Commonwealth Automobile Reinsurers

Forms

Producer

Agency Information Update
To change agency information including; new office location(s), change in office address(es), new employee(s), incorporation of the agency, agency sale or merger, etc.

Application for ARP Certification
To apply for Certification as an Assigned Risk Producer.

Power of Attorney Authorization
To authorize non-licensed agency employee(s) to certify that insurance coverage is in effect via signature on a MAIP stamped Massachusetts RMV form. To be signed by the licensed agency principal.

Producer Security Access
To designate a new or change an existing Agency Security Administrator. Each agency is required to designate one person who will be responsible for requesting agency employee user IDs, overseeing the agency's MAIP Policy Application access and communicating user IDs that should be terminated.

Request for Review/Relief
To request a review of any action of CAR or a member of CAR with whom a producer or company may feel aggrieved.

Stamp Request
To request additional MAIP stamps - new office location, replacement of lost or worn out stamp, return of stamp.

Company

Authorization for the Sale and Transfer of Credits
To provide CAR with information necessary to execute the sale and transfer of MAIP Credit Premiums.

Daily Assignment Transfer Request
To provide CAR with information necessary to receive daily assignments via secure FTP or Web Services.

Low Frequency Discount
To advise CAR of the method chosen by the company to verify eligibility for the low frequency discount.

Request for Review/Relief
To request a review of any action of CAR or a member of CAR with whom a producer or company may feel aggrieved.

Security
Log-on to the Security Administration area to designate the specific individuals that have access, and to which applications that access has been granted.

Policy Forms

Premium Calculation Disclosure (MP-0001)
To identify the source of the rates used to calculate the premium on a MAIP assigned policy.

Notice of Expiration of Policy Assignment (MP 00 02)
For use commencing on April 15, 2014, impacting policies expiring on June 1, 2014 and subsequent.
To notify a policyholder that the company intends to non-renew the insuredís MAIP policy at the expiration of its three-year assignment period.