KnightBrook - Rental Supplemental Liability Insurance PDF

SERFF Tracking #: PERR-128641539 State Tracking #: 12-6599 Company Tracking #: KBIC-CA-SLI-12-08
State: California Filing Company: KnightBrook Insurance Company

TOI/Sub-TOI: 20.0 Commercial Auto/20.0003 Other
Product Name: Auto Rental Excess Liability
Project Name/Number: KBIC-CA-SLI-12-08/KBIC-CA-SLI-12-08
Filing at a Glance
Company: KnightBrook Insurance Company
State: California
TOI: 20.0 Commercial Auto
Sub-TOI: 20.0003 Other
Filing Type: New Program
Date Submitted: 08/15/2012
SERFF Tr Num: PERR-128641539
SERFF Status: Closed-Approved
State Tr Num: 12-6599
State Status: Approved
Co Tr Num: KBIC-CA-SLI-12-08
Effective Date On Approval

Requested (New):
Effective Date On Approval
Requested (Renewal):
Author(s): Neresa Torres, Olga E. Garcia
Reviewer(s): Kari Davis (primary), Geff Greenfield
Disposition Date: 10/17/2012
Disposition Status: Approved
Effective Date (New): 10/17/2012
Effective Date (Renewal): 10/17/2012
PDF Pipeline for SERFF Tracking Number PERR-128641539 Generated 07/05/2017 12:22 PM

General Information
Project Name: KBIC-CA-SLI-12-08 Status of Filing in Domicile: Not Filed
Project Number: KBIC-CA-SLI-12-08 Domicile Status Comments:
Reference Organization: N/A Reference Number: N/A
Reference Title: N/A Advisory Org. Circular: N/A
Filing Status Changed: 10/17/2012
State Status Changed: 10/17/2012 Deemer Date: 10/30/2012
Created By: Neresa Torres Submitted By: Olga E. Garcia
Corresponding Filing Tracking Number: N/A
Filing Description:
On behalf of KnightBrook Insurance Company (“the Company”), we are submitting this filing to introduce a new Auto Rental
Excess Liability Program.
The Auto Rental Excess Liability Program will be marketed to commercial automobile rental companies. Under this program,
Supplemental Liability Insurance (SLI) is offered at the rental counter, to customers of the insured. This coverage provides
supplemental bodily injury and property damage liability coverage for rented vehicles above the minimum financial
responsibility limits to the selected combined single limit with an hourly rate component for hourly rentals.
As this is a new program for KnightBrook Insurance Company, and the Company does not have its own experience off of
which to base its rates, this program is based on that of Empire Fire and Marine Insurance Company approved under State
Tracking number 11-7983.
This program was previously filed under State Tracking Number 12-4799, but was rejected at intake due to the failure to
provide the Countrywide direct earned premium for lines of business subject to Proposition 103 by the due date for the
response. Please note that this information is now included on page 13 of this application.
Included with this filing is authorization for Perr & Knight to submit this filing on behalf of the Company. All correspondence
related to this filing should be directed to Perr & Knight. The Company has prepared the materials contained in this filing. If
there are any requests for additional information related to materials prepared by the Company, we will forward the request
immediately to the Company’s contact. We will submit the Company’s response to your attention as soon as we receive it.
We request either your acknowledgement or approval of this filing with an effective date for new and renewal business at the
earliest possible date allowed under your state filing laws.
Company and Contact

Filing Contact Information
Neresa Torres, State Filing Analyst III ntorres@perrknight.com
401 Wilshire Blvd. 310-889-0950 [Phone]
Suite 300
Santa Monica, CA 90401

Filing Company Information

(This filing was made by a third party - perrandknightactuaryconsultants)
KnightBrook Insurance Company CoCode: 13722 State of Domicile: Delaware
Brandywine Village Group Code: 1316 Company Type: Property
1807 North Market Street Group Name: KnightBrook Casualty
Wilmigton, DE 19802-4810 Insurance Grp State ID Number:
(323) 692-8437 ext. [Phone] FEIN Number: 51-0098159
Filing Fees
Fee Required? No
Retaliatory? No
Fee Explanation:
State Specific
Variance Requested? (Yes/No): No

Correspondence Summary
Dispositions
Status Created By Created On Date Submitted
Approved Kari Davis 10/17/2012 10/17/2012
Objection Letters and Response Letters

Objection Letters Response Letters
Status Created By Created On Date Submitted Responded By Created On Date Submitted
Pending Kari Davis 09/20/2012 09/20/2012 Neresa Torres 09/26/2012 09/26/2012
company
response
company
response
company
response

Disposition
Disposition Date: 10/17/2012
Effective Date (New): 10/17/2012
Effective Date (Renewal): 10/17/2012
Status: Approved
Comment: Only the changes specifically indicated in the application set forth above, as it may have been amended, are approved. Nothing in this letter shall constitute
approval of any other application, whether incorporated by reference, or filed prior or subsequent to the application set forth above. The insurer shall begin issuing
policies pursuant to this approval within 90 days of the date of this approval, provided that the insurer is licensed in California to transact the line of insurance for which
the approval is given. The insurer may implement this approval earlier if it is able to do so. Regardless of the implementation date, the insurer shall implement this
approval with the same effective date for both new and renewal business and shall offer this product to all eligible applicants as of the implementation date. This
approval shall continue to have full force and effect until such time as a subsequent change for the referenced lines or programs may be approved or ordered by the
Insurance Commissioner.
If any portion of the application or related documentation conflicts with California law, that portion is specifically not approved. This approval does not constitute an
approval of underwriting guidelines nor the specific language, coverages, terms, covenants and conditions contained in any forms, or the forms themselves. Policy
forms and underwriting guidelines included in this filing were reviewed only insofar as they relate to rates contained in this filing or currently on file with the California
Department of Insurance. Any subsequent changes to underwriting guidelines or coverage, terms, covenants and conditions contained in any forms must be submitted
with supporting documentation where those changes result in any rating impact. The Commissioner may at any time take any action allowed by law if he determines
that any underwriting guidelines, forms or procedures for application of rates, or any other portions of the application conflict with any applicable laws or regulations.
Overall % Overall % Written Premium Number of Policy Written Maximum % Minimum %

Company Indicated Rate Change for Holders Affected Premium for Change Change
Name: Change: Impact: this Program: for this Program: this Program: (where req'd): (where req'd):
KnightBrook Insurance 0.000% 0.000% $0 0 $0 0.000% 0.000%
Company
Schedule Schedule Item Schedule Item Status Public Access

Supporting Document (revised) Prior Approval Rate Application Yes
Supporting Document Prior Approval Rate Application Yes
Supporting Document Prior Approval Rate Application Yes
Supporting Document Exhibit 17 Yes
Supporting Document Letter of Authorization Yes

Schedule Schedule Item Schedule Item Status Public Access

Form Declaration Page Yes
Form Automobile Rental Liability Excess Policy (Rental Car Yes
Companies Only)
Form Rental Car Company Endorsement Yes
Form California Amendatory Endorsement Yes
Form Nuclear Energy Liability Exclusion Endorsement Yes
Form Declarations and Summary of Coverage (Renter's Yes
Disclosure)
Form Supplemental Liability Insurance Application Yes
Rate Underwriting Guidelines Yes
Rate Manual Yes

Objection Letter
Objection Letter Status Pending company response
Objection Letter Date 09/20/2012
Submitted Date 09/20/2012
Respond By Date 09/26/2012
Dear Neresa Torres,
Introduction:
1. Are you buying or taking over a current program or book of business in this filing?
2. How long has this program been written in other states?
Thank you.
Conclusion:
Sincerely,
Kari Davis

Objection Letter
Dear Neresa Torres,
Introduction:
I cannot currently approve this filing because it is out of range. The template currently has a change at max of -18.13% and a
change at min of -43.48%. In order for this filing to be approved, 0.0% must be within this range. Please revise the template so that it
is within range and resubmit the new template to me.
Thank you.
Conclusion:
Sincerely,
Kari Davis

Objection Letter
Dear Neresa Torres,
Introduction:
1. The written and earned premium must be the same for a new program filing. Please change your template so the written and
earned premiums are equal and resubmit.
2. Has this program been filed and approved in any other states? Does any other program like this exist in California or any other
states?
3. Were the 7 forms also based on the Empire Fire and Marine file #11-7983? Or are these forms all newly created by Knightbrook?
Thank you.
Conclusion:
Sincerely,
Kari Davis

Response Letter
Response Letter Status Submitted to State
Response Letter Date 09/26/2012
Dear Kari Davis,
Introduction:
Response 1
Comments:
Response #1:
The proposed new program will be written through a Managing General Agency, Knight Management Insurance Services (KMIS).
Both KMIS and KnightBrook Insurance Company are owned by the same company and KMIS currently writes a similar program in
California through another insurance carrier.
Response #2:
KMIS has written this type of insurance in other states through multiple carriers since 2004.
Changed Items:
No Supporting Documents changed.
No Form Schedule items changed.
No Rate/Rule Schedule items changed.

Conclusion:
Sincerely,
Neresa Torres

Response Letter
Dear Kari Davis,
Introduction:
Response 1
Comments:
Please find the attached updated CA prior approval application which addresses the Department's concern.
Changed Items:
Supporting Document Schedule Item Changes

Satisfied - Item: Prior Approval Rate Application
Comments:
Attachment(s): PriorApprovalRateApplication022812--KBIC CA SLI, New Pgm Filing (for Response, 9-19-12 CDI questions).pdf
PriorApprovalRateApplication022812--KBIC CA SLI, New Pgm Filing (for Response, 9-19-12 CDI questions).xls
Previous Version
Comments:
Attachment(s): PriorApprovalRateApplication022812--KBIC CA SLI, New Pgm Filing (for Response).pdf
PriorApprovalRateApplication022812--KBIC CA SLI, New Pgm Filing (for Response).xls
Previous Version
Comments:
Attachment(s): PriorApprovalRateApplication022812--KBIC CA SLI, New Pgm Filing.xls
PriorApprovalRateApplication022812--KBIC CA SLI, New Pgm Filing.pdf

Conclusion:

Sincerely,
Neresa Torres

Response Letter
Dear Kari Davis,
Introduction:
Response 1
Comments:
1. Please find the attached revised Application with the requested changes.
2. Yes this program exists and is approved in most states.
3. In developing the rates for the program, we relied on Empire Fire and Marine filing number 11-7983; however, the information available to us contained only Empires rates
and not their forms. As such, KnightBrook developed the forms filed for this program. We used as reference the forms promulgated in Texas for this type of coverage, since
they are tailored specifically for this product.
Changed Items:
Supporting Document Schedule Item Changes

Comments:
Attachment(s): PriorApprovalRateApplication022812--KBIC CA SLI, New Pgm Filing (for Response).pdf
PriorApprovalRateApplication022812--KBIC CA SLI, New Pgm Filing (for Response).xls
Previous Version
Comments:
Attachment(s): PriorApprovalRateApplication022812--KBIC CA SLI, New Pgm Filing.xls
PriorApprovalRateApplication022812--KBIC CA SLI, New Pgm Filing.pdf

Conclusion:

Sincerely,
Neresa Torres

Form Schedule
Item Schedule Item Form Form Edition Form Form Action Specific Readability
No. Status Name Number Date Type Action Data Score Attachments
1 Declaration Page KBIC-SLI- 12/09 DEC New KBIC-SLI-
0001 0001Dec
Page.pdf
2 Automobile Rental Liability KBIC-SLI- 05/10 PCF New KBIC-SLI- 0002
Excess Policy (Rental Car 0002 _05-10_ Policy
Companies Only) Body Final.pdf
3 Rental Car Company KBIC-SLI- 04/10 END New KBIC-SLI-0003
Endorsement 0003 _RAC
Endorsement.pdf
4 California Amendatory SLIKB 01/10 END New KBIC-SLI-0004 -
Endorsement 0004 (CA) CA
Endorsement.pdf
5 Nuclear Energy Liability KBIC-SLI- 10/10 END New KBIC-SLI-0005
Exclusion Endorsement 0005 (10-10) Nuclear
Endorsement.pdf
6 Declarations and KBIC-SLI- 08/08 DSC New KBIC-SLI- 0007
Summary of Coverage 0007 _Renter's
(Renter's Disclosure) Disclosure_le.pdf
7 Supplemental Liability KBIC-SLI- 04/10 ABE New KBIC-SLI- 0008
Insurance Application 0008 Application(Repr
esentation).pdf
Form Type Legend:

ABE Application/Binder/Enrollment ADV Advertising
BND Bond CER Certificate
CNR Canc/NonRen Notice DEC Declarations/Schedule
DSC Disclosure/Notice END Endorsement/Amendment/Conditions
ERS Election/Rejection/Supplemental Applications OTH Other
KnightBrook Insurance Company, Brandywine Village, 1807 North Market Street, Wilmington, DE 19802-4810
Administered by:
4751 Wilshire Boulevard, Suite 111

Los Angeles, CA 90010
(888) 333-8198
POLICY NUMBER:
AUTOMOBILE RENTAL LIABILITY EXCESS POLICY
DECLARATIONS PAGE
NAMED INSURED and Address (POLICYHOLDER)
Producer:
The NAMED INSURED is a:

 Individual  Partnership  Corporation  Joint Venture  Other
POLICY PERIOD
EFFECTIVE DATE: EXPIRATION DATE:
(12:01 am at the address of the NAMED INSURED as stated herein)
All Coverages are Excess of any other applicable insurance:

Section I: The difference between the elected Combined
Single Limit for each accident, and the higher of state
required Financial Responsibility Limits or underlying policy
limits.
Section IV: $100,000 Combined Single Limit excess of the
state required minimum UM limits or other underlying
insurance.
PREMIUM $ Premium Rate per day of rental

_________ Premium Rate per hour of rental
$ UM Premium Rate per day of rental
_________ UM Premium Rate per hour of rental
The Premium shall be calculated monthly and shall be equal to the sum of the applicable rate per day or hour.
Hourly rates apply if car rental is for a period of less than 8 hours; otherwise daily rate applies.
FORMS AND ENDORSEMENTS

Forms and Endorsements applying to this Coverage Part and made part of this Policy at the time of issue:
KBIC-SLI-0002 KBIC-SLI-0003 KBIC-SLI-0004
KBIC-SLI-0005 KBIC-SLI-0007
Authorized Countersignature: ________________________________
KBIC-SLI-0001 (12/09) KnightBrook Insurance Company

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AUTOMOBILE RENTAL LIABILITY EXCESS POLICY
(RENTAL CAR COMPANIES ONLY)
Various provisions in this policy restrict coverage. a. That driver had the permission of an
Read the entire policy carefully to determine rights, insured; or
duties and what is and is not covered.
b. That driver is covered by the underlying
Throughout this policy, the words “we”, “us”, and insurer for the minimum financial
“our” refer to the Company named in the responsibility liability limits.
Declarations. In addition, certain words or phrases
that appear in bold type have special meaning. Refer D. LIMIT OF INSURANCE
to SECTION III – DEFINITIONS.
Regardless of the number of insured’s, rental
SECTION I – EXCESS LIABILITY vehicles, premiums paid, claims made or
COVERAGE vehicles involved in the accident, for each rental
agreement the most we will pay for the ultimate
A. COVERAGE net loss and defense costs, resulting from any
one accident, is the difference between the dollar
We will pay the ultimate net loss, in excess of amount shown on the Declarations and the
the minimum financial responsibility liability minimum financial responsibility liability limits
limits, to which this coverage applies, provided or limit of any other underlying insurance.
that:
E. EXCLUSIONS
1. It results from an accident involving a rental
vehicle. This insurance does not apply to any of the
following:
2. The accident occurs while the rental
agreement is in effect and the rental 1. Bodily injury or property damage arising out of
agreement becomes effective during the the use, or permitting the use, of a rental vehicle:
policy period; and
a. By any driver other than the renter or an
3. Excess rental liability insurance has been authorized driver;
elected by the renter at the origin of the
rental agreement. b. By any driver while under the influence of
drugs or alcohol in violation of law;
B. WHO IS AN INSURED
c. For any illegal purpose;
Only the following are insureds under this excess
policy: d. To carry persons or property for hire;
1. The named insured shown in the e. To tow or propel any other auto;
Declarations; and
f. In any race, contest, or training activity; or
2. The renter who has:
g. Off-road or on unpaved roads that are not
a. Entered into a rental agreement with the regularly maintained.
named insured shown in the
Declarations; and 2. Liability arising out of, or benefits payable
under, any uninsured or underinsured motorist
b. Elected under the rental agreement to law, personal injury protection or other first
purchase optional excess rental liability party benefit law or no-fault law, or any similar
insurance. law, in any jurisdiction.
3. Additional authorized drivers as defined 3. Bodily injury to the renter or any family
herein. member, if such family member resides in the
same household with the renter and any
C. WHO IS AN AUTHORIZED DRIVER authorized driver while driving the rental
vehicle.
1. Only the following are authorized drivers under
this excess policy: 4. Property damage to the rental vehicle.
a. A driver whose name is listed on the original 5. Bodily injury or property damage expected or
rental agreement; or intended from the standpoint of the insured.
b. A driver designated by description, if any, in 6. Any obligation for which the insured or the
the rental agreement. insured’s insurer may be held liable under any
workers’ compensation, disability benefits or
2. Any driver who does not meet one of the unemployment compensation law or any similar
conditions in Item C. a. of this section is not an law.
authorized driver, even if:
KBIC-SLI-0002 (05/10) 1 KnightBrook Insurance Company

