Section 4 - Workers Compensation and Employers Liability

Work Comp Part 2 - Employers Liability - 8. Work subject to the Longshore and Harbor Workers' Compensation Act (LHWCA); as well as the following:

- Non appropriated Fund Instrumentalities Act (NAFIA) * -Outer Continental Shelf Lands Act (OCSLA) * -Defense Base Act (DBA) * -Federal Mine Safety and Health Act (FMSHA) * -Any other federal workers compensation law or federal occupational disease law, or any amendments Note: * Coverage can be added back by endorsement

Work Comp Policy Part 1 - Insurer's Promise to Defend

-Right and duty to defend at the insurance company's expense any claim for benefits -Right to investigate and settle claims -No coverage - no defense

Information Page Items - 1: The Insured

-The insured is the person or organization designated to be covered under the Policy -Type of business: The employer may be an individual, partnership, joint venture, corporation, limited liability company, association, other legal entity, or a fiduciary such as a trustee, receiver or executor -Mailing address -Other workplaces, other than indicated in the mailing address

Introduction to the Policy Coverages - Policy Structure

1. Information Page (would be called Declarations under other policies) 2. Workers Compensation and Employers Liability Insurance Policy WC 00 00 00 C (Only a 6‐page policy) (a) General Section -Part One - Workers Compensation Insurance -Part Two - Employers Liability Insurance -Part Three - Other States Insurance -Part Four - Your Duties If Injury Occurs -Part Five - Premium -Part Six - Conditions 3. Endorsements

Common Law System - Additional Limitations

Common law held that only the injured employee, not the spouse nor dependents, had the right to sue for an employee's work‐related injury. If the employee died, the spouse and dependents had no right to sue. Since employers won most of the suits, seriously injured workers and their families were left without any means of support that could lead them to becoming impoverished. This led to public pressure to enact WC laws and modification of common law. The current system based on WC Law (statutes) supersedes common law; however, the common law system is not totally eliminated. Tort action can still arise in certain circumstances, which will be addressed during the discussion on Part Two - Employers Liability Insurance.

Work Comp Policy Part 1 - Other Insurance

Equal shares payment if other insurance

Work Comp Part 2 - Employers Liability - 7. Employment‐related practices

Excludes damages arising out of coercion, criticism, demotion, evaluation, reassignment, discipline, defamation, harassment, humiliation, discrimination against or termination of any employee, or any personnel practices, policies, acts or omissions

Work Comp Part 2 - Employers Liability - 6. Injury outside the U.S., its territories or possessions, and Canada

Exclusion does not apply to those who are temporarily on work assignments outside of this area

Work Comp Part 2 - Employers Liability - 9. Work subject to Federal Employers' Liability Act (FELA) *

can buyback

Information Page Items - 4.: Classifications, Payrolls, and Premiums

mailing address, classified, etc.

Compliance with Work Comp Laws - Three Common Funding Methods Used to Comply with WC Laws - 3. Self-Insurance where permitted

self insured

Information Page Items - Activation of Coverages (triggers) - 3.B: Part Two - Employers Liability Insurance

-Applies only for those states listed under Item 3.A. -Limits of liability -Standard limits BI by Accident - $100,000 each accident BI by Disease - $500,000 policy limit BI by Disease - $100,000 each employee Limits may be increased

Work Comp Policy Part 1 - Waiver of Our Rights to Recover From Others Endorsement WC 00 03 13

-Used in states, where it is permitted, to waive the insurance company's right to recovery against anyone liable for an employee's injury -Sentence in parenthesis is optional by carrier. Including the sentence makes it a viable endorsement for construction contracts only. -CAREFUL! Only applies to the person/organization named in the endorsement Schedule -The underwriter may agree to attach a non‐standard "blanket" endorsement when a waiver is required by written contract to avoid having to schedule each time. No NCCI "blanket" form available. Failure to schedule can lead to an E & O claim.

