PERSONAL INJURY PROTECTION ENDORSEMENT - FLORIDA We agree, subject to all the provisions of this endorsement and to all of the provisions of the policy except as modified herein, to provide Personal Injury Protection coverage as follows: SECTION I COVERAGE Q - PERSONAL INJURY PROTECTION INSURING AGREEMENT We will pay, in accordance with the Florida Motor Vehicle No-Fault Law, as amended, to or for the benefit of the injured person: (a) if an "insured" receives initial services and care within 14 days after the "motor vehicle" accident, 80 of "medical expenses", and (b) 60

of "work loss", and

(c) "replacement services expenses", and (d) death benefits, incurred as a result of "bodily injury" caused by an accident arising out of the ownership, maintenance or use of a "motor vehicle" and sustained by an "insured". "Medical expenses" shall only be reimbursed for: (a) Initial services and care that are: (1) Lawfully provided, supervised, ordered, or prescribed by a physician licensed under Florida Statutes, chapter 458 or 459, dentist licensed under Florida Statutes, chapter 466, or chiropractic physician licensed under Florida Statutes, chapter 460; or (2) Provided in a hospital or in a facility that owns, or is wholly owned by, a hospital; or (3) Provided by a person or entity licensed under part III of Florida Statutes, chapter 401 to provide emergency transportation and treatment;

dent, if provided, supervised, ordered or prescribed by a physician licensed under Florida statutes, chapter 458 or chapter 459, a chiropractic physician licensed under Florida Statutes, chapter 460, a dentist licensed under Florida Statutes, chapter 466, or, to the extent permitted by applicable law and under the supervision of such physician, osteopathic physician, chiropractic physician, or dentist, by a physician assistant licensed under chapter 458 or chapter 459 or an advanced registered nurse practitioner licensed under chapter 464. Follow up services and care may also be provided by any of the following persons or entities: (1) A hospital or ambulatory surgical center licensed under chapter 395. (2) An entity wholly owned by one or more physicians licensed under chapter 458 or chapter 459, chiropractic physicians licensed under chapter 460, or dentists licensed under chapter 466 or by such practitioners and the spouse, parent, child, or sibling of such practitioners. (3) An entity that owns or is wholly owned, directly or indirectly, by a hospital or hospitals. (4) A physical therapist licensed under chapter 486, based upon a referral by a provider described in subparagraph (b). (5) A health care clinic licensed under part X of chapter 400 which is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the American Osteopathic Association, the Commission on Accreditation of Rehabilitation Facilities, or the Accreditation Association for Ambulatory Health Care, Inc., or

as authorized by the Florida Motor Vehicle No-Fault Law.

(I) Has a medical director licensed under chapter 458, chapter 459, or chapter 460;

(b) Follow-up services and care referred by a licensed health care provider described in Paragraphs a.(1), (2) and (3) above consistent with the underlying medical diagnosis rendered within 14 days after the "motor vehicle" acci-

(II) Has been continuously licensed for more than 3 years or is a publicly traded corporation that issues securities traded on an exchange registered with the United States Securities and

PL-6798 Rev. 08-13

Page 1 of 8

Endorsement Symbol Number A09027

Exchange Commission as a national securities exchange; and (III)Provides at least four of the following medical specialties: a. General medicine;

DEFINITIONS When used in reference to this Section: "bodily injury" means bodily injury, sickness or disease, including death at any time resulting there from. “insured” as used in this endorsement means:

b. Radiography;

1. The “named insured” or any “family member” while:

c. Orthopedic medicine;

a. “Occupying” a “motor vehicle”; or

d. Physical medicine;

b. A “pedestrian” struck by a “motor vehicle”.

e. Physical therapy; f.

Physical rehabilitation;

2. Any other person while:

g. Prescribing or dispensing outpatient prescription medication; or

a. “Occupying” “your covered auto”; or

h. Laboratory services;

b. A “pedestrian” struck by “your covered auto”.

as authorized by the Florida Motor Vehicle No-Fault Law.