RENTAL
overturned or damaged as a result of the

7. Bodily injury to: maintenance or use of a rental vehicle; and
b. The discharge, dispersal, release or escape
a. An employee of the insured arising out of of the pollutants is caused directly by such
and in the course of employment by the upset, overturn or damage.
insured; or
11. Any loss, cost or expense arising out of any
b. The spouse, child, parent, brother or sister of governmental direction or request that you test for,
that employee as a consequence of monitor, clean up, remove, contain, treat, detoxify or
paragraph a. above. neutralize pollutants.
This exclusion applies: 12. Bodily injury or property damage excluded by

NUCLEAR ENERGY LIABILITY EXCLUSION
(1) Whether the insured may be liable as an ENDORSEMENT (Broad Farm) IL 00 21 made a
employer or in any other capacity; and part herein.
(2) To any obligation to share damages SECTION II – CONDITIONS

with or repay someone else who must
pay damages because of the injury. A. LOSS CONDITIONS
But this exclusion does not apply to bodily 1. DUTIES IN THE EVENT OF
injury to domestic employees not entitled to ACCIDENT, CLAIM, OR SUIT
workers compensation benefits.
a. In the event of accident, claim, or suit
8. Bodily injury to any fellow employee of the that is likely to involve this policy, we
insured arising out of and in the course of the must provide a copy of the policy to the
fellow employee’s employment. insured at their last known mailing
address.
9. Property damage to property owned or
transported by the insured or in the insured’s b. In the event of accident, claim, or suit
care, custody or control. that is likely to involve this policy, that
named insured or the insured must give
10. Bodily injury or property damage arising out of us or our authorized representative
the actual, alleged or threatened discharge, prompt notice of the accident include:
dispersal, release or escape of pollutants:
(1) How, when and where the accident
a. That are, or that are contained in any occurred;
property that is:
(2) The insured’s name and address;
(1) Being transported or towed by, or and
handled for movement into, onto or
from the rental vehicle; (3) To the extent possible, the names
and addresses of any injured
(2) Otherwise in the course of transit; or persons and witnesses.
(3) Being stored, disposed of, treated or Notice to the named insured by the
processed in or upon the rental vehicle; insured constitutes notice to us.
b. Before the pollutants or any property in If we show that the insured’s failure to
which the pollutants are contained are provide notice prejudices our defense,
moved from the place where they are there is no coverage under the policy.
accepted by the insured for movement into
or onto the rental vehicle; or c. Additionally, the insured and any other
involved insured must:
c. After the pollutants or any property in which
the pollutants are contained are moved from (1) Assume no obligation, make no
the rental vehicle to the place where they are payment or incur no expense
finally delivered, disposed of or abandoned without our consent, except at the
by the insured. Insured’s own cost.
Paragraph 10.a.(3) does not apply to fuels, lubricants, (2) Immediately send us copies of any
fluids, exhaust gases or other similar pollutants that demand, notice, summons or legal
are needed for or result from the normal electrical, paper received concerning the
hydraulic or mechanical functioning of the rental claim or suit.
vehicle or its parts, if the pollutants escape or are
discharged, dispersed or released directly from an (3) Cooperate with us in the
auto part designed by its manufacturer to hold, store, investigation. Settlement or defense
receive or dispose of such pollutants. of the claim or suit.
Paragraphs 10.b. and 10.c. of this exclusion do not (4) Authorize us to obtain medical
apply it: records or other pertinent
information.
a. The pollutants or any property in which the
pollutants are contained are upset, (5) Submit to examination, at our
expense, by physicians of our

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choice, as often as we reasonably 1. PREMIUM

require.
2. LEGAL ACTION AGAINST US The premium for this policy shall be computed
on the basis stated in the Declarations. The
No one may bring a legal action against us premium shall be remitted to us on the basis
under this policy until: stated in the Declarations by the named insured
for each day of exposure during that period,
a. There has been full compliance with all along with summarizing reports as requested by
the terms of this policy; and us. The premium will be considered fully earned
upon receipt and not subject to refund upon
b. We agree in writing that the insured has policy cancellation. This premium shall be
an obligation to pay or until the amount subject to audit by our representatives. The
of that obligation has finally been named insured shall maintain, and permit our
determined by judgment after trial. access to, such records as are necessary to
substantiate the premium for a period of not less
No one has the right under this policy to than three years.
bring us into an action to determine the
insured’s liability. 2. ATTACHMENT OF LIABILITY
3. DEFENSE OF CLAIMS OR SUITS Liability under this policy shall not attach until
all applicable limits have been exhausted by
payment of judgments or settlements and the
If we are required or elect to provide a insured has become legally obligated to pay the
defense, we may do so by counsel of our ultimate net loss in excess of all applicable
choice. underlying insurance including but not limited to
minimum financial responsibility liability limits.
If we provide defense we will pay, with
respect to any claim or suit: 3. CANCELLATION OR NON-RENEWAL
a. All expenses we incur. a. The named insured shown in the

Declarations may cancel this policy by
b. Up to $250 for cost of bail bonds mailing or delivering to us advance written
(including bonds for related traffic law notice of cancellation.
violations) required because of an
accident we cover. We do not have to b. We may cancel or non-renew as follows:
furnish these bonds.
(1) Cancellation
c. The cost of bonds to release
attachments in any suit we defend, but (a) We may cancel this policy by
only for bond amount within our limit mailing or delivering to the named
of liability. insured written notice of
cancellation, stating the reason for
d. All reasonable expenses incurred by the cancellation, at least 10 days before
insured at our request, including actual the effective date of cancellation.
loss of earning up to $100 a day
because of time off from work. (b) If this is not a renewal or
continuation policy, and if it has
e. All costs taxed against the insured in been in effect for 80 or fewer days,
any suit we defend. we may cancel for any reason.
f. All interest on the full amount of any (c) If this is a renewal or continuation
judgment that accrues after entry of the policy, or if it has been in effect for
judgment in any suit we defend; but our more than 60 days in the initial
duty to pay interest ends when we have policy period, we may cancel only
paid, offered to pay or deposited in for one or more of the following
court the part of the judgment that is reasons:
within our limit of liability.
(i) Fraud in obtaining coverage;
These payments will apply toward the limit
of insurance. (ii) Failure to pay premiums when
due;
4. APPEALS (iii) An increase in hazard within of

the control of the named
If an insured or underlying insurer elects not insured which would produce
to appeal judgments in excess of the an increase in rate;
minimum financial responsibility liability
limits, we may elect to appeal such (iv) Loss of our reinsurance
judgments at our own expense, but in no covered by the policy; or
event shall our liability for the ultimate net
loss exceed the Limit of insurance plus (v) If we have been placed in
expenses incurred in such an appeal. supervision, conservator-ship,
or receivership and the
B. GENERAL CONDITIONS cancellation or non-renewal is
approved or directed by the

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supervisor, conservator, or damages shall be deemed not to exceed the

receiver. higher of the applicable limits of liability of this
insurance and such other insurance, and the
(2) Non-Renewal company shall not be liable for a greater
proportion of any loss to which this coverage
(a) We may elect not to renew this applies than the limit of liability hereunder bears
policy by mailing or delivering to to the sum of the applicable limits of liability of
the named insured written notice of this insurance and such other insurance.
non-renewal, stating the reason for
non-renewal, at least 60 days 6. BANKRUPTCY
before the expiration date. If notice
is mailed or delivered less than 60 Bankruptcy or insolvency of the insured or the
days before the expiration date, this insured’s estate will not relieve us of any
policy will remain in effect until obligations under this policy.
the 61st day after the date on which
the notice is mailed or delivered. 7. LIBERALIZATION
Earned premium for any period of
coverage that extends beyond the If we revise this policy to provide more coverage
expiration date will be computed without additional premium charge, this policy
on the bases stated in the will automatically provide the additional
Declarations. coverage as of the day the revision is effective.
(b) If notice is mailed, proof of mailing 8. TRANSFER OF RIGHTS AND DUTIES

will be sufficient proof of notice. UNDER THIS POLICY
We may not cancel or non-renew based solely on the The rights and duties of the named insured under
fact that the named insured is an elected official. this policy may not be transferred without our
written consent. The rights and duties of the
c. We will mail or deliver our notice to the named insured under this policy may not be transferred
insured’s last mailing address known to us. without our written consent except in the case of
death of an insured, if an insured dies, their
d. Notice of cancellation will state the effective rights and duties will be transferred to their legal
date of cancellation. The policy period will end representative but only while acting within the
on that date. scope of duties as their legal representative.
e. If notice is mailed, proof of mailing will be 9. CHANGES

sufficient proof of notice.
This policy contains all the agreements between
f. Cancellation or non-renewal of the policy will the named insured and us concerning the
not affect the right of an insured where excess insurance afforded. The Named insured shown in
rental liability insurance had been elected under the Declaration is authorized to make changes in
a rental agreement while the policy was in force. the terms of this policy with our consent. This
In that case, coverage will continue until policy’s terms can be amended or waived only
termination of any such rental agreement. by endorsement issued by us and made a part of
this policy.
4. COVERAGE TERRITORY
10. CONCEALMENT,
Under this policy, we cover accidents occurring MISREPRESENTATION, OR FRAUD
within the coverage territory.
The coverage provided under this policy for the
The coverage territory is: insured is void in any case of fraud by the
a. The United States of America; insured relating to it. It is also void if the insured
b. The territories and possessions of the intentionally conceals or misrepresents a material
United States of America; fact concerning this policy.
c. Canada.
5. OTHER INSURANCE SECTION III – DEFINITIONS
With respect to bodily injury to an insured while A. Accident includes continuous or repeated
occupying a highway vehicle not owned by the exposure to the same conditions resulting in
named insured, this insurance shall apply only as bodily injury or property damage.
excess insurance over any other similar
insurance available to such insured and B. Authorized driver means any person qualifying
applicable to such vehicle as primary insurance, as an authorized driver in the WHO IS AN
and this insurance shall then apply only in the AUTHORIZED DRIVER provision – (Section 1
amount by which the limit of liability for this Part C).
coverage exceeds the applicable limit of liability
of such other insurance. C. Auto means a motor vehicle of the private
passenger type including passenger vans,
Except as provided in the foregoing paragraph, if minivans and pick-up trucks that are primarily
the insured has other similar insurance available intended for the transport of persons (Does not
to him and applicable to the accident, the

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include any vehicle over 6000 lbs. except for waste. Waste includes materials to be recycled,
recreational vehicles rented by an insured) reconditioned or reclaimed.
D. Bodily injury means bodily injury, sickness or K. Property damage means physical injury to or
disease sustained by a person including death destruction of tangible property including any
resulting from these. resulting loss of use of that property.
E. Excess rental liability insurance means L. Rental agreement means any written agreement
optional excess liability coverage effected by a entered into setting forth the terms and
renter and for which premium is paid. conditions governing the use of a vehicle
provided by the rental car company.
F. Family member means a person who is a
resident of the insured’s household and related to M. Rental vehicle means the auto rented or leased
the insured by blood, marriage or adoption. This by the renter from the named insured and
definition includes a ward or foster child who is described in the rental agreement.
a resident of the insured’s household, and also N. Renter means any person obtaining the use of an
includes the insured’s spouse even when not a auto from the named insured (rental car company
resident of the insured’s household during a or its franchisee) under the terms of a rental
period of separation in contemplation of divorce. agreement.
G. Insured means any person qualifying an insured O. Suit means a civil proceeding in which damages
in the WHO IS AN INSURED provision – because of bodily injury or property damages to
(Section I Part B). Except with respect to the which this insurance applies are alleged. Suit
limit of insurance, the coverage afforded applies includes an arbitration proceeding alleging such
separately to each insured who is seeking damages to which the insured must submit or
coverage or against whom a claim or suit is submit with our consent.
brought.
P. Ultimate net loss means all sums for which an
H. Minimum financial responsibility liability insured becomes legally obligated to pay, as
limits means the minimum coverage amounts for damages for bodily injury and property damage
financial responsibility as required by the combined. Ultimate net loss will be reduced by
applicable jurisdiction. deduction for all salvage or recoveries which
have been or will be paid.
I. Named Insured or Policy Holder mean the
person on the Declarations, who has agreed to Q. Underlying insurer means the insurance
the terms and conditions of this policy. company or the certified self-insurer who
provides the minimum financial responsibility
J. Pollutants mean any solid, liquid, gaseous or liability limits. This includes any insurance
thermal irritant or contaminant, including smoke, available to the renter.
vapor, soot, fumes, acids, alkalis, chemicals and

RENTAL
SECTION IV – UNINSURED C. PERSONS INSURED

MOTORISTS INSURANCE Each of the following is an insured under this
insurance to the extent set forth below:
A. COVERAGE
1. the named insured and any designated
The Company will pay all sums which the insured and while residents of the same
insured or his legal representative shall be legally household, the spouse and relatives of
entitled to recover as damages from the owner or either,
operator of an uninsured highway vehicle
because of bodily injury sustained by the 2. any other person while occupying an
insured, caused by accident and arising out of insured highway vehicle; and
ownership, maintenance or use of such uninsured
highway vehicle; provided , for the purposes of 3. any person, with respect to damages he
this coverage, determination as to whether the is entitled to recover because of bodily
insured or such representative is legally entitled injury to which this insurance applies
to recover such damages, and if so the amount sustained by an insured under (a) or (b)
thereof, shall be made by agreement between the above.
insured or such representative and the company
or, if they fail to agree, by arbitration. The insurance applies separately with respect to
each insured, except with respect to the limits of
No Judgment against any person or organization the company’s liability.
alleged to be legally responsible for the bodily
injury shall be conclusive, as between the D. LIMITS OF LIABILITY
insured and the company, of the issues of
liability of such person or organization or of the Regardless of the number of (1) persons or
amount of damages to which the insured is organizations who are insureds under this policy,
legally entitled unless such judgment is entered (2) persons who sustain bodily injury (3) claims
pursuant to an action prosecuted by the insured made or suits brought on account of bodily
with the written consent of the Company. injury, or (4) highway vehicles to which this
policy applies,
B. EXCLUSIONS
1. The limit of liability stated in the
This insurance does not apply: declarations as applicable is the limit of
the company’s liability for all damages
1. to bodily injury to an insured with respect to because of bodily injury sustained by
which such insured, his legal representative one person or more persons as the result
or any person entitled to payment under this of any one accident and subject to the
insurance shall, without written consent of above provision respecting the limit of
the company, make any settlement with any liability stated in the declarations.
person or organization who may be legally
liable therefor, 2. Any amount payable under the terms of
this insurance because of bodily injury
2. to bodily injury to an insured while sustained in an accident by a person
occupying a highway vehicle (other than an who is an insured under this coverage
insured highway vehicle) owned by the shall be reduced by
named insured or designated insured, or any
relative resident in the same household as (a) all sums paid on account of such bodily
the named or designated insured, or through injury by or on behalf of
being struck by such a vehicle, but this
exclusion does not apply to the named i. the owner or operator of the
insured or his relatives while occupying or if uninsured highway vehicle and
struck by a highway vehicle owned by a
designated insured or his relatives; ii. any other person or organization
jointly or severally liable
3. so as to inure directly or indirectly to the together with such owner or
benefit of any workmen’s compensation or operator for such bodily injury.
disability benefits carrier or any person of Including all sums paid under the
organizations qualifying as a self-insurer bodily injury liability coverage of
under any workmen’s compensation or the policy, and
disability benefits law or any similar law.
(b) the amount paid and the present value
4. To bodily injury or property damage caused of all amounts payable on account of
intentionally by or at the direction of an such bodily injury under any
insured. workmen’s compensation law,
disability benefits law or any similar
law
3. Any payment made under this insurance

to or for any insured shall be applied in
reduction of the amount of damages
which he may be entitled to recover
from any person or organization who is
an insured under the bodily injury
liability coverage of the policy.

