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Risk Scoring Auto Insurance

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					                                                                       PRIVATE PASSENGER AUTOMOBILE QUOTATIONS
                                     RETURN THIS FORM TO BONITA PERRY OF THE ARIZONA DEPARTMENT OF INSURANCE BY AUGUST 21, 2003.
                                                                (USE RATES IN EFFECT AS OF AUGUST 1, 2003)
                                                                      E-Mail to : bperry@id.state.az.us
COVERAGES & LIMITS FOR HYPOTHETICALS: LIABILITY LIMITS AS SHOWN BELOW; MEDICAL PAYMENTS OF $5,000;
UNINSURED MOTORISTS LIMITS SAME AS LIABILITY; $100 DEDUCTIBLE COMPREHENSIVE; $200 DEDUCTIBLE COLLISION.

                      IF INSURER USES POLICYHOLDER'S CREDIT HISTORY IN PRICING THE RISK, ASSUME HYPOTHETICAL RISK HAS A MEDIAN CREDIT SCORE UNLESS OTHERWISE NOTED.
                                       NOTE: INSURER MUST BE ACTIVELY WRITING NEW PRIVATE PASSENGER AUTOMOBILE BUSINESS.
UNMARRIED MALE, AGE 21; DRIVES 15 MILES EACH WAY TO WORK (30 MILES ROUND-TRIP); CLEAN DRIVING RECORD LAST 3 YEARS; 2003 FORD F150 XLT 4X2 PICKUP, REGULAR CAB, 8 CYLINDER.
               HYPOTHETICAL 1: COMBINED SINGLE LIMITS OF $40,000 OR SPLIT LIMITS OF $15,000/$30,000 BI AND $10,000 PD
               HYPOTHETICAL 2: COMBINED SINGLE LIMITS OF $300,000 OR SPLIT LIMITS OF $100,000/$300,000 BI AND $50,000 PD

MARRIED COUPLE; AGE 48; DRIVES 15 MILES EACH WAY TO WORK (30 MILES ROUND TRIP); CLEAN DRIVING RECORD LAST 3 YEARS; HUSBAND DRIVES 2001 FORD EXPLORER, 4X4, 2 DOOR, SPORT;
WIFE DRIVES 2003 FORD TAURUS LX, 4-DOOR SEDAN, AUTOMATIC.
                 HYPOTHETICAL 3: COMBINED SINGLE LIMITS OF $40,000 OR SPLIT LIMITS OF $15,000/$30,000 BI AND $10,000 PD
                 HYPOTHETICAL 4: COMBINED SINGLE LIMITS OF $300,000 OR SPLIT LIMITS OF $100,000/$300,000 BI AND $50,000 PD

UNMARRIED FEMALE AGE 35; RIDES BUS TO WORK WHERE BUS SERVICE IS AVAILABLE; CLEAN DRIVING RECORD LAST 3 YEARS; PLEASURE USE; 2003 FORD TAURUS LX, 4-DOOR SEDAN, AUTOMATIC.
               HYPOTHETICAL 5: COMBINED SINGLE LIMITS OF $40,000 OR SPLIT LIMITS OF $15,000/$30,000 BI AND $10,000 PD
               HYPOTHETICAL 6: COMBINED SINGLE LIMITS OF $300,000 OR SPLIT LIMITS OF $100,000/$300,000 BI AND $50,000 PD

UNMARRIED FEMALE, AGE 43; DRIVES 15 MILES EACH WAY TO WORK (30 MILES ROUND-TRIP) AND HAS A 16 YEAR OLD SON WHO IS AN OCCASIONAL OPERATOR; BOTH DRIVERS HAVE A CLEAN
DRIVING RECORD. 2003 FORD TAURUS LX, 4-DOOR SEDAN, AUTOMATIC.
                HYPOTHETICAL 7: COMBINED SINGLE LIMITS OF $40,000 OR SPLIT LIMITS OF $15,000/$30,000 BI AND $10,000 PD
                HYPOTHETICAL 8: COMBINED SINGLE LIMITS OF $300,000 OR SPLIT LIMITS OF $100,000/$300,000 BI AND $50,000 PD

MARRIED MALE, AGE 43; DRIVES 15 MILES EACH WAY TO WORK (30 MILES ROUND-TRIP) EXCEPT HAS 1 AT-FAULT ACCIDENT IN 2002;
2003 FORD EXPEDITION XLT, 4X4, FOUR-DOOR, 4.6 LITER, 8 CYLINDER, SPORT UTILITY VEHICLE.
                HYPOTHETICAL 9: COMBINED SINGLE LIMITS OF $40,000 OR SPLIT LIMITS OF $15,000/$30,000 BI AND $10,000 PD
                HYPOTHETICAL 10: COMBINED SINGLE LIMITS OF $300,000 OR SPLIT LIMITS OF $100,000/$300,000 BI AND $50,000 PD

MARRIED COUPLE - MALE AGE 79 AND FEMALE AGE 78 - PLEASURE USE; BOTH DRIVERS HAVE A CLEAN DRIVING RECORD AND NO CREDIT HISTORY; 2003 FORD TAURUS LX, 4-DOOR SEDAN, AUTOMATIC.
                HYPOTHETICAL 11: COMBINED SINGLE LIMITS OF $40,000 OR SPLIT LIMITS OF $15,000/$30,000 BI AND $10,000 PD
                HYPOTHETICAL 12: COMBINED SINGLE LIMITS OF $300,000 OR SPLIT LIMITS OF $100,000/$300,000 BI AND $50,000 PD

IN PREPARING THE QUOTATIONS, DO NOT APPLY ANY CREDITS OR DISCOUNTS THAT CANNOT BE DETERMINED BASED SOLELY ON THE HYPOTHETICAL INFORMATION PROVIDED.
                                              PLEASE USE 6 MONTH PREMIUMS ROUNDED TO THE NEAREST DOLLAR.
                                                         URBAN                                                                             RURAL
                      PHOENIX,      SCOTTSDALE,          MESA,         GLENDALE,         TUCSON,        CASA GRANDE,       FLAGSTAFF,        NOGALES,           SAFFORD,            YUMA,
 HYPOTHETICAL           AZ              AZ                AZ              AZ                AZ               AZ                AZ                AZ                AZ                AZ
                       85022           85257             85202           85301             85719            85222             86001            85621              85546             85364

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                                                                      ATTACH ALL RATING WORKSHEETS.
1. Does this insurer write limits higher than $15,000/30,000/10,000?                                YES       _________              NO         _________
2. Number of Arizona policyholders within your insurer group written at $15,000/30,000/10,000 AS OF 12/31/02:                                 ___________________
3. Name of insurer in which premiums were quoted:
4. Number of insurer's in force Arizona auto policies as of 12/31/02:                                                          ___________________________
5. Does insurer use an applicant's or policyholder's credit history in deciding to write the risk? Yes        _________               NO        _________       Price the risk? Yes _________     NO _________
6. If insurer uses credit scoring, what is insurer's median credit score?
7. What was insurer's 2002 private passenger automobile incurred loss ratio in Arizona? _____________ %
Completed by:         ________________________________________   Title:      __________________________________________________                 Telephone #     _______________________________
Fax #:                ______________________________                 E-mail address:           _______________________________
Telephone number to be used by Arizona public for quotations:                                  _______________________________
Insurer’s Web Site Address:             _____________________________________________________

				
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