"your covered auto" as used in this endorsement means:

EXCLUSIONS This coverage does not apply:

1. Any vehicle shown in the Declarations; 2. Any of the following types of vehicles on the date you become the owner:

(a) to you or any "family member" while "occupying" a "motor vehicle" of which you are the owner and which is not "your covered auto";

a. A private passenger auto; or b. A pickup or van.

(b) to any person while operating "your covered auto" without your express or implied consent;

This subparagraph 2. applies only if: a. you acquire the vehicle during the policy period; and

(c) to any person, if such person's conduct contributed to his or her "bodily injury" under any of the following circumstances:

b. if the vehicle you acquire is in addition to any vehicle shown in the Declarations, you ask us to insure it within 30 days after you become the owner; and

(i) causing "bodily injury" to that person intentionally; or (ii) while committing a felony;

c. with respect to a pickup or van, no other insurance policy provides coverage for that vehicle.

(d) to any "pedestrian", other than you or any "family member", not a legal resident of the State of Florida;

3. Any "motor vehicle" you do not own while used as a temporary substitute for any other vehicle as described in this definition which is out of normal use because of its

(e) to any person, other than you, if such person is the owner of a "motor vehicle" with respect to which security is required under the Florida Motor Vehicle No-Fault Law, as amended;

a. Breakdown;

(f) to any person, other than you or any "family member", who is entitled to personal injury protection benefits from the owner of a "motor vehicle" which is not "your covered auto" or from the owner's insurer; (g) to any person who sustains "bodily injury" while "occupying" a "motor vehicle" located for use as a residence or premises. PL-6798 Rev. 08-13

b. Repair; c. Servicing; d. Loss; or e. Destruction. "medical expenses" means reasonable expenses for "medically necessary" medical, surgical, X-ray, dental,

Page 2 of 8

Endorsement Symbol Number A09027

and rehabilitative services, including prosthetic devices, and medically necessary ambulance, hospital, and nursing services. However, "medical expenses" do not include massage or acupuncture regardless of the person, entity, or licensee providing the massage or acupuncture. A licensed massage therapist or licensed acupuncturist will not be reimbursed for any "medical expenses". This is subject to the limitations in the Use of Medical Fee Schedule for Personal Injury Protection Claims section below. "emergency medical condition" means a medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following: (a) Serious jeopardy to "insured's" health; (b) Serious impairment to bodily functions; or (c) Serious dysfunction of any bodily organ or part. "medically necessary" means a medical service or supply that a prudent physician would provide for the purpose of preventing, diagnosing, or treating an illness, injury, disease, or symptom in a manner that is: (a) in accordance with generally accepted standards of medical practice; (b) clinically appropriate in terms of type, frequency, extent, site, and duration; and

transit, other than public school transportation, and designed to transport more than five passengers exclusive of the operator of the motor vehicle and which is owned by a municipality, a transit authority, or a political subdivision of the state. "named insured" as used in this endorsement means the person(s) named in the Declarations of the policy in the section marked Named Insured and the spouse if a resident of the same household. "occupying" means in or upon or entering into, getting out of, or alighting from. "pedestrian" means a person while not an occupant of any self-propelled vehicle. "replacement services expenses" means, with respect to the period of disability of the injured person, all expenses reasonably incurred in obtaining from others ordinary and necessary services in lieu of those that, but for such injury, the injured person would have performed without income for the benefit of his or her household. "work loss" means, with respect to the period of disability of the injured person, any loss of income and earning capacity from inability to work proximately caused by the injury sustained by the injured person. However, "work loss" does not include any loss after the death of an injured person. LIMIT OF LIABILITY

(c) not primarily for the convenience of the patient, physician, or other health care provider. "motor vehicle" means any self-propelled vehicle with four or more wheels which is of a type both designed and required to be licensed for use on the highways of Florida and any trailer or semi-trailer designed for use with such vehicle and includes: (a) A "private passenger motor vehicle," which is any motor vehicle which is a sedan, station wagon, or jeep-type vehicle and, if not used primarily for occupational, professional, or business purposes, a motor vehicle of the pickup, panel, van, camper, or motor home type.

