1. For this coverage to apply, at the time of the loss, the at-fault operator must: a. be an experienced operator (licensed at least six years); and

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1 QUINCY MUTUAL GROUP MERIT RATING POINTS/ACCIDENT FORGIVENESS ENDORSEMENT QMAF This endorsement provides forgiveness of the additional premium generated by merit rating points associated with at-fault accidents, subject to the following eligibility requirements. Eligibility Requirements A. Policy and Vehicle B. Operator(s) 1. This endorsement must be purchased and be part of the policy before the at-fault accident occurred. 2. This endorsement must be attached to the policy. If the endorsement is deleted accident forgiveness no longer applies and the additional premium associated with merit rating points will be applied to the policy. 3. At the time this endorsement is purchased, at least one operator listed on the policy must: a. be an experienced operator (licensed at least six years); and b. have a merit rating code of 99 as determined by the MA Merit Rating Board. 4. A forgiven accident is still considered a loss for the purpose of applying other applicable company rating provisions or rules, and may affect underwriting decisions. 5. In order for accident forgiveness to apply, the vehicle involved in the at-fault accident must be a private passenger vehicle, pick-up or van. Accident Forgiveness does not apply to motor homes, motorcycles, antique autos, and trailers. 1. For this coverage to apply, at the time of the loss, the at-fault operator must: a. be an experienced operator (licensed at least six years); and b. have a Merit rating code of 99 as determined by the MA Merit Rating Board; and c. be listed on the Coverage Selections Page. 2. Only one at-fault accident will be forgiven per operator during the six year experience period. 3. Merit rating points and the premium associated with those points will be applied to an operator for any additional at-fault accident(s) occurring after an accident is forgiven for that operator during the six year experience period. QMAF Page 1 of 2

2 C. Accident 1. The operator must be determined by Quincy Mutual to be more than 50% at fault. 2. Claims payments must be at least $500 in excess of any applicable deductible for this coverage to apply. 3. Moving violations are not accidents and are not eligible for forgiveness. Merit Rating points are normally applied to a policy at renewal. Accident forgiveness as defined above therefore does not affect a policy s premium until renewal. This endorsement does not impact the determination of eligible operators merit rating code under Quincy Mutual s Merit rating plan. This endorsement is forgiving the additional premium points associated with a single at-fault accident subject to the terms and conditions of this endorsement. QMAF Page 2 of 2

3 ISSUED BY: POL.COMPANY.GROUP.NAME MASSACHUSETTS AUTOMOBILE RENEWAL FORM INSURED NAME AND ADDRESS: POL.INSURED.NAME POL.INSURED.AD1 POL.INSURED.AD2 POL.INSURED.AD3 POL.INSURED.AD4 Dear Insured, POL.COMPANY.NAME POL.COMPANY.TELEPHONE (STATEMENT OF FACTS) POLICY NUMBER: POLICY RENEWAL DATE: AGENT NAME AND ADDRESS: POL.AGENT.NAME POL.AGENT.AD1 POL.AGENT.AD2 POL.AGENT.AD3 POL.AGENT.AD4 POL.NUMBER POLICY.EFFECTIVE.DATE.MM It is very important that we have accurate driver and garaging information. All household members who are licensed to drive and any individual(s) that regularly use your autos must be listed on your policy s Coverage Selection Page. You must also verify where your vehicles are garaged. Failure to list all licensed household members and individual(s) who regularly operate your autos, and the failure to provide accurate garaging information may reduce or eliminate coverages under your policy. Please verify this information and make any necessary changes. It is your obligation to review this renewal form. You further warrant that the information contained is true, accurate, and complete and that no material facts have been omitted, misrepresented or misstated. Operators currently shown on your policy: Our records show the following individuals are licensed household members or have regular access to your autos. Lic. Date First Licensed % of Use for Auto Please indicate the reason for any changes Opr. Operator Name Date of Birth License Number St. Auto Motorcycle Veh Veh Veh Veh (for example, "Driver Added" or No. mm/dd/yy mm/dd/yy mm/dd/yy "Corrected Information") DRV.1.NUM DRV.1.NAME DRV.1.DOBDRV.1.LICENSE DRV.1.STATE DRV.1.LIC.DATE DRV.1.MCDATE DRV.2.NUM DRV.2.NAME DRV.2.DOBDRV.2.LICENSE DRV.2.STATE DRV.2.LIC.DATE DRV.2.MCDATE DRV.3.NUM DRV.3.NAME DRV.3.DOBDRV.3.LICENSE DRV.3.STATE DRV.3.LIC.DATE DRV.3.MCDATE DRV.4.NUM DRV.4.NAME DRV.4.DOBDRV.4.LICENSE DRV.4.STATE DRV.4.LIC.DATE DRV.4.MCDATE DRV.5.NUM DRV.5.NAME DRV.5.DOBDRV.5.LICENSE DRV.5.STATE DRV.5.LIC.DATE DRV.5.MCDATE DRV.6.NUM DRV.6.NAME DRV.6.DOBDRV.6.LICENSE DRV.6.STATE DRV.6.LIC.DATE DRV.6.MCDATE Vehicles currently shown on your policy: Our records show the following automobiles are listed on your policy and are garaged at the location(s) listed below. Veh # Year Make and Model of Vehicle Garaging Location Please indicate the reason for any changes (for example, "Vehicle Deleted" or "Garaging Location Changed") VEH.DESC.QUEST VEH.DESC.QUEST #002 VEH.DESC.QUEST #003 VEH.DESC.QUEST #004 VEH.GARAGE.QUEST VEH.GARAGE.QUEST #002 VEH.GARAGE.QUEST #003 VEH.GARAGE.QUEST #004 Important Notice: If you or someone on your behalf knowingly gives us false, deceptive, misleading or incomplete information in this application and if such false, deceptive, misleading or incomplete information increases our risk of loss, we may refuse to pay claims under any or all of the Optional Insurance Parts, we may also limit payments under Part 3 and Part 4, and we may cancel your policy. Such information includes the description and the place of garaging of the vehicles to be insured, the names of household members, and customary operators required to be listed. IF YOU ARE MAKING CHANGES OR CORRECTING INFORMATION, PLEASE SIGN THIS FORM AND RETURN IT TO YOUR AGENT AT THE ADDRESS LISTED ABOVE. DATE INSURED'S SIGNATURE DO NOT RETURN THIS FORM IF THE VEHICLE, VEHICLE GARAGING AND DRIVER INFORMATION LISTED ABOVE IS ACCURATE OR IF YOU ARE NOT ATTACHING ANY DOCUMENTATION FOR CREDITS/DISCOUNTS (SEE REVERSE FOR DESCRIPTION OF CREDITS/DISCOUNTS AND REQUIRED DOCUMENTATION) 04/13

