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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br />WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br />In return for the payment of the premium and subject to <br />all terms of this policy, we agree with you as follows: <br />GENERAL SECTION <br />A. The Policy <br />This policy includes at its effective date the <br />Information Page and all endorsements and <br />schedules listed there. It is a contract of insurance <br />between you (the employer named in Item 1 of the <br />Information Page) and us (the insurer named on <br />the Information Page). The only agreements <br />relating to this insurance are stated in this policy. <br />The terms of this policy may not be changed or <br />waived except by endorsement issued by us to be <br />part of this policy. <br />B. Who is Insured <br />You are insured if you are an employer named in <br />Item 1 of the Information Page. If that employer is a <br />partnership, and if you are one of its partners, you <br />are insured, but only in your capacity as an <br />employer of the partnership's employees. <br />C. Workers Compensation Law <br />Workers Compensation Law means the workers or <br />workmen's compensation law and occupational <br />disease law of each state or territory named in Item <br />3.A. of the Information Page. It includes any <br />amendments to that law which are in effect during <br />the policy period. It does not include any federal <br />workers or workmen's compensation law, any <br />federal occupational disease law or the provisions <br />of any law that provide nonoccupational disability <br />benefits. <br />D. State <br />State means any state of the United States of <br />America, and the District of Columbia. <br />E. Locations <br />This policy covers all of your workplaces listed in <br />Items 1 or 4 of the Information Page; and it covers <br />all other workplaces in Item 3.A. states unless you <br />have other insurance or are self -insured for such <br />workplaces. <br />WC 00 00 00 C <br />(Ed. 1-15) <br />PART ONE <br />WORKERS COMPENSATION INSURANCE <br />A. How This Insurance Applies <br />This workers compensation insurance applies to <br />bodily injury by accident or bodily injury by disease. <br />Bodily injury includes resulting death. <br />1. Bodily injury by accident must occur during the <br />policy period. <br />2. Bodily injury by disease must be caused or <br />aggravated by the conditions of your <br />employment. The employee's last day of last <br />exposure to the conditions causing or <br />aggravating such bodily injury by disease must <br />occur during the policy period. <br />B. We Will Pay <br />We will pay promptly when due the benefits required <br />of you by the workers compensation law. <br />C. We Will Defend <br />We have the right and duty to defend at our expense <br />any claim, proceeding or suit against you for benefits <br />payable by this insurance. We have the right to <br />investigate and settle these claims, proceedings or <br />suits. <br />We have no duty to defend a claim, proceeding or <br />suit that is not covered by this insurance. <br />D. We Will Also Pay <br />We will also pay these costs, in addition to other <br />amounts payable under this insurance, as part of <br />any claim, proceeding or suit we defend: <br />1. reasonable expenses incurred at our request, <br />but not loss of earnings; <br />2. premiums for bonds to release attachments and <br />for appeal bonds in bond amounts up to the <br />amount payable under this insurance; <br />3. litigation costs taxed against you; <br />4. interest on a judgment as required by law until <br />we offer the amount due under this insurance; <br />and <br />5. expenses we incur. <br />E. Other Insurance <br />We will not pay more than our share of benefits and <br />costs covered by this insurance and other <br />1 of 6 <br />© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved. <br />�oRaN <br />} z <br />RiskMmRgemerdDivisiun <br />REVIEWED & APPROVED BY.- <br />cc <br />Risk Management Analyst <br />