Regardless of the number of persons insured, policies or bonds applicable, vehicles involved or claims made, the total aggregate limit of personal injury protection benefits available under the Florida Motor Vehicle NoFault Law, as amended, from all sources combined, including this coverage, for all loss and expense incurred by or on behalf of any one person who sustains "bodily injury" as the result of any one accident shall be:

(b) A "commercial motor vehicle," which is any motor vehicle which is not a private passenger motor vehicle. The term "motor vehicle" does not include a mobile home or any motor vehicle which is used in mass

PL-6798 Rev. 08-13

Page 3 of 8

(a) Up to $10,000. for "medical expenses", only if a physician licensed under Florida Statutes chapter 458 or 459, dentist licensed under Florida Statutes chapter 466, physician assistant licensed under Florida Statutes chapter 458 or 459 or advanced registered nurse practitioner licensed under Florida Statutes 464, has determined that the "insured" had an "emergency medical condition"; or (b) Up to $2,500 for "medical expenses", only if: (1) Initial care and services are: Endorsement Symbol Number A09027

a. Lawfully provided, supervised, ordered, or prescribed by a physician licensed under Florida Statutes, chapter 458 or 459, dentist licensed under Florida Statutes, chapter 466, or chiropractic physician licensed under Florida Statutes, chapter 460; or b. Provided in a hospital or in a facility that owns, or is wholly owned by, a hospital; or c. Provided by a person or entity licensed under part III of Florida Statutes, chapter 401 to provide emergency transportation and treatment; as authorized by the Florida Motor Vehicle No-Fault Law. (2) Follow-up services and care referred by a licensed health care provider described in Paragraphs (1) a., b. and c. above consistent with the underlying medical diagnosis rendered within 14 days after the "motor vehicle" accident, if provided, supervised, ordered or prescribed by a physician licensed under Florida statutes, chapter 458 or chapter 459, a chiropractic physician licensed under Florida Statutes, chapter 460, a dentist licensed under Florida Statutes, chapter 466, or, to the extent permitted by applicable law and under the supervision of such physician, osteopathic physician, chiropractic physician, or dentist, by a physician assistant licensed under chapter 458 or chapter 459 or an advanced registered nurse practitioner licensed under chapter 464. Follow up services and care may also be provided by any of the following persons or entities: a. A hospital or ambulatory surgical center licensed under chapter 395. b. An entity wholly owned by one or more physicians licensed under chapter 458 or chapter 459, chiropractic physicians licensed under chapter 460, or dentists licensed under chapter 466 or by such practitioners and the spouse, parent, child, or sibling of such practitioners.

PL-6798 Rev. 08-13

Page 4 of 8

c. An entity that owns or is wholly owned, directly or indirectly, by a hospital or hospitals. d. A physical therapist licensed under chapter 486, based upon a referral by a provider described in subparagraph (2). e. A health care clinic licensed under part X of chapter 400 which is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the American Osteopathic Association, the Commission on Accreditation of Rehabilitation Facilities, or the Accreditation Association for Ambulatory Health Care, Inc., or 1. Has a medical director licensed under chapter 458, chapter 459, or chapter 460; 2. Has been continuously licensed for more than 3 years or is a publicly traded corporation that issues securities traded on an exchange registered with the United States Securities and Exchange Commission as a national securities exchange; and 3. Provides at least four of the following medical specialties: A. General medicine; B. Radiography; C. Orthopedic medicine; D. Physical medicine; E. Physical therapy; F. Physical rehabilitation; G. Prescribing or dispensing outpatient prescription medication; or H. Laboratory services; as authorized by the Florida Motor Vehicle No-Fault Law has determined that the "insured" did not have an "emergency medical condition"; and Endorsement Symbol Number A09027

(c) $5000 death benefits per each "insured".

(2) Medicare Part B, in the case of services, supplies, and care provided by ambulatory surgical centers and clinical laboratories.

The total limit available for "medical expenses", "work loss" and "replacement services expenses" is $10,000.

(3) The Durable Medical Equipment Prosthetics/Orthotics and Supplies fee schedule of Medicare Part B, in the case of durable medical equipment.