RENTAL
1. described as an insured highway vehicle

4. The company shall not be obligated to to which the bodily injury liability
pay under this insurance that part of the coverage of the policy applies;
damages which the insured may be
entitled to recover from the owner or 2. while temporarily used as a substitute
operator of an uninsured highway for an insured highway vehicle as
vehicle which represents expenses for described in subparagraph (a) above,
medical services paid or payable under when withdrawn from normal use
the medical payments coverage of the because of its breakdown, repair,
policy. servicing, loss or destruction;
E. POLICY PERIOD; TERRITORY 3. while being operated by the named or

This insurance applies only to accidents which designated insured or by the spouse of
occur during the policy period and within the either if a resident of the same
United States of America, its territories or household;
possessions, or Canada.
but the term “insured highway vehicle” shall
F. ADDITIONAL DEFINITIONS not include
When used in reference to this insurance (i) a vehicle while used as a public or
(including endorsements forming a part of the livery conveyance, unless such use is
policy): specifically declared and described in
this policy;
designated insured means an individual named
in the schedule under Designated Insured; (ii) a vehicle while being used without the
permission of the owner
highway vehicle means a land or motor vehicle
or trailer other than (iii) under subparagraphs (b) and (c) above,
a vehicle owned by the named insured,
1. a farm type tractor or other equipment and designated insured or any resident
designed for use principally off public or the same household as the named or
roads, while not upon public roads, designated insured; or
2. a vehicle operated on rails or crawler- (iv) under subparagraph (b) and (c) above, a
treads, or vehicle furnished for the regular use of
the named insured or any resident of the
3. a vehicle while located for use as a same household;
residence or premises;
occupying means in or upon or entering into or
hit and run vehicle means a highway vehicle alighting from:
which causes bodily injury to an insured arising
out of physical contact of such vehicle with the state includes the District of Columbia, a
insured or with a vehicle which the insured is territory or possession of the United States, and a
occupying at the time of the accident, provided: province of Canada
1. there cannot be ascertained the identity uninsured highway vehicle means

of either the operator or owner of such
highway vehicle; 1. a highway vehicle with respect to the
ownership, maintenance or use of which
2. the insured or someone on his behalf there is in at least the amounts specified
shall have reported the accident within by the financial responsibility law of the
24 hours to a police, peace or judicial state in which the insured highway
officer or to the Commissioner of Motor vehicle is principally garaged, no bodily
Vehicles, and shall have filed with the injury liability bond or insurance policy
company within 30 days thereafter a applicable at the time of the accident
statement under oath that the insured or with respect to any person or
his legal representative has a cause or organization legally responsible for the
causes of action arising out of such use of such vehicle, or with respect to
accident for damages against a person which there is a bodily injury liability
or persons whose identity is bond or insurance policy applicable at
unascertainable, and setting forth the the time of the accident, but the
facts in support thereof; and company writing the same denies
coverage thereunder or is or becomes
3. at the company’s request, the insured or insolvent; or
his legal representative makes available
for inspection the vehicle which the 2. a hit and run vehicle;
insured was occupying at the time of the but the term “uninsured highway vehicle” shall
accident; not include;
(i) an insured highway vehicle,
Insured highway vehicle means a highway
vehicle: (ii) a highway vehicle which is owned or
operated by a self-insurer within the
meaning of any motor vehicle financial
responsibility law, motor carrier law or any
similar law,

RENTAL
involved in the accident, a copy of the summons

(iii) a highway vehicle which is owned by and complaint or other process served in
the United States of America, Canada, a connection which such legal action shall be
state, a political subdivisions of such forwarded immediately to the company by the
government or an agency of any of the insured or his legal representative.
foregoing.
5. Other Insurance
G. ADDITIONAL CONDITIONS
With respect to bodily injury to an insured while
1. Premium occupying a highway vehicle not owned by the
named insured, this insurance shall apply only as
If during the policy period the number of insured excess insurance over any other similar
highway vehicles owned by the named insured insurance available to such insured and
or spouse or the number of dealer’s license plates applicable to such vehicle as primary insurance,
issued to the named insured changes, the named and this insurance shall then apply only in the
insured shall notify the company during the amount by which the limit of liability for this
policy period of any change and the premium coverage exceeds the applicable limit of liability
shall be adjusted in accordance with the manuals of such other insurance.
in use by the company. If the earned premium
thus computed exceeds the advance premium Except as provided in the foregoing paragraph, if
paid, the named insured shall pay the excess to the insured has other similar insurance available
the company, if less, the company shall return to to him and applicable to the accident, the
the named insured the unearned portion paid by damages shall be deemed not to exceed the
such insured. higher of the applicable limits of liability of this
insurance and such other insurance, and the
2. Proof of Claim; Medical Reports company shall not be liable for a greater
proportion of any loss to which this coverage
As soon as practicable, the insured or other applies than the limit of liability hereunder bears
person making claims shall give to the company to the sum of the applicable limits of liability of
written proof of claim, under oath if required, this insurance and such other insurance.
including full particulars of the nature and extent
of the injuries, treatment, and other details 6. Arbitration
entering into the determination of the amount
payable hereunder. The insured and every other If any person making claim hereunder and the
person making claim hereunder shall submit to company do not agree that such person is legally
examinations under oath by any person named entitled to recover damages from the owner or
by the company and subscribe the same, as often operator of an uninsured highway vehicle
as may reasonably be required. Proof of claim because of bodily injury to the insured, or do not
shall be made upon forms furnished by the agree as to the amount of payment which may be
company unless the company shall have failed to owing under this insurance, then upon written
furnish such forms within fifteen days after demand of either, the matter or matters upon
receiving notice of claim. which such person and the company do not agree
shall be settled by arbitration, which shall be
The injured person shall submit to physical conducted in accordance with the rules of the
examinations by physicians selected by the American Arbitration Association unless other
company when and as often as the company may means of conducting the arbitration are agreed to
reasonably require and he, or in the event of his between the insured and the company, and
incapacity his legal representative, or in the judgment upon the award rendered by the
event of his death his legal representative or the arbitrators may be entered in any court having
person or person entitled to sue therefor, shall jurisdiction thereof. Such person and the
upon each request from the company execute company each agree to consider itself bound and
authorization to enable the company to obtain to be bound by any award made by the
medical reports and copies of records. arbitrators pursuant to this insurance.
7. Trust Agreement
3. Assistance and Cooperation of Insured
In the event of payment to any person under this
After notice of claim under this insurance, the insurance:
company may require the insured to take such
action as may be necessary or appropriate to (a) the company shall be entitled to the extent of
preserve his right to recover damages from any such payment to the proceeds of any
person or organization alleged to be legally settlement or judgment that may result from
responsible for the bodily injury, and in any the exercise of any rights of recovery of
action against the company, the company may such person against any person or
require the insured to join such person or organization legally responsible for the
organization as a party defendant bodily injury because of which such
payment it made;
4. Notice of Legal Action (b) such person shall hold in trust for the benefit
of the company all rights of recovery which
If, before the company makes payment of loss he shall have against such other person or
hereunder the insured or his legal representative organization because of the damages which
shall institute any legal action for bodily injury are the subject of claim made under this
against any person or organization legally insurance;
responsible for the use of a highway vehicle

RENTAL
(c) such person shall do whatever is proper to may be appropriate to secure the rights and
secure and shall do nothing after loss to obligations of such person and the company
prejudice such rights; established by this provision.
(d) if requested in writing by the company, such 8. Payment of Loss by the Company
person shall take, through any representative
designated by the company, such action as Any amount due hereunder is payable
may be necessary or appropriate to recover
such payment as damages from such other (a) to the insured, or
person or organization, such action to be (b) if the insured be a minor to his parent or
taken in the name of such person; in the guardian, or
event of a recovery, the company shall be (c) if the insured be deceased to his surviving
reimbursed out of such recovery for spouse, otherwise
expenses, costs and attorneys fees incurred (d) to a person authorized by law to receive
by it in connection therewith; such payment or to a person legally entitled
to recover the damages which the payment
(e) no action may be filed against us with represents.
respect to uninsured motor vehicle coverage
unless, within one year from the date of the provided the company may at its option pay any
accident suit for bodily injury has been filed amount due hereunder in accordance with
in the proper court against the uninsured division (d) hereof.
motorist or an agreement as to the amount
due under the policy has been concluded or
the insured or his representative has
demanded arbitration in writing.
(f) such person shall execute and deliver to the

company such instruments and papers as
IN WITNESS WHEREOF, the company has caused this policy to be signed by its
president and secretary but this policy shall not be valid unless completed by the
attachment hereto of a declarations page and countersigned on the aforesaid declarations
page by a duly authorized representative of the company.
All other terms, exclusions and conditions of this policy remain unchanged.
______________________________ _______________________________
Secretary President

KNIGHT MANAGEMENT INSURANCE SERVICES, LLC, Administrator
4751 Wilshire Blvd., Ste. 111, Los Angeles, CA 90010 (888) 333-8198
RENTAL CAR COMPANY ENDORSEMENT

In consideration of the premium at which this policy is written, the terms and conditions of this policy are hereby
amended as follows:
COVERAGE
The coverage provided under this Policy to the Named Insured named in the Declarations shall be extended to all
individuals who rent an automobile from the Named Insured and who elect to accept Supplemental Liability
Insurance coverage on the face of the Rental Contract, with coverage inception dates within the policy term stated
on the Declarations. The limits of liability will be afforded separately to each covered Rental Contract.
CONDITIONS
Any terms, conditions and exclusions that apply to coverage as described in the Rental Contract shall also apply to
coverage, if any, as provided by the policy, provided the Rental Contract has been supplied or approved by the
insurance company. Wherever there is a conflict between an insurer-approved Rental Contract and this insurance
Policy, this insurance Policy shall apply.
ADDITIONAL CONDITIONS
1) Coverages hereunder are voided, do not provide protection and have no force and effect under the following
conditions:
A. The Renter’s failure to pay for charges due under the Rental Contract in accordance with the terms of the
Rental Contract;
B. Failure to accept Supplemental Liability Insurance on the face of the Rental Contract at the inception of
the rental period. Such acceptance shall be in the form of an initial by the Renter on the face of the Rental
Contract, in a box indicating acceptance of Supplemental Liability Insurance; failure to decline coverage is
not evidence of coverage;
C. Use or operation of the vehicle in violation of the terms of the Rental Contract, including, without
limitation, participation in any speed contest, driving under the influence of drugs or alcohol, driving the
vehicle beyond the geographic limitations stated in the Rental Contract;
D. Where the driver of the automobile at the time of loss is not a Renter or additional driver specifically
authorized by the Named Insured in the Rental Contract.
E. Obtaining the vehicle by fraud or misrepresentation;
2) Coverages (other than Uninsured Motorist coverage where required by law and not waived by Renter) are not
provided to the Renter, or a member of Renter’s family related by blood, marriage, adoption, or person who
reside with Renter in the same household. Coverages (other than Uninsured Motorist coverage where required
by law and not waived by Renter) are not provided to passengers in the rental vehicle.
3) Coverage does not apply in Mexico.
4) Coverage is not provided for uninsured motorist property damage, underinsured motorist property damage, first
party benefits, no-fault or other optional liability protection.
DEFINITIONS
The definitions of “automobile”,“owned automobile,” “private passenger automobile,” “temporary substitute

automobile,” “designated automobile,” and “highway vehicle” stated anywhere in the policy are hereby deleted
in their entirety and replaced by the following definition:
KBIC-SLI-0003 (04/10) 1 KNIGHTBROOK INSURANCE COMPANY

“Automobile”, “owned automobile,” “private passenger automobile,” “temporary substitute automobile,”

“designated automobile,” and “highway vehicle” mean a land motor vehicle of the private passenger type which
is owned by the Named Insured, and which the Named Insured rents to a Renter who has indicated acceptance of
Supplemental Liability Insurance on the face of the Rental Contract.
ADDITIONAL DEFINITIONS
As used in this endorsement:
“Policy Holder” means the Named Insured specified in the Policy Declarations Page who is any person or
organization engaged in the rental of new or used automobiles of the private passenger type.
“Renter” means any person or organization or additional authorized driver which has rented an automobile of the
private passenger type from the Named Insured under a written rental agreement during the Master Policy Period.
“Rental Contract” means any agreement, pre-approved by insurer, providing for the rental of an automobile from
the Named Insured to the Renter, with a rental period not to exceed thirty-one calendar days.
“Policy” means the policy issued to the Named Insured.
This endorsement is a part of the policy and takes effect on the effective date
of the policy unless another effective date is shown below.
Complete only when this endorsement is not prepared with

the policy or is not to be effective with the policy.
Endorsement # Policy #
Effective on and after: ___________, 20_____, 12:01 a.m. standard time
Issued to : ________________________________________________
Issued by:
Expiration Date:
Authorized Representative
KBIC-SLI-0003 (04/10) 2 KNIGHTBROOK INSURANCE COMPANY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CALIFORNIA AMENDATORY ENDORSEMENT

This endorsement modifies insurance provided under the AUTOMOBILE RENTAL
LIABILITY EXCESS POLICY.
A. Part 3 Cancellation or Non-Renewal under B. GENERAL CONDITIONS of

SECTION II – CONDITIONS is deleted in its entirety and replaced with the
following:
Cancellation
This policy may be cancelled by the named insured by surrender thereof to the
company or any of its authorized agents or by mailing to the company written notice
stating when thereafter the cancellation shall be effective.
This policy may be cancelled by the company by mailing to the named insured at the
last mailing address known to the company, written notice stating when not less than
ten days thereafter such cancellation shall be effective for nonpayment of premium or
fraud or misrepresentation by any insured or its representative in obtaining this
policy or submitting a claim there under, and not less than thirty days thereafter such
cancellation shall be effective for all other reasons. The mailing of notice as aforesaid
shall be sufficient proof of notice. The time of surrender or the effective date and hour
of cancellation stated in the notice shall become effective, but payment or tender of
unearned premium is not a condition of cancellation.
If this policy has been in effect for more than sixty days, the company may cancel for
one or more of the following reasons:
a. Nonpayment of premium;
b. Material misrepresentation or fraud by an insured or the insured’s representative in

obtaining or submitting a claim under this policy;
c. The conviction of an insured of a crime for an act which materially increases any of
the risks insured against;
d. The insured’s or the insured’s representatives acts or omissions, or of any

violations of state laws or regulations establishing safety standards, which increase
any of the risks insured against;
e. Failure of the insured of the insured’s representative to implement agreed loss

control measures, as condition of issuing this policy, or which were conditions
prior to the company using a particular rate or rating plan, if that failure increases
SLIKB 0004 (CA) (01/10) Page 1 of 2

any of the risks insured against;
f. Determination by the California Commissioner Of Insurance that loss of, or

changes in, the company’s reinsurance covering all or part of this policy would
threaten the financial integrity or solvency of the company, or continuation of this
policy coverage would place the company in violation of California or the laws of
the state of domicile of the company, or threaten the solvency of the company;
g. A change in the insured’s or the insured’s representative’s activities or property

which results in an additional, increased or changed risk, unless that additional,
increased or changed risks is included in the policy.
If the named insured cancels, earned premium shall be computed in accordance with the
customary short rate table and procedure. If the company cancels, earned premium shall
be computed pro rata. Premium adjustment bay be made either at the time cancellation is
effected or as soon as practicable after cancellation becomes effective, but payment or
tender of unearned premium is not a condition of cancellation.
Nonrenewal
If the company decides not to renew or continue this policy, the company will mail or
deliver to the named insured and the producer of record at the last known mailing
address written notice, stating the reason for nonrenewal, at least sixty days, but not more
than one hundred twenty days before the end of the policy period.
SLIKB 0004 (CA) (01/10) Page 2 of 2

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NUCLEAR ENERGY
LIABILITY EXCLUSION ENDORSEMENT
This endorsement modifies insurance provided under the AUTOMOBILE RENTAL LIABILITY EXCESS
POLICY
SECTION I-THE INSURANCE DOES NOT APPLY
A. Under any Liability Coverage, to bodily injury or property damage;
1. With respect to which an insured under the policy is also an insured under a
Nuclear Energy Liability Policy issued by Nuclear Energy Liability Insurance Association,
Mutual Atomic Energy Liability Underwriters, Nuclear Insurance Association of Canada or
any of their successors, or would be an insured under any such policy but for its termination
upon exhaustion of its limits of liability; or
2. Resulting from the hazardous properties of nuclear material and with

respect to which (a) any person or organization is required to maintain financial protection
pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (b) the
insured is, or had this policy not been issued would be, entitled to indemnity from the United
States of America, or any agency thereof, under any agreement entered into by the United
States of America, or any agency thereof, with any person or organization.
B. Under any Medical Payments coverage, to expenses incurred with respect to bodily
injury resulting from the hazardous properties of nuclear material and
arising out of the operation of a nuclear facility by any person or organization.
C. Under any Liability Coverage, to bodily injury or property damage resulting

from hazardous properties of nuclear material, if:
1. The nuclear material (a) is at any nuclear facility owned by, or operated by or on behalf of
an insured or (b) has been discharged or dispersed therefrom;
2. The nuclear material is contained in spent fuel or waste at any time possessed, handled,
used, processed, stored, transported or disposed of, by or on behalf of an insured, or
3. The bodily injury or property damage arises out of the furnishing by an

insured of services, materials, parts or equipment in connection with the planning,
construction, maintenance, operation or use of any nuclear facility
SECTION II- AS USED IN THIS ENDORSEMENT
“Hazardous properties” includes radioactive, toxic or explosive properties.
“Nuclear material” means source material, special nuclear material or by-product material.
“Source material,” “special nuclear material,” and “by-product material” have the meanings
given them in the Atomic Energy Act of 1954 or in any law amendatory thereof.
“Spent fuel” means any fuel element or fuel component, solid or liquid, which has been used or
exposed to radiation in a nuclear reactor.
KBIC-SLI- 0005 (10/10) -1- KnightBrook Insurance Company

“Waste” means any waste material (a) containing by-product material other than the tailings or
wastes produced by the extraction or concentration of uranium or thorium from any ore processed
primarily for its source material content, and (b) resulting from the operation by any person or
organization of any nuclear facility included under the first two paragraphs of the definition of
nuclear facility.
“Nuclear facility” means:
(a) Any nuclear reactor,
(b) Any equipment or device designed or used for (1) separating the isotopes of
uranium or plutonium, or (2) processing or utilizing spent fuel, or (3) handling, processing or
packaging waste,
(c) Any equipment or device used for the processing, fabricating or alloying of
special nuclear material if at any time the total amount of such material at the premises
where such equipment or device is located consists of or contains more than 25 grams of
plutonium or uranium 233 or any combination thereof, or more than 250 grams of uranium
235;
(d) Any structure, basin, excavation, premises or place prepared or used for the
storage or disposal of waste,
and includes the site on which any of the foregoing is located, all operations conducted on such
site and all premises used for such operations.
“Nuclear reactor” means any apparatus designed or used to sustain nuclear fission in a self-supporting
chain reaction or to contain a critical mass of fissionable material.
“Property damage” includes, without limitation, all forms of radioactive contamination of property.
This endorsement is a part of the policy and takes effect on the effective date
of the policy unless another effective date is shown below.
Complete only when this endorsement is not prepared with

the policy or is not to be effective with the policy.
Endorsement # Policy #
Effective on and after: ___________, 20_____, 12:01 a.m. standard time
Issued to : ________________________________________________
Issued by: _________________________________________________
Expiration Date:_____________________________________________
Authorized Representative_____________________________________
KBIC-SLI- 0005 (10/10) -2- KnightBrook Insurance Company