Work Comp Policy Part 2 - Employers Liability - Insurance Company's Promise to Pay

-Will pay all sums the insured legally must pay as damages -Because of bodily injury to an employee -Where permitted by law, coverage is included for four types of claims 1. Third party over 2. Care and loss of services 3. Consequential bodily injury 4. Dual capacity

Potential Penalties for an Employer's Non‐Compliance with WC Laws (6)

1. Cease work orders 2. Fines 3. Misdemeanors 4. Imprisonment 5. Injured employees allowed to sue employer for WC benefits 6. Employer loses common law defenses

Work Comp Part 2 - Employers Liability - 11. Fines and penalties imposed for violation of federal or state law

11. Fines and penalties imposed for violation of federal or state law

Work Comp Part 2 - Employers Liability - 12. Damages payable under the Migrant and Seasonal Agricultural Worker Protection Act (MSAWPA) *

12. Damages payable under the Migrant and Seasonal Agricultural Worker Protection Act (MSAWPA) *

Purposes of Current Workers Compensation Law - 4. Employers gain predictability for the cost of providing WC benefits

4. Employers gain predictability for the cost of providing WC benefits

Purposes of Current Workers Compensation Law - 5. Encourages loss prevention and promotes interest in safety

5. Encourages loss prevention and promotes interest in safety

Compliance with Work Comp Laws - Compulsory vs. Elective States

All states, except Texas and New Jersey, have WC laws that require employers to accept the law and provide for the payment of WC benefits to an injured employee. New Jersey and Texas have elective WC laws. -New Jersey has many rules and regulations which for all practical purposes makes them more of a compulsory state than an elective state -Employers in Texas can accept the law or may choose to non‐subscribe to the law -Note: Texas WC law has some exceptions that require certain employers to provide WC coverage, such as the State of Texas, cities, counties, school districts -If an employer chooses not to accept the state's WC law, and an injured worker files a suit, the employer is denied the use of the three common law defenses

Work Comp Part 2 - Employers Liability - 10. Bodily injury to masters or crew members of any vessel *

Also excludes punitive damages related to named insured's duty or obligation to provide transportation, wages, maintenance, and cure under any applicable maritime law

Common Law System - Employer Common Law Obligations (5)

An injured employee had to prove his/her employer was negligent in failing to meet one or more of what are known as an employers' common law obligations to their employees: 1. Reasonably safe place to work 2. Reasonably safe tools 3. Competent (safe and sober) fellow employees 4. Safety rules established and enforced 5. Warn workers of any known dangers

Work Comp Part 3 - Other States Insurance - How it applies

Coverage applies to: 1. States listed under Item 3.C. of the Information Page 2. Must begin work in that state after the effective date -Employees injured in a scheduled 3.C. state will receive the WC benefits prescribed under that state's law if required by application of law or court decision. Thus, the policy pays benefits in listed 3.C. states just as if the state was scheduled under 3.A. (Not listed, no coverage for that state's benefits.) -CAUTION! If work began in a state on or before the effective date, thatstate should be listed in Item 3.A. 3. The insurance company will reimburse the named insured if the insurance company is not allowed to pay benefits directly to the injured employee 4. 30 days to notify the insurance company of operations existing on effective date in any state not listed in Item 3.A. Notice: Insured is obligated to notify the insurance company at once if any work begins in any state listed in Item 3.C.

Foreign Workers Compensation and Employers Liability Endorsement

Endorsement coverages typically include: 1. Repatriation expenses -Cost to bring an injured or deceased employee back to the U.S., OR 2. Endemic disease -Disease prevalent in a country or region Limitations typically include: 1. Employee must have been hired in the U.S. 2. Covers temporary assignments only and can't exceed certain time period, usually 90 days 3. Pays only statutory benefits of the designated state(s)

Work Comp Part 6 - Conditions (A-E) - Not on Test

Inspection Long Term Policy - reinstate at 12 months Transfer Of Your Rights And Duties Cancellation Sole Representative - first Named Insured will communicate w/ carrier, CANC and Premium

Work Comp Part 2 - Employers Liability - D, E, F, G, H, I

Insurer's Promise To Defend Insurer's Promise To Pay Additional Costs Other Insurance Limits of Liability Recovery From Others Actions Against The Insurer