4 Credits and Discounts Available: Please review the following questions. If you answer "YES" to any of these questions, you may be eligible for a credit/discount. If you have any questions about these credits/discounts, or the verification information required in order to receive the credit/discount, please contact your agent. QU QU QU QU QU YES NO 1. Do you travel less than 7,500 miles a year? If YES, you may be eligible for a discount, contact your agent for further information. YES NO 2. Do you use public transportation to commute to work? If YES, attach verification of monthly passes or tickets purchased for at least 8 of the previous 11 months or contact your agent for further information. YES NO 3. Have you, or any operator listed on your policy, completed an Advanced Driver Training Class with In-Control Crash Prevention? If YES, attach verification of class or contact your agent for further information. YES NO 4. Is your home insured by Quincy Mutual Group (Quincy Mutual Fire Insurance Company or New England Mutual Insurance Company) or Andover Companies (Cambridge Mutual, Merrimac Mutual, Baystate Mutual) or the Massachusetts Property Insurance Underwriting Association)? If YES, you may be eligible for up to 30% credit on your Homeowners policy. Include the policy number and the name of the insurance company or contact your agent for further information. YES NO 5. Are there any inexperienced operators (less than 6 years of driving experience) listed on your policy who maintain a grade point average of 3.0 (B) or better? If YES attach a certificate completed by a school official who can verify the operator's academic record or contact your agent for further information. (This discount is removed when the policy expires. You must apply for this Good Student discount every time the policy is renewed.) QUYES NO 6. Are there any inexperienced operators (less than 6 years of driving experience) listed on your policy who is a student and lives more than 100 miles or more from your residence premises? If YES provide the name of the school and where it is located. (This discount is removed when the policy expires. You must apply for this Student Away discount every time the policy is renewed.) QUEST.CREDIT.MSG Important Coverage Questions: Please review the following questions. If you answer "YES" to any of these questions you should contact your agent immediately in order to verify that you have the correct coverage on your policy. YES NO 1. Have you customized any vehicle or motorcycle listed on your policy? Examples of customization includes installing electronic equipment or custom furnishings; non-auto antennas; awnings, cabanas, or any equipment that creates additional living space. YES NO 2. Are any of your vehicles listed on your policy used for business or occupational duties other than commuting to and from work? For example, deliveries, business calls or transporting someone for a fee. YES NO 3. Are there any licensed driver(s) not currently listed on your policy who regularly operate any vehicle that is currently listed on your policy? YES NO 4. Are there any licensed household members that are not currently listed on your policy? YES NO 5. Are you, or any licensed household member, operating a motor vehicle without a Massachusetts license? Note that Massachusetts law requires that you obtain a Massachusetts license within one year. Failure to obtain a MA license could result in non-renewal of your policy. For more information on this matter consult the Registry of Motor Vehicles website at www. mass.gov/rmv If you answered YES to any of the above questions, please contact your Insurance agency: POL.AGENT.NAME POL.AGENT.AD1 POL.AGENT.AD2 POL.AGENT.AD3 POL.AGENT.AD4 It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment, fines or a denial of insurance benefits.

5 RULE 19. DISCOUNTS Rule 19. Discounts are applicable to private passenger vehicles defined under Rule 27. See the Miscellaneous rate pages and rules for discounts applicable to Miscellaneous Type vehicles. A. Multi-Car- Not applicable in Tier V 1. A policyholder who owns two or more automobiles and purchases coverage from the same company for at least two such automobiles, shall be entitled to a 10 % reduction of the premium applicable to Coverage Parts 1, 2, 4, 5, 7, 8 and 9. At least two of the automobiles must be private passenger vehicles as defined in Rule 27, except that vehicles classified as antiques are not eligible. The premium reduction applies only to private passenger vehicles as defined in Rule The 10% reduction in premium as outlined in 1. above may also be applied if one private passenger auto is owned by the named insured(s) and a company vehicle is furnished to the named insured or resident spouse. A copy of the company car s registration must be provided. B. Public Transit-Not applicable in Tier V A discount of the premiums paid for Part 4 and Part 7 coverages will be given to eligible policyholders who provide evidence of purchase of eleven monthly passes or tickets from a qualifying mass transit system during the automobile policy period. Refer to the Miscellaneous Rating Factors page by Tier for the applicable discount. 1. Eligibility The vehicle must be a private passenger vehicle as defined in Rule 27 and be classified as use class 11, 12, 13, 14, 15, 17, 18, 20, 21, 25 or 26 for a minimum of eleven of twelve months of the policy year. In addition, the vehicle must not be driven to work or school ten days or more per month. A minimum of eight of the eleven monthly passes or tickets may be submitted, provided other evidence of purchase is submitted for the missing passes or tickets. The insurer shall collect all such passes and other evidence used by a policyholder to obtain the discount. NOTE: If a policyholder purchases a pre-paid non-refundable annual pass and furnishes proof of such purchase, the discount will be applied to the current policy rather than the expiring policy. 2. Replaced Vehicles The discount will be computed on the basis of combined earned premium for Parts 4 and 7 provided the replacement vehicle otherwise qualifies for the discount. If the insured changes insurance companies and replaces the vehicle at the same time, the second company will be responsible for the discount provided the policy has been in effect six months or more. 3. Application of Discount A discount will be applied to Part 4 and 7 premiums for each eligible vehicle in the order shown on our rating worksheet, page R-68 of this manual. The Merit rating plan does not apply to this discount. If there is only one eligible operator with more than one vehicle, the discount will be applied to the vehicle with the higher combined premium. If the policy insures only one vehicle, but there are two or more eligible operators, the discount shall be applied only once. If two or more vehicles and operators are eligible for discount, the discount shall first be applied to the vehicle which develops the highest combined premium for Parts 4 and 7, and then in descending order to the vehicle with the lowest combined premium. This discount is fully earned and returnable directly to the policyholder unless the policyholder directs that the discount be applied as a credit to premium charges for a renewal policy or it is used to offset undisputed outstanding premium due the insurer. The maximum discount per eligible vehicle is $ Qualifying Massachusetts Transit Systems Refer to the Rate Section for a list of approved public transit systems. 20