SUPPLEMENTAL LIABILITY INSURANCE

Declarations and Summary of Coverage
Policy No. 7SLIXX_ Effective Dates_ to

(Rental Agreement Number) (Car Out) (Car In)
Renter:
This is a condensed version of the policy issued to the insured rent a car company. It DOES NOT include all of the
limitations and terms of the policy or the terms of any endorsements attached thereto. The entire policy can be
viewed at the Insured Rent A Car Company’s office where the rental originated, a copy will be provided by the
administrator named above upon request. RENTER’S OWN PERSONAL AUTOMOBILE INSURANCE POLICY
FOR AN OWNED VEHICLE MAY PROVIDE RENTER WITH SUCH LIABILITY COVERAGE ON A
PRIMARY BASIS, WITH OR WITHOUT A DEDUCTIBLE.
COVERAGE
The coverage provided under this policy shall be extended to all individuals who rent an automobile from the
insured rent a car company and who elect to accept Supplemental Liability Insurance coverage on the face of the
rental contract identified above, during the term of the rental as stated on the rental contract, which term may be
extended, but not to exceed thirty days. The limits of liability will be afforded separately to each covered rental
contract.
CONDITIONS
Any terms, conditions and exclusions that apply to coverage as described in the Rental Contract shall also apply to
coverage, if any, as provided by the policy, provided the Rental Contract has been supplied or approved by the
insurance company. Wherever there is a conflict between an insurer-approved Rental Contract and this insurance
policy, this insurance policy shall apply.
1. Coverages hereunder are voided, do not provide protection and have no force and effect under the following
conditions:
A. The Renter’s failure to pay for charges due under the Rental Contract in accordance with the terms of the
Rental Contract;
B. Failure to accept Supplemental Liability Insurance on the face of the Rental Contract at the inception of the
Rental period. Such acceptance shall be in the form of an initial by the Renter on the face of the Rental
Contract, in a box indicating acceptance of Supplemental Liability Insurance; failure to decline coverage is
not evidence of coverage;
C. Use or operation of the vehicle in violation of the terms of the Rental Contract, including, without
limitation, participation in any speed contest, driving under the influence of drugs or alcohol, driving the
vehicle beyond the geographic limitations stated in the Rental Contract;
D. Where the driver of the automobile at the time of loss is not a Renter or additional driver specifically
authorized by the policyholder in the Rental Contract.
E. Obtaining the vehicle by fraud or misrepresentation;
2. Coverages (other than Uninsured Motorist coverage where required by law) are not provided to the Renter, or a
member of Renter’s family related by blood, marriage, adoption, or person who reside with Renter in the same
household. Coverages (other than Uninsured Motorist coverage where required by law) are not provided to
passengers in the rental vehicle.
3. Coverage does not apply in Mexico.
4. Coverage is not provided for uninsured motorist property damage, underinsured motorist property damage, first
party benefits, no-fault or other optional liability protection.
For any questions, complaints, or problems associated with this insurance please contact the administrator listed
above.
KBIC-SLI-0007 (08/08) KnightBrook Insurance Company

RLP- Renter's Liability Protection
SLI - Supplemental Liability Insurance
APPLICANT'S SECTION:
1. Business name (s) of applicant (list full entity name, dba's, etc., and state of incorporation, if applicable) and FEIN:
2. Names and Titles of all owners, partners, and managers:
3. Telephone number (s) of applicant and name of 3a. E-mail Address 3b.Business Web Site Address
person to contact regarding insurance matters:
4. Address of main business location (including zip code):
5. Mailing address of applicant:
6. Name of current insurance carrier, and policy period dates:
7. Is the policy described in item #6 being canceled or non-renewed?:
8. (a) Current/renewal premium rate?:
9. Describe current coverage:
(a) Owner's Liability Limit:________________ (c) Fire, Theft, CAC (or Comprehensive) Deduction________
(b) Customer's Liability Limit______________ (d) Collision Deductible:_________________
10. Does the applicant have any experience in the short-term rental business?
(a) If yes, describe, including number of years owning this or other rental business:
(b) If no, describe other business experience:
KBIC-SLI- 0008 (04/10) KnightBrook Insurance Company
1
11. Describe all OTHER business(es) (ie., OTHER than the one described in this application):
12. (a) Total number of vehicles for rent:

Private Passenger:___________________ Trucks & Vans____________________
(b) Does applicant request our company to insure all vehicles held available for rent by applicant? Yes or No
if no, explain why and enter total number of vehicles to be insured. (CIRCLE ONE)
(c) Does the applicant rent vehicles with the "option to buy" or "rent to own"? Yes or No
(d) Does the applicant hold any vehicle(s) that:

(I) has more than one rear axle Yes or No
(ii) is designed to haul other vehicles (like tractors or tow-trucks) Yes or No
(iii) is designed to transport more than 15 people Yes or No
(iv) has a gross vehicle weight of 20,000 pounds or more? Yes or No
13. Describe the rental practices followed by the applicant, including specific reference to age restrictions, cash
rentals, local customer rentals, military personnel, and additional drivers:
14. Does the applicant review the driving record of employees before they are hired?
15. Describe vehicle maintenance procedures followed by the applicant:
16. Describe percentage of rental customers:

AIRPORT/ TOURIST TRAFFIC: _______________
Business/ Corporate: _______________
Personal/Pleasure: _______________
LOCAL TRAFFIC: _______________
Insurance Replacement: _______________
Other: _______________
17. Provide the total average of vehicles available for rent during each of the last 3 years:
2008 _______ 2009________ 2010________
18. Provide the total number of accidents during each of the last 3 years:
2008 _______ 2009________ 2010________
2
19. Provide a detailed description of each accident which caused, in total, bodily injury or property damage in excess
of $15,000.00:
20. Please include each of the following:

(a) Copy of present liability policy, if any
(b) Description of losses (past 3 years) - include company issued loss report (if not available, please ask your agent)
(c) Schedule of vehicles - include years, makes, models
(d) Sample rental contract/agreement - must be original
(e) Copy of all telephone directory advertising
APPLICANT REPRESENTATIONS:
Applicant represents that all the information on this application is true, correct, and complete. Applicant understands
that it is their responsibility to read and comprehend the contents of this application, and that any material
misrepresentations or omission will invalidate coverage; and, note that this is not a policy of insurance, and that,
regardless of the form's content, this document imparts no coverage whatsoever:
NOTICE TO ALASKA APPLICANTS: A person who knowingly and with the intent to injure, defraud, or deceive an
insurance company files a claim containing false, incomplete, or misleading information is guilty of a felony.
NOTICE TO ARKANSAS APPLICANTS: Any person who knowingly presents a false or fraudulent claim for payment
of a loss or benefit or knowingly presents false information in an application for insurance may be guilty of a crime and
subject to fines and confinement in prison.
NOTICE TO CALIFORNIA APPLICANTS: For your protection California law requires the following to appear on this
form. Any person who knowingly presents false or fraudulent claim for the payment of a loss is guilty of a crime and
may be subject to fines and confinement in prison. Any person who knowingly files a statement of claim containing
any false or misleading information is subject to criminal and civil penalties.
NOTICE TO COLORADO APPLICANTS: It is unlawful to knowingly provide false, incomplete or misleading facts or
information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties
may include imprisonment, fines, denial of insurance, and civil damages. Any insurance company or agent of an
insurance company who knowingly provides false, incomplete or misleading facts or information to a policyholder or
claimant for the purpose of defrauding or attempting to defraud the policy holder or claimant with regard to a
settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within
the Department of Regulatory Agencies.
NOTICE TO DELAWARE APPLICANTS: Any person who knowingly, and with the intent to injure, defraud or deceive
an insurer, files a statement of claim containing any false, incomplete or misleading information is guilty of a felony.
NOTICE TO DISTRICT OF COLUMBIA APPLICANTS: It is a crime to provide false or misleading information to an

insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment and/or fines. In
addition, any insurer may deny insurance benefits if false information materially related to a claim was provided by the
applicant.
3
NOTICE TO FLORIDA APPLICANTS: Any person who knowingly, and with the intent to injure, defraud or deceive
any insurance company files a statement of claim containing any false, incomplete or misleading information is guilty
of a felony of the third degree.
NOTICE TO HAWAII APPLICANTS: For your protection, Hawaii law requires you to be informed that presenting a
fraudulent claim for payment of a loss or benefit is a crime punish able by fines, imprisonment or both.
NOTICE TO IDAHO APPLICANTS: Any person who knowingly, and with the intent to defraud or deceive any false,
incomplete or misleading information is guilty of a felony.
NOTICE TO INDIANA RESIDENTS: A person who knowingly and with the intent to defraud an insurer files a
statement of claims containing any false, incomplete or misleading information commits a felony.
NOTICE TO KENTUCKY APPLICANTS: Any person who knowingly and with the intent to defraud an insurance
company or other person files an application for insurance or statement of claim containing any materially false
information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a
fraudulent insurance act, which is a crime.
NOTICE TO LOUISIANA MAINE AND TENNESSEE APPLICANTS: Any person who knowingly and with the intent
to defraud any insurance company or another person, files a statement of claim contain any materially false
information, or conceals for the purpose of misleading, information concerning any fact, material thereto, commits a
fraudulent insurance act, which is a crime, subject to criminal prosecution and civil penalties. Insurance benefits may
also be denied.
NOTICE TO MINNESOTA APPLICANTS: A person who submits an application or files a claim with intent to defraud
or helps commit a fraud against an insurer is guilty of a crime.
NOTICE TO NEVADA APPLICANTS: Pursuant to NRS 686A.291, any person who knowingly and willfully files a
statement that contains any false, incomplete or misleading information concerning a material fact is guilty of a felony.
NOTICE TO NEW HAMPSHIRE APPLICANTS: Any person who, with the purpose to injure, defraud or deceive any
insurance company, files a statement of claim containing any false , incomplete or misleading information is subject to
prosecution and punishment for insurance fraud, as provided in RSA 638:20.
NOTICE TO NEW JERSEY APPLICANTS: Any person who includes any false or misleading information on an
application for an insurance policy is subject to criminal and civil penalties.
NOTICE TO NEW MEXICO APPLICANTS: Any person who knowingly presents a false information in an application
for insurance is guilty of a crime and may be subject to civil fines and criminal penalties.
NOTICE TO NEW YORK APPLICANTS: Any person who knowingly makes or knowingly assists, abets, solicits or
conspires with another to make a false report of the theft, destruction, damage or conversion of any motor vehicle to a
law enforcement agency, the department of motor vehicles or any insurance company, commits a fraudulent
insurance act, which is a crime, and subject to a civil penalty not to exceed five thousand dollars and the value of the
subject motor vehicle or stated claim for each violation.
NOTICE TO OHIO APPLICANTS: Any person who, with the intent to defraud or knowing that he is facilitating a fraud
against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of
insurance fraud.
NOTICE TO OKLAHOMA APPLICANTS: WARNING: Any person who knowingly and with the intent to injure,
defraud or deceive any insurer, makes any claim for the proceeds of a n insurance policy containing any false,
incomplete or misleading information is guilty of a felony.
4
NOTICE TO PENNSYLVANIA APPLICANTS: Any person who knowingly and with the intent to defraud any
insurance company or other person files an application for insurance or statement of claim containing any materially
false information or conceals for the purpose of misleading, information concerning any fact thereto commits a
fraudulent insurance act , which is a crime and subjects such a person to criminal and civil penalties.
NOTICE TO VIRGINIA APPLICANTS: 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 and
denial of insurance benefits.
Applicants Signature (must be owner or officer)
Title: Date:
(NOTE: APPLICANT MUST SIGN even if submitted through an agent or broker)
Below Please Describe the current computer system you operate.

Do you have internet access? Yes No
How do you connect to the internet (circle one) Modem Cable Modem DSL T1 Other
How many customer service workstations do you have with computers ____________________
Do the customer service workstations have internet access? ____________________
What operating system do your computers run on? Mac / Win NT / Win 3.1 / Win 95 / Win 98 / Win 2000 / DOS
Win XP/ Win Vista /Win 7
Which Rental System do you use? TSD (Rent 200) Bluebird Other____________
5

Rate Information
Rate data applies to filing.
Filing Method: Prior Approval
Rate Change Type: Neutral
Overall Percentage of Last Rate Revision: %
Effective Date of Last Rate Revision:
Filing Method of Last Filing:
Company Rate Information

Overall % Overall % Written Premium Number of Policy Written Maximum % Minimum %
Company Indicated Rate Change for Holders Affected Premium for Change Change
Name: Change: Impact: this Program: for this Program: this Program: (where req'd): (where req'd):
KnightBrook Insurance 0.000% 0.000% $0 0 $0 0.000% 0.000%
Company

Rate/Rule Schedule
Item Schedule Item Previous State

No. Status Exhibit Name Rule # or Page # Rate Action Filing Number Attachments
1 Underwriting Guidelines Page 1 of 1 New Underwriting guidelines.pdf
2 Manual Page 1 of 1 New New SLI rates & rules.pdf
Supplemental Liability Insurance (SLI) – Underwriting Guidelines
The Supplemental Liability Insurance program, SLI, is a commercial automobile policy issued to rental car
companies, and underwritten on an individual account basis. This coverage is then offered over the
counter to customers of the insured. It provides third party liability protection excess of the minimum
required state limits, and up to the selected limit.
There are several qualifying factors for the rental car operator that wishes to obtain an SLI policy. The
rental company must complete and sign an application and submit it for review along with a copy of
their current fleet list, past three year loss runs, copy of limited insurance license, and copy of rental
agreement with appropriate SLI language. The application and loss runs are reviewed and qualified
prior to issuing the policy.
The applicant must have at least three years of rental car experience. In the event that this is a new
operator, we require copy of resume and / or references contingent with their past business experience.
All rental operators must also have internet access in order to report electronically or must be affiliated
with an accepted rental software provider such as Bluebird or TSD. The average fleet age must not be
more than five years old. The three year loss runs are evaluated on a combined basis, and the loss ratio
cannot exceed 60%. If the loss ratio is greater than 60%, we consider the account a high risk and do not
accept it.
COMMERCIAL LINES MANUAL
SUPPLEMENTAL LIABILITY INSURANCE
RATES & RULES
CAR RENTAL
Supplemental Liability Insurance
Bodily Injury and Property Damage Premiums
Combined Single Limits Private Passenger Rate Per Private Passenger Rate Per
Car Day Car Hour*
$300,000 $7.45 $0.93

$500,000 $8.75 $1.09
$1,000,000 $9.95 $1.24
$2,000,000 $11.28 $1.41
$100,000 UM $1.00 $0.25
*Three hour minimum rental. Total hourly rate cannot exceed the daily rate.
For trucks over 8,000 pounds, Recreational Vehicles, Motorcycles and 15 passenger or more vans, a
charge range of 1.3 to 3.75 times the private passenger car rates above.
UNDERWRITING DEBITS/CREDITS:
Maximum Credit: 25%

Maximum Debit 25%
Modification Grounds Credit Debit
Management Experience, Qualification & Stability 10% 10%

Audit, Internal Management and Administration 10% 10%
Number of Agencies and Length of Association 10% 10%
Loss Experience 10% 10%
Program Administrative Expenses 10% 10%

Supporting Document Schedules

Comments:
Attachment(s): PriorApprovalRateApplication022812--KBIC CA SLI, New Pgm Filing (for Response, 9-19-12 CDI questions).pdf
PriorApprovalRateApplication022812--KBIC CA SLI, New Pgm Filing (for Response, 9-19-12 CDI questions).xls
Item Status:
Status Date:
Satisfied - Item: Exhibit 17

Comments:
Attachment(s): Exhibit 17.pdf
Item Status:
Status Date:
Satisfied - Item: Letter of Authorization

Comments:
Attachment(s): Filing Authorization Letter - CA SLI.pdf
Item Status:
Status Date:

Attachment PriorApprovalRateApplication022812--KBIC CA SLI, New Pgm Filing (for Response, 9-19-12

CDI questions).xls is not a PDF document and cannot be reproduced here.
STATE OF CALIFORNIA Company Name KnightBrook Insurance
DEPARTMENT OF INSURANCE (CDI) Line of Insurance AUTO LIABILITY
Edition Date: 2/28/2012
PRIOR APPROVAL RATE APPLICATION

Completed by: Neresa Torres Date: 9/19/2012
Your File #: KBIC-CA-SLI-12-08 DEPARTMENT USE ONLY

( 15 Characters Maximum)
SERFF CD (plus 1 paper copy) Paper (1 original plus 1 copy) Filing No.:
Does this filing include a variance request? No
SERFF No.:
Is this a variance request submitted after the prior approval application to
which it applies? No
Date Filed:
If yes, provide the applicable CDI File Number: Compliance Date:
Does this file contain group data? No Date Public Notified:
Note: Complete page 2 if this is a group filing Deemer Date:
Is this a specialty filing? No Intake Analyst:
Latest applicable CDI file number in this line, subline and/or program: Bureau & Senior:
12-4799
Group Filing: Yes No
Company Name KnightBrook Insurance Company
X-Reference No.:
NAIC Company Code 13722
Rate New Program Rule
Group Name KnightBrook Insurance Group
NAIC Group Code 1316

Form Variance % Change
Organized under the Laws of the State of DE
Line Type COMMERCIAL

Line of Insurance: AUTO LIABILITY
Subline 20.0003 Other Program Auto Rental Excess Liability
Home Office Brandywine Village, 1807 N. Market Street, Wilmington, DE 19802-4810
Name and Title of Contact Person Neresa Torres, Filing Analyst III
Toll Free Phone No.: (888) 201-5123, x111 Fax No.: (310) 230-8529
Email Address doi@perrknight.com
Mailing Address cc: Perr&Knight, Inc. 401 Wilshire Blvd, Suite 300, Santa Monica, CA 90401
I declare under penalty of perjury under the laws of the State of California, that the information filed is true, complete, and correc
Neresa Torres September 19, 2012 (888) 201-5123, x111

Authorized Signature Date of Filing Telephone Number
Important note: Refer to CDI website at http://www.insurance.ca.gov/0250-insurers/0800-rate-filings/for the most current

rate template and prior approval factors.
Prior Approval Rate Application

(General Information) Page 1
STATE OF CALIFORNIA Company Name KnightBrook Insurance Company
INSURER GROUP MULTI-COMPANY FILING
For private passenger auto insurance only, does CIC, 1861.16(c) apply? No
If yes, please complete (Super Group) Exhibit 19.
List each insurance company in alphabetical order.
Company Name CDI Filing No.

