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WC000000(C) (Ed. 1-15) The Travelers Insurance Companies (Each a Stock Insurance Company) Hartford, Connecticut WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY In return for the payment of the premium and subject PART ONE to all terms of this policy, we agree with you as WORKERS COMPENSATION INSURANCE follows: GENERAL SECTION A. The Policy This policy includes at its effective date the In- formation Page and all endorsements and sched- ules listed there. It is a contract of insurance be- tween you (the employer named in Item 1 of the Information Page) and us (the insurer named on the Information Page). The only agreements re- lating to this insurance are stated in this policy. The terms of this policy may not be changed or waived except by endorsement issued by us to be part of this policy. B. Who is Insured You are insured if you are an employer named in Item 1 of the Information Page. If that employer is a partnership, and if you are one of its partners, you are insured, but only in your capacity as an employer of the partnership's employees. C. Workers Compensation Law Workers Compensation Law means the workers or workmen's compensation law and occupational disease law of each state or territory named in Item 3.A. of the Information Page. It includes any amendments to that law which are in effect dur- ing the policy period. It does not include any fed- eral workers or workmen's compensation law, any federal occupational disease law or the provisions of any law that provide nonoccupational disability benefits. D. State State means any state of the United States of America, and the District of Columbia. E. Locations This policy covers all of your workplaces listed in Items 1 or 4 of the Information Page; and it cov- ers all other workplaces in Item 3.A. states unless you have other insurance or are self -insured for such workplaces. A. How This Insurance Applies This workers compensation insurance applies to bodily injury by accident or bodily injury by dis- ease. Bodily injury includes resulting death. 1. Bodily injury by accident must occur during the policy period. 2. Bodily injury by disease must be caused or aggravated by the conditions of your em- ployment. The employee's last day of last exposure to the conditions causing or aggra- vating such bodily injury by disease must occur during the policy period. B. We Will Pay We will pay promptly when due the benefits re- quired of you by the workers compensation law. C. We Will Defend We have the right and duty to defend at our ex- pense any claim, proceeding or suit against you for benefits payable by this insurance. We have the right to investigate and settle these claims, proceedings or suits. We have no duty to defend a claim, proceeding or suit that is not covered by this insurance. D. We Will Also Pay We will also pay these costs, in addition to other amounts payable under this insurance, as part of any claim, proceeding or suit we defend: 1. reasonable expenses incurred at our request, but not loss of earnings; 2. premiums for bonds to release attachments and for appeal bonds in bond amounts up to the amount payable under this insurance; 3. litigation costs taxed against you; 4. interest on a judgment as required by law until we offer the amount due under this in- surance; and 5. expenses we incur. © Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved. Rule Management Division v' REv1EWm&APPRovm By: m�m�aarra�q-"a i. Risk Management Analyst