6 C. Anti-Theft Device Refer to Anti-Theft Devices Standards and Discounts Rule 54. D. Class 15 Premiums otherwise applicable to class 11, 12, 13, and 14 automobiles shall be reduced by 25% for insureds age 65 or older. If the principal operator becomes age 65 during the policy year, the class 11, 12, 13, and 14 premium must be adjusted as of that date. The premium adjustment shall be credited to the policyholder on that date unless that date is within sixty days of the expiration date of the policy, in which case the adjustment may be credited to the renewal policy. A notice of this classification change must be sent to the policyholder either prior to or with the proposed adjustment. The policyholder is required to notify the company of any change in operator usage which would affect entitlement to the discount. The 25% discount is applied to the final premium for each part after all other discounts and rating factors have been completed. It is the last step in the rating process prior to the application of the merit rating plan adjustment. E. Annual Mileage Discount A discount of the premium paid for Parts 1, 2, 3, 4, 5, 6, 7, 8 and 12 will be given to eligible policyholders on request, when the annual mileage of the vehicle falls into one of two categories. The discount will be based on the actual mileage driven in the previous policy year as determined by a comparison of two odometer readings, at least six months apart, from Registry of Motor Vehicle information or the Annual Mileage Discount Form and other standard automobile insurance forms available to the company. Refer to the Miscellaneous Rating Factors page by Tier for the applicable categories and discounts. 1. Eligibility The vehicle must be a private passenger vehicle as defined in Rule 27, except that vehicles classified as Antiques are not eligible. The company may request that the applicant for the discount complete the Annual Mileage Discount Form for the verification of eligibility for the discount. 2. Verification The company may use the odometer readings provided by the applicant on the Annual Mileage Discount Form or other standard forms available to the company, in order to verify the mileage driven in the past year. The company shall compute the annualized difference between the odometer reading at the time of application and the previous odometer reading to determine eligibility. If a vehicle replaces a vehicle which is receiving the discount, the annual mileage of the prior vehicle will be attributed to the replacement vehicle. The company may use information from the Vehicle Inspection System of the Registry of Motor Vehicles to verify annual mileage. The difference in the two most recent odometer readings reported by the Registry, if at least six months apart, shall be annualized to determine eligibility for the discount. If the Registry reports only one reading, which is more than six months before the application for the discount, the applicant may provide a current odometer reading on the Annual Mileage Discount Form, and the difference shall be annualized to determine eligibility. If two odometer readings, at least six months apart, are not available to the company through the Registry of Motor Vehicles, the Annual Mileage Discount Form or other standard forms, the vehicle is not eligible for the annual mileage discount. 3. Application of Discount The applicable discount applies to rates otherwise determined for each insured vehicle by; a. coverage, limits purchased, territory, driver class, and model year and symbol for model years 2010 and prior or, b. by coverage, limits purchased, territory, driver class, and model year and Vehicle Rating Group for model years 2011 and greater, prior to the application of the merit rating plan adjustment. 21

7 F. Passive Restraint Discount- Not applicable in Tier V A 25% discount of the premium paid for Parts 2, 3, 6 and 12 will be given to eligible policyholders for qualifying vehicles which contain occupant safety features approved by the Commissioner of Insurance. These features are: an airbag installed for either the driver s seating position or both front outboard designated seating positions or an automatic seatbelt installed for either the driver s seating positions or both front outboard designated seating positions. G. Advanced Driver Training- Not applicable in Tier V A 5% credit will be applied against all coverage parts, for all driver classes, on a per vehicle basis, where a premium is shown on the coverage selections page for a rated operator who has successfully completed the Advanced Driver Training Class. Advanced Driver Training class must be recognized and approved by the MA RMV. A certificate of completion must be provided in order to apply the credit. H. Preferred Operator Discount-Not applicable to Tier V On a renewal policy or on policies that are part of a qualified book transfer meeting the underwriting rules established by the company, a 4% premium credit is applied against all coverage parts on a per vehicle basis where a premium is shown on the coverage selections page for that vehicle. In order to be eligible for the credit the vehicle must be: Rated in classes Have Bodily Injury limits, Part 5, equal to or above $50,000 per person. The rated operator must have a merit rating code of 99 (Excellent Driver Discount Plus), 98 (Excellent Driver Discount) or 00 (Neutral). This discount applies to vehicles as defined under Rule 27. I. Account Credit-Not applicable to Tier V A 10% premium credit is applied against all coverage parts on a per vehicle basis where a premium is shown on the coverage selections page for that vehicle. For the purposes of this discount, vehicle includes personal automobiles, miscellaneous vehicles, trailers and motorcycles. To be eligible for the premium credit, the Named insured must have a supporting homeowners policy (all policy forms) that is written with Quincy Mutual, The Andover Companies, (Merrimack Mutual, Cambridge Mutual or Bay State) or MPIUA (FAIR Plan). This discount does not apply to Use of Other Auto coverage. J. Good Student Discount- Not applicable in Tier V A 5% Good Student Discount applies to all coverage parts when the rated operator is an inexperienced operator, driver classifications17,18,20,21,25, or 26, is a full time high school, college or university student and meets one of the following requirements: Is in the top 20% of his/her class or has been recognized on a Dean s list or honor roll. Has maintained at least a B average in a letter grading system or a 3.0 average in a 4 point system or any equivalent. If the operator is home schooled, evidence of scoring in the top 20% of standardized national exams or a third party certification indicating that the student has met the requirements stated above are acceptable. The company must be presented certification signed by a school official that verifies the operator s academic achievements when the discount is requested and at subsequent renewals in order for the discount to be applied. This discount applies to vehicles as defined under Rule 27. K. Student Away From Home Discount- Not applicable in Tier V A 5% credit will be applied to all coverage parts when the rated operator meets the following criteria: The rated operator is an inexperienced operator, driver classes 17, 18, 20, 21, 25 or

