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4. liability for any consequence, whether of America necessarily incurred as a direct result <br />direct or indirect, of war, invasion, act of of bodily injury. <br />Foreign enemy, hostilities (whether war Our reimbursement shall be limited as follows: <br />be declared or not), civil war, rebellion, <br />revolution, insurrection or military or 1. to the amount by which such expenses <br />usurped power. No endorsement now or exceed the normal cost of returning the <br />subsequently attached to this policy shall officer or employee if in good health, or <br />be construed as overriding or waiving 2. in the event of death, to the amount by which <br />this limitation unless specific reference is such expenses exceed the normal cost of <br />made thereto. returning the officer or employee if alive and <br />D. Before We Pay in good health. <br />Before we reimburse you for the benefits to In no event shall our reimbursement exceed the <br />the persons entitled to them, you must have bodily injury by accident limit shown in Item 3.13. <br />them: of the Information Page as respects any one <br />1. release you and us, in writing, of all such officer or employee whether dead or alive. <br />responsibility for the injury or death, H. Endemic Disease <br />2. transfer to us their right to recover from The word "disease" includes any endemic <br />others who may be responsible for their diseases. <br />injury or death, The coverage applies as if endemic diseases <br />3. cooperate with us and do everything were included in the provisions of the workers' <br />necessary to enable us to enforce the compensation law. <br />right to recover from others. 5. Longshore and Harbor Workers' Compensation <br />If the persons entitled to the benefits paid fail Act Coverage <br />to do these things, our duty to reimburse General Section C. Workers' Compensation Law <br />ends at once. If they claim damages from us is replaced by the following: <br />for the injury or death, our duty to reimburse C. Workers' Compensation Law <br />ends at once. Workers' Compensation Law means the workers <br />E. Recovery From Others or workers' compensation law and occupational <br />If we make a recovery from others, we will disease law of each state or territory named in <br />keep an amount equal to our expenses of Item 3.A. of the Information Page and the <br />recovery and the benefits we reimbursed. Longshore and Harbor Workers' Compensation <br />We will pay the balance to the persons Act (33 USC Sections 901-950). It includes any <br />entitled to it. If persons entitled to the amendments to those laws that are in effect <br />benefits make a recovery from others, they during the policy period. It does not include any <br />must repay us for the amounts that we have other federal workers or workers' compensation <br />reimbursed you. law, other federal occupational disease law or the <br />F. Reimbursement for Actual Loss provisions of any law that provide <br />Sustained nonoccupational disability benefits. <br />This endorsement provides only for Part Two (Employers' Liability Insurance), C. <br />reimbursement for the loss you actually Exclusions, exclusion 8, does not apply to work <br />sustain. In order for you to recover loss or subject to the Longshore and Harbor Workers' <br />expenses under this reimbursement you Compensation Act. <br />must: This coverage does not apply to work subject to <br />1. actually sustain and pay the loss or the Defense Base Act, the Outer Continental <br />expense in money after trial, or Shelf Lands Act, or the Nonappropriated Fund <br />Instrumentalities Act. <br />2. secure our consent for the payment of <br />the loss or expense. <br />G. Repatriation <br />Our reimbursement includes the additional <br />expenses of repatriation to the United States <br />"P-", Risk ManagementDMsian <br />f ' REVIEWED & APPROVED BY. <br />°Aezv <br />1" Risk Management Specialist <br />V NJ <br />Form WC 99 03 03 B Printed in U.S.A. (Ed. 8/00) Page 5 of 6 <br />