Any amount payable under this coverage shall be reduced by the amount of benefits an injured person has recovered or is entitled to recover for the same elements of loss under the workmen's compensation laws of any state or the federal government.

We may use the Medicare coding policies and payment methodologies for the Federal Centers for Medicare and Medicaid Services to determine the appropriate amount of reimbursement for medical services, supplies or care.

Use of Medical Fee Schedule for Personal Injury Protection Claims: We will limit reimbursement of medical expenses to 80 percent of a properly billed reasonable charge, but in no event will we pay more than 80 percent of the following schedule of maximum charges:

However, if such services, supplies, or care is not reimbursable under Medicare Part B, as provided in section (f) above, we will limit reimbursement to 80 percent of the maximum reimbursable allowance under workers’ compensation, as determined under s.440.13, Florida Statutes, and rules adopted there under which are in effect at the time such services, supplies, or care is provided. Services, supplies, or care that is not reimbursable under Medicare or workers’ compensation will not be reimbursed by us.

(a) For emergency transport and treatment by providers licensed under Chapter 401, Florida Statutes, 200 percent of Medicare. (b) For emergency services and care provided by a hospital licensed under Chapter 395, Florida Statutes, 75 percent of the hospital’s usual and customary charges. (c) For emergency services and care as defined by s. 395.002, Florida Statutes, provided in a facility licensed under Chapter 395, Florida Statutes, rendered by a physician or dentist, and related hospital inpatient services rendered by a physician or dentist, the usual and customary charges in the community. (d) For hospital inpatient services, other than emergency services and care, 200 percent of the Medicare Part A prospective payment applicable to the specific hospital providing the inpatient services. (e) For hospital outpatient services, other than emergency services and care, 200 percent of the Medicare Part A Ambulatory Payment Classification for the specific hospital providing the outpatient services. (f) For all other medical services, supplies, and care, 200 percent of the allowable amount under: (1) the participating physicians fee schedule of Medicare Part B, except as provided in sections (2) and (3) below.

PL-6798 Rev. 08-13

For purposes of the above, the applicable fee schedule or payment limitation under Medicare is the fee schedule or payment limitation in effect on March 1 of the year in which the services, supplies, or care is rendered and for the area in which such services, supplies, or care is rendered, and the applicable fee schedule or payment limitation applies throughout the remainder of that year, notwithstanding any subsequent change made to the fee schedule or payment limitation, except that it will not be less than the allowable amount under the applicable schedule of Medicare Part B for 2007 for medical services, supplies, and care subject to Medicare Part B. APPLICATION OF DEDUCTIBLE If one of the following deductible options is shown on the Declarations as applicable to this coverage, the deductible amount must be applied to 100 percent of the "medical expenses", "work loss" and "replacement services expenses" incurred by each "named insured" and, if elected, each dependent "family member". After the deductible is met, each "named insured" and, if elected, each dependent "family member" is eligible to receive up to $10,000 in total benefits. The deductible indicated below shall not apply to death benefits.

Page 5 of 8

Endorsement Symbol Number A09027

SCHEDULE OF DEDUCTIBLE OPTIONS Deductible Option A B C E F G

Deductible Amount $ 250 500 1,000 250 500 1,000

Deductible Amount Applicable To each "named insured" and each dependent "family member" each "named insured" and each dependent "family member" each "named insured" and each dependent "family member" each "named insured" each "named insured" each "named insured"

PRO-RATA APPLICATION

1. Duties After An Accident Or Loss

If benefits have been received under the Florida Motor Vehicle No-Fault Law, as amended, from any insurer for the same items of loss and expense for which benefits are available under this coverage, we shall not be liable to make duplicate payments to or for the benefit of the injured person, but the insurer paying such benefits shall be entitled to recover from us its equitable pro-rata share of the benefits paid and expenses incurred in processing the claim. If we make payments under this coverage and benefits are available under the Florida Motor Vehicle No-Fault Law, as amended, from any insurer for the same items of loss and expense, we shall be entitled to recover from such other insurer our equitable pro-rata share of the benefits paid and expenses incurred in processing the claim. POLICY PERIOD, TERRITORY This coverage applies only to accidents which occur during the policy period:

