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SECTION I <br />PARTS ONE and TWO <br />1. WE WILL ALSO PAY <br />D. We Will Also Pay of Part One (WORKERS' <br />COMPENSATION INSURANCE); and <br />E. We Will Also Pay of Part Two (EMPLOYERS' <br />LIABILITY INSURANCE) is replaced by the <br />following: <br />We Will Also Pay <br />We will also pay these costs, in addition to <br />other amounts payable under this insurance, <br />as part of any claim, proceeding, or suit we <br />defend: <br />1. reasonable expenses incurred at our <br />request, INCLUDING loss of earnings; <br />2. premiums for bonds to release <br />attachments and for appeal bonds in bond <br />amounts up to the limit of our liability <br />under this insurance; <br />3. litigation costs taxed against you; <br />4. interest on a judgment as required by law <br />until we offer the amount due under this <br />law; and <br />5. expenses we incur. <br />PART THREE <br />2. How This Insurance Applies <br />the Information Page, coverage will not be <br />afforded for that state unless we are notified <br />within sixty days. <br />PART SIX <br />3. Transfer Of Your Rights and Duties <br />C. Transfer Of Your Rights and Duties of Part 6 <br />(Conditions) is replaced by the following: <br />Your rights or duties under this policy may not <br />be transferred without our written consent. <br />If you die and we receive notice within sixty <br />days after your death, we will cover your legal <br />representative as insured. <br />4. Cancellation <br />Paragraph 2. of D. Cancellation of Part 6 <br />(Conditions) is replaced by the following: <br />2. We may cancel this policy. We must mail or <br />deliver to you not less than 15 days advance <br />written notice stating when the cancellation is <br />to take effect. Mailing that notice to you at <br />your mailing address shown in Item 1 of the <br />Information Page will be sufficient to prove <br />notice. <br />5. Liberalization <br />Paragraph 4. of A. How This Insurance Applies <br />of Part 3 (Other States Insurance) is replaced by <br />the following: <br />4. If you have work on the effective date of this <br />policy in any state not listed in Item 3.A. of <br />SECTION II <br />VOLUNTARY COMPENSATION AND EMPLOYERS' <br />LIABILITY COVERAGE <br />6. Voluntary Compensation Insurance <br />A. How This Insurance Applies <br />This insurance applies to bodily injury by <br />accident or bodily injury by disease. Bodily <br />injury includes resulting death. <br />1. The bodily injury must be sustained by any <br />officer or employee not subject to the <br />workers' compensation law of any state <br />shown in Item 3.A. of the Information <br />Page. <br />Form WC 99 03 01 B Printed in U.S.A. (Ed. 8/00) <br />If we adopt a change in this form that would <br />broaden the coverage of this form without extra <br />charge, the broader coverage will apply to this <br />policy. It will apply when the change becomes <br />effective in your state. <br />2. The bodily injury must arise out of and in <br />the course of employment or incidental to <br />work in a state shown in Item 3.A. of the <br />Information Page. <br />3. The bodily injury must occur in the United <br />States of America, its territories or <br />possessions, or Canada, and may occur <br />elsewhere if the employee is a United <br />States or Canadian citizen, or otherwise <br />legal resident, and legally employed, in the <br />United States or Canada and temporarily <br />away from those places. <br />�,y ortnNC RWtMwwgwwntll <br />REVIEWED&APPROVED Br. <br />Risk Management Supervisor <br />