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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 04 22 A
<br />(Ed. 9-08)
<br />TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT DISCLOSURE ENDORSEMENT
<br />This endorsement addresses the requirements of the Terrorism Risk Insurance Act of 2002 as amended and extended by
<br />the Terrorism Risk Insurance Program Reauthorization Act of 2007. It serves to notify you of certain limitations under the
<br />Act, and that your insurance carrier is charging premium for losses that may occur in the event of an Act of Terrorism.
<br />Your policy provides coverage for workers compensation losses caused by Acts of Terrorism, including workers
<br />compensation benefit obligations dictated by state law. Coverage for such losses is still subject to all terms, definitions,
<br />exclusions, and conditions in your policy, and any applicable federal and/or state laws, rules, or regulations.
<br />Definitions
<br />The definitions provided in this endorsement are based on and have the same meaning as the definitions in the Act .If
<br />words or phrases not defined in this endorsement are defined in the Act, the definitions in the Act will apply.
<br />"Act" means the Terrorism Risk Insurance Act of 2002, which took effect on November 26, 2002, and any amendments
<br />thereto resulting from the Terrorism Risk Insurance Program Reauthorization Act of 2007.
<br />"Act of Terrorism" means any act that is certified by the Secretary of the Treasury, in concurrence with the Secretary of
<br />State, and the Attorney General of the United States as meeting all of the following requirements:
<br />a. The act is an act of terrorism.
<br />b. The act is violent or dangerous to human life, property or infragtructure.
<br />c. The act resulted in damage within the United States, or outside of the United States in the case of the premises
<br />of United States missions or certain air carriers or vessels.
<br />d. The act has been committed by an individual or individuals as part of an effort to coerce the civilian population
<br />of the United States or to influence the policy or affect the conduct of the United States Government by coercion.
<br />sured Loss" means any loss resulting from an act of terrorism (and, except for Pennsylvania, including an act of war,
<br />~~ ~ the case of workers compensation) that is covered by primary or excess property and casualty insurance issued by an
<br />insurer if the loss occurs in the United States or at the premises of United States missions or to certain air carriers or
<br />vessels.
<br />"Insurer Deductible" means, for the period beginning on January 1, 2008, and ending on December 31, 2014, an
<br />amount equal to 20% of our direct earned premiums, over the calendar year immediately preceding the applicable
<br />Program Year.
<br />"Program Year" refers to each calendar year between January 1, 2008 and December 31, 2014, as applicable.
<br />Limitation of Liability
<br />The Act limits our liability to you under this policy. If aggregate Insured Losses exceed $100,000,000,000 in a Program
<br />Year and if we have met our Insurer Deductible, we are not liable for the payment of any portion of the amount of
<br />Insured Losses that exceeds $100,000,000,000; and for aggregate Insured Losses up to $100,000,000,000, we will pay
<br />only a pro rata share of such Insured Losses as determined by the Secretary of the Treasury.
<br />Policyholder Disclosure Notice
<br />1. Insured Losses would be partially reimbursed by the United States Government. If the aggregate industry Insured
<br />Losses exceed $100,000,000 in a Program Year, the United States Government would pay 85% of our Insured
<br />Losses that exceed our Insurer Deductible.
<br />2. Notwithstanding item 1 above, the United States Government will not make any payment under the Act for any
<br />portion of Insured Losses that exceed $100,000,000,000.
<br />3. The premium charge for the coverage your policy provides for Insured Losses is included in the amount shown in
<br />Item 4 of the Information Page or in the Schedule below.
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<br />U Copyright 2008 National Council on Compensation Insurance, Inc. All Rights Reserved.
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