(1) In the event of an accident, provide prompt written notice of loss to us or our authorized agent. (2) Promptly forward to us a copy of the: a. Summons and complaint; or b. Other process; served in connection with any legal action that person takes against a third party to recover damages for "bodily injury". (3) Promptly give us written proof of claim, under oath if required. Such proof shall include: a. Full details of the nature and extent of the injuries and treatment received and contemplated; and

(a) in the State of Florida; or (b) as respects you or a "family member", while "occupying" "your covered auto" outside the State of Florida but within the United States of America, its territories or possessions or Canada, or (c) as respects you, while "occupying" a "motor vehicle" of which a "family member" is the owner and for which security is maintained under the Florida Motor Vehicle No-Fault Law, as amended, outside the State of Florida but within the United States of America, its territories or possessions or Canada. CONDITIONS The conditions below apply in addition to those in the policy that apply to all coverages. In the event of conflict, the conditions below control over those in the policy. PL-6798 Rev. 08-13

(a) A person seeking Personal Injury Protection Coverage must:

Page 6 of 8

b. Any other information which may assist us in determining the amount due and payable. (4) Submit to examination under oath. The scope of questioning during the examination under oath is limited to relevant information or information that could reasonably be expected to lead to relevant information. Compliance with the provisions of Paragraphs (a)(1), (2), (3) and (4) above is a condition precedent to receiving benefits. (b) A person seeking Personal Injury Protection Coverage must also submit as often as we reasonably require to mental or physical exams. We will: Endorsement Symbol Number A09027

(1) Pay for these exams; and

the contrary, if you rent a vehicle under a rental or lease agreement satisfying the requirements of Florida Statute 627.7263, as amended, and naming this policy as the primary policy, these coverages shall be applied as if that rented or leased vehicle were "your covered auto".

(2) Forward a copy of the medical report to that person if requested. If that person unreasonably refuses to submit to, or fails to appear at, an exam, we will not be liable for subsequent personal injury protection benefits. A person's refusal to submit to or failure to appear at two exams raises a rebuttable presumption that such person's refusal or failure was unreasonable. 2. Action Against Us. No action may be brought against us unless there has been full compliance with all terms of this coverage and any statute providing a condition precedent to filing such an action. No legal action may be brought against us until 30 days after the required notice of accident and reasonable proof of claim has been filed with us. 3. Whenever a person making claims is charged with committing a felony, we shall withhold benefits until at the trial level the prosecution makes a formal entry on the record that it will not prosecute the case against the person, the charge is dismissed or the person is acquitted. In order to withhold benefits, the commission of a felony by an "insured" must be causally connected to the "insured’s" claim for personal injury protection benefits. 4. Reimbursement and Subrogation. In the event of payment to or for the benefit of any injured person under this endorsement: (a) we shall be entitled to reimbursement to the extent of the payment of personal injury protection benefits from the owner or insurer of the owner of a commercial motor vehicle, as defined in the Florida Motor Vehicle No-Fault Law, if such injured person sustained the injury while "occupying" or while a "pedestrian" through being struck by, such commercial motor vehicle. This does not apply to owners or registrants identified as taxi-cabs as defined in Florida Statute 627.733(1)(b). (b) It is understood that the GENERAL PROVISION regarding OUR RIGHT TO RECOVER PAYMENT specifically applies to these coverages to the fullest extent allowed by law. 5. Special Provision for Rented or Leased Vehicles. Notwithstanding any provision of this coverage to PL-6798 Rev. 08-13