8 The rated operator is student residing at an educational facility over one hundred road miles from the autos place of garaging, The rated operator does not have regular access to any covered vehicle shown on the coverage selection page. Policies with the Student Away From Home Discount will renew without the discount. In order for the discount to be applied, the Named Insured or rated operator must confirm that the rated operator continues to be eligible. The company may require written confirmation. This discount applies to vehicles as defined under Rule 27. L. Continuously Insured Discount A 10% discount will be applied to coverage parts 1, 2, 4 and 5 on a per vehicle basis when the rated operator has been continuously insured without a lapse in coverage during the 12 months preceding the effective date of the policy. A rated operator is considered continuously insured if the operator was the named, listed, or rated insured on an automobile insurance policy for the 12 months preceding the effective date of the policy. For new policies, proof of continuous coverage may be required under certain circumstances when the company is unable to substantiate or verify 12 months of continuous insurance coverage. The discount will automatically be applied at renewal provided the policy was in effect for 12 continuous months. This discount applies to vehicles as defined under Rule 27. M. Good Driver Discount (This is the equivalent to Low Frequency Discount in the MAIP program.) A 10% discount will be applied to coverage parts 1,2, 4 and 5 on a per vehicle basis when the rated operator has no more than 4 merit rating points reported by the Merit Rating Board as provided by Rule 56, Merit rating Plan. This discount applies to vehicles as defined under Rule 27. N. Superior Client Discount- Not applicable in Tier V A 7% premium credit is applied against all coverage parts on a per vehicle basis where a premium is shown on the coverage selections page for that vehicle. In order to be eligible for the credit the vehicle must be: Rated in classes Have Bodily Injury limits, Part 5, equal to or above $250,000 per person. The rated operator must have a merit rating code of 99 (excellent driver discount plus). This discount applies to vehicles as defined under Rule 27. O. Early Issue Client Discount- Not applicable in Tier V A 5% premium credit will be applied against all coverage parts on a per vehicle basis where a premium is shown on the coverage selections page for that vehicle. In order to be eligible for the credit the policy must be: New business to Quincy Mutual Be entered for issuance into Quincy On-Line at least 5 days prior to the effective date or received at Quincy Mutual in paper format at least 5 days prior to the effective date All vehicle types except trailers This discount will be applied to new business for one year only. Rule 20. MODEL YEAR RATING Model Year Defined The model year of an auto is used in rating physical damage coverage on an actual cash value basis. The model year of the auto is the year assigned by the auto manufacturer. The model year of rebuilt or structurally altered autos is determined by the model year of the chassis. 23

9 The rated operator is student residing at an educational facility over one hundred road miles from the autos place of garaging, The rated operator does not have regular access to any covered vehicle shown on the coverage selection page. Policies with the Student Away From Home Discount will renew without the discount. In order for the discount to be applied, the Named Insured or rated operator must confirm that the rated operator continues to be eligible. The company may require written confirmation. This discount applies to vehicles as defined under Rule 27. L. Continuously Insured Discount A 10% discount will be applied to coverage parts 1, 2, 4 and 5 on a per vehicle basis when the rated operator has been continuously insured without a lapse in coverage during the 12 months preceding the effective date of the policy. A rated operator is considered continuously insured if the operator was the named, listed, or rated insured on an automobile insurance policy for the 12 months preceding the effective date of the policy. For new policies, proof of continuous coverage may be required under certain circumstances when the company is unable to substantiate or verify 12 months of continuous insurance coverage. The discount will automatically be applied at renewal provided the policy was in effect for 12 continuous months. This discount applies to vehicles as defined under Rule 27. M. Good Driver Discount (This is the equivalent to Low Frequency Discount in the MAIP program.) A 10% discount will be applied to coverage parts 1,2, 4 and 5 on a per vehicle basis when the rated operator has no more than 4 merit rating points reported by the Merit Rating Board as provided by Rule 56, Merit rating Plan. This discount applies to vehicles as defined under Rule 27. N. Superior Client Discount- Not applicable in Tier V A 7% premium credit is applied against all coverage parts on a per vehicle basis where a premium is shown on the coverage selections page for that vehicle. In order to be eligible for the credit the vehicle must be: Rated in classes Have Bodily Injury limits, Part 5, equal to or above $250,000 per person. The rated operator must have a merit rating code of 99 (excellent driver discount plus). This discount applies to vehicles as defined under Rule 27. O. Early Issue Client Discount- Not applicable in Tier V A 5% premium credit will be applied against all coverage parts on a per vehicle basis where a premium is shown on the coverage selections page for that vehicle. In order to be eligible for the credit the policy must be: New business to Quincy Mutual Be entered for issuance into Quincy On-Line at least 5 days prior to the effective date or received at Quincy Mutual in paper format at least 5 days prior to the effective date All vehicle types except trailers This discount will be applied to new business for one year only. Rule 20. MODEL YEAR RATING Model Year Defined The model year of an auto is used in rating physical damage coverage on an actual cash value basis. The model year of the auto is the year assigned by the auto manufacturer. The model year of rebuilt or structurally altered autos is determined by the model year of the chassis. 23

