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Effective Date: 12/14/2023
<br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
<br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
<br />enforce our right against the person or organization named in the Schedule. (This agreement applies only to the
<br />extent that you perform work under a written contract that requires you to obtain this agreement from us.)
<br />This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
<br />Not Applicable in AK, KY, NH and NJ
<br />Schedule
<br />Any person or organization for which the employer has agreed by written contract, executed prior to loss, may
<br />execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver
<br />of subrogation does not apply to any construction group of classifications as designated by the waiver of right to
<br />recover from others (subrogation) rule in our manual.
<br />The waiver does not apply to any right to recover payments which the Minnesota Workers Compensation
<br />Reinsurance Association may have or pursue under M.S. 79.36,
<br />Use of this endorsement is limited by the Kansas Fairness in Private Construction Contract Act (K.S.A. 16-1801
<br />through 16-1807 and any amendments thereto) and the Kansas Fairness in Public Construction Contract Act
<br />(K.S.A. 16-1901 through 16-1908 and any amendments thereto). According to the Acts, a provision in a contract for
<br />private or public construction purporting to waive subrogation rights for losses or claims covered or paid by liability or
<br />workers compensation insurance shall be against public policy and shall be void and unenforceable except that,
<br />subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a consolidated or
<br />wrap-up insurance program.
<br />Where required by contract or written agreement prior to loss and allowed
<br />by law.
<br />In the states of AL, AZ, AR, CO, DE, DC, GA, ID, IL, IN, KS, ME, MI, MN,
<br />MS, MO, MT, NM, NC, PA, RI, SC, SD, VT and WV, the premium charge is 2% of
<br />the total manual premium, subject to a minimum premium of $100 per policy.
<br />In the state of MA, the premium charge is 1 % of the total manual premium.
<br />In the states of CT, FL, IA, MD, NE, NV and OR, the premium charge is 1 %
<br />of the total manual premium, subject to a minimum premium of $250 per
<br />policy.
<br />In the state of IA, the premium charge is 2% of the total standard
<br />premium, subject to a minimum premium of $250 per policy.
<br />WC 00 03 13 © 1983 National Council on Compensation Insurance.
<br />Ed.04/01/1984
<br />.v', Ew Risk Managem dDMsian
<br />°_ RD & APmovm BY:
<br />_-,
<br />Risk Management Spenalist
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