6. If we pay only a portion of a claim or reject a claim due to an alleged error in the claim, we, at the time of the partial payment or rejection, shall provide an itemized specification or explanation of benefits due to the specified error. Upon receiving the specification or explanation, the person making the claim, at the person’s option and without waiving any other legal remedy for payment, has 15 days to submit a revised claim, which shall be considered a timely submission of written notice of a claim. 7. Fraud. If we have a reasonable belief that a fraudulent insurance act has been committed, we shall notify the claimant, in writing, within 30 days after submission of the claim that the claim is being investigated for suspected fraud. Beginning at the end of the initial 30-day period, we have an additional 60 days to conduct our own fraud investigation. We must deny the claim or pay the claim with simple interest no later than 90 days after the submission of the claim. Interest shall be assessed from the day the claim was submitted until the day the claim is paid. All claims denied for suspected fraudulent acts shall be reported to the Division of Insurance Fraud. Any insurance fraud voids all Personal Injury Protection Coverage arising from the claim with respect to the "insured" who committed the fraud. Any benefits paid before the discovery of the fraud are recoverable from that "insured". 8. We shall create and maintain for each "insured" a log of personal injury protection benefits paid by us on behalf of the "insured". If litigation is commenced, we shall provide to the "insured" a copy of the log within 30 days after receiving a request for the log from the "insured". 9. In a dispute between the "insured" and us, or between an assignee of the "insured’s" rights and us, upon request, we must notify the "insured" or the assignee that the policy limits under this section have been reached within 15 days after the limits have been reached.

Page 7 of 8

Endorsement Symbol Number A09027

SECTION II COVERAGE Q1 - PERSONAL INJURY PROTECTION EXCLUSION OF WORK LOSS BENEFIT If Coverage Q1 is shown on the Declarations, the provisions of Section I - Coverage Q apply except coverage for "work loss" does not apply to each "named insured" and each dependent "family member". SECTION III COVERAGE Q2 - PERSONAL INJURY PROTECTION EXCLUSION OF WORK LOSS BENEFIT If Coverage Q2 is shown on the Declarations, the provisions of Section I - Coverage Q apply except coverage for "work loss" does not apply to each "named insured". SECTION IV EXTENDED PERSONAL INJURY PROTECTION (Option R1 and R2) If an Extended Personal Injury Protection coverage option (R1 and R2) is shown on the Declarations, the Personal Injury Protection provided under Section I of this endorsement is amended as follows for benefits to you and each "family member": 1. If Option R1 is shown, the first paragraph of Section I is amended by replacing the term "80 of" in item (a) with the term "100 of". 2. If Option R2 is shown, the first paragraph of Section I is amended by replacing the term "80 of" in item (a) with the term "100 of" and replacing the term "60 of" in item (b) with the term "80 of". 3. If either Option R1 or R2 is shown on the Declarations, the first sentence under Use of Medical Fee Schedule for Personal Injury Protection Claims in Section I is amended by replacing "We will limit reimbursement of medical expenses to 80 percent of a properly billed reasonable charge" with "We will limit reimbursement of "medical expenses" to 100 percent of a properly billed reasonable charge".

PL-6798 Rev. 08-13

This Section is subject to all the terms and provisions of Section I. SECTION V MODIFICATION OF POLICY COVERAGES Any automobile medical payments insurance or any uninsured motorists coverage afforded by the policy shall be excess over any personal injury protection benefits paid or payable or which would be available but for the application of a deductible. Regardless of whether the full amount of personal injury protection benefits have been exhausted, any medical payments insurance afforded by this policy shall pay the portion of any claim for personal injury protection medical expenses which are otherwise covered but not payable due to the limitation of 80 "medical expenses" contained in Section I but shall not be payable for the amount of the deductible selected. SECTION VI PROVISIONAL PREMIUM It is agreed that in the event of any change in the rules, rates, rating plan, premiums or minimum premiums applicable to the insurance afforded, because of an adverse judicial finding as to the constitutionality of any provisions of the Florida Motor Vehicle No-Fault Law, as amended, providing for the exemption of persons from tort liability, the premium stated in the declarations for any Liability, Medical Payments and Uninsured Motorists insurance shall be deemed provisional and subject to recomputation. If this policy is a renewal policy, such recomputation shall also include a determination of the amount of any return premium previously credited or refunded to the "named insured" pursuant to the Florida Motor Vehicle No-Fault Law, as amended, with respect to insurance afforded under a previous policy. If the final premium thus recomputed exceeds the premium stated in the Declarations the "named insured" shall pay to us the excess as well as the amount of any return premium previously credited or refunded. All other provisions of this policy apply.

Page 8 of 8

Endorsement Symbol Number A09027