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officer’soremployee’semployment.TheIfthepersonsentitledtothebenefitsofthis <br />officer’soremployee’slastdayoflastinsurancemakearecoveryfromothers,they <br />exposuretotheconditionscausingormust reimburse us for the benefits we paid them. <br />aggravatingsuchbodilyinjurybydisease <br />F.Employers’ Liability Insurance <br />must occur during the policy period. <br />PartTwo(Employers’LiabilityInsurance)applies <br />B.We Will Pay <br />tobodilyinjurycoveredbythisendorsementas <br />WewillpayanamountequaltothebenefitsthoughtheStateofEmploymentwasshownin <br />thatwouldberequiredofyouasifyouandItem 3.A. of the Information Page. <br />youremployeesweresubjecttotheworkers’ <br />Thisprovision5.doesnotapplyinNewJerseyor <br />compensationlawofanystateshowninItem <br />Wisconsin. <br />3.A.oftheInformationPage.Wewillpay <br />EMPLOYERS’ LIABILITY STOP GAP COVERAGE <br />thoseamountstothepersonswhowouldbe <br />6.Employers’ Liability Stop Gap Coverage <br />entitled to them under the law. <br />A.ThiscoverageonlyappliesinMontana,North <br />C.Exclusion <br />Dakota,Ohio,Washington,WestVirginiaand <br />This insurance does not cover: <br />Wyoming. <br />1.anyobligationimposedbyworkers’ <br />B.PartOne(Workers’CompensationInsurance) <br />compensationoroccupationaldisease <br />doesnotapplytoworkinstatesshownin <br />law or any similar law. <br />Paragraph A above. <br />2.bodilyinjuryintentionallycausedor <br />C.PartTwo(Employers’LiabilityInsurance)applies <br />aggravated by you. <br />inthestates,showninParagraphA.,asthough <br />3.officersoremployeeswhohaveelected <br />theywereshowninItem3.A.oftheInformation <br />nottobesubjecttothestateworkers’ <br />Page. <br />compensation law. <br />D.PartTwo,SectionC.Exclusionsischangedby <br />4.partnersorsoleproprietorsnotcovered <br />adding these exclusions. <br />undertheStandardSoleProprietors, <br />This insurance does not cover; <br />Partners,OfficersandOthersCoverage <br />5.bodilyinjuryintentionallycausedor <br />Endorsement. <br />aggravatedbyyouorinOhiobodilyinjury <br />D.Before We Pay <br />resultingfromanactwhichisdeterminedby <br />Beforewepaybenefitstothepersons <br />anOhiocourtoflawtohavebeencommitted <br />entitled to them, they must: <br />byyouwiththebeliefthananinjuryis <br />1.Releaseyouandus,inwriting,ofallsubstantiallycertaintooccur.However,the <br />responsibility for the injury or death.costofdefendingsuchclaimsorsuitsinOhio <br />is covered. <br />2.Transfertoustheirrighttorecoverfrom <br />otherswhomayberesponsibleforthe13.bodilyinjurysustainedbyanymemberofthe <br />injury or death.flying crew of any aircraft. <br />3.Cooperatewithusanddoeverything14.anyclaimforbodilyinjurywithrespectto <br />necessarytoenableustoenforcethewhichyouaredeprivedofanydefenseor <br />right to recover from others.defensesorareotherwisesubjecttopenalty <br />becauseofdefaultinpremiumunderthe <br />Ifthepersonsentitledtothebenefitsofthis <br />provisionsoftheworkers’compensationlaw <br />insurancefailtodothosethings,ourdutyto <br />or laws of a state shown in Paragraph A. <br />payendsatonce.Iftheyclaimdamages <br />fromyouorfromusfortheinjuryordeath,E.Thisinsuranceappliestodamagesforwhichyou <br />our duty to pay ends at once.areliableunderWestVirginiaCodeAnnot.S23- <br />4-2. <br />E.Recovery From Others <br />Ifwemakearecoveryfromothers,wewill <br />keepanamountequaltoourexpensesof <br />recoveryandthebenefitswepaid.Wewill <br />pay the balance to the persons entitled to it/ <br />Form WC 99 03 03 BPrinted in U.S.A. (Ed. 8/00)Page3 of6 <br /> <br />