates that Limited Collision Coverage is provided for that auto and provided the operator of "your covered auto" was not more than 50% of the cause of the accident from which the damage arose. B. "Collision" means the upset of "your covered auto" or its impact with another vehicle or object. Loss caused by the following is considered other than "collision": 1. Missiles or falling objects; 2. Fire; 3. Theft or larceny; 4. Explosion or earthquake; 5. Windstorm; 6. Hail, water or flood; 7. Malicious mischief or vandalism; 8. Riot or civil commotion; 9. Contact with bird or animal; or 10. Breakage of glass. If breakage of glass is caused by a "collision", you may elect to have it considered a loss caused by "collision". We will consider the operator of "your covered auto" to be not more than 50% of the cause of the accident from which the damage arose if: 1. The operator of "your covered auto" is entitled to recover in a legal action against another identified person. In this case the operator of "your covered auto" must preserve our rights against the identified person or his or her insurer; 2. "Your covered auto" was legally parked and the loss or damage is the result of impact with another auto owned by another identified person; 3. "Your covered auto" was struck in the rear by another auto moving in the same direction owned by another identified person; or 4. The operator of the other auto causing loss or damage to "your covered auto" as a result of the operation of that auto at the time of the accident has been convicted of: a. Operating the auto under the influence of alcohol or a narcotic drug; b. Driving the wrong way on a one-way street; or c. Operating at an excessive speed. PP Insurance Services Office, Inc., 2009 Page 1 of 2

69 However, this Paragraph (4.) does not apply if the operator of "your covered auto" is convicted of any of the violations described in a., b. or c. above as a result of the operation of "your covered auto" at the time of the accident. Paragraphs 2., 3. and 4. apply regardless of any right of the operator of "your covered auto" to recover damages from another person in a legal action for loss or damage. II. The Transportation Expenses provision of the Insuring Agreement in Part D is replaced by the following: Transportation Expenses In addition, we will pay, without application of a deductible, up to a maximum of $600 for temporary transportation expenses not exceeding $20 per day incurred by you in the event of a loss to "your covered auto". We will pay for such expenses if the loss is caused by "collision" only if the Declarations indicates that Limited Collision Coverage is provided for that auto. Subject to the provisions described above, if the loss is caused by: 1. A total theft of "your covered auto", we will pay only expenses incurred during the period: a. Beginning 48 hours after the theft; and b. Ending when "your covered auto" is returned to use or we pay for its loss. 2. Other than theft of "your covered auto", we will pay only expenses beginning when the auto is withdrawn from use for more than 24 hours. Our payment will be limited to that period of time reasonably required to repair or replace "your covered auto". III. Paragraph A. of the Limit Of Liability provision is replaced by the following: A. Our limit of liability for loss will be the lesser of the: 1. Actual cash value of the stolen or damaged property; or 2. Amount necessary to repair or replace the property with other property of like kind and quality. However, the most we will pay for loss to electronic equipment that reproduces, receives or transmits audio, visual or data signals, which is permanently installed in the auto in locations not used by the auto manufacturer for installation of such equipment, is $1,000. This endorsement must be attached to the Change Endorsement when issued after the policy is written. Page 2 of 2 Insurance Services Office, Inc., 2009 PP

70 PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CUSTOM EQUIPMENT EXCLUSION ENDORSEMENT With respect to the coverage provided by this endorsement, the provisions of the policy apply unless modified by the endorsement. Part D Coverage For Damage To Your Auto is amended as follows: A. Insuring Agreement The following definition is added to Part D: "Custom equipment" means equipment, furnishings and parts in or upon any auto, other than: 1. Original manufacturer equipment, furnishings or parts; or 2. Any replacement of original manufacturer equipment, furnishings or parts with other equipment, furnishings or parts of like kind and quality. "Custom equipment" includes but is not limited to: 1. Special carpeting or insulation; 2. Furniture or bars; 3. Height-extending roofs; 4. Body, engine, exhaust or suspension enhancers; 5. Winches, or anti-roll or anti-sway bars; 6. Custom grilles, louvers, side pipes, hood scoops or spoilers; 7. Custom wheels, tires or spinners; 8. Custom chrome, murals, paintwork, decals or other graphics; or 9. Caps, covers or bedliners. "Custom equipment" does not include electronic equipment that reproduces, receives or transmits audio, visual or data signals. B. Exclusions Exclusion 10. is replaced by the following: We will not pay for: 10. Loss to any "custom equipment" in or upon "your covered auto" or any "non-owned auto". This Exclusion (10.) does not apply to the first $1,500 of "custom equipment" in or upon "your covered auto" or any "non-owned auto". C. Limit of Liability Paragraph A. of the Limit Of Liability Provision is replaced by the following: Our limit of liability for loss will be the lesser of the: 1. Actual cash value of the stolen or damaged property; or 2. Amount necessary to repair or replace the property with other property of like kind and quality. However, the most we will pay for loss to: 1. Any "non-owned auto" which is a trailer is $1, Electronic equipment that reproduces, receives or transmits audio, visual or data signals, which is permanently installed in the auto in locations not used by the auto manufacturer for installation of such equipment, is $1, "Custom equipment" in or upon "your covered auto" or any "non-owned auto" is $1,500. This endorsement must be attached to the Change Endorsement when issued after the policy is written. PP Insurance Services Office, Inc., 2008 Page 1 of 1

71 POLICY NUMBER: PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER THAN COLLISION COVERAGE SPECIFIED ACTUAL CASH VALUE LIMIT OF LIABILITY MASSACHUSETTS SCHEDULE Description Of Vehicle Other Than Collision Coverage Specified Actual Cash Value Limit Of Liability And Deductible $ Less $ Ded. $ Less $ Ded. $ Less $ $ $ Premium $ Ded. With respect to the coverage provided by this endorsement, the provisions of the policy apply unless modified by this endorsement. N Part D Coverage For Damage To Your Auto is amended as follows: Limit Of Liability With respect to the Other Than Collision Coverage Specified Actual Cash Value shown as applicable to a vehicle described in the Schedule or in the Declarations, the Limit Of Liability provision in Part D is replaced by the following: Limit Of Liability A. Our limit of liability for loss will be the lesser of the: 1. Actual cash value of the stolen or damaged property; or 2. Amount necessary to repair or replace the property with other property of like kind and quality. B. In determining actual cash value, no deduction for depreciation shall be allowed to reduce the value of the vehicle described in the Schedule or in the Declarations to less than the Other Than Collision Coverage Specified Actual Cash Value Limit Of Liability shown in the Schedule or in the Declarations. C. Our payment for loss will be reduced by any applicable deductible shown in the Schedule or in the Declarations. This endorsement must be attached to the Change Endorsement when issued after the policy is written. E W PP Insurance Services Office, Inc., 2009 Page 1 of 1

72 POLICY NUMBER: PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NAMED DRIVER EXCLUSION ENDORSEMENT MASSACHUSETTS With respect to the coverage(s) for which the Schedule or Declarations indicate that the Named Driver Exclusion applies, the provisions of the policy apply unless modified by the endorsement. SCHEDULE The Named Driver Exclusion Endorsement applies with respect to the "named excluded driver" and the coverages indicated below or in the Declarations. Name of "Named Excluded Driver": Coverages To Which This Endorsement Applies: This endorsement applies to all coverages unless otherwise indicated below or in the Declarations. If indicated to the left or in the Declarations, this endorsement applies only to those coverages indicated below: Liability Medical Payments Uninsured Motorists Underinsured Motorists Collision Other Than Collision Personal Injury Protection Coverage Limited Collision Coverage N E W I. Definitions The following definition is added: "Named excluded driver" means a person who is shown in the Schedule or in the Declarations as a named excluded driver who is excluded from one or more coverages under the policy. II. Named Driver Exclusion With respect to the coverages to which this endorsement applies, as indicated in the Schedule or in the Declarations, we will not pay damages, expenses, benefits or loss arising out of the maintenance or use of any auto or trailer by the "named excluded driver". This endorsement must be attached to the Change Endorsement when issued after the policy is written. PP Insurance Services Office, Inc., 2009 Page 1 of 1

73 POLICY NUMBER: PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. UNDERINSURED MOTORISTS COVERAGE MASSACHUSETTS SCHEDULE Premium Limit Of Liability Auto 1 Auto 2 Auto 3 $ Each Person $ $ $ $ Each Accident With respect to the coverage provided by this endorsement, the provisions of the policy apply unless modified by the endorsement. Insuring Agreement A. We will pay compensatory damages which an "insured" is legally entitled to recover from the owner or operator of an "underinsured motor vehicle" because of "bodily injury": 1. Sustained by an "insured"; and 2. Caused by an accident. The owner's or operator's liability for these damages must arise out of the ownership, maintenance or use of the "underinsured motor vehicle". We will pay under this coverage only if 1. or 2. below applies: 1. The limits of liability under any bodily injury liability bonds or policies applicable to the "underinsured motor vehicle" have been exhausted by payment of judgments or settlements; or 2. A tentative settlement has been made between an "insured" and the insurer of the "underinsured motor vehicle" and we: a. Have been given prompt written notice of such tentative settlement; and b. Advance payment to the "insured" in an amount equal to the tentative settlement within 30 days after receipt of notification. B. "Insured" as used in this endorsement means: 1. You or any "family member". 2. Any other person "occupying" "your covered auto". 3. Any person for damages that person is entitled to recover because of "bodily injury" to which this coverage applies sustained by a person described in 1. or 2. above. C. "Underinsured motor vehicle" means a land motor vehicle or trailer of any type to which a bodily injury liability bond or policy applies at the time of the accident but its limit for bodily injury liability is less than the limit of liability for this coverage. However, "underinsured motor vehicle" does not include any vehicle or equipment: 1. Owned by or furnished or available for the regular use of you or any "family member". 2. Owned by any governmental unit or agency unless the insurer of the vehicle or equipment owned by the governmental unit or agency is or becomes insolvent. 3. Operated on rails or crawler treads. 4. Designed mainly for use off public roads while not upon public roads. 5. While located for use as a residence or premises. 6. Owned or operated by a person qualifying as a self-insurer under any applicable motor vehicle law. 7. To which a bodily injury liability bond or policy applies at the time of the accident but the bonding or insuring company: Exclusions a. Denies coverage; or b. Is or becomes insolvent. A. We do not provide Underinsured Motorists Coverage for "bodily injury" sustained: 1. By you while "occupying", or when struck by, any motor vehicle owned by you for which the minimum limits of liability as required by Massachusetts law to be provided under a motor vehicle liability policy are not in effect. N E W PP Insurance Services Office, Inc., 2009 Page 1 of 3