10 Rule 22. NON-SYMBOLLED VEHICLES AND RATING VEHICLES FOR WHICH SYMBOLS ARE NOT SHOWN ON THE RATE PAGES (Applicable to Model Years 2010 and Prior) A. Non-Symbolled Vehicles 1. For rating of newly announced models of 2010 and prior for which no symbol is shown, use the symbol of the latest corresponding model which is shown until announcement is made. 2. For rating of other 2010 and prior model year vehicles which have no prior corresponding model, determine the appropriate symbol based on the FOB List Price or Purchase Price, whichever is higher, from the following table. Symbol Model Years 1980 & Prior Model Years Model Years & above & above & above 3. Stated or Agreed Amount If an automobile is appraised for stated or agreed amount coverage, the appraised value must be used to determine the symbol. For model years 1980 and prior, with values of $20,001 and above, the auto must be rated on a Stated Amount Basis in accordance with Rule 41. The insurer has the option to waive the requirement of obtaining an appraisal as required under Rule Equipment: Vans and Pick-ups Except with respect to the coverage provided under Rule 47 for custom furnishings or custom equipment, the cost of any equipment installed in or upon a pick-up or van shall be added to the FOB List Price, Purchase Price or Appraisal Value in determining the applicable symbol. B. Rating Vehicles with Symbol 27 *Determine the actual cash value premium for Symbol 27 vehicles by: Increase the factor for Symbol 26 by +.15 for each $10,000 or portion of $10,000 above $80,000 of the FOB List Price or Purchase Price, whichever is higher. 25

11 NOTE: For the first instance of a material misrepresentation in the application for insurance, the lower indicated factor may be used, at the option of the company. Application of Factors A. Single Vehicle Policies Where more than one category applies to the same operator or vehicle, the highest applicable factor shall be used respectively for Collision and Comprehensive. For example, if a listed operator is convicted of vehicular homicide and also has a high-theft vehicle, the factor for both Collision and Comprehensive is 1.5. The factors do not compound. In cases where separate policies are issued by the same insurer to the common owner of two or more vehicles, the highest applicable factors for Collision and Comprehensive shall be assigned to the vehicle with the highest premium for Collision and Comprehensive respectively. For each subsequent vehicle, the next highest applicable factor shall be assigned to the next highest premium for Collision and Comprehensive respectively, etc. If one or more of the extra-risk categories of insurance fraud, auto theft or material misrepresentation apply to such common owner, the applicable factor shall be used for both Collision and Comprehensive for each insured vehicle. B. Multi-Vehicle Policies The highest applicable factors for Collision and Comprehensive shall be assigned to the vehicle with the highest premium for Collision and Comprehensive respectively. Each subsequent vehicle shall be assigned the next highest applicable factor and so forth. If one or more of the extra-risk categories of insurance fraud, auto theft or material misrepresentation apply to the insured owner, the applicable factor shall be used for both Collision and Comprehensive for each insured vehicle. RULE 25. VEHICLE SERIES RATING (Applicable to Model Years 2010 and Prior) Vehicle Series Rating (VSR) is a program applied by the Insurance Services Office (ISO) to adjust the Price New Symbols of vehicles to increase or decrease the symbol due to loss experience reflecting crash damage, ease of repair, cost of repair parts, and theft for the particular vehicle, resulting in the Rating Symbol. The Rating Symbol is used to determine a vehicle s premium for Collision, Limited Collision and Comprehensive coverage. The VSR program reviews the symbol assignments for all vehicle series up to five times: when the model year is introduced and in each of the subsequent annual VSR review years. The symbol for a particular series may be upsymbolled, downsymbolled, or may remain the same. Reassignment of symbols shall be effective with 2006 and subsequent model year vehicles and may only be applied at policy issuance or renewal. A policy shall not be changed mid-term solely due to a change in symbol assignment based on symbol review. RULE 26.1 TIER ASSIGNMENT This rule applies to all vehicle types. A. DeterminingThe Assigned Tier Tier assignment is determined at the policy s inception, at renewal and when a policy is endorsed. Tier assignments are on a policy level but determined by evaluating policy and operator characteristics. To determine the tier begin by identifying the risk characteristics for each policy and rated operator. Apply the characteristics to the tier definition shown below in consecutive order. If a policy or rated operator does not meet the requirement of a tier, continue onto the next tier until a tier has been determined. Tier I. Corresponding Account with Personal Umbrella Liability Endorsement. 1. The Named insured must have a supporting homeowners policy (all policy forms) that is written with Quincy Mutual, The Andover Companies, (Merrimack Mutual, Cambridge Mutual or Bay State) and; 2. Have a Personal Umbrella Liability Endorsement attached to the Homeowners policy and; 3. Have 3 or fewer intent -to- cancel notices in each of the last three years. 27

12 Tier II. Corresponding Account 1. The Named insured must have a supporting homeowners policy (all policy forms) that is written with Quincy Mutual, The Andover Companies, (Merrimack Mutual, Cambridge Mutual or Bay Sate) or MPIUA (Fair Plan) and; 2. Have 3 or fewer intent -to- cancel notices in each of the last three years. Tier III. Renewal Policies-(without a supporting homeowners and or personal umbrella.) Tier IV. 1. Any policy that has been insured with Quincy Mutual for more than one continuous year that does not have a supporting account or supporting account with an umbrella and; 2. Has three or fewer intent -to- cancel notices in each of the last three years. 1. New Business Policy With: a. Continuously Insured Rated Operator or; b. The Multi-Car Discount has been appliedor; 2. Renewal Policy with four or more intent -to- cancel notices in any one of the previous three years. A rated operator has been continuously insured if they have been without a lapse in coverage during the 12 months preceding the effective date of the policy. A rated operator is considered continuously insured if the operator was the named, listed, or rated insured on an automobile insurance policy for the 12 months preceding the effective date of the policy. Tier V. Basic Tier- New Business Policy- All Other *This tier includes any rated operator not otherwise eligible for Tiers I through IV. The basic tier will be made up of new policies that are not supported by a homeowner policy and are single car policies where the rated operator is not continuously insured. B. Tier Rating Factor Apply the appropriate tier factor below to the base premiums as shown on the appropriate rating worksheet from pages RW 1-6 and in accordance with Rule. 11. Premium Determination. The factor applies to all coverage parts on a per vehicle basis for which a premium is shown on the coverage selections page. Tier I Tier II Tier III Tier IV Tier V See Tier V rate pages. RULE 26.2 RISK UNDERWRITING FACTOR- Not applicable in Tier V This rule applies to private passenger vehicles as defined in Rule 27. A Risk Underwriting Factor will be applied to each vehicle based upon an evaluation of policy and operator risk characteristics. The Risk Underwriting Factor is applied to the Base Premiums as shown in Rule 11. Premium Determination Rule. The rating sequence is shown on our Rating worksheet page RW-1. The factor applies to all coverage parts on a per vehicle basis for which a premium is shown on the coverage selections page. The Risk Underwriting Factor is determined at policy inception and will be updated upon renewal and when a policy is endorsed. The Risk Underwriting Factor will be determined based upon the following six criteria: Minimum years licensed of all operators listed on the policy(including deferred and excluded) Years licensed of the assigned operator 28

