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CASE NO. 18 Z 600 10886 03 2 AMERICAN ARBITRATION ASSOCIATION NO-FAULT/ACCIDENT CLAIMS In the Matter of the Arbitration between (Claimant) v. Palisades Safety Insurance Company (Respondent) AAA CASE

REASONS FOR ARBITRATION: The American Arbitration Association (AAA) administers and interprets the Commercial Arbitration Rules in effect in the State of Massachusetts pursuant to the Federal Arbitration Act. The arbitrator, in resolving any dispute, shall be bound by the rules of the AAA and shall be obligated to follow this interpretation and to enforce it in all courts in the State of Massachusetts. The arbitrator will be entitled to receive fees and expenses incurred by the AAA in enforcing the terms of the AAA's rules and procedures. The American Arbitration Association may choose, from time to time at its discretion, a hearing forum other than the Western District of Pennsylvania. The parties will notify the American Arbitration Association at least one calendar month prior to commencement of arbitration, whether the arbitration will be conducted in Massachusetts or elsewhere, if in California, or whether the arbitration will be conducted in New York or wherever such other jurisdiction may be, if in the State of New York. All hearings will take place at an AAA office or, in instances where an arbitration will be conducted elsewhere, at the office on the same block of the same city where the proceedings are being held. The fee to be paid by the claimant for filing the arbitration or hearing is twenty-five dollars (25). The fee for each hearing is fifteen dollars (15). If the parties are able to agree on a fee, the fee for each arbitration will be twenty-five dollars (25). The AAA's rules are available on its website at and will be administered pursuant to their terms by a staff attorney in the AAA's office in Philadelphia, Pennsylvania. The arbitrator and the AAA will also have the right to provide you and other parties with free copies of the Consumer Arbitration Rules at no cost. If you are an individual, and you have received this notice in connection with a transaction where you were the account holder, you may also contact the Secretary for the American Arbitration Association at the address provided in this notice and request that the AAA inform you of the location of the official location if you are sending documents to the arbitrator or the AAA and you are a resident of a state having or hereafter adopting the Consumer Arbitration Rules.

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