Work Comp Part 3 - Other States Insurance - Extraterritorial States

Most WC laws are extraterritorial: -Many states have an extraterritorial provision in the law that determines how that state's WC law will apply when an employee is injured out of state -Depending on the circumstances, some, but not all, of these WC statutes will extend coverage to pay the benefit level of a state other than where an employee is hired in the event an injury occurs in that other state -However, some states, but not all, honor the extraterritorial provisions of other states aslong asthe other state honorsthat state's extraterritorial provisions (this is called reciprocity). The permanent employment contract of hire between the worker and employer is established in the other state. -REMINDER: Employee benefits received are determined by WC statutes or by the courts -Application of jurisdictional statutes when an "out of state" employee is injured varies

Work Comp Part 2 - Insurance Company's Promise to Pay - 3. Consequential bodily injury

Protects against a lawsuit filed by a family member for an injury or disease suffered as a consequence of the employee's injury

Work Comp Part 2 - Insurance Company's Promise to Pay - 4. Dual capacity claims

Protects against lawsuits brought by an injured employee, against the employer when the injury arises from the activities of the employer in a capacity other than as an employer. In such a case, the employer is liable not only as an employer for workers compensation benefits but also as an entity acting in a different capacity. Note: Employers Liability Insurance is not limited to the above specified four types of claims.

Compliance with Work Comp Laws - Three Common Funding Methods Used to Comply with WC Laws - 1. Private carriers

Purchase a Workers Compensation And Employers Liability Insurance Policy from an insurance company

Covered vs. Exempt Employments - Volunteer Workers

Volunteer workers in the private sector typically are not entitled to benefits under WC law as they are not considered employees. However, there are some jurisdictions that have WC laws that grant benefits to volunteer fire fighters, emergency personnel, or certain other persons that provide voluntary services to public entities.

Covered vs. Exempt Employments - 2. General exemptions for certain types of employees

- Domestic employees Generally, means employees hired to perform dutiesin or around a residence such as housekeepers, maids, butlers, babysitters, and chauffeurs that are typically employed directly by the residence owner -Agricultural or farm workers The exemption varies by state and may apply depending on varying circumstances such as: Gross annual payroll Pay level Full time or part‐time Number of agricultural or farm workers Family member Migrant or seasonal -Real estate salespersons -Casual laborers Generally, means a worker that is hired to perform work that is not in the usual course or furtherance of the business. Should NOT be confused with seasonal, part‐time, or temporary employees Optional ENDT Voluntary Compensation and Employers Liability WC 00 03 11 A - Employer may opt to cover those not typically covered

Understanding Employer Status - 4. Regular/general employer and special employers

-A person/organization isreferred to as a regular or general employer when they lend, rent, or lease an employee to another employer. The other employer is referred to as the special employer. -When the statute is silent and/or there is no written contract, under common law, the special employer has the obligation to provide WC benefits to the injured worker -Where allowed by statute, a written contractual arrangement can be made between the regular and special employer indicating who is responsible for providing WC benefits to an injured worker, such as in an employee leasing arrangement

Information Page Items - Activation of Coverages (triggers) - 3.C: Part Three - Other States Insurance

-Activates both WC and EL Insurance for states where work begins after the effective date ─ Include states where unexpected work or incidental exposures subject to the WC act may arise after the effective date -States must be listed in 3.C. for Other States Insurance coverage to apply -Suggested wording: All states except North Dakota, Ohio, Washington, Wyoming, and the states designated in Item 3.A. of this Information Page -Some states, such as New York and Florida, may require their states be listed under 3.A. in lieu of 3.C. under certain situations

Covered vs. Exempt Employments - Alternate Employer Endorsement WC 00 03 01 A

-Attach to the regular employer's policy to provide protection to the alternate employer from claims brought against the alternate employer due to injuries to an employee who is loaned or leased to them from their regular employer -Coverage applies only with respect to compensable injury to employees of the insured when in the course of special or temporary employment by the alternate employer in the state(s) listed in Item 2. of the Schedule -Part One (WC) and Part Two (EL) apply to the alternate employer as though they were an insured -The alternate employer must be named in the endorsement Schedule -Item 3 of the endorsement Schedule limits coverage to apply only to the specific jobs or contracts of the insured as scheduled - does not apply in Wisconsin Note: This endorsement does not satisfy the Alternate Employer's duty to purchase Workers Compensation Insurance