74 2. By any "family member" while "occupying", or when struck by, any motor vehicle owned by that "family member" for which the minimum limits of liability as required by Massachusetts law to be provided under a motor vehicle liability policy are not in effect. B. We do not provide Underinsured Motorists Coverage for "bodily injury" sustained by: 1. You while "occupying" "your covered auto" when it is being used as a public or livery conveyance and which is not insured for this coverage under this policy. This Exclusion (B.1.) does not apply to a share-the-expense car pool. 2. Any "insured" using a vehicle without a reasonable belief that that "insured" is entitled to do so. This Exclusion (B.2.) does not apply to a "family member" using "your covered auto" which is owned by you. C. This coverage shall not apply directly or indirectly to benefit any insurer or self-insurer under any of the following or similar law: 1. Workers' compensation law; or 2. Disability benefits law. D. We do not provide Underinsured Motorists Coverage for punitive or exemplary damages. Limit Of Liability A. The limit of liability shown in the Schedule or in the Declarations for each person for Underinsured Motorists Coverage is our maximum limit of liability for all damages, including damages for care, loss of services or death, arising out of "bodily injury" sustained by any one person in any one accident. Subject to this limit for each person, the limit of liability shown in the Schedule or in the Declarations for each accident for Underinsured Motorists Coverage is our maximum limit of liability for all damages for "bodily injury" resulting from any one accident. This is the most we will pay regardless of the number of: 1. "Insureds"; 2. Claims made; 3. Vehicles or premiums shown in the Schedule or in the Declarations; or 4. Vehicles involved in the accident. B. The limit of liability shall be reduced by all sums paid because of the "bodily injury" by or on behalf of persons or organizations who may be legally responsible. This includes all sums paid under Part A of this policy. C. No one will be entitled to receive duplicate payments for the same elements of loss under this coverage and: 1. Part A, Part B or Part C of this policy; or 2. Personal Injury Protection Coverage. D. We will not make a duplicate payment under this coverage for any element of loss for which payment has been made by or on behalf of persons or organizations who may be legally responsible. E. We will not pay for any element of loss if a person is entitled to receive payment for the same element of loss under any of the following or similar law: 1. Workers' compensation law; or 2. Disability benefits law. Other Insurance A. If you sustain "bodily injury" while "occupying" a vehicle you do not own, including any vehicle while used as a temporary substitute for "your covered auto", any recovery for damages under all such policies or provisions of coverage will only be from the policy providing the highest limits of Underinsured Motorists Coverage under which you are the named insured. If there is more than one policy that provides the same highest limits of Underinsured Motorists Coverage under which you are the named insured, we will pay only our share of the loss. Our share is the proportion that our limit of liability bears to the total of all applicable limits of liability of such policies. B. If: 1. A "family member" sustains "bodily injury" while "occupying" any vehicle; and 2. There is other applicable insurance available under one or more policies or provisions of coverage that is similar to the insurance provided by this endorsement; any recovery for damages under all such policies or provisions of coverage will only be from the policy providing the highest limits of Underinsured Motorists Coverage under which that person is insured as a "family member". If there is more than one policy that provides the same highest limits of Underinsured Motorists Coverage under which that person is insured as a "family member", we will pay only our share of the loss. Our share is the proportion that our limit of liability bears to the total of all applicable limits of liability of such policies. Arbitration A. If we and an "insured" do not agree: 1. Whether that "insured" is legally entitled to recover damages; or N E W Page 2 of 3 Insurance Services Office, Inc., 2009 PP

75 2. As to the amount of damages which are recoverable by that "insured"; from the owner or operator of an "underinsured motor vehicle", then the matter may be arbitrated. However, disputes concerning coverage under this endorsement may not be arbitrated. Both parties must agree to arbitration. If so agreed, each party will select an arbitrator. The two arbitrators will select a third. If they cannot agree within 30 days, either may request that selection be made by a judge of a court having jurisdiction. B. Each party will: 1. Pay the expenses it incurs; and 2. Bear the expenses of the third arbitrator equally. C. Unless both parties agree otherwise, arbitration will take place in the county in which the "insured" lives. Local rules of law as to procedure and evidence will apply. A decision agreed to by at least two of the arbitrators will be binding as to: 1. Whether the "insured" is legally entitled to recover damages; and 2. The amount of damages. This applies only if the amount does not exceed the minimum limit for bodily injury liability specified by the compulsory automobile insurance law of Massachusetts. If the amount exceeds that limit, either party may demand the right to a trial. This demand must be made within 60 days of the arbitrators' decision. If this demand is not made, the amount of damages agreed to by the arbitrators will be binding. Additional Duties A person seeking coverage under this endorsement must also promptly: 1. Send us copies of the legal papers if a suit is brought; and 2. Notify us in writing of a tentative settlement between the "insured" and the insurer of the "underinsured motor vehicle" and allow us 30 days to advance payment to that "insured" in an amount equal to the tentative settlement to preserve our rights against the insurer, owner or operator of such "underinsured motor vehicle". General Provisions The following is added to the Our Right To Recover Payment provision in Part F: Our Right To Recover Payment We shall be entitled to a recovery under Paragraph A. or B. only after the person has been fully compensated for damages. Our rights do not apply under Paragraph A. with respect to Underinsured Motorists Coverage if we: 1. Have been given prompt written notice of a tentative settlement between an "insured" and the insurer of an "underinsured motor vehicle"; and 2. Fail to advance payment to the "insured" in an amount equal to the tentative settlement within 30 days after receipt of notification. If we advance payment to the "insured" in an amount equal to the tentative settlement within 30 days after receipt of notification: 1. That payment will be separate from any amount the "insured" is entitled to recover under the provisions of Underinsured Motorists Coverage; and 2. We also have a right to recover the advanced payment. This endorsement must be attached to the Change Endorsement when issued after the policy is written. N E W PP Insurance Services Office, Inc., 2009 Page 3 of 3

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82 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page 1 Introduction of the ISO Personal Auto Policy and Related Endorsements in Massachusetts Background Section of Massachusetts Regulation 211:CMR establishes, in part, that a Rating Organization, with the participation of its members, may prepare, distribute and file policy forms and endorsements on behalf of any member or subscriber that authorizes it to make such a filing. In response to Massachusetts Regulation 211:CMR 79.00, we are filing the ISO Personal Auto Policy and related endorsements in Massachusetts. About This Filing This filing introduces the current ISO multistate Personal Auto Policy and related endorsements for use in Massachusetts. This filing consists of a Table of Contents and two components: Multistate portion of the filing; and Massachusetts Supplement. Copyright Explanation The material distributed by Insurance Services Office, Inc., is copyrighted. All rights reserved. Possession of these pages does not confer the right to print, reprint, publish, copy, sell, file or use same in any manner without the written permission of the copyright owner. Important Note Insurance Services Office, Inc. (ISO) makes available advisory services to U.S. property/casualty insurers. ISO has no adherence requirements. ISO policy forms and explanatory materials are intended solely for the information and use of ISO's participating insurers, their representatives and state regulators. Neither ISO's general explanations of policy intent nor opinions expressed by ISO's staff necessarily reflect every insurer's view or control any insurer's determination of coverage for a specific claim. ISO does not intercede in coverage disputes arising

83 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page 2 from insurance policies. If there is any conflict between a form and any other part of the attached material, the provisions of the form apply.

84 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page 3 Table of Contents Introduction of the ISO Personal Auto Policy And Related Endorsements in Massachusetts... 1 Personal Auto Policy and Optional Multistate Endorsements Section I: Personal Auto Policy - Explanatory Memorandum...4 Section II: Optional Multistate Endorsements - Explanatory Memorandum...6 Attachments: Personal Auto Policy and Optional Multistate Endorsements...14 Massachusetts State Supplement...S-1 Massachusetts Supplement: Explanatory Memorandum... S-2 Attachments: Massachusetts Specific Endorsements... S-16

85 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page 4 Section I: Personal Auto Policy Introduction Background Description To introduce PP , Personal Auto Policy, for use in Massachusetts. The auto policy is the basic product of the automobile insurance industry. It is important to have this basic product understandable to the average person. In keeping with this idea, an easily readable policy has been developed by ISO to be used to insure personal auto type risks. PP , Personal Auto Policy, has been designed for long-range use on a multistate basis. The policy language has been written in a simplified format to be understandable to the average person. Also, the policy has been organized to provide a logical flow of thoughts for clear understanding. The policy is divided into six parts with letter designations. Also included for informational purposes are a Title page and PP R , Quick Reference page. Companies may use the Title page and Quick Reference page or develop their own. Part A Liability Coverage provides both bodily injury and property damage liability coverage for damages an insured becomes legally responsible for to a third party. Part B Medical Payments Coverage covers expenses incurred by an insured for medical and funeral services rendered within three years from the date of the accident. Part C Uninsured Motorists Coverage provides coverage for compensatory damages an insured is legally entitled to recover from an uninsured motorist. Part D Coverage For Damage To Your Auto provides physical damage coverage for loss to a covered auto. Temporary transportation and loss of use expenses coverage is provided as a supplementary payment under Part D. Part E Duties After An Accident Or Loss provides the conditions an insured must comply with when seeking any coverage. Part F General Provisions presents the general provisions of the policy, including the multistate Termination provisions.

86 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page 5 Attachment Also being filed is a sample Declarations Page. Companies may rearrange and reformat this sample page to be compatible with their machine processing requirements. Matter in brackets on the sample page may be omitted or amended if an insurer elects. PP , Personal Auto Policy

87 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page 6 Section II: Optional Multistate Endorsements Introduction Background Description To introduce the optional multistate endorsements that are available for use with PP , Personal Auto Policy, in Massachusetts. The accompanying multistate endorsements can be used to modify the Personal Auto Policy. These endorsements allow insureds and insurers to custom-tailor the Personal Auto Policy to fit a particular personal auto exposure. The ISO forms numbering system consists of a ten-character designator for each form or endorsement. For Personal Auto, the two "PP" characters at the beginning of the number signify a Personal Auto form or endorsement. This is followed by an endorsement category identifier as the third and fourth characters. This category identifier signifies the different types of endorsements used in the Personal Auto Program. Currently, the Personal Auto categories are: 00 Policy Forms 01 State Amendatory Endorsements 02 Termination, Suspension and Reinstatement Endorsements 03 Miscellaneous Endorsements 04 Uninsured and Underinsured Motorists Endorsements 05 No-Fault Endorsements 13 Additional Miscellaneous Endorsements 14 Additional Uninsured And Underinsured Motorists Endorsements The fifth and sixth characters signify the number for the endorsement within that category, while the last four characters signify the edition date of the endorsement. In addition, several endorsements contain Schedules, which provide an insurer with the option of listing specific coverage information on the endorsement without having to amend the Declarations page to include all optional coverages. However, the language contained in the endorsement references both the Insurance Services Office, Inc., 2009

88 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page 7 Schedule and the Declarations so the insurer has the flexibility of using either the Schedule or the Declarations to list the coverages being provided. The following multistate endorsements will be available for use with PP , Personal Auto Policy, in Massachusetts: PP , Suspension of Insurance This endorsement is attached to the policy whenever coverage is to be suspended. A schedule is provided for the coverage(s) on particular auto(s) that are to be suspended. PP , Reinstatement of Insurance This endorsement is used in conjunction with PP , Suspension of Insurance, and is attached to the policy when the suspended coverage(s) and/or auto(s) are to be reinstated. PP , Federal Employees Using Autos In Government Business This endorsement provides limited coverage for federal employees using autos in government business. PP , Optional Limits Transportation Expenses Coverage This endorsement provides increased limits for the temporary transportation and loss of use expenses that are provided under the Transportation Expenses provision of Part D Coverage For Damage To Your Auto. PP , Towing And Labor Costs Coverage This endorsement provides optional coverage for towing and labor costs under Part D Coverage For Damage To Your Auto. PP , Loss Payable Clause This endorsement provides coverage to the loss payee. PP , Extended Non-Owned Coverage For Named Individual This endorsement provides extended non-owned Liability and Medical Payments coverages for vehicles furnished or available for regular use of the named individual, by deleting the PAP exclusions and specifically stating the coverage being bought back. Insurance Services Office, Inc., 2009