( Department use only )
NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

(Insurer Group Information) Page 2
STATE OF CALIFORNIA Company Name: KnightBrook Insurance Company
DEPARTMENT OF INSURANCE (CDI) Line of Insurance: AUTO LIABILITY
PROPERTY AND LIABILITY FILING SUBMISSION DATA SHEET
The purpose of this filing is as follows: (More than one may be marked )
TYPE OF FILING PRIOR APPROVAL RATE APPLICATION

PAGES and EXHIBITS REQUIRED
New Program ( Including adoption of advisory organization loss costs, Pages 1 through 7, 10, 12, 13 & 14,
forms and rules.) plus exhibit 17
Rates ( Including adoption of advisory organization loss costs. )
Increase rates Pages 1 through 10, 13 & 14, plus exhibits
Decrease rate Pages 1 through 10, 13 & 14, plus exhibits
Zero Overall rate impact Pages 1 through 10, 13 & 14, plus exhibits
Variance
Filed together with the prior approval application to which it Page 11 and exhibit 13
applies.
Filed after the prior approval application to which it applies. Pages 1 through 6, 11, plus exhibit 13
Coverage Forms ( Including adoption of advisory organization forms. )
With rate impact Pages 1 through 10, 12a, 13 & 14 plus exhibits
Without rate impact Pages 1 through 5, 12a
Rules ( Including adoption of advisory organization rules. )
With rate impact Pages 1 through 10, 12b, 13 & 14 plus exhibits
Without rate impact Pages 1 through 5, 12b, Exhibit 20
All Private Passenger Automobile class plans must be filed separately from
the Prior Approval Rate Applications.

(Filing Data) Page 3
PROPERTY AND LIABILITY FILING SUBMISSION DATA SHEET (Continued)
Proposed Earned Premium Per Exposure: $ 9.65 CSL Rate

300000 7.45 0.25
Proposed Overall Rate Change 500000 8.75 0.2
1000000 9.95 0.5
2000000 11.28 0.05
9.1515 1
INDICATED PROPOSED ADJUSTED PROJECTED UM 1

COVERAGE* CHANGE (%) CHANGE (%) EARNED PREMIUM* EARNED PREMIUM 9.6515
1. Commercial Auto Liability 193,000
2.
3.
4.
5.
6.
7.
8.
9.
10.
TOTAL:
Total earned premium must include all income derived from miscellaneous fees and other charges.
* Commercial Auto Liability and Physical damage must be combined in one application, with separate rate templates for liability and
physical damage.
* Adjusted earned premium is the historical earned premium for the most recent year adjusted to the current rate level and trended
to the average date of loss of the proposed rating period.
Prior Approval Rate Application Page 4

(Filing Data Continued)
FILING CHECKLIST
Use this checklist to assemble a complete application
Prior Approval Rate Application, Page 1
Group Filing, Page 2
Property and Liability Filing Submission

Data Sheet, Page 3

Data Sheet, Page 4
Filing Checklist, Page 5
Supporting Data Exhibits, Page 6
Ratemaking Data and Template (s), Page 7
Reconciliation of Direct Earned Premium, Page 8
Additional Data Required by Statute, Page 9
Miscellaneous Fees and Other Charges, Page 10
Variance Request, Page 11
Forms and Rules, Page 12
Excluded Expenses, Page 13
Projected Yield and Federal Income Tax Rate on Investment Income, Page 14
Filing Memorandum
See the prior approval rate filing instructions regarding the following attachments.
Printed Rate and Rule Manual Pages
Underwriting Rules
Forms (Attach all independent forms and list all advisory organization forms )
Copies of Reinsurance Agreements

( Applies only to Medical Malpractice with facultative reinsurance attachment points above one million dollars and
Earthquake, where the cost of reinsurance is included in the rate development.)

(Filing Checklist) Page 5
SUPPORTING DATA EXHIBITS

Use this document to assemble a complete application
Exhibit 1: Filing History
Exhibit 2: Rate Level History
Exhibit 3: Policy Term Distribution
Exhibit 4: Premium Adjustment Factor
Exhibit 5: Premium Trend Factor
Exhibit 6: Miscellaneous Fees and

Other Charges
Exhibit 7: Loss and Defense & Cost Containment Expense

( DCCE ) Development Factors
Exhibit 8: Loss and DCCE Trend
Exhibit 9: Catastrophe Adjustment
Exhibit 10: Credibility Adjustment
Exhibit 11: Ancillary Income
Exhibit 12: Reinsurance Premium and Recoverables
Exhibit 13: Variance
Exhibit 14: Insurer's Ratemaking Calculations
Exhibit 15: Rate Distribution
Exhibit 16: Rate Classification Relativities
Exhibit 17: New Program
Exhibit 18: Group Filing
Exhibit 19: Super Group Corporate Structure Verification (PPA only)
Exhibit 20: Rules
Exhibit 21:

(Supporting Data Exhibits) Page 6
Instructions for completing Prior Approval Rate Template (in application) :
* A separate rate template is required for each coverage (i.e. BI,PD,MP,UM,Comp&Coll) for which a
separate premium is charged. Download and complete a multi-coverage template (PPA for
personal auto) if more than one template is needed.
* Enter data in lined boxes on RateMakingData page only (Do not enter data directly in Template.).
For more than three years of data, click + button.
* In the rate making data tab, enter the following data: Line Description (select from menu);
Coverage; Marketing System (percentage of each system used, totaling 100%); Prior Effective
Date (of current rates); Proposed Effective Date (of proposed new rates); statistical period used;
one or more years of appropriate data.
* Enter numerical data only; no comments please. (For inapplicable fields: 0 for $ or %; 1.00 for
factors)
* Enter Variance data, only if supported by Variance Request. Final decisions regarding variances
will be made by CDI and/or administrative hearing.
* If you are filing Advisory Organization Loss Costs with a Loss Cost Multiplier, read the LCM
Instructions tab and complete the LCM template.
* For results, see Template tab (Disregard Reinsurance indication if not applicable).
RATEMAKING DATA
(Click + to expand for more than 3 years; - to contract)
Completed by
Neresa Torres
Date Completed
9/19/2012
Company/Group KnightBrook Insurance Company
Line Description COMMERCIAL
COMMERCIAL AUTOAUTO
LIABILITY
LIABILITY
Coverage
%Captive %Direct %Independent (Must add up to 100%)
Marketing System: 100.00%
Prior Effective Date (current rates)
Proposed Effective Date (new rates)
CDI File Number (Department use only ) 0
Does the data provided below reflect a Request for Variance? No Variance #:
Data below is: Accident Year Data
Projected*/ New
2nd Prior Year 1st Prior Year Most Recent Year Program**
1 California Direct Written Premium 193,000
2 California Direct Earned Premium 193,000
3 Premium Adjustment Factor (Developed in Exhibit 4)
4 Premium Trend Factor * (Developed in Exhibit 5)
5 Miscellaneous Fees and Flat Charges (Not included in Line 2;

Developed in Exhibit 6)
6 Earned Exposure Units 20,000
7 Historic Losses (Projected for New Programs) 144,750

0.579691 5.647566 0.570209 2.265822
8 Historic Defense and Cost Containment Expense (DCCE)
0.015968 0 0
9 Loss Development Factor (Developed in Exhibit 7)
0.531211
10 DCCE Development Factor (Developed in Exhibit 7)
11 Loss Trend Factor* (Developed in Exhibit 8)
12 DCCE Trend Factor* (Developed in Exhibit 8)
13 Catastrophe Adjustment Factor (Developed in Exh 9)
14 Credibility Factor for Losses & DCCE (Developed in Exhibit 10)
15 Excluded Expense Factor (From Page 13) 1.97%
16 Ancillary Income (Developed in Exhibit 11)
17 Projected Federal Income Tax Rate on Investment Income (From 29.72%

Page 14)
18 Projected Yield (From Page 14) 5.03%
Complete 19, 20 & 21 For Earthquake and certain Medical

Malpractice with Reinsurance Only (see instructions)
19 Direct Commissions
20 Reinsurance Premium (Developed in Exhibit 12)
21 Reinsurance Recoverables (Developed in Exhibit 12)
Variance Change to Leverage on the basis that the insurer either

writes at least 90% of its direct earned premium in one line or writes
No
at least 90% of its direct earned premium in California. (Must be
accompanied by Variance Request, subject to CDI approval)
Variance Change to Efficiency Standard (Must be accompanied by

Variance Request, subject to CDI approval)
For all trend factors, the Projected Column should reflect the
* annual trend expressed as a percentage.
** For New Programs, please see Rate Filing Instructions, Page 4.

(Ratemaking Data) Page 7
STATUTORY PAGE 14 CALENDAR YEAR DATA

RECONCILIATION OF DIRECT EARNED PREMIUM DATA PER PROGRAM
2nd 1st Most

Prior Prior Recent
Year Year Year
Most Recent
Program CDI File # 0 0 0
1.
2.
3.
4. $ - $ - $ -
5. $ - $ - $ -
6. $ - $ - $ -
7. $ - $ - $ -
8. $ - $ - $ -
9. $ - $ - $ -
10. $ - $ - $ -
TOTAL $ - $ - $ -
Statutory
Page 14
Difference $ - $ - $ -
Explain the Differences:
This exhibit requires insurers to itemize each program until all data is reconciled to the corresponding annual statement line
of insurance ( Statutory Page 14 ).
For residual market data, a filing number is not required.

(Premium Reconciliation) Page 8
ADDITIONAL DATA REQUIRED BY STATUTE*

Calendar Year Year 0
DATA
1. Number of claims outstanding at beginning of year
2. Number of claims during the year
3. Number of claims closed during the year
4. Number of claims outstanding at year's end ( (1) + (2) - (3) )
5. Unearned Premiums
6. Dollar amount of claims paid
7. Net loss reserves for outstanding claims excluding claims incurred but not reported
8. Net loss reserves for claims incurred but not reported
9. Losses incurred as a percentage of premiums earned - including IBNR
10. Net investment gain or loss and other income or gain or loss allocated to the line.
11. Net income before federal and foreign income taxes ( line 10 plus line 15 )
12. Total number of policies in force on the last day of the reporting period
13. Total number of policies cancelled
14. Total number of policies non-renewed
15. Net underwriting gain or loss

( =CY earned premiums minus CY incurred loss minus CY incurred expense )
16. Separate allocations of expenses for:
a) commissions and brokerage expense,
b) other acquisition costs,
c) general office expenses,
d) taxes, licenses and fees,
e) loss adjustment expense ( DCCE & AOE ), and
f) other expenses
*CIC 1857.7, CIC 1857.9 and CIC 1864

(Additional Data) Page 9
MISCELLANEOUS FEES AND OTHER CHARGES
Do any fees or installment finance charges apply to this program? No

If yes, identify the fee and the amount charged for each type of fee and for each transaction.
INDIVIDUAL POLICY CHARGES
New Business Renewals
Policy fee
Installment fee
Installment finance charges ( ancillary income ) APR
Endorsement fee
Inspection fee
Cancellation fee
Reinstatement fee
Late fee
SR 22
Non-sufficient funds ( NSF ) fee ( ancillary income )
Membership dues ( ancillary income )
Other, specify:
Except for installment finance charges, NSF fees, and membership dues, data relating to fees must be included in the ratemaking data, Page
7, Line 2 ( direct earned premium) or Line 5 ( miscellaneous fees ) and Exhibit 6, miscellaneous fees, must be completed. Refer to the
instructions for additional information.

(Miscellaneous Fees) Page 10
REQUEST FOR VARIANCE
1. Identify each variance requested. ((See below (F))
2.
Identify the extent or amount of the variance requested and the applicable component of the ratemaking formula. [ Complete Exhibit 13 ]
3. Set forth the expected result or impact on the maximum and minimum permitted earned premium that the granting of the variance will have as compared to the expected result if the variance
is denied. [ Complete Exhibit 13 ]
4.
IMPORTANT: Identify the facts and their source justifying the variance request and provide the documentation supporting the amount of the change to the component of the ratemaking
formula. (Complete Exhibit 13)
IDENTIFY THE BASES FOR VARIANCE - Refer to CCR 2644.27 (f) for the full regulation text.
Maximum Permitted Rate Change % Excluding Variance

(Change At Max Per Template)
1. Relief from the efficiency standard for bona fide loss-prevention and loss reduction activities.
A. Allocated cost for SIU.

B. Expenses for loss prevention programs.
Maximum Permitted Rate Change % With Only This Variance

2. Relief from the efficiency standard due to any of the following:
A. Higher quality of service, as demonstrated by objective measures of consumer satisfaction; or

B. Demonstrated superior service to underserved communities ( CCR 2646.6 ); or
C. Significantly smaller or larger than average California policy premium, including any applicable fees.

3. The leverage factor should be different from the leverage factor determined pursuant to section 2644.17 on the basis that the insurer either writes at least 90%
of its direct earned premium in one line or writes at least 90% of its direct earned premium in California, and its mix of business presents investment risks
different from the risks that are typical of the line as a whole.

4. Relief from operation of the efficiency standard for a line of insurance in which the insurer has never written over $1 million in earned premium annually and
the insurer is making a substantial investment in order to enter the market.

5. The minimum permitted earned premium should be lower on the basis of the insurer's certification that the rate will not cause the insurer's financial condition
to present an undue risk to its solvency.
6. The insurer's financial condition is such that its maximum permitted earned premium should be increased in order to protect solvency.

7. The loss development formula in CCR 2644.6 does not produce an actuarially sound result because:
A. There is not enough data to be credible

B. There is not enough years of data to fully calculate the development to ultimate;
C. There are changes in the insurer's reserving or claims closing practices that significantly affect the data; or,
D. There are changes in coverage or other policy terms that significantly affect the data; or,
E. There are changes in the law that significantly affect the data.
F. There is a significant increase or decrease in the amount of business written or significant changes in the mix of business.


8. The trend formula in CCR 2644.7 does not produce the most an actuarially sound result because:
A. There is a significant increase/decrease in the amount of business written or changes in the mix of business:
B. There are not enough years of data to calculate the trend factor;
C There is a significant change in the law affecting frequency or severity of claims;
D It can be shown that a trend calculated over a period of at least 4 quarters other than a period permitted pursuant to section
2644.7(b) is more reliable prospectively.
E. There are changes in the insurer's claims closing practices that significantly affect the data; or,
F. There are changes in coverage or other policy terms that significantly affect the data.