Understanding Employer Status - 2. De facto employer

-De facto - Latin for in fact or in reality -Some employers hire workers and classify them as independent contractors when in fact they qualify as employees REFER TO: (IRS 20-factor test) -The de facto employer has an obligation to provide WC benefits to the de facto employee according to the state WC law

Information Page Items - Activation of Coverages (triggers) - 3a. Part One - Work Comp Insurance

-List all states in which insured has operations known or expected -Activates compensation laws for those states -Cannot list monopolistic states (North Dakota, Ohio, Washington, Wyoming)

Work Comp Part 3 - Other States Insurance - Coverage Issues

-Only 30 days to notify the insurance company of operations existing on effective date in any state not listed in Item 3.A. -Reliance on Item 3.C. to provide automatic coverage -Insured should notify the insurance company at once if work is begun in any 3.C. state -It is a challenge if regional carriers and state specific carriers are not licensed in a particular state where insured conducts operations - won't be able to place these states in 3.A. at renewal

Covered vs. Exempt Employments - Employee Leasing Endorsements

-Other NCCI endorsements are available for use in employee leasing arrangements -State WC rules vary as to the approved NCCI endorsement forms and edition dates used for PEO type risks, including labor contractor entities. Be sure to check the specific jurisdictions on a risk‐by‐risk basis. State specific endorsements may apply. -Following are examples on arranging WC Insurance in the WC voluntary market

Four categories of Work Comp Benefits - 1. Medical Benefits

-Pays for the necessary medical care to treat a compensable work‐related injury or occupational disease -May be subject to reasonable & necessary provisions and medical guidelines -Choice of physician by employee or employer varies by state (Utah is employer chooses panel of physicians that the employee can utilize)

Work Comp Part 2 - Insurance Company's Promise to Pay - 2. Care and loss of services

-Protects against lawsuits filed by an injured employee's spouse and/or children for loss of the services resulting from injury to the employee in the course of employment -Services may include sexual relations, companionship, help in performing household chores, etc

Work Comp & Employers Liability Policy Endorsements - Longshoremen And Harbor Workers Compensation Act Coverage Endorsement (LHWCA) WC 00 01 06 A

-Provides both WC Insurance and EL Insurance for work subject to the LHWCA -Covers employees in traditional maritime occupations such as longshore workers, ship‐repairers, shipbuilders or harbor construction workers -Injuries on the job must occur on the navigable waters of the U.S., or in adjoining areas customarily used for loading, unloading, repairing, or building of a vessel -Does not apply to master/crew member of a vessel What are navigable waters? -Navigable waters are usually defined as waters that provide a channel for interstate or international commerce and transportation of people and goods

Work Comp Policy Part 1 - Statutory Provisions

-Since WC laws vary by jurisdiction, this section of the Policy makes it possible for the Policy to apply as required by law -A discussion of extraterritorial provisions is provided later in this Section

Covered vs. Exempt Employments - 1. Numeric exemptions in some states

-Some states exempt employers from WC law if that employer has less than a specific number of employees -This numeric exemption may not apply to certain types of industries, such as construction

Information Page Items - Activation of Coverages (triggers) - 3.D. - Lists the endorsements and schedules applicable

-State Specific Amendatory Endorsements -Various Optional Endorsements

Understanding Employer Status - 3. Statutory employer or de jure employer (synonymous in this context)

-Statutes - Laws determined by each state's legislature -De Jure - Latin for by right or according to the law -Some WC laws are specific as to when a person/organization who does not directly hire a worker is considered the employer with the obligation to provide WC benefits -Some statutes are silent in certain situations, and determination is based on common law to determine who has the legal obligation to provide WC benefits to an injured worker