89 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page 8 PP , Trailer/Camper Body Coverage (Maximum Limit of Liability) This endorsement is a "buyback" endorsement for Exclusion 7. under Part D Coverage For Damage To Your Auto. It provides physical damage coverage for trailers and/or camper bodies listed in the Schedule or, alternatively, in the Declarations. It also provides coverage for the facilities or equipment used with such trailers and/or camper bodies such as cooking, dining, plumbing and refrigeration facilities, awnings or cabanas, and other facilities or equipment in or attached to the trailers and/or camper bodies. PP , Coverage For Damage To Your Auto (Maximum Limit of Liability) This endorsement allows the insured and the insurer to pre-determine the desired amount of physical damage coverage for a particular vehicle for which standard underwriting criteria does not apply. This determination is usually made after receiving an appraisal. Examples of the types of vehicles, which can be underwritten with this endorsement, include antique autos and classic autos. PP , Single Liability Limit This endorsement revises the Limit of Liability provision of Part A Liability Coverage to provide liability coverage on a single limit basis. PP , Change Endorsement This endorsement is used when any endorsement is attached to the Personal Auto Policy after the effective date of the policy. It documents the date the policy change is to become effective. PP , Excess Electronic Equipment Coverage The endorsement provides the following physical damage coverage options to an insured: An option to purchase coverage for electronic equipment that reproduces, receives or transmits audio, visual or data signals that is permanently installed in the auto in locations not used by the auto manufacturer for installation of such equipment. An option for $200 worth of coverage for tapes, records, discs, and other media. PP , Excess Custom Equipment Coverage This endorsement is a "buyback" endorsement for Exclusion 10. under Part D Coverage For Damage To Your Auto. It provides additional physical damage coverage for custom equipment in or upon any "your covered auto" or "non- Insurance Services Office, Inc., 2009

90 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page 9 owned auto" in excess of the $1,500 of custom equipment coverage that is provided under the Personal Auto Policy via PP , Custom Equipment Exclusion Endorsement. PP , Additional Insured Lessor This endorsement provides coverage for the lessor as an additional insured. PP , Snowmobile Endorsement This endorsement provides liability, medical payments, uninsured motorists, and physical damage coverages for owners and users of snowmobiles. PP , Limited Mexico Coverage This endorsement extends liability, medical payments, uninsured motorists, and physical damage and no-fault coverages to an insured to apply to accidents occurring in Mexico: Within 25 miles of the United States border; and While that insured is on a trip of ten days or less. As a prerequisite to coverage under this endorsement, liability insurance must be purchased through a licensed Mexican insurance company. A warning containing this requirement is prominently displayed. PP , Named Non-Owner Coverage This endorsement provides liability, medical payments, and uninsured motorists coverages for a named individual who does not own an auto, but wishes to maintain coverage for the use of non-owned autos. Coverage is provided for the named individual with an option to cover the individual's family members. A schedule is provided for listing the named individual(s) and the desired coverages and limits. PP , Miscellaneous Type Vehicle Endorsement This endorsement provides liability, medical payments, uninsured motorists and physical damage coverages for owners and users of certain types of miscellaneous type vehicles, including motor homes, motorcycles, all-terrain vehicles, dune buggies and golf carts. Insurance Services Office, Inc., 2009

91 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page 10 PP , Liability Coverage Exclusion Endorsement This endorsement allows an insurer the option of adding an exclusion to Part A Liability Coverage in the Personal Auto Policy which eliminates coverage for damages resulting from bodily injury to members of the insured s family or household. PP , Miscellaneous Type Vehicle Amendment (Motor Homes) This endorsement accommodates those insureds who rent their owned motor homes to others as a means of defraying the cost of ownership. It is to be used in combination with PP , Miscellaneous Type Vehicle Endorsement. PP excludes liability, medical payments and/or physical damage coverages on an owned motor home when the insured rents the motor home to another person or organization. A warning at the top of the endorsement alerts the insured to this excluded coverage. If an insured does not rent his motor home to others, this additional endorsement does not modify the coverage provided under the policy, since the additional exposure being excluded (i.e. the renting of the motor home) is not present in the first place. For insureds who rent their motor home to others, this endorsement allows the insured to "buy back" the excluded coverages by paying the appropriate premium. Coverage will only be provided where a specific premium for Motor Home Rental Coverage is indicated. This endorsement also excludes physical damage coverage if the motor home is fraudulently acquired by another person or organization. This type of exposure is greatly increased for those insureds who rent their motor homes to others. PP , Joint Ownership Coverage This endorsement allows joint owners of an auto to be afforded the full coverage of the Personal Auto Policy. The endorsement amends the definition of "you" and "your" to include: Individuals, other than husband and wife, who are residents of the same household; or Relatives residing in separate households. PP , Auto Loan/Lease Coverage This endorsement provides optional "gap" coverage for new vehicles, which are leased or financed by an insured. In the event of a total loss to a leased or financed "your covered auto", this endorsement would provide additional Insurance Services Office, Inc., 2009

92 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page 11 physical damage coverage under Part D Coverage For Damage To Your Auto, to: Reimburse an insured who leased the auto for the difference between the amount due under the terms of the lease and the Actual Cash Value (ACV) of the auto; and Pay any outstanding indebtedness incurred by an insured who financed the auto if the amount due under the finance agreement is greater than the ACV of the auto. PP , Single Uninsured Motorists Limit This endorsement revises the Limit of Liability provision of Part C Uninsured Motorists Coverage to provide uninsured motorists coverage on a single limit basis. PP , Single Underinsured Motorists Limit This endorsement revises the Limit of Liability provision of PP , Underinsured Motorists Coverage - Massachusetts, to provide underinsured motorists coverage on a single limit basis. PP , Coverage For Damage To Your Auto Exclusion Endorsement This endorsement contains an exclusion, which specifies that there is no coverage for the actual or perceived loss in market or resale value, or "diminution in value". PP , Trip Interruption Coverage The Trip Interruption Coverage endorsement provides coverage for extra expenses incurred when a covered physical damage loss, or a mechanical or electrical breakdown, occurs away from the insured's home. PP , Trust Endorsement The Trust Endorsement is to be used to provide coverage if title to a vehicle has been transferred to a trust. PP C , Certificate of Personal Auto Insurance - Trusts Also included with this filing for information is a Certificate of Personal Auto Insurance - Trusts policywriting support document. PP C 001 may be used in situations where a person or organization requires proof that vehicles owned by a trust have been provided coverage under Part A - Liability Coverage of the Personal Auto Policy. Insurance Services Office, Inc., 2009

93 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page 12 Attachments PP , Extended Non-Owned Coverage - Vehicles Furnished Or Available For Use As a Public Or Livery Conveyance This endorsement provides extended non-owned Liability and Medical Payments coverages arising out of the operation of vehicles furnished or available for use of the named individual as a public or livery conveyance, by deleting the PAP exclusions and specifically stating the coverage being bought back. PP , Custom Equipment Exclusion Endorsement PP , Custom Equipment Exclusion Endorsement, will be attached to all Personal Auto Policies. PP amends Part D - Coverage For Damage To Your Auto to: Add a definition of custom equipment. Include a custom equipment exclusion that specifies that the exclusion does not apply to the first $1,500 of custom equipment in or upon any auto. Revise the Limit of Liability Provision to reiterate that the most that will be paid for loss to custom equipment in or upon "your covered auto" or any "non-owned auto" is $1,500. PP , Suspension of Insurance PP , Reinstatement of Insurance PP , Federal Employees Using Autos in Government Business PP , Optional Limits Transportation Expenses Coverage PP , Towing and Labor Costs Coverage PP , Loss Payable Clause PP , Extended Non-Owned Coverage For a Named Individual PP , Trailer/Camper Body Coverage (Maximum Limit of Liability) PP , Coverage For Damage To Your Auto (Maximum Limit of Liability) PP , Single Liability Limit PP , Change Endorsement PP , Excess Electronic Equipment Coverage PP , Excess Custom Equipment Coverage Insurance Services Office, Inc., 2009

94 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page 13 PP , Additional Insured Lessor PP , Snowmobile Endorsement PP , Limited Mexico Coverage PP , Named Non-Owner Coverage PP , Miscellaneous Type Vehicle Endorsement PP , Liability Coverage Exclusion Endorsement PP , Miscellaneous Type Vehicle Amendment (Motor Homes) PP , Joint Ownership Coverage PP , Auto Loan/Lease Coverage PP , Single Uninsured Motorists Limit PP , Single Underinsured Motorists Limit PP , Coverage For Damage To Your Auto Exclusion Endorsement PP , Trip Interruption Coverage PP , Trust Endorsement PP , Extended Non-Owned Coverage - Vehicles Furnished Or Available For Use As A Public Or Livery Conveyance PP , Custom Equipment Exclusion Endorsement PP C , Certificate of Personal Auto Insurance - Trusts Insurance Services Office, Inc., 2009

95 MASSACHUSETTS - PERSONAL AUTO Page S-2 FORMS FILING PP-2009-OEND1 Purpose Description Massachusetts Supplement To introduce the Massachusetts-specific endorsements to be used with PP , Personal Auto Policy, and the related multistate endorsements, in Massachusetts. PP , Amendment of Policy Provisions - Massachusetts This mandatory endorsement is used to modify the coverage provided in the multistate program in accordance with legislation, case law, insurance department regulation or bulletin in the state of Massachusetts. This endorsement amends the Personal Auto Policy as follows: Section I. amends the Definitions section to include the actual dollar limits of the Massachusetts compulsory insurance law found in MASS. GEN. LAWS ANN. Ch. 90, 34A (WEST 2008) and MASS. GEN. LAWS ANN. Ch. 90, 34O (WEST 2008). Section II. amends Part A - Liability Coverage as follows: In Paragraph A. the fourth sentence of the Insuring Agreement is revised to reflect the last sentence of the second paragraph of MASS. GEN. LAWS ANN. Ch. 90, 34O (WEST 2008) that states: Under terms and conditions approved by the commissioner the insurer shall have the right and duty to defend any suit against the insured seeking damages on account of such injury to or destruction of property even if any of the allegations of the suit are groundless, false or fraudulent. (Emphasis supplied) Paragraph B. is revised to include loading and unloading with respect to "property damage" based on MASS. GEN. LAWS ANN. Ch. 90, 34O (WEST 2008). Paragraph C. amends the second paragraph of the Limit of Liability provision to prevent duplicate payments for the same elements of loss under Part A and Personal Injury Protection Coverage. Section III. amends Part B - Medical Payments Coverage to replace the second paragraph of the Limit of Liability provision to prevent duplicate recovery for the same element of loss. Section IV. amends Part D - Coverage For Damage To Your Auto as follows: Insurance Services Office, Inc., 2009

