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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br />QUICK REFERENCE <br />Beginning <br />on Page <br />INFORMATION PAGE <br />General Section ............................ <br />A. The Policy ............................. <br />B. Who Is Insured ..................... <br />C. Workers Compensation Law <br />D. State ..................................... <br />E. Locations .............................. <br />PART ONE- WORKERS COMPENSATION INSURANCE. <br />A. How This Insurance Applies ................................. <br />B. We Will Pay........................................................... <br />C. We Will Defend ..................................................... <br />D. We Will Also Pay ................................................... <br />E. Other Insurance .................................................... <br />F. Payments You Must Make .................................... <br />G. Recovery From Others .......................................... <br />H. Statutory Provisions .............................................. <br />1 <br />1 <br />1 <br />1 <br />1 <br />2 <br />2 <br />2 <br />2 <br />PART TWO - EMPLOYERS LIABILITY INSURANCE...... 2 <br />Beginning <br />on Page <br />PART TWO - Continued <br />G. Limits of Liability ......... <br />H. Recovery From Others <br />I. Actions Against Us...... <br />PART THREE - OTHER STATES INSURANCE <br />A. How This Insurance Applies .................... <br />B. Notice ...................................................... <br />PART FOUR -YOUR DUTIES IF INJURY OCCURS <br />PART FIVE - PREMIUM...... <br />A. <br />Our Manuals........... <br />B. <br />Classifications......... <br />C. <br />Remuneration......... <br />D. <br />Premium Payments <br />E. <br />Final Premium........ <br />F. <br />Records .................. <br />G. <br />Audit ....................... <br />4 <br />4 <br />4 <br />4 <br />4 <br />5 <br />5 <br />5 <br />5 <br />5 <br />5 <br />5 <br />5 <br />6 <br />6 <br />A. <br />How This Insurance Applies ................................... <br />2 <br />PART SIX - CONDITIONS ....................................... 6 <br />B. <br />We will Pay............................................................. <br />3 <br />A. <br />Inspection......................................................... 6 <br />C. <br />Exclusions.............................................................. <br />3 <br />B. <br />Long Term Policy ............................................. 6 <br />D. <br />We Will Defend ....................................................... <br />3 <br />C. <br />Transfer of Your Rights and Duties.................. 6 <br />E. <br />We Will Also Pay .................................................... <br />4 <br />D. <br />Cancellation..................................................... 6 <br />F. <br />Other Insurance...................................................... <br />4 <br />E. <br />Sole Representative......................................... 6 <br />IMPORTANT: This Quick Reference is not part of the Workers Compensation and Employers Liability Policy and does <br />not provide coverage. Refer to the Workers Compensation and Employers Liability Policy itself for <br />actual contractual provisions. <br />PLEASE READ THE WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CAREFULLY. <br />Form WC 66 01 56 B Printed in U.S.A. <br />Process Date: 05/25/20 <br />cF RAMmWmentDMsian <br />REVIEWED & APPROVED BY.- <br />--� Risk janagement Analyst <br />