Work Comp Policy Part 1 - Recovery From Others

-The insurance company has the rights (subrogation rights) of the named insured, or the person or persons to whom payment is made under the policy, to recover from anyone liable for the injury -Must protect the subrogation rights of the insurance company -There may be a contractual insurance obligation requiring the named insured to waive subrogation -No waiver allowed before or after a loss without an endorsement -An endorsement is required as the policy has no implied right to waive subrogation before a loss as under the CGL Policy or BAP

Understanding Employer Status - 1. Primary or direct employer

-Traditional employer/employee relationship -The employer directly hires an employee ─ Includes part‐time or seasonal that are direct hires -The employer has an obligation to provide WC benefits to an injured employee according to the WC law

Four categories of Work Comp Benefits - 2. Compensation for lost wages (disability benefits)

-Typically, four types - titles and description to qualify varies by jurisdiction 1) Temporary partial 2) Permanent partial 3) Temporary total 4) Permanent total -Amount paid varies by statute -Length of payment varies by statute -Waiting period (how long before benefits begin) and retroactive period, if any (how long before goes back and pays for waiting period) varies by statute - UTAH IS 3 DAY WAITING AND 2 WEEK RETRO

Four categories of Work Comp Benefits - 3. Rehabilitation benefits

-Usually included under medical benefits - may have a separate provision -Physical rehabilitation to restore the injured employee to maximum physical capacity -Vocational training may or may not be included

Common Law System - Three Employer Common Law Defenses (3)

1. Assumption of risk -Common law doctrine which finds by doing certain acts an employee assumes the risk of injury 2. Contributory negligence -Common law doctrine holding that if an employee was injured in part due to his/her own negligence, the injured employee would not be entitled to collect any damages from his/her employer who supposedly caused, in part, the injury 3. Fellow‐servant rule (aka fellow employee rule) -Common law doctrine holding if a worker was injured because of the actions of a coworker as opposed to the negligence of the employer, the employer was not liable.

Purposes of Current Workers Compensation Law - 1. Negligence is no longer a basis for determining liability or recovery

1. Negligence is no longer a basis for determining liability or recovery -No fault system

Work Comp Policy - General Section (5)

1. The policy - contract & cant be changed except by ENDT 2. Who is an Insured - you if you are employer, partners are insureds in capacity as employers 3. Workers Compensation laws - states in 3.A (not federal law) 4. State - lists states from 3.A 5. locations - Covers the insured's workplaces listed in Items 1 or 4 of the Information Page; and all workplaces in states listed in Item 3.A. unless there is other insurance or self‐ insurance in place

Purposes of Current Workers Compensation Law - 2. Provides for prompt and reasonable payment of benefits

2. Provides for prompt and reasonable payment of benefits -Statutory benefits are paid to an injured employee (benefits are discussed in more detail later) - Statute may require payment of benefits within a stated number of days (a) Benefits are primarily partial and final (b) Employee's Injury or disease must "arise out of" and "arise in the course of" employment ─ "Arising out of" generally means an injury/disease was caused by a worker's employment ─ "Arising in the course of" generally means the injury/disease must be factually linked to a worker's employment in terms of time, place, and circumstances (activity) (c) Compensable work‐related injuries ─ WC law describes what type of injuries are compensable (d) Compensable occupational diseases ─ Characteristic of occupation ─ Peculiar to occupation

Work Comp Policy Part 2 - Employers Liability - How it Applies

Applies to bodily injury by accident or bodily injury by disease including resulting death: 1. Must arise out of and in the course of employment (determined by litigation) 2. Employment necessary or incidental to named insured's work in a state or territory listed in Item 3.A. (does not say that the injury needs to occur in a state in 3.A) 3. Bodily injury by accidental must occur during policy period 4. Bodily Injury by disease must be caused or aggravated by work conditions - last day of exposure must occur during the policy period 5. Original suit must be brought in the U.S., its territories or possessions, or Canada

Information Page Items - 2: Policy Period

At the Insured's mailing address

Work Comp Part 2 - Employers Liability - 3. BI in violation of Law

Bodily injury to an employee, while employed in violation of the law, with the named insured's knowledge or with the knowledge of the named insured's executive officers

