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Workers Compensation / Employers Liability
WORKERS COMPENSATION INSURANCE AND EMPLOYERS LIABILITY INSURANCE GENERAL INFORMATION / POLICY SUMMARY.
The workers compensation insurance policy consists of one section and six parts, as follows:
GENERAL SECTION
Section indicates that the insurance policy, the Information Page and all endorsements and schedules in effect on the inception date represent the contract of insurance between the insured employer and the insurance company. Defines who the insured is and explains how the workers compensation insurance and employers liability laws of the state apply. It also explains the meaning of workplace locations and defines “State” to mean states of the United States and the District of Columbia.
PART ONE–WORKERS COMPENSATION INSURANCE
Explains how the workers compensation insurance provided applies and outlines the payments the workers compensation insurance company is obligated to make. These include benefits required by law, costs of defense of suits brought against the insured for benefits paid by the insurance and additional costs incurred as a result of a claim or legal action. It explains what happens if other insurance covers the same claim and outlines the payments the insured must make. It also outlines the procedures in the event of any recoveries from others and summarizes the statutory provisions that apply in the event of loss.
PART TWO–EMPLOYERS LIABILITY INSURANCE
Explains what employers liability insurance is, how it applies, and outlines the payments for which the insurance company is responsible. It provides a detailed list of exclusions and circumstances where coverage does not apply. It outlines the circumstances under which the insurance company will defend the insured for suits brought due to damages paid by the insurance and details the additional costs the insurer pays as part of any legal action it defends. It explains what happens if other insurance covers the same claim and defines the meaning of the terms and limits that apply to this coverage. It also outlines the obligations of the insured in the event of recoveries from others responsible for a covered loss and summarizes the requirements of each party before an action can be brought against the insurance company.
PART THREE–OTHER STATES INSURANCE
How this coverage applies when one or more states are listed in the space provided for this coverage on the Information Page. Coverage applies to any state listed on the Information Page but does not apply to any other state unless the insured reports the start of any work in that state within 30 days of it beginning. The insured is required to immediately inform the company of the commencement of operations in any state listed in this section on the Information Page.
PART FOUR–YOUR DUTIES IF INJURY OCCURS
This part outlines the duties and responsibilities of the insured with respect to both the injured employee and the company if an injury occurs that may be covered by the insurance policy.
PART FIVE–PREMIUM
Explains insurance company’s use of its manuals, rules, rates, rating plans and classifications to determine the premium charged. Method used to determine the classifications and outlines how remuneration is used as the basis for premium development in most cases. Requires the insured to pay premiums when due and provides details on how the final premium is determined. Provides details of the records the insured must maintain and the manner in which premium audit uses those records.
PART SIX–CONDITIONS
This part outlines the right of the company to inspect workplaces at any time and clarifies that those inspections are not an obligation, nor serve as safety inspections. Explains that the insured cannot transfer any of its rights or duties without the written consent of the insurance company. Details how the policy may be cancelled by either party, and how long-term policies are handled. Also requires the first named insured on the Information Page to act on behalf of all insured’s with respect to all policy transactions.
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