9. The maximum permitted earned premium would be confiscatory if applied.

Overall Maximum Permitted Rate Change %
Not withstanding any other section of these regulations, the aggregate total adjustment to the
efficiency standard for all variances combined shall not exceed the difference between the Most Recent
insurer's most recent year total expense ratio excluding defense and cost containment Year Total
expenses and the efficiency standard. Expense Ratio %

STATE OF CALIFORNIA Company Name: KnightBrook Insurance
FORMS
Insurers who wish to use a new or replacement form in connection with a new or existing program must furnish the following information and documentation for our review.
Revisions must be highlighted and the corresponding manual pages must be provided.
Restricts Broadens Rate
SOURCE Coverage Coverage Impact % Flat
FORM NO. TITLE TYPE SOURCE FORM NO * CATEGORY [ Yes/ No ] [ Yes/ No ] [ Yes / No ] Change Rate
1] New: KBIC-SLI-0001 (12/09) Declarations Page 4 3 N/A 1 N N N N/A N/A
Old:
2] New: KBIC-SLI-0002 (05/10) Automobile Rental Liability Excess Policy (Rental Car Companies Only) 3 3 N/A 1 N N N N/A N/A
Old:
3] New: KBIC-SLI-0003 (04/10) Rental Car Company Endorsement 2 3 N/A 1 N N N N/A N/A
4] New: SLIKB 0004 (CA) (01/10) California Amendatory Endorsement 2 3 N/A 1 N N N N/A N/A
5] New: KBIC-SLI-0005 (10/10) Nuclear Energy Liability Exclusion Endorsement 2 3 N/A 1 N N N N/A N/A
6] New: KBIC-SLI-0007 (08/08) Declarations and Summary of Coverage (Renter's Disclosure) 4 3 N/A 1 N N N N/A N/A
7] New: KBIC-SLI-0008 (04/10) Supplemental Liability Insurance Application 1 3 N/A 1 N N N N/A N/A
Old:
REQUIRED RESPONSES FOR THE ITEMS ABOVE
TYPE: SOURCE CATEGORY
1) Application 1) ISO* 1) New, mandatory

2) Endorsement 2) Other Advisory Organization* 2) New, optional
3) Policy 3) Company 3) Replacement, mandatory
4) Other ( Please define ) 4) Other (describe) 4) Replacement, optional
5) Withdrawn, mandatory
6) Withdrawn, optional
* Provide California Dept. of Insurance number ( CDI# ) under the column identified as Source Form No.
Additional Information and Documents Required
Describe the purpose of the form or form change
For NEW FORMS, furnish a copy of the form to be filed, unless identical to an advisory organization form. If the form is a new endorsement to the policy, describe any changes in coverage under the policy. Describe
what adjustments, if any, will be made to the premium due to the introduction of the forms.
For REVISED FORMS, describe any changes in coverages between the proposed form and the current form. Reference pertinent sections of each form affected. Brackets [ ] should be used to identify any deletions on
the current form and underline all changes in the revised form. Describe what adjustments, if any, will be made to the premium due to the revisions.
(Forms) Page 12(a)
STATE OF CALIFORNIA Company Name: KnightBrook
RULES
Insurers wishing to make a rule change filing must provide the following information.
Exhibit 20 may be completed to provide additional information.
Identify the option(s) that applies.
Introducing a new rule (New Program Filing)

Revising an existing rule
Adopting an approved Advisory Organization rule
Withdrawing an approved rule
Use the following as a checklist to provide the required information.
If introducing a new rule or revising an existing rule, provide:
The purpose for the rule or an explanation for revising an existing rule
A copy of the current and proposed manual page corresponding to the rule
The charge for the rule. Support or justify the charge and provide the rate or premium
development method.
The rate impact of the rule to the current book of business, showing the calculation.
Advise if the rule is: Optional Mandatory
If withdrawing an approved rule, provide:
An explanation for withdrawing the rule
A copy of the current and proposed manual page(s) corresponding to the withdrawn rule
The rate impact of the withdrawn rule to the current book of business
If adopting an approved Advisory Organization rule(s), specify the

approved CDI filing number(s) of the AO rule(s):
Insurer Comments:

(Rules) Page 12(b)
STATE OF CALIFORNIA Company Name: KnightBrook Insurance Compa
EXCLUDED EXPENSE FACTOR

(Insurer Group Data)
Company Organization: Stock Most Recent

2nd Prior Year 1st Prior Year Year
(Enter Year)
Countrywide direct earned premium:
5,418,119 21,225,461 54,548,464
Countrywide direct earned premium for lines of business subject
to Proposition 103: 5,418,119 21,225,461 54,548,464
2644.10 (b): Executive Compensation

2nd Prior Year 1st Prior Year Most Recent Year
0 0 0
Cash & Salary Bonus Cash & Salary Bonus Cash & Salary Bonus
1st Highest Paid 282,500 282,500 0 438,098 0

2nd Highest Paid 180,000 180,000 0 379,049 0
3rd Highest Paid 101,700 101,700 0 370,000 0
4th Highest Paid 88,747 88,747 0 256,155 0
5th Highest Paid 67,800 67,800 0 127,500 0

0 0 0
Max Permissible Excessive Max Permissible Excessive Max Permissible Excessive
Exc Comp Compensation Exc Comp Compensation Exc Comp Compensation
1st Highest Paid 174,311 108,189 174,311 108,189 174,311 263,787

2nd Highest Paid 123,071 56,929 123,071 56,929 123,071 255,978
3rd Highest Paid 92,906 8,794 92,906 8,794 92,906 277,094
4th Highest Paid 87,048 1,699 87,048 1,699 87,048 169,107
5th Highest Paid 81,141 0 81,141 0 81,141 46,359
Total Excessive Executive Comp: 175,611 175,611 1,012,325

(Excluded Expense Factor) P13a
Excluded Expense Factor
Most Recent
Countrywide Data 2nd Prior Year 1st Prior Year Year
0 0 0
2644.10 (a): Political contribution and lobbying 0 0 0
2644.10 (b): Excessive Executive Compensation 175,611 175,611 1,012,325
2644.10 (c): Bad faith judgments and associated DCCE
2644.10 (d): All costs for unsuccessful defense of discrimination claims
2644.10 (e): Fines and penalties
2644.10 (f): Institution advertising expenses
2644.10 (g): Excessive payments to affiliates
Total excluded expenses 175,611 175,611 1,012,325
Excluded expense factor 3.24% 0.83% 1.86%
3-year average excluded expense factor 1.97%

(Excluded Expense Factor) P13b
PROJECTED YIELD AND FEDERAL INCOME TAX RATE ON INVESTMENT INCOME
Short Term Intermediate Long Term

Assets Term Assets Assets
Over 1 yr Over 5 yrs Over 10 yrs
Line number One year or less through 5 yrs through 10 yrs through 20 yrs Over 20 yrs
1.7 US governments 0 3,078,395 0 0 0
2.7 All other governments 0 0 0 0 0

States, territories and
3.7 possessions 0 0 0 0 0
4.7 Political subdivisions 0 0 0 0 0

Special revenue and
5.7 assessment obligations 0 0 0 0 0
6.7 Public utilities unaffiliated 0 0 0 0 0
7.7 Industrial and miscellaneous 4,205,030 3,711,691 6,267,672 0 0
8.7 Credit tenant loans 0 0 0 0 0

Parent, subsidiaries and
9.7 affiliates 0 0 0 0 0
One year or less Over 1 year through 10 years Over 10 years
US government bonds Sum

(1) of line 1.7 and 2.7 0 3,078,395 0
Other taxable bonds
Sum of line 6.7, 7.7, 8.7, 9.7
(2) and half of 5.7 4,205,030 9,979,363 0
Tax exempt bonds
Sum of line 3.7, 4.7, and half
(3) of 5.7 0 0 0
Data on line 1.7 through 9.7 are from the insurer group's most recent consolidated statutory annual statement, schedule D,
part 1A, section 1.
Page 14a
(Yield Tax Worksheet)
Currently Federal
Invested Available Return On Income Federal Income
Assets Yield * Invested Assets Tax Rate Taxes
[1] [2] [3]=[1]*[2] [4] [5]=[3]*[4]
(1) US government bonds

(A) Short 0 0.09% 0 35.00% 0
(B) Intermediate 3,078,395 1.65% 50,794 35.00% 17,778
(C) Long 0 2.35% 0 35.00% 0
(2) Other taxable bonds
(A) Short 4,205,030 0.22% 9,251 35.00% 3,238
(B) Intermediate 9,979,363 2.86% 285,410 35.00% 99,893
(C) Long 0 4.52% 0 35.00% 0
(3) Tax exempt bonds
(A) Short 0 0.14% 0 5.25% 0
(B) Intermediate 0 2.26% 0 5.25% 0
(C) Long 0 3.47% 0 5.25% 0
(4) Common Stock 28,985,116
(A) Dividends 1.95% 565,210 14.18% 80,118
(B) Capital gains 7.09% 2,055,045 34.10% 700,770
(5) Preferred stock 1,863,500
dividends 5.35% 99,697 14.18% 14,132
(6) Mortgage loans 0 4.52% 0 35.00% 0
(7) Real estate 75,546 3.04% 2,297 35.00% 804
(8) Cash** 5,019,574 0.09% 4,518 35.00% 1,581
(9) Other*** 0
(A) Dividends 1.95% 0 14.18% 0
(B) Capital gains 7.09% 0 34.10% 0
(10) Total
Sum of line (1) thru (9) 53,206,524 3,072,220 918,315
Data in column [1], line 4 through (9), are from the insurer group's most recent consolidated statutory annual statement page 2 - Assets.
* Currently available yields are defined in CCR §2644.20. Latest values are posted at
http://www.insurance.ca.gov/0250-insurers/0800-rate-filings/0200-prior-approval-factors/
** Annual statement page 2, line 5, cash only. Cash equivalents and short-term investments are included in Schedule D.
*** Annual statement page 2, line 6 through 9.
Page 14b
Currently Federal
Assets Yield Invested Assets Tax Rate Taxes
[1] [2] [3]=[1]*[2] [4] [5]=[3]*[4]
(10) Total 53,206,524 3,072,220 918,315

line (10)
exhibit 13, page 2
(11) Investment expense 96,836 35.00% 33,893
Annual Statement (AS)
page 11, line 25
(12) Total 53,206,524 2,975,384 884,422
after investment expense
line (10) - line (11)
(13) Federal income tax rate
line (12)
column [5] / column [3] 29.72%
(14) Projected yield 5.59%

on invested assets
line (12)
column [3] / column [1]
Most Recent Year
(15) Loss reserves 10,810,476

AS page 3, line 1
(16) Loss adjustment 850,271
expense reserves
AS page 3, line 3
(17) Unearned premium 20,825,790
reserves
AS page 3, line 9
(18) Surplus as regards 26,609,101
to policyholders
AS page 3, line 35
(19) Total reserves and 59,095,638
surplus
Sum of line (15) to (18)
(20) Projected yield

adjusted to reserve and surplus base
line (14) * line (12) / line (19) 5.03%
Page 14c

RATE TEMPLATE Edition Date: 2/28/2012
(No input by filer)
CDI FILE NUMBER: 0
COMPANY/GROUP: KnightBrook Insurance Company
LINE OF INSURANCE: COMMERCIAL AUTO LIABILITY
COVERAGE: 0
PRIOR_EFF_DATE: 9/19/2012 Completed by: Neresa Torres
PROPOSED_EFF_DATE: 9/19/2012 Date: 9/19/2012
DATA PROVIDED BY FILER

Year: 0 0 0
PROJECTED/
PRIOR2 PRIOR1 RECENT SUMMARY
WRT_PREM 0 0 0 193,000
ERN_PREM 0 0 0 193,000
PREM_ADJ 1.000 1.000 1.000
PREM_TREND 1.000 1.000 1.000 0.000
MISCELLANEOUS_FEES (& other flat charges) 0 0 0 0
EARNED_EXP 0 0 0 20,000
LOSSES 0 0 0 144,750
DCCE 0 0 0 0
LOSS_DEV 1.000 1.000 1.000
DCCE_DEV 1.000 1.000 1.000
LOSS_TREND 1.000 1.000 1.000 0.000
DCCE_TREND 1.000 1.000 1.000 0.000
CAT_ADJ 1.000 1.000 1.000
CREDIBILITY 100.00%
EXPENSE EXCLUSION FACTOR 1.97%
ANC_INC 0 0 0 0
FIT_INV 29.72%
YIELD 5.03%
CDI PARAMETERS:
FIT_UW 35.00%
EFF_STANDARD 32.60%
LEVERAGE 0.72
PREMIUM_TAX_RATE 2.35%
SURPLUS_RATIO 1.40
UEP_RES_RATIO 0.46
LOSS_RES_RATIO 2.73
RISK FREE RATE OF RETURN 1.04% July 2012
MAXIMUM RATE OF RETURN 7.04%
MINIMUM RATE OF RETURN -6.00%
CDI CALCULATIONS:
ADJ_PREM 0 0 0 193,000
ADJUSTED_LOSSES 0 0 0 144,750
ADJUSTED_DCCE 0 0 0 0
ADJUSTED_LOSS+DCCE_RATIO 0.00% 0.00% 0.00% 75.00%
TRENDED_CURRENT_RATE_LEVEL_PREMIUM #DIV/0! #DIV/0! #DIV/0! 9.65
LOSS+DCCE_PER_EXP #DIV/0! #DIV/0! #DIV/0! 7.24
COMP_LOSS+DCCE_PER_EXP #DIV/0! #DIV/0! #DIV/0! 7.07
CRED_LOSS_PER_EXP #DIV/0! #DIV/0! #DIV/0! 7.24
ANC_INC_PER_EXP #DIV/0! #DIV/0! #DIV/0! 0.00
FIXED_INV_INC_FACTOR 14.86%
VAR_INV_INC_FACTOR 10.10%
ANNUAL_NET_TREND 0.00%
COMP_TREND 0.00%
MAX_PROFIT 15.11%
MIN_PROFIT -12.88%
UW_PROFIT -5.88%
MAX_DENOM 0.624
MIN_DENOM 0.904
MAX_PREMIUM $9.88
MIN_PREMIUM $6.82
CHANGE_AT_MIN -29.35%
CHANGE_AT_MAX 2.33%
Alternate Calculation with Reinsurance

COMMISSION_RATE 0.00%
RE_PREM - - - 0
RE_RECOV - - - 0
RE_PREM_PER_EXP #DIV/0! #DIV/0! #DIV/0! 0.00
RE_RECOV_PER_EXP #DIV/0! #DIV/0! #DIV/0! 0.00
COMP_LOSS_RE #DIV/0! #DIV/0! #DIV/0! 7.07
RMAX_PREMIUM NA
RCHANGE_AT_MAX NA
Blended Captive Direct Indep
EFFICIENCY STANDARD TABLE ES: 34.57% 36.24% 34.57% 35.34%
SOURCE:2008 - 2010 ROLLING AVG
DATE REVISED: 11/15/2011
Line Captive Direct Indep Line Description
1.0 38.07% 18.57% 32.21% FIRE
2.1 39.29% 19.67% 29.35% ALLIED LINES
3.0 33.84% 39.38% 32.17% FARMOWNERS MULTIPLE PERIL
4.0 36.23% 25.46% 37.33% HOMEOWNERS MULTIPLE PERIL
5.0 34.70% 41.89% 37.93% COMMERCIAL MULTIPLE (5.1 & 5.2 Combined)
5.1 35.53% 42.43% 36.87% COMMERCIAL MULTIPLE PERIL(NON-LIABILITY)
5.2 32.64% 38.26% 39.46% COMMERCIAL MULTIPLE PERIL(LIABILITY)
9.0 40.68% 26.79% 28.90% INLAND MARINE
11.0 29.98% 27.18% 35.46% MEDICAL MALPRACTICE
11.1 29.98% 27.18% 35.46% MEDICAL MALPRACTICE(occ)
11.2 29.98% 27.18% 35.46% MEDICAL MALPRACTICE (cm)
12.0 13.54% 14.66% 19.77% EARTHQUAKE
17.0 30.90% 27.91% 31.95% OTHER LIABILITY
17.1 30.90% 27.91% 31.95% OTHER LIABILITY (occ)
17.2 30.90% 27.91% 31.95% OTHER LIABILITY (cm)
18.0 25.20% 22.99% 35.30% PRODUCTS LIABILITY
18.1 25.20% 22.99% 35.30% PRODUCTS LIABILITY (occ)
18.2 25.20% 22.99% 35.30% PRODUCTS LIABILITY (cm)
19.2 34.15% 26.45% 37.64% PRIVATE PASSENGER AUTO LIABILITY
19.4 36.24% 34.57% 35.34% COMMERCIAL AUTO LIABILITY
21.1 34.13% 26.81% 35.82% PRIVATE PASSENGER AUTO PHYSICAL DAMAGE
21.2 34.57% 31.78% 36.55% COMMERCIAL AUTO PHYSICAL DAMAGE
22.0 35.64% 30.11% 27.77% AIRCRAFT
23.0 33.06% 44.18% 32.65% FIDELITY
24.0 37.14% 35.54% 43.62% SURETY
26.0 31.17% 31.17% 31.17% BURGLARY & THEFT
27.0 27.52% 26.73% 39.92% BOILER & MACHINERY
LEVERAGE RATIO TABLE
SOURCE: Bests Aggregates and Averages, 2011 Edition
Line LF Line Description
1.0 1.1280 Fire
2.1 1.1953 Allied Lines
3.0 1.1882 Farmowners
4.0 1.1753 Homeowners
5.1 1.0952 CMP - NL
5.2 0.5073 CMP - Liab.
5.0 0.7783 CMP
9.0 1.1764 Inland Marine
11.1 0.3311 Med. Mal. Occ.
11.2 0.5216 Med. Mal. cm.
11.0 0.4558 Med. Mal.
12.0 1.0000 Earthquake
17.1 0.4072 O. Liab. Occ.
17.2 0.5220 O. Liab. cm.
17.0 0.4372 O. Liab.
18.1 0.2141 Products - Occ.
18.2 0.4644 Products - cm.
18.0 0.2363 Products
19.2 0.9677 PP Auto Liab.
19.4 0.7168 C. Auto Liab.
21.1 1.5765 PP Auto PD
21.2 1.2355 Comm Auto PD
22.0 0.5902 Aircraft
23.0 0.7692 Fidelity
24.0 0.8941 Surety
26.0 1.1144 Burglary & Theft
27.0 1.0782 Boiler & Mach.
RESERVES RATIO TABLE
SOURCE: AM Best's Aggregates & Averages - Property Casualty, 2011 Edition
LINE UEP LOSS Line Description
1 0.47 1.16 FIRE
2.1 0.46 0.99 ALLIED LINES
3 0.47 1.39 FARMOWNER MP
4 0.52 0.80 HOMEOWNER MP
5 0.50 2.39 CMP
5.1 0.49 1.00 CMP (N-LIAB)
5.2 0.50 4.12 CMP (LIAB)
9 0.33 0.62 INLAND MRN
11.0 0.47 4.34 MED MAL
11.1 0.55 5.33 MED MAL - occurrence
11.2 0.45 3.87 MED MAL - claims-made
12.0 0.47 1.00 EARTHQUAKE
17.0 0.52 5.05 OTHER LIAB
17.1 0.52 6.67 OTHER LIAB - occurrence
17.2 0.52 3.24 OTHER LIAB - claims-made
18.0 0.50 5.14 PROD LIAB
18.1 0.53 5.83 PROD LIAB - occurrence
18.2 0.39 2.22 PROD LIAB - claims-made
19.2 0.33 1.13 PPA LIAB
19.4 0.46 2.73 COMLA LIAB
21.1 0.34 0.09 PPA PD
21.2 0.49 0.32 COMLA PD
22.0 0.43 2.84 AIRCRAFT
23.0 0.59 2.78 FIDELITY
24.0 0.58 4.69 SURETY
26.0 0.57 0.90 BRGLRY THEFT
27.0 0.46 1.51 BLR & MCHNRY
Loss Cost Multiplier (LCM) Template Instructions
The LCM Template spreadsheet must be completed for those rate filing submissions where the filed
line or coverage utilizes a Loss Cost Multiplier. Examples include new or existing program rate
filings that involve the adoption of Advisory Organization loss costs, and existing program rate
filings where the LCM is being revised.
There are a number of data cells on the LCM Template spreadsheet that automatically populate
either by reference to cells on other spreadsheets or by formula calculation. However there are five
lines within the LCM Template spreadsheet for which additional data entry is required. The first
three data entry items pertain to rate filing submissions that include an adoption of Advisory
Organization loss costs. The last two data entry items are required only for existing programs.
Complete the following for existing and new program rate filings when Advisory
Organization loss costs are being adopted:
Spreadsheet Item #1.1 CDI Filing Number – Please enter the CDI filing number of the
Advisory Organization loss cost filing being adopted. If additional loss cost updates are being
covered, please also identify the CDI filing number(s) of the additional loss cost updates being
covered.
Spreadsheet Item #1.2 Loss Cost Percent Change Approved for the Line or Coverage –
Please enter the CDI percent change approved for the Advisory Organization loss cost filing
identified as Item #1.1. If multiple loss cost updates are being covered, identify the
cumulative percent change approved.
Spreadsheet Item #1.3 AOE or LAE Load Approved for the Line or Coverage – As identified
within the Advisory Organization loss cost filing entered as Item #1.1, please indicate the type
of AOE or LAE expense loading the Advisory Organization used in its loss cost filingand
enter the load amount.
Complete the following for existing programs only; do not complete the following for new
program filings:
Spreadsheet Item #2.1 Current Expense Based LCM – Please enter the current expense based
LCM for the filed line/coverage.
Spreadsheet Item #2.2 Current Loss Cost Modification Expressed as a Factor – Please enter
the current Loss Cost Modification Factor applicable to the current expense based LCM.
Spreadsheet Items #3 through #7 are calculated fields.