Four categories of Work Comp Benefits - 4. Death or survivorship benefits

Burial expenses - amount varies statute Income benefits to eligible dependents: ─ Dependents as defined in statute ─ Amount and payment period varies by statute

Compliance with Work Comp Laws - Three Common Funding Methods Used to Comply with WC Laws - 2. State Funds

Competitive state funds ─ Employers in many states have the option of purchasing WC Insurance and Employers Liability Insurance from a state fund that competes with the private carriers ─ Some of these competitive state funds may also be the market of last resort Monopolistic state (territory) funds ─ North Dakota, Ohio, Washington, Wyoming (NOWW) ─ The fund in each of these states is the only provider of workers compensation insurance, which is why they are referred to as monopolistic state funds ─ How does an employer obtain Workers Compensation Insurance for operations in a monopolistic state? Workers Compensation Insurance is purchased directly from the state fund How does an employer obtain Employers Liability Insurance for exposures in a monopolistic state? -Stop gap or employers liab coverage endt

Covered vs. Exempt Employments - 4. Others such as independent contractors, volunteer workers, and leased workers may or may not be exempt

Employee vs. independent contractor WC Statute: -Some statutes define the difference and indicate whether or not an individual qualifies as an independent contractor or as an employee -Statutes may also describe other special employments as to whether they qualify as employees or not -Some states may have an independent contractor "test" that may be used in addition to what is indicated in the statute Common Law: -Common law criteria are used when a statute is silent -Some states use the current IRS criteria to determine employee vs. independent contractor status. The current IRS criteria includes three main categories: 1) Behavioral control 2) Financial control 3) Relationship of the parties NOTE: Some states still use the former IRS 20 Factor Test or a version of it as a guide to determine if a worker is an employee or an independent contractor.

Work Comp Policy Part 1 - Work Comp Insurance

How the insurance applies - Applies to bodily injury by accident or bodily injury by disease. Bodily injury includes resulting death -Bodily injury by accident must occur during the policy period -Bodily injury by disease must be caused by or aggravated by conditions of employment -Employees last day of exposure must occur during policy period (LAST POLICY WILL RESPOND) Insurer's Promise to pay - Pays benefits promptly when due as required by workers compensation law Note: Since WC benefits are determined by WC law, no standard limit of liability applies to Part One - Workers Compensation Insurance. The Insuring Agreement incorporates the law by specific reference. (APPLIES TO EMPLOYERS LIABILITY)

Work Comp Part 2 - Insurance Company's Promise to Pay - 1. Third Party Over

Lawsuits filed by a third party seeking recovery from the insured because it was held liable for an insured's employee's injury No contract between the third party and the employer, they will look to this coverage part. If there is an insured contract, and the third party wants to be indemnified, then it goes to CGL policy. (Hold harmless goes to CGL, but negligence goes to employers liability claim).

Work Comp Part 2 - Employers Liability - Exclusion 1. Contractual Liability

No carveback, Look to the BAP and CGL Policy

Work Comp Part 2 - Employers Liability - 5. Intentional injury caused or aggravated by the named insured

No coverage for intentional injury to employees

Work Comp Part 2 - Employers Liability - 2. Punitive or exemplary damages

Note: This is different under Employers Liability Insurance. The unendorsed BAP and CGL Policy do not have this exclusion In violation of law

Covered vs. Exempt Employments - General Information

Now that we have addressed employer status, we now need to address to whom the employer is required to provide WC benefits to. Each state's WC law dictates as to whom an employer is obligated to provide benefits as a result of a compensable injury. Most types of employments are covered under the WC law; however, some states have exceptions to WC law that may exempt employers from having to provide WC insurance for employees and/or other types of workers.