13 RULE 26.3 DRIVER EXPERIENCE FACTOR- Not applicable in Tier V This rule applies to private passenger vehicles as defined in Rule 27. The Driver Experience Factor is based upon a listed operators date first licensed. The factor will be applied to each vehicle based upon the number of years the assigned operator has been licensed. The number of years licensed will be determined by the number of full years the operator has held a valid United States driver s license as of the effective date of the policy. Information may be obtained from the Massachusetts Registry of Motor Vehicles or any other evidence of prior licensure to determine the number of years licensed. If the date first licensed is not provided by the insured, we will assign the earliest possible date the driver s license could be obtained in the Commonwealth of Massachusetts. The Driver Experience Factor will be updated upon each renewal and on endorsement transactions if the assignment of operators is changed. The factor is applied to the Base Premiums as shown in Rule 11. Premium Determination Rule. The rating sequence is shown on our Rating worksheet page RW-1. The factor applies to all coverage parts on a per vehicle basis for which a premium is shown on the coverage selections page. If the operator has not been insured in the Commonwealth of Massachusetts during the 12 months preceding the application for coverage, and no evidence of licensure is available, we will use the experience factor for <1 year as the starting point for that operator. In the event that an operator s driving privileges have ever been suspended or revoked due to driving related offenses, for a period of three or more years, the years driving experience will be determined by the number of years since the last reinstatement of driving privileges. Foreign driving experience will be accepted if the company is provided with a certified English language translation of the vehicle operator report from the applicable country. Apply the Driver Experience factor as follows: Years of Driving Factor Years of Driving Factor Years of Driving Factor Experience Experience Experience <

14 4. Operator Use Operators will be classified by the amount of use of an insured automobile: Principal Operator a person who has an operator s license and operates the insured automobile more than any other listed operator as determined by the percentage of use of the automobile. Occasional Operator a person who has an operator s license and operates the insured automobile less than the principal operator. C. Classification Changes Classification of each automobile shall be determined by the facts existing as of the effective date of the policy. Premium adjustments shall be made on a pro rata basis if changes occur during the policy period. D. Satisfactory Driver Training Program 1. Completion and receipt of a certificate under the Massachusetts Driver Education Program prescribed by the Registrar of Motor Vehicles, or 2. The presenting of satisfactory evidence (certificate signed by school officials) that such operators have successfully completed a driver education course in a state other than Massachusetts meeting the following standards: a. The course had the official approval of the State Department of Education or other responsible state agency, and was conducted by: (1) a recognized secondary school, college or university, or (2) other school approved and supervised by the State Department of Education or other responsible state agency. b. The course was conducted by instructors certified by the State Department of Education or other responsible state agency. c. The course was composed of a minimum of thirty clock hours for classroom instruction, plus a minimum of twelve clock hours per student in the practice driving phase. RULE 29. RESERVED FOR FUTURE USE RULE 30. PERSONAL INJURY PROTECTION - DEDUCTIBLE FORM The policyholder, at his or her option, may elect an amount to be deducted from the amounts otherwise due each person subject to the deduction, under the following conditions: 1. The option of electing a deductible shall be limited to individual insureds and shall apply only to private passenger vehicles as defined in this Section and motor homes owned by such insureds. 2. The eligible policyholder may select a deductible amount of $100, $250, $500, $1,000, $2,000, $4,000 or $8, The deductible applicable to the Policyholder alone is the only deductible available if the policyholder is the only member of the household, regardless of the number of vehicles which he owns. Lawfully married individuals having joint ownership and registration of a single motor vehicle which is the only vehicle in the household shall be considered to be an individual for purposes of paragraph 4 of this rule. In such a case the same form of deductible must apply to both of the lawfully married individuals. 35

15 4. Either the deductible for the policyholder alone or the policyholder and household members is available to a policyholder who has two or more members in his household and there is one motor vehicle in the household. 5. The deductible applicable to the policyholder and household members is the only deductible available for election if there are two or more members in the household, and also two or more motor vehicles insured for Personal Injury Protection by household members. 6. If two or more vehicles are insured under a single policy, the same deductible election shall apply to all vehicles insured under such a policy. 7. As used in this rule, the term household members means those persons living in the policyholder s household who are related to the policyholder by blood, marriage or adoption. This includes wards or foster children. The Personal Injury Protection premium otherwise applicable shall be reduced by the dollar amount determined by applying the percentage shown on the Part 2 Rate page by Tier to the manual premium. RULE 31. TRANSPORTATION OF FELLOW EMPLOYEES If a private passenger motor vehicle has a seating capacity of not more than eight passengers other than the driver and is used to carry fellow employees, students or others for a consideration, expressed or implied, to or from, or near their place of employment or education, the premium to be charged shall be the otherwise applicable private passenger automobile premium. For vehicles in excess of eight passengers, refer to the rule for van pools in the commercial automobile manual. All policies subject to this rule must contain the endorsement titled Transportation of Fellow Employees, Students or Others, M-0004-S. RULE 32. NON-SYMBOLLED PICK-UPS, VANS AND SIMILAR TYPE VEHICLES OR PICK-UPS, VANS AND SIMILAR TYPE VEHICLES NOT ASSIGNED TO VEHICLE RATING GROUPS A. Non-Symbolled Vehicles Model Years 2010 and Prior Refer to the Miscellaneous Motor Vehicles page by Tier for rating methods and factors. To determine the private passenger symbol group for Parts 7, 8 and 9, refer to Rule 22. Using FOB List or purchase price, whichever is greater, apply the age group factor for the model year and follow ACV rating procedure. B. Vehicles not Assigned to Vehicle Rating Groups Model Years 2011 and Greater To determine the private passenger Vehicle Rating Group for Parts 7, 8 and 9, refer to Rule 21.B. RULE 33. TOWING AND LABOR The Towing and Labor coverage is available for Private Passenger Automobiles and Motorcycles only. Refer to the Statewide Rates Page, Part 11 by Tier for limits and premiums. 36