Spreadsheet Item #3 calculates the insurer’s current Final LCM.
Spreadsheet Item #4 calculates the Advisory Organization’s AOE as a percent of loss and DCCE.
Spreadsheet Item #5 calculates the maximum CDI allowable expense based LCM for the filed
line/coverage.
Spreadsheet Item #6 calculates the maximum CDI allowable loss cost modification factor for the
filed line/coverage.
Spreadsheet Item #7 calculates the maximum CDI allowable Final LCM for the filed
line/coverage. If the Insurer’s current Final LCM (Item #3) and/or proposed Final LCM is greater
than the Max Final LCM (Item #7), the Insurer will need to reduce its Final LCM so that it is no
greater than the CDI calculated maximum allowable Final LCM. Otherwise, exceeding the CDI
calculated maximum allowable Final LCM will require the filing of a Variance.
LCM TEMPLATE
CDI FILE NUMBER: 0

LINE CODE: 19.4
COVERAGE: 0
ADVISORY ORGANIZATION FILING INFORMATION
1 For filings that include an adoption of Advisory Organization loss costs, complete lines 1.1, 1.2, and 1.3;
for all other filings skip lines 1.1, 1.2 and 1.3, and go to line 2.
1.1 CDI Filing Number
1.2 Loss Cost Percent Change Approved for the

Line or Coverage
1.3 AOE or LAE Load Approved for the Line or Type of Load Amount of Load
Coverage (LOSS+DCCE+AOE)/LOSS
COMPANY LCM INFORMATION
2 If this is a New Program filing, skip lines 2.1 and 2.2 and review the Max_Final LCM result on line 7;
for all other filings complete lines 2.1 and 2.2.
2.1 Current Expense Based LCM
2.2 Current Loss Cost Modification Expressed

as a Factor (see examples below)
Example 1: If the company's loss cost modification is +15%, enter 1.15

Example 2: If the company's loss cost modification is -10%, enter 0.9
Example 3: If the company currently does not apply a loss cost modification factor, enter 1.0
3 Insurer's Current Final LCM (Line 2.1 * Line 2.2) NA
4 Advisory Organization's AOE as a Percent of Loss and -1.000

DCCE (Derived from Line 1.3 and the IncLoss&DCCE page)
5 Max_Expense Based Loss Cost Multiplier N/A 7.2375
6 Max_Loss Cost Modification (Existing program only) N/A

Max_Loss Cost Modification for new program is 1.0
7 Max_Final LCM (Line 5 * Line 6) #VALUE!

INCURRED LOSS AND DCCE EXHIBIT
Source: 2008 Edition of Best's Aggregates & Averages, Statement File Supplement - Insurance Expense Exhib
Revised: 2/17/2009
Line Line Description INC LOSS DCCE
1.0 FIRE 4,016,127 151,767
2.1 ALLIED LINES 3,394,918 216,167
3.0 FARM OWNERS MULTIPLE PERIL 1,473,328 55,438
4.0 HOMEOWNERS MULTIPLE PERIL 31,520,720 899,394
5.0 COMMERCIAL MULTIPLE PERIL (COMBINED) 15,043,900 3,062,099
5.1 COMMERCIAL MULTIPLE PERIL(NON-LIABILITY) 9,640,109 667,280
5.2 COMMERCIAL MULTIPLE PERIL(LIABILITY) 5,403,791 2,394,819
9.0 INLAND MARINE 5,314,416 125,783
11.0 MEDICAL MALPRACTICE (Combined) 4,334,271 2,067,254
11.1 MEDICAL MALPRACTICE (Occurrence) 4,334,271 2,067,254 *
11.2 MEDICAL MALPRACTICE (Claims-made) 4,334,271 2,067,254 *
12.0 EARTHQUAKE -32,814 -2,659
17.0 OTHER LIABILITY (Combined) 27,204,022 7,099,766
17.1 OTHER LIABILITY (Occurrence) 27,204,022 7,099,766 *
17.2 OTHER LIABILITY (Claims-made) 27,204,022 7,099,766 *
18.0 PRODUCTS LIABILITY (Combined) 1,611,095 1,423,559
18.1 PRODUCTS LIABILITY (Occurrence) 1,611,095 1,423,559 *
18.2 PRODUCTS LIABILITY (Claims-made) 1,611,095 1,423,559 *
19.2 PRIVATE PASSENGER AUTO LIABILITY 61,960,518 3,457,812
19.4 COMMERCIAL AUTO LIABILITY 11,819,076 1,416,766
21.1 PRIVATE PASSENGER AUTO PHYSICAL DAMAGE 38,742,126 223,827
21.2 COMMERCIAL AUTO PHYSICAL DAMAGE 3,674,613 72,844
22.0 AIRCRAFT 1,608,088 149,853
23.0 FIDELITY 476,389 39,573
24.0 SURETY 962,488 256,711
26.0 BURGLARY & THEFT 28,019 2,792
27.0 BOILER & MACHINERY 376,293 17,336
33 MISCELLANEOUS 2,087,451 26,788
* line totals are used for occurrence and claims-made policies.

bit, Part III -Total US PC Industry - ($000 omitted).
Exhibit 17
KNIGHTBROOK INSURANCE COMPANY

COMMERCIAL AUTO LIABILITY
AUTO EXCESS RENTAL LIABILITY PROGRAM
NEW PROGRAM INTRODUCTION
FILING MEMORANDUM
With this filing, KnightBrook Insurance Company is proposing to introduce a new Supplemental Rental
Liability Program.
The Supplemental Rental Liability Program will be marketed to commercial automobile rental companies.
Under this program, Supplemental Liability Insurance (SLI) is offered at the rental counter, to customers
of the insured. This coverage provides supplemental bodily injury and property damage liability coverage
for rented vehicles above the minimum financial responsibility limits to the selected combined single limit
with an hourly rate component for hourly rentals.
As this is a new program for KnightBrook Insurance Company, and the Company does not have its own
experience off of which to base its rates, this program is based on that of Empire Fire and Marine
Insurance Company, approved under State Tracking number 11-7983.
KnightBrook Insurance Company
927 West Main Street
Valley View, PA 17983
July 23, 2012
Re: Letter of Filing Authorization

KnightBrook Insurance Company
Commercial Auto
Initial Rate/Rule and Form Filing
Dear Ladies/Gentlemen:
This letter will certify that Perr & Knight have been given full authorization to submit the
captioned filing on behalf of KnightBrook Insurance Company. This authorization extends to all
correspondence related to the referenced filing only. It does not apply to any subsequent filings
made after the approval of the referenced filing.
Please direct all correspondence in relation to this filing directly to Lupe Esquivel located at
4751 Wilshire Blvd. #111, Los Angeles, CA 90010.
Should you have any questions concerning this filing, please feel free to contact Julie Russell at
Perr & Knight at (310) 230-9339 x 117 or Stephen Su of KnightBrook Insurance Company at
(323) 692-8488, Fax (323) 954-5404 or email at lupe@knightcompany.com. Thank you for your
assistance in this matter.
Sincerely,
Lupe Esquivel
Program Director
4751 Wilshire Blvd. #111, Los Angeles, CA 90010 (323) 692-8488 FAX (323) 954-5404
lupe@knightcompany.com

Superseded Schedule Items

Please note that all items on the following pages are items, which have been replaced by a newer version. The newest version is located with the appropriate schedule
on previous pages. These items are in date order with most recent first.
Schedule Item Replacement

Creation Date Status Schedule Schedule Item Name Creation Date Attached Document(s)
09/17/2012 Supporting Prior Approval Rate Application 09/19/2012 PriorApprovalRateApplication02281
Document 2--KBIC CA SLI, New Pgm Filing
(for Response).pdf (Superceded)
PriorApprovalRateApplication02281
2--KBIC CA SLI, New Pgm Filing
(for Response).xls (Superceded)
08/15/2012 Supporting Prior Approval Rate Application 09/17/2012 PriorApprovalRateApplication02281
Document 2--KBIC CA SLI, New Pgm Filing.xls
(Superceded)
PriorApprovalRateApplication02281
2--KBIC CA SLI, New Pgm Filing.pdf
(Superceded)

Attachment PriorApprovalRateApplication022812--KBIC CA SLI, New Pgm Filing (for Response).xls is

not a PDF document and cannot be reproduced here.
Attachment PriorApprovalRateApplication022812--KBIC CA SLI, New Pgm Filing.xls is not a PDF

document and cannot be reproduced here.


SERFF No.:
Date Filed:
12-4799
X-Reference No.:


Neresa Torres September 17, 2012 (888) 201-5123, x111




NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code


Variance
applies.


300000 7.45 0.25
1000000 9.95 0.5
2000000 11.28 0.05
9.1515 1

2.
3.
4.
5.
6.
7.
8.
9.
10.
TOTAL:
physical damage.

FILING CHECKLIST

Data Sheet, Page 3

Data Sheet, Page 4
Filing Memorandum
Underwriting Rules




Other Charges

Exhibit 20: Rules
Exhibit 21:

Instructions for completing Prior Approval Rate Template (in application
* A separate rate template is required for each coverage (i.e. BI,PD,MP,UM,Comp&Coll) for which
a separate premium is charged. Download and complete a multi-coverage template (PPA for
factors)
RATEMAKING DATA
Completed by
Neresa Torres
Date Completed
9/17/2012
COMMERCIAL AUTOAUTO LIABILITY
LIABILITY
Coverage
Most Recent Projected*/ New

2nd Prior Year 1st Prior Year Year Program**


0.579691 5.647566 0.570209
0.015968 0 0
0.531211

Page 14)


writes at least 90% of its direct earned premium in one line or
No
writes at least 90% of its direct earned premium in California.
(Must be accompanied by Variance Request, subject to CDI
approval)
Variance Change to Efficiency Standard (Must be accompanied
by Variance Request, subject to CDI approval)


2nd 1st Most

Prior Prior Recent
Year Year Year
Most Recent
1.
2.
3.
4. $ - $ - $ -
5. $ - $ - $ -
6. $ - $ - $ -
7. $ - $ - $ -
8. $ - $ - $ -
9. $ - $ - $ -
10. $ - $ - $ -
TOTAL $ - $ - $ -
Statutory
Page 14


DATA

f) other expenses
*CIC 1857.7, CIC 1857.9 and CIC 1864

STATE OF CALIFORNIA Company Name:
DEPARTMENT OF INSURANCE (CDI) Line of Insurance:
No
Policy fee
Installment fee
Endorsement fee
Inspection fee
Cancellation fee
Reinstatement fee
Late fee
SR 22
Other, specify:

2.
4.














FORMS
Old:
Old:
Old:

(Forms) Page 12(a)
RULES

development method.

Insurer Comments:

(Rules) Page 12(b)


(Enter Year)
5,418,119 21,225,461 54,548,464
to Proposition 103: 5,418,119 21,225,461 54,548,464

0 0 0
1st Highest Paid 282,500 282,500 0 438,098 0

2nd Highest Paid 180,000 180,000 0 379,049 0
3rd Highest Paid 101,700 101,700 0 370,000 0
4th Highest Paid 88,747 88,747 0 256,155 0
5th Highest Paid 67,800 67,800 0 127,500 0

0 0 0
1st Highest Paid 174,311 108,189 174,311 108,189 174,311 263,787

2nd Highest Paid 123,071 56,929 123,071 56,929 123,071 255,978
3rd Highest Paid 92,906 8,794 92,906 8,794 92,906 277,094
4th Highest Paid 87,048 1,699 87,048 1,699 87,048 169,107
5th Highest Paid 81,141 0 81,141 0 81,141 46,359

Most Recent
0 0 0


1.7 US governments 0 3,078,395 0 0 0


Special revenue and


(1) of line 1.7 and 2.7 0 3,078,395 0
Other taxable bonds
Sum of line 6.7, 7.7, 8.7, 9.7
(2) and half of 5.7 4,205,030 9,979,363 0
Tax exempt bonds
(3) of 5.7 0 0 0
part 1A, section 1.
Page 14a
Currently Federal
[1] [2] [3]=[1]*[2] [4] [5]=[3]*[4]

(A) Short 0 0.09% 0 35.00% 0
(B) Intermediate 3,078,395 1.65% 50,794 35.00% 17,778
(C) Long 0 2.35% 0 35.00% 0
(A) Short 4,205,030 0.22% 9,251 35.00% 3,238
(B) Intermediate 9,979,363 2.86% 285,410 35.00% 99,893
(C) Long 0 4.52% 0 35.00% 0
(A) Short 0 0.14% 0 5.25% 0
(B) Intermediate 0 2.26% 0 5.25% 0
(C) Long 0 3.47% 0 5.25% 0
(A) Dividends 1.95% 565,210 14.18% 80,118
(B) Capital gains 7.09% 2,055,045 34.10% 700,770
dividends 5.35% 99,697 14.18% 14,132
(6) Mortgage loans 0 4.52% 0 35.00% 0
(7) Real estate 75,546 3.04% 2,297 35.00% 804
(8) Cash** 5,019,574 0.09% 4,518 35.00% 1,581
(9) Other*** 0
(A) Dividends 1.95% 0 14.18% 0
(B) Capital gains 7.09% 0 34.10% 0
(10) Total
Sum of line (1) thru (9) 53,206,524 3,072,220 918,315
Page 14b
Currently Federal
[1] [2] [3]=[1]*[2] [4] [5]=[3]*[4]
(10) Total 53,206,524 3,072,220 918,315

line (10)
exhibit 13, page 2
page 11, line 25
(12) Total 53,206,524 2,975,384 884,422
line (10) - line (11)
line (12)

on invested assets
line (12)
Most Recent Year

AS page 3, line 1
expense reserves
AS page 3, line 3
reserves
AS page 3, line 9
to policyholders
AS page 3, line 35
surplus

line (14) * line (12) / line (19) 5.03%
Page 14c

(No input by filer)
CDI FILE NUMBER: 0
COVERAGE: 0

Year: 0 0 0
PROJECTED/
WRT_PREM 0 0 0 193,000
ERN_PREM 0 0 0 193,000
PREM_ADJ 1.000 1.000 1.000
PREM_TREND 1.000 1.000 1.000 0.000
EARNED_EXP 0 0 0 20,000
LOSSES 0 0 0 115,800
DCCE 0 0 0 0
LOSS_DEV 1.000 1.000 1.000
DCCE_DEV 1.000 1.000 1.000
LOSS_TREND 1.000 1.000 1.000 0.000
DCCE_TREND 1.000 1.000 1.000 0.000
CAT_ADJ 1.000 1.000 1.000
CREDIBILITY 100.00%
ANC_INC 0 0 0 0
FIT_INV 29.72%
YIELD 5.03%
CDI PARAMETERS:
FIT_UW 35.00%
EFF_STANDARD 32.60%
LEVERAGE 0.72
SURPLUS_RATIO 1.40
UEP_RES_RATIO 0.46
LOSS_RES_RATIO 2.73
CDI CALCULATIONS:
ADJ_PREM 0 0 0 193,000
COMP_TREND 0.00%
MAX_PROFIT 15.11%
MIN_PROFIT -12.88%
UW_PROFIT -5.88%
MAX_DENOM 0.624
MIN_DENOM 0.904
MAX_PREMIUM $7.90
MIN_PREMIUM $5.45
CHANGE_AT_MAX -18.13%

