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Ti❑e officers or employee-9 last day of <br />last e::posiEre to tiu conditions caring <br />or aggraCating s--t❑ ❑odily inUry ❑y <br />disease milt occ:1- diFi-ing tiu policy <br />period. <br />B. We Will Pay <br />We will pay an amoEnt e❑uI to to unefits <br />tut world ❑e re❑Eired of yo❑ as if yo❑ and <br />yob employees were s❑❑iect to to worurs❑ <br />compensation law of any state sown in Item <br />3.A. of to Information Page. We will pay <br />t❑ose amounts to to persons w❑o woLld u <br />entitled to tium iEnder tiu law. <br />C. Exclusion <br />T!❑is insi-iance does not cour❑ <br />1. any oFligation imposed ❑y worurs❑ <br />compensation or occ-A)ational disease <br />law or any similar law. <br />2. Fodily inE:Dry intentionally caiued or <br />aggrauted ❑y yo❑. <br />3. officers or employees w::o uiu elected <br />not to iu s❑❑iiect to tiu state worurs❑ <br />compensation law. <br />4. partners or sole proprietors not coured <br />Ender to Standard Sole Proprietors, <br />Partners, Officers and Oturs Courage <br />Endorsement. <br />D. Before We Pay <br />Before we pay unefits to tiFe persons <br />entitled to tium, tuy mint❑ <br />1. Release yo❑ and i-is, in writing, of all <br />responsii❑ility for tiu inTUry or deatEl <br />2. Transfer to iu tiuir rigid to recour from <br />of ers w❑o may a responsiiFle for tiu <br />inufly or deat:1 <br />3. Cooperate wit❑ iu and do eiuryti❑ing <br />necessary to ena:1e iu to enforce tiu <br />rigid to recoiur from oturs. <br />If to persons entitled to to unefits of tEJs <br />instance fail to do t❑ose t-Jngs, o0- dEty to <br />pay ends at once. If tuy claim damages <br />from yo❑ or from E8 for to iniFiry or deatq <br />oFir dEty to pay ends at once. <br />E. Recovery From Others <br />If we mau a recoury from oturs, we will <br />uep an amount e❑Llal to oil e:])enses of <br />recoiury and tiu iunefits we paid. We will <br />pay t❑e ❑alance to tie persons entitled to it. <br />If tiu persons entitled to tiu iunefits of tus <br />insEirance main a recoury from oturs, t❑ey <br />miut reim❑Erse iu for tiu unefits we paid tium. <br />F. Employers' Liability Insurance <br />Part Two [Employers ELiaEIity Ins tance❑applies <br />to ❑odily in❑ry coured ❑y tEJs endorsement as <br />t biEg❑ to State of Employment was sown in <br />Item 3.A. of t❑e Information Page. <br />Ti❑is pro:1sion :1 does not apply in ❑ew ursey or <br />Wisconsin. <br />EMPLOYERS' LIABILITY STOP GAP COVERAGE <br />6. Employers' Liability Stop Gap Coverage <br />A. Ti❑is courage only applies in Montana, ❑ort❑ <br />Daiuta, OIJo, Wasungton, West ❑irginia and <br />Wyoming. <br />B. Part One Worurs❑ Compensation Insurance❑ <br />does not apply to wor❑ in states s❑own in <br />Paragrap❑A a❑ou. <br />C. Part Two [Employers ELiaE lity Ins tance❑applies <br />in to states, sown in Paragrap❑ A., as t❑oiEg❑ <br />tuy were sown in Item 3.A. of tiu Information <br />Page. <br />D. Part Two, Section C. Exclusions is cunged ❑y <br />adding tuse eiulC�-,ions. <br />T❑is insisance does not coiur'❑ <br />El iudily iniii y intentionally ca!ued or <br />aggrauted i❑y yo❑ or in Oi❑io ::tidily inlory <br />res:1ting from an act wiJc❑ is determined !❑y <br />an O❑io coi-irt of law to uu uen committed <br />❑y yo❑ wit❑ tiu iulief tun an inlory is <br />s❑iutantially certain to occij. ❑oweur, to <br />cost of defending siu❑ claims or sits in Oi❑io <br />is coiured. <br />13. iudily ini❑ry siutained i❑y any memur of to <br />flying crew of any aircraft. <br />14. any claim for iudily inE:Iry wit❑ respect to <br />w::Jci❑ yo❑ are depriud of any defense or <br />defenses or are oturwise s❑❑iiect to penalty <br />ucaiue of defa:]t in premii-n i-nder to <br />pro:Jsions of tiu worurs❑compensation law <br />or laws of a state si:own in Paragrap❑A. <br />E. T❑is instance applies to damages for wEJc❑ yo❑ <br />are liade Ender West ❑irginia Code Annot. S 23- <br />4-2. <br />Form WC 99 03 02 B Printed in -.S.A. iFEd. 8/00❑ Page 3 of 4 <br />