16 4. Either the deductible for the policyholder alone or the policyholder and household members is available to a policyholder who has two or more members in his household and there is one motor vehicle in the household. 5. The deductible applicable to the policyholder and household members is the only deductible available for election if there are two or more members in the household, and also two or more motor vehicles insured for Personal Injury Protection by household members. 6. If two or more vehicles are insured under a single policy, the same deductible election shall apply to all vehicles insured under such a policy. 7. As used in this rule, the term household members means those persons living in the policyholder s household who are related to the policyholder by blood, marriage or adoption. This includes wards or foster children. The Personal Injury Protection premium otherwise applicable shall be reduced by the dollar amount determined by applying the percentage shown on the Part 2 Rate page by Tier to the manual premium. RULE 31. TRANSPORTATION OF FELLOW EMPLOYEES If a private passenger motor vehicle has a seating capacity of not more than eight passengers other than the driver and is used to carry fellow employees, students or others for a consideration, expressed or implied, to or from, or near their place of employment or education, the premium to be charged shall be the otherwise applicable private passenger automobile premium. For vehicles in excess of eight passengers, refer to the rule for van pools in the commercial automobile manual. All policies subject to this rule must contain the endorsement titled Transportation of Fellow Employees, Students or Others, M-0004-S. RULE 32. NON-SYMBOLLED PICK-UPS, VANS AND SIMILAR TYPE VEHICLES OR PICK-UPS, VANS AND SIMILAR TYPE VEHICLES NOT ASSIGNED TO VEHICLE RATING GROUPS A. Non-Symbolled Vehicles Model Years 2010 and Prior Refer to the Miscellaneous Motor Vehicles page by Tier for rating methods and factors. To determine the private passenger symbol group for Parts 7, 8 and 9, refer to Rule 22. Using FOB List or purchase price, whichever is greater, apply the age group factor for the model year and follow ACV rating procedure. B. Vehicles not Assigned to Vehicle Rating Groups Model Years 2011 and Greater To determine the private passenger Vehicle Rating Group for Parts 7, 8 and 9, refer to Rule 21.B. RULE 33. TOWING AND LABOR The Towing and Labor coverage is available for Private Passenger Automobiles and Motorcycles only. Refer to the Statewide Rates Page, Part 11 by Tier for limits and premiums. 36

17 RULE 37. AUTO LOAN/LEASE COVERAGE 1. Eligibility A policy providing both collision and comprehensive coverage may be extended to provide coverage for the difference between the outstanding indebtedness on a loan/lease agreement on a vehicle, and the actual cash value of the vehicle, subject to the following: a. Auto Loan/Lease Coverage may be provided only to a vehicle that is a private passenger auto, pickup or van; and b. The insured must request the auto loan/lease coverage within 30 days of leasing or financing a vehicle. 2. Rates Charge 6% of both the Collision and Comprehensive Coverage Base Premiums for the auto loan/lease coverage. 3. Endorsement Attach the auto loan/lease coverage endorsement to the policy. Please refer to endorsement QMAL for specific terms and conditions of this endorsement. *This form is only available on policies effective 07/01/09 and greater. RULE 38. MERIT RATING POINTS/ACCIDENT FORGIVENESS ENDORSEMENT The Merit Rating Points/Accident Forgiveness Endorsement provides forgiveness of the additional premium generated by the Merit Rating Points associated with an at-fault accident. This endorsement will forgive the points associated with one at-fault accident per operator during the six year experience period subject to the following eligibility requirements and conditions: A. Underwriting Conditions and Eligibility Requirements: 1. The Merit Rating Points/Accident Forgiveness Endorsement must be purchased before an at-fault accident occurs. The endorsement form must also be attached to the policy. If the form is deleted, the coverage will no longer apply and the appropriate associated merit rating points will be charged. 2. At the time of purchase, at least one operator on the policy must: a. be an experienced operator (licensed at least six years); and b. have a merit rating code of A forgiven accident is still considered a loss for the purpose of applying other applicable company rating provisions or rules and may affect underwriting decisions. 4. Accident forgiveness applies only to private passenger vehicles, pick-ups and vans. It does not apply to motor homes, motorcycles, antique autos and trailers. 5. Moving violations are not eligible for forgiveness. B. Merit Rating Points/Accident Forgiveness Endorsement Conditions: 1. Accident Forgiveness Coverage applies at the time of loss only if the operator involved in the accident is: a. an experienced operator (licensed at least six years) and has a merit rating code of 99; and b. determined by Quincy Mutual to be more than 50% at-fault. 2. The claim payment is at least $500 in excess of any applicable deductible provision. 3. Merit rating points are normally applied to a policy at renewal. This endorsement forgives the additional premium surcharge associated with a single at-fault accident, subject to the terms and conditions of this endorsement, upon the policy renewal after the accident occurs. 4. Merit rating points associated with any additional at-fault accident(s) for any operator after one accident has been forgiven, will be applied to the policy premium. This endorsement does not impact the determination of eligible operators merit rating code under Quincy Mutual s Merit rating plan. C. Premium: The additional premium is $12 per policy per year. Please refer to endorsement QMAF for specific terms and conditions of this endorsement. 38