96 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page S-3 Paragraphs A.1. and A.2. address portions of MASS. GEN. LAWS ANN. Ch. 175, 113O (WEST 2008) and MASS. GEN. LAWS ANN. Ch. 94, 34O (WEST 2008) regarding payments to the insured for losses to vehicles insured under Part D. Paragraphs A.1. and A.2., in part, contain provisions that describe the penalties that apply if the insured does not: Repair the vehicle for which a claim payment has been made; Provide a claim form stating that the repair work described in an appraisal made pursuant to regulations promulgated by the auto damage appraisers licensing board has been completed. In addition, Paragraph A.2.a. describes the conditions under which an insurer may pay a repair shop directly for loss under Part D if it does not have a plan approved by the Commissioner of Insurance that provides for direct payment of loss to the vehicle(s) insured under Part D. Paragraph B. amends the Appraisal provision of Part D to address the appraisal process outlined in MASS. GEN. LAWS ANN. Ch. 175, 191A (WEST 2008). Paragraph C. addresses Massachusetts Regulation 211:CMR Mandatory pre-insurance inspection regulation. The general purpose of the regulation is to establish standards and procedures for the inspection of certain new and used cars prior to issuing physical damage coverage. Section V. amends Paragraphs A. and D. of Part E - Duties After An Accident Or Loss to address MASS. GEN. LAWS ANN. Ch. 175, 191A (WEST 2008), that in general provides for notice to an insured's authorized agent and for the notification requirements in the event of larceny, robbery or pilferage. Section V. also replaces the Termination provision of Part F - General Provisions by amending Paragraphs A. Cancellation and B. Nonrenewal of the Termination provision, while otherwise maintaining consistency with our multistate approach, to address the following statutes: MASS. GEN. LAWS ANN. Ch. 175, 113A(2) (WEST 2008) which, in part, provides that: No cancellation shall be valid unless written notice is given at least 20 days prior to the effective date of cancellation. No written notice of cancellation shall be effective when mailed by the company unless the company obtains a certificate of mailing receipt from the United States Postal service. Insurance Services Office, Inc., 2009

97 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page S-4 MASS. GEN. LAWS ANN. Ch. 175, 113F (WEST 2008) which, in part, provides that any company which does not intend to renew a motor vehicle liability policy shall provide 45 days' notice of nonrenewal before the end of the policy period. PP , Personal Injury Protection Coverage Massachusetts We have developed PP to provide Personal Injury Protection Coverage in accordance with MASS. GEN. LAWS ANN. Ch. 90, 34A (WEST 2008), MASS. GEN. LAWS ANN. Ch. 90, 34M (WEST 2008), and several other relevant provisions of the Massachusetts motor vehicle laws. The following is a description of several of the features of PP : Schedule We have included a Schedule at the beginning of the endorsement that addresses the Personal Injury Protection (PIP) Coverages described in the definition of personal injury protection of MASS. GEN. LAWS ANN. Ch. 90, 34M (WEST 2008) and the deductible option described in the last paragraph of MASS. GEN. LAWS ANN. Ch. 90, 34M (WEST 2008). Definitions The definitions of family member, occupying, trailer and your covered auto of the ISO PAP have been replaced and the definitions of health benefits plan, motor vehicle, insured, named insured and pedestrian have been added to address the provisions of MASS. GEN. LAWS ANN. Ch. 90, 34A (WEST 2008). Insuring Agreement Paragraph A. outlines in accordance with Massachusetts General Laws, the circumstances in which insurers will pay PIP benefits to an insured who sustains bodily injury. Exclusions Exclusions A.1., A.2. and A.3. address the "driving under the influence," "committing a felony or avoiding lawful apprehension or arrest" and "intentional acts" exclusions of the second paragraph of MASS. GEN. LAWS ANN. Ch. 90, 34A (WEST 2008). Exclusion A.4. excludes benefits under workers compensation law as addressed in MASS. GEN. LAWS ANN. Ch. 90, 34A (WEST 2008). Exclusion B.1., a "follow-the-car" exclusion, addresses MASS. GEN. LAWS ANN. Ch. 90, 34A (WEST 2008) that, in part: Describes the persons entitled to PIP Coverage benefits under the insured's policy with respect to an owned auto; and Insurance Services Office, Inc., 2009

98 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page S-5 Requires that PIP Coverage benefits be provided to the insured and family members under the insured's policy when they are injured in an accident by a motor vehicle that is not insured for PIP Coverage benefits. The "follow-the-car" exclusion applies when the insured or any family member is injured in an accident while occupying a non-owned vehicle. In this case, PIP Coverage benefits are excluded under the insured's policy if the benefits are available under the policy applicable to the owner of the nonowned vehicle the insured or any family member were occupying at the time of the accident, and is consistent with the provisions of 34A described above. Exclusion B.2. reinforces the exemption from tort liability provision of MASS. GEN. LAWS ANN. Ch. 90, 34M (WEST 2008) by excluding PIP Coverage benefits to any person other than the insured or a family member or a Massachusetts resident, if the accident occurs outside of Massachusetts. Exclusion C. contains a war and nuclear exclusion. Limit of Liability Paragraph A., in part, generally concerns a cap on necessary medical and funeral expenses in certain circumstances as addressed in MASS. GEN. LAWS ANN. Ch. 90, 34A (WEST 2008). Paragraph B. addresses the offset provision in MASS. GEN. LAWS ANN. Ch. 90, 34M (WEST 2008). The offset provision is described as a nonduplication of benefits statement that prevents duplicate recovery for the same element of loss under Personal Injury Protection Coverage and payments that have been made by or on behalf of persons or organizations who may be legally responsible. Paragraph C. has been developed in response to Cox v. Safety Insurance Company 1996 Mass. App. Div. (1996). In Cox, because the policy at issue did not contain the phrase "or any similar law" with respect to the PIP exclusions, the Court held that an insured who received benefits from his employer that reimbursed him for medical expenses and lost wages under MASS. GEN. LAWS ANN. Ch. 41, 100 (WEST 2008) was entitled to recover personal injury protection coverage benefits under his automobile policy. In response to Cox, Paragraph C. of the Limit of Liability provision states the following: We will not pay for any element of loss if a person is entitled to receive payment for the same element of loss under any disability benefits law or similar law. Paragraph D. describes the application of the deductible. The amount of any deductible shown in the Schedule or Declarations will be deducted from the total amount of expenses and losses listed in Paragraphs B.1., B.2. and B.3. Insurance Services Office, Inc., 2009

99 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page S-6 of the Personal Injury Protection Coverage Insuring Agreement, before the application of any percentage limitation. Such deductible shall be applicable to: The "named insured"; or The "named insured" and any "family member"; as shown in the Schedule or the Declarations. Other Insurance The Other Insurance provision, in general, addresses situations when other Personal Injury Protection Insurance applies to the same loss. Part E - Duties After An Accident Or Loss The Duties outlined in Part E address notice requirements, assistance in obtaining medical reports and other needed information and authorization for the insurer to obtain certain wage and salary information and authorization to make any necessary and reasonable investigation as to whether loss may be reduced as a result of wage continuation programs during absence from work, as set forth in MASS. GEN. LAWS ANN. Ch. 90, 34M (WEST 2008). Part F - General Provisions Paragraph A. Policy Period and Territory amends Paragraph B. of Policy Period and Territory provision of Part F - General Provisions of the Personal Auto Policy to limit the policy territory to: The United States of America, its territories or possessions; or Canada. The Prompt Payment of Claims provision addresses MASS. GEN. LAWS ANN. Ch. 90, 34M (WEST 2008). The Premium Recomputation provision, in part, gives the insurer the right to recompute the policy premium if a court of competent jurisdiction: Declares; or Enters a judgment, the effect of which is to render; invalid or unenforceable, in whole or in part, the Massachusetts General Laws related to the limitations on the right to recover damages. The Coordination of Coverage provision addresses Metropolitan Property and Casualty Insurance Co. v. Blue Cross and Blue Shield of Massachusetts, Inc., 451 Mass. 389 (2008) and which is clarified by Massachusetts Consumer Affairs and Business Regulation (September 16, 2008). The Supreme Judicial Court of the State of Massachusetts, in Blue Cross and Blue Shield of Massachusetts, Inc., held that a health insurer may defer coverage of medical Insurance Services Office, Inc., 2009

100 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page S-7 costs above $2,000 when the insured has purchased optional medical payments coverage as part of his or her automobile policy and where the health insurance policy contains a provision stating that coverage is secondary to other coverage for health care services. The Renewal Or Continuation Of A Policy Of Health, Sickness Or Disability Insurance provision describes the conditions under which the PIP insurer may, within 2 years from the date of the accident, pay the cost of renewing or continuing a policy of health, sickness or disability insurance to an insured who is unwilling or unable to pay the cost of the insurance. Upon receipt of such payment, the insured shall continue that policy of insurance or an equivalent policy in force for the 2 year period. Prior to receipt of such payment, the insured shall not be compelled to renew or maintain any policy of insurance that is in force and the payment of such cost by the insurer shall not interfere in any way with the insured's choice of physician or course of medical treatment. PP , Other Than Collision Coverage Specified Actual Cash Value Limit of Liability - Massachusetts This optional endorsement addresses the following provision of MASS. GEN. LAWS ANN. Ch. 175, 113O (WEST 2008) that, in part, states the following: Insurers shall make available additional coverage to provide that, in determining actual cash value, no deduction for depreciation shall be allowed to reduce the value of the vehicle to less than an agreed value for that particular vehicle, provided that the insurer is permitted to inspect the vehicle at the time of application for such additional coverage. PP amends Part D - Coverage For Damage To Your Auto of the Personal Auto Policy as follows: Schedule We have included a Schedule at the beginning of the endorsement that provides for a description of the vehicle and the limit of liability and premium for the Other Than Collision Coverage Specified Actual Cash Value Limit of Liability. Limit of Liability The Limit of Liability provision in optional endorsement PP includes additional coverage with respect to determining the actual cash value of the vehicle(s) listed in the endorsement s schedule or declarations. Specifically, any deduction for depreciation should not reduce the value of the vehicle (s) listed in the schedule or declarations to less than the Other Than Collision Coverage Specified Actual Cash Value Limit of Liability shown in the Schedule or in the Declarations. Insurance Services Office, Inc., 2009

101 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page S-8 PP , Limited Collision Coverage - Massachusetts This optional endorsement has been developed to address the provisions with respect to the limited collision coverage specified in MASS. GEN. LAWS ANN. Ch. 90, 34O(2) (WEST 2008). Paragraph A. of PP replaces paragraphs A., B. and C. of the Insuring Agreement of Part D - Coverage For Damage To Your Auto of the Personal Auto Policy (PAP) so that the provision applies only to "your covered auto." Paragraph B. of PP replaces the Transportation Expenses provision of Part D of the PAP so that the provision applies only to "your covered auto." Paragraph C. of PP replaces paragraph A. of the Limit of Liability provision of Part D of the PAP to delete reference to the $1,500 sublimit applicable to a "non-owned auto" which is a trailer. Paragraph D. addresses portions of MASS. GEN. LAWS ANN. Ch. 175, 113O (WEST 2008) and MASS. GEN. LAWS ANN. Ch. 94, 34O (WEST 2008) regarding payments to the insured for losses to vehicles insured under PP Paragraph D., in part, contain provisions that describe the penalties that apply if the insured does not: Repair the vehicle for which a claim payment has been made; Provide a claim form stating that the repair work described in an appraisal made pursuant to regulations promulgated by the auto damage appraisers licensing board has been completed. In addition, Paragraph D.2.a. describes the conditions under which an insurer may pay a repair shop directly for loss under PP if it does not have a plan approved by the Commissioner of Insurance that provides for direct payment of loss to the vehicle(s) insured under PP PP , Named Driver Exclusion Endorsement - Massachusetts We have developed PP 13 31, Named Driver Exclusion Endorsement Massachusetts, to address the provisions of the following statutes: Massachusetts Regulation 211:CMR that, in part, makes reference to an operator exclusion form regarding a listed operator. MASS. GEN. LAWS ANN. Ch. 175E, 11A (WEST 2008) that in part states the following: Insurance Services Office, Inc., 2009