Work Comp Part 5 - Premium (A-G) - Not on Test

Our Manuals Premium determined by the insurance company's manuals Classifications Classifications based on estimated exposures Remuneration Remuneration most common premium basis Premium Payments Named insured obligated to pay premium when due Final Premium Final premium determined after policy ends Records Records should be kept and provided upon insurer's request G. Audits -Audits can be conducted during the policy period and within three years after the policy period ends

Covered vs. Exempt Employments - Leased Workers (BEWARE! E & O danger zone)

Parties in a leasing arrangement 1) Professional Employment Organization (PEO) aka Labor Contractor, Employee Leasing Company, Lessor, Regular Employer 2) Client - Special Employer Responsibility for providing WC benefits: -The employer with the exclusive remedy protection is typically responsible for providing the WC benefits to the leased worker Note: The party to a contract not protected under exclusive remedy can still be sued for bodily injury to a leased worker -Some states consider both the labor contractor/PEO and the client as co‐ employers. The exclusive remedy protection then applies to both. -Where permitted, an employee leasing agreement will stipulate who is responsible for securing the insurance coverage. -If WC law is silent, common law usually dictates the client company (special employer) is the employer responsible for providing benefits in the event a leased worker incurs bodily injury

Covered vs. Exempt Employments - 3. Specific positions may be exempt

Sole proprietors and partners are usually not considered employees and, therefore, are not subject to the WC law Executive officers on the other hand are typically defined as employees and are covered under most state's WC law Opt‐out/Opt‐in rules and applicable endorsements for these vary by state Optional ENDTs - Partners, Officers, and Others Exclusion WC 00 03 08 AND Sole Proprietors, Partners, Officers, and Others Coverage WC 00 03 10

Work Comp & Employers Liability Policy Endorsements - Maritime Coverage Endorsement WC 00 02 01 B

Still no coverage for transport, wages, maintenance, and cure unless premium is shown. Law of the sea means you owe the sailors the above 4. It will respond to liability, but not to those 4, unless premium. -Applies to Part Two - Employers Liability Insurance only. No statutory benefits -Provides Employers Liability Insurance for suits/claims brought against the employer due to BI to a master or crew member of any vessel -Must occur in the operation of a vessel sailing directly between the ports of the continental U.S., Alaska, Hawaii, or Canada -No coverage for transportation, wages, maintenance, and cure unless a premium is shown on the endorsement Schedule, if purchased, excludes punitive damages related to duty or obligation to provide these

Work Comp Policy Part 1 - Insurer's Promise to Pay Additional Costs

Supplementary payments made by the insurance company as part of any claims, proceeding or suit that the insurer is defending

Work Comp Part 4 - Your duties if Injury Occurs

The Insured's Duties are Similar to Other Liability Policies 1. Provide for immediate medical and other services required by the law 2. Provide information on injury 3. Promptly provide the insurance company with notices, demands and legal papers 4. Cooperate 5. Do nothing after an injury to interfere with subrogation rights 6. No voluntary payments or incurring expenses

Work Comp & Employers Liability Policy Foreign Coverage Endorsements - General Info

There is limited foreign coverage under the unendorsed Workers Compensation And Employer Liability Insurance Policy for U.S. employers with employees working outside of the country. Part One - WC Insurance is limited to each state's WC Law and its extraterritorial provisions. Part Two - EL Insurance only applies while temporarily outside the U.S., its territories, or Canada

Work Comp Policy Part 1 - Payments the insured must make

These payments are in excess of benefits regularly provided by the law because of: -the insured's serious and willful misconduct -the insured knowingly employed an employee in violation of law -the insured's failure to comply with health or safety law -the insured's discharge, coercion, or discrimination against an employee in violation of the WC law Note: The named insured employer is responsible for reimbursing the insurance company for any payment in excess of the benefits regularly provided by the WC law

Purposes of Current Workers Compensation Law - 3. Establishes what is categorized as Exclusive or Sole Remedy

WC law generally provides protection for the employers and insurance companiesfrom tort actions. This is known as the "exclusive remedy". -Exists to protect the employers from additional exposure after being legally required to provide benefits on a no‐fault basis per statute -The protection generally extends to co‐workers (fellow servants) who may have caused injury to another worker -There are exceptions in various states to the exclusive remedy provision that allow an injured worker to bring suit