18 RULE 43. LOW SPEED VEHICLES The term low speed vehicle shall include any 4-wheel motor vehicle that has a seventeen digit Vehicle Identification Number (VIN), has been issued a Certificate of Origin, has a gross vehicle weight rating (GVWR) of less than 3000 pounds, and has a top speed greater than 20 mph but not greater than 25 mph. The motor vehicle must be National Highway Traffic Safety Administration (NHTSA) certified as a Low Speed Vehicle demonstrated by the Certificate of Origin listing the body style as LSV or Low Speed Vehicle or by the Manufacturer s Certification Label posted on the vehicle containing the VIN and indicating the Type of Vehicle as LSV or Low Speed Vehicle. Rates for Low speed vehicles are based on the class 14 rates times a factor for Tiers I-IV and class 10 rates times a factor for Tier V. Refer to the Miscellaneous Rate Pages by Tier for rating methods, factors and applicable discounts. Low speed vehicles shall be eligible for a 20% discount if the vehicle is equipped with a Vehicle Recovery System which falls under Category IV of the Anti-Theft Device Standards and Discounts, as defined in Rule 54. This discount is applicable to Comprehensive coverage or other combinations of specified perils which afford Theft coverage. The merit rating status shall be determined as follows: 1. The merit rating status of operators shall be assigned to low speed vehicles in order of the highest merit rating status, after assignment to other private passenger vehicles on the policy. 2. if only one operator is listed on the policy, the merit rating status assigned to the low speed vehicle will reflect the merit rating status of the operator. 3. if the merit rating status of each listed operator has been used in rating an automobile on the policy, any remaining low speed vehicles shall be assigned the lowest merit rating status of the listed operators. The merit rating adjustment shall be determined using the merit rating factor defined in Rule 56. applicable to Classes 11,12,13 or 14 for Tiers I-IV or Class 10 for Tier V. RULE 44. MOTORCYCLES, MOTORSCOOTERS, MOPEDS AND SIMILAR MOTOR VEHICLES Experienced or inexperienced operator classifications apply to coverage parts 1, 2, 4, 5, 7 and 8. The experienced operator classification is applied when the operator of the motorcycle has been licensed to operate a motorcycle for at least six years. The inexperienced operator class is applied when the operator of the motorcycle has been licensed to operate a motorcycle for less than six years, or holds a motorcycle permit. When an inexperienced operator classification is applied to a motorcycle, the rates for parts 1, 2, 4, 5, 7 and 8 must be multiplied by a factor of The merit rating code assigned to an operator on a private passenger automobile insurance policy, if available, shall also be applied to the motorcycle policy in accordance with the merit rating plan (Rule 56). Operators assigned to motorcycles will also be considered for assignment to automobiles listed on the policy in accordance with Rule 28. If there is more than one operator on a policy, the operators shall be assigned to the motorcycles in the order which produces the highest Combined Premium. The Combined Premium is the sum of the premium for Parts 1, 2, 4, 5, 7, 8 and 9 for the operator s classification, including the 25% discount for operators age 65 and over, and the operator s merit rating code. Any motorcycles remaining after assignment of all operators shall be assigned the classification and merit rating code producing the lowest Combined Premium for the listed operators. If an inexperienced operator is the only listed operator of the motorcycle on the policy, all motorcycles shall be assigned an inexperienced operator classification. Personal Injury Protection coverage for any operator or occupant of a motorcycle is excluded under the policy. The Personal Injury Protection premium in the rate pages must be charged for all motorcycles subject to the Compulsory Law. If Optional Bodily Injury to Others (Part 5) is purchased with guest occupants excluded, Endorsement M-0002-S titled Guest Occupants Exclusion must be issued with the policy. The term Motorcycle shall include any motor vehicle having a seat or saddle for the use of the rider and designed to travel on not more than three wheels in contact with the ground, including any bicycle with a motor or driving wheel attached, except a tractor, a motorized lawnmower, a motor vehicle designed for the carrying of golf clubs and not more than four persons, an industrial three wheel truck, or a motor vehicle on which the operator and passengers ride within an enclosed cab. 41

19 The multi-car discount does not apply to any motorcycle. Motorcycles shall be classified on the basis of cubic centimeter displacement in accordance with the following groups and written at the rate shown on the Rate Sheets. Group A - Cubic Centimeter Engine Displacement of 100 or less. Group B - Cubic Centimeter Engine Displacement of Group C - Cubic Centimeter Engine Displacement of Group D - Cubic Centimeter Engine Displacement over 650 Fire - See rate section by Tier. Theft - See rate section Tier. Comprehensive - See rate section by Tier. Collision - See rate section by Tier. Limited Collision - See rate section by Tier. Substitute Transportation See Miscellaneous Rating Factors page by Tier. Towing and Labor See Miscellaneous Rating Factors page by Tier. Motorcycles subject to the Compulsory Law and classified in accordance with this Rule, shall be eligible for a 25% discount if the experienced operator has attained age 65, or older. The discount applies to all Parts. Motorcycles subject to the Compulsory Law and classified in accordance with this Rule shall be eligible for a 10% discount if the principal operator has completed an approved motorcycle rider training program. The discount applies to Parts 1, 2, 3, 4, 5, 6, 7, 8 and 12. Refer to the Miscellaneous Motor Vehicles Page by Tier for a list of approved sites. Motorcycles subject to the Compulsory Law and classified in accordance with this Rule shall be eligible for a 20% discount if the motorcycle is equipped with a Vehicle Recovery System which falls under Category IV of the Anti-Theft Device Standards and Discounts, as defined in Rule 54. This discount is applicable to Comprehensive coverage or other combinations of specified perils which afford Theft coverage. Coverage for vehicles rated in accordance with this Rule and not subject to the Compulsory Law shall be provided on a Personal Auto Policy without a Personal Injury Protection Endorsement. RULE 45. AGREED AMOUNT COVERAGE - COMPREHENSIVE At the option of the policyholder, Comprehensive (Part 9) coverage may be written to provide that in determining the actual cash value of a motor vehicle to be insured, no deduction shall be made to reduce the value of the vehicle to less than the agreed value in the event of loss. Agreed value means the value of the vehicle as determined by agreement between the insurer and the policyholder. As a condition to this coverage, the insurer shall be permitted to inspect the vehicle at the time of application. The vehicle shall be rated by Tier and in accordance to Rule 11. of this manual and as follows: 1. An appraisal is to be made to establish the current market value of the vehicle. The cost of appraisal shall be borne by the policyholder. 2. a. Model Years 2010 and Prior-Refer to Rule 22 to determine the appraised value symbol group. 42

20 2013 MASSACHUSETTS PRIVATE PASSENGER AUTOMOBILE INSURANCE MANUAL QUINCY MUTUAL FIRE INSURANCE COMPANY Edition Date QUINCY MUTUAL FIRE INSURANCE COMPANY 57 Washington Street Quincy, MA 02169