102 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page S-9 Insurance companies or their agents shall disclose in simple language to every person they insure or solicit for insurance that person's coverage options, including the option to exclude oneself and member's of one's household from personal injury protection coverage.... (Although MASS. GEN. LAWS ANN. Ch. 175E, 11A (WEST 2008) allows the named insured and family members to be excluded from personal injury protection coverage, coverage would still be required to be provided to other persons such as guest passengers, permissive operators and pedestrians.) MASS. GEN. LAWS ANN. Ch. 90, 34O(1) and (2) (WEST 2008) that, in part, provide that collision or limited collision benefits are not payable if loss or damage occurs to the insured vehicle when the operator of the vehicle is a household member, other than the named insured, who is not listed as an operator on the policy. With respect to a named excluded driver, all coverages under the policy will be excluded unless specific coverages are otherwise indicated as excluded in the Schedule or in the Declarations. Section I of PP provides that a named excluded driver means a person who is shown in the Schedule or in the Declarations as a named excluded driver who is excluded from one or more coverages under the policy. Section II. Named Driver Exclusion of PP provides that, with respect to the coverages to which PP applies as indicated in the Schedule or in the Declarations, the insurer will not pay damages, expenses, benefits or loss arising out of the maintenance or use of any auto or trailer by the named excluded driver. PP N , Named Driver Exclusion Acknowledgment Also included with this filing for information is a Named Driver Exclusion Acknowledgment policywriting support document. This Acknowledgment provides that the named insured acknowledges and understands that the Named Driver Exclusion Endorsement becomes effective on the date shown in the endorsement and that it shall remain in effect for the term of the policy and for each renewal, reinstatement, substitute, modified, replacement or amended policy, unless discontinued by the insurer. The signature of the named insured and the date of the signature are required to be provided on PP N 003. Insurance Services Office, Inc., 2009

103 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page S-10 PP , Uninsured Motorists Coverage - Massachusetts This mandatory endorsement provides Uninsured Motorists (UM) Coverage under the ISO Personal Auto Policy in Massachusetts. The following is an explanation of several of the coverage features of PP 14 19, Uninsured Motorists Coverage - Massachusetts. Insuring Agreement We have employed the word "compensatory" to describe covered "damages" in the Insuring Agreement of PP 14 19, and also included an Exclusion D. to state that punitive or exemplary damages are not covered under Uninsured Motorists (UM) Coverage. A provision is included that provides that any judgment for damages arising out of a suit brought without the insurer's consent is not binding on the insurer. Definition of Uninsured Motor Vehicle Paragraph 4. amends the definition of uninsured motor vehicle to provide the applicable time limitation for Uninsured Motorists Coverage claims resulting from a liability insurer's insolvency that addresses Paragraph 3. of MASS. GEN. LAWS ANN. Ch. 175, 113L (WEST 2008) which states: (3) An insurer's extension of coverage as provided in paragraph (2) shall be applicable only to accidents occurring during a policy period in which its insured's uninsured motor vehicle coverage is in effect and where the liability insurer of the tort-feasor has been declared to be insolvent by a court of competent jurisdiction as of the accident date, or has been declared to be insolvent by a court of competent jurisdiction within one year after the accident date. (Emphasis supplied) Paragraph 4. also amends the definition of uninsured motor vehicle in response to Massachusetts Insurers Insolvency Fund v. Premier Insurance Co., 449 Mass. 422 (Mass. 07/12/2007). In Premier, the Supreme Judicial Court of Massachusetts held that the "exclusionary language in the [Massachusetts] standard automobile policy that prohibits UM coverage for 'an auto owned by a governmental unit' conflicts with 113L and, therefore, must be deemed invalid and unenforceable." The Court considered the scope of the obligation of the Massachusetts Insurers Insolvency Fund to compensate individual insureds injured in motor vehicle accidents where the vehicle causing the accident was owned by a governmental entity and was insured by an insurer that became insolvent. The Court concluded that the Fund's obligation to compensate the injured individuals did not arise, if at all, Insurance Services Office, Inc., 2009

104 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page S-11 until the individual's own uninsured motor vehicle coverage had been exhausted. In response to Premier, the exception to the definition of uninsured motor vehicle for vehicles owned by any governmental unit or agency has been revised to provide that the exception does not apply to any vehicle or equipment owned by any governmental unit or agency if the insurer of the vehicle or equipment is or becomes insolvent. This exception also applies to the definition of underinsured motor vehicle. Refer to PP 14 18, Underinsured Motorist Coverage - Massachusetts. The second paragraph of the Limit of Liability provision is replaced to include Personal Injury Protection Coverage in the non-duplication language. This exception also applies to PP 14 18, Underinsured Motorist Coverage - Massachusetts. The Our Right To Recover Payment provision of Part F - General Provisions of the Personal Auto Policy is amended via PP to address the requirement in MASS. GEN. LAWS ANN. Ch. 175, 113L(4) (WEST 2008) that the insured must be fully compensated for damages before the insurer may bring an action for subrogation. Exclusions Exclusion A.1. of PP 14 19, which addresses the provisions of MASS. GEN. LAWS ANN. Ch. 175, 113L(5), provides for a two-part exclusion, as follows: Under A.1. we have provided that "you" (the named insured shown in the Declarations and the spouse, if a resident of the same household) is excluded from UM coverage while "occupying," or when struck by, any motor vehicle owned by "you" for which the minimum limits of liability as required by Massachusetts law to be provided under a motor vehicle liability policy are not in effect. Under A.2., we have set forth language which excludes UM coverage by any "family member" while "occupying", or when struck by, any motor vehicle owned by that "family member" for which the minimum limits of liability as required by Massachusetts law to be provided under a motor vehicle liability policy are not in effect. Exclusion B.1. which also addresses the provisions of MASS. GEN. LAWS ANN. Ch. 175, 113L(5), provides that UM Coverage is not provided for bodily injury sustained by "you" while occupying your covered auto when it is being used as a public or livery conveyance and which is not insured for this coverage under this policy. The Exclusion does not apply to a share-the-expense car pool. Exclusions A.1., A.2. and B.1. described above also apply to PP 04 18, Underinsured Motorists Coverage - Massachusetts. Insurance Services Office, Inc., 2009

105 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page S-12 Limit of Liability ISO's limit of liability provision provides that the "per person" bodily injury limit, includes damages for care, loss of services, or death, arising out of "bodily injury" sustained by any one person in any one accident. In Mayo v. Aetna Casualty and Surety Company, 419 Mass. 596, 646 N.E.2d 746 (1995), the Supreme Judicial Court of Massachusetts held that the workers' compensation setoff provision in the underinsured motorist section of the standard Massachusetts Motor Vehicle Combination policy was enforceable. The provision, in pertinent part, provided that: Any amount payable because of bodily injury sustained in an accident by a person insured under this coverage shall be reduced by the amount paid... under any workers' compensation law, disability benefits law or similar law. The Court reasoned, in part as follows: The contractual policy provision [described above] accomplishes that result; prevention of double recovery and, as a consequence, a lessening of the cost of motor vehicle insurance, without diminution or circumvention of statutorily mandated minimum limits of coverage. In response to Mayo, Paragraphs B., C., and D. of PP include nonduplication of benefits statements. The non-duplication of benefits statements also apply to the corresponding paragraphs of PP 14 18, Underinsured Motorists Coverage - Massachusetts described below. Other Insurance The Other Insurance provision, which also addresses the provisions of MASS. GEN. LAWS ANN. Ch. 175, 113L(5) (WEST 2008), provides the following: If the named insured shown in the Declarations and spouse if a resident of the same household sustain bodily injury while occupying a vehicle the insured does not own, including any vehicle while used as a temporary substitute for the insured's covered auto, any recovery for damages under all such policies or provisions of coverage will only be from the policy providing the highest limits of Uninsured Motorists Coverage under the named insured. If there is more than one policy that provides the same highest limits of Uninsured Motorists Coverage under the named insured, the insurer will pay only its share of the loss. The insurer's share is the proportion that its limit of liability bears to the total of all limits of liability of such policies. If a family member sustains bodily injury while occupying any vehicle and there is other applicable insurance available under one or more policies or Insurance Services Office, Inc., 2009

106 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page S-13 provisions of coverage that is similar to the insurance provided under the Uninsured Motorists Coverage endorsement, any recovery for damages under all such policies or provisions of coverage will only be from the policy providing the highest limits of Uninsured Motorists Coverage under which that person is insured as a family member. If there is more than one policy that provides the same highest limits of Uninsured Motorists Coverage under which that person is insured as a family member, the insurer will pay only its share of the loss. The insurer's share is the proportion that its limit of liability bears to the total of all applicable limits of liability of such policies. The Other Insurance provision described above also applies to PP 04 18, Underinsured Motorists Coverage - Massachusetts. Arbitration Paragraph A. of the Arbitration provision, in general, : Provides that the matters that may be arbitrated are legal entitlement to damages and the amount of damages. However disputes concerning coverage may not be arbitrated. Provides that both parties must agree to arbitration. Sets forth the process of selecting the arbitrators. Paragraph B. provides that each party will pay the expenses it incurs and bear the expenses of the third arbitrator equally. Paragraph C. allows the insured or the company to appeal the arbitrator's decision within 60 days on awards that exceed a state's financial responsibility limits. Through this procedure, recourse is available with respect to the amount awarded. PP , Underinsured Motorists Coverage - Massachusetts This optional endorsement provides Underinsured Motorists (UIM) Coverage under the ISO Personal Auto Policy in Massachusetts. In addition to those described above, the following is an explanation of several of the coverage features of PP 14 18, Underinsured Motorists Coverage - Massachusetts: Definition of Underinsured Motor Vehicle The definition of underinsured motor vehicle provides the "limits trigger" for UIM coverage that addresses MASS. GEN. LAWS ANN. Ch. 175, 113L(2) (WEST 2008) that, in part, states that: Insurance Services Office, Inc., 2009

107 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page S the term " uninsured motor vehicle " shall also include protection of persons insured thereunder who are legally entitled to recover damages from owners or operators of insured motor vehicles, trailers or semitrailers, to which a bodily injury liability bond or policy applies at the time of the accident and its bodily injury liability bond amount or policy limit is less than the policy limit for uninsured motor vehicle coverage.... (Emphasis supplied) Limit of Liability Paragraph B. provides that the limit of liability shall be reduced by all sums paid because of the bodily injury by or on behalf of persons or organizations who may be legally responsible and includes all sums paid under Part A of the policy. Paragraph B. addresses MASS. GEN. LAWS ANN. Ch. 175, 113L(2) (WEST 2008) that in part states: For the purpose of said coverage, if the policyholder or obligor elects to purchase the coverage described in this paragraph, the term " uninsured motor vehicle " shall also include protection of persons insured thereunder who are legally entitled to recover damages from owners or operators of insured motor vehicles, trailers or semitrailers, to which a bodily injury liability bond or policy applies at the time of the accident and its bodily injury liability bond amount or policy limit is less than the policy limit for uninsured motor vehicle coverage and is insufficient to satisfy the damages of persons insured thereunder and only to the extent that the uninsured motor vehicle coverage limits exceed said limits of bodily injury liability subject to the terms of the policy. (Emphasis supplied) "Matching Offer Subrogation" A "matching offer subrogation" procedure is introduced that allows the Underinsured Motorist insurer the option of either matching a tentative settlement offer made by the tortfeasor's insurer to the insured (and thus preserve the UIM insurer's subrogation rights) or relinquishing those rights (if, for example, subrogation is not a foreseeable option) by allowing the insured to sign a release and settle directly with the tortfeasor's insurer. The provisions that include this procedure consist of the following: 1. A modified Insuring Agreement which allows the insured to "trigger" UIM coverage if a tentative settlement offer is received from the tortfeasor's carrier. 2. An additional duty requiring the insured to promptly notify the UIM carrier, in writing, of a tentative settlement offer with the tortfeasor's carrier. Insurance Services Office, Inc., 2009