RE_PREM - - - 0
RE_RECOV - - - 0
RMAX_PREMIUM NA
RCHANGE_AT_MAX NA
1.0 38.07% 18.57% 32.21% FIRE
2.1 39.29% 19.67% 29.35% ALLIED LINES
9.0 40.68% 26.79% 28.90% INLAND MARINE
12.0 13.54% 14.66% 19.77% EARTHQUAKE
17.0 30.90% 27.91% 31.95% OTHER LIABILITY
22.0 35.64% 30.11% 27.77% AIRCRAFT
23.0 33.06% 44.18% 32.65% FIDELITY
24.0 37.14% 35.54% 43.62% SURETY
26.0 31.17% 31.17% 31.17% BURGLARY & THEFT
1.0 1.1280 Fire
5.1 1.0952 CMP - NL
5.2 0.5073 CMP - Liab.
5.0 0.7783 CMP
11.1 0.3311 Med. Mal. Occ.
11.2 0.5216 Med. Mal. cm.
11.0 0.4558 Med. Mal.
17.1 0.4072 O. Liab. Occ.
17.2 0.5220 O. Liab. cm.
17.0 0.4372 O. Liab.
18.2 0.4644 Products - cm.
19.4 0.7168 C. Auto Liab.
21.1 1.5765 PP Auto PD
24.0 0.8941 Surety
27.0 1.0782 Boiler & Mach.
1 0.47 1.16 FIRE
5 0.50 2.39 CMP
5.1 0.49 1.00 CMP (N-LIAB)
5.2 0.50 4.12 CMP (LIAB)
11.0 0.47 4.34 MED MAL
17.0 0.52 5.05 OTHER LIAB
18.0 0.50 5.14 PROD LIAB
19.2 0.33 1.13 PPA LIAB
19.4 0.46 2.73 COMLA LIAB
21.1 0.34 0.09 PPA PD
21.2 0.49 0.32 COMLA PD
22.0 0.43 2.84 AIRCRAFT
23.0 0.59 2.78 FIDELITY
24.0 0.58 4.69 SURETY
27.0 0.46 1.51 BLR & MCHNRY
covered.
program filings:

line/coverage.
LCM TEMPLATE
CDI FILE NUMBER: 0

LINE CODE: 19.4
COVERAGE: 0

Line or Coverage





Revised: 2/17/2009
1.0 FIRE 4,016,127 151,767
2.1 ALLIED LINES 3,394,918 216,167
9.0 INLAND MARINE 5,314,416 125,783
12.0 EARTHQUAKE -32,814 -2,659
22.0 AIRCRAFT 1,608,088 149,853
23.0 FIDELITY 476,389 39,573
24.0 SURETY 962,488 256,711
26.0 BURGLARY & THEFT 28,019 2,792
33 MISCELLANEOUS 2,087,451 26,788



SERFF No.:
Date Filed:
12-4799
X-Reference No.:


Neresa Torres August 15, 2012 (888) 201-5123, x111




NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code

NAIC Company Code


Variance
applies.


300000 7.45 0.25
1000000 9.95 0.5
2000000 11.28 0.05
9.1515 1

2.
3.
4.
5.
6.
7.
8.
9.
10.
TOTAL:
physical damage.

FILING CHECKLIST

Data Sheet, Page 3

Data Sheet, Page 4
Filing Memorandum
Underwriting Rules




Other Charges

Exhibit 20: Rules
Exhibit 21:

Instructions for completing Prior Approval Rate Template (in application) :
* A separate rate template is required for each coverage (i.e. BI,PD,MP,UM,Comp&Coll) for which a
separate premium is charged. Download and complete a multi-coverage template (PPA for
factors)
RATEMAKING DATA
Completed by
Neresa Torres
Date Completed
8/15/2012
COMMERCIAL AUTOAUTO LIABILITY
LIABILITY
Coverage
Most Recent Projected*/ New

2nd Prior Year 1st Prior Year Year Program**


0.579691 5.647566 0.570209
0.015968 0 0
0.531211

Page 14)


writes at least 90% of its direct earned premium in one line or
No
writes at least 90% of its direct earned premium in California.
(Must be accompanied by Variance Request, subject to CDI
approval)
Variance Change to Efficiency Standard (Must be accompanied
by Variance Request, subject to CDI approval)


2nd 1st Most

Prior Prior Recent
Year Year Year
Most Recent
1.
2.
3.
4. $ - $ - $ -
5. $ - $ - $ -
6. $ - $ - $ -
7. $ - $ - $ -
8. $ - $ - $ -
9. $ - $ - $ -
10. $ - $ - $ -
TOTAL $ - $ - $ -
Statutory
Page 14


DATA

f) other expenses
*CIC 1857.7, CIC 1857.9 and CIC 1864

MISCELLANEOUS FEES AND OTHER CHARGES
Do any fees or installment finance charges apply to this program? No

If yes, identify the fee and the amount charged for each type of fee and for each transaction.
Policy fee
Installment fee
Endorsement fee
Inspection fee
Cancellation fee
Reinstatement fee
Late fee
SR 22
Other, specify:
Except for installment finance charges, NSF fees, and membership dues, data relating to fees must be included in the ratemaking data, Page
7, Line 2 ( direct earned premium) or Line 5 ( miscellaneous fees ) and Exhibit 6, miscellaneous fees, must be completed. Refer to the
instructions for additional information.

2.
4.














FORMS
Old:
Old:
Old:

(Forms) Page 12(a)
RULES

development method.

Insurer Comments:

(Rules) Page 12(b)


(Enter Year)
5,418,119 21,225,461 54,548,464
to Proposition 103: 5,418,119 21,225,461 54,548,464

0 0 0
1st Highest Paid 282,500 282,500 0 438,098 0

2nd Highest Paid 180,000 180,000 0 379,049 0
3rd Highest Paid 101,700 101,700 0 370,000 0
4th Highest Paid 88,747 88,747 0 256,155 0
5th Highest Paid 67,800 67,800 0 127,500 0

0 0 0
1st Highest Paid 174,311 108,189 174,311 108,189 174,311 263,787

2nd Highest Paid 123,071 56,929 123,071 56,929 123,071 255,978
3rd Highest Paid 92,906 8,794 92,906 8,794 92,906 277,094
4th Highest Paid 87,048 1,699 87,048 1,699 87,048 169,107
5th Highest Paid 81,141 0 81,141 0 81,141 46,359

Most Recent
0 0 0


1.7 US governments 0 3,078,395 0 0 0


Special revenue and


(1) of line 1.7 and 2.7 0 3,078,395 0
Other taxable bonds
Sum of line 6.7, 7.7, 8.7, 9.7
(2) and half of 5.7 4,205,030 9,979,363 0
Tax exempt bonds
(3) of 5.7 0 0 0
part 1A, section 1.
Page 14a
Currently Federal
[1] [2] [3]=[1]*[2] [4] [5]=[3]*[4]

(A) Short 0 0.09% 0 35.00% 0
(B) Intermediate 3,078,395 1.65% 50,794 35.00% 17,778
(C) Long 0 2.35% 0 35.00% 0
(A) Short 4,205,030 0.22% 9,251 35.00% 3,238
(B) Intermediate 9,979,363 2.86% 285,410 35.00% 99,893
(C) Long 0 4.52% 0 35.00% 0
(A) Short 0 0.14% 0 5.25% 0
(B) Intermediate 0 2.26% 0 5.25% 0
(C) Long 0 3.47% 0 5.25% 0
(A) Dividends 1.95% 565,210 14.18% 80,118
(B) Capital gains 7.09% 2,055,045 34.10% 700,770
dividends 5.35% 99,697 14.18% 14,132
(6) Mortgage loans 0 4.52% 0 35.00% 0
(7) Real estate 75,546 3.04% 2,297 35.00% 804
(8) Cash** 5,019,574 0.09% 4,518 35.00% 1,581
(9) Other*** 0
(A) Dividends 1.95% 0 14.18% 0
(B) Capital gains 7.09% 0 34.10% 0
(10) Total
Sum of line (1) thru (9) 53,206,524 3,072,220 918,315
Page 14b
Currently Federal
[1] [2] [3]=[1]*[2] [4] [5]=[3]*[4]
(10) Total 53,206,524 3,072,220 918,315

line (10)
exhibit 13, page 2
page 11, line 25
(12) Total 53,206,524 2,975,384 884,422
line (10) - line (11)
line (12)

on invested assets
line (12)
Most Recent Year

AS page 3, line 1
expense reserves
AS page 3, line 3
reserves
AS page 3, line 9
to policyholders
AS page 3, line 35
surplus

line (14) * line (12) / line (19) 5.03%
Page 14c

(No input by filer)
CDI FILE NUMBER: 0
COVERAGE: 0

Year: 0 0 0
PROJECTED/
WRT_PREM 0 0 0 193,000
ERN_PREM 0 0 0 96,500
PREM_ADJ 1.000 1.000 1.000
PREM_TREND 1.000 1.000 1.000 0.000
EARNED_EXP 0 0 0 20,000
LOSSES 0 0 0 57,900
DCCE 0 0 0 0
LOSS_DEV 1.000 1.000 1.000
DCCE_DEV 1.000 1.000 1.000
LOSS_TREND 1.000 1.000 1.000 0.000
DCCE_TREND 1.000 1.000 1.000 0.000
CAT_ADJ 1.000 1.000 1.000
CREDIBILITY 100.00%
ANC_INC 0 0 0 0
FIT_INV 29.72%
YIELD 5.03%
CDI PARAMETERS:
FIT_UW 35.00%
EFF_STANDARD 32.60%
LEVERAGE 0.72
SURPLUS_RATIO 1.40
UEP_RES_RATIO 0.46
LOSS_RES_RATIO 2.73
CDI CALCULATIONS:
ADJ_PREM 0 0 0 96,500
COMP_TREND 0.00%
MAX_PROFIT 15.11%
MIN_PROFIT -12.88%
UW_PROFIT -5.88%
MAX_DENOM 0.624
MIN_DENOM 0.904
MAX_PREMIUM $3.95
MIN_PREMIUM $2.73
CHANGE_AT_MAX -18.13%

RE_PREM - - - 0
RE_RECOV - - - 0
RMAX_PREMIUM NA
RCHANGE_AT_MAX NA
1.0 38.07% 18.57% 32.21% FIRE
2.1 39.29% 19.67% 29.35% ALLIED LINES
9.0 40.68% 26.79% 28.90% INLAND MARINE
12.0 13.54% 14.66% 19.77% EARTHQUAKE
17.0 30.90% 27.91% 31.95% OTHER LIABILITY
22.0 35.64% 30.11% 27.77% AIRCRAFT
23.0 33.06% 44.18% 32.65% FIDELITY
24.0 37.14% 35.54% 43.62% SURETY
26.0 31.17% 31.17% 31.17% BURGLARY & THEFT
1.0 1.1280 Fire
5.1 1.0952 CMP - NL
5.2 0.5073 CMP - Liab.
5.0 0.7783 CMP
11.1 0.3311 Med. Mal. Occ.
11.2 0.5216 Med. Mal. cm.
11.0 0.4558 Med. Mal.
17.1 0.4072 O. Liab. Occ.
17.2 0.5220 O. Liab. cm.
17.0 0.4372 O. Liab.
18.2 0.4644 Products - cm.
19.4 0.7168 C. Auto Liab.
21.1 1.5765 PP Auto PD
24.0 0.8941 Surety
27.0 1.0782 Boiler & Mach.
1 0.47 1.16 FIRE
5 0.50 2.39 CMP
5.1 0.49 1.00 CMP (N-LIAB)
5.2 0.50 4.12 CMP (LIAB)
11.0 0.47 4.34 MED MAL
17.0 0.52 5.05 OTHER LIAB
18.0 0.50 5.14 PROD LIAB
19.2 0.33 1.13 PPA LIAB
19.4 0.46 2.73 COMLA LIAB
21.1 0.34 0.09 PPA PD
21.2 0.49 0.32 COMLA PD
22.0 0.43 2.84 AIRCRAFT
23.0 0.59 2.78 FIDELITY
24.0 0.58 4.69 SURETY
27.0 0.46 1.51 BLR & MCHNRY
covered.
program filings:

line/coverage.
LCM TEMPLATE
CDI FILE NUMBER: 0

LINE CODE: 19.4
COVERAGE: 0

Line or Coverage





Revised: 2/17/2009
1.0 FIRE 4,016,127 151,767
2.1 ALLIED LINES 3,394,918 216,167
9.0 INLAND MARINE 5,314,416 125,783
12.0 EARTHQUAKE -32,814 -2,659
22.0 AIRCRAFT 1,608,088 149,853
23.0 FIDELITY 476,389 39,573
24.0 SURETY 962,488 256,711
26.0 BURGLARY & THEFT 28,019 2,792
33 MISCELLANEOUS 2,087,451 26,788


KnightBrook - Rental Supplemental Liability Insurance PDF

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SERFF Tracking #: PERR-128641539 State Tracking #: 12-6599 Company Tracking #: KBIC-CA-SLI-12-08

State: California Filing Company: KnightBrook Insurance Company

Effective Date On Approval

State: California Filing Company: KnightBrook Insurance Company

Company and Contact

State: California Filing Company: KnightBrook Insurance Company

Filing Company Information

State: California Filing Company: KnightBrook Insurance Company

Objection Letters and Response Letters

State: California Filing Company: KnightBrook Insurance Company

Overall % Overall % Written Premium Number of Policy Written Maximum % Minimum %

Schedule Schedule Item Schedule Item Status Public Access

State: California Filing Company: KnightBrook Insurance Company

Schedule Schedule Item Schedule Item Status Public Access

State: California Filing Company: KnightBrook Insurance Company

2. How long has this program been written in other states?

State: California Filing Company: KnightBrook Insurance Company

State: California Filing Company: KnightBrook Insurance Company

State: California Filing Company: KnightBrook Insurance Company

No Supporting Documents changed.

No Form Schedule items changed.

No Rate/Rule Schedule items changed.

State: California Filing Company: KnightBrook Insurance Company

Supporting Document Schedule Item Changes

No Form Schedule items changed.

No Rate/Rule Schedule items changed.

State: California Filing Company: KnightBrook Insurance Company

State: California Filing Company: KnightBrook Insurance Company

2. Yes this program exists and is approved in most states.

Supporting Document Schedule Item Changes

No Form Schedule items changed.

No Rate/Rule Schedule items changed.

State: California Filing Company: KnightBrook Insurance Company

State: California Filing Company: KnightBrook Insurance Company

Form Type Legend:

4751 Wilshire Boulevard, Suite 111

NAMED INSURED and Address (POLICYHOLDER)

The NAMED INSURED is a:

(12:01 am at the address of the NAMED INSURED as stated herein)

All Coverages are Excess of any other applicable insurance:

PREMIUM $ Premium Rate per day of rental

FORMS AND ENDORSEMENTS

Authorized Countersignature: ________________________________

KBIC-SLI-0001 (12/09) KnightBrook Insurance Company

AUTOMOBILE RENTAL LIABILITY EXCESS POLICY

(RENTAL CAR COMPANIES ONLY)

KBIC-SLI-0002 (05/10) 1 KnightBrook Insurance Company

overturned or damaged as a result of the

This exclusion applies: 12. Bodily injury or property damage excluded by

(2) To any obligation to share damages SECTION II – CONDITIONS

KBIC-SLI-0002 (05/10) 2 KnightBrook Insurance Company

choice, as often as we reasonably 1. PREMIUM

a. All expenses we incur. a. The named insured shown in the

4. APPEALS (iii) An increase in hazard within of

KBIC-SLI-0002 (05/10) 3 KnightBrook Insurance Company

supervisor, conservator, or damages shall be deemed not to exceed the

(b) If notice is mailed, proof of mailing 8. TRANSFER OF RIGHTS AND DUTIES

e. If notice is mailed, proof of mailing will be 9. CHANGES

5. OTHER INSURANCE SECTION III – DEFINITIONS

KBIC-SLI-0002 (05/10) 4 KnightBrook Insurance Company

KBIC-SLI-0002 (05/10) 5 KnightBrook Insurance Company

SECTION IV – UNINSURED C. PERSONS INSURED

3. Any payment made under this insurance