108 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 Page S-15 New Forms 3. An addition to the PAP's "Our Right to Recover Payment" provision to outline the steps necessary on the part of the company to preserve its subrogation rights. This section states that, if the insured promptly notifies the UIM carrier of a tentative settlement in writing, the UIM carrier can "match" the offer within 30 days, in order to preserve its subrogation rights. This section also states that any "matching offer" made by the UIM carrier: Is separate from any payment made under UIM; and May also be recovered by the UIM carrier through subrogation. PP , Amendment of Policy Provisions Massachusetts PP , Personal Injury Protection Coverage Massachusetts PP , Other Than Collision Coverage Specified Actual Cash Value Limit of Liability - Massachusetts PP , Limited Collision Coverage - Massachusetts PP , Named Driver Exclusion Endorsement Massachusetts PP , Underinsured Motorists Coverage - Massachusetts PP , Uninsured Motorists Coverage - Massachusetts PP N , Named Driver Exclusion Acknowledgement Insurance Services Office, Inc., 2009

109 GENERAL INSTRUCTIONS PERSONAL AUTO POLICY 1. STANDARD LANGUAGE The provisions of the policy are in standard language and may not be amended except as indicated in these instructions. 2. OPTIONAL SEQUENCE AND ARRANGEMENT The Parts of the policy and the provisions of the Parts and Declarations Page may appear in any sequence or arrangement the company elects. 3. OPTIONAL PROVISIONS (a) Matter in brackets on the Declarations Page may be omitted or amended as the company elects. (b) Provisions that pertain to Liability, Medical Payments and Uninsured Motorists Coverage may be deleted if only Coverage for Damage to Your Auto is provided. (c) Defined terms may be italicized or boldfaced instead of being placed in quotation marks. If done, appropriate reference should be made in the policy. (d) The use of a Schedule and the form and arrangement of the matter contained in any Schedule is optional with the company, provided that the substance of the Schedule is included in either a different form of Schedule or elsewhere in the policy using appropriate connective language where necessary. (e) The provisions of endorsements may be incorporated into the policy at the election of the company. (f) Mutual companies, participating stock companies and reciprocal associations may add special provisions applying to their members or policyholders. (g) The following language is to be incorporated into the policy or the Declarations Page if the policy is written on a continuous basis or without a fixed expiration date: PREMIUM The premium stated in the Declarations is the initial premium for this policy. On each renewal, continuation or anniversary of the effective date of this policy the premium shall be computed by us in accordance with our manuals then in use. ISO Properties, Inc., 2000

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126 MASSACHUSETTS PERSONAL AUTO FORMS FILING PP-2009-OEND1 (AMENDMENT 2) Second Amendment To ISO Filing PP-2009-OEND1 About This Filing Revised Forms New Forms This amendment to ISO Filing PP-2009-OEND1 is being made in response to further correspondence with the Massachusetts Division of Insurance. We are revising the following forms: PP , Amendment of Policy Provisions - Massachusetts. PP , Underinsured Motorists Coverage - Massachusetts. PP , Uninsured Motorists Coverage - Massachusetts. We have used a format of striking-through deletions, underlining additions and inserting a revision bar in the left margin to indicate changes from the prior pending versions of PP 01 48, PP and PP In this amendment, we have revised the proposed edition date of PP and PP from to We are introducing: Background PP , Compulsory Motor Vehicle Liability Coverage - Massachusetts. PP , Fire, Theft or Larceny Coverage - Massachusetts. Filing PP-2009-OEND1, which was submitted in response to Section of Massachusetts Regulation 211:CMR 79, introduced the current ISO multistate Personal Auto Policy and related endorsements for use in Massachusetts. We subsequently amended filing PP-2009-OEND1 in response to correspondence with the Massachusetts Division of Insurance to: Insurance Services Office, Inc., 2009

127 MASSACHUSETTS - PERSONAL AUTO FORMS FILING PP-2009-OEND1(AMENDMENT 2) Page 2 Revise PP 01 48, Amendment of Policy Provisions - Massachusetts, PP 05 75, Personal Injury Protection Coverage - Massachusetts, and PP 13 30, Limited Collision Coverage - Massachusetts. Introduce PP 13 08, Full Collision Coverage - Massachusetts. The Massachusetts Insurance Division has requested that: The Termination provision of Part F - General Provisions of PP 01 48, Amendment of Policy Provisions - Massachusetts be revised to include the circumstances where the policy terminates by operation of law. An endorsement be made available to reduce bodily injury liability coverage to the amount required by MASS. GEN. LAWS ANN. Ch. 90, 34A (WEST 2008) to comply with Massachusetts compulsory insurance laws. MASS. GEN. LAWS ANN. Ch. 90, 34A (WEST 2008), with respect to motor vehicle liability policies, in part, provides that such policies: Provide indemnity for or protection to the insured and any person responsible for the operation of the insured's motor vehicle with his express or implied consent; Pay damages to others for bodily injuries sustained during the term of the policy by any person other than a guest passenger; Pay damages arising out of the ownership, operation, maintenance, control or use of the motor vehicle in Massachusetts; and Provide a split limit bodily injury liability limit of $20,000/40,000. Exclusion 3. ("Reasonable Belief") of PP 14 19, Uninsured Motorists Coverage - Massachusetts, be revised to provide limited coverage when the insured is occupying a vehicle being operated without the consent of the owner. Item c.iii.2.b. of the Massachusetts Motor Vehicle Forms Filing Checklist (which sets forth minimum forms filing guidelines for motor vehicle insurance forms filings), in part, provides the following: 2. Coverage for insureds that are injured in one of the following circumstances shall not exceed the lesser of the limit of coverage in effect at the time of the accident or 35/80: b. The injury occurred while the person occupying the insured motor vehicle was being used without the consent of its owner. In order to comply with MASS. GEN. LAWS ANN. Ch. 175, 113C (WEST 2008), specific coverage be made available for the perils of fire and theft. MASS. GEN. LAWS ANN. Ch. 175, 113C (WEST 2008), in part, provides that, subject to certain exceptions, no company shall issue motor

128 MASSACHUSETTS - PERSONAL AUTO FORMS FILING PP-2009-OEND1(AMENDMENT 2) Page 3 vehicle liability policies unless it makes a mandatory offer to issue to any person purchasing such policy, at his option, fire and theft coverage. The Other Insurance Provision for Underinsured Motorists Coverage be revised to reinforce conditions when a guest passenger is and is not eligible for coverage. Explanation of Changes In response to correspondence from the Massachusetts Insurance Division, the following revisions are being made: PP 01 48, Amendment of Policy Provisions - Massachusetts The Termination provision of Part F is amended to include a Termination By Operation Of Law section that addresses the provisions of Massachusetts Regulation 211:CMR 97.05(6). The Termination By Operation Of Law section states that the policy will terminate with respect to "your covered auto" by operation of law in any of the following circumstances: 1. Another insurer files with the Registrar of Motor Vehicles a certificate of insurance covering the same "your covered auto" insured under the terminating policy. In this case, the policy will terminate on the date on which a new certificate of insurance filed with the Registrar of Motor Vehicles becomes effective. 2. You sell or transfer title to such "your covered auto". In this case, coverage under the policy will terminate 30 days from the date of the sale or transfer, unless within the 30 day period you transfer the registration of "your covered auto" to a "newly acquired auto" that is a replacement vehicle. 3. You surrender the registration plates for such "your covered auto" to the Registrar of Motor Vehicles. (REFER TO PAGE 3 OF PP ) PP 14 18, Underinsured Motorists Coverage - Massachusetts The Other Insurance Provision in PP is revised to address the priorities of recovery from underinsured motorist coverage available to an insured under more than one policy. (REFER TO PAGE 2 OF PP )

129 MASSACHUSETTS - PERSONAL AUTO FORMS FILING PP-2009-OEND1(AMENDMENT 2) Page 4 PP 14 19, Uninsured Motorists Coverage - Massachusetts The Other Insurance Provision in PP is revised to address the priorities of recovery from uninsured motorist coverage available to an insured under more than one policy. Exclusion B.3. ("Reasonable Belief") is revised as follows: B. We do not provide Uninsured Motorists Coverage for "bodily injury" sustained by: 3. Any "insured" while "occupying" using: a vehicle without a reasonable belief that the insured is entitled to do so. " your covered auto" without your express or implied consent but only to the extent that the limits of liability for this coverage exceed the lesser of: a. The limit of liability for this coverage; or b. $35,000 for each person, subject to $80,000 for each accident. This Exclusion (B.3.) does not apply to a "family member" using "your covered auto" which is owned by you. (REFER TO PAGE 2 OF PP ) Editorial Revision Paragraph B.1. of the definition of insured in PP has been revised to add the words "or any 'family member.'" PP 13 14, Compulsory Motor Vehicle Liability Coverage - Massachusetts This optional endorsement has been developed at the request of the Massachusetts Division of Insurance to reduce bodily injury liability coverage required by MASS. GEN. LAWS ANN. Ch. 90, 34A (WEST 2008). The following is a description of the features of PP 13 14: Paragraph A. amends Part A - Liability Coverage of the Personal Auto Policy as follows: Paragraph B. of the Insuring Agreement is amended as follows: The definition of insured as used in Part A means: "You" (the named insured shown in the Declarations or spouse if a resident of the same household) for the ownership, maintenance or use of "your covered auto". Any other person operating your covered auto. For your covered auto, any person or organization but only with respect to legal responsibility for acts or omissions of a person for whom coverage is afforded under Part A.

130 MASSACHUSETTS - PERSONAL AUTO FORMS FILING PP-2009-OEND1(AMENDMENT 2) Page 5 Exclusion A.7. is amended to exclude liability coverage for any insured maintaining or using any vehicle other than "your covered auto" while that "insured" is employed or otherwise engaged in any "business" (other than farming or ranching) not described in Exclusion A.6. An exclusion is added to exclude Liability Coverage for any insured for bodily injury to any person occupying your covered auto. The Out of State Coverage provision does not apply. Paragraph B. amends the Policy Period and Territory provision of Part F - General Provisions to state that the policy territory is the state of Massachusetts. PP 13 15, Fire, Theft or Larceny Coverage - Massachusetts This optional endorsement has been developed to address the provisions with respect to the specific coverage to be made available for the perils of fire and theft of MASS. GEN. LAWS ANN. Ch. 175, 113C (WEST 2008). The Schedule of PP provides for a description of the vehicle, the premium and deductible. Section I. of PP replaces paragraphs A. and B. of the Insuring Agreement of Part D - Coverage For Damage To Your Auto of the Personal Auto Policy (PAP) to provide, in part, that the company will pay for direct and accidental loss to your covered auto or any non-owned auto, including their equipment, caused by fire, theft or larceny minus any applicable deductible shown in the Schedule or in the Declarations only if the Declarations indicate that Fire, Theft or Larceny Coverage is provided for that auto. Section II. of PP amends Paragraph A. of the Transportation Expenses provision of the Insuring Agreement in Part D to provide, in part, that the company will pay, without application of a deductible, up to a maximum of $600 for: Temporary transportation expenses not exceeding $20 per day incurred by you in the event of a loss to your covered auto if the loss is caused by fire, theft or larceny only if the Declarations indicate that Fire, Theft or Larceny Coverage is provided for that auto. Expenses for which "you" become legally responsible in the event of loss to a non-owned auto if the loss is caused by fire, theft or larceny only if the Declarations indicate that Fire, Theft or Larceny Coverage is provided for that auto.

131 MASSACHUSETTS - PERSONAL AUTO FORMS FILING PP-2009-OEND1(AMENDMENT 2) Page 6 Copyright Explanation The material distributed by Insurance Services Office, Inc. is copyrighted. All rights reserved. Possession of these pages does not confer the right to print, reprint, publish, copy, sell, file or use same in any manner without the written permission of the copyright owner. Important Note Insurance Services Office, Inc. (ISO) makes available advisory services to property/casualty insurers. ISO has no adherence requirements. ISO policy forms and explanatory materials are intended solely for the information and use of ISO's participating insurers and their representatives, and insurance regulators. Neither ISO's general explanations of policy intent nor opinions expressed by ISO's staff necessarily reflect every insurer's view or control any insurer's determination of coverage for a specific claim. ISO does not intercede in coverage disputes arising from insurance policies. If there is any conflict between a form and any other part of the attached material, the provisions of the form apply.

132 PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF POLICY PROVISIONS MASSACHUSETTS I. Definitions The following is added to the Definitions section: Throughout the policy, "minimum limits" refers to the following limits of liability as required by Massachusetts law, to be provided under a policy of automobile liability insurance: 1. $20,000 for each person, subject to $40,000 for each accident, with respect to "bodily injury"; and 2. $5,000 for each accident with respect to "property damage". II. Part A Liability Coverage Part A is amended as follows: A. Paragraph A. of the Insuring Agreement is replaced by the following: Insuring Agreement We will pay damages for "bodily injury" or "property damage" for which any "insured" becomes legally responsible because of an auto accident. Damages include prejudgment interest awarded against the "insured". We will settle or defend, as we consider appropriate, any claim or suit asking for these damages. This applies even if any of the allegations of the suit are groundless, false or fraudulent. In addition to our limit of liability, we will pay all defense costs we incur. Our duty to settle or defend ends when our limit of liability for this coverage has been exhausted by payment of judgments or settlements. We have no duty to defend any suit or settle any claim for "bodily injury" or "property damage" not covered under this policy. B. The following is added: Throughout Part A of this policy, with respect to "property damage", ownership, maintenance or use of a vehicle includes its loading and unloading. C. Paragraph B. of the Limit Of Liability provision is replaced by the following: No one will be entitled to receive duplicate payments for the same elements of loss under this coverage and: 1. Part B or Part C of this policy; or 2. Any Underinsured Motorists Coverage or Personal Injury Protection Coverage provided by this policy. III. Part B Medical Payments Coverage Paragraph B. of the Limit Of Liability provision is replaced by the following: No one will be entitled to receive duplicate payments for the same elements of loss under this coverage and: 1. Part A or Part C of this policy; or 2. Any Underinsured Motorists Coverage or Personal Injury Protection Coverage provided by this policy. IV. Part D Coverage For Damage To Your Auto Part D is amended as follows: A. The following is added to the Payment Of Loss provision: 1. If we have a plan approved by the Commissioner of Insurance providing for direct payment for loss to the vehicle(s) insured under Part D prior to our receipt of a claim form stating that the repair work described in an appraisal made pursuant to regulations promulgated by the auto damage appraisers licensing board has been completed, then the following applies: a. If you elect not to repair the vehicle for which a claim payment has been made; or b. If you have not provided us with the claim form described above; R E V I S E D PP Insurance Services Office, Inc., 2009 Page 1 of 4

133 we will decrease the actual cash value of the vehicle by the amount of damage sustained plus any applicable deductible until we receive a claim form described above. 2. If you choose not to accept payment under our plan described in Paragraph A.1. above, or if we do not have a plan approved by the Commissioner of Insurance that provides for direct payment for loss to the vehicle(s) insured under Part D, then the following applies: a. If you instruct us in writing, we will pay the repair shop directly within seven days of receipt of the claim form that states that the repair work described in an appraisal made pursuant to the regulations promulgated by the auto damage appraisers licensing board has been completed. Receipt of the claim form described above by registered mail shall be sufficient proof of receipt. b. If you elect not to repair the vehicle, or do not provide us with a claim form described above, we will decrease the actual cash value of the vehicle by the amount of damage sustained. c. If you do not provide us with a claim form described above, we will pay only the decrease in actual cash value of the vehicle, less any deductible. B. The Appraisal provision is replaced by the following: Appraisal A. If you and we fail to agree as to the amount of loss, each will, on the written demand of either, within 60 days after we receive the proof of loss, select a competent and disinterested appraiser. The appraisal will be made at a reasonable time and place. The appraisers will first select a competent and disinterested umpire, and failing for 15 days to agree upon the umpire, at our request or your request, the umpire will be selected by a judge of a court of record in the county and state in which the appraisal is pending. The appraisers will then appraise the loss, stating separately the actual cash value and the amount of loss. If they fail to agree, they will submit their differences to the umpire. An award in writing of any two will determine the amount of loss. Each party will: 1. Pay its chosen appraiser; and 2. Bear the expenses of the appraisal and umpire equally. B. We do not waive any of our rights under this policy by agreeing to an appraisal. C. The following provision is added and applies in place of any conflicting policy provision: Mandatory Inspection 1. We have the right as authorized by Massachusetts Regulation to inspect any: a. Private passenger auto; or b. Pickup or van; which you insure or intend to insure for Coverage For Damage To Your Auto under this policy. 2. When we require an inspection you must: a. Cooperate; and b. Make the vehicle available for the inspection. V. Part E Duties After An Accident Or Loss Paragraphs A. and D. are replaced by the following: A. We must be notified promptly of how, when and where the accident or loss happened. Notice should also include the names and addresses of any injured persons and of any witnesses. Notice to our authorized representative is considered notice to us. D. A person seeking Coverage For Damage To Your Auto must also: 1. Take reasonable steps after a loss to protect "your covered auto" or any "non-owned auto" and their equipment from further loss. We will pay reasonable expenses incurred to do this. 2. Promptly notify the police in the event of larceny, robbery or pilferage. 3. Permit us to inspect and appraise the damaged property before its repair or disposal. 4. In the event of loss due to fire, submit a signed statement to the fire department that contains information concerning the fire loss as required by the state fire marshal. R E V I S E D Page 2 of 4 Insurance Services Office, Inc., 2009 PP

134 VI. Part F General Provisions The Termination provision of Part F is replaced by the following: Termination A. Cancellation This policy may be cancelled during the policy period as follows: 1. The named insured shown in the Declarations may cancel by: a. Returning this policy to us; or b. Giving us advance written notice of the date cancellation is to take effect. 2. We may cancel by mailing notice at least 20 days prior to the effective date to the named insured shown in the Declarations at the address shown in this policy and obtaining a certificate of mailing receipt issued by the United States Post Office. 3. We will cancel only: a. For nonpayment of premium; or b. If your driver's license or that of: (1) Any driver who lives with you; or (2) Any driver who customarily uses "your covered auto"; has been suspended or revoked. This must have occurred: (1) During the policy period; or (2) Since the last anniversary of the original effective date if the policy period is other than one year; or c. If the policy was obtained through material misrepresentation. B. Nonrenewal If we decide not to renew or continue this policy, we will mail notice by obtaining a certificate of mailing receipt issued by the United States Post Office to the named insured shown in the Declarations at the address shown in this policy. Notice will be mailed at least 45 days before the end of the policy period. Subject to this notice requirement, if the policy period is: 1. Less than six months, we will have the right not to renew or continue this policy every six months, beginning six months after its original effective date. 2. Six months or longer, but less than one year, we will have the right not to renew or continue this policy at the end of the policy period. 3. One year or longer, we will have the right not to renew or continue this policy at each anniversary of its original effective date. C. Automatic Termination If we offer to renew or continue and you or your representative does not accept, this policy will automatically terminate at the end of the current policy period. Failure to pay the required renewal or continuation premium when due shall mean that you have not accepted our offer. If you obtain other insurance on "your covered auto", any similar insurance provided by this policy will terminate as to that auto on the effective date of the other insurance. D. Termination By Operation Of Law This policy will terminate with respect to "your covered auto" by operation of law in any of the following circumstances: 1. Another insurer files with the Registrar of Motor Vehicles a certificate of insurance covering the same "your covered auto" insured under the terminating policy. In this case, the policy will terminate on the date on which a new certificate of insurance filed with the Registrar of Motor Vehicles becomes effective. 2. You sell or transfer title to such "your covered auto". In this case, the coverage under this policy will terminate 30 days from the date of the sale or transfer, unless within the 30-day period you transfer the registration of "your covered auto" to a "newly acquired auto" that is a replacement vehicle. 3. You surrender the registration plates for such "your covered auto" to the Registrar of Motor Vehicles. R E V I S E D PP Insurance Services Office, Inc., 2009 Page 3 of 4

135 E.D. Other Termination Provisions 1. We may deliver any notice instead of mailing it. Proof of mailing of any notice shall be sufficient proof of notice. 2. If this policy is cancelled, you may be entitled to a premium refund. If so, we will send you the refund. The premium refund, if any, will be computed according to our manuals. However, making or offering to make the refund is not a condition of cancellation. 3. The effective date of cancellation stated in the notice shall become the end of the policy period. This endorsement must be attached to the Change Endorsement when issued after the policy is written. R E V I S E D Page 4 of 4 Insurance Services Office, Inc., 2009 PP

136 PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMPULSORY MOTOR VEHICLE LIABILITY COVERAGE MASSACHUSETTS With respect to the coverage provided by this endorsement, the provisions of the Definitions section, Part A Liability Coverage, Part E Duties After An Accident Or Loss and Part F General Provisions apply unless modified by this endorsement. A. Part A Liability Part A is amended as follows: 1. Paragraph B. of the Insuring Agreement is replaced by the following: B. "Insured" as used in this Part means: 1. You for the ownership, maintenance or use of "your covered auto". 2. Any other person operating "your covered auto". 3. For "your covered auto", any person or organization but only with respect to legal responsibility for acts or omissions of a person for whom coverage is afforded under this Part. 2. Exclusion A.7. is replaced by the following: We do not provide Liability Coverage for any "insured": 7. Maintaining or using any vehicle other than "your covered auto" while that "insured" is employed or otherwise engaged in any "business" (other than farming or ranching) not described in Exclusion A The following exclusion is added: We do not provide Liability Coverage for any "insured" for bodily injury to any person "occupying" "your covered auto". 4. The Out Of State Coverage provision does not apply. B. The Policy Period And Territory provision of Part F General Provisions is replaced by the following: POLICY PERIOD AND TERRITORY 1. This policy applies only to accidents and losses which occur: a. During the policy period as shown in the Declarations; and b. Within the policy territory. 2. The policy territory is the State of Massachusetts. This endorsement must be attached to the Change Endorsement when issued after the policy is written. N E W PP Insurance Services Office, Inc., 2009 Page 1 of 1

137 POLICY NUMBER: PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FIRE, THEFT OR LARCENY COVERAGE MASSACHUSETTS SCHEDULE Description Of Vehicle $ Fire, Theft Or Larceny Coverage Premium $ $ Fire, Theft Or Larceny Coverage Deductible: $ With respect to the coverage provided by this endorsement, the provisions of the Definitions section, Part D Coverage For Damage To Your Auto, Part E Duties After An Accident Or Loss and Part F General Provisions apply unless modified by this endorsement. The following provisions apply with respect to the vehicle(s) described in the Schedule or in the Declarations: I. Paragraphs A. and B. of the Insuring Agreement in Part D are replaced by the following: We will pay for direct and accidental loss to "your covered auto" or any "non-owned auto", including their equipment, caused by fire, theft or larceny minus any applicable deductible shown in the Schedule or in the Declarations. We will pay for loss to "your covered auto" caused by fire, theft or larceny only if the Schedule or Declarations indicates that Fire, Theft or Larceny Coverage is provided for that auto. If there is a loss to a "non-owned auto", we will provide the broadest coverage applicable to any "your covered auto" shown in the Schedule or in the Declarations. II. Paragraph A. of the Transportation Expenses provision of the Insuring Agreement in Part D is replaced by the following: A. In addition, we will pay, without application of a deductible, up to a maximum of $600 for: 1. Temporary transportation expenses not exceeding $20 per day incurred by you in the event of a loss to "your covered auto". We will pay for such expenses if the loss is caused by fire, theft or larceny only if the Schedule or Declarations indicates that Fire, Theft or Larceny Coverage is provided for that auto. 2. Expenses for which you become legally responsible in the event of loss to a "nonowned auto". We will pay for such expenses if the loss is caused by fire, theft or larceny only if the Schedule or Declarations indicates that Fire, Theft or Larceny Coverage is provided for any "your covered auto". However, the most we will pay for any expenses for loss of use is $20 per day. This endorsement must be attached to the Change Endorsement when issued after the policy is written. N E W PP Insurance Services Office, Inc., 2009 Page 1 of 1

138 POLICY NUMBER: PERSONAL AUTO PP THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. UNDERINSURED MOTORISTS COVERAGE MASSACHUSETTS SCHEDULE Premium Limit Of Liability Auto 1 Auto 2 Auto 3 $ Each Person $ $ $ $ Each Accident R With respect to the coverage provided by this endorsement, the provisions of the policy apply unless modified by the endorsement. Insuring Agreement A. We will pay compensatory damages which an "insured" is legally entitled to recover from the owner or operator of an "underinsured motor vehicle" because of "bodily injury": 1. Sustained by an "insured"; and 2. Caused by an accident. The owner's or operator's liability for these damages must arise out of the ownership, maintenance or use of the "underinsured motor vehicle". We will pay under this coverage only if 1. or 2. below applies: 1. The limits of liability under any bodily injury liability bonds or policies applicable to the "underinsured motor vehicle" have been exhausted by payment of judgments or settlements; or 2. A tentative settlement has been made between an "insured" and the insurer of the "underinsured motor vehicle" and we: a. Have been given prompt written notice of such tentative settlement; and b. Advance payment to the "insured" in an amount equal to the tentative settlement within 30 days after receipt of notification. B. "Insured" as used in this endorsement means: 1. You or any "family member". 2. Any other person "occupying" "your covered auto". 3. Any person for damages that person is entitled to recover because of "bodily injury" to which this coverage applies sustained by a person described in 1. or 2. above. C. "Underinsured motor vehicle" means a land motor vehicle or trailer of any type to which a bodily injury liability bond or policy applies at the time of the accident but its limit for bodily injury liability is less than the limit of liability for this coverage. However, "underinsured motor vehicle" does not include any vehicle or equipment: 1. Owned by or furnished or available for the regular use of you or any "family member". 2. Owned by any governmental unit or agency unless the insurer of the vehicle or equipment owned by the governmental unit or agency is or becomes insolvent. 3. Operated on rails or crawler treads. 4. Designed mainly for use off public roads while not upon public roads. 5. While located for use as a residence or premises. 6. Owned or operated by a person qualifying as a self-insurer under any applicable motor vehicle law. 7. To which a bodily injury liability bond or policy applies at the time of the accident but the bonding or insuring company: Exclusions a. Denies coverage; or b. Is or becomes insolvent. A. We do not provide Underinsured Motorists Coverage for "bodily injury" sustained: 1. By you while "occupying", or when struck by, any motor vehicle owned by you for which the minimum limits of liability as required by Massachusetts law to be provided under a motor vehicle liability policy are not in effect. E V I S E D PP Insurance Services Office, Inc., 2009 Page 1 of 4

139 2. By any "family member" while "occupying", or when struck by, any motor vehicle owned by that "family member" for which the minimum limits of liability as required by Massachusetts law to be provided under a motor vehicle liability policy are not in effect. B. We do not provide Underinsured Motorists Coverage for "bodily injury" sustained by: 1. You while "occupying" "your covered auto" when it is being used as a public or livery conveyance and which is not insured for this coverage under this policy. This Exclusion (B.1.) does not apply to a share-the-expense car pool. 2. Any "insured" using a vehicle without a reasonable belief that that "insured" is entitled to do so. This Exclusion (B.2.) does not apply to a "family member" using "your covered auto" which is owned by you. C. This coverage shall not apply directly or indirectly to benefit any insurer or self-insurer under any of the following or similar law: 1. Workers' compensation law; or 2. Disability benefits law. D. We do not provide Underinsured Motorists Coverage for punitive or exemplary damages. Limit Of Liability A. The limit of liability shown in the Schedule or in the Declarations for each person for Underinsured Motorists Coverage is our maximum limit of liability for all damages, including damages for care, loss of services or death, arising out of "bodily injury" sustained by any one person in any one accident. Subject to this limit for each person, the limit of liability shown in the Schedule or in the Declarations for each accident for Underinsured Motorists Coverage is our maximum limit of liability for all damages for "bodily injury" resulting from any one accident. This is the most we will pay regardless of the number of: 1. "Insureds"; 2. Claims made; 3. Vehicles or premiums shown in the Schedule or in the Declarations; or 4. Vehicles involved in the accident. B. The limit of liability shall be reduced by all sums paid because of the "bodily injury" by or on behalf of persons or organizations who may be legally responsible. This includes all sums paid under Part A of this policy. C. No one will be entitled to receive duplicate payments for the same elements of loss under this coverage and: 1. Part A, Part B or Part C of this policy; or 2. Personal Injury Protection Coverage. D. We will not make a duplicate payment under this coverage for any element of loss for which payment has been made by or on behalf of persons or organizations who may be legally responsible. E. We will not pay for any element of loss if a person is entitled to receive payment for the same element of loss under any of the following or similar law: 1. Workers' compensation law; or 2. Disability benefits law. Other Insurance If there is other applicable insurance available under more than one policy or provision of coverage that is similar to the insurance provided under this endorsement: A. Any recovery for damages under all such policies or provisions of coverage may equal but not exceed the highest applicable limit for any one vehicle under any insurance providing coverage on the same level of priority. B. The following priorities of recovery apply: First Second Third Any policy affording Underinsured Motorists Coverage to the "insured" as a named insured Any policy affording Underinsured Motorists Coverage to the "insured" as a family member The Underinsured Motorists Coverage applicable to the vehicle the "insured" was "occupying" at the time of the accident However, with respect to you while "occupying" a vehicle owned by you, only the Underinsured Motorists Coverage applicable to that vehicle will apply. C. We will pay only our share of the loss. Our share is the proportion that our limit of liability bears to the total of all limits applicable on the same level of priority. R E V I S E D Page 2 of 4 Insurance Services Office, Inc., 2009 PP

140 A. If you sustain "bodily injury" while "occupying" a vehicle you do not own, including any vehicle while used as a temporary substitute for "your covered auto", any recovery for damages under all such policies or provisions of coverage will only be from the policy providing the highest limits of Underinsured Motorists Coverage under which you are the named insured. If there is more than one policy that provides the same highest limits of Underinsured Motorists Coverage under which you are the named insured, we will pay only our share of the loss. Our share is the proportion that our limit of liability bears to the total of all applicable limits of liability of such policies. B. If: 1. A "family member" sustains "bodily injury" while "occupying" any vehicle; and 2. There is other applicable insurance available under one or more policies or provisions of coverage that is similar to the insurance provided by this endorsement; any recovery for damages under all such policies or provisions of coverage will only be from the policy providing the highest limits of Underinsured Motorists Coverage under which that person is insured as a "family member". If there is more than one policy that provides the same highest limits of Underinsured Motorists Coverage under which that person is insured as a "family member", we will pay only our share of the loss. Our share is the proportion that our limit of liability bears to the total of all applicable limits of liability of such policies. Arbitration A. If we and an "insured" do not agree: 1. Whether that "insured" is legally entitled to recover damages; or 2. As to the amount of damages which are recoverable by that "insured"; from the owner or operator of an "underinsured motor vehicle", then the matter may be arbitrated. However, disputes concerning coverage under this endorsement may not be arbitrated. Both parties must agree to arbitration. If so agreed, each party will select an arbitrator. The two arbitrators will select a third. If they cannot agree within 30 days, either may request that selection be made by a judge of a court having jurisdiction. B. Each party will: 1. Pay the expenses it incurs; and 2. Bear the expenses of the third arbitrator equally. C. Unless both parties agree otherwise, arbitration will take place in the county in which the "insured" lives. Local rules of law as to procedure and evidence will apply. A decision agreed to by at least two of the arbitrators will be binding as to: 1. Whether the "insured" is legally entitled to recover damages; and 2. The amount of damages. This applies only if the amount does not exceed the minimum limit for bodily injury liability specified by the compulsory automobile insurance law of Massachusetts. If the amount exceeds that limit, either party may demand the right to a trial. This demand must be made within 60 days of the arbitrators' decision. If this demand is not made, the amount of damages agreed to by the arbitrators will be binding. Additional Duties A person seeking coverage under this endorsement must also promptly: 1. Send us copies of the legal papers if a suit is brought; and 2. Notify us in writing of a tentative settlement between the "insured" and the insurer of the "underinsured motor vehicle" and allow us 30 days to advance payment to that "insured" in an amount equal to the tentative settlement to preserve our rights against the insurer, owner or operator of such "underinsured motor vehicle". General Provisions The following is added to the Our Right To Recover Payment provision in Part F: Our Right To Recover Payment We shall be entitled to a recovery under Paragraph A. or B. only after the person has been fully compensated for damages. Our rights do not apply under Paragraph A. with respect to Underinsured Motorists Coverage if we: 1. Have been given prompt written notice of a tentative settlement between an "insured" and the insurer of an "underinsured motor vehicle"; and 2. Fail to advance payment to the "insured" in an amount equal to the tentative settlement within 30 days after receipt of notification. If we advance payment to the "insured" in an amount equal to the tentative settlement within 30 days after receipt of notification: 1. That payment will be separate from any amount the "insured" is entitled to recover under the provisions of Underinsured Motorists Coverage; and R E V I S E D PP Insurance Services Office, Inc., 2009 Page 3 of 4

141 2. We also have a right to recover the advanced payment. This endorsement must be attached to the Change Endorsement when issued after the policy is written. R E V I S E D Page 4 of 4 Insurance Services Office